Sample records for air ambulance services

  1. Air ambulance medical transport advertising and marketing. (United States)


    The National Association of EMS Physicians (NAEMSP), the American College of Emergency Physicians (ACEP), the Air Medical Physician Association (AMPA), the Association of Air Medical Services (AAMS), and the National Association of State EMS Officials (NASEMSO) believe that patient care and outcomes are optimized by using air medical transport services that are licensed air ambulance providers with robust physician medical director oversight and ongoing quality assessment and review. Only air ambulance medical transport services with these credentials should advertise/market themselves as air ambulance services.

  2. Oregon Air Ambulance Services. (United States)


    34 SECURITY CLASSIFICATION OF THjIS PAGE (147.- D.In Enieod) REPORT DO~ CUMEN ~TATIONI PAGE REAL) 1NST1RucTrIONSMB 1E1ORE COMP1LETI-’YNG FORM 1 . REPORT NUMBER... reactions to flight must be guarded. 4. Aeromedical Transport. A breakdown of the 152 patients transported by agency is presented on Table 8. Agency No. 11

  3. Understanding the factors that influence patient satisfaction with ambulance services. (United States)

    Bogomolova, Svetlana; Tan, P J; Dunn, S P; Bizjak-Mikic, M


    The quality of ambulance services has an immense impact on patients' future well-being and quality of life. Patient satisfaction is one of the key metrics for evaluating the quality of this service. Yet, the patient satisfaction measurement may be limited in its ability to accurately reflect this service quality, and even reflect factors beyond the patient experiences. We analyze 10 years of survey data to reveal a number of factors that systematically bias ambulance satisfaction ratings. Taking into account these biases provides more robust comparison of ambulance performance over time or across different jurisdictions.

  4. Cardiac arrest: comparison of paramedic and conventional ambulance services.



    A prospective study conducted in the Greater Vancouver area compared survival rates in prehospital cardiac arrest managed by an advanced life support (paramedic) service with those in cardiac arrest managed by conventional ambulance service. Management by the paramedic service was associated with higher survival rates for patients found in cardiac arrest but not for patients who suffered the arrest while the ambulance was present. Cardiopulmonary resuscitation by bystanders was associated wit...

  5. Computer assisted assessment and advice for "non-serious" 999 ambulance service callers: the potential impact on ambulance despatch


    Dale, Jeremy; Higgins, J.; Williams, S.; Foster, T.; Snooks, Helen; Crouch, R; Hartley-Sharpe, C; Glucksman, E; Hooper, R.; George, S.


    Objective: To investigate the potential impact for ambulance services of telephone assessment and\\ud triage for callers who present with non-serious problems (Category C calls) as classified by ambulance\\ud service call takers.\\ud Design: Pragmatic controlled trial. Calls identified using priority dispatch protocols as non-serious\\ud were allocated to intervention and control groups according to time of call. Ambulance dispatch\\ud occurred according to existing procedures. During intervention...

  6. Mission impossible or border security – Practical and effective infection control on air ambulances

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    M. Kuhn*


    These principles have been applied to our air ambulance system based from Lanseria International Airport. By combining preventative and control measures, there has been no breach in our infection control strategies, as evidenced by no growth noted on specific and random swabs even when more and more ”super bugs” are being identified in hospital. As an air ambulance service flying patients from various African countries, we have the responsibility to conduct our own ”Border Security” to keep our hospitals, patients, aircraft and crews clean and safe. In this presentation we will share our ”Border Security” principles and experiences with the audience.

  7. 29 CFR 553.215 - Ambulance and rescue service employees. (United States)


    ... employees have received training in the rescue of fire, crime, and accident victims or firefighters or law... REGULATIONS APPLICATION OF THE FAIR LABOR STANDARDS ACT TO EMPLOYEES OF STATE AND LOCAL GOVERNMENTS Fire... rescue service employees. (a) Ambulance and rescue service employees of a public agency other than a...

  8. Health status in the ambulance services: a systematic review

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    Hem Erlend


    Full Text Available Abstract Background Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services. Methods We identified the relevant empirical literature by searching several electronic databases including Medline, EMBASE, PsychINFO, CINAHL, and ISI Web of Science. Other relevant sources were identified through reference lists and other relevant studies known by the research group. Results Forty-nine studies are included in this review. Our analysis shows that ambulance workers have a higher standardized mortality rate, higher level of fatal accidents, higher level of accident injuries and a higher standardized early retirement on medical grounds than the general working population and workers in other health occupations. Ambulance workers also seem to have more musculoskeletal problems than the general population. These conclusions are preliminary at present because each is based on a single study. More studies have addressed mental health problems. The prevalence of post-traumatic stress symptom caseness was > 20% in five of seven studies, and similarly high prevalence rates were reported for anxiety and general psychopathology in four of five studies. However, it is unclear whether ambulance personnel suffer from more mental health problems than the general working population. Conclusion Several indicators suggest that workers in the ambulance services experience more health problems than the general working population and workers in other health occupations. Several methodological challenges, such as small sample sizes, non-representative samples, and lack of comparisons with normative data limit the interpretation of many studies. More coordinated research and replication are needed to compare data across studies. We discuss some strategies for

  9. Private Ambulance Services, ambulance zone, Published in 2008, 1:24000 (1in=2000ft) scale, Box Elder County. (United States)

    NSGIC GIS Inventory (aka Ramona) — This Private Ambulance Services dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2008. It is described as...

  10. The Barbados Emergency Ambulance Service: High Frequency of Nontransported Calls

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    Sherwin E. Phillips


    Full Text Available Objectives. There are no published studies on the Barbados Emergency Ambulance Service and no assessment of the calls that end in nontransported individuals. We describe reasons for the nontransport of potential clients. Methods. We used the Emergency Medical Dispatch (Medical Priority Dispatch System instrument, augmented with five local call types, to collect information on types of calls. The calls were categorised under 7 headings. Correlations between call types and response time were calculated. Results. Most calls were from the category medical (54%. Nineteen (19% percent of calls were in the non-transported category. Calls from call type Cancelled accounted for most of these and this was related to response time, while Refused service was inversely related (. Conclusions. The Barbados Ambulance Service is mostly used by people with a known illness and for trauma cases. One-fifth of calls fall into a category where the ambulance is not used often due to cancellation which is related to response time. Other factors such as the use of alternative transport are also important. Further study to identify factors that contribute to the non-transported category of calls is necessary if improvements in service quality are to be made.

  11. Evaluation on Ambulance Design and Musculoskeletal Disorders Risk Factors among Ambulance Emergency Medical Service Per¬sonnel

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    Baba M. DEROS


    Full Text Available Background: Injuries or pains occurred at various body's joints, ligaments, muscles, nerves, tendons, limbs, back and neck are classified as musculoskeletal disorders (MSDs. A single forceful exertion or repeated exposure to force, vibration or awkward posture can result in MSDs. This study was carried out by evaluating the relevant physical measurements of Class B ambulance used in Malaysia. The two main objectives of the study are to evaluate on the ambulance physical dimensions and workstation design and to conduct a Rapid Entire Body Assessment (REBA to examine ambulance’s emergency medical service (EMS workers’ activities and their associated MSDs risk factors.Methods: The two methodologies adopted for the study conducted in 2014 were direct measurement of the ambulance physical dimensions and workstation layout; and in-depth interviews of five EMS workers that provides patient care during transporting patient to a public hospital in Kota Bharu, Kelantan. REBA was conducted on seven commonly performed activities by EMS workers for identifying postural risks.Results: The study found ambulance width is too narrow and workstation layout may exposed EMS workers to MSDs risks. REBA scores for the seven commonly performed activities in the ambulance ranges from medium to very high. Conclusion: Seven important MSDs risk factors to be considered in the design of the Class B ambulance for performing patient care activities that may lead towards EMS workers’ injury are awkward posture, bumping, instability, narrow workspace dimension, inappropriate arrangement of storage cabinet, inappropriate arrangement of medical equipment, inadequate railing and seat, and inappropriate stretcher.  Keywords: Musculoskeletal disorders, Ambulance, EMS, Workers, REBA, Risks

  12. Air ambulance and hospital services for critically ill and injured in Greenland, Iceland and the Faroe Islands: how can we improve? (United States)

    Gunnarsson, Björn; Jensen, Niels S Kieler; Garði, Tummas I; Harðardóttir, Helga; Stefánsdóttir, Lilja; Heimisdóttir, María


    The Nordic Atlantic Cooperation (NORA) is an intergovernmental organization under the auspices of the Nordic Council of Ministers. The NORA region comprises Greenland, Iceland, Faroe Islands and western coastal areas of Norway. Historical, cultural and institutional links bind these nations together in multiple ways, and regional co-operation has in recent years become a focus of interest. This commentary addresses air medical services (AMSs) and available advanced hospital services in the 3 smallest NORA countries challenged sparse populations, hereafter referred to as the region. It seems likely that strengthened regional co-operation can help these countries to address common challenges within health care by exchanging know-how and best practices, pooling resources and improving the efficiency of care delivery. The 4 largest hospitals in the region, Dronning Ingrids Hospital in Nuuk (Greenland), Landspítali in Reykjavík and Sjúkrahúsið á Akureyri, (both in Iceland) and Landssjúkrahúsið Tórshavn on the Faroe Islands, have therefore undertaken the project Network for patient transport in the North-West Atlantic (in Danish: Netværk for patienttransport i Vest-Norden). The goal of the project, and of this article, is to exchange information and provide an overview of current AMSs and access to acute hospital care for severely ill or injured patients in the 3 participating countries. Of equal importance is the intention to highlight the need for increased regional co-operation to optimize use of limited resources in the provision of health care services.

  13. 75 FR 62639 - Air Ambulance and Commercial Helicopter Operations, Part 91 Helicopter Operations, and Part 135... (United States)


    ...--Nautical mile NTSB--National Transportation Safety Board NVG--Night vision goggles NVIS--Night-vision... ambulances have varying situational- awareness technology (such as night vision goggles, HTAWS, radio... during night conditions as four common factors in helicopter air ambulance accidents. A review...

  14. The equestrian sport-related injury workload of a regional doctor-led air ambulance unit. (United States)

    Bleetman, David


    The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load. Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport-related injuries occur in areas inaccessible to land crews. We conducted a retrospective analysis of the ASU mission database from July 2008 to December 2009 (18 months) and identified 29 patients that were attended to by the ASU. The patient cohort had a female majority with an average age of 31.9. 10 Patients (34.5%) were under the age of 20. The ISS ranged from 1 to 75 (mean, 4.8; median, 1) and injuries to the extremities were commonest. The location of the accident was inaccessible to land ambulance in 55.2% of missions. The average mission time was over 2h. Doctors delivered more advanced (medical) interventions in 20.7% of missions. In 41.4% of missions, there were no such interventions performed by the attending doctor and no access to land ambulance. We therefore conclude that a large proportion of ASU dispatches were due to limited access rather than for the delivery of advanced interventions. However, our results support the opinion that horse riding carries some risk of serious injury and when employed appropriately, HEMS doctors on the ASU are a useful resource for a minority of equestrian sport-related injuries.

  15. Hospital survival upon discharge of ill-neonates transported by ground or air ambulance to a tertiary center

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    Jorge Luis Alvarado-Socarras


    Full Text Available Abstract Objective: To evaluate the differences in hospital survival between modes of transport to a tertiary center in Colombia for critically ill neonates. Methods: Observational study of seriously ill neonates transported via air or ground, who required medical care at a center providing highly complex services. Data on sociodemographic, clinical, the Transport Risk Index of Physiologic Stability (TRIPS, and mode of transport were collected. Patients were described, followed by a bivariate analysis with condition (live or dead at time of discharge as the dependent variable. A multiple Poisson regression with robust variance model was used to adjust associations. Results: A total of 176 neonates were transported by ambulance (10.22% by air over six months. The transport distances were longer by air (median: 237.5 km than by ground (median: 11.3 km. Mortality was higher among neonates transported by air (33.33% than by ground (7.79%. No differences in survival were found between the two groups when adjusted by the multiple model. An interaction between mode of transport and distance was observed. Live hospital discharge was found to be associated with clinical severity upon admittance, birth weight, hemorrhaging during the third trimester, and serum potassium levels when admitted. Conclusions: Mode of transport was not associated with the outcome. In Colombia, access to medical services through air transport is a good option for neonates in critical condition. Further studies would determine the optimum distance (time of transportation to obtain good clinical outcomes according type of ambulance.

  16. 42 CFR 410.40 - Coverage of ambulance services. (United States)


    ... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.40... following conditions are met: (1) The supplier meets the applicable vehicle, staff, and billing and reporting requirements of § 410.41 and the service meets the medical necessity and origin and...

  17. Ambulance emergency services for patients with coronary heart disease in Lancashire: achieving standards and improving performance


    Stoykova, B; Dowie, R; Bastow, P; Rowsell, K; GREGORY, R.


    Methods: Audit datasets on two cohorts of patients with chest pain and suspected AMI were assembled by the Lancashire Ambulance Service NHS Trust in north west England: 3706 patients during 1996/97 and 3423 in 2001. They were transported to four hospitals. The analyses covered journey timings, role of rapid response vehicles (RRV), and clinical procedures and the results were compared with prevailing national standards.

  18. Manager-employee interaction in ambulance services: an exploratory study of employee perspectives on management communication. (United States)

    Nordby, Halvor


    Managers of ambulance stations face many communicative challenges in their interaction with employees working in prehospital first-line services. The article presents an exploratory study of how paramedics experience these challenges in communication with station leaders. On the basis of a dialogue perspective in qualitative method, 24 paramedics were interviewed in one-to-one and focus group settings. Naturalistic and phenomenological approaches were used to analyze the interviews. All the paramedics said that they wished to be more involved in decision processes and that station managers should provide better explanations of information "from above." The paramedics understood that it was difficult for the managers to find time for extensive dialogue, but many thought that the managers should give more priority to communication. The paramedics' views correspond to theoretical assumptions in human resource management. According to this model, employees should be involved in decision processes on management levels, as long as it is realistically possible to do so. Furthermore, expressing emotional support and positive attitudes does not take much time, and the study suggests that many ambulance managers should focus more on interpersonal relations to employees. It has been extensively documented that management communication affects organizational performance. The study indicates that managers of ambulance stations should be more aware of how their leadership style affects professional commitment and motivation in the first-line services.

  19. Risk Management Analysis of Air Ambulance Blood Product Administration in Combat Operations (United States)


    Combat Operations 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Nicole Powell-Dunford, Jose F. Quesada , Robert F...Analysis of Air Ambulance Blood Product Administration in Combat Operations Nicole Powell-Dunford , Jose F. Quesada , Robert F. Malsby , Victoria...Schofi eld Barracks, Wahiawa, HI; Jose F. Quesada , M.S., M.D., 440th Blood Support Detachment, and Robert Gerhardt, M.D., M.P.H., FACEP, U.S. Army

  20. Design and Development of an Intelligent Mobile Health Tele-assistance System in Ambulance Practice Service

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    Rachid Merzougui


    Full Text Available Our attention has focused on the choice of a relevant work. It concerns an implemented and conceived service of medical Teleassistance for monitoring risky persons brought by ambulance service. Thus, a medical bulletin is automatically filled on mobile terminal, immediately transmitted to the service of the emergency (on doctors mobile terminal, data base of clinic. This paper recalls a complete architecture of an economic wireless transmission system with the implementation of an effective application, adapted to the portable phone, allowing the doctor to have the medical information of patients who have a risk of accident. Thus, the stakes of setting up such systems are numerous, so much for patients, medical staff and the society in general.

  1. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

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    James R. Langabeer II


    Full Text Available Introduction: Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods: The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results: During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion: We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  2. [Implantation of the emergency ambulance service in Salvador, Bahia: reality and challenges]. (United States)

    Vieira, Célia Maria Sales; Mussi, Fernanda Carneiro


    The goal of this study was to describe the implementation of the emergency ambulance service of Salvador, Bahia (SAMU-192). The Ministry of Health provided the legal basis and regulations for its implementation. The main purpose of this service is the provision of free primary level healthcare to individuals, with clinical, surgical, traumatic and psychiatric aggravations that cause suffering, sequels or death and occur outside the hospital environment. The specific goals of SAMU-192 was to grant free healthcare to urgency and emergency situations, under the hierarchy and regulations of the Single Health System (SUS) of the Brazilian government, assuring that public resources will be available and integrated to the complementary healthcare network. Investments for the installation of the service were agreed on in the city and with federal and state management commissions. To turn SAMU-192 into reality, several challenges need to be accomplished, including community education, professional qualification and evaluation of human and material resources so as to provide basic emergency care with the appropriate quality.

  3. Planning like an Olympian. How London Ambulance Service successfully handled their 'summer of sport'. (United States)

    Killens, Jason


    LOCOG Medical managed thousands of patient contacts across all the Games venues without our intervention. A polyclinic in the athlete's village had extensive diagnostic options, including X-ray and magnetic resonance imaging for athletes and the Olympic family. These helped limit the number of patients who needed transport to the ED. Although the delivery was seamless, there were "behind the scenes" moments in the final stages of planning that made us think. We received additional requests for ambulance cover at training venues that hadn't been planned for on short notice. In addition, the torch relay attracted bigger crowds than initially planned for. Some of the planning assumptions and agreements changed on short notice for various reasons. This meant we had to adjust our plans while also solving human resource issues that you would expect to see among a workforce of around 500 across a six-week period. As part of the National Health Service (NHS) ambulance service Games cohort, more than 500 staff were deployed across 18 venues and 30 days of sport in London. In doing so, they delivered in excess of 165,000 hours of standby and care, responded to nearly 1,500 Games-related incidents and conveyed 800 patients to emergency departments across the capital. After such an influx, it wasn't easy to return to business as usual. Officials with previous host cities had advised us that there would be a feeling of "what next" once the Games concluded. When I first heard this, I thought the opposite would be the case. I expected feeling relieved of overwhelming emotion as well as from the exhaustion of the long days. I do have to say that although this was the case, it's also true that there is a "post Games" come down. We had just been part of a fantastic summer of sport with a brilliant medal tally from Team Great Britain and Paralympics Great Britain that, of course, helped the euphoria. But we did feel real sense of uncertainty about what to do next. We had spent five

  4. Calls Forecast for the Moscow Ambulance Service. The Impact of Weather Forecast (United States)

    Gordin, Vladimir; Bykov, Philipp


    We use the known statistics of the calls for the current and previous days to predict them for tomorrow and for the following days. We assume that this algorithm will work operatively, will cyclically update the available information and will move the horizon of the forecast. Sure, the accuracy of such forecasts depends on their lead time, and from a choice of some group of diagnoses. For comparison we used the error of the inertial forecast (tomorrow there will be the same number of calls as today). Our technology has demonstrated accuracy that is approximately two times better compared to the inertial forecast. We obtained the following result: the number of calls depends on the actual weather in the city as well as on its rate of change. We were interested in the accuracy of the forecast for 12-hour sum of the calls in real situations. We evaluate the impact of the meteorological errors [1] on the forecast errors of the number of Ambulance calls. The weather and the Ambulance calls number both have seasonal tendencies. Therefore, if we have medical information from one city only, we should separate the impacts of such predictors as "annual variations in the number of calls" and "weather". We need to consider the seasonal tendencies (associated, e. g. with the seasonal migration of the population) and the impact of the air temperature simultaneously, rather than sequentially. We forecasted separately the number of calls with diagnoses of cardiovascular group, where it was demonstrated the advantage of the forecasting method, when we use the maximum daily air temperature as a predictor. We have a chance to evaluate statistically the influence of meteorological factors on the dynamics of medical problems. In some cases it may be useful for understanding of the physiology of disease and possible treatment options. We can assimilate some personal archives of medical parameters for the individuals with concrete diseases and the relative meteorological archive. As a

  5. Response times of ambulances to calls from Midwife Obstetric Units of the Peninsula Maternal and Neonatal Service (PMNS in Cape Town

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    J.K. Marcus


    Full Text Available Response times of ambulances to calls from Midwife Obstetric Units, although varied, are perceived as slow. Delays in transporting women experiencing complications during or after their pregnancies to higher levels of care may have negative consequences such as fetal, neonatal or maternal morbidity or death. An exploratory descriptive study was undertaken to investigate the response times of ambulances of the Western Cape Emergency Medical Services to calls from midwife obstetric units (MOUs in the Peninsula Maternal and Neonatal Services (PMNS in Cape Town. Response times were calculated from data collected in specific MOUs using a specifically developed instrument. Recorded data included time of call placed requesting transfer, diagnosis or reason for transfer, priority of call and the time of arrival of ambulance to the requesting facility. Mean, median and range of response times, in minutes, to various MOUs and priorities of calls were calculated. These were then compared using the Kruskal-Wallis test. A comparison was then made between the recorded and analysed response times to national norms and recommendations for ambulance response times and maternal transfer response times respectively.A wide range of response times was noted for the whole sample. Median response times across all priorities of calls and to all MOUs in sample fell short of national norms and recommendations. No statistical differences were noted between various priorities of calls and MOUs.The perception of delayed response times of ambulances to MOUs in the PMNS was confirmed in this pilot study.

  6. Superior Ambulance Call Out Rate Forecasting Using Meteorological Data (United States)

    Mahmood, M. A.; Thornes, J. E.; Bloss, W.; Pope, F.


    Ambulances are an integral part of a country's infrastructure ensuring its citizens and visitors are kept healthy. The impact of weather, climate and climate change on ambulance services around the world has received increasing attention in recent years but most studies have been area specific and there is a need to establish basic relationships between ambulance data (both response and illness data) and meteorological parameters. In this presentation, the effects of temperature and relative humidity on ambulance call out rates for different medical categories will be investigated. We use call out data obtained from the London Ambulance Service (LAS) and meteorological data from a central London meteorological station. A time-series analysis was utilized to understand the relation between temperature, relative humidity, air pollutants and different call out categories. There are statistically significant relationships between mean temperature and ambulance callout rate for most of the categories investigated. Most categories show a negative dependence on temperature, i.e. call outs increase with decreasing temperature but some categories showed a positive dependence such as alcohol related call outs. Relative humidity is significant for some categories but in general is much less important than temperature. Significant time lag effects were observed for most of the categories related to infectious illnesses, which are transferrable through human contact. These findings support the opinion that ambulance attendance callouts records are an effective and well-timed source of data and can be used for health early warning systems. Furthermore the presented results can much improve our understanding of the relationships between meteorological conditions and human health thereby allowing for better prediction of ambulance use through the application of long and short-term weather forecasts.

  7. 42 CFR 410.41 - Requirements for ambulance suppliers. (United States)


    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements for ambulance suppliers. 410.41... § 410.41 Requirements for ambulance suppliers. (a) Vehicle. A vehicle used as an ambulance must meet the... ALS services. (c) Billing and reporting requirements. An ambulance supplier must comply with...

  8. The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial

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    Naredi Peter


    Full Text Available Abstract Background Prevention and treatment of hypothermia by active warming in prehospital trauma care is recommended but scientifical evidence of its effectiveness in a clinical setting is scarce. The objective of this study was to evaluate the effect of additional active warming during road or air ambulance transportation of trauma patients. Methods Patients were assigned to either passive warming with blankets or passive warming with blankets with the addition of an active warming intervention using a large chemical heat pad applied to the upper torso. Ear canal temperature, subjective sensation of cold discomfort and vital signs were monitored. Results Mean core temperatures increased from 35.1°C (95% CI; 34.7-35.5°C to 36.0°C (95% CI; 35.7-36.3°C (p Conclusions In mildly hypothermic trauma patients, with preserved shivering capacity, adequate passive warming is an effective treatment to establish a slow rewarming rate and to reduce cold discomfort during prehospital transportation. However, the addition of active warming using a chemical heat pad applied to the torso will significantly improve thermal comfort even further and might also reduce the cold induced stress response. Trial Registration NCT01400152

  9. Ag-Air Service (United States)


    Econ, Inc.'s agricultural aerial application, "ag-air," involves more than 10,000 aircraft spreading insecticides, herbicides, fertilizer, seed and other materials over millions of acres of farmland. Difficult for an operator to estimate costs accurately and decide what to charge or which airplane can handle which assignment most efficiently. Computerized service was designed to improve business efficiency in choice of aircraft and determination of charge rates based on realistic operating cost data. Each subscriber fills out a detailed form which pertains to his needs and then receives a custom-tailored computer printout best suited to his particular business mix.

  10. Expected Annual Emergency Miles per Ambulance: An Indicator for Measuring Availability of Emergency Medical Services Resources (United States)

    Patterson, P. Daniel; Probst, Janice C.; Moore, Charity G.


    Context: To ensure equitable access to prehospital care, as recommended by the Rural and Frontier Emergency Medical Services (EMS) Agenda for the Future, policymakers will need a uniform measure of EMS infrastructure. Purpose and Methods: This paper proposes a county-level indicator of EMS resource availability that takes into consideration…

  11. Elderly and Nonelderly Use of a Dedicated Ambulance Corps’ Emergency Medical Services in Taiwan

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    Chien-Chia Huang


    Full Text Available Backgrounds and Aim. Taiwan’s population is gradually aging; however, there are no comparative data on emergency medical services (EMS use between the elderly and nonelderly. Methods. We analyzed the emergency calls dealt with between January 1 and April 4, 2014, by EMS in one city in Taiwan. All calls were divided into two groups: elderly (≥65 years and nonelderly (<65 years. Nontransport and transport calls were compared between the groups for demographic characteristics, transport time, reasons for calling EMS, vital signs, and emergency management. Results. There were 1,001 EMS calls: 226 nontransport and 775 transport calls. The elderly accounted for significantly (P<0.05 fewer (28 (9.2% nontransport calls than did the nonelderly (136 (21.4%. In the transport calls, 276 (35.6% were the elderly. The elderly had a higher proportion of histories for cardiovascular disease, cerebrovascular disease, hypertension, diabetes, end-stage renal disease, cancer, Parkinson’s disease, and Alzheimer’s disease. In addition, the elderly had significantly longer total transport time, more nontrauma reasons, and poorer consciousness levels and lower oxygen saturation and needed more respiratory management and more frequent resuscitation during transport than did the nonelderly. Conclusion. The elderly have more specific needs than do the nonelderly. Adapting EMS training, operations, and government policies to aging societies is mandatory and should begin now.

  12. Riding Third: Social Work in Ambulance Work (United States)

    Campbell, Hilary; Rasmussen, Brian


    This research explored the possible role of social work alongside emergency ambulance services. An ethnographic study included semistructured interviews and direct observations collected over 300 hours while riding in ambulances in an urban setting. The data suggest that social work could play a role by providing needed psychosocial care during…

  13. Ambulance 3G. (United States)

    Banitsas, Konstantinos; Perakis, Konstantinos; Koutsouris, Dimitrios; Konis, Georgios; Tachakra, Sapal


    Minimising the time required for a patient to receive primary care has always been the concern of the Accidents and Emergency units. Ambulances are usually the first to arrive on the scene and to administer first aid. However, as the time that it takes to transfer the patient to the hospital increases, so does the fatality rate. In this paper, a mobile teleconsultation system is presented, based primarily on third generation mobile links and on Wi-Fi hotspots around a city. This system can be installed inside an ambulance and will permit high-resolution videoconferencing between the moving vehicle and a doctor or a consultant within a base station (usually a hospital). In addition to video and voice, high quality still images and screenshots from medical equipment can also be sent. The test was carried out in Athens, Greece where a 3G system was recently deployed by Vodafone. The results show that the system can perform satisfactory in most conditions and can effectively increase the patient's quality of service, while having a modest cost.

  14. Monitoring the effect of air pollution episodes on health care consultations and ambulance call-outs in England during March/April 2014: A retrospective observational analysis. (United States)

    Elliot, Alex J; Smith, Sue; Dobney, Alec; Thornes, John; Smith, Gillian E; Vardoulakis, Sotiris


    There is an increasing body of evidence illustrating the negative health effects of air pollution including increased risk of respiratory, cardiac and other morbid conditions. During March and April 2014 there were two air pollution episodes in England that occurred in close succession. We used national real-time syndromic surveillance systems, including general practitioner (GP) consultations, emergency department attendances, telehealth calls and ambulance dispatch calls to further understand the impact of these short term acute air pollution periods on the health seeking behaviour of the general public. Each air pollution period was comparable with respect to particulate matter concentrations (PM10 and PM2.5), however, the second period was longer in duration (6 days vs 3 days) and meteorologically driven 'Sahara dust' contributed to the pollution. Health surveillance data revealed a greater impact during the second period, with GP consultations, emergency department attendances and telehealth (NHS 111) calls increasing for asthma, wheeze and difficulty breathing indicators, particularly in patients aged 15-64 years. Across regions of England there was good agreement between air quality levels and health care seeking behaviour. The results further demonstrate the acute impact of short term air pollution episodes on public health and also illustrate the potential role of mass media reporting in escalating health care seeking behaviour.

  15. Investigation of the contamination of air and articles in ambulance and the effect of disinfection observation%救护车内空气、物品染菌量调查及干预效果观察

    Institute of Scientific and Technical Information of China (English)



    Objective: To investigate the bacterial contamination of air and articles in ambulance, and observe the effect of disinfection. Methods: The bacterial contamination of the air and articles in one ambulance were detected before and after disinfection in early,middle and end per month from May. 2009 to Oct. 2009. Results :The pollution situation of air and articles in ambulance was serious before disinfection. The bacterial contamination was decreased significantly after disinfection. And the difference was statistically significant( P < 0.01 ). Conclusions: The pollution situation of air and articles in ambulance is serious. It is necessary to establish a strict disinfection management system.%目的:调查救护车内空气、物品的染菌量情况,观察消毒处理的效果.方法:2009年5~10月的每月上、中、下旬对3辆救护车内空气和物品表面进行消毒前后染菌量监测.结果:消毒前救护车内空气和物品的污染情况严重,消毒后染菌量明显下降(P<0.01).结论:救护车内空气和物品的污染状况严重,需加强其消毒和监测工作.

  16. A comparison of adherence to correctly documented triage level of critically ill patients between emergency department and the ambulance service nurses. (United States)

    Jönsson, Kenneth; Fridlund, Bengt


    Priority or triage has always occurred in emergency care. Today it is performed by both nurses in emergency departments (EDs) and ambulance services (ASs) to ensure patient safety. Recent studies have shown that nurses are unlikely to change their first impressions and patients suffering from blunt trauma are undertriaged. Our study aimed to compare and evaluate the adherence to correct triage level documentation, between nurses in the ED and the AS, according to current regulations. Of 592 analysed triage records from a university, a central and a district hospital, the adherence was 64% by ED nurses and 43% by AS nurses (pnurses do not adhere to the triage system and do not correctly document the triage level. Internal feedback and control are two approaches to improve the patient outcome, indicating that organisational actions must be taken.

  17. Intelligent Ambulance Traffic Assistance System

    Directory of Open Access Journals (Sweden)



    Full Text Available With the increase in traffic road density, several causalities occur due to delay in taking a patient to the hospital in an ambulance. In this paper, we have developed an algorithm to find the shortest path to reach the required destination. As required the software will identify the present location of the vehicle and ask the user for the destination. Then it will show all the available paths, highlighting the shortest one or in several cases the most optimum one. Further we made the traffic signals automated for special vehicles like an ambulance or a fire-engine such that the signals will go green for the ambulance as it comes in the vicinity of the traffic signal, thus providing them with a clear path to reach its destination. The original signal is restored as soon as the ambulance goes undetected by the Bluetooth scanner of the traffic signal.

  18. [Ambulant treatment of alcohol withdrawal]. (United States)

    Nüstedt, Volker


    Most of the patients addicted to alcohol are socially well integrated. The offer of a low threshold ambulant withdrawal therapy opens an opportunity to build a sustainable therapeutic relationship. The so started empathic addiction therapy will be well accepted and will lead to a satisfying outcome. Using Clomethiazole or Oxazepam in a daily reduced dose and with daily personal contacts, the ambulant withdrawal in patients without seizures or delir in medical history is a secure and successful therapeutic option.

  19. An integration of Emergency Department Information and Ambulance Systems. (United States)

    Al-Harbi, Nada; El-Masri, Samir; Saddik, Basema


    In this paper we propose an Emergency Department Information System that will be integrated with the ambulance system to improve the communication, enhance the quality of provided emergency services and facilitate information sharing. The proposed system utilizes new advanced technologies such as mobile web services that overcome the problems of interoperability between different systems, HL7 and GPS. The system is unique in that it allows ambulance officers to locate the nearest specialized hospital and allows access to the patient's electronic health record as well as providing the hospital with required information to prepare for the incoming patient.

  20. Physical workload of ambulance assistants. (United States)

    Doormaal, M T; Driessen, A P; Landeweerd, J A; Drost, M R


    The physical workload of ambulance assistants was assessed by means of the Ovako Working posture Analysis System (OWAS) observation method and a Work and Health Questionnaire (WHQ) for measuring perceived workload. In addition, a biomechanical model was applied to several specifically strenuous conditions that were simulated in a laboratory situation. Bad postures were identified for a number of activities: 16% to 29% of a work shift was spent in harmful positions. Strenuous situations occur particularly during rides in emergency situations. The results of observed and perceived workload are generally in agreement. A number of practical recommendations are made. They concern, for example, the equipment in ambulance cars, training of ambulance assistants and adaptations in working procedures.

  1. Risk of Transmission of MRSA on Contact Surfaces in Ambulance

    NARCIS (Netherlands)

    Lukas, R. -P.; Keppler, P. -A.; Brinkrolf, P.; Friedrich, A. W.; Van Aken, H.; Bohn, A.


    The gram-positive bacterium methicillin-resistant Staphylococcus aureus (MRSA) is one of the most frequent causes of treatment-associated nosocomial infections. The incidence of MRSA among the population and in hospitalised patients is growing worldwide. Ambulance service is an interface between the

  2. A Theory of Ambulance Chasing

    CERN Document Server

    Backović, Mihailo


    Ambulance chasing is a common socio-scientific phenomenon in particle physics. I argue that despite the seeming complexity, it is possible to gain insight into both the qualitative and quantitative features of ambulance chasing dynamics. Compound-Poisson statistics suffices to accommodate the time evolution of the cumulative number of papers on a topic, where basic assumptions that the interest in the topic as well as the number of available ideas decrease with time appear to drive the time evolution. It follows that if the interest scales as an inverse power law in time, the cumulative number of papers on a topic is well described by a di-gamma function, with a distinct logarithmic behavior at large times. In cases where the interest decreases exponentially with time, the model predicts that the total number of papers on the topic will converge to a fixed value as time goes to infinity. I demonstrate that the two models are able to fit at least 9 specific instances of ambulance chasing in particle physics us...

  3. Mobile-Based Medical Emergency Ambulance Scheduling System

    Directory of Open Access Journals (Sweden)

    Bassey Isong


    Full Text Available Effective and efficient public service delivery like healthcare services are very important in today's society, especially in the rural areas. People in rural areas are expected to have access to public facilities at all times. However, these services are not always available when they are needed. This paper discusses the problems faced by rural areas of Mafikeng in South Africa (SA when public and basic healthcare facilities like medical ambulance transports are needed during emergency situation. The challenges ranges from poor communication, poor road network and unstructured address to non-arrival of ambulances leading loss of lives that are preventable. This paper designed and implemented a system prototype using mobile application technologies to offer cost-effective services to patients during emergencies. It is intended to reduce long queues in hospitals and long waiting periods for an ambulance via location-based services. By using this application, lives in the rural areas can be made easier and loss of lives prevented by providing timely response from the appropriate healthcare providers during emergencies.

  4. Emergency Medical Service (United States)


    Lewis Research Center helped design the complex EMS Communication System, originating from space operated telemetry, including the telemetry link between ambulances and hospitals for advanced life support services. In emergency medical use telemetry links ambulances and hospitals for advanced life support services and allows transmission of physiological data -- an electrocardiogram from an ambulance to a hospital emergency room where a physician reads the telemetered message and prescribes emergency procedures to ambulance attendants.

  5. [Design of a mechanical system for the balanceable system of ambulance]. (United States)

    Zheng, Yi; Luo, Yibin; Zhang, Guangpeng; Zhang, Zhide; Chen, Chaomin


    This is the design of a mechanical systems for use in the balanceable system of ambulance, which can keep the medical service bed at the ambulance level, whatever the terrain is. A level detector will detect the level state of the bed and turn it to a signal. The central processing unit will use this signal to analyse and control the movement of the motor. By this design (which uses the rolling rail as a drive transmission and makes three supports of the bed go up and down), the bed will keep level. With the use of this design, the balanceable system of ambulance can counteract 35 degrees. The error is controlled within +/- 1 degree. And the response time is within 0.3 s. The method of registration can be effective for keeping the bed at the ambulance level, and for reducing the chance of making the patient get hurt on the way to hospital.

  6. Post-Service Utilization of Air Force-Gained Skills. (United States)

    Winkler, Anthony J.; Thompson, Paul D.

    More complete information is needed to determine the extent of utilization in the civilian economy of skills developed during military service. Post-service occupation data have been obtained through a questionnaire mailed ten months after separation to each first-term Air Force enlisted man separated between 1 July 1968 and 31 March 1970. As of…

  7. Death by a Thousand Cuts: Micro-Air Vehicles (MAV) in the Service of Air Force Missions (United States)


    exotic approaches as air suction/injection along the wing surface (which might require micro -valves and micro - pumps ), wall heat transfer, or...AU/AWC/___/2001-4 AIR WAR COLLEGE AIR UNIVERSITY DEATH BY A THOUSAND CUTS: MICRO -AIR VEHICLES (MAV) IN THE SERVICE OF AIR FORCE MISSIONS by...Dates Covered (from... to) - Title and Subtitle Death by a thousand Cuts: Micro -Air Vehicles (MAV) in the Service of Air Force Missions Contract

  8. Improving community ambulation after stroke: the AMBULATE trial

    Directory of Open Access Journals (Sweden)

    Lindley Richard


    Full Text Available Abstract Background It has been reported that following rehabilitation, only 7% of stroke survivors are able to walk at a level commensurate with community participation. Previous research indicates that treadmill and overground walking training can improve walking capacity in people living in the community after stroke. The main objectives of the AMBULATE trial are to determine (i whether a 4-month treadmill walking program is more effective than a 2-month program, compared to control, in improving walking capacity, health and community participation and (ii the "threshold" walking speed that results in sufficient walking capacity that makes walking self-sustaining. Methods/Design A prospective randomised controlled trial of unsupported treadmill training with a 12 month follow-up with concealed allocation and blinded assessment will be conducted. 210 community-dwelling people after stroke who are able to walk independently but slowly will be recruited and randomly allocated to either a 4 month training group, 2 month training group or the control (no intervention group. Intervention for the two training groups will occur 3 days per week for 30 minutes each session. Measurements of walking, health and community participation will be taken at baseline, 2 months, 4 months, 6 months and 12 months. This study has obtained ethical approval from the relevant Human Research Ethics Committees. Discussion By improving stroke survivors' walking ability, it is likely also to improve their general wellbeing by promoting better health and greater community participation. Furthermore, if stroke survivors can reach a point where their walking and community participation is self-sustaining, this will reduce the burden of care on family and friends as well as the economic burden on the health system. Given the major demographic shift in developed nations involving significant growth in the aged population, this research will make an important evidence

  9. Weather factors in the short-term forecasting of daily ambulance calls. (United States)

    Wong, Ho-Ting; Lai, Poh-Chin


    The daily ambulance demand for Hong Kong is rising, and it has been shown that weather factors (temperature and humidity) play a role in the demand for ambulance services. This study aimed at developing short-term forecasting models of daily ambulance calls using the 7-day weather forecast data as predictors. We employed the autoregressive integrated moving average (ARIMA) method to analyze over 1.3 million cases of emergency attendance in May 2006 through April 2009 and the 7-day weather forecast data for the same period. Our results showed that the ARIMA model could offer reasonably accurate forecasts of daily ambulance calls at 1-7 days ahead of time and with improved accuracy by including weather factors. Specifically, the inclusion of average temperature alone in our ARIMA model improved the predictability of the 1-day forecast when compared to that of a simple ARIMA model (8.8% decrease in the root mean square error, RMSE=53 vs 58). The improvement in the 7-day forecast with average temperature as a predictor was more pronounced, with a 10% drop in prediction error (RMSE=62 vs 69). These findings suggested that weather forecast data can improve the 1- to 7-day forecasts of daily ambulance demand. As weather forecast data are readily accessible from Hong Kong Observatory's official website, there is virtually no cost to including them in the ARIMA models, which yield better prediction for forward planning and deployment of ambulance manpower.

  10. Selecting appropriate Internet advertising type in air transport services,Case Study: Iran Air Airlines (Homa

    Directory of Open Access Journals (Sweden)

    Hamid Zargham Borojeni


    Full Text Available This study is looking for selecting the appropriate form of Internet advertising in the air transport services. The model which is used in this research is a combination of structural models of the interactive advertising, interactive advertising model TOORSON Mr. RAGERS, Mr. Kasipo, and Patty probability model complexity and model of how advertising Mr. Vaqn, obtained, is used. The purpose of this study is to select the appropriate form of Internet advertising in the air transport services, (case study: Iran Air. This study is descriptive - survey. For gathering information, a questionnaire was used. The questionnaire included four parts. With applying exploratory data analysis methods (comparison of the relative frequencies according to the results of Sections 2 and 4 of questionnaires, the Internet advertising Skyscraper as the most desirable form of Internet advertising in air transport services is selected.

  11. Selecting appropriate Internet advertising type in air transport services,Case Study: Iran Air Airlines (Homa

    Directory of Open Access Journals (Sweden)

    anna alaei


    Full Text Available This study is looking for selecting the appropriate form of Internet advertising in the air transport services. The model which is used in this research is a combination of structural models of the interactive advertising, interactive advertising model TOORSON Mr. RAGERS, Mr. Kasipo, and Patty probability model complexity and model of how advertising Mr. Vaqn, obtained, is used. The purpose of this study is to select the appropriate form of Internet advertising in the air transport services, (case study: Iran Air. This study is descriptive - survey. For gathering information, a questionnaire was used. The questionnaire included four parts. With applying exploratory data analysis methods (comparison of the relative frequencies according to the results of Sections 2 and 4 of questionnaires, the Internet advertising Skyscraper as the most desirable form of Internet advertising in air transport services is selected.

  12. Application of 4 different sterilization methods applied for ambulance air disinfection%4种消毒方法在急救车物体表面消毒的应用效果

    Institute of Scientific and Technical Information of China (English)

    舒艳; 杨建国; 李素英; 王梅; 陈明


    目的 通过对北京市救护车污染状况、污染菌种的分析,研究探讨快速、有效、规范的救护车的消毒方法及卫生学监测标准. 方法 将164辆急救车分为4组,紫外线组、臭氧组、二氧化氯消毒剂组为3个试验组,清水组为对照组;每次急救车使用后及清洗消毒后对物体表面采样,并进行细菌培养计数及细菌鉴定. 结果 对照组、紫外线组、臭氧组及二氧化氯消毒剂组清洗消毒后菌落数分别是0.68、0.56、0.24、0.36 CFU/m2,均能达到消毒技术管理规范要求,符合Ⅲ类环境物体表面菌落总数≤10 CFU/m2范围,杀菌率分别为71.5%、82.9%、87.1%及82.1%,二氧化氯消毒剂擦拭的消毒效果明显好于对照组,差异有统计学意义(P<0.05),紫外线和臭氧的消毒效果与对照比较,差异无统计学意义. 结论 二氧化氯消毒剂擦拭方法快速、有效,适用于急救车内壁及院外急救设备的卫生学监测标准.%OBJECTIVE To explore a rapid, effective and normative disinfection method and hygiene monitoring standard by analyzing ambulance pollution status and bacteria species. METHODS A total of 164 ambulances were divided into 4 groups, namely UV group, Ozone group, chlorine dioxide disinfectant group was set as experimental group and pure water group as control group. Every time after the use of ambulance and disinfection,the surfaces of ambulances were sampled, bacterial culture counts and the bacterial identification were performed.RESULTS After being disinfected, the colonies of 4 different methods were 0. 68,0. 56,0. 24 and 0. 36 CFU/m2 ,respectively, which met the requirement of management regulation and the No. 3 environmental standard on the total number of surface colonies (≤ 10 CFU/m2 ). The sterilization rates were 71. 5 %, 82. 9%, 87. 1 % and 82. 1 %, respectively. By pairwise comparison, the effect of chlorine dioxide aerosols was significantly better than that of control group (P<0

  13. Ambulance officers' use of online clinical evidence

    Directory of Open Access Journals (Sweden)

    Westbrook Mary T


    Full Text Available Abstract Background Hospital-based clinicians have been shown to use and attain benefits from online evidence systems. To our knowledge there have been no studies investigating whether and how ambulance officers use online evidence systems if provided. We surveyed ambulance officers to examine their knowledge and use of the Clinical Information Access Program (CIAP, an online evidence system providing 24-hour access to information to support evidence-based practice. Methods A questionnaire was completed by 278 ambulance officers in New South Wales, Australia. Comparisons were made between those who used CIAP and officers who had heard of, but not used CIAP. Results Half the sample (48.6% knew of, and 28.8% had used CIAP. Users were more likely to have heard of CIAP from a CIAP representative/presentation, non-users from written information. Compared to ambulance officers who had heard of but had not used CIAP, users were more likely to report better computer skills and that their supervisors regarded use of CIAP as a legitimate part of ambulance officers' clinical role. The main reasons for non-use were lack of access(49.0% and training(31.4%. Of users, 51.3% rated their skills at finding information as good/very good, 67.5% found the information sought all/most of the time, 87.3% believed CIAP had the potential to improve patient care and 28.2% had directly experienced this. Most access to CIAP occurred at home. The databases frequently accessed were MIMS (A medicines information database (73.8% and MEDLINE(67.5%. The major journals accessed were Journal of Emergency Nursing(37.5%, American Journal of Medicine(30.0% and JAMA(27.5%. Conclusion Over half of ambulance officers had not heard of CIAP. The proportion who knew about and used CIAP was also low. Reasons for this appear to be a work culture not convinced of CIAP's relevance to pre-hospital patient care and lack of access to CIAP at work. Ambulance officers who used CIAP accessed it

  14. CERN'S Fire and Rescue Group Gets New Ambulance

    CERN Multimedia


    The ambulance is to replace another based on the off-road vehicle design which was originally acquired for the civil engineering phase of LEP construction. Just one figure, in 1999, the CERN ambulance was called out 195 times.

  15. Environment and air pollution: health services bequeath to grotesque menace. (United States)

    Qureshi, Muhammad Imran; Rasli, Amran Md; Awan, Usama; Ma, Jian; Ali, Ghulam; Faridullah; Alam, Arif; Sajjad, Faiza; Zaman, Khalid


    The objective of the study is to establish the link between air pollution, fossil fuel energy consumption, industrialization, alternative and nuclear energy, combustible renewable and wastes, urbanization, and resulting impact on health services in Malaysia. The study employed two-stage least square regression technique on the time series data from 1975 to 2012 to possibly minimize the problem of endogeniety in the health services model. The results in general show that air pollution and environmental indicators act as a strong contributor to influence Malaysian health services. Urbanization and nuclear energy consumption both significantly increases the life expectancy in Malaysia, while fertility rate decreases along with the increasing urbanization in a country. Fossil fuel energy consumption and industrialization both have an indirect relationship with the infant mortality rate, whereas, carbon dioxide emissions have a direct relationship with the sanitation facility in a country. The results conclude that balancing the air pollution, environment, and health services needs strong policy vistas on the end of the government officials.

  16. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus


    Much information is shared, interpreted and recreated between caller, emergency dispatch personnel and ambulance crew during an emergency call. This paper studies the use of reflection in the ambulance control center based on the information an ambulance crew produces during patient treatment in ...... to understand and use the feedback delivered through the system. The paper argues for broadening the scope of telemedicine use outside the boundaries of communication between ambulance and emergency department....... in the ambulance. The study is based on an ethnographical single case study of a Danish ambulance control center that uses a system called “amPHI” to monitor outgoing and homebound ambulance runs from scene of injury to arrival at the emergency department. The paper finds that the control center uses...

  17. Variation in ambulance call rates for care homes in Torbay, UK. (United States)

    Hancock, Jason; Matthews, Justin; Ukoumunne, Obioha C; Lang, Iain; Somerfield, David; Wenman, James; Dickens, Chris


    Emergency ambulance calls represent one of the routes of emergency hospital admissions from care homes. We aimed to describe the pattern of ambulance call rates from care homes and identify factors predicting those homes calling for an ambulance most frequently. We obtained data from South Western Ambulance Service NHS Foundation Trust on 3138 ambulance calls relating to people aged 65 and over from care homes in the Torbay region between 1 April 2012 and 31 July 2013. We supplemented this with data from the Care Quality Commission (CQC) website on home characteristics and outcomes of CQC inspections. We used descriptive statistics to identify variation in ambulance call rates for residential and nursing homes and fitted negative binomial regression models to determine if call rates were predicted by home type (nursing versus residential), the five standards in the CQC reports, dementia care status or travel time to hospital. One hundred and forty-six homes (119 residential and 27 nursing) were included in the analysis. The number of calls made ranged from 1 to 99. The median number (IQR; range) of calls per resident per year was 0.51 (0.21-0.89; 0.03-2.45). Nursing homes had a lower call rate than residential homes [adjusted rate ratio (ARR) 0.29; 95% CI: 0.22-0.40; P call rate compared to those who passed (ARR 0.67; 95% CI: 0.50-0.90; P = 0.006); and homes specialising in dementia had a higher call rate compared to those not specialising (ARR 1.56; 95% CI: 1.23-1.96; P call rate variability reflects the different needs of resident populations or differences in care home policies and practice.

  18. Shoes versus sneakers in toddler ambulation. (United States)

    Gould, N


    The purpose of this study was to determine the relative values and differences between shoes and sneakers for young children just learning to walk. In phase 1 of the study, 79 toddlers (47 females and 32 males), ranging in age from 11 months to 3 years, were carefully measured for footwear. Only 15 toddlers (19%) could be properly fitted in the medium-width sneakers that are currently available on the market. The majority of the measured toddlers required widths greater than D, and to accommodate these wider feet, it was necessary to fit them with longer sneakers than they actually needed otherwise, thus making ambulation a bit more difficult and clumsy. In phase 2, eight toddlers, randomly selected except for sex (four male and four female), ranging in age from 11 to 16 months who had been ambulating 2 weeks to 5 months, were tagged with an identifying letter and videotaped in four walking situations: sneakers on tile, shoes on tile, sneakers on rugging, and shoes on rugging. Four hours of video taping was edited down to one-half hour. Twenty-three observers (orthopaedic surgeons, pediatricians, and shoe fitters) carefully reviewed the tape on multiple occasions and came to the following conclusions: better fit, stance, gait, cadence, and stability were noted with shoes in all the toddlers and in all situations. Falls were three times more frequent in sneakers as compared to shoes on tile surfaces and five times more frequent on rugging. It was concluded that the slight economic advantage of sneakers over shoes was not that great to warrant jeopardizing the capabilities of the toddler in the earliest stages of ambulation.

  19. Leg Spasticity and Ambulation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Swathi Balantrapu


    Full Text Available Background. Spasticity of the legs is common in multiple sclerosis (MS, but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal and 4 (contracted. Patients completed the 6-minute walk (6 MW, timed 25 foot walk (T25FW, and timed up-and-go (TUG, and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc. for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12 and wore an accelerometer over a seven-day period. Results. 52% (n=44 of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P=0.0001, d=-0.86, T25FW (P=0.003,d=0.72, TUG (P=0.001, d=0.84, MSWS-12 (P=0.0001,d=1.09, O2 cost of walking (P=0.001, d=0.75, average steps/day (P<0.05, d=-0.45, and walking velocity (P<0.05, d=-0.53 and cadence (P<0.05, d=-0.46. Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.

  20. US EPA 2012 Air Quality Fused Surface for the Conterminous U.S. Map Service (United States)

    U.S. Environmental Protection Agency — This web service contains a polygon layer that depicts fused air quality predictions for 2012 for census tracts in the conterminous United States. Fused air quality...

  1. Numerical Simulation and Experimental Research on Air Pattern and Temperature Distribution Inside Compartment of All-Terrain Emergency Ambulance Vehicle%全地形履带式卫生急救车车厢内气流组织及温度分布的数值模拟与试验研究

    Institute of Scientific and Technical Information of China (English)

    赵秀国; 徐新喜; 刘亚军; 崔向东


    运用计算流体动力学方法,对全地形履带式卫生急救车车厢内的气流组织和温度分布进行了数值模拟,分析了车厢内气流组织形式和温度分布规律,同时将数值模拟结果与试验结果进行了对比分析,验证了数值模拟结果的准确性。结果表明:在人员活动的绝大部分区域内气流速度分布在0.5 m/s以下,仅在空调送风口射流区域内,气流速度较高,整个车厢内气流速度分布较均匀;车厢内垂直方向和前后方向上不存在明显的温度梯度,整个车厢内温度分布均匀性较好,温度分布在27.5℃左右,温差较小;车厢内人员的舒适性较好,能够满足相关医学作业要求。%The air pattern and the temperature distribution inside the compartment of all-terrain emergency ambulance vehicle are simulated by the technique of computational fluid dynamics(CFD),the air pattern and the temperature distribu-tion are analysed and the simulation result are compared with experimental result.The results show that the air velocity is under 0.5 m/s in the most zone of person activity and the air velocity is distributed uniformly in compartment.The high air velocity exists in the jet zone of the air conditioning.The obvious temperature gradient doesn’t exist in the vertical plane and the anteroposterior of the compartment.The temperature distribution in the compartment is quite uniform and the tempera-ture is almost at 27.5℃ with little temperature difference.The human thermal comfort is good in the compartment and the environment in the compartment can satisfy requirements of the medical operation.

  2. Actively-controlled Beds for Ambulances

    Institute of Scientific and Technical Information of China (English)

    Takahiko Ono; Hikaru Inooka


    During transportation by ambulance,a patient is exposed to inertial acceleration when an ambulance decelerates or turns a corner.Such acceleration often gives a patient physical stress such as blood pressure variation or body sway,which causes strong pain,feeling of discomfort or sometimes critical damage for seriously injured persons.To reduce this undesirable effect of the acceleration,the authors developed the actively-controlled bed (ACB) which controls the posture of a stretcher in real time to reduce foot-to-head and lateral acceleration acting on a supine person.This paper describes development of the ACB,including control system design and performance evaluation.The control system is designed by Zakian's framework,which comprises the principle of matching and the method of inequalities,so that the design specifications on the tracking error and the motor torque are satisfied.From the results of driving experiments and simulation,it is estimated that the ACB can reduce the acceleration acting on a patient by 65% in the foot-to-head direction and by 75% in the lateral direction.

  3. Design of an Efficient Integrated System for Ambulance Management

    Directory of Open Access Journals (Sweden)

    Raid S. Sarhan


    Full Text Available Because the increases in accidents and emergencies require less time and faster access whenever possible in order to reduce the chances of death, This study designed an ambulance management system (AMaSy which utilize GIS, GPS, and GPRS that was tested in principle in Al-Mansoura City - EGYPT. The proposed system takes into consideration the emergency cases that could possibly occur. The research work considers all possible cases. While an ambulance could already be occupied with one patient, the system considers it as an available ambulance and requests it for another case, being that the ambulance only needs a short period of time to drop-off the current case and that the second case is relatively close to the ambulance. This forces the ambulance to quicken the processes of drop-off and pick-up between the two cases. The main objective of this research work is to make an ambulance system which enables ambulances to have faster arrivals and take less time to reach accident sites

  4. Offload zone patient selection criteria to reduce ambulance offload delay

    NARCIS (Netherlands)

    Laan, Corine M.; Vanberkel, Peter T.; Boucherie, Richard J.; Carter, Alix J.E.


    Emergency department overcrowding is a widespread problem and often leads to ambulance offload delay. If no bed is available when a patient arrives, the patient has to wait with the ambulance crew. A recent Canadian innovation is the offload zone—an area where multiple patients can wait with a singl

  5. 78 FR 26103 - Proposed Standard Operating Procedure (SOP) of the Aircraft Certification Service (AIR) Project... (United States)


    ... Federal Aviation Administration Proposed Standard Operating Procedure (SOP) of the Aircraft Certification... comments on, the Aircraft Certification Service (AIR) standard operating procedure (SOP) describing the... comments on the SOP to: Federal Aviation Administration (FAA) Aircraft Certification Service,...

  6. 29 CFR 4.130 - Types of covered service contracts illustrated. (United States)


    ...) Aerial reconnaissance for fire detection. (3) Ambulance service. (4) Barber and beauty shop services. (5... maintenance and operation and engineering support services. (16) Exploratory drilling (other than part...

  7. Board Certification. Registered EMT-Paramedic. Registered EMT-Intermediate. Registered EMT-Ambulance. Registered EMT-Non-Ambulance. (United States)

    National Registry of Emergency Medical Technicians, Columbus, OH.

    These three brochures outline entry requirements and certification information for: (1) emergency medical technician (EMT)-ambulance and EMT-non-ambulance; (2) EMT-intermediate; and (3) EMT-paramedic. Each brochure provides information on entry requirements, including provisional registration and expiration date; lapsed registration; examination…

  8. Feasibility of AmbulanCe-Based Telemedicine (FACT) Study : Safety, Feasibility and Reliability of Third Generation Ambulance Telemedicine

    NARCIS (Netherlands)

    Yperzeele, Laetitia; Van Hooff, Robbert-Jan; De Smedt, Ann; Espinoza, Alexis Valenzuela; Van Dyck, Rita; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; Lauwaert, Door; De Keyser, Jacques; Brouns, Raf


    Background: Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third

  9. Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in prehospital emergency care – an intervention study

    Directory of Open Access Journals (Sweden)

    Jonas Aléx


    Full Text Available Background: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients’ exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in the prehospital emergency care. Methods: A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30 was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30 no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS, subjective comments on cold experiences, and finger, ear and air temperatures. Results: Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001 but decreased in the control group (p=0.014. A significant higher proportion (57% of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001. At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes. Conclusions: The use of active heat from underneath increases the patients’ thermal comfort and may prevent the negative consequences of cold stress.

  10. EPA Facility Registry Service (FRS): AIRS_AFS Sub Facilities (United States)

    U.S. Environmental Protection Agency — The Air Facility System (AFS) contains compliance and permit data for stationary sources regulated by EPA, state and local air pollution agencies. The sub facility...

  11. Emergency ambulance assistance in The Netherlands: is the Dutch situation optimal? (United States)

    van Vugt, A B; van Olden, G D; Edwards, M J


    The system of prehospital trauma care in the Netherlands is the subject of great concern. Although many improvements have been achieved in the last decade, there are still some deficits. Legislation concerning the minimal level of education for ambulance attendants was recently upgraded to 'registered nurse', a standard which must be achieved by 1997. Standardization with regard to extrication techniques, equipment and methods of treatment in prehospital trauma care does not yet exist. Although aware of the fact that large regional differences exist throughout the USA, a system of care in accordance with the advanced trauma life support (ATLS) standard of the American College of Surgeons (ACS) and by means of prehospital and advanced trauma life support (PHTLS) given according to the standards of the National Association of Emergency Medical Technicians (NAEMS) was considered to be the 'golden standard'. Nineteen ground ambulance and two helicopter services in different states of the USA, working according to ACS/NAEMS standard, were visited to analyse the system of care, with special reference to (para)medical education, communication, logistics, and immobilization materials and techniques. In the Netherlands all 41 central post ambulance services (CPAs) were asked to return a questionnaire. This resulted in a 90% (37 out of 41) response. The deficits of the Dutch system of care related to the PHTLS/ATLS standard are pointed out, resulting in recommendations to improve the Dutch system. The requirements of the dispatcher are far inferior to the optimal situation, which, together with the lack of technical equipment, results in serious communication problems. The Dutch ambulance attendant education, in which in the present system the education level reaches 'registered nurse' in only 91% and specialized courses are not mandatory, should be upgraded to the PHTLS level of care.

  12. Emergency obstetric referral in rural Sierra Leone: what can motorbike ambulances contribute? A mixed-methods study. (United States)

    Bhopal, Sunil S; Halpin, Stephen J; Gerein, Nancy


    Giving birth remains a dangerous endeavour for many of the world's women. Progress to improve this has been slow in sub-Saharan Africa. The second delay, where transport infrastructure is key in allowing a woman to reach care, has been a relatively neglected field of study. Six eRanger motorbike ambulances, specifically engineered for use on poor roads in resource-poor situations were provided in 2006 as part of an emergency referral system in rural Sierra Leone. The aim of this study was to evaluate the implementation of this referral system in terms of its use, acceptability and accessibility. Data were collected from usage records, and a series of semi-structured interviews and focus groups conducted to provide deeper understanding of the service. A total of 130 records of patients being transported to a health facility were found, 1/3 of which were for obstetric cases. The ambulance is being used regularly to transport patients to a health care facility. It is well known to the communities, is acceptable and accessible, and is valued by those it serves. District-wide traditional birth attendant training and the sensitisation activities provided a foundation for the introduction of the ambulance service, creating a high level of awareness of the service and its importance, particularly for women in labour. Motorbike ambulances are suited to remote areas and can function on poor roads inaccessible to other vehicles.

  13. Efficacy and safety of intravenous fentanyl administered by ambulance personnel

    DEFF Research Database (Denmark)

    Friesgaard, Kristian Dahl; Nikolajsen, Lone; Giebner, Matthias


    BACKGROUND: Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered...... by ambulance personnel. METHODS: Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival...... patients (1.3%) and hypotension observed in 71 patients (3.0%). CONCLUSION: Intravenous fentanyl caused clinically meaningful pain reduction in most patients and was safe in the hands of ambulance personnel. Many patients had moderate to severe pain at hospital arrival. As the protocol allowed higher doses...

  14. Would You Feel Safe in A Driverless Ambulance? (United States)

    ... configuration, while they had mixed feelings about the autopilot configuration," said Rice, an associate professor of human ... people's emotional responses to it because ambulances on autopilot aren't a part of our everyday lives ...

  15. Emerging organizational structures in the ambulance industry in the United States. (United States)

    Narad, R A


    This analysis seeks to identify emerging forms of organizations in emergency medical services (EMS) in the United States, to provide examples of them, to relate them to changes in healthcare generally, and to apply a classification scheme. Public policy issues related to these new forms of organizations and lessons from other areas of the healthcare system are identified. Recent changes in the healthcare system in the United States have been marked by modifications in the structure of organizations that provide and pay for health services. New forms of organizations and alliances among existing organizations have emerged in an effort to improve the efficiency of the services provided and to improve organizations' market positions. Reflecting increased competition within EMS and the demands of the changing health-care delivery system, several types of organizations have begun to emerge in EMS that resemble those occurring in health care generally. These include forms of horizontal integration, such as consolidated ambulance services and various models of ambulance service networks; and forms of vertical integration, such as demand management programs and public-private joint ventures. The ultimate end might be complete integration with a carve-out of all non-scheduled care. Although changes in EMS organizations result largely from marketplace decisions by sellers and purchasers, this does not mean that there is no public policy role. While new organizational forms may increase the ambulance industry's efficiency, public policy makers must be concerned about quality and access as well. Some policy responses will promote marketplace changes, others will accept them generally, but will seek to correct problems, and a third group will attempt to restrain the market.

  16. Demand Forecast Using Data Analytics for the Preallocation of Ambulances. (United States)

    Chen, Albert Y; Lu, Tsung-Yu; Ma, Matthew Huei-Ming; Sun, Wei-Zen


    The objective of prehospital emergency medical services (EMSs) is to have a short response time. By increasing the operational efficiency, the survival rate of patients could potentially be increased. The geographic information system (GIS) is introduced in this study to manage and visualize the spatial distribution of demand data and forecasting results. A flexible model is implemented in GIS, through which training data are prepared with user-desired sizes for the spatial grid and discretized temporal steps. We applied moving average, artificial neural network, sinusoidal regression, and support vector regression for the forecasting of prehospital emergency medical demand. The results from these approaches, as a reference, could be used for the preallocation of ambulances. A case study is conducted for the EMS in New Taipei City, where prehospital EMS data have been collected for three years. The model selection process has chosen different models with different input features for the forecast of different areas. The best daily mean absolute percentage error during testing of the EMS demand forecast is 23.01%, which is a reasonable forecast based on Lewis' definition. With the acceptable prediction performance, the proposed approach has its potential to be applied to the current practice.

  17. EPA Facility Registry Service (FRS): AIRS_AFS (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  18. EPA Facility Registry Service (FRS): AIRS_AQS (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  19. EPA Facility Registry Service (FRS): AIRS_AFS_MAJOR (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  20. Customer Service Analysis of Air Combat Command Vehicle Maintenance Support (United States)


    the survey, the researchers categorized the services or variables into marketing mix components: product, price, promotion, and customer service...comparing and analyzing the variables identified in the previous three phases to determine a strategic marketing mix (46:9). After analyzing the data...service/physical distribution. Additionally, they found that customer service/physical distribution was an integral component of the marketing mix , and

  1. 72-Hour Forecast of Air Temperatures from the National Weather Service's National Digital Forecast Database (NDFD) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of air temperature. In...

  2. 48-Hour Forecast of Air Temperatures from the National Weather Service's National Digital Forecast Database (NDFD) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of air temperature. In...

  3. 24-Hour Forecast of Air Temperatures from the National Weather Service's National Digital Forecast Database (NDFD) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of air temperature. In...

  4. A Consumer Evaluation of Air Force Food Service (United States)


    dishes and glasses CD CD CD CD CD Dirty disSies and glasses i. Dirty floors CD CD CD CD CD Clean floors j...have decided to have an INEXPENSIVE NOON or EVENING MEAL. Would you prefer a cafeteria, self-service system or a waitress -service system? Self-service...345 > 2 E 4) 2 0 1 c O et 2 C Q CD CD CD a> ■Ii Waitress service 73 APPENDIX 11/ TABLE 28 Sex of Samples Male Female Totals Travis

  5. CERN'S Fire and Rescue Group Gets New Ambulance

    CERN Multimedia


    The arrival of a new vehicle is always an important moment in the life of a fire station. So when a new ambulance was delivered to the CERN Fire Brigade on Wednesday 16 September 2000, it was given a warm welcome, attended by staff of the different divisions involved in its purchase. It took a year from the first administrative moves to the day of acquisition. On the one hand there were the calls for tender needed for such a purchase and on the other the development of this custom-designed ambulance with its unique features. Three visits to the manufacturer had to be made, including two to the head office of the Miesen factory at Bonn to study and incorporate in the ambulance the special requirements called for by its future users. These requirements, born from the past experience of CERN’s ambulance crews, concerned not only interior arrangements but also included a new side panel, opening up a stowage compartment where everything will be put that gets dirty during ambulance operations. This will minimize ...

  6. Transition of AIRS Products to the National Weather Service (United States)

    Zavodsky, Bradley


    Short-term Prediction Research and Transition Center (SPoRT) is a proven community leader for transitioning satellite products to operational end users and is working hard to bring data from Atmospheric Infrared Sounder (AIRS) to forecasters. SPoRT products using AIRS data are currently or will soon be evaluated at WFOs and National Centers (1) T and q profiles: HWT, Alaska WFOs, HRD/OPC, HMT (2) Ozone profiles: HPC/OPC (3) Carbon Monoxide: Southern and Western Region WFOs SPoRT is actively evaluating differences between V5 and V6 profiles for selected cases and will continue to provide feedback to the AIRS team as V6 development efforts conclude.

  7. Influence of ambulance use on early reperfusion therapies for acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    SONG Li; HU Da-yi; YAN Hong-bing; YANG Jin-gang; SUN Yi-hong; LI Chao; LIU Shu-shan; WU Dong; FENG Qi


    Background Ambulance use expedites the definitive treatment of acute myocardial infarction (AMI). The aim of this study was to evaluate the effect of ambulance use on the administration of early reperfusion therapies for patients with AMI in Beijing, China.Methods Data were prospectively collected from 498 patients with ST-elevation myocardial infarction (STEMI) who were admitted within 12 hours of symptom onset to 19 hospitals in Beijing between November 1,2005 and December 31, 2006. The baseline characteristics of and the initial management of the ambulance users and the non-ambulance users were compared.Results Only 186 (37.3%) patients used an ambulance as transportation to the hospital. Ambulance users were, on average, older and at relatively higher risk on presentation than the non-ambulance users. After adjustment for patient and hospital characteristics, ambulance use was associated with a greater early reperfusion rate, mainly because of a greater incidence of primary percutaneous coronary intervention. In addition, ambulance users had a significantly shorter median door-to-balloon (120 compared with 145 minutes, P<0.001) and symptom onset-to-balloon (223 compared with 300 minutes, P<0.001) time than non-ambulance users.Conclusions Ambulances are underused by AMI patients in Beijing. Ambulance use may lead to more frequent and faster receipt of early reperfusion therapies. New public health strategies should be developed to facilitate an increased use of ambulances by AMI patients.

  8. Masculinity and Lifting Accidents among Danish Ambulance Personnel

    DEFF Research Database (Denmark)

    Hansen, Claus D.; Nielsen, Kent J

    Background Work injuries related to lifting are the most prevalent among ambulance personnel (AP) despite the introduction of ‘assistive technologies’ (AT) that help reduce situations of manual lifting. One third of the AP report using AT only ‘sometimes’ and 10% report having lifted a patient...... alone. For those 5% scoring lowest on MRNI the probability of reporting lifting alone was 6% while this figure was 17% for those scoring above the 95th percentile. Conclusion This study suggests that male ambulance workers performance of masculinity might pose a threat to their safety. AP...

  9. Defining a 21st Century Air Force (Services) Business Model (United States)


    information and technology age. Understanding this generation is important because Air Force millennial generation Airmen comprise 69 percent of...multi-tasking and are extremely savvy with electronics. Even though it is well known that millennials are technologically savvy, the Air Force has...Activity Business Model……………………3 The Millennial Generation……………………………………………………………….9 Sequestration Impacts………………………………………………………………...…10 Failures of

  10. A Correlational Study of How Airline Customer Service and Consumer Perception of Airline Customer Service Affect the Air Rage Phenomenon (United States)

    Hunter, Joyce A.


    Between 1995 and 2000, customer service declined throughout the airline industry, as reported in February 2001 by the U.S. Department of Transportation (2001). One of the biggest problems today within the airline industry is the constant complaining from customers regarding the deterioraton of service (McCollough, Berry, & Yadav, 2000). Since 1995, unfortunately no airline has been immune from service deterioration, as reported by the Airline Quality Rating, an annual report by two airline industry experts who analyzed Department of Transportation statistics (Harrison & Kleinsasser, 1999). The airline' refusal to recognize the issue of customer service has perpetuated an environment that has become dangerous and detrimental to the traveling public as well as to airline employees, which in turn has fueled a new phenomenon, now referred to as "air rage".

  11. A implantação do projeto de atendimento Móvel de Urgência em Salvador/BA: panorama e desafios La implantación del proyecto de Atención de Urgencia Móvil en Salvador/BAHIA: panorama y retos Implantation of the Emergency Ambulance Service in Salvador, Bahia: reality and challenges

    Directory of Open Access Journals (Sweden)

    Célia Maria Sales Vieira


    retos en la dinámica y calidad de la atención: educación comunitaria, capacitación profesional, evaluación de recursos humanos y materiales.The goal of this study was to describe the implementation of the emergency ambulance service of Salvador, Bahia (SAMU-192. The Ministry of Health provided the legal basis and regulations for its implementation. The main purpose of this service is the provision of free primary level healthcare to individuals, with clinical, surgical, traumatic and psychiatric aggravations that cause suffering, sequels or death and occur outside the hospital environment. The specific goals of SAMU-192 was to grant free healthcare to urgency and emergency situations, under the hierarchy and regulations of the Single Health System (SUS of the Brazilian government, assuring that public resources will be available and integrated to the complementary healthcare network. Investments for the installation of the service were agreed on in the city and with federal and state management commissions. To turn SAMU-192 into reality, several challenges need to be accomplished, including community education, professional qualification and evaluation of human and material resources so as to provide basic emergency care with the appropriate quality.

  12. Den præhospitale service i Danmark

    DEFF Research Database (Denmark)

    Trier, H; Larsen, C F


    In Denmark, emergency ambulances are dispatched by 41 centres manned either by trained firemen (in Copenhagen) or policemen (outside Copenhagen). In 1990, emergency ambulance calls totalled 284,000. Utilisation of emergency ambulance services increases with urbanisation. A doctor-manned ambulance...... is in operation in Copenhagen, and in some other large towns anaesthesiology and intensive care teams can be dispatched from hospital to give on-the-spot care. In less populated areas, some general practitioners give advanced life-support. Although many areas are serviced by ambulances equipped...... with defibrillators, the majority of patients receive only basic life-support from ambulance personnel. New initiatives resulting from a recent report by a commission appointed by central authorities, and focused on prehospital treatment, are expected to improve the service by raising the level of training given...


    Directory of Open Access Journals (Sweden)

    Mara Ćujić


    Full Text Available This paper examines the possibilities for measuring performance of current Air Navigation Services Providers (ANSPs in Europe. ANSPs are in the process of operational integration into functional air blocks (FABs tracking direction towards Single European Sky goals, but there are a lot of obstacles and air traffic management is still organized in a fragmented way. This is a reason for comparing national ANSPs. A Data Envelopment Analysis (DEA is applied as a tool for performance measurement. Effectiveness of 36 units of ANS system is measured and the limitations and benefits of this kind of performance model are presented.

  14. How urgent are cases brought to the emergency department by ambulance?

    Directory of Open Access Journals (Sweden)

    Melih Yuksel


    Full Text Available Objective: Emergency departments are the first places to which patients present with unexpected or unforeseen health problems. The purpose of this study was to assess the urgency of cases brought by ambulance to the Hospital on the basis of a three-level triage system. Methods: This study was performed between 01.06.2013 and 31.09.2013 at the Diyarbakır Education and Research Hospital. Our emergency service unit is a third degree service for all adult patient groups and all child trauma types. Triage of patients brought to the emergency department by ambulance was performed by emergency medicine specialists. Patients’ vital findings, identity data and triage categories were assessed. Results: 712 patients were included, 382 (53.7% male and 330 (46.3% female, with a mean age of 45. In this study, 619 (86.9% patients were transferred from the scene and 93 (13.1 between hospitals, 483 (67.8% patients were brought by emergency medicine technician (EMT teams, 107 (15% by physician-led teams, 107 (15 by paramedic teams and 15 (2.1% by other teams, 442 (62.1% patients were assessed as yellow, 141 (19.8% as green and 129 (19.1% as red zone. Five hundred eighty (81.5% patients were discharged and 115 (15.9% were hospitalized. Conclusion: Emergency health services are clearly developing rapidly in Turkey. In order for pre-hospital emergency health services not to be abused, we think that these services should be up to the standards of those in developed countries and that public awareness needs to be increased, particularly with regard to triage. J Clin Exp Invest 2015; 6 (2: 126-129

  15. 76 FR 54528 - Standard Operating Procedures (SOP) of the Aircraft Certification Service (AIR) Process for the... (United States)


    ... Federal Aviation Administration Standard Operating Procedures (SOP) of the Aircraft Certification Service...) standard operating procedure (SOP) describing the process used to sequence certification projects that are... before October 3, 2011. ADDRESSES: Send all comments on the SOP : AIR-100-001; Standard...

  16. 76 FR 52731 - On-Line Complaint Form for Service-Related Issues in Air Transportation (United States)


    ... Office of the Secretary On-Line Complaint Form for Service-Related Issues in Air Transportation AGENCY... is complaining, flight date, flight number, and origin and destination cities of complainant's trip...- travel related information from the ACPD. The Department has limited its informational request to...

  17. 14 CFR 71.13 - Classification of Air Traffic Service (ATS) routes. (United States)


    ...) routes. 71.13 Section 71.13 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... ROUTES; AND REPORTING POINTS § 71.13 Classification of Air Traffic Service (ATS) routes. Unless otherwise specified, ATS routes are classified as follows: (a) In subpart A of this part: (1) Jet routes. (2)...

  18. 77 FR 30437 - Proposed Amendment of Air Traffic Service Routes; Southwestern United States (United States)


    ... Federal Aviation Administration 14 CFR Part 71 RIN 2120-AA66 Proposed Amendment of Air Traffic Service Routes; Southwestern United States AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of... Administration, 800 Independence Avenue SW., Washington, DC 20591; telephone: (202) 267-8783....


    Directory of Open Access Journals (Sweden)

    Yuriy Chynchenko


    Full Text Available Abstract. The article deals with the analysis of the researches conducted in field of the SESAR concept.Benefits of the concept, work packages and stakeholders of SESAR joint undertake have been reviewed.Principles of implementation and impact on air traffic services system have been analysed and generalsolutions appropriable for Ukraine have been proposed.

  20. Is the Ability to Ambulate Associated with Better Employment Outcomes in Participants with Traumatic Spinal Cord Injury? (United States)

    Krause, James S.


    The author compares current employment status after spinal cord injury between participants who were independent in ambulation (required no assistance from others) and those who were dependent in ambulation (required assistance from at least one other person to ambulate). Those who were independent of assistance from others in ambulation were…

  1. Approach to decreasing emergency department ambulance diversion hours. (United States)

    Vilke, Gary M; Brown, Lana; Skogland, Patty; Simmons, Charles; Guss, David A


    Analysis between two local Emergency Departments (EDs) suggested an oscillatory phenomenon for ambulance diversion: When one hospital went on diversion it led to a disproportionate flow of ambulance traffic to a neighboring facility that subsequently was forced to go on divert. We hypothesized if one hospital could avoid diversion status, the need for diversion could be averted in the neighboring facility. ED A secured additional resources and made a commitment to no diversion for 1 week. No changes in operations occurred in hospital B. We found no differences in ambulance runs or ED census at either facility comparing the week before, during, and after the trial. There was a dramatic decline in diversion hours from 19.7 to 1.4 and 27.7 to 0 at hospitals A and B, respectively, during the trial period (p < 0.05) compared to the weeks before and after. We conclude that reciprocating effects can be decreased with one institution's commitment to avoid diversion, thus decreasing the need for diversion at a neighboring facility.

  2. Clinical characteristics affecting motor recovery and ambulation in stroke patients (United States)

    Yetisgin, Alparslan


    [Purpose] To describe the clinical characteristics affecting motor recovery and ambulation in stroke patients. [Subjects and Methods] Demographic and clinical characteristics of 53 stroke patients (31 M, 22 F), such as age, gender, etiology, hemiplegic side, Brunnstrom stage, functional ambulation scale scores, history of rehabilitation, and presence of shoulder pain and complex regional pain syndrome were evaluated. [Results] The etiology was ischemic in 79.2% of patients and hemorrhagic in 20.8%. Brunnstrom hand and upper extremity values in females were lower than in males. Complex regional pain syndrome was observed at a level of 18.9% in all patients (more common in females). Brunnstrom hand stage was lower in complex regional pain syndrome patients than in those without the syndrome. Shoulder pain was present in 44.4% of patients. Brunnstrom lower extremity values and functional ambulation scale scores were higher in rehabilitated than in non-rehabilitated cases. [Conclusion] Brunnstrom stages of hand and upper extremity were lower and complex regional pain syndrome was more common in female stroke patients. Shoulder pain and lower Brunnstrom hand stages were related to the presence of complex regional pain syndrome. PMID:28265142

  3. 42 CFR 410.10 - Medical and other health services: Included services. (United States)


    ... other diagnostic tests. (f) X-ray therapy and other radiation therapy services. (g) Medical supplies, appliances, and devices. (h) Durable medical equipment. (i) Ambulance services. (j) Rural health...

  4. Differences in police, ambulance, and emergency department reporting of traffic injuries on Karachi-Hala road, Pakistan

    Directory of Open Access Journals (Sweden)

    Lagarde Emmanuel


    Full Text Available Abstract Background Research undertaken in developing countries has assessed discrepancies in police reporting of Road Traffic Injury (RTI for urban settings only. The objective of this study was to assess differences in RTI reporting across police, ambulance, and hospital Emergency Department (ED datasets on an interurban road section in Pakistan. Methods The study setting was the 196-km long Karachi-Hala road section. RTIs reported to the police, Edhi Ambulance Service (EAS, and five hospital EDs in Karachi during 2008 (Jan to Dec were compared in terms of road user involved (pedestrians, motorcyclists, four-wheeled vehicle occupants and outcome (died or injured. Further, records from these data were matched to assess ascertainment of traffic injuries and deaths by the three datasets. Results A total of 143 RTIs were reported to the police, 531 to EAS, and 661 to hospital EDs. Fatality per hundred traffic injuries was twice as high in police records (19 per 100 RTIs than in ambulance (10 per 100 RTIs and hospital ED records (9 per 100 RTIs. Pedestrian and motorcyclist involvement per hundred traffic injuries was lower in police records (8 per 100 RTIs than in ambulance (17 per 100 RTIs and hospital ED records (43 per 100 RTIs. Of the 119 deaths independently identified after matching, police recorded 22.6%, EAS 46.2%, and hospital ED 50.4%. Similarly, police data accounted for 10.6%, EAS 43.5%, and hospital ED 54.9% of the 1 095 independently identified injured patients. Conclusions Police reporting, particularly of non-fatal RTIs and those involving vulnerable road users, should be improved in Pakistan.

  5. 75 FR 81335 - Reasonable Charges for Medical Care or Services; 2011 Calendar Year Update (United States)


    ... professional charges for anesthesia services and dental services; pathology and laboratory charges; observation... and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and...

  6. Factors on green service industry: Case study at AirAsia (United States)

    Abdullah, Muhammad-Azfar; Chew, Boon-Cheong; Hamid, Syaiful-Rizal


    Presently service organizations are challenged by fierce global competition, new technology and changing customer demands. These trends force service sectors to adapt environmental factors and places innovation at the core of their competitive strategy. On the other hand, service sectors challenge to deliver value memorable experiences and complete "service solutions" while lowering costs and keep sustainable. Despite, many studies have attempted to explore the factors that help toward environmental sustainability in the manufacturing sector, the service sector has not yet received a considerable attention in all world countries generally and in developing countries particularly. Thus, this paper aims to explore the factors that help to attain environmental sustainability in the service sector. A qualitative case study through semi-structured interview conducted with twenty managers from AirAsia to explore the factors that are related to environmental sustainability and green services. Besides, secondary data from document analysis was reviewed to gain more comprehensive understanding and triangulate the interview data. The finding of this paper emphasizes to three important factors namely institutional factors, process factors and result factors that each factor contain sustainability and innovations to promote competitive green service in the marketplace.

  7. The Medical Duty Officer: An Attempt to Mitigate the Ambulance At-Hospital Interval

    Directory of Open Access Journals (Sweden)

    Megan H. Halliday


    Full Text Available Introduction: A lack of coordination between emergency medical services (EMS, emergency departments (ED and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD placed a medical duty officer (MDO in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time. Methods: The MDO was implemented on November 11, 2013. A senior EMS paramedic was assigned to the position and was placed in the fire communication bureau from 9 a.m. to 9 p.m., seven days a week. We defined the pre-intervention period as August 2013 - October 2013 and the post-intervention period as December 2013 - February 2014. We also compared the post-intervention period to the “seasonal match control” one year earlier to adjust for seasonal variation in EMS volume. The MDO was tasked with the prospective management of city EMS resources through intensive monitoring of unit availability and hospital ED traffic. The MDO could suggest alternative transport destinations in the event of ED crowding. We collected and analyzed data from BCFD computer-aided dispatch (CAD system for the following: ambulance response times, ambulance at-hospital interval, hospital diversion and alert status, and “suppression wait time” (defined as the total time suppression units remained on scene until ambulance arrival. The data analysis used a pre/post intervention design to examine the MDO impact on the BCFD EMS system. Results: There were a total of 15,567 EMS calls during the pre-intervention period, 13,921 in the post-intervention period and 14,699 in the seasonal match control period one year earlier. The average at-hospital time decreased by 1.35 minutes from pre- to post-intervention periods and 4.53 minutes from the pre- to seasonal match

  8. Simulation of Emergency Medical Services Delivery Performance Based on Real Map

    Directory of Open Access Journals (Sweden)

    Mohd Hafiz Azizan


    Full Text Available Performance of Emergency Medical Services (EMS delivery is normally measured via ambulance response time. Quick ambulance response can effectively reduce the disability, morbidity and mortality of the emergency patients. Ambulance dispatch policy and ambulance location model both have a significant impact on the ambulance response time. In this paper, we present a prototype of simulation framework to study the performance of local EMS delivery in terms of a simulation model that consists of both ambulance dispatch policy and ambulance location model. Several real-life dispatch policies are simulated in a real map to evaluate the efficiency of local EMS delivery in Johor Bahru. By using a suitable dispatch policy, the results show an improvement in average response time for higher priority call. The total calls covered are also found to increase significantly with the application of Maximal Covering Location Problem (MCLP, especially at a bigger fleet size.

  9. Acute Pain Management Services: What Does the Air Force Have to Offer? (United States)


    Unrelieved pain due to this nociception , after surgery or trauma is often unhealthy, but it is preventable or controllable in a majority of cases...DC 20503. 1. AGENCY USE ONLY (Leaveblank) 2. REPORT DATE 26-Sep-97 3. REPORT TYPE AND DATES COVERED 4. TITLE AND SUBTITLE ACUTE PAIN MANAGEMENT...Prescribed by ANSI Std. 239.18 Designed using Perform Pro, WHS/DIOR. Oct 94 ACUTE PAIN MANAGEMENT SERVICES: WHAT DOES THE AIR FORCE HAVE TO OFFER

  10. The Role of Organizational Culture in the Leadership of United States Air Force Services Squadrons (United States)


    The purpose of this monograph is to examine the role organizational culture plays in the leadership of United States Air Force (USAF) Services...squadrons. While some might argue that the study of organizational culture is a somewhat vague notion, there is significant theory and findings to show...determine the link between organizational culture and financial performance as indicated by Standard and Poor’s financial ratios. In summarizing his

  11. Helicopter emergency medical services accident rates in different international air rescue systems


    Hinkelbein, J; Schwalbe, M.; H V Genzwuerker


    J Hinkelbein1,2, M Schwalbe2, H V Genzwuerker2,31Department for Anesthesiology and Intensive Care Medicine, University Hospital Cologne, Germany; 2Working Group “Emergency Medicine and Air Rescue”, German Society of Aviation and Space Medicine (DGRLM) eV; 3Clinic of Anesthesiology and Intensive Care Medicine, Neckar-Odenwald-Kliniken gGmbH, Hospitals Buchen and Mosbach, Buchen, GermanyAim: Each year approximately two to four helicopter emergency medical services (HEMS) cra...

  12. Contribution of ecosystem services to air quality and climate change mitigation policies: the case of urban forests in Barcelona, Spain. (United States)

    Baró, Francesc; Chaparro, Lydia; Gómez-Baggethun, Erik; Langemeyer, Johannes; Nowak, David J; Terradas, Jaume


    Mounting research highlights the contribution of ecosystem services provided by urban forests to quality of life in cities, yet these services are rarely explicitly considered in environmental policy targets. We quantify regulating services provided by urban forests and evaluate their contribution to comply with policy targets of air quality and climate change mitigation in the municipality of Barcelona, Spain. We apply the i-Tree Eco model to quantify in biophysical and monetary terms the ecosystem services "air purification," "global climate regulation," and the ecosystem disservice "air pollution" associated with biogenic emissions. Our results show that the contribution of urban forests regulating services to abate pollution is substantial in absolute terms, yet modest when compared to overall city levels of air pollution and GHG emissions. We conclude that in order to be effective, green infrastructure-based efforts to offset urban pollution at the municipal level have to be coordinated with territorial policies at broader spatial scales.

  13. Application of ESE Data and Tools to Air Quality Management: Services for Helping the Air Quality Community use ESE Data (SHAirED) (United States)

    Falke, Stefan; Husar, Rudolf


    The goal of this REASoN applications and technology project is to deliver and use Earth Science Enterprise (ESE) data and tools in support of air quality management. Its scope falls within the domain of air quality management and aims to develop a federated air quality information sharing network that includes data from NASA, EPA, US States and others. Project goals were achieved through a access of satellite and ground observation data, web services information technology, interoperability standards, and air quality community collaboration. In contributing to a network of NASA ESE data in support of particulate air quality management, the project will develop access to distributed data, build Web infrastructure, and create tools for data processing and analysis. The key technologies used in the project include emerging web services for developing self describing and modular data access and processing tools, and service oriented architecture for chaining web services together to assemble customized air quality management applications. The technology and tools required for this project were developed within, a shared infrastructure that supports collaborative atmospheric data sharing and processing web services. Much of the collaboration was facilitated through community interactions through the Federation of Earth Science Information Partners (ESIP) Air Quality Workgroup. The main activities during the project that successfully advanced DataFed, enabled air quality applications and established community-oriented infrastructures were: develop access to distributed data (surface and satellite), build Web infrastructure to support data access, processing and analysis create tools for data processing and analysis foster air quality community collaboration and interoperability.

  14. Perioperative transfusion threshold and ambulation after hip revision surgery

    DEFF Research Database (Denmark)

    Nielsen, Kamilla; Johansson, Pär I; Dahl, Benny;


    BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision...... received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing....

  15. Effects of Weather and Heliophysical Conditions on Emergency Ambulance Calls for Elevated Arterial Blood Pressure

    Directory of Open Access Journals (Sweden)

    Jone Vencloviene


    Full Text Available We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009–2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs, in which the conditions for the emergency calls were made coded I.10–I.15. The Kaunas Weather Station provided daily records of air temperature (T, wind speed (WS, relative humidity, and barometric pressure (BP. We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS > 600 km/s increased the daily number of elevated arterial blood pressure (EABP by 12% (RR = 1.12; 95% confidence interval (CI 1.04–1.21; and WS ≥ 3.5 knots during days of T < 1.5 °C and T ≥ 12.5 °C by 8% (RR = 1.08; CI 1.04–1.12. An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T ≥ 17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population’s sensitivity to different weather conditions.

  16. Evaluation of an algorithm for estimating a patient's life threat risk from an ambulance call

    Directory of Open Access Journals (Sweden)

    Moriwaki Yoshihiro


    Full Text Available Abstract Background Utilizing a computer algorithm, information from calls to an ambulance service was used to calculate the risk of patients being in a life-threatening condition (life threat risk, at the time of the call. If the estimated life threat risk was higher than 10%, the probability that a patient faced a risk of dying was recognized as very high and categorized as category A+. The present study aimed to review the accuracy of the algorithm. Methods Data collected for six months from the Yokohama new emergency system was used. In the system, emergency call workers interviewed ambulance callers to obtain information necessary to assess triage, which included consciousness level, breathing status, walking ability, position, and complexion. An emergency patient's life threat risk was then estimated by a computer algorithm applying logistic models. This study compared the estimated life threat risk occurring at the time of the emergency call to the patients' state or severity of condition, i.e. death confirmed at the scene by ambulance crews, resulted in death at emergency departments, life-threatening condition with occurrence of cardiac and/or pulmonary arrest (CPA, life-threatening condition without CPA, serious but not life-threatening condition, moderate condition, and mild condition. The sensitivity, specificity, predictive values, and likelihood ratios of the algorithm for categorizing A+ were calculated. Results The number of emergency dispatches over the six months was 73,992. Triage assessment was conducted for 68,692 of these calls. The study targets account for 88.8% of patients who were involved in triage calls. There were 2,349 cases where the patient had died or had suffered CPA. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the algorithm at predicting cases that would result in a death or CPA were 80.2% (95% confidence interval

  17. 78 FR 76413 - Reasonable Charges for Medical Care or Services; V3.14, 2014 Calendar Year Update and National... (United States)


    ... professional charges for anesthesia services and dental services; pathology and laboratory charges; observation...; physician and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and...

  18. nowCOAST's Map Service for NOAA NWS NDFD Forecasts of Daily Max Surface Air Temperature (deg. F) (Time Offsets) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Map Information: This nowCOAST time-offsets map service provides maps depicting the NWS daily maximum surface air temperature forecasts from the National Digital...

  19. nowCOAST's Map Service for NOAA NWS NDFD Forecasts of Daily Min Surface Air Temperature (deg. F) (Time Offsets) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Map Information: This nowCOAST time-offsets map service provides maps depicting the NWS daily minimum surface air temperature forecasts from the National Digital...

  20. Living in critical times: The impact of critical incidents on frontline ambulance personnel--a qualitative perspective.

    LENUS (Irish Health Repository)

    Gallagher, Sharon


    Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel. One-to-one interviews were conducted with 27 participants who had experienced CIs during the previous 12 months in order to: assess the nature and impact of CIs on health and well-being; examine attitudes toward support services; and explore barriers to service use. The results showed that incidents involving children, suicides, and grotesque mutilation were the most distressing. Participants reported a wide range of physical and mental health problems including sleep difficulties, angry outbursts, irrationality and feelings of alienation. Key themes included: low support service uptake due to fears relating to confidentiality and machismo; a perceived lack of concern and support from management; and a need for professional counselling and stress awareness training. Emergency Medical Controllers (EMCs) also reported a number of difficulties unique to their role. The findings suggest that exposure to CIs has a significant impact on health and well-being; this has important implications for recognizing and appropriately addressing the health and training needs of ambulance personnel, including the effective management of Critical Incident Stress.

  1. Stigma and barriers to accessing mental health services perceived by Air Force nursing personnel. (United States)

    Hernandez, Stephen H A; Bedrick, Edward J; Parshall, Mark B


    We investigated perceptions of stigma and barriers associated with accessing mental health services among active component U.S. Air Force officer and enlisted nursing personnel (N = 211). The Britt and Hoge et al Stigma scale and Hoge et al Barriers to Care scale were administered via an anonymous, online survey. Stigma items pertained to concerns that might affect decisions to seek mental health treatment. Most of the sample agreed with the items "Members of my unit might have less confidence in me" and "My unit leadership might treat me differently." Approximately 20% to 46% agreed with the other four stigma items. Officer nursing personnel were significantly more likely than enlisted to agree that accessing mental health services would be embarrassing, harm their career, or cause leaders to blame them for the problem (p ≤ 0.03 for each comparison). Getting time off from work for treatment and scheduling appointments were perceived as barriers by 41% and 21% of respondents, respectively. We conclude that proportions of Air Force nursing personnel reporting concerns about potential stigmatizing consequences of seeking mental health care are substantial and similar to ranges previously reported by military service members screening positive for mental health problems after deployment.

  2. Efficient supersonic air vehicle design using the Service-Oriented Computing Environment (SORCER

    Directory of Open Access Journals (Sweden)

    Burton Scott A.


    Full Text Available The Air Force Research Lab’s Multidisciplinary Science and Technology Center is investigating conceptual design processes and computing frameworks that could significantly impact the design of the next generation efficient supersonic air vehicle (ESAV. The ESAV conceptual design process must accommodate appropriate fidelity multidisciplinary engineering analyses (MDAs to assess the impact of new air vehicle technologies. These analyses may be coupled and computationally expensive, posing a challenge due to the large number of air vehicle configurations analyzed during conceptual design. In light of these observations, a design process using the Service-Oriented Computing Environment (SORCER software is implemented to combine propulsion, structures, aerodynamics, aeroelasticity, and performance in an integrated MDA. The SORCER software provides the automation and tight integration to grid computing resources necessary to achieve the volume of appropriate fidelity analyses required. Two design studies are performed using a gradient-based optimization method to produce long and short range ESAV wing designs. The studies demonstrate the capability of the ESAV MDA, the optimization algorithm, and the computational scalability and reliability of the SORCER software.

  3. An exploration of factors influencing ambulance and emergency nurses protocol adherence in the Netherlands

    NARCIS (Netherlands)

    Ebben, Remco; Vloet, Lilian; Mintjes, Joke; Achterberg, Theo van


    Adherence to ambulance and ED protocols is often suboptimal. Insight into factors influencing adherence is a requisite for improvement of adherence. This study aims to gain an in-depth understanding of factors that influence ambulance and emergency nurses’ adherence to protocols.

  4. 42 CFR 413.70 - Payment for services of a CAH. (United States)


    ... compensating these specified medical emergency room staff are allowable only if the costs are incurred under... or the entity is the only provider or supplier of ambulance services located within a 35-mile drive... only if the CAH or the entity is the only provider or supplier of ambulance services located within...

  5. Prognostic Predictors for Ambulation in Thai Children With Cerebral Palsy Aged 2 to 18 Years. (United States)

    Keeratisiroj, Orawan; Thawinchai, Nuanlaor; Siritaratiwat, Wantana; Buntragulpoontawee, Montana


    The objectives of this study were to determine prognostic predictors for ambulation among Thai children with cerebral palsy and identify their ambulatory status. A retrospective cohort study was performed at 6 special schools or hospitals for children with physical disabilities. The prognostic predictors for ambulation were analyzed by multivariable ordinal continuation ratio logistic regression. The 533 participants aged 2 to 18 years were divided into 3 groups: 186 with independent ambulation (Gross Motor Function Classification System [GMFCS I-II]), 71 with assisted ambulation (Gross Motor Function Classification System III), and 276 with nonambulation (Gross Motor Function Classification System IV-V). The significant positive predictors for ambulation were type of cerebral palsy (spastic diplegia, spastic hemiplegia, dyskinesia, ataxia, hypotonia, and mixed type), sitting independently at age 2 years, and eating independently. These predictors were used to develop clinical scoring for predicting the future ability to walk among Thai children with cerebral palsy.

  6. 48 CFR 47.403-1 - Availability and unavailability of U.S.-flag air carrier service. (United States)


    ... the time in a travel status, including delay at origin and accelerated arrival at destination, by at... at origin, delay en route, and accelerated arrival at destination. (f) For all short-distance travel... service would not accomplish an agency's mission, foreign-flag air carrier service may be deemed...

  7. AIRS/AMSU-A/HSB Data On-demand Subsetting and Visualization Services at NASA GES DISC DAAC (United States)

    Li, J.; Cho, S.; Sun, D.; Qin, J.; Sharma, A. K.


    The Atmospheric Infrared Sounder (AIRS) is a high-resolution infrared sounder closely coupled with AMSU-A (Advanced Microwave Sounding Unit-A) and HSB (Humidity Sounder for Brazil) on EOS Aqua spacecraft launched on May 4, 2002. The data products from AIRS/AMSU-A/HSB will be archived and distributed at the Goddard Distributed Active Archive Center (GDAAC) located in the NASA Goddard Earth Sciences Data and Information Services Center (GES DAAC). The ADDST is developing tools to read, visualize, analyze and reformat AIRS/AMSU-A/HSB data. The web-based AIRS on-the-fly/on-demand subsetter will be available to perform channel/variable subsetting and restructuring for Level1B (Calibrated Radiances) and Level2 (Atmospheric Retrievals) data products. One can narrow down criteria to subset data files with desired channels and variables and then download the subsetted file. AIRS QuickLook allows users to view AIRS/HSB/AMSU Level-1B data online for a specific channel prior to ordering or downloading data. Global map is also provided along with image to show geographic coverage of the granule and flight direction of the spacecraft. The Atmospheric Dynamics Data Support Team (ADDST) at the GES DISC/DAAC is providing various services to assist users in understanding, accessing, and using AIRS data product. Information on AIRS data and data analysis tools can be found at AIRS data support informational web site ( ) that provides access to various technical online documents, such as, readmes, user's guides, instrument guides, images from AIRS/AMSU-A/HSB data, product search and ordering interfaces, HDF-EOS format information, format conversion software, online data analysis tools, other AIRS related web links and more. Other data support services provided by the ADDST are assist with data mining, helpdesk for user questions on data and information, data ordering, and educational resources.

  8. AIRS Data Service at NASA Goddard Earth Sciences Data and Information Services (GES DISC) and Its Application to Climate Change Study (United States)

    Won, Young-In; Vollimer, Bruce; Theobald, Mike; Hua, Xin-Min


    The Atmospheric Infrared Sounder (AIRS) instrument suite is designed to observe and characterize the entire atmospheric column from the surface to the top of the atmosphere in terms of surface emissivity and temperature, atmospheric temperature and humidity profiles, cloud amount and height, and the spectral outgoing infrared radiation on a global scale. The AIRS Data Support Team at the GES DISC provides data support to assist others in understanding, retrieving and extracting information from the AIRS/AMSU/HSB data products. Because a number of years has passed since its operation started, the amount of data has reached a certain level of maturity where we can address the climate change study utilizing AIRS data, In this presentation we will list various service we provide and to demonstrate how to utilize/apply the existing service to long-term and short-term variability study.

  9. Stylistic analysis of the poem "Ambulance" by Philip Larkin

    Directory of Open Access Journals (Sweden)

    Muhammad Yasir Khan


    Full Text Available Philip Larkin is known as a movement poet, because there are many poems which were published in the book of poetic movement, New Lines. This movement was started in 1950, against the unreasonable, inflated and extortionate romanticism of 1930's and 1940's. The common features of movement poetry are; the use of irony and wit, an element of satire, the loneliness of modern man, pessimistic outlook on life, realism, use of ordinary diction, use of symbols, and loss of religious faith. Robert Conquest is known as the representative poet of this movement. The poets of this movement believed that the language of poetry should be simple, lucid and intelligible. The poem Ambulance deals with the important features of movement poetry. Through the stylistics study of this poem the researchers will show the loneliness and concept of death in modern man.

  10. How public ambulance arrivals impact on Emergency Department workload and resource use

    Directory of Open Access Journals (Sweden)

    Enrico Ferri


    Full Text Available Objectives: To examine patient’s characteristics associated with ED arrival mode, and to determine EMS impact on ED clinical resource use, workload and crowding. Methods: This is a retrospective study of patients seen at Sant’Andrea Hospital ED. Comparison focused on visit characteristics, and on resource use. Results: The use of EMS ambulance confirms association to older age, higher rate of hospital admission, longer length of stay, and severity of injury. Moreover our data show that ambulance referred patients are triaged into a higher acuity category and have a greater intensive care unit admission. Conclusion: Ambulance arrivals have a significant impact on ED resource use, workload and crowding.

  11. A Moderator’s Perspective From Service Quality and Purchase Intentions Relationship: A Case Study of AirAsia Airlines

    Directory of Open Access Journals (Sweden)

    Meysam Salimi


    Full Text Available In this study, it was aimed to examine the relationships between service quality, brand loyalty and intention to buy among AirAsia passengers in Malaysia. The results obtained indicate that there is a positive relationship between service quality, brand loyalty and purchase intentions, while there is a moderator effect of ticket price affecting the relationship between service quality and intention to buy among customers. With more scrutinizing, it was revealed that the effect of service quality on intention to buy is not significant for passengers when there is a higher ticket price.

  12. Association of monthly frequencies of diverse diseases in the calls to the public emergency service of the city of Buenos Aires during 1999-2004 with meteorological variables and seasons (United States)

    Alexander, P.


    This work aims to study associations between monthly averages of meteorological variables and monthly frequencies of diverse diseases in the calls to the public ambulance emergency service of the city of Buenos Aires during the years 1999-2004. Throughout this time period no changes were made in the classification codes of the illnesses. Heart disease, arrhythmia, heart failure, cardiopulmonary arrest, angina pectoris, psychiatric diseases, stroke, transient ischemic attack, syncope and the total number of calls were analyzed against 11 weather variables and the four seasons. All illnesses exhibited some seasonal behavior, except cardiorespiratory arrest and angina pectoris. The largest frequencies of illnesses that exhibited some association with the meteorological variables used to occur in winter, except the psychiatric cases. Heart failure, stroke, psychiatric diseases and the total number of calls showed significant correlations with the 11 meteorological variables considered, and the largest indices (absolute values above 0.6) were found for the former two pathologies. On the other side, cardiorespiratory arrest and angina pectoris revealed no significant correlations and nearly null indices. Variables associated with temperature were the meteorological proxies with the largest correlations against diseases. Pressure and humidity mostly exhibited positive correlations, which is the opposite of variables related to temperature. Contrary to all other diseases, psychiatric pathologies showed a clear predominance of positive correlations. Finally, the association degree of the medical dataset with recurrent patterns was further evaluated through Fourier analysis, to assess the presence of statistically significant behavior. In the Northern Hemisphere high morbidity and mortality rates in December are usually assigned to diverse factors in relation to the holidays, but such an effect is not observed in the present analysis. There seems to be no clearly preferred

  13. The Smart Ring Experience in l’Aquila (Italy: Integrating Smart Mobility Public Services with Air Quality Indexes

    Directory of Open Access Journals (Sweden)

    Maria-Gabriella Villani


    Full Text Available This work presents the “City Dynamics and Smart Environment” activities of the Smart Ring project, a model for the smart city, based on the integration of sustainable urban transport services and environmental monitoring over a 4–5-km circular path, the “Smart Ring”, around the historical center of l’Aquila (Italy. We describe our pilot experience performed during an experimental on-demand public service electric bus, “SmartBus”, which was equipped with a multi-parametric air quality low-cost gas electrochemical sensor platform, “NASUS IV”. For five days (28–29 August 2014 and 1–3 September 2014, the sensor platform was installed inside the SmartBus and measured air quality gas compounds (nitrogen dioxide, carbon oxide, sulfur dioxide, hydrogen sulfide during the service. Data were collected and analyzed on the bases of an air quality index, which provided qualitative insights on the air status potentially experienced by the users. The results obtained are in agreement with the synoptic meteorological conditions, the urban background air quality reference measurements and the potential traffic flow variations. Furthermore, they indicated that the air quality status was influenced by the gas component NO 2 , followed by H 2 S, SO 2 and CO. We discuss the features of our campaign, and we highlight the potential, limitations and key factors to consider for future project designs.

  14. Occupant accelerations and injury potential during an ambulance-to-curb impact. (United States)

    Lee, Ellen L; Hayes, Wilson C


    This paper presents real world acceleration data for an ambulance driving up and over a curb. A full scale reenactment was performed for a litigated case in which a patient on a gurney in an ambulance claimed a variety of bodily injuries after the ambulance struck a curb. A height and weight matched surrogate rode on the gurney during the tests. Results demonstrated that peak vehicle and occupant accelerations never exceeded 1.1g's. To address the claimed injuries, the accelerations likely sustained by the patient were compared to those experienced during daily life. Since ambulances are wide vehicles that travel fast on potentially narrow arterial, collector or local roadways, curb or median impacts may occur during the normal course of driving. Thus, these results may be useful for forensic experts in dealing with similar cases involving claimed injuries following curb impacts.

  15. The Fire Brigade acquires a new ambulance with all the bells and whistles!

    CERN Multimedia

    Anaïs Schaeffer


    On 19 April the Fire Brigade unveiled its latest acquisition: a brand-new ambulance specially designed for CERN.   One of the Fire Brigade's two ambulances has just been replaced by a state-of-the-art vehicle tailor-made to meet CERN's unique requirements. At 4.6 metres long it's much more spacious than its predecessors, providing plenty of room for patient, doctor and paramedic. The ambulance's design and manufacture are the result of a successful collaboration between the Fire Brigade and the technicians from Profile Vehicles, the Finnish company that won the contract following a call for tenders launched in June 2011. "It took us six months to finalise the specification for our new ambulance," explains Patrick Berlinghi, who is responsible for the Fire Brigade's logistics. "We wanted it to be spacious enough for us to be able to work comfortably and to have the latest safety and patient care equipment.  We also reques...

  16. Public service obligations for air transport in the United States and Europe: Connectivity effects and value for money


    Wittman, Michael; Allroggen, Florian; Malina, Robert


    Public service obligations (PSOs) are used by governments in many countries, including the United States and 11 countries in Europe, to mandate a minimum level of commercial air transportation service, especially for small or rural communities. This paper analyzes PSOs in these 12 countries for the year 2010 using the recently proposed Global Connectivity Index to measure direct and indirect market access and a novel subsidy database covering 90% of PSO movements in these countries to assess ...

  17. Improving community ambulation after hip fracture: protocol for a randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    D Orwig


    Discussion: This multicentre randomised study will be the first to test whether a home-based multi-component physiotherapy intervention targeting specific precursors of community ambulation (PUSH is more likely to lead to community ambulation than a home-based non-specific multi-component physiotherapy intervention (PULSE in older adults after hip fracture. The study will also estimate the potential economic value of the interventions.

  18. Solving the dynamic ambulance relocation and dispatching problem using approximate dynamic programming. (United States)

    Schmid, Verena


    Emergency service providers are supposed to locate ambulances such that in case of emergency patients can be reached in a time-efficient manner. Two fundamental decisions and choices need to be made real-time. First of all immediately after a request emerges an appropriate vehicle needs to be dispatched and send to the requests' site. After having served a request the vehicle needs to be relocated to its next waiting location. We are going to propose a model and solve the underlying optimization problem using approximate dynamic programming (ADP), an emerging and powerful tool for solving stochastic and dynamic problems typically arising in the field of operations research. Empirical tests based on real data from the city of Vienna indicate that by deviating from the classical dispatching rules the average response time can be decreased from 4.60 to 4.01 minutes, which corresponds to an improvement of 12.89%. Furthermore we are going to show that it is essential to consider time-dependent information such as travel times and changes with respect to the request volume explicitly. Ignoring the current time and its consequences thereafter during the stage of modeling and optimization leads to suboptimal decisions.

  19. NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory (United States)

    Federal Laboratory Consortium — The NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory is a 2005 Wheeled Coach Type III ambulance mounted on a Ford E-450 cut-away van chassis....

  20. ASME N511-19XX, Standard for periodic in-service testing of nuclear air treatment, heating, ventilating and air conditioning systems

    Energy Technology Data Exchange (ETDEWEB)



    A draft version of the Standard is presented in this document. The Standard covers the requirements for periodic in-service testing of nuclear safety-related air treatment, heating, ventilating, and air conditioning systems in nuclear facilities. The Standard provides a basis for the development of test programs and does not include acceptance criteria, except in cases where the results of one test influence the performance of other tests. The Standard covers general inspection and test requirements, reference values, inspection and test requirements, generic tests, acceptance criteria, in-service test requirements, testing following an abnormal incident, corrective action requirements, and quality assurance. Mandatory appendices provide a visual inspection checklist and four test procedures. Non-mandatory appendices provide additional information and guidance on mounting frame pressure leak test procedure, corrective action, challenge gas substitute selection criteria, and test program development. 8 refs., 10 tabs.

  1. Applying the ecosystem service concept to air quality management in the UK: a case study for ammonia

    DEFF Research Database (Denmark)

    Smart, James Christopher Rudd; Hicks, Kevin; Morrissey, Tim


    in magnitude to those for human health impacts. The ecosystem service approach thus offers the potential to provide a holistic appraisal of the effects of emission reductions, and could therefore make a valuable contribution to future air quality management. However, improvements in data collection...

  2. Improving Pre-Service Elementary Teachers' Education via a Laboratory Course on Air Pollution: One University's Experience (United States)

    Mandrikas, Achilleas; Parkosidis, Ioannis; Psomiadis, Ploutarchos; Stoumpa, Artemisia; Chalkidis, Anthimos; Mavrikaki, Evangelia; Skordoulis, Constantine


    This paper describes the structure of the "Air Pollution Course", an environmental science laboratory course developed at the Science Education Laboratory of the Faculty of Primary Education, University of Athens, as well as the findings resulting from its implementation by pre-service elementary teachers. The course proposed in this study deals…

  3. Advances of air pollution science: from forest decline to multiple-stress effects on forest ecosystem services. (United States)

    Paoletti, E; Schaub, M; Matyssek, R; Wieser, G; Augustaitis, A; Bastrup-Birk, A M; Bytnerowicz, A; Günthardt-Goerg, M S; Müller-Starck, G; Serengil, Y


    Over the past 20 years, the focus of forest science on air pollution has moved from forest decline to a holistic framework of forest health, and from the effects on forest production to the ecosystem services provided by forest ecosystems. Hence, future research should focus on the interacting factorial impacts and resulting antagonistic and synergistic responses of forest trees and ecosystems. The synergistic effects of air pollution and climatic changes, in particular elevated ozone, altered nitrogen, carbon and water availability, must be key issues for research. Present evidence suggests air pollution will become increasingly harmful to forests under climate change, which requires integration amongst various stressors (abiotic and biotic factors, including competition, parasites and fire), effects on forest services (production, biodiversity protection, soil protection, sustained water balance, socio-economical relevance) and assessment approaches (research, monitoring, modeling) to be fostered.

  4. Health problems and help-seeking in a nationwide sample of operational Norwegian ambulance personnel

    Directory of Open Access Journals (Sweden)

    Ekeberg Øivind


    Full Text Available Abstract Background To estimate the prevalence of anxiety and depression symptoms, and their association with professional help-seeking, among operational ambulance personnel and a general working population, and to study the symptoms of musculoskeletal pain and disturbed sleep among ambulance personnel. Methods The results of a comprehensive nationwide questionnaire survey of operational ambulance personnel (n = 1180 were compared with the findings of a population-based Norwegian health study of working people (n = 31,987. The questionnaire included measures of help-seeking, the Hospital Anxiety and Depression Scale, the Subjective Health Complaints Questionnaire, the Karolinska Sleep Questionnaire and the Need for Recovery after Work Scale. Results Compared with those in the reference population, the mean of level anxiety symptoms in the ambulance sample was lower for men (3.5 vs. 3.9, P 0.001 and women (4.0 vs. 4.4, P 0.05, and the mean level of depression symptoms in ambulance workers was lower for men (2.3 vs. 2.8, P 0.05 but not for women (2.9 vs. 3.1, P = 0.22. A model adjusted for anxiety and depression symptoms indicated that ambulance personnel had lower levels of help-seeking except for seeing a chiropractor (12% vs. 5%, P 0.01. In the ambulance sample, symptoms of musculoskeletal pain were most consistently associated with help-seeking. In the adjusted model, only symptoms of disturbed sleep were associated with help-seeking from a psychologist/psychiatrist (total sample = 2.3%. Help-seeking was more often reported by women but was largely unaffected by age. Conclusion The assumption that ambulance personnel have more anxiety and depression symptoms than the general working population was not supported. The level of musculoskeletal pain and, accordingly, the level of help-seeking from a chiropractor were higher for ambulance workers. More research should address the physical strains among ambulance personnel.

  5. Ambulation following spinal cord injury and its correlates

    Directory of Open Access Journals (Sweden)

    Nitin Menon


    Full Text Available Objectives: To assess walking ability of spinal cord injury (SCI patients and observe its correlation with functional and neurological outcomes. Patients and Methods: The present prospective, observational study was conducted in a tertiary research hospital in India with 66 patients (46 males between January 2012 and December 2013. Mean age was 32.62 ± 11.85 years (range 16-65 years, mean duration of injury was 85.3 ± 97.6 days (range 14-365 days and mean length of stay in the rehabilitation unit was 38.08 ± 21.66 days (range 14-97 days in the study. Walking Index for spinal cord injury (WISCI II was used to assess ambulation of the SCI patients. Functional recovery was assessed using Barthel Index (BI and Spinal Cord Independence Measures (SCIM. Neurological recovery was assessed using ASIA impairment scale (AIS. We tried to correlate ambulatory ability of the patients with functional and neurological recovery. Results: Ambulatory ability of the patients improved significantly using WISCI II (P < 0.001 when admission and discharge scores were compared (1.4 ± 3.5 vs 7.6 ± 6.03. Similarly, functional (BI: 31.7 ± 20.5 vs 58.4 ± 23.7 and SCIM: 29.9 ± 15.1 vs 56.2 ± 20.6 and neurological recovery were found to be very significant (P < 0.001 when admission vs discharge scores were compared. Improvement in WISCI II scores was significantly correlated with improvement in neurological (using AIS scores and functional status (using BI and SCIM scores (P < 0.001. Conclusions: Significant improvement was seen in WISCI II, BI, and SCIM scores after in-patient rehabilitation. Improvement in WISCI II scores also significantly correlated with functional and neurological recovery.

  6. The Ontario Energy Board`s draft standard supply service code: effects on air quality

    Energy Technology Data Exchange (ETDEWEB)

    Gibbons, J.; Bjorkquist, S. [Ontario Clean Air Alliance, Toronto, ON (Canada)


    The Ontario Clean Air Alliance (OCAA), a coalition of 67 organizations, takes issue with the Ontario Energy Board`s draft document `Standard Supply Service Code`, particularly sections 2.2.2. and 2.5.2 which they claim are not in the public interest unless the Ontario government implements the OCAA`s recommended emission caps. The alliance is of the view that without strict new environmental regulations the proposed Code would encourage the use of coal for electricity generation. Public health, the environment, consumer interests, job creation and promotion of a competitive electricity market would all be jeopardized by this development, the alliance states. The argument is supported by extensive reference to the Final Report of the Ontario Market Design Committee (MDC) which also emphasized the importance of combining the introduction of competition with appropriate environmental regulations, singling out the emission cap and trade program, and recommending that it be launched concurrently with the electricity market opening for competition. The view of the MDC was that public support for restructuring would not be forthcoming in the absence of regulatory measures to control power plant emissions. 25 refs.

  7. Tools for Schools: Filtration for Improved Air Quality. Technical Services Bulletin. (United States)


    This product bulletin addresses air pollution control in educational facilities to enhance educational performance, provides air quality recommendations for schools, and examines the filtration needs of various school areas. The types of air particles typically present are highlighted, and the use of proper filtration to control gases and vapors…

  8. Ontogeny of sex differences in open-field ambulation in the rat. (United States)

    Slob, A K; Huizer, T; Van der Werff ten Bosch, J J


    The effects of age and gonads were studied in rats subjected to open-field tests, during which ambulation behavior was recorded. Subjects were three groups of male and female rats: sham-operation on day 1 and day 21; gonadectomy on day 1 and sham-operation on day 21; and sham-operation on day 1 and gonadectomy on day 21. Half of each group were tested in a circular open field (3 min/day, 3 consecutive days) on days 28-30; the others were tested on days 47-49. Representatives of both batches were tested again in a square open field on days 76-78. There was a sex difference in ambulation at 77 days, but not at earlier ages. In animals gonadectomized on day 1 or day 21 the sex difference in adulthood failed to occur, because castration caused the males to ambulate as much as sham-operated and ovariectomized females. On the basis of our results and reports in the literature it is suggested that testicular secretions around puberty have an organizing effect on ambulation behavior. The intact adult male rat ambulates less than the adult female and this difference persists after castration in adulthood. Castration well before puberty prevents the development of the adult sex difference.

  9. 76 FR 2744 - Disclosure of Code-Share Service by Air Carriers and Sellers of Air Transportation (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION... agents must inform the consumer of the code-share service ``before booking transportation'' and state... global distribution systems, which may be assisting travel agents to establish airline ticket sales...

  10. Suicidal ideation and suicide attempts in a nationwide sample of operational Norwegian ambulance personnel. (United States)

    Sterud, Tom; Hem, Erlend; Lau, Bjørn; Ekeberg, Oivind


    This is the first paper on suicidal ideation and attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and suicide attempts among ambulance personnel, and to identify important correlates and the factors to which ambulance personnel attribute their serious suicidal ideation. A comprehensive nationwide questionnaire survey of 1,180 operational ambulance personnel was conducted. Measurements included: Paykel's Suicidal Feelings in the General Population questionnaire, the Hospital Anxiety and Depression scale, the Subjective Health Complaints Questionnaire, the Maslach Burnout Inventory, the Job Satisfaction Scale, the Basic Character Inventory, and the Rosenberg Self-Esteem Scale. Lifetime prevalence ranged from 28% for feelings that life was not worth living to 10.4% for seriously considered suicide and 3.1% for a suicide attempt. Serious suicidal ideation was independently associated with job-related emotional exhaustion (feelings of being overextended and depleted of resources) (OR 1.5, 95% CI 1.1-2.0) and bullying at work (OR 1.7, 95% CI 1.02-2.7), younger age, not married/cohabitant, depression symptoms, low self-esteem and the personality trait reality weakness. In general, suicidal thoughts were hardly attributable to working conditions, since only 1.8% of ambulance personnel attributed suicidal ideation to work problems alone. In conclusion, ambulance personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-related factors like emotional exhaustion and bullying may be of importance.

  11. Impact of subtropical climate on frequency of ambulance use for trauma patients in a coastal area of China

    Institute of Scientific and Technical Information of China (English)

    Yuqiang Chen; Yucheng Lai; Jiajie Ke; Yuefeng Chen; Yuling Xu; Yuqin Ma; Jiayin Yuan


    Purpose:To explore the impact of subtropical maritime monsoon climate on the frequency of ambulance use for trauma patients in a coastal region in China.Method:Statistical analysis of data on ambulance use from the 120 Emergency Command Center in Shantou City,Guangdong Province,from January to December 2012 as well as daily meteorological data from a Shantou observatory was performed to determine how climatic factors (seasons,time,and weather) affect the frequency of ambulance use for trauma patients.Results:The daily ambulance use for trauma patients differed between spring and summer or autumn (p < 0.05),between sunny and rainy days (p < 0.05),and between cloudy and lightly or moderately rainy days (p < 0.05).We found a linear correlation between daily maximum temperature and daily ambulance use for trauma patients (R2 =0.103,p < 0.05).In addition,there was significant difference in ambulance use between good and bad weather (p < 0.05).Conclusion:Frequency of ambulance use for trauma patients is affected by the subtropical maritime monsoon climate in the coastal region.Better weather contributes to increased daily frequency of ambulance use,which is the highest in autumn and lowest in spring.

  12. The design of road and air networks for express service providers

    NARCIS (Netherlands)

    Meuffels, W.J.M.


    Express service providers move packages (i.e. parcels, documents, or pieces of freight) from senders to receivers under various but guaranteed service level agreements. These service level agreements specify date and time of collection at the sender, and receiving at the customer. Research in this d

  13. Helicopter emergency medical services accident rates in different international air rescue systems

    Directory of Open Access Journals (Sweden)

    J Hinkelbein


    Full Text Available J Hinkelbein1,2, M Schwalbe2, H V Genzwuerker2,31Department for Anesthesiology and Intensive Care Medicine, University Hospital Cologne, Germany; 2Working Group “Emergency Medicine and Air Rescue”, German Society of Aviation and Space Medicine (DGRLM eV; 3Clinic of Anesthesiology and Intensive Care Medicine, Neckar-Odenwald-Kliniken gGmbH, Hospitals Buchen and Mosbach, Buchen, GermanyAim: Each year approximately two to four helicopter emergency medical services (HEMS crashes occur in Germany. The aim of the present study was to compare crash rates and fatal crash rates in Germany to rates in other countries.Materials and methods: A MEDLINE search from 1970 to 2009 was performed using combinations of the keywords “HEMS”, “rescue helicopter”, “accident”, “accident rate”, “crash”, and “crash rate”. The search was supplemented by additional published data. Data were compared on the basis of 10,000 missions and 100,000 helicopter flying hours. These data were allocated to specific time frames for analyis.Results: Eleven relevant studies were identified. Five studies (three from Germany, one from the US, one from Australia analyzing HEMS accidents on the basis of 10,000 missions were identified. Crash rates per 10,000 missions ranged between 0.4 and 3.05 and fatal crash rates between 0.04 and 2.12. In addition, nine studies (six from the US, two from Germany, one from Australia used 100,000 flying hours as a denominator. Here, crash rates ranged between 1.7 and 13.4 and fatal crash rates between 0.91 and 4.7.Conclusions: Data and accident rates were inhomogeneous and differed significantly. Data analysis was impeded by publication of mean data, use of different time frames, and differences in HEMS systems.Keywords: fatal accident rate, rescue helicopter, fatal crash rate, helicopter emergency medical system, accident analysis

  14. The Scope of State Aid and Public Service Obligation for Airports and Air Carriers in the Light of European Law

    Directory of Open Access Journals (Sweden)

    Grzegorz Zajac


    Full Text Available Public aid is the kind of advantage granted directly or indirectly for private companies from State resources. The European Commission prerogative to control the transfer of public resources by the public authorities (national or local for the benefit of private undertakings, as a general rule, there is an obligation of notification, as provided for in article 108 (3 of the Treaty on the Functioning of the European Union (TFEU. It should be noted in the beginning that State aid given to undertakings conducting economic activity is, in principle, incompatible with the European Union’ law, as provided for in article. 107 (1 of the TFEU. There are certain situations that the granting of public funds will not constitute “public aid” within the meaning of article 107 of the TFEU and, therefore, will not violate European rules in this field. One of them are activities related to the exercise of the prerogatives of the public authority (security, safety, customs, air traffic control. The other is related to the exercise of services in general economic interest. This could be an example of public service obligation (PSO. This service can be applied in the light of the provisions of European law on two types of action on air routes, and on airport managing body. The imposition of a PSO to the specified route is the support given by the State to the outermost regions that due to their unfavourable geographical position cannot fully develop economically, and no carrier had not been interested in performing air services to that region due to the lack of cost effectiveness. Some activities at the airport may be considered as activities of general economic interest.

  15. US EPA Office of Research and Development Community-Focused Exposure and Risk Screening Tool (C-FERST) Air Pollutants 2011 web mapping service (United States)

    U.S. Environmental Protection Agency — This map service displays all air-related layers used in the USEPA Community/Tribal-Focused Exposure and Risk Screening Tool (C/T-FERST) mapping application...

  16. Requirements for regional short-haul air service and the definition of a flight program to determine neighborhood reactions to small transport aircraft (United States)

    Feher, K.; Bollinger, L.; Bowles, J. V.; Waters, M. H.


    An evaluation of the current status and future requirements of an intraregional short haul air service is given. A brief definition of the different types of short haul air service is given. This is followed by a historical review of previous attempts to develop short haul air service in high density urban areas and an assessment of the current status. The requirements for intraregional air service, the need for economic and environmental viability and the need for a flight research program are defined. A detailed outline of a research program that would determine urban community reaction to frequent operations of small transport aircraft is also given. Both the operation of such an experiment in a specific region (San Francisco Bay area) and the necessary design modifications of an existing fixed wing aircraft which could be used in the experiment are established. An estimate is made of overall program costs.

  17. US EPA Office of Research and Development Community-Focused Exposure and Risk Screening Tool (C-FERST) Air web mapping service (United States)

    U.S. Environmental Protection Agency — This map service displays all air-related layers used in the USEPA Community/Tribal-Focused Exposure and Risk Screening Tool (C/T-FERST) mapping application...

  18. Ambulation with the reciprocating-gait orthosis - Experience in 15 children with myelomeningocele or paraplegia

    NARCIS (Netherlands)

    GerritsmaBleeker, CLE; Heeg, M; VosNiel, H


    We reviewed 15 children with spina bifida or paraplegia who have used a reciprocating-gait orthosis between 1985 and 1995. All were nonfunctional ambulators. The level of the spinal lesions ranged from Th10 to L3. The mean age of fitting the orthosis was 5 years. 8 children have stopped using it at

  19. Community ambulation in patients with chronic stroke : How is it related to gait speed?

    NARCIS (Netherlands)

    van de Port, Ingrid G.; Kwakkel, Gert; Lindeman, Eline


    Objective: To explore the strength of the association between gait speed and community ambulation and whether this association is significantly distorted by other variables. Design: Cross-sectional study conducted 3 years after stroke. Subjects: A total of 102 patients after first-ever stroke follow

  20. Spinal fusion in children with spina bifida : influence on ambulation level and functional abilities

    NARCIS (Netherlands)

    Schoenmakers, MAGC; Gulmans, VAM; Gooskens, RHJM; Pruijs, JEH; Helders, PJM


    The aim of this study was to determine the influence of spinal fusion on ambulation and functional abilities in children with spina bifida for whom early mobilization was stimulated. Ten children (three males and seven females) with myelomeningocele were prospectively followed. Their mean age at ope

  1. Osteogenesis imperfecta in childhood : effects of spondylodesis on functional ability, ambulation and perceived competence

    NARCIS (Netherlands)

    Tolboom, N; Cats, EA; Helders, PJM; Pruijs, JEH; Engelbert, RHH


    We studied the effects of spondylodesis on spinal curvature, functional outcome, level of ambulation and perceived competence in 11 children with osteogenesis imperfecta (OI). Mean age at surgical intervention was 13.1 years (SD 2.5 years) and follow-up amounted to 3.4 years (SD 2.3 years). Spinal c

  2. A strategic approach for the ambulance covering of the province of Friesland

    NARCIS (Netherlands)

    Schreuder, J.A.M.; Macfarlane, J.D.


    In the summer of 1995 the University of Twente, commissioned by the Province of Friesland, carried out research into the consequences of alternative locations for ambulances. The approach to this research was based on a network model, which represents the area to be covered. With this model the atte

  3. Radiology trainer. Surgical ambulance. 2. rev. and enl. ed.; Roentgen-Trainer. Chirurgische Ambulanz

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, Ole [Wedau-Kliniken Duisburg (Germany). Klinik fuer Unfallchirurgie; Ruchholtz, Steffen [Universitaetsklinikum Giessen und Marburg GmbH, Marburg (Germany). Klinik fuer Unfall-, Hand- und Wiederherstellungschirurgie; Siemann, Holger [LVR Klinikum Essen (Germany); Barkhausen, Joerg [Universitaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin


    The radiology trainer for surgical ambulance includes informative X-ray imaging examples for the following issues: zygoma, nasal bone, spinal cord, clavicle, shoulder, upper arms, elbow, forearms, wrist, hand, phalanx, thorax, sternum, pelvis, abdomen, hips, femur, knee, lower leg, ankle, feet.

  4. Design and methods of European Ambulance Acute Coronary Syndrome Angiography Trial (EUROMAX)

    DEFF Research Database (Denmark)

    Steg, Philippe Gabriel; van 't Hof, Arnoud; Clemmensen, Peter;


    In patients with ST-segment elevation myocardial infarction (STEMI) triaged to primary percutaneous coronary intervention (PCI), anticoagulation often is initiated in the ambulance during transfer to a PCI site. In this prehospital setting, bivalirudin has not been compared with standard-of-care...

  5. A clinical prediction rule for ambulation outcomes after traumatic spinal cord injury: a longitudinal cohort study

    NARCIS (Netherlands)

    Middendorp, J.J. van; Hosman, A.J.F.; Donders, A.R.T.; Pouw, M.H.; Ditunno Jr., J.F.; Curt, A.; Geurts, A.C.H.; Meent, H. van de


    BACKGROUND: Traumatic spinal cord injury is a serious disorder in which early prediction of ambulation is important to counsel patients and to plan rehabilitation. We developed a reliable, validated prediction rule to assess a patient's chances of walking independently after such injury. METHODS: We

  6. Cross-cultural validation of the Italian version of the Cumulated Ambulation Score

    DEFF Research Database (Denmark)

    Grana, Elisa; Verzellotti, Simone; Grassi, Federico A;


    Hip fractures are common in elderly patients, and walking impairment is a frequent complication. The Cumulated Ambulation Score (CAS) is a validated functional scale used to monitor easily three basic mobility activities in patients with hip fracture. The aim of this study was to translate, cross...

  7. Knee disarticulation : Survival, wound healing and ambulation. A historic cohort study

    NARCIS (Netherlands)

    Ten Duis, K.; Bosmans, J. C.; Voesten, H. G. J.; Geertzen, J. H. B.; Dijkstra, P. U.


    The aim of this study was to analyze survival, wound healing and ambulation after knee disarticulation (KD). A historic cohort study using medical records and nursing home records was performed. Data included demographics, reason for amputation, concomitant diseases, survival, wound healing, re-ampu

  8. Effect of fee-for-service air-conditioning management in balancing thermal comfort and energy usage. (United States)

    Chen, Chen-Peng; Hwang, Ruey-Lung; Shih, Wen-Mei


    Balancing thermal comfort with the requirement of energy conservation presents a challenge in hot and humid areas where air-conditioning (AC) is frequently used in cooling indoor air. A field survey was conducted in Taiwan to demonstrate the adaptive behaviors of occupants in relation to the use of fans and AC in a school building employing mixed-mode ventilation where AC use was managed under a fee-for-service mechanism. The patterns of using windows, fans, and AC as well as the perceptions of students toward the thermal environment were examined. The results of thermal perception evaluation in relation to the indoor thermal conditions were compared to the levels of thermal comfort predicted by the adaptive models described in the American Society of Heating, Refrigerating, and Air-Conditioning Engineers Standard 55 and EN 15251 and to that of a local model for evaluating thermal adaption in naturally ventilated buildings. A thermal comfort-driven adaptive behavior model was established to illustrate the probability of fans/AC use at specific temperature and compared to the temperature threshold approach to illustrate the potential energy saving the fee-for-service mechanism provided. The findings of this study may be applied as a reference for regulating the operation of AC in school buildings of subtropical regions.

  9. An observational study of patient characteristics associated with the mode of admission to acute stroke services in North East, England.

    Directory of Open Access Journals (Sweden)

    Christopher I Price

    Full Text Available OBJECTIVE: Effective provision of urgent stroke care relies upon admission to hospital by emergency ambulance and may involve pre-hospital redirection. The proportion and characteristics of patients who do not arrive by emergency ambulance and their impact on service efficiency is unclear. To assist in the planning of regional stroke services we examined the volume, characteristics and prognosis of patients according to the mode of presentation to local services. STUDY DESIGN AND SETTING: A prospective regional database of consecutive acute stroke admissions was conducted in North East, England between 01/09/10-30/09/11. Case ascertainment and transport mode were checked against hospital coding and ambulance dispatch databases. RESULTS: Twelve acute stroke units contributed data for a mean of 10.7 months. 2792/3131 (89% patients received a diagnosis of stroke within 24 hours of admission: 2002 arrivals by emergency ambulance; 538 by private transport or non-emergency ambulance; 252 unknown mode. Emergency ambulance patients were older (76 vs 69 years, more likely to be from institutional care (10% vs 1% and experiencing total anterior circulation symptoms (27% vs 6%. Thrombolysis treatment was commoner following emergency admission (11% vs 4%. However patients attending without emergency ambulance had lower inpatient mortality (2% vs 18%, a lower rate of institutionalisation (1% vs 6% and less need for daily carers (7% vs 16%. 149/155 (96% of highly dependent patients were admitted by emergency ambulance, but none received thrombolysis. CONCLUSION: Presentations of new stroke without emergency ambulance involvement were not unusual but were associated with a better outcome due to younger age, milder neurological impairment and lower levels of pre-stroke dependency. Most patients with a high level of pre-stroke dependency arrived by emergency ambulance but did not receive thrombolysis. It is important to be aware of easily identifiable

  10. Self-paced brain-computer interface control of ambulation in a virtual reality environment (United States)

    Wang, Po T.; King, Christine E.; Chui, Luis A.; Do, An H.; Nenadic, Zoran


    Objective. Spinal cord injury (SCI) often leaves affected individuals unable to ambulate. Electroencephalogram (EEG) based brain-computer interface (BCI) controlled lower extremity prostheses may restore intuitive and able-body-like ambulation after SCI. To test its feasibility, the authors developed and tested a novel EEG-based, data-driven BCI system for intuitive and self-paced control of the ambulation of an avatar within a virtual reality environment (VRE). Approach. Eight able-bodied subjects and one with SCI underwent the following 10-min training session: subjects alternated between idling and walking kinaesthetic motor imageries (KMI) while their EEG were recorded and analysed to generate subject-specific decoding models. Subjects then performed a goal-oriented online task, repeated over five sessions, in which they utilized the KMI to control the linear ambulation of an avatar and make ten sequential stops at designated points within the VRE. Main results. The average offline training performance across subjects was 77.2±11.0%, ranging from 64.3% (p = 0.001 76) to 94.5% (p = 6.26×10-23), with chance performance being 50%. The average online performance was 8.5±1.1 (out of 10) successful stops and 303±53 s completion time (perfect = 211 s). All subjects achieved performances significantly different than those of random walk (p ambulation after only 10 minutes training. The ability to achieve such BCI control with minimal training indicates that the implementation of future BCI-lower extremity prosthesis systems may be feasible.

  11. Análise da configuração de SAMU utilizando múltiplas alternativas de localização de ambulâncias Analysis of SAMU configuration using multiple alternatives of ambulance location

    Directory of Open Access Journals (Sweden)

    Regiane Máximo de Souza


    Full Text Available O Sistema de Atendimento Móvel de Urgência (SAMU no Brasil é um sistema médico emergencial de responsabilidade do poder público, em que a demanda de usuários em uma região urbana é usualmente separada por subregiões e classes de chamados emergenciais. Essa demanda pode mudar de forma significativa ao longo do dia, geograficamente e temporalmente, devido à sua natureza aleatória, mas também devido aos diferentes padrões de comportamentos da população ao longo do dia. Por exemplo, tipicamente há menos demanda durante a noite do que de dia. Os objetivos deste trabalho são: verificar se o conhecido modelo hipercubo de filas espacialmente distribuídas é adequado para analisar medidas de desempenho do SAMU, tais como tempos médios de resposta aos usuários, e utilizar este modelo para analisar múltiplas alternativas de localização das ambulâncias, explorando variações importantes da demanda e do serviço ao longo do dia. Para verificar a viabilidade e a aplicabilidade desta abordagem, foi realizado um estudo de caso no SAMU de Ribeirão Preto-SP.The Brazilian emergency medical system SAMU (Sistema de Atendimento Móvel de Urgência is an emergency medical system of public government liability, in which the users' service demand in an urban region is usually separated into subregions and classes of emergency calls. This demand can change substantially during the day, geographically and temporally, due to its random nature and also to the different behavior patterns of the population throughout the day. For instance, typically there is less demand during the night hours than during the day. The goals of this study are to verify whether the hypercube queuing model is adequate to analyze performance measures of SAMU, such as mean response times to the users, and use this model to analyze multiple alternatives of ambulance location considering significant variations in the demand and service throughout the day. In order to verify

  12. Idling Reduction for Emergency and Other Service Vehicles

    Energy Technology Data Exchange (ETDEWEB)



    This is a fact sheet about reducing idling for emergency and service vehicles. Emergency vehicles, such as police cars, ambulances, and fire trucks, along with other service vehicles such as armored cars, are often exempt from laws that limit engine idling. However, these vehicles can save fuel and reduce emissions with technologies that allow them to perform vital services without idling.

  13. Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting

    Directory of Open Access Journals (Sweden)

    Nielsen Anne


    Full Text Available Abstract Background Ambulance personnel play an essential role in the ‘Chain of Survival’. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island. Methods The Basic Life Support (BLS and Automated External Defibrillator (AED skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given. Results On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2 was used by 80%. A mean compression depth of 40–50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm. The mean compression rate was 123 per min (SD 15/min. The mean tidal volume was 746 ml (SD 221 ml. Only the mean tidal volume deviated significantly from the recommended (p = 0.01. During the rhythm analysis, 65% did not perform any visual or verbal safety check. Conclusion The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.

  14. Effective Delivery of Transition Assistance to Air Force Members Leaving the Service. (United States)


    assistance—defense outplacement referral system and transition bulletin board Transitional healthcare benefits and conversion health policies Extended use... Outplacement ," Personnel Journal, May 1994. 9 See Note 7, this chapter. 3-6 Service Departments Transition Assistance Programs coordinates all on...Each JAC provides a full range of outplacement counseling services similar to those found in private industry. Their role has been described as

  15. 77 FR 50420 - Proposed Provision of Navigation Services for the Next Generation Air Transportation System... (United States)


    ... airspace and procedure redesign. Comment #1: Several commenters (International Air Traffic Association... inventory of Second Generation VORs, are maintained by the State, who reports there have been no problems... that instructors will still require students to learn VOR navigation. FAA Response: Pilots may...

  16. Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan. (United States)

    Tasmin, Saira; Ueda, Kayo; Stickley, Andrew; Yasumoto, Shinya; Phung, Vera Ling Hui; Oishi, Mizuki; Yasukouchi, Shusuke; Uehara, Yamato; Michikawa, Takehiro; Nitta, Hiroshi


    Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7μg/m(3). In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10μg/m(3) increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in 3weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being.

  17. On-scene alternatives for emergency ambulance crews attending patients who do not need to travel to the accident and emergency department: a review of the literature. (United States)

    Snooks, H A; Dale, J; Hartley-Sharpe, C; Halter, M


    With rising demand and recognition of the variety of cases attended by emergency ambulance crews, services have been considering alternative ways of providing non-urgent care. This paper describes and appraises the research literature concerning on-scene alternatives to conveyance to an emergency department, focusing on the: (1) profile and outcomes of patients attended but not conveyed by emergency crews; (2) triage ability of crews; (3) effectiveness and safety of protocols that allow crews to convey patients to alternative receiving units or to self care. The literature search was conducted through standard medical databases, supplemented with manual searches. Very few "live" studies were identified, and fewer still that included a control group. Findings indicated a complex area, with the introduction of protocols allowing crews to leave patients at scene carrying clinical risk. Robust research evidence concerning alternatives to current emergency care models is needed urgently to inform service and practice development.

  18. Cross-Cultural Perspectives of Service Quality and Risk in Air Transportation (United States)

    Cunningham, Lawrence F.; Young, Clifford E.; Lee, Moonkyu


    This study compares US and Korean customers in terms of their perceptions of airline service quality based on SERVPERF and industry-based measures, as well as their perceptions of risks involved in the airline choice. SERVPERF is a set of multi-dimensional measures of customer evaluations of service quality. The results indicate that: (1) US passengers are generally more satisfied with their airline service than Korean customers on most of the SERVPERF dimensions; (2) Koreans are generally more satisfied with the bumping procedures whereas US participants feel more satisfied with the airline's baggage handling, operations/safety, and connections; and (3) US participants perceive higher levels of performance and financial risks whereas Koreans feel greater social risk in choosing an airline. This study also examines the SERVPERF, industry-based measure, and perceived risk in predicting customer satisfaction with, and intention to repatronize the airline. The results suggest that US customers consider service reliability, in-flight comfort, and connections as the key factors determining satisfaction with airline service whereas Korean passengers generally regard reliability, assurance, and risk factors as predictors of satisfaction. The determining factors of customer intention to repatronize the airline are reliability and empathy for US, and reliability and overall risk for Korean customers. The study demonstrates the applicability of SERVPERF as a cross-cultural tool and indicates the importance of perceived risk in cross-cultural studies.

  19. Optimizing Air Transportation Service to Metroplex Airports. Par 2; Analysis Using the Airline Schedule Optimization Model (ASOM) (United States)

    Donoue, George; Hoffman, Karla; Sherry, Lance; Ferguson, John; Kara, Abdul Qadar


    The air transportation system is a significant driver of the U.S. economy, providing safe, affordable, and rapid transportation. During the past three decades airspace and airport capacity has not grown in step with demand for air transportation; the failure to increase capacity at the same rate as the growth in demand results in unreliable service and systemic delay. This report describes the results of an analysis of airline strategic decision-making that affects geographic access, economic access, and airline finances, extending the analysis of these factors using historic data (from Part 1 of the report). The Airline Schedule Optimization Model (ASOM) was used to evaluate how exogenous factors (passenger demand, airline operating costs, and airport capacity limits) affect geographic access (markets-served, scheduled flights, aircraft size), economic access (airfares), airline finances (profit), and air transportation efficiency (aircraft size). This analysis captures the impact of the implementation of airport capacity limits, as well as the effect of increased hedged fuel prices, which serve as a proxy for increased costs per flight that might occur if auctions or congestion pricing are imposed; also incorporated are demand elasticity curves based on historical data that provide information about how passenger demand is affected by airfare changes.

  20. A Service in Transition: Forging an Integrated Institutional Identity for the United States Air Force (United States)


    more money. 140 Although Quesada fought hard for his share of the budgetary pie , he was disillusioned by what he saw. TAC was being ignored, while...and Jack C. Plano , The Public Administration Dictionary (New York, NY: John Wiley & Sons, Inc., 1982), 120-121. 19 Neuhauser, Tribal Warfare in...Base, AL: Air University Press, 1992. Chandler, Ralph C., and Jack C. Plano . The Public Administration Dictionary. New York, NY: John Wiley & Sons

  1. Oceanic Area System Improvement Study (OASIS). Volume IV. Caribbean Region Air Traffic Services System Description. (United States)


    Departamento de Transito Aereo) of the National Airways Division (Division de Aerovias Nacionales) as the authority responsible for the general...Directorate of Air Transport and Traffic (Direccion General Sectorial de Transporte y Transito Aereo - DGTTA), which in turn falls under the authority of...Northern Coastal Region of 4 the Directorate of Engineering and Systems (Direccion de Ingenieria y Sistemas), which is responsible for maintenance of the

  2. Prosthetic ambulation in a paraplegic patient with a transfemoral amputation and radial nerve palsy. (United States)

    Shin, J C; Park, C; Kim, D Y; Choi, Y S; Kim, Y K; Seong, Y J


    Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side. The difficulties of fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed.

  3. Contributing factors and issues associated with rural ambulance crashes: literature review and annotated bibliography. (United States)

    Sanddal, Nels D; Albert, Steve; Hansen, Joseph D; Kupas, Douglas F


    Ambulance crashes occur with greater frequency and severity than crashes involving vehicles of similar size and weight characteristics. Crashes in rural areas tend to be more severe in terms of injury or death to vehicle occupants. The purpose of this article was to examine the extant literature, as well as summarize and discuss the overlapping findings of that body of literature. A stepwise literature search was conducted using the following MeSH search terms ambulance; accident, traffic; emergency medical technician; occupational health; and rural in descending combination. MEDLINE was used as the primary database but was augmented by searches of Academic Search Premier, Comprehensive Index of Nursing, Allied Health Literature, and ProQuest Dissertation International. The search resulted in 32 article citations, and of these, 28 were included. An annotated bibliography is followed by a discussion and conclusion that identify opportunities for prevention activities in the areas of education, enforcement, and engineering.

  4. Pre-Hospital Fast Positive Cases Identified by DFB Ambulance Paramedics – Final Clinical Diagnosis

    LENUS (Irish Health Repository)

    Feeney, A


    Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten ‘door to needle time’. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face Arm Speech Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014. The final clinical diagnosis was acute stroke in 57.1% (n=101) of patients. Of these, 76 were ischaemic strokes of whom 56.5% (n=43) were thrombolysed. In the pre-hospital setting Ambulance Paramedics can identify, with reasonable accuracy, acute stroke using the FAST test. Over half of the ischaemic stroke patients presenting via this pathway can be treated with intravenous thrombolysis

  5. Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Kristensen, Morten Tange; Kehlet, Henrik


    to short-term outcome parameters. RESULTS: The cumulated ambulation score was a highly significant predictor for length of hospitalization, time to discharge status, 30-day mortality and postoperative medical complications (P ...OBJECTIVE: To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients. DESIGN: Prospective, descriptive study. SETTING: An orthopaedic hip fracture unit in a university hospital. PATIENTS: Four hundred and twenty-six consecutive hip...... fracture patients with an independent walking function admitted from their own home. Rehabilitation followed a well-defined multimodal rehabilitation regimen and discharge criteria. MAIN OUTCOME MEASURE: Admission tests with a new mobility score to assess prefracture functional mobility and a short mental...

  6. 10-year experience of CO2-laser application in ambulance gynecology (United States)

    Stachanov, Michael L.; Masychev, Victor I.; Velsher, Leonid Z.; Kirkin, Vladimir V.; Zhashkov, Roman V.; Kocharian, Emilia A.


    CO2-laser surgical systems have come to stay in everyday practice of modern physicians and are successfully used in colposcopic and laparoscopic surgery. Results, obtained in ambulance gynecology are especially impressing. CO2- laser provides high medical- and cost-effective treatment. Presented work describes many-years experience of CO2- laser application. 439 patients with various vulvaric and cervix diseases were operated within this period. Laser beam parameters were selected according to requirements ((tau) =4 J/cm2) treatment without carbonization. Analyses of the results showed that the laser successfully destructs uterine cervix erosion, endocervicosis, dysplasia, leukoplakia, eritoplakia of uterine cervix, various benignant pathologies and focus degenerative process in ambulate conditions.

  7. The role of physician-staffed ambulances:the outcome of a pilot study

    Institute of Scientific and Technical Information of China (English)

    A Haner; P rninge; A Khorram-Manesh


    Objective:To evaluate the outcome of physician-staffed ambulances in a pilot study. Methods:All physician-staffed ambulance missions conducted in Gothenburg, Sweden, in 2013 were retrospectively reviewed and evaluated for the type of missions and the need of a physician. Results:Out of 1 381 physician-staffed missions, 511 were cancelled or managed by telephone. Around 239 (17%) missions required active intervention, of which only one was considered directly life-saving. Conclusions: Most of the missions neither required the interventional skills of a physician, nor could they be performed at distance. However, the added medical value of physicians was found to be in other prehospital situations, such as critical decision-making, staff education and research.

  8. Neurotherapeutic and neuroprosthetic effects of implanted functional electrical stimulation for ambulation after incomplete spinal cord injury. (United States)

    Bailey, Stephanie Nogan; Hardin, Elizabeth C; Kobetic, Rudi; Boggs, Lisa M; Pinault, Gilles; Triolo, Ronald J


    The purpose of this single-subject study was to determine the neurotherapeutic and neuroprosthetic effects of an implanted functional electrical stimulation (FES) system designed to facilitate walking in an individual with a longstanding motor and sensory incomplete spinal cord injury. An implanted pulse generator and eight intramuscular stimulating electrodes were installed unilaterally, activating weak or paralyzed hip flexors, hip and knee extensors, and ankle dorsiflexors during 36 sessions of gait training with FES. The neurotherapeutic effects were assessed by a comparison of pre- and posttraining volitional walking. The neuroprosthetic effects were assessed by a comparison of posttraining volitional and FES-assisted walking. Treatment resulted in significant (p ambulation to limited community ambulation. Additionally, the subject could perform multiple walks per day when using FES-assisted gait, which was impossible with volitional effort alone.

  9. 76 FR 55347 - Aerospace Executive Service Trade Mission at Singapore Air Show (United States)


    ...: International Trade Administration, Department of Commerce. ACTION: Notice. Mission Description The United.... Pavilion for displaying company literature and posters and conducting meetings; Copy of the official 2012... business size. The dual pricing reflects the Commercial Service's user fee schedule that became...

  10. Management and Oversight of Services Acquisition Within the United States Air Force (United States)


    47 Figure 14. Training Received............................................................................................48 Figure 15. QAP ...Surveillance Plan QAP Quality Assurance Personnel PSC Product Service Code SOO Statement of Objectives USA United States Army USN United States...Assurance Personnel ( QAP ), and the multi-functional teams (USAF, 2005). This policy has established clear guidelines and responsibilities for the USAF in

  11. Use of Microcomputers in Air Weather Service Units for Administrative, Managerial and Technical Activities (United States)


    20 Softwre ............................................... 62 Officem Auomaiontins the.Busiess.Worl...but professional and managerial staff as well1 ... (9:2) The General Services Administration was even more specific when * it defined office automation...Conquests for the Computer," Nation’s Business, Vol. 70, No. 6 (June 1982): pp. 67-76. Spindle, Les. "Computerizing Your Office," Radio -Electronics, Vol

  12. Effects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty

    DEFF Research Database (Denmark)

    Jenstrup, M T; Jæger, P; Lund, J;


    Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We...... hypothesized that the adductor-canal-blockade may reduce morphine consumption (primary endpoint), improve pain relief, enhance early ambulation ability, and reduce side effects (secondary endpoints) after TKA compared with placebo....

  13. Relation Between Objectively Measured Growth Determinants and Ambulation in Children with Cerebral Palsy


    GÖKKAYA, N. Kutay ORDU; ÇALIŞKAN, Aslı; KARAKUŞ, Dilek; Uçan, Halil


    Aims: Cerebral palsy (CP) is a well-known neurodevelopmental condition beginning in early childhood and persisting throughout one´s life span. Feeding problems and eating impairments in CP children are well documented in the literature. The aims of our study were to determine the prevalence of linear growth retardation and the other growth determinants in this patient group and to identify the contributing factors and their relationship with ambulation. Materials and Methods: A cross-section...

  14. Design and validation of a platform robot for determination of ankle impedance during ambulation. (United States)

    Rouse, Elliott J; Hargrove, Levi J; Peshkin, Michael A; Kuiken, Todd A


    In order to provide natural, biomimetic control to recently developed powered ankle prostheses, we must characterize the impedance of the ankle during ambulation tasks. To this end, a platform robot was developed that can apply an angular perturbation to the ankle during ambulation and simultaneously acquire ground reaction force data. In this study, we detail the design of the platform robot and characterize the impedance of the ankle during quiet standing. Subjects were perturbed by a 3° dorsiflexive ramp perturbation with a length of 150 ms. The impedance was defined parametrically, using a second order model to map joint angle to the torque response. The torque was determined using the inverted pendulum assumption, and impedance was identified by the least squares best estimate, yielding an average damping coefficient of 0.03 ± 0.01 Nms/° and an average stiffness coefficient of 3.1 ± 1.2 Nm/°. The estimates obtained by the proposed platform robot compare favorably to those published in the literature. Future work will investigate the impedance of the ankle during ambulation for powered prosthesis controller development.

  15. Determining the Feasibility of Ambulance-Based Randomised Controlled Trials in Patients with Ultra-Acute Stroke: Study Protocol for the "Rapid Intervention with GTN in Hypertensive Stroke Trial" (RIGHT, ISRCTN66434824). (United States)

    Ankolekar, Sandeep; Sare, Gillian; Geeganage, Chamila; Fuller, Michael; Stokes, Lynn; Sprigg, Nikola; Parry, Ruth; Siriwardena, A Niroshan; Bath, Philip M W


    Background. Time from acute stroke to enrolment in clinical trials needs to be reduced to improve the chances of finding effective treatments. No completed randomised controlled trials of ambulance-based treatment for acute stroke have been reported in the UK, and the practicalities of recruiting, consenting, and treating patients are unknown. Methods. RIGHT is an ambulance based, single-blind, randomised controlled trial with blinded-outcome assessment. The trial will assess feasibility of using ambulance services to deliver ultra-acute stroke treatments; a secondary aim is to assess the effect of glyceryl trinitrate (GTN) on haemodynamic variables and functional outcomes. Initial consent, randomisation, and treatment are performed by paramedics prior to hospitalisation. Patients with ultra-acute stroke (≤4 hours of onset) are randomised to transdermal GTN (5 mg/24 hours) or gauze dressing daily for 7 days. The primary outcome is systolic blood pressure at 2 hours. Secondary outcomes include feasibility, haemodynamics, dependency, and other functional outcomes. A nested qualitative study is included. Trial Status. The trial has all relevant ethics and regulatory approvals and recruitment started on February 15, 2010. The trial stopped recruitment in December 2011 after 41 patients were recruited. Trial Registration. The trial registration number is ISRCTN66434824 and EudraCT number is 2007-004766-40.

  16. Environmental Assessment for the Hilltop Community Services District, Wright-Patterson Air Force Base, Ohio (United States)


    exposure limits for  workplace  stressors. The  Air Force standards also address protection from occupational noise exposure compliant with OSHA’s...of the action ( extinction  of a threatened or  endangered species or the destruction of a cultural site).  Labor, energy, materials, and capital would


    Directory of Open Access Journals (Sweden)

    A. Cifuentes


    Full Text Available El Observatorio Naval Buenos Aires (ONBA, a trav ́es del Servicio P ́ublico de la H ora Oficial Argentina, mantiene, conserva y difunde la representaci ́on local de UTC como UTC (ONBA (BIPM Circular T, la cual es la base legal del tiempo en la Rep ́ublica Argentina. Se presentan las actividades y proyectos del ONBA, entre ellos, la participaci ́on en la Firma Digital y el nuevo equipamiento que permiti ́o mejorar la trazabilidad de UTC ̇ (ONBA a UTC.

  18. A Strategic Decision Matrix for Analyzing Food Service Operations at Air Force Bases (United States)


    comment addressing this area on the returned questionnaire stated “Since our wartime mission is food and we earn a large portion of our go-to-war...looking to satisfy a craving for fast food . The menu also changes from day to day to add additional variety. But, their strategy is not based solely on...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT A Strategic Decision Matrix for Analyzing Food Service

  19. Delinquent Medical Service Accounts at David Grant Air Force Medical Center Need Additional Management Oversight (United States)


    17 counties. DGMC Uniform Business Office (UBO) uses MSAs to record billing and fee collection for medical and dental services from Uniformed...personnel processed new accounts, the process used by DGMC did not manage or prioritize the aging MSAs or alert clerks of delinquent accounts...have been applied to other valid requirements such as administrative, operating, and equipment costs; readiness training; or trauma consortium

  20. Customer Service Analysis of Tactical Air Command Base Level Supply Support (United States)


    other components of the marketing mix , i.e. price, product, and promotion, and identifying the contribution of each of these components to the overall...identify a customer service and marketing strategy (28:6). They set out to test the hypothesis that the " marketing mix components of product, price...relevant criteria identified during the first three phases of the study to determine a strategic marketing mix for the industry (28:9). The variables used

  1. Feasibility, Reliability and Predictive Value Of In-Ambulance Heart Rate Variability Registration.

    Directory of Open Access Journals (Sweden)

    Laetitia Yperzeele

    Full Text Available Heart rate variability (HRV is a parameter of autonomic nervous system function. A decrease of HRV has been associated with disease severity, risk of complications and prognosis in several conditions.We aim to investigate the feasibility and the reliability of in-ambulance HRV registration during emergency interventions, and to evaluate the association between prehospital HRV parameters, patient characteristics, vital parameters and short-term outcome.We conducted a prospective study using a non-invasive 2-lead ECG registration device in 55 patients transported by the paramedic intervention team of the Universitair Ziekenhuis Brussel. HRV assessment included time domain parameters, frequency domain parameters, nonlinear analysis, and time-frequency analysis. The correlation between HRV parameters and patient and outcome characteristics was analyzed and compared to controls.Artifact and ectopic detection rates were higher in patients during ambulance transportation compared to controls in resting conditions, yet technical reasons precluding in-ambulance HRV analysis occurred in only 9.6% of cases. HRV acquisition was possible without safety issues or interference with routine emergency care. Reliability of the results was considered sufficient for Sample entropy (SampEn, good for the ratio of low frequency and high frequency components (LF/HF ratio in the frequency and the time frequency domain, and excellent for the triangular interpolation of the NN interval histogram (TINN, and for the short-term scaling exponent of the detrended fluctuation analysis (DFA α1. HRV indices were significantly reduced inpatients with unfavorable outcome compared to patients with favorable outcome and controls. Multivariate analysis identified lower DFA α1 as an independent predictor of unfavorable outcome (OR, 0.155; 95% CI 0.024-0.966; p = 0.049.In-ambulance HRV registration is technically and operationally feasible and produces reliable results for parameters

  2. Role of Air Cargo and Road Feeder Services for Regional Airports – Case Studies from the Baltic Sea Region

    Directory of Open Access Journals (Sweden)

    Beifert Anatoli


    the regional airports and their possible participation in the air cargo market as a supplement instrument to generate additional revenue also by means of so-called “air trucking” services will be presented and discussed.

  3. Logistics Image of Outsourcing Clients to The Wireless Telecommunications Industry: How is it related to The Service Value of Air Cargo Logistics Providers?



    This study explored the relationship between aspects of the logistics image of an outsourcing client and the service value of air cargo logistics providers (ACLPs). Given the range of client groups served by the electronics industry in Taiwan, we focused on telecommunication industries to analyze the correlation between the service value of ACLPs and the logistics image of telecommunication clients. The research subjects in this study were actual outsourcing logistics decision makers in the t...

  4. Evaluation of Dutch Helicopter Emergency Medical Services in transporting children

    NARCIS (Netherlands)

    Peters, J.H.; Beekers, C.; Eijk, R.J.R.; Edwards, M.J.; Hoogerwerf, N.


    OBJECTIVE: In the Netherlands, helicopter emergency medical services (HEMS) function as an adjunct to paramedic ambulance service delivering hospital-level medical care to a prehospital location. The main goal of Dutch HEMS is to provide on-scene medical expertise and not primarily to serve as trans

  5. Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zhenlei Liu

    Full Text Available Bed rest has been considered as the cornerstone of management of deep vein thrombosis (DVT for a long time, though it is not evidence-base, and there is growing evidence favoring early ambulation.Electronic databases including Medline, PubMed, Cochrane Library and three Chinese databases were searched with key words of "deep vein thrombosis", "pulmonary embolism", "venous thrombosis", "bed rest", "immobilization", "mobilization" and "ambulation". We considered randomized controlled trials, prospective or retrospective cohort studies that compared the outcomes of acute DVT patients managed with early ambulation versus bed rest, in addition to standard anticoagulation. Meta-analysis pertaining to the incidence of new pulmonary embolism (PE, progression of DVT, and DVT related deaths were conducted, as well as the extent of remission of pain and edema.13 studies were included with a total of 3269 patients. Compared to bed rest, early ambulation was not associated with a higher incidence of new PE, progression of DVT, or DVT related deaths (RD -0.03, 95% CI -0.05∼ -0.02; Z = 1.24, p = 0.22; random effect model, Tau2 = 0.01. Moreover, if the patients suffered moderate or severe pain initially, early ambulation was related to a better outcome, with respect to remission of acute pain in the affected limb (SMD 0.42, 95%CI 0.09∼0.74; Z = 2.52, p = 0.01; random effect model, Tau2 = 0.04. Meta-analysis of alleviation of edema cannot elicit a solid conclusion because of significant heterogeneity among the few studies.Compared to bed rest, early ambulation of acute DVT patients with anticoagulation was not associated with a higher incidence of new PE, progression of DVT, and DVT related deaths. Furthermore, for the patients suffered moderate or severe pain initially, a better outcome can be seen in early ambulation group, regarding to the remission of acute pain in the affected limb.

  6. Daily variations in ambulance calls for selected causes in Arkhangelsk, Russia: potential role of excessive alcohol consumption on weekends

    Directory of Open Access Journals (Sweden)

    Sergei N. Drachev


    Full Text Available Objectives. To assess daily variations in ambulance calls for cardiovascular diseases (CVDs, mental and behavioral disorders, and external causes in Arkhangelsk, Northwest Russia, in 2000–2008. Study design. A population-based study. Methods. Data about all ambulance calls during the years 2000–2008 were obtained from the Arkhangelsk ambulance station. Information about patient's gender, age, doctor's diagnosis according to International Classification of Diseases, 10th revision, and the date of call were recorded. Pearson's Chi-squared tests were used for comparing proportions of ambulance calls across the week for CVDs (I00-99, mental and behavioral disorders (F00-F99, and external causes (S00-T98, V01-Y98. The ratio of incidence of ambulance calls on Saturday, Sunday, and Monday versus the rest of week was also calculated. Results. There is a significant daily variation (p < 0.001 in calls for CVDs in men and women aged 18–59 and women aged 60 years and older, with increased numbers of calls on weekends and Mondays varying between 2 and 3% excess calls. For mental and behavioral disorders, a similar pattern was found in the age group of 18–59 year-olds. Ratios for the number of calls during weekends and Mondays vs. the rest of the week were 1.05 (95% CI: 1.02–1.08 among women and 1.02 (95% CI: 1.00–1.05 among men. For external causes, a significant variation and an increase in ambulance calls during Saturdays, Sundays, and Mondays from 4 to 17% excess calls was observed for both age and gender groups. Conclusions. The observed daily variations in ambulance calls with an increased number of calls on weekends and Mondays for CVDs, mental and behavioral disorders, and external causes may be associated with excessive alcohol consumption on the weekends. Further research using data on individual levels of alcohol consumption are warranted.

  7. Tractor-Maintenance: Operation & Daily Care [and] Servicing Air Cleaner & Lubrication. Student Materials. V. A. III. [V-C-1 through V-C-4]. (United States)

    Texas A and M Univ., College Station. Vocational Instructional Services.

    Designed for use by students in vocational agricultural classes, this manual deals with tractor maintenance. Operation and daily care are the topics of the first section. Safety is also covered. In the final part of the manual, servicing the air cleaner and lubricating the engine are discussed. Both sections conclude with a quiz. (PLB)

  8. The Correlation between Sex, Age, Educational Background, and Hours of Service on Vigilance Level of ATC Officers in Air Nav Surabaya, Indonesia (United States)

    Saleh, Lalu Muhammad; Suwandi, Tjipto; Hamidah


    The vigilance of an Air Traffic Control (ATC) officer determines aviation safety. The number of aviation accidents tends to be increasing in recent years. Aviation accidents may be caused by human errors (i.e. errors made by pilot or ATC officer) or unsafe work condition. Sex, age, educational background, and hours of service might affect…

  9. Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes.

    Directory of Open Access Journals (Sweden)

    Ann M Simon

    Full Text Available Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent. The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140 had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.

  10. Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes. (United States)

    Simon, Ann M; Ingraham, Kimberly A; Fey, Nicholas P; Finucane, Suzanne B; Lipschutz, Robert D; Young, Aaron J; Hargrove, Levi J


    Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.


    Directory of Open Access Journals (Sweden)

    Gajanan Bhalerao


    Full Text Available Background: Stroke subjects face reduced tolerance to activity and sedentary lifestyle due to various impairments, such as muscle weakness, pain, spasticity, and poor balance. Thus, loss of independent ambulation especially outdoors is generally observed in them. Methods: Chronic stroke patients (> 6 months with Functional Ambulation Category score > 2 and able to walk at least 10 meters of distance with and without assistance from a tertiary healthcare centre were selected and treated. Subjects were randomly divided into 2 groups control group (n=14 and experimental group (n=13. Each group received Motor Relearning Programme for 60 minutes, 6 times a week for 4 weeks. The experimental group received an additional shoe-raise of 1 cm on the unaffected side along with while ambulating during therapy as well as at home. Pre and post treatment the patients were assessed for spatio-temporal parameters using foot print analysis method and Rivermead Visual Gait Assessment (RVGA Score using RVGA scale. Results: There was significant improvement seen in almost all the spatio-temporal gait parameters and RVGA score in within group analysis. Whereas on between group the results from between group comparison suggests that subjects in MRP with shoe-raise group showed better results in spatio-temporal parameters of gait than subjects receiving MRPalone. But there was no additional benefit of shoe-raise seen on RGVA score and angle of toe-out parameter. Conclusion: Additional use of shoe-raise helps to improve spatio-temporal gait parameters. However, there was no additional change seen in RVGA score.

  12. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton. (United States)

    Asselin, Pierre K; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M


    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment.

  13. Preoperative Predictors of Ambulation Ability at Different Time Points after Total Hip Arthroplasty in Patients with Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Akiko Kamimura


    Full Text Available The aims of this study were to identify the preoperative factors influencing ambulation ability at different postoperative time points after total hip arthroplasty (THA and to examine the cutoff values of predictive preoperative factors by receiver operating characteristic (ROC curves. Forty-eight women with unilateral THA were measured for hip extensor, hip abductor, and knee extensor muscle strength in both legs; hip pain (visual analog scale, VAS; and the Timed Up and Go (TUG test pre- and postoperatively. Multiple regression analysis indicated that preoperative knee extensor strength (β=-0.379,R2=0.409 at 3 weeks, hip abductor strength (β=-0.572,R2=0.570 at 4 months, and age (β=0.758,R2= 0.561 at 7 months were strongly associated with postoperative ambulation, measured using the TUG test. Optimal preoperative cutoff values for ambulation ability were 0.56 Nm/kg for knee extensor strength, 0.24 Nm/kg for hip abductor strength, and 73 years of age. Our results suggest that preoperative factors predicting ambulation ability vary by postoperative time point. Preoperative knee extensor strength, hip abductor strength, and age were useful predictors of ambulation ability at the early, middle, and late time points, respectively, after THA.

  14. Why did the patient die? The relationship between ambulance accidents and death of patients: forensic medical issues. (United States)

    Ersoy, Gokhan; Ersoy, Ozlem; Yuksekbas, Ozlem; Kurnaz, Gulay; Akyildiz, Elif Ulker; Ekemen, Suheyla


    This article's aim is investigating traumatic consequences of ambulance accident on patients and discussing difficulties to give a decision about the relation between death and accident at these cases. The cases were selected among the forensic medical reports concluded between 1996 and 2005 years. They were documented for age, sex, causes of urgent call, localization and extent of traumatic lesion, properties of events and board decisions. A total of 21 cases were found. 15 cases died on the day of the accident. Skin injuries at head (8 cases) and legs (6 cases) were most common traumatic lesions. Totally 6 deaths were found related with ambulance accident. Death of patient after ambulance accidents may not be associated easily to the accident. Delay due to accident or concomitant contributing medical conditions may also facilitate the death in this type of cases. Reliable medical records were needed for accurate medicolegal evaluation.

  15. An Analysis of the Efficiency of Sourcing Knowledge-Based Services in the United States Air Force (United States)


    strategies for delivering knowledge-based services in a borderless world: The case of management education. Journal of Services Marketing , 23(6), 371...Rozemeijer, F. (2009). Buying business services: Towards a structured service purchasing process. Journal of Services Marketing , 23(1), 3–10

  16. Neurotherapeutic and neuroprosthetic effects of implanted functional electrical stimulation for ambulation after incomplete spinal cord injury

    Directory of Open Access Journals (Sweden)

    Ronald J. Triolo, PhD


    Full Text Available The purpose of this single-subject study was to determine the neurotherapeutic and neuroprosthetic effects of an implanted functional electrical stimulation (FES system designed to facilitate walking in an individual with a long-standing motor and sensory incomplete spinal cord injury. An implanted pulse generator and eight intramuscular stimulating electrodes were installed unilaterally, activating weak or paralyzed hip flexors, hip and knee extensors, and ankle dorsiflexors during 36 sessions of gait training with FES. The neurotherapeutic effects were assessed by a comparison of pre- and posttraining volitional walking. The neuroprosthetic effects were assessed by a comparison of posttraining volitional and FES-assisted walking. Treatment resulted in significant (p < 0.005 volitional improvements in 6-minute walking distance and speed, speed during maximum walk, double support time, and 10 m walking speed. Posttraining FES-assisted walking resulted in significant additional improvements in all these measures, except 10 m walking speed. When the subject was using FES-assisted gait, maximum walking distance, peak knee flexion in swing, peak ankle dorsiflexion in swing, and knee extension moment also significantly increased. Neuroprosthetic gains were sufficient to enable the subject to advance from household ambulation to limited community ambulation. Additionally, the subject could perform multiple walks per day when using FES-assisted gait, which was impossible with volitional effort alone.

  17. Benefits of microprocessor-controlled prosthetic knees to limited community ambulators: systematic review. (United States)

    Kannenberg, Andreas; Zacharias, Britta; Pröbsting, Eva


    The benefits of microprocessor-controlled prosthetic knees (MPKs) have been well established in community ambulators (Medicare Functional Classification Level [MFCL]-3) with a transfemoral amputation (TFA). A systematic review of the literature was performed to analyze whether limited community ambulators (MFCL-2) may also benefit from using an MPK in safety, performance-based function and mobility, and perceived function and satisfaction. We searched 10 scientific databases for clinical trials with MPKs and identified six publications with 57 subjects with TFA and MFCL-2 mobility grade. Using the criteria of a Cochrane Review on prosthetic components, we rated methodological quality moderate in four publications and low in two publications. MPK use may significantly reduce uncontrolled falls by up to 80% as well as significantly improve indicators of fall risk. Performance-based outcome measures suggest that persons with MFCL-2 mobility grade may be able to walk about 14% to 25% faster on level ground, be around 20% quicker on uneven surfaces, and descend a slope almost 30% faster when using an MPK. The results of this systematic review suggest that trial fittings may be used to determine whether or not individuals with TFA and MFCL-2 mobility grade benefit from MPK use. Criteria for patient selection and assessment of trial fitting success or failure are proposed.

  18. Ambulation and independence among Veterans with nontraumatic bilateral lower–limb loss

    Directory of Open Access Journals (Sweden)

    Sherene E. Sharath, MPH


    Full Text Available In describing functional outcomes and independent living in a cohort of bilateral major amputees, we sought to provide current estimates of function and independence after a second major amputation in an elderly Veteran population with peripheral arterial disease and/or diabetes. After retrospectively reviewing and excluding the electronic health records of those failing to meet the inclusion criteria, we identified 40 patients with a history of unilateral major amputation who underwent a second major amputation during the defined study period. Of these, 43% (17 were bilateral transfemoral amputations (TFAs; bilateral transtibial amputations (TTAs and TFA–TTA accounted for the rest (33% and 25%, respectively. Of the 19 (48% patients who were ambulatory prior to bilateral amputation, only 2 (11% remained ambulatory after the second amputation, while 17 (89% patients lost ambulatory capabilities. Compared with those who were ambulate precontralateral amputation (p = 0.03. All patients with bilateral TFA were nonambulatory. Independence postcontralateral amputation decreased from 88% (35 to 53% (21. When data were available (58%, pre and post Functional Independence Measure scores showed a decrease in 74% of patients, while 22% showed an increase. In conclusion, bilateral lower–limb amputation among dysvascular Veterans is highly associated with a loss of ambulation.

  19. Improving community ambulation after hip fracture: protocol for a randomised, controlled trial (United States)

    Orwig, D; Mangione, KK; Baumgarten, M; Terrin, M; Fortinsky, R; Kenny, AM; Gruber-Baldini, AL; Beamer, B; Tosteson, ANA; Shardell, M; Magder, L; Binder, E; Koval, K; Resnick, B; Craik, RL; Magaziner, J


    Introduction After a hip fracture in older persons, significant disability often remains; dependency in functional activities commonly persists beyond 3 months after surgery. Endurance, dynamic balance, quadriceps strength, and function are compromised, and contribute to an inability to walk independently in the community. In the United States, people aged 65 years and older are eligible to receive Medicare funding for physiotherapy for a limited time after a hip fracture. A goal of outpatient physiotherapy is independent and safe household ambulation 2 to 3 months after surgery. Current Medicare-reimbursed post-hip-fracture rehabilitation fails to return many patients to pre-fracture levels of function. Interventions delivered in the home after usual hip fracture physiotherapy has ended could promote higher levels of functional independence in these frail and older adult patients. Primary objective To evaluate the effect of a specific multicomponent physiotherapy intervention (PUSH), compared with a non-specific multi-component control physiotherapy intervention (PULSE), on the ability to ambulate independently in the community 16 weeks after randomisation. Design Parallel, two-group randomised multicentre trial of 210 older adults with a hip fracture assessed at baseline and 16 weeks after randomisation, and at 40 weeks after randomisation for a subset of approximately 150 participants. Participants and setting A total of 210 hip fracture patients are being enrolled at three clinical sites and randomised up to 26 weeks after admission. Study inclusion criteria are: closed, non-pathologic, minimal trauma hip fracture with surgical fixation; aged ≥ 60 years at the time of randomisation; community residing at the time of fracture and randomisation; ambulating without human assistance 2 months prior to fracture; and being unable to walk at least 300 m in 6 minutes at baseline. Participants are ineligible if the interventions are deemed to be unsafe or unfeasible

  20. Using HSPA to improve the telemedical links on a moving ambulance. (United States)

    Banitsas, Konstantinos; Tachakra, Sapal; Stefanidis, Euclid; Boletis, Konstantinos


    As the demand for faster and more effective health care increases, there is a growing need to establish mobile, high-speed communications between a moving ambulance and a consultation point (usually a hospital). The recent addition of HSPA (HSDPA and HSUPA) into the UMTS suite provides higher bandwidth and reduced delays, making this choice ideal for real-time telemedical applications. In this paper, we will describe a set of scenarios that took place in a typical large city area, along with their equivalent results: a moving ambulance was linked with a consultation station using HSPA and several videoconferencing sessions were initiated. Best-case, worst-case and average scenarios were recorded. Furthermore, in areas where the UMTS reception was marginal, a repeater was placed on top of the vehicle to boost up the signal power and thus maintain the higher bandwidth. Finally, treating doctors were asked to evaluate the effectiveness of this system's outputs, based on a variety of objective and subjective criteria.

  1. Humeral fracture in non-ambulant infants - a possible accidental mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Somers, John M.; Halliday, Katharine E. [Nottingham University Hospitals, Radiology Department, Nottingham (United Kingdom); Chapman, Stephen [Birmingham Children' s Hospital, Birmingham (United Kingdom)


    Humeral fracture in a non-ambulant infant younger than 1 year is suspicious for a non-accidental injury unless there is a credible accidental explanation. A previously unrecognised accidental mechanism was described in 1996 whereby a 5-month-old infant was rolled by a 3-year-old sibling from a prone to a supine position. To investigate the widely accepted view that an infant with limited mobility cannot sustain a fracture of the humerus by his or her own actions in the absence of the intervention of an external party. We present seven cases of non-ambulant infants between 4 and 7 months of age in whom an isolated humeral fracture was the only injury present. In each case the caregiver described the fracture occurring when the child rolled over, trapping the dependent arm, without the intervention of another party. There is no proof for this mechanism in the form of an independent witness or video recording. However, we propose that this mechanism is worthy of further consideration as a rare and unusual cause for the injury. Further study is required. (orig.)

  2. Four Square Step Test in ambulant persons with multiple sclerosis: validity, reliability, and responsiveness. (United States)

    Wagner, Joanne M; Norris, Rosemary A; Van Dillen, Linda R; Thomas, Florian P; Naismith, Robert T


    The aim of this study was to establish the concurrent validity and relative and absolute reliability, define the minimal detectable change, and evaluate the floor and ceiling effects of the Four Square Step Test (FSST) in ambulant persons with multiple sclerosis (pwMS). Twenty-five pwMS performed the FSST on two occasions, 8.1±4.1 days apart. During the first testing, session participants also reported their fall history, performed the Berg Balance Scale, Dynamic Gait Index, and completed the Activities-Specific Balance Confidence Scale. Performance on the FSST was significantly (P<0.001) and strongly associated with performance on the Berg Balance Scale (rs=-0.84), Dynamic Gait Index (rs=-0.81), and Activities-Specific Balance Confidence Scale (rs=-0.78). Relative reliability of the FSST was excellent (ICC2,1=0.922). The minimal detectable change estimate for the FSST was 4.6 s. The FSST is a valid and reliable measure of dynamic standing balance in ambulant pwMS. However, because a substantial change (43%) is required to demonstrate a real change in individual performance, the FSST is unlikely to be sensitive in detecting longitudinal change in dynamic standing balance.

  3. Benefits of microprocessor-controlled prosthetic knees to limited community ambulators: Systematic review

    Directory of Open Access Journals (Sweden)

    Andreas Kannenberg, MD, PhD


    Full Text Available The benefits of microprocessor-controlled prosthetic knees (MPKs have been well established in community ambulators (Medicare Functional Classification Level [MFCL]-3 with a transfemoral amputation (TFA. A systematic review of the literature was performed to analyze whether limited community ambulators (MFCL-2 may also benefit from using an MPK in safety, performance-based function and mobility, and perceived function and satisfaction. We searched 10 scientific databases for clinical trials with MPKs and identified six publications with 57 subjects with TFA and MFCL-2 mobility grade. Using the criteria of a Cochrane Review on prosthetic components, we rated methodological quality moderate in four publications and low in two publications. MPK use may significantly reduce uncontrolled falls by up to 80% as well as significantly improve indicators of fall risk. Performance-based outcome measures suggest that persons with MFCL-2 mobility grade may be able to walk about 14% to 25% faster on level ground, be around 20% quicker on uneven surfaces, and descend a slope almost 30% faster when using an MPK. The results of this systematic review suggest that trial fittings may be used to determine whether or not individuals with TFA and MFCL-2 mobility grade benefit from MPK use. Criteria for patient selection and assessment of trial fitting success or failure are proposed.

  4. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and... (United States)


    ... offering the MA plan. (2) MA organization financial responsibility. The MA organization is financially... condition regardless of final diagnosis; (iv) For which a plan provider or other MA organization... improve or resolve the enrollee's condition. (2) MA organization financial responsibility. The...




  6. What an ambulance nurse needs to know: a content analysis of curricula in the specialist nursing programme in prehospital emergency care. (United States)

    Sjölin, Helena; Lindström, Veronica; Hult, Håkan; Ringsted, Charlotte; Kurland, Lisa


    In Sweden, ambulances must be staffed by at least one registered nurse. Twelve universities offer education in ambulance nursing. There is no national curriculum for detailed course content and there is a lack of knowledge about the educational content that deals with the ambulance nurse practical professional work. The aim of this study was to describe the content in course curricula for ambulance nurses. A descriptive qualitative research design with summative content analysis was used. Data were generated from 49 courses in nursing and medical science. The result shows that the course content can be described as medical, nursing and contextual knowledge with a certain imbalance with largest focus on medical knowledge. There is least focus on nursing, the registered nurses' main profession. This study clarifies how the content in the education for ambulance nurses in Sweden looks today but there are reasons to discuss the content distribution.

  7. Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service

    Directory of Open Access Journals (Sweden)

    Jonhan Ho


    Full Text Available Background: Advances in digital pathology are accelerating integration of this technology into anatomic pathology (AP. To optimize implementation and adoption of digital pathology systems within a large healthcare organization, initial assessment of both end user (pathologist needs and organizational infrastructure are required. Contextual inquiry is a qualitative, user-centered tool for collecting, interpreting, and aggregating such detailed data about work practices that can be employed to help identify specific needs and requirements. Aim: Using contextual inquiry, the objective of this study was to identify the unique work practices and requirements in AP for the United States (US Air Force Medical Service (AFMS that had to be targeted in order to support their transition to digital pathology. Subjects and Methods: A pathology-centered observer team conducted 1.5 h interviews with a total of 24 AFMS pathologists and histology lab personnel at three large regional centers and one smaller peripheral AFMS pathology center using contextual inquiry guidelines. Findings were documented as notes and arranged into a hierarchal organization of common themes based on user-provided data, defined as an affinity diagram. These data were also organized into consolidated graphic models that characterized AFMS pathology work practices, structure, and requirements. Results: Over 1,200 recorded notes were grouped into an affinity diagram composed of 27 third-level, 10 second-level, and five main-level (workflow and workload distribution, quality, communication, military culture, and technology categories. When combined with workflow and cultural models, the findings revealed that AFMS pathologists had needs that were unique to their military setting, when compared to civilian pathologists. These unique needs included having to serve a globally distributed patient population, transient staff, but a uniform information technology (IT structure. Conclusions: The

  8. Effect of Planned Early Recommended Ambulation Technique on Selected Post caesarean Biophysiological Health Parameters

    Directory of Open Access Journals (Sweden)

    Jyoti V. Dube


    Full Text Available Background: Caesarean section has been a part of human culture since ancient times. It has been used effectively throughout the 20th century and among the major abdominal surgeries, it is the most common, oldest worldwide surgery performed in obstetrics. Despite the life saving advantages, there are several adverse consequences of caesarean delivery for a woman and to her household. The rate and risk of these complications increases due to the increasing incidence mainly in countries like India. The role of nurse midwife is to act in the best interest of patient and newborn and make the patient independent in carrying out the activities of daily living as soon as possible. This can lead to a faster recovery and shorter hospital stay. Also it can indirectly help in reducing the complications associated with prolonged bed rest and can improve the maternal newborn bonding. Aim and Objectives: The present study was done to evaluate the effect of planned early ambulation on selected biophysiological health parameters of post caesarean patients. Material and Methods: The study included total 500 study subjects, 250 in experimental and 250 in control group. Quasi experimental approach with multiple time series design was adopted for the study. The experimental group was given an early planned recommended ambulation technique starting from the day of surgery. This consisted of deep breathing exercise, cough exercise, leg exercise and early mobilization. Over and above, the routine general health care was given by the doctors and nurses. The control group received only by routine general care by doctors and nurses and mobilization on third post operative day as per strategy adopted by the hospital. The deep breathing exercises, coughing exercises and leg exercises were not given routinely and hence were not given to the control group. Post caesarean biophysiological parameters chart was used to assess the selected parameters for first five post operative

  9. Aplicação do modelo hipercubo de filas para avaliar a descentralização de ambulâncias em um sistema urbano de atendimento médico de urgência

    Directory of Open Access Journals (Sweden)

    Renata Algisi Takeda


    Full Text Available Uma das maiores preocupações de sistemas urbanos de atendimento médico-emergencial é a rapidez no atendimento às vítimas. Os tempos de resposta dependem de diversos fatores como condições de tráfego local, dia da semana e período do dia, tipo e número de veículos disponíveis, localização destes veículos, políticas de despacho, etc. Neste trabalho apresenta-se uma análise dos efeitos da descentralização de ambulâncias que operam no sistema de atendimento médico-emergencial (SAMU-192 de Campinas, SP. O problema é tratado por meio do modelo hipercubo de filas espacialmente distribuídas, que considera variações aleatórias dos processos de chegada e atendimento dos chamados emergenciais. A aplicação do modelo produz uma ampla variedade de indicadores de desempenho para o sistema, que são comparados com os valores reais observados. Os resultados obtidos com a descentralização das ambulâncias mostraram uma significativa elevação do nível de serviço oferecido aos usuários.One of the major concerns of urban emergency medical systems is to provide the fastest possible first care medical assistance to the victims. The response times depend on different aspects such as: local traffic conditions, weekday and time, type and number of available vehicles, location of these vehicles, dispatching policies, etc. This work analyzes the effects of decentralizing ambulances in the emergency medical system (SAMU-192 of Campinas, SP. The problem is dealt with the hypercube queuing model, which considers stochastic variations of the arrival and service processes of the emergency calls. The application of the model produces a wide variety of system performance indicators, which are compared to the actual observed values. The results obtained with ambulance decentralization showed a significant increase in the service level offered to the users.

  10. High intertester reliability of the cumulated ambulation score for the evaluation of basic mobility in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Andersen, Lene; Bech-Jensen, Rie;


    OBJECTIVE: To examine the intertester reliability of the three activities of the Cumulated Ambulation Score (CAS) and the total CAS, and to define limits for the smallest change in basic mobility that indicates a real change in patients with hip fracture. DESIGN: An intertester reliability study....

  11. Early ambulance initiation versus in-hospital initiation of high dose clopidogrel in ST-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Postma, S.; Dambrink, J.H.; Ottervanger, J.P.; Gosselink, A.T.M.; Koopmans, P.C.; Berg, J.M. van den; Suryapranata, H.; Hof, A.W. van 't


    Pre-hospital infarct diagnosis gives the opportunity to start anti-platelet and anti-thrombotic agents before arrival at the PCI centre. However, more evidence is necessary to demonstrate whether high dose (HD) clopidogrel (600 mg) administered in the ambulance is associated with improved initial pa

  12. Cumulated Ambulation Score to evaluate mobility is feasible in geriatric patients and in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Jakobsen, Thomas Linding; Nielsen, Jesper Westphal;


    Regaining basic mobility independence is considered important for elderly hospitalised patients. The Cumulated Ambulation Score (CAS) is a valid tool for evaluating these patients' basic mobility (getting in and out of bed, sit-to-stand from a chair and walking) in orthopaedic wards, and its use...

  13. Use of Functional Ambulation Performance Score as measurement of gait ability: Review

    Directory of Open Access Journals (Sweden)

    Arnaud Gouelle, PhD


    Full Text Available Gait analysis systems are widely used for the assessment of gait disabilities and provide more accurate and detailed information than clinical tests. Scores and indexes have been proposed to summarize the large volume of data produced, each emphasizing different aspects of gait. Based on specific spatiotemporal gait parameters, the Functional Ambulation Performance Score (FAPS quantifies gait at a self-selected speed. Integrated within electronic walkways, the FAPS is commonly used for clinical evaluations and has been used in an increasing number of publications over the past few years. However, its use is sometimes distorted by misunderstandings of its composition and calculation, practical and/or conceptual limits, and even the meaning of the score. This technical report reviews the use of the FAPS for the evaluation of gait based on peer-reviewed articles and clinical experience and addresses important issues that must be considered for an optimal unbiased understanding and analysis of the score.

  14. [The evaluation of health of medical personnel of ambulance care and impacting factors]. (United States)


    The analysis of self-assessment of medical personnel of ambulance care revealed that 13.2% of respondents consider themselves as healthy persons, 35.1%--as practically healthy, 39.2%--as rarely being ill, 12%--as often being ill According to the poll data, deterioration of health is promoted by such personal factors as disregard of one's health (35%) and chronic diseases (25.3%). Its own role play such external factors as professional characteristics (34%). ecological conditions (23%), poor conditions of work (22.2%). The amelioration of health is supported mainly by sport exercises (42.8%). The significant role in this process play the improvement of work conditions, the enhancement of quality of medical examninations and the introduction of professional dispanserization.

  15. Geographic information system data from ambulances applied in the emergency department: effects on patient reception

    DEFF Research Database (Denmark)

    Raaber, Nikolaj; Pedersen, Iben Duvald; Riddervold, Ingunn Skogstad;


    BACKGROUND: Emergency departments (ED) recognize crowding and handover from prehospital to in-hospital settings to be major challenges. Prehospital Geographical Information Systems (GIS) may be a promising tool to address such issues. In this study, the use of prehospital GIS data was implemented...... was displayed in the ED. Data included real-time estimated time of arrival, distance to ED, dispatch criteria, patient data and ambulance contact information. Data was used by coordinating nurses for time activation of TT and MET involved in the initial treatment of severely-injured or critically-ill patients....... DISCUSSION: The contradiction of measured median wait time and nurses perceived improved timing of team activation may result from having both RT- ETA and supplemental patient information not only for seriously-injured or critically-ill patients received by the TT and MET, but for all patients transported...

  16. Early ambulation and prevention of post-operative thrombo-embolic risk. (United States)

    Talec, P; Gaujoux, S; Samama, C M


    The prevention of post-operative risk of venous thrombo-embolism (VTE) is of fundamental importance, but preventive methods have progressed with the introduction of direct oral anticoagulants (DOAC), the development of ambulatory surgery and enhanced recovery programs (ERP) after surgery. Surgery is, inherently a trigger for venous thrombo-embolic disease, as is prolonged immobilization. However, the risk of VTE is very low following ambulatory surgery, especially in this selected population. ERP, consists of a set of measures to optimize the patient's peri-operative management while reducing length of stay, costs and morbidity and mortality; one measure is the encouragement of early ambulation. This will undoubtedly have an impact on the incidence of VTE and lessen the need for prolonged thrombo-prophylaxis.

  17. Reducing Ambulance Diversion at Hospital and Regional Levels: Systemic Review of Insights from Simulation Models

    Directory of Open Access Journals (Sweden)

    M Kit Delgado


    Full Text Available Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED crowding are unclear. We performed a systematic review of published simulation studies to identify: 1 the tradeoff between ambulance diversion and ED wait times; 2 the predicted impact of patient flow interventions on reducing diversion; and 3 the optimal regional strategy for reducing diversion.Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional studies identified through bibliography review, Google Scholar, and scientific conference proceedings. Study Selection: Only simulations modeling ambulance diversion as a result of ED crowding or inpatient capacity problems were included. Data extraction: Independent extraction by two authors using predefined data fields.Results: We identified 5,116 potentially relevant records; 10 studies met inclusion criteria. In models that quantified the relationship between ED throughput times and diversion, diversion was found to only minimally improve ED waiting room times. Adding holding units for inpatient boarders and ED-based fast tracks, improving lab turnaround times, and smoothing elective surgery caseloads were found to reduce diversion considerably. While two models found a cooperative agreement between hospitals is necessary to prevent defensive diversion behavior by a hospital when a nearby hospital goes on diversion, one model found there may be more optimal solutions for reducing region wide wait times than a regional ban on diversion.Conclusion: Smoothing elective surgery caseloads, adding ED fast tracks as well as holding units for inpatient boarders, improving ED lab turnaround times, and implementing regional cooperative agreements among hospitals. [West J Emerg Med. 2013;14(5:489-498.

  18. Case Study – Idling Reduction Technologies for Emergency Service Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Laughlin, Michael [Argonne National Lab. (ANL), Argonne, IL (United States); Owens, Russell J. [Argonne National Lab. (ANL), Argonne, IL (United States)


    This case study explores the use of idle reduction technologies (IRTs) on emergency service vehicles in police, fire, and ambulance applications. Various commercially available IRT systems and approaches can decrease, or ultimately eliminate, engine idling. Fleets will thus save money on fuel, and will also decrease their criteria pollutant emissions, greenhouse gas emissions, and noise.

  19. Optimisation of compressed-air supply for control purposes at Valorec Services AG; Optimierung der Steuerluft - Versorgung bei der Valorec Services AG

    Energy Technology Data Exchange (ETDEWEB)

    Dott, R.; Afjei, T.


    This final report for the Swiss Federal Office of Energy (SFOE) presents the results of a project that looked at the possibilities of optimising the supply of compressed air provided around the clock by four compressor systems of varying ages in a facility in Basle, Switzerland. The initial situation is analysed and the potential for making savings is estimated. Various possibilities for improvement are considered including changing the topology of the compressed-air network, the replacement of certain compressors and a new control system. Appropriate measures are proposed and compared with new installations.

  20. The US Air Force medical service system%美国空军的医疗保障体系

    Institute of Scientific and Technical Information of China (English)



    借鉴与学习美国空军医疗保障体系与先进理念,以及稳定航空军医队伍的有效手段.主要引用美国空军两个网络资料,文献4篇,军标1个.这些资料表明,美国空军高层已形成共识——良好的医疗服务是飞行安全与战斗力的重要保障.因此,每年预算庞大的经费,以维持75个医疗中心、医院、诊所或医疗站的专一而高效地运转.而军事人员通用医疗保险制度(TRICARE)使三军人员就近就诊,大幅节省费用.全球搜救、空运医疗服务系统和分级健康维护与治疗,构成完备的医疗保障体系.航空军医则是保障空军全体官兵健康的重要前哨,通过分级培训与较高待遇,使航空军医在专业与生活水平两方面均能不断提升,有效地稳定了这支队伍.美国TRICARE制度可以借鉴,稳定航空军医队伍的手段值得学习.%To analyze the United State Air Force (USAF) medical service system in order to obtain core concepts and methods to maintain high level and active flight surgeon team. Data from 4 articles, 1 military standard and 2 websites were cited. The data indicated that the USAF leadership had a consensus: good medical service was an important guarantee for flight safety and fighting capacity. Therefore, the 75 medical centers, hospitals, clinics or stations were maintained by a huge annual budget of funds. TRICARE medical insurance program provided the military personnel with the nearest medication to save substantial cost. Global search and rescue, aeromedical evacuation and grading healthcare constitute a comprehensive medical insurance system. The flight surgeon was as an outpost for healthcare of all the officers and airmen. The higher annual salary and grading professional training can effectively stabilize and improve the flight surgeon team. The medical insurance program serving uniformed military members should be followed as an example. The means of maintaining flight surgeon team was worth

  1. FANTASTIC-5G: flexible air interface for scalable service delivery within wireless communication networks of the 5th generation

    DEFF Research Database (Denmark)

    Schaich, Frank; Sayrac, Berna; Elayoubi, Salaheddine


    5th generation mobile networks will have to cope with a high degree of heterogeneity in terms of services, mobility, number of devices and so on. Thus, diverse and often contradicting key performance indicators need to be supported, but having multiple radio access technologies for multi-service ...

  2. L’ambulantage : Représentations du commerce ambulant ou informel et métropolisation


    MONNET, Jérôme


    Les représentations sociales font du commerce dit ambulant, informel ou de rue un ensemble flou d’activités liées à l’illégalité, à l’archaïsme et au sous-développement. En première partie, une cybergéographie de ces représentations présente les trois identifications dominantes de ce type de commerce et différencie des approches selon que l’on s’exprime en anglais ou en français et en espagnol. Cependant, elles ont en commun de marginaliser le commerce ambulant, et en particulier de ne pas co...

  3. Analysis of Air Cargo Transfer Service Chain at Pudong International Airport%浦东国际机场货运中转服务链分析

    Institute of Scientific and Technical Information of China (English)

    刘锐; 崔诚靓; 陈川


    Air cargo transfer involves several participants in its operation process, including ship pers, freight forwarders, airport cargo terminal, airlines, customs and other regulatory agencies. All of the related participants constitute the entire service chain of air cargo transfer, making the air transport continuous and convenient. Based on field research into the related enterprises, this study summarizes the developing situation about the air cargo transfer at Pudong International Airport as well as the related appeals proposed by the relevant partici pants, points out the problems at Pudong International Airport and presents some suggestions from the perspec tive of service chain.%现代航空货物中转运输在其运营过程中涉及到许多参与方,包括货主、货代、机场货站、航空公司以及海关等监管机构,所有这一系列参与方构成了整个货运中转服务链条,维系着航空运输的连续性和快捷性. 在立足对浦东机场各个货运相关参与方的实地调研的基础上,通过收集整理国外枢纽机场和相关企业的资料,分析总结浦东机场各个参与方的发展现状,梳理了参与方对中转联程运输的相关诉求,指出了浦东机场货运中转服务链中所存在的相关问题,最后从服务链的角度提出改善浦东机场货运中转的建议.

  4. Emergency department visits, ambulance calls, and mortality associated with an exceptional heat wave in Sydney, Australia, 2011: a time-series analysis

    Directory of Open Access Journals (Sweden)

    Schaffer Andrea


    Full Text Available Abstract Background From January 30-February 6, 2011, New South Wales was affected by an exceptional heat wave, which broke numerous records. Near real-time Emergency Department (ED and ambulance surveillance allowed rapid detection of an increase in the number of heat-related ED visits and ambulance calls during this period. The purpose of this study was to quantify the excess heat-related and all-cause ED visits and ambulance calls, and excess all-cause mortality, associated with the heat wave. Methods ED and ambulance data were obtained from surveillance and administrative databases, while mortality data were obtained from the state death registry. The observed counts were compared with the average counts from the same period from 2006/07 through 2009/10, and a Poisson regression model was constructed to calculate the number of excess ED visits, ambulance and deaths after adjusting for calendar and lag effects. Results During the heat wave there were 104 and 236 ED visits for heat effects and dehydration respectively, and 116 ambulance calls for heat exposure. From the regression model, all-cause ED visits increased by 2% (95% CI 1.01-1.03, all-cause ambulance calls increased by 14% (95% CI 1.11-1.16, and all-cause mortality increased by 13% (95% CI 1.06-1.22. Those aged 75 years and older had the highest excess rates of all outcomes. Conclusions The 2011 heat wave resulted in an increase in the number of ED visits and ambulance calls, especially in older persons, as well as an increase in all-cause mortality. Rapid surveillance systems provide markers of heat wave impacts that have fatal outcomes.

  5. Strategies to reduce the configuration time for a powered knee and ankle prosthesis across multiple ambulation modes. (United States)

    Simon, Ann M; Fey, Nicholas P; Finucane, Suzanne B; Lipschutz, Robert D; Hargrove, Levi J


    Recently developed powered lower limb prostheses allow users to more closely mimic the kinematics and kinetics of non-amputee gait. However, configuring such a device, in particular a combined powered knee and ankle, for individuals with a transfemoral amputation is challenging. Previous attempts have relied on empirical tuning of all control parameters. This paper describes modified stance phase control strategies - which mimic the behavior of biological joints or depend on the instantaneous loads within the prosthesis - developed to reduce the number of control parameters that require individual tuning. Three individuals with unilateral transfemoral amputations walked with a powered knee and ankle prosthesis across five ambulation modes (level ground walking, ramp ascent/descent, and stair ascent/descent). Starting with a nominal set of impedance parameters, the modified control strategies were applied and the devices were individually tuned such that all subjects achieved comfortable and safe ambulation. The control strategies drastically reduced the number of independent parameters that needed to be tuned for each subject (i.e., to 21 parameters instead of a possible 140 or approximately 4 parameters per mode) while relative amplitudes and timing of kinematic and kinetic data remained similar to those previously reported and to those of non-amputee subjects. Reducing the time necessary to configure a powered device across multiple ambulation modes may allow users to more quickly realize the benefits such powered devices can provide.

  6. [Helpful Factors of Ambulant Art Therapy in the Group and Changes of Experiences in Psychosomatic Patients]. (United States)

    Oster, Jörg; Moser, Anna Sophie; Danner-Weinberger, Alexandra; von Wietersheim, Jörn


    The aim of this study was to analyze the experiences of patients suffering from mostly chronic psychosomatic disorders in an ambulant art therapy in the group. Especially, the focus was on the experienced changes, helpful factors and specifics of the therapy as well as on the experienced benefit. For this, 30 patients were interviewed in a semi-standardized way. Additionally, the symptom-based strain was psychometrically recorded in a part of the patients (21) at the beginning of the therapy and after at least 6 months of participation. The evaluation of those interviews with the qualitative analysis of the therapy subjects surrendered an improvement of the health state in most of the participants. Especially group factors, art as a mean of communication, becoming aware of feelings but also diversion and fun were proved to be beneficial. The art therapy also serves for structuring the week as well as a contact point and a resource in the interpersonal communication of everyday life. Nearly all of the patients referred to some important turning point pictures. Mostly, the benefit was valued as being high. But, in contrast, the psychometric measure did not show any significant change. The results emphasize the stabilizing function of art therapy in the examined patients, whereat the classification of the psychometric result is complicated by the absence of a control group.

  7. Leg Lengthening as a Means of Improving Ambulation Following an Internal Hemipelvectomy

    Directory of Open Access Journals (Sweden)

    Wakyo Sato


    Full Text Available Reconstructive surgery following an internal hemipelvectomy for a malignant pelvic tumor is difficult due to the structural complexity of the pelvis and the massive extension of the tumor. While high complication rates have been encountered in various types of reconstructive surgery, resection without reconstruction reportedly involved fewer complications. However, this method often results in limb shortening with resultant instability during walking. We reported herein leg lengthening performed to correct lower limb shortening after an internal hemipelvectomy, which improved ambulatory stability and overall QOL. An 18-year-old male patient came to our hospital to correct a lower limb discrepancy resulting from a left internal hemipelvectomy. His left pelvis and proximal femur had been resected, and the femur remained without an acetabular roof. His left lower limb was about 8 centimeters shorter. The left tibia was lengthened 8 centimeters with an external fixator. After the lengthening, the patient was able to walk without support and his gait remarkably improved. Additionally he no longer required placing a wallet in his back pocket as a pad as a means of raising the left side of his torso while sitting. Leg lengthening was a useful method of improving ambulation after an internal hemipelvectomy.

  8. Powered ankle-foot prosthesis for the improvement of amputee ambulation. (United States)

    Au, Samuel K; Herr, Hugh; Weber, Jeff; Martinez-Villalpando, Ernesto C


    This paper presents the mechanical design, control scheme, and clinical evaluation of a novel, motorized ankle-foot prosthesis, called MIT Powered Ankle-Foot Prosthesis. Unlike a conventional passive-elastic ankle-foot prosthesis, this prosthesis can provide active mechanical power during the stance period of walking. The basic architecture of the prosthesis is a unidirectional spring, configured in parallel with a force-controllable actuator with series elasticity. With this architecture, the anklefoot prosthesis matches the size and weight of the human ankle, and is also capable of delivering high mechanical power and torque observed in normal human walking. We also propose a biomimetic control scheme that allows the prosthesis to mimic the normal human ankle behavior during walking. To evaluate the performance of the prosthesis, we measured the rate of oxygen consumption of three unilateral transtibial amputees walking at self-selected speeds to estimate the metabolic walking economy. We find that the powered prosthesis improves amputee metabolic economy from 7% to 20% compared to the conventional passive-elastic prostheses (Flex-Foot Ceterus and Freedom Innovations Sierra), even though the powered system is twofold heavier than the conventional devices. This result highlights the benefit of performing net positive work at the ankle joint to amputee ambulation and also suggests a new direction for further advancement of an ankle-foot prosthesis.

  9. Neutral Caregivers or Military Support? The British Red Cross, the Friends’ Ambulance Unit, and the Problems of Voluntary Medical Aid in Wartime (United States)


    During the First World War the British Red Cross Society (BRCS) served as the coordinating body for voluntary medical aid giving in Britain. Among the many units which came within its purview was the Friends’ Ambulance Unit (FAU), formed by a group of young men whose desire to serve their nation in wartime conflicted with their pacifist principles. Both the BRCS and the FAU were wracked by ideological conflicts in the years which preceded and throughout the war. These struggles over voluntarist identity highlight the contested meanings of service and conscience in wartime. Through a critical examination of the language of official histories and biographies, this article will argue that the war formed a key moment in the relationship between the British state and voluntary medical aid, with the state’s increasing role in the work of such organizations raising questions about the voluntarist principles to which aid organizations laid claim. The struggles that both organizations and individuals within them faced in reconciling the competing pressures that this new relationship created form a legacy of the war which continues to have important implications for the place of medical voluntarism in wartime today. PMID:26213442

  10. Neutral Caregivers or Military Support? The British Red Cross, the Friends' Ambulance Unit, and the Problems of Voluntary Medical Aid in Wartime. (United States)

    Meyer, Jessica


    During the First World War the British Red Cross Society (BRCS) served as the coordinating body for voluntary medical aid giving in Britain. Among the many units which came within its purview was the Friends' Ambulance Unit (FAU), formed by a group of young men whose desire to serve their nation in wartime conflicted with their pacifist principles. Both the BRCS and the FAU were wracked by ideological conflicts in the years which preceded and throughout the war. These struggles over voluntarist identity highlight the contested meanings of service and conscience in wartime. Through a critical examination of the language of official histories and biographies, this article will argue that the war formed a key moment in the relationship between the British state and voluntary medical aid, with the state's increasing role in the work of such organizations raising questions about the voluntarist principles to which aid organizations laid claim. The struggles that both organizations and individuals within them faced in reconciling the competing pressures that this new relationship created form a legacy of the war which continues to have important implications for the place of medical voluntarism in wartime today.

  11. US Army Order of Battle 1919-1941. Volume 3. The Services: Air Service, Engineers, and Special Troops, 1919-41 (United States)


    army’s airspace to allow the service’s attack squadrons the freedom to attack enemy formations and key installations as well as cooperate with, and maintained contact with wide-spread infantry and supporting cavalry formations . The service could supplement divisions for various operations...missions during the summer training of the 264th and 265th Coast Artillery Regiments at Fort Barrancas and Key West Barracks, FL. Inducted into

  12. Privatization and emergency medical services. (United States)

    Reissman, S G


    Osborne and Gaebler's Reinventing Government has sparked discussion amongst elected officials, civil servants, the media, and the general public regarding advantages of privatizing government services. Its support stems from an effort to provide services to municipalities while reducing taxpayer expenditure. Many echo the sentiment of former New York Governor Mario Cuomo, who said, "It is not government's obligation to provide services, but to see that they're provided." Even in the area of public safety, privatization has found a "market." In many localities, privatizing Emergency Medical Services (EMS) is a popular and successful method for providing ambulance services. Privately owned ambulance services staff and respond to medical emergencies in a given community as part of the 9-1-1 emergency response system. Regulations for acceptable response times, equipment, and other essential components of EMS systems are specified by contract. This allows the municipality oversight of the service provided, but it does not provide the service directly. As will be discussed, this "contracting-out" model has many benefits. Privatizing EMS services is a decision based not only on cost-savings, but on accountability. A thorough evaluation must be utilized in the selection process. Issues of efficiency, effectiveness, quality, customer service, responsiveness, and equity must be considered by the government, in addition to cost of service. The uncertain future of health care in the United States has led those in EMS to look beyond the field's internal market to explore additional opportunities for expanding and redefining its roles beyond emergency care. It is important, however, to consider how emergency medical care, the original role of EMS, can be best delivered. Responding to emergencies is not just one of the functions involved in this field, it is the principal function from which public perception of EMS is formed, and from which support for entering other markets can

  13. Successful trans-Atlantic air ambulance transfer of a patient supported by a bi-ventricular assist device. (United States)

    McLean, Neilson; Copeland, Ryan; Casey, Neil; Samoukovic, Gordon; Quigley, Robert


    The ventricular assist device (VAD) is a hemodynamic support device that augments cardiac output for patients with severe ventricular dysfunction. With improved reliability and technological advances, the use of VADs to support patients is increasing. Many VAD-dependent patients ultimately require heart transplants that are only available in specialized centers, necessitating an interhospital transfer. To date there are few reports of long-distance fixed wing aeromedical transport of patients dependent on a VAD. Here we describe the successful transfer of a patient supported by a biventricular assist device (BiVAD) from Cambridge, UK, to Durham, NC, via fixed-wing jet aircraft. During this transfer, we observed hemodynamic alterations secondary to gravitational forces, which should be anticipated and may be mitigated with simple maneuvers. With high-level logistical planning and appropriate medical oversight, patients dependant on BiVADs can be safely transported by fixed wing aircraft over long distances.

  14. An Analysis of Factors Related to Retirement Intentions of Upper Level Civil Service Employees in the Air Force. (United States)


    Commission Proposals to Change the Civil Service Retirement System. OCG-85-31. Washington DC: US GAO, 13 February 1985. Fishbein, Martin and Ajzen , Icek ...intentions produced a weighted average correlation of .50 between intention and turnover (Steel and Ovalle, 1984). Fishbein and Ajzen (1975) state that

  15. Health Risk Assessment of Ambient Air Concentrations of Benzene, Toluene and Xylene (BTX in Service Station Environments

    Directory of Open Access Journals (Sweden)

    Benjamin Edokpolo


    Full Text Available A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted as Cumulative Probability Distributions (CPD plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ at 50% (CEXP50 and 95% (CEXP95 exposure levels. HQ50 and HQ95 > 1 were obtained with benzene in the scenario for service station attendants and mechanics repairing petrol dispensing pumps indicating a possible health risk. The risk was minimized for service stations using vapour recovery systems which greatly reduced the benzene exposure levels. HQ50 and HQ95 < 1 were obtained for all other scenarios with benzene suggesting minimal risk for most of the exposed population. However, HQ50 and HQ95 < 1 was also found with toluene and xylene for all scenarios, suggesting minimal health risk. The lifetime excess Cancer Risk (CR and Overall Risk Probability for cancer on exposure to benzene was calculated for all Scenarios and this was higher amongst service station attendants than any other scenario.

  16. 78 FR 38783 - Grant Applications; Small Community Air Service Development Program under 49 U.S.C. 41743 et seq.; (United States)


    ... results of those efforts (including marketing and promotional efforts). A strategic plan for meeting those... of a marketing plan in support of the service sought. Subsidies for a carrier to compete against an... incorporated into the grant agreement, along with the strategic plan, and define the grant agreement's...

  17. A Web Service Tool (SOAR) for the Dynamic Generation of L1 Grids of Coincident AIRS, AMSU and MODIS Satellite Sounding Radiance Data for Climate Studies (United States)

    Halem, M.; Yesha, Y.; Tilmes, C.; Chapman, D.; Goldberg, M.; Zhou, L.


    Three decades of Earth remote sensing from NASA, NOAA and DOD operational and research satellites carrying successive generations of improved atmospheric sounder instruments have resulted in petabytes of radiance data with varying spatial and spectral resolutions being stored at different data archives in various data formats by the respective agencies. This evolution of sounders and the diversities of these archived data sets have led to data processing obstacles limiting the science community from readily accessing and analyzing such long-term climate data records. We address this problem by the development of a web based Service Oriented Atmospheric Radiance (SOAR) system built on the SOA paradigm that makes it practical for the science community to dynamically access, manipulate and generate long term records of L1 pre-gridded sounding radiances of coincident multi-sensor data for regions specified according to user chosen criteria. SOAR employs a modification of the standard Client Server interactions that allows users to represent themselves directly to the Process Server through their own web browsers. The browser uses AJAX to request Javascript libraries and DHTML interfaces that define the possible client interactions and communicates the SOAP messages to the Process server allowing for dynamic web dialogs with the user to take place on the fly. The Process Server is also connected to an underlying high performance compute cluster and storage system which provides much of the data processing capabilities required to service the client requests. The compute cluster employs optical communications to NOAA and NASA for accessing the data and under the governance of the Process Server invokes algorithms for on-demand spatial, temporal, and spectral gridding. Scientists can choose from a variety of statistical averaging techniques for compositing satellite observed sounder radiances from the AIRS, AMSU or MODIS instruments to form spatial-temporal grids for

  18. Predictive Validity of the Armed Services Vocational Aptitude Battery for Several US Air Force Enlisted Training Specialties (United States)


    Military to qualify applicants for enlistment. AFQT = AR + MK + 2*VE, where AR is Arithmetic Reasoning, MK is Math Knowledge, and VE (Verbal Expression) is...previously discussed, the AFQT, a composite of the verbal and math subtests, is used by all US military services for enlistment qualification. Each...Comptroller 1289 G 57 .718 .643 .708 .704 .666 9S100 Technical Applications Specialist 245 M 88 & E 85 .726 .751 .657 .762 .743 a The

  19. Characterization of Artifacts produced by gel displacement on non-invasive Brain-Machine Interfaces during ambulation

    Directory of Open Access Journals (Sweden)

    Alvaro eCosta


    Full Text Available So far, Brain-Machine Interfaces (BMIs have been mainly used to study brain potentials during movement-free conditions. Recently, due to the emerging concern of improving rehabilitation therapies, these systems are also being used during gait experiments. Under this new condition, the evaluation of motion artifacts has become a critical point to assure the validity of the results obtained. Due to the high signal to noise ratio provided, the use of wet electrodes is a widely accepted technic to acquire electroencephalographic (EEG signals. To perform these recordings it is necessary to apply a conductive gel between the scalp and the electrodes. This work is focused on the study of gel displacements produced during ambulation and how they affect the amplitude of EEG signals. Data recorded during three ambulation conditions (gait training and one movement-free condition (BMI motor imagery task are compared to perform this study.Two phenomenons, manifested as unusual increases of the signals' amplitude, have been identified and characterized during this work. Results suggest that they are caused by abrupt changes on the conductivity between the electrode and the scalp due to gel displacement produced during ambulation and head movements. These artifacts significantly increase the Power Spectral Density (PSD of EEG recordings at all frequencies from 5 to 90 Hz, corresponding to the main bandwidth of electrocortical potentials. They should be taken into consideration before performing EEG recordings in order to asses the correct gel allocation and to avoid the use of electrodes on certain scalp areas depending on the experimental conditions.

  20. Effects of robot-assisted gait training on the balance and gait of chronic stroke patients: focus on dependent ambulators. (United States)

    Cho, Duk Youn; Park, Si-Woon; Lee, Min Jin; Park, Dae Sung; Kim, Eun Joo


    [Purpose] The purpose of this study was to confirm the effect of robot-assisted gait training on the balance and gait ability of stroke patients who were dependent ambulators. [Subjects and Methods] Twenty stroke patients participated in this study. The participants were allocated to either group 1, which received robot-assisted gait training for 4 weeks followed by conventional physical therapy for 4 weeks, or group 2, which received the same treatments in the reverse order. Robot-assisted gait training was conducted for 30 min, 3 times a week for 4 weeks. The Berg Balance Scale, Modified Functional Reach Test, Functional Ambulation Category, Modified Ashworth Scale, Fugl-Meyer Assessment, Motricity Index, and Modified Barthel Index were assessed before and after treatment. To confirm the characteristics of patients who showed a significant increase in Berg Balance Scale after robot-assisted gait training as compared with physical therapy, subgroup analysis was conducted. [Results] Only lateral reaching and the Functional Ambulation Category were significantly increased following robot-assisted gait training. Subscale analyses identified 3 patient subgroups that responded well to robot-assisted gait training: a subgroup with hemiplegia, a subgroup in which the guidance force needed to be decreased to needed to be decreased to ≤45%, and a subgroup in which weight bearing was decreased to ≤21%. [Conclusion] The present study showed that robot-assisted gait training is not only effective in improving balance and gait performance but also improves trunk balance and motor skills required by high-severity stroke patients to perform activities daily living. Moreover, subscale analyses identified subgroups that responded well to robot-assisted gait training.

  1. Indications and results of the unilateral /sup 123/I-hippurate-clearance in an ambulant urological-nephrological patients collective

    Energy Technology Data Exchange (ETDEWEB)

    Mariss, P.; Haubold, E.


    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg /sup 123/I-hippurate using a large field scintillation camera, external scintillation probe over the right shoulder and a computer system. The indications were patients with hypertension, chronic pyelonephritis, unilateral nephrocirrhosis, exclusion or approval of renal failure, furthermore diverse malformations of the urovesical system, nephrolithiasis and follow-up after urological operations. The unilateral renal clearance by /sup 123/I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods.

  2. Ambulant photodynamic therapy of superficial malignomas with 5-ALA in combination with folic acid and use of noncoherent light. (United States)

    Jindra, R H; Kubin, A; Kolbabek, H; Alth, G; Dobrowsky, W


    This study reports our first results of ambulant photodynamic treatment with 5-aminolevulinic acid (5-ALA) in combination with folic acid and subsequent illumination with a noncoherent light source. The compound was topically applied to avoid total body skin sensitivity which occurs in the case of systemic administration. If no therapeutic response could be proved, we added folic acid to 5-ALA for a further treatment attempt. Illumination was performed by broad band red thermic light to also excitate reaction products with absorption bands located near to that of the sensitizer. As a result, we observed a response in all cases, however, in some cases only after the addition of folic acid.

  3. Otimização da localização das bases de ambulâncias e do dimensionamento das suas regiões de cobertura em rodovias Optimizing the location of ambulance bases and the districting of their covering regions on highways

    Directory of Open Access Journals (Sweden)

    Ana Paula Iannoni


    Full Text Available Neste artigo combinamos extensões do modelo hipercubo de filas com algoritmos genéticos para otimizar a configuração e operação de sistemas médicos emergenciais em rodovias. Inicialmente apresentamos um método para localizar as bases de ambulâncias ao longo da rodovia, de forma a otimizar as principais medidas de desempenho do sistema. Em seguida estendemos a abordagem para apoiar duas decisões combinadas: a localização das bases de ambulâncias e o dimensionamento das regiões de cobertura de cada base na rodovia. Por exemplo, a abordagem permite determinar os locais para posicionar as bases de ambulâncias e dimensionar os tamanhos das suas áreas de atuação, tais que minimizem o tempo médio de resposta aos usuários e/ou o desbalanceamento das cargas de trabalho das ambulâncias do sistema. Para ilustrar a aplicação dos métodos propostos, analisamos os resultados de dois estudos de caso em rodovias brasileiras.In this paper we combine extensions of the hypercube queueing model with genetic algorithms to optimize the configuration and operation of emergency medical systems on highways. Initially we present a method to locate the ambulance bases along the highway so that the main system performance measures are optimized. Then we extend the approach to support combined decisions: the location of ambulance bases and the districting of the covering regions of each base on the highway. For instance, the approach can search for locals to place the ambulance bases and determine the sizes of their operation areas, such that the mean user response time and/or the ambulance workload imbalance are minimized. To illustrate the application of the proposed methods, we analyze the results of two case studies of Brazilian highways.

  4. Maximizing resource efficiency in rural prehospital emergency medical services through call frequency analysis


    Flynn, Andrew


    Rural prehospital emergency medical services are often lacking when compared with their urban counterparts in terms of resources and coordinated resource use: can only employ important resources, such as paramedics, during limited shifts. This project demonstrates a method for determining the most effective use of these limited resources in a rural Red Cross ambulance service in Guápiles, Costa Rica. In this community, paramedic services are only available six days a week for twelve hours. Em...

  5. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - a cross-sectional study

    DEFF Research Database (Denmark)

    Hansen, Claus D; Rasmussen, Kurt; Kyed, Morten


    Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance......,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self...... and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor...

  6. Minimally Invasive Posterior Stabilization Improved Ambulation and Pain Scores in Patients with Plasmacytomas and/or Metastases of the Spine

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    Joseph H. Schwab


    Full Text Available Background. The incidence of spine metastasis is expected to increase as the population ages, and so is the number of palliative spinal procedures. Minimally invasive procedures are attractive options in that they offer the theoretical advantage of less morbidity. Purpose. The purpose of our study was to evaluate whether minimally invasive posterior spinal instrumentation provided significant pain relief and improved function. Study Design. We compared pre- and postoperative pain scores as well as ambulatory status in a population of patients suffering from oncologic conditions in the spine. Patient Sample. A consecutive series of patients with spine tumors treated minimally invasively with stabilization were reviewed. Outcome Measures. Visual analog pain scale as well as pre- and postoperative ambulatory status were used as outcome measures. Methods. Twenty-four patients who underwent minimally invasive posterior spinal instrumentation for metastasis were retrospectively reviewed. Results. Seven (29% patients were unable to ambulate secondary to pain and instability prior to surgery. All patients were ambulating within 2 to 3 days after having surgery (=0.01. The mean visual analog scale value for the preoperative patients was 2.8, and the mean postoperative value was 1.0 (=0.001. Conclusion. Minimally invasive posterior spinal instrumentation significantly improved pain and ambulatory status in this series.


    Directory of Open Access Journals (Sweden)

    F. Manes


    Full Text Available The background concentrations of tropospheric ozone (O3 are increasing in both industrialized and developing countries, thus posing a concrete risk to human health, natural vegetation and crops. Several papers have reported that the total O3 flux from the atmosphere to canopy surfaces can have positive effects on air quality, and consequently to human health and wellbeing. In this work, we have estimated the role of the main natural woody vegetation classes of the CORINE Land cover Classification System in the Latium Region (Central Italy in removing O3 during the growing season of the year 2005. Cumulated O3 fluxes data allowed to estimate the externality value of this ecosystem service provided by deciduous and evergreen forests in the Latium region to be around a total value of 85025821.  In the Apennine chain Province, this value should be around 57248431 $ while  in the Tyrrhenian Borderland Province 2286567 $, 22376136 $ and 3114686 $ for deciduous and evergreen forests, respectively. This corresponds, for the growing season 2005, to a total value of 85025821 $ attributable to the ecosystem service of tropospheric O3 removal provided by the natural forests of the Latium region. Although we acknowledge the uncertainty in producing such estimate, we think our effort  as a useful first contribution addressed to the monetization of one of the ecosystem services of Italian forests at a regional level, and more in general, to open the discussion in a field that would be very useful in forest management and environmental policy-making. 

  8. Transporte de crianças em ambulâncias terrestres: segurança e conhecimentos dos profissionais

    Directory of Open Access Journals (Sweden)

    Sílvia Faria


    Full Text Available Introdução: O transporte de crianças em ambulâncias terrestres é uma problemática ainda insuficientemente investigada em todo o mundo. Neste contexto pretende-se conhecer as medidas de segurança usadas no transporte de crianças em ambulâncias terrestres e identificar o conhecimento dos profissionais acerca das medidas a adotar para este tipo de transporte. Materiais e Métodos: Estudo quantitativo, exploratório descritivo. A análise das medidas de segurança usadas no transporte de crianças tem por base as recomendações da National Highway Traffic Safety Administration. Aplicado um questionário a 135 enfermeiros e bombeiros/tripulantes de ambulâncias portuguesas baseado em 4 possíveis situações de transporte e abrangendo 5 faixas etárias pediátricas. Resultados: Os profissionais adotam uma grande variedade de medidas de segurança na prática havendo uma diferença significativa entre a forma como transportam as crianças e o modo que consideram ser o ideal. Os resultados da avaliação do transporte situam-se mais próximos dos níveis de segurança aceitáveis do que dos níveis recomendados como ideais. Verifica-se que mulheres, profissionais graduados e enfermeiros de pediatria transportam as crianças em ambulâncias com mais segurança. Discussão e Conclusões: Muitos profissionais desconhecem as possibilidades de transporte seguro para as crianças nem conhecem recomendações para este tipo de transporte. A dispersão apurada na forma como o transporte é efetuado e os resultados obtidos sugerem a necessidade de regulamentação deste transporte, de investimento na formação dos profissionais e de sensibilização das instituições de saúde para a importância do uso de sistemas de retenção para crianças durante o seu transporte. Cómo citar este artículo: Faria S, Lomba L, Carvalhais M, Apóstolo J. Transporte de crianças em ambulâncias terrestres: segurança e conhecimentos dos profissionais. Rev Cuid

  9. Caracterización de los Servicios de Atención en Violencia Familiar del área metropolitana de Buenos Aires, Argentina Analysis of Services Targeting Family Violence Against Women in Greater Metropolitan Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Roxana Cecilia Ynoub


    Full Text Available Se presentan, en este trabajo, un diagnóstico y evaluación de la disponibilidad de servicios existentes en la región metropolitana de Buenos Aires para la atención en Violencia Familiar Contra la Mujer. De ellos se describen las redes existentes y las articulaciones intersectoriales. Asimismo se evaluan su desarrollo institucional, los enfoques teóricos, las modalidades de intervención y la producción de información e investigaciones. Entre los resultados, se destaca la presencia de distintas perspectivas teóricas ­ particularmente entre quienes incluyen o no la temática de género ­, a las que corresponden distintas modalidades de intervención; y las conexiones ­ más informales que formales ­ entre distintos sectores y áreas oficiales y las organizaciones no gubernamentales. Finalmente se proponen las experiencias institucionales desarrolladas en esta tema como un modelo de nuevas modalidades en el diseño de políticas públicas y de salud.This study presents a diagnosis and evaluation of the availability of services related to family violence against women in Greater Metropolitan Buenos Aires, Argentina. The paper focuses on institutional development, theoretical foci, intervention modalities, and production of information and research. Existing networks and interprofessional relationships are also described. Results point to several noteworthy theoretical perspectives. Some programs include gender as an issue, while others do not. The relationship (more informal than formal between governmental and nongovernmental organizations is also a relevant issue. The paper concludes by proposing these institutional experiences as a model for the design of new public health policies.

  10. Facility Registry Service (FRS) (United States)

    U.S. Environmental Protection Agency — The Facility Registry Service (FRS) provides an integrated source of comprehensive (air, water, and waste) environmental information about facilities across EPA,...

  11. Walk-in ambulant lungefunktionsservice for rygere i Kobenhavn--etarsopgorelse

    DEFF Research Database (Denmark)

    Backer, V.; Bolton, S.; Ehlers, H.D.


    participants about their lung function level and all received a preventive talk about tobacco consumption. Those with signs of COPD spoke with the doctor immediately. RESULTS: A total of 1169 subjects, 59% women, with a mean (SD) age of 60 years (15), visited the walk-in services, 602 (52%) of whom visited...... the walk-in service at the clinic. Among the participants, 826 (71%) were smokers (n=452) or former smokers (n=374). The mean tobacco consumption was 32 (18) packs a year. We found that more current smokers visited the walk-in service at the clinic (45% versus 33%), whereas more ex-smokers visited the lung...... function service at the mall (38% versus 25%) (p tobacco consumption was 32 (18) packs a year, with a difference between those visiting the mall and the clinic (32 (20) versus 23 (16), p

  12. Comparative evaluation of ambulation patterns and isokinetic muscle strength for the application of rehabilitation exercise in patients with patellofemoral pain syndrome. (United States)

    Kim, Soonyoung


    [Purpose] The aim of this study was to evaluate the differences in the ambulation patterns and knee joint performance between people with and without patellofemoral pain. The present study also aimed to utilize these results as a basis for the development of pain-alleviating and performance-improving treatment programs. [Subjects and Methods] Subjects consisted of 32 adult females diagnosed with patellofemoral pain syndrome and 25 adult females without patellofemoral pain (controls). Contact ratio patterns during ambulation and isokinetic muscle strength around the knee joint were measured in both groups and then compared. [Results] Ambulation patterns, specifically the contact ratios of the left forefoot and right forefoot, differed significantly between patients with patellofemoral pain syndrome and controls. An isokinetic muscle strength test demonstrated that left and right knee extensor and flexor torques also significantly differed between these two groups. [Conclusion] Basic analysis based on ambulation patterns and muscle strength can be used to indicate functional recovery from patellofemoral pain syndrome and provide insight into improving the rehabilitation of patients.

  13. Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology. (United States)

    Takeuchi, Ryohei; Harada, Hiroshi; Masuda, Kohji; Ota, Gen-ichiro; Yokoi, Masaki; Teramura, Nobuyasu; Saito, Tomoyuki


    We report the testing of a mobile Robotic Tele-echo system that was placed in an ambulance and successfully transmitted clear real time echo imaging of a patient's abdomen to the destination hospital from where this device was being remotely operated. Two-way communication between the paramedics in this vehicle and a doctor standing by at the hospital was undertaken. The robot was equipped with an ultrasound probe which was remotely controlled by the clinician at the hospital and ultrasound images of the patient were transmitted wirelessly. The quality of the ultrasound images that were transmitted over the public mobile telephone networks and those transmitted over the Multimedia Wireless Access Network (a private networks) were compared. The transmission rate over the public networks and the private networks was approximately 256 Kbps, 3 Mbps respectively. Our results indicate that ultrasound images of far higher definition could be obtained through the private networks.

  14. A atividade de trabalho de motoristas de ambulância sob o ponto de vista ergológico

    Directory of Open Access Journals (Sweden)

    Francinaldo do Monte Pinto

    Full Text Available Objetivo: analisar a atividade dos motoristas de ambulância do Serviço Móvel de Urgência (SAMU. Métodos: foi empregada a perspectiva ergológica, que se opera a partir da concepção de vida-saúde-doença postulada por George Canguilhem, e a Ergonomia da Atividade. Foram realizadas onze entrevistas dialógicas com motoristas da Unidade de Terapia Intensiva Móvel, em 2010, no estado da Paraíba. Resultados: os motoristas atribuem as principais dificuldades para realizar o trabalho ao modo de organização prescrita do trabalho no SAMU, à gestão temporal da atividade, à atividade no trânsito, à relação com a população usuária e ao risco de contrair doenças. Em contraposição, os motoristas adquirem sentido no trabalho ao salvarem vidas, em uma conjunção de valores – solidariedade, confiança e cooperação – em relação aos socorridos e aos seus acompanhantes. Quando essa possibilidade não se concretiza, o coletivo de trabalho serve de apoio para que permaneçam na profissão, apesar das frustrações. Conclusão: evidenciou-se que, mesmo diante das variabilidades cotidianas da atividade de trabalho, os motoristas de ambulâncias produzem modos operatórios para dar conta das situações de trabalho, cooperando para solução dos problemas e/ou manejando as imprevisibilidades no trabalho em equipe.

  15. Mechanical CPR devices compared to manual CPR during out-of-hospital cardiac arrest and ambulance transport: a systematic review

    Directory of Open Access Journals (Sweden)

    Ong Marcus


    Full Text Available Abstract Aims The aim of this paper was to conduct a systematic review of the published literature to address the question: “In pre-hospital adult cardiac arrest (asystole, pulseless electrical activity, pulseless Ventricular Tachycardia and Ventricular Fibrillation, does the use of mechanical Cardio-Pulmonary Resuscitation (CPR devices compared to manual CPR during Out-of-Hospital Cardiac Arrest and ambulance transport, improve outcomes (e.g. Quality of CPR, Return Of Spontaneous Circulation, Survival”. Methods Databases including PubMed, Cochrane Library (including Cochrane database for systematic reviews and Cochrane Central Register of Controlled Trials, Embase, and AHA EndNote Master Library were systematically searched. Further references were gathered from cross-references from articles and reviews as well as forward search using SCOPUS and Google scholar. The inclusion criteria for this review included manikin and human studies of adult cardiac arrest and anti-arrhythmic agents, peer-review. Excluded were review articles, case series and case reports. Results Out of 88 articles identified, only 10 studies met the inclusion criteria for further review. Of these 10 articles, 1 was Level of Evidence (LOE 1, 4 LOE 2, 3 LOE 3, 0 LOE 4, 2 LOE 5. 4 studies evaluated the quality of CPR in terms of compression adequacy while the remaining six studies evaluated on clinical outcomes in terms of return of spontaneous circulation (ROSC, survival to hospital admission, survival to discharge and Cerebral Performance Categories (CPC. 7 studies were supporting the clinical question, 1 neutral and 2 opposing. Conclusion In this review, we found insufficient evidence to support or refute the use of mechanical CPR devices in settings of out-of-hospital cardiac arrest and during ambulance transport. While there is some low quality evidence suggesting that mechanical CPR can improve consistency and reduce interruptions in chest compressions, there is no

  16. Upper limb strength and function changes during a one-year follow-up in non-ambulant patients with Duchenne Muscular Dystrophy: an observational multicenter trial.

    Directory of Open Access Journals (Sweden)

    Andreea Mihaela Seferian

    Full Text Available INTRODUCTION: Upper limb evaluation of patients with Duchenne Muscular Dystrophy is crucially important to evaluations of efficacy of new treatments in non-ambulant patients. In patients who have lost ambulation, there are few validated and informative outcome measures. In addition, longitudinal data demonstrating sensitivity to clinical evolution of outcome measures over short-term periods are lacking. PATIENTS AND METHODS: We report here the results of a one-year multicenter study using specifically designed tools to assess grip, pinch strength, and hand function in wheelchair-bound patients. Our study assessed 53 non-ambulant patients with Duchenne muscular dystrophy aged 17.1 ± 4.8 years (range: 9 - 28.1 years. The average Brooke functional score of these patients was 4.6 ± 1.1. The average forced vital capacity was 44.5% predicted and 19 patients used non-invasive ventilation. Patients were assessed at baseline, 6 months, and one year using the Motor Function Measure and innovative devices (namely the MyoSet composed of MyoGrip, MyoPinch, and MoviPlate. RESULTS: Our study confirmed preliminary data previously reported regarding feasibility of use and of reliability of the MyoSet and the correlation at baseline between distal strength and clinical outcomes such as FVC, Brooke score, age, and duration since loss of ambulation. A significant correlation was observed between the distal upper limb strength and clinical variables. The sensitive dynamometers (MyoGrip and MyoPinch and MoviPlate captured a 12-month change in non-ambulant Duchenne muscular dystrophy patients of all ages. TRIAL REGISTRATION: NCT00993161 NCT00993161.

  17. CHIS – Services available during CERN’s end-of-year closure

    CERN Multimedia

    HR Department


    The UNIQA Helpdesk at CERN, which has been temporarily relocated to Building 510, will be closed during CERN's end-of-year closure (20 December 2014 to 4 January 2015).     During this period, UNIQA’s Head Office in Geneva will be open from 8 a.m. to 5 p.m. on 23, 24 (until 4 p.m.), 26, 27 and 30 December 2014 and on 2 and 3 January 2015. The UNIQA Helpdesk at CERN will open again on 5 January 2015 and its opening hours have been extended: Monday to Friday: from 9 a.m. to 1 p.m., and Tuesday and Thursday: from 2 p.m. to 4 p.m. During the end-of-year closure, the following services are also at your disposal: Until the end of 2014: the telephone numbers printed on your old insurance card: +41 (0)22 718 63 00 for UNIQA’s Head Office, available during office hours only (see above), +43 512 224 22 for Tyrolean Air Ambulance - urgent medical assistance 24/7.   From January 2015: the numbers printed on your new insura...

  18. Salud/Servicios Personales. Libro del Profesor. (Health/Personal Services. Teacher's Guide). B2. CHOICE (Challenging Options in Career Education). (United States)

    Mid-Hudson Migrant Education Center, New Paltz, NY.

    Written in Spanish, the guide comprises the first grade unit of a career education curriculum developed for migrant students. The guide covers 12 health and personal service occupations--blacksmith, television repairer, hairdresser/barber, day care worker, waitress, gas station attendant, family doctor, ambulance driver/attendant, dietician,…

  19. Chasing the ambulance. The emerging crisis in the preservation of modern health records. (United States)

    Higgs, E; Melling, J


    In this brief essay we argue that the best efforts of archivists, scholars, and practitioners within the National Health Service have not prevented the wholesale destruction of the bulk of patient records created during the twentieth century. This is a matter of vital concern not merely for historians of modern medicine. Important clinical work has frequently been undertaken on materials which have survived, usually by chance or by the foresight of physicians, matrons, and administrators. Even the significant fragments of historical documents which remain in the hands of the health authorities have been threatened by the continuing drive to reduce storage and maintenance costs within hospitals. Archivists and academics have struggled to address the problems of sampling, storage, and access which the enormous bulk of modern records present. In this essay we suggest that the first step must be to raise awareness amongst professionals and the public of the extent to which any future history of the medical services and of patient care will depend on a reasonable rate of survival of these records. The second step must be to confront the problem of resources and the inevitable task of selection which must form the foundations of any long-term policy of preservation. An initial survey of archival materials in Devon indicates that the records of community health care form a substantial and potentially invaluable research source for future historians, though their relevance has rarely been recognized within the academic community.

  20. A Case of Blunt Traumatic Cardiac Tamponade Successfully Treated by Out-of-hospital Pericardial Drainage in a "Doctor-helicopter" Ambulance Staffed by Skilled Emergency Physicians. (United States)

    Otsuka, Hiroyuki; Sato, Toshiki; Morita, Seiji; Nakagawa, Yoshihide; Inokuchi, Sadaki


    We report a 55-year-old man who relapsed into a state of shock in an ambulance before arriving at our critical care center after a fall injury. The diagnosis of cardiac tamponade was made by portable ultrasound, and immediate pericardiocentesis and drainage were performed at the heliport. He was then transported immediately to our hospital with continuous drainage and surgery was performed. After surgery, the patient was transferred to the intensive care unit in stable condition. After undergoing rehabilitation, he made a full recovery and was discharged. This case illustrates that such patients can be treated reliably by pericardial drainage performed by skilled emergency physicians in the field by making use of the "doctor-helicopter" ambulance transportation system, followed by emergency surgery in a critical care center.

  1. Relations of compassion fatigue to occupational stress and job burnout in ambulance nurses%院前急救护士共情疲劳与职业应激、职业倦怠关系研究

    Institute of Scientific and Technical Information of China (English)

    魏华; 黄敬堂; 申培红


    Objective To explore the relationship of compassion fatigue and occupational stress and job burnout in ambulance nurses.Methods By stratified cluster random sampling method, a total of 380 ambulance nurses from 5 cities in Henan Province were selected as objects, and 261 emergency nurses from the same hospital were selected as control.A assessment survey was performed using the Chinese version of Professional Quality of Life, the Maslach Burnout Inventory ( MBI) , and the Chinese Nursing Stressor Scale ( NSS) which included the stressor related to working expectation ( factor 1), the stressor related to family (factor 2), the stressor related to interpersonal relationships (factor 3), the stressor related to job specification (factor 4), related to patients (factor 5), and to the working load (factor 6).Results The ambulance nurses had higher compassion fatigue scores than the emergency nurses ( P <0.01 ) .One-way analysis of variance showed that the ambulance nurses with length of service less than 3.0 years had higher compassion fatigue scores than those with 3.0 or more years and those with over 10.0 years of service length ( P<0.05 ) .The compassion fatigue scores of general nurses were higher than those professional titled as senior nurses and nurse supervisors or above ( P<0.05).The correlation analysis showed that the compassion fatigue scores of ambulance nurse were positively correlated with the factor 2, 3, 4, 5 and 6 of NSS scores and MBI scores [the correlation coefficients (r) were 0.15, 0.28, 0.25, 0.34, 0.32 and 0.36, P<0.05].The MBI scores were positively correlated with all the 6 factors of NSS (r were 0.31, 0.25, 0.36, 0.32, 0.37 and 0.31, respectively, P<0.05).The multiple linear regression analysis results showed that the regression correlations among MBI score, NSS factor 5 score, interaction effect of MBI and NSS factor 5 and the compassion fatigue score were confirmed (the standardized partial regression coefficient were 0.39, 0.24 and 0

  2. A validation of ground ambulance pre-hospital times modeled using geographic information systems

    Directory of Open Access Journals (Sweden)

    Patel Alka B


    Full Text Available Abstract Background Evaluating geographic access to health services often requires determining the patient travel time to a specified service. For urgent care, many research studies have modeled patient pre-hospital time by ground emergency medical services (EMS using geographic information systems (GIS. The purpose of this study was to determine if the modeling assumptions proposed through prior United States (US studies are valid in a non-US context, and to use the resulting information to provide revised recommendations for modeling travel time using GIS in the absence of actual EMS trip data. Methods The study sample contained all emergency adult patient trips within the Calgary area for 2006. Each record included four components of pre-hospital time (activation, response, on-scene and transport interval. The actual activation and on-scene intervals were compared with those used in published models. The transport interval was calculated within GIS using the Network Analyst extension of Esri ArcGIS 10.0 and the response interval was derived using previously established methods. These GIS derived transport and response intervals were compared with the actual times using descriptive methods. We used the information acquired through the analysis of the EMS trip data to create an updated model that could be used to estimate travel time in the absence of actual EMS trip records. Results There were 29,765 complete EMS records for scene locations inside the city and 529 outside. The actual median on-scene intervals were longer than the average previously reported by 7–8 minutes. Actual EMS pre-hospital times across our study area were significantly higher than the estimated times modeled using GIS and the original travel time assumptions. Our updated model, although still underestimating the total pre-hospital time, more accurately represents the true pre-hospital time in our study area. Conclusions The widespread use of generalized EMS pre

  3. Quality Control Circle of Standard Management of Ambulance%提高抢救车规范管理达标率的品管圈实践

    Institute of Scientific and Technical Information of China (English)

    刘晓梅; 张国梅; 邵继凤; 张玉莲; 刘红梅


    Objective To explore the practice and effect of quality control circle (QCC) in the standard management of ambulance. Methods A QCC team was established then improvement measures were formulated after the analysis of the reasons for non-standard management of ambulances then the effect of 6-month practice was assessed. Results The rate of standard management of ambulance was improved from 49% to 79% after QCC practice and memebers in QCC team regarded that the practice benefited the improvement of management awareness and working ability. Conclusion QCC practice benefits the management of ambulances and the improvement of QCC team members ’ ability, which promotes nursing management and nursing quality.%目的:探讨品管圈活动在抢救车规范管理中的实践和效果。方法成立品管圈小组,应用品管圈活动步骤,对全院57辆抢救车管理不规范原因进行分析,制定改进措施,规范抢救车管理,实施6个月后评价效果。结果实施品管圈活动后,抢救车规范管理达标率由活动前的49%提高到活动后的79%,圈员认为本次品管圈活动提升了参与管理的意识和工作能力。结论开展品管圈活动规范了全院抢救车的管理,提高了圈员能力,对提高精细化管理水平、提升护理质量起到了积极推动的作用。

  4. Skylab IMSS checklist application study for emergency medical care. [emergency medical care operations involving the use and operation of the portable ambulance module (United States)

    Carl, J. G.; Furukawa, S.


    A manual is presented that provides basic technical documentation to support the operation and utilization of the Portable Ambulance Module (PAM) in the field. The PAM is designed to be used for emergency resuscitation and victim monitoring. The functions of all the controls, displays, and stowed equipment of the unit are defined. Supportive medical and physiological data in those areas directly related to the uses of the PAM unit are presented.

  5. 22 CFR 228.22 - Air transportation. (United States)


    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Air transportation. 228.22 Section 228.22... for USAID Financing § 228.22 Air transportation. (a) The eligibility of air transportation is... U.S. flag air carriers for all international air travel and transportation, unless such service...

  6. Posicionamento de ambulâncias do SAMU através de Programação Inteira e Teoria de Filas

    Directory of Open Access Journals (Sweden)

    Bruno Barreto

    Full Text Available Resumo: A configuração de redes logísticas para serviços de emergência é questão estratégica de imensa importância, visto que pequenas variações no tempo de resposta podem implicar na morte do solicitante. Partindo dessa premissa, o trabalho propõe novas alternativas de posicionamento para as ambulâncias do sistema SAMU na cidade de Duque de Caxias, RJ, capazes de reduzir o tempo de resposta do serviço. Essas propostas de reposicionamento das ambulâncias foram construídas em duas etapas: na primeira, dois modelos de Programação Inteira foram aplicados para se obter soluções que provejam maior cobertura à população. Posteriormente, o Modelo do Hipercubo foi empregado para avaliar a disponibilidade dos servidores, dentre outros indicadores de desempenho relevantes, como o tempo médio de resposta e a taxa de ocupação das ambulâncias.

  7. Pilot Field Test: The Ability to Ambulate After Landing as Assessed with Seat Egress, Walk, and Obstacle Test (United States)

    Fisher, E. A.; Fomina, E. V.; Reschke, M. F.; Cerisano, J. M.; Kofman, I. S.; Gadd, N. E.; Phillips, T. R.; Lee, S. M. C.; Laurie, S. S.; Stenger, M. B.; Bloomberg, J. J.; Mulavara, A. P.; Kozlovskaya, I. B.; Tomilovskaya, E. S.


    Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity conditions of space flight. These changes lead to disruption in the ability to ambulate and perform functional tasks during the initial reintroduction to a gravitational environment. Figure 1 shows a schematic representation of the components involved in postflight ataxia. Full functional recovery has not been sufficiently investigated for long-duration crewmembers. The joint U.S./Russian Pilot Field Test (PFT) experiment (a pre-cursor to Field Test (FT)) was developed to address this gap in knowledge. The PFT was conducted on crewmembers traveling on Soyuz expeditions 34S - 41S and was comprised of several tasks designed to study the recovery of sensorimotor abilities of crewmembers during the first 24 hours after landing and for several days thereafter. Closing this gap will allow us to characterize the ability of crewmembers to perform critical mission tasks that they will be expected to perform after an unassisted landing following 6 to 12 months in microgravity. The Seat Egress, Walk and Obstacle (SEWO) Test will be discussed in this poster.

  8. Advanced glycation end-products in the peritoneal fluid and in the peritoneal membrane of continuous ambulant peritoneal dialysis patients. (United States)

    Mahiout, A; Ehlerding, G; Brunkhorst, R


    In patients on continuous ambulant peritoneal dialysis (CAPD) treatment, the peritoneal membrane is continuously exposed to the high glucose concentration contained in the dialysate. This may lead to the local generation of advanced glycation end-products (AGEs). To test this hypothesis we evaluated the plasma and dialysate AGE concentrations in five CAPD patients. The dialysate was measured after a 1 h and after a 12 h dwell time. Additionally, in two patients an immunohistochemical investigation of the peritoneal membrane for AGE was performed. For the determination of AGE an ELISA using a polyclonal antibody against AGE bovine serum albumin was used; the immunohistochemical staining was performed using the streptavidin-biotin complex method. We found only low concentrations of AGE in the dialysate after a 1 h dwell time; after 12 h, however, the dialysate AGE was even greater than the plasma concentration. In both peritoneal specimens we found positive staining for AGE in the interstitium of the mesothelial layer. The dialysate AGE contained a high proportion of high-molecular-weight AGE proteins and low-molecular-weight AGE was found to be in the same concentration range as the total serum AGE. We conclude that there is local generation of AGE in the peritoneal membrane and a 'washing out' of AGE from the peritoneal membrane during longer dwell times. We speculate that the accumulation of AGE might lead to some of the functional and morphological alterations observed after long-term CAPD.

  9. An art therapy intervention for cancer patients in the ambulant aftercare - results from a non-randomised controlled study. (United States)

    Geue, K; Richter, R; Buttstädt, M; Brähler, E; Singer, S


    Art therapy in psycho-oncology is gaining increasing importance, but systematic evaluations of its effects are rare. The aim of this study is to investigate the effects of an art therapy intervention for cancer patients in ambulant aftercare on psychological distress and coping. The intervention consisted of 22 sessions. At three points of measurement (t1: before intervention, t2: following intervention, t3: 6 months after t2), participants responded to questionnaires (Freiburg Questionnaire on Coping with Illness, Perceived Adjustment to Chronic Illness Scale, Hospital Anxiety and Depression Scale). A group of haemato-oncological patients served as the comparison group (CG). Pre-post comparisons and analyses of variance were applied for statistical analysis. Relevant confounders were controlled. Fifty-four patients (intervention group, IG) with various cancer diagnoses completed the intervention. One hundred and twenty-nine data sets were available for the CG. Analyses of variance included group membership (IG vs. CG) and the following factors: gender, other psychosocial help and major life events. None of these variables was a predictor for changes in depression, anxiety and coping. Therefore, we could not prove intervention effects over time. Our results contradict those of preliminary studies and raise important questions. Further work on evaluating art therapy is necessary to explore which intervention concepts in which setting at which treatment stage show significant effects. Therefore, controlling for relevant confounders is needed.

  10. Prehospital emergency medical services in Malaysia. (United States)

    Hisamuddin, N A R Nik; Hamzah, M Shah; Holliman, C James


    Once a very slowly developing country in a Southeast Asia region, Malaysia has undergone considerable change over the last 20 years after the government changed its focus from agriculture to developing more industry and technology. The well-known "Vision 2020," introduced by the late Prime Minister, set a target for the nation to be a developed country in the Asia region by the year 2020. As the economy and standard of living have improved, the demand from the public for a better health care system, in particular, emergency medical services (EMS), has increased. Despite the effort by the government to improve the health care system in Malaysia, EMS within the country are currently limited, best described as being in the "developing" phase. The Ministry of Health, Ministry of Education, Civil Defense, and non-governmental organizations such as Red Crescent and St. John's Ambulance, provide the current ambulance services. At the present time, there are no uniform medical control or treatment protocols, communication systems, system management, training or education, or quality assurance policies. However, the recent development of and interest in an Emergency Medicine training program has gradually led to improved EMS and prehospital care.

  11. A Conceptual Model of the Severe-Storm Environment for Inclusion into Air Weather Service Severe-Storm Analysis and Forecast Procedures. (United States)


    instability of the air beneath the lid isa increased both through advection of moist air from the Gulf of Mexico and through surface evaporation over...T67 mb * TC • 35C (95"F1) II 101 2~~C -67 mb.:. = Figure C2. Skew T-Log P Sounding for Topeka, Kansas, at 1200 GMT 3 April 1981. CCL and Tc analyses

  12. 中央空调压缩机驱动电机绕组重绕时的维修工艺%The Central Air-conditioning Compressor Actuates Time Electric Motor Winding Reroll Service Craft

    Institute of Scientific and Technical Information of China (English)



    中央空调用压缩机电机,工作条件十分恶劣。在电机大修更换绕组后,由于维修工艺达不到要求,运行时间极短即烧毁,导致维修失败的例子很多。可以说维修工艺水平,是空调压缩机电机更换绕组成功的关键,必须予以极大的注意。%The central air conditioning uses the compressor electrical machinery overhaul replacement winding, because the electrical machinery, the working condition to be very bad. After service craft cannot meet the requirements, the running time is short is the over burning extremely, causes the service defeat's example to be many. May say that the service technological level, is the air-conditioning compressor electrical machinery replacement winding successful key, must in by the enormous attention.

  13. Establishing a successful pre-hospital emergency service in a developing country: experience from Rescue 1122 service in Pakistan. (United States)

    Waseem, Hunniya; Naseer, Rizwan; Razzak, Junaid Abdul


    As in many other developing countries, emergency medical services, especially pre-hospital emergency care, has long been neglected in Pakistan. Consequently, patients are brought to the emergency departments by relatives or bystanders in private cars, taxis or any other readily available mode of transportation. Ambulances, where they exist, have barely a stretcher and arrangements for oxygen supply. Modern emergency services are considered too costly for many countries. A model of pre-hospital emergency services, called Rescue 1122 and established in Punjab province of Pakistan, is presented. The system is supported by government funding and provides a quality service. The article describes the process of establishment of the service, the organisational structure, the scope of services and the role it is currently playing in the healthcare of the region it serves.

  14. Services Supply Chain in the Department of Defense: A Comparison of Acquisition Management Practices in the Army, Navy, and Air Force (United States)


    k^s^i=mlpqdo^ar^qb=p`elli= models; and Schiele and McCue (2006) studied the acquisition of consulting services in the public sector. Although these...Aeronautics and Astronautics. Schiele , J. J., & McCue, C. P. (2006). Professional service acquisition in public sector procurement. International

  15. Air Pollution (United States)

    Air pollution is a mixture of solid particles and gases in the air. Car emissions, chemicals from factories, dust, ... a gas, is a major part of air pollution in cities. When ozone forms air pollution, it's ...

  16. A cross-sectional study of Victorian mobile intensive care ambulance paramedics knowledge of the Valsalva manoeuvre

    Directory of Open Access Journals (Sweden)

    Boyle Malcolm J


    Full Text Available Abstract Background The Valsalva Manoeuvre (VM is a primary measure for terminating haemodynamically stable supraventricular tachycardia (SVT in the emergency care setting. The clinical use and termination success of the VM in the prehospital setting has not been investigated to date. The objective of this study was to determine Melbourne Mobile Intensive Care Ambulance (MICA Paramedic knowledge of the VM, and to compare this understanding with an evidence-based model of VM performance. Methods A cross-sectional study in the form of a face-to-face interview was used to determine Melbourne MICA Paramedic understanding of VM instruction between January and February, 2008. The results were then compared with an evidence-based model of VM performance to ascertain compliance with the three criteria of position, pressure and duration. Ethics approval was granted. Results There were 28 participants (60.9% who elected a form of supine posturing, some 23 participants (50% selected the syringe method of pressure generation, with 16 participants (34.8% selecting the "as long as you can" option for duration. On comparison, one out of 46 MICA Paramedics correctly identified the three evidence-based criteria. Conclusions The formal education of Melbourne's MICA Paramedics would benefit from the introduction of an evidence based model of VM performance, which would impact positively on patient care and may improve reversion success in the prehospital setting. The results of this study also demonstrate that an opportunity exists to promote the evidence-based VM criteria across the primary emergency care field.

  17. Development of an implanted intramuscular EMG-triggered FES system for ambulation after incomplete spinal cord injury. (United States)

    Dutta, Anirban; Kobetic, Rudi; Triolo, Ronald


    Ambulation after spinal cord injury is possible with the aid of neuroprosthesis employing functional electrical stimulation (FES). Individuals with incomplete spinal cord injury (iSCI) retain partial volitional control of muscles below the level of injury, necessitating careful integration of FES with intact voluntary motor function for efficient walking. In this study, the intramuscular electromyogram (iEMG) was used to detect the intent to step and trigger FES-assisted walking in a volunteer with iSCI via an implanted neuroprosthesis consisting of two channels of bipolar iEMG signal acquisition and 12 independent channels of stimulation. The detection was performed with two types of classifiers- a threshold-based classifier that compared the running mean of the iEMG with a discrimination threshold to generate the trigger and a pattern recognition classifier that compared the time-history of the iEMG with a specified template of activity to generate the trigger whenever the cross-correlation coefficient exceeded a discrimination threshold. The pattern recognition classifier generally outperformed the threshold-based classifier, particularly with respect to minimizing False Positive triggers. The overall True Positive rates for the threshold-based classifier were 61.6% and 87.2% for the right and left steps with overall False Positive rates of 38.4% and 33.3%. The overall True Positive rates for the left and right step with the pattern recognition classifier were 57.2% and 93.3% and the overall False Positive rates were 11.9% and 24.4%. The subject showed no preference for either the threshold or pattern recognition-based classifier as determined by the Usability Rating Scale (URS) score collected after each trial and both the classifiers were perceived as moderately easy to use.

  18. Contrôle de qualité des produits radio-pharmaceutiques utilisés au Service de medecine nucléaire au CHU de Tlemcen


    BENHADA, Henene; RACHEDI, Chafiqa


    Les médicaments radio-pharmaceutiques constituent l'un des outils essentiels des services de Médecine Nucléaire. Ces médicaments sont principalement réservés au diagnostic (95% des applications) mais également à la thérapie (< 5%). De par leur spécificité (administration unique lors d'une exploration fonctionnelle ; durée de vie du médicament courte, du fait du principe même de la radioactivité), les radiopharmaceutiques posent des problèmes quant à la réalisation des tests req...

  19. Emergency medical services in India: the present and future. (United States)

    Sharma, Mohit; Brandler, Ethan S


    India is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.

  20. A Movement Monitor Based on Magneto-Inertial Sensors for Non-Ambulant Patients with Duchenne Muscular Dystrophy: A Pilot Study in Controlled Environment.

    Directory of Open Access Journals (Sweden)

    Anne-Gaëlle Le Moing

    Full Text Available Measurement of muscle strength and activity of upper limbs of non-ambulant patients with neuromuscular diseases is a major challenge. ActiMyo® is an innovative device that uses magneto-inertial sensors to record angular velocities and linear accelerations that can be used over long periods of time in the home environment. The device was designed to insure long-term stability and good signal to noise ratio, even for very weak movements. In order to determine relevant and pertinent clinical variables with potential for use as outcome measures in clinical trials or to guide therapy decisions, we performed a pilot study in non-ambulant neuromuscular patients. We report here data from seven Duchenne Muscular Dystrophy (DMD patients (mean age 18.5 ± 5.5 years collected in a clinical setting. Patients were assessed while wearing the device during performance of validated tasks (MoviPlate, Box and Block test and Minnesota test and tasks mimicking daily living. The ActiMyo® sensors were placed on the wrists during all the tests. Software designed for use with the device computed several variables to qualify and quantify muscular activity in the non-ambulant subjects. Four variables representative of upper limb activity were studied: the rotation rate, the ratio of the vertical component in the overall acceleration, the hand elevation rate, and an estimate of the power of the upper limb. The correlations between clinical data and physical activity and the ActiMyo® movement parameters were analyzed. The mean of the rotation rate and mean of the elevation rate appeared promising since these variables had the best reliability scores and correlations with task scores. Parameters could be computed even in a patient with a Brooke functional score of 6. The variables chosen are good candidates as potential outcome measures in non-ambulant patients with Duchenne Muscular Dystrophy and use of the ActiMyo® is currently being explored in home environment

  1. Efficiency of the prehospital cardiopulmonary resuscitation of 785 patients treaded by the team of the Berlin-Friedrichshain-ambulance between 1995 and 1998



    Between 1995 and 1998 the Berlin-Friedrichshain-Ambulance (BFA) started 785 cardiopulmonary resuscitations (CPR) (96,2 % adults). Registered are 498 (66,0 %) male and 257 (34,0 %) female persons at the age between 18 and 94 years (ys) (63,7 ± 16,7 ys). In 40,7 % the CPR has been initial successful. 37 patients have been discharged from the hospital. That means only 4,9 % of all registered adults (n = 755) have been discharged, it also means that 12,1 % of the initial successful treated...

  2. Physician presence in an ambulance car is associated with increased survival in out-of-hospital cardiac arrest: a prospective cohort analysis.

    Directory of Open Access Journals (Sweden)

    Akihito Hagihara

    Full Text Available The presence of a physician seems to be beneficial for pre-hospital cardiopulmonary resuscitation (CPR of patients with out-of-hospital cardiac arrest. However, the effectiveness of a physician's presence during CPR before hospital arrival has not been established. We conducted a prospective, non-randomized, observational study using national data from out-of-hospital cardiac arrests between 2005 and 2010 in Japan. We performed a propensity analysis and examined the association between a physician's presence during an ambulance car ride and short- and long-term survival from out-of-hospital cardiac arrest. Specifically, a full non-parsimonious logistic regression model was fitted with the physician presence in the ambulance as the dependent variable; the independent variables included all study variables except for endpoint variables plus dummy variables for the 47 prefectures in Japan (i.e., 46 variables. In total, 619,928 out-of-hospital cardiac arrest cases that met the inclusion criteria were analyzed. Among propensity-matched patients, a positive association was observed between a physician's presence during an ambulance car ride and return of spontaneous circulation (ROSC before hospital arrival, 1-month survival, and 1-month survival with minimal neurological or physical impairment (ROSC: OR = 1.84, 95% CI 1.63-2.07, p = 0.00 in adjusted for propensity and all covariates; 1-month survival: OR = 1.29, 95% CI 1.04-1.61, p = 0.02 in adjusted for propensity and all covariates; cerebral performance category (1 or 2: OR = 1.54, 95% CI 1.03-2.29, p = 0.04 in adjusted for propensity and all covariates; and overall performance category (1 or 2: OR = 1.50, 95% CI 1.01-2.24, p = 0.05 in adjusted for propensity and all covariates. A prospective observational study using national data from out-of-hospital cardiac arrests shows that a physician's presence during an ambulance car ride was independently associated with

  3. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Freeman Jennifer


    Full Text Available Abstract Background People with Multiple Sclerosis (MS frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect. This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training 2 Comparing core stability training with standardised physiotherapy exercise 3 Exploring underlying mechanisms of change associated with this intervention Methods This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control. All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12, the Functional Reach (forwards and lateral, a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC Scale. In addition, ultrasound imaging of the

  4. Veterans Medical Care: FY2010 Appropriations (United States)


    medical services such as: medical, surgical, and mental health care, including care for substance abuse; prescription drugs, including over-the- payments to eligible veterans were paid when specialized modes of transportation, such as ambulance or wheelchair van, were medically required...reimbursement who are traveling by special modes of transportation such as ambulance, air ambulance, wheelchair van, or to receive a compensation and pension

  5. The Groningen Ambulance Study

    NARCIS (Netherlands)

    Svilaas, T; Dijk, WA; Busman, JP; Dassen, WRM; de Vos, R; Zijlstra, F


    This paper describes the effects of a treatment protocol for patients with ST elevation myocardial infarction, which was introduced in 2004. The setup of the new approach is described. The principle goal is to minimize time between onset of symptoms associated with acute myocardial infarction and re

  6. 特种氯丁橡胶在热空气及热海水中的老化与使用寿命预测%Aging in Sea Water and in Hot Air and Service Life Prediction of Neoprene

    Institute of Scientific and Technical Information of China (English)

    余超; 文庆珍; 朱金华; 余红伟; 王小军


    The heat air-oven method and heat seawater method were designed and the accelerated aging tests of the neoprene were carried in laboratory. The mechanical property of elongation at break of the neoprene in aging time was investigated systemically. The rule of elongation at break and aging time was studied. The service life prediction functions of the neoprene were established and service life at 25 ℃ was estimated basing on the index of elongation at break. The result shows that elongation at break of the neoprene decreases in exponential form with aging time, and the service life of the neoprene at 25 ℃ when used in sea water is 31.29 years and when used in air is 40.02 years.%文中进行了特种氯丁橡胶在空气及海水中的实验室加速老化实验,研究了特种氯丁橡胶在不同温度和不同介质中老化的断裂伸长率随老化时间的变化规律,得到了该橡胶的断裂伸长率与老化时间之间的数学关系式,并通过计算预测了该橡胶的使用寿命.研究结果表明,在不同温度、不同介质中老化时,该橡胶的断裂伸长率随老化时间呈指数下降,预测得25℃该氯丁橡胶在海水及空气中的使用寿命分别为31.29年、40.02年.

  7. Services Supply Chain in the Department of Defense: Comparison and Analysis of Acquisition Management in the Army, Navy, and Air Force (United States)


    product-based manufacturing models; and Schiele and McCue (2006) studied the acquisition of consulting services in public sector. Although these and...2008). Management of defense acquisition projects. Reston, VA: American Institute of Aeronautics and Astronautics. Schiele , J.J., & McCue, C.P

  8. Air/Water Purification (United States)


    After 18 years of research into air/water pollution at Stennis Space Center, Dr. B. C. Wolverton formed his own company, Wolverton Environmental Services, Inc., to provide technology and consultation in air and water treatment. Common houseplants are used to absorb potentially harmful materials from bathrooms and kitchens. The plants are fertilized, air is purified, and wastewater is converted to clean water. More than 100 U.S. communities have adopted Wolverton's earlier water hyacinth and artificial marsh applications. Catfish farmers are currently evaluating the artificial marsh technology as a purification system.

  9. A seamless ubiquitous emergency medical service for crisis situations. (United States)

    Lin, Bor-Shing


    In crisis situations, a seamless ubiquitous communication is necessary to provide emergency medical service to save people's lives. An excellent prehospital emergency medicine provides immediate medical care to increase the survival rate of patients. On their way to the hospital, ambulance personnel must transmit real-time and uninterrupted patient information to the hospital to apprise the physician of the situation and provide options to the ambulance personnel. In emergency and crisis situations, many communication channels can be unserviceable because of damage to equipment or loss of power. Thus, data transmission over wireless communication to achieve uninterrupted network services is a major obstacle. This study proposes a mobile middleware for cognitive radio (CR) for improving the wireless communication link. CRs can sense their operating environment and optimize the spectrum usage so that the mobile middleware can integrate the existing wireless communication systems with a seamless communication service in heterogeneous network environments. Eventually, the proposed seamless mobile communication middleware was ported into an embedded system, which is compatible with the actual network environment without the need for changing the original system architecture.

  10. An Agent-Based Model for Analyzing Control Policies and the Dynamic Service-Time Performance of a Capacity-Constrained Air Traffic Management Facility (United States)

    Conway, Sheila R.


    Simple agent-based models may be useful for investigating air traffic control strategies as a precursory screening for more costly, higher fidelity simulation. Of concern is the ability of the models to capture the essence of the system and provide insight into system behavior in a timely manner and without breaking the bank. The method is put to the test with the development of a model to address situations where capacity is overburdened and potential for propagation of the resultant delay though later flights is possible via flight dependencies. The resultant model includes primitive representations of principal air traffic system attributes, namely system capacity, demand, airline schedules and strategy, and aircraft capability. It affords a venue to explore their interdependence in a time-dependent, dynamic system simulation. The scope of the research question and the carefully-chosen modeling fidelity did allow for the development of an agent-based model in short order. The model predicted non-linear behavior given certain initial conditions and system control strategies. Additionally, a combination of the model and dimensionless techniques borrowed from fluid systems was demonstrated that can predict the system s dynamic behavior across a wide range of parametric settings.

  11. 32 CFR 1602.17 - Military service. (United States)


    ... 32 National Defense 6 2010-07-01 2010-07-01 false Military service. 1602.17 Section 1602.17 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.17 Military service. The term military service includes service in the Army, the Navy, the Air...

  12. Evaluation of publicly financed and privately delivered model of emergency referral services for maternal and child health care in India.

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    Full Text Available BACKGROUND: Emergency referral services (ERS are being strengthened in India to improve access for institutional delivery. We evaluated a publicly financed and privately delivered model of ERS in Punjab state, India, to assess its extent and pattern of utilization, impact on institutional delivery, quality and unit cost. METHODS: Data for almost 0.4 million calls received from April 2012 to March 2013 was analysed to assess the extent and pattern of utilization. Segmented linear regression was used to analyse month-wise data on number of institutional deliveries in public sector health facilities from 2008 to 2013. We inspected ambulances in 2 districts against the Basic Life Support (BLS standards. Timeliness of ERS was assessed for determining quality. Finally, we computed economic cost of implementing ERS from a health system perspective. RESULTS: On an average, an ambulance transported 3-4 patients per day. Poor and those farther away from the health facility had a higher likelihood of using the ambulance. Although the ERS had an abrupt positive effect on increasing the institutional deliveries in the unadjusted model, there was no effect on institutional delivery after adjustment for autocorrelation. Cost of operating the ambulance service was INR 1361 (USD 22.7 per patient transported or INR 21 (USD 0.35 per km travelled. CONCLUSION: Emergency referral services in Punjab did not result in a significant change in public sector institutional deliveries. This could be due to high baseline coverage of institutional delivery and low barriers to physical access. Choice of interventions for reduction in Maternal Mortality Ratio (MMR should be context-specific to have high value for resources spent. The ERS in Punjab needs improvement in terms of quality and reduction of cost to health system.

  13. Construction of Air Quality Real-time Collaborative Service System in Changzhou City%常州市空气质量实时发布协同服务体系建设

    Institute of Scientific and Technical Information of China (English)

    孙南; 蔡继军


    从空气质量实时发布的发布接口、集成环节、发布要素三个方面建立空气质量实时发布协同服务体系,在此基础上建立了协同服务框架,对发布信息的统计计算、数据质控、数据聚合计算、数据自动化处理等功能进行阐述,由此保证了不同层次、不同接口间发布信息的质量和一致性,具有较大的实际应用价值。%On the basis of real-time air quality publishing service systeme stablished from the interfaces,integrated parts and release factors,the framework of collaborative services has been built,which publishes information of statistical computing,data quality con-trol,data aggregation calculation ,automated data processing and other functions,ensuring the quality and consistency of different lev-els and different interfaces.It definitely has practical value.

  14. Anàlisi dels referents culturals en les traduccions catalana i castellana de la pel·lícula 'El castell ambulant'


    Gorgas Canals, Maria


    Els referents culturals són un fenomen que ha estat molt estudiat en el camp de la traducció a causa de la complexitat que suposa expressar una realitat pròpia d'una llengua i d'una cultura en una altra llengua diferent. En aquest treball de final de grau es pretén realitzar una anàlisi i una classificació dels referents culturals que apareixen a la pel•lícula d'animació japonesa d'El Castell Ambulant i de la traducció que se n'ha fet a les versions espanyola i catalana. Aprofitant que dispos...

  15. Weakness and the Inability to Ambulate in a 14-Month-Old Female: A Case Report and Concise Review of Guillain-Barre Syndrome

    Directory of Open Access Journals (Sweden)

    Scott A. Bloch


    Full Text Available Guillain-Barre syndrome (GBS is an acquired disease of the peripheral nervous system which causes demyelination and leads to weakness, ataxia, and areflexia. There are a variety of forms of the syndrome, and although it is found in all age groups, it is rare in children less than two years of age. The present complaint of weakness, ataxia, or lower extremity pain in the pediatric population should cause the practitioner to consider GBS in the differential. We describe a case of a 14-month-old girl presenting with weakness and the inability to ambulate who was diagnosed with GBS. The purpose of this paper is to review the emergency medicine diagnosis and management of Guillain-Barre syndrome in children.

  16. An artificial neural network to safely reduce the number of ambulance ECGs transmitted for physician assessment in a system with prehospital detection of ST elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Forberg Jakob L


    Full Text Available Abstract Background Pre-hospital electrocardiogram (ECG transmission to an expert for interpretation and triage reduces time to acute percutaneous coronary intervention (PCI in patients with ST elevation Myocardial Infarction (STEMI. In order to detect all STEMI patients, the ECG should be transmitted in all cases of suspected acute cardiac ischemia. The aim of this study was to examine the ability of an artificial neural network (ANN to safely reduce the number of ECGs transmitted by identifying patients without STEMI and patients not needing acute PCI. Methods Five hundred and sixty ambulance ECGs transmitted to the coronary care unit (CCU in routine care were prospectively collected. The ECG interpretation by the ANN was compared with the diagnosis (STEMI or not and the need for an acute PCI (or not as determined from the Swedish coronary angiography and angioplasty register. The CCU physician's real time ECG interpretation (STEMI or not and triage decision (acute PCI or not were registered for comparison. Results The ANN sensitivity, specificity, positive and negative predictive values for STEMI was 95%, 68%, 18% and 99%, respectively, and for a need of acute PCI it was 97%, 68%, 17% and 100%. The area under the ANN's receiver operating characteristics curve for STEMI detection was 0.93 (95% CI 0.89-0.96 and for predicting the need of acute PCI 0.94 (95% CI 0.90-0.97. If ECGs where the ANN did not identify a STEMI or a need of acute PCI were theoretically to be withheld from transmission, the number of ECGs sent to the CCU could have been reduced by 64% without missing any case with STEMI or a need of immediate PCI. Conclusions Our ANN had an excellent ability to predict STEMI and the need of acute PCI in ambulance ECGs, and has a potential to safely reduce the number of ECG transmitted to the CCU by almost two thirds.

  17. Upper limb evaluation and one-year follow up of non-ambulant patients with spinal muscular atrophy: an observational multicenter trial.

    Directory of Open Access Journals (Sweden)

    Andreea Mihaela Seferian

    Full Text Available Assessment of the upper limb strength in non-ambulant neuromuscular patients remains challenging. Although potential outcome measures have been reported, longitudinal data demonstrating sensitivity to clinical evolution in spinal muscular atrophy patients are critically lacking. Our study recruited 23 non-ambulant patients, 16 patients (males/females = 6/10; median age 15.4 years with a range from 10.7 to 31.1 years with spinal muscular atrophy type II and 7 patients (males/females = 2/5; median age 19.9 years with a range from 8.3 to 29.9 years with type III. The Brooke functional score was on median 3 with a range from 2 to 6. The average total vital capacity was 46%, and seven patients required non-invasive ventilation at night. Patients were assessed at baseline, 6 months, and 1 year using the Motor Function Measure and innovative devices MyoGrip, MyoPinch, and MoviPlate, which assess handgrip strength, key pinch strength, and hand/finger extension-flexion function, respectively. The study demonstrated the feasibility and reliability of these measures for all patients, and sensitivity to negative changes after the age of 14 years. The younger patients showed an increase of the distal force in the follow-up period. The distal force measurements and function were correlated to different functional scales. These data represent an important step in the process of validating these devices as potential outcome measures for future clinical trials.

  18. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation (United States)

    Tan, Tan-Hsu; Gochoo, Munkhjargal; Chen, Yung-Fu; Hu, Jin-Jia; Chiang, John Y.; Chang, Ching-Su; Lee, Ming-Huei; Hsu, Yung-Nian; Hsu, Jiin-Chyr


    This study presents a new ubiquitous emergency medical service system (UEMS) that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients’ biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient’s biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios. PMID:28117724

  19. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation

    Directory of Open Access Journals (Sweden)

    Tan-Hsu Tan


    Full Text Available This study presents a new ubiquitous emergency medical service system (UEMS that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients’ biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient’s biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios.

  20. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation. (United States)

    Tan, Tan-Hsu; Gochoo, Munkhjargal; Chen, Yung-Fu; Hu, Jin-Jia; Chiang, John Y; Chang, Ching-Su; Lee, Ming-Huei; Hsu, Yung-Nian; Hsu, Jiin-Chyr


    This study presents a new ubiquitous emergency medical service system (UEMS) that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients' biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient's biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios.

  1. National Air and Space Museum Library. (United States)

    Pietropaoli, Frank A.


    A branch of Smithsonian Institution Libraries, the National Air and Space Museum Library provides materials and services to support research programs of National Air and Space Museum. Brief histories of museum and its library and summary of museum programs provide background for overview of current library users, resources, and services.…


    Directory of Open Access Journals (Sweden)

    M.K. Sahu


    Full Text Available The lives of human beings are full of complexities, but LGBT face much more trauma compared to other people. What is necessary is to understand the sentiments of the LGBT community and also to grant them common human rights. But the world lowers its eyes and refuses a discussion over the granting of basic human rights to the LGBT community. And it is so sad to see that such discrimination exists even in the 21st century. Indian law, on the whole, only recognizes the paradigm of the binary genders of male and female, based on a person’s sex assigned at birth, which permits a gender system, including the laws relating to marriage, adoption, inheritance, succession and taxation, and welfare legislation. The most pertinent question with respect to the LGBT community is whether LGBT are to be discriminated against by other human beings. Merely being different does not give others the authority to ostracize one from society. In fact, in July 2009 the Delhi High Court ruled that consensual same-sex relations between adults in private could not be criminalized. Then in a recent judgment, the Supreme Court of India expressed its concerns over the mental trauma, emotional agony and pain of the members of the transgender community: all forms of mental suffering of the LGBT community, as well as ignorance and isolation of the community, were brought to an end by the Court’s decision in National Legal Services Authority v. Union of India & Others.

  3. Air quality and air quality related values in Chassahowitzka National Wildlife Refuge and Wilderness Area (United States)

    US Fish and Wildlife Service, Department of the Interior — Chassahowitzka Wilderness Area is a Class I air quality area administered by the U.S. Fish and Wildlife Service. Despite the special protection mandated for...

  4. Proposal for the award of a contract for the design, supply, installation and commissioning of a ventilation and air conditioning system for the ECN3 experimental area and the TCC8 and GHN300 service tunnels and for the dismantling of the existing system

    CERN Document Server


    Proposal for the award of a contract for the design, supply, installation and commissioning of a ventilation and air conditioning system for the ECN3 experimental area and the TCC8 and GHN300 service tunnels and for the dismantling of the existing system

  5. Characteristics of out-of-hospital paediatric emergencies attended by ambulance- and helicopter-based emergency physicians

    NARCIS (Netherlands)

    Eich, Christoph; Russo, Sebastian G.; Heuer, Jan F.; Timmermann, Arnd; Gentkow, Uta; Quintel, Michael; Roessler, Markus


    Background: In Germany, as in many other countries, for the vast majority of cases, critical out-of-hospital (OOH) paediatric emergencies are attended by non-specialised emergency physicians (EPs). As it is assumed that this may lead to deficient service we aimed to gather robust data on the charact

  6. Determinants of Service Contract Outcomes (United States)


    Management, Industrial Marketing Management, Supply Chain Management: An International Journal, the Journal of Marketing Channels, Air Force Journal to applications of service quality in business-to-consumer (B2C) contexts. The five dimensions of service quality do not always fit B2B ...Buyers of customer-defined B2B services often state service expectations in requirement documents that are incorporated into contracts. Within public

  7. Effects of different kinds of artificial airway in prehospital ambulance%不同人工气道在院外救护车内的应用

    Institute of Scientific and Technical Information of China (English)

    张吉新; 李士华; 张颖; 毕宝林; 崔兆伟


    Objective To compare the effects in cardiopulmonary resuscitation of 3 kinds of artificial airway: conventional tracheal intubation, blind insertion of laryngeal mask, and esophageal-tracheal combined tube in prehospital ambulance.Methods 328 cases undergoing CPR in the prehospital ambulance were Randomly divided into 3 groups: Group A (n=68) undergoing conventional tracheal intubation, Group B (n=140) undergoing blind insertion of laryngeal mask, and Group C (n=l 10) undergoing insertion of esophageal-tracheal combined tube. The time needed to establish artificial airway, one-time success rate of insertion, and resuscitation success rate were compared among these 3 groups. Results The time needed to establish artificial airway of Group B was (26±11.3) s, significantly shorter than those of Groups A and C[(l46±14.7)s and (81±16.5)s respectively , both P0.05). There were not significant differences in the resuscitation success rate among these 3 groups (26.5%,25.7% and 27.3%). Conclusion blind insertion of laryngeal mask is the best choice for CPR in prehospital ambulance, followed by insertion of esophageal tracheal combitube.%目的 探讨院外急救车上心肺复苏(CPR)建立人工气道通气的最佳方法和对复苏成功率的影响.方法 对院外急救车上发生心跳呼吸骤停患者318例,根据当时CPR时对患者随机建立人工气道的3种不同方法,将其分为3组,进行回顾性分析,A组68例,常规行气管导管插管;B组140例,盲插喉罩通气;C组110例,食管气管联合导管通气.结果 B组建立人工通气需(26±11.3)s,显著短于A组和C组[分别为(146±14.7)s和(81±16.5),均P<0.05].A组建立人工通气所需时间显著长于C组(P<0.05).盲插喉罩通气时间最短,其次是食管气管联合导管插管术,气管插管术最慢.B组一次插管成功率为100%,显著高于A组(60.3%,P<0.05),与C组的差异无显著性(98.2%,P>0.05).B组与C组之间差异无统计学意义(P>0.05).A

  8. Pediatric emergency medical services and their drawbacks

    Directory of Open Access Journals (Sweden)

    Abdullah Foraih Al-Anazi


    Full Text Available Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established.

  9. Challenges in researching violence affecting health service delivery in complex security environments. (United States)

    Foghammar, Ludvig; Jang, Suyoun; Kyzy, Gulzhan Asylbek; Weiss, Nerina; Sullivan, Katherine A; Gibson-Fall, Fawzia; Irwin, Rachel


    Complex security environments are characterized by violence (including, but not limited to "armed conflict" in the legal sense), poverty, environmental disasters and poor governance. Violence directly affecting health service delivery in complex security environments includes attacks on individuals (e.g. doctors, nurses, administrators, security guards, ambulance drivers and translators), obstructions (e.g. ambulances being stopped at checkpoints), discrimination (e.g. staff being pressured to treat one patient instead of another), attacks on and misappropriation of health facilities and property (e.g. vandalism, theft and ambulance theft by armed groups), and the criminalization of health workers. This paper examines the challenges associated with researching the context, scope and nature of violence directly affecting health service delivery in these environments. With a focus on data collection, it considers how these challenges affect researchers' ability to analyze the drivers of violence and impact of violence. This paper presents key findings from two research workshops organized in 2014 and 2015 which convened researchers and practitioners in the fields of health and humanitarian aid delivery and policy, and draws upon an analysis of organizational efforts to address violence affecting healthcare delivery and eleven in-depth interviews with representatives of organizations working in complex security environments. Despite the urgency and impact of violence affecting healthcare delivery, there is an overall lack of research that is of health-specific, publically accessible and comparable, as well as a lack of gender-disaggregated data, data on perpetrator motives and an assessment of the 'knock-on' effects of violence. These gaps limit analysis and, by extension, the ability of organizations operating in complex security environments to effectively manage the security of their staff and facilities and to deliver health services. Increased research

  10. Mechanical Service; Service Mechanique

    Energy Technology Data Exchange (ETDEWEB)

    Alliaume, T.; Benoit, A.; Bonin, H.; Ducimetiere, D.; Essertaize, D.; Gelin, G.; Guillot, G.; Lemoine, C.; Mabo, J.C.; Mounier, F.; Tissot, S.; Verdier, G. [Inst. de Physique Nucleaire, Lyon-1 Univ., 69 - Villeurbanne (France)


    The service studies the mechanical part of the experiment or detectors used by the physics groups in collaboration with the physicists, engineers and the technicians of the experiment assistance group as well as with other technical groups. The mechanical service was implied in the following projects: CMS, VIRGO (the IGISOL ion guide chamber), PIAFE, NA50 (reaction chamber, metallic cluster source), ORION, SICANE, EDELWEISS II 2 figs.

  11. The Statement Airline Service Quality Development

    Institute of Scientific and Technical Information of China (English)



    As the recent emergence of the Low Cost Carriers (LLCs) in Air-line industry, service differentiation and customer satisfaction takes critical role in order to sharpen competitive edges to both Full Service Carriers (FSCs) and LLCs. The current research aims to explore the nature of service quality in airline and its relationship to customer satisfaction. Air service quality dimensions using factor analysis are classified as Ticketing and Boarding Processes, Customer Encounter Services, and Tangibles. Further, the regression analysis reveals the strength of relationships between each of service quality dimensions and customer satisfaction scales that the Ticketing and Boarding Process dimension has the strongest co-relations with customer satisfaction scales.

  12. Communicative Management in Ambulatory Services: Prehospital Management Communication--Limits and Possibilities. (United States)

    Nordby, Halvor


    Poor management communication in healthcare services affects employees' motivation, commitment, and, in the final instance, organizational performance and the quality of patient care. In any area of health management, good communication is, therefore, key to successful management. This article discusses how managers of ambulance stations should secure communication with their paramedic crews. The first part uses ethical concepts to analyze communicative disagreement in interactive dialogue between managers and paramedics. The second part outlines basic communication principles that can serve as conceptual tools for avoiding misinterpretation in prehospital manager-employee interaction.

  13. Immediate Return to Ambulation and Improved Functional Capacity for Rehabilitation in Complex Regional Pain Syndrome following Early Implantation of a Spinal Cord Stimulation System

    Directory of Open Access Journals (Sweden)

    Brandon Jesse Goff


    Full Text Available Complex regional pain syndrome (CRPS is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervical disc fusion. This condition resulted in severe pain and functional impairment that was unresponsive to pharmacological management. The patient’s rehabilitation was severely stymied by her excruciating pain. However, with the initiation of spinal cord stimulation, her pain was adequately controlled allowing for progression to full unassisted ambulation, advancing functional capacity, and improving quality of life. This case report supports the concept that rapid progression to neuromodulation, rather than delays that occur due to attempts at serial sympathetic blocks, may better control symptoms leading allowing for a more meaningful recovery.

  14. Integrated Suit Test 1 - A Study to Evaluate Effects of Suit Weight, Pressure, and Kinematics on Human Performance during Lunar Ambulation (United States)

    Gernhardt, Michael L.; Norcross, Jason; Vos, Jessica R.


    In an effort to design the next generation Lunar suit, NASA has initiated a series of tests aimed at understanding the human physiological and biomechanical affects of space suits under a variety of conditions. The first of these tests was the EVA Walkback Test (ICES 2007-01-3133). NASA-JSC assembled a multi-disciplinary team to conduct the second test of the series, titled Integrated Suit Test 1 (IST-1), from March 6 through July 24, 2007. Similar to the Walkback Test, this study was performed with the Mark III (MKIII) EVA Technology Demonstrator suit, a treadmill, and the Partial Gravity Simulator in the Space Vehicle Mock-Up Facility at Johnson Space Center. The data collected for IST-1 included metabolic rates, ground reaction forces, biomechanics, and subjective workload and controllability feedback on both suited and unsuited (shirt-sleeve) astronaut subjects. For IST-1 the center of gravity was controlled to a nearly perfect position while the weight, pressure and biomechanics (waist locked vs. unlocked) were varied individually to evaluate the effects of each on the ability to perform level (0 degree incline) ambulation in simulated Lunar gravity. The detailed test methodology and preliminary key findings of IST-1 are summarized in this report.

  15. 75 FR 1770 - Proposed Consent Decree, Clean Air Act Citizen Suit (United States)


    ... Health and Environment, Air Pollution Division, to the Public Service of Colorado to operate the Hayden... Department of Public Health and Environment, Air Pollution Division, to the Public Service of Colorado...

  16. CDC WONDER: Daily Air Temperatures and Heat Index (United States)

    U.S. Department of Health & Human Services — The Daily Air Temperature and Heat Index data available on CDC WONDER are county-level daily average air temperatures and heat index measures spanning the years...

  17. Index of Air Weather Service Technical Publications. (United States)


    Sonde Flight Test Report," by Capt T. Earl Ley and Maj E. J. Heald, January 1976, 31 p. (AD-A056159). 76-262 "Development/Decay Potential of Active...80/001 "Wind Factor Simulation Model: Model Description," by Maj Roger C. Whiton and Capt Patrick L. Herod , April 1980, 39 p. (AD-A085733). 80/002...34Wind Factor Simulation Model: User’s Manual," by Maj Roger C. Whiton and Capt Patrick L. Herod , April 1980, 66 p. (AD-A085486). 80/003 "Bivariate

  18. Air Weather Service Model Output Statistics Systems. (United States)


    Columbus CNK Concordia COF Patrick AFB CON Concord COS Colorado Spgs COU Columbia CPR Casper CRP Corpus Christi CRW Charleston CSM Clinton...NAHE Bardenas Reales, SP Zaragoza (USAF), SP Barcelona/Munta, SP Madrid /Torrejon, SP Moron De La Frontera, SP Cordoba, SP Rota Naval Station, SP...Matacan, SP 082210 LEMD Madrid /Barajas, SP 082330 LECH Calamocha, SP 082610 - Caceres, SP 082800 LEAB Albacete/Los Llano, SP 082840 LEVC Valencia

  19. Service Gateway

    Institute of Scientific and Technical Information of China (English)

    WANG Guozhong; HOU Gang; HUANG Zeqing


    This article focuses on the service gateway which implements the Open Service gateway Initiative (OSGI), it manages voice, data, Internet, and multimedia communications to and from the home, office and other locations. This service gateway can also function as an application server for a range of high value services such as energy management and control, safety and security services, health care monitoring services, device control and maintenance, electronic commerce services and more.

  20. Korean Air Excellence in Flight

    Institute of Scientific and Technical Information of China (English)


    @@ Korean Air with a fleet of 119 aircraft, is one of the world's top 20 airlines, and oper-ates almost 400 flights everyday to 90 cities in 33 countries. The airline has about 50 flights per week between the US and Asia from nine US gateways: New York, Los Angeles, Washington,Chicago, Dallas, San Francisco, Atlanta, Anchorage and Honolulu.The carrier is a founding member of SkyTeam, the global airline alliance partnering AeroMexico, Air France, Alitalia, CSA Czech Airlines, Continental Airlines, Delta Air Lines, KLM and Northwest Airlines to provide customers with extensive worldwide destina-tions, flights and services.

  1. Air Pollution (United States)

    ... to view this content or go to source URL . What NIEHS is Doing on Air Pollution Who ... Junction Last Reviewed: February 06, 2017 This page URL: NIEHS website: Email ...

  2. Application of trans-theoretical model of behavior in ambulation training of stroke hemiplegic patients%行为转变理论在脑卒中偏瘫患者步行训练中的应用

    Institute of Scientific and Technical Information of China (English)

    张艳; 陈剑苹; 蒋辛


    Objective To study the effect of trans-theoretical model of behavior on ambulation training in stroke hemiplegic patients. Methods Sixty hospitalized stroke hemiplegic patients from June to December 2013 were selected as control group. The control group was treated with routine nursing and ambulation training guidance. Sixty-two hospitalized stroke hemiplegia patients, from January 2014 to June 2014, were selected as intervention group. Patients in the intervention group received trans-theoretical model of behavior together with ambulation training guidance for 3 weeks and follow-up record for 6 months. Holden functional ambulation categories ( FAC ) and Bathel index were used to evaluate the effect of ambulation training . Result Trans-theoretical model of behavior training improved the walking function and activities of daily living in intervention group patients , compared with those of the control group. Conclusions Taking trans-theoretical model of behavior in walking training health education can improve the ambulation ability and ability of daily living of stroke hemiplegic patients. Therefore this theory can enhance the stroke hemiplegic patients′life quality.%目的:探讨行为转变理论在脑卒中偏瘫患者步行训练中的应用效果。方法将2013年6~12月在本院住院60例脑卒中偏瘫患者设为对照组,实施常规的护理及步行训练指导;将2014年1~6月在本院住院62例脑卒中偏瘫患者设为干预组,将行为转变理论应用于患者步行训练健康教育中,干预时间3周,随访时间6个月。采用Holden步行功能分级(functional ambulation categories, FAC)和Bathel指数对患者进行测评。结果训练后两组患者FAC测评结果和Bathel得分比较,差异均有统计学意义(P<0.05),干预组患者步行功能和日常活动能力均优于对照组。结论将行为转变理论应用于脑卒中偏瘫患者步行训练健康教育中,可提高患者步行能


    CERN Multimedia

    Telephone Service


    As from 1st of July 2002, responsibility for running the Fax Service will be transfered to the Printer Service. Future requests for machines, toner and breakdown should be sent to - tel 78888. Telephone Service


    Three refrigerant blends used to replace CFC-12 in automotive air conditioners were evaluated for composition changes due to typical servicing and leakage. When recommended service procedures were followed, changes in blend compositions were relatively small. Small changes in b...

  5. NOAA NOS SOS, EXPERIMENTAL - Air Temperature (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA NOS SOS server is part of the IOOS DIF SOS Project. The stations in this dataset have air temperature data. *These services are for testing and evaluation...

  6. Comprehensive Smokefree Indoor Air PDF Slides (United States)

    U.S. Department of Health & Human Services — Download the comprehensive smokefree indoor air slides. These slides are available in PDF and PowerPoint formats. The PowerPoint version can be found at:...

  7. Medical Services: Ophthalmic Services (United States)


    Atlan- tic Treaty Organization (NATO) nations and of other officially rec- ognized foreign military personnel at military installations within the...representatives of religious groups, celebrities, and enter- tainers; representatives of the United Service Organization( USO ), other social agencies, and...from DOD, or from one of the military depart- ments, to visit military commands overseas. b. Dependents of USO oversea area executives, club directors

  8. Service Modularity

    DEFF Research Database (Denmark)

    Avlonitis, Viktor; Hsuan, Juliana


    The purpose of this research is to investigate the studies on service modularity with a goal of informing service science and advancing contemporary service systems research. Modularity, a general systems property, can add theoretical underpinnings to the conceptual development of service science...... in general and service systems in particular. Our research is guided by the following question: how can modularity theory inform service system design? We present a review of the modularity literature and associated concepts. We then introduce the contemporary service science and service system discourse...

  9. Pediatric telephone advice: a new medical service in Israel. (United States)

    Sher, C; Mimouni, M; Weitzen, T; Waisman, Y


    Although controversy still exists about dispensing medical advice over the telephone, such services are widely offered by pediatricians in the USA. In Israel, however, such services have not yet been developed. In a joint project of the Moked Keshev (a private medical help line) at Magen David Adom (national ambulance service) and the Children's Medical Center of Israel, the first pediatric telephone advice service in Israel was established. In this study we analyzed 512 consecutive incoming calls received during the first 11 months of service operation. Of these, 42% of calls concerned children in the 1 month to 1 year age group. Unexpectedly, calls were almost evenly distributed throughout the week with a slight decrease on Fridays and Saturdays (sabbath), and 45.7% of the calls were received during the morning shift. The three most common reasons for contact were: of a general nature such as fever (23%), gastrointestinal problems (19%), and medical questions (18%). In only 20.7% of the cases were the patients advised to go to the nearest hospital emergency department, emphasizing the non-emergent nature of the calls. At the time of follow-up (within 24 h), patient status was assessed as: improved (73.7%), same (22.6%), and worse (3.8%). Of those who became worse, none required an emergency department evaluation. The present study demonstrates that a Pediatric Telephone Advice Service in Israel is technically functional, medically safe, and contributes to the health management of children.

  10. Robot-assisted gait training improves brachial–ankle pulse wave velocity and peak aerobic capacity in subacute stroke patients with totally dependent ambulation (United States)

    Han, Eun Young; Im, Sang Hee; Kim, Bo Ryun; Seo, Min Ji; Kim, Myeong Ok


    Abstract Objective: Brachial–ankle pulse wave velocity (baPWV) evaluates arterial stiffness and also predicts early outcome in stroke patients. The objectives of this study were to investigate arterial stiffness of subacute nonfunctional ambulatory stroke patients and to compare the effects of robot-assisted gait therapy (RAGT) combined with rehabilitation therapy (RT) on arterial stiffness and functional recovery with those of RT alone. Method: The RAGT group (N = 30) received 30 minutes of robot-assisted gait therapy and 30 minutes of conventional RT, and the control group (N = 26) received 60 minutes of RT, 5 times a week for 4 weeks. baPWV was measured and calculated using an automated device. The patients also performed a symptom-limited graded exercise stress test using a bicycle ergometer, and parameters of cardiopulmonary fitness were recorded. Clinical outcome measures were categorized into 4 categories: activities of daily living, balance, ambulatory function, and paretic leg motor function and were evaluated before and after the 4-week intervention. Results: Both groups exhibited significant functional recovery in all clinical outcome measures after the 4-week intervention. However, peak aerobic capacity, peak heart rate, exercise tolerance test duration, and baPWV improved only in the RAGT group, and the improvements in baPWV and peak aerobic capacity were more noticeable in the RAGT group than in the control group. Conclusion: Robot-assisted gait therapy combined with conventional rehabilitation therapy represents an effective method for reversing arterial stiffness and improving peak aerobic capacity in subacute stroke patients with totally dependent ambulation. However, further large-scale studies with longer term follow-up periods are warranted to measure the effects of RAGT on secondary prevention after stroke. PMID:27741123


    Lennox Industries, Inc., Marshalltown, IA.


  12. Measuring Air Force Contracting Customer Satisfaction (United States)


    firm’s market research budget (Olsen, Witell & Gustafsson, 2014). With all the research and popularity surrounding Customer Relationship Management ( CRM ... Customer Relationship Management CS Contracting Specialist DAU Defense Acquisition University DFARS Defense Federal Acquisition Regulation Supplement...AFSVA Air Force Services Activity AMC Air Mobility Command CE Civil Engineering CEM Customer Experience Management CO Contracting Officer COA

  13. Air surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Patton, G.W.


    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).

  14. Enabling Mobile Air Quality App Development with an AirNow API (United States)

    Dye, T.; White, J. E.; Ludewig, S. A.; Dickerson, P.; Healy, A. N.; West, J. W.; Prince, L. A.


    The U.S. Environmental Protection Agency's (EPA) AirNow program works with over 130 participating state, local, and federal air quality agencies to obtain, quality control, and store real-time air quality observations and forecasts. From these data, the AirNow system generates thousands of maps and products each hour. Each day, information from AirNow is published online and in other media to assist the public in making health-based decisions related to air quality. However, an increasing number of people use mobile devices as their primary tool for obtaining information, and AirNow has responded to this trend by publishing an easy-to-use Web API that is useful for mobile app developers. This presentation will describe the various features of the AirNow application programming interface (API), including Representational State Transfer (REST)-type web services, file outputs, and RSS feeds. In addition, a web portal for the AirNow API will be shown, including documentation on use of the system, a query tool for configuring and running web services, and general information about the air quality data and forecasts available. Data published via the AirNow API includes corresponding Air Quality Index (AQI) levels for each pollutant. We will highlight examples of mobile apps that are using the AirNow API to provide location-based, real-time air quality information. Examples will include mobile apps developed for Minnesota ('Minnesota Air') and Washington, D.C. ('Clean Air Partners Air Quality'), and an app developed by EPA ('EPA AirNow').

  15. 深圳地区办公建筑服务水平与空调能耗的相关性分析%Correlation Analysis of Service Level and Air Conditioning Energy Consumption of Office Buildings-Taking Office Buildings in Shenzhen for Example

    Institute of Scientific and Technical Information of China (English)

    吴银萍; 付祥钊; 孙冬梅; 余能辉


    For the similar buildings,the differences in level of construction services will lead to differences in the indoor environmental control parameters and the distribution of heat sources,thus affecting the energy consumption of air conditioning.This paper briefly describes the content of the level of construction services,and then without taking into account climate and building form parameters on the impact of energy consumption,it sets different service levels and technical level for an office building in Shenzhen and analyzes the association between construction services and air-conditioning energy consumption by simulations.Conclusion is that not only from a technical level,choosing the appropriate level of construction services can also effectively reduce building air conditioning load requirements.On this basis,significances of service-related factors on the impact of energy consumption are analyzed,which providing a reference for reasonable setting of level of construction services.%对于同类建筑,建筑服务水平的差异会导致室内环境控制参数及热源分布的差异,从而影响建筑空调能耗。本文首先对建筑服务水平的内涵进行了简要阐述,然后在不考虑气候及建筑体形参数对能耗影响的条件下,运用DeST-c软件对深圳地区某办公建筑设定不同的服务水平和技术水平进行对比分析,得出建筑服务水平与空调能耗的相关性,进而指出不单从技术水平,选择恰当的服务水平可有效降低空调系统负荷需求。最后,对各服务水平相关因素对能耗影响的显著性进行了分析,为合理的服务水平设置提供参考依据。

  16. Royal Danish Air Force. Air Operations Doctrine

    DEFF Research Database (Denmark)

    Nørby, Søren

    This brief examines the development of the first Danish Air Force Air Operations Doctrine, which was officially commissioned in October 1997 and remained in effect until 2010. The development of a Danish air power doctrine was heavily influenced by the work of Colonel John Warden (USAF), both...... through his book ”The Air Campaign” and his subsequent planning of the air campaign against Iraq in 1990-1991. Warden’s ideas came to Denmark and the Danish Air Force by way of Danish Air Force students attending the United States Air Force Air University in Alabama, USA. Back in Denmark, graduates from...... the Air University inspired a small number of passionate airmen, who then wrote the Danish Air Operations Doctrine. The process was supported by the Air Force Tactical Command, which found that the work dovetailed perfectly with the transformation process that the Danish Air Force was in the midst...

  17. Dynamic Policy-Driven Quality of Service in Service-Oriented Information Management Systems (United States)


    middleware, such as the Java Message Service (JMS) [20], the Data Distribution Service (DDS) [35], CORBA Notification Service [36], or Web Services...much in the way that component models, such as the CORBA Compo- nent Model (CCM), encapsulated functionality as components. Service interfaces in SOA...and assemblies, facilitating deployment of Lightweight CORBA Component Model (CCM)-based applications. VEST [44] and AIRES [19] ana- lyze domain

  18. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Moratoria-Designated Geographic Locations. Implementation of the waiver demonstration. (United States)


    This notice announces the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in 6 states. The demonstration is being implemented in accordance with section 402 of the Social Security Amendments of 1967 and gives CMS the authority to grant waivers to the statewide enrollment moratoria on a case-by-case basis in response to access to care issues, and to subject providers and suppliers enrolling via such waivers to heightened screening, oversight, and investigations.

  19. Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales (United States)

    Jegasothy, Edward; McGuire, Rhydwyn; Nairn, John; Fawcett, Robert; Scalley, Benjamin


    Periods of successive extreme heat and cold temperature have major effects on human health and increase rates of health service utilisation. The severity of these events varies between geographic locations and populations. This study aimed to estimate the effects of heat waves and cold waves on health service utilisation across urban, regional and remote areas in New South Wales (NSW), Australia, during the 10-year study period 2005-2015. We divided the state into three regions and used 24 over-dispersed or zero-inflated Poisson time-series regression models to estimate the effect of heat waves and cold waves, of three levels of severity, on the rates of ambulance call-outs, emergency department (ED) presentations and mortality. We defined heat waves and cold waves using excess heat factor (EHF) and excess cold factor (ECF) metrics, respectively. Heat waves generally resulted in increased rates of ambulance call-outs, ED presentations and mortality across the three regions and the entire state. For all of NSW, very intense heat waves resulted in an increase of 10.8% (95% confidence interval (CI) 4.5, 17.4%) in mortality, 3.4% (95% CI 0.8, 7.8%) in ED presentations and 10.9% (95% CI 7.7, 14.2%) in ambulance call-outs. Cold waves were shown to have significant effects on ED presentations (9.3% increase for intense events, 95% CI 8.0-10.6%) and mortality (8.8% increase for intense events, 95% CI 2.1-15.9%) in outer regional and remote areas. There was little evidence for an effect from cold waves on health service utilisation in major cities and inner regional areas. Heat waves have a large impact on health service utilisation in NSW in both urban and rural settings. Cold waves also have significant effects in outer regional and remote areas. EHF is a good predictor of health service utilisation for heat waves, although service needs may differ between urban and rural areas.

  20. 47 CFR 24.55 - Antenna structures; air navigation safety. (United States)


    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Antenna structures; air navigation safety. 24... SERVICES PERSONAL COMMUNICATIONS SERVICES Technical Standards § 24.55 Antenna structures; air navigation safety. Licensees that own their antenna structures must not allow these antenna structures to become...

  1. 47 CFR 27.56 - Antenna structures; air navigation safety. (United States)


    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Antenna structures; air navigation safety. 27... SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Technical Standards § 27.56 Antenna structures; air navigation safety. A licensee that owns its antenna structure(s) must not allow such antenna structure(s)...

  2. GSPEL - Air Filtration Laboratory (United States)

    Federal Laboratory Consortium — Evaluation capabilities for air filtration devices The Air Filtration Lab provides testing of air filtration devices to demonstrate and validate new or legacy system...

  3. Ambulation and spinal cord injury. (United States)

    Hardin, Elizabeth C; Kobetic, Rudi; Triolo, Ronald J


    Walking is possible for many patients with a spinal cord injury. Avenues enabling walking include braces, robotics and FES. Among the benefits are improved musculoskeletal and mental health, however unrealistic expectations may lead to negative changes in quality of life. Use rigorous assessment standards to gauge the improvement of walking during the rehabilitation process, but also yearly. Continued walking after discharge may be limited by challenges, such as lack of accessibility in and outside the home, and complications, such as shoulder pain or injuries from falls. It is critical to determine the risks and benefits of walking for each patient.

  4. 40 CFR 52.1778 - Significant deterioration of air quality. (United States)


    ... quality. 52.1778 Section 52.1778 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) (c) All applications and other information required pursuant... Air Quality, 1641 Mail Service Center, Raleigh, North Carolina 27699-1641 or local agencies,...


    Institute of Scientific and Technical Information of China (English)


    @@ Air Canada, together with its regional airline subsidiary, Air Canada Jazz, provides scheduled and charter air transportation for passengers and cargo to more than 150 destinations,vacation packages to over 90 destinations, as well as maintenance, ground handling and train ing services to other airlines.

  6. Service Innovations

    DEFF Research Database (Denmark)

    Sørensen, Lene Tolstrup; Nicolajsen, Hanne Westh


    This article discusses the challenges in relation to an ongoing project named converged advanced mobile media platform (CAMMP), where all the different stakeholders need to have a saying in the service development for the upcoming rich, mobile broadcasting services....

  7. Air-to-Air Missile Vector Scoring (United States)


    64 4.6. Unscented Kalman Filter Performance in Air-to-Air Missile Scor - ing Application with Continuous Velocity Dynamics Model (Tar- get...Filter Performance in Air-to-Air Missile Scor - ing Application with Continuous Velocity Dynamics Model (Tar- get Aircraft Executing a Vertical Climb...Kalman Filter Performance in Air-to-Air Missile Scor - ing Application with Continuous Velocity Dynamics Model (Tar- get Aircraft Non-maneuvering

  8. IGP Services (United States)

    Smith, Warren


    The goal is location-independent computing. Implementing a set of services to satisfy this goal, build upon the GLOBUS toolkit services, and implementing with OGSA. Current status includes: Event service, Job manager, Resource selector and Broker, Next versions in development.Development includes: Monitoring and testing, Portability manager, Performance prediction, Dynamic accounting, and MDS evaluation.

  9. Heat and mass transfer in building services design

    CERN Document Server

    Moss, Keith


    Building design is increasingly geared towards low energy consumption. Understanding the fundamentals of heat transfer and the behaviour of air and water movements is more important than ever before. Heat and Mass Transfer in Building Services Design provides an essential underpinning knowledge for the technology subjects of space heating, water services, ventilation and air conditioning. This new text: *provides core understanding of heat transfer and fluid flow from a building services perspective *complements a range of courses in building services engineering *

  10. R9 Air Districts (United States)

    U.S. Environmental Protection Agency — The Region 9 Air Districts layer is a compilation of polygons representing the California Air Pollution Control and Air Quality Management Districts, Arizona Air...

  11. AirData (United States)

    U.S. Environmental Protection Agency — The AirData site provides access to yearly summaries of United States air pollution data, taken from EPA's air pollution databases. AirData has information about...

  12. California Air Basins (United States)

    California Department of Resources — Air ResourcesCalifornia Air Resources BoardThe following datasets are from the California Air Resources Board: * arb_california_airbasins - California Air BasinsThe...

  13. Air Warfare (United States)


    undoubtedly begat the shield; poisonous gases were countered by the mask. Surely men on the surface of the earth will not have to submit to violent air, production methods and cost of helium are given in “Balloon and Airship Gases ,” a volume of the Ronald Aeronautic Library. 5 More complete...becomes and more inse - cure. We shall see later that even some of the men who were advancing in the path prescribed by the principle of mass

  14. United States Air Force Statistical Digest, Fiscal Year 1979, Thirty-Fourth Edition (United States)


    Force Simpson Historical Research Center Air Force Service Information and News Center Air Force Intelligence Service. Air Force Inspection and Saftey ...Examination (Standard Form 88); physical inspections of food handlers or barbers are not included nor are examina- tions of personnel who are ill

  15. Teaching Air Pollution in an Authentic Context (United States)

    Mandrikas, Achilleas; Stavrou, Dimitrios; Skordoulis, Constantine


    This paper describes a teaching-learning sequence (TLS) about air pollution and the findings resulting from its implementation by pre-service elementary teachers (PET) currently undergraduate students of the Department of Primary Education in the National and Kapodistrian University of Athens, Greece. The TLS focused on the relation of air pollution with wind and topography in local conditions. An authentic context was provided to the students based on daily up-to-date meteorological data via the Internet in order to estimate air pollution. The results are encouraging given that PET can correlate wind and concentration of air pollutants through reading specialized angular diagrams and weather maps, can recognize the correlation of topography in the concentration of air pollutants, and can describe temperature inversion. However, the PET demonstrated clear difficulties in ability of orientation, in wind naming, and in interpretation of symbols on weather map. Finally, the implications on teaching air pollution are discussed.

  16. Teaching Air Pollution in an Authentic Context (United States)

    Mandrikas, Achilleas; Stavrou, Dimitrios; Skordoulis, Constantine


    This paper describes a teaching-learning sequence (TLS) about air pollution and the findings resulting from its implementation by pre-service elementary teachers (PET) currently undergraduate students of the Department of Primary Education in the National and Kapodistrian University of Athens, Greece. The TLS focused on the relation of air pollution with wind and topography in local conditions. An authentic context was provided to the students based on daily up-to-date meteorological data via the Internet in order to estimate air pollution. The results are encouraging given that PET can correlate wind and concentration of air pollutants through reading specialized angular diagrams and weather maps, can recognize the correlation of topography in the concentration of air pollutants, and can describe temperature inversion. However, the PET demonstrated clear difficulties in ability of orientation, in wind naming, and in interpretation of symbols on weather map. Finally, the implications on teaching air pollution are discussed.

  17. Occupational accidents among ambulance drivers in the emergency relief Accidentes del trabajo de conductores de ambulancia que brindan atención de urgencia Acidentes de trabalho com motoristas de ambulâncias que realizam socorro de urgência

    Directory of Open Access Journals (Sweden)

    Elisabete Takeda


    Full Text Available We analyzed the occurrence of occupational accidents (OA among ambulance drivers in Emergency Relief (ER, with a view to disclosing the types of events and their causes. A quantitative-qualitative study was carried out through the interview of 22 workers in a city in São Paulo, Brazil. The subjects were male, between 36 and 40 years old (40.9%, married (81.82%, with uncompleted primary education (40.9%, individual (90.9% and family (54.55% income between two and four Brazilian minimum wages, not performing any other paid occupation (45.45%. The majority of the OA were typical, due to an excess of exercises and vigorous and repeated movements (42.11% and aggression through body strength and other means (26.33%. The OA occurs mainly because drivers carry out tasks that do not suit their professional formation.Fue estudiada la frecuencia de accidentes del trabajo (AT con chóferes de ambulancia que brinda Atención de Urgencia (AU, buscando encontrar los tipos de accidentes y sus causas. La investigación fue cuanti-cualitativa, para lo cual fueron entrevistados 22 trabajadores de una ciudad en el Estado de São Paulo. Los sujetos eran de sexo masculino, con edades entre 36 y 40 años (40,9%, casados (81,82%, con educación primaria incompleta (40,9%, sueldo individual (90,9%, sueldo familiar (54,55% entre dos y cuatro sueldos mínimos y sin otra ocupación (45,45%. La gran mayoría de los AT fueron típicos, por exceso de ejercicios, movimientos enérgicos y repetidos (42,11% y daño por fuerza corporal y otras formas (26,33%. Los AT se dieron principalmente porque los chóferes realizaban actividades que no iban de acuerdo con su formación profesional.Estudou-se a ocorrência de acidentes de trabalho (AT com motoristas de ambulância que realizam Socorro de Urgência (SU, buscando evidenciar os tipos desses eventos e suas causas. A investigação foi quanti-qualitativa, entrevistando-se 22 trabalhadores que atuam em uma cidade paulista. Os

  18. Dosimetry Service

    CERN Multimedia


    Cern Staff and Users can now consult their dose records for an individual or an organizational unit with HRT. Please see more information on our web page: Dosimetry Service is open every morning from 8.30 - 12.00. Closed in the afternoons. We would like to remind you that dosimeters cannot be sent to customers by internal mail. Short-term dosimeters (VCT's) must always be returned to the Service after the use and must not be left on the racks in the experimental areas or in the secretariats. Dosimetry Service Tel. 7 2155

  19. The evaluation of time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. (United States)

    Mohammadi, Mohsen; Nasiripour, Amir Ashkan; Fakhri, Mahmood; Bakhtiari, Ahad; Azari, Samad; Akbarzadeh, Arash; Goli, Ali; Mahboubi, Mohammad


    This study evaluated the time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. This study was a descriptive retrospective cross-sectional study. In this study 500 cases of patients from Shahrivar (September) 2012 to the end of Shahrivar (September) 2013 were selected and studied by the non-probability quota method. The measuring tool included a preset cases record sheet and sampling method was completing the cases record sheet by referring to the patients' cases. Data were analyzed using SPSS version 18 and the concepts of descriptive and inferential statistics (Kruskal-Wallis test, benchmark Eta (Eta), Games-Howell post hoc test). The results showed that the interval mean between receiving the mission to reaching the scene, between reaching the scene to moving from the scene, and between moving from the scene to a health center was 7.28, 16.73 and 7.28 minutes. The overall mean of time performance from the scene to the health center was 11.34 minutes. Any intervention in order to speed up service delivery, reduce response times, ambulance equipment and facilities required for accuracy, validity and reliability of the data recorded in the emergency dispatch department, Continuing Education of ambulance staffs, the use of manpower with higher specialize levels such as nurses, supply the job satisfaction, and increase the coordination with other departments that are somehow involved in this process can provide the ground for reducing the loss and disability resulting from traffic accidents.

  20. CDBG Public Services Activity (United States)

    Department of Housing and Urban Development — CDBG activity related to public services, including senior services, legal services, youth services, employment training, health services, homebuyer counseling, food...

  1. Proyecto "Encuesta a los Servicios Alimentarios de Comedores Escolares Estatales" (PESCE: alcance de las metas nutricionales de las prestaciones alimentarias de los comedores escolares de Gran Buenos Aires, Argentina Proyect: "Survey of State School meal service" (PESCE: Scope of Food Supply Nutritional Goals in State School in Gran Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Susana Buamden


    Full Text Available Objetivo: Evaluar el alcance de las metas nutricionales de las prestaciones alimentarias de los comedores escolares estatales de la región Gran Buenos Aires, Argentina, en 2007. Materiales y Métodos: Unidad de análisis: prestación alimentaria de todas las escuelas estatales de la región. Metas nutricionales: elaboradas por prestación, para energía, nutrientes y alimentos críticos por grupo etario (Grupo 1: 3 años; Grupo 2: 4-8 años; Grupo 3: 9-14 años. Encuesta ad-hoc: administrada por nutricionistas. Muestreo: aleatorio estratificado bietápico; total 301 escuelas, 299 relevadas. Análisis de datos: sistema informático ad-hoc. Resultados: Desayuno/Merienda: el aporte de leche fue menor a la meta para todos los grupos etarios. La ración brindada al Grupo 1 alcanzó la meta para todos los nutrientes excepto el Calcio. Para el Grupo 2 la ración brindada solo fue aceptable en zinc y hierro. El Grupo 3 no alcanzó ninguna meta. Almuerzo: para todos los grupos etarios, existió un aporte calórico por debajo de la meta y exceso proteico. Para el Grupo 1, la ración ofrecida superó las metas de hierro y zinc; y no alcanzó la de Vitamina A. Para el Grupo 2, los aportes de zinc y vitamina C superaron la meta; calcio, hierro y vitamina A presentaron aportes bajos. Para el Grupo 3, solo se alcanzó la meta en vitamina C. El aporte de carne solo superó las metas establecidas para el grupo 1. El aporte de fruta superó la meta para el grupo 1 y 2, y fue aceptable para el grupo 3. El Desayuno/Merienda para Grupo 2 aportó más kcal en las escuelas que no brindaban almuerzo. Conclusiones: El Desayuno/Merienda solo alcanzó las metas nutricionales (excepto calcio en el grupo de 3 años. En Almuerzo, se observó aporte calórico por debajo de la meta y exceso proteico para todos los grupos etarios.Objective: To assess the scope of food supply nutritional goals in state school in the area of Gran Buenos Aires, Argentina, in 2007. Materials and

  2. Effects of weight relieving ambulator on walking function of hemiplegic patients with cerebral stroke%减重步态机器人对脑卒中偏瘫患者步行功能的影响

    Institute of Scientific and Technical Information of China (English)

    程明; 崔微; 王雪梅; 余茜


    目的 研究步态机器人训练对脑卒中偏瘫患者运动功能的影响.方法 将50例偏瘫患者分为2组,综合康复组行常规康复及减重步态机器人治疗,普通康复组行单纯康复治疗,疗程均为一个月,采用Carr-Shepherd运动功能评定(MAS)中的步行评定法对两组步行能力及临床疗效进行评定并且比较.结果 综合康复组患者步行能力较普通康复组改善明显,总有效率明显高于普通康复组(P<0.05).结论 减重步态机器人对偏瘫患者的恢复步行能力及改善异常步态有积极的作用.%Objective To study the effects of weight relieving ambulator on walking function of hemiplegic patients suffered from cerebral stroke. Methods Fifty hemiplegic patients were randomly divided into two groups: the comprehensive rehabilitation group and the general rehabilitation group. The comprehensive rehabilitation group was treated in the conventional method combined with weight relieving ambulator, while the general rehabilitation group was treated with the conventional method only. The period of treatment was one month. After treatment, the Carr-Shepherd assessment of motor function ( MAS ) was used to compare the walking function between the two groups. Results Patients of the comprehensive rehabilitation group had more improvements in walking ability than those of the general rehabilitation group did. Conclusion It is concluded that the weight relieving ambulator has a positive effect on the improvement of walking ability and abnormal gait of hemiplegic patients.

  3. Direct ambulance transport to catheterization laboratory reduces door-to-balloon time in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the DIRECT-STEMI study

    Institute of Scientific and Technical Information of China (English)

    QIU Jian-ping; ZHANG Qi; LU Ji-de; WANG Hai-rong; LIN Jie; GE Zhi-ru; ZHANG Rui-yan; SHEN Wei-feng


    Background Primary percutaneous coronary intervention (PCI) has been clearly identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI). The importance of reducing door-to-balloon (D2B) time has gained increased recognition. This study aimed to assess the feasibility, safety and efficacy of the strategy of direct ambulance transportation of patients with acute STEMI to catheterization lab to receive primary PCI.Methods The study population included 141 consecutive patients with chest pain and ST-segment elevation who were admitted to the catheterization laboratory directly by the ambulance and underwent primary PCI (DIRECT group).Another 145 patients with STEMI randomly selected from the PCI database, were served as control group (conventional group); they were transported to catheterization laboratory from emergency room (ER). The primary endpoint of D2B time,and secondary endpoint of in-hospital and 30-day major adverse cardiac events (MACE, including death, non-fatal reinfarction, and target vessel revascularization) were compared.Results Baseline and procedural characteristics between the two groups were comparable, except more patients in the DIRECT group presented TIMI 0-1 flow in culprit vessel at initial angiogram (80.1% and 73.8%, P=0.04). Comparing to conventional group, the primary endpoint of D2B time was reduced ((54±18) minutes and (112±55) minutes, P <0.0001)and the percentage of patients with D2B <90 minutes was increased in the DIRECT group (96.9% and 27.0%, P<0.0001).The success rate of primary PCI with stent implantation with final Thrombolysis in Myocardial Infarction (TIMI) 3 flow was significantly higher in the DIRECT group (93.8% and 85.2%, P=0.03). Although no significant difference was found at 30-day MACE free survival rate between the two groups (95.0% and 89.0%, P=0.06), a trend in improving survival status in the DIRECT group was demonstrated by Kaplan-Meier analysis

  4. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Thorley Megan


    Full Text Available Abstract Background Children with cerebral palsy (CP whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V, compared with standard therapy alone (cycle I, and whether repeated injections with the same regime of adjunctive therapy results in greater benefits compared with a single injecting episode (cycle II. The regime of therapy will include serial casting, splinting and/or provision of orthoses, as indicated, combined with four sessions of goal directed occupational therapy or physiotherapy. Method/design This study is a double blind randomized controlled trial. Forty participants will be recruited. In cycle I, participants will be randomized to either a treatment group who will receive BoNT-A injections into selected upper and/or lower limb muscles, or a control group who will undergo sham injections. Both groups will receive occupational therapy and /or physiotherapy following injections. Groups will be assessed at baseline then compared at 4 and 16 weeks following injections or sham control. Parents, treating clinicians and assessors will be masked to group allocation. In cycle II, all participants will undergo intramuscular BoNT-A injections to selected upper and/or lower limb muscles, followed by therapy. The primary outcome measure will be change in parent ratings in identified areas of concern for their child’s care and comfort, using the Canadian Occupational Performance Measure (COPM. Secondary measures will include the Care and Comfort Hypertonicity Scale (ease of care, the Cerebral Palsy Quality of Life Questionnaire (CP QoL–Child (quality of life, the Caregiver Priorities and Child

  5. Telephone Service

    CERN Multimedia


    As part of the upgrade of telephone services, the CERN exchange switches will be updated on Thursday 2 June between 7.00 p.m. and midnight. Telephone services may be affected and possibly even disrupted during this operation. 

  6. Registration Service

    CERN Multimedia

    GS Department


    Following a reorganization in Building 55, please note that the Registration Service is now organised as follows :  Ground floor: access cards (76903). 1st floor : registration of external firms’ personnel (76611 / 76622); car access stickers (76633); biometric registration (79710). Opening hours: 07-30 to 16-00 non-stop. GS-SEM Group General Infrastructure Services Department

  7. Attribute Perception Mapping Services Domestic Airlines Using Correspondence Analysis

    Directory of Open Access Journals (Sweden)

    Reni Heviandri Riandarini


    Full Text Available Positioning analysis provides a better understanding of the position based on the perception of passenger flights to service these attributes attached to each airline. This study aims to perform positioning of the domestic airline services based attributes, which characterize the air-line based on the perception of consumers. Correspondence Analysis (CA is used to determine the positioning of the six commercial airlines in Indonesia. The results of correspondence analysis showed that the airline Garuda, Lion Air, Citilink and Air Asia already has its own characteristics inherent in the minds of consumers, while the two other airlines, namely Batik Air and Sriwijaya Air has not had a special identifier.

  8. Impact of the daily variations of the air pollution on the ambulatory emergency health services activity. Study in the urban area of Rouen (France); Impact des variations quotidiennes de la pollution atmospherique sur l'activite du dispositif d'urgences pre-hospitalieres. Etude dans l'agglomeration de Rouen

    Energy Technology Data Exchange (ETDEWEB)

    Hautemaniere, A.; Czernichow, P.; Germain, J.M.; Zeghnoun, K. [Centre Hospitalier Universitaire, Dept. d' Epidemiologie et de Sante Publique, 76 - Rouen (France); Delmas, V. [Air Normand, 76 - Rouen (France); Falourd, J.C.; Dureuil, B. [Service d' Aide Medicale Urgente de Seine Maritime, 76 - Rouen (France)


    The aim of this study was to evaluate feasibility of using both the emergency phone calls (SAMU) and medical interventions (SMUR) related to ambulatory emergency services for local epidemiological surveillance of health impact of air pollution. A temporal ecological study was performed at Rouen area (france) (380000 inhabitants) for 1990-1997 (SAMU) and 1990-1996 (SMUR). The pollutants tested were: Sulphur dioxide (SO{sub 2}), Particles (PM13), and Nitrogen dioxide (NO{sub 2}), as collected routinely by a local automated network. For each phone call (SAMU) or emergency interventions (SMUR), the date, medical reason for calling (SAMU) or diagnosis after interventions (SMUR) (classified as respiratory, cardiovascular or other diseases) have been extracted from a specific information system. A statistical analysis based on time series analysis associated to a Poisson regression was conducted, taking into account temporal trend, seasonal variations, influenza, days of the week, holiday and meteorological data. An association was observed between ambulatory emergency services activity for cardiovascular diseases, and the daily variations of both SO{sub 2} (relative risk = 1.008 [1.001-1.016] for SAMU with an increase of 10{mu}g/m{sup 3}) and NO{sub 2} (relative risk 1.018 [1.008-1.030] for SAMU, relative risk = 1.016 [1.001-1.032] for SMUR with an increase of 10{mu}g/m{sup 3}). No association could be observed with the respiratory diseases for these pollutants. The ambulatory emergency services activity data could contribute to an epidemiological surveillance of the health impact of the air pollution, but a better quality of data collected (concerning both procedures and codification) is requested. The interest of an epidemiological surveillance, rather than usual pollutant monitoring, remains to evaluate. (authors)

  9. Air filtration and indoor air quality

    DEFF Research Database (Denmark)

    Bekö, Gabriel


    decent ventilation and air cleaning/air filtration, high indoor air quality cannot be accomplished. The need for effective air filtration has increased with increasing evidence on the hazardous effects of fine particles. Moreover, the air contains gaseous pollutants, removal of which requires various air....... These contradictions should motivate manufacturers and researchers to develop new efficient filtration techniques and/or improve the existing ones. Development of low polluting filtration techniques, which are at the same time easy and inexpensive to maintain is the way forward in the future....

  10. Air pollution

    Energy Technology Data Exchange (ETDEWEB)


    Air pollution conditions in Iwakuni city were monitored at 9 monitoring stations, and 21 locations where sulfur oxides were measured by the lead peroxide candle method, and 13 locations where particulates concentrations were determined by the deposit cage method. The average SO/sub x/ concentrations in 1973 measured by the lead peroxide candle method ranged from 0.17 mg sulfur trioxide/day/100 sq cm at the Miso Office to 0.58 mg SO/sub 3//day/100 sq cm at Mitsui Sekiyu Shataku. The average SO/sub x/ concentrations measured by the conductivity method ranged from 0.021 ppM at Kazuki Kominkan to 0.037 ppM at the Higashi Fire Department. Only 58% of a total of 264 measurement days gave hourly average concentrations below the environmental standard of 0.04 ppM at the Higashi Fire Deparment. The average airborne particulate concentrations ranged from 0.050 mg/cu m at Totsu Kominkan to 0.056 mg/cu at the Higashi Fire Department. The average nitrogen oxides concentrations measured by the Saltzman method ranged from 0.007 ppM to 0.061 ppM. The average oxidant concentrations at the Iwakuni Municipal Office and Kazuki Kominkan were 0.028 ppM and 0.037 ppM, respectively.

  11. ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Van't Hof, Arnoud; Giannini, Francesco; Ten Berg, Jurrien;


    BACKGROUND: Myocardial reperfusion after primary percutaneous coronary intervention (PCI) can be assessed by the extent of post-procedural ST-segment resolution. The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trial compared pre-hospital bivalirudin and pre-hospital heparin...... with electrocardiographic data available in 824 patients (95%). Residual ST-segment deviation one hour after PCI was 3.8±4.9 mm versus 3.9±5.2 mm for bivalirudin and heparin+GPI, respectively (p=0.0019 for non-inferiority). Overall, there were no differences between randomized treatments in any measures of ST......-segment resolution either before or after the index procedure. CONCLUSIONS: Pre-hospital treatment with bivalirudin is non-inferior to pre-hospital heparin + GPI with regard to residual ST-segment deviation or ST-segment resolution, reflecting comparable myocardial reperfusion with the two strategies....

  12. 关于化解院前急救救护车压担架难题的思考%Thoughts of resolving the ambulance retention of pre-hospital emergency

    Institute of Scientific and Technical Information of China (English)

    田建广; 朱勤忠


    介绍了近几年上海市院前急救救护车压担架状况、国外急诊预检分级救治的经验、我国急诊预检分级的机制和实践探索,并分析了影响急诊预检分级制度推行的相关问题。%This paper introduced the status of the ambulance retention in recent years,the overseas experience of emergency triage grading treatment,the exploration of the mechanism and the practice of emergency triage classification in China,and analyzed related problems affecting the implementation of emergency triage grading system.

  13. 院前急救调度质量控制对救护车空返率的影响%Effects of scheduling quality control on empty return rate of ambulance in prehospital emergency care

    Institute of Scientific and Technical Information of China (English)

    李丽梅; 刘菁; 胡远扬


    Objective To investigate the effect of scheduling quality control on ambulance empty return rate in prehospital e-mergency care.Methods New formulation of scheduling quality implementation method is launched in 2013, the record of dispatc-hing prehospital emergency care ambulances in Quanzhou Emergency Command Center were selected, then empty return rate and scheduling quality of 2012 and 2013 were compared.Results In 2012, a total of 13 639 ambulances were dispatched.In 2013, a to-tal of 13 245 ambulances, empty return rate in 2012 was higher than in 2013(19.80% vs 17.98%), the difference was statistically significance(χ2 =14.392,P<0.001);The average response time(4.3 s vs 4.1 s) and processing time(56.3 s vs 48 s) of dispatch-ers’ answering alarm and off-hook in 2012 is higher than that in 2013, frequency of the processing time longer than 90 s was signifi-cantly declined in 2013(χ2 =105.820,P<0.001).Conclusions Through the improvement of prehospital emergency system, and strengthen the implementation of dispatchers’ quality control.It can effectively reduce the empty return rate, and improve the prehospi-tal emergency rescue efficiency.%目的:探讨调度质量控制对救护车空返率的影响。方法2013年泉州市急救指挥中心启用新制定的调度质量实施方法,选取统计其2012年和2013年院前急救出车情况,并比较两年的救护车空返率和调度质量。结果2012年共出车13639车次,2013年共出车13245车次,其中2012年空返率高于2013年(19.80% vs 17.98%),差异有统计学意义(χ2=14.392,P<0.001);2012年调度员接警摘机平均反应时间(4.3 s vs 4.1 s),平均受理时间(56.3 s vs 48.0 s)均高于2013年,其中2013年的受理时间大于90 s的次数明显下降(χ2=105.820,P<0.001)。结论通过完善院前急救体制和加强实施中心调度员质量控制,可以有效地降低院前急救空返率、提高院前急救抢救效率。

  14. Characteristics analysis of pneumatic artificial muscle isolation system of vehicle-mounted stretcher on ambulance%救护车载 PAM担架缓冲系统特性分析

    Institute of Scientific and Technical Information of China (English)

    孙大刚; 高蓬; 宋勇; 梁培根; 沈毅


    Based on the analysis of the vibration isolation system of ambulance stretcher and the study on its dynamic model,a new buffer system of stretcher based on pneumatic artificial muscle was proposed.Then a vehicle-stretcher-human vibration model was built up,and a semi-active neural network PID controller for stretcher vibration control based on pneumatic artificial muscle was designed.The vibration isolation system performances were simulated by using the Simulation software,and the simulation results were analysed.The results show that compared with traditional system,the pneumatic artificial muscle buffer system using neural network PID control has more obvious isolation effect on stretcher and patient vibration,indicating the feasibility of using pneumatic artificial muscle in buffer system of ambulance stretcher.%经对救护车担架隔振系统及动力学模型研究分析,提出气动人工肌肉(PAM)救护车担架隔振系统。建立车体-担架-分段人体振动模型,设计基于该系统的半主动神经网络 PID 控制器,并用 Simulink 对隔振系统进行性能仿真分析。仿真结果表明,与被动系统相比,采用神经网络 PID 控制的气动人工肌肉隔振系统对担架及人体有明显隔振效果,气动人工肌肉用于救护车担架隔振系统具有可行性。

  15. Air Sensor Toolbox (United States)

    Air Sensor Toolbox provides information to citizen scientists, researchers and developers interested in learning more about new lower-cost compact air sensor technologies and tools for measuring air quality.

  16. HEPA air filter (image) (United States)

    ... pet dander and other irritating allergens from the air. Along with other methods to reduce allergens, such ... controlling the amount of allergens circulating in the air. HEPA filters can be found in most air ...

  17. GSPEL - Air Filtration Laboratory (United States)

    Federal Laboratory Consortium — Evaluation capabilities for air filtration devicesThe Air Filtration Lab provides testing of air filtration devices to demonstrate and validate new or legacy system...

  18. Lead (Pb) Air Pollution (United States)

    ... States Environmental Protection Agency Search Search Lead (Pb) Air Pollution Share Facebook Twitter Google+ Pinterest Contact Us As ... and protect aquatic and terrestrial ecosystems. Lead (Pb) Air Pollution Lead Air Pollution Basics How does lead get ...

  19. AirPEx: Air Pollution Exposure Model


    Freijer JI; Bloemen HJTh; de Loos S; Marra M; Rombout PJA; Steentjes GM; Veen MP van; LBO


    Analysis of inhalatory exposure to air pollution is an important area of investigation when assessing the risks of air pollution for human health. Inhalatory exposure research focuses on the exposure of humans to air pollutants and the entry of these pollutants into the human respiratory tract. The principal grounds for studying the inhalatory exposure of humans to air pollutants are formed by the need for realistic exposure/dose estimates to evaluate the health effects of these pollutants. T...

  20. Determination of individual preparation behaviors of emergency health services personnel towards disasters

    Institute of Scientific and Technical Information of China (English)

    Hseyin Koak; Cneyt aliskan; Edip Kaya; merYavuz; Kerim Hakan Altintas


    Objective: To determine certain behaviors regarding preparation of Canakkale 112 ambulance service personnel towards emergency situations and disasters. Methods: This study is an epidemiological descriptive study. The population of the study consists of 281 people working for Command Control Center and Emergency Medical Services Station of Canakkale 112 Ambulance Service. About 176 people agreed to participate in the study were interviewed within the scope of the study. Necessary information was obtained by a survey. In the statistical analysis of the study, descriptive statistics, Mann-Whitney, Kruskal-Wallis and Chi-square tests were used. Results: The participation rate of the study was 62.6% (176 people). The participants were in the range of 17-64 years of age. The average age of the participants was (31.6 ± 9.1) years. About 54% of the participants (95 people) were under the age of 29 and 54% of them (95 people) were male, 23.3% of them (41 people) held a bachelor degree and 35.7% (63 people) of them were Emergency Medical Technicians, respectively. In the study, a statistical relationship was found between some questions of the survey and some variables such as age, gender, degree, membership status for non-governmental organizations, experience of emergency situations, being trained against disasters and desire to have such a training (P Conclusions: As a result of the study, a significant relationship was found between being trained related to disaster and emergency situations and development of positive attitudes about training for disasters and emergencies. This indicates that people, no matter what educational level they are in, have to be trained for disasters and emergencies.

  1. AirPEx: Air Pollution Exposure Model

    NARCIS (Netherlands)

    Freijer JI; Bloemen HJTh; Loos S de; Marra M; Rombout PJA; Steentjes GM; Veen MP van; LBO


    Analysis of inhalatory exposure to air pollution is an important area of investigation when assessing the risks of air pollution for human health. Inhalatory exposure research focuses on the exposure of humans to air pollutants and the entry of these pollutants into the human respiratory tract. The

  2. Air Pollution Monitoring | Air Quality Planning & Standards ... (United States)


    The basic mission of the Office of Air Quality Planning and Standards is to preserve and improve the quality of our nation's air. To accomplish this, OAQPS must be able to evaluate the status of the atmosphere as compared to clean air standards and historical information.

  3. IT Service (United States)

    Department of Homeland Security — Means of delivering value to customers by facilitating outcomes customers want to achieve without the ownership of specific costs and risks. The term 'service' is...

  4. Serviced Living

    Institute of Scientific and Technical Information of China (English)

    LIU BO


    @@ As recently as ten years ago,the term serviced apartment made no sense to most people living in Beijing and residing in hotels was the only options for foreign visitors. But since then, serviced apartments have begun to appear in big cities all around China. In Beijing alone, it is estimated that there are more than 30,000service apartments spread across dozens of properties occupying a space of more than I million square meters. Concentrating in the Financial Street, the Central Business District and Zhongguancun, also known as China's Silicon Valley, the explosion in service apartments in the city continues to be fueled by the influx of overseas and domestic business people.

  5. Transplant services (United States)

    ... this page: // Transplant services To use the sharing features on this ... are comfortable before, during, and after surgery. Information Transplant surgery is typically done to replace a diseased ...

  6. Final Environmental Assessment for the Update and Implementation of the Total Force Training Mission for Visiting Units (Operation Snowbird, Multi-Service, and Foreign Military Sales), Davis-Monthan Air Force Base, Arizona (United States)


    not constitute a hard look absent a justification regarding why more definitive information could not be provided.” League of Wilderness Defenders...8217%&2#1 22:9 League of Wilderness Defenders-Blue Mountains Biodiversity Project v. U.S. Forest Service C.?:2 C 4...Alternative 1 and Alternative 2 DNL Contours Legend D Davis Monthan AFB No Action DNL Contours -- Alternative 1 DNL Contours -- Alternative 2 DNL

  7. 75 FR 21716 - Agency Information Collection; Activity Under OMB Review; Airline Service Quality Performance... (United States)


    ...; Airline Service Quality Performance--Part 234 AGENCY: Research and Innovative Technology Administration... monitor the quality of air service that major air carriers are providing the flying public. The Federal... and returned. SUPPLEMENTARY INFORMATION: OMB Approval No. 2138-0041. Title: Airline Service...

  8. 75 FR 45091 - Notice of Request for Nominations to the Agricultural Air Quality Task Force (United States)


    ... Task Force AGENCY: Natural Resources Conservation Service, United States Department of Agriculture... the Agricultural Air Quality Task Force (AAQTF) and requests nominations for qualified persons to... Chief of the Natural Resources Conservation Service (NRCS) will establish a task force to...

  9. CDC STATE System Tobacco Legislation - Smokefree Indoor Air (United States)

    U.S. Department of Health & Human Services — 1995-2016. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation – Smokefree Indoor Air....

  10. CDC STATE System Tobacco Legislation - Smokefree Indoor Air Summary (United States)

    U.S. Department of Health & Human Services — 1995-2016. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation – Smokefree Indoor Air....

  11. Air flotation treatment of salmon processing waste water (United States)

    US Fish and Wildlife Service, Department of the Interior — This paper discusses methods for the reduction of the pollution strength of salmon processing waste water. Past research has indicated the success of air pressure...

  12. Buenos Aires National Wildlife Refuge [Land Status Map (United States)

    US Fish and Wildlife Service, Department of the Interior — This map was produced by the Division of Realty to depict landownership at Buenos Aires National Wildlife Refuge. It was generated from rectified aerial photography,...

  13. NOS CO-OPS Meteorological Data, Air Temperature, 6-Minute (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset has Air Temperature data from NOAA NOS Center for Operational Oceanographic Products and Services (CO-OPS). WARNING: These preliminary data have not...

  14. 77 FR 39321 - Air Traffic Procedures Advisory Committee (United States)


    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF... Kyker, Environmental Specialist, Air Traffic Eastern Service Center, Operations Support Group, 1701...- point operations help enhance reliability and reduce delays by defining more precise terminal...

  15. EnviroAtlas - Clean Air Metrics for Conterminous United States (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas ( The Clean Air category in this...

  16. Air Quality Measures on the National Environmental Health Tracking Network (United States)

    U.S. Department of Health & Human Services — The Environmental Protection Agency (EPA) provides air pollution data about ozone and particulate matter (PM2.5) to CDC for the Tracking Network. The EPA maintains a...

  17. 32 CFR 881.3 - Individual Service Review Board. (United States)


    ... 32 National Defense 6 2010-07-01 2010-07-01 false Individual Service Review Board. 881.3 Section... Individual Service Review Board. (a) The Commander, Headquarters Air Force Personnel Center (HQ AFPC/CC) establishes the Individual Service Review Board as necessary. (b) The Board consists of military members...

  18. Beyond 'flood hotspots': Modelling emergency service accessibility during flooding in York, UK (United States)

    Coles, Daniel; Yu, Dapeng; Wilby, Robert L.; Green, Daniel; Herring, Zara


    This paper describes the development of a method that couples flood modelling with network analysis to evaluate the accessibility of city districts by emergency responders during flood events. We integrate numerical modelling of flood inundation with geographical analysis of service areas for the Ambulance Service and the Fire & Rescue Service. The method was demonstrated for two flood events in the City of York, UK to assess the vulnerability of care homes and sheltered accommodation. We determine the feasibility of emergency services gaining access within the statutory 8- and 10-min targets for high-priority, life-threatening incidents 75% of the time, during flood episodes. A hydrodynamic flood inundation model (FloodMap) simulates the 2014 pluvial and 2015 fluvial flood events. Predicted floods (with depth >25 cm and areas >100 m2) were overlain on the road network to identify sites with potentially restricted access. Accessibility of the city to emergency responders during flooding was quantified and mapped using; (i) spatial coverage from individual emergency nodes within the legislated timeframes, and; (ii) response times from individual emergency service nodes to vulnerable care homes and sheltered accommodation under flood and non-flood conditions. Results show that, during the 2015 fluvial flood, the area covered by two of the three Fire & Rescue Service stations reduced by 14% and 39% respectively, while the remaining station needed to increase its coverage by 39%. This amounts to an overall reduction of 6% and 20% for modelled and observed floods respectively. During the 2014 surface water flood, 7 out of 22 care homes (32%) and 15 out of 43 sheltered accommodation nodes (35%) had modelled response times above the 8-min threshold from any Ambulance station. Overall, modelled surface water flooding has a larger spatial footprint than fluvial flood events. Hence, accessibility of emergency services may be impacted differently depending on flood mechanism

  19. REACH. Air Conditioning Units. (United States)

    Garrison, Joe; And Others

    As a part of the REACH (Refrigeration, Electro-Mechanical, Air-Conditioning, Heating) electromechanical cluster, this student manual contains individualized instructional units in the area of air conditioning. The instructional units focus on air conditioning fundamentals, window air conditioning, system and installation, troubleshooting and…

  20. Statistical air quality mapping

    NARCIS (Netherlands)

    Kassteele, van de J.


    This thesis handles statistical mapping of air quality data. Policy makers require more and more detailed air quality information to take measures to improve air quality. Besides, researchers need detailed air quality information to assess health effects. Accurate and spatially highly resolved maps

  1. The Effectiveness of Emergency Response System’s Service Providers for Road Accidents in Johor Bahru, Malaysia

    Directory of Open Access Journals (Sweden)

    Kazunori H.


    Full Text Available In Malaysia, there are three core services involved in emergency, namely the fire and rescue, police, and ambulance services. The aim of the service providers is to prevent the loss of life and damage by improving their response time. The Civil Defence Department and the 999 call centre also assist the main providers. This paper aims to provide an overview of emergency response system (ERS for road accidents in Johor Bahru. The objective is to find the effective services from ERS works. There are three sections of chronological events involved: the call centre receiving reports on accidents, at location of the accident and the time during which the victims are brought to the hospital. The paper studies the operation scheme of the ERS by describing the condition; to analyse the questionnaire using a set of questions on the ERS service; and to determine the effectiveness of the services provided. The provider’s services can be identified as a main factor in improving the ERS services provided in the study area.

  2. Service refinement

    Institute of Scientific and Technical Information of China (English)

    HE JiFeng


    This paper presents a refinement calculus for service components. We model the behaviour of individual service by a guarded design, which enables one to separate the responsibility of clients from the commitment made by the system, and to iden-tify a component by a set of failures and divergences. Protocols are introduced to coordinate the interactions between a component with the external environment. We adopt the notion of process refinement to formalize the substitutivity of components, and provide a complete proof method based on the notion of simulations.

  3. Maintenance of air worthiness of aircrafts

    Directory of Open Access Journals (Sweden)

    В. А. Горячев


    Full Text Available Described are modem conditions of operation of Russian civil aviation, state of aircraft stock, the main principles of maintaining air worthiness of airplanes and helicopters. Considered is a stage by stage prolongation of the service life of each specimen of aircraft with certification being obligatory

  4. Innovation in Services: From Service Concepts to Service Experiences


    Fynes, Brian; Lally, Anne Marie


    ABSTRACT Identifying the nature of service experiences is recognised As being of primary importance in the shaping of an enhanced competitive position for industry; however service managers often have difficulty articulating the true nature of their service concept. The definition of service concept is a fundamental part of the strategic advantage seeking Processes of service design, service development and service innovation. In response to the competitive Imperative for improved product/...

  5. Air movement and perceived air quality

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Kaczmarczyk, J.


    The impact of air movement on perceived air quality (PAQ) and sick building syndrome (SBS) symptoms was studied. In total, 124 human subjects participated in four series of experiments performed in climate chambers at different combinations of room air temperature (20, 23, 26 and 28 °C), relative...... and the humidity of the room air. At a low humidity level of 30% an increased velocity could compensate for the decrease in perceived air quality due to an elevated temperature ranging from 20 °C to 26 °C. In a room with 26 °C, increased air movement was also able to compensate for an increase in humidity from 30...

  6. 7 CFR 29.6002 - Air-cured. (United States)


    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Air-cured. 29.6002 Section 29.6002 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Standards Definitions § 29.6002 Air-cured. Tobacco cured under natural atmospheric...

  7. 49 CFR 1510.7 - Air transportation advertisements and solicitations. (United States)


    ... 49 Transportation 9 2010-10-01 2010-10-01 false Air transportation advertisements and... PASSENGER CIVIL AVIATION SECURITY SERVICE FEES § 1510.7 Air transportation advertisements and solicitations... part as “September 11th Security Fee” in all its advertisements and solicitations for...

  8. Mail Service

    CERN Multimedia

    TS-FM Group


    Tuesday 19 October 2004 Please note that the distribution and collection of mail are likely to be disrupted on Tuesday, October 19, 2004, because of traffic and other restrictions enforced on that day in connection with CERN's fiftieth anniversary celebrations. The service may be completely interrupted in certain areas. Group TS-FM, Tel. 77551

  9. PFInancial services

    Index Scriptorium Estoniae


    Briti ettevõttest International Financial Services, mis viib maailmas läbi kampaaniat PPP (Public Private Partnership) ja PFI (Private Finance Initiative) - erasektori ja avaliku sektori vahelise koostöö reklaamimiseks ja edendamiseks. Firma esindajad kohtusid Eesti ametnikega

  10. Refrigeration Servicing. (United States)

    Hamilton, Donald L.; And Others

    This self-study course is designed to familiarize Marine enlisted personnel with the services required to be performed on refrigeration equipment. The course contains four study units. Each study unit begins with a general objective, which is a statement of what the student should learn from the unit. The study units are divided into numbered work…

  11. The impact of a temporary ice-rink on an emergency department service.

    LENUS (Irish Health Repository)

    Clarke, Heather J


    BACKGROUND: A temporary ice-rink opened close to Cork city for 6 weeks from 30 November 2003. During this time, a number of patients presented to the local emergency departments with ice-skating-related injuries. We documented these injuries. METHODS: All patients presenting to emergency departments in Cork city with ice-skating-related complaints were included. Information on age and sex, mechanism of injury, diagnosis, follow-up\\/disposition and ambulance service utilization was recorded. RESULTS: One hundred and twenty-five ice-rink-related attendances were reported at Cork emergency departments, representing 1.25% of total attendances. One hundred and twenty-three patients presented with skating-related injuries and two with medical complaints occurring at the ice-rink: 70.8% were female patients and 29.2% were male patients. In the 4-14-year age group, however, 48.5% were girls and 51.5% were boys. Most injuries were directly due to falls; 5.6% were due to skate blades. The commonest site of injury was the upper limb. Fractures and dislocations accounted for 53.9% of injuries, with 20.5% of these requiring orthopaedic admission. Lacerations and digital injuries accounted for 7.1%, with 11% of these required admission for surgery. One minor head injury was reported. 38.1% had soft tissue injuries. Fifteen patients were transported by ambulance. These attendances represented a minimum overall cost of 77,510 euro to the local health service. CONCLUSIONS: A temporary ice-rink had a significant impact on local emergency departments. Currently, there is no specific legislation in Ireland relating to public health and safety in ice-rinks. We recommend consultation with local public bodies before opening such facilities, and appropriate regulation.

  12. Documentation Service; Service de Documentation

    Energy Technology Data Exchange (ETDEWEB)

    Charnay, J.; Chosson, L.; Croize, M.; Ducloux, A.; Flores, S.; Jarroux, D.; Melka, J.; Morgue, D.; Mottin, C. [Inst. de Physique Nucleaire, Lyon-1 Univ., 69 - Villeurbanne (France)


    This service assures the treatment and diffusion of the scientific information and the management of the scientific production of the institute as well as the secretariat operation for the groups and services of the institute. The report on documentation-library section mentions: the management of the documentation funds, search in international databases (INIS, Current Contents, Inspects), Pret-Inter service which allows accessing documents through DEMOCRITE network of IN2P3. As realizations also mentioned are: the setup of a video, photo database, the Web home page of the institute`s library, follow-up of digitizing the document funds by integrating the CD-ROMs and diskettes, electronic archiving of the scientific production, etc 1 fig.

  13. Information Technology Service; Service Informatique

    Energy Technology Data Exchange (ETDEWEB)

    Ageron, M.; Boninchi, V.; Chartoire, M.; Combroux, A.; Giraud, N.; Jacquet, G.; Lagrange, B.; Malleret, S.; Martin, C.; Mas, J.; Morgue, M.; Ollivier, T. [Inst. de Physique Nucleaire, Lyon-1 Univ., 69 - Villeurbanne (France)


    The information technology service works out the choices concerning the information technology systems of general use in the laboratory: computers, network, peripherals, workstations, software. It intervenes at the same time in the definition of the procedures and equipment specific to the research groups. The entire data acquisition is centralized by the service. The personnel is sharing the following two large directions of activities: - management of information technology park (setup, configuration and maintenance of the materials and soft ensemble, training and assistance afforded to users); - participation in software projects either in elaboration of applications or in realization and maintenance of specific tools


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND: Several initiatives by Government of India under NRHM have been put forth for better facilities to the pregnant women & sick new born babies in government institutions under the schemes like JSY & JSSK, in which free transport services are being provided. AIMS & OBJECTIVES: To assess the utilization of free referral services under JSSK in Ganderbal D istrict of Kashmir ( J & K. METHODOLOGY: A cross sectional study was conducted for a period of one y ear in district Ganderbal, in which 50% of the Sub centers were selected. 10 recently delivered mothers were chosen randomly from each sub center & a sample size of 230 beneficiary were chosen, who had delivered in previous six months. Results : 51.7% of r ecently delivered women were provided free ambulance services from home to the facility, & 68% were provided free service from facility to the home. The money by cheque was provided to 2.8% of the women only, who had hired a vehicle. RECOMMENDATIONS: Better fund flow and gaps in knowledge need to be filled for proper utilization of the services by the beneficiaries

  15. 40 CFR 265.1061 - Alternative standards for valves in gas/vapor service or in light liquid service: percentage of... (United States)


    ... gas/vapor service or in light liquid service: percentage of valves allowed to leak. 265.1061 Section... FACILITIES Air Emission Standards for Equipment Leaks § 265.1061 Alternative standards for valves in gas/vapor service or in light liquid service: percentage of valves allowed to leak. (a) An owner or...

  16. 40 CFR 265.1062 - Alternative standards for valves in gas/vapor service or in light liquid service: skip period... (United States)


    ... gas/vapor service or in light liquid service: skip period leak detection and repair. 265.1062 Section... FACILITIES Air Emission Standards for Equipment Leaks § 265.1062 Alternative standards for valves in gas/vapor service or in light liquid service: skip period leak detection and repair. (a) An owner...

  17. 40 CFR 90.118 - Certification procedure-service accumulation and usage of deterioration factors. (United States)


    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION... recommended lubrication and filter changes, may be performed during service accumulation without...

  18. Random Vibration Analysis of an Integrated Airborne Aid Unit on Ambulance Helicopter%救护直升机机载急救单元随机振动分析

    Institute of Scientific and Technical Information of China (English)

    刘孝辉; 徐新喜; 白松; 谭树林; 杨猛


    为了解某救护直升机机载综合急救单元随机振动响应特性,针对载机平台振动特点,将载机宽带随机叠加正弦振动激励谱转换为ANSYS软件可用的纯随机振动谱,在ANSYS软件中建立了机载综合急救单元有限元模型,通过模态分析,获取了机载综合急救单元固有频率和振型。在此基础上施加转换后的载机振动谱并进行随机振动分析,得到了机载综合急救单元不同部位在激励频带范围内的动力响应及危险频率点,并对单元结构动强度进行了校核。仿真分析结果可为机载综合急救单元的抗减振设计提供参考依据。%To understand the random vibration reponse characteristics of the integrated airborne aid unit on ambulance helicopter, the finite element model of the unit was built by using ANSYS software. According to the vibration characteris-tics of the airborne platform of the ambulance helicopter, the randomly superimposed sinusoidal excitation spectrum of the airborne broadband was converted into a pure random vibration spectrum useable directly for ANSYS. The natural frequen-cies and modals of the unit were obtained by modal analysis. On this basis, the converted vibration spectrum was exerted so that the dynamic response and the critical frequencies in different positions of the integrated airborne aid unit were derived by the random vibration analysis. Meanwhile, the dynamic strength of the unit structure was checked up. The result of the analysis has provided a reference for anti-vibration design of the integrated airborne aid unit.

  19. Pure Air`s advanced flue gas desulfurization clean coal project

    Energy Technology Data Exchange (ETDEWEB)

    Brown, J.R. [Pure Air Bailly Station, Chesterton, IN (United States)


    Pure Air`s Advanced Flue Gas Desulfurization (AFGD) Clean Coal Project successfully completed four and a half years of operation in December 1996 at Northern Indiana Public Service Company`s (NIPSCO) Bailly Generating Station. This project received a $60 million grant from the DOE Clean Coal II program. Included in this was a three year DOE demonstration period. The facility was designed, built and is owned and operated by Pure Air of Allentown, Pennsylvania, through its project company, Pure Air on the Lake, Limited Partnership. The project met or exceeded all performance criteria. It has averaged 95.3% SO{sub 2} removal, 99.9% availability and produced high quality commercial gypsum during this four and a half year period. It demonstrated many advanced technology features including a single, large absorber module serving two boilers, a wastewater evaporation system, an air rotary sparger for oxidation, and a new technology for agglomerating gypsum.

  20. Connectable solar air collectors

    Energy Technology Data Exchange (ETDEWEB)

    Oestergaard Jensen, S.; Bosanac, M.


    The project has proved that it is possible to manufacture solar air collector panels, which in an easy way can be connected into large collector arrays with integrated ducting without loss of efficiency. The developed connectable solar air collectors are based on the use of matrix absorbers in the form of perforated metal sheets. Three interconnected solar air collectors of the above type - each with an transparent area of approx. 3 m{sup 2} - was tested and compared with parallel tests on two single solar air collectors also with a transparent area of approx. 3 m{sup 2} One of the single solar air collectors has an identical absorber as the connectable solar air collectors while the absorber of the other single solar air collector was a fibre cloth. The efficiency of the three solar air collectors proved to be almost identical in the investigated range of mass flow rates and temperature differences. The solar air collectors further proved to be very efficient - as efficient as the second most efficient solar air collectors tested in the IEA task 19 project Solar Air Systems. Some problems remain although to be solved: the pressure drop across especially the connectable solar air collectors is too high - mainly across the inlets of the solar air collectors. It should, however, be possible to considerably reduce the pressure losses with a more aerodynamic design of the inlet and outlet of the solar air collectors; The connectable solar air collectors are easy connectable but the air tightness of the connections in the present form is not good enough. As leakage leads to lower efficiencies focus should be put on making the connections more air tight without loosing the easiness in connecting the solar air collectors. As a spin off of the project a simple and easy way to determine the efficiency of solar, air collectors for pre-heating of fresh air has been validated. The simple method of determining the efficiency has with success been compared with an advance method

  1. Breathe the air!

    CERN Multimedia


    Feeling a bit cooped up in your office? Want to share your interest in science and technology with others but your computer's heard it all before and your colleagues won't even listen anymore? Then here's the answer - come and get some fresh air with the Education and Communication Group. The Visits Service and the Press Office offer you the opportunity to come into contact with CERN visitors. - Be a guide! In becoming a guide you get the opportunity to introduce the Laboratory to vast array of visitors of all nationalities and ages and communicate to them your passion for science and technology. You can get involved as a CERN guide on various levels - giving presentations and tours of the Laboratory, but also leading a «Drôle de Physique» workshop and giving tours of Microcosm. Guides receive training. If you're interested, take a look at the Guides Homepage where all the relevant information and formalities are explained: See also the article in the Bulletin n°25/2002. - Fa...

  2. Dosimetry Service

    CERN Multimedia

    Dosimetry Service


    Please remember to read your dosimeter at least once every month. A regular read-out is indispensable to ensure periodic monitoring of your personal dose. You must read your dosimeter even if you have not visited the controlled areas. Film badges are no longer valid at CERN and holders of film badges are no longer allowed to enter the controlled radiation areas or work with a source. Dosimetry Service Tel. 72155

  3. Organizations And Services In The System Of International Aviation Navigation

    Directory of Open Access Journals (Sweden)

    Alexander I. Travnikov


    Full Text Available In the present article author reveals the order of creation, structure, aims and objectives of national and international intergovernmental aeronautical organizations, governing procedure for flight operations and providing direct air traffic control over sovereign territory and abroad. In this article, author notes that in the world there are three main organizational and legal forms of air traffic control systems to ensure coordination between civil and military air navigation services (agencies. In the Russian Federation, author notes that air navigation services on behalf of the State are made by the State Corporation for Air Traffic Management that has the legal status of the commercial organization - the Federal State Unitary Enterprise. Author analyzes the work of the Organization for the Civil Air Navigation Services (CANSO, the International Federation of Air Traffic Controllers (IFATCA. During the study author also concludes that in the past decade, there is the steady trend of transferring functions of air navigation from the State to commercial organizations (joint stock companies and limited liability companies, which are financed from the funds received as payment for air traffic services. The responsibility for the improper maintenance of international air navigation, of course, is borne by the State. Author notes that regional and international intergovernmental aeronautical organizations operate in respect of all aircraft (public, civil, experimental, i.e., perform general air navigation, unlike ICAO, which takes standards and recommended practices, rules and procedures for safety and air traffic services only to civil aircraft, that does not ensure the creation of a regulatory framework for the global unification of aeronautical processes.

  4. Uncovering ecosystem service bundles through social preferences.

    Directory of Open Access Journals (Sweden)

    Berta Martín-López

    Full Text Available Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem's capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem's capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis. We found a clear trade-off among provisioning services (and recreational hunting versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs.

  5. AirCompare (United States)

    U.S. Environmental Protection Agency — AirCompare contains air quality information that allows a user to compare conditions in different localities over time and compare conditions in the same location...

  6. Allegheny County Air Quality (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Air quality data from Allegheny County Health Department monitors throughout the county. Air quality monitored data must be verified by qualified individuals before...

  7. Air Quality Facilities (United States)

    Iowa State University GIS Support and Research Facility — Facilities with operating permits for Title V of the Federal Clean Air Act, as well as facilities required to submit an air emissions inventory, and other facilities...

  8. Indoor Air Pollution (United States)

    We usually think of air pollution as being outdoors, but the air in your house or office could also be polluted. Sources of indoor pollution include Mold and pollen Tobacco smoke Household products ...

  9. Air Quality System (AQS) (United States)

    U.S. Environmental Protection Agency — The Air Quality System (AQS) database contains measurements of air pollutant concentrations from throughout the United States and its territories. The measurements...

  10. Using Service Scenarios to Model Business Services

    DEFF Research Database (Denmark)

    Bækgaard, Lars

    The purpose of the paper is to present and evaluate the notion of service scenarios. A service is work done by a service executor in interaction with a service consumer. A service scenario is a model of a service system and the roles that are played by the actors participating and interacting dur...... of a case study in a public library. The case study indicates that service systems should be understood as socio-technical systems in which service executors and service consumers co-create value in mutual interaction with each other and with a set of shared resources....

  11. Health Extension Workers' and Mothers' Attitudes to Maternal Health Service Utilization and Acceptance in Adwa Woreda, Tigray Region, Ethiopia (United States)

    Jackson, Ruth; Tesfay, Fisaha Haile; Godefay, Hagos; Gebrehiwot, Tesfay Gebregzabher


    Background The maternal health system in Ethiopia links health posts in rural communities (kebeles) with district (woreda) health centres, and health centres with primary hospitals. At each health post two Health Extension Workers (HEWs) assist women with birth preparedness, complication readiness, and mobilize communities to facilitate timely referral to mid-level service providers. This study explored HEWs’ and mother’s attitudes to maternal health services in Adwa Woreda, Tigray Region. Methods In this qualitative study, we trained 16 HEWs to interview 45 women to gain a better understanding of the social context of maternal health related behaviours. Themes included barriers to health services; women’s social status and mobility; and women’s perceptions of skilled birth attendant’s care. All data were analyzed thematically. Findings There have been substantial efforts to improve maternal health and reduce maternal mortality in Adwa Woreda. Women identified barriers to healthcare including distance and lack of transportation due to geographical factors; the absence of many husbands due to off-woreda farming; traditional factors such as zwar (some pregnant women are afraid of meeting other pregnant women), and discouragement from mothers and mothers-in-law who delivered their children at home. Some women experienced disrespectful care at the hospital. Facilitators to skilled birth attendance included: identification of pregnant women through Women’s Development Groups (WDGs), and referral by ambulance to health facilities either before a woman’s Expected Due Date (EDD) or if labour started at home. Conclusion With the support of WDGs, HEWs have increased the rate of skilled birth attendance by calling ambulances to transfer women to health centres either before their EDD or when labour starts at home. These findings add to the growing body of evidence that health workers at the community level can work with women’s groups to improve maternal

  12. Service registry design: an information service approach

    NARCIS (Netherlands)

    Ferreira Pires, Luis; Oostrum, van Arjen; Wijnhoven, Fons; Wang, J.


    A service registry is a Service-Oriented Architecture (SOA) component that keeps a ‘catalogue’ of available services. It stores service specifications so that these specifications can be found by potential users. Discussions on the design of service registries currently focus on technical issues, wh

  13. Air Power and Warfare (United States)


    Memorial, 1963. (T) 767.8 A3 ser .3, V.4) Air war against Germany and Italy, 1939-1943. Canberra: Australian War Memorial, 1954. (D 767.8 A3 Ser .3, al. Air poder indivisible Air University Ouarterly Review 2:5-18, Fall 1950. Spaatz, Crrl. Air-power odds against us. Readers Digest 58:11-14, June

  14. Indoor air quality

    DEFF Research Database (Denmark)

    Jensen, Trine Susanne; Recevska, Ieva

     The objective of the 35th specific agreement is to provide support to the EEA activities in Environment and Health (E&H) on the topic of indoor air quality. The specific objectives have been to provide an overview of indoor air related projects in EU and indoor air related policies as well...... as idenfiying "good practices" to reduce health impact of indoor air exposure and suggest areas for future improvements....

  15. We Pollute the Air

    Institute of Scientific and Technical Information of China (English)


    1.Clean air is important to good health.If the aircontains impurities,they may be absorbed by ourbodies and make us ill.We need clean air,butunfortunately,air pollution is generally present,especially in cities. 2.Our cities have many factories,which we need tomake food products,clothing and many other things.

  16. Air Pollution Training Programs. (United States)

    Public Health Service (DHEW), Rockville, MD.

    This catalog lists the universities, both supported and not supported by the Division of Air Pollution, which offer graduate programs in the field of air pollution. The catalog briefly describes the programs and their entrance requirements, the requirements, qualifications and terms of special fellowships offered by the Division of Air Pollution.…

  17. Effect of High-Dose Vitamin D3 Intake on Ambulation, Muscular Pain and Bone Mineral Density in a Woman with Multiple Sclerosis: A 10-Year Longitudinal Case Report

    Directory of Open Access Journals (Sweden)

    François Feron


    Full Text Available Mounting evidence correlate vitamin D3 (cholecalciferol supplementation or higher serum levels of vitamin D (25(OHD with a lower risk of developing multiple sclerosis (MS, reduced relapse rate, slower progression or fewer new brain lesions. We present here the case of a woman who was diagnosed with MS in 1990. From 1980 to 2000, her ability to walk decreased from ~20 to 1 km per day. Since January 2001, a vitamin D3 supplement was ingested daily. The starting dose was 20 mcg (800 IU/day and escalated to 100 mcg (4000 IU/day in September 2004 and then to 150 mcg (6000 IU/day in December 2005. Vitamin D3 intake reduced muscular pain and improved ambulation from 1 (February 2000 to 14 km/day (February 2008. Vitamin D intake over 10 years caused no adverse effects: no hypercalcaemia, nephrolithiasis or hypercalciuria were observed. Bowel problems in MS may need to be addressed as they can cause malabsorption including calcium, which may increase serum PTH and 1,25(OH2D levels, as well as bone loss. We suggest that periodic assessment of vitamin D3, calcium and magnesium intake, bowel problems and the measurement of serum 25(OHD, PTH, Ca levels, UCa/Cr and bone health become part of the integral management of persons with MS.

  18. 76 FR 27003 - Notice of Meeting of the Agricultural Air Quality Task Force (United States)


    ... Natural Resources Conservation Service Notice of Meeting of the Agricultural Air Quality Task Force AGENCY...: Notice of meeting. SUMMARY: The Agricultural Air Quality Task Force (AAQTF) will meet to continue... Updates D. Federal Travel Regulations E. Air Quality Issues/Concerns from Previous Task Force...

  19. 78 FR 10127 - Request for Nominations to the Agricultural Air Quality Task Force (United States)


    ... Air Quality Task Force AGENCY: Natural Resources Conservation Service, United States Department of Agriculture. ACTION: Notice of Request for Nominations to the Agricultural Air Quality Task Force. SUMMARY... term on the Agricultural Air Quality Task Force (AAQTF) which was established by the...

  20. 75 FR 66125 - Federal Land Managers' Air Quality Related Values Work Group (FLAG) (United States)


    ... National Park Service Federal Land Managers' Air Quality Related Values Work Group (FLAG) AGENCY: National...' Air Quality Related Values Work Group (FLAG) was formed (1) to develop a more consistent and objective... constituencies (e.g., State air regulatory agencies, concerned citizens, environmental groups,...

  1. 47 CFR 0.431 - The FCC service frequency lists. (United States)


    ..., except the following: Aircraft, amateur, personal (except General Mobile Radio Service), Civil Air Patrol..., D.C., in the Office of Engineering and Technology. Copies may be purchased from the...

  2. Stochastic Modeling of Airlines' Scheduled Services Revenue (United States)

    Hamed, M. M.


    Airlines' revenue generated from scheduled services account for the major share in the total revenue. As such, predicting airlines' total scheduled services revenue is of great importance both to the governments (in case of national airlines) and private airlines. This importance stems from the need to formulate future airline strategic management policies, determine government subsidy levels, and formulate governmental air transportation policies. The prediction of the airlines' total scheduled services revenue is dealt with in this paper. Four key components of airline's scheduled services are considered. These include revenues generated from passenger, cargo, mail, and excess baggage. By addressing the revenue generated from each schedule service separately, air transportation planners and designers are able to enhance their ability to formulate specific strategies for each component. Estimation results clearly indicate that the four stochastic processes (scheduled services components) are represented by different Box-Jenkins ARIMA models. The results demonstrate the appropriateness of the developed models and their ability to provide air transportation planners with future information vital to the planning and design processes.

  3. Manual for THOR-AirPAS - air pollution assessment system

    DEFF Research Database (Denmark)

    Jensen, Steen Solvang; Ketzel, Matthias; Brandt, Jørgen

    The report provides an outline of the THOR-AirPAS - air pollution assessment system and a brief manual for getting started with the air quality models and input data included in THOR-AirPAS.......The report provides an outline of the THOR-AirPAS - air pollution assessment system and a brief manual for getting started with the air quality models and input data included in THOR-AirPAS....

  4. Tinted Blue: Air Force Culture and American Civil-Military Relations (United States)


    debates of 2007–08—providing spectral variation on the depen- dent variable of cooperation or resistance. This variation creates a useful array for...roles and missions among the services spawned fractious debate and bureaucratic wrangling.48 These dynamics imbued the Air Force with a sensitivity to...among the services. In fact, the Air Force was eager to cooperate. As the following analysis highlights, the Air Force formed a unique en- clave of

  5. Innovation in the United States Air Force: Evidence from Six Cases (United States)

    Air Force senior leaders have initiated a conversation about what can and should be done to make the service more innovative . The purpose of is to contribute to that conversation by assessing a series of historical cases of Air Force innovation , or apparent failure to innovate , in the...context of the scholarly literature on military innovation . Our primary aim is to inform Air Force efforts to make the service more innovative .

  6. Developing an active emergency medical service system based on WiMAX technology. (United States)

    Li, Shing-Han; Cheng, Kai-An; Lu, Wen-Hui; Lin, Te-Chang


    The population structure has changed with the aging of population. In the present, elders account for 10.63% of the domestic population and the percentage is still gradually climbing. In other words, the demand for emergency services among elders in home environment is expected to grow in the future. In order to improve the efficiency and quality of emergency care, information technology should be effectively utilized to integrate medical systems and facilities, strengthen human-centered operation designs, and maximize the overall performance. The improvement in the quality and survival rate of emergency care is an important basis for better life and health of all people. Through integrated application of medical information systems and information communication technology, this study proposes a WiMAX-based emergency care system addressing the public demands for convenience, speed, safety, and human-centered operation of emergency care. This system consists of a healthcare service center, emergency medical service hospitals, and emergency ambulances. Using the wireless transmission capability of WiMAX, patients' physiological data can be transmitted from medical measurement facilities to the emergency room and emergency room doctors can provide immediate online instructions on emergency treatment via video and audio transmission. WiMAX technology enables the establishment of active emergency medical services.

  7. Les dispositifs de gestion d’un contexte à l’autre : métissage, ruptures, innovations ? Management Arrangements from One Context to Another : Crossbreeding, Ruptures and Innovations ? French Water and Electricity Service Groups in the Shantytowns of Buenos Aires

    Directory of Open Access Journals (Sweden)

    Sarah Botton


    Full Text Available Cet article interroge les pratiques gestionnaires de deux entreprises de services urbains, filiales des groupes français Suez et EDF qui sont intervenues dans les années 1990 et 2000 dans la distribution privatisée de l’eau et de l’électricité à Buenos Aires. Le questionnement repose sur les dispositifs de gestion que ces organisations ont alors mis en place à destination des habitants de quartiers défavorisés, nouveaux acteurs d’une relation de service « marchandisée », dont la particularité est qu’ils sont peu solvables, souvent installés de manière informelle, voire clandestine, au cœur d’un véritable « problème politique ». Nous interrogeons ainsi, grâce aux grilles de lecture proposées par la sociologie de la gestion notamment, les outils mis en place par ces entreprises, les dynamiques de recomposition, d’innovation ou de métissage de dispositifs de gestion « importés » des expériences européennes (formation ou de projets de développement (modalité participative d’intervention. Nous questionnons également l’émergence d’une nouvelle profession d’« ingénieur social » dans un contexte particulier de très forte polarisation sociale, ainsi que les analyses connexes relatives aux modes de légitimation et d’ancrage de cette nouvelle profession.This article looks at the management practices of two urban service enterprises, subsidiaries of the French groups Suez and EDF, who intervened in the 1990’s and after 2000 in the privatized distribution of water and electricity in Buenos Aires. The questioning involves the management arrangements that these organizations set up for the inhabitants of the downtrodden quarters, new actors in a “merchandized” service relationship, whose particularity is that they are practically insolvent, often housed informally, or in a clandestine manner, at the heart of a truly “political problem”. Thanks to question charts, notably proposed by

  8. Tractor Mechanics: Maintaining and Servicing the Fuel System. Learning Activity Packages 20-33. (United States)

    Clemson Univ., SC. Vocational Education Media Center.

    Learning activity packages are presented for instruction in tractor mechanics. The packages deal with the duties involved in maintaining the fuel system. The following fourteen learning activity packages are included: servicing fuel and air filters, servicing fuel tanks and lines, adjusting a carburetor, servicing a carburetor, servicing the…

  9. Impacts of Climate Policy on Regional Air Quality, Health, and Air Quality Regulatory Procedures (United States)

    Thompson, T. M.; Selin, N. E.


    Both the changing climate, and the policy implemented to address climate change can impact regional air quality. We evaluate the impacts of potential selected climate policies on modeled regional air quality with respect to national pollution standards, human health and the sensitivity of health uncertainty ranges. To assess changes in air quality due to climate policy, we couple output from a regional computable general equilibrium economic model (the US Regional Energy Policy [USREP] model), with a regional air quality model (the Comprehensive Air Quality Model with Extensions [CAMx]). USREP uses economic variables to determine how potential future U.S. climate policy would change emissions of regional pollutants (CO, VOC, NOx, SO2, NH3, black carbon, and organic carbon) from ten emissions-heavy sectors of the economy (electricity, coal, gas, crude oil, refined oil, energy intensive industry, other industry, service, agriculture, and transportation [light duty and heavy duty]). Changes in emissions are then modeled using CAMx to determine the impact on air quality in several cities in the Northeast US. We first calculate the impact of climate policy by using regulatory procedures used to show attainment with National Ambient Air Quality Standards (NAAQS) for ozone and particulate matter. Building on previous work, we compare those results with the calculated results and uncertainties associated with human health impacts due to climate policy. This work addresses a potential disconnect between NAAQS regulatory procedures and the cost/benefit analysis required for and by the Clean Air Act.

  10. Air Conditioning Does Reduce Air Pollution Indoors (United States)

    Healy, Bud


    Report of the winter meeting of the American Society of Heating, Refrigerating and Air-Conditioning Engineers. Subjects covered are--(1) title subject, (2) predictions for the human habitat in 1994, (3) fans, and (4) fire safety in buildings. (JW)

  11. The Service Utility Model in Service Management

    Institute of Scientific and Technical Information of China (English)

    LI Yan; ZHOU Wen-an; SONG Jun-de


    Aiming to provide a measurable service Quality of Service (QoS) evaluating method for service inventory management, this paper proposes a new mobile Service Utility Model (SUM), considers the service and business layer elements into the service utility influence profile, and proposes an self-adaptive service inventory management algorithm as a QoS control scheme based on SUM. It can be concluded from the simulation result that the service inventory utility can be fully reflected by SUM and the whole system efficiency is greatly increased by using SUM as the adaptive rule.

  12. Hand Washing Practices Among Emergency Medical Services Providers

    Directory of Open Access Journals (Sweden)

    Joshua Bucher


    Full Text Available Introduction: Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS workers, respectively. Methods: We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results: There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003. Providers who brought their own sanitizer were more likely to clean their hands. Conclusion: Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

  13. Cornerstone: Foundational Models and Services for Integrated Battle Planning (United States)


    Defense Advanced Research Projects Agency (DARPA) Joint Air Ground Unified Adaptive Re-planner ( JAGUAR ) program [ JAGUAR ]. For the cyber domain...loaded the Plan Repository with a 50-mission dataset adapted from the previous DARPA JAGUAR program. For space missions, we authored the OPIR mission...2013) include, by service: • Integrate Cornerstone with BAE Systems’ DARPA JAGUAR automated air mission generator and CACI’s AFRL-sponsored Air

  14. Air quality and future energy system planning (United States)

    Sobral Mourao, Zenaida; Konadu, Dennis; Lupton, Rick


    Ambient air pollution has been linked to an increasing number of premature deaths throughout the world. Projected increases in demand for food, energy resources and manufactured products will likely contribute to exacerbate air pollution with an increasing impact on human health, agricultural productivity and climate change. Current events such as tampering emissions tests by VW car manufacturers, failure to comply with EU Air Quality directives and WHO guidelines by many EU countries, the problem of smog in Chinese cities and new industrial emissions regulations represent unique challenges but also opportunities for regulators, local authorities and industry. However current models and practices of energy and resource use do not consider ambient air impacts as an integral part of the planing process. Furthermore the analysis of drivers, sources and impacts of air pollution is often fragmented, difficult to understand and lacks effective visualization tools that bring all of these components together. This work aims to develop a model that links impacts of air quality on human health and ecosystems to current and future developments in the energy system, industrial and agricultural activity and patterns of land use. The model will be added to the ForeseerTM tool, which is an integrated resource analysis platform that has been developed at the University of Cambridge initially with funding from BP and more recently through the EPSRC funded Whole Systems Energy Modeling (WholeSEM) project. The basis of the tool is a set of linked physical models for energy, water and land, including the technologies that are used to transform these resources into final services such as housing, food, transport and household goods. The new air quality model will explore different feedback effects between energy, land and atmospheric systems with the overarching goal of supporting better communication about the drivers of air quality and to incorporate concerns about air quality into

  15. Prehospital electronic patient care report systems: early experiences from emergency medical services agency leaders.

    Directory of Open Access Journals (Sweden)

    Adam B Landman

    Full Text Available BACKGROUND: As the United States embraces electronic health records (EHRs, improved emergency medical services (EMS information systems are also a priority; however, little is known about the experiences of EMS agencies as they adopt and implement electronic patient care report (e-PCR systems. We sought to characterize motivations for adoption of e-PCR systems, challenges associated with adoption and implementation, and emerging implementation strategies. METHODS: We conducted a qualitative study using semi-structured in-depth interviews with EMS agency leaders. Participants were recruited through a web-based survey of National Association of EMS Physicians (NAEMSP members, a didactic session at the 2010 NAEMSP Annual Meeting, and snowball sampling. Interviews lasted approximately 30 minutes, were recorded and professionally transcribed. Analysis was conducted by a five-person team, employing the constant comparative method to identify recurrent themes. RESULTS: Twenty-three interviewees represented 20 EMS agencies from the United States and Canada; 14 EMS agencies were currently using e-PCR systems. The primary reason for adoption was the potential for e-PCR systems to support quality assurance efforts. Challenges to e-PCR system adoption included those common to any health information technology project, as well as challenges unique to the prehospital setting, including: fear of increased ambulance run times leading to decreased ambulance availability, difficulty integrating with existing hospital information systems, and unfunded mandates requiring adoption of e-PCR systems. Three recurring strategies emerged to improve e-PCR system adoption and implementation: 1 identify creative funding sources; 2 leverage regional health information organizations; and 3 build internal information technology capacity. CONCLUSION: EMS agencies are highly motivated to adopt e-PCR systems to support quality assurance efforts; however, adoption and

  16. Dosimetry Service

    CERN Multimedia

    Dosimetry Service


    Please remember to read your dosimeter every month at least once and preferably during the first week. A regular read-out is indispensable in order to ensure a periodic monitoring of the personal dose. You should read your dosimeter even if you have not visited the controlled areas. If you still have the old dosimeter (film badge), please send it immediately for evaluation to us (Bdg 24 E-011). After January 2005 there will be no developing process for the old film system. Information for Contractors: Please remember also to bring the form ‘Confirm Reception of a CERN Dosimeter' signed with ‘Feuille d'enregistrement du CERN'. Without these forms the dosimeter cannot be assigned. Thank you for your cooperation. Dosimetry Service Tel 767 2155

  17. Air filtration in HVAC systems

    CERN Document Server

    Ginestet, Alain; Tronville, Paolo; Hyttinen, Marko


    Air filtration Guidebook will help the designer and user to understand the background and criteria for air filtration, how to select air filters and avoid problems associated with hygienic and other conditions at operation of air filters. The selection of air filters is based on external conditions such as levels of existing pollutants, indoor air quality and energy efficiency requirements.

  18. Eight Year Climatologies from Observational (AIRS) and Model (MERRA) Data (United States)

    Hearty, Thomas; Savtchenko, Andrey; Won, Young-In; Theobalk, Mike; Vollmer, Bruce; Manning, Evan; Smith, Peter; Ostrenga, Dana; Leptoukh, Greg


    We examine climatologies derived from eight years of temperature, water vapor, cloud, and trace gas observations made by the Atmospheric Infrared Sounder (AIRS) instrument flying on the Aqua satellite and compare them to similar climatologies constructed with data from a global assimilation model, the Modern Era Retrospective-Analysis for Research and Applications (MERRA). We use the AIRS climatologies to examine anomalies and trends in the AIRS data record. Since sampling can be an issue for infrared satellites in low earth orbit, we also use the MERRA data to examine the AIRS sampling biases. By sampling the MERRA data at the AIRS space-time locations both with and without the AIRS quality control we estimate the sampling bias of the AIRS climatology and the atmospheric conditions where AIRS has a lower sampling rate. While the AIRS temperature and water vapor sampling biases are small at low latitudes, they can be more than a few degrees in temperature or 10 percent in water vapor at higher latitudes. The largest sampling biases are over desert. The AIRS and MERRA data are available from the Goddard Earth Sciences Data and Information Services Center (GES DISC). The AIRS climatologies we used are available for analysis with the GIOVANNI data exploration tool. (see,

  19. 40 CFR 94.220 - Service accumulation. (United States)


    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Service accumulation. 94.220 Section 94.220 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... than recommended lubrication and filter changes or maintenance otherwise allowed by this part, may...

  20. Emergency Medical Service (EMS): Rotorcraft Technology Workshop (United States)

    Bauchspies, J. S.; Adams, R. J.


    A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

  1. Rehabilitation and Prosthetic Services (United States)

    ... Service » Prosthetic & Sensory Aids Service (PSAS) Rehabilitation and Prosthetic Services Menu Menu Rehabilitation and Prosthetics Rehabilitation and ... Enter ZIP code here Enter ZIP code here Prosthetic & Sensory Aids Service (PSAS) Our Mission The mission ...

  2. Flying through code/space: the real virtuality of air travel


    Dodge, Martin; Kitchin, Rob


    Commercial air travel is a key global industry facilitating the complex daily movements of planes, people, goods, and services across the world. In this paper we analyse contemporary air travel through the conceptualisation of a culture of real virtuality.We contend that air travel now consists of passage through 'code/space'. Such code/space includes travel websites, check-in, security check- points, flight decks, air-traffic control, immigration, and customs checkpoints, which t...

  3. ITER diagnostics ex-vessel engineering services

    Energy Technology Data Exchange (ETDEWEB)

    Arumugam, A.P., E-mail:; Walker, C.I.; Andrew, P.; Barnsley, R.; Beltran, D.; Bertalot, L.; Dammann, A.; Direz, M.F.; Drevon, J.M.; Encheva, A.; Giacomin, T.; Hourtoule, J.; Kuehn, I.; Lanza, R.; Levesy, B.; Maquet, P.; Patel, K.M.; Patisson, L.; Pitcher, C.S.; Portales, M.; and others


    Highlights: • This paper describes about the ITER diagnostics ex-vessel engineering services. • It describes various diagnostics systems, its location and its environment. • Diagnostics interfaces with other services such as the buildings, HVAC, electrical services, cooling water, vacuum, liquid and gas distribution. • All the interfaces with these services are identified and defined. • Buildings services for diagnostics, such as penetrations, local shielding, embedment and temperature control are discussed. -- Abstract: Extensive diagnostics systems will be installed on the ITER machine to provide the measurements necessary to control, evaluate and optimize plasma performance in ITER and to further the understanding of plasma physics. These include measurements of temperature, density, impurity concentration, and particle and energy confinement times. ITER diagnostic systems extend from the center of the Tokamak to the various diagnostic areas, where they are controlled and acquired data is processed. This mainly includes the areas such as ports, port cells, gallery, diagnostics enclosures and cubicle areas. The diagnostics port plugs encloses the front end of the diagnostic systems and the diagnostics building houses the diagnostics equipment, instrumentation and control cubicles. There are several systems providing services to diagnostics. These mainly include ITER buildings, electrical power services, cooling water services, Heating Ventilation and Air Conditioning (HVAC), vacuum services, liquid and gas distribution services, cable engineering, de-tritiation systems, control cubicles, etc. Requirements of these service systems have to be defined, even though many of the diagnostics are at an early stage of development. It is a real challenge to define and to design diagnostics systems considering the constraints imposed by these service systems. This paper summarizes the provision of these services to the individual diagnostics and diagnostics areas

  4. 走近Air

    Institute of Scientific and Technical Information of China (English)



    @@ 大家对air这个单词并不陌生,它通常用作名词,表示"空气".例如: 1.Better let in fresh air. 最好让新鲜空气进来. 2.The air smells of paint. 空气里散发着油漆味. 3.The air was heavy with perfume of the flowers. 空气里弥漫着花朵的芳香.

  5. Contact air abrasion. (United States)

    Porth, R


    The advantages of contact air abrasion techniques are readily apparent. The first, of course, is the greatly increased ease of use. Working with contact also tends to speed the learning curve by giving the process a more natural dental feel. In addition, as one becomes familiar with working with a dust stream, the potential for misdirecting the air flow is decreased. The future use of air abrasion for deep decay removal will make this the treatment of choice for the next millennium.

  6. Olefin metathesis in air. (United States)

    Piola, Lorenzo; Nahra, Fady; Nolan, Steven P


    Since the discovery and now widespread use of olefin metathesis, the evolution of metathesis catalysts towards air stability has become an area of significant interest. In this fascinating area of study, beginning with early systems making use of high oxidation state early transition metal centers that required strict exclusion of water and air, advances have been made to render catalysts more stable and yet more functional group tolerant. This review summarizes the major developments concerning catalytic systems directed towards water and air tolerance.

  7. Annual Report 2009 (Project Air Force) (United States)


    occurs at fas- tener holes and is marked by bubbling up or flaking of material, similar to the way lumber that has been attacked by termites flakes...were flown at higher OPTEMPOs over longer service lives. However, the option is currently not attractive for several reasons. 48 RAND Project AIR FORCE...operating at high-altitude runways and/or in hot temperatures , winglets may improve the aircraft’s climb performance and shorten the runway length

  8. 14 CFR 217.4 - Data collected (service classes). (United States)



  9. 46 CFR 128.410 - Ship's service refrigeration systems. (United States)


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Ship's service refrigeration systems. 128.410 Section 128.410 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS... service refrigeration systems. No self-contained unit either for air-conditioning or for...

  10. The service Ouroboros: Designing personas service cycles

    DEFF Research Database (Denmark)

    Gudiksen, Sune Klok; Brandt, Eva


    Many companies investigate new business opportunities in a turn from product to service design. As service offerings expand over time and space, such notions as ‘customer journey’ or ‘service blueprint’ have been suggested to grasp and design the nature of the emergent services. However, we find...... that there is room for improve ment on two levels. First, customer journeys and service blueprint tools could benefit from an empathic customer understanding; that is the design of customer - specific services. Secondly, the existing customer journey and service blueprint tools are less concerned with the cyclic...... nature of services,by which we mean the dynamics of a customer relationship and its development over time. We report findings from collaborative workshops, in which we challenged two companies to try a new concept and tool we call ‘The service Ouroboros’. We suggest it as a more appropriate way to design...

  11. Cabin air temperature of parked vehicles in summer conditions: life-threatening environment for children and pets calculated by a dynamic model (United States)

    Horak, Johannes; Schmerold, Ivo; Wimmer, Kurt; Schauberger, Günther


    In vehicles that are parked, no ventilation and/or air conditioning takes place. If a vehicle is exposed to direct solar radiation, an immediate temperature rise occurs. The high cabin air temperature can threaten children and animals that are left unattended in vehicles. In the USA, lethal heat strokes cause a mean death rate of 37 children per year. In addition, temperature-sensitive goods (e.g. drugs in ambulances and veterinary vehicles) can be adversely affected by high temperatures. To calculate the rise of the cabin air temperature, a dynamic model was developed that is driven by only three parameters, available at standard meteorological stations: air temperature, global radiation and wind velocity. The transition from the initial temperature to the constant equilibrium temperature depends strongly on the configuration of the vehicle, more specifically on insulation, window area and transmission of the glass, as well as on the meteorological conditions. The comparison of the model with empirical data showed good agreement. The model output can be applied to assess the heat load of children and animals as well as temperature-sensitive goods, which are transported and/or stored in a vehicle.


    Bradshaw, R.L.; Thomas, J.W.


    The monitor is designed to minimize undesirable background buildup. It consists of an elongated column containing peripheral electrodes in a central portion of the column, and conduits directing an axial flow of radioactively contaminated air through the center of the column and pure air through the annular portion of the column about the electrodes. (AEC)

  13. Air-Conditioning Mechanic. (United States)

    Marine Corps Inst., Washington, DC.

    This student guide, one of a series of correspondence training courses designed to improve the job performance of members of the Marine Corps, deals with the skills needed by air conditioning mechanics. Addressed in the four chapters, or lessons, of the manual are the following topics: principles of air conditioning, refrigeration components as…

  14. The Air We Breathe (United States)

    Davila, Dina


    Topics discussed include NASA mission to pioneer the future in space exploration, scientific discovery and aeronautics research; the role of Earth's atmosphere, atmospheric gases, layers of the Earth's atmosphere, ozone layer, air pollution, effects of air pollution on people, the Greenhouse Effect, and breathing on the International Space Station.

  15. Air/liquid collectors

    DEFF Research Database (Denmark)

    Jensen, Søren Østergaard; Olesen, Ole; Kristiansen, Finn Harken


    This report determine efficiency equations for combined air/liquid solar collectors by measurements on to different air/liquid collectors. Equations which contain all relevant informations on the solar collectors. A simulation program (Kviksol) has been modified in order to be able to handle...

  16. Bad Air For Children (United States)

    Kane, Dorothy Noyes


    Children are especially sensitive to air pollution and consequences to them maybe of longer duration than to adults. The effects of low-level pollution on children are the concern of this article. The need for research on the threat of air pollution to childrens' health is emphasized. (BT)

  17. Air pollution and society


    Brimblecombe P.


    Air pollution is as much a product of our society as it is one of chemistry and meteorology. Social variables such as gender, age, health status and poverty are often linked with our exposure to air pollutants. Pollution can also affect our behaviour, while regulations to improve the environment can often challenge of freedom.

  18. Over the air test

    DEFF Research Database (Denmark)


    [1] This invention relates to over-the-air testing of a device in an anechoic chamber. In particular, the invention is suitable for simulating both uplink and downlink over-the-air communication with a device under test even when the anechoic chamber has different numbers of uplink and downlink...

  19. Air Pollution, Teachers' Edition. (United States)

    Lavaroni, Charles W.; O'Donnell, Patrick A.

    One of three in a series about pollution, this teacher's guide for a unit on air pollution is designed for use in junior high school grades. It offers suggestions for extending the information and activities contained in the textual material for students. Chapter 1 discusses the problem of air pollution and involves students in processes of…

  20. Air Pollution and Industry. (United States)

    Ross, R. D., Ed.

    This book is an authoritative reference and practical guide designed to help the plant engineer identify and solve industrial air pollution problems in order to be able to meet current air pollution regulations. Prepared under the editorial supervision of an experienced chemical engineer, with each chapter contributed by an expert in his field,…