WorldWideScience

Sample records for ambulance location monitoring

  1. Optimizing the location of ambulances in Tijuana, Mexico.

    Science.gov (United States)

    Dibene, Juan Carlos; Maldonado, Yazmin; Vera, Carlos; de Oliveira, Mauricio; Trujillo, Leonardo; Schütze, Oliver

    2017-01-01

    In this work we report on modeling the demand for Emergency Medical Services (EMS) in Tijuana, Baja California, Mexico, followed by the optimization of the location of the ambulances for the Red Cross of Tijuana (RCT), which is by far the largest provider of EMS services in the region. We used data from more than 10,000 emergency calls surveyed during the year 2013 to model and classify the demand for EMS in different scenarios that provide different perspectives on the demand throughout the city, considering such factors as the time of day, work and off-days. A modification of the Double Standard Model (DSM) is proposed and solved to determine a common robust solution to the ambulance location problem that simultaneously satisfies all specified constraints in all demand scenarios selecting from a set of almost 1000 possible base locations. The resulting optimization problems are solved using integer linear programming and the solutions are compared with the locations currently used by the Red Cross. Results show that demand coverage and response times can be substantially improved by relocating the current bases without the need for additional resources. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Using genetic algorithms to optimise current and future health planning - the example of ambulance locations

    Directory of Open Access Journals (Sweden)

    Suzuki Hiroshi

    2010-01-01

    Full Text Available Abstract Background Ambulance response time is a crucial factor in patient survival. The number of emergency cases (EMS cases requiring an ambulance is increasing due to changes in population demographics. This is decreasing ambulance response times to the emergency scene. This paper predicts EMS cases for 5-year intervals from 2020, to 2050 by correlating current EMS cases with demographic factors at the level of the census area and predicted population changes. It then applies a modified grouping genetic algorithm to compare current and future optimal locations and numbers of ambulances. Sets of potential locations were evaluated in terms of the (current and predicted EMS case distances to those locations. Results Future EMS demands were predicted to increase by 2030 using the model (R2 = 0.71. The optimal locations of ambulances based on future EMS cases were compared with current locations and with optimal locations modelled on current EMS case data. Optimising the location of ambulance stations locations reduced the average response times by 57 seconds. Current and predicted future EMS demand at modelled locations were calculated and compared. Conclusions The reallocation of ambulances to optimal locations improved response times and could contribute to higher survival rates from life-threatening medical events. Modelling EMS case 'demand' over census areas allows the data to be correlated to population characteristics and optimal 'supply' locations to be identified. Comparing current and future optimal scenarios allows more nuanced planning decisions to be made. This is a generic methodology that could be used to provide evidence in support of public health planning and decision making.

  3. A decision making method based on interval type-2 fuzzy sets: An approach for ambulance location preference

    Directory of Open Access Journals (Sweden)

    Lazim Abdullah

    2018-01-01

    Full Text Available Selecting the best solution to deploy an ambulance in a strategic location is of the important variables that need to be accounted for improving the emergency medical services. The selection requires both quantitative and qualitative evaluation. Fuzzy set based approach is one of the well-known theories that help decision makers to handle fuzziness, uncertainty in decision making and vagueness of information. This paper proposes a new decision making method of Interval Type-2 Fuzzy Simple Additive Weighting (IT2 FSAW as to deal with uncertainty and vagueness. The new IT2 FSAW is applied to establish a preference in ambulance location. The decision making framework defines four criteria and five alternatives of ambulance location preference. Four experts attached to a Malaysian government hospital and a university medical center were interviewed to provide linguistic evaluation prior to analyzing with the new IT2 FSAW. Implementation of the proposed method in the case of ambulance location preference suggests that the ‘road network’ is the best alternative for ambulance location. The results indicate that the proposed method offers a consensus solution for handling the vague and qualitative criteria of ambulance location preference.

  4. Comparing population and incident data for optimal air ambulance base locations in Norway.

    Science.gov (United States)

    Røislien, Jo; van den Berg, Pieter L; Lindner, Thomas; Zakariassen, Erik; Uleberg, Oddvar; Aardal, Karen; van Essen, J Theresia

    2018-05-24

    Helicopter emergency medical services are important in many health care systems. Norway has a nationwide physician manned air ambulance service servicing a country with large geographical variations in population density and incident frequencies. The aim of the study was to compare optimal air ambulance base locations using both population and incident data. We used municipality population and incident data for Norway from 2015. The 428 municipalities had a median (5-95 percentile) of 4675 (940-36,264) inhabitants and 10 (2-38) incidents. Optimal helicopter base locations were estimated using the Maximal Covering Location Problem (MCLP) optimization model, exploring the number and location of bases needed to cover various fractions of the population for time thresholds 30 and 45 min, in green field scenarios and conditioned on the existing base structure. The existing bases covered 96.90% of the population and 91.86% of the incidents for time threshold 45 min. Correlation between municipality population and incident frequencies was -0.0027, and optimal base locations varied markedly between the two data types, particularly when lowering the target time. The optimal solution using population density data put focus on the greater Oslo area, where one third of Norwegians live, while using incident data put focus on low population high incident areas, such as northern Norway and winter sport resorts. Using population density data as a proxy for incident frequency is not recommended, as the two data types lead to different optimal base locations. Lowering the target time increases the sensitivity to choice of data.

  5. Lake Beach Monitoring Locations in Iowa

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Monitored state lake beach locations in Iowa. The Watershed Monitoring & Assessment Section of the Iowa DNR takes regular water samples at these listed beaches...

  6. 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

    2008-01-01

    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.

  7. Data Center Equipment Location and Monitoring System

    DEFF Research Database (Denmark)

    2013-01-01

    Abstract: Data center equipment location systems include hardware and software to provide information on the location, monitoring, and security of servers and other equipment in equipment racks. The systems provide a wired alternative to the wireless RFID tag system by using electronic ID tags...... connected to each piece of equipment, each electronic ID tag connected directly by wires to an equipment rack controller on the equipment rack. The equipment rack controllers link to a central control computer that provides an operator ...

  8. 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

    2013-06-01

    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

  9. Ambulating radiography

    International Nuclear Information System (INIS)

    Magnusson, K.

    1989-01-01

    Strong gamme or X-ray sources are utilized for non-destructive testing of i.e. bridges. The activities involve certain risks of accident that might lead to serious injuries caused by radiation. The National Institute of Radiation Protection has during the laste decade greatly yhe inspection rate in this area. It has today made controls of most enterprieses running ambulating radiography. (O.S.)

  10. Data center equipment location and monitoring system

    DEFF Research Database (Denmark)

    2011-01-01

    A data center equipment location system includes both hardware and software to provide for location, monitoring, security and identification of servers and other equipment in equipment racks. The system provides a wired alternative to the wireless RFID tag system by using electronic ID tags...... connected to each piece of equipment, each electronic ID tag connected directly by wires to a equipment rack controller on the equipment rack. The equipment rack controllers then link over a local area network to a central control computer. The central control computer provides an operator interface......, and runs a software application program that communicates with the equipment rack controllers. The software application program of the central control computer stores IDs of the equipment rack controllers and each of its connected electronic ID tags in a database.; The software application program...

  11. A piezoelectric micro control valve with integrated capacitive sensing for ambulant blood pressure waveform monitoring

    Science.gov (United States)

    Groen, Maarten S.; Wu, Kai; Brookhuis, Robert A.; van Houwelingen, Marc J.; Brouwer, Dannis M.; Lötters, Joost C.; Wiegerink, Remco J.

    2014-12-01

    We have designed and characterized a MEMS microvalve with built-in capacitive displacement sensing and fitted it with a miniature piezoelectric actuator to achieve active valve control. The integrated displacement sensor enables high bandwidth proportional control of the gas flow through the valve. This is an essential requirement for non-invasive blood pressure waveform monitoring based on following the arterial pressure with a counter pressure. Using the capacitive sensor, we demonstrate negligible hysteresis in the valve control characteristics. Fabrication of the valve requires only two mask steps for deep reactive ion etching (DRIE) and one release etch.

  12. A piezoelectric micro control valve with integrated capacitive sensing for ambulant blood pressure waveform monitoring

    International Nuclear Information System (INIS)

    Groen, Maarten S; Wu, Kai; Brookhuis, Robert A; Lötters, Joost C; Wiegerink, Remco J; Van Houwelingen, Marc J; Brouwer, Dannis M

    2014-01-01

    We have designed and characterized a MEMS microvalve with built-in capacitive displacement sensing and fitted it with a miniature piezoelectric actuator to achieve active valve control. The integrated displacement sensor enables high bandwidth proportional control of the gas flow through the valve. This is an essential requirement for non-invasive blood pressure waveform monitoring based on following the arterial pressure with a counter pressure. Using the capacitive sensor, we demonstrate negligible hysteresis in the valve control characteristics. Fabrication of the valve requires only two mask steps for deep reactive ion etching (DRIE) and one release etch. (paper)

  13. Feasibility of real-time location systems in monitoring recovery after major abdominal surgery.

    Science.gov (United States)

    Dorrell, Robert D; Vermillion, Sarah A; Clark, Clancy J

    2017-12-01

    Early mobilization after major abdominal surgery decreases postoperative complications and length of stay, and has become a key component of enhanced recovery pathways. However, objective measures of patient movement after surgery are limited. Real-time location systems (RTLS), typically used for asset tracking, provide a novel approach to monitoring in-hospital patient activity. The current study investigates the feasibility of using RTLS to objectively track postoperative patient mobilization. The real-time location system employs a meshed network of infrared and RFID sensors and detectors that sample device locations every 3 s resulting in over 1 million data points per day. RTLS tracking was evaluated systematically in three phases: (1) sensitivity and specificity of the tracking device using simulated patient scenarios, (2) retrospective passive movement analysis of patient-linked equipment, and (3) prospective observational analysis of a patient-attached tracking device. RTLS tracking detected a simulated movement out of a room with sensitivity of 91% and specificity 100%. Specificity decreased to 75% if time out of room was less than 3 min. All RTLS-tagged patient-linked equipment was identified for 18 patients, but measurable patient movement associated with equipment was detected for only 2 patients (11%) with 1-8 out-of-room walks per day. Ten patients were prospectively monitored using RTLS badges following major abdominal surgery. Patient movement was recorded using patient diaries, direct observation, and an accelerometer. Sensitivity and specificity of RTLS patient tracking were both 100% in detecting out-of-room ambulation and correlated well with direct observation and patient-reported ambulation. Real-time location systems are a novel technology capable of objectively and accurately monitoring patient movement and provide an innovative approach to promoting early mobilization after surgery.

  14. [Ambulance in emergency medicine].

    Science.gov (United States)

    Aksoy, Fikret; Ergun, Alper

    2002-07-01

    The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services

  15. Ambulance Reasonable Charge Public Use Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulance Reasonable Charge public use files for calendar years (CY) 2003 through 2005 are located in the Downloads section below. These public use files are...

  16. Evaluation of environmental monitoring thermoluminescent dosimeter locations

    International Nuclear Information System (INIS)

    Kinnison, R.

    1992-12-01

    Geostatistics, particularly kriging, has been used to assess the adequacy of the existing NTS thermoluminescent dosimeter network for determination of environmental exposure levels. (Kriging is a linear estimation method that results in contour plots of both the pattern of the estimated gamma radiation over the area of measurements and also of the standard deviations of the estimated exposure levels.) Even though the network was not designed as an environmental monitoring network, ft adequately serves this function in the region of Pahute and Rainier Mesas.. The Yucca Flat network is adequate only if a reasonable definition of environmental exposure levels is required; R is not adequate for environmental monitoring in Yucca Flat if a coefficient of variation of 10 percent or less is chosen as the criterion for network design. A revision of the Yucca Flat network design should be based on a square grid pattern with nodes 5000 feet (about one mile) apart, if a 10 percent coefficient of variation criterion is adopted. There were insufficient data for southern and western sections of the NTS to perform the geostatistical analysis. A very significant finding was that a single network design cannot be used for the entire NTS, because different areas have different variograms. Before any design can be finalized, the NTS management must specify the exposure unit area and coefficient of variation that are to be used as design criteria

  17. Evaluating public ambulance service levels by applying a GIS based accessibility analysis approach

    CSIR Research Space (South Africa)

    Baloyi, Ethel

    2017-08-01

    Full Text Available Ambulance vehicles are required to respond rapidly to medical emergencies. A number of factors may affect response times, most importantly the location of emergency services stations, the number of ambulance vehicles available at each station, road...

  18. FLUES - A new monitoring system for leak detection and location

    International Nuclear Information System (INIS)

    Jax, P.; Streicher, V.

    1995-01-01

    A new Leakage Monitoring and Location System with high sensitivity was developed and tested by Siemens during the last years. Now this system has been installed in a Nuclear Power Plant. The experiences gained during the qualification test and the first months of operation can be reported. (author)

  19. Evaluating public ambulance service levels by applying a GIS based ...

    African Journals Online (AJOL)

    Ambulance vehicles are required to respond rapidly to medical emergencies. A number of factors may affect response times, most importantly the location of emergency services stations, the number of ambulance vehicles available at each station, road conditions and traffic volumes. To support spatial planning and provide ...

  20. Monitoring Location and Angular Orientation of a Pill

    Science.gov (United States)

    Schipper, John F.

    2012-01-01

    A mobile pill transmitter system moves through, or adjacent to, one or more organs in an animal or human body, while transmitting signals from its present location and/or present angular orientation. The system also provides signals from which the present roll angle of the pill, about a selected axis, can be determined. When the location coordinates angular orientation and the roll angle of the pill are within selected ranges, an aperture on the pill container releases a selected chemical into, or onto, the body. Optionally, the pill, as it moves, provides a sequence of visually perceptible images. The times for image formation may correspond to times at which the pill transmitter system location or image satisfies one of at least four criteria. This invention provides and supplies an algorithm for exact determination of location coordinates and angular orientation coordinates for a mobile pill transmitter (PT), or other similar device that is introduced into, and moves within, a GI tract of a human or animal body. A set of as many as eight nonlinear equations has been developed and applied, relating propagation of a wireless signal between either two, three, or more transmitting antennas located on the PT, to four or more non-coplanar receiving antennas located on a signal receiver appliance worn by the user. The equations are solved exactly, without approximations or iterations, and are applied in several environments: (1) association of a visual image, transmitted by the PT at each of a second sequence of times, with a PT location and PT angular orientation at that time; (2) determination of a position within the body at which a drug or chemical substance or other treatment is to be delivered to a selected portion of the body; (3) monitoring, after delivery, of the effect(s) of administration of the treatment; and (4) determination of one or more positions within the body where provision and examination of a finer-scale image is warranted.

  1. Automatised Data Quality Monitoring of the LHCb Vertex Locator

    CERN Multimedia

    Szumlak, Tomasz

    2016-01-01

    The LHCb Vertex Locator (VELO) is a silicon strip semiconductor detector operating at just 8mm distance to the LHC beams. Its 172,000 strips are read at a frequency of 1 MHz and processed by off-detector FPGAs followed by a PC cluster that reduces the event rate to about 10 kHz. During the second run of the LHC, which lasts from 2015 until 2018, the detector performance will undergo continued change due to radiation damage effects. This necessitates a detailed monitoring of the data quality to avoid adverse effects on the physics analysis performance. The VELO monitoring infrastructure has been re-designed compared to the first run of the LHC when it was based on manual checks. The new system is based around an automatic analysis framework, which monitors the performance of new data as well as long-term trends and flags issues whenever they arise. An unbiased subset of the detector data are processed about once per hour by monitoring algorithms. The new analysis framework then analyses the plots that are prod...

  2. Energy expenditure during ambulation with ortho crutches and axillary crutches.

    Science.gov (United States)

    Hinton, C A; Cullen, K E

    1982-06-01

    Thirteen normal male college students were studied during unassisted ambulation and nonweight-bearing ambulation with Ortho crutches and axillary crutches to determine energy expenditure. Subjects walked at self-selected velocities. Energy expenditure was determined by analyzing expired air collected by a calorimeter. Heart rate was monitored by telemetry. During the first 2.5 minutes of walking, heart rate and energy expenditure were significantly greater for ambulation with axillary crutches than with Ortho crutches. After 11.5 minutes of walking, no difference in energy cost was found between crutch types; however, heart rate increased significantly (p less than .01) during ambulation with axillary crutches. Differences in energy cost and heart rate were attributed to increased upper extremity work performed when using axillary crutches. We concluded that during nonweight-bearing ambulation for short periods of time or over a short distance, the Ortho crutch is less taxing in terms of energy cost and heart rate demands.

  3. An inverse source location algorithm for radiation portal monitor applications

    International Nuclear Information System (INIS)

    Miller, Karen A.; Charlton, William S.

    2010-01-01

    Radiation portal monitors are being deployed at border crossings throughout the world to prevent the smuggling of nuclear and radiological materials; however, a tension exists between security and the free-flow of commerce. Delays at ports-of-entry have major economic implications, so it is imperative to minimize portal monitor screening time. We have developed an algorithm to locate a radioactive source using a distributed array of detectors, specifically for use at border crossings. To locate the source, we formulated an optimization problem where the objective function describes the least-squares difference between the actual and predicted detector measurements. The predicted measurements are calculated by solving the 3-D deterministic neutron transport equation given an estimated source position. The source position is updated using the steepest descent method, where the gradient of the objective function with respect to the source position is calculated using adjoint transport calculations. If the objective function is smaller than the convergence criterion, then the source position has been identified. This paper presents the derivation of the underlying equations in the algorithm as well as several computational test cases used to characterize its accuracy.

  4. Breached fuel location in FFTF by delayed neutron monitor triangulation

    International Nuclear Information System (INIS)

    Bunch, W.L.; Tang, E.L.

    1985-10-01

    The Fast Flux Test Facility (FFTF) features a three-loop, sodium-cooled 400 MWt mixed oxide fueled reactor designed for the irradiation testing of fuels and materials for use in liquid metal cooled fast reactors. To establish the ultimate capability of a particular fuel design and thereby generate information that will lead to improvements, many of the fuel irradiations are continued until a loss of cladding integrity (failure) occurs. When the cladding fails, fission gas escapes from the fuel pin and enters the reactor cover gas system. If the cladding failure permits the primary sodium to come in contact with the fuel, recoil fission products can enter the sodium. The presence of recoil fission products in the sodium can be detected by monitoring for the presence of delayed neutrons in the coolant. It is the present philosophy to not operate FFTF when a failure has occurred that permits fission fragments to enter the sodium. Thus, it is important that the identity and location of the fuel assembly that contains the failed cladding be established in order that it might be removed from the core. This report discusses method of location of fuel element when cladding is breached

  5. Automatised data quality monitoring of the LHCb Vertex Locator

    Science.gov (United States)

    Bel, L.; Crocombe, A. Ch.; Gersabeck, M.; Pearce, A.; Majewski, M.; Szumlak, T.

    2017-10-01

    The LHCb Vertex Locator (VELO) is a silicon strip semiconductor detector operating at just 8mm distance to the LHC beams. Its 172,000 strips are read at a frequency of 1.1 MHz and processed by off-detector FPGAs followed by a PC cluster that reduces the event rate to about 10 kHz. During the second run of the LHC, which lasts from 2015 until 2018, the detector performance will undergo continued change due to radiation damage effects. This necessitates a detailed monitoring of the data quality to avoid adverse effects on the physics analysis performance. The VELO monitoring infrastructure has been re-designed compared to the first run of the LHC when it was based on manual checks. The new system is based around an automatic analysis framework, which monitors the performance of new data as well as long-term trends and using dedicated algorithms flags issues whenever they arise. The new analysis framework then analyses the plots that are produced by these algorithms. One of its tasks is to perform custom comparisons between the newly processed data and that from reference runs. The most-likely scenario in which this analysis would identify an issue is the parameters of the readout electronics no longer being optimal and requiring retuning. The data of the monitoring plots can be reduced further, e.g. by evaluating averages, and these quantities are input to long-term trending. This is used to detect slow variation of quantities, which are not detectable by the comparison of two nearby runs. Such gradual change is what is expected due to radiation damage effects. It is essential to detect these changes early such that measures can be taken, e.g. adjustments of the operating voltage, to prevent any impact on the quality of high-level quantities and thus on physics analyses. The plots as well as the analysis results and trends are made available through graphical user interfaces (GUIs). These GUIs are dynamically configured by a single configuration that determines the

  6. Lunar Impact Flash Locations from NASA's Lunar Impact Monitoring Program

    Science.gov (United States)

    Moser, D. E.; Suggs, R. M.; Kupferschmidt, L.; Feldman, J.

    2015-01-01

    Meteoroids are small, natural bodies traveling through space, fragments from comets, asteroids, and impact debris from planets. Unlike the Earth, which has an atmosphere that slows, ablates, and disintegrates most meteoroids before they reach the ground, the Moon has little-to-no atmosphere to prevent meteoroids from impacting the lunar surface. Upon impact, the meteoroid's kinetic energy is partitioned into crater excavation, seismic wave production, and the generation of a debris plume. A flash of light associated with the plume is detectable by instruments on Earth. Following the initial observation of a probable Taurid impact flash on the Moon in November 2005,1 the NASA Meteoroid Environment Office (MEO) began a routine monitoring program to observe the Moon for meteoroid impact flashes in early 2006, resulting in the observation of over 330 impacts to date. The main objective of the MEO is to characterize the meteoroid environment for application to spacecraft engineering and operations. The Lunar Impact Monitoring Program provides information about the meteoroid flux in near-Earth space in a size range-tens of grams to a few kilograms-difficult to measure with statistical significance by other means. A bright impact flash detected by the program in March 2013 brought into focus the importance of determining the impact flash location. Prior to this time, the location was estimated to the nearest half-degree by visually comparing the impact imagery to maps of the Moon. Better accuracy was not needed because meteoroid flux calculations did not require high-accuracy impact locations. But such a bright event was thought to have produced a fresh crater detectable from lunar orbit by the NASA spacecraft Lunar Reconnaissance Orbiter (LRO). The idea of linking the observation of an impact flash with its crater was an appealing one, as it would validate NASA photometric calculations and crater scaling laws developed from hypervelocity gun testing. This idea was

  7. 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

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

    Science.gov (United States)

    Le Moing, Anne-Gaëlle; Seferian, Andreea Mihaela; Moraux, Amélie; Annoussamy, Mélanie; Dorveaux, Eric; Gasnier, Erwan; Hogrel, Jean-Yves; Voit, Thomas; Vissière, David; Servais, Laurent

    2016-01-01

    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. ClinicalTrials.gov NCT

  9. Continuous wavelet transform analysis and modal location analysis acoustic emission source location for nuclear piping crack growth monitoring

    International Nuclear Information System (INIS)

    Shukri Mohd

    2013-01-01

    Full-text: Source location is an important feature of acoustic emission (AE) damage monitoring in nuclear piping. The ability to accurately locate sources can assist in source characterisation and early warning of failure. This paper describe the development of a novelAE source location technique termed Wavelet Transform analysis and Modal Location (WTML) based on Lamb wave theory and time-frequency analysis that can be used for global monitoring of plate like steel structures. Source location was performed on a steel pipe of 1500 mm long and 220 mm outer diameter with nominal thickness of 5 mm under a planar location test setup using H-N sources. The accuracy of the new technique was compared with other AE source location methods such as the time of arrival (TOA) technique and DeltaTlocation. The results of the study show that the WTML method produces more accurate location results compared with TOA and triple point filtering location methods. The accuracy of the WTML approach is comparable with the deltaT location method but requires no initial acoustic calibration of the structure. (author)

  10. Continuous wavelet transform analysis and modal location analysis acoustic emission source location for nuclear piping crack growth monitoring

    International Nuclear Information System (INIS)

    Mohd, Shukri; Holford, Karen M.; Pullin, Rhys

    2014-01-01

    Source location is an important feature of acoustic emission (AE) damage monitoring in nuclear piping. The ability to accurately locate sources can assist in source characterisation and early warning of failure. This paper describe the development of a novelAE source location technique termed 'Wavelet Transform analysis and Modal Location (WTML)' based on Lamb wave theory and time-frequency analysis that can be used for global monitoring of plate like steel structures. Source location was performed on a steel pipe of 1500 mm long and 220 mm outer diameter with nominal thickness of 5 mm under a planar location test setup using H-N sources. The accuracy of the new technique was compared with other AE source location methods such as the time of arrival (TOA) techniqueand DeltaTlocation. Theresults of the study show that the WTML method produces more accurate location resultscompared with TOA and triple point filtering location methods. The accuracy of the WTML approach is comparable with the deltaT location method but requires no initial acoustic calibration of the structure

  11. Continuous wavelet transform analysis and modal location analysis acoustic emission source location for nuclear piping crack growth monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Mohd, Shukri [Nondestructive Testing Group, Industrial Technology Division, Malaysian Nuclear Agency, 43000, Bangi, Selangor (Malaysia); Holford, Karen M.; Pullin, Rhys [Cardiff School of Engineering, Cardiff University, Queen' s Buildings, The Parade, CARDIFF CF24 3AA (United Kingdom)

    2014-02-12

    Source location is an important feature of acoustic emission (AE) damage monitoring in nuclear piping. The ability to accurately locate sources can assist in source characterisation and early warning of failure. This paper describe the development of a novelAE source location technique termed 'Wavelet Transform analysis and Modal Location (WTML)' based on Lamb wave theory and time-frequency analysis that can be used for global monitoring of plate like steel structures. Source location was performed on a steel pipe of 1500 mm long and 220 mm outer diameter with nominal thickness of 5 mm under a planar location test setup using H-N sources. The accuracy of the new technique was compared with other AE source location methods such as the time of arrival (TOA) techniqueand DeltaTlocation. Theresults of the study show that the WTML method produces more accurate location resultscompared with TOA and triple point filtering location methods. The accuracy of the WTML approach is comparable with the deltaT location method but requires no initial acoustic calibration of the structure.

  12. Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study.

    Science.gov (United States)

    Togher, Fiona J; O'Cathain, Alicia; Phung, Viet-Hai; Turner, Janette; Siriwardena, Aloysius Niroshan

    2015-12-01

    There is an increasing need to assess the performance of emergency ambulance services using measures other than the time taken for an ambulance to arrive on scene. In line with government policy, patients and carers can help to shape new measures of ambulance service performance. To investigate the aspects of emergency ambulance service care valued by users. Qualitative interview study. One of 11 ambulance services in England. Twenty-two users and eight of their spouses (n = 30). Users of the emergency ambulance service, experiencing different types of ambulance service response, valued similar aspects of their pre-hospital care. Users were often extremely anxious about their health, and the outcome they valued was reassurance provided by ambulance service staff that they were receiving appropriate advice, treatment and care. This sense of being reassured was enhanced by the professional behaviour of staff, which instilled confidence in their care; communication; a short wait for help; and continuity during transfers. A timely response was valued in terms of allaying anxiety quickly. The ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service. Measures developed to assess and monitor the performance of emergency ambulance services should include the proportion of users reporting feeling reassured by the response they obtained. © 2014 John Wiley & Sons Ltd.

  13. 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.

    Science.gov (United States)

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

    2016-07-01

    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. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  14. Automatic cross-sectioning and monitoring system locates defects in electronic devices

    Science.gov (United States)

    Jacobs, G.; Slaughter, B.

    1971-01-01

    System consists of motorized grinding and lapping apparatus, sample holder, and electronic control circuit. Low power microscope examines device to pinpoint location of circuit defect, and monitor displays output signal when defect is located exactly.

  15. Real-time bus location monitoring using Arduino

    Science.gov (United States)

    Ibrahim, Mohammad Y. M.; Audah, Lukman

    2017-09-01

    The Internet of Things (IoT) is the network of objects, such as a vehicles, mobile devices, and buildings that have electronic components, software, and network connectivity that enable them to collect data, run commands, and be controlled through the Internet. Controlling physical items from the Internet will increase efficiency and save time. The growing number of devices used by people increases the practicality of having IoT devices on the market. The IoT is also an opportunity to develop products that can save money and time and increase work efficiency. Initially, they need more efficiency for real-time bus location systems, especially in university campuses. This system can easily find the accurate locations of and distances between each bus stop and the estimated time to reach a new location. This system has been separated into two parts, which are the hardware and the software. The hardware parts are the Arduino Uno and the Global Positioning System (GPS), while Google Earth and GpsGate are the software parts. The GPS continuously takes input data from the satellite and stores the latitude and longitude values in the Arduino Uno. If we want to track the vehicle, we need to send the longitude and latitude as a message to the Google Earth software to convert these into maps for navigation. Once the Arduino Uno is activated, it takes the last received latitude and longitude positions' values from GpsGate and sends a message to Google Earth. Once the message has been sent to Google Earth, the current location will be shown, and navigation will be activated automatically. Then it will be broadcast using ManyCam, Google+ Hangouts, and YouTube, as well as Facebook, and appear to users. The additional features use Google Forms for determining problems faced by students, who can also take immediate action against the responsible department. Then after several successful simulations, the results will be shown in real time on a map.

  16. An integration of Emergency Department Information and Ambulance Systems.

    Science.gov (United States)

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

    2012-01-01

    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.

  17. Locations of Sampling Stations for Water Quality Monitoring in Water Distribution Networks.

    Science.gov (United States)

    Rathi, Shweta; Gupta, Rajesh

    2014-04-01

    Water quality is required to be monitored in the water distribution networks (WDNs) at salient locations to assure the safe quality of water supplied to the consumers. Such monitoring stations (MSs) provide warning against any accidental contaminations. Various objectives like demand coverage, time for detection, volume of water contaminated before detection, extent of contamination, expected population affected prior to detection, detection likelihood and others, have been independently or jointly considered in determining optimal number and location of MSs in WDNs. "Demand coverage" defined as the percentage of network demand monitored by a particular monitoring station is a simple measure to locate MSs. Several methods based on formulation of coverage matrix using pre-specified coverage criteria and optimization have been suggested. Coverage criteria is defined as some minimum percentage of total flow received at the monitoring stations that passed through any upstream node included then as covered node of the monitoring station. Number of monitoring stations increases with the increase in the value of coverage criteria. Thus, the design of monitoring station becomes subjective. A simple methodology is proposed herein which priority wise iteratively selects MSs to achieve targeted demand coverage. The proposed methodology provided the same number and location of MSs for illustrative network as an optimization method did. Further, the proposed method is simple and avoids subjectivity that could arise from the consideration of coverage criteria. The application of methodology is also shown on a WDN of Dharampeth zone (Nagpur city WDN in Maharashtra, India) having 285 nodes and 367 pipes.

  18. Use of space-filling curves to select sample locations in natural resource monitoring studies

    Science.gov (United States)

    Andrew Lister; Charles T. Scott

    2009-01-01

    The establishment of several large area monitoring networks over the past few decades has led to increased research into ways to spatially balance sample locations across the landscape. Many of these methods are well documented and have been used in the past with great success. In this paper, we present a method using geographic information systems (GIS) and fractals...

  19. Ambulance traffic accidents in Taiwan.

    Science.gov (United States)

    Chiu, Po-Wei; Lin, Chih-Hao; Wu, Chen-Long; Fang, Pin-Hui; Lu, Chien-Hsin; Hsu, Hsiang-Chin; Chi, Chih-Hsien

    2018-04-01

    Ambulance traffic accidents (ATAs) are the leading cause of occupation-related fatalities among emergency medical service (EMS) personnel. We aim to use the Taiwan national surveillance system to analyze the characteristics of ATAs and to assist EMS directors in developing policies governing ambulance operations. A retrospective, cross-sectional and largely descriptive study was conducted using Taiwan national traffic accidents surveillance data from January 1, 2011 to October 31, 2016. Among the 1,627,217 traffic accidents during the study period, 715 ATAs caused 8 deaths within 24 h and 1844 injured patients. On average, there was one ATA for every 8598 ambulance runs. Compared to overall traffic accidents, ATAs were 1.7 times more likely to result in death and 1.9 times more likely to have injured patients. Among the 715 ATAs, 8 (1.1%) ATAs were fatal and 707 (98.9%) were nonfatal. All 8 fatalities were associated with motorcycles. The urban areas were significantly higher than the rural areas in the annual number of ATAs (14.2 ± 7.3 [7.0-26.7] versus 3.1 ± 1.9 [0.5-8.4], p = 0.013), the number of ATA-associated fatalities per year (0.2 ± 0.2 [0.0-0.7] versus 0.1 ± 0.1 [0.0-0.2], p = 0.022), and the annual number of injured patients (who needed urgent hospital visits) in ATAs (19.4 ± 7.3 [10.5-30.9] versus 5.2 ± 3.8 [0.9-15.3], p traffic accident reporting system should be built to provide EMS policy guidance for ATA reduction and outcome improvements. Copyright © 2018. Published by Elsevier B.V.

  20. Substantiation of the radiation monitoring scope in the region of nuclear power plant location

    Energy Technology Data Exchange (ETDEWEB)

    Zykova, A S; Zhakov, Yu A; Yambrovskii, Ya M

    1977-12-01

    To provide radiation safety of the population in the region of nuclear power plant location, it is necessary to define the character and quantity of radiation monitoring. On the basis of radiation monitoring of effluents from operating nuclear power plants it is found that the effluents can be registered at a distance of 5-7 km from the plant. The quantity of sample analysis of the main enviromental objectives must provide an exact definition of the content of radioactive substances produced by radioactive fallouts and effluents from nuclear power plants.

  1. Substantiation of the radiation monitoring scope in the region of nuclear power plant location

    International Nuclear Information System (INIS)

    Zykova, A.S.; Zhakov, Yu.A.; Jambrovskij, Ya.M.

    1977-01-01

    To provide radiation safety of the population in the region of nuclear power plant location, it is necessary to define the character and quantity of radiation monitoring. On the basis of radiation monitoring of flowouts from operating nuclear power plants it is found that the flowouts can be registered at a distance of 5-7 km from the plant. The quantity of sample analysis of the main enviromental objectives must provide an exact definition of the content of radioactive substances produced by radioactive fallouts and flowouts from nuclear power plants

  2. Air ambulance medical transport advertising and marketing.

    Science.gov (United States)

    2011-01-01

    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.

  3. Radiation monitoring of local foodstuffs in some settlements in Belarus located not far from woodlands

    International Nuclear Information System (INIS)

    Devojno, A.N.; Nesterenko, V.B.; Mukhlaev, A.A.; Troyanovskij, S.V.

    2005-01-01

    Here are the results of radiation monitoring performed by the local centres for radiation control in some settlements located in radiation contaminated territories not far from woodlands. It is shown that within the decennial period from 1993 to 2003 the Caesium 137 radiation contamination of mushrooms, game and milk from private household makes significant values and do not have the decreasing tendency. It is recommended to use possible radioprotective measures of the population under above stated circumstances. (authors)

  4. Finding candidate locations for aerosol pollution monitoring at street level using a data-driven methodology

    Science.gov (United States)

    Moosavi, V.; Aschwanden, G.; Velasco, E.

    2015-09-01

    Finding the number and best locations of fixed air quality monitoring stations at street level is challenging because of the complexity of the urban environment and the large number of factors affecting the pollutants concentration. Data sets of such urban parameters as land use, building morphology and street geometry in high-resolution grid cells in combination with direct measurements of airborne pollutants at high frequency (1-10 s) along a reasonable number of streets can be used to interpolate concentration of pollutants in a whole gridded domain and determine the optimum number of monitoring sites and best locations for a network of fixed monitors at ground level. In this context, a data-driven modeling methodology is developed based on the application of Self-Organizing Map (SOM) to approximate the nonlinear relations between urban parameters (80 in this work) and aerosol pollution data, such as mass and number concentrations measured along streets of a commercial/residential neighborhood of Singapore. Cross-validations between measured and predicted aerosol concentrations based on the urban parameters at each individual grid cell showed satisfying results. This proof of concept study showed that the selected urban parameters proved to be an appropriate indirect measure of aerosol concentrations within the studied area. The potential locations for fixed air quality monitors are identified through clustering of areas (i.e., group of cells) with similar urban patterns. The typological center of each cluster corresponds to the most representative cell for all other cells in the cluster. In the studied neighborhood four different clusters were identified and for each cluster potential sites for air quality monitoring at ground level are identified.

  5. Locatable-body temperature monitoring based on semi-active UHF RFID tags.

    Science.gov (United States)

    Liu, Guangwei; Mao, Luhong; Chen, Liying; Xie, Sheng

    2014-03-26

    This paper presents the use of radio-frequency identification (RFID) technology for the real-time remote monitoring of body temperature, while an associated program can determine the location of the body carrying the respective sensor. The RFID chip's internal integrated temperature sensor is used for both the human-body temperature detection and as a measurement device, while using radio-frequency communication to broadcast the temperature information. The adopted RFID location technology makes use of reference tags together with a nearest neighbor localization algorithm and a multiple-antenna time-division multiplexing location system. A graphical user interface (GUI) was developed for collecting temperature and location data for the data fusion by using RFID protocols. With a puppy as test object, temperature detection and localization experiments were carried out. The measured results show that the applied method, when using a mercury thermometer for comparison in terms of measuring the temperature of the dog, has a good consistency, with an average temperature error of 0.283 °C. When using the associated program over the area of 12.25 m2, the average location error is of 0.461 m, which verifies the feasibility of the sensor-carrier location by using the proposed program.

  6. Locatable-Body Temperature Monitoring Based on Semi-Active UHF RFID Tags

    Directory of Open Access Journals (Sweden)

    Guangwei Liu

    2014-03-01

    Full Text Available This paper presents the use of radio-frequency identification (RFID technology for the real-time remote monitoring of body temperature, while an associated program can determine the location of the body carrying the respective sensor. The RFID chip’s internal integrated temperature sensor is used for both the human-body temperature detection and as a measurement device, while using radio-frequency communication to broadcast the temperature information. The adopted RFID location technology makes use of reference tags together with a nearest neighbor localization algorithm and a multiple-antenna time-division multiplexing location system. A graphical user interface (GUI was developed for collecting temperature and location data for the data fusion by using RFID protocols. With a puppy as test object, temperature detection and localization experiments were carried out. The measured results show that the applied method, when using a mercury thermometer for comparison in terms of measuring the temperature of the dog, has a good consistency, with an average temperature error of 0.283 °C. When using the associated program over the area of 12.25 m2, the average location error is of 0.461 m, which verifies the feasibility of the sensor-carrier location by using the proposed program.

  7. An assessment of air sampling location for stack monitoring in nuclear facility

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Bok [University of Science and Technology, Daejeon (Korea, Republic of); Kim, Tae Hyoung; Lee, Jong Il; Kim, Bong Hwan [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2017-06-15

    In this study, air sampling locations in the stack of the Advanced Fuel Science Building (AFSB) at the Korea Atomic Energy Research Institute (KAERI) were assessed according to the ANSI/HPS N13.1-1999 specification. The velocity profile, flow angle and 10 μm aerosol particle profile at the cross-section as functions of stack height L and stack diameter D (L/D) were assessed according to the sampling location criteria using COMSOL. The criteria for the velocity profile were found to be met at 5 L/D or more for the height, and the criteria for the average flow angle were met at all locations through this assessment. The criteria for the particle profile were met at 5 L/D and 9 L/D. However, the particle profile at the cross-section of each sampling location was found to be non-uniform. In order to establish uniformity of the particle profile, a static mixer and a perimeter ring were modeled, after which the degrees of effectiveness of these components were compared. Modeling using the static mixer indicated that the sampling locations that met the criteria for the particle profile were 5-10 L/D. When modeling using the perimeter ring, the sampling locations that met the criteria for particle profile were 5 L/D and 7-10 L/D. The criteria for the velocity profile and the average flow angle were also met at the sampling locations that met the criteria for the particle profile. The methodologies used in this study can also be applied during assessments of air sampling locations when monitoring stacks at new nuclear facilities as well as existing nuclear facilities.

  8. Complexity, fractal dynamics and determinism in treadmill ambulation: Implications for clinical biomechanists.

    Science.gov (United States)

    Hollman, John H; Watkins, Molly K; Imhoff, Angela C; Braun, Carly E; Akervik, Kristen A; Ness, Debra K

    2016-08-01

    Reduced inter-stride complexity during ambulation may represent a pathologic state. Evidence is emerging that treadmill training for rehabilitative purposes may constrain the locomotor system and alter gait dynamics in a way that mimics pathological states. The purpose of this study was to examine the dynamical system components of gait complexity, fractal dynamics and determinism during treadmill ambulation. Twenty healthy participants aged 23.8 (1.2) years walked at preferred walking speeds for 6min on a motorized treadmill and overground while wearing APDM 6 Opal inertial monitors. Stride times, stride lengths and peak sagittal plane trunk velocities were measured. Mean values and estimates of complexity, fractal dynamics and determinism were calculated for each parameter. Data were compared between overground and treadmill walking conditions. Mean values for each gait parameter were statistically equivalent between overground and treadmill ambulation (P>0.05). Through nonlinear analyses, however, we found that complexity in stride time signals (P<0.001), and long-range correlations in stride time and stride length signals (P=0.005 and P=0.024, respectively), were reduced on the treadmill. Treadmill ambulation induces more predictable inter-stride time dynamics and constrains fluctuations in stride times and stride lengths, which may alter feedback from destabilizing perturbations normally experienced by the locomotor control system during overground ambulation. Treadmill ambulation, therefore, may provide less opportunity for experiencing the adaptability necessary to successfully ambulate overground. Investigators and clinicians should be aware that treadmill ambulation will alter dynamic gait characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Using a noise monitoring station in a small quarry located in an urban area.

    Science.gov (United States)

    Wichers, Michiel; Iramina, Wilson Siguemasa; de Eston, Sérgio Médici; Ayres da Silva, Anna Luiza Marques

    2017-12-22

    Mining plays an important role in Brazilian exports. On the other hand, large urban centers like São Paulo, with approximately 21 million inhabitants, also demand an increasing domestic consumption of natural resources, such as construction aggregate. There are many quarries located in the surroundings of urban centers in Brazil, competing with the growth of urbanized areas. Such proximity leads to a series of conflicts involving quarries and surrounding communities, where the increase in noise levels is highlighted. Operations in quarries, in general, are intermittent. Noisier equipment, such as drilling rigs and primary crushers, operates only a few hours during the day, while other operations, such as screening and secondary and tertiary crushing, are more constant. This paper presents a study carried out in a quarry located near São Paulo, where in addition to conventional short term noise measurements at surrounding receptors, one noise monitoring station was installed, allowing to identify the noisiest moments during the quarry operating time. Through data transmitted by wireless technology, it was possible to follow the noise variations emitted from mining activities in real time and observe the noisiest events that were recorded for events that exceeded the established standards. A mobile application associated to this monitoring station facilitated the quarry's manager and employees to access immediately the monitoring information. Therefore, by using this system, it was possible to evaluate the effectiveness of noise reduction measures already taken and indicate what steps still need to be held.

  10. Performance Measurement of Location Enabled e-Government Processes: A Use Case on Traffic Safety Monitoring

    Science.gov (United States)

    Vandenbroucke, D.; Vancauwenberghe, G.

    2016-12-01

    The European Union Location Framework (EULF), as part of the Interoperable Solutions for European Public Administrations (ISA) Programme of the EU (EC DG DIGIT), aims to enhance the interactions between governments, businesses and citizens by embedding location information into e-Government processes. The challenge remains to find scientific sound and at the same time practicable approaches to estimate or measure the impact of location enablement of e-Government processes on the performance of the processes. A method has been defined to estimate process performance in terms of variables describing the efficiency, effectiveness, as well as the quality of the output of the work processes. A series of use cases have been identified, corresponding to existing e-Government work processes in which location information could bring added value. In a first step, the processes are described by means of BPMN (Business Process Model and Notation) to better understand the process steps, the actors involved, the spatial data flows, as well as the required input and the generated output. In a second step the processes are assessed in terms of the (sub-optimal) use of location information and the potential enhancement of the process by better integrating location information and services. The process performance is measured ex ante (before using location enabled e-Government services) and ex-post (after the integration of such services) in order to estimate and measure the impact of location information. The paper describes the method for performance measurement and highlights how the method is applied to one use case, i.e. the process of traffic safety monitoring. The use case is analysed and assessed in terms of location enablement and its potential impact on process performance. The results of applying the methodology on the use case revealed that performance is highly impacted by factors such as the way location information is collected, managed and shared throughout the

  11. US8,994,532 "Data Center Equipment Location and Monitoring System"

    DEFF Research Database (Denmark)

    2014-01-01

    A data center equipment location system includes both hardware and software to provide for location, monitoring, security and identification of servers and other equipment in equipment racks. The system provides a wired alternative to the wireless RFID tag system by using electronic ID tags...... connected to each piece of equipment, each electronic ID tag connected directly by wires to a equipment rack controller on the equipment rack. The equipment rack controllers then link over a local area network to a central control computer. The central control computer provides an operator interface......, and runs a software application program that communicates with the equipment rack controllers. The software application program of the central control computer stores IDs of the equipment rack controllers and each of its connected electronic ID tags in a database. The software application program...

  12. ENVIRONMENTAL SAMPLING USING LOCATION SPECIFIC AIR MONITORING IN BULK HANDLING FACILITIES

    Energy Technology Data Exchange (ETDEWEB)

    Sexton, L.; Hanks, D.; Degange, J.; Brant, H.; Hall, G.; Cable-Dunlap, P.; Anderson, B.

    2011-06-07

    Since the introduction of safeguards strengthening measures approved by the International Atomic Energy Agency (IAEA) Board of Governors (1992-1997), international nuclear safeguards inspectors have been able to utilize environmental sampling (ES) (e.g. deposited particulates, air, water, vegetation, sediments, soil and biota) in their safeguarding approaches at bulk uranium/plutonium handling facilities. Enhancements of environmental sampling techniques used by the IAEA in drawing conclusions concerning the absence of undeclared nuclear materials or activities will soon be able to take advantage of a recent step change improvement in the gathering and analysis of air samples at these facilities. Location specific air monitoring feasibility tests have been performed with excellent results in determining attribute and isotopic composition of chemical elements present in an actual test-bed sample. Isotopic analysis of collected particles from an Aerosol Contaminant Extractor (ACE) collection, was performed with the standard bulk sampling protocol used throughout the IAEA network of analytical laboratories (NWAL). The results yielded bulk isotopic values expected for the operations. Advanced designs of air monitoring instruments such as the ACE may be used in gas centrifuge enrichment plants (GCEP) to detect the production of highly enriched uranium (HEU) or enrichments not declared by a State. Researchers at Savannah River National Laboratory in collaboration with Oak Ridge National Laboratory are developing the next generation of ES equipment for air grab and constant samples that could become an important addition to the international nuclear safeguards inspector's toolkit. Location specific air monitoring to be used to establish a baseline environmental signature of a particular facility employed for comparison of consistencies in declared operations will be described in this paper. Implementation of air monitoring will be contrasted against the use of smear

  13. Universal access to ambulance does not increase overall demand for ambulance services in Queensland, Australia.

    Science.gov (United States)

    Tippett, Vivienne C; Toloo, Ghasem Sam; Eeles, David; Ting, Joseph Y S; Aitken, Peter J; Fitzgerald, Gerard J

    2013-02-01

    To determine the impact of the introduction of universal access to ambulance services via the implementation of the Community Ambulance Cover (CAC) program in Queensland in 2003-04. The study involved a 10-year (2000-01 to 2009-10) retrospective analysis of routinely collected data reported by the Queensland Ambulance Service (QAS) and by the Council of Ambulance Authorities. The data were analysed for the impact of policy changes that resulted in universal access to ambulance services in Queensland. QAS is a statewide, publically funded ambulance service. In Queensland, ambulance utilisation rate (AUR) per 1000 persons grew by 41% over the decade or 3.9% per annum (10-year mean=149.8, 95% CI: 137.3-162.3). The AUR mean after CAC was significantly higher for urgent incidents than for non-urgent ones. However projection modelling demonstrates that URs after the introduction of CAC were significantly lower than the projected utilisation for the same period. The introduction of universal access under the Community Ambulance Cover program in Queensland has not had any significant independent long-term impact on demand overall. There has been a reduction in the long-term growth rate, which may have been contributed to by an 'appropriate use' public awareness program.

  14. Software structure for tritium-in-air monitoring in classified locations

    International Nuclear Information System (INIS)

    Ionete, Eusebiu Ilarian; Benchea, Dumitru

    2009-01-01

    Full text: In the working areas of heavy water detritiation facilities, were hydrogen gas is generated, the risk of air-hydrogen explosive mixture production is present. This paper gives the description of a software architecture solution for a fixed area tritium-in-air monitoring system suitable to be used in such hazardous locations. Tritium-in-air monitoring system was designed as a distributed system containing a number of fixed tritium in air monitoring units, each of them being composed of an ionisation chamber flow-through type and a fix sampling unit with a number of sample lines and one additional blow line. For each unit, software and hardware architecture structure enable independent performance with a fail-safe concept, remote control operation and data storage in a DCS-DCU module. This software architecture secures the setting possibility of alarm levels for tritium concentration, graphical visualisation and acoustic alarm in the case of level overtaking. The afferent software architecture contains applications in connection with hardware architecture and with a hydrogen detection system: RU-1 software application for control sampling; RU-2 software application for measured values display; RU-3 software application for remote data display; RU-4 software application for SQL conversion server; RU-5 software application for OPC standard conversion. The interconnection of all hardware components, between each PLC and each display unit, between tritium-in-air monitoring units and PLC sampling units will be internally carried out using interfaces. The interconnection between PLCs and tritium-in-air monitoring DCU will be made using a communication network, for instance Ethernet Profibus or RS 485. (authors)

  15. Task and Progress of Iaeg-Sdgs Wggi in Monitoring Sdgs Through a `GEOGRAPHIC Location' Lens

    Science.gov (United States)

    Geng, W.; Chen, J.; Zhang, H. P.; Xu, K.

    2018-04-01

    In September 2015, the 193 Member States of the United Nations (UN) unanimously adopted the 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals (SDGs), aiming to transform the world over the next 15 years (ESDN, 2016). To meet the ambitions and demands of the 2030 Agenda, it is necessary for the global indicator framework to adequately and systematically address the issue of alternative data sources and methodologies, including geospatial information and Earth observations in the context of geographic location (UN-GGIM, 2016). For this purpose, the Inter-Agency and Expert Group on Sustainable Development Goals Indicator (IAEG-SDGs) created the Working Group on Geospatial Information (IAEG-SDGs: WGGI) to give full play to the role of geospatial data in SDGs measurement and monitoring. The Working Group reviewed global indicators through a `geographic location' lens to pick out those which geospatial information can significantly support the production, and analyzed the methodological and measurements issues. This paper has discussed the progress in monitoring SDGs ever since the establishment of IAEG-SDGs: WGGI, as well as the existing problems, appropriate solutions and plans for the next stage of work.

  16. [Customer orientation in ambulant medicine].

    Science.gov (United States)

    Heinrich, M

    2014-07-01

    Due to developments of the health market, economic aspects of the health system are more relevant. In this upcoming market the patient is regarded as customer and the doctor as provider of medical services. Studies on customer orientation in the ambulant medicine lag behind this dynamic. An aim of the study is to comprehend the attitudes of the doctors referring to the customer orientation. In a second step the findings are discussed according to statements of health-care paticipants. Developments in role comprehension of doctor and patient are focused to gain results in scientific and practical applications. Guideline-supported, partly narrative interviews with n=9 gynaecologists and n=11 general practitioners in Freiburg/Germany are recorded, transcribed and reviewed in a qualitative analysis. The statements of the doctors show patient satisfaction has an incremental meaning sspecially regarding the sequence of patient relationship and economic management of the doctor's workplace. The doctor's role comprehension meets with a refusal of the role of salesman and the patient as customer. The method of interviews is suitable to gather empirical impressions of the doctors. The control sample is adequate, however a bias due to inhomogeneous thematic affinitiy and local social-demographics might be possible. The customer orientation has become an important factor in doctor-patient relationtships. The relevance of the doctor-patient conversation and the risk of misuse of the patient confidence are mentioned by the doctors. The doctor as paternalistic care provider gives way to the customer-focused service provider. The doctor's necessity of autonomyssss and dependency on patient satisfaction have potential for conflict. Intensive mention of customer orientation in medicine in the media emphasises its importance. Rational handling with the possibilities of individual health markets is a prospective challange. Further research could be established in all aspects of

  17. Fixed-location hydroacoustic monitoring designs for estimating fish passage using stratified random and systematic sampling

    International Nuclear Information System (INIS)

    Skalski, J.R.; Hoffman, A.; Ransom, B.H.; Steig, T.W.

    1993-01-01

    Five alternate sampling designs are compared using 15 d of 24-h continuous hydroacoustic data to identify the most favorable approach to fixed-location hydroacoustic monitoring of salmonid outmigrants. Four alternative aproaches to systematic sampling are compared among themselves and with stratified random sampling (STRS). Stratifying systematic sampling (STSYS) on a daily basis is found to reduce sampling error in multiday monitoring studies. Although sampling precision was predictable with varying levels of effort in STRS, neither magnitude nor direction of change in precision was predictable when effort was varied in systematic sampling (SYS). Furthermore, modifying systematic sampling to include replicated (e.g., nested) sampling (RSYS) is further shown to provide unbiased point and variance estimates as does STRS. Numerous short sampling intervals (e.g., 12 samples of 1-min duration per hour) must be monitored hourly using RSYS to provide efficient, unbiased point and interval estimates. For equal levels of effort, STRS outperformed all variations of SYS examined. Parametric approaches to confidence interval estimates are found to be superior to nonparametric interval estimates (i.e., bootstrap and jackknife) in estimating total fish passage. 10 refs., 1 fig., 8 tabs

  18. Hydrogeological monitoring in Riberao da onca basin located in out croup area of Guarani Aquifer

    International Nuclear Information System (INIS)

    Wendland, E.; Andrade Gomes Barreto, C.; Gomes, L. . E mail:ew@sc.usp.br

    2004-01-01

    Objective of this project is the estimation of the direct recharge rate of the Guarani Aquifer System, based on a water balance study in the Ribeirao da Onca basin, located in the outcrop area of the Botucatu Formation, in Brotas-SP (Brazil). It is intended to monitor the groundwater level behavior and the superficial outflow from the basin, as function of the registered precipitation and evapotranspiration, during two hydrological cycles. The results to be obtained are of general interest in the context of the Project for Environmental Protection and Integrated Sustainable Management of the Guarani Aquifer System, since understanding the process and rate of direct recharge are essential information for any initiative for management of the aquifer. In this work, the main activities proposed are presented [es

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

    CERN Multimedia

    2000-01-01

    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.

  20. Electrocardiogram interpretation skills among ambulance nurses.

    Science.gov (United States)

    Werner, Kristoffer; Kander, Kristofer; Axelsson, Christer

    2016-06-01

    To describe ambulance nurses' practical electrocardiogram (ECG) interpretation skills and to measure the correlation between these skills and factors that may impact on the level of knowledge. This study was conducted using a prospective quantitative survey with questionnaires and a knowledge test. A convenience sample collection was conducted among ambulance nurses in three different districts in western Sweden. The knowledge test consisted of nine different ECGs. The score of the ECG test were correlated against the questions in the questionnaire regarding both general ECG interpretation skill and ability to identify acute myocardial infarction using Mann-Whitney U test, Kruskal-Wallis test and Spearman's rank correlation. On average, the respondents had 54% correct answers on the test and identified 46% of the ECGs indicating acute myocardial infarction. The median total score was 9 of 16 (interquartile range 7-11) and 1 of 3 (IQR 1-2) in infarction points. No correlation between ECG interpretation skill and factors such as education and professional experience was found, except that coronary care unit experience was associated with better results on the ECG test. Ambulance nurses have deficiencies in their ECG interpretation skills. This also applies to conditions where the ambulance crew has great potential to improve the outcome of the patient's health, such as myocardial infarction and cardiac arrest. Neither education, extensive experience in ambulance service nor in nursing contributed to an improved result. The only factor of importance for higher ECG interpretation knowledge was prior experience of working in a coronary care unit. © The European Society of Cardiology 2014.

  1. Geodetic monitoring (TLS of a steel transport trestle bridge located in an active mining exploitation site

    Directory of Open Access Journals (Sweden)

    Skoczylas Arkadiusz

    2016-09-01

    Full Text Available Underground mining exploitation causes, in general, irregular vertical and horizontal shifts in the superficial layer of the rock mass. In the case of construction objects seated on this layer, a deformation of the object’s foundation can be observed. This leads to additional loads and deformations. Identification of surface geometry changes in construction objects located within the premises of underground mining exploitation areas is an important task as far as safety of mining sites is concerned. Surveys targeting shifts and deformations in engineering objects preformed with the use of classic methods are of a selective nature and do not provide the full image of the phenomenon being the subject of the observation. This paper presents possibilities of terrestrial laser scanning technology application in the monitoring of engineering objects that allows for a complete spatial documentation of an object subjected to the influence of an active mining exploitation. This paper describes an observation of a 100 m section of a steel transport trestle bridge located on the premises of hard coal mine Lubelski Węgiel “Bogdanka” S.A. carried out in 2015. Measurements were carried out using a Z+F Imager 5010C scanner at an interval of 3.5 months. Changes in the structure’s geometry were determined by comparing the point clouds recorded during the two measurement periods. The results of the analyses showed shifts in the trestle bridge towards the exploited coal wall accompanied by object deformation. The obtained results indicate the possibility of of terrestrial laser scanning application in studying the aftereffects of underground mining exploitation on surface engineering objects.

  2. VETRA - offline analysis and monitoring software platform for the LHCb Vertex Locator

    International Nuclear Information System (INIS)

    Szumlak, Tomasz

    2010-01-01

    The LHCb experiment is dedicated to studying CP violation and rare decay phenomena. In order to achieve these physics goals precise tracking and vertexing around the interaction point is crucial. This is provided by the VELO (VErtex LOcator) silicon detector. After digitization, FPGAs are employed to run several algorithms to suppress noise and reconstruct clusters. This is performed by an FPGA based processing board. An off-line software project, VETRA, has been developed which performs a bit perfect emulation of this complex processing in the FPGAs. This is a novel development as this hardware emulation is not standalone but rather is fully integrated into the LHCb software to allow the reconstruction of full data from the detector. This software platform facilitates the development and understanding of the behaviour of the processing algorithms, the optimization of the parameters of the algorithms that will be loaded into the FPGA and monitoring of the detector performance. This framework has also been adopted by the Silicon Tracker detector of LHCb. This processing framework was successfully used with the first 1500 tracks of data in the VELO obtained from the first LHC beam in September 2008. The software architecture and utilisation of the VETRA project will be discussed in detail.

  3. Monitoring of Radiation Levels in Mines of Kaolin Located in the Region Serido-PB, Brazil

    International Nuclear Information System (INIS)

    Guerra Spacov, Isabel Cristina; Dos Santos Amaral, Milton; Araujo dos Santos Junior, Jose

    2015-01-01

    Kaolin is formed mainly by kaolinite and is used in many industrial sectors. Kaolin may be associated with by-products such as quartz, mica, feldspar and sand. The background radiation from nature is very important, since it represents the main source of human exposure to radiation. In kaolin, radionuclides are present as the 40 K and series 238 U and 232 Th. This study aimed to obtain the rates of effective doses of kaolin mines in the region of Serido-PB, Brazil, where there are several productions and mineral occurrences, including kaolin and uranium at nearby areas. Four kaolin mines located in the Serido-PB region were monitored by a portable discriminator detector NaI(Ti). Measurements were obtained outdoors in triplicate, at a distance of 1.0 meters from the Earth's surface. According to the report of UNSCEAR, the world average effective dose from exposure to natural radiation sources is 2.42 mSvy -1 . the rates of effective doses identified in this study ranged from 1.37 mSvy -1 , and provided the construction of isodose curves. The highest dose rate obtained may be related to pegmatite bodies in a nearby area that contain uranium minerals. However, based on the development of this research, the results indicate that further study in this area is needed in order to infer damage associated with mining of kaolin in the Serido-PB area. (Author)

  4. Energy cost of ambulation in healthy and disabled Filipino children.

    Science.gov (United States)

    Luna-Reyes, O B; Reyes, T M; So, F Y; Matti, B M; Lardizabal, A A

    1988-11-01

    The energy expenditures (Ee) for locomotion by nondisabled and disabled Filipino children aged 7 to 13 were determined and compared using indirect calorimetry. Forty-one controls (20 boys and 21 girls) ambulated at a comfortable pace; 16 children (eight boys and eight girls) with lower extremity poliomyelitis of varying severity ambulated by (1) wheelchair propulsion, (2) bilateral axillary crutches, (3) unilateral lower extremity ankle-foot orthoses or knee-ankle-foot orthoses, and (4) unassisted. Disabled children, regardless of their mode of ambulation, had to expend significantly more energy to ambulate than normal children (p less than 0.05). Wheelchair propulsion cost 16% more energy than the normal gait; crutch ambulation cost 41% more than the control. Children using unilateral braces sacrificed speed to attain near-normal Ee. When they ambulated without orthoses, their Ee increased by 109% over the control. In ascending order, the least energy was expanded by normal ambulation followed by disabled ambulation with unilateral brace, disabled propelling a wheelchair, disabled ambulation with bilateral axillary crutches, and disabled ambulation without brace. Efficiency of locomotion was reflected in the values obtained for Ee in terms of kcal x 10(-3)/kg/m, as demonstrated by the lower Ee but slower ambulation of children with braces, as compared to the nondisabled children.

  5. Location, location, location

    NARCIS (Netherlands)

    Anderson, S.P.; Goeree, J.K.; Ramer, R.

    1997-01-01

    We analyze the canonical location-then-price duopoly game with general log- concave consumer densities. A unique pure-strategy equilibrium to the two-stage game exists if the density is not "too asymmetric" and not "too concave." These criteria are satisfied by many commonly used densities.

  6. Factors affecting ambulance utilization for asthma attack treatment: understanding where to target interventions.

    Science.gov (United States)

    Raun, L H; Ensor, K B; Campos, L A; Persse, D

    2015-05-01

    Asthma is a serious, sometimes fatal condition, in which attacks vary in severity, potentially requiring emergency medical services (EMS) ambulance treatment. A portion of asthma attacks requiring EMS ambulance treatment may be prevented with improved education and access to care. The aim of this study was to identify areas of the city with high rates of utilization of EMS ambulance for treatment, and the demographics, socio-economic status, and time of day associated with these rates, to better target future interventions to prevent emergencies and reduce cost. A cross-sectional study was conducted on individuals in Houston, TX (USA) requiring ambulance treatment for asthma attacks from 2004 to 2011. 12,155 EMS ambulance-treated asthma attack cases were linked to census tracts. High rate treatment areas were identified with geospatial mapping. Census tract demographic characteristics of these high rate areas were compared with the remainder of the city using logistic regression. The association between case level demographics and the time of day of asthma attack within the high rate area was also assessed with logistic regression. EMS ambulance-treated high rate areas were identified and found to have a utilization incidence rate over six times higher per 100,000 people than the remainder of the city. There is an increased risk of location in this high rate area with a census tract level increase of percent of population: earning less than $10,000 yearly income (RR 1.21, 1.16-1.26), which is black (RR 1.08, 1.07-1.10), which is female (RR 1.34, 1.20-1.49) and have obtained less than a high school degree (RR 1.02, 1.01-1.03). Within the high rate area, case level data indicates an increased risk of requiring an ambulance after normal doctor office hours for men compared with women (RR 1.13, 1.03-1.22), for black compared with Hispanic ethnicity (RR 1.31, 1.08-1.59), or for adults (less than 41 and greater than 60) compared with children. Interventions to prevent

  7. Air ambulance services--integrated emergency care.

    Science.gov (United States)

    Ferdinand, M

    1994-10-01

    In the name of cost-conscious care, air ambulance program directors and service contractors are seeing the dawn of integrated networks as a boon to their business. As integrated networks form, facilities will become increasingly specialized in the types of services they provide. Patients will need to be moved around the system, resulting in more frequent patient transport and more points of transfer. Many programs are considering aircraft replacement and additions, rather than leasing. Financial benefits could come on depreciation and the high resale value of aircraft. Unless reimbursement levels increase, more program mergers and affiliations may take place to spread and reduce cost. Air ambulance services will increasingly become part of a facility's strategic plan.

  8. Establishing an air pollution monitoring network for intra-urban population exposure assessment : a location-allocation approach

    Energy Technology Data Exchange (ETDEWEB)

    Kanaroglou, P.S. [McMaster Univ., Hamilton, ON (Canada). School of Geography and Geology; Jerrett, M.; Beckerman, B.; Arain, M.A. [McMaster Univ., Hamilton, ON (Canada). School of Geography and Geology]|[McMaster Univ., Hamilton, ON (Canada). McMaster Inst. of Environment and Health; Morrison, J. [Carleton Univ., Ottawa, ON (Canada). School of Computer Science; Gilbert, N.L. [Health Canada, Ottawa, ON (Canada). Air Health Effects Div; Brook, J.R. [Meteorological Service of Canada, Toronto, ON (Canada)

    2004-10-01

    A study was conducted to assess the relation between traffic-generated air pollution and health reactions ranging from childhood asthma to mortality from lung cancer. In particular, it developed a formal method of optimally locating a dense network of air pollution monitoring stations in order to derive an exposure assessment model based on the data obtained from the monitoring stations and related land use, population and biophysical information. The method for determining the locations of 100 nitrogen dioxide monitors in Toronto, Ontario focused on land use, transportation infrastructure and the distribution of at-risk populations. The exposure assessment produced reasonable estimates at the intra-urban scale. This method for locating air pollution monitors effectively maximizes sampling coverage in relation to important socio-demographic characteristics and likely pollution variability. The location-allocation approach integrates many variables into the demand surface to reconfigure a monitoring network and is especially useful for measuring traffic pollutants with fine-scale spatial variability. The method also shows great promise for improving the assessment of exposure to ambient air pollution in epidemiologic studies. 19 refs., 3 tabs., 4 figs.

  9. Economic regulation of ambulance services in California.

    Science.gov (United States)

    Narad, R A

    1997-01-01

    This study was intended to identify economic regulatory programs used by California counties (including ambulance franchising and rate setting), to inventory their foci and application, and to identify differences around the state. By studying the variety of programs used in one state, this study establishes a framework for evaluation of state and local regulatory programs elsewhere. This study surveyed all California local EMS agencies (LEMSAs); these are California's equivalent of regional EMS organizations. The survey achieved a 100% response rate, and all data involve population parameters obviating the need for inferential statistics. Seventy-three percent of California counties use economic regulations. Large-population counties and those that operate their own LEMSAs are more likely to use economic regulations than are small counties and those that participate in multicounty EMS agencies. Despite a preference for competition in the authorizing statute, most franchises were granted without competition to existing providers. The majority of franchises in the state were granted to public services. Most ambulance rate setting occurs outside of a competitive process. Economic regulations that were intended to provide a structured marketplace are often being used to protect existing providers, particularly public services, from competition. The growing interest by fire departments in entering the market for emergency ambulance service, along with the existing bias toward them in granting of franchises, does not bode well for use of the competitive process. The growth of managed care may change or eliminate the need for economic regulations but, if they are to continue, more state oversight should be considered.

  10. An association between fine particulate matter (PM2.5) levels and emergency ambulance dispatches for cardiovascular diseases in Japan.

    Science.gov (United States)

    Ichiki, Toshihiro; Onozuka, Daisuke; Kamouchi, Masahiro; Hagihara, Akihito

    2016-11-01

    The aim of this study is to determine whether short-term exposure to fine particulate matter (PM 2.5 ) is associated with emergency ambulance dispatches for cardiovascular diseases in Japan. The nationwide data on emergency dispatches of ambulance for cardiovascular diseases classified as I00-I99 by International Classification of Diseases-10th revision in 30 Japanese prefectures between April 1 and December 31, in 2010 were analyzed. Data on weather variability including PM 2.5 , temperature and relative humidity were acquired from ambient air pollution monitoring stations. Conditional Poisson regression models were used to estimate the prefecture-specific effects of PM 2.5 on morbidity, and adjust for confounding factors. A meta-analysis was then applied to pool estimates at the 30-prefecture level. A total of 160,566 emergency ambulance dispatches for cardiovascular diseases were reported during the study period. The risk of emergency ambulance dispatch for cardiovascular diseases significantly increased with an increase in the exposure to PM 2.5 in Fukuoka and Iwate Prefectures. However, we found no statistically significant associations between PM 2.5 and emergency ambulance dispatches in the pooled analysis (odds ratio 1.00, 95 % confidence interval 0.99-1.00). Heterogeneity was not observed between prefectures (Cochran Q test, p = 0.187, I 2  = 18.4 %). Exposure to PM 2.5 is not associated with overall emergency ambulance dispatches for cardiovascular diseases in Japan.

  11. Integrating smart-phone based momentary location tracking with fixed site air quality monitoring for personal exposure assessment.

    Science.gov (United States)

    Su, Jason G; Jerrett, Michael; Meng, Ying-Ying; Pickett, Melissa; Ritz, Beate

    2015-02-15

    Epidemiological studies investigating relationships between environmental exposures from air pollution and health typically use residential addresses as a single point for exposure, while environmental exposures in transit, at work, school or other locations are largely ignored. Personal exposure monitors measure individuals' exposures over time; however, current personal monitors are intrusive and cannot be operated at a large scale over an extended period of time (e.g., for a continuous three months) and can be very costly. In addition, spatial locations typically cannot be identified when only personal monitors are used. In this paper, we piloted a study that applied momentary location tracking services supplied by smart phones to identify an individual's location in space-time for three consecutive months (April 28 to July 28, 2013) using available Wi-Fi networks. Individual exposures in space-time to the traffic-related pollutants Nitrogen Oxides (NOX) were estimated by superimposing an annual mean NOX concentration surface modeled using the Land Use Regression (LUR) modeling technique. Individual's exposures were assigned to stationary (including home, work and other stationary locations) and in-transit (including commute and other travel) locations. For the individual, whose home/work addresses were known and the commute route was fixed, it was found that 95.3% of the time, the individual could be accurately identified in space-time. The ambient concentration estimated at the home location was 21.01 ppb. When indoor/outdoor infiltration, indoor sources of air pollution and time spent outdoors were taken into consideration, the individual's cumulative exposures were 28.59 ppb and 96.49 ppb, assuming a respective indoor/outdoor ratio of 1.33 and 5.00. Integrating momentary location tracking services with fixed-site field monitoring, plus indoor-outdoor air exchange calibration, makes exposure assessment of a very large population over an extended time period

  12. Summary of detection, location, and characterization capabilities of AE for continuous monitoring of cracks in reactors

    International Nuclear Information System (INIS)

    Hutton, P.H.; Kurtz, R.J.; Friesel, M.A.; Pappas, R.A.; Skorpik, J.R.; Dawson, J.F.

    1984-10-01

    The objective of the program is to develop acoustic emission (AE) methods for continuous monitoring of reactor pressure boundaries to detect and evaluate crack growth. The approach involves three phases: develop relationships to identify crack growth AE signals and to use identified crack growth AE data to estimate flaw severity; evaluate and refine AE/flaw relationships through fatigue testing a heavy section vessel under simulated reactor conditions; and demonstrate continuous AE monitoring on a nuclear power reactor system

  13. Monitoring of dispersed smoke-plume layers by determining locations of the data-point clusters

    Science.gov (United States)

    Kovalev, Vladimir; Wold, Cyle; Petkov, Alexander; Min Hao, Wei

    2018-04-01

    A modified data-processing technique of the signals recorded by zenith-directed lidar, which operates in smoke-polluted atmosphere, is discussed. The technique is based on simple transformations of the lidar backscatter signal and the determination of the spatial location of the data point clusters. The technique allows more reliable detection of the location of dispersed smoke layering. Examples of typical results obtained with lidar in a smokepolluted atmosphere are presented.

  14. Air ambulance tasking: mechanism of injury, telephone interrogation or ambulance crew assessment?

    Science.gov (United States)

    Wilmer, Ian; Chalk, Graham; Davies, Gareth Edward; Weaver, Anne Elizabeth; Lockey, David John

    2015-10-01

    The identification of serious injury is critical to the tasking of air ambulances. London's Air Ambulance (LAA) is dispatched by a flight paramedic based on mechanism of injury (MOI), paramedical interrogation of caller (INT) or land ambulance crew request (REQ).This study aimed to demonstrate which of the dispatch methods was most effective (in accuracy and time) in identifying patients with serious injury. A retrospective review of 3 years of data (to December 2010) was undertaken. Appropriate dispatch was defined as the requirement for LAA to escort the patient to hospital or for resuscitation on-scene. Inaccurate dispatch was where LAA was cancelled or left the patient in the care of the land ambulance crew. The χ(2) test was used to calculate p values; with significance adjusted to account for multiple testing. There were 2203 helicopter activations analysed: MOI 18.9% (n=417), INT 62.4% (n=1375) and REQ 18.7% (n=411). Appropriate dispatch rates were MOI 58.7% (245/417), INT 69.7% (959/1375) and REQ 72.2% (297/411). INT and REQ were both significantly more accurate than MOI (pinterrogation of the caller by a flight paramedic is as accurate as ground ambulance crew requests, and both are significantly better than MOI in identifying serious injury. Overtriage remains an issue with all methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Noise exposure during ambulance flights and repatriation operations.

    Science.gov (United States)

    Küpper, Thomas E; Zimmer, Bernd; Conrad, Gerson; Jansing, Paul; Hardt, Aline

    2010-01-01

    Although ambulance flights are routine work and thousands of employees work in repatriation organizations, there is no data on noise exposure which may be used for preventive advice. We investigated the noise exposure of crews working in ambulance flight organizations for international patient repatriation to get the data for specific guidelines concerning noise protection. Noise levels inside Learjet 35A, the aircraft type which is most often used for repatriation operations, were collected from locations where flight crews typically spend their time. A sound level meter class 1 meeting the DIN IEC 651 requirements was used for noise measurements, but several factors during the real flight situations caused a measurement error of ~3%. Therefore, the results fulfill the specifications for class 2. The data was collected during several real repatriation operations and was combined with the flight data (hours per day) regarding the personnel to evaluate the occupationally encountered equivalent noise level according to DIN 45645-2. The measured noise levels were safely just below the 85 dB(A) threshold and should not induce permanent threshold shifts, provided that additional high noise exposure by non-occupational or private activities was avoided. As the levels of the noise produced by the engines outside the cabin are significantly above the 85 dB(A) threshold, the doors of the aircraft must be kept closed while the engines are running, and any activity performed outside the aircraft - or with the doors opened while the engines are running - must be done with adequate noise protection. The new EU noise directive (2003/10/EG) states that protective equipment must be made available to the aircrew to protect their hearing, though its use is not mandatory.

  16. BURNOUT SYNDROM AMONG PUBLIC AMBULANCE STAFF.

    Science.gov (United States)

    Iorga, Magdalena; Dascalu, Neonila; Soponaru, Camelia; Ioan, Beatrice

    2015-01-01

    Healthcare professionals are frequently confronted with urgent situations and a high-risk human intervention. They are usually exposed to what is called burnout syndrome. To identify the effects of burnout syndrome on the professional conduct and attitudes of doctors and nurses who work in the Romanian public ambulance service. Secondary, the causal relationships between burnout and various socio-demographic variables were analyzed. The 20-item Toronto Alexithymia Scale (TAS- 20), Maslach Burnout Inventory and Job Satisfaction Questionnaire were administered to 122 ambulance doctors, nurses and drivers (62 females and 60 males). The degree of job satisfaction is the most important indicator of burnout syndrome. Significant differences were found between low and high alexithymic subjects. Women are more susceptible to experience higher levels of burnout than men. The level of burnout is influenced by the combined effect of job satisfaction and alexithymia. Burnout syndrome is a common problem among people working in the emergency medical system. The causes of job-related burnout have to be identified in order to apply an appropriate level of burnout intervention program and to increase the efficiency of coping strategies.

  17. Urban sprawl and delayed ambulance arrival in the U.S.

    Science.gov (United States)

    Trowbridge, Matthew J; Gurka, Matthew J; O'Connor, Robert E

    2009-11-01

    Minimizing emergency medical service (EMS) response time is a central objective of prehospital care, yet the potential influence of built environment features such as urban sprawl on EMS system performance is often not considered. This study measures the association between urban sprawl and EMS response time to test the hypothesis that features of sprawling development increase the probability of delayed ambulance arrival. In 2008, EMS response times for 43,424 motor-vehicle crashes were obtained from the Fatal Analysis Reporting System, a national census of crashes involving > or =1 fatality. Sprawl at each crash location was measured using a continuous county-level index previously developed by Ewing et al. The association between sprawl and the probability of a delayed ambulance arrival (> or =8 minutes) was then measured using generalized linear mixed modeling to account for correlation among crashes from the same county. Urban sprawl is significantly associated with increased EMS response time and a higher probability of delayed ambulance arrival (p=0.03). This probability increases quadratically as the severity of sprawl increases while controlling for nighttime crash occurrence, road conditions, and presence of construction. For example, in sprawling counties (e.g., Fayette County GA), the probability of a delayed ambulance arrival for daytime crashes in dry conditions without construction was 69% (95% CI=66%, 72%) compared with 31% (95% CI=28%, 35%) in counties with prominent smart-growth characteristics (e.g., Delaware County PA). Urban sprawl is significantly associated with increased EMS response time and a higher probability of delayed ambulance arrival following motor-vehicle crashes in the U.S. The results of this study suggest that promotion of community design and development that follows smart-growth principles and regulates urban sprawl may improve EMS performance and reliability.

  18. Source term assessment using inverse modeling of radiation dose measured with environmental radiation monitors located at different positions

    International Nuclear Information System (INIS)

    Srinivas, C.V.; Rakesh, P.T.; Baskaran, R.; Venkatraman, B.

    2018-01-01

    Source term is an important input for consequence analysis using Decision Support Systems (DSS) to project radiological impact in the event of nuclear emergencies. A source term model called 'ASTER' is incorporated in the Online Nuclear Emergency Response System (ONERS) operational at Kalpakkam site for decision making during nuclear emergencies. This computes release rates using inverse method by employing an atmospheric dispersion model and gamma dose rates measured by environmental radiation monitors (ERM) deployed around the nuclear plant. The estimates may depend on the distribution of ERMs around the release location. In this work, data from various gamma monitors located at different radii 0.75 km and 1.5 km is used to assess the accuracy in the source term estimation for stack releases of MAPS-PHWR at Kalpakkam

  19. Meteorological monitoring Program in the location to the Juragua Nuclear Power Plant

    International Nuclear Information System (INIS)

    Linares Gonzalez, M.E.; Ramos Biltres, E.O.; Prendes Alonso, M.

    1998-01-01

    The objective gives the work it is to present the meteorological Monitoring program in the Juragua nuclear power plant, which you makes according to the standards settled down by the OIEA, the standards give the World meteorological organization and the demands to the content and elaboration gives the Nuclear Power Plant security documents DTN-1.03.91

  20. 29 CFR 553.215 - Ambulance and rescue service employees.

    Science.gov (United States)

    2010-07-01

    ... activities, the applicable standard is the one which applies to the activity in which the employee spends the majority of work time during the work period. (b) Ambulance and rescue service employees of public agencies... 29 Labor 3 2010-07-01 2010-07-01 false Ambulance and rescue service employees. 553.215 Section 553...

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

    NARCIS (Netherlands)

    Laan, Corine Maartje; Vanberkel, Peter T.; Boucherie, Richardus J.; Carter, Alix J.E.

    2016-01-01

    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

  2. 42 CFR 410.40 - Coverage of ambulance services.

    Science.gov (United States)

    2010-10-01

    ..., which are defined in § 414.605 of this chapter: (1) Basic life support (BLS) (emergency and nonemergency). (2) Advanced life support, level 1 (ALS1) (emergency and nonemergency). (3) Advanced life support... Coverage of ambulance services. (a). Basic rules. Medicare Part B covers ambulance services if the...

  3. A proposal to design a Location-based Mobile Cardiac Emergency System (LMCES).

    Science.gov (United States)

    Keikhosrokiani, Pantea; Mustaffa, Norlia; Zakaria, Nasriah; Sarwar, Muhammad Imran

    2012-01-01

    Healthcare for elderly people has become a vital issue. The Wearable Health Monitoring System (WHMS) is used to manage and monitor chronic disease in elderly people, postoperative rehabilitation patients and persons with special needs. Location-aware healthcare is achievable as positioning systems and telecommunications have been developed and have fulfilled the technology needed for this kind of healthcare system. In this paper, the researchers propose a Location-Based Mobile Cardiac Emergency System (LMCES) to track the patient's current location when Emergency Medical Services (EMS) has been activated as well as to locate the nearest healthcare unit for the ambulance service. The location coordinates of the patients can be retrieved by GPS and sent to the healthcare centre using GPRS. The location of the patient, cell ID information will also be transmitted to the LMCES server in order to retrieve the nearest health care unit. For the LMCES, we use Dijkstra's algorithm for selecting the shortest path between the nearest healthcare unit and the patient location in order to facilitate the ambulance's path under critical conditions.

  4. Comparison of Hydraulic Conductivity Determinations in Co-located Conventional and Direct-Push Monitoring Wells

    Science.gov (United States)

    2011-03-08

    and Development Center (ERDC) provided the funding for this project. We wish to thank our project monitors Tony Bednar (ERDC Environmental Laboratory...method for field determination of hy- draulic conductivity at contaminated sites (Butler 1997; Henebry and Robbins 2000; Bartlett et al. 2004). For a...ASTM International. www.astm.org Bartlett, Stephen A., Gary A. Robbins , J. Douglas Mandrick, Michael Barcelona, Wes McCall, and Mark Kram. 2004

  5. Automated personnel-assets-consumables-drug tracking in ambulance services for more effective and efficient medical emergency interventions.

    Science.gov (United States)

    Utku, Semih; Özcanhan, Mehmet Hilal; Unluturk, Mehmet Suleyman

    2016-04-01

    Patient delivery time is no longer considered as the only critical factor, in ambulatory services. Presently, five clinical performance indicators are used to decide patient satisfaction. Unfortunately, the emergency ambulance services in rapidly growing metropolitan areas do not meet current satisfaction expectations; because of human errors in the management of the objects onboard the ambulances. But, human involvement in the information management of emergency interventions can be reduced by electronic tracking of personnel, assets, consumables and drugs (PACD) carried in the ambulances. Electronic tracking needs the support of automation software, which should be integrated to the overall hospital information system. Our work presents a complete solution based on a centralized database supported by radio frequency identification (RFID) and bluetooth low energy (BLE) identification and tracking technologies. Each object in an ambulance is identified and tracked by the best suited technology. The automated identification and tracking reduces manual paper documentation and frees the personnel to better focus on medical activities. The presence and amounts of the PACD are automatically monitored, warning about their depletion, non-presence or maintenance dates. The computerized two way hospital-ambulance communication link provides information sharing and instantaneous feedback for better and faster diagnosis decisions. A fully implemented system is presented, with detailed hardware and software descriptions. The benefits and the clinical outcomes of the proposed system are discussed, which lead to improved personnel efficiency and more effective interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Factors influencing ambulance nurses' adherence to a national protocol ambulance care: an implementation study in the Netherlands

    NARCIS (Netherlands)

    Ebben, R.H.; Vloet, L.C.M.; Grunsven, P.M. van; Breeman, W.; Goosselink, B.; Lichtveld, R.A.; Groot, J. de; Achterberg, T. van

    2015-01-01

    OBJECTIVES: Adherence to prehospital guidelines and protocols is suboptimal. Insight into influencing factors is necessary to improve adherence. The aim of this study was to identify factors that influence ambulance nurses' adherence to a National Protocol Ambulance Care (NPAC). METHODS: A

  7. Locations of Joint Physical Activity in Parent-Child Pairs Based on Accelerometer and GPS Monitoring

    Science.gov (United States)

    Dunton, Genevieve Fridlund; Liao, Yue; Almanza, Estela; Jerrett, Micheal; Spruijt-Metz, Donna; Pentz, Mary Ann

    2012-01-01

    Background Parental factors may play an important role in influencing children’s physical activity levels. Purpose This cross-sectional study sought to describe the locations of joint physical activity among parents and children. Methods Parent-child pairs (N = 291) wore an Actigraph GT2M accelerometer and GlobalSat BT-335 Global Positioning Systems (GPS) device over the same 7-day period. Children were ages 8–14 years. Joint behavior was defined by a linear separation distance of less than 50m between parent and child. Land use classifications were assigned to GPS data points. Results Joint physical activity was spread across residential locations (35%), and commercial venues (24%), and open spaces/parks (20%). Obese children and parents performed less joint physical activity in open spaces/parks than under/normal weight children and parents (p’s parent-child physical activity naturally occurs may inform location-based interventions to promote these behaviors. PMID:23011914

  8. Global and Regional 3D Tomography for Improved Seismic Event Location and Uncertainty in Explosion Monitoring

    Science.gov (United States)

    Downey, N.; Begnaud, M. L.; Hipp, J. R.; Ballard, S.; Young, C. S.; Encarnacao, A. V.

    2017-12-01

    The SALSA3D global 3D velocity model of the Earth was developed to improve the accuracy and precision of seismic travel time predictions for a wide suite of regional and teleseismic phases. Recently, the global SALSA3D model was updated to include additional body wave phases including mantle phases, core phases, reflections off the core-mantle boundary and underside reflections off the surface of the Earth. We show that this update improves travel time predictions and leads directly to significant improvements in the accuracy and precision of seismic event locations as compared to locations computed using standard 1D velocity models like ak135, or 2½D models like RSTT. A key feature of our inversions is that path-specific model uncertainty of travel time predictions are calculated using the full 3D model covariance matrix computed during tomography, which results in more realistic uncertainty ellipses that directly reflect tomographic data coverage. Application of this method can also be done at a regional scale: we present a velocity model with uncertainty obtained using data obtained from the University of Utah Seismograph Stations. These results show a reduction in travel-time residuals for re-located events compared with those obtained using previously published models.

  9. Psychometric properties of the Cumulated Ambulation Score

    DEFF Research Database (Denmark)

    Ferriero, Giorgio; Kristensen, Morten T; Invernizzi, Marco

    2018-01-01

    INTRODUCTION: In the geriatric population, independent mobility is a key factor in determining readiness for discharge following acute hospitalization. The Cumulated Ambulation Score (CAS) is a potentially valuable score that allows day-to-day measurements of basic mobility. The CAS was developed...... and validated in older patients with hip fracture as an early postoperative predictor of short-term outcome, but it is also used to assess geriatric in-patients with acute medical illness. Despite the fast- accumulating literature on the CAS, to date no systematic review synthesizing its psychometric properties....... Of 49 studies identified, 17 examined the psychometric properties of the CAS. EVIDENCE SYNTHESIS: Most papers dealt with patients after hip fracture surgery, and only 4 studies assessed the CAS psychometric characteristics also in geriatric in-patients with acute medical illness. Two versions of CAS...

  10. Measuring the interactions between different locations in a muscle to monitor localized muscle fatigue.

    Science.gov (United States)

    Bingham, Adrian; Arjunan, Sridhar P; Kumar, Dinesh K

    2017-07-01

    In this study we investigated a technique for estimating the progression of localized muscle fatigue. This technique measures the dependence between motor units using high density surface electromyogram (HD-sEMG) and is based on the Normalized Mutual Information (NMI) measure. The NMI between every pair combination of the electrode array is computed to measure the interactions between electrodes. Participants in the experiment had an array of 64 electrodes (16 by 4) placed over the TA of their dominate leg such that the columns of the array ran parallel with the muscle fibers. The HD-sEMG was recorded whilst the participants maintained an isometric dorsiflexion with their dominate foot until task failure at 40% and 80% of their maximum voluntary contraction (MVC). The interactions between different locations over the muscle were computed using the recorded HD-sEMG signals. The results show that the average interactions between various locations over the TA significantly increased during fatigue at both levels of contraction. This can be attributed to the dependence in the motor units.

  11. An alarm instrument for monitoring leakage of oil storage tanks and the location of their leak position using radioisotope tracers

    International Nuclear Information System (INIS)

    Lu Qingqian; Sun Xiaolei; Hu Xusheng

    1990-01-01

    Usually it is difficult to find out gasoline leakage at the bottom of a storage tank from the very beginning. In order to solve this problem, a leak-monitoring technique and an instrument based on the detection of nuclear radiation have been successfully developed. The instrument possesses high sensitivity, short reaction time, excellent stability and rellability. When very small leaks at the bottom of a tank appear, the instrument will show a leak signal and give an alarm. In the meantime, however, the tank can be still used until the preparations for repairing are completed. Then its leak position can be accurately located by using radioisotope tracers

  12. Prerequisites for Accurate Monitoring of River Discharge Based on Fixed-Location Velocity Measurements

    Science.gov (United States)

    Kästner, K.; Hoitink, A. J. F.; Torfs, P. J. J. F.; Vermeulen, B.; Ningsih, N. S.; Pramulya, M.

    2018-02-01

    River discharge has to be monitored reliably for effective water management. As river discharge cannot be measured directly, it is usually inferred from the water level. This practice is unreliable at places where the relation between water level and flow velocity is ambiguous. In such a case, the continuous measurement of the flow velocity can improve the discharge prediction. The emergence of horizontal acoustic Doppler current profilers (HADCPs) has made it possible to continuously measure the flow velocity. However, the profiling range of HADCPs is limited, so that a single instrument can only partially cover a wide cross section. The total discharge still has to be determined with a model. While the limitations of rating curves are well understood, there is not yet a comprehensive theory to assess the accuracy of discharge predicted from velocity measurements. Such a theory is necessary to discriminate which factors influence the measurements, and to improve instrument deployment as well as discharge prediction. This paper presents a generic method to assess the uncertainty of discharge predicted from range-limited velocity profiles. The theory shows that a major source of error is the variation of the ratio between the local and cross-section-averaged velocity. This variation is large near the banks, where HADCPs are usually deployed and can limit the advantage gained from the velocity measurement. We apply our theory at two gauging stations situated in the Kapuas River, Indonesia. We find that at one of the two stations the index velocity does not outperform a simple rating curve.

  13. Human Arsenic Poisoning Issues in Central-East Indian Locations: Biomarkers and Biochemical Monitoring

    Directory of Open Access Journals (Sweden)

    Madhurima Pandey

    2007-03-01

    Full Text Available The study reports the use of three biomarkers i.e. total arsenic in hair and nails, total arsenic in blood, and total arsenic in urine to identify or quantify arsenic exposure and concomitant health effects. The main source of arsenic was inorganic exposure through drinking water. The arsenic levels and the health effects were analyzed closely in a family having maximum symptoms of arsenic. Based on the result of this study it is reported that there exist a correlation between the clinically observable symptoms, the blood and urine arsenic level, and the arsenic intake through drinking water. An intensive study on the urinary arsenic levels was carried out in which the urine levels of arsenic and the urine sufficiency tests were performed. A composite picture of body burden of arsenic has been obtained by carrying out a complete biochemical analysis of a maximum affected family. This confirms pronounced chronic exposure of the arsenic to these people. A combined correlation study on the arsenic levels measured in whole blood, urine, hair, nails and age present a remarkable outcome. Accordingly, the arsenic levels in blood are negatively correlated with the urine arsenic levels, which indicate either the inadequacy of the renal system in cleaning the blood arsenic or a continuous recirculation of the accumulated arsenic. This is an important conclusion about arsenical metabolism in humans. The study also raises the issues of the prospects of complete elimination of the accumulated arsenic and the reversibility of the health effects. Based on the work in Kourikasa village we report that there are very remote chances of complete purging of arsenic and thus reversibility of the health effects owing to various factors. The paper also discusses the various issues concerning the chronic arsenic poisoning management in the affected locations.

  14. Prediction of landslide activation at locations in Beskidy Mountains using standard and real-time monitoring methods

    Science.gov (United States)

    Bednarczyk, Z.

    2012-04-01

    The paper presents landslide monitoring methods used for prediction of landslide activity at locations in the Carpathian Mountains (SE Poland). Different types of monitoring methods included standard and real-time early warning measurement with use of hourly data transfer to the Internet were used. Project financed from the EU funds was carried out for the purpose of public road reconstruction. Landslides with low displacement rates (varying from few mm to over 5cm/year) had size of 0.4-2.2mln m3. Flysch layers involved in mass movements represented mixture of clayey soils and sandstones of high moisture content and plasticity. Core sampling and GPR scanning were used for recognition of landslide size and depths. Laboratory research included index, IL oedometer, triaxial and direct shear laboratory tests. GPS-RTK mapping was employed for actualization of landslide morphology. Instrumentation consisted of standard inclinometers, piezometers and pore pressure transducers. Measurements were carried 2006-2011, every month. In May 2010 the first in Poland real-time monitoring system was installed at landslide complex over the Szymark-Bystra public road. It included in-place uniaxial sensors and 3D continuous inclinometers installed to the depths of 12-16m with tilt sensors every 0.5m. Vibrating wire pore pressure and groundwater level transducers together with automatic meteorological station analyzed groundwater and weather conditions. Obtained monitoring and field investigations data provided parameters for LEM and FEM slope stability analysis. They enabled prediction and control of landslide behaviour before, during and after stabilization or partly stabilization works. In May 2010 after the maximum precipitation (100mm/3hours) the rates of observed displacements accelerated to over 11cm in a few days and damaged few standard inclinometer installations. However permanent control of the road area was possible by continuous inclinometer installations. Comprehensive

  15. Novel, continuous monitoring of fine‐scale movement using fixed‐position radiotelemetry arrays and random forest location fingerprinting

    Science.gov (United States)

    Harbicht, Andrew B.; Castro-Santos, Theodore R.; Ardren, William R.; Gorsky, Dimitry; Fraser, Dylan

    2017-01-01

    Radio‐tag signals from fixed‐position antennas are most often used to indicate presence or absence of individuals, or to estimate individual activity levels from signal strength variation within an antenna's detection zone. The potential of such systems to provide more precise information on tag location and movement has not been explored in great detail in an ecological setting.By reversing the roles that transmitters and receivers play in localization methods common to the telecommunications industry, we present a new telemetric tool for accurately estimating the location of tagged individuals from received signal strength values. The methods used to characterize the study area in terms of received signal strength are described, as is the random forest model used for localization. The resulting method is then validated using test data before being applied to true data collected from tagged individuals in the study site.Application of the localization method to test data withheld from the learning dataset indicated a low average error over the entire study area (movement data for tagged fish along a single axis (a migratory path) and is particularly useful for monitoring passage along migratory routes. The new methods applied in this study can also be expanded to include multiple axes (x, y, z) and multiple environments (aquatic and terrestrial) for remotely monitoring wildlife movement.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  17. Evaluating public ambulance service levels by applying a GIS based ...

    African Journals Online (AJOL)

    Hunadi Mokgalaka

    based analysis of ambulance response time was undertaken. The purpose was to .... He tested the travel time of the primary response vehicles and ..... Real CORP Proceedings / Tagungsband, ISBN: 978-3-9502139-7-3, pp, 22-25, viewed 18.

  18. Implementation and Analysis of a Wireless Sensor Network-Based Pet Location Monitoring System for Domestic Scenarios.

    Science.gov (United States)

    Aguirre, Erik; Lopez-Iturri, Peio; Azpilicueta, Leyre; Astrain, José Javier; Villadangos, Jesús; Santesteban, Daniel; Falcone, Francisco

    2016-08-30

    The flexibility of new age wireless networks and the variety of sensors to measure a high number of variables, lead to new scenarios where anything can be monitored by small electronic devices, thereby implementing Wireless Sensor Networks (WSN). Thanks to ZigBee, RFID or WiFi networks the precise location of humans or animals as well as some biological parameters can be known in real-time. However, since wireless sensors must be attached to biological tissues and they are highly dispersive, propagation of electromagnetic waves must be studied to deploy an efficient and well-working network. The main goal of this work is to study the influence of wireless channel limitations in the operation of a specific pet monitoring system, validated at physical channel as well as at functional level. In this sense, radio wave propagation produced by ZigBee devices operating at the ISM 2.4 GHz band is studied through an in-house developed 3D Ray Launching simulation tool, in order to analyze coverage/capacity relations for the optimal system selection as well as deployment strategy in terms of number of transceivers and location. Furthermore, a simplified dog model is developed for simulation code, considering not only its morphology but also its dielectric properties. Relevant wireless channel information such as power distribution, power delay profile and delay spread graphs are obtained providing an extensive wireless channel analysis. A functional dog monitoring system is presented, operating over the implemented ZigBee network and providing real time information to Android based devices. The proposed system can be scaled in order to consider different types of domestic pets as well as new user based functionalities.

  19. Implementation and Analysis of a Wireless Sensor Network-Based Pet Location Monitoring System for Domestic Scenarios

    Directory of Open Access Journals (Sweden)

    Erik Aguirre

    2016-08-01

    Full Text Available The flexibility of new age wireless networks and the variety of sensors to measure a high number of variables, lead to new scenarios where anything can be monitored by small electronic devices, thereby implementing Wireless Sensor Networks (WSN. Thanks to ZigBee, RFID or WiFi networks the precise location of humans or animals as well as some biological parameters can be known in real-time. However, since wireless sensors must be attached to biological tissues and they are highly dispersive, propagation of electromagnetic waves must be studied to deploy an efficient and well-working network. The main goal of this work is to study the influence of wireless channel limitations in the operation of a specific pet monitoring system, validated at physical channel as well as at functional level. In this sense, radio wave propagation produced by ZigBee devices operating at the ISM 2.4 GHz band is studied through an in-house developed 3D Ray Launching simulation tool, in order to analyze coverage/capacity relations for the optimal system selection as well as deployment strategy in terms of number of transceivers and location. Furthermore, a simplified dog model is developed for simulation code, considering not only its morphology but also its dielectric properties. Relevant wireless channel information such as power distribution, power delay profile and delay spread graphs are obtained providing an extensive wireless channel analysis. A functional dog monitoring system is presented, operating over the implemented ZigBee network and providing real time information to Android based devices. The proposed system can be scaled in order to consider different types of domestic pets as well as new user based functionalities.

  20. Towards a Personal Health Record System for the Assesment and Monitoring of Sedentary Behavior in Indoor Locations.

    Science.gov (United States)

    Ceron, Jesus D; Lopez, Diego M

    2016-01-01

    Sedentary behavior has been associated to the development of noncommunicable diseases (NCD) such as cardiovascular diseases (CVD), type 2 diabetes, and cancer. Accelerometers and inclinometers have been used to estimate sedentary behaviors, however a major limitation is that these devices do not provide contextual information such as the activity performed, e.g., TV viewing, sitting at work, driving, etc. The main objective of the thesis is to propose and evaluate a Personal Health Record System to support the assessment and monitoring of sedentary behaviors. Until now, we have implemented a system, which identifies individual's sedentary behaviors and location based on accelerometer data obtained from a smartwatch, and symbolic location data obtained from Bluetooth beacons. The system infers sedentary behaviors by means of a supervised Machine Learning Classifier. The precision in the classification of the six studied sedentary behaviors exceeded 90%, being the Random Forest algorithm the most precise. The proposed system allows the recognition of specific sedentary behaviors and their location with very high precision.

  1. Enhanced 911/global position system wizard: a telemedicine application for the prevention of severe hypoglycemia--monitor, alert, and locate.

    Science.gov (United States)

    Dassau, Eyal; Jovanovic, Lois; Doyle, Francis J; Zisser, Howard C

    2009-11-01

    Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.

  2. THE MOSCOW AMBULANCE STATION. FROM THE SOURSE TO THE PRESENT

    Directory of Open Access Journals (Sweden)

    N. F. Plavunov

    2017-01-01

    Full Text Available This article is devoted to 130th anniversary and publication of academic writings of Alexander Puchkov — Doctor of Med. Sci., Honored Doctor of Russian Soviet Federative Socialist Republic. He was permanent leader of Moscow Ambulance Station from 1923 to 1952. Data presented in Puchkov’s articles were used to compare performance of work of Moscow ambulance in it’s formative period and our days. This article shows specificities, characteristics and environment of Moscow ambulance in 1926 and 2016. For example, the number of brigades had increased by 67,9 times (from 15 in 1926 to 1018 in 2016. Average time of arrival to accident is 10-12 minutes is same for 1926 and 2016. The proportion of pediatric interventions (from birth to 15 years old had increased. Analysis of indicators allows to look at development of Moscow ambulance station from it’s formative period to our days. Fundamental principles laid down by A. Puchkov last in many cases in work of Moscow Ambulance in our days. Ambulance doctors continue to provide medical assistance promptly in the framework spelt out more than 90 years ago.

  3. Self- and peer-assessments of ambulance drivers' driving performance

    Directory of Open Access Journals (Sweden)

    Anna Sundström

    2012-07-01

    Full Text Available The aim of the present study was to develop and examine the quality of the Ambulance Driver Self-assessment Questionnaire (ADSQ and the Ambulance Driver Peer-assessment Questionnaire (ADPQ measuring aspects of, driving performance, driving style and driving competence. In addition the ADSQ measures self-reflection and safety-attitudes. The aim of the study was also to examine ambulance drivers' self- and peer-assessments as well as to examine the accuracy of self-assessments by comparing self-assessed and peer-assessed driving performance, driving style and competence. 76 ambulance drivers employed at two ambulance stations in northern Sweden completed ADSQ and ADPQ. Item analyses were conducted to examine the psychometric properties of the items, and based on the results some revisions were made to improve the questionnaires. The revised questionnaires were functioning rather well, although some subscale demonstrated low internal consistency. Subscale inter-correlations provided support for construct validity. Self- and peer-assessments indicated safe driving performance and good driver competence, which is positive from a traffic safety perspective. A comparison of mean self- and peer-assessment ratings, controlling for age, gender and driving experience showed no significant differences, except for the subscale overtaking. This indicates that ambulance drivers' self-assessments are realistic in most areas.

  4. Barriers to Implementation of Recommendations for Transport of Children in Ground Ambulances.

    Science.gov (United States)

    Woods, Rashida H; Shah, Manish; Doughty, Cara; Gilchrest, Anthony

    2017-10-16

    The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed. Of 62 eligible EMS agencies that took the survey, 35.7% were aware of the NHTSA guidelines, 62.5% agreed they would improve safety, and 41.1% planned to implement them. Seventy-five percent of EMS agencies used the ideal or acceptable alternative to transport children requiring continuous monitoring, and 69.5% chose ideal or acceptable alternatives for children requiring spinal immobilization. The ideal or acceptable alternative was not chosen for children who were not injured or ill (93.2%), ill or injured but not requiring continuous monitoring (53.3%), and situations when multiple patients required transport (57.6%). The main requirements for implementation were provider education, ambulance interior modifications, new guidelines in the EMS agency, and purchase of new equipment. Few EMS agencies are aware of the NHTSA guidelines on safe transport of children in ground ambulances. Although most agencies appropriately transport children who require monitoring, interventions, or spinal immobilization, they use inappropriate means to transport children in situations with multiple patients, lack of injury or illness, or lack of need for monitoring.

  5. A Survey of Restraint Methods for the Safe Transport of Children in Ground Ambulances.

    Science.gov (United States)

    Woods, Rashida H; Shah, Manish; Doughty, Cara; Gilchrest, Anthony

    2018-03-01

    The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed. Of 62 eligible EMS agencies that took the survey, 35.7% were aware of the NHTSA guidelines, 62.5% agreed they would improve safety, and 41.1% planned to implement them. Seventy-five percent of EMS agencies used the ideal or acceptable alternative to transport children requiring continuous monitoring, and 69.5% chose ideal or acceptable alternatives for children requiring spinal immobilization. The ideal or acceptable alternative was not chosen for children who were not injured or ill (93.2%), ill or injured but not requiring continuous monitoring (53.3%), and situations when multiple patients required transport (57.6%). The main requirements for implementation were provider education, ambulance interior modifications, new guidelines in the EMS agency, and purchase of new equipment. Few EMS agencies are aware of the NHTSA guidelines on safe transport of children in ground ambulances. Although most agencies appropriately transport children who require monitoring, interventions, or spinal immobilization, they use inappropriate means to transport children in situations with multiple patients, lack of injury or illness, or lack of need for monitoring.

  6. Crew Configuration, Ingress/Egress Procedures, and In-Flight Caregiving Capacity in a Space Ambulance Based on the Boeing X-37B

    Science.gov (United States)

    Halberg, Ephriam Etan

    This study proposes that a Boeing X-37B space plane, its dimensions and performance characteristics estimated from publicly available documents, diagrams, and photographs, could be internally redesigned as a medical evacuation (ambulance) vehicle for the International Space Station. As of 2017, there is currently no spacecraft designed to accommodate a contingency medical evacuation wherein a crew member aboard the ISS is injured or ailing and must be returned to Earth for immediate medical attention. The X-37B is an unmanned vehicle with a history of success in both sub-orbital testing and all four of its long-duration orbital missions to date. Research conducted at UC Davis suggests that it is possible to retain the outer mold line of the X-37B while expanding the internal payload compartment to a volume sufficient for a crew of three--pilot, crew medical officer, and injured crew member--throughout ISS un-dock and atmospheric entry, descent, and landing. In addition to crew life support systems, this re-purposed X-37B, hereafter referred to as the X-37SA (Space Ambulance), includes medical equipment for stabilization of a patient in-transit. This study suggests an optimal, ergonomic crew configuration and berthing port location, procedures for microgravity ingress and 1G egress, a minimum medical equipment list and location within the crew cabin for the medical care and monitoring equipment. Conceptual crew configuration, ingress/egress procedures, and patient/equipment access are validated via physical simulation in a full-scale mockup of the proposed X-37SA crew cabin.

  7. EGS hydraulic stimulation monitoring by surface arrays - location accuracy and completeness magnitude: the Basel Deep Heat Mining Project case study

    Science.gov (United States)

    Häge, Martin; Blascheck, Patrick; Joswig, Manfred

    2013-01-01

    The potential and limits of monitoring induced seismicity by surface-based mini arrays was evaluated for the hydraulic stimulation of the Basel Deep Heat Mining Project. This project aimed at the exploitation of geothermal heat from a depth of about 4,630 m. As reference for our results, a network of borehole stations by Geothermal Explorers Ltd. provided ground truth information. We utilized array processing, sonogram event detection and outlier-resistant, graphical jackknife location procedures to compensate for the decrease in signal-to-noise ratio at the surface. We could correctly resolve the NNW-SSE striking fault plane by relative master event locations. Statistical analysis of our catalog data resulted in M L 0.36 as completeness magnitude, but with significant day-to-night dependency. To compare to the performance of borehole data with M W 0.9 as completeness magnitude, we applied two methods for converting M L to M W which raised our M C to M W in the range of 0.99-1.13. Further, the b value for the duration of our measurement was calculated to 1.14 (related to M L), respectively 1.66 (related to M W), but changes over time could not be resolved from the error bars.

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

    CERN Multimedia

    2000-01-01

    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 ...

  9. Community-acquired pneumonia; Ambulant erworbene Pneumonien

    Energy Technology Data Exchange (ETDEWEB)

    Poetter-Lang, S.; Herold, C.J. [Medizinische Universitaet Wien, Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Wien (Austria)

    2017-01-15

    The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging. The radiological findings serve as proof or exclusion of pneumonia and can also be used to evaluate the extent of the disease (e.g. monolobular, multilobular, unilateral or bilateral). In cases of prolonged disease, suspicion of complications (e.g. pleural effusion or empyema, necrotizing pneumonia or abscess) or comorbid conditions (e.g. underlying pulmonary or mediastinal diseases) computed tomography is an important diagnostic tool in addition to chest radiography. Ultrasound is often used to diagnose pleural processes (e.g. parapneumonic effusion or pleural empyema). (orig.) [German] Anhand der klinischen Symptome und laborchemischen Befundkonstellation alleine ist es oft nicht moeglich, die Diagnose einer ambulant erworbenen Pneumonie (''community-acquired pneumonia'', CAP) zu stellen. Bei jedem Patienten mit Verdacht auf CAP sollte eine Roentgenthoraxaufnahme in 2 Ebenen angefertigt werden. Weiter muss eine Risikostratifizierung im Sinne der Entscheidung ambulante Therapie vs. Hospitalisierung erfolgen. Anhand der Analyse radiologischer Muster sowie deren Verteilung und Ausdehnung koennen eine grobe Zuordnung zu sogenannten Erregergruppen sowie eine Differenzierung zwischen viralen und bakteriellen Infektionen gelingen. Da

  10. [Examination of work-related stress and coping strategies among ambulance- and air-ambulance workers].

    Science.gov (United States)

    Schiszler, Bence; Karamánné Pakai, Annamária; Szabó, Zoltán; Raposa, László Bence; Pónusz, Róbert; Radnai, Balázs; Endrei, Dóra

    2016-11-01

    Among Hungary's health sector workers the presence of a high level of stress is known, which can affect the individual. The aim of the authors was to uncover major risk factors causing work-related stress, as well as its extent, and positive and negative coping strategies among ground and aerial rescue workers. From June until October 2015, a national survey was conducted among Hungarian rescue workers. An own questionnaire and Rahe Stress and coping validated short questionnaire online form were used. A total of 141 persons took part in the survey. As compared to air-ambulance workers, ground rescue workers were exposed to higher work-related stress effects (pStress and Coping Index effective coping mechanisms were observed among air rescue workers (pstress reduction. Orv. Hetil., 2016, 157(45), 1802-1808.

  11. [Índice de Saturación Modificado y Ambulancias (ISMA): Ambulance assignment and remote Emergency Room Bed Reservation].

    Science.gov (United States)

    Polanco-González, Carlos; Castañón-González, Jorge Alberto; Villanueva-Martínez, Sebastián; Samaniego-Mendoza, José Lino; Buhse, Thomas

    2015-01-01

    In most places all over the world–including our country–services in emergency rooms are oversaturated. This situation frequently forces the continuously arriving ambulances to be redirected to other medical units, delaying the admission of patients moved and thus adversely affecting their physical condition. To introduce an improvement to the Índicede Saturación Modificado computational system, which monitors the degree of saturation of a network of emergency medical services, to include a network of ambulances, enabling in the system: (i) the effective allocation of ambulances to the site of the accident, or severe clinical event, and (ii) the remote booking of beds in the nearest and least saturated emergency room available. The evaluation and connectivity of the computational improvement to the Índicede Saturación Modificado system was carried out with a computational test verifying these two aspects, using only differences in postal codes, for time measuring. The verification of its sustainability online showed the new Índice de Saturación Modificado y Ambulancias system (ISMA) has a robust structure capable of being adapted to mobile phones, laptops or tablets, and can efficiently administrate: (i) the quantification of excessive demand in the emergency room services of a hospital network, (ii) the allocation of ambulances attending the site of the event or contingency, and (iii) the allocation of ambulances and patients, in the best distance-time conditions, from the site of the accident or clinical event to the nearest and least saturated emergency room service. This administrative management tool is efficient and simple to use, and it optimally relates independent service networks.

  12. Patients' experiences of cold exposure during ambulance care.

    Science.gov (United States)

    Aléx, Jonas; Karlsson, Stig; Saveman, Britt-Inger

    2013-06-06

    Exposure to cold temperatures is often a neglected problem in prehospital care. Cold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until ultimately reaching hypothermia. It may also impair cognitive function, increase pain and contribute to fear and an overall sense of dissatisfaction. The aim of this study was to investigate injured and ill patients' experiences of cold exposure and to identify related factors. During January to March 2011, 62 consecutively selected patients were observed when they were cared for by ambulance nursing staff in prehospital care in the north of Sweden. The field study was based on observations, questions about thermal discomfort and temperature measurements (mattress air and patients' finger temperature). Based on the observation protocol the participants were divided into two groups, one group that stated it was cold in the patient compartment in the ambulance and another group that did not. Continuous variables were analyzed with independent sample t-test, paired sample t-test and dichotomous variables with cross tabulation. In the ambulance 85% of the patients had a finger temperature below comfort zone and 44% experienced the ambient temperature in the patient compartment in the ambulance to be cold. There was a significant decrease in finger temperature from the first measurement indoor compared to measurement in the ambulance. The mattress temperature at the ambulance ranged from -22.3°C to 8.4°C. Cold exposure in winter time is common in prehospital care. Sick and injured patients immediately react to cold exposure with decreasing finger temperature and experience of discomfort from cold. Keeping the patient in the comfort zone is of great importance. Further studies are needed to increase knowledge which can be a base for implications in prehospital care for patients who probably already suffer for other reasons.

  13. Patients’ experiences of cold exposure during ambulance care

    Science.gov (United States)

    2013-01-01

    Background Exposure to cold temperatures is often a neglected problem in prehospital care. Cold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until ultimately reaching hypothermia. It may also impair cognitive function, increase pain and contribute to fear and an overall sense of dissatisfaction. The aim of this study was to investigate injured and ill patients’ experiences of cold exposure and to identify related factors. Method During January to March 2011, 62 consecutively selected patients were observed when they were cared for by ambulance nursing staff in prehospital care in the north of Sweden. The field study was based on observations, questions about thermal discomfort and temperature measurements (mattress air and patients’ finger temperature). Based on the observation protocol the participants were divided into two groups, one group that stated it was cold in the patient compartment in the ambulance and another group that did not. Continuous variables were analyzed with independent sample t-test, paired sample t-test and dichotomous variables with cross tabulation. Results In the ambulance 85% of the patients had a finger temperature below comfort zone and 44% experienced the ambient temperature in the patient compartment in the ambulance to be cold. There was a significant decrease in finger temperature from the first measurement indoor compared to measurement in the ambulance. The mattress temperature at the ambulance ranged from −22.3°C to 8.4°C. Conclusion Cold exposure in winter time is common in prehospital care. Sick and injured patients immediately react to cold exposure with decreasing finger temperature and experience of discomfort from cold. Keeping the patient in the comfort zone is of great importance. Further studies are needed to increase knowledge which can be a base for implications in prehospital care for patients who probably already suffer for other reasons. PMID:23742143

  14. Utility of Ambulance Data for Real-Time Syndromic Surveillance: A Pilot in the West Midlands Region, United Kingdom.

    Science.gov (United States)

    Todkill, Dan; Loveridge, Paul; Elliot, Alex J; Morbey, Roger A; Edeghere, Obaghe; Rayment-Bishop, Tracy; Rayment-Bishop, Chris; Thornes, John E; Smith, Gillian

    2017-12-01

    Introduction The Public Health England (PHE; United Kingdom) Real-Time Syndromic Surveillance Team (ReSST) currently operates four national syndromic surveillance systems, including an emergency department system. A system based on ambulance data might provide an additional measure of the "severe" end of the clinical disease spectrum. This report describes the findings and lessons learned from the development and preliminary assessment of a pilot syndromic surveillance system using ambulance data from the West Midlands (WM) region in England. Hypothesis/Problem Is an Ambulance Data Syndromic Surveillance System (ADSSS) feasible and of utility in enhancing the existing suite of PHE syndromic surveillance systems? An ADSSS was designed, implemented, and a pilot conducted from September 1, 2015 through March 1, 2016. Surveillance cases were defined as calls to the West Midlands Ambulance Service (WMAS) regarding patients who were assigned any of 11 specified chief presenting complaints (CPCs) during the pilot period. The WMAS collected anonymized data on cases and transferred the dataset daily to ReSST, which contained anonymized information on patients' demographics, partial postcode of patients' location, and CPC. The 11 CPCs covered a broad range of syndromes. The dataset was analyzed descriptively each week to determine trends and key epidemiological characteristics of patients, and an automated statistical algorithm was employed daily to detect higher than expected number of calls. A preliminary assessment was undertaken to assess the feasibility, utility (including quality of key indicators), and timeliness of the system for syndromic surveillance purposes. Lessons learned and challenges were identified and recorded during the design and implementation of the system. The pilot ADSSS collected 207,331 records of individual ambulance calls (daily mean=1,133; range=923-1,350). The ADSSS was found to be timely in detecting seasonal changes in patterns of respiratory

  15. Ambulation in adults with myelomeningocele. Is it possible to predict the level of ambulation in early life?

    DEFF Research Database (Denmark)

    Seitzberg, A.; Lind, M.; Biering-Sørensen, Fin

    2008-01-01

    OBJECTIVE: The objective of this study was to evaluate the prediction of ambulation in adults with myelomeningocele from muscle strength testing and ambulation in early life. MATERIALS AND METHODS: Fifty-two myelomeningocele (MMC) individuals at the age 18-37 years at follow-up were studied....... Information on muscle strength and ambulatory function in early life was retrieved from medical records. The motor levels determined by the muscle strength were used to predict ambulatory function later in life. At follow-up, a clinical examination was performed. RESULTS: Of 20 MMC individuals assessed...... life than predicted. Good strength in quadriceps muscles gave significant better prospect for adult walking. Of the 52 participants, 41 retained their ambulation status from 5-8 years of age. CONCLUSION: For MMC individuals with motor levels L3-L5, adult ambulatory function cannot be determined from...

  16. Managing the impact of growing low-acuity demand on ambulance services

    OpenAIRE

    KATHRYN JEAN EASTWOOD

    2018-01-01

    Increasing demand for emergency ambulances places a substantial burden on ambulance services. Many cases are low-acuity, having no urgent clinical need for paramedic treatment. Ambulance Victoria implemented a secondary telephone triage services to divert low-acuity cases away from emergency ambulances to more appropriate care. This research found this ‘Referral Service’ has had a substantial impact upon emergency operations, referring over 70% of the cases it managed away from emergency am...

  17. Ambulant ST-segmentmonitorering efter akut myokardieinfarkt

    DEFF Research Database (Denmark)

    Mickley, H; Junker, A; Friis, E V

    1994-01-01

    Over the last decade the concept of silent myocardial ischaemia has received considerable attention. Without doubt, the increased use of ambulatory ST-segment monitoring is the most important reason for the growing interest in this field. The prevalence of ambulatory ischaemia after myocardial...... with previous myocardial infarction, but there is considerable disagreement about how this is expressed in terms of cardiac events. Patient selection, small patient numbers, and different timing of ambulatory monitoring are proposed as important reasons for the inconsistent findings. The precise role...

  18. Cost-efficient evaluation of ambulance services for community ...

    African Journals Online (AJOL)

    A total of 12,674 victims were transported to different tares of hospital and referrals ... The mean cost-efficiency (technical) of Machakos ambulance transport services was 90.6% (C.I 82.7% - 98.2%). ... EMAIL FULL TEXT EMAIL FULL TEXT

  19. Stress and organization change in the ambulance service

    NARCIS (Netherlands)

    Wastell, D.; Newman, M.

    1996-01-01

    The development of information systems (IS) is a problematic process that all too often ends in failure. This paper reports a comparative analysis of two projects involving the computerisation of ambulance control-room operations in London and Manchester. The outcomes were strikingly different. In

  20. Predictors of workplace violence among ambulance personnel : A longitudinal study.

    NARCIS (Netherlands)

    van der Velden, Peter; Bosmans, Mark; van der Meulen, Erik

    Abstract Aim To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations. Although previous research assessed

  1. Radiology trainer. Surgical ambulance. Revision 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Ackermann, Ole; Barkhausen, Joerg

    2013-01-01

    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.

  2. Proposals for in-service inspection and monitoring of selected components located within or part of the primary containment of sodium cooled fast reactors

    International Nuclear Information System (INIS)

    Bolt, P.R.

    1976-01-01

    Design and operational experience of CEGB gas cooled reactors and certain overseas reactor plant is reviewed in relation to in-service inspection and monitoring capabilities. Design guidelines and preliminary proposals are given for in-service inspection and monitoring of selected components located within or part of the primary containment of sodium cooled fast reactors. Specific comments are made on the items of further design and development work believed to be necessary

  3. 42 CFR 414.620 - Publication of the ambulance fee schedule.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Publication of the ambulance fee schedule. 414.620... SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedule for Ambulance Services § 414.620 Publication of the ambulance fee schedule. Changes in payment rates resulting...

  4. Multi-Agent Simulation of Allocating and Routing Ambulances Under Condition of Street Blockage after Natural Disaster

    Science.gov (United States)

    Azimi, S.; Delavar, M. R.; Rajabifard, A.

    2017-09-01

    In response to natural disasters, efficient planning for optimum allocation of the medical assistance to wounded as fast as possible and wayfinding of first responders immediately to minimize the risk of natural disasters are of prime importance. This paper aims to propose a multi-agent based modeling for optimum allocation of space to emergency centers according to the population, street network and number of ambulances in emergency centers by constraint network Voronoi diagrams, wayfinding of ambulances from emergency centers to the wounded locations and return based on the minimum ambulances travel time and path length implemented by NSGA and the use of smart city facilities to accelerate the rescue operation. Simulated annealing algorithm has been used for minimizing the difference between demands and supplies of the constrained network Voronoi diagrams. In the proposed multi-agent system, after delivering the location of the wounded and their symptoms, the constraint network Voronoi diagram for each emergency center is determined. This process was performed simultaneously for the multi-injuries in different Voronoi diagrams. In the proposed multi-agent system, the priority of the injuries for receiving medical assistance and facilities of the smart city for reporting the blocked streets was considered. Tehran Municipality District 5 was considered as the study area and during 3 minutes intervals, the volunteers reported the blocked street. The difference between the supply and the demand divided to the supply in each Voronoi diagram decreased to 0.1601. In the proposed multi-agent system, the response time of the ambulances is decreased about 36.7%.

  5. Is the Ability to Ambulate Associated with Better Employment Outcomes in Participants with Traumatic Spinal Cord Injury?

    Science.gov (United States)

    Krause, James S.

    2010-01-01

    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…

  6. Perioperative transfusion threshold and ambulation after hip revision surgery

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... surgery. METHODS: The trial was registered at Clinicaltrials.gov ( NCT00906295). Sixty-six patients aged 18 years or older undergoing hip revision surgery were randomized to receive RBC at a Hb threshold of either 7.3 g/dL (restrictive group) or 8.9 g/dL (liberal group). Postoperative ambulation...... 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....

  7. 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. Aim This presentation investigates whether failure to use AT is linked to male ambulance workers’ gender identity? Is lifting patients alone a way of performing masculinity for AP’s? Method Data is taken from MARS, a panel study of AP workers in Denmark (n = 1606). Information from questionnaires...... measuring traditional male role norms (MRNI), safety attitudes and safety behavior will be linked to company register information on work injuries categorized as lifting accidents. Logistic regression is used to analyse associations between masculinity, lifting behavior, and lifting accidents. Results...

  8. HOMING PLACE: TOWARDS A PARTICIPATORY, AMBULANT AND CONVERSIVE METHODOLOGY

    OpenAIRE

    Myers, Misha

    2009-01-01

    The practice-as-research project Homing Place proposes a transferable percipient-led methodology of performance and research activated by ambulant and conversive mechanisms as the culmination of this research. The thesis is comprised of a range of activity that represents a moment and way of writing practice. Three artworks that comprise part of the practical component of this thesis--- way from home, Take me to a place and Yodel Rodeo-- each involved participation and contribu...

  9. Predictors of workplace violence among ambulance personnel: a longitudinal study

    OpenAIRE

    van der Velden, Peter G.; Bosmans, Mark W.G.; van der Meulen, Erik

    2015-01-01

    Abstract Aim To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations. Although previous research assessed the prevalences among this group, little is known about predictors, to what extent PTE’s are WPV-related and their abilities to prevent escalations. Design A longitudinal study with a 6 months’ time ...

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

    Directory of Open Access Journals (Sweden)

    Sherwin E. Phillips

    2012-01-01

    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. [The Swedish ambulance services 1935-1936 of Gunnar Agge].

    Science.gov (United States)

    Gustavsson, Pär; Nilsson, Peter M

    2006-01-01

    The fact that Sweden has been spared from war on its soil for almost 200 years, has not stopped Swedish citizens from participating in conflicts worldwide during this period. This has been described, especially from the soldiers perspective. The contribution of Swedish physicians has not been written about to the same extent. When Mussolini's Italy in October 1935 invaded the poor and underdeveloped country of Ethiopia (former Abyssinia) an ambulance was immediately organized by the Swedish Red Cross. To lead such an expedition, a great knowledge of Ethiopian culture och maybe most importantly, of the weather and geographical conditions, was undoubtedly demanded. Therefore, the Swedish Red Cross turned to two Ethiopian veterans. Doctor Fride Hylander, a missionary-son who had been working on a hospital project in the Ethiopian province of Harrar and his friend since school years, doctor Gunnar Agge, were assigned the leadership of the ambulance. Dr Agge had also participated in improving the Ethiopian health care both in Harrar and later as civilian and military doctor in the province of Ogaden, where he was medically responsible for the more than 9 000 men strong army that the Ethiopian emperor had stationed there after Italian provocations. Most of the other members of the ambulance were handpicked by these two leaders and many of them had, just like themselves, a stong religious belief. A money-raise was immediately initiated and in less than six weeks 700 000 Swedish crowns had been collected, more then twice the sum the ambulance was calculated to cost. In early november 1935 the ambulance was clear to go. Their primary objective was to travel through British Somaliland and establish a field-hospital in the province of Harrar. However, the Ethiopian emperor had other things in mind. He wanted to reorganize the ambulance and divide it in two and place it closer to the front line. The ambulance decided to go along with his wish. Both groups started eventually

  12. Automated radioxenon monitoring for the comprehensive nuclear-test-ban treaty in two distinctive locations: Ottawa and Tahiti

    International Nuclear Information System (INIS)

    Stocki, T.J.; Blanchard, X.; D'Amours, R.; Ungar, R.K.; Fontaine, J.P.; Sohier, M.; Bean, M.; Taffary, T.; Racine, J.; Tracy, B.L.; Brachet, G.; Jean, M.; Meyerhof, D.

    2005-01-01

    In preparation for verification of the Comprehensive Nuclear-Test-Ban-Treaty, automated radioxenon monitoring is performed in two distinctive environments: Ottawa and Tahiti. These sites are monitored with SPALAX (Systeme de Prelevement d'air Automatique en Ligne avec l'Analyse des radioXenons) technology, which automatically extracts radioxenon from the atmosphere and measures the activity concentrations of 131m,133m,133,135 Xe. The resulting isotopic concentrations can be useful to discern nuclear explosions from nuclear industry xenon emissions. Ambient radon background, which may adversely impact analyser sensitivity, is discussed. Upper concentration limits are reported for the apparently radioxenon free Tahiti environment. Ottawa has a complex radioxenon background due to proximity to nuclear reactors and medical isotope facilities. Meteorological models suggest that, depending on the wind direction, the radioxenon detected in Ottawa can be characteristic of the normal radioxenon background in the Eastern United States, Europe, and Japan or distinctive due to medical isotope production

  13. Automated radioxenon monitoring for the comprehensive nuclear-test-ban treaty in two distinctive locations: Ottawa and Tahiti.

    Science.gov (United States)

    Stocki, T J; Blanchard, X; D'Amours, R; Ungar, R K; Fontaine, J P; Sohier, M; Bean, M; Taffary, T; Racine, J; Tracy, B L; Brachet, G; Jean, M; Meyerhof, D

    2005-01-01

    In preparation for verification of the Comprehensive Nuclear-Test-Ban-Treaty, automated radioxenon monitoring is performed in two distinctive environments: Ottawa and Tahiti. These sites are monitored with SPALAX (Systeme de Prelevement d'air Automatique en Ligne avec l'Analyse des radioXenons) technology, which automatically extracts radioxenon from the atmosphere and measures the activity concentrations of (131m,133m,133,135)Xe. The resulting isotopic concentrations can be useful to discern nuclear explosions from nuclear industry xenon emissions. Ambient radon background, which may adversely impact analyser sensitivity, is discussed. Upper concentration limits are reported for the apparently radioxenon free Tahiti environment. Ottawa has a complex radioxenon background due to proximity to nuclear reactors and medical isotope facilities. Meteorological models suggest that, depending on the wind direction, the radioxenon detected in Ottawa can be characteristic of the normal radioxenon background in the Eastern United States, Europe, and Japan or distinctive due to medical isotope production.

  14. Appraisal of work ability in relation to job-specific health requirements in ambulance workers

    OpenAIRE

    van Schaaijk, A.; Boschman, J. S.; Frings-Dresen, M. H. W.; Sluiter, J. K.

    2016-01-01

    Purpose To gain insight into which job-specific health requirements relate to work ability, the following two research questions were formulated: Which job-specific health requirements are associated with the appraisal of work ability in ambulance drivers and paramedics? How are appraisals of physical and mental work ability associated with the appraisal of overall work ability in ambulance drivers and paramedics? Method Workers Health Surveillance cross-sectional data of 506 ambulance worker...

  15. Ambulance Work : Relationships between occupational demands, individual characteristics and health-related outcomes

    OpenAIRE

    Aasa, Ulrika

    2005-01-01

    Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel. A random sample of 234 female and 953 male ambulance personnel participated in a nat...

  16. The pattern of ambulance arrivals in the emergency department of an acute care hospital in Singapore

    OpenAIRE

    Seow, E; Wong, H; Phe, A

    2001-01-01

    Methods—All (13 697) ambulance arrivals in 1996 to the ED of Tan Tock Seng Hospital were studied and where relevant compared with the walk in and total arrivals of the same year. The following data were obtained from computer records: (a) patients' demographic data; (b) number of ambulance arrivals by hour; (c) the classification of the ambulance arrivals by emergency or non-emergency, trauma or non-trauma; (d) cause of injury for trauma cases; (e) discharge status.

  17. Monitoring of lightning from the April-May 2010 Eyjafjallajoekull volcanic eruption using a very low frequency lightning location network

    International Nuclear Information System (INIS)

    Bennett, A J; Odams, P; Edwards, D; Arason, P.

    2010-01-01

    The April-May 2010 explosive eruption of the Eyjafjallajoekull volcano in Iceland produced a tephra plume extending to an altitude of over 9 km. During many, but not all, of the periods of significant volcanic activity the plume was sufficiently electrified to generate lightning. This lightning was located by the UK Met Office long-range lightning location network (ATDnet), operating in the very low frequency radio spectrum. An approximately linear relationship between hourly lightning count rate and radar-derived plume height was found. A minimum plume height for lightning generation of sufficient strength to be detected by ATDnet was shown to be 5 km above sea level. It is not clear why some plumes exceeding 5 km did not produce lightning detected by ATDnet, although ambient atmospheric conditions may be an important factor.

  18. Monitoring of lightning from the April-May 2010 Eyjafjallajoekull volcanic eruption using a very low frequency lightning location network

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, A J; Odams, P; Edwards, D [Met Office, FitzRoy Road, Exeter EX1 3PB (United Kingdom); Arason, P., E-mail: alec.bennett@metoffice.gov.uk [Icelandic Meteorological Office, Bustaoavegi 9, IS-150 ReykjavIk (Iceland)

    2010-10-15

    The April-May 2010 explosive eruption of the Eyjafjallajoekull volcano in Iceland produced a tephra plume extending to an altitude of over 9 km. During many, but not all, of the periods of significant volcanic activity the plume was sufficiently electrified to generate lightning. This lightning was located by the UK Met Office long-range lightning location network (ATDnet), operating in the very low frequency radio spectrum. An approximately linear relationship between hourly lightning count rate and radar-derived plume height was found. A minimum plume height for lightning generation of sufficient strength to be detected by ATDnet was shown to be 5 km above sea level. It is not clear why some plumes exceeding 5 km did not produce lightning detected by ATDnet, although ambient atmospheric conditions may be an important factor.

  19. Mobile phone technology identifies and recruits trained citizens to perform CPR on out-of-hospital cardiac arrest victims prior to ambulance arrival.

    Science.gov (United States)

    Ringh, Mattias; Fredman, David; Nordberg, Per; Stark, Tomas; Hollenberg, Jacob

    2011-12-01

    In a two-parted study, evaluate a new concept were mobile phone technology is used to dispatch lay responders to nearby out-of-hospital cardiac arrests (OHCAs). Mobile phone positioning systems (MPS) can geographically locate selected mobile phone users at any given moment. A mobile phone service using MPS was developed and named Mobile Life Saver (MLS). Simulation study: 25 volunteers named mobile responders (MRs) were connected to MLS. Ambulance time intervals from 22 consecutive OHCAs in 2005 were used as controls. The MRs randomly moved in Stockholm city centre and were dispatched to simulated OHCAs (identical to controls) if they were within a 350 m distance. Real life study: during 25 weeks 1271-1801 MRs trained in CPR were connected to MLS. MLS was activated at the dispatch centre in parallel with ambulance dispatch when an OHCA was suspected. The MRs were dispatched if they were within 500 m from the suspected OHCA. Simulation study: mean response time for the MRs compared to historical ambulance time intervals was reduced by 2 min 20s (44%), pMobile phone technology can be used to identify and recruit nearby CPR-trained citizens to OHCAs for bystander CPR prior to ambulance arrival. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Lower air temperature is associated with ambulance transports and death in Takamatsu area, Japan.

    Science.gov (United States)

    Mochimasu, Kazumi Dokai; Miyatake, Nobuyuki; Tanaka, Naoko; Kinoshita, Hiroshi

    2014-07-01

    The aim of this study was to investigate the linkage among ambulance transports, the number of death and air temperature in Takamatsu area, Japan. Monthly data of ambulance transports (total and acute disease) and the number of death from 2004 to 2012 were obtained from Fire Department Service in Takamatsu and Takamatsu city official website, Japan. Climate parameters for required period were also obtained from Japan Meteorological Agency. Population data in Takamatsu area were also used to adjust ambulance transports and the number of death. The linkage among ambulance transports, the number of death and climate parameters was evaluated by ecological analysis. Total ambulance transports (/a hundred thousand people/day) and ambulance transports due to acute disease (/a hundred thousand people/day) were 12.3 ± 0.9 and 6.8 ± 0.7, respectively. The number of death (/a hundred thousand people/day) was 2.5 ± 0.4. By quadratic curve, ambulance transports due to acute disease and the number of death were significantly correlated with the parameters of air temperature. However, the number of death was the highest in January and the lowest in August. Although higher air temperature was only associated with higher ambulance transports, lower air temperature was associated with both higher ambulance transports and the number death in Takamatsu area, Japan.

  1. Basic life support and automated external defibrillator skills among ambulance personnel

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Isbye, Dan Lou; Lippert, Freddy Knudsen

    2012-01-01

    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.......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....

  2. Skylab IMSS checklist application study for emergency medical care. [emergency medical care operations involving the use and operation of the portable ambulance module

    Science.gov (United States)

    Carl, J. G.; Furukawa, S.

    1975-01-01

    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.

  3. Use of CFD modeling for estimating spatial representativeness of urban air pollution monitoring sites and suitability of their locations

    International Nuclear Information System (INIS)

    Santiago, J. L.; Martin, F.

    2015-01-01

    A methodology to estimate the spatial representativeness of air pollution monitoring sites is applied to two urban districts. This methodology is based on high resolution maps of air pollution computed by using Computational Fluid Dynamics (CFD) modelling tools. Traffic-emitted NO 2 dispersion is simulated for several meteorological conditions taking into account the effect of the buildings on air flow and pollutant dispersion and using a steady state CFD-RANS approach. From these results, maps of average pollutant concentrations for January -May 2011 are computed as a combination of the simulated scenarios. Two urban districts of Madrid City were simulated. Spatial representativeness areas for 32 different sites within the same district (including the site of the operative air quality stations) have been estimated by computing the portion of the domains with average NO 2 concentration differing less than a 20% of the concentration at each candidate monitoring site. New parameters such as the ratio AR between the representativeness area and the whole domain area or the representativeness index (IR) has been proposed to discuss and compare the representativeness areas. Significant differences between the spatial representativeness of the candidate sites of both studied districts have been found. The sites of the Escuelas Aguirre district have generally smaller representativeness areas than those of the Plaza de Castilla. More stations are needed to cover the Escuelas Aguirre district than for the Plaza de Castilla one. The operative air quality station of the Escuelas Aguirre district is less representative than the station of the Plaza de Castilla district. The cause of these differences seems to be the differences in urban structure of both districts prompting different ventilation. (Author)

  4. Use of CFD modeling for estimating spatial representativeness of urban air pollution monitoring sites and suitability of their locations

    Energy Technology Data Exchange (ETDEWEB)

    Santiago, J. L.; Martin, F.

    2015-07-01

    A methodology to estimate the spatial representativeness of air pollution monitoring sites is applied to two urban districts. This methodology is based on high resolution maps of air pollution computed by using Computational Fluid Dynamics (CFD) modelling tools. Traffic-emitted NO{sub 2} dispersion is simulated for several meteorological conditions taking into account the effect of the buildings on air flow and pollutant dispersion and using a steady state CFD-RANS approach. From these results, maps of average pollutant concentrations for January -May 2011 are computed as a combination of the simulated scenarios. Two urban districts of Madrid City were simulated. Spatial representativeness areas for 32 different sites within the same district (including the site of the operative air quality stations) have been estimated by computing the portion of the domains with average NO{sub 2} concentration differing less than a 20% of the concentration at each candidate monitoring site. New parameters such as the ratio AR between the representativeness area and the whole domain area or the representativeness index (IR) has been proposed to discuss and compare the representativeness areas. Significant differences between the spatial representativeness of the candidate sites of both studied districts have been found. The sites of the Escuelas Aguirre district have generally smaller representativeness areas than those of the Plaza de Castilla. More stations are needed to cover the Escuelas Aguirre district than for the Plaza de Castilla one. The operative air quality station of the Escuelas Aguirre district is less representative than the station of the Plaza de Castilla district. The cause of these differences seems to be the differences in urban structure of both districts prompting different ventilation. (Author)

  5. Use of CFD modeling for estimating spatial representativeness of urban air pollution monitoring sites and suitability of their locations

    Energy Technology Data Exchange (ETDEWEB)

    Santiago, J.L.; Martin, F.

    2015-07-01

    A methodology to estimate the spatial representativeness of air pollution monitoring sites is applied to two urban districts. This methodology is based on high resolution maps of air pollution computed by using Computational Fluid Dynamics (CFD) modelling tools. Traffic-emitted NO2 dispersion is simulated for several meteorological conditions taking into account the effect of the buildings on air flow and pollutant dispersion and using a steady state CFD-RANS approach. From these results, maps of average pollutant concentrations for January–May 2011 are computed as a combination of the simulated scenarios. Two urban districts of Madrid City were simulated. Spatial representativeness areas for 32 different sites within the same district (including the site of the operative air quality stations) have been estimated by computing the portion of the domains with average NO2 concentration differing less than a 20% of the concentration at each candidate monitoring site. New parameters such as the ratio AR between the representativeness area and the whole domain area or the representativeness index (IR) has been proposed to discuss and compare the representativeness areas. Significant differences between the spatial representativeness of the candidate sites of both studied districts have been found. The sites of the Escuelas Aguirre district have generally smaller representativeness areas than those of the Plaza de Castilla. More stations are needed to cover the Escuelas Aguirre district than for the Plaza de Castilla one. The operative air quality station of the Escuelas Aguirre district is less representative than the station of the Plaza de Castilla district. The cause of these differences seems to be the differences in urban structure of both districts prompting different ventilation. (Author)

  6. Three-year summary report of biological monitoring at the Southwest Ocean dredged-material disposal site and additional locations off Grays Harbor, Washington, 1990--1992

    Energy Technology Data Exchange (ETDEWEB)

    Antrim, L.D.; Shreffler, D.K.; Pearson, W.H.; Cullinan, V.I. [Battelle Marine Research Lab., Sequim, WA (United States)

    1992-12-01

    The Grays Harbor Navigation Improvement Project was initiated to improve navigation by widening and deepening the federal channel at Grays Harbor. Dredged-material disposal sites were selected after an extensive review process that included inter-agency agreements, biological surveys, other laboratory and field studies, and preparation of environmental impact statements The Southwest Site, was designated to receive materials dredged during annual maintenance dredging as well as the initial construction phase of the project. The Southwest Site was located, and the disposal operations designed, primarily to avoid impacts to Dungeness crab. The Final Environmental Impact Statement Supplement for the project incorporated a Site Monitoring Plan in which a tiered approach to disposal site monitoring was recommended. Under Tier I of the Site Monitoring Plan, Dungeness crab densities are monitored to confirm that large aggregations of newly settled Dungeness crab have not moved onto the Southwest Site. Tier 2 entails an increased sampling effort to determine whether a change in disposal operations is needed. Four epibenthic surveys using beam trawls were conducted in 1990, 1991, and 1992 at the Southwest Site and North Reference area, where high crab concentrations were found in the spring of 1985. Survey results during these three years prompted no Tier 2 activities. Epibenthic surveys were also conducted at two nearshore sites where construction of sediment berms has been proposed. This work is summarized in an appendix to this report.

  7. The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

    NARCIS (Netherlands)

    Ploeg, E. van der

    2003-01-01

    The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

  8. SUZAKU MONITORING OF THE SEYFERT 1 GALAXY NGC 5548: WARM ABSORBER LOCATION AND ITS IMPLICATION FOR COSMIC FEEDBACK

    International Nuclear Information System (INIS)

    Krongold, Y.; Andrade-Velazquez, M.; Binette, L.; Jimenez-Bailon, E.; Elvis, M.; Nicastro, F.; Brickhouse, N. S.; Liu, Y.; Wilkes, B.; Mathur, S.; Reeves, J. N.; Grupe, D.; McHardy, I. M.; Minezaki, T.; Yoshii, Y.

    2010-01-01

    We present a 2 month Suzaku X-ray monitoring of the Seyfert 1 galaxy NGC 5548. The campaign consists of seven observations (with exposure time of ∼30 ks each), separated by ∼1 week. This paper focus on the X-ray Imaging Spectrometer data of NGC 5548. We analyze the response in the opacity of the gas that forms the well-known ionized absorber in this source for ionizing flux variations. Despite variations by a factor of ∼4 in the impinging continuum, the soft X-ray spectra of the source show little spectral variations, suggesting no response from the ionized absorber. A detailed time modeling of the spectra confirms the lack of opacity variations for an absorbing component with high ionization (U X ∼ -0.85), and high outflow velocity (v out ∼ 1040 km s -1 ), as the ionization parameter was found to be consistent with a constant value during the whole campaign. Instead, the models suggest that the ionization parameter of a low ionization (U X ∼ -2.8), low velocity (v out ∼ 590 km s -1 ) absorbing component might be changing linearly with the ionizing flux, as expected for gas in photoionization equilibrium. However, given the lack of spectral variations among observations, we consider the variations in this component as tentative. Using the lack of variations, we set an upper limit of n e 7 cm -3 for the electron density of the gas forming the high ionization, high velocity component. This implies a large distance from the continuum source (R>0.033 pc; R>5000R S ). If the variations in the low ionization, low velocity component are real, they imply n e >9.8 x 10 4 cm -3 and R 1.2 x 10 56 erg) can be enough to disrupt the interstellar medium, possibly quenching or regulating large-scale star formation. However, the total mass and energy ejected by the wind may still be lower than the one required for cosmic feedback, even when extrapolated to quasar luminosities. Such feedback would require that we are observing the wind before it is fully accelerated.

  9. [Structure Parameters and Quality Outcomes of Ambulant Home-care].

    Science.gov (United States)

    Suhr, Ralf; Raeder, Kathrin; Kuntz, Simone; Strube-Lahmann, Sandra; Latendorf, Antje; Klingelhöfer-Noe, Jürgen; Lahmann, Nils

    2018-05-14

    So far, there are few data available on the changes of ambulant home-care in Germany over the last decades. Therefore, the aim of this research was to provide structure data on nursing personnel, funding, size, regional differences, and training needs of ambulant home-care services in Germany. In addition, a possible association between structure parameters and quality outcomes for pressure ulcer and malnutrition was investigated. In 2015, a multicenter cross-sectional study was conducted in home-care services in Germany. Structure data from 99 randomly selected home-care services as well as data on pressure ulcers and malnutrition of 903 care-dependent clients were analyzed. The median (home-care services. From a cut-off of 20,000 inhabitants, a region was considered urban. The average prevalence for decubitus and malnutrition (BMIhome-care service, and possible associations with structure parameters were analyzed using a multiple linear regression model. The proportion of registered nurses in non-private (private) home-care services was 60.6% (52.3%). The proportion of employees with a 200- h basic qualification in nursing was higher in private (12.5 vs. 4.7%), small home-care services (14.0 vs. 5.8%) and in urban regions (11.5 vs 5.7%). In average, registered nurses working in small home-care services spent significantly more time per client than the ones working in large services (3.8 vs. 2.9 h/week). The highest need for further training was shown on the subjects of pain, medication and cognitive impairment. No statistically significant correlation could be found between the average decubitus prevalence and structure parameters. Only the association between malnutrition prevalence and the proportion of registered nurses was statistically significant. The present representative study provides structure data on nursing personnel, funding, size, regional differences, and training needs of ambulant home-care services in Germany that could be used as a baseline

  10. A model of survival following pre-hospital cardiac arrest based on the Victorian Ambulance Cardiac Arrest Register.

    Science.gov (United States)

    Fridman, Masha; Barnes, Vanessa; Whyman, Andrew; Currell, Alex; Bernard, Stephen; Walker, Tony; Smith, Karen L

    2007-11-01

    This study describes the epidemiology of sudden cardiac arrest patients in Victoria, Australia, as captured via the Victorian Ambulance Cardiac Arrest Register (VACAR). We used the VACAR data to construct a new model of out-of-hospital cardiac arrest (OHCA), which was specified in accordance with observed trends. All cases of cardiac arrest in Victoria that were attended by Victorian ambulance services during the period of 2002-2005. Overall survival to hospital discharge was 3.8% among 18,827 cases of OHCA. Survival was 15.7% among 1726 bystander witnessed, adult cardiac arrests of presumed cardiac aetiology, presenting in ventricular fibrillation or ventricular tachycardia (VF/VT), where resuscitation was attempted. In multivariate logistic regression analysis, bystander CPR, cardiac arrest (CA) location, response time, age and sex were predictors of VF/VT, which, in turn, was a strong predictor of survival. The same factors that affected VF/VT made an additional contribution to survival. However, for bystander CPR, CA location and response time this additional contribution was limited to VF/VT patients only. There was no detectable association between survival and age younger than 60 years or response time over 15min. The new model accounts for relationships among predictors of survival. These relationships indicate that interventions such as reduced response times and bystander CPR act in multiple ways to improve survival.

  11. Trauma care in Scotland: effect of rurality on ambulance travel times and level of destination healthcare facility.

    Science.gov (United States)

    Yeap, E E; Morrison, J J; Apodaca, A N; Egan, G; Jansen, J O

    2014-06-01

    The aim of this study was to determine the effect of rurality on the level of destination healthcare facility and ambulance response times for trauma patients in Scotland. We used a retrospective analysis of pre-hospital data routinely collected by the Scottish Ambulance Service from 2009-2010. Incident locations were categorised by rurality, using the Scottish urban/rural classification. The level of destination healthcare facility was coded as either a teaching hospital, large general hospital, general hospital, or other type of facility. A total of 64,377 incidents met the inclusion criteria. The majority of incidents occurred in urban areas, which mostly resulted in admission to teaching hospitals. Incidents from other areas resulted in admission to a lower-level facility. The majority of incidents originating in very remote small towns and very remote rural areas were treated in a general hospital. Median call-out times and travel times increased with the degree of rurality, although with some exceptions. Trauma is relatively rare in rural areas, but patients injured in remote locations are doubly disadvantaged by prolonged pre-hospital times and admission to a hospital that may not be adequately equipped to deal with their injuries. These problems may be overcome by the regionalisation of trauma care, and enhanced retrieval capability.

  12. Using a discrete-event simulation to balance ambulance availability and demand in static deployment systems.

    Science.gov (United States)

    Wu, Ching-Han; Hwang, Kevin P

    2009-12-01

    To improve ambulance response time, matching ambulance availability with the emergency demand is crucial. To maintain the standard of 90% of response times within 9 minutes, the authors introduce a discrete-event simulation method to estimate the threshold for expanding the ambulance fleet when demand increases and to find the optimal dispatching strategies when provisional events create temporary decreases in ambulance availability. The simulation model was developed with information from the literature. Although the development was theoretical, the model was validated on the emergency medical services (EMS) system of Tainan City. The data are divided: one part is for model development, and the other for validation. For increasing demand, the effect was modeled on response time when call arrival rates increased. For temporary availability decreases, the authors simulated all possible alternatives of ambulance deployment in accordance with the number of out-of-routine-duty ambulances and the durations of three types of mass gatherings: marathon races (06:00-10:00 hr), rock concerts (18:00-22:00 hr), and New Year's Eve parties (20:00-01:00 hr). Statistical analysis confirmed that the model reasonably represented the actual Tainan EMS system. The response-time standard could not be reached when the incremental ratio of call arrivals exceeded 56%, which is the threshold for the Tainan EMS system to expand its ambulance fleet. When provisional events created temporary availability decreases, the Tainan EMS system could spare at most two ambulances from the standard configuration, except between 20:00 and 01:00, when it could spare three. The model also demonstrated that the current Tainan EMS has two excess ambulances that could be dropped. The authors suggest dispatching strategies to minimize the response times in routine daily emergencies. Strategies of capacity management based on this model improved response times. The more ambulances that are out of routine duty

  13. The monitoring results of electromagnetic radiation of 110-kV high-voltage lines in one urban location in Chongqing P.R. China.

    Science.gov (United States)

    Qin, Qi-Zhong; Chen, Yu; Fu, Ting-Ting; Ding, Li; Han, Ling-Li; Li, Jian-Chao

    2012-03-01

    To understand electromagnetic radiation field strength and its influencing factors of certain 110-kV high-voltage lines in one urban area of Chongqing by measuring 110-kV high-voltage line's electromagnetic radiation level. According to the methodology as determined by the National Hygienic Standards, we selected certain adjacent residential buildings, high-voltage lines along a specific street and selected different distances around its vertical projection point as monitoring points. The levels of electromagnetic radiations were measured respectively. In this investigation within the frequency of 5-1,000 Hz both the electric field strength and magnetic field strength of each monitoring sites were lower than the public exposure standards as determined by the International Commission on Non-Ionizing Radiation Protection. However, the electrical field strength on the roof adjacent to the high-voltage lines was significantly higher than that as measured on the other floors in the same buildings (p electromagnetic radiation measurements of different monitoring points, under the same high-voltage lines, showed the location which is nearer the high-voltage line maintain a consistently higher level of radiation than the more distant locations (p Electromagnetic radiation generated by high-voltage lines decreases proportionally to the distance from the lines. The buildings can to some extent shield (or absorb) the electric fields generated by high-voltage lines nearby. The electromagnetic radiation intensity near high-voltage lines may be mitigated or intensified by the manner in which the high-voltage lines are set up, and it merits attention for the potential impact on human health.

  14. Occupational accidents among ambulance drivers in the emergency relief.

    Science.gov (United States)

    Takeda, Elisabete; do Carmo Cruz Robazzi, Maria Lúcia

    2007-01-01

    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.

  15. Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

    Directory of Open Access Journals (Sweden)

    Chin-Sheng Tang

    Full Text Available To prevent surgical site infection (SSI, the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH, and carbon dioxide (CO2, suspended particulate matter (PM, and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18% and traumatic surgery room (8%. The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

  16. Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

    Science.gov (United States)

    Tang, Chin-Sheng; Wan, Gwo-Hwa

    2013-01-01

    To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

  17. The linkage among ambulance transports, death and climate parameters in Asahikawa City, Japan.

    Science.gov (United States)

    Kataoka, Hiroaki; Mochimasu, Kazumi Dokai; Katayama, Akihiko; Kanda, Kanae Oda; Sakano, Noriko; Tanaka, Keiko; Miyatake, Nobuyuki

    2015-01-01

    The aim of this study was to investigate the linkage among climate parameters, total ambulance transports and the number of deaths in Asahikawa City in northern Japan. Monthly data on total ambulance transports and the number of deaths from January 2004 to December 2011 were obtained from Asahikawa City Fire Department and the Asahikawa City official website. Climate parameters for the required period were also obtained from the Japan Meteorological Agency, Japan. To adjust for the population, we also used monthly population data on Asahikawa City. The linkage among climate parameters, total ambulance transports and the number of deaths was evaluated by ecological analysis. The mean air temperature in the Asahikawa area was 7.3 ± 10.1 °C. Total ambulance transports (/a hundred thousand people/day) and the number of deaths (/a hundred thousand people/day) were 10.0 ± 0.6 and 2.6 ± 0.3, respectively. Using quadratic curves, total ambulance transports and the number of deaths were weakly correlated with some climate parameters. The number of deaths was weakly and positively correlated with total ambulance transports. A weak linkage among climate parameters, total ambulance transports and the number of deaths was noted in Asahikawa City, Japan. However, these associations were not as high as expected.

  18. Results of a prospective randomized controlled trial of early ambulation for patients with lower extremity autografts.

    Science.gov (United States)

    Lorello, David John; Peck, Michael; Albrecht, Marlene; Richey, Karen J; Pressman, Melissa A

    2014-01-01

    It is common practice to keep those patients with lower extremity autografts immobile until post-operative day (POD) 5. There is however inherent risks associated with even short periods of immobility. As of now there are no randomized controlled trials looking at early ambulation of patients with lower extremity autografts in the burn community.The objective of this study was to show that patients who begin ambulation within 24 hours of lower extremity autografting will have no increased risk of graft failure than those patients who remain immobile until POD 5. Thirty-one subjects who received autografts to the lower extremity were randomized after surgery into either the early ambulation group (EAG;17 subjects) or the standard treatment group (STG;14 subjects). Those subjects randomized to the EAG began ambulating with physical therapy on POD 1. Subjects in the STG maintained bed rest until POD 5. There was no difference in the number of patients with graft loss in either the EAG or STG on POD 5, and during any of the follow-up visits. No subjects required regrafting. There was a significant difference in the mean minutes of ambulation, with the EAG ambulating longer than the STG (EAG 23.4 minutes [SD 12.03], STG 14.1 [SD 9.00], P=.0235) on POD 5. Burn patients with lower extremity autografts can safely ambulate on POD 1 without fear of graft failure compared with those patients that remain on bed rest for 5 days.

  19. An Approach Using Gas Monitoring to Find the Residual TCE Location in the Unsaturated Zone of Woosan Industrial Complex (WIC), Korea

    Science.gov (United States)

    Koh, Y.; Lee, S.; Yang, J.; Lee, K.

    2012-12-01

    An area accommodating various industrial facilities has fairly high probability of groundwater contamination with multiple chlorinated solvents such as trichloroethene (TCE), carbon tetrachloride (CT), and chloroform (CF). Source tracing of chlorinated solvents in the unsaturated zone is an essential procedure for the management and remediation of contaminated area. From the previous study on seasonal variations in hydrological stresses and spatial variations in geologic conditions on a TCE plume, the existence of residual DNAPLs at or above the water table has proved. Since TCE is one of the frequently detected VOCs (Volatile Organic Compounds) in groundwater, residual TCE can be detected by gas monitoring. Therefore, monitoring of temporal and spatial variations in the gas phase TCE contaminant at an industrial complex in Wonju, Korea, were used to find the residual TCE locations. As pilot tests, TCE gas samples collected in the unsaturated zone at 4 different wells were analyzed using SPME (Solid Phase MicroExtraction) fiber and Gas Chromatography (GC). The results indicated that detecting TCE in gas phase was successful from these wells and TCE analysis on gas samples, collected from the unsaturated zone, will be useful for source area characterization. However, some values were too high to doubt the accuracy of the current method, which needs a preliminary lab test with known concentrations. The modified experiment setups using packer at different depths are in process to find residual TCE locations in the unsaturated zone. Meanwhile, several PVD (polyethylene-membrane Passive Vapor Diffusion) samplers were placed under water table to detect VOCs by equilibrium between air in the vial and VOCs in pore water.

  20. Monitoring the Change in Urban Vegetation in 13 Chilean Cities Located in a Rainfall Gradient. What is the Contribution of the Widespread Creation of New Urban Parks?

    Science.gov (United States)

    de la Barrera, Francisco; Henríquez, Cristian

    2017-10-01

    The well-being of people living in cities is strongly dependent on the existence of urban vegetation because of the ecosystem services or benefits it provides. This is why governments develop plans to create green spaces, plant trees, promote the maintenance of vegetation in private spaces and also monitor their status over time. In Latin America, and particularly in Chile, the increase of urban vegetation has been stimulated through different initiatives and regulations. However, development of monitoring programs at the national level is scarce, so it is yet unknown if these initiatives and regulations have had positive effects. In this article, we monitor the change in urban vegetation in 13 Chilean cities located in a latitudinal gradient of practically zero to almost 1800 mm of annual rainfall. We calculated the trends in NDVI (2000-2016) as an indicator of change in urban greenery using data from the MODIS Subsets platform. Likewise, to assess whether the initiatives have had an effect we quantified the number of urban parks existing at the beginning of the period and how many were created during the study period. For this, we analysed official databases and high spatial resolution satellite images. Armed with said data, we assessed whether these new parks had impacted the tendency toward change in urban greenery. The results indicate that, in general, Chilean cities vary greatly inter-annually in urban greenery and have lost urban vegetation in the last 16 years, with significant losses in four of those cities. Two cities located in desert ecosystems represent an exception and showed positive trends in their urban vegetation. The rainfall in cities has an impact on the amount of vegetation, but not on their tendency to change, i.e. there are cities with loss of vegetation at all levels of precipitation. The creation of parks has not been able to reverse negative trends, which indicates the prevalence of other drivers of change that are not sufficiently

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

    CERN Multimedia

    Anaïs Schaeffer

    2012-01-01

    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...

  2. Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

    DEFF Research Database (Denmark)

    Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

    2017-01-01

    ) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48......: Population-based cohort study with linkage of Danish national registries. SETTING: The North Denmark Region in 2007-2014. PARTICIPANTS: Cohort of 148 757 patients transported to hospital by ambulance after calling emergency services. MAIN OUTCOME MEASURES: The number of emergency ambulance service patients......, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased....

  3. Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

    DEFF Research Database (Denmark)

    Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

    ) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48......: Population-based cohort study with linkage of Danish national registries. SETTING: The North Denmark Region in 2007-2014. PARTICIPANTS: Cohort of 148 757 patients transported to hospital by ambulance after calling emergency services. MAIN OUTCOME MEASURES: The number of emergency ambulance service patients......, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased....

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

    Directory of Open Access Journals (Sweden)

    D Orwig

    2017-01-01

    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.

  5. Availability of Life Support Equipment and its Utilization by Ambulance Drivers.

    Science.gov (United States)

    Acharya, Rija; Badhu, Angur; Shah, Tara; Shrestha, Sharmila

    2017-09-08

    An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers. Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method. Self- constructed observation checklist and semi structured interview schedule was used for data collection. More than half of the respondents had less than five years of experience and were not trained in first aid. About two-third of the respondents had adequate knowledge on first aid. About 90% of the ambulance had oxygen cylinder and adult oxygen mask which was 'usually' used equipment. More than half of ambulance had equipment less than 23% as compared to that of national guidelines. There was significant association of knowledge with the experience (p = 0.004) and training (p = 0.001). Availability of equipment was associated with training received (p = 0.007),organization (p= 0.032)and district (p = 0.023) in which the ambulance is registered. The study concludes that maximum ambulance linked to BPKIHS, Nepal did not have even one fourth of the equipment for basic life support. Equipment usually used was oxygen cylinder and oxygen mask. Majority of driver had adequate knowledge on first aid and it was associated with training and experience.

  6. Community ambulation: influences on therapists and clients reasoning and decision making.

    Science.gov (United States)

    Corrigan, Rosemary; McBurney, Helen

    2008-01-01

    Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

  7. Predictors of workplace violence among ambulance personnel: a longitudinal study.

    Science.gov (United States)

    van der Velden, Peter G; Bosmans, Mark W G; van der Meulen, Erik

    2016-04-01

    To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations. Although previous research assessed the prevalences among this group, little is known about predictors, to what extent PTE's are WPV-related and their abilities to prevent escalations. A longitudinal study with a 6 months' time interval ( N  =   103). At T1 demographics, workplace violence and potentially traumatic events in the past year, mental health, personality, handling of rules, coping and social organizational stressors were assessed. Confrontations with aggression were also examined at T2. Multivariate logistic regression analyses showed that only problems with superiors independently predicted repeated verbal aggression and that only the (absence of the) ability to compromise very easily predicted repeatedly being on guard and repeatedly confronted with any form of aggression. Due to very low prevalences, we could not examine predictors of repeated confrontations with physical aggression ( N  =   5) and serious threat ( N  =   7). A large majority reported that in most workplace violence cases they could prevent further escalations. About 2% reported a potentially traumatic event in the year before T1 that was WPV related and perceived as very stressful.

  8. Patients' perception of the ambulance services at Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Anisah, A; Chew, K S; Mohd Shaharuddin Shah, C H; Nik Hisamuddin, N A R

    2008-08-01

    Little is known regarding public opinion of prehospital care in Malaysia. This study was conducted to find out the public's perception and expectations of the ambulance services in one of the university hospitals in Malaysia. A six-month prospective cross-sectional study to look at patients' perception of Hospital Universiti Sains Malaysia's (HUSM) ambulance service was conducted from February 2006 to July 2006. Upon arrival at the hospital, patients or their relatives (who used our hospital's ambulances) were interviewed with a set of questions regarding their perception of the ambulance services and were asked to rate the perception on a Likert Scale from 1 to 10. A convenient sampling method was applied. A total of 87 samples were obtained. Despite the many problems faced by the ambulance service in HUSM, the mean score for each of the questions on patient's perception ranged from 9.33 to 9.70 out of 10. The questions with the highest mean score, which were both 9.70 each, were related to staff attentiveness and staff gentleness. Patients' perceptions can be very subjective, but until further similar studies could be carried out in other parts of Malaysia, this set of data merely represents a numerical measure of public perception of the ambulance services from HUSM.

  9. Impact of Air Temperature on London Ambulance Call-Out Incidents and Response Times

    Directory of Open Access Journals (Sweden)

    Marliyyah A. Mahmood

    2017-08-01

    Full Text Available Ambulance services are in operation around the world and yet, until recently, ambulance data has only been used for operational purposes rather than for assessing public health. Ambulance call-out data offers new and valuable (near real-time information that can be used to assess the impact of environmental conditions, such as temperature, upon human health. A detailed analysis of London ambulance data at a selection of dates between 2003 and 2015 is presented and compared to London temperature data. In London, the speed of ambulance response begins to suffer when the mean daily air temperature drops below 2 °C or rises above 20 °C. This is explained largely by the increased number of calls past these threshold temperatures. The baseline relationships established in this work will inform the prediction of likely changes in ambulance demand (and illness types that may be caused by seasonal temperature changes and the increased frequency and intensity of extreme/severe weather events, exacerbated by climate change, in the future.

  10. Higher energy prices are associated with diminished resources, performance and safety in Australian ambulance systems.

    Science.gov (United States)

    Brown, Lawrence H; Chaiechi, Taha; Buettner, Petra G; Canyon, Deon V; Crawford, J Mac; Judd, Jenni

    2013-02-01

    To evaluate the impact of changing energy prices on Australian ambulance systems. Generalised estimating equations were used to analyse contemporaneous and lagged relationships between changes in energy prices and ambulance system performance measures in all Australian State/Territory ambulance systems for the years 2000-2010. Measures included: expenditures per response; labour-to-total expenditure ratio; full-time equivalent employees (FTE) per 10,000 responses; average salary; median and 90th percentile response time; and injury compensation claims. Energy price data included State average diesel price, State average electricity price, and world crude oil price. Changes in diesel prices were inversely associated with changes in salaries, and positively associated with changes in ambulance response times; changes in oil prices were also inversely associated with changes in salaries, as well with staffing levels and expenditures per ambulance response. Changes in electricity prices were positively associated with changes in expenditures per response and changes in salaries; they were also positively associated with changes in injury compensation claims per 100 FTE. Changes in energy prices are associated with changes in Australian ambulance systems' resource, performance and safety characteristics in ways that could affect both patients and personnel. Further research is needed to explore the mechanisms of, and strategies for mitigating, these impacts. The impacts of energy prices on other aspects of the health system should also be investigated. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  11. Combined use of thermal methods and seepage meters to efficiently locate, quantify, and monitor focused groundwater discharge to a sand-bed stream

    Science.gov (United States)

    Rosenberry, Donald O.; Briggs, Martin A.; Delin, Geoffrey N.; Hare, Danielle K.

    2016-01-01

    Quantifying flow of groundwater through streambeds often is difficult due to the complexity of aquifer-scale heterogeneity combined with local-scale hyporheic exchange. We used fiber-optic distributed temperature sensing (FO-DTS), seepage meters, and vertical temperature profiling to locate, quantify, and monitor areas of focused groundwater discharge in a geomorphically simple sand-bed stream. This combined approach allowed us to rapidly focus efforts at locations where prodigious amounts of groundwater discharged to the Quashnet River on Cape Cod, Massachusetts, northeastern USA. FO-DTS detected numerous anomalously cold reaches one to several m long that persisted over two summers. Seepage meters positioned upstream, within, and downstream of 7 anomalously cold reaches indicated that rapid groundwater discharge occurred precisely where the bed was cold; median upward seepage was nearly 5 times faster than seepage measured in streambed areas not identified as cold. Vertical temperature profilers deployed next to 8 seepage meters provided diurnal-signal-based seepage estimates that compared remarkably well with seepage-meter values. Regression slope and R2 values both were near 1 for seepage ranging from 0.05 to 3.0 m d−1. Temperature-based seepage model accuracy was improved with thermal diffusivity determined locally from diurnal signals. Similar calculations provided values for streambed sediment scour and deposition at subdaily resolution. Seepage was strongly heterogeneous even along a sand-bed river that flows over a relatively uniform sand and fine-gravel aquifer. FO-DTS was an efficient method for detecting areas of rapid groundwater discharge, even in a strongly gaining river, that can then be quantified over time with inexpensive streambed thermal methods.

  12. Microbial air quality and bacterial surface contamination in ambulances during patient services.

    Science.gov (United States)

    Luksamijarulkul, Pipat; Pipitsangjan, Sirikun

    2015-03-01

    We sought to assess microbial air quality and bacterial surface contamination on medical instruments and the surrounding areas among 30 ambulance runs during service. We performed a cross-sectional study of 106 air samples collected from 30 ambulances before patient services and 212 air samples collected during patient services to assess the bacterial and fungal counts at the two time points. Additionally, 226 surface swab samples were collected from medical instrument surfaces and the surrounding areas before and after ambulance runs. Groups or genus of isolated bacteria and fungi were preliminarily identified by Gram's stain and lactophenol cotton blue. Data were analyzed using descriptive statistics, t-test, and Pearson's correlation coefficient with a p-value of less than 0.050 considered significant. The mean and standard deviation of bacterial and fungal counts at the start of ambulance runs were 318±485cfu/m(3) and 522±581cfu/m(3), respectively. Bacterial counts during patient services were 468±607cfu/m(3) and fungal counts were 656±612cfu/m(3). Mean bacterial and fungal counts during patient services were significantly higher than those at the start of ambulance runs, p=0.005 and p=0.030, respectively. For surface contamination, the overall bacterial counts before and after patient services were 0.8±0.7cfu/cm(2) and 1.3±1.1cfu/cm(2), respectively (pair samples and bacterial counts on medical instruments and allocated areas. This study revealed high microbial contamination (bacterial and fungal) in ambulance air during services and higher bacterial contamination on medical instrument surfaces and allocated areas after ambulance services compared to the start of ambulance runs. Additionally, bacterial and fungal counts in ambulance air showed a significantly positive correlation with the bacterial surface contamination on medical instruments and allocated areas. Further studies should be conducted to determine the optimal intervention to reduce

  13. Bringing humanity into view: action research with Qatar's ambulance service.

    Science.gov (United States)

    Coleman, Gill; Wiggins, Liz

    2017-08-21

    Purpose The purpose of this paper is to argue for the widening of attention in healthcare improvement efforts, to include an awareness of the humanity of people who work in the sector and an appreciation of the part human connection plays in engagement around good quality work. Theoretical frameworks and research approaches which draw on action-based, interpretive and systemic thinking are proposed, as a complement to current practices. Design/methodology/approach The paper describes the early stages of an action research (AR) project, which used the appreciative inquiry "4D" framework to conduct participative inquiry in Hamad Medical Corporation's ambulance service in Qatar, in which staff became co-researchers. Findings The co-researchers were highly motivated to work with improvement goals as a result of their participation in the AR. They, and their managers, saw each other and the work in new ways and discovered that they had much to offer. Research limitations/implications This was a small-scale pilot project, from which findings must be considered tentative. The challenges of establishing good collaboration across language, culture and organisational divides are considerable. Practical implications Appreciative and action-oriented inquiry methods can serve not only to find things out, but also to highlight and give value to aspects of humanity in the workplace that are routinely left invisible in formal processes. This, in turn, can help with quality improvement. Originality/value This paper is a challenge to the orthodox way of viewing healthcare organisations, and improvement processes within them, as reliant on control rather than empowerment. An alternative is to actively include the agency, sense-making capacity and humanity of those involved.

  14. Simulation-based decision support framework for dynamic ambulance redeployment in Singapore.

    Science.gov (United States)

    Lam, Sean Shao Wei; Ng, Clarence Boon Liang; Nguyen, Francis Ngoc Hoang Long; Ng, Yih Yng; Ong, Marcus Eng Hock

    2017-10-01

    Dynamic ambulance redeployment policies tend to introduce much more flexibilities in improving ambulance resource allocation by capitalizing on the definite geospatial-temporal variations in ambulance demand patterns over the time-of-the-day and day-of-the-week effects. A novel modelling framework based on the Approximate Dynamic Programming (ADP) approach leveraging on a Discrete Events Simulation (DES) model for dynamic ambulance redeployment in Singapore is proposed in this paper. The study was based on the Singapore's national Emergency Medical Services (EMS) system. Based on a dataset comprising 216,973 valid incidents over a continuous two-years study period from 1 January 2011-31 December 2012, a DES model for the EMS system was developed. An ADP model based on linear value function approximations was then evaluated using the DES model via the temporal difference (TD) learning family of algorithms. The objective of the ADP model is to derive approximate optimal dynamic redeployment policies based on the primary outcome of ambulance coverage. Considering an 8min response time threshold, an estimated 5% reduction in the proportion of calls that cannot be reached within the threshold (equivalent to approximately 8000 dispatches) was observed from the computational experiments. The study also revealed that the redeployment policies which are restricted within the same operational division could potentially result in a more promising response time performance. Furthermore, the best policy involved the combination of redeploying ambulances whenever they are released from service and that of relocating ambulances that are idle in bases. This study demonstrated the successful application of an approximate modelling framework based on ADP that leverages upon a detailed DES model of the Singapore's EMS system to generate approximate optimal dynamic redeployment plans. Various policies and scenarios relevant to the Singapore EMS system were evaluated. Copyright © 2017

  15. EFFECTIVENESS OF SCHEDULED AMBULATION ON EARLY POSTOPERATIVE OUTCOME AMONG PATIENTS WHO HAVE UNDERGONE ABDOMINAL HYSTERECTOMY

    Directory of Open Access Journals (Sweden)

    Rinku Girija

    2017-01-01

    Full Text Available BACKGROUND Abdominal hysterectomy is one of the most frequently performed surgical procedures in women. The non-ambulatory postoperative period is a high risk period for the development of various complications like wound infection, venous stasis, lower respiratory infection, secondary haemorrhage, deep vein thrombosis, pulmonary embolism, paralytic ileus etc. Prolonged surgery, delayed ambulation and not feeding the patient within 48 hours of surgery are often associated with post-operative morbidity and mortality. This study aims to assess the effectiveness of Scheduled Ambulation on early post-operative outcome among patients undergone abdominal hysterectomy by introduction of Scheduled Ambulation from second day of surgery. MATERIALS AND METHODS Method used is quantitative and quasi experimental post-test control method. Scheduled ambulation technique and pattern were taught pre operatively to 35 patients consecutively selected from general and post-operative ward who formed the experimental group. They were given scheduled ambulation from second to fifth post-operative days and results analysed. Another 35 patients taken as control were given the routine post-operative care. Data Analysis- was performed using SPSS version 17.0. Between group comparisons, quantitative variables analysed by Chisquare test p value >0, 05 considered significant. RESULTS The indication of hysterectomy was fibroid uterus in 80% of the control group and 88, 6% of the experimental group. 51.4% of the hysterectomies were encountered in the age group 40-49 years. There was a statistically significant reduction in the severity of pain, fatigue, postural hypotension and risk for developing Deep vein thrombosis in the experimental group on practicing Scheduled Ambulation from second to fifth post-operative days. CONCLUSION Scheduled ambulation helped the abdominal hysterectomy patients to recover from fatigue, pain, postural hypotension and risk for Deep vein thrombosis

  16. Locative media

    CERN Document Server

    Wilken, Rowan

    2014-01-01

    Not only is locative media one of the fastest growing areas in digital technology, but questions of location and location-awareness are increasingly central to our contemporary engagements with online and mobile media, and indeed media and culture generally. This volume is a comprehensive account of the various location-based technologies, services, applications, and cultures, as media, with an aim to identify, inventory, explore, and critique their cultural, economic, political, social, and policy dimensions internationally. In particular, the collection is organized around the perception that the growth of locative media gives rise to a number of crucial questions concerning the areas of culture, economy, and policy.

  17. Open field modifications needed to measure, in the mouse, exploration- driven ambulation and fear of open space.

    OpenAIRE

    Vidal Gómez, José

    2014-01-01

    The open field test is used to assess ambulation and anxiety; one way to assess anxiety is to compare ambulation in the center with ambulation in the periphery: the more anxious is the mouse, the less it moves in the center. The results of this report cast doubts on the generality of that rule, because they show that ambulation, both in the center and in the periphery, depends on the mouse strain and on the size of the open field; specifically, in a brightly lit open-field of moderate size (3...

  18. Point prevalence of suboptimal footwear features among ambulant older hospital patients: implications for fall prevention.

    Science.gov (United States)

    Chari, Satyan R; McRae, Prue; Stewart, Matthew J; Webster, Joan; Fenn, Mary; Haines, Terry P

    2016-09-01

    Objective The aim of the present study was to establish the point prevalence of 'suboptimal' features in footwear reported to have been used by older hospital patients when ambulating, and to explore underpinning factors for their choice of footwear. Method A cross-sectional investigation was undertaken on 95 of 149 eligible in-patients across 22 high fall-risk wards in a large metropolitan hospital in Brisbane, Australia. Results Over 70% of participants experienced an unplanned admission. Although most participants had access to some form of footwear in hospital (92%), nearly all reported ambulating in footwear with 'suboptimal' features (99%). Examples included slippers (27%), backless slippers (16%) or bare feet (27%). For patients who ambulated in bare feet, only one-third reported 'lack of access to footwear' as the primary cause, with others citing foot wounds, pain, oedema and personal choice as the main reason for bare foot ambulation. Conclusions Admitted patients frequently use footwear with 'suboptimal' features for ambulation in hospital. While some footwear options (for example well-fitting slippers) could be suited for limited in-hospital ambulation, others are clearly hazardous and might cause falls. Since footwear choices are influenced by multiple factors in this population, footwear education strategies alone may be insufficient to address the problem of hazardous footwear in at-risk patients. Footwear requirements may be more effectively addressed within a multidisciplinary team approach encompassing foot health, mobility and safety. What is known about the topic? Accidental falls while ambulating are an important health and safety concern for older people. Because certain footwear characteristics have been negatively linked to posture and balance, and specific footwear types linked to falls among seniors, the use of footwear with fewer suboptimal characteristics is generally recommended as a means of reducing the risk of falling. While footwear

  19. A case study from the perspective of medical ethics: refusal of treatment in an ambulance.

    Science.gov (United States)

    Erbay, Hasan; Alan, Sultan; Kadıoğlu, Selim

    2010-11-01

    This paper will examine a sample case encountered by ambulance staff in the context of the basic principles of medical ethics. An accident takes place on an intercity highway. Ambulance staff pick up the injured driver and medical intervention is initiated. The driver suffers from a severe stomach ache, which is also affecting his back. Evaluating the patient, the ambulance doctor suspects that he might be experiencing internal bleeding. For this reason, venous access, in the doctor's opinion, should be achieved and the patient should be quickly started on an intravenous serum. The patient, however, who has so far kept his silence, objects to the administration of the serum. The day this is taking place is within the month of Ramadan and the patient is fasting. The patient states that he is fasting and that his fast will be broken and his religious practice disrupted in the event that the serum is administered. The ambulance doctor informs him that his condition is life-threatening and that the serum must be administered immediately. The patient now takes a more vehement stand. 'If I am to die, I want to die while I am fasting. Today is Friday and I have always wanted to die on such a holy day,' he says. The ambulance physician has little time to decide. How should the patient be treated? Which type of behaviour will create the least erosion of his values?

  20. Location, location, location: Extracting location value from house prices

    OpenAIRE

    Kolbe, Jens; Schulz, Rainer; Wersing, Martin; Werwatz, Axel

    2012-01-01

    The price for a single-family house depends both on the characteristics of the building and on its location. We propose a novel semiparametric method to extract location values from house prices. After splitting house prices into building and land components, location values are estimated with adaptive weight smoothing. The adaptive estimator requires neither strong smoothness assumptions nor local symmetry. We apply the method to house transactions from Berlin, Germany. The estimated surface...

  1. Effectiveness of media awareness campaigns on the proportion of vehicles that give space to ambulances on roads: An observational study.

    Science.gov (United States)

    Shaikh, Shiraz; Baig, Lubna A; Polkowski, Maciej

    2017-01-01

    The findings of the Health Care in Danger project in Karachi suggests that there is presence of behavioral negligence among vehicle operators on roads in regards to giving way to ambulances. A mass media campaign was conducted to raise people's awareness on the importance of giving way to ambulances. The main objective of this study was to determine the effectiveness of the campaign on increasing the proportion of vehicles that give way to ambulances. This was a quasi-experimental study that was based on before and after design. Three observation surveys were carried out in different areas of the city in Karachi, Pakistan before, during and after the campaign by trained observers who recorded their findings on a checklist. Each observation was carried out at three different times of the day for at least two days on each road. The relationship of the media campaign with regards to a vehicle giving space to an ambulance was calculated by means of odds ratios and 95% confidence intervals using multivariate logistic regression. Overall, 245 observations were included in the analysis. Traffic congestion and negligence/resistance, by vehicles operators who were in front of the ambulance, were the two main reasons why ambulances were not given way. Other reasons include: sudden stops by minibuses and in the process causing obstruction, ambulances not rushing through to alert vehicle operators to give way and traffic interruption by VIP movement. After adjustment for site, time of day, type of ambulance and number of cars in front of the ambulance, vehicles during (OR=2.13, 95% CI=1.22-3.71, p=0.007) and after the campaign (OR=1.73, 95% CI=1.02-2.95, p=0.042) were significantly more likely give space to ambulances. Mass media campaigns can play a significant role in changing the negligent behavior of people, especially when the campaign conveys a humanitarian message such as: giving way to ambulances can save lives.

  2. R.I.P. squad bench. European ambulances designed around the patient, not the vehicle.

    Science.gov (United States)

    Heightman, A J

    2013-07-01

    You can see and hear more about my journey throughout Germany and England in a special, archived, free Webcast on jems.com. And in future articles, videos and Web presentations, you'll see and learn about the different EMS delivery models I saw, the men and women whom I met and rode with on calls, and, most importantly, their impressive attitude about patient care, customer service and safety. Progressive American and Canadian ambulance manufacturers now agree with safety experts and forward-thinking ambulance operators that the squad bench is dead. These manufacturers now offer innovative seats that are much safer and functional than those coffin-like obstructions that gobbled up so much space in our rigs for the past three decades. Design your next ambulance around the needs and safety of your crews and their patients, and spec a patient compartment that is laid out logiclaly and efficient.

  3. Suicidal ideation and suicide attempts in a nationwide sample of operational Norwegian ambulance personnel.

    Science.gov (United States)

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

    2008-01-01

    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.

  4. Telestroke ambulances in prehospital stroke management: concept and pilot feasibility study.

    Science.gov (United States)

    Liman, Thomas G; Winter, Benjamin; Waldschmidt, Carolin; Zerbe, Norman; Hufnagl, Peter; Audebert, Heinrich J; Endres, Matthias

    2012-08-01

    Pre- and intrahospital time delays are major concerns in acute stroke care. Telemedicine-equipped ambulances may improve time management and identify patients with stroke eligible for thrombolysis by an early prehospital stroke diagnosis. The aims of this study were (1) to develop a telestroke ambulance prototype; (2) to test the reliability of stroke severity assessment; and (3) to evaluate its feasibility in the prehospital emergency setting. Mobil, real-time audio-video streaming telemedicine devices were implemented into advanced life support ambulances. Feasibility of telestroke ambulances and reliability of the National Institutes of Health Stroke Scale assessment were tested using current wireless cellular communication technology (third generation) in a prehospital stroke scenario. Two stroke actors were trained in simulation of differing right and left middle cerebral artery stroke syndromes. National Institutes of Health Stroke Scale assessment was performed by a hospital-based stroke physician by telemedicine, by an emergency physician guided by telemedicine, and "a posteriori" on the basis of video documentation. In 18 of 30 scenarios, National Institutes of Health Stroke Scale assessment could not be performed due to absence or loss of audio-video signal. In the remaining 12 completed scenarios, interrater agreement of National Institutes of Health Stroke Scale examination between ambulance and hospital and ambulance and "a posteriori" video evaluation was moderate to good with weighted κ values of 0.69 (95% CI, 0.51-0.87) and 0.79 (95% CI, 0.59-0.98), respectively. Prehospital telestroke examination was not at an acceptable level for clinical use, at least on the basis of the used technology. Further technical development is needed before telestroke is applicable for prehospital stroke management during patient transport.

  5. Assessment of prehospital medical care for the patients transported to emergency department by ambulance

    Directory of Open Access Journals (Sweden)

    Sehnaz Akın Paker

    2015-09-01

    Full Text Available Objectives: In our study we aimed to investigate the quality and quantity of medical management inside ambulances for 14 and over 14 years old patients transported to a level three emergency department (ED. Material and methods: Our study was conducted prospectively at a level three ED. 14 and over 14 years old patients who were transported to the ED by ambulance were included in the study consecutively. “Lack of vital rate” was described as missing of one or more of five vital rates during ambulance transportation. Both of two attending emergency physicians evaluated the medical procedures and management of patients at the ambulance simultaneously and this was recorded on the study forms. Results: Four hundred and fifty six patients were included in the study. Missing vital signs were identified for 90.1% (n = 322 of the patients that were transported by physicians and 92.4% (n = 73 of the patients that were transported by paramedics. For five patients with cardiac arrest two (33.3% had cardiopulmonary resuscitation (CPR, one (20% was intubated, one (20% received adrenaline. Out of 120 patients, needed spinal immobilization, 69 (57.5% had spinal board. Cervical collar usage was 65.1% (n = 69 We have revealed that 316 (69.3% patients did not receive at least one of the necessary medical intervention or treatment. Conclusion: During ambulance transportation, life-saving procedures like cardiopulmonary resuscitation, vital sign measurement, crucial treatment administration, endotracheal intubation, defibrillation, fracture immobilization were not performed adequately. Increasing the training on the deficient interventions and performing administrative inspections may improve quality of patient care. Keywords: Emergency department, Ambulance, Prehospital emergency care

  6. Ambulation and survival following surgery in elderly patients with metastatic epidural spinal cord compression.

    Science.gov (United States)

    Itshayek, Eyal; Candanedo, Carlos; Fraifeld, Shifra; Hasharoni, Amir; Kaplan, Leon; Schroeder, Josh E; Cohen, José E

    2017-12-28

    Metastatic epidural spinal cord compression (MESCC) is a disabling consequence of disease progression. Surgery can restore/preserve physical function, improving access to treatments that increase duration of survival; however, advanced patient age may deter oncologists and surgeons from considering surgical management. Evaluate the duration of ambulation and survival in elderly patients following surgical decompression of MESCC. Retrospective file review of a prospective database, under IRB waiver of informed consent, of consecutive patients treated in an academic tertiary care medical center from 8/2008-3/2015. Patients ≥65 years presenting neurological and/or radiological signs of cord compression due to metastatic disease, who underwent surgical decompression. Duration of ambulation and survival. Patients underwent urgent multidisciplinary evaluation and surgery. Ambulation and survival were compared with age, pre- and postoperative neurological (American Spinal Injury Association [ASIA] Impairment Scale [AIS]) and performance status (Karnofsky Performance Status [KPS], and Tokuhashi Score using Kruskal-Wallis and Wilcoxon signed-rank tests, Pearson correlation coefficient, Cox regression model, log rank analysis, and Kaplan Meir analysis. 40 patients were included (21 male, 54%; mean age 74 years, range 65-87). Surgery was performed a mean 3.8 days after onset of motor symptoms. Mean duration of ambulation and survival were 474 (range 0-1662) and 525 days (range 11-1662), respectively; 53% of patients (21/40) survived and 43% (17/40) retained ambulation for ≥1 year. There was no significant relationship between survival and ambulation for patients aged 65-69, 70-79, or 80-89, although Kaplan Meier analysis suggested stratification. There was a significant relationship between duration of ambulation and pre- and postoperative AIS (p=0.0342, p=0.0358, respectively) and postoperative KPS (p=0.0221). Tokuhashi score was not significantly related to duration of

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

    Directory of Open Access Journals (Sweden)

    M. Kuhn*

    2013-12-01

    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.

  8. 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

    2013-01-01

    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 ......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...

  9. Reflective and collaborative skills enhances Ambulance nurses' competence - A study based on qualitative analysis of professional experiences.

    Science.gov (United States)

    Wihlborg, Jonas; Edgren, Gudrun; Johansson, Anders; Sivberg, Bengt

    2017-05-01

    The Swedish ambulance health care services are changing and developing, with the ambulance nurse playing a central role in the development of practice. The competence required by ambulance nurses in the profession remains undefined and provides a challenge. The need for a clear and updated description of ambulance nurses' competence, including the perspective of professional experiences, seems to be essential. The aim of this study was to elucidate ambulance nurses' professional experiences and to describe aspects affecting their competence. For data collection, the study used the Critical Incident Technique, interviewing 32 ambulance nurses. A qualitative content analysis was applied. This study elucidates essential parts of the development, usage and perceptions of the competence of ambulance nurses and how, in various ways, this is affected by professional experiences. The development of competence is strongly affected by the ability and possibility to reflect on practice on a professional and personal level, particularly in cooperation with colleagues. Experiences and communication skills are regarded as decisive in challenging clinical situations. The way ambulance nurses perceive their own competence is closely linked to patient outcome. The results of this study can be used in professional and curriculum development. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Treatment of presumed acute cardiogenic pulmonary oedema in an ambulance system by nurses using Boussignac continuous positive airway pressure

    NARCIS (Netherlands)

    Dieperink, Willem; Weelink, E. E. M.; van der Horst, I. C. C.; de Vos, R.; Jaarsma, T.; Aarts, L. P. H. J.; Zijlstra, F.; Nijsten, M. W. N.

    Background: Early initiation of continuous positive airway pressure (CPAP) applied by face mask benefits patients with acute cardiogenic pulmonary oedema (ACPE). The simple disposable Boussignac CPAP (BCPAP) has been used in ambulances by physicians. In the Netherlands, ambulances are manned by

  11. Library Locations

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Carnegie Library of Pittsburgh locations including address, coordinates, phone number, square footage, and standard operating hours. The map below does not display...

  12. AFRICOM: Does Location Matter?

    Science.gov (United States)

    2009-03-01

    Decision Model,” 242-244. 26 Susan Hesse Owen & Mark S. Daskin , “Strategic Facility Location: A Review,” European Journal of Operational Research...Susan Hesse & Mark S. Daskin . “Strategic Facility Location: A Review,” European Journal of Operational Research 111 (1998), 423-447. Paye-Layeleh...ES) N/ A 10. SPONSORING/MONITORING AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in this thesis are those of the author and

  13. Monitoring of the natural gas exploitation in the Wadden Sea from the locations Moddergat, Lauwersoog and Vierhuizen, Netherlands. Advice of the Audit Committee on method for monitoring and null-measurement; Monitoring van de aardgaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen. Advies van de Auditcommissie over de opzet van de monitoring en de nulmeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-12-21

    The Dutch governmental decree ('Rijksprojectenbesluit') on the project for natural gas exploitation in the Wadden Sea for the locations Moddergat, Lauwersoog Vierhuizen gives the Dutch Petroleum Company (NAM) the possibility to produce natural gas under specific conditions in the Wadden Sea area from the six fields Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog East and Vierhuizen East. The precondition is that the (dynamic) nature in and around the Wadden Sea is not affected by subsidence as a result of the gas exploitation. For this, the NAM must monitor the subsidence and the nature values and report annually to the Dutch government. Also in the Rijksprojectbesluit it is determined that the Commission for Environmental Impact Assessment (EIA), as the independent auditor, will annually advise the responsible ministers on the EIA-report. This is the first recommendation of the Audit Committee for exploitation of natural gas in the Wadden Sea which in particular deals with the method for the monitoring and baseline measurement. [Dutch] Het Rijksprojectbesluit Gaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen geeft de Nederlandse Aardolie Maatschappij (NAM) de mogelijkheid om onder randvoorwaarden aardgas te produceren in het Waddenzeegebied uit de zes velden Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog Oost en Vierhuizen Oost. De randvoorwaarde is dat de (dynamische) natuur in en rondom de Waddenzee niet wordt aangetast door bodemdaling als gevolg van de gaswinning. Daarvoor moet de NAM de bodemdaling en de natuurwaarden monitoren en jaarlijks rapporteren aan de Nederlandse overheid. Ook is in het Rijksprojectbesluit bepaald dat de Commissie voor de milieueffectrapportage (m.e.r.) als onafhankelijke auditor de verantwoordelijke ministers jaarlijks zal adviseren over deze Rapportage. Dit is het eerste advies van de Auditcommissie gaswinning onder de Waddenzee waarin specifiek wordt ingegaan op de

  14. Pacific Reef Assessment and Monitoring Program: Subsurface Temperature Recorders (STRs) at selected coral reef locations across the Pacific Ocean from 2001 to 2012

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Water temperature data are collected using subsurface temperature recorders (STRs) that aid in the monitoring of seawater temperature variability at permanent coral...

  15. METABOLIC SYNDROME AND DAILY AMBULATION IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS

    Science.gov (United States)

    Gardner, Andrew W.; Parker, Donald E.; Krishnan, Sowmya; Chalmers, Laura J.

    2012-01-01

    Purposes To compare daily ambulatory measures in children, adolescents, and young adults with and without metabolic syndrome, and to assess which metabolic syndrome components, demographic measures, and body composition measures are associated with daily ambulatory measures. Methods Two-hundred fifty subjects between the ages of 10 and 30 years were assessed on metabolic syndrome components, demographic and clinical measures, body fat percentage, and daily ambulatory strides, durations, and cadences during seven consecutive days. Forty-five of the 250 subjects had metabolic syndrome, as defined by the International Diabetes Federation. Results Subjects with metabolic syndrome ambulated at a slower daily average cadence than those without metabolic syndrome (13.6 ± 2.2 strides/min vs. 14.9 ± 3.2 strides/min; p=0.012), and they had slower cadences for continuous durations of 60 minutes (p=0.006), 30 minutes (p=0.005), 20 minutes (p=0.003), 5 minutes (p=0.002), and 1 minute (p=0.001). However, the total amount of time spent ambulating each day was not different (p=0.077). After adjustment for metabolic syndrome status, average cadence is linearly associated with body fat percentage (pmetabolic syndrome ambulate more slowly and take fewer strides throughout the day than those without metabolic syndrome, even though the total amount of time spent ambulating is not different. Furthermore, the detrimental influence of metabolic syndrome on ambulatory cadence is primarily a function of body fatness. PMID:22811038

  16. 75 FR 62639 - Air Ambulance and Commercial Helicopter Operations, Part 91 Helicopter Operations, and Part 135...

    Science.gov (United States)

    2010-10-12

    ... helicopter air ambulance operators implement a safety management system program that includes sound risk... partially address NTSB Safety Recommendation A-09-89 regarding the implementation of sound risk management... documents. Authority for This Rulemaking The FAA's authority to issue rules on aviation safety is found in...

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

    NARCIS (Netherlands)

    Yperzeele, Laetitia; van Hooff, Robbert-Jan; De Smedt, Ann; Nagels, Guy; Hubloue, Ives; De Keyser, Jacques; Brouns, Raf

    2016-01-01

    Background 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. Objective We aim to investigate the feasibility and the reliability of in-ambulance HRV

  18. Abnormalities of left colonic motility in ambulant nonconstipated patients with irritable bowel syndrome

    NARCIS (Netherlands)

    Clemens, C. H. M.; Samsom, M.; van Berge Henegouwen, G. P.; Smout, A. J. P. M.

    2003-01-01

    Our objective was to evaluate left colonic motility patterns recorded under physiological conditions during 24 hr in fully ambulant nonconstipated IBS patients compared to healthy controls. A 42-hr manometry of the left colon was performed in 11 nonconstipated IBS patients and 10 age- and

  19. [The correlation between personality characteristics and burnout syndrome in emergency ambulance workers].

    Science.gov (United States)

    Bergmueller, A; Zavgorodnii, I; Zavgorodnia, N; Kapustnik, W; Boeckelmann, I

    The work in Emergency Medical Ambulance Service is one of the professions, which is accompanied by high psychological and emotional stress. The aim was to determine the risk of professional burnout syndrome of Emergency Medical Ambulance Service staff and the relationship between burnout syndrome and personality. Ninety-seven doctors (57 women and 40 men, aged 37.0±12.21) of Emergency Medical Ambulance Service were interviewed using the MBI-GS questionnaire and the Freiburg personality questionnaire (FPI). Correlation and regression analysis were used. Nine (11.5%) of respondents had a risk of burnout syndrome and 28 (35.9%) had some symptoms. In the group, aged 45 years and older, the risk of burnout syndrome was not identified. The staff of Emergency Medical Ambulance Service is characterized by stable personality features. It is necessary to identify the prevalence of burnout syndrome and also to identity the causes for its prevention and development of measures on the increase of personal stress resilience.

  20. A new vibration isolation bed stage with magnetorheological dampers for ambulance vehicles

    International Nuclear Information System (INIS)

    Chae, Hee Dong; Choi, Seung-Bok

    2015-01-01

    The vibration experienced in an ambulance can lead to secondary injury to a patient and discourage a paramedic from providing emergency care. In this study, with the goal of resolving this problem, a new vibration isolation bed stage associated with magnetorheological (MR) dampers is proposed to ensure ride quality as well as better care for the patient while he/she is being transported. The bed stage proposed in this work can isolate vibrations in the vertical, rolling and pitching directions to reflect the reality that occurs in the ambulance. Firstly, an appropriate-sized MR damper is designed based on the field-dependent rheological properties of MR fluid, and the damping force characteristics of a MR damper are evaluated as a function of the current. A mechanical model of the proposed vibration isolation bed stage is then established to derive the governing equations of motion. Subsequently, a sliding mode controller is formulated to control the vibrations caused from the imposed excitation signals; those signals are directly measured using a real ambulance subjected to bump-and-curve road conditions. Using the controller based on the dynamic motion of the bed stage, the vibration control performance is evaluated in both the vertical and pitch directions. It is demonstrated that the magnitude of the vibration in the patient compartment of the ambulance can be significantly reduced by applying an input current to the MR dampers installed for the new bed stage. (technical note)

  1. 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.

    2009-01-01

    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,

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

    NARCIS (Netherlands)

    Tolboom, N.; Cats, E. A.; Helders, P. J. M.; Pruijs, J. E. H.; Engelbert, R. H. H.

    2004-01-01

    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

  3. Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial.

    Science.gov (United States)

    Abdollahi, Ali Akbar; Mehranfard, Shahzad; Behnampour, Nasser; Kordnejad, Abdol Mohamad

    2015-06-01

    After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol), early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS) of pain and Kristin Swain's check list was applied to evaluate the severity of bleeding and hematoma. None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference. Based on the findings of this study, changing patients' position can be safe and they can be ambulated early after angiography.

  4. Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Ali Akbar Abdollahi

    2015-06-01

    Full Text Available Introduction: After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. Methods: In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol, early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS of pain and Kristin Swain’s check list was applied to evaluate the severity of bleeding and hematoma. Results: None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference.Conclusion: Based on the findings of this study, changing patients’ position can be safe and they can be ambulated early after angiography.

  5. Effects of international football matches on ambulance call profiles and volumes during the 2006 World Cup.

    Science.gov (United States)

    Deakin, Charles D; Thompson, Fizz; Gibson, Caroline; Green, Mark

    2007-06-01

    Prompt ambulance attendance is aimed at improving patient care. With finite resources struggling to meet performance targets, unforeseen demand precludes the ability to tailor resources to cope with increased call volumes, and can have a marked detrimental effect on performance and hence patient care. The effects of the 2006 World Cup football matches on call volumes and profiles were analysed to understand how public events can influence demands on the ambulance service. All emergency calls to the Hampshire Ambulance Service NHS Trust (currently the Hampshire Division of South Central Ambulance Service, Winchester, UK) during the first weekend of the 2006 World Cup football matches were analysed by call volume and classification of call (call type). On the day of the first football match, call volume was over 50% higher than that on a typical Saturday, with distinct peaks before and after the inaugural match. Call profile analysis showed increases in alcohol-related emergencies, including collapse, unconsciousness, assault and road traffic accidents. The increase in assaults was particularly marked at the end of each match and increased again into the late evening. A detailed mapping of call volumes and profiles during the World Cup football shows a significant increase in overall emergency calls, mostly alcohol related. Mapping of limited resources to these patterns will allow improved responses to emergency calls.

  6. Self-paced brain-computer interface control of ambulation in a virtual reality environment

    Science.gov (United States)

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

    2012-10-01

    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 prosthesis systems may be feasible.

  7. Long-term outcome of neurosurgical untethering on neurosegmental motor and ambulation levels

    NARCIS (Netherlands)

    Schoenmakers, M. A. G. C.; Gooskens, R. H. J. M.; Gulmans, V. A. M.; Hanlo, P. W.; Vandertop, W. P.; Uiterwaal, C. S. P. M.; Helders, P. J. M.

    2003-01-01

    The aim of this study was to determine the long-term outcome of neurosurgical untethering on neurosegmental motor level and ambulation level in children with tethered spinal cord syndrome. Forty-four children were operated on (17 males, 27 females; mean age at operation 6 years 2 months, SD 5

  8. Paramedic identification of acute pulmonary edema in a metropolitan ambulance service.

    Science.gov (United States)

    Williams, Teresa A; Finn, Judith; Celenza, Antonio; Teng, Tiew-Hwa; Jacobs, Ian G

    2013-01-01

    Acute pulmonary edema (APE) is a common cause of acute dyspnea. In the prehospital setting, it is often difficult to differentiate APE from other causes of shortness of breath (SOB). Radiography and echocardiography aid in the identification of APE but are often not available. There is little information on how accurately ambulance paramedics identify patients with APE. Objectives. This study aimed to 1) describe the prehospital clinical presentation and management of patients with a clinical diagnosis of APE and 2) compare the accuracy of coding of APE by paramedics against the emergency department (ED) medical discharge diagnosis. This study included a retrospective cohort of all patients who had episodes identified as APE by ambulance paramedics and were transported to a metropolitan hospital ED in 2011. Two databases were used: an ambulance database and the Emergency Department Information System. The ED medical discharge diagnosis (using International Statistical Classification of Diseases and Related Problems, 10th Revision, Australian Modification [ICD-10-AM] codes) was used as the comparator with paramedic-assigned problem codes for APE. The outcomes for the study were the positive predictive value, i.e., the proportion of patients identified as having APE in the ambulance database who also had an ED discharge diagnosis of APE, and the sensitivity of paramedic identification of APE, i.e., the proportion of patients with an ED discharge diagnosis of APE that were correctly identified as APE by the ambulance paramedics. Four hundred ninety-five patients were transported to an ED with APE identified by the paramedics as the primary problem code. Shortness of breath, crepitations, high systolic blood pressure, and chest pain were the most common presenting signs and symptoms. Pink frothy sputum was rare (3% of patient episodes of APE). One hundred eighty-six patients received an ED discharge diagnosis of APE, i.e., a positive predictive value of 41%. Of 631 ED

  9. Potential Exposure to Ebola Virus from Body Fluids due to Ambulance Compartment Permeability in Sierra Leone.

    Science.gov (United States)

    Casey, Megan L; Nguyen, Duong T; Idriss, Barrie; Bennett, Sarah; Dunn, Angela; Martin, Stephen

    2015-12-01

    Prehospital care, including patient transport, is integral in the patient care process during the Ebola response. Transporting ill persons from the community to Ebola care facilities can stop community spread. Vehicles used for patient transport in infectious disease outbreaks should be evaluated for adequate infection prevention and control. An ambulance driver in Sierra Leone attributed his Ebola infection to exposure to body fluids that leaked from the patient compartment to the driver cabin of the ambulance. A convenience sample of 14 vehicles used to transport patients with suspected or confirmed Ebola in Sierra Leone were assessed. The walls separating the patient compartment and driver cabin in these vehicles were evaluated for structural integrity and potential pathways for body fluid leakage. Ambulance drivers and other staff were asked to describe their cleaning and decontamination practices. Ambulance construction and design standards from the National Fire Protection Association, US General Services Administration, and European Committee on Standardization (CEN) were reviewed. Many vehicles used by ambulance staff in Sierra Leone were not traditional ambulances, but were pick-up trucks or sport-utility vehicles that had been assembled or modified for patient transport. The wall separating the patient compartment and driver cabin in many vehicles did not have a waterproof seal around the edges. Staff responsible for cleaning and disinfection did not thoroughly clean bulk body fluids with disposable towels before disinfection of the patient compartment. Pressure from chlorine sprayers used in the decontamination process may have pushed body fluids from the patient compartment into the driver cabin through gaps around the wall. Ambulance design standards do not require a waterproof seal between the patient compartment and driver cabin. Sealing the wall by tightening or replacing existing bolts is recommended, followed by caulking of all seams with a

  10. Gene Locater

    DEFF Research Database (Denmark)

    Anwar, Muhammad Zohaib; Sehar, Anoosha; Rehman, Inayat-Ur

    2012-01-01

    software's for calculating recombination frequency is mostly limited to the range and flexibility of this type of analysis. GENE LOCATER is a fully customizable program for calculating recombination frequency, written in JAVA. Through an easy-to-use interface, GENE LOCATOR allows users a high degree...... of flexibility in calculating genetic linkage and displaying linkage group. Among other features, this software enables user to identify linkage groups with output visualized graphically. The program calculates interference and coefficient of coincidence with elevated accuracy in sample datasets. AVAILABILITY...

  11. Factors associated with utilization of motorcycle ambulances by pregnant women in rural eastern Uganda: a cross-sectional study.

    Science.gov (United States)

    Ssebunya, Rogers; Matovu, Joseph K B

    2016-03-03

    Evidence suggests that use of motorcycle ambulances can help to improve health facility deliveries; however, few studies have explored the motivators for and barriers to their usage. We explored the factors associated with utilization of motorcycle ambulances by pregnant women in eastern Uganda. This was a cross-sectional, mixed-methods study conducted among 391 women who delivered at four health facilities supplied with motorcycle ambulances in Mbale district, eastern Uganda, between April and May 2014. Quantitative data were collected on socio-demographic and economic characteristics, pregnancy and delivery history, and community and health facility factors associated with utilization of motorcycle ambulances using semi-structured questionnaires. Qualitative data were collected on the knowledge and attitudes towards using motorcycle ambulances by pregnant women through six focus group discussions. Using STATA v.12, we computed the characteristics of women using motorcycle ambulances and used a logistic regression model to assess the correlates of utilization of motorcycle ambulances. Qualitative data were analyzed manually using a master sheet analysis tool. Of the 391 women, 189 (48.3%) reported that they had ever utilized motorcycle ambulances. Of these, 94.7% were currently married or living together with a partner while 50.8% earned less than 50,000 Uganda shillings (US $20) per month. Factors independently associated with use of motorcycle ambulances were: older age of the mother (≥35 years vs ≤24 years; adjusted Odds Ratio (aOR) = 4.3, 95% CI: 2.03, 9.13), sharing a birth plan with the husband (aOR = 2.5, 95% CI: 1.19, 5.26), husband participating in the decision to use the ambulance (aOR =3.22, 95% CI: 1.92, 5.38), and having discussed the use of the ambulance with a traditional birth attendant (TBA) before using it (aOR =3.12, 95% CI: 1.88, 5.19). Qualitative findings indicated that community members were aware of what motorcycle ambulances

  12. Performance of an automated external defibrillator in a moving ambulance vehicle.

    Science.gov (United States)

    Yun, Jong Geun; Jeung, Kyung Woon; Lee, Byung Kook; Ryu, Hyun Ho; Lee, Hyoung Youn; Kim, Mu Jin; Heo, Tag; Min, Yong Il; You, Yeonho

    2010-04-01

    The available data suggest that automated external defibrillators (AED) can be safely used in vibration-like moving conditions such as rigid inflatable boats and aircraft environments. However, little literature exists examining their performance in a moving ambulance. The present study was undertaken to determine whether an AED is able to analyse the heart rhythm correctly during ambulance transport. An ambulance was driven on paved (20-100 km/h) and unpaved (10 km/h) roads. The performance of two AED devices (CU ER 2, CU Medical Systems Inc., Korea, and Heartstart MRx, Phillips, USA) was determined in a moving ambulance using manikins. Vibration intensity was measured simultaneously with a digital vibrometer. AED performance was then evaluated again on manikins and on a swine model under simulated vibration intensities (0.5-5m/s(2)) measured by the vibrometer in the previous phase of the investigation. The vibration intensity increased with increasing speeds on paved roads (1.98+/-0.44 m/s(2) at 100 km/h). While driving on unpaved roads, it increased to 6.40+/-1.06 m/s(2). Both AED algorithms analysed the heart rhythm correctly under resting state. When tested on pigs, both algorithms showed substantially degraded performances, even at low vibration intensities of 0.5-1m/s(2), which corresponded to vibration intensities while driving on paved roads at 20-60 km/h. This study also showed that electrocardiograms generated on manikins were more resistant to motion artifacts than were the pig electrocardiograms. Ambulance personnel should consider the possibility of misinterpretation by an AED when this device is used while transporting a patient. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  13. A correction factor for estimating statewide agricultural injuries from ambulance reports.

    Science.gov (United States)

    Scott, Erika E; Earle-Richardson, Giulia; Krupa, Nicole; Jenkins, Paul

    2011-10-01

    Agriculture ranks as one of the most hazardous industries in the nation. Agricultural injury surveillance is critical to identifying and reducing major injury hazards. Currently, there is no comprehensive system of identifying and characterizing fatal and serious non-fatal agricultural injuries. Researchers sought to calculate a multiplier for estimating the number of agricultural injury cases based on the number of times the farm box indicator was checked on the ambulance report. Farm injuries from 2007 that used ambulance transport were ascertained for 10 New York counties using two methods: (1) ambulance reports including hand-entered free text; and (2) community surveillance. The resulting multiplier that was developed from contrasting these two methods was then applied to the statewide Emergency Medical Services database to estimate the total number of agricultural injuries for New York state. There were 25,735 unique ambulance runs due to injuries in the 10 counties in 2007. Among these, the farm box was checked a total of 90 times. Of these 90, 63 (70%) were determined to be agricultural. Among injury runs where the farm box was not checked, an additional 59 cases were identified from the free text. Among these 122 cases (63 + 59), four were duplicates. Twenty-four additional unique cases were identified from the community surveillance for a total of 142. This yielded a multiplier of 142/90 = 1.578 for estimating all agricultural injuries from the farm box indicator. Sensitivity and specificity of the ambulance report method were 53.4% and 99.9%, respectively. This method provides a cost-effective way to estimate the total number of agricultural injuries for the state. However, it would not eliminate the more labor intensive methods that are required to identify of the actual individual case records. Incorporating an independent source of case ascertainment (community surveillance) increased the multiplier by 17%. Copyright © 2011 Elsevier Inc. All rights

  14. The results of long term coral reef monitoring at three locations in Jamaica: Monkey Island, “Gorgo City” and Southeast Cay

    Directory of Open Access Journals (Sweden)

    Marcia Creary Ford

    2014-09-01

    Full Text Available The global and regional impacts of climate change are having devastating consequences on the coral reef ecosystems of the Caribbean. Long term monitoring are important tool for assessing reef health. Monitoring was established in 2000 in the Bahamas, Belize and Jamaica. Following the pilot project, the program was institutionalized in Jamaica and monitoring was conducted on eight occasions from 2000 to 2010. Monkey Island and “Gorgo City” near Discovery Bay (both on the north coast and Southeast Cay at Port Royal on the south coast were selected. Macroalgae dominated the benthic substrate. Monkey Island and “Gorgo City” had the highest coral cover. Porites astreoides, Montastraea spp., Porites porities, Siderastrea siderea, and Agaricia agaricites were the most common species. Data from this programme have been used in local and regional coral reef assessment and management initiatives.

  15. Walker devices and microswitch technology to enhance assisted indoor ambulation by persons with multiple disabilities: three single-case studies.

    Science.gov (United States)

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Campodonico, Francesca; Buono, Serafino

    2013-07-01

    These three single-case studies assessed the use of walker devices and microswitch technology for promoting ambulation behavior among persons with multiple disabilities. The walker devices were equipped with support and weight lifting features. The microswitch technology ensured that brief stimulation followed the participants' ambulation responses. The participants were two children (i.e., Study I and Study II) and one man (i.e., Study III) with poor ambulation performance. The ambulation efforts of the child in Study I involved regular steps, while those of the child in Study II involved pushing responses (i.e., he pushed himself forward with both feet while sitting on the walker's saddle). The man involved in Study III combined his poor ambulation performance with problem behavior, such as shouting or slapping his face. The results were positive for all three participants. The first two participants had a large increase in the number of steps/pushes performed during the ambulation events provided and in the percentages of those events that they completed independently. The third participant improved his ambulation performance as well as his general behavior (i.e., had a decline in problem behavior and an increase in indices of happiness). The wide-ranging implications of the results are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Does use of the recognition of stroke in the emergency room stroke assessment tool enhance stroke recognition by ambulance clinicians?

    Science.gov (United States)

    Fothergill, Rachael T; Williams, Julia; Edwards, Melanie J; Russell, Ian T; Gompertz, Patrick

    2013-11-01

    U.K ambulance services assess patients with suspected stroke using the Face Arm Speech Test (FAST). The Recognition Of Stroke In the Emergency Room (ROSIER) tool has been shown superior to the FAST in identifying strokes in emergency departments but has not previously been tested in the ambulance setting. We investigated whether ROSIER use by ambulance clinicians can improve stroke recognition. Ambulance clinicians used the ROSIER in place of the FAST to assess patients with suspected stroke. As the ROSIER includes all FAST elements, we calculated a FAST score from the ROSIER to enable comparisons between the two tools. Ambulance clinicians' provisional stroke diagnoses using the ROSIER and calculated FAST were compared with stroke consultants' diagnosis. We used stepwise logistic regression to compare the contribution of individual ROSIER and FAST items and patient demographics to the prediction of consultants' diagnoses. Sixty-four percent of strokes and 78% of nonstrokes identified by ambulance clinicians using the ROSIER were subsequently confirmed by a stroke consultant. There was no difference in the proportion of strokes correctly detected by the ROSIER or FAST with both displaying excellent levels of sensitivity. The ROSIER detected marginally more nonstroke cases than the FAST, but both demonstrated poor specificity. Facial weakness, arm weakness, seizure activity, age, and sex predicted consultants' diagnosis of stroke. The ROSIER was not better than the FAST for prehospital recognition of stroke. A revised version of the FAST incorporating assessment of seizure activity may improve stroke identification and decision making by ambulance clinicians.

  17. A piezoelectric micro control valve with integrated capacitive sensing for ambulant blood pressure waveform monitoring

    NARCIS (Netherlands)

    Groen, Maarten; Wu, Kai; Brookhuis, Robert Anton; van Houwelingen, Marc J.; Brouwer, Dannis Michel; Lötters, Joost Conrad; Wiegerink, Remco J.

    2014-01-01

    We have designed and characterized a MEMS microvalve with built-in capacitive displacement sensing and fitted it with a miniature piezoelectric actuator to achieve active valve control. The integrated displacement sensor enables high bandwidth proportional control of the gas flow through the valve.

  18. A micro control valve with integrated capacitive sensing for ambulant blood pressure waveform monitoring

    NARCIS (Netherlands)

    Groen, Maarten; Brookhuis, Robert Anton; van Houwelingen, M.J.; Brouwer, Dannis Michel; Lötters, Joost Conrad; Wiegerink, Remco J.

    2013-01-01

    We have designed and fabricated the first single-wafer proportional micro control valve with built-in capacitive dis-placement sensing. The displacement sensor can facilitate high-speed active proportional control of gas flow through the valve. This is an essential requirement for non-invasive blood

  19. [Evaluation of a simple screening tool for ambulant fall prevention].

    Science.gov (United States)

    Knobe, M; Rasche, P; Rentemeister, L; Bliemel, C; Bücking, B; Bollheimer, L C; Pape, H-C

    2018-02-02

    An individual's risk of falling is generally difficult to detect and it is likely to be underestimated. Thus, preventive measures are challenging and they demand sufficient integration and implementation into aftercare and outpatient management. The Aachen Falls Prevention Scale (AFPS) is a quick and easy tool for patient-driven fall risk assessment. Older adults' risk of falling is identified in a suitable manner and they then have the opportunity to independently assess and monitor their risk of falling. The aim of the current study was to evaluate the AFPS as a simple screening tool in geriatric trauma patients via the identification of influencing factors, e.g. objective or subjective fall risk, fear of falling (FOF) and demographic data. In this context, we investigated older adults' willingness to take part in special activities concerning fall prevention. Retrospectively, all patients over 70 years of age who received in-hospital fracture treatment between July 2014 and April 2016 were analyzed at a level I trauma center. After identification of 884 patients, participants completed a short questionnaire (47 questions, yes/no, Likert scale) comprising the AFPS. A history of falls in the past year was considered an indicator of a balance disorder. In addition, ambulant patients were invited to participate between July and August 2016. In total, 201 patients (mean 80.4 years, range 63-97 years) performed a self-assessment based on the AFPS. After steps 1 and 2 of the AFPS had been completed, 95 (47%) participants rated their subjective risk of falling as high (more than 5 points). Of the participants 84 (42%) were objectively classified as "fallers" with significant effects on their AFPS evaluation and rating of their subjective risk of falling. Furthermore, 67% of the participants identified a general practitioner as their main contact person, and 43% of the respondents viewed the AFPS as a beneficial screening tool in fall risk evaluation (8

  20. 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

    2012-05-01

    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.

  1. Interpreting streaming biosignals : in search of best approaches to augmenting mobile health monitoring with machine learning for adaptive clinical decision support

    NARCIS (Netherlands)

    Jones, Valerie M.; Mendes Batista, R.J.; Bults, Richard G.A.; op den Akker, Harm; Widya, I.A.; Hermens, Hermanus J.; Huis in 't Veld, M.H.A.; Tönis, Thijs; Tonis, T.; Vollenbroek-Hutten, Miriam Marie Rosé

    2011-01-01

    We investigate Body Area Networks for ambulant patient monitoring. As well as sensing physiological parameters, BAN applications may provide feedback to patients. Automating formulation of feedback requires realtime analysis and interpretation of streaming biosignals and other context and knowledge

  2. Locating Ethics

    DEFF Research Database (Denmark)

    Douglas-Jones, Rachel

    2013-01-01

    Research ethics has become integrated into what it means to conduct good science. This thesis is about the nature of that integration, which I argue is not neutral, carrying with it ideas of duty, moral obligations, organisational mechanisms, and processes of monitoring. For developing countries...... to participate in global research, the pre-requisite of ethical review has necessitated a growth in capacity building exercises. The chapters aim to elucidate ethnographically the activities and implications of 'capacity building' activities in biomedical research ethics, through following the trainings......, assessments and networking of the Forum of Ethics Review Committees of Asia and the Pacific (FERCAP), a Non-Governmental Organisation. The work provides a critical reflection on the spread and uptake of ethics, contributing particularly to literatures in medical anthropology, organisational studies...

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

    LENUS (Irish Health Repository)

    Feeney, A

    2016-04-01

    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

  4. Effect of introduction of electronic patient reporting on the duration of ambulance calls.

    Science.gov (United States)

    Kuisma, Markku; Väyrynen, Taneli; Hiltunen, Tuomas; Porthan, Kari; Aaltonen, Janne

    2009-10-01

    We examined the effect of the change from paper records to the electronic patient records (EPRs) on ambulance call duration. We retrieved call duration times 6 months before (group 1) and 6 months after (group 2) the introduction of EPR. Subgroup analysis of group 2 was fulfilled depending whether the calls were made during the first or last 3 months after EPR introduction. We analyzed 37 599 ambulance calls (17 950 were in group 1 and 19 649 were in group 2). The median call duration in group 1 was 48 minutes and in group 2 was 49 minutes (P = .008). In group 2, call duration was longer during the first 3 months after EPR introduction. In multiple linear regression analysis, urgency category (P introduction was noticed, reflecting adaptation process to a new way of working.

  5. Aspects of neutrality: two Dutch ambulances at the eastern front in the First World War.

    Science.gov (United States)

    van Bergen, Leo

    2010-01-01

    The paper looks at two First World War ambulance teams which distinctly differed from each other, both in the way they perceived the war and the places at the front where they worked. The first was working on the Serbian side and the second on the Austrian-Hungarian. The questions raised are: how was medical neutrality defined (was it defined at all)? Was neutrality maintained, and if so how? The writings of several protagonists are closely examined, and placed in context, to show that total neutrality was not adhered to by the physicians and nurses of these ambulances. Apparently neutrality in wartime is difficult, even for men and women coming from a neutral country with an occupation seen as essentially neutral.

  6. Dyspnea in the ambulance - etiology, mortality, and point-of-care diagnostics

    DEFF Research Database (Denmark)

    Bøtker, Morten Thingemann

    2016-01-01

    dyspnea in the ambulance requires identification of high-risk groups and early correct treatment. Bringing forward simplified versions of advanced diagnostic modalities known from the hospital as point-of-care diagnostics already in the ambulance may aid the discrimination of underlying conditions causing......, we included all patients dialing the emergency number (1-1-2) due to a medical emergency in three of five Danish regions. For identification of highrisk patients and evaluation of electrocardiogram-based triage, we compared short-term mortality between patients included in the first study based...... that are highly prioritized in emergency medical services – including chest pain and trauma. Whether this increased mortality can be ascribed to an older age and comorbidity among patients suffering dyspnea, or if modifiable risk factors are also present, is unsettled. Improving outcome for patients suffering...

  7. [Ambulant compression therapy for crural ulcers; an effective treatment when applied skilfully].

    Science.gov (United States)

    de Boer, Edith M; Geerkens, Maud; Mooij, Michael C

    2015-01-01

    The incidence of crural ulcers is high. They reduce quality of life considerably and create a burden on the healthcare budget. The key treatment is ambulant compression therapy (ACT). We describe two patients with crural ulcers whose ambulant compression treatment was suboptimal and did not result in healing. When the bandages were applied correctly healing was achieved. If correctly applied ACT should provide sufficient pressure to eliminate oedema, whilst taking local circumstances such as bony structures and arterial qualities into consideration. To provide pressure-to-measure regular practical training, skills and regular quality checks are needed. Knowledge of the properties of bandages and the proper use of materials for padding under the bandage enables good personalised ACT. In trained hands adequate compression and making use of simple bandages and dressings provides good care for patients suffering from crural ulcers in contrast to inadequate ACT using the same materials.

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

    Directory of Open Access Journals (Sweden)

    Naredi Peter

    2011-10-01

    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 ClinicalTrials.gov: NCT01400152

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

    Science.gov (United States)

    Lundgren, Peter; Henriksson, Otto; Naredi, Peter; Björnstig, Ulf

    2011-10-21

    Prevention and treatment of hypothermia by active warming in prehospital trauma care is recommended but scientific 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. 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. 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 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. ClinicalTrials.gov: NCT01400152.

  10. The effect of early ambulation on the incidence of neurological complication after spinal anesthesia with lidocaine

    Directory of Open Access Journals (Sweden)

    Reihanak Talakoub

    2015-01-01

    Full Text Available Background: Transient neurological symptoms (TNS, was described in patients recovering from spinal anesthesia with lidocaine but its etiology remains unknown this study was evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with lidocaine 5%. Materials and Methods: This randomized clinical trial was conducted on 60 patients with American Society of Anesthesiologists Grades I and II, who were candidates for lower abdominal surgery in supine or lithotomy positions. Patients were randomly divided into early ambulation group (Group A who were asked to start walking as soon as the anesthesia was diminished or to the late ambulation group (Group B who walked after at least 12 h bedridden. Participants were contacted 2 days after spinal anesthesia to assess any type of pain at surgical or anesthesia injection site, muscle weakness, fatigue, vertigo, nausea, vomiting, headache, and difficult urination or defecation. Results: Four subjects (13.3% in Group A and two patients (6.7% in Group B had pain at anesthesia injection site (P = 0.019. Fourteen patients in Group A (46.7% and six patients in Group B (20% had post-dural puncture headache (P = 0.014. Participants in Group B reported difficult urination more than Group A (P = 0.002. there were not statistically significant differences between two groups regarding frequency of fatigue, muscle weakness, vertigo, nausea, vomiting, difficult defecation, paresthesia, and the mean of visual analogue scale at the surgical site. Conclusion: Early ambulation after spinal anesthesia with lidocaine did not increase the risk of neurologic complication.

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

    OpenAIRE

    Delgado, M. Kit; Meng, Lesley J.; Mercer, Mary P.; Pines, Jesse M.; Owens, Douglas K.; Zaric, Gregory S.

    2013-01-01

    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 st...

  12. Ambulance cardiopulmonary resuscitation: outcomes and associated factors in out-of-hospital cardiac arrest.

    Science.gov (United States)

    Rosell Ortiz, Fernando; García Del Águila, Javier; Fernández Del Valle, Patricia; J Mellado-Vergel, Francisco; Vergara-Pérez, Santiago; R Ruiz-Montero, María; Martínez-Lara, Manuela; J Gómez-Jiménez, Francisco; Gonzáez-Lobato, Ismael; García-Escudero, Guillermo; Ruiz-Bailén, Manuel; Caballero-García, Auxiliadora; Vivar-Díaz, Itziar; Olavarría-Govantes, Luis

    2018-06-01

    To assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport. Retrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non-heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance CPR, survival, and neurologic outcome. Out of a total of 7241 cases, 259 (3.6%) were given CPR during emergency transport. The mean (SD) age was 51.6 (23.6) years; 27 (10.1%) were aged 16 years or younger. The following variables were associated with the use of CPR during transport: age 16 years or under (odds ratio [OR], 6.48; 95% CI, 3.91-10.76); P<.001)], witnessed OHCA (OR, 1.62; 95% CI, 1.16-2.26; P=.004), cardiac arrest outside the home (OR, 3.17; 95% CI, 2.38-4.21; P<.001), noncardiac cause (OR, 1.47; 95% CI, 1.07-2.02; P=.019], initially shockable rhythm (OR, 1.67; 95% CI, 1.17-2.37; P=.004), no prior basic life support (OR, 3.48; 95% CI, 2.58-4.70; P<.001), and orotracheal intubation (OR, 1.93; 95% CI, 1.24-2.99; P=.003). One patient (0.38%) survived to discharge with good neurologic outcome. Ambulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance CPR, a strategy that can be considered futile.

  13. Manager-employee interaction in ambulance services: an exploratory study of employee perspectives on management communication.

    Science.gov (United States)

    Nordby, Halvor

    2015-01-01

    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.

  14. Assessing the value of variational assimilation of streamflow data into distributed hydrologic models for improved streamflow monitoring and prediction at ungauged and gauged locations in the catchment

    Science.gov (United States)

    Lee, Hak Su; Seo, Dong-Jun; Liu, Yuqiong; McKee, Paul; Corby, Robert

    2010-05-01

    State updating of distributed hydrologic models via assimilation of streamflow data is subject to "overfitting" because large dimensionality of the state space of the model may render the assimilation problem seriously underdetermined. To examine the issue in the context of operational hydrology, we carried out a set of real-world experiments in which we assimilate streamflow data at interior and/or outlet locations into gridded SAC and kinematic-wave routing models of the U.S. National Weather Service (NWS) Research Distributed Hydrologic Model (RDHM). We used for the experiments nine basins in the southern plains of the U.S. The experiments consist of selectively assimilating streamflow at different gauge locations, outlet and/or interior, and carrying out both dependent and independent validation. To assess the sensitivity of the quality of assimilation-aided streamflow simulation to the reduced dimensionality of the state space, we carried out data assimilation at spatially semi-distributed or lumped scale and by adjusting biases in precipitation and potential evaporation at a 6-hourly or larger scale. In this talk, we present the results and findings.

  15. Ambulance Dispatches From Unaffected Areas After the Great East Japan Earthquake: Impact on Emergency Care in the Unaffected Areas.

    Science.gov (United States)

    Hagihara, Akihito; Onozuka, Daisuke; Nagata, Takashi; Abe, Takeru; Hasegawa, Manabu; Nabeshima, Yoshihiro

    2015-12-01

    Although dispatching ambulance crews from unaffected areas to a disaster zone is inevitable when a major disaster occurs, the effect on emergency care in the unaffected areas has not been studied. We evaluated whether dispatching ambulance crews from unaffected prefectures to those damaged by the Great East Japan Earthquake was associated with reduced resuscitation outcomes in out-of-hospital cardiac arrest (OHCA) cases in the unaffected areas. We used the Box-Jenkins transfer function model to assess the relationship between ambulance crew dispatches and return of spontaneous circulation (ROSC) before hospital arrival or 1-month survival after the cardiac event. In a model whose output was the rate of ROSC before hospital arrival, dispatching 1000 ambulance crews was associated with a 0.474% decrease in the rate of ROSC after the dispatch in the prefectures (p=0.023). In a model whose output was the rate of 1-month survival, dispatching 1000 ambulance crews was associated with a 0.502% decrease in the rate of 1-month survival after the dispatch in the prefectures (p=0.011). The dispatch of ambulances from unaffected prefectures to earthquake-stricken areas was associated with a subsequent decrease in the ROSC and 1-month survival rates in OHCA cases in the unaffected prefectures.

  16. Early Ambulation Decreases Length of Hospital Stay, Perioperative Complications and Improves Functional Outcomes in Elderly Patients Undergoing Surgery for Correction of Adult Degenerative Scoliosis.

    Science.gov (United States)

    Adogwa, Owoicho; Elsamadicy, Aladine A; Fialkoff, Jared; Cheng, Joseph; Karikari, Isaac O; Bagley, Carlos

    2017-09-15

    Ambispective cohort review. To examine the effects of early mobilization on patient outcomes, complications profile, and 30-day readmission rates. Prolonged immobilization after surgery can result in functional decline and an increased risk of hospital-associated complications. We conducted an ambispective study of 125 elderly patients (>65 years) undergoing elective spinal surgery for correction of adult degenerative scoliosis. We identified all unplanned readmissions within 30 days of discharge. Unplanned readmissions were defined to have occurred as a result of either a surgical or a nonsurgical complication. "Days of immobility" was defined as the number of days until a patient moved out of bed beyond a chair. Patients in the top and bottom quartiles were dichotomized into "early ambulators" and "late ambulators", respectively. Early ambulators were ambulatory within 24 hours of surgery, whereas late ambulators were ambulatory at a minimum of 48 hours after surgery. Complication rates, duration of hospital stay, and 30-day readmission rates were compared between early ambulators and late ambulators. Baseline characteristics were similar between both cohorts. Compared with patients with a longer duration of immobility (i.e., late ambulators), the prevalence of at least one perioperative complication was significantly lower in the early ambulators cohort (30% vs. 54%, P = 0.06). The length of inhospital stay was 34% shorter in the early ambulators cohort (5.33 days vs. 8.11 days, P = 0.01). Functional independence was superior in the early ambulators cohort, with the majority of patients discharged directly home after surgery compared with late ambulators (71.2% vs. 22.0%, P = 0.01). Early ambulation after surgery significantly reduces the incidence of perioperative complications, shortens duration of inhospital stay, and contributes to improved perioperative functional status in elderly patients. Even a delay of 24 hours to ambulation is

  17. Effects of high ambient temperature on ambulance dispatches in different age groups in Fukuoka, Japan.

    Science.gov (United States)

    Kotani, Kazuya; Ueda, Kayo; Seposo, Xerxes; Yasukochi, Shusuke; Matsumoto, Hiroko; Ono, Masaji; Honda, Akiko; Takano, Hirohisa

    2018-01-01

    The elderly population has been the primary target of intervention to prevent heat-related illnesses. According to the literature, the highest risks have been observed among the elderly in the temperature-mortality relationship. However, findings regarding the temperature-morbidity relationship are inconsistent. This study aimed to examine the association of temperature with ambulance dispatches due to acute illnesses, stratified by age group. Specifically, we explored the optimum temperature, at which the relative health risks were found to be the lowest, and quantified the health risk associated with higher temperatures among different age groups. We used the data for ambulance dispatches in Fukuoka, Japan, during May and September from 2005 to 2012. The data were grouped according to age in 20-year increments. We explored the pattern of the association of ambulance dispatches with temperature using a smoothing spline curve to identify the optimum temperature for each age group. Then, we applied a distributed lag nonlinear model to estimate the risks of the 85th-95th percentile temperature relative to the overall optimum temperature, for each age group. The relative risk of ambulance dispatches at the 85th and 95th percentile temperature for all ages was 1.08 [95% confidence interval (CI): 1.05, 1.12] and 1.12 (95% CI: 1.08, 1.16), respectively. In comparison, among age groups, the optimum temperature was observed as 25.0°C, 23.2°C, and 25.3°C for those aged 0-19, 60-79, and ≥80, respectively. The optimum temperature could not be determined for those aged 20-39 and 40-59. The relative risks of high temperature tended to be higher for those aged 20-39 and 40-59 than those for other age groups. We did not find any definite difference in the effect of high temperature on ambulance dispatches for different age groups. However, more measures should be taken for younger and middle-aged people to avoid heat-related illnesses.

  18. Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances

    Directory of Open Access Journals (Sweden)

    Agata Bielawska-Drózd

    2017-08-01

    Full Text Available Objectives: Assessment of microbial air quality and surface contamination in ambulances and administration offices as a control place without occupational exposure to biological agents; based on quantitative and qualitative analysis of bacteria, yeasts and filamentous fungi found in collected samples. Material and Methods: The sampling was done by wet cyclone technology using the Coriolis recon apparatus, imprint and swab methods, respectively. In total, 280 samples from 28 ambulances and 10 offices in Warszawa were tested. Data was analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test with α = 0.05. P value ≤ 0.05 was considered as significant. Results: The levels of air contamination were from 0 to 2.3×101 colony-forming unit (CFU/m3 for bacteria and for yeast and filamentous fungi were from 0 to 1.8×101 CFU/m3. The assessment of office space air samples has shown the following numbers of microorganisms: bacteria from 3.0×101 to 4.2×101 CFU/m3 and yeast and filamentous fungi from 0 to 1.9×101 CFU/m3. For surface contamination the mean bacterial count in ambulances has been between 1.0×101 and 1.3×102 CFU/25 cm2 and in offices – between 1.1×101 and 8.5×101 CFU/25 cm2. Mean fungal count has reached the level from 2.8×100 to 4.2×101 CFU/25 cm2 in ambulances and 1.3×101 to 5.8×101 CFU/25 cm2 in offices. The qualitative analysis has revealed the presence of Acinetobacter spp. (surfaces, coagulase – negative Staphylococci (air and surfaces, Aspergillus and Penicillium genera (air and surfaces. Conclusions: The study has revealed a satisfactory microbiological quantity of analyzed air and surface samples in both study and control environments. However, the presence of potentially pathogenic microorganisms in the air and on surfaces in ambulances may endanger the medical emergency staff and patients with infection. Disinfection and cleaning techniques therefore should be constantly developed and implemented. Int J Occup

  19. Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances.

    Science.gov (United States)

    Bielawska-Drózd, Agata; Cieślik, Piotr; Wlizło-Skowronek, Bożena; Winnicka, Izabela; Kubiak, Leszek; Jaroszuk-Ściseł, Jolanta; Depczyńska, Daria; Bohacz, Justyna; Korniłłowicz-Kowalska, Teresa; Skopińska-Różewska, Ewa; Kocik, Janusz

    2017-06-19

    Assessment of microbial air quality and surface contamination in ambulances and administration offices as a control place without occupational exposure to biological agents; based on quantitative and qualitative analysis of bacteria, yeasts and filamentous fungi found in collected samples. The sampling was done by wet cyclone technology using the Coriolis recon apparatus, imprint and swab methods, respectively. In total, 280 samples from 28 ambulances and 10 offices in Warszawa were tested. Data was analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test with α = 0.05. P value ≤ 0.05 was considered as significant. The levels of air contamination were from 0 to 2.3×101 colony-forming unit (CFU)/m3 for bacteria and for yeast and filamentous fungi were from 0 to 1.8×101 CFU/m3. The assessment of office space air samples has shown the following numbers of microorganisms: bacteria from 3.0×101 to 4.2×101 CFU/m3 and yeast and filamentous fungi from 0 to 1.9×101 CFU/m3. For surface contamination the mean bacterial count in ambulances has been between 1.0×101 and 1.3×102 CFU/25 cm2 and in offices - between 1.1×101 and 8.5×101 CFU/25 cm2. Mean fungal count has reached the level from 2.8×100 to 4.2×101 CFU/25 cm2 in ambulances and 1.3×101 to 5.8×101 CFU/25 cm2 in offices. The qualitative analysis has revealed the presence of Acinetobacter spp. (surfaces), coagulase - negative Staphylococci (air and surfaces), Aspergillus and Penicillium genera (air and surfaces). The study has revealed a satisfactory microbiological quantity of analyzed air and surface samples in both study and control environments. However, the presence of potentially pathogenic microorganisms in the air and on surfaces in ambulances may endanger the medical emergency staff and patients with infection. Disinfection and cleaning techniques therefore should be constantly developed and implemented. Int J Occup Med Environ Health 2017;30(4):617-627. This work is available in Open Access

  20. The Seminole Serpent Warrior At Miramar, FL, Shows Settlement Locations Enabled Environmental Monitoring Reminiscent Of the Four-corners Kokopelli-like EMF Phenomena, and Related to Earthquakes, Tornados and Hurricanes.

    Science.gov (United States)

    Balam Matagamon, Chan; Pawa Matagamon, Sagamo

    2004-03-01

    Certain Native Americans of the past seem to have correctly deduced that significant survival information for their tradition-respecting cultures resided in EMF-based phenomena that they were monitoring. This is based upon their myths and the place or cult-hero names they bequeathed us. The sites we have located in FL have been detectable by us visually, usually by faint blue light, or by the elicitation of pin-like prickings, by somewhat intense nervous-system response, by EMF interactions with aural electrochemical systems that can elicit tinitus, and other ways. In the northeast, Cautantowit served as a harbinger of Indian summer, and appears to be another alter ego of the EMF. The Miami, FL Tequesta site along the river clearly correlates with tornado, earthquake and hurricane locations. Sites like the Mohave Deserts giant man may have had similar significance.

  1. Wireless system for location of permanent faults by short circuit current monitoring in electric power distribution network; Sistema wireless para localizacao de faltas permanentes atraves da monitoracao da corrente de curto-circuito em redes de distribuicao de energia eletrica

    Energy Technology Data Exchange (ETDEWEB)

    Machado, A.G.; Correa, A.C.; Machado, R.N. das M.; Ferreira, A.M.D.; Pinto, J.A.C. [Instituto Federal de Educacao, Ciencia e Tecnologia do Para (IFPA), Belem, PA (Brazil)], E-mail: alcidesmachado000@yahoo.com.br; Barra Junior, W. [Universidade Federal do Para (UFPA), Belem, PA (Brazil). Inst. de Tecnologia. Faculdade de Engenharia Eletrica], E-mail: walbarra@ufpa.br

    2009-07-01

    This paper presents the development of an automatic system for permanent short-circuits location in medium voltage (13.8 kV) electric power system distribution feeders, by indirect monitoring of the line current. When a permanent failure occurs, the developed system uses mobile telephony (GSM) text messages (SMS) to inform the power company operation center where the failure most likely took place. With this information in real time, the power company operation center may provide the network restoration in a faster and efficient way. (author)

  2. Improving the coding and classification of ambulance data through the application of International Classification of Disease 10th revision.

    Science.gov (United States)

    Cantwell, Kate; Morgans, Amee; Smith, Karen; Livingston, Michael; Dietze, Paul

    2014-02-01

    This paper aims to examine whether an adaptation of the International Classification of Disease (ICD) coding system can be applied retrospectively to final paramedic assessment data in an ambulance dataset with a view to developing more fine-grained, clinically relevant case definitions than are available through point-of-call data. Over 1.2 million case records were extracted from the Ambulance Victoria data warehouse. Data fields included dispatch code, cause (CN) and final primary assessment (FPA). Each FPA was converted to an ICD-10-AM code using word matching or best fit. ICD-10-AM codes were then converted into Major Diagnostic Categories (MDC). CN was aligned with the ICD-10-AM codes for external cause of morbidity and mortality. The most accurate results were obtained when ICD-10-AM codes were assigned using information from both FPA and CN. Comparison of cases coded as unconscious at point-of-call with the associated paramedic assessment highlighted the extra clinical detail obtained when paramedic assessment data are used. Ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Coding of ambulance data using ICD-10-AM allows for comparison of not only ambulance service users but also with other population groups. WHAT IS KNOWN ABOUT THE TOPIC? There is no reliable and standard coding and categorising system for paramedic assessment data contained in ambulance service databases. WHAT DOES THIS PAPER ADD? This study demonstrates that ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Representation of ambulance case types using ICD-10-AM-coded information obtained after paramedic assessment is more fine grained and clinically relevant than point-of-call data, which uses caller information before ambulance attendance. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? This paper describes

  3. [RADIATION HYGIENIC MONITORING AT THE AREA OF THE LOCATION OF THE FAR EASTERN CENTER FOR RADIOACTIVE WASTE MANAGEMENT (FEC "DALRAO"--BRANCH OF FSUE "ROSRAO")].

    Science.gov (United States)

    Kiselev, S M; Shandala, N K; Akhromeev, S V; Gimadova, T I; Seregin, V A; Titov, A V; Biryukova, N G

    2015-01-01

    Intensification ofactivities in the field of spent nuclear fuel (SNF) and radioactive waste (RW) management in the Far East region of Russia assumes an increase of the environmental load on the territories adjacent to the enterprise and settlements. To ensure radiation safety during works on SNF and radioactive waste management in the standard mode of operation and during the rehabilitation works in the contaminated territories, there is need for the optimization of the existing system of radiation-hygienic monitoring, aimed at the implementation of complex dynamic observation of parameters of radiation-hygienic situation and radiation amount of the population living in the vicinity of the Far Eastern Center for Radioactive Waste Management (FEC "DALRAO"). To solve this problem there is required a significant amount of total and enough structured information on the character of the formation of the radiation situation, the potential ways of the spread of man-made pollution to the surrounding area, determining the radiation load on the population living in the vicinity of the object. In this paper there are presented the results of field studies of the radiation situation at the plant FEC "DALRAO", which were obtained during the course of expedition trips in 2009-2012.

  4. Gully monitoring at two locations in the Grand Canyon National Park, Arizona, 1996-2010, with emphasis on documenting effects of the March 2008 high-flow experiment

    Science.gov (United States)

    Schott, Nathan D.; Hazel, Joseph E.; Fairley, Helen C.; Kaplinski, Matt; Parnell, Roderic A.

    2014-01-01

    Many archeological sites in the Grand Canyon are being impacted by gully incision. In March 2008, a high-flow experiment (2008 HFE) was conducted with the intention of redistributing fine sediment (sand, silt, and clay) from the bed of the Colorado River to higher elevations along the channel margin. Deposition of fine sediment in gully mouths has been hypothesized to slow gully erosion rates and lessen impacts to archeological sites. The effects of the 2008 HFE on gullies were evaluated by comparing the topographic changes of three gullies at two study sites before and after the 2008 HFE. Comparison results indicated that sediment was deposited in gully mouths during the 2008 HFE, and that the inundated areas nearest to the river can be extensively altered by mainstream flow during high-flow events. Additionally, the history of gully evolution at the two study sites was examined between 1996 and 2010 and indicated that gullies have been subjected to thalweg incision and gully widening processes over a decadal timescale. Although the small sample size precludes extrapolating the results to other gullies, the findings contribute to the understanding of gully erosion in archeologically significant areas and have implications for future monitoring of gully erosion and evaluating the effectiveness of check dams intended to mitigate that erosion at archaeological sites in the Grand Canyon National Park.

  5. Long-Term Monitoring of Fresco Paintings in the Cathedral of Valencia (Spain) Through Humidity and Temperature Sensors in Various Locations for Preventive Conservation

    Science.gov (United States)

    Zarzo, Manuel; Fernández-Navajas, Angel; García-Diego, Fernando-Juan

    2011-01-01

    We describe the performance of a microclimate monitoring system that was implemented for the preventive conservation of the Renaissance frescoes in the apse vault of the Cathedral of Valencia, that were restored in 2006. This system comprises 29 relative humidity (RH) and temperature sensors: 10 of them inserted into the plaster layer supporting the fresco paintings, 10 sensors in the walls close to the frescoes and nine sensors measuring the indoor microclimate at different points of the vault. Principal component analysis was applied to RH data recorded in 2007. The analysis was repeated with data collected in 2008 and 2010. The resulting loading plots revealed that the similarities and dissimilarities among sensors were approximately maintained along the three years. A physical interpretation was provided for the first and second principal components. Interestingly, sensors recording the highest RH values correspond to zones where humidity problems are causing formation of efflorescence. Recorded data of RH and temperature are discussed according to Italian Standard UNI 10829 (1999). PMID:22164100

  6. Long-Term Monitoring of Fresco Paintings in the Cathedral of Valencia (Spain Through Humidity and Temperature Sensors in Various Locations for Preventive Conservation

    Directory of Open Access Journals (Sweden)

    Angel Fernández-Navajas

    2011-09-01

    Full Text Available We describe the performance of a microclimate monitoring system that was implemented for the preventive conservation of the Renaissance frescoes in the apse vault of the Cathedral of Valencia, that were restored in 2006. This system comprises 29 relative humidity (RH and temperature sensors: 10 of them inserted into the plaster layer supporting the fresco paintings, 10 sensors in the walls close to the frescoes and nine sensors measuring the indoor microclimate at different points of the vault. Principal component analysis was applied to RH data recorded in 2007. The analysis was repeated with data collected in 2008 and 2010. The resulting loading plots revealed that the similarities and dissimilarities among sensors were approximately maintained along the three years. A physical interpretation was provided for the first and second principal components. Interestingly, sensors recording the highest RH values correspond to zones where humidity problems are causing formation of efflorescence. Recorded data of RH and temperature are discussed according to Italian Standard UNI 10829 (1999.

  7. 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.

  8. Installation restoration program: Hydrologic measurements with an estimated hydrologic budget for the Joliet Army Ammunition Plant, Joliet, Illinois. [Contains maps of monitoring well locations, topography and hydrologic basins

    Energy Technology Data Exchange (ETDEWEB)

    Diodato, D.M.; Cho, H.E.; Sundell, R.C.

    1991-07-01

    Hydrologic data were gathered from the 36.8-mi{sup 2} Joliet Army Ammunition Plant (JAAP) located in Joliet, Illinois. Surface water levels were measured continuously, and groundwater levels were measured monthly. The resulting information was entered into a database that could be used as part of numerical flow model validation for the site. Deep sandstone aquifers supply much of the water in the JAAP region. These aquifers are successively overlain by confining shales and a dolomite aquifer of Silurian age. This last unit is unconformably overlain by Pleistocene glacial tills and outwash sand and gravel. Groundwater levels in the shallow glacial system fluctuate widely, with one well completed in an upland fluctuating more than 17 ft during the study period. The response to groundwater recharge in the underlying Silurian dolomite is slower. In the upland recharge areas, increased groundwater levels were observed; in the lowland discharge areas, groundwater levels decreased during the study period. The decreases are postulated to be a lag effect related to a 1988 drought. These observations show that fluid at the JAAP is not steady-state, either on a monthly or an annual basis. Hydrologic budgets were estimated for the two principal surface water basins at the JAAP site. These basins account for 70% of the facility's total land area. Meteorological data collected at a nearby dam show that total measured precipitation was 31.45 in. and total calculated evapotranspiration was 23.09 in. for the study period. The change in surface water storage was assumed to be zero for the annual budget for each basin. The change in groundwater storage was calculated to be 0.12 in. for the Grant Creek basin and 0. 26 in. for the Prairie Creek basin. Runoff was 7.02 in. and 7.51 in. for the Grant Creek and Prairie Creek basins, respectively. The underflow to the deep hydrogeologic system in the Grant Creek basin was calculated to be negligible. 12 refs., 17 figs., 15 tabs.

  9. EFFECT OF SHOE RAISE ALONG WITH MOTOR RELEARNING PROGRAMME (MRP ON AMBULATION IN CHRONIC STROKE

    Directory of Open Access Journals (Sweden)

    Gajanan Bhalerao

    2016-06-01

    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.

  10. Appraisal of work ability in relation to job-specific health requirements in ambulance workers.

    Science.gov (United States)

    van Schaaijk, A; Boschman, J S; Frings-Dresen, M H W; Sluiter, J K

    2017-01-01

    To gain insight into which job-specific health requirements relate to work ability, the following two research questions were formulated: Which job-specific health requirements are associated with the appraisal of work ability in ambulance drivers and paramedics? How are appraisals of physical and mental work ability associated with the appraisal of overall work ability in ambulance drivers and paramedics? Workers Health Surveillance cross-sectional data of 506 ambulance workers (236 drivers and 270 paramedics) were used. The tests for specific job requirements were divided into six categories. Work ability was appraised as overall, physical and mental/emotional. Multiple linear stepwise regression analyses were used to model the associations. Outcomes in 'raised alertness and judgment ability' (R 2  = 0.09), 'job-specific physical abilities' (R 2  = 0.10) and 'emotional peak load' (R 2  = 0.07) significantly explained appraised overall, physical and mental/emotional work ability. Physical and mental/emotional work ability together explained 48.3% of the variance of overall work ability. The explained variance by physical and mental/emotional work ability was almost 4% higher in drivers than in paramedics. Overall work ability was significantly explained by outcomes in 'raised alertness and judgment ability' and 'emotional peak load.' Physical work ability was significantly explained by 'job-specific physical abilities' and 'raised alertness and judgment ability' outcomes, while 'emotional peak load' and 'raised alertness and judgment ability' outcomes significantly explained mental/emotional work ability. Physical and mental/emotional work ability explains the same proportion of variance in overall work ability.

  11. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

    Science.gov (United States)

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

    2016-01-01

    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. PMID:27340808

  12. Effects of weather conditions on emergency ambulance calls for acute coronary syndromes

    Science.gov (United States)

    Vencloviene, Jone; Babarskiene, Ruta; Dobozinskas, Paulius; Siurkaite, Viktorija

    2015-08-01

    The aim of this study was to evaluate the relationship between weather conditions and daily emergency ambulance calls for acute coronary syndromes (ACS). The study included data on 3631 patients who called the ambulance for chest pain and were admitted to the department of cardiology as patients with ACS. We investigated the effect of daily air temperature ( T), barometric pressure (BP), relative humidity, and wind speed (WS) to detect the risk areas for low and high daily volume (DV) of emergency calls. We used the classification and regression tree method as well as cluster analysis. The clusters were created by applying the k-means cluster algorithm using the standardized daily weather variables. The analysis was performed separately during cold (October-April) and warm (May-September) seasons. During the cold period, the greatest DV was observed on days of low T during the 3-day sequence, on cold and windy days, and on days of low BP and high WS during the 3-day sequence; low DV was associated with high BP and decreased WS on the previous day. During June-September, a lower DV was associated with low BP, windless days, and high BP and low WS during the 3-day sequence. During the warm period, the greatest DV was associated with increased BP and changing WS during the 3-day sequence. These results suggest that daily T, BP, and WS on the day of the ambulance call and on the two previous days may be prognostic variables for the risk of ACS.

  13. The importance of manager support for the mental health and well-being of ambulance personnel.

    Science.gov (United States)

    Petrie, Katherine; Gayed, Aimée; Bryan, Bridget T; Deady, Mark; Madan, Ira; Savic, Anita; Wooldridge, Zoe; Counson, Isabelle; Calvo, Rafael A; Glozier, Nicholas; Harvey, Samuel B

    2018-01-01

    Interventions to enhance mental health and well-being within high risk industries such as the emergency services have typically focused on individual-level factors, though there is increasing interest in the role of organisational-level interventions. The aim of this study was to examine the importance of different aspects of manager support in determining the mental health of ambulance personnel. A cross-sectional survey was completed by ambulance personnel across two Australian states (N = 1,622). Demographics, manager support and mental health measures were assessed. Hierarchical multiple linear regressions were conducted to determine the explanatory influence of the employee's perception of the priority management places upon mental health issues (manager psychosocial safety climate) and managers' observed behaviours (manager behaviour) on employee common mental disorder and well-being within ambulance personnel. Of the 1,622 participants, 123 (7.6%) were found to be suffering from a likely mental disorder. Manager psychosocial safety climate accounted for a significant amount of the variance in levels of employee common mental health disorder symptoms (13%, pManager behaviour had a lesser, but still statistically significant influence upon symptoms of common mental disorder (7% of variance, pmanagement places on mental health and managers' actual behaviour are related but distinct concepts, and each appears to impact employee mental health. While the overall variance explained by each factor was limited, the fact that each is potentially modifiable makes this finding important and highlights the significance of organisational and team-level interventions to promote employee well-being within emergency services and other high-risk occupations.

  14. The importance of manager support for the mental health and well-being of ambulance personnel.

    Directory of Open Access Journals (Sweden)

    Katherine Petrie

    Full Text Available Interventions to enhance mental health and well-being within high risk industries such as the emergency services have typically focused on individual-level factors, though there is increasing interest in the role of organisational-level interventions. The aim of this study was to examine the importance of different aspects of manager support in determining the mental health of ambulance personnel. A cross-sectional survey was completed by ambulance personnel across two Australian states (N = 1,622. Demographics, manager support and mental health measures were assessed. Hierarchical multiple linear regressions were conducted to determine the explanatory influence of the employee's perception of the priority management places upon mental health issues (manager psychosocial safety climate and managers' observed behaviours (manager behaviour on employee common mental disorder and well-being within ambulance personnel. Of the 1,622 participants, 123 (7.6% were found to be suffering from a likely mental disorder. Manager psychosocial safety climate accounted for a significant amount of the variance in levels of employee common mental health disorder symptoms (13%, p<0.01 and well-being (13%, p<0.01. Manager behaviour had a lesser, but still statistically significant influence upon symptoms of common mental disorder (7% of variance, p<0.01 and well-being (10% of variance, p<0.05. The perceived importance management places on mental health and managers' actual behaviour are related but distinct concepts, and each appears to impact employee mental health. While the overall variance explained by each factor was limited, the fact that each is potentially modifiable makes this finding important and highlights the significance of organisational and team-level interventions to promote employee well-being within emergency services and other high-risk occupations.

  15. 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

    2006-01-01

    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......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...... of short-term postoperative outcome after hip fracture surgery....

  16. Evaluation of insight training of ambulance drivers in Sweden using DART, a new e-learning tool.

    Science.gov (United States)

    Albertsson, Pontus; Sundström, Anna

    2011-12-01

    The aim of the study was to evaluate whether a new e-learning tool for insight training of ambulance drivers can have an effect on drivers' driving behaviors, perceived driving competence, competence to assess risks, self-reflection, and safety attitudes. A quasi-experimental study design, with participants nonrandomly assigned into a control and intervention group, was used. The intervention group participated in the insight-training course and the control group did not. Both groups completed a self- and peer assessment online questionnaire before and after the training. The main finding is that the ambulance drivers assessed themselves through the instruments after the training, with the e-learning tool Driver Access Recording Tool (DART), as safer drivers in the areas of speed adaptation, closing up, and overtaking. In the answers from the group-based evaluation, the ambulance drivers responded that they were more reflective/analytical, had increased their risk awareness, and had changed their driving behaviors. After insight training, the ambulance drivers in this study assessed themselves as safer drivers in several important areas, including speed adaptation, closing up, and overtaking. In future training of ambulance drivers there should be more focus on insight training instead of previous training focusing on maneuvering capabilities.

  17. A systematic review of job-specific workers' health surveillance activities for fire-fighting, ambulance, police and military personnel.

    Science.gov (United States)

    Plat, M J; Frings-Dresen, M H W; Sluiter, J K

    2011-12-01

    Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers' health surveillance (WHS) activities and (2) the effectiveness of job-specific WHS interventions with respect to work functioning, for selected jobs. The search strategy systematically searched the PubMed, PsycINFO and OSH-update databases. The search strategy consisted of several synonyms of the job titles of interest, combined with synonyms for workers' health surveillance. The methodological quality was checked. At least one study was found for each of the following occupations fire fighters, ambulance personnel, police personnel and military personnel. For the first objective, 24 studies described several job-specific WHS activities aimed at aspects of psychological, 'physical' (energetic, biomechanical and balance), sense-related, environmental exposure or cardiovascular requirements. The seven studies found for the second objective measured different outcomes related to work functioning. The methodological quality of the interventions varied, but with the exception of one study, all scored over 55% of the maximum score. Six studies showed effectiveness on at least some of the defined outcomes. The studies described several job-specific interventions: a trauma resilience training, healthy lifestyle promotion, physical readiness training, respiratory muscle training, endurance and resistance training, a physical exercise programme and comparing vaccines. Several examples of job-specific WHS activities were found for the four occupations. Compared to studies focusing on physical tasks, a few studies were found that focus on psychological tasks. Effectiveness studies for job-specific WHS interventions were scarce, although their results were promising. We recommend studying

  18. Referral to the Hospital And Emergency Ambulance Service Uses Patterns of the Inmates and Convicts

    Directory of Open Access Journals (Sweden)

    Emine Oncu

    2014-03-01

    Full Text Available Aim: The purpose of this study was to determine the reasons for referral to the hospital and 112 emergency ambulance service uses patterns of the inmates and convicts in an E type prison. Material and Method: In this descriptive study, it was evaluated the prison records associated with referral to the hospital and 112 emergency ambulance service uses for one year in 2010- 2011. Of the statistical analysis, descriptive statistics, chi-square test and Fisher%u2019s Exact Test were used. Results: All inmates and convicts were man, the median of age was 30,0 (min 18- max 68 years and substance use was 34,5%. The number of prisoners were referred to the hospital 815, total referrals were 1491; (referrals ranged from one to six and most common in January; and according to frequency, reasons of the referral were eyes problems, musculoskeletal disorders and psychological problems. Emergency medical service was used for in medical causes (78,3%, accident, trauma and injuries (16,4%, suicide (5,3%. Discussion: Findings from the study show that prisoners are more likely to have suffered physical and mental health problems that compared to the rest of society and have significantly high substance use rates.

  19. Peripubertal castration of male rats, adult open field ambulation and partner preference behavior.

    Science.gov (United States)

    Brand, T; Slob, A K

    1988-09-15

    The validity of the hypothesis put forward earlier, that testicular secretions during puberty have an organizing effect on open field ambulation was examined. Male rats were castrated or sham-operated at days 21, 43 or 70. At the age of 17 weeks the males were tested in an automated, octagonal open field (3 consecutive days, 3 min/day) for locomotor activity. Male rats castrated at day 21 or day 43 ambulated more than sham-castrated controls. Males castrated at day 70 did not differ from sham-castrated controls. It thus appears that pubertal testicular secretion(s) organize adult open field locomotor activity in male rats. From 18 weeks of age partner preference behavior was tested in the same open field apparatus with one adjacent cage containing an ovariectomized female and an opposite one containing an ovariectomized female brought into heat. The females in the adjacent cages were separated from the experimental males in the octagonal cage by wire mesh. Peripubertally castrated males did not show a clear-cut partner preference, whereas the intact males preferred the vicinity of the estrous female. There were no differences among the males castrated either before, during or after puberty. Testosterone treatment (crystalline T in silastic capsules) caused peripubertally castrated males to prefer the estrous female. Thus, adult partner preference behavior does not seem to be organized by peripubertal testicular androgens.

  20. Rehabilitation of children and infants with osteogenesis imperfecta. A program for ambulation.

    Science.gov (United States)

    Gerber, L H; Binder, H; Weintrob, J; Grange, D K; Shapiro, J; Fromherz, W; Berry, R; Conway, A; Nason, S; Marini, J

    1990-02-01

    Management of children and infants with osteogenesis imperfecta (OI) poses difficult decisions for pediatricians, orthopedists, and physiatrists. These children are frequently frail with disabling bone and joint deformities and fractures. In an eight-year cumulative management of 12 children with OI, a comprehensive program included strengthening exercises to the pelvic girdle and lower extremity muscles, in addition to pool exercises and molded seating to support upright posture. Long leg braces were fitted when the children were able to sit unsupported. All 12 were fitted with braces; nine were functional ambulators, and three were home ambulators. Six children required femoral plating or rodding, two of whom subsequently had the metal removed. Lower extremity fractures averaged one and one-half per year prior to bracing for nine children who had fractures. There was 0.83 fracture per year for the ten children who had fractures after bracing. The degree of femoral bowing increased in four, decreased in four, and remained unchanged in four, while the degree of tibial bowing increased in two, decreased in nine, and remained unchanged in one during the observation period. A comprehensive rehabilitation program and long leg bracing with surgical operations on the femur result in a high level of functional activity for children with OI with an acceptable level of risk for fracture.

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

    Science.gov (United States)

    Langabeer, James R; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

    2016-11-01

    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. 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. 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 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. The relationship between airborne fine particle matter and emergency ambulance dispatches in a southwestern city in Chengdu, China

    International Nuclear Information System (INIS)

    Liu, Ruicong; Zeng, Jie; Jiang, Xianyan; Chen, Jianyu; Gao, Xufang; Zhang, Li; Li, Tiantian

    2017-01-01

    High levels of fine particulate matter (PM 2.5 ) are known to cause adverse effects to human health. The goal of this study was to estimate the acute health effects of short-term exposure to ambient PM 2.5 by analyzing cause-specific emergency ambulance dispatches as the endpoint in Chengdu, a city in Sichuan Province in southwest China. The ambient PM 2.5 concentration of Chengdu reached 63 μg/m 3 in 2015. Data related to the causes of specific emergency ambulance dispatches, air pollution, and meteorological conditions were collected from 2013 to 2015 (1095 days). A generalized additive model (GAM) was constructed to control the confounding conditions and to estimate the effects of PM 2.5 on human health conditions. Emergency ambulance dispatches for all causes with (RR for lag0 = 1.0010, 95%CI: 1.0002, 1.0019) or without injuries (RR for lag0 = 1.0012, 95%CI: 1.0002, 1.0022), respiratory diseases (RR for lag0 = 1.0051, 95%CI: 1.0012, 1.0089), and cardiovascular diseases (RR for lag0 = 1.0041, 95%CI: 1.0009, 1.0074) were associated with ambient PM 2.5 concentrations in Chengdu. In addition, the effects of PM 2.5 were not confounded by ozone. - Highlights: • Short-term exposure to PM 2.5 was associated to emergency ambulance dispatches. • PM 2.5 strongly affected ambulance dispatches for respiratory and cardiovascular diseases. • High PM 2.5 levels induced acute health effects in Chengdu and other east China cities. - PM 2.5 strongly affected emergency ambulance dispatches for respiratory and cardiovascular diseases in Chengdu, a southwestern city in China.

  3. Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke : Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project

    NARCIS (Netherlands)

    Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study

  4. Patterns of emergency ambulance use, 2009-13: a comparison of older people living in Residential Aged Care Facilities and the Community.

    Science.gov (United States)

    Dwyer, R; Gabbe, B; Tran, T D; Smith, K; Lowthian, J A

    2018-04-24

    to examine demand for emergency ambulances by older people. retrospective cohort study using secondary analysis of routinely collected clinical and administrative data from Ambulance Victoria, and population data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare. Victoria, Australia. people aged 65 years and over, living in Residential Aged Care Facilities (RACF) and the community, attended by emergency ambulance paramedics, 2009-13. rates of emergency ambulance attendance. older people living in RACF experienced high rates of emergency ambulance attendance, up to four times those for age- and sex-matched people living in the community. Rates remained constant during the study period equating to a consistent, 1.45% average annual increase in absolute demand. Rates peak among the 80-84-year group where the number of attendances equates to greater than one for every RACF-dwelling person each year. Increased demand was associated with winter months, increasing age and being male. these data provide strong evidence of high rates of emergency ambulance use by people aged 65 years and over living in RACF. These results demonstrate a clear relationship between increased rate of ambulance use among this vulnerable group of older Australians and residence, sex, age and season. Overall, absolute demand continues to increase each year adding to strain on health resources. Additional research is needed to elucidate individual characteristics, illness and health system contributors to ambulance use to inform strategies to appropriately reduce demand.

  5. Respiratory, cardiovascular and metabolic responses during different modes of overground bionic ambulation in persons with motor-incomplete spinal cord injury: A case series

    Directory of Open Access Journals (Sweden)

    Jochen Kressler

    2017-09-01

    Full Text Available Objective: To investigate the effects of overground bionic ambulation with variable assistance on cardiorespiratory and metabolic responses in persons with motor-incomplete spinal cord injury. Design: Case series. Subjects: Four participants with chronic, motor-incomplete spinal cord injury. Methods: Subjects completed a maximal graded exercise test on an arm-ergometer and 3 6-min bouts of overground bionic ambulation using different modes of assistance, i.e. Maximal, Adaptive, Fixed. Cardiorespiratory (oxygen consumption and metabolic (caloric expenditure and substrate utilization measures were taken using a mobile metabolic cart at each overground bionic ambulation assistance. Results: Cardiorespiratory responses ranged from low (24% VO2peak for the least impaired and fittest individual to supramaximal (124% VO2peak for the participant with the largest impairments and the lowest level of fitness. Different overground bionic ambulation assistive modes elicited small (3–8% VO2peak differences in cardiorespiratory responses for 3 participants. One participant had a large (28% VO2peak difference in cardiorespiratory responses to different modes of overground bionic ambulation. Metabolic responses mostly tracked closely with cardiorespiratory responses. Total energy expenditure ranged from 1.39 to 7.17 kcal/min. Fat oxidation ranged from 0.00 to 0.17 g/min across participants and different overground bionic ambulation modes. Conclusion: Overground bionic ambulation with variable assistance can substantially increase cardiorespiratory and metabolic responses; however, these responses vary widely across participants and overground bionic ambulation modes.

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

    Science.gov (United States)

    Aléx, Jonas; Karlsson, Stig; Björnstig, Ulf; Saveman, Britt-Inger

    2015-01-01

    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%, pthermal comfort and may prevent the negative consequences of cold stress.

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

    Science.gov (United States)

    Aléx, Jonas; Karlsson, Stig; Björnstig, Ulf; Saveman, Britt-Inger

    2015-01-01

    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. 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. 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%, pthermal comfort and may prevent the negative consequences of cold stress.

  8. What an ambulance nurse needs to know: a content analysis of curricula in the specialist nursing programme in prehospital emergency care.

    Science.gov (United States)

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

    2015-04-01

    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. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Jyoti V. Dube

    2014-01-01

    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

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

    Science.gov (United States)

    Raaber, Nikolaj; Duvald, Iben; Riddervold, Ingunn; Christensen, Erika F; Kirkegaard, Hans

    2016-03-31

    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 in an ED in order to investigate its effect on 1) wait time and unprepared activations of Trauma Teams (TT) and Medical Emergency Teams (MET) and 2) nurses' perceptions regarding patient reception, workflow and resource utilization. From May 1st 2014 to October 31th 2014, GIS data 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. In addition, it was used as a logistics tool for handling all other patients transported by ambulance to the ED. The study followed a mixed-methods design, consisting of a quantitative study (before and after intervention) and a qualitative study (survey and interviews). Participants included all patients received by TT or MET and coordinating nurses in the ED. 1.) Quantitative: 599 patients were included. The median wait time for TT and MET was 5 min both before and after the GIS intervention, showing no difference (p = 0.18). A significant reduction in the subgroup of waits >10 min was found (p GIS data as a tool to optimize resource utilization and quality of all patients' reception, critically or non-critically ill. No substantial disadvantages were reported. 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 by ambulance. The reduction in waits > 10

  11. A comparison of general and ambulance specific stressors: predictors of job satisfaction and health problems in a nationwide one-year follow-up study of Norwegian ambulance personnel

    Directory of Open Access Journals (Sweden)

    Lau Bjørn

    2011-03-01

    Full Text Available Abstract Objectives To address the relative importance of general job-related stressors, ambulance specific stressors and individual characteristics in relation to job satisfaction and health complaints (emotional exhaustion, psychological distress and musculoskeletal pain among ambulance personnel. Materials and methods A nationwide prospective questionnaire survey of ambulance personnel in operational duty at two time points (n = 1180 at baseline, T1 and n = 298 at one-year follow up, T2. The questionnaires included the Maslach Burnout Inventory, The Job Satisfaction Scale, Hopkins Symptom Checklist (SCL-10, Job Stress Survey, the Norwegian Ambulance Stress Survey and the Basic Character Inventory. Results Overall, 42 out of the possible 56 correlations between job stressors at T1 and job satisfaction and health complaints at T2 were statistically significant. Lower job satisfaction at T2 was predicted by frequency of lack of leader support and severity of challenging job tasks. Emotional exhaustion at T2 was predicted by neuroticism, frequency of lack of support from leader, time pressure, and physical demands. Adjusted for T1 levels, emotional exhaustion was predicted by neuroticism (beta = 0.15, p Psychological distress at T2 was predicted by neuroticism and lack of co-worker support. Adjusted for T1 levels, psychological distress was predicted by neuroticism (beta = 0.12, p Musculoskeletal pain at T2 was predicted by, higher age, neuroticism, lack of co-worker support and severity of physical demands. Adjusted for T1 levels, musculoskeletal pain was predicted neuroticism, and severity of physical demands (beta = 0.12, p Conclusions Low job satisfaction at T2 was predicted by general work-related stressors, whereas health complaints at T2 were predicted by both general work-related stressors and ambulance specific stressors. The personality variable neuroticism predicted increased complaints across all health outcomes.

  12. Body weight-supported bedside treadmill training facilitates ambulation in ICU patients: An interventional proof of concept study

    NARCIS (Netherlands)

    Sommers, Juultje; Wieferink, Denise C.; Dongelmans, Dave A.; Nollet, Frans; Engelbert, Raoul H. H.; van der Schaaf, Marike

    2017-01-01

    Purpose: Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore

  13. 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

    2014-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Jorge Luis Alvarado‐Socarras

    2016-05-01

    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.

  15. Day-to-day consistency of lower extremity kinematics during stair ambulation in 24-45 years old athletes.

    Science.gov (United States)

    Husa-Russell, Johanna; Ukelo, Thomas; List, Renate; Lorenzetti, Silvio; Wolf, Peter

    2011-04-01

    Before making interpretations on the effects of interventions or on the features of pathological gait patterns during stair ambulation, the day-to-day consistency of the investigated variables must be established. In this article, the day-to-day consistency was determined for kinematic variables during barefoot stair ambulation. Ten healthy athletes performed two gait analysis sessions, at least one week apart, utilizing a marker set of 47 skin markers, and a functional joint center/axes determination. Being found on limits of agreement and mean differences between the repeated stair ambulation sessions, totally 43 ranges of motions were examined at the hip, knee, ankle, and midfoot joints. The day-to-day consistency was generally in the magnitude of three degrees, irrespective of test condition, investigated joint, or regarded cardinal body plane. The reported values of the day-to-day consistency provide guidelines to distinguish between pathological and healthy gait patterns, and thresholds to determine minimal effects of interventions during stair ambulation. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Hippotherapy effects on trunk, pelvic, and hip motion during ambulation in children with neurological impairments.

    Science.gov (United States)

    Encheff, Jenna L; Armstrong, Charles; Masterson, Michelle; Fox, Christine; Gribble, Phillip

    2012-01-01

    This study investigated the effects of a 10-week hippotherapy program on trunk, pelvis, and hip joint positioning during the stance phase of gait. Eleven children (6 boys and 5 girls; 7.9 ± 2.7 years) with neurological disorders and impaired ambulation participated. Joint range of motion data were collected via 3-dimensional computerized gait analysis before and after the program. Paired t tests were performed on kinematic data for each joint. Significant improvements (P ≤ .008) and large effect sizes (ESs) for sagittal plane hip positions at initial contact and toe-off were found. No differences in pelvic or trunk positioning were determined, although sagittal plane pelvic positioning displayed a trend toward improvement with large ESs. Several trunk variables displayed moderate ESs with a trend toward more upright positioning. Improvements in pelvic and hip joint positioning and more normalized vertical trunk position may indicate increased postural control during gait after 10 sessions of hippotherapy.

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

    DEFF Research Database (Denmark)

    Jenstrup, M T; Jæger, P; Lund, J

    2012-01-01

    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 hypothe...... 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.......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...

  18. Objectively measured work load, health status and sickness absence among Danish ambulance personnel. A longitudinal study

    DEFF Research Database (Denmark)

    Hansen, Claus D.

    2013-01-01

    Background: Reviews show that ambulance personnel (AP) have an increased risk of work-related health problems especially musculoskeletal disorders. Because of the unpredictable character of the AP’s work environment, standard measures of work environment exposures are imprecise. The aim...... of this presentation is to examine the associations between objectively measured work load taken from the company register, health and long-term sickness absence (LTSA) in 1-year follow up period. Methods: Data is taken from the first round of MARS – Men, accidents, risk and safety, a two wave panel study of AP...... workers in Denmark (n = 1606) collected in winter 2010/11. The response rate to the questionnaire was 62% in the baseline. The respondents were asked about health status, physical (DMQ) and psychosocial work environment factors (COPSOQ). Information from the company register about work load (e.g. mean...

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

    Directory of Open Access Journals (Sweden)

    M Kit Delgado

    2013-09-01

    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.

  20. Managing emergency department overcrowding via ambulance diversion: a discrete event simulation model.

    Science.gov (United States)

    Lin, Chih-Hao; Kao, Chung-Yao; Huang, Chong-Ye

    2015-01-01

    Ambulance diversion (AD) is considered one of the possible solutions to relieve emergency department (ED) overcrowding. Study of the effectiveness of various AD strategies is prerequisite for policy-making. Our aim is to develop a tool that quantitatively evaluates the effectiveness of various AD strategies. A simulation model and a computer simulation program were developed. Three sets of simulations were executed to evaluate AD initiating criteria, patient-blocking rules, and AD intervals, respectively. The crowdedness index, the patient waiting time for service, and the percentage of adverse patients were assessed to determine the effect of various AD policies. Simulation results suggest that, in a certain setting, the best timing for implementing AD is when the crowdedness index reaches the critical value, 1.0 - an indicator that ED is operating at its maximal capacity. The strategy to divert all patients transported by ambulance is more effective than to divert either high-acuity patients only or low-acuity patients only. Given a total allowable AD duration, implementing AD multiple times with short intervals generally has better effect than having a single AD with maximal allowable duration. An input-throughput-output simulation model is proposed for simulating ED operation. Effectiveness of several AD strategies on relieving ED overcrowding was assessed via computer simulations based on this model. By appropriate parameter settings, the model can represent medical resource providers of different scales. It is also feasible to expand the simulations to evaluate the effect of AD strategies on a community basis. The results may offer insights for making effective AD policies. Copyright © 2012. Published by Elsevier B.V.

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

    Directory of Open Access Journals (Sweden)

    Jone Vencloviene

    2015-02-01

    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.

  2. Longitudinal effect of eteplirsen versus historical control on ambulation in Duchenne muscular dystrophy

    Science.gov (United States)

    Goemans, Nathalie; Lowes, Linda P.; Alfano, Lindsay N.; Berry, Katherine; Shao, James; Kaye, Edward M.; Mercuri, Eugenio; Hamid, Hoda Abdel; Byrne, Barry J.; Connolly, Anne M.; Dracker, Robert A.; Matthew Frank, L.; Heydemann, Peter T.; O'Brien, Kevin C.; Sparks, Susan E.; Specht, Linda A.; Rodino‐Klapac, Louise; Sahenk, Zarife; Al‐Zaidy, Samiah; Cripe, Linda H.; Lewis, Sarah; M, Pane; E, Mazzone; S, Messina; GL, Vita; Bertini, D Amico A; Casimiro, Berardinelli A; Y, Torrente; F, Magri; GP, Comi; G, Baranello; T, Mongini; A, Pini; R, Battini; E, Pegoraro; C, Bruno; L, Politano; S, Previtali

    2016-01-01

    Objective To continue evaluation of the long‐term efficacy and safety of eteplirsen, a phosphorodiamidate morpholino oligomer designed to skip DMD exon 51 in patients with Duchenne muscular dystrophy (DMD). Three‐year progression of eteplirsen‐treated patients was compared to matched historical controls (HC). Methods Ambulatory DMD patients who were ≥7 years old and amenable to exon 51 skipping were randomized to eteplirsen (30/50mg/kg) or placebo for 24 weeks. Thereafter, all received eteplirsen on an open‐label basis. The primary functional assessment in this study was the 6‐Minute Walk Test (6MWT). Respiratory muscle function was assessed by pulmonary function testing (PFT). Longitudinal natural history data were used for comparative analysis of 6MWT performance at baseline and months 12, 24, and 36. Patients were matched to the eteplirsen group based on age, corticosteroid use, and genotype. Results At 36 months, eteplirsen‐treated patients (n = 12) demonstrated a statistically significant advantage of 151m (p < 0.01) on 6MWT and experienced a lower incidence of loss of ambulation in comparison to matched HC (n = 13) amenable to exon 51 skipping. PFT results remained relatively stable in eteplirsen‐treated patients. Eteplirsen was well tolerated. Analysis of HC confirmed the previously observed change in disease trajectory at age 7 years, and more severe progression was observed in patients with mutations amenable to exon skipping than in those not amenable. The subset of patients amenable to exon 51 skipping showed a more severe disease course than those amenable to any exon skipping. Interpretation Over 3 years of follow‐up, eteplirsen‐treated patients showed a slower rate of decline in ambulation assessed by 6MWT compared to untreated matched HC. Ann Neurol 2016;79:257–271 PMID:26573217

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

    Directory of Open Access Journals (Sweden)

    James Robert Langabeer

    2016-11-01

    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.

  4. Methodology for the location of PMU for the monitoring of critical oscillations in power systems; Metodologia para la ubicacion de PMU para el monitoreo de oscilaciones criticas en sistemas electricos de potencia

    Energy Technology Data Exchange (ETDEWEB)

    Calderon Guizar, Jorge Guillermo [Instituto de Investigaciones Electricas, Cuernavaca, Morelos (Mexico)

    2009-07-01

    The deregulation and restructuring undergone by the electrical industry, as well as the tendency at world-wide level of reorganization in generation, transmission and distribution units has brought about, as a consequence, drastic changes in the operation of the electric power systems. The difficulties to construct new transmission power lines and the continuous increase in the electricity consumption are forcing more and more to operate the electric power systems every time nearer their safety limits. Nevertheless, to assure the system reliability without mattering what so plaintiff is the operating condition is a requirement that the electrical companies must satisfy. This panorama has motivated and impelled the use of new technologies for the critical indicators the monitoring that allow the electrical companies to guarantee the system safe operation. In this paper a methodology for the location of Fasorial Measurement Units, better known as FMU for the monitoring of the critical oscillation modes in the electric power systems is presented. [Spanish] La desregulacion y reestructuracion experimentada por la industria electrica, asi como la tendencia a nivel mundial de reorganizacion en unidades de generacion, transmision y distribucion ha traido como consecuencia cambios drasticos en la operacion de los sistemas electricos de potencia. Las dificultades para construir nuevas lineas de transmision y el incremento continuo en el consumo de electricidad estan forzando a operar el sistema electrico de potencia cada vez mas cerca de sus limites de seguridad. Sin embargo, asegurar la confiabilidad del sistema sin importar que tan demandante sea la condicion de operacion es un requisito que las companias electricas deben satisfacer. Este panorama ha motivado e impulsado el uso de nuevas tecnologias para el monitoreo de indicadores criticos que permitan a las companias electricas garantizar una operacion segura del sistema. En este trabajo se presenta una metodologia para

  5. Localização de áreas de monitoramento telemétrico em ambientes aquáticos da Amazônia Location of telemetric monitoring sites in Amazon floodplain lakes

    Directory of Open Access Journals (Sweden)

    Ivan Bergier Tavares de Lima

    2006-01-01

    Full Text Available O presente trabalho demonstra a aplicabilidade de imagens de sensoriamento remoto e de métodos de processamento de imagens digitais para definição de locais adequados à instalação de sistemas telemétricos de monitoramento de variáveis ambientais em sistemas aquáticos, localizados em regiões de difícil acesso. A técnica consiste essencialmente da aplicação de operações Booleanas entre mapas da pluma do Rio Amazonas e de zonas inundadas do Lago de Curuai em diferentes etapas do ciclo hidrológico. A localização exata para o sistema de monitoramento telemétrico será vital para o desenvolvimento de modelos de troca de gases traço entre a planície de inundação Amazônica e a atmosfera.The present work illustrates the application of remote sensing and image processing methods to define appropriate sites for installing buoy moored telemetric systems at the surface of Amazon floodplain lakes for long-term limnologic-micrometeorologic monitoring. The technique consists essentially of Boolean operations over Amazon plume maps and historic inundation of the Curuai Lake at distinct stages of the hydrologic cycle. The precise location for the long-term monitoring is vital to the development of models concerning air-water trace gas exchange in the Amazon floodplains.

  6. Privacy for location-based services

    CERN Document Server

    Ghinita, Gabriel

    2013-01-01

    Sharing of location data enables numerous exciting applications, such as location-based queries, location-based social recommendations, monitoring of traffic and air pollution levels, etc. Disclosing exact user locations raises serious privacy concerns, as locations may give away sensitive information about individuals' health status, alternative lifestyles, political and religious affiliations, etc. Preserving location privacy is an essential requirement towards the successful deployment of location-based applications. These lecture notes provide an overview of the state-of-the-art in locatio

  7. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test.

    Science.gov (United States)

    Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

    2015-10-01

    The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p < 0.001). The 12-month changes ranged between -20 and 4 (mean -4.4). The mean changes were -3.79 in the glucocorticoid group, -5.52 in those who stopped at loss of ambulation and -4.44 in the naïve group. This was more obvious in the patients between 12 and 18 years and at shoulder and elbow levels. Our findings suggest that continuing glucocorticoids throughout teenage years and adulthood after loss of ambulation appears to have a beneficial effect on upper limb function. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  8. The potential benefits of location-specific biometeorological indexes

    Science.gov (United States)

    Wong, Ho Ting; Wang, Jinfeng; Yin, Qian; Chen, Si; Lai, Poh Chin

    2017-09-01

    It is becoming popular to use biometeorological indexes to study the effects of weather on human health. Most of the biometeorological indexes were developed decades ago and only applicable to certain locations because of different climate types. Merely using standard biometeorological indexes to replace typical weather factors in biometeorological studies of different locations may not be an ideal research direction. This research is aimed at assessing the difference of statistical power between using standard biometeorological indexes and typical weather factors on describing the effects of extreme weather conditions on daily ambulance demands in Hong Kong. Results showed that net effective temperature and apparent temperature did not perform better than typical weather factors in describing daily ambulance demands in this study. The maximum adj- R 2 improvement was only 0.08, whereas the maximum adj- R 2 deterioration was 0.07. In this study, biometeorological indexes did not perform better than typical weather factors, possibly due to the differences of built environments and lifestyles in different locations and eras. Regarding built environments, the original parameters for calculating the index values may not be applicable to Hong Kong as buildings in Hong Kong are extremely dense and most are equipped with air conditioners. Regarding lifestyles, the parameters, which were set decades ago, may be outdated and not suitable to modern lifestyles as using hand-held electrical fans on the street to help reduce heat stress are popular. Hence, it is ideal to have tailor-made updated location-specific biometeorological indexes to study the effects of weather on human health.

  9. Planning like an Olympian. How London Ambulance Service successfully handled their 'summer of sport'.

    Science.gov (United States)

    Killens, Jason

    2013-03-01

    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

  10. Predicting Ambulance Time of Arrival to the Emergency Department Using Global Positioning System and Google Maps

    Science.gov (United States)

    Fleischman, Ross J.; Lundquist, Mark; Jui, Jonathan; Newgard, Craig D.; Warden, Craig

    2014-01-01

    Objective To derive and validate a model that accurately predicts ambulance arrival time that could be implemented as a Google Maps web application. Methods This was a retrospective study of all scene transports in Multnomah County, Oregon, from January 1 through December 31, 2008. Scene and destination hospital addresses were converted to coordinates. ArcGIS Network Analyst was used to estimate transport times based on street network speed limits. We then created a linear regression model to improve the accuracy of these street network estimates using weather, patient characteristics, use of lights and sirens, daylight, and rush-hour intervals. The model was derived from a 50% sample and validated on the remainder. Significance of the covariates was determined by p times recorded by computer-aided dispatch. We then built a Google Maps-based web application to demonstrate application in real-world EMS operations. Results There were 48,308 included transports. Street network estimates of transport time were accurate within 5 minutes of actual transport time less than 16% of the time. Actual transport times were longer during daylight and rush-hour intervals and shorter with use of lights and sirens. Age under 18 years, gender, wet weather, and trauma system entry were not significant predictors of transport time. Our model predicted arrival time within 5 minutes 73% of the time. For lights and sirens transports, accuracy was within 5 minutes 77% of the time. Accuracy was identical in the validation dataset. Lights and sirens saved an average of 3.1 minutes for transports under 8.8 minutes, and 5.3 minutes for longer transports. Conclusions An estimate of transport time based only on a street network significantly underestimated transport times. A simple model incorporating few variables can predict ambulance time of arrival to the emergency department with good accuracy. This model could be linked to global positioning system data and an automated Google Maps web

  11. Violence against ambulance personnel: a retrospective cohort study of national data from Safe Work Australia

    Directory of Open Access Journals (Sweden)

    Brian J Maguire

    2018-03-01

    Full Text Available Objectives and importance: Paramedics have high rates of occupational injury and fatality. The objective of this study is to describe their specific risks of violence-related injury. Study type: This retrospective cohort study is an examination of retrospective data provided by Safe Work Australia (SWA. Methods: An examination of the 300 cases of serious claims of injury related to assaults, violence, harassment and bullying that occurred among individuals identified as ambulance officers and paramedics in Australia from 2001 to 2014. Paramedic risks likely vary by exposures such as hours worked and call volume. To examine how those exposures may influence risk, the available data were used to estimate rates based on hours worked and call volume. Results: The data show that, for serious injuries among paramedics in Australia between 2001 and 2014, the total number of violence-related cases increased from 5 to 40 per year; the number of cases of injury secondary to assault tripled from 10 to 30; and the rate of cases by call volume doubled from 6 to 12. The cost of these injuries was approximately AUD$250 000 for the year 2013–14. The median time at work lost per individual case of ‘work-related harassment and/or workplace bullying’ was 9.6 weeks. Although females comprised 32% of the paramedic workforce, they were the victims in 42% of cases of exposure to violence and 40% of harassment cases. Conclusions: Although anecdotal reports indicate that some interventions have been attempted, violence against paramedics continues to be a growing problem in Australia. The data presented in this study allow for a better understanding of the problem and can support efforts by ambulance service administrators, physicians, paramedics and university researchers to work together to develop and publish evidence based, cost-effective solutions to reduce the risk of workplace violence. Effective solutions will likely be multifaceted and include training

  12. A Location Privacy Aware Friend Locator

    DEFF Research Database (Denmark)

    Siksnys, Laurynas; Thomsen, Jeppe Rishede; Saltenis, Simonas

    2009-01-01

    to trade their location privacy for quality of service, limiting the attractiveness of the services. The challenge is to develop a communication-efficient solution such that (i) it detects proximity between a user and the user’s friends, (ii) any other party is not allowed to infer the location of the user...

  13. Five-year mortality after acute poisoning treated in ambulances, an emergency outpatient clinic and hospitals in Oslo.

    Science.gov (United States)

    Lund, Cathrine; Bjornaas, Mari A; Sandvik, Leiv; Ekeberg, Oivind; Jacobsen, Dag; Hovda, Knut E

    2013-08-21

    The long-term mortality after prehospital treatment for acute poisoning has not been studied previously. Thus, we aimed to estimate the five-year mortality and examine the causes of death and predictors of death for all acutely poisoned patients treated in ambulances, the emergency outpatient clinic, and hospitals in Oslo during 2003-2004. A prospective cohort study included all adults (≥16 years; n=2045, median age=35 years, male=58%) who were discharged after treatment for acute poisoning in ambulances, the emergency outpatient clinic, and the four hospitals in Oslo during one year. The patients were observed until the end of 2008. Standardized mortality rates (SMRs) were calculated and multivariate Cox regression analysis was applied. The study comprised 2045 patients; 686 treated in ambulances, 646 treated in the outpatient clinic, and 713 treated in hospitals. After five years, 285 (14%) patients had died (four within one week). The SMRs after ambulance, outpatient, and hospital treatment were 12 (CI 9-14), 10 (CI 8-12), and 6 (CI 5-7), respectively. The overall SMR was 9 (CI 8-10), while the SMR after opioid poisoning was 27 (CI 21-32). The most frequent cause of death was accidents (38%). In the regression analysis, opioids as the main toxic agents (HR 2.3, CI 1.6-3.0), older age (HR 1.6, CI 1.5-1.7), and male sex (HR 1.4, CI 1.1-1.9) predicted death, whereas the treatment level did not predict death. The patients had high mortality compared with the general population. Those treated in hospital had the lowest mortality. Opioids were the major predictor of death.

  14. Exploration of contextual factors in a successful quality improvement collaborative in English ambulance services: cross‐sectional survey

    Science.gov (United States)

    Phung, Viet‐Hai; Essam, Nadya; Asghar, Zahid; Spaight, Anne

    2015-01-01

    Abstract Rationale, aims and objectives Clinical leadership and organizational culture are important contextual factors for quality improvement (QI) but the relationship between these and with organizational change is complex and poorly understood. We aimed to explore the relationship between clinical leadership, culture of innovation and clinical engagement in QI within a national ambulance QI Collaborative (QIC). Methods We used a self‐administered online questionnaire survey sent to front‐line clinicians in all 12 English ambulance services. We conducted a cross‐sectional analysis of quantitative data and qualitative analysis of free‐text responses. Results There were 2743 (12% of 22 117) responses from 11 of the 12 participating ambulance services. In the 3% of responders that were directly involved with the QIC, leadership behaviour was significantly higher than for those not directly involved. QIC involvement made no significant difference to responders' perceptions of the culture of innovation in their organization, which was generally considered poor. Although uptake of QI methods was low overall, QIC members were significantly more likely to use QI methods, which were also significantly associated with leadership behaviour. Conclusions Despite a limited organizational culture of innovation, clinical leadership and use of QI methods in ambulance services generally, the QIC achieved its aims to significantly improve pre‐hospital care for acute myocardial infarction and stroke. We postulate that this was mediated through an improvement subculture, linked to the QIC, which facilitated large‐scale improvement by stimulating leadership and QI methods. Further research is needed to understand success factors for QI in complex health care environments. PMID:26303398

  15. North Star Ambulatory Assessment, 6-minute walk test and timed items in ambulant boys with Duchenne muscular dystrophy.

    Science.gov (United States)

    Mazzone, Elena; Martinelli, Diego; Berardinelli, Angela; Messina, Sonia; D'Amico, Adele; Vasco, Gessica; Main, Marion; Doglio, Luca; Politano, Luisa; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Carlesi, Adelina; Bonetti, Anna Maria; Zucchini, Elisabetta; De Sanctis, Roberto; Scutifero, Marianna; Bianco, Flaviana; Rossi, Francesca; Motta, Maria Chiara; Sacco, Annalisa; Donati, Maria Alice; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Pane, Marika; Pasquini, Elisabetta; Bruno, Claudio; Vita, Giuseppe; de Waure, Chiara; Bertini, Enrico; Mercuri, Eugenio

    2010-11-01

    The North Star Ambulatory Assessment is a functional scale specifically designed for ambulant boys affected by Duchenne muscular dystrophy (DMD). Recently the 6-minute walk test has also been used as an outcome measure in trials in DMD. The aim of our study was to assess a large cohort of ambulant boys affected by DMD using both North Star Assessment and 6-minute walk test. More specifically, we wished to establish the spectrum of findings for each measure and their correlation. This is a prospective multicentric study involving 10 centers. The cohort included 112 ambulant DMD boys of age ranging between 4.10 and 17 years (mean 8.18±2.3 DS). Ninety-one of the 112 were on steroids: 37/91 on intermittent and 54/91 on daily regimen. The scores on the North Star assessment ranged from 6/34 to 34/34. The distance on the 6-minute walk test ranged from 127 to 560.6 m. The time to walk 10 m was between 3 and 15 s. The time to rise from the floor ranged from 1 to 27.5 s. Some patients were unable to rise from the floor. As expected the results changed with age and were overall better in children treated with daily steroids. The North Star assessment had a moderate to good correlation with 6-minute walk test and with timed rising from floor but less with 10 m timed walk/run test. The 6-minute walk test in contrast had better correlation with 10 m timed walk/run test than with timed rising from floor. These findings suggest that a combination of these outcome measures can be effectively used in ambulant DMD boys and will provide information on different aspects of motor function, that may not be captured using a single measure. Copyright © 2010. Published by Elsevier B.V.

  16. 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

    2015-09-01

    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.

  17. Development and pilot testing of 24/7 in-ambulance telemedicine for acute stroke : prehospital stroke study at the Universitair Ziekenhuis Brussel-project

    OpenAIRE

    Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    Abstract: Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Methods: Successful execution of the project involved the develop...

  18. Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project

    OpenAIRE

    Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Methods: Successful execution of the project involved the development and v...

  19. Impact of an implanted neuroprosthesis on community ambulation in incomplete SCI.

    Science.gov (United States)

    Lombardo, Lisa M; Kobetic, Rudolf; Pinault, Gilles; Foglyano, Kevin M; Bailey, Stephanie N; Selkirk, Stephen; Triolo, Ronald J

    2018-03-01

    Test the effect of a multi-joint control with implanted electrical stimulation on walking after spinal cord injury (SCI). Single subject research design with repeated measures. Hospital-based biomechanics laboratory and user assessment of community use. Female with C6 AIS C SCI 30 years post injury. Lower extremity muscle activation with an implanted pulse generator and gait training. Walking speed, maximum distance, oxygen consumption, upper extremity (UE) forces, kinematics and self-assessment of technology. Short distance walking speed at one-year follow up with or without stimulation was not significantly different from baseline. However, average walking speed was significantly faster (0.22 m/s) with stimulation over longer distances than volitional walking (0.12 m/s). In addition, there was a 413% increase in walking distance from 95 m volitionally to 488 m with stimulation while oxygen consumption and maximum upper extremity forces decreased by 22 and 16%, respectively. Stimulation also produced significant (P ≤ 0.001) improvements in peak hip and knee flexion, ankle angle at foot off and at mid-swing. An implanted neuroprosthesis enabled a subject with incomplete SCI to walk longer distances with improved hip and knee flexion and ankle dorsiflexion resulting in decreased oxygen consumption and UE support. Further research is required to determine the robustness, generalizability and functional implications of implanted neuroprostheses for community ambulation after incomplete SCI.

  20. Effects of weather and heliophysical conditions on emergency ambulance calls for elevated arterial blood pressure.

    Science.gov (United States)

    Vencloviene, Jone; Babarskiene, Ruta M; Dobozinskas, Paulius; Sakalyte, Gintare; Lopatiene, Kristina; Mikelionis, Nerijus

    2015-02-27

    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 Tweather conditions. These results may help in the understanding of the population's sensitivity to different weather conditions.

  1. Identifying rural-urban differences in the predictors of emergency ambulance service demand and misuse.

    Science.gov (United States)

    Wong, Ho Ting; Lin, Teng-Kang; Lin, Jen-Jia

    2018-06-13

    This study aims to assess rural-urban differences in the predictors of emergency ambulance service (EAS) demand and misuse in New Taipei City. Identifying the predictors of EAS demand will help the EAS service managing authority in formulating focused policies to maintain service quality. Over 160,000 electronic EAS usage records were used with a negative binomial regression model to assess rural-urban differences in the predictors of EAS demand and misuse. The factors of 1) ln-transformed population density, 2) percentage of residents who completed up to junior high school education, 3) accessibility of hospitals without an emergency room, and 4) accessibility of EAS were found to be predictors of EAS demand in rural areas, whereas only the factor of percentage of people aged above 65 was found to predict EAS demand in urban areas. For EAS misuse, only the factor of percentage of low-income households was found to be a predictor in rural areas, whereas no predictor was found in the urban areas. Results showed that the factors predicting EAS demand and misuse in rural areas were more complicated compared to urban areas and, therefore, formulating EAS policies for rural areas based on the results of urban studies may not be appropriate. Copyright © 2018. Published by Elsevier B.V.

  2. Gait characteristics, balance performance and falls in ambulant adults with cerebral palsy: An observational study.

    Science.gov (United States)

    Morgan, P; Murphy, A; Opheim, A; McGinley, J

    2016-07-01

    The relationship between spatiotemporal gait parameters, balance performance and falls history was investigated in ambulant adults with cerebral palsy (CP). Participants completed a single assessment of gait using an instrumented walkway at preferred and fast speeds, balance testing (Balance Evaluation Systems Test; BESTest), and reported falls history. Seventeen ambulatory adults with CP, mean age 37 years, participated. Gait speed was typically slow at both preferred and fast speeds (mean 0.97 and 1.21m/s, respectively), with short stride length and high cadence relative to speed. There was a significant, large positive relationship between preferred gait speed and BESTest total score (ρ=0.573; pfalls taking shorter strides. Faster gait speed was associated with better performance on tests of anticipatory and postural response components of the BESTest, suggesting potential therapeutic training targets to address either gait speed or balance performance. Future exploration of the implications of slow walking speed and reduced stride length on falls and community engagement, and the potential prognostic value of stride length on identifying falls risk is recommended. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  3. Police Mental Health Partnership project: Police Ambulance Crisis Emergency Response (PACER) model development.

    Science.gov (United States)

    Huppert, David; Griffiths, Matthew

    2015-10-01

    To review internationally recognized models of police interactions with people experiencing mental health crises that are sometimes complex and associated with adverse experience for the person in crisis, their family and emergency service personnel. To develop, implement and review a partnership model trial between mental health and emergency services that offers alternative response pathways with improved outcomes in care. Three unique models of police and mental health partnership in the USA were reviewed and used to develop the PACER (Police Ambulance Crisis Emergency Response) model. A three month trial of the model was implemented and evaluated. Significant improvements in response times, the interactions with and the outcomes for people in crisis were some of the benefits shown when compared with usual services. The pilot showed that a partnership involving mental health and police services in Melbourne, Australia could be replicated based on international models. Initial data supported improvements compared with usual care. Further data collection regarding usual care and this new model is required to confirm observed benefits. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  4. Evaluation of a Novel Wireless Transmission System for Trauma Ultrasound Examinations From Moving Ambulances.

    Science.gov (United States)

    Morchel, Herman; Ogedegbe, Chinwe; Chaplin, William; Cheney, Brianna; Zakharchenko, Svetlana; Misch, David; Schwartz, Matthew; Feldman, Joseph; Kaul, Sanjeev

    2018-03-01

    To determine if physicians trained in ultrasound interpretation perceive a difference in image quality and usefulness between Extended Focused Assessment with Sonography ultrasound examinations performed at bedside in a hospital vs. by emergency medical technicians minimally trained in medical ultrasound on a moving ambulance and transmitted to the hospital via a novel wireless system. In particular, we sought to demonstrate that useful images could be obtained from patients in less than optimal imaging conditions; that is, while they were in transport. Emergency medical technicians performed the examinations during transport of blunt trauma patients. Upon patient arrival at the hospital, a bedside Extended Focused Assessment with Sonography examination was performed by a physician. Both examinations were recorded and later reviewed by physicians trained in ultrasound interpretation. Data were collected on 20 blunt trauma patients over a period of 13 mo. Twenty ultrasound-trained physicians blindly compared transmitted vs. bedside images using 11 Questionnaire for User Interaction Satisfaction scales. Four paired samples t-tests were conducted to assess mean differences between ratings for ambulatory and base images. Although there is a slight tendency for the average rating across all subjects and raters to be slightly higher in the base than in the ambulatory condition, none of these differences are statistically significant. These results suggest that the quality of the ambulatory images was viewed as essentially as good as the quality of the base images.

  5. Issues in recruiting community-dwelling stroke survivors to clinical trials: the AMBULATE trial.

    Science.gov (United States)

    Lloyd, Gemma; Dean, Catherine M; Ada, Louise

    2010-07-01

    Recruitment to clinical trials is often slow and difficult, with a growing body of research examining this issue. However there is very little work related to stroke. The aim of this study was to examine the success and efficiency of recruitment of community-dwelling stroke survivors over the first two years of a clinical trial aiming to improve community ambulation. Recruitment strategies fell into 2 broad categories: (i) advertisement (such as newspaper advertising and media releases), and (ii) referral (via hospital and community physiotherapists, a stroke liaison officer and other researchers). Records were kept of the number of people who were screened, were eligible and were recruited for each strategy. The recruitment target of 60 in the first two years was not met. 111 stroke survivors were screened and 57 were recruited (i.e., a recruitment rate of 51%). The most successful strategy was referral via hospital-based physiotherapists (47% of recruited participants) and the least successful were media release and local newspaper advertising. The referral strategies were all more efficient than any of the advertisement strategies. In general, recruitment was inefficient and costly in terms of human resources. Given that stroke research is underfunded, it is important to find efficient ways of recruiting stroke survivors to clinical trials. An Australian national database similar to other disease-specific data bases (such as the National Cancer Database) is under development. In the interim, recruiting for several clinical trials at once may increase efficiency.

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

    Directory of Open Access Journals (Sweden)

    Wakyo Sato

    2016-01-01

    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.

  7. Creative prosthetic foot selection enables successful ambulation in stiletto high heels.

    Science.gov (United States)

    Russell Esposito, Elizabeth; Lipe, Delbert H; Rábago, Christopher A

    2017-11-01

    Walking in high heels presents biomechanical challenges, yet they remain part of many women's attire. However, women with a lower limb amputation are limited in available footwear options. Case description and methods: This case study is in response to one patient's assertion that she walked better and more symmetrically in heels than flat shoes with her below-knee prosthesis. She underwent gait analysis in athletic shoes and 10-cm stiletto high heels worn with a pediatric running foot to determine if these claims could be substantiated through biomechanical measures. Global gait asymmetry indices were calculated. Findings and outcomes: Asymmetry indices were nearly identical between athletic shoes and heels but joint-level findings differed substantially. Ankle mechanics were more symmetrical in heels but hip mechanics were less. The maintenance of symmetry in stiletto high heels does not imply maintenance of gait quality, as high heels are known to adversely affect some components walking mechanics. Clinical relevance Returning to high-heel wear is achievable for prosthesis users. Accommodations can be made using creativity in prosthetic foot selection to enable successful ambulation; however, attention to gait mechanics may be important for patient safety.

  8. Quality of closed chest compression on a manikin in ambulance vehicles and flying helicopters with a real time automated feedback.

    Science.gov (United States)

    Havel, Christof; Schreiber, Wolfgang; Trimmel, Helmut; Malzer, Reinhard; Haugk, Moritz; Richling, Nina; Riedmüller, Eva; Sterz, Fritz; Herkner, Harald

    2010-01-01

    Automated verbal and visual feedback improves quality of resuscitation in out-of-hospital cardiac arrest and was proven to increase short-term survival. Quality of resuscitation may be hampered in more difficult situations like emergency transportation. Currently there is no evidence if feedback devices can improve resuscitation quality during different modes of transportation. To assess the effect of real time automated feedback on the quality of resuscitation in an emergency transportation setting. Randomised cross-over trial. Medical University of Vienna, Vienna Municipal Ambulance Service and Helicopter Emergency Medical Service Unit (Christophorus Flugrettungsverein) in September 2007. European Resuscitation Council (ERC) certified health care professionals performing CPR in a flying helicopter and in a moving ambulance vehicle on a manikin with human-like chest properties. CPR sessions, with real time automated feedback as the intervention and standard CPR without feedback as control. Quality of chest compression during resuscitation. Feedback resulted in less deviation from ideal compression rate 100 min(-1) (9+/-9 min(-1), ptime. Applied work was less in the feedback group compared to controls (373+/-448 cm x compression; ptime automated feedback improves certain aspects of CPR quality in flying helicopters and moving ambulance vehicles. The effect of feedback guidance was most pronounced for chest compression rate. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  9. Use of 3G mobile phone links for teleconsultation between a moving ambulance and a hospital base station.

    Science.gov (United States)

    Banitsas, Konstantinos A; Perakis, Konstantinos; Tachakra, Sapal; Koutsouris, Dimitrios

    2006-01-01

    We developed a mobile teleconsultation system based on third-generation mobile phone links. The system comprised a laptop computer and a digital camcorder. It was installed inside an ambulance to allow video-conferencing between the moving vehicle and a doctor at a base station. In addition to video and voice, high-quality still images could also be transmitted. A series of 17 trial runs with real ambulance patients was conducted in the city of Athens. In general, the videoconferencing sessions produced relatively clear video. The bandwidth was high enough for a satisfactory video of 10-15 frames/s. During a total testing period of 23 h and in an area of about 180 km2, there were nine instances of signal loss, amounting to a total of 17 min. The general opinion formed by the doctors was that the system produced good results. All initial diagnoses made using the system agreed with the final diagnoses of the patients. The study showed that the mobile system could reduce the time before an ambulance patient is seen by a doctor.

  10. Onderzoek Location Based Marketing: Mobile = location = effect

    NARCIS (Netherlands)

    Gisbergen, M.S. van; Huhn, A.E.; Khan, V.J.; Ketelaar, P.E.

    2011-01-01

    Onderzoekers van de NHTV (Internationaa Hoger Onderwijs Breda, Radboud Universiteit, DVJ Insights en Popai Benelux lieten consumenten in een virtuele supermarkt advertenties via de smartphone ontvangen wanneer men langs het geadverteerde product liep. De uitkomsten laten zien dat 'location based

  11. Process monitoring

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    Many of the measurements and observations made in a nuclear processing facility to monitor processes and product quality can also be used to monitor the location and movements of nuclear materials. In this session information is presented on how to use process monitoring data to enhance nuclear material control and accounting (MC and A). It will be seen that SNM losses can generally be detected with greater sensitivity and timeliness and point of loss localized more closely than by conventional MC and A systems if process monitoring data are applied. The purpose of this session is to enable the participants to: (1) identify process unit operations that could improve control units for monitoring SNM losses; (2) choose key measurement points and formulate a loss indicator for each control unit; and (3) describe how the sensitivities and timeliness of loss detection could be determined for each loss indicator

  12. 25 CFR 571.10 - Geographical location.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Geographical location. 571.10 Section 571.10 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR COMPLIANCE AND ENFORCEMENT PROVISIONS MONITORING AND INVESTIGATIONS Subpoenas and Depositions § 571.10 Geographical location. The attendance of...

  13. Pre-hospital management and outcome of acute poisonings by ambulances in Yekaterinburg, Russia.

    Science.gov (United States)

    Krayeva, Yulia V; Brusin, Konstantin M; Bushuev, Alexander V; Kondrashov, Dmitriy L; Sentsov, Valentin G; Hovda, Knut Erik

    2013-01-01

    Large, prospective pre-hospital studies of acute poisonings are scarce. We present the epidemiology of the pre-hospital poisonings, the treatment given, the complications of the poisoning itself and the treatment, predictors for hospitalization, and the safety of the present approach in a large industrial Russian city. Data were collected from March 2009 to March 2010. All adult (≥ 16 years) acute poisonings in the city of Yekaterinburg, Russia were included. The prospective cohort inclusion of data included age, gender, simple clinical features (including consciousness, respiratory status, circulatory status, convulsions, etc.), main toxic agent, reason why poisoning was suspected, treatment given, and outcome. Multivariate logistic regression analysis was used to identify the factors associated with hospitalization of the patients. In total, 1795/2536 patients (71%) were brought to hospitals, 736/2536 (29%) were discharged by the ambulance, and 5/2536 (0.2%) died on scene. The most frequent main agents were opioids (25%), ethanol (9%), benzodiazepines (8%), corrosive substances (7%), carbon monoxide (5%), and neuroleptics (5%). Pre-hospital treatment was given to 73% of patients; 3% were intubated, and antidotes were given in 27% (naloxone 24%, atropine 2%, and flumazenil 0.2%). Gastric lavage was performed in 34%, but only 20% within the first hour after ingestion; 49% had a Glasgow Coma Scale (GCS)treatment practice in most places, especially concerning the use of gastric lavage. Whether the current practice led to an increased morbidity and mortality is uncertain, but it justifies the need for thorough evaluation of clinical practice. These findings highlight the importance of studies like the present to improve diagnostics, triage, and treatment in acute poisonings.

  14. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes.

    Directory of Open Access Journals (Sweden)

    Marika Pane

    Full Text Available The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3% lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14% and 11 between 24 and 36 months (12%. The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3 m at 12 months, of -58.9 (SD 125.7 m at 24 months and -104.22 (SD 146.2 m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m (p<0.001. The changes were also significantly different according to steroid treatment (p = 0.01. Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available.

  15. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes.

    Science.gov (United States)

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Sormani, Maria Pia; Messina, Sonia; D'Amico, Adele; Carlesi, Adelina; Vita, Gianluca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; Lanzillotta, Valentina; Viggiano, Emanuela; D Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Barp, Andrea; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Graziano, Alessandra; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P; Bertini, Enrico; Mercuri, Eugenio

    2014-01-01

    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3) m at 12 months, of -58.9 (SD 125.7) m at 24 months and -104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available.

  16. A better understanding of ambulance personnel's attitude towards real-time resuscitation feedback.

    Science.gov (United States)

    Brinkrolf, Peter; Lukas, Roman; Harding, Ulf; Thies, Sebastian; Gerss, Joachim; Van Aken, Hugo; Lemke, Hans; Schniedermeier, Udo; Bohn, Andreas

    2018-03-01

    High-quality chest compressions during cardiopulmonary resuscitation (CPR) play a significant role in surviving cardiac arrest. Chest-compression quality can be measured and corrected by real-time CPR feedback devices, which are not yet commonly used. This article looks at the acceptance of such systems in comparison of equipped and unequipped personnel. Two groups of emergency medical services' (EMS) personnel were interviewed using standardized questionnaires. The survey was conducted in the German cities Dortmund and Münster. Overall, 205 persons participated in the survey: 103 paramedics and emergency physicians from the Dortmund fire service and 102 personnel from the Münster service. The staff of the Dortmund service were not equipped with real-time feedback systems. The test group of equipped personnel of the ambulance service of Münster Fire brigade uses real-time feedback systems since 2007. What is the acceptance level of real-time feedback systems? Are there differences between equipped and unequipped personnel? The total sample is receptive towards real-time feedback systems. More than 80% deem the system useful. However, this study revealed concerns and prejudices by unequipped personnel. Negative ratings are significantly lower at the Münster site that is experienced with the use of the real-time feedback system in contrast to the Dortmund site where no such experience exists-the system's use in daily routine results in better evaluation than the expectations of unequipped personnel. Real-time feedback systems receive overall positive ratings. Prejudices and concerns seem to decrease with continued use of the system.

  17. Location | FNLCR Staging

    Science.gov (United States)

    The Frederick National Laboratory for Cancer Research campus is located 50 miles northwest of Washington, D.C., and 50 miles west of Baltimore, Maryland, in Frederick, Maryland. Satellite locations include leased and government facilities extending s

  18. Appraising manufacturing location

    NARCIS (Netherlands)

    Steenhuis, H.J.; de Bruijn, E.J.

    2002-01-01

    International location of manufacturing activities is an issue for managers of manufacturing companies as well as public policy makers. For managers, the issue is relevant because international locations offer opportunities for lowering costs due to productivity improvements. For governments the

  19. Law Enforcement Locations

    Data.gov (United States)

    Kansas Data Access and Support Center — Law Enforcement Locations in Kansas Any location where sworn officers of a law enforcement agency are regularly based or stationed. Law enforcement agencies "are...

  20. Pacific Reef Assessment and Monitoring Program: Subsurface Temperature Recorders (STRs) at selected coral reef locations across the Pacific Ocean from 2001-09-20 to 2012-09-28 (NCEI Accession 0162471)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Water temperature data are collected using subsurface temperature recorders (STRs) that aid in the monitoring of seawater temperature variability at permanent coral...

  1. Management of patients brought in by ambulance to the emergency department: role of the Advanced Musculoskeletal Physiotherapist.

    Science.gov (United States)

    Kinsella, Rita; Collins, Tom; Shaw, Bridget; Sayer, James; Cary, Belinda; Walby, Andrew; Cowan, Sallie

    2017-05-09

    Objective The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED). Methods This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen by an AMP were compared with a matched group seen by other ED staff. Primary outcome measures were wait time and length of stay (LOS) in the ED. Results Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3-5 with musculoskeletal complaints were included in the analysis. Subgroup analysis of 825 patients aged ≤65 years demonstrated that for Category 4 (semi-urgent) patients, the median wait time to see the AMP was 9.5min (interquartile range (IQR) 3.25-18.00min) compared with 25min (IQR 10.00-56.00min) to see other ED staff (P ≤ 0.05). LOS analysis was undertaken on patients discharged home and demonstrated that there was a 1.20 greater probability (95% confidence interval 1.07-1.35) that ATS Category 4 patients managed by the AMP were discharged within the 4-hour public hospital target compared with patients managed by other ED staff: 87.04% (94/108) of patients managed by the AMPs met this standard compared with 72.35% (123/170) of patients managed by other ED staff (P=0.002). Conclusions Patients aged ≤65 years with musculoskeletal complaints brought in by ambulance to the ED and triaged to ATS Category 4 are likely to wait less time to be seen and are discharged home more quickly when managed by an AMP. This study has added to the evidence that AMPs improve patient flow in the ED, freeing up time for other ED staff to see higher-acuity, more complex patients. What is known about the topic? There is a growing body of evidence establishing that AMPs improve the flow of patients presenting with musculoskeletal conditions to the ED through reduced wait times and LOS and, at the same time

  2. Smartphones as locative media

    CERN Document Server

    Frith, Jordan

    2015-01-01

    Smartphone adoption has surpassed 50% of the population in more than 15 countries, and there are now more than one million mobile applications people can download to their phones. Many of these applications take advantage of smartphones as locative media, which is what allows smartphones to be located in physical space. Applications that take advantage of people's location are called location-based services, and they are the focus of this book. Smartphones as locative media raise important questions about how we understand the complicated relationship between the Internet and physical space

  3. 40 CFR 141.621 - Routine monitoring.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Routine monitoring. 141.621 Section....621 Routine monitoring. (a) Monitoring. (1) If you submitted an IDSE report, you must begin monitoring..., you must monitor at the location(s) and dates identified in your monitoring plan in § 141.132(f...

  4. Feasibility of AmbulanCe-Based Telemedicine (FACT study: safety, feasibility and reliability of third generation in-ambulance telemedicine.

    Directory of Open Access Journals (Sweden)

    Laetitia Yperzeele

    Full Text Available 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 generation.A routine ambulance was equipped with a system for real-time bidirectional audio-video communication, automated transmission of vital parameters, glycemia and electronic patient identification. All patients ( ≥ 18 years transported during emergency missions by a Prehospital Intervention Team of the Universitair Ziekenhuis Brussel were eligible for inclusion. To guarantee mobility and to facilitate 24/7 availability, the teleconsultants used lightweight laptop computers to access a dedicated telemedicine platform, which also provided functionalities for neurological assessment, electronic reporting and prehospital notification of the in-hospital team. Key registrations included any safety issue, mobile connectivity, communication of patient information, audiovisual quality, user-friendliness and accuracy of the prehospital diagnosis.Prehospital teleconsultation was obtained in 41 out of 43 cases (95.3%. The success rates for communication of blood pressure, heart rate, blood oxygen saturation, glycemia, and electronic patient identification were 78.7%, 84.8%, 80.6%, 64.0%, and 84.2%. A preliminary prehospital diagnosis was formulated in 90.2%, with satisfactory agreement with final in-hospital diagnoses. Communication of a prehospital report to the in-hospital team was successful in 94.7% and prenotification of the in-hospital team via SMS in 90.2%. Failures resulted mainly from limited mobile connectivity and to a lesser extent from software, hardware or human error. The user acceptance was high.Ambulance-based telemedicine of the third generation is safe, feasible and reliable but further research and development, especially with regard to high

  5. Coupling the effect of mental practice and Pilates on ambulation of individuals with multiple sclerosis: Five case studies

    Directory of Open Access Journals (Sweden)

    Darshpreet Kaur

    2016-01-01

    Full Text Available Pilates, a popular form of exercise, greatly emphasizes on the strengthening of the core muscles; however, the efficacy of exercise program can be impaired in patients with cognitive impairments. To bridge this gap, mental practice of a desired task can help to mentally simulate a given action and retain many properties of the corresponding real action. This study tries to gain preliminary understanding on the effectiveness of the combination of mental practice and core-strengthening Pilates exercises. To explore the effectiveness of mental practice and Pilates-based training on core strength, balance and mobility in multiple sclerosis (MS patients. This study highlights a single center case series describing the outcomes in ambulant patients with MS treated with mental practice and Pilates. Five volunteer ambulant individuals with stable relapsing-remitting MS participated in 20 individualized sessions, spread over 10-week duration. Pilates with mental practice session was delivered by a physiotherapist. Each session comprised 20 min of mental practice followed by 40 min of core-strengthening Pilates exercises. All the included patients were screened with Movement Imagery Questionnaire-Revised Second Version to determine if they are were able to effectively engage in imagery practice. A range of outcomes were measured: Timed up and go, chair stand test, curl-ups, the abdominal angle through leg raises, and the Activities-specific Balance Confidence Scale before and after the intervention. Group data analysis indicated significant improvement between baseline and post-intervention phases for all the tested parameters. This study provides preliminary insight into this novel combination technique to improve balance and mobility in ambulant people with MS. Mental practice played an important role in keeping the patient's compliance, which was analyzed through structured interviews. Variations in response to the intervention are evident.

  6. Task-specific gross motor skills training for ambulant school-aged children with cerebral palsy: a systematic review.

    Science.gov (United States)

    Toovey, Rachel; Bernie, Charmaine; Harvey, Adrienne R; McGinley, Jennifer L; Spittle, Alicia J

    2017-01-01

    The primary objective is to systematically evaluate the evidence for the effectiveness of task-specific training (TST) of gross motor skills for improving activity and/or participation outcomes in ambulant school-aged children with cerebral palsy (CP). The secondary objective is to identify motor learning strategies reported within TST and assess relationship to outcome. Systematic review. Relevant databases were searched for studies including: children with CP (mean age >4 years and >60% of the sample ambulant); TST targeting gross motor skills and activity (skill performance, gross motor function and functional skills) and/or participation-related outcomes. Quality of included studies was assessed using standardised tools for risk of bias, study design and quality of evidence across outcomes. Continuous data were summarised for each study using standardised mean difference (SMD) and 95% CIs. Thirteen studies met inclusion criteria: eight randomised controlled trials (RCTs), three comparative studies, one repeated-measures study and one single-subject design study. Risk of bias was moderate across studies. Components of TST varied and were often poorly reported. Within-group effects of TST were positive across all outcomes of interest in 11 studies. In RCTs, between-group effects were conflicting for skill performance and functional skills, positive for participation-related outcomes (one study: Life-HABITS performance SMD=1.19, 95% CI 0.3 to 2.07, pmotor function. The quality of evidence was low-to-moderate overall. Variability and poor reporting of motor learning strategies limited assessment of relationship to outcome. Limited evidence for TST for gross motor skills in ambulant children with CP exists for improving activity and participation-related outcomes and recommendations for use over other interventions are limited by poor study methodology and heterogeneous interventions. PROSPERO ID42016036727.

  7. 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

    2012-08-01

    Health Index of Life with Disabilities Questionnaire (CPCHILD© (health status and the Paediatric Pain Profile (PPP (pain. Adverse events will be carefully monitored by a clinician masked to group allocation. Discussion This paper outlines the theoretical basis, study hypotheses and outcome measures for a trial of BoNT-A injections and therapy for children with non-ambulant CP. Trial registration Australia New Zealand Clinical Trials Registry:N12609000360213

  8. 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

    2009-01-01

    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....... SETTING: An acute 20-bed orthopaedic hip fracture unit. SUBJECTS: Fifty consecutive patients with a median age of 83 (25-75% quartile, 68-86) years. INTERVENTIONS: The CAS, which describes the patient's independency in three activities - (1) getting in and out of bed, (2) sit to stand from a chair, and (3...

  9. 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

    2012-01-01

    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 ...... is recommended in Denmark for patients with hip fracture. The aims of the present study were to evaluate the feasibility of the CAS in a geriatric ward and to describe its use after hip fracture in Denmark....

  10. Demand for Emergency Services Trends in New South Wales Years 2010-2014 (DESTINY): Age and Clinical Factors Associated with Ambulance Transportation to Emergency Departments.

    Science.gov (United States)

    Dinh, Michael M; Muecke, Sandy; Berendsen Russell, Saartje; Chalkley, Dane; Bein, Kendall J; Muscatello, David; Nagaraj, Guruprasad; Paoloni, Richard; Ivers, Rebecca

    2016-01-01

    The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses. This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department data collection (EDCC) collects patient level data on presentations to designated EDs across NSW. Patients that presented to EDs by ambulance between January 2010 and December 2014 were included. Patients dead on arrival, transferred from another hospital, or planned ED presentations were excluded. A total of 10.8 million ED attendances were identified of which 2.6 million (23%) were transported to ED by ambulance. The crude rate of ambulance transportations to EDs across all ages increased by 3.0% per annum over the five years with the highest rate observed in those 85 years and over (620.5 presentations per 1,000 population). There was an increase in the proportion of category 1 and 2 (life-threatening or potentially life-threatening) cases from 18.1% to 24.0%. Demand for ambulance services appears to be driven by older patients presenting with higher acuity problems. Alternative models of acute care for elderly patients need to be planned and implemented to address these changes.

  11. Ambulance Clinical Triage for Acute Stroke Treatment: Paramedic Triage Algorithm for Large Vessel Occlusion.

    Science.gov (United States)

    Zhao, Henry; Pesavento, Lauren; Coote, Skye; Rodrigues, Edrich; Salvaris, Patrick; Smith, Karen; Bernard, Stephen; Stephenson, Michael; Churilov, Leonid; Yassi, Nawaf; Davis, Stephen M; Campbell, Bruce C V

    2018-04-01

    Clinical triage scales for prehospital recognition of large vessel occlusion (LVO) are limited by low specificity when applied by paramedics. We created the 3-step ambulance clinical triage for acute stroke treatment (ACT-FAST) as the first algorithmic LVO identification tool, designed to improve specificity by recognizing only severe clinical syndromes and optimizing paramedic usability and reliability. The ACT-FAST algorithm consists of (1) unilateral arm drift to stretcher <10 seconds, (2) severe language deficit (if right arm is weak) or gaze deviation/hemineglect assessed by simple shoulder tap test (if left arm is weak), and (3) eligibility and stroke mimic screen. ACT-FAST examination steps were retrospectively validated, and then prospectively validated by paramedics transporting culturally and linguistically diverse patients with suspected stroke in the emergency department, for the identification of internal carotid or proximal middle cerebral artery occlusion. The diagnostic performance of the full ACT-FAST algorithm was then validated for patients accepted for thrombectomy. In retrospective (n=565) and prospective paramedic (n=104) validation, ACT-FAST displayed higher overall accuracy and specificity, when compared with existing LVO triage scales. Agreement of ACT-FAST between paramedics and doctors was excellent (κ=0.91; 95% confidence interval, 0.79-1.0). The full ACT-FAST algorithm (n=60) assessed by paramedics showed high overall accuracy (91.7%), sensitivity (85.7%), specificity (93.5%), and positive predictive value (80%) for recognition of endovascular-eligible LVO. The 3-step ACT-FAST algorithm shows higher specificity and reliability than existing scales for clinical LVO recognition, despite requiring just 2 examination steps. The inclusion of an eligibility step allowed recognition of endovascular-eligible patients with high accuracy. Using a sequential algorithmic approach eliminates scoring confusion and reduces assessment time. Future

  12. Lost in Location

    DEFF Research Database (Denmark)

    Hansen, Lone Koefoed

    2009-01-01

    traversed. While becoming destination aware, the individual loses her location awareness. The article proposes that the reason people get lost when using sat-nav is due to a wrong location-performative paradigm. As an alternative, the article introduces and analyzes two performance-related examples...... that illustrate an alternative location-performative paradigm: Meredith Warner's Lost/Found knitting series and Etter and Schecht's Melodious Walkabout. In both examples, the artist's hand becomes the intermediary between alien and location. Thus, by exploring how wayfinding can be a poetically situated...... performance, the article examines how the growing locative media industry can learn from the location-aware performative strategies employed by artists who create situated and urban performances for the curious participant. The academic frames employed in the analysis draw on psychogeography, site...

  13. Internet Geo-Location

    Science.gov (United States)

    2017-12-01

    INTERNET GEO-LOCATION DUKE UNIVERSITY DECEMBER 2017 FINAL TECHNICAL REPORT APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED STINFO COPY AIR...REPORT TYPE FINAL TECHNICAL REPORT 3. DATES COVERED (From - To) MAY 2014 – MAY 2017 4. TITLE AND SUBTITLE INTERNET GEO-LOCATION 5a. CONTRACT...of SpeedTest servers that are used by end users to measure the speed of their Internet connection. The servers log the IP address and the location

  14. Smart Location Database - Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Smart Location Database (SLD) summarizes over 80 demographic, built environment, transit service, and destination accessibility attributes for every census block...

  15. Smart Location Database - Download

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Smart Location Database (SLD) summarizes over 80 demographic, built environment, transit service, and destination accessibility attributes for every census block...

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

    LENUS (Irish Health Repository)

    Gallagher, Sharon

    2007-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Joseph H. Schwab

    2011-01-01

    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.

  18. Body weight-supported bedside treadmill training facilitates ambulation in ICU patients: An interventional proof of concept study.

    Science.gov (United States)

    Sommers, Juultje; Wieferink, Denise C; Dongelmans, Dave A; Nollet, Frans; Engelbert, Raoul H H; van der Schaaf, Marike

    2017-10-01

    Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore the feasibility of Body Weight-Supported Treadmill Training (BWSTT) in critically ill patients in the ICU. A custom build bedside Body Weight-Supported Treadmill was used and evaluated in medical and surgical patients in the ICU. Feasibility was evaluated according to eligibility, successful number of BWSTT, number of staff needed, adverse events, number of patients that could not have walked without BWSTT, patient satisfaction and anxiety. Twenty participants, underwent 54 sessions BWSTT. Two staff members executed the BWSTT and no adverse events occurred. Medical equipment did not have to be disconnected during all treatment sessions. In 74% of the sessions, the participants would not have been able to walk without the BWSTT. Patient satisfaction with BWSTT was high and anxiety low. This proof of concept study demonstrated that BWSTT is safe, reduces staff resource, and facilitates the first time to ambulation in critically ill patients with severe muscle weakness in the ICU. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Reduction in Fatalities, Ambulance Calls, and Hospital Admissions for Road Trauma After Implementation of New Traffic Laws

    Science.gov (United States)

    Chan, Herbert; Brasher, Penelope; Erdelyi, Shannon; Desapriya, Edi; Asbridge, Mark; Purssell, Roy; Macdonald, Scott; Schuurman, Nadine; Pike, Ian

    2014-01-01

    Objectives. We evaluated the public health benefits of traffic laws targeting speeding and drunk drivers (British Columbia, Canada, September 2010). Methods. We studied fatal crashes and ambulance dispatches and hospital admissions for road trauma, using interrupted time series with multiple nonequivalent comparison series. We determined estimates of effect using linear regression models incorporating an autoregressive integrated moving average error term. We used neighboring jurisdictions (Alberta, Saskatchewan, Washington State) as external controls. Results. In the 2 years after implementation of the new laws, significant decreases occurred in fatal crashes (21.0%; 95% confidence interval [CI] = 15.3, 26.4) and in hospital admissions (8.0%; 95% CI = 0.6, 14.9) and ambulance calls (7.2%; 95% CI = 1.1, 13.0) for road trauma. We found a very large reduction in alcohol-related fatal crashes (52.0%; 95% CI = 34.5, 69.5), and the benefits of the new laws are likely primarily the result of a reduction in drinking and driving. Conclusions. These findings suggest that laws calling for immediate sanctions for dangerous drivers can reduce road trauma and should be supported. PMID:25121822

  20. Journal Article: Atmospheric Measurements of CDDs, CDFs, and Coplanar PCBs in Rural and Remote Locations of the U.S. for the Years 1998-2001 from the National Dioxin Air Monitoring Network (Ndamn)

    Science.gov (United States)

    The U.S. EPA established a National Dioxin Air Monitoring Network (NDAMN) to determine background air concentrations of PCDDs, PCDFs, and cp-PCBs in rural and remote areas of the United States. Background is defined as average ambient air concentrations inferred from long-term a...

  1. A Summary of Aquatic Vegetation Monitoring at Selected Locations in Pools 4, 8, 13, and 26 and La Grange Pool of the Upper Mississippi River System. 1993 Annual Status Report,

    Science.gov (United States)

    1998-07-01

    Monitoring Program, arranged alphabetically by common name within family . Family Common name"b Scientific name’ Ceratophyllaceae Coon’s tail, coontail...pondweed Potamogeton pectinatus L. Potamogetonaceae Variableleaf pondweed Potamogeton gramineus L. 8 Table 2. Continued. Family Common nameab Scientific...name’ Ranunculaceae Longbeak buttercup Ranunculus longirostris Godron. Ranunculaceae White water-crowfoot Ranunculus trichophyllus Chauix

  2. Green facility location

    NARCIS (Netherlands)

    Velázquez Martínez, J.C.; Fransoo, J.C.; Bouchery, Y.; Corbett, C.J.; Fransoo, J.C.; Tan, T.

    2017-01-01

    Transportation is one of the main contributing factors of global carbon emissions, and thus, when dealing with facility location models in a distribution context, transportation emissions may be substantially higher than the emissions due to production or storage. Because facility location models

  3. Industrial location and competitiveness

    NARCIS (Netherlands)

    S. Brakman (Steven); J.H. Garretsen (Harry); J.G.M. van Marrewijk (Charles)

    2006-01-01

    textabstractThe interaction between the extent of location advantages and the intensity of firm competition relative to the size of the market jointly determines the location of industrial activity. Technology, factor endowments, geography, and scale economies are influential for determining

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

    OpenAIRE

    Barreto,Bruno; Alexandrino,Fernando; Coelho,Ormeu

    2016-01-01

    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 p...

  5. Sewage Monitors

    Science.gov (United States)

    1987-01-01

    Every U.S. municipality must determine how much waste water it is processing and more importantly, how much is going unprocessed into lakes and streams either because of leaks in the sewer system or because the city's sewage facilities were getting more sewer flow than they were designed to handle. ADS Environmental Services, Inc.'s development of the Quadrascan Flow Monitoring System met the need for an accurate method of data collection. The system consists of a series of monitoring sensors and microcomputers that continually measure water depth at particular sewer locations and report their findings to a central computer. This provides precise information to city managers on overall flow, flow in any section of the city, location and severity of leaks and warnings of potential overload. The core technology has been expanded upon in terms of both technical improvements, and functionality for new applications, including event alarming and control for critical collection system management problems.

  6. Monitoring of the natural gas exploitation in the Wadden Sea from the locations Moddergat, Lauwersoog and Vierhuizen, Netherlands. Advice of the Audit Committee 2011; Monitoring van de aardgaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen. Advies 2011 van de Auditcommissie

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-04-15

    The Dutch governmental decree ('Rijksprojectenbesluit') on the project for natural gas exploitation in the Wadden Sea for the locations Moddergat, Lauwersoog and Vierhuizen gives the Dutch Petroleum Company (NAM) the possibility to produce natural gas under specific conditions in the Wadden Sea area from the six fields Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog East and Vierhuizen East. The precondition is that the (dynamic) nature in and around the Wadden Sea is not affected by subsidence as a result of the gas exploitation. For this, the NAM must monitor the subsidence and the nature values and report annually to the Dutch government. Also in the Rijksprojectbesluit it is determined that the Commission for Environmental Impact Assessment (EIA), as the independent auditor, will annually advise the responsible ministers on the EIA-report. This is the 2011 recommendation of the Audit Committee for exploitation of natural gas in the Wadden Sea [Dutch] Het Rijksprojectbesluit Gaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen geeft de Nederlandse Aardolie Maatschappij (NAM) de mogelijkheid om onder randvoorwaarden aardgas te produceren in het Waddenzeegebied uit de zes velden Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog Oost en Vierhuizen Oost. De randvoorwaarde is dat de (dynamische) natuur in en rondom de Waddenzee niet wordt aangetast door bodemdaling als gevolg van de gaswinning. Daarvoor moet de NAM de bodemdaling en de natuurwaarden monitoren en jaarlijks rapporteren aan de Nederlandse overheid. Ook is in het Rijksprojectbesluit bepaald dat de Commissie voor de milieueffectrapportage (m.e.r.) als onafhankelijke auditor de verantwoordelijke ministers jaarlijks zal adviseren over deze Rapportage. Dit is het 2011 advies van de Auditcommissie gaswinning onder de Waddenzee.

  7. Monitoring of the natural gas exploitation in the Wadden Sea from the locations Moddergat, Lauwersoog and Vierhuizen, Netherlands. Advice of the Audit Committee 2009; Monitoring van de aardgaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen. Advies 2009 van de Auditcommissie

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-05-07

    The Dutch governmental decree ('Rijksprojectenbesluit') on the project for natural gas exploitation in the Wadden Sea for the locations Moddergat, Lauwersoog Vierhuizen gives the Dutch Petroleum Company (NAM) the possibility to produce natural gas under specific conditions in the Wadden Sea area from the six fields Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog East and Vierhuizen East. The precondition is that the (dynamic) nature in and around the Wadden Sea is not affected by subsidence as a result of the gas exploitation. For this, the NAM must monitor the subsidence and the nature values and report annually to the Dutch government. Also in the Rijksprojectbesluit it is determined that the Commission for Environmental Impact Assessment (EIA), as the independent auditor, will annually advise the responsible ministers on the EIA-report. This is the 2009 recommendation of the Audit Committee for exploitation of natural gas in the Wadden Sea. [Dutch] Het Rijksprojectbesluit Gaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen geeft de Nederlandse Aardolie Maatschappij (NAM) de mogelijkheid om onder randvoorwaarden aardgas te produceren in het Waddenzeegebied uit de zes velden Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog Oost en Vierhuizen Oost. De randvoorwaarde is dat de (dynamische) natuur in en rondom de Waddenzee niet wordt aangetast door bodemdaling als gevolg van de gaswinning. Daarvoor moet de NAM de bodemdaling en de natuurwaarden monitoren en jaarlijks rapporteren aan de Nederlandse overheid. Ook is in het Rijksprojectbesluit bepaald dat de Commissie voor de milieueffectrapportage (m.e.r.) als onafhankelijke auditor de verantwoordelijke ministers jaarlijks zal adviseren over deze Rapportage. Dit is het 2009 advies van de Auditcommissie gaswinning onder de Waddenzee.

  8. Monitoring of the natural gas exploitation in the Wadden Sea from the locations Moddergat, Lauwersoog and Vierhuizen, Netherlands. Advice of the Audit Committee 2010; Monitoring van de aardgaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen. Advies 2010 van de Auditcommissie

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-10-15

    The Dutch governmental decree ('Rijksprojectenbesluit') on the project for natural gas exploitation in the Wadden Sea for the locations Moddergat, Lauwersoog and Vierhuizen gives the Dutch Petroleum Company (NAM) the possibility to produce natural gas under specific conditions in the Wadden Sea area from the six fields Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog East and Vierhuizen East. The precondition is that the (dynamic) nature in and around the Wadden Sea is not affected by subsidence as a result of the gas exploitation. For this, the NAM must monitor the subsidence and the nature values and report annually to the Dutch government. Also in the Rijksprojectbesluit it is determined that the Commission for Environmental Impact Assessment (EIA), as the independent auditor, will annually advise the responsible ministers on the EIA-report. This is the 2010 recommendation of the Audit Committee for exploitation of natural gas in the Wadden Sea. [Dutch] Het Rijksprojectbesluit Gaswinning onder de Waddenzee vanaf de locaties Moddergat, Lauwersoog en Vierhuizen geeft de Nederlandse Aardolie Maatschappij (NAM) de mogelijkheid om onder randvoorwaarden aardgas te produceren in het Waddenzeegebied uit de zes velden Moddergat, Nes, Lauwersoog C, Lauwersoog West, Lauwersoog Oost en Vierhuizen Oost. De randvoorwaarde is dat de (dynamische) natuur in en rondom de Waddenzee niet wordt aangetast door bodemdaling als gevolg van de gaswinning. Daarvoor moet de NAM de bodemdaling en de natuurwaarden monitoren en jaarlijks rapporteren aan de Nederlandse overheid. Ook is in het Rijksprojectbesluit bepaald dat de Commissie voor de milieueffectrapportage (m.e.r.) als onafhankelijke auditor de verantwoordelijke ministers jaarlijks zal adviseren over deze Rapportage. Dit is het 2010 advies van de Auditcommissie gaswinning onder de Waddenzee.

  9. Allegheny County Dam Locations

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset shows the point locations of dams in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data portal...

  10. Smart Location Mapping

    Science.gov (United States)

    The Smart Location Database, Access to Jobs and Workers via Transit, and National Walkability Index tools can help assess indicators related to the built environment, transit accessibility, and walkability.

  11. OAS :: Our Locations

    Science.gov (United States)

    the Human Resources of the OAS, including its organizational structure, each organizational unit's contract and travel control measure reports, the applicable procurement rules and regulations, and the Charter Organizational Charts Organizational List Authorities Our Locations Contact Us Telephone: +1 (202

  12. VT Hospital Site Locations

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...

  13. SGA Project Locations

    Data.gov (United States)

    Vermont Center for Geographic Information — The stream geomorphic assessment is a physical assessment competed by geomorphologists to determine the condition and sensitivity of a stream. The SGA locations...

  14. Waste Recovery Locations

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Locations where City residents are encouraged to drop off and dispose or recycle of unwanted materials. Information provided is subject to change. Please call ahead...

  15. Global Volcano Locations Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC maintains a database of over 1,500 volcano locations obtained from the Smithsonian Institution Global Volcanism Program, Volcanoes of the World publication. The...

  16. USAID Activity Locations

    Data.gov (United States)

    US Agency for International Development — The USAID Activities dataset is a snapshot of activities supported by USAID including their geographical locations within countries at the time of the snapshot. The...

  17. Uranium Location Database

    Data.gov (United States)

    U.S. Environmental Protection Agency — A GIS compiled locational database in Microsoft Access of ~15,000 mines with uranium occurrence or production, primarily in the western United States. The metadata...

  18. Location-based Scheduling

    DEFF Research Database (Denmark)

    Andersson, Niclas; Christensen, Knud

    on the market. However, CPM is primarily an activity based method that takes the activity as the unit of focus and there is criticism raised, specifically in the case of construction projects, on the method for deficient management of construction work and continuous flow of resources. To seek solutions...... to the identified limitations of the CPM method, an alternative planning and scheduling methodology that includes locations is tested. Location-based Scheduling (LBS) implies a shift in focus, from primarily the activities to the flow of work through the various locations of the project, i.e. the building. LBS uses...... the graphical presentation technique of Line-of-balance, which is adapted for planning and management of work-flows that facilitates resources to perform their work without interruptions caused by other resources working with other activities in the same location. As such, LBS and Lean Construction share...

  19. Reliability testing of failed fuel location system

    International Nuclear Information System (INIS)

    Vieru, G.

    1996-01-01

    This paper presents the experimental reliability tests performed in order to prove the reliability parameters for Failed Fuel Location System (FFLS), equipment used to detect in which channel of a particular heat transport loop a fuel failure is located, and to find in which channel what particular bundle pair is failed. To do so, D20 samples from each reactor channel are sequentially monitored to detect a comparatively high level of delayed neutron activity. 15 refs, 8 figs, 2 tabs

  20. An analysis of Emergency Medical Services demand: Time of day, day of the week, and location in the city.

    Science.gov (United States)

    Sariyer, Gorkem; Ataman, Mustafa Gokalp; Akay, Serhat; Sofuoglu, Turhan; Sofuoglu, Zeynep

    2017-06-01

    Effective planning of Emergency Medical Services (EMS), which is highly dependent on the analysis of past data trends, is important in reducing response time. Thus, we aimed to analyze demand for these services based on time and location trends to inform planning for an effective EMS. Data for this retrospective study were obtained from the Izmir EMS 112 system. All calls reaching these services during first six months of 2013 were descriptively analyzed, based on time and location trends as a heat-map form. The analyses showed that demand for EMS varied within different time periods of day, and according to day of the week. For the night period, demand was higher at the weekend compared to weekdays, whereas for daytime hours, demand was higher during the week. For weekdays, a statistically significant relation was observed between the call distribution of morning and evening periods. It was also observed that the percentage of demand changed according to location. Among 30 locations, the five most frequent destinations for ambulances, which are also correlated with high population densities, accounted for 55.66% of the total. The results of this study shed valuable light on the areas of call center planning and optimal ambulance locations of Izmir, which can also be served as an archetype for other cities.

  1. On English Locative Subjects

    Directory of Open Access Journals (Sweden)

    Gabriela Brůhová

    2017-07-01

    Full Text Available The paper analyses English sentences with thematic locative subjects. These subjects were detected as translation counterparts of Czech sentenceinitial locative adverbials realized by prepositional phrases with the prepositions do (into, na (on, v/ve (in, z/ze (from complemented by a noun. In the corresponding English structure, the initial scene-setting adverbial is reflected in the thematic subject, which results in the locative semantics of the subject. The sentences are analysed from syntactic, semantic and FSP aspects. From the syntactic point of view, we found five syntactic patterns of the English sentences with a locative subject (SV, SVA, SVO, SVpassA and SVCs that correspond to Czech sentences with initial locative adverbials. On the FSP level the paper studies the potential of the sentences to implement the Presentation or Quality Scale. Since it is the “semantic content of the verb that actuates the presentation semantics of the sentence” (Duškova, 2015a: 260, major attention is paid to the syntactic-semantic structure of the verb. The analysis of the semantics of the English sentences results in the identification of two semantic classes of verbs which co-occur with the English locative subject.

  2. Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest.

    Science.gov (United States)

    Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik; Hansen, Steen Møller; Gerds, Thomas A; Kragholm, Kristian; Hansen, Carolina Malta; Karlsson, Lena; Lippert, Freddy K; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

    2016-12-20

    response time in this study) to 5 minutes. The absolute survival associated with bystander CPR declined rapidly with time. Yet bystander CPR while waiting for an ambulance was associated with a more than doubling of 30-day survival even in case of long ambulance response time. Decreasing ambulance response time by even a few minutes could potentially lead to many additional lives saved every year. © 2016 American Heart Association, Inc.

  3. Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.

    Science.gov (United States)

    Armstrong, Stephanie; Langlois, Adele; Laparidou, Despina; Dixon, Mark; Appleton, Jason P; Bath, Philip M; Snooks, Helen; Siriwardena, A Niroshan

    2017-09-16

    We sought to understand the main ethical considerations when conducting clinical trials in the prehospital ambulance based setting. A systematic review of the literature on randomised controlled trials in ambulance settings was undertaken. A search of eight databases identified published studies involving recruitment of ambulance service users. Four independent authors undertook abstract and full-text reviews to determine eligibility and extract relevant data. The data extraction concentrated on ethical considerations, with any discussion of ethics being included for further analysis. The resultant data were combined to form a narrative synthesis. In all, 56 papers were identified as meeting the inclusion criteria. Issues relating to consent were the most significant theme identified. Type of consent differed depending on the condition or intervention being studied. The country in which the research took place did not appear to influence the type of consent, apart from the USA where exception from consent appeared to be most commonly used. A wide range of terms were used to describe consent. Consent was the main ethical consideration in published ambulance based research. A range of consent models were used ranging from informed consent to exception from consent (waiver of consent). Many studies cited international guidelines as informing their choice of consent model but diverse and sometimes confused terms were used to describe these models. This suggests that standardisation of consent models and the terminology used to describe them is warranted.

  4. Training of Ambulance Personnel and Others Responsible for Emergency Care of the Sick and Injured at the Scene and During Transport.

    Science.gov (United States)

    National Academy of Sciences - National Research Council, Washington, DC. Div. of Medical Sciences.

    Ambulance personnel must be able to (1) appraise the extent of first aid rendered by others, (2) carry out additional measures at the scene and en route, (3) operate vehicles safely, (4) maintain communication with traffic authorities, dispatchers, and emergency departments, and (5) keep records for medical and other authorities. Guidelines for…

  5. Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review

    Directory of Open Access Journals (Sweden)

    Stephanie Armstrong

    2017-09-01

    Full Text Available Abstract Background We sought to understand the main ethical considerations when conducting clinical trials in the prehospital ambulance based setting. Methods A systematic review of the literature on randomised controlled trials in ambulance settings was undertaken. A search of eight databases identified published studies involving recruitment of ambulance service users. Four independent authors undertook abstract and full-text reviews to determine eligibility and extract relevant data. The data extraction concentrated on ethical considerations, with any discussion of ethics being included for further analysis. The resultant data were combined to form a narrative synthesis. Results In all, 56 papers were identified as meeting the inclusion criteria. Issues relating to consent were the most significant theme identified. Type of consent differed depending on the condition or intervention being studied. The country in which the research took place did not appear to influence the type of consent, apart from the USA where exception from consent appeared to be most commonly used. A wide range of terms were used to describe consent. Conclusions Consent was the main ethical consideration in published ambulance based research. A range of consent models were used ranging from informed consent to exception from consent (waiver of consent. Many studies cited international guidelines as informing their choice of consent model but diverse and sometimes confused terms were used to describe these models. This suggests that standardisation of consent models and the terminology used to describe them is warranted.

  6. Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project.

    Science.gov (United States)

    Valenzuela Espinoza, Alexis; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Fernandez Tellez, Helio; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Successful execution of the project involved the development and validation of a novel stroke scale, design and creation of specific hardware and software solutions, execution of field tests for mobile internet connectivity, design of new care processes and information flows, recurrent training of all professional caregivers involved in acute stroke management, extensive testing on healthy volunteers, organisation of a 24/7 teleconsultation service by trained stroke experts and 24/7 technical support, and resolution of several legal issues. In all, it took 41 months of research and development to confirm the safety, technical feasibility, reliability, and user acceptance of the PreSSUB approach. Stroke-specific key information can be collected safely and reliably before and during ambulance transportation and can adequately be communicated with the inhospital team awaiting the patient. This paper portrays the key steps required and the lessons learned for successful implementation of a 24/7 expert telemedicine service supporting patients with acute stroke during ambulance transportation to the hospital. © 2016 S. Karger AG, Basel.

  7. Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology.

    Science.gov (United States)

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

    2008-06-01

    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.

  8. Development of an emergency medical video multiplexing transport system. Aiming at the nation wide prehospital care on ambulance.

    Science.gov (United States)

    Nagatuma, Hideaki

    2003-04-01

    The Emergency Medical Video Multiplexing Transport System (EMTS) is designed to support prehospital cares by delivering high quality live video streams of patients in an ambulance to emergency doctors in a remote hospital via satellite communications. The important feature is that EMTS divides a patient's live video scene into four pieces and transports the four video streams on four separate network channels. By multiplexing four video streams, EMTS is able to transport high quality videos through low data transmission rate networks such as satellite communications and cellular phone networks. In order to transport live video streams constantly, EMTS adopts Real-time Transport Protocol/Real-time Control Protocol as a network protocol and video stream data are compressed by Moving Picture Experts Group 4 format. As EMTS combines four video streams with checking video frame numbers, it uses a refresh packet that initializes server's frame numbers to synchronize the four video streams.

  9. The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians.

    Science.gov (United States)

    Myers, J A; Powell, D M C; Aldington, S; Sim, D; Psirides, A; Hathaway, K; Haney, M F

    2017-11-01

    The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design). Trained assessors blinded to participants' fatigue status performed detailed structured assessments based on expected behaviours in four non-technical skills domains: teamwork, situational awareness, task management, and decision making. Participants also provided self-ratings of their performance. The primary endpoint was the sum score of overall non-technical performance. The main finding, the overall non-technical skills performance rating of the clinicians, was better in rested than fatigued states (mean difference with 95% CI, 2.8 [2.2-3.4]). The findings remained consistent across individual non-technical skills domains; also when controlling for an order effect and examining the impact of a number of possible covariates. There was no difference in self-ratings of clinical performance between rested and fatigued states. Non-technical performance of critical care air transfer clinicians is degraded when they are fatigued. Fatigued clinicians may fail to recognise the degree to which their performance is compromised. These findings represent risk to clinical care quality and patient safety in the dynamic and isolated environment of air ambulance transfer. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. Eight months of emergency services by ambulance (with doctor on board) of the Emergency Department of Prato, Italy.

    Science.gov (United States)

    Olia, P M; Mollica, T V; Querci, A

    2002-11-01

    The aim of the present study was to analyse the types of calls attended by the authors in their ambulance, assigned to one sector of the urban area of Prato. We analysed 1060 consecutive calls carried out by our ambulance; 33 calls (3.1%), cancelled for various reasons, were excluded from statistical analysis. The calls regarded 1027 patients, 549 (53.5%) males and 478 (46.5%) females. 46% of calls concerned non trauma cases, 17% trauma cases and 7.2% transfers between hospitals. Calls in the non trauma group were for dyspnea (16.7%), unconsciousness (16.6%), chest pain (11.8%), cerebrovascular pathology (7.7%), mental disorders (7.1%), abdominal pain (5.1%), use of psychotropic substances (4%) and convulsions (3.2%). Support to patients with terminal cancer accounted for 2.3% of cases, metabolic disorders 2.2%, hypertensive events 2.1%, tachycardia 1.9%, vertigo 1.9%, allergies 1%, obstetric pathology 0.5% and cardiorespiratory resuscitation 2,2%. Thirteen point seven percent were miscellaneous, including poisonings, migraines, haemorrhages and flu syndromes. Trauma cases included road accidents (62.6%), falls (27%), aggression (6.9%), work-related accidents (3.5%). The percentage of trauma cases (17%) was similar to that reported for a Swedish urban area (20%). Cases of cardiorespiratory resuscitation were 1.65% of our calls, compared to 1.73% and 1.8% reported in Northeastern Germany and Taiwan. Although prehospital emergency medical services are organised differently in different countries, our data suggest that emergency medical services in our area have a percentage distribution of case types similar to services in other countries.

  11. General minisum circle location

    DEFF Research Database (Denmark)

    Körner, Mark; Brimberg, Jack; Juel, Henrik

    2009-01-01

    In our paper we approximate a set of given points by a general circle. More precisely, we consider the problem of locating and scaling the unit ball of some given norm k1 with respect to xed points on the plane such that the sum of weighted distances between the circle and the xed points is minim......In our paper we approximate a set of given points by a general circle. More precisely, we consider the problem of locating and scaling the unit ball of some given norm k1 with respect to xed points on the plane such that the sum of weighted distances between the circle and the xed points...

  12. Location-based games

    DEFF Research Database (Denmark)

    Ejsing-Duun, Stine

    In this dissertation, it is explored which prerequisites are necessary in location-based games (LBGs) to make meaningful the meeting between players and spatiality with an emphasis on physical locations. Throughout the dissertation, it has been shown that LBGs affect players’ perception of and be...... possible. The practical contribution is my creation of the LBG Visions of Sara. People continue to play this game in Odense more than two years after its launch, and DJEEO uses it as a showcase, enabling the company to sell similar LBGs....

  13. Capacitive system detects and locates fluid leaks

    Science.gov (United States)

    1966-01-01

    Electronic monitoring system automatically detects and locates minute leaks in seams of large fluid storage tanks and pipelines covered with thermal insulation. The system uses a capacitive tape-sensing element that is adhesively bonded over seams where fluid leaks are likely to occur.

  14. The analysis of the cases of circulatory and respiratory arrest in the work of the Regional Unit of Ambulance Service - Sródmieście Station.

    Science.gov (United States)

    Chemperek, Ewa; Mikuła, Agnieszka; Goniewicz, Mariusz; Krawczyk, Wojciech

    2004-01-01

    The major causes of deaths all over the world are circulatory system diseases, neoplasms and injuries. Each man can become a participant of the event which results in life-threatening emergencies and the most immediate possible actions are essential. The period of time for starting efficient life-restoration actions is very short, estimated at 4-5 minutes. Ambulance Service is a medical organization created to apply aid in life-threatening emergencies. The standards of the developed western countries determine the arrival time at 7-10 minutes from the call time. Both first-aid applied by the accident witnesses and efficient actions of ambulance service have significance for effective pre-hospital aid and increasing the chances of survival of people in need. The study analysed emergency records of the ambulance cars of the Regional Unit of Ambulance Service - Sródmieście Station in Lublin in the year 2000. 3,723 calls were recorded. In 142 cases complete resuscitation actions were carried out due to circulatory and respiratory arrest. The records selected this way went through a detailed analysis. In 3.8% of the interventions of emergency teams the necessity of applying advanced life support was observed. The time of arrival at the scene, transport of the patient to the admission room as well as efficiency of resuscitation comply with the European standards. The efficiency of resuscitation actions estimated at 51.4% depended on the age of the patient, the cause of circulatory and respiratory arrest and ambulance arrival time. Taking up basic life support by witnesses of the event was observed in 2.8% of cases, in 8.5% aid was applied by the medical staff members who happened to be at the scene.

  15. IMPRESS: medical location-aware decision making during emergencies

    Science.gov (United States)

    Gkotsis, I.; Eftychidis, G.; Leventakis, G.; Mountzouris, M.; Diagourtas, D.; Kostaridis, A.; Hedel, R.; Olunczek, A.; Hahmann, S.

    2017-09-01

    Emergency situations and mass casualties involve several agencies and public authorities, which need to gather data from the incident scene and exchange geo-referenced information to provide fast and accurate first aid to the people in need. Tracking patients on their way to the hospitals can prove critical in taking lifesaving decisions. Increased and continuous flow of information combined by vital signs and geographic location of emergency victims can greatly reduce the response time of the medical emergency chain and improve the efficiency of disaster medicine activity. Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware medical applications. IMPRESS is an advanced ICT platform based on adequate technologies for developing location-aware medical response during emergencies. The system incorporates mobile and fixed components that collect field data from diverse sources, support medical location and situation-based services and share information on the patient's transport from the field to the hospitals. In IMPRESS platform tracking of victims, ambulances and emergency services vehicles is integrated with medical, traffic and crisis management information into a common operational picture. The Incident Management component of the system manages operational resources together with patient tracking data that contain vital sign values and patient's status evolution. Thus, it can prioritize emergency transport decisions, based on medical and location-aware information. The solution combines positioning and information gathered and owned by various public services involved in MCIs or large-scale disasters. IMPRESS solution, were validated in field and table top exercises in cooperation with emergency services and hospitals.

  16. The Czech Locative Chameleon

    Directory of Open Access Journals (Sweden)

    Tarald Taraldsen

    2007-12-01

    Full Text Available We show that under certain circumstances, the Czech locative prepositions (LOC show up as directional prepositions (DIR and vice versa, (under different circumstances the Czech DIR PPs show up as LOC. We argue that such a chameleon life of the PPs is structurally dependent.

  17. Immigrants' location preferences

    DEFF Research Database (Denmark)

    Damm, Anna Piil

    This paper exploits a spatial dispersal policy for refugee immigrants to estimate the importance of local and regional factors for refugees' location preferences. The main results of a mixed proportional hazard competing risks model are that placed refugees react to high regional unemployment...

  18. Tracking, say, SKYPE Locations

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Tracking, say, SKYPE Locations. Real Time Communication: Peer-to-Peer (P2P). Datagram flows between the two conversing partners; Exposes the IP addresses of all the participants to one another. If A knows B's VoIP ID, she can establish a call with Bob & obtain his current ...

  19. RFID Location Algorithm

    Directory of Open Access Journals (Sweden)

    Wang Zi Min

    2016-01-01

    Full Text Available With the development of social services, people’s living standards improve further requirements, there is an urgent need for a way to adapt to the complex situation of the new positioning technology. In recent years, RFID technology have a wide range of applications in all aspects of life and production, such as logistics tracking, car alarm, security and other items. The use of RFID technology to locate, it is a new direction in the eyes of the various research institutions and scholars. RFID positioning technology system stability, the error is small and low-cost advantages of its location algorithm is the focus of this study.This article analyzes the layers of RFID technology targeting methods and algorithms. First, RFID common several basic methods are introduced; Secondly, higher accuracy to political network location method; Finally, LANDMARC algorithm will be described. Through this it can be seen that advanced and efficient algorithms play an important role in increasing RFID positioning accuracy aspects.Finally, the algorithm of RFID location technology are summarized, pointing out the deficiencies in the algorithm, and put forward a follow-up study of the requirements, the vision of a better future RFID positioning technology.

  20. Spatiotemporal AED Location Optimization

    NARCIS (Netherlands)

    Chan, Timothy C.Y.; Sun, Christopher L.F.; Demirtas, Derya; Morrison, Laurie J.; Brooks, Steven C.

    2015-01-01

    Background: Mathematical optimization can be used to plan future AED placement to maximize out-of-hospital cardiac arrest (OHCA) coverage. Many public access AEDs are placed in locations without 24/7 access. AED coverage can be overestimated unless temporal availability is considered. Objective: To

  1. Location of New Firms

    DEFF Research Database (Denmark)

    Backman, Mikaela; Karlsson, Charlie

    2017-01-01

    characteristics, such as the commuting experience. Our results show that commuting influences the firm location choice. The probability of establishing a firm in the work municipality increases if the entrepreneur is a commuter, holding constant the type of region and unobservable and observable individual...

  2. Source Location of Noble Gas Plumes

    International Nuclear Information System (INIS)

    Hoffman, I.; Ungar, K.; Bourgouin, P.; Yee, E.; Wotawa, G.

    2015-01-01

    In radionuclide monitoring, one of the most significant challenges from a verification or surveillance perspective is the source location problem. Modern monitoring/surveillance systems employ meteorological source reconstruction — for example, the Fukushima accident, CRL emissions analysis and even radon risk mapping. These studies usually take weeks to months to conduct, involving multidisciplinary teams representing meteorology; dispersion modelling; radionuclide sampling and metrology; and, when relevant, proper representation of source characteristics (e.g., reactor engineering expertise). Several different approaches have been tried in an attempt to determine useful techniques to apply to the source location problem and to develop rigorous methods that combine all potentially relevant observations and models to identify a most probable source location and size with uncertainties. The ultimate goal is to understand the utility and limitations of these techniques so they can transition from R&D to operational tools. (author)

  3. Electrostatic beam-position monitor

    CERN Multimedia

    CERN PhotoLab

    1969-01-01

    Electrostatic beam-position monitor installed in its final location (bake-out cover removed). The ISR will contain about 110 of these monitors. Their accuracy is better than 1 mm, their band width about 1 MHz.

  4. Iowater Water Quality Monitoring Sites

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This coverage contains points representing monitoring locations on streams, lakes and ponds that have been registered by IOWATER monitors. IOWATER, Iowa's volunteer...

  5. Aquatic Nuisance Species Locator

    Science.gov (United States)

    Data in this map has been collected by the United States Geological Survey's Nonindigenous Aquatic Species program located in Gainesville, Florida (http://nas.er.usgs.gov/default.aspx). This dataset may have some inaccuracies and is only current to June 15, 2012. The species identified in this dataset are not inclusive of all aquatic nuisance species, but rather a subset identified to be at risk for transport by recreational activities such as boating and angling. Additionally, the locations where organisims have been identified are also not inclusive and should be treated as a guide. Organisms are limited to the following: American bullfrog, Asian clam, Asian shore crab, Asian tunicate, Australian spotted jellyfish, Chinese mitten crab, New Zealand mudsnail, Colonial sea squirt, Alewife, Bighead carp, Black carp, Flathead catfish, Grass carp, Green crab, Lionfish, Northern snakehead, Quagga mussel, Round Goby, Ruffe, Rusty crayfish, Sea lamprey, Silver carp, Spiny water flea, Veined rapa whelk, Zebra mussel

  6. Locating underground uranium deposits

    International Nuclear Information System (INIS)

    Felice, P.E.

    1979-01-01

    Underground uranium deposits are located by placing wires of dosimeters each about 5 to 18 mg/cm 2 thick underground in a grid pattern. Each dosimeter contains a phosphor which is capable of storing the energy of alpha particles. In each pair one dosimeter is shielded from alpha particles with more than 18 mg/cm 2 thick opaque material but not gamma and beta rays and the other dosimeter is shielded with less than 1 mg/cm 2 thick opaque material to exclude dust. After a period underground the dosimeters are heated which releases the stored energy as light. The amount of light produced from the heavily shielded dosimeter is subtracted from the amount of light produced from the thinly shielded dosimeter to give an indication of the location and quantity of uranium underground

  7. Web cache location

    Directory of Open Access Journals (Sweden)

    Boffey Brian

    2004-01-01

    Full Text Available Stress placed on network infrastructure by the popularity of the World Wide Web may be partially relieved by keeping multiple copies of Web documents at geographically dispersed locations. In particular, use of proxy caches and replication provide a means of storing information 'nearer to end users'. This paper concentrates on the locational aspects of Web caching giving both an overview, from an operational research point of view, of existing research and putting forward avenues for possible further research. This area of research is in its infancy and the emphasis will be on themes and trends rather than on algorithm construction. Finally, Web caching problems are briefly related to referral systems more generally.

  8. Location based services

    OpenAIRE

    Doan, Cong Nam

    2015-01-01

    Mobile devices (tablets, smart phones, laptops) are proving themselves to be the main means of accessing information of the future. The embodiment of Recommender Systems (RSs) into mobile environments, as a matter of fact, has come about to serve as a way to solve the nuisances of data overwhelming. RSs' main advantage is their ability to allow users to find useful information according to the users' preferences and location. Even though they are not free of shortcoming such as the limitation...

  9. Location Intelligence Solutions

    International Nuclear Information System (INIS)

    Schmidt, D.

    2015-01-01

    Location Intelligence (LI) means using the spatial dimension of information as a key to support business processes. This spatial dimension has to be defined by geographic coordinates. Storing these spatial objects in a database allows for attaching a 'meaning' to them, like 'current position', 'border', 'building' or 'room'. Now the coordinates represent real-world objects, which can be relevant for the measurement, documentation, control or optimization of (parameters of) business processes aiming at different business objectives. But LI can only be applied, if the locations can be determined with an accuracy (in space and time) appropriate for the business process in consideration. Therefore the first step in any development of a LI solution is the analysis of the business process itself regarding its requirements for spatial and time resolution and accuracy. The next step is the detailed analysis of the surrounding conditions of the process: Does the process happen indoor and/or outdoor? Are there moving objects? If yes, how fast are they? How does the relevant environment look like? Is technical infrastructure available? Is the process restricted by regulations? As a result, a proper Location Detection Technology (LDT) has to be chosen in order to get reliable and accurate positions of the relevant objects. At the highly challenging conditions of the business processes IAEA inspectors are working with, the chosen LDTs have to deliver reliable positioning on ''room-level'' accuracy, even if there is no location enabling infrastructure in place, the objects (people) mostly are indoors and have to work under strong regulations. The presentation will give insights into innovative LI solutions based on technologies of different LDT providers. Pros and cons of combinations of different LDT (like multi- GNSS, IMU, camera, and human interaction based positioning) will be discussed from the

  10. Ammonia Leak Locator Study

    Science.gov (United States)

    Dodge, Franklin T.; Wuest, Martin P.; Deffenbaugh, Danny M.

    1995-01-01

    The thermal control system of International Space Station Alpha will use liquid ammonia as the heat exchange fluid. It is expected that small leaks (of the order perhaps of one pound of ammonia per day) may develop in the lines transporting the ammonia to the various facilities as well as in the heat exchange equipment. Such leaks must be detected and located before the supply of ammonia becomes critically low. For that reason, NASA-JSC has a program underway to evaluate instruments that can detect and locate ultra-small concentrations of ammonia in a high vacuum environment. To be useful, the instrument must be portable and small enough that an astronaut can easily handle it during extravehicular activity. An additional complication in the design of the instrument is that the environment immediately surrounding ISSA will contain small concentrations of many other gases from venting of onboard experiments as well as from other kinds of leaks. These other vapors include water, cabin air, CO2, CO, argon, N2, and ethylene glycol. Altogether, this local environment might have a pressure of the order of 10(exp -7) to 10(exp -6) torr. Southwest Research Institute (SwRI) was contracted by NASA-JSC to provide support to NASA-JSC and its prime contractors in evaluating ammonia-location instruments and to make a preliminary trade study of the advantages and limitations of potential instruments. The present effort builds upon an earlier SwRI study to evaluate ammonia leak detection instruments [Jolly and Deffenbaugh]. The objectives of the present effort include: (1) Estimate the characteristics of representative ammonia leaks; (2) Evaluate the baseline instrument in the light of the estimated ammonia leak characteristics; (3) Propose alternative instrument concepts; and (4) Conduct a trade study of the proposed alternative concepts and recommend promising instruments. The baseline leak-location instrument selected by NASA-JSC was an ion gauge.

  11. Ocean Disposal Site Monitoring

    Science.gov (United States)

    EPA is responsible for managing all designated ocean disposal sites. Surveys are conducted to identify appropriate locations for ocean disposal sites and to monitor the impacts of regulated dumping at the disposal sites.

  12. Improved Infrasound Event Location

    Science.gov (United States)

    2007-09-01

    Bolide (20) —— 1 signal —— 5-8 signals Mine Explosion (112) Volcano (20) —— 2 signals —— >8 signals Rocket Motor Test (1) Landslide (1) —— 3-4...significant bookkeeping, since the ray-tracing programs must be executed separately for each source-receiver-model scenario, each producing multiple...Infrasound monitoring of volcanoes to probe high-altitude winds, J. Geophys. Res. 110, D13106, doi: 10.1029/2004JD005587. Le Pichon, A., K

  13. Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

    Science.gov (United States)

    Myers, Julia A; Powell, David M C; Psirides, Alex; Hathaway, Karyn; Aldington, Sarah; Haney, Michael F

    2016-03-08

    In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. In the first phase of the project the anaesthetists' non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between different assessment approaches and assessors. The framework developed during phase one was referred to as an aeromedical non-technical skills framework, or AeroNOTS. During phase two 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study. Clinicians with inter-hospital transport experience performed more highly than those without experience, according to both AeroNOTS non-technical skills ratings (p = 0.001) and general performance ratings (p = 0.003). Self-ratings did not distinguish experienced from inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (r(s) = 0.4, p = 0

  14. 40 CFR 58.60 - Federal monitoring.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Federal monitoring. 58.60 Section 58.60... QUALITY SURVEILLANCE Federal Monitoring § 58.60 Federal monitoring. The Administrator may locate and operate an ambient air monitoring site if the State or local agency fails to locate, or schedule to be...

  15. Location Privacy with Randomness Consistency

    Directory of Open Access Journals (Sweden)

    Wu Hao

    2016-10-01

    Full Text Available Location-Based Social Network (LBSN applications that support geo-location-based posting and queries to provide location-relevant information to mobile users are increasingly popular, but pose a location-privacy risk to posts. We investigated existing LBSNs and location privacy mechanisms, and found a powerful potential attack that can accurately locate users with relatively few queries, even when location data is well secured and location noise is applied. Our technique defeats previously proposed solutions including fake-location detection and query rate limits.

  16. Indoor Location Technologies

    CERN Document Server

    Goswami, Subrata

    2013-01-01

    Focusing on the special challenges posed by accurately pinpointing a location indoors, this volume reflects the distance we have come in the handful of decades since the germination of GPS technology. Not only can we locate a signal to within a meter’s accuracy, but we now have this technology in the most basic mobile phone. Tracing recent practical developments in positioning technology and in the market it supplies, the author examines the contributions of the varied research—in silicon, signal and image processing, radio communications and software—to a fast-evolving field. The book looks forward to a time when, in addition to directing your road journey, positioning systems can peer indoors and guide you to an available photocopier in your office building. Featuring standalone chapters each dealing with a specific aspect of the subject, including treatments of systems such as Zebra, Awarepoint, Aeroscout, IEEE 802.11, etc. This study has all the detail needed to get up to speed on a key modern techn...

  17. Comparing the Effects of Dual-Task Gait Testing in New and Established Ambulators With Lower Extremity Amputations.

    Science.gov (United States)

    Frengopoulos, Courtney; Payne, Michael W C; Holmes, Jeffrey D; Viana, Ricardo; Hunter, Susan W

    2018-04-05

    Gait is a complex process that involves coordinating motor and sensory systems through higher-order cognitive processes. Walking with a prosthesis after lower extremity amputation challenges these processes. However, the factors that influence the cognitive-motor interaction in gait among lower extremity amputees has not been evaluated. To assess the interaction of cognition and mobility, individuals must be evaluated using the dual-task paradigm. To investigate the effect of etiology and time with prosthesis on dual-task performance in those with lower extremity amputations. Cross-sectional study. Outpatient and inpatient amputee clinics at an academic rehabilitation hospital. Sixty-four individuals (aged 58.20±12.27 years; 74.5% male) were stratified into 3 groups; 1 group of new prosthetic ambulators with transtibial amputations (NewPA) and 2 groups of established ambulators: transtibial amputations of vascular etiology (TTA-vas), transtibial amputations of nonvascular etiology (TTA-nonvas). Not applicable. Time to complete the L Test measured functional mobility under single and dual-task conditions. A serial arithmetic task (subtraction by 3s) was paired with the L Test to create the dual-task test condition. Single-task performance on the cognitive arithmetic task was also recorded. Dual-task costs (DTCs) were calculated for performance on the cognitive and gait tasks. Analysis of variance determined differences between groups. A performance-resource operating characteristic (POC) graph was used to graphically display DTCs. Gait performance was worse under dual-task conditions for all groups. Gait was significantly slower under dual-task conditions for the TTA-vas (P Dual-task conditions also had a negative impact on cognitive task performance for the TTA-nonvas (P = .02) and NewPA groups (P dual-task conditions and has a positive DTCcog as a result (P = .04). However, no between-group differences were seen for DTCcog. The POC graph demonstrated that many

  18. Seismic and Infrasound Location

    Energy Technology Data Exchange (ETDEWEB)

    Arrowsmith, Stephen J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Begnaud, Michael L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-03-19

    This presentation includes slides on Signal Propagation Through the Earth/Atmosphere Varies at Different Scales; 3D Seismic Models: RSTT; Ray Coverage (Pn); Source-Specific Station Corrections (SSSCs); RSTT Conclusions; SALSA3D (SAndia LoS Alamos) Global 3D Earth Model for Travel Time; Comparison of IDC SSSCs to RSTT Predictions; SALSA3D; Validation and Model Comparison; DSS Lines in the Siberian Platform; DSS Line CRA-4 Comparison; Travel Time Δak135; Travel Time Prediction Uncertainty; SALSA3D Conclusions; Infrasound Data Processing: An example event; Infrasound Data Processing: An example event; Infrasound Location; How does BISL work?; BISL: Application to the 2013 DPRK Test; and BISL: Ongoing Research.

  19. Demographics and remote locations

    Energy Technology Data Exchange (ETDEWEB)

    Coppus, G. [Dynawise Inc., Calgary, AB (Canada)

    2005-07-01

    Within the next decade, the number of people leaving the workforce will exceed the number of new entrants. The demand for workers is expected to increase in Alberta due to oil sands industry growth. Sixty-four per cent of all responding federal, provincial, and municipal government organizations have reported shortages in their work environments, and almost 8 in 10 organizations predict they will continue to be understaffed in the next 3 to 5 years. Tightness in the general labour market will have an impact on employers in remote locations, and planning is essential to avoid the creation of a mercenary culture and a reliance on compensation. Challenges found in remote locations include high turnover rates among recent hires; critical gaps in service length; aggressive retirement; and the fact that the local population is often seen as unqualified for many industrial jobs. This Power Point presentation suggested that although decisions to join or quit a company are often based on considerations such as the organizational environment and amount of compensation, the relationship between employees and management is the most important attribute in many career decisions. Rigorous quantitative analysis of current demographics combined with forecasting analysis may help to forestall recruitment difficulties for many companies. Productivity analyses, and the effects of work overload on absenteeism, attrition and quality of workmanship must also be examined. Many companies are now focusing on retention and development strategies on mid-career staff to address depletion, as well as redesigning procedures to operate with less skilled staff. It was concluded that extra efforts are now being made to attract non-traditional employees, and non-traditional employment models are being considered by some companies. refs., tabs., figs.

  20. Effects of a Static Bicycling Programme on the Functional Ability of Young People with Cerebral Palsy Who Are Non-Ambulant

    Science.gov (United States)

    Williams, Heather; Pountney, Teresa

    2007-01-01

    This study investigated the effects of exercise on the motor function of 11 young people (10 females, one male; age range 11-15y; mean age 12y 7mo [SD 1y 4mo]) with cerebral palsy (CP) who were non-ambulant (Gross Motor Function Classification System Levels IV or V), using an adapted static bicycle. Three participants had dyskinetic quadriplegia,…

  1. Feasibility of robotic exoskeleton ambulation in a C4 person with incomplete spinal cord injury: a case report.

    Science.gov (United States)

    Lester, Robert M; Gorgey, Ashraf S

    2018-01-01

    To determine whether an individual with C4 incomplete spinal cord injury (SCI) with limited hand functions can effectively operate a powered exoskeleton (Ekso) to improve parameters of physical activity as determined by swing-time, up-time, walk-time, and total number of steps. A 21-year-old male with incomplete chronic (>1 year postinjury) SCI C4, participated in a clinical exoskeleton program to determine the feasibility of standing up and walking with limited hand functions. The participant was invited to attend 3 sessions including fitting, familiarization and gait training separated by one week intervals. Walk-time, up-time and total number of steps were measured during each training session. A complete body composition assessment using dual-energy X-ray absorptiometry (DXA) of the spine, knees and hips was conducted before training.Using a platform walker and cuffing both hands, the participant managed to stand up and ambulate successfully using exoskeleton. Over the course of 2 weeks, maximum walk-time increased from 7 to 17 min and number of steps increased from 83 to 589 steps. The total up-time increased from 19 to 31 min. Exoskeleton training may be a safe and feasible approach for persons with higher levels of SCI after effectively providing a supportive assistive device for weight shifting. The current case study demonstrates the use of a powered exoskeleton for an individual with high level tetraplegia (C4 and above) and limited hand functions.

  2. Barriers to the medication error reporting process within the Irish National Ambulance Service, a focus group study.

    Science.gov (United States)

    Byrne, Eamonn; Bury, Gerard

    2018-02-08

    Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring. Even though reporting systems are in place, the levels appear to be well below what might be expected. Little data is available to explain this apparent discrepancy. To identify, investigate and document the barriers to medication error reporting within the NAS. An independent moderator led four focus groups in March of 2016. A convenience sample of 18 frontline Paramedics and Advanced Paramedics from Cork City and County discussed medication errors and the medication error reporting process. The sessions were recorded and anonymised, and the data was analysed using a process of thematic analysis. Practitioners understood the value of reporting errors. Barriers to reporting included fear of consequences and ridicule, procedural ambiguity, lack of feedback and a perceived lack of both consistency and confidentiality. The perceived consequences for making an error included professional, financial, litigious and psychological. Staff appeared willing to admit errors in a psychologically safe environment. Barriers to reporting are in line with international evidence. Time constraints prevented achievement of thematic saturation. Further study is warranted.

  3. The Doctor Can See You Now: A Key Stakeholder Study Into The Acceptability Of Ambulance Based Telemedicine.

    LENUS (Irish Health Repository)

    Gilligan, P

    2018-06-01

    Using telecommunications technology it would be possible to link a patient and paramedic to a Doctor in the Emergency Department (ED) at the point of first patient contact. A questionnaire-based study on telemedicine in the pre-hospital environment involving patients, paramedics, doctors and nurses in the ED, was performed to assess if they would want and accept telemedicine in pre-hospital emergency care. When asked 98.5% (55) of patients, 89% (11) of doctors, 76% (14) of nurses and 91% (42) of ambulance personnel saw the potential of an audio-visual link from the pre-hospital environment to the ED. The potential benefits were felt to be in diagnosis of time-dependent illnesses, time management, increased hospital preparedness for incoming patients and increased triage efficiency. Stakeholder enthusiasm for pre-hospital telemedicine must be met with the technological requirements to provide such a service. As noted by one patient a pre-hospital audio-visual link to the ED could be “potentially a life saving service”.

  4. 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.

  5. Location constrained resource interconnection

    International Nuclear Information System (INIS)

    Hawkins, D.

    2008-01-01

    This presentation discussed issues related to wind integration from the perspective of the California Independent System Operator (ISO). Issues related to transmission, reliability, and forecasting were reviewed. Renewable energy sources currently used by the ISO were listed, and details of a new transmission financing plan designed to address the location constraints of renewable energy sources and provide for new transmission infrastructure was presented. The financing mechanism will be financed by participating transmission owners through revenue requirements. New transmission interconnections will include network facilities and generator tie-lines. Tariff revisions have also been implemented to recover the costs of new facilities and generators. The new transmission project will permit wholesale transmission access to areas where there are significant energy resources that are not transportable. A rate impact cap of 15 per cent will be imposed on transmission owners to mitigate short-term costs to ratepayers. The presentation also outlined energy resource area designation plans, renewable energy forecasts, and new wind technologies. Ramping issues were also discussed. It was concluded that the ISO expects to ensure that 20 per cent of its energy will be derived from renewable energy sources. tabs., figs

  6. On location at CERN

    CERN Multimedia

    Joannah Caborn Wengler

    2012-01-01

    CERN continues to be a very popular candidate for film locations at the moment. Not only has it inspired a German author and a film-maker interested in the more exotic interpretations of the science being worked on at the Organization, but even the recent puppet animation film by the legendary Muppets featured some CERN scenes.   Dr Bunsen Honeydew (far left) and his friends at ATLAS. Beaker, Bunsen's assistant, has just been sucked up the vacuum tube top left... Image courtesy Walt Disney Studios. In “The Muppet Movie”, released in November 2011 in North America and world-wide in January and February this year, Kermit is reuniting his friends who have ended up in some far-flung places since they last worked together 10 years ago. CERN caught the imagination of the film-makers as the perfect place for the Muppet scientists, Dr. Honeydew Bunsen and his hapless assistant Beaker. After a brief scene filmed in front of a backdrop of the ATLAS detector, the rest of the ...

  7. The leak detection and location system design of petroleum pipeline

    International Nuclear Information System (INIS)

    Liu Lixia

    2011-01-01

    In order to improve the sensibility and location precision of petroleum pipeline leak with traditional negative pressure wave detection, a multi-point distributed detection and location monitoring system composed of detection nodes along pipeline, monitoring sub-stations and pressure monitoring center was designed using C/S structure. The detection node gets the pressure signal in pipeline, and sends it to monitoring center through CPRS network that achieves online monitoring for the whole pipeline in real time. The received data was analyzed and processed with multi-point distributed negative pressure wave detection and correlation analysis method. The system can rapidly detect the leak point in pipeline timely and locate accurately to avoid enormous economic loss and environment pollutions accidents. (author)

  8. Ground-based photo monitoring

    Science.gov (United States)

    Frederick C. Hall

    2000-01-01

    Ground-based photo monitoring is repeat photography using ground-based cameras to document change in vegetation or soil. Assume those installing the photo location will not be the ones re-photographing it. This requires a protocol that includes: (1) a map to locate the monitoring area, (2) another map diagramming the photographic layout, (3) type and make of film such...

  9. Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control.

    Science.gov (United States)

    Low Choy, Nancy L; Lucey, Mary-Therese M; Lewandowski, Susan L; Panizza, Benedict J

    2017-05-01

    To investigate balance, community mobility, gaze instability, and dizziness handicap and assess falls risk in people who are conservatively managed with small vestibular schwannoma (VS). Cross-sectional study with controls. The study involved 18 people (mean age 58.7 ± 12.2 years) diagnosed with VS (<12 mm) and 22 age-matched controls (mean age 56.9 ± 8.0 years). Measures included standing on firm and foam surfaces with feet apart, then together with eyes open and closed, Timed Up and Go (TUG) test and dual TUG test, Dynamic Gait Index, 6-Minute Walk Test, Halmagyi Impulse Test, Dynamic Visual Acuity Test, and the Dizziness Handicap Inventory. The clinical group failed more trials standing feet together on foam with eyes closed (P < .05); had inferior mobility and walked more slowly with divided attention (P < .05); had more difficulty walking with head movement, negotiating obstacles, and using stairs (P < .01); and walked shorter distances (P < .001) than controls. Reduced gaze stability (P < .01) and higher total (P = .007) and subcategory dizziness handicap scores (P < .05) were revealed compared to age-matched controls. Although outcomes for the clinical group are inferior to the control group across all measures and the dizziness impact is higher, the results fall in the low-risk category for falls. Preliminary data (level 4 evidence) support using a suite of clinical measures to monitor people with VS during conservative management. 4 Laryngoscope, 127:1147-1152, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  10. Costly location in Hotelling duopoly

    NARCIS (Netherlands)

    Hinloopen, J.; Martin, S.

    2013-01-01

    We introduce a cost of location into Hotelling’s (1929) spatial duopoly. We derive the general conditions on the cost-of-location function under which a pure strategy price-location Nash equilibrium exists. With linear transportation cost and a suitably specified cost of location that rises toward

  11. Costly location in Hotelling duopoly

    NARCIS (Netherlands)

    Hinloopen, J.; Martin, S.

    We introduce a cost of location into Hotelling's (1929) spatial duopoly model. We derive the general conditions on the cost-of-location function under which a pure strategy price-location Nash equilibrium exists. With linear transportation cost and a suitably specified cost of location that rises

  12. Environmental Monitoring, Water Quality - MO 2009 Stream Team Volunteer Water Quality Monitoring Sites (SHP)

    Data.gov (United States)

    NSGIC State | GIS Inventory — This data set shows the monitoring locations of trained Volunteer Water Quality Monitors. A monitoring site is considered to be a 300 foot section of stream channel....

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

    Science.gov (United States)

    Patel, Alka B; Waters, Nigel M; Blanchard, Ian E; Doig, Christopher J; Ghali, William A

    2012-10-03

    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. 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. 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. The widespread use of generalized EMS pre-hospital time assumptions based on US data may not be appropriate in a

  14. Material monitoring

    International Nuclear Information System (INIS)

    Kotter, W.; Zirker, L.; Hancock, J.A.

    1995-01-01

    Waste Reduction Operations Complex (WROC) facilities are located at the Idaho National Engineering Laboratory (INEL). The overall goal for the Pollution Prevention/Waste Minimization Unit is to identify and establish the correct amount of waste generated so that it can be reduced. Quarterly, the INEL Pollution Prevention (P2) Unit compares the projected amount of waste generated per process with the actual amount generated. Examples of waste streams that would be addresses for our facility would include be are not limited to: Maintenance, Upgrades, Office and Scrap Metal. There are three potential sources of this variance: inaccurate identification of those who generate the waste; inaccurate identification of the process that generates the waste; and inaccurate measurement of the actual amount generated. The Materials Monitoring Program was proposed to identify the sources of variance and reduce the variance to an acceptable level. Prior to the implementation of the Material Monitoring Program, all information that was gathered and recorded was done so through an informal estimation of waste generated by various personnel concerned with each processes. Due to the inaccuracy of the prior information gathering system, the Material Monitoring Program was established. The heart of this program consists of two main parts. In the first part potential waste generators provide information on projected waste generation process. In the second part, Maintenance, Office, Scrap Metal and Facility Upgrade wastes from given processes is disposed within the appropriate bin dedicated to that process. The Material Monitoring Program allows for the more accurate gathering of information on the various waste types that are being generated quarterly

  15. Short-Term Changes in Weather and Space Weather Conditions and Emergency Ambulance Calls for Elevated Arterial Blood Pressure

    Directory of Open Access Journals (Sweden)

    Jone Vencloviene

    2018-03-01

    Full Text Available Circadian rhythm influences the physiology of the cardiovascular system, inducing diurnal variation of blood pressure. We investigated the association between daily emergency ambulance calls (EACs for elevated arterial blood pressure during the time intervals of 8:00–13:59, 14:00–21:59, and 22:00–7:59 and weekly fluctuations of air temperature (T, barometric pressure, relative humidity, wind speed, geomagnetic activity (GMA, and high-speed solar wind (HSSW. We used the Poisson regression to explore the association between the risk of EACs and weather variables, adjusting for seasonality and exposure to CO, PM10, and ozone. An increase of 10 °C when T > 1 °C on the day of the call was associated with a decrease in the risk of EACs during the time periods of 14:00–21:59 (RR (rate ratio = 0.78; p < 0.001 and 22:00–7:59 (RR = 0.88; p = 0.35. During the time period of 8:00–13:59, the risk of EACs was positively associated with T above 1 °C with a lag of 5–7 days (RR = 1.18; p = 0.03. An elevated risk was associated during 8:00–13:59 with active-stormy GMA (RR = 1.22; p = 0.003; during 14:00–21:59 with very low GMA (RR = 1.07; p = 0.008 and HSSW (RR = 1.17; p = 0.014; and during 22:00–7:59 with HSSW occurring after active-stormy days (RR = 1.32; p = 0.019. The associations of environmental variables with the exacerbation of essential hypertension may be analyzed depending on the time of the event.

  16. Continuous versus patient-controlled epidural analgesia for labour analgesia and their effects on maternal motor function and ambulation.

    Science.gov (United States)

    Lovach-Chepujnoska, Margarita; Nojkov, Jordan; Joshevska-Jovanovska, Slagjana; Domazetov, Robert

    2014-01-01

    The advantages of patient-controlled epidural analgesia (PCEA) for delivery compared with continuous epidural analgesia (CEA) have been a point of interest in research obstetric anaesthesia for more than two decades. The aim of this single blind randomized controlled study was to evaluate the incidence of motor block and ability to perform partial knee flexion in women who received CEA or PCEA. Fifty-one healthy nulliparous women were included in this study. After an initial dose and established sensory block at Th 10, parturients were randomized into two groups: group CEA (10 ml/h), and group PCEA (bolus - 5 ml, lockout interval - 15 minutes, basal rate - 0 ml) with bupivacaine 0.08% and fentanyl 2 µg/ml. The motor function of the lower limbs was evaluated by modified Bromage scale at regular hourly intervals until full cervical dilatation. The quality of analgesia was assessed using a visual analogue pain scale (VAPS) and maternal satisfaction. Mode of delivery, the total number of additional rescue boluses, foetal and neonatal outcomes were recorded. Motor block was significantly lower in the third (33.3% vs. 4.35%; p = 0.008), fourth (57.9% vs. 6.3%; p = 0.003) and fifth hour (75.0% vs. 18.2%; p = 0.001) in the PCEA group. Ambulation occurred in 18% in the CEA and 46% in the PCEA group (p = 0.036). VAPS was with borderline significance in the second (p = 0.076) and significantly lower in the fourth hour (p = 0.034). Compared with CEA, PCEA provided less motor block and better first-stage analgesia, which leads to the conclusion that patient-controlled analgesia techniques are the preferred model in obstetric anesthesia.

  17. Duality in constrained location problems

    DEFF Research Database (Denmark)

    Juel, Henrik; Love, Robert F.

    1987-01-01

    The dual of a facility location problem with general norms, distance constraints, and linear constraints is formulated.......The dual of a facility location problem with general norms, distance constraints, and linear constraints is formulated....

  18. ICE Online Detainee Locator System

    Data.gov (United States)

    Department of Homeland Security — The Online Detainee Locator datasets provide the location of a detainee who is currently in ICE custody, or who was release from ICE custody for any reason with the...

  19. OLBS: Offline location based services

    OpenAIRE

    Coelho, P; Ana Aguiar; João Correia Lopes

    2011-01-01

    Most existing location-based services rely on ubiquitous connectivity to deliver location-based contents to the users. However, connectivity is not available anywhere at anytime even in urban centres. Underground, indoors, remote areas, and foreign countries are examples situations where users commonly do not have guaranteed connectivity but could profit from location-based contents. In this work, we propose an open platform for publishing, distributing and maintaining location-based contents...

  20. LOCAT - A Data Retrieval Program.

    Science.gov (United States)

    1984-12-01

    onoitode of scified location - P C RADIUS - maximum distance between specified location and C file locationsC . ’ CONNON /LOCN/ LOCLAT, LOCLNG, RADIUS...rrr’, ,r:.- r -’ - r- rJ Z. . . , . -.-. - - - - - - -- , -• .. . . FILMED 8-85 DTIC .-. ... , ,- . . . . ...: .--. :,.:. ..-..-- ,-, .-..-...

  1. Location theory a unified approach

    CERN Document Server

    Nickel, Stefan

    2006-01-01

    Although modern location theory is now more than 90 years old, the focus of researchers in this area has been mainly problem oriented. However, a common theory, which keeps the essential characteristics of classical location models, is still missing.This monograph addresses this issue. A flexible location problem called the Ordered Median Problem (OMP) is introduced. For all three main subareas of location theory (continuous, network and discrete location) structural properties of the OMP are presented and solution approaches provided. Numerous illustrations and examples help the reader to bec

  2. Location of Urban Logistic Terminals as Hub Location Problem

    Directory of Open Access Journals (Sweden)

    Jasmina Pašagić Škrinjar

    2012-09-01

    Full Text Available In this paper the problems of locating urban logistic terminals are studied as hub location problems that due to a large number of potential nodes in big cities belong to hard non-polynomial problems, the so-called NP-problems. The hub location problems have found wide application in physical planning of transport and telecommunication systems, especially systems of fast delivery, networks of logistic and distribution centres and cargo traffic terminals of the big cities, etc. The paper defines single and multiple allocations and studies the numerical examples. The capacitated single allocation hub location problems have been studied, with the provision of a mathematical model of selecting the location for the hubs on the network. The paper also presents the differences in the possibilities of implementing the exact and heuristic methods to solve the actual location problems of big dimensions i.e. hub problems of the big cities.

  3. Location, Location, Location: Does Place Provide the Opportunity for Differentiation for Universities?

    Science.gov (United States)

    Winter, Emma; Thompson-Whiteside, Helen

    2017-01-01

    The fiercely competitive HE market has led HEIs to invest significant resources in building a distinct identity. An HEI's location forms an inherent part of its identity and the uniqueness of location offers an opportunity to differentiate. However there has been limited examination of how location is used by HEIs and little consideration of how…

  4. Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial.

    Science.gov (United States)

    Park, Hyun-Ju; Oh, Duck-Won; Choi, Jong-Duk; Kim, Jong-Man; Kim, Suhn-Yeop; Cha, Yong-Jun; Jeon, Su-Jin

    2017-08-01

    To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. Randomized, controlled pilot study. Inpatient rehabilitation hospital. A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group ( n = 12) or control group ( n = 13). Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. Changes in the values for the 10-m walk test (0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s), community walk test (-151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds), and activities-specific balance confidence (6.25 ±5.61 scores vs. 0.72 ±2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 ±11.34 cm vs. 3.16 ±11.20 cm), single support (5.87 ±5.13% vs. 0.25 ±5.95%), and velocity (15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.

  5. Ambulant transbrachial 4-french-arteriograhy with special reference to the aorto-femoral territory. Ambulante transbrachiale 4-French-Arteriographie unter besonderer Beruecksichtigung der aortofemoralen Strombahn

    Energy Technology Data Exchange (ETDEWEB)

    Spindler-Thiele, S. (Klinikum Ingolstadt (Germany). Inst. fuer Strahlendiagnostik); Schmitt, R. (Klinikum Ingolstadt (Germany). Inst. fuer Strahlendiagnostik); Helmberger, T. (Klinikum Ingolstadt (Germany). Inst. fuer Strahlendiagnostik); Pogan, J. (Klinikum Ingolstadt (Germany). Inst. fuer Strahlendiagnostik); Gullotta, U. (Klinikum Ingolstadt (Germany). Inst. fuer Strahlendiagnostik)

    1993-08-01

    Arteriograms were carried out on 176 patients using 4-F catheters through a transbrachial approach. Criteria for exclusion from the series were injuries to the upper limb, hemiparesis or poor pulses in the presence of a normal femoral pulse. There were no local vascular complications requiring treatment. On two occasions the brachial artery could not be punctured. Acute posterior cerebral infarction was the only serious complication (0.5%). 67% of the patients were examined on an outpatient basis and this did not appear to increase the risk of complication. We regard this as a suitable method for demonstrating the pelvic and lower limb arteries on ambulant patients. (orig.)

  6. Interfacility transfer of pregnant women using publicly funded emergency call centre-based ambulance services: a cross-sectional analysis of service logs from five states in India.

    Science.gov (United States)

    Singh, Samiksha; Doyle, Pat; Campbell, Oona Mr; Oakley, Laura; Rao, Gv Ramana; Murthy, Gvs

    2017-06-09

    To estimate the proportion of interfacility transfers (IFTs) transported by '108' ambulances and to compare the characteristics of the IFTs and non-IFTs to understand the pattern of use of '108' services for pregnant women in India. A cross-sectional analysis of '108' ambulance records from five states for the period April 2013 to March 2014. Data were obtained from the call centre database for the pregnant women, who called '108'. Proportion of all pregnancies and institutional deliveries in the population who were transported by '108', both overall and for IFT. Characteristics of the women transported; obstetric emergencies, the distances travelled and the time taken for both IFT and non-IFT. The '108' ambulances transported 6 08 559 pregnant women, of whom 34 993 were IFTs (5.8%) in the five states. We estimated that '108' transferred 16.5% of all pregnancies and 20.8% of institutional deliveries. Only 1.2% of all institutional deliveries in the population were transported by '108' for IFTs-lowest 0.6% in Gujarat and highest 3.0% in Himachal Pradesh. Of all '108' IFTs, only 8.4% had any pregnancy complication. For all states combined, on adjusted analysis, IFTs were more likely than non-IFTs to be for older and younger women or from urban areas, and less likely to be for women from high-priority districts, from backward or scheduled castes, or women below the poverty line. Obstetric emergencies were more than twice as likely to be IFTs as pregnant women without obstetric emergencies (OR=2.18, 95% CI 2.09 to 2.27). There was considerable variation across states. Only 6% institutional deliveries made use of the '108' ambulance for IFTs in India. The vast majority did not have any complication or emergency. The '108' service may need to consider strategies to prioritise the transfer of women with obstetric emergency and those requiring IFT, over uncomplicated non-IFT. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  7. Location Systems An Introduction to the Technology Behind Location Awareness

    CERN Document Server

    LaMarca, Anthony

    2008-01-01

    Advances in electronic location technology and the coming of age of mobile computing have opened the door for location-aware applications to permeate all aspects of everyday life. Location is at the core of a large number of high-value applications ranging from the life-and-death context of emergency response to serendipitous social meet-ups. For example, the market for GPS products and services alone is expected to grow to US200 billion by 2015. Unfortunately, there is no single location technology that is good for every situation and exhibits high accuracy, low cost, and universal coverage.

  8. 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

    2012-04-01

    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

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

    Science.gov (United States)

    Freeman, Jennifer; Fox, Esther; Gear, Margaret; Hough, Alan

    2012-04-05

    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 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 abdominal muscles will be performed before

  10. Location-based prospective memory.

    Science.gov (United States)

    O'Rear, Andrea E; Radvansky, Gabriel A

    2018-02-01

    This study explores location-based prospective memory. People often have to remember to do things when in a particular location, such as buying tissues the next time they are in the supermarket. For event cognition theory, location is important for structuring events. However, because event cognition has not been used to examine prospective memory, the question remains of how multiple events will influence prospective memory performance. In our experiments, people delivered messages from store to store in a virtual shopping mall as an ongoing task. The prospective tasks were to do certain activities in certain stores. For Experiment 1, each trial involved one prospective memory task to be done in a single location at one of three delays. The virtual environment and location cues were effective for prospective memory, and performance was unaffected by delay. For Experiment 2, each trial involved two prospective memory tasks, given in either one or two instruction locations, and to be done in either one or two store locations. There was improved performance when people received instructions from two locations and did both tasks in one location relative to other combinations. This demonstrates that location-based event structure influences how well people perform on prospective memory tasks.

  11. Préambule

    OpenAIRE

    Guedj, Pauline; P. Santiago, Jorge

    2013-01-01

    En France, depuis le début des années 2000, l’analyse des pratiques musicales est devenue un champ particulièrement dynamique de l’anthropologie. La musique, tout comme la danse, constituent des objets stimulants pour notre discipline, que les anthropologues investissent et qui les positionnent dans un dialogue sans cesse renouvelé avec des ethnomusicologues, des historiens de la musique, des sociologues de l’art, des philosophes et des géographes. Pour ces anthropologues, la musique revêt p...

  12. Evaluating Trajectory Queries over Imprecise Location Data

    DEFF Research Database (Denmark)

    Xie, Scott, Xike; Cheng, Reynold; Yiu, Man Lung

    2012-01-01

    Trajectory queries, which retrieve nearby objects for every point of a given route, can be used to identify alerts of potential threats along a vessel route, or monitor the adjacent rescuers to a travel path. However, the locations of these objects (e.g., threats, succours) may not be precisely...... obtained due to hardware limitations of measuring devices, as well as the constantly-changing nature of the external environment. Ignoring data uncertainty can render low query quality, and cause undesirable consequences such as missing alerts of threats and poor response time in rescue operations. Also......, the query is quite time-consuming, since all the points on the trajectory are considered. In this paper, we study how to efficiently evaluate trajectory queries over imprecise location data, by proposing a new concept called the u-bisector. In general, the u-bisector is an extension of bisector to handle...

  13. Quarter Dates Location(s) Purpose Transportation and Travel ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    Dates. Location(s). Purpose. Transportation and Travel. Accommodation,. Meals and Other. Hospitality. Total. Expenses. Quarter 1. May 15. Ottawa, ON. Meetings. May 20 to 21. Washington DC. Conference. 11,364.93. 3,274.71. 53.50. 14,693.14. May 5 to June 5. Kenya and England. Meetings. June 18 to 21. Winnipeg, MB.

  14. Locating industrial VOC sources with aircraft observations

    International Nuclear Information System (INIS)

    Toscano, P.; Gioli, B.; Dugheri, S.; Salvini, A.; Matese, A.; Bonacchi, A.; Zaldei, A.; Cupelli, V.; Miglietta, F.

    2011-01-01

    Observation and characterization of environmental pollution, focussing on Volatile Organic Compounds (VOCs), in a high-risk industrial area, are particularly important in order to provide indications on a safe level of exposure, indicate eventual priorities and advise on policy interventions. The aim of this study is to use the Solid Phase Micro Extraction (SPME) method to measure VOCs, directly coupled with atmospheric measurements taken on a small aircraft environmental platform, to evaluate and locate the presence of VOC emission sources in the Marghera industrial area. Lab analysis of collected SPME fibres and subsequent analysis of mass spectrum and chromatograms in Scan Mode allowed the detection of a wide range of VOCs. The combination of this information during the monitoring campaign allowed a model (Gaussian Plume) to be implemented that estimates the localization of emission sources on the ground. - Highlights: → Flight plan aimed at sampling industrial area at various altitudes and locations. → SPME sampling strategy was based on plume detection by means of CO 2 . → Concentrations obtained were lower than the limit values or below the detection limit. → Scan mode highlighted presence of γ-butyrolactone (GBL) compound. → Gaussian dispersion modelling was used to estimate GBL source location and strength. - An integrated strategy based on atmospheric aircraft observations and dispersion modelling was developed, aimed at estimating spatial location and strength of VOC point source emissions in industrial areas.

  15. Location Based Services and Applications

    OpenAIRE

    Elenis Gorrita Michel; Rónier Sierra Dávila; Samuel Montejo Sánchez

    2012-01-01

    Location Based Services (LBS) continue to grow in popularity, effectiveness and reliability, to the extent that applications are designed and implemented taking into account the facilities of the user location information. In this work, some of the main applications are addressed, in order to make an assessment of the current importance of the LBS, as a branch of technology in full swing. In addition, the main techniques for location estimation are studied, essential information to the LBS. B...

  16. Radiation monitoring

    International Nuclear Information System (INIS)

    Larsson, L.Eh.; B'yuli, D.K.; Karmikel, Dzh.Kh.E.

    1985-01-01

    Recommendations on radiation monitoring of personnel, used medical ionizing radiation source, are given. The necessity to carry out radiation monitoring of situation at medical personnel's positions and personnel dosimetry is marked. It is convenient to subdivide radiation monitoring into 3 types: usual, surgical and special. Usual monitoring is connected with current work; surgical monitoring is carried out to receive information during a concrete operation; special monitoring is used to detect possible deviation from standard conditions of work or when suspecting them

  17. Ambulance services in London and Great Britain from 1860 until today: a glimpse of history gleaned mainly from the pages of contemporary journals.

    Science.gov (United States)

    Pollock, Alexander

    2013-03-01

    Little has been published on the subject of civil ambulance services and their development from the mid-19th century in the UK until modern times. There is limited secondary literature available which provides useful background information on the subject and most organisations may give brief histories of their early days but these sources lack historical adequacy in terms of detail. This article shows part of the uncertain path which the history followed towards the service which we enjoy today. From the pages of the British Medical Journal and the Lancet and Hansard, the battle to set up the service is followed and an indication of the drivers towards change over the period is revealed in the attitudes expressed. In particular, the two World Wars are seen to be the stepwise stimuli to providing a necessary service to the British population where the will to achieve this had hitherto been lacking at a parliamentary level. The history of the London Ambulance Service is chosen because more is written about it in these journals but services in other British cities and the USA are mentioned since they played a part in influencing change.

  18. Use of a unipedal standing test to assess the ambulation reacquisition time during the early postoperative stage after hip fracture in elderly Japanese: prospective study.

    Science.gov (United States)

    Murata, Koichi; Sugitani, Shigeki; Yoshioka, Hiroki; Noguchi, Takashi; Aoto, Toshiyuki; Nakamura, Takashi

    2010-01-01

    The aim of this study was to predict the ambulation reacquisition time after hip fracture in elderly people using the unipedal standing test during the early postoperative stage. Patients with an intertrochanteric fracture treated with internal fixation (n = 35) and patients with a femoral neck fracture treated with hemiarthroplasty (n = 22) were included. A unipedal standing test using the nonoperated leg was performed on days 3 and 7 after the operation. Among the patients with an intertrochanteric fracture, those with a positive result on the unipedal standing test on postoperative day (POD) 3 attained gait with parallel guide bars (BG) and walker-assisted gait (WG) significantly earlier than did patients with a negative result on the unipedal standing test. Patients with a positive result on the unipedal standing test on POD 7 attained BG, WG, and cane-assisted gait (CG) significantly earlier than did patients with a negative test. Among patients with a femoral neck fracture, those with a positive unipedal standing test result on POD 3 attained BG, WG, and CG significantly earlier than did patients with a negative test. Those with a positive test result on POD 7 attained BG, WG, and CG significantly earlier than did patients with a negative test. The unipedal standing test given during the early postoperative stage is a good test for predicting the ambulation reacquisition time. Moreover, it gives information that can help determine the need for subacute rehabilitation and about discharge planning and health service provision.

  19. Location i det geopolitiske rum

    DEFF Research Database (Denmark)

    Agger, Gunhild

    2017-01-01

    Hovedformålet med artiklen er at undersøge forholdet mellem genrehåndtering og location i The Night Manager. Genren er thrilleren i den spionudgave, der er kendt fra tidligere John Le Carré-filmatiseringer. Location passer perfekt til genren med valget af glamourøse steder, der har kunnet bruges i...

  20. Improved Dynamic Planar Point Location

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Arge, Lars; Georgiadis, Loukas

    2006-01-01

    We develop the first linear-space data structures for dynamic planar point location in general subdivisions that achieve logarithmic query time and poly-logarithmic update time.......We develop the first linear-space data structures for dynamic planar point location in general subdivisions that achieve logarithmic query time and poly-logarithmic update time....

  1. Evolutionary economics and industry location

    NARCIS (Netherlands)

    Boschma, R.A.; Frenken, K.

    2003-01-01

    This paper aims to provide the outlines of an evolutionary economic geography of industry location. We discuss two evolutionary explanations of industry location, that is, one that concentrates on spin-offs, and one that focuses attention on knowledge and agglomeration economies. We claim that both

  2. Locations in television drama series

    DEFF Research Database (Denmark)

    Waade, Anne Marit

    in the extra bonus material (Gray, 2010; Waade, 2013), and film tours and film apps become part of the television series’ trans-media franchise (Reijnders, 2011; Thompson, 2007). Location has so far been a practical term describing the place where the series is shot. Ellis (1992) used to see location...

  3. Locations in Television Drama Series

    DEFF Research Database (Denmark)

    Waade, Anne Marit

    2017-01-01

    This special issue is dedicated to the analysis of the increasingly significant role of location as a key element in television drama. In recent years, the popularity of serial television has progressively been tied to the expanded use of location as a central element in productions, both as sett...... mainly been considered as a practical term in film and television productions....

  4. Family ties and residential locations

    NARCIS (Netherlands)

    Mulder, C.H.; Cooke, T.J.

    2009-01-01

    In this paper, and in the Special Issue it introduces, the focus is on the role of family ties in residential location choice and, conversely, the role of residential locations in maintaining family ties. Not only do events in the nuclear family trigger residential relocations, but nearby family

  5. Uncapacitated facility location problems: contributions

    Directory of Open Access Journals (Sweden)

    Galvão Roberto Diéguez

    2004-01-01

    Full Text Available The objective of the present paper is to review my personal contributions in the field of uncapacitated facility location problems. These contributions took place throughout my academic career, from the time I was a Ph.D. student at Imperial College to the present day. They cover approximately 30 years, from 1973 to 2003; they address: algorithms developed for the p-median problem and for a general formulation of uncapacitated location problems; the study of dynamic location models; covering and hierarchical location problems; queuing-based probabilistic location models. The contributions encompass theoretical developments, computational algorithms and practical applications. All work took place in an academic environment, with the invaluable collaboration of colleagues (both in Brazil and abroad and research students at COPPE. Each section in the paper is dedicated to a topic that involves a personal contribution. Every one of them is placed within the context of the existing literature.

  6. Modeling discrete competitive facility location

    CERN Document Server

    Karakitsiou, Athanasia

    2015-01-01

    This book presents an up-to-date review of modeling and optimization approaches for location problems along with a new bi-level programming methodology which captures the effect of competition of both producers and customers on facility location decisions. While many optimization approaches simplify location problems by assuming decision making in isolation, this monograph focuses on models which take into account the competitive environment in which such decisions are made. New insights in modeling, algorithmic and theoretical possibilities are opened by this approach and new applications are possible. Competition on equal term plus competition between market leader and followers are considered in this study, consequently bi-level optimization methodology is emphasized and further developed. This book provides insights regarding modeling complexity and algorithmic approaches to discrete competitive location problems. In traditional location modeling, assignment of customer demands to supply sources are made ...

  7. Integrated environmental monitoring -- prototype demonstration

    International Nuclear Information System (INIS)

    Bryce, R.W.; Vail, L.W.; Hostetler, D.D.; Meyer, P.D.; Carlson, T.J.; Miller, P.L.

    1994-01-01

    Groundwater monitoring is an important activity at US Department of Energy (DOE) sites. Monitoring programs at DOE facilities have evolved in response to operational needs at the facilities, public outcries for information, regulatory requirements, DOE orders, and improvements in monitoring technology. Decisions regarding sampling location, sampling frequency, analyses performed, and other aspects of monitoring network design can have major implications for detecting releases and for making subsequent higher level decisions about facility operation and remediation. The Integrated Environmental Monitoring (IEM) concept is a set of analytical procedures and software tools that can be used to improve monitoring network design decisions. Such decisions include the choice of monitoring locations, sampling frequencies, sensor technologies, and monitored constituents. IEM provides a set of monitoring alternatives that balance the tradeoffs between competing monitoring objectives such as the minimization of cost and the minimization of uncertainty. The alternatives provided are the best available with respect to the monitoring objectives, consistent with the physical and chemical characteristics of the site, and consist with applicable regulatory requirements. The selection of the best monitoring alternative to implement is made by the stakeholders after reviewing the alternatives and tradeoffs produced by the IEM process

  8. VT School Locations - K-12

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) FacilitiesSchools_PTSCHOOL is designed to provide point locations of every Vermont School along with the established school ID (PSID) for...

  9. Hull properties in location problems

    DEFF Research Database (Denmark)

    Juel, Henrik; Love, Robert F.

    1983-01-01

    Some properties of the solution set for single and multifacility continuous location problems with lp distances are given. A set reduction algorithm is developed for problems in k-dimensional space having rectangular distances....

  10. WHERE2 Location Aided Communications

    DEFF Research Database (Denmark)

    Dammann, Armin; Agapiou, George; Brunel, Loïc

    2013-01-01

    This paper presents an overview of preliminary results of investigations within the WHERE2 Project on identifying promising avenues for location aided enhancements to wireless communication systems. The wide ranging contributions are organized according to the following targeted systems: cellular...

  11. Water Well Locations - Conservation Wells

    Data.gov (United States)

    NSGIC Education | GIS Inventory — The conservation well layer identifies the permitted surface location of oil and gas conservation wells that have not been plugged. These include active, regulatory...

  12. Allegheny County Blazed Trails Locations

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Shows the location of blazed trails in all Allegheny County parks. This is the same data used in the Allegheny County Parks Trails Mobile App, available for Apple...

  13. CBP List of Preclearance Locations

    Data.gov (United States)

    Department of Homeland Security — CBP Preclearance provides for the U.S. border inspection and clearance of commercial air passengers and their goods at (15) locations in (6) foreign countries. CBP...

  14. Allegheny County WIC Vendor Locations

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains the locations of Women, Infants, and Children (WIC) program vendors. If viewing this description on the Western Pennsylvania Regional Data...

  15. New leak detection and location techniques for pipework and vessels

    International Nuclear Information System (INIS)

    Jax, P.; Leuker, W.

    1992-01-01

    The new monitoring systems are based on the moisture measurement with permeable sensor tubing or on acoustic measurement of leakage noise. An important characteristic is the capability to detect and locate leakages sensitively. Various physical dimensions are measured and accordingly there are differences in response time, sensitivity, accuracy of location and the ability to make statements about leakage rate. This paper considers in detail the basic principles, the technical system, areas of application and experience available. (orig.) [de

  16. Enhancing source location protection in wireless sensor networks

    Science.gov (United States)

    Chen, Juan; Lin, Zhengkui; Wu, Di; Wang, Bailing

    2015-12-01

    Wireless sensor networks are widely deployed in the internet of things to monitor valuable objects. Once the object is monitored, the sensor nearest to the object which is known as the source informs the base station about the object's information periodically. It is obvious that attackers can capture the object successfully by localizing the source. Thus, many protocols have been proposed to secure the source location. However, in this paper, we examine that typical source location protection protocols generate not only near but also highly localized phantom locations. As a result, attackers can trace the source easily from these phantom locations. To address these limitations, we propose a protocol to enhance the source location protection (SLE). With phantom locations far away from the source and widely distributed, SLE improves source location anonymity significantly. Theory analysis and simulation results show that our SLE provides strong source location privacy preservation and the average safety period increases by nearly one order of magnitude compared with existing work with low communication cost.

  17. The six-spot-step test - a new method for monitoring walking ability in patients with chronic inflammatory polyneuropathy

    DEFF Research Database (Denmark)

    Kreutzfeldt, Melissa; Jensen, Henrik B; Ravnborg, Mads

    2017-01-01

    OBJECTIVE: To evaluate whether the Six-Spot-Step-Test (SSST) is more suitable for monitoring walking ability in patients with chronic inflammatory polyneuropathy than the Timed-25-Foot-Walking test (T25FW). METHOD: In the SSST, participants have to walk as quickly as possible across a field...... of effect size, standardized response means and relative efficiency. Both ambulation tests correlated moderately to PGIC. CONCLUSION: The SSST may be superior to the T25FW in terms of dynamic range, floor effect and responsiveness which makes the SSST a possible alternative for monitoring walking ability...

  18. A Calculus of Located Entities

    Directory of Open Access Journals (Sweden)

    Adriana Compagnoni

    2014-03-01

    Full Text Available We define BioScapeL, a stochastic pi-calculus in 3D-space. A novel aspect of BioScapeL is that entities have programmable locations. The programmer can specify a particular location where to place an entity, or a location relative to the current location of the entity. The motivation for the extension comes from the need to describe the evolution of populations of biochemical species in space, while keeping a sufficiently high level description, so that phenomena like diffusion, collision, and confinement can remain part of the semantics of the calculus. Combined with the random diffusion movement inherited from BioScape, programmable locations allow us to capture the assemblies of configurations of polymers, oligomers, and complexes such as microtubules or actin filaments. Further new aspects of BioScapeL include random translation and scaling. Random translation is instrumental in describing the location of new entities relative to the old ones. For example, when a cell secretes a hydronium ion, the ion should be placed at a given distance from the originating cell, but in a random direction. Additionally, scaling allows us to capture at a high level events such as division and growth; for example, daughter cells after mitosis have half the size of the mother cell.

  19. Residential Location, Job Location, and Wages: Theory and Empirics

    DEFF Research Database (Denmark)

    Vejlin, Rune Majlund

    -to-job transition without changing workplace location. However, workers making a job-to-job transition which makes the workplace location closer to the residence experiences a wage drop. Furthermore, low wage workers and workers with high transportation costs are more likely to make job-to-job transitions, but also......I develop a stylized partial on-the-job equilibrium search model which incorporate a spatial dimension. Workers reside on a circle and can move at a cost. Each point on the circle has a wage distribution. Implications about wages and job mobility are drawn from the model and tested on Danish...... matched employer-employee data. The model predictions hold true. I find that workers working farther away from their residence earn higher wages. When a worker is making a job-to-job transition where he changes workplace location he experiences a higher wage change than a worker making a job...

  20. Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review.

    Science.gov (United States)

    Block, Valerie A J; Pitsch, Erica; Tahir, Peggy; Cree, Bruce A C; Allen, Diane D; Gelfand, Jeffrey M

    2016-01-01

    To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps. Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined. 137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering. These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability.

  1. Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review

    Science.gov (United States)

    Block, Valerie A. J.; Pitsch, Erica; Tahir, Peggy; Cree, Bruce A. C.; Allen, Diane D.; Gelfand, Jeffrey M.

    2016-01-01

    Objective To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps. Methods Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined. Results 137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering. Conclusions These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability. PMID:27124611

  2. Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury.

    Science.gov (United States)

    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Abe, Tetsuya; Ueno, Tomoyuki; Soma, Yuichiro; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2017-01-01

    Patients with complete paraplegia after spinal cord injury (SCI) are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL) in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman) were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20-67) years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS) grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60-90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG) was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad) in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs) score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention. These findings

  3. Semi-Automated Analysis of Diaphragmatic Motion with Dynamic Magnetic Resonance Imaging in Healthy Controls and Non-Ambulant Subjects with Duchenne Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Courtney A. Bishop

    2018-01-01

    Full Text Available Subjects with Duchenne Muscular Dystrophy (DMD suffer from progressive muscle damage leading to diaphragmatic weakness that ultimately requires ventilation. Emerging treatments have generated interest in better characterizing the natural history of respiratory impairment in DMD and responses to therapy. Dynamic (cine Magnetic Resonance Imaging (MRI may provide a more sensitive measure of diaphragm function in DMD than the commonly used spirometry. This study presents an analysis pipeline for measuring parameters of diaphragmatic motion from dynamic MRI and its application to investigate MRI measures of respiratory function in both healthy controls and non-ambulant DMD boys. We scanned 13 non-ambulant DMD boys and 10 age-matched healthy male volunteers at baseline, with a subset (n = 10, 10, 8 of the DMD subjects also assessed 3, 6, and 12 months later. Spirometry-derived metrics including forced vital capacity were recorded. The MRI-derived measures included the lung cross-sectional area (CSA, the anterior, central, and posterior lung lengths in the sagittal imaging plane, and the diaphragm length over the time-course of the dynamic MRI. Regression analyses demonstrated strong linear correlations between lung CSA and the length measures over the respiratory cycle, with a reduction of these correlations in DMD, and diaphragmatic motions that contribute less efficiently to changing lung capacity in DMD. MRI measures of pulmonary function were reduced in DMD, controlling for height differences between the groups: at maximal inhalation, the maximum CSA and the total distance of motion of the diaphragm were 45% and 37% smaller. MRI measures of pulmonary function were correlated with spirometry data and showed relationships with disease progression surrogates of age and months non-ambulatory, suggesting that they provide clinically meaningful information. Changes in the MRI measures over 12 months were consistent with weakening of

  4. Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Yukiyo Shimizu

    2017-11-01

    Full Text Available Patients with complete paraplegia after spinal cord injury (SCI are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20–67 years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60–90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention

  5. Microseismic event location by master-event waveform stacking

    Science.gov (United States)

    Grigoli, F.; Cesca, S.; Dahm, T.

    2016-12-01

    Waveform stacking location methods are nowadays extensively used to monitor induced seismicity monitoring assoiciated with several underground industrial activities such as Mining, Oil&Gas production and Geothermal energy exploitation. In the last decade a significant effort has been spent to develop or improve methodologies able to perform automated seismological analysis for weak events at a local scale. This effort was accompanied by the improvement of monitoring systems, resulting in an increasing number of large microseismicity catalogs. The analysis of microseismicity is challenging, because of the large number of recorded events often characterized by a low signal-to-noise ratio. A significant limitation of the traditional location approaches is that automated picking is often done on each seismogram individually, making little or no use of the coherency information between stations. In order to improve the performance of the traditional location methods, in the last year, alternative approaches have been proposed. These methods exploits the coherence of the waveforms recorded at different stations and do not require any automated picking procedure. The main advantage of this methods relies on their robustness even when the recorded waveforms are very noisy. On the other hand, like any other location method, the location performance strongly depends on the accuracy of the available velocity model. When dealing with inaccurate velocity models, in fact, location results can be affected by large errors. Here we will introduce a new automated waveform stacking location method which is less dependent on the knowledge of the velocity model and presents several benefits, which improve the location accuracy: 1) it accounts for phase delays due to local site effects, e.g. surface topography or variable sediment thickness 2) theoretical velocity model are only used to estimate travel times within the source volume, and not along the whole source-sensor path. We

  6. Permian Basin location recommendation report

    International Nuclear Information System (INIS)

    1983-09-01

    Candidate study areas are screened from the Palo Duro and Dalhart Basin areas using data obtained from studies to date and criteria and specifications that consider: rock geometry; rock characteristics; human intrusion potential; surface characteristics; and environmental and socioeconomic conditions. Two preferred locations are recommended from among these areas for additional characterization to identify potential National Waste Terminal Storage (NWTS) salt repository sites. One location, in northeastern Deaf Smith County and southeastern Oldham County, is underlain by two salt units that meet the adopted screening specifications. The other location, in northcentral Swisher County, is underlain by one salt unit that meets the adopted screening specifications. Both locations have several favorable features, relative to surrounding areas, and no obviously undesirable characteristics. Both lie wholly on the Southern High Plains surface, are in relatively sparsely populated areas, contain no unique land use conflicts, and comprise large enough geographic areas to provide flexibility in site selection. Data gathered to date indicate that these locations contain salt units sufficient in thickness and in depth for the safe construction and operation of the underground facilities under consideration. 93 references, 34 figures, 6 tables

  7. 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

    2017-01-01

    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 o...

  8. Location and activity specific site-management for military locations

    NARCIS (Netherlands)

    Maring, L.; Hulst, M. van; Meuken, D.

    2009-01-01

    pace is limited in the Netherlands and military activities, that may cause nuisance or environmental hazards, should therefore be considered and evaluated during the use of military locations. The last few years TNO and Deltares have worked on a research program on environmental effects due to

  9. 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

    2013-01-01

    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.

  10. Forældres oplevelse af genindlæggelse af deres nyfødte barn efter ambulant fødsel

    DEFF Research Database (Denmark)

    Feenstra, Maria Monberg; Nilsson, Ingrid; Danbjørg, Dorthe Boe

    . telefon i døgnets 24 timer. Derudover kommer familien til ambulant opfølgning på sygehuset 48-72 timer efter fødslen. Til trods for den tætte kontakt til sundhedspersonalet, oplever stadig flere familier at blive genindlagt kort tid efter udskrivelsen grundet komplikationer vedrørende deres nyfødte barns...... fødslen og hvis nyfødte barn blev genindlagt på grund af manglende trivsel, blev inviteret til at deltage i undersøgelsen. Forældre, der ikke talte dansk, norsk eller svensk blev ekskluderet. Familierne blev interviewet via telefon efter de havde haft 1. sundhedsplejerskebesøg efter genindlæggelsen. Mødre...

  11. The Loyal Customer Phenomenon as a Social Relationship: A Study with Ambulant Coffee Salesmen in the City of Ibagué

    Directory of Open Access Journals (Sweden)

    Lady Grey Javela**

    2009-12-01

    Full Text Available The purpose of this research was to study the relationship established between an ambulant coffee salesman (ACSM and his loyal client, in the frame of Michael Argyle’s social relationships model. Thirty couples were interviewed about the ACSM and loyal clients relationship; also interactions among 183 ACSM – loyal clients and 117 ACS M –sporadic clients were registered. Our research found that the commercial relationship between an ACSM and his/her loyal client is a social relationship, taking into account that it brought evidence about the constitutive elements of a relationship of this nature under Argyle’s perspective; and coincidences were observed in the declarations that the actors of the relationship made about it. Additionally, we found that the ACSM’s behavior is different depending on the type of client that he/she is attending –loyal or sporadic–.

  12. Wireless Damage Location Sensing System

    Science.gov (United States)

    Woodard, Stanley E. (Inventor); Taylor, Bryant Douglas (Inventor)

    2012-01-01

    A wireless damage location sensing system uses a geometric-patterned wireless sensor that resonates in the presence of a time-varying magnetic field to generate a harmonic response that will experience a change when the sensor experiences a change in its geometric pattern. The sensing system also includes a magnetic field response recorder for wirelessly transmitting the time-varying magnetic field and for wirelessly detecting the harmonic response. The sensing system compares the actual harmonic response to a plurality of predetermined harmonic responses. Each predetermined harmonic response is associated with a severing of the sensor at a corresponding known location thereof so that a match between the actual harmonic response and one of the predetermined harmonic responses defines the known location of the severing that is associated therewith.

  13. A systematic review of job-specific workers' health surveillance activities for fire-fighting, ambulance, police and military personnel

    NARCIS (Netherlands)

    Plat, M. J.; Frings-Dresen, M. H. W.; Sluiter, J. K.

    2011-01-01

    Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers' health

  14. 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

    2012-02-01

    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.

  15. Environmental impact of site location on macro- and microelements ...

    African Journals Online (AJOL)

    Human activities cause specific impact on the enveronment, which also could been monitored by mineral contents in the soil and in the plants. Two different caracteristic locations had been selected for the experiments: anthropogenic-Ada Huja contamineted industrial zone and non anthropogenic- Topcider park area.

  16. Radar Location Equipment Development Program: Phase I

    Energy Technology Data Exchange (ETDEWEB)

    Sandness, G.A.; Davis, K.C.

    1985-06-01

    The work described in this report represents the first phase of a planned three-phase project designed to develop a radar system for monitoring waste canisters stored in a thick layer of bedded salt at the Waste Isolation Pilot Plant near Carlsbad, New Mexico. The canisters will be contained in holes drilled into the floor of the underground waste storage facility. It is hoped that these measurements can be made to accuracies of +-5 cm and +-2/sup 0/, respectively. The initial phase of this project was primarily a feasibility study. Its principal objective was to evaluate the potential effectiveness of the radar method in the planned canister monitoring application. Its scope included an investigation of the characteristics of radar signals backscattered from waste canisters, a test of preliminary data analysis methods, an assessment of the effects of salt and bentonite (a proposed backfill material) on the propagation of the radar signals, and a review of current ground-penetrating radar technology. A laboratory experiment was performed in which radar signals were backscattered from simulated waste canisters. The radar data were recorded by a digital data acquisition system and were subsequently analyzed by three different computer-based methods to extract estimates of canister location and tilt. Each of these methods yielded results that were accurate within a few centimeters in canister location and within 1/sup 0/ in canister tilt. Measurements were also made to determine the signal propagation velocities in salt and bentonite (actually a bentonite/sand mixture) and to estimate the signal attenuation rate in the bentonite. Finally, a product survey and a literature search were made to identify available ground-penetrating radar systems and alternative antenna designs that may be particularly suitable for this unique application. 10 refs., 21 figs., 4 tabs.

  17. Radar Location Equipment Development Program: Phase I

    International Nuclear Information System (INIS)

    Sandness, G.A.; Davis, K.C.

    1985-06-01

    The work described in this report represents the first phase of a planned three-phase project designed to develop a radar system for monitoring waste canisters stored in a thick layer of bedded salt at the Waste Isolation Pilot Plant near Carlsbad, New Mexico. The canisters will be contained in holes drilled into the floor of the underground waste storage facility. It is hoped that these measurements can be made to accuracies of +-5 cm and +-2 0 , respectively. The initial phase of this project was primarily a feasibility study. Its principal objective was to evaluate the potential effectiveness of the radar method in the planned canister monitoring application. Its scope included an investigation of the characteristics of radar signals backscattered from waste canisters, a test of preliminary data analysis methods, an assessment of the effects of salt and bentonite (a proposed backfill material) on the propagation of the radar signals, and a review of current ground-penetrating radar technology. A laboratory experiment was performed in which radar signals were backscattered from simulated waste canisters. The radar data were recorded by a digital data acquisition system and were subsequently analyzed by three different computer-based methods to extract estimates of canister location and tilt. Each of these methods yielded results that were accurate within a few centimeters in canister location and within 1 0 in canister tilt. Measurements were also made to determine the signal propagation velocities in salt and bentonite (actually a bentonite/sand mixture) and to estimate the signal attenuation rate in the bentonite. Finally, a product survey and a literature search were made to identify available ground-penetrating radar systems and alternative antenna designs that may be particularly suitable for this unique application. 10 refs., 21 figs., 4 tabs

  18. New Location Improves Efficiency | Poster

    Science.gov (United States)

    By Nancy Parrish, Staff Writer The physical proximity of the SAIC-Frederick Intellectual Property (IP) Office to the NCI Technology Transfer Center (NCI-TTC) is one of the many benefits of being at the Advanced Technology Research Facility (ATRF), according to Courtney Silverthorn, Ph.D. Being in one location “has increased the effectiveness of both informal communication and

  19. Part Objects and Their Location

    DEFF Research Database (Denmark)

    Madsen, Ole Lehrmann; Møller-Pedersen, Birger

    1992-01-01

    The notion of location of part objects is introduced, yielding a reference to the containing object. Combined with locally defined objects and classes (block structure), singularly defined part objects, and references to part objects, it is a powerful language mechanism for defining objects...

  20. Locating a buried magnetic dipole

    Energy Technology Data Exchange (ETDEWEB)

    Caffey, T.W.H.

    1977-01-01

    The theoretical basis and required computations for locating a buried magnetic dipole are outlined. The results are compared with measurements made with a tiltable coil lowered to a depth of 20 m in a vertical borehole within a three-layered earth. this work has application to the rescue of trapped miners. 3 figures, 1 table. (RWR)

  1. Interaction in activity location scheduling

    NARCIS (Netherlands)

    Tabak, V.; Vries, de B.; Dijkstra, J.; Jessurun, A.J.

    2006-01-01

    In this paper we discuss the interaction in activity location scheduling which is the main subject of an ongoing research project called "User Simulation of Space Utilization". The aim of this research project is to develop an overall model for the simulation of human movement and utilization of

  2. WHO Standard Acupuncture Point Locations

    Directory of Open Access Journals (Sweden)

    Sabina Lim

    2010-01-01

    Full Text Available ‘WHO Standard Acupuncture Point Locations in the Western Pacific Region (WHO Standard was released in 2008. Initially, there were 92/361 controversial acupuncture points (acupoints. Through seven informal consultations and four task force team meetings, 86 points were agreed upon among the 92 controversial acupoints, leaving 6 remaining controversial acupoints, demanding active research in the future. This will enhance the reproducibility and validity of acupuncture studies. It will also lead to a better understanding of acupuncture mechanisms in order to optimize its clinical efficacy for a range of diseases and syndromes. This book has two parts: General Guidelines for Acupuncture Point Locations and WHO Standard Acupuncture Point Locations. First of all, familiarity with the General Guidelines for Acupuncture Point Locations in this book can help the reader to understand and use the contents of this book in depth. I would like to thank all of the participating experts and scholars for this great work, who have overcome the limits of previous acupuncture references. I also appreciate the dedicated effort and harmonious leadership of Dr Choi Seung-hoon, former Regional Adviser in Traditional Medicine of Western Pacific Office, WHO.

  3. The Location of Digital Ethnography

    Directory of Open Access Journals (Sweden)

    Dana M. Walker

    2010-10-01

    Full Text Available Qualitative researchers interested in digitally-located social and cultural practices have struggled with ways in which to design studies that can account for the digital aspect of cultural practices while also taking into account that those digital practices do not exist as separate (or separable in terms of our research from other social and cultural practices. As such, one of the primary and ongoing challenges facing internet-based ethnographic research is the question of how to construct the location of a project when the sites, technologically-mediated practices, and people we study exist and flow through a wider information ecology that is neither fixed nor can easily be located as “online” or “offline.” This is as much a methodological challenge as a theoretical one. If one accepts that a rigid distinction between online and offline makes little theoretical sense, then drawing a methodological line between online and offline only reifies such a dualism. While there is a developing body of internet-related ethnographic literature which is attempting to take into account the fluid nature of our information ecology (e.g. Burrell, 2009, Leander and McKim, 2003, Hine, 2007, we continue to operate on shifting ground. This article uses the case of my own work on city-specific discussion forums in Philadelphia, Pennsylvania to highlight the complexities of locating digital ethnographic work and also argue for the necessity of accounting for both movement and placed-ness.

  4. Small Business Location and Layout.

    Science.gov (United States)

    Small Business Administration, Washington, DC.

    As an approach to teaching small-business location and layout, this publication contains material for teaching one session of a basic course. The sections of the publication are as follows: (1) The Lesson Plan--an outline of the material covered, which may be used as a teaching guide, presented in two columns: an outline of the presentation, and a…

  5. LOCATING LEAKS WITH ACOUSTIC TECHNOLOGY

    Science.gov (United States)

    Many water distribution systems in this country are almost 100 years old. About 26 percent of piping in these systems is made of unlined cast iron or steel and is in poor condition. Many methods that locate leaks in these pipes are time-consuming, costly, disruptive to operations...

  6. Competition in spatial location models

    NARCIS (Netherlands)

    Webers, H.M.

    1996-01-01

    Models of spatial competition are designed and analyzed to describe the fact that space, by its very nature, is a source of market power. This field of research, lying at the interface of game theory and economics, has attracted much interest because location problems are related to many aspects of

  7. Smart location system; Sistema de localizacao inteligente Smart Location System

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Jose Augusto Pereira da; Antunes, Rodrigo de Castro; Azevedo, Fabio Augusto Ferreira de [PipeWay Engenharia, Rio de Janeiro, RJ (Brazil); Afonso, Orlando de Jesus Ribeiro [Instituto de Pesquisas da Marinha, Rio de Janeiro, RJ (Brazil); Matsuura, Minoru; Santa Cruz, Sergio de Freitas [TRANSPETRO - PETROBRAS Transportes, Rio de Janeiro, RJ (Brazil); Santos, Jose Alberto Costa dos; Hashiguchi, Decio Issao [GDK Engenharia (Brazil)

    2003-07-01

    This paper describes the technology used in the Intelligent Location System developed by Pipeway and includes some of the results already obtained optimizing repair time and logistic costs during the location of anomalies detected by intelligent pigs, a joint operation within the scope of the contract for Sub sea Pipeline Recovery in the Guanabara Bay with PETROBRAS/TRANSPETRO and GDK Engenharia. The system uses the ELF (Extra Low Frequency) transmission and reception technology at points near a pipe, with or without concrete coating, whose signals are recorded in the inspection tool memory to accurately establish reference points, thus preventing excessive dig work or dredging when human and operational risks tend to be high. (author)

  8. Earthquake location in island arcs

    Science.gov (United States)

    Engdahl, E.R.; Dewey, J.W.; Fujita, K.

    1982-01-01

    A comprehensive data set of selected teleseismic P-wave arrivals and local-network P- and S-wave arrivals from large earthquakes occurring at all depths within a small section of the central Aleutians is used to examine the general problem of earthquake location in island arcs. Reference hypocenters for this special data set are determined for shallow earthquakes from local-network data and for deep earthquakes from combined local and teleseismic data by joint inversion for structure and location. The high-velocity lithospheric slab beneath the central Aleutians may displace hypocenters that are located using spherically symmetric Earth models; the amount of displacement depends on the position of the earthquakes with respect to the slab and on whether local or teleseismic data are used to locate the earthquakes. Hypocenters for trench and intermediate-depth events appear to be minimally biased by the effects of slab structure on rays to teleseismic stations. However, locations of intermediate-depth events based on only local data are systematically displaced southwards, the magnitude of the displacement being proportional to depth. Shallow-focus events along the main thrust zone, although well located using only local-network data, are severely shifted northwards and deeper, with displacements as large as 50 km, by slab effects on teleseismic travel times. Hypocenters determined by a method that utilizes seismic ray tracing through a three-dimensional velocity model of the subduction zone, derived by thermal modeling, are compared to results obtained by the method of joint hypocenter determination (JHD) that formally assumes a laterally homogeneous velocity model over the source region and treats all raypath anomalies as constant station corrections to the travel-time curve. The ray-tracing method has the theoretical advantage that it accounts for variations in travel-time anomalies within a group of events distributed over a sizable region of a dipping, high

  9. Wide area monitoring study

    International Nuclear Information System (INIS)

    Wogman, N.A.; Holdren, G.R. Jr.

    1999-01-01

    Environmental sampling can be used to complement the safeguarding of nuclear material, especially in the detection of undeclared nuclear activities. Routine monitoring of nuclear installations has provided valuable information about the fate of key signature materials within different environmental settings. The approach collates information regarding the generation of individual radiochemical signatures within different nuclear processes, the potential for release of these signatures to the environment and, the chemical form and mobility of the signatures in environmental media along which the material could migrate. Meteorological, geological and hydrological information is used to determine where to sample, what to sample, and how often to sample to provide the greatest likelihood for detection. Multiple strategies can be used to implement wide area monitoring for safeguards purposes. The most complex, and expensive of these, involves establishing extensive networks of fixed location sampling sites. The sites would be operated continuously, and would be instrumented with automated sampling, analysis, and communication equipment to relay information regarding potential anomalies to control centers in near-real time. Alternative strategies can be used to supplement fixed location monitoring equipment, especially in regions that cannot support (financially or logistically) the fixed stations. Through combinations of these various strategies, using a variety of environmental media to monitor a region, we believe that a competent network, one with a quantifiable probability for detecting undeclared nuclear activities, can be designed. While this approach cannot and should not replace other inspection and monitoring activities, it can potentially contribute valuable information to an international safeguards system. (author)

  10. Locating and limiting radon in dwellings

    International Nuclear Information System (INIS)

    Hildingson, O.; Gustafsson, J.; Nilsson, I.

    1984-01-01

    More than 3,300 Swedish dwellings have an indoor radon daughter concentration above 400 Bq.m -3 (or 0.108 WL). It is considered to be unsafe to live in any of these dwellings and the radon daughter concentration has to be reduced. Before deciding what measures to take, it is important to determine the radon sources. Possible sources are exhalation from building materials and/or radon transport from the ground into the building through cracks and joints in the slab. Different methods of locating the sources have been developed. To locate cracks and joints in slabs the ventilation rate and the air pressure difference relative to the ground are changed while monitoring radon/radon daughter concentration. The effect of five different measures to reduce the indoor radon daughter concentration have also been evaluated: increased ventilation rate by mechanical ventilation, ventilation of the small spaces between the floor and the slab, sealing the surface of radon exhaling walls, sealing joints and cracks in the slab, and ventilation of the drainage under the slab. (author)

  11. Intelligent geocoding system to locate traffic crashes.

    Science.gov (United States)

    Qin, Xiao; Parker, Steven; Liu, Yi; Graettinger, Andrew J; Forde, Susie

    2013-01-01

    State agencies continue to face many challenges associated with new federal crash safety and highway performance monitoring requirements that use data from multiple and disparate systems across different platforms and locations. On a national level, the federal government has a long-term vision for State Departments of Transportation (DOTs) to report state route and off-state route crash data in a single network. In general, crashes occurring on state-owned or state maintained highways are a priority at the Federal and State level; therefore, state-route crashes are being geocoded by state DOTs. On the other hand, crashes occurring on off-state highway system do not always get geocoded due to limited resources and techniques. Creating and maintaining a statewide crash geographic information systems (GIS) map with state route and non-state route crashes is a complicated and expensive task. This study introduces an automatic crash mapping process, Crash-Mapping Automation Tool (C-MAT), where an algorithm translates location information from a police report crash record to a geospatial map and creates a pinpoint map for all crashes. The algorithm has approximate 83 percent mapping rate. An important application of this work is the ability to associate the mapped crash records to underlying business data, such as roadway inventory and traffic volumes. The integrated crash map is the foundation for effective and efficient crash analyzes to prevent highway crashes. Published by Elsevier Ltd.

  12. It's All about Location, Location, Location: Children's Memory for the "Where'' of Personally Experienced Events

    Science.gov (United States)

    Bauer, Patricia J.; Doydum, Ayzit O.; Pathman, Thanujeni; Larkina, Marina; Guler, O. Evren; Burch, Melissa

    2012-01-01

    Episodic memory is defined as the ability to recall specific past events located in a particular time and place. Over the preschool and into the school years, there are clear developmental changes in memory for when events took place. In contrast, little is known about developmental changes in memory for where events were experienced. In the…

  13. Location, Location, Location: How Would a High-Performing Charter School Network Fare in Different States?

    Science.gov (United States)

    Lozier, Chris; Rotherham, Andrew J.

    2011-01-01

    In this paper the authors do not examine different operating strategies for charter schools or analyze the impact of their often educationally intensive models on finance. Instead, because public charter schools are funded predominantly by public dollars, they simply ask what impact location--and its associated variances in public funding and the…

  14. MICROGRIDS: THE AGRIA TEST LOCATION

    Directory of Open Access Journals (Sweden)

    Aleksandra Krkoleva

    2010-01-01

    Full Text Available The paper presents the pilot Microgrid in Macedonia, developed within the framework of the MOREMICROGRIDS (EU EP6 projecet, contract No. SES6-019864 project. This Microgrid is the first of its kind being developed in the Western Balkan region and serves as pilot site for introduction and examination of the Microgrids concept in non European Union conditions. The test network consists of a part of the low voltage grid, located on a pig farm. The main electricity source for the Microgrid is a small biogas plant, which uses the biogas produced by a waste water treatment process. The paper addresses the Microgrid design, development of test scenarios and test results from the pilot location.

  15. Location Privacy in RFID Applications

    Science.gov (United States)

    Sadeghi, Ahmad-Reza; Visconti, Ivan; Wachsmann, Christian

    RFID-enabled systems allow fully automatic wireless identification of objects and are rapidly becoming a pervasive technology with various applications. However, despite their benefits, RFID-based systems also pose challenging risks, in particular concerning user privacy. Indeed, improvident use of RFID can disclose sensitive information about users and their locations allowing detailed user profiles. Hence, it is crucial to identify and to enforce appropriate security and privacy requirements of RFID applications (that are also compliant to legislation). This chapter first discusses security and privacy requirements for RFID-enabled systems, focusing in particular on location privacy issues. Then it explores the advances in RFID applications, stressing the security and privacy shortcomings of existing proposals. Finally, it presents new promising directions for privacy-preserving RFID systems, where as a case study we focus electronic tickets (e-tickets) for public transportation.

  16. Location Estimation using Delayed Measurements

    DEFF Research Database (Denmark)

    Bak, Martin; Larsen, Thomas Dall; Nørgård, Peter Magnus

    1998-01-01

    When combining data from various sensors it is vital to acknowledge possible measurement delays. Furthermore, the sensor fusion algorithm, often a Kalman filter, should be modified in order to handle the delay. The paper examines different possibilities for handling delays and applies a new techn...... technique to a sensor fusion system for estimating the location of an autonomous guided vehicle. The system fuses encoder and vision measurements in an extended Kalman filter. Results from experiments in a real environment are reported...

  17. Akzeptanz von Location Based Services

    OpenAIRE

    Bauer, Hans H.; Haber, Tobias E.; Reichardt, Tina; Bökamp, Marten

    2006-01-01

    Die enormen Investitionen in UMTS-Lizenzen und den Aufbau einer neuen Netzinfrastruktur zwingen die Mobilfunkanbieter zur Erschließung neuer Umsatzpotenziale. Durch Entwicklung neuer mobiler Mehrwertdienste hoffen sie, die „Killerapplikation“ der 3. Mobilfunkgeneration zu finden, die ähnlich wie der Short Message Service (SMS) für GSM, zum Treiber des UMTS-Markterfolges werden kann. Nach Meinung vieler Marktbeobachter könnten Location Based Services, d.h. mobile Dienste, die ...

  18. Location, location, location: does early cancer in Barrett's esophagus have a preference?

    Science.gov (United States)

    Enestvedt, Brintha K; Lugo, Ricardo; Guarner-Argente, Carlos; Shah, Pari; Falk, Gary W; Furth, Emma; Ginsberg, Gregory G

    2013-09-01

    Early cancer (high-grade dysplasia [HGD] and intramucosal carcinoma [ImCa]) associated with Barrett's esophagus (BE) may have a circumferential spatial predilection. To describe the esophageal circumferential location of early cancer in BE. Retrospective study, single tertiary referral center. One hundred nineteen patients were referred for endoscopic eradication therapy for early cancer associated with BE. Endoscopic images and reports and pathology were reviewed. Circumferential location designation of early cancer in BE by using a clock-face orientation. One hundred nineteen of 131 patients referred for endoscopic eradication therapy had a location designation for their advanced histology (91.9%). There were a total of 57 patients (47.9%) with HGD and 62 patients (52.1%) with ImCa. There was a significantly higher rate of early cancer (HGD or ImCa) in the right hemisphere (12 to 6 o'clock location) compared with the left hemisphere (84.9% vs 15.1%, P cancer was found in the 12 to 3 o'clock quadrant (64.7%); 71.9% of HGD and 58.1% of ImCa lesions were located in the 12 to 3 o'clock quadrant. Retrospective design, single center. Early cancer associated with BE is far more commonly found in the right hemisphere of the esophagus (12 to 6 o'clock) with the highest rate in the 12 to 3 o'clock quadrant. These findings support enhanced scrutiny of the right hemisphere of the esophagus during surveillance and endoscopic treatment of patients with BE. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  19. DESIGN OF A REAL TIME REMOTE VEHICLE LOCATION SYSTEM

    Directory of Open Access Journals (Sweden)

    Ahmet Emir DİRİK

    2004-02-01

    Full Text Available In this study, a low-cost, real-time vehicle location system is developed. The vehicle location system includes three main modules, i.e. positioning, wireless communication and digital map modules. The positioning module used in location systems computes position of the mobile vehicle. These vehicle location data are transmitted through a wireless communication system to host. The host has a capability to monitor a fleet of vehicles by analyzing data collected from wireless communication system. In this project, mobile vehicle location positions can be computed in a range of 10m position error and by using these position data, its possible to monitor the fleet of mobile vehicles on a digital map in the observation and control center. In this study, vehicle analog mobile radios are used to establish wireless communication system. Thus, there is no need to use satellite or GSM systems for communication and a low-cost and high-performance vehicle location system is realized.

  20. Location, Location: Jurisdiction & Conflicts in Transborder Contract Litigation

    DEFF Research Database (Denmark)

    Lookofsky, Joseph

    In transborder contract litigation place-based factors are often decisive, both as regards jurisdiction to adjudicate as well as the rules which determine the applicable substantive law. Relevant locations include the place where the contract was made, where the parties reside, transact business...... or own property, the place of delivery, payment or other performance etc. Using concrete case-based examples, Professor Lookofsky explains how rules of jurisdiction and contract conflicts in Europe are tied to rigidly defined, single-place-based factors. In the United States, by contrast...