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.

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.

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

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...

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.

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.

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 ...

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.)

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%.

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.

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...

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...

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.

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...

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.

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...

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.

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.

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....

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.

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

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.

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

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

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

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...

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.

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.

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...

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.

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.

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

[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.

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.

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...

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

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.

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 ...

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.

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)

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

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.

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.

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…

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

[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

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.

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

[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.

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.

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...

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

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

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

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.

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.

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.

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.

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

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....

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....

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.

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...

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.

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.

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.

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...

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

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.

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...

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.

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.

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.

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...

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

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.

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

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

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

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.

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.

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

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

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

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

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...

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.

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.

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)

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...

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.

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.

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

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.

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)

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

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.

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....

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?

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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

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.

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

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.

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...

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.

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.

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.

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.

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.

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

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.

[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.

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.

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,

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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...

[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.

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.

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.

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

[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

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)

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.

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...

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.

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

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

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

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

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 ...

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

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

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

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.

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.

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

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

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.

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.

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.

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.

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.

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

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.

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

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

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...

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

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...

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.

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

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.

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

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...

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...

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.

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.

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.

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

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.

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.

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.

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...

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.

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.

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

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.

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...

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.

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.

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.

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

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

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.

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.

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.

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.

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)

Accelerometry: A feasible method to monitor physical activity during sub-acute rehabilitation of persons with stroke.

Science.gov (United States)

Joseph, Conran; Strömbäck, Björn; Hagströmer, Maria; Conradsson, David

2018-05-08

To investigate the feasibility of using accelerometers to monitor physical activity in persons with stroke admitted to inpatient rehabilitation. Longitudinal observational study. Persons with stroke admitted to a specialized rehabilitation centre for sub-acute rehabilitation were recruited between August and December 2016. Volume and intensity of physical activity were assessed with accelerometers throughout the rehabilitation period. Indicators of feasibility included processes (recruitment, protocol adherence and participants' experiences) and scientific feasibility, which assessed the accelerometers' ability to detect change in physical activity among stroke survivors who ambulate independently and those who are dependent on a mobility device. Twenty-seven out of 31 eligible individuals took part in this study, with 23 (85%) completing it. In total, 432 days of rehabilitation were monitored and valid physical activity data were obtained for 408 days (94%). There were no indications that the measurement interfered with participants' ability to participate in rehabilitation. Despite the subjects' ambulation status, the number of steps and time spent in moderate-to-vigorous physical activity increased significantly across the first 18 days of rehabilitation, whereas sedentary time was unchanged. This study supports the feasibility of using accelerometers to capture physical activity behaviour in survivors of stroke during inpatient rehabilitation.

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.

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.

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...

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

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.

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

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.

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.

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...

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.

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.

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

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.

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.

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.

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

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.

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

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.

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...

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)

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.

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

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.

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

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....

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

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

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...

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

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.

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.

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...

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…

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

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

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

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

Enhancing source location protection in wireless sensor networks

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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.

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....

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)

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,…

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

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.

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.

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...

[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

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.

Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury.

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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

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

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.

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.

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.

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)

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.

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

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

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

[Ambulance services in Copenhagen, Odense and Ringkøbing County. Results of the spot test conducted by the Ministry of Health and the County Councils Association in 1990. 1. Epidemiological data].

Science.gov (United States)

Trier, H; Larsen, C F

1992-02-17

In 1990, The Danish Ministry of Health and the County Council Association undertook a spot test investigation of the activities in connection with 3,182 emergency ambulance services (AU) in the Municipality of Copenhagen (a city), the Odense district (a large provincial town) and the County of Ringkøbing (a mixed rural and urban region). The investigation included data collected by the ambulance staff before hospitalization and the diagnoses on discharge from casualty and hospital departments. The frequency of AU per 1,000 population was found to be 101 annually in Copenhagen, 44 in Odense and 19 in the County of Ringkøbing. More than 10% of the services in all three regions did not result in transport of the patient to hospital treatment. The average age of the patients was 52 years in Copenhagen compared with 44 years in the other two regions. The age-specific frequency of AU for patients aged 0-4 year-old was nine times as great in Copenhagen than in Odense and the County of Ringkøbing and, where patients aged more than 80 years were concerned, the frequency was 4-10 times as great. In all three regions, the activities of ambulance services were most numerous between 6-16 hours and lowest during the period 0-6 hours. Services to patients' homes constituted 44-46% and to traffic regions 32-40%. Services on account of illness constituted 41-45% and, on account of accidents, 27-35%. In cases of rapid emergency transport (using signals), 78% of the ambulances had reached the patient within five minutes in Copenhagen as compared with 44% in Odense and the County of Ringkøbing.(ABSTRACT TRUNCATED AT 250 WORDS)

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

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.

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...

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.

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.

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.

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.

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....

Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

DEFF Research Database (Denmark)

Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

1995-01-01

Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant...... device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P blood pressures...... were almost similar in the two groups (108 vs. 110; 65 vs. 67; 78 vs. 82 mm Hg, NS). Conversely, HR was significantly higher in the patients both in the daytime (86 vs. 72/min, P blood pressure and HR from daytime...

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.

[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

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.

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.

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

Radiological aspects in hot-spot removal from spare LPRM location

International Nuclear Information System (INIS)

Nagarajan, V.; Raveendran, P.S.; Parashar, Vivek; Mharse, R.S.; Phadnis, P.S.

2012-01-01

TAPS 1 and 2 comprises of twin units of boiling water reactors with vertical core. Cruciform shaped control blades are driven from the bottom through the core using hydraulic Control Rod Drives (CRD). Neutron flux monitoring is carried out by in-core devices such as Source Range Monitors (SRM) and Intermediate Range Monitors (IRM) during the start up and later using Power Range Monitors located in the biological shield. In addition, Local Power Range Monitor (LPRM) assemblies located symmetrically in the core gives information about axial and radial neutron flux. There are 18 LPRM locations out of which 13 are used for mounting the LPRMs and rest are spare locations. The lower head of the reactor vessel has 120 nozzles for CRD housings, SRM, IRM, LPRMs, vessel drain etc. Maintenance work on CRDs, removal and installation of in-core monitoring devices etc are carried out from under vessel area in the primary containment known as CRD housing area. While conducting radiation survey of CRD housing area after shut down of unit no. 1 for the 21st refueling outage, hotspot was observed at spare LPRM 40-21 location showing radiation level of 10 Gy/h and general back ground of 30-50 mGy/h. An attempt is made to bring out the ALARA efforts taken during hot spot removal. Options like hotspot shielding were not feasible. After core unloading, efforts were made to remove the hotspot. To assess the change in radiation levels, a high range silicon semiconductor based gamma monitor's detector was mounted on a pole and fixed near hotspot. Radiation level at the detector was 6 Gy/h. In addition detector of another low range area monitor was fixed at the trolley in the CRD housing area and radiation level was 7 mGy/h. Monitors of both the detectors were kept outside the primary containment in low back ground area at reactor building 103' El. Hotspot removal was attempted initially by vacuuming from the top of reactor vessel using 1 inch dia tube from spare LPRM location. Vacuum

Willingness to pay for emergency referral transport in a developing setting: a geographically randomized study.

Science.gov (United States)

Bose, Sourav K; Bream, Kent D W; Barg, Frances K; Band, Roger A

2012-07-01

The objective was to identify the correlates of willingness to pay for ambulance transports from a rural city to a regional hospital in Guatemala. An innovative methodology that utilizes a novel randomization technique and satellite imagery was used to select a sample of homes in Santiago Atitlán, Guatemala. The respondents were surveyed at these homes about their willingness to pay for ambulance transport to a regional hospital. A price ladder was used to elicit respondents' willingness to pay for ambulance transport, depending on the level of severity of three types of emergencies: life-threatening emergencies, disability-causing emergencies, and simple emergencies. Simple and multiple linear regression modeling was used to identify the social and economic correlates of respondents' willingness to pay for ambulance transport and to predict demand for ambulance transport at a variety of price levels. Beta coefficients (β) expressed as percentages with 95% confidence intervals (CIs) were estimated. The authors surveyed 134 respondents (response rate=3.3%). In the multivariable regression models, three variables correlated with willingness to pay: household income, location of residence (rural district vs. urban district), and respondents' education levels. Correlates for ambulance transport in life-threatening emergencies included greater household daily income (β=1.32%, 95% CI=0.63% to 2.56%), rural location of residence (β=-37.3%, 95% CI=-51.1% to -137.5%), and higher educational levels (β=4.41%, 95% CI=1.00% to 6.36%). Correlates of willingness to pay in disability-causing emergencies included greater household daily income (β=1.59%, 95% CI=0.81% to 3.19%) and rural location of residence (β=-19.4%, 95% CI=-35.7% to -89.4%). Correlates of willingness to pay in simple emergencies included rural location of residence (β=59.4%, 95% CI=37.9% to 133.7%) and higher educational levels (β=7.96%, 95% CI=1.96% to 11.8%). At all price levels, more individuals were

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...

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

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

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...

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...

Determination of geostatistically representative sampling locations in Porsuk Dam Reservoir (Turkey)

Science.gov (United States)

Aksoy, A.; Yenilmez, F.; Duzgun, S.

2013-12-01

Several factors such as wind action, bathymetry and shape of a lake/reservoir, inflows, outflows, point and diffuse pollution sources result in spatial and temporal variations in water quality of lakes and reservoirs. The guides by the United Nations Environment Programme and the World Health Organization to design and implement water quality monitoring programs suggest that even a single monitoring station near the center or at the deepest part of a lake will be sufficient to observe long-term trends if there is good horizontal mixing. In stratified water bodies, several samples can be required. According to the guide of sampling and analysis under the Turkish Water Pollution Control Regulation, a minimum of five sampling locations should be employed to characterize the water quality in a reservoir or a lake. The European Union Water Framework Directive (2000/60/EC) states to select a sufficient number of monitoring sites to assess the magnitude and impact of point and diffuse sources and hydromorphological pressures in designing a monitoring program. Although existing regulations and guidelines include frameworks for the determination of sampling locations in surface waters, most of them do not specify a procedure in establishment of monitoring aims with representative sampling locations in lakes and reservoirs. In this study, geostatistical tools are used to determine the representative sampling locations in the Porsuk Dam Reservoir (PDR). Kernel density estimation and kriging were used in combination to select the representative sampling locations. Dissolved oxygen and specific conductivity were measured at 81 points. Sixteen of them were used for validation. In selection of the representative sampling locations, care was given to keep similar spatial structure in distributions of measured parameters. A procedure was proposed for that purpose. Results indicated that spatial structure was lost under 30 sampling points. This was as a result of varying water

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.

Balancing Machine Work, Comfort Work, and Sentimental Work

DEFF Research Database (Denmark)

Pedersen, Maria Ie; Hansen, Magnus; Hertzum, Morten

2011-01-01

and attention. We investigate ambulance care in three of Denmark’s five healthcare regions, which staff ambulances with emergency medical technicians, paramedics, and physicians. Using the concept of illness trajectory we analyse how the ambulance crews balance machine work, which involves continuously...... monitoring the equipment, comfort work, which is actions taken to relieve the pain or discomfort of the patient, and sentimental work, which is care for the patient’s physical and mental well-being, often verbal in nature. The analysis shows that comfort and sentimental work often takes priority over machine...... work, but also that this has negative consequences. Equipment for use in ambulances should aim at supporting the ambulance crews in competently and dynamically balancing the different types of work and should, consequently, avoid binding the crew’s attention for unbroken periods of time....

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.

Patterns of urban violent injury: a spatio-temporal analysis.

Directory of Open Access Journals (Sweden)

Michael Cusimano

2010-01-01

Full Text Available Injury related to violent acts is a problem in every society. Although some authors have examined the geography of violent crime, few have focused on the spatio-temporal patterns of violent injury and none have used an ambulance dataset to explore the spatial characteristics of injury. The purpose of this study was to describe the combined spatial and temporal characteristics of violent injury in a large urban centre.Using a geomatics framework and geographic information systems software, we studied 4,587 ambulance dispatches and 10,693 emergency room admissions for violent injury occurrences among adults (aged 18-64 in Toronto, Canada, during 2002 and 2004, using population-based datasets. We created kernel density and choropleth maps for 24-hour periods and four-hour daily time periods and compared location of ambulance dispatches and patient residences with local land use and socioeconomic characteristics. We used multivariate regressions to control for confounding factors. We found the locations of violent injury and the residence locations of those injured were both closely related to each other and clearly clustered in certain parts of the city characterised by high numbers of bars, social housing units, and homeless shelters, as well as lower household incomes. The night and early morning showed a distinctive peak in injuries and a shift in the location of injuries to a "nightlife" district. The locational pattern of patient residences remained unchanged during those times.Our results demonstrate that there is a distinctive spatio-temporal pattern in violent injury reflected in the ambulance data. People injured in this urban centre more commonly live in areas of social deprivation. During the day, locations of injury and locations of residences are similar. However, later at night, the injury location of highest density shifts to a "nightlife" district, whereas the residence locations of those most at risk of injury do not change.

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

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.

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

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

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.

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

Location estimation method of steam leak in pipeline using leakage area analysis

International Nuclear Information System (INIS)

Kim, Se Oh; Jeon, Hyeong Seop; Son, Ki Sung; Park, Jong Won

2016-01-01

It is important to have a pipeline leak-detection system that determines the presence of a leak and quickly identifies its location. Current leak detection methods use a acoustic emission sensors, microphone arrays, and camera images. Recently, many researchers have been focusing on using cameras for detecting leaks. The advantage of this method is that it can survey a wide area and monitor a pipeline over a long distance. However, conventional methods using camera monitoring are unable to target an exact leak location. In this paper, we propose a method of detecting leak locations using leak-detection results combined with multi-frame analysis. The proposed method is verified by experiment

Location estimation method of steam leak in pipeline using leakage area analysis

Energy Technology Data Exchange (ETDEWEB)

Kim, Se Oh; Jeon, Hyeong Seop; Son, Ki Sung [Sae An Engineering Corp., Seoul (Korea, Republic of); Park, Jong Won [Dept. of Information Communications Engineering, Chungnam National University, Daejeon (Korea, Republic of)

2016-10-15

It is important to have a pipeline leak-detection system that determines the presence of a leak and quickly identifies its location. Current leak detection methods use a acoustic emission sensors, microphone arrays, and camera images. Recently, many researchers have been focusing on using cameras for detecting leaks. The advantage of this method is that it can survey a wide area and monitor a pipeline over a long distance. However, conventional methods using camera monitoring are unable to target an exact leak location. In this paper, we propose a method of detecting leak locations using leak-detection results combined with multi-frame analysis. The proposed method is verified by experiment.

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...

Multi-metric model-based structural health monitoring

Science.gov (United States)

Jo, Hongki; Spencer, B. F.

2014-04-01

ABSTRACT The inspection and maintenance of bridges of all types is critical to the public safety and often critical to the economy of a region. Recent advanced sensor technologies provide accurate and easy-to-deploy means for structural health monitoring and, if the critical locations are known a priori, can be monitored by direct measurements. However, for today's complex civil infrastructure, the critical locations are numerous and often difficult to identify. This paper presents an innovative framework for structural monitoring at arbitrary locations on the structure combining computational models and limited physical sensor information. The use of multi-metric measurements is advocated to improve the accuracy of the approach. A numerical example is provided to illustrate the proposed hybrid monitoring framework, particularly focusing on fatigue life assessment of steel structures.

Anonymity Preserving Routing In Location Privacy Schemes In Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

R Regin

2015-12-01

Full Text Available Location privacy measures need to be developed to prevent the opponent from determining the physical locations of source sensors and sinks. An opponent can easily intercept network traffic due to the use of a broadcast medium for routing packets and get detailed information such as packet transmission time and frequency to perform traffic analysis and infer the locations of monitored objects and data sinks. On the other hand, sensors usually have limited processing speed and energy supplies. It is very expensive to apply traditional anonymous communication techniques for hiding the communication between sensor nodes and sinks. The existing source-location privacy protects the location of monitored objects to increase the number of messages sent by the source before the object is located by the attacker. The flooding technique has the source node send each packet through numerous paths to a sink making it difficult for an opponent to trace the source. The locations of sinks can be protected from a local eavesdropper by hashing the ID field in the packet header. But opponent can track sinks by carrying out time correlation and rate monitoring attacks. Besides protection some source nodes are transferring relatively large amounts of data in existing system. As a result, these nodes run out of battery faster due to improper position of nodes and sinks. Thus in the proposed system the sinks should be located as optimally as possible to reduce traffic flow and energy consumption for sensor nodes. Hence Sink placement problem is resolved for minimizing the delay as well as maximizing the lifetime of a WSN. Thus proposed system is efficient in terms of overhead and functionality when compared to existing system.

Development of a portable Linux-based ECG measurement and monitoring system.

Science.gov (United States)

Tan, Tan-Hsu; Chang, Ching-Su; Huang, Yung-Fa; Chen, Yung-Fu; Lee, Cheng

2011-08-01

This work presents a portable Linux-based electrocardiogram (ECG) signals measurement and monitoring system. The proposed system consists of an ECG front end and an embedded Linux platform (ELP). The ECG front end digitizes 12-lead ECG signals acquired from electrodes and then delivers them to the ELP via a universal serial bus (USB) interface for storage, signal processing, and graphic display. The proposed system can be installed anywhere (e.g., offices, homes, healthcare centers and ambulances) to allow people to self-monitor their health conditions at any time. The proposed system also enables remote diagnosis via Internet. Additionally, the system has a 7-in. interactive TFT-LCD touch screen that enables users to execute various functions, such as scaling a single-lead or multiple-lead ECG waveforms. The effectiveness of the proposed system was verified by using a commercial 12-lead ECG signal simulator and in vivo experiments. In addition to its portability, the proposed system is license-free as Linux, an open-source code, is utilized during software development. The cost-effectiveness of the system significantly enhances its practical application for personal healthcare.

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.

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.

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...

DAMT - DISTRIBUTED APPLICATION MONITOR TOOL (HP9000 VERSION)

Science.gov (United States)

Keith, B.

1994-01-01

Typical network monitors measure status of host computers and data traffic among hosts. A monitor to collect statistics about individual processes must be unobtrusive and possess the ability to locate and monitor processes, locate and monitor circuits between processes, and report traffic back to the user through a single application program interface (API). DAMT, Distributed Application Monitor Tool, is a distributed application program that will collect network statistics and make them available to the user. This distributed application has one component (i.e., process) on each host the user wishes to monitor as well as a set of components at a centralized location. DAMT provides the first known implementation of a network monitor at the application layer of abstraction. Potential users only need to know the process names of the distributed application they wish to monitor. The tool locates the processes and the circuit between them, and reports any traffic between them at a user-defined rate. The tool operates without the cooperation of the processes it monitors. Application processes require no changes to be monitored by this tool. Neither does DAMT require the UNIX kernel to be recompiled. The tool obtains process and circuit information by accessing the operating system's existing process database. This database contains all information available about currently executing processes. Expanding the information monitored by the tool can be done by utilizing more information from the process database. Traffic on a circuit between processes is monitored by a low-level LAN analyzer that has access to the raw network data. The tool also provides features such as dynamic event reporting and virtual path routing. A reusable object approach was used in the design of DAMT. The tool has four main components; the Virtual Path Switcher, the Central Monitor Complex, the Remote Monitor, and the LAN Analyzer. All of DAMT's components are independent, asynchronously executing

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.

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

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.

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.

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.

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...

Assessment of background particulate matter concentrations in small cities and rural locations--Prince George, Canada.

Science.gov (United States)

Veira, Andreas; Jackson, Peter L; Ainslie, Bruce; Fudge, Dennis

2013-07-01

This study investigates the development and application of a simple method to calculate annual and seasonal PM2.5 and PM10 background concentrations in small cities and rural areas. The Low Pollution Sectors and Conditions (LPSC) method is based on existing measured long-term data sets and is designed for locations where particulate matter (PM) monitors are only influenced by local anthropogenic emission sources from particular wind sectors. The LPSC method combines the analysis of measured hourly meteorological data, PM concentrations, and geographical emission source distributions. PM background levels emerge from measured data for specific wind conditions, where air parcel trajectories measured at a monitoring station are assumed to have passed over geographic sectors with negligible local emissions. Seasonal and annual background levels were estimated for two monitoring stations in Prince George, Canada, and the method was also applied to four other small cities (Burns Lake, Houston, Quesnel, Smithers) in northern British Columbia. The analysis showed reasonable background concentrations for both monitoring stations in Prince George, whereas annual PM10 background concentrations at two of the other locations and PM2.5 background concentrations at one other location were implausibly high. For those locations where the LPSC method was successful, annual background levels ranged between 1.8 +/- 0.1 microg/m3 and 2.5 +/- 0.1 microg/m3 for PM2.5 and between 6.3 +/- 0.3 microg/m3 and 8.5 +/- 0.3 microg/m3 for PM10. Precipitation effects and patterns of seasonal variability in the estimated background concentrations were detectable for all locations where the method was successful. Overall the method was dependent on the configuration of local geography and sources with respect to the monitoring location, and may fail at some locations and under some conditions. Where applicable, the LPSC method can provide a fast and cost-efficient way to estimate background PM

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...

Wireless Indoor Location Estimation Based on Neural Network RSS Signature Recognition (LENSR)

Energy Technology Data Exchange (ETDEWEB)

Kurt Derr; Milos Manic

2008-06-01

Location Based Services (LBS), context aware applications, and people and object tracking depend on the ability to locate mobile devices, also known as localization, in the wireless landscape. Localization enables a diverse set of applications that include, but are not limited to, vehicle guidance in an industrial environment, security monitoring, self-guided tours, personalized communications services, resource tracking, mobile commerce services, guiding emergency workers during fire emergencies, habitat monitoring, environmental surveillance, and receiving alerts. This paper presents a new neural network approach (LENSR) based on a competitive topological Counter Propagation Network (CPN) with k-nearest neighborhood vector mapping, for indoor location estimation based on received signal strength. The advantage of this approach is both speed and accuracy. The tested accuracy of the algorithm was 90.6% within 1 meter and 96.4% within 1.5 meters. Several approaches for location estimation using WLAN technology were reviewed for comparison of results.

Emotion Monitoring – Verification of Physiological Characteristics Measurement Procedures

Directory of Open Access Journals (Sweden)

Landowska Agnieszka

2014-12-01

Full Text Available This paper concerns measurement procedures on an emotion monitoring stand designed for tracking human emotions in the Human-Computer Interaction with physiological characteristics. The paper addresses the key problem of physiological measurements being disturbed by a motion typical for human-computer interaction such as keyboard typing or mouse movements. An original experiment is described, that aimed at practical evaluation of measurement procedures performed at the emotion monitoring stand constructed at GUT. Different locations of sensors were considered and evaluated for suitability and measurement precision in the Human- Computer Interaction monitoring. Alternative locations (ear lobes and forearms for skin conductance, blood volume pulse and temperature sensors were proposed and verified. Alternative locations proved correlation with traditional locations as well as lower sensitiveness to movements like typing or mouse moving, therefore they can make a better solution for monitoring the Human-Computer Interaction.

40 CFR 141.623 - Reduced monitoring.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Reduced monitoring. 141.623 Section....623 Reduced monitoring. (a) You may reduce monitoring to the level specified in the table in this paragraph (a) any time the LRAA is ≤0.040 mg/L for TTHM and ≤0.030 mg/L for HAA5 at all monitoring locations...

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

Data summary report: Southern sector monitoring well installations

International Nuclear Information System (INIS)

Jones, W.E.

2000-01-01

This report provides construction documentation for four double-screen monitoring wells installed as part of the groundwater monitoring strategy identified in the Groundwater Effectiveness Monitoring Strategy for the Proposed Southern Sector Phase I Groundwater Corrective Action (WSRC-RP-99-4114, Rev. 0, July 1999). The proposed corrective action includes In-Well Vapor Stripping Wells SSR-001 through SSR-012, designed to intercept and ameliorate the TCE and PCE plumes at the 500 parts per billion isoconcentration contour. The four monitoring wells (SSM-10, -15A, -16-, and -17) constructed during this project are designed to monitor the effectiveness of the In-Well Vapor Stripping Well system. One monitoring well (SSM-10) is located hydraulically upgradient of vapor stripping wells. The other three wells are located hydraulically downgradient of the vapor stripping wells. Four monitoring wells additional to those describe in this report will be installed for effectiveness monitoring in the future

OPTIMIZING RADIOLOGICAL MONITOR SITING OVER THE CONTINENTAL U.S

International Nuclear Information System (INIS)

Chen, K; Robert Buckley, R; Robert Kurzeja, R; Lance Osteen, L; Saleem Salaymeh, S

2007-01-01

The US Environmental Protection Agency (EPA) is installing a network of sensors in the US to monitor background radiation and elevated radiation levels expected from a possible nuclear incident. The network (RadNet) of 180 fixed sensors is intended to provide a basic estimate of the radiation level throughout the US and enhanced accuracy near population centers. This report discusses one of the objective methods for locating these monitors based on criteria outlined by the EPA. The analysis employs a representative climatology of incident scenarios that includes 50 release locations, four seasons and four times of the day. This climatology was calculated from 5,600 simulations generated with NOAA-ARL's HYSPLIT Lagrangian trajectory model. The method treats the release plumes as targets and monitors are located to maximize the number of plumes detected with the network. Weighting schemes based on detection only, dose-weighted detection and population-dose weighted detection were evaluated. The result shows that most of the monitors are located around the population centers, as expected. However, there are monitors quite uniformly distributed around the less populated areas. The monitors at the populated areas will provide early warning to protect the general public, and the monitors spread across the country will provide valuable data for modelers to estimate the extent and the transport of the radioactive contamination

Surveillance systems (PWR) - loose parts monitoring - vibration monitoring - leakage detection

International Nuclear Information System (INIS)

Schuette, A.; Blaesig, H.

1982-01-01

The contribution is engaged in the task and the results of the loose parts monitoring and the vibration monitoring following from the practice at the PWR of Biblis. First a description of both systems - location and type of the sensors used, the treatment of the measurements and the indications - is given. The results of the analysis of some events picked up by the surveillance systems are presented showing applicabilty and benefit of such systems. (orig.)

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.

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.

Environmental monitoring at the Savannah River Plant. Annual report, 1976

International Nuclear Information System (INIS)

Ashley, C.; Zeigler, C.C.

1978-03-01

The environmental monitoring program at the Savannah River Plant (SRP) provides reliable measurement of radioactive materials released at the source (approximately 40 locations) and present in the environment (approximately 500 locations). In recent years, water-quality testing and analysis have become an essential part of the environmental monitoring program. Aqueous discharges to plant streams are monitored for nonradioactive materials by chemical analyses of water sampled in flowing streams (approximately 25 locations). A brief discussion of plant releases to the environment and radioactive and nonradioactive materials detected in the environment are presented. The appendices contain data analysis and quality control information, sensitivities of laboratory analyses, tables of environmental sample analyses, and maps of sampling locations

Emergency information systems for cars

Science.gov (United States)

Thirunavukkarasu, M.; Vani Manasa, N.; Kumar, K. Rajesh; Sundar, S.

2017-11-01

The main objective of this work is to create a Health Care monitoring and Guidance system for persons who are travelling in outdoor environments like cars. GSM (Global System for Mobile Communications) and GPS (Global Positioning System) technologies are separately and combined today in many applications in our day to day life. The GSM module will send a message along with the GPS location to the end user through text, and a call is initiated to the user for further instructions. The Global Positioning System (GPS) will give the location of the interested vehicle. This system helps the doctor or anyone to monitor the accident who is outdoor and has less help. This will help the hospital to monitor the accident as well as guide the injured through difficult situations. Using a buzzer, the persons nearby will come to know that the person is in danger or in poor health conditions. This project provides a good two-way communication with the injured and the hospital to assist them to give first aid before an ambulance arrives. So, this paper devices a novel technique to assist the people who just met with accident through GPS and GSM.

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.

Pressure monitoring during neuroendoscopy : new insights

NARCIS (Netherlands)

Dewaele, F.; Kalmar, A. F.; Van Canneyt, K.; Vereecke, H.; Absalom, A.; Caemaert, J.; Struys, M. M. R. F.; Van Roost, D.

Background. Significant increases in intracranial pressure (ICP) may occur during neuroendoscopic procedures. To detect and prevent serious and sustained increases, ICP should be monitored. At present, controversy exists on the optimal location of the monitoring sensor. Therefore, we conducted an in

Enabling affordable and efficiently deployed location based smart home systems.

Science.gov (United States)

Kelly, Damian; McLoone, Sean; Dishongh, Terry

2009-01-01

With the obvious eldercare capabilities of smart environments it is a question of "when", rather than "if", these technologies will be routinely integrated into the design of future houses. In the meantime, health monitoring applications must be integrated into already complete home environments. However, there is significant effort involved in installing the hardware necessary to monitor the movements of an elder throughout an environment. Our work seeks to address the high infrastructure requirements of traditional location-based smart home systems by developing an extremely low infrastructure localisation technique. A study of the most efficient method of obtaining calibration data for an environment is conducted and different mobile devices are compared for localisation accuracy and cost trade-off. It is believed that these developments will contribute towards more efficiently deployed location-based smart home systems.

Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report.

Science.gov (United States)

Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Saotome, Kousaku; Ueno, Tomoyuki; Abe, Tetsuya; Marushima, Aiki; Watanabe, Hiroki; Endo, Ayumu; Tsurumi, Kazue; Ishimoto, Ryu; Matsushita, Akira; Koda, Masao; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

2018-01-19

We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury. A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient's manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees. Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.

Environmental monitoring at the Savannah River Plant. Annual report, 1975

International Nuclear Information System (INIS)

Ashley, C.; Zeigler, C.C.

1975-01-01

The environmental monitoring program at the Savannah River Plant (SRP) provides reliable measurement of radioactive materials both released at the source (approximately 40 locations) and concentrated in the environment (approximately 500 locations). In recent years, water quality testing and analysis have become an essential part of the environmental monitoring program. Aqueous discharges to plant streams are monitored for nonradioactive materials by chemical analyses of water sampled in flowing streams (approximately 25 locations). A brief discussion of plant releases to the environment and radioactive and nonradioactive materials detected in the environment are presented in the following text, figures, and tables. The appendices contain an interpretation of data treatment, tables of results of environmental sample analyses, sensitivities of laboratory analyses, and maps of sampling locations

Long term pipeline monitoring in geomechanically sensitive environments

Energy Technology Data Exchange (ETDEWEB)

Weir-Jones, I.; Sun, M. [Weir-Jones Engineering Consultants Ltd. (Canada)

2011-07-01

In the oil industry, monitoring pipeline structural integrity is necessary for both regulatory and environmental purposes. Weir-Jones Engineering Consultants developed an automated structural integrity monitoring (SIM) system, data on strain, displacement and temperature are continuously acquired and automatically transmitted to the monitoring personnel. The aim of this paper is to present this technology and its implementation on one of Inter Pipeline Fund's lines as well. The automated SIM equipment was installed on a new 42'' line at the crossing of the Clearwater River close to Fort McMurray. Results showed that this technology is a good way to monitor pipelines in remote locations, environmentally sensitive areas, river and embankment crossings and in locations where external forces can put the pipeline at risk; but it should not be used otherwise as that would not be cost effective. This paper described the developed automated SIM and showed that it should only be used in specific locations to be cost effective.

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.

Self-Monitoring and the Metatraits.

Science.gov (United States)

Wilmot, Michael P; DeYoung, Colin G; Stillwell, David; Kosinski, Michal

2016-06-01

Prior attempts at locating self-monitoring within general taxonomies of personality traits have largely proved unsuccessful. However, past research has typically neglected (a) the bidimensionality of the Self-Monitoring Scale and (b) the hierarchical nature of personality. The objective of this study was to test hypotheses that the two self-monitoring factors are located at the level of the metatraits. Using data from two large multi-informant samples, one community (Sample 1: N = 552, Mage  = 51.26, 61% female; NPeers  = 1,551, Mage  = 48.61, 37% female) and one online (Sample 2: N = 3,726, Mage  = 24.89, 59% female; NPeers  = 17,868, Mage  = 26.23, 64% female), confirmatory factor analysis was used to test the hypotheses. Results confirmed hypotheses that acquisitive self-monitoring would have a strong positive relation to metatrait Plasticity, whereas protective self-monitoring would have a moderate negative relation to metatrait Stability. In both samples, constraining the correlation between acquisitive self-monitoring and Plasticity to unity did not alter model fit indices, indicating that the two putatively distinct constructs are identical. Findings have wide-ranging implications, including integration of the construct of self-monitoring into the mainstream of personality research, as the latter moves toward the development of broad explanatory theories. © 2015 Wiley Periodicals, Inc.

Eddy current monitoring of spacers in coolant channel assemblies of nuclear reactor

International Nuclear Information System (INIS)

Bhole, V.M.; Rastogi, P.K.; Kulkarni, P.G.; Vijayaraghavan, R.

1993-01-01

An eddy current testing method has been standardised for monitoring spacer springs which are used in coolant channel assemblies of pressurised heavy water nuclear reactors (PHWRs). The standard bobbin coil probe used for monitoring the spacer spring detects only the location but does not monitor the tilt orientation and tilt angle of a tilted spacer spring. The knowledge of location along with the tilt orientation of the spacer spring greatly improves the performance of repositioning methods. A modified probe with angular windings has been developed in laboratory tests for monitoring the location as well as the tilt orientation of the spacer springs. Experimental results are presented showing excellent performance of the modified probe in monitoring the exact location as well as tilt orientation of a spacer spring. The modified probe has also been used successfully in the field during repositioning of spacer springs in PHWRs before commissioning. (Author)

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.

Establishment of a Background Environmental Monitoring Station for the PNNL Campus

Energy Technology Data Exchange (ETDEWEB)

Fritz, Brad G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Snyder, Sandra F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Barnett, J. Matthew [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bisping, Lynn E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rishel, Jeremy P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2014-12-01

The environmental surveillance of background levels of radionuclides and, in particular, the siting of a background environmental surveillance (monitoring) station are examined. Many published works identify and stress the need for background monitoring; however, little definitive and comprehensive information for siting a station exists. A definition of an ideal background monitoring location and the generic criteria recommended for use in establishing such a background monitoring location are proposed. There are seven primary (mandatory) criteria described with two additional, optional criteria. The criteria are applied to the Richland, Washington (WA), Pacific Northwest National Laboratory (PNNL) Campus, which currently uses background monitoring data from the nearby Hanford Site. Eleven potential background monitoring sites were identified, with one location in Benton City, WA found to meet all of the mandatory and optional criteria. It is expected that the new sampler will be installed and operating by the end of June, 2015.

Wide area continuous offender monitoring

Energy Technology Data Exchange (ETDEWEB)

Hoshen, J. [Lucent Technologies (United States); Drake, G. [New Mexico Dept. of Corrections, Santa Fe, NM (United States); Spencer, D. [Sandia National Labs., Albuquerque, NM (United States)

1996-11-01

The corrections system in the U.S. is supervising over five million offenders. This number is rising fast and so are the direct and indirect costs to society. To improve supervision and reduce the cost of parole and probation, first generation home arrest systems were introduced in 1987. While these systems proved to be helpful to the corrections system, their scope is rather limited because they only cover an offender at a single location and provide only a partial time coverage. To correct the limitations of first-generation systems, second-generation wide area continuous electronic offender monitoring systems, designed to monitor the offender at all times and locations, are now on the drawing board. These systems use radio frequency location technology to track the position of offenders. The challenge for this technology is the development of reliable personal locator devices that are small, lightweight, with long operational battery life, and indoors/outdoors accuracy of 100 meters or less. At the center of a second-generation system is a database that specifies the offender`s home, workplace, commute, and time the offender should be found in each. The database could also define areas from which the offender is excluded. To test compliance, the system would compare the observed coordinates of the offender with the stored location for a given time interval. Database logfiles will also enable law enforcement to determine if a monitored offender was present at a crime scene and thus include or exclude the offender as a potential suspect.

Citizen-based environmental radiation monitoring network

International Nuclear Information System (INIS)

Alemayehu, B.; Mckinzie, M.; Cochran, T.; Sythe, D.; Randrup, R.; Lafargue, E.

2017-01-01

This paper discusses a Citizen Radiation Monitoring project designed and implemented by the Natural Resources Defense Council . The goal of the project was to implement a radiation monitoring system that provides radiation data accessible to the public. The monitoring system consisted of usage of a radiation detector integrated with near real-time data collection and visualization. The monitoring systems were installed at five different locations and background radiation measurements were taken. The developed monitoring system demonstrated that citizen-based monitoring system could provide accessible radiation data to the general public and relevant to the area where they live. (author)

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)

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

The Multi-Location Transshipment Problem with Positive Replenishment Lead Times

NARCIS (Netherlands)

Y. Gong (Yeming); E. Yucesan

2006-01-01

textabstractTransshipments, monitored movements of material at the same echelon of a supply chain, represent an effective pooling mechanism. With a single exception, research on transshipments overlooks replenishment lead times. The only approach for two-location inventory systems with

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.

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”.

Geophysical monitoring of the Purace volcano, Colombia

Directory of Open Access Journals (Sweden)

M. Arcila

1996-06-01

Full Text Available Located in the extreme northwestern part of the Los Coconucos volcanic chain in the Central Cordillera, the Purace is one of Colombia's most active volcanoes. Recent geological studies indicate an eruptive history of mainly explosive behavior which was marked most recently by a minor ash eruption in 1977. Techniques used to forecast the renewal of activity of volcanoes after a long period of quiescence include the monitoring of seismicity and ground deformation near the volcano. As a first approach toward the monitoring of the Purace volcano, Southwest Seismological Observatory (OSSO, located in the city of Cali, set up one seismic station in 1986. Beginning in June 1991, the seismic signals have also been transmitted to the Colombian Geological Survey (INGEOMINAS at the Volcanological and Seismological Observatory (OVS-UOP, located in the city of Popayan. Two more seismic stations were installed early in 1994 forming a minimum seismic network and a geodetic monitoring program for ground deformation studies was established and conducted by INGEOMINAS.

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.

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.

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.

Epidemiology and location of primary retrieval missions in a Scottish aeromedical service.

Science.gov (United States)

Neagle, Gregg; Curatolo, Lisa; Ferris, John; Donald, Mike; Hearns, Stephen; Corfield, Alasdair R

2017-07-25

Prehospital critical care teams comprising an appropriately trained physician and paramedic or nurse have been associated with improved outcomes in selected trauma patients. These teams are a scarce and expensive resource, especially when delivered by rotary air assets. The optimal tasking of prehospital critical care teams is therefore vital and remains a subject of debate. Emergency Medical Retrieval Service (EMRS) provides a prehospital critical care response team to incidents over a large area of Scotland either by air or by road. A convenience sample of consecutive EMRS missions covering a period of 18 months from May 2013 to January 2015 was taken. These missions were matched with the ambulance service information on geographical location of the incident. In order to assess the appropriateness of tasking, interventions undertaken on each mission were analysed and divided into two subcategories: 'critical care interventions' and 'advanced medical interventions'. A tasking was deemed appropriate if it included either category of intervention or if a patient was pronounced life extinct at the scene. A total of 1279 primary missions were undertaken during the study period. Of these, 493 primary missions met the inclusion criteria and generated complete location data. The median distance to scene was calculated as 5.6 miles for land responses and 34.2 miles for air responses. Overall, critical care interventions were performed on 17% (84/493) of patients. A further 21% (102/493) of patients had an advanced medical intervention. Including those patients for whom life was pronounced extinct on scene by the EMRS team, a total of 42% (206/493) taskings were appropriate. Overall, our data show a wide geographical spread of tasking for our service, which is in keeping with other suburban/rural models of prehospital care. Tasking accuracy is also comparable to the accuracy shown by other similar services.

A radiation monitoring system for nuclear power plants

International Nuclear Information System (INIS)

Iwai, Masaru; Nakamori, S.; Ikeda, H.; Oda, M.

1974-01-01

Safety with respect to radiation is vital factor, particularly in view of the increasing number of nuclear power plants. For this purpose, a radiation monitoring system is provided to perform constant supervision. This article describes the purpose, installation location, specifications and circuitry of a system which is divided into three units: the process monitor, area monitor and off-site monitor. (auth.)

Tracer verification and monitoring of containment systems (II)

International Nuclear Information System (INIS)

Williams, C.V.; Dunn, S.D.; Lowry, W.E.

1997-01-01

A tracer verification and monitoring system, SEAtrace trademark, has been designed and field tested which uses gas tracers to evaluate, verify, and monitor the integrity of subsurface barriers. This is accomplished using an automatic, rugged, autonomous monitoring system combined with an inverse optimization code. A gaseous tracer is injected inside the barrier and an array of wells outside the barrier are monitored. When the tracer gas is detected, a global optimization code is used to calculate the leak parameters, including leak size, location, and when the leak began. The multipoint monitoring system operates in real-time, can be used to measure both the tracer gas and soil vapor contaminants, and is capable of unattended operation for long periods of time (months). The global optimization code searches multi-dimensional open-quotes spaceclose quotes to find the best fit for all of the input parameters. These parameters include tracer gas concentration histories from multiple monitoring points, medium properties, barrier location, and the source concentration. SEAtrace trademark does not attempt to model all of the nuances associated with multi-phase, multi-component flow, but rather, the inverse code uses a simplistic forward model which can provide results which are reasonably accurate. The system has calculated leak locations to within 0.5 meters and leak radii to within 0.12 meters

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.

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.

Integrated Monitoring Plan for the Hanford Groundwater Monitoring Project

International Nuclear Information System (INIS)

Newcomer, D.R.; Thornton, E.C.; Hartman, M.J.; Dresel, P.E.

1999-01-01

Groundwater is monitored at the Hanford Site to fulfill a variety of state and federal regulations, including the Atomic Energy Act of 1954 the Resource Conservation and Recovery Act of 1976 the Comprehensive Environmental Response, Compensation, and Liability Act of 1980; and Washington Administrative Code. Separate monitoring plans are prepared for various requirements, but sampling is coordinated and data are shared among users to avoid duplication of effort. The US Department of Energy manages these activities through the Hanford Groundwater Monitoring Project. This document is an integrated monitoring plan for the groundwater project. It documents well and constituent lists for monitoring required by the Atomic Energy Act of 1954 and its implementing orders; includes other, established monitoring plans by reference; and appends a master well/constituent/frequency matrix for the entire site. The objectives of monitoring fall into three general categories plume and trend tracking, treatment/storage/disposal unit monitoring, and remediation performance monitoring. Criteria for selecting Atomic Energy Act of 1954 monitoring networks include locations of wells in relation to known plumes or contaminant sources, well depth and construction, historical data, proximity to the Columbia River, water supplies, or other areas of special interest, and well use for other programs. Constituent lists were chosen based on known plumes and waste histories, historical groundwater data, and, in some cases, statistical modeling. Sampling frequencies were based on regulatory requirements, variability of historical data, and proximity to key areas. For sitewide plumes, most wells are sampled every 3 years. Wells monitoring specific waste sites or in areas of high variability will be sampled more frequently

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.

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

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

Challenges in Locating Microseismic Events Using Distributed Acoustic Sensors

Science.gov (United States)

Williams, A.; Kendall, J. M.; Clarke, A.; Verdon, J.

2017-12-01

Microseismic monitoring is an important method of assessing the behaviour of subsurface fluid processes, and is commonly acquired using geophone arrays in boreholes or on the surface. A new alternative technology has been recently developed - fibre-optic Distributed Acoustic Sensing (DAS) - using strain along a fibre-optic cable as a measure of seismic signals. DAS can offer high density arrays and full-well coverage from the surface to bottom, with less overall disruption to operations, so there are many exciting possible applications in monitoring both petroleum and other subsurface industries. However, there are challenges in locating microseismic events recorded using current DAS systems, which only record seismic data in one-component and consequently omit the azimuthal information provided by a three-component geophone. To test the impact of these limitations we used finite difference modelling to generate one-component synthetic DAS datasets and investigated the impact of picking solely P-wave or both P- and S-wave arrivals and the impact of different array geometries. These are then compared to equivalent 3-component synthetic geophone datasets. In simple velocity models, P-wave arrivals along linear arrays cannot be used to constrain locations using DAS, without further a priori information. We then tested the impact of straight cables vs. L-shaped arrays and found improved locations when the cable is deviated, especially when both P- and S-wave picks are included. There is a trade-off between the added coverage of DAS cables versus sparser 3C geophone arrays where particle motion helps constrains locations, which cannot be assessed without forward modelling.

Peer-to-Peer Location-Based Services based on Blockchain and Web Technologies

OpenAIRE

Brambilla, Giacomo

2017-01-01

A distinctive feature of smart cities is the fruitful and effective interconnection among mobile users and resources, to support the fulfillment of sophisticated location-based services (LBSs). LBSs are increasingly taking advantage of user geographic location to provide a broad range of applications, such as traffic monitoring, social networking, emergency management and advertising. Unfortunately, most LBSs rely upon centralized infrastructures, thus raising, besides scalability and r...

Long-term Monitoring Plan for the Shoal Underground Nuclear Test

International Nuclear Information System (INIS)

Ahmed Hassan

2005-01-01

The flow and transport model of Shoal is used to design a three-well monitoring network to be part of the long-term monitoring network for the site and achieve two objectives: (1) detect the presence of radionuclides in case they migrate to the monitoring well locations, and (2) provide field data to compare with model predictions as part of the model validation process. Using three different quantitative approaches and the numerical groundwater flow and transport model developed for Shoal, three new monitoring well locations were identified from 176 different networks. In addition to the quantitative analyses using the numerical model, the development of the monitoring network for Shoal will also be subject to qualitative hydrogeologic interpretation during implementation. information will only be available during the fieldwork, it will be incorporated in the monitoring well design at the time of well installation. Finally, it should be noted that the CADD-CAP for Shoal, including the compliance boundary, is not yet approved. Should the compliance boundary change from the 1,000-year MCL contaminant boundary, well locations may also need to change. However, the analysis reported here provides a number of alternatives with reasonable detection efficiency

Long-term Monitoring Plan for the Shoal Underground Nuclear Test

Energy Technology Data Exchange (ETDEWEB)

Ahmed Hassan

2005-02-01

The flow and transport model of Shoal is used to design a three-well monitoring network to be part of the long-term monitoring network for the site and achieve two objectives: (1) detect the presence of radionuclides in case they migrate to the monitoring well locations, and (2) provide field data to compare with model predictions as part of the model validation process. Using three different quantitative approaches and the numerical groundwater flow and transport model developed for Shoal, three new monitoring well locations were identified from 176 different networks. In addition to the quantitative analyses using the numerical model, the development of the monitoring network for Shoal will also be subject to qualitative hydrogeologic interpretation during implementation. information will only be available during the fieldwork, it will be incorporated in the monitoring well design at the time of well installation. Finally, it should be noted that the CADD-CAP for Shoal, including the compliance boundary, is not yet approved. Should the compliance boundary change from the 1,000-year MCL contaminant boundary, well locations may also need to change. However, the analysis reported here provides a number of alternatives with reasonable detection efficiency.

Design of position monitor module in radioactive material transport monitoring system

International Nuclear Information System (INIS)

Adi Abimanyu; Dwi Yuliansari N

2013-01-01

Aspects of safety and security of radioactive substances from the sender to the receiver is to be secured so as not to harm humans. In general, monitoring is done through conversation by telephone to determine the location and rate of exposure of radioactive substances. Through the development of science and technology makes it possible to develop a system of monitoring the transport of radioactive substances in real time by combining radiation monitor module, position monitors module and sending information nir-cable. Position monitor module developed using GPS-receiver and a micro controller ATMega8 based serial interrupts communication. Testing is done by testing communication between micro controller and GPS and also testing reading position by GPS receiver. From the test results concluded that the developed modules is good in serial communication is based on serial interrupts, good position measurement to be used outdoors and is not good enough for measurements indoors because the GPS receiver used is not using an outdoor antenna. (author)

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.

The SSRL injector beam position monitoring systems

International Nuclear Information System (INIS)

Lavender, W.; Baird, S.; Brennan, S.; Borland, M.; Hettel, R.; Nuhn, H.D.; Ortiz, R.; Safranek, J.; Sebek, J.; Wermelskirchen, C.; Yang, J.

1991-01-01

The beam position monitoring system of the SSRL injector forms a vital component of its operation. Several different types of instrumentation are used to measure the position or intensity of the electron beam in the injector. These include current toroids, fluorescent screens, Faraday cups, the 'Q' meter, a synchrotron light monitor, and electron beam position monitors. This paper focuses on the use of the electron beam position monitors to measure electron trajectories in the injector transport lines and the booster ring. The design of the beam position monitors is described in another paper to be presented at this conference. There are three different beam position monitor systems in the injector. One system consists of a set of five BPMs located on the injection transport line from the linac to the booster (known as the LTB line). There is a second system of six BPMs located on the ejection transport line (known as the BTS line). Finally, there is an array of 40 BPMs installed on the main booster ring itself. This article describes the software and processing electronics of the systems used to measure electron beam trajectories for the new SSRL injector for SPEAR

Steps in formulating an environmental monitoring program

International Nuclear Information System (INIS)

Anon.

1991-01-01

This section describes the process of establishing a complete equipment environmental monitoring program; the step by step process is also illustrated in Table 3 of the Summary. The following decisions must be made in defining the program: an initial characterization of plant environment, how to integrate with existing programs to realize the maximum benefits, identification of the specific monitoring locations, determining the monitoring techniques, frequency of recording data, monitoring duration, quality assurance requirements, and finally, establishing the recordkeeping requirements

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.

Development of radiation monitoring and visualization systems for Fukushima. GPS monitoring system, Dose3DMap system, and LED-coupled scintillating fiber detector

International Nuclear Information System (INIS)

Nakao, Noriaki; Kosako, Kazuaki; Kinoshita, Norikazu; Kawaguchi, Masato

2016-01-01

Lands that were contaminated with radioactive elements following the Fukushima Daiichi Nuclear Power Plant accident in 2011 have been decontaminated, and the construction of an interim storage facility for radioactive waste is planned. A GPS monitoring system was developed to concomitantly determine a location and measure the radiation level at the location. Moreover, a mapping system that produces radiation maps at the measurement locations and also predicts post-decontamination radiation maps using the compiled Monte Carlo simulation program was constructed. These systems were used for decontamination planning and estimation of the decontamination effect. An LED-coupled scintillating fiber detector was developed for visually monitoring radiation in real time at the interim storage facility. The LEDs display different colors corresponding to different radiation levels at the measurement locations along the fiber detector, the maximum length of which is 50 m. Thus, the radiation levels at all positions along the length of the detector can be visually monitored in real time. Moreover, it is useful for radiation safety and for risk communication with radiation workers and residents close to the site. (author)

Head ballistocardiogram based on wireless multi-location sensors.

Science.gov (United States)

Onizuka, Kohei; Sodini, Charles G

2015-08-01

Recently a wearable BCG monitoring technique based on an accelerometer worn at the ear was demonstrated to replace a conventional bulky BCG acquisition system. In this work, a multi-location wireless vital signs monitor was developed, and at least two common acceleration vectors correlating to sitting-BCG were found in the supine position by using head PPG signal as a reference for eight healthy human subjects. The head side amplitude in the supine position is roughly proportional to the sitting amplitude that is in turn proportional to the stroke volume. Signal processing techniques to identify J-waves in a subject having small amplitude was also developed based on the two common vectors at the head side and top.

Underground ventilation remote monitoring and control system

International Nuclear Information System (INIS)

Strever, M.T.; Wallace, K.G. Jr.; McDaniel, K.H.

1995-01-01

This paper presents the design and installation of an underground ventilation remote monitoring and control system at the Waste Isolation Pilot Plant. This facility is designed to demonstrate safe underground disposal of U.S. defense generated transuranic nuclear waste. To improve the operability of the ventilation system, an underground remote monitoring and control system was designed and installed. The system consists of 15 air velocity sensors and 8 differential pressure sensors strategically located throughout the underground facility providing real-time data regarding the status of the ventilation system. In addition, a control system was installed on the main underground air regulators. The regulator control system gives indication of the regulator position and can be controlled either locally or remotely. The sensor output is displayed locally and at a central surface location through the site-wide Central Monitoring System (CMS). The CMS operator can review all sensor data and can remotely operate the main underground regulators. Furthermore, the Virtual Address Extension (VAX) network allows the ventilation engineer to retrieve real-time ventilation data on his personal computer located in his workstation. This paper describes the types of sensors selected, the installation of the instrumentation, and the initial operation of the remote monitoring system

Practical Field Calibration of Portable Monitors for Mobile Measurements of Multiple Air Pollutants

Directory of Open Access Journals (Sweden)

Chun Lin

2017-11-01

Full Text Available To reduce inaccuracies in the measurement of air pollutants by portable monitors it is necessary to establish quantitative calibration relationships against their respective reference analyser. This is usually done under controlled laboratory conditions or one-off static co-location alongside a reference analyser in the field, neither of which may adequately represent the extended use of portable monitors in exposure assessment research. To address this, we investigated ways of establishing and evaluating portable monitor calibration relationships from repeated intermittent deployment cycles over an extended period involving stationary deployment at a reference site, mobile monitoring, and completely switched off. We evaluated four types of portable monitors: Aeroqual Ltd. (Auckland, New Zealand S500 O3 metal oxide and S500 NO2 electrochemical; RTI (Berkeley, CA, USA MicroPEM PM2.5; and, AethLabs (San Francisco, CA, USA AE51 black carbon (BC. Innovations in our study included: (i comparison of calibrations derived from the individual co-locations of a portable monitor against its reference analyser or from all the co-location periods combined into a single dataset; and, (ii evaluation of calibrated monitor estimates during transient measurements with the portable monitor close to its reference analyser at separate times from the stationary co-location calibration periods. Within the ~7 month duration of the study, ‘combined’ calibration relationships for O3, PM2.5, and BC monitors from all co-locations agreed more closely on average with reference measurements than ‘individual’ calibration relationships from co-location deployment nearest in time to transient deployment periods. ‘Individual’ calibrations relationships were sometimes substantially unrepresentative of the ‘combined’ relationships. Reduced quantitative consistency in field calibration relationships for the PM2.5 monitors may have resulted from generally low PM2

Telemetric intra-cranial pressure monitoring: clinical and financial considerations.

Science.gov (United States)

Barber, James M; Pringle, Catherine J; Raffalli-Ebezant, Helen; Pathmanaban, Omar; Ramirez, Roberto; Kamaly-Asl, Ian D

2017-06-01

Intracranial pressure (ICP) measurement is an important diagnostic tool in Neurosurgery. Until relatively recently, conventional monitoring has required that subjects be admitted to a hospital bed and the device is only able to be left in-situ for limited periods of time. We have evaluated a Telemetric ICP monitoring system that has been proven, by several other groups worldwide, to permit rapid, repeated and prolonged ICP measurement, in multiple environments. In our unit, 4 patients have been implanted to-date, between the ages of 4 and 16, manifesting a wide range of complex neurosurgical conditions. The sensors have been left in-situ for between 460 and 632 days. There have been no clinical complications and the system has been universally well tolerated. Clinical events, costs and patient experience were all assessed prior to and following implantation. Overall, there was a significant reduction in associated admissions (44.3%), imaging requirements (72.5%) and costs (50.0%). Subjective feedback from both the patients (where possible) and their families was overwhelmingly positive, partly due to (a) the system's ease of use, (b) its ability to reduce the number of admissions/tests required and (c) the facility for rapid measurement of ICP that permitted on-the-spot reassurance of concerns. Additionally, the ability to monitor ICP at home and/or whilst ambulant, has provided measurements that were hitherto inaccessible to our team, facilitating all the potential benefits that analysis of such information would provide. Indeed, we have seen the resultant management in each case has been completely altered by the availability of this data, reaffirming that the importance of being able to obtain it should not be underestimated. The combination of both this and the ability to markedly improve patient experience, along with generating significant cost-savings, lead the authors to suggest that the implantation of this system should be strongly considered in selected

Temporal and Location Based RFID Event Data Management and Processing

Science.gov (United States)

Wang, Fusheng; Liu, Peiya

Advance of sensor and RFID technology provides significant new power for humans to sense, understand and manage the world. RFID provides fast data collection with precise identification of objects with unique IDs without line of sight, thus it can be used for identifying, locating, tracking and monitoring physical objects. Despite these benefits, RFID poses many challenges for data processing and management. RFID data are temporal and history oriented, multi-dimensional, and carrying implicit semantics. Moreover, RFID applications are heterogeneous. RFID data management or data warehouse systems need to support generic and expressive data modeling for tracking and monitoring physical objects, and provide automated data interpretation and processing. We develop a powerful temporal and location oriented data model for modeling and queryingRFID data, and a declarative event and rule based framework for automated complex RFID event processing. The approach is general and can be easily adapted for different RFID-enabled applications, thus significantly reduces the cost of RFID data integration.

Engineering considerations for corrosion monitoring of gas gathering pipeline systems

Energy Technology Data Exchange (ETDEWEB)

Braga, T.G.; Asperger, R.G.

1987-01-01

Proper corrosion monitoring of gas gathering pipelines requires a system review to determine the appropriate monitor locations and types of monitoring techniques. This paper develops and discusses a classification of conditions such as flow regime and gas composition. Also discussed are junction categories which, for corrosion monitoring, need to be considered from two points of view. The first is related to fluid flow in the line and the second is related corrosion inhibitor movement along the pipeline. The appropriate application of the various monitoring techniques such as coupons, hydrogen detectors, electrical resistance probe and linear polarization probes are discussed in relation to flow regime and gas composition. Problems caused by semi-conduction from iron sulfide are considered. Advantages and disadvantages of fluid gathering methods such as pots and flow-through drips are discussed in relation to their reliability as on-line monitoring locations.

Integrated Monitoring Plan for the Hanford Groundwater Monitoring Project

International Nuclear Information System (INIS)

Hartman, Mary J.; Dresel, P. Evan; Lindberg, Jon W.; Newcomer, Darrell R.; Thornton, Edward C.

2000-01-01

Groundwater is monitored at the Hanford Site to fulfill a variety of state and federal regulations, including the Atomic Energy Act of 1954; the Resource Conservation and Recovery Act of 1976; the Comprehensive Environmental Response, Compensation, and Liability Act of 1980; and Washington Administrative Code. Separate monitoring plans are prepared for various requirements, but sampling is coordinated and data are shared among users to avoid duplication of effort. The U.S. Department of Energy manages these activities through the Hanford Groundwater Monitoring Project. This document is an integrated monitoring plan for the groundwater project. It documents well and constituent lists for monitoring required by the Atomic Energy Act of 1954 and its implementing orders; includes other, established monitoring plans by reference; and appends a master well/constituent/ frequency matrix for the entire site. The objectives of monitoring fall into three general categories: plume and trend tracking, treatment/ storage/disposal unit monitoring, and remediation performance monitoring. Criteria for selecting Atomic Energy Act of 1954 monitoring networks include locations of wells in relation to known plumes or contaminant sources, well depth and construction, historical data, proximity to the Columbia River, water supplies, or other areas of special interest, and well use for other programs. Constituent lists were chosen based on known plumes and waste histories, historical groundwater data, and, in some cases, statistical modeling. Sampling frequencies were based on regulatory requirements, variability of historical data, and proximity to key areas. For sitewide plumes, most wells are sampled every 3 years. Wells monitoring specific waste sites or in areas of high variability will be sampled more frequently

Microprocessor multi-task monitor

International Nuclear Information System (INIS)

Ludemann, C.A.

1983-01-01

This paper describes a multi-task monitor program for microprocessors. Although written for the Intel 8085, it incorporates features that would be beneficial for implementation in other microprocessors used in controlling and monitoring experiments and accelerators. The monitor places permanent programs (tasks) arbitrarily located throughout ROM in a priority ordered queue. The programmer is provided with the flexibility to add new tasks or modified versions of existing tasks, without having to comply with previously defined task boundaries or having to reprogram all of ROM. Scheduling of tasks is triggered by timers, outside stimuli (interrupts), or inter-task communications. Context switching time is of the order of tenths of a milllisecond

Trial of real-time locating and messaging system with Bluetooth low energy.

Science.gov (United States)

Arisaka, Naoya; Mamorita, Noritaka; Isonaka, Risa; Kawakami, Tadashi; Takeuchi, Akihiro

2016-09-14

Hospital real-time location systems (RTLS) are increasing efficiency and reducing operational costs, but room access tags are necessary. We developed three iPhone 5 applications for an RTLS and communications using Bluetooth low energy (BLE). The applications were: Peripheral device tags, Central beacons, and a Monitor. A Peripheral communicated with a Central using BLE. The Central communicated with a Monitor using sockets on TCP/IP (Transmission Control Protocol/Internet Protocol) via a WLAN (wireless local area network). To determine a BLE threshold level for the received signal strength indicator (RSSI), relationships between signal strength and distance were measured in our laboratory and on the terrace. The BLE RSSI threshold was set at -70 dB, about 10 m. While an individual with a Peripheral moved around in a concrete building, the Peripheral was captured in a few 10-sec units at about 10 m from a Central. The Central and Monitor showed and saved the approach events, location, and Peripheral's nickname sequentially in real time. Remote Centrals also interactively communicate with Peripherals by intermediating through Monitors that found the nickname in the event database. Trial applications using BLE on iPhones worked well for patient tracking, and messaging in indoor environments.

Soil monitoring as a part of environment monitoring in Slovakia

International Nuclear Information System (INIS)

Kobza, J.

1997-01-01

In frame of Soil monitoring system it is going about a lot of methods in advance as follows: methods of soil monitoring sites selection and soil monitoring network construction, as well; methods of soil survey and soil sampling; analytical methods (indicating of chemical, agrochemical and physical properties); soil database and methods of evaluation and interpretation of measured results. The monitoring network was constructed on the base of ecological principles - including the monitoring of all soil types and subtypes, various climatic and emission regions as well as relatively clean regions, lowland and highland. Soil monitoring network in forest land is regular (8 x 8 km) with regard to International monitoring system in Forestry. The soil monitoring network in Slovakia consist of 650 monitoring sites (312 sites in farming land and 338 sites in forest land). In addition soil monitoring network includes also 21 monitoring sites. All monitoring sites are geodesically located and reported on the map at a scale of 1:5000. There are the methods concerning the important soil parameters indication with regard to main soil degradation processes a s follows: soil contamination (heavy metals and organic contaminants); soil acidification; soil salinity; soil erosion (deluometrically by the Cs-137 and remote sensing methods); soil compaction; soil fertility and protection. Analytical control system was elaborated according to Good Laboratory Practice. Evaluation of soil monitoring network results is not simple because it depends on various monitored parameters, on aim of evaluation as well as on the scale of landscape which is object for evaluation. There are used the modern statistical methods in monitoring system which can be: universal; disjunctive; simulated. Used statistical methods are significant for interpretation of measured results as follows: trends in landscape; anisotropy; comparison. The evaluation and interpretation way is very significant with regard not

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.

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.)

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)

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–.

Beam profile monitors in the NLCTA

International Nuclear Information System (INIS)

Nantista, C.; Adolphsen, C.; Brown, R.L.; Fuller, R.; Rifkin, J.

1997-05-01

The transverse current profile in the Next Linear Collider Test Accelerator (NLCTA) electron beam can be monitored at several locations along the beam line by means of profile monitors. These consist of insertable phosphor screens, light collection and transport systems, CID cameras, a frame-grabber, and PC and VAX based image analysis software. In addition to their usefulness in tuning and steering the accelerator, the profile monitors are utilized for emittance measurement. A description of these systems and their performance is presented

Proceedings of the 2011 Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies

International Nuclear Information System (INIS)

Wetovsky, Marvin A.; Patterson, Eileen F.; Sandoval, Marisa N.

2011-01-01

These proceedings contain papers prepared for the Monitoring Research Review 2011: Ground-Based Nuclear Explosion Monitoring Technologies, held 13-15 September, 2011 in Tucson, Arizona. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Defense Threat Reduction Agency (DTRA), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), National Science Foundation (NSF), and other invited sponsors. The scientific objectives of the research are to improve the United States' capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

Proceedings of the 2011 Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies

Energy Technology Data Exchange (ETDEWEB)

Wetovsky, Marvin A. [Editor; Patterson, Eileen F. [Editor; Sandoval, Marisa N. [Editor

2011-09-13

These proceedings contain papers prepared for the Monitoring Research Review 2011: Ground-Based Nuclear Explosion Monitoring Technologies, held 13-15 September, 2011 in Tucson, Arizona. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Defense Threat Reduction Agency (DTRA), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), National Science Foundation (NSF), and other invited sponsors. The scientific objectives of the research are to improve the United States' capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

Proceedings of the 30th Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring

Energy Technology Data Exchange (ETDEWEB)

Wetovsky, Marv A [Los Alamos National Laboratory; Aguilar-chang, Julio [Los Alamos National Laboratory; Arrowsmith, Marie [Los Alamos National Laboratory; Arrowsmith, Stephen [Los Alamos National Laboratory; Baker, Diane [Los Alamos National Laboratory; Begnaud, Michael [Los Alamos National Laboratory; Harste, Hans [Los Alamos National Laboratory; Maceira, Monica [Los Alamos National Laboratory; Patton, Howard [Los Alamos National Laboratory; Phillips, Scott [Los Alamos National Laboratory; Randall, George [Los Alamos National Laboratory; Revelle, Douglas [Los Alamos National Laboratory; Rowe, Charlotte [Los Alamos National Laboratory; Stead, Richard [Los Alamos National Laboratory; Steck, Lee [Los Alamos National Laboratory; Whitaker, Rod [Los Alamos National Laboratory; Yang, Xiaoning [Los Alamos National Laboratory

2008-09-23

These proceedings contain papers prepared for the 30th Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies, held 23-25 September, 2008 in Portsmouth, Virginia. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Air Force Technical Applications Center (AFTAC), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), and other invited sponsors. The scientific objectives of the research are to improve the United States’ capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

Proceedings of the 2010 Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies

Energy Technology Data Exchange (ETDEWEB)

Wetovsky, Marvin A [Editor; Patterson, Eileen F [Editor

2010-09-21

These proceedings contain papers prepared for the Monitoring Research Review 2010: Ground-Based Nuclear Explosion Monitoring Technologies, held 21-23 September, 2010 in Orlando, Florida,. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, National Science Foundation (NSF), Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), and other invited sponsors. The scientific objectives of the research are to improve the United States capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

Proceedings of the 2009 Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies

Energy Technology Data Exchange (ETDEWEB)

Wetovsky, Marv A [Los Alamos National Laboratory; Aguilar - Chang, Julio [Los Alamos National Laboratory; Anderson, Dale [Los Alamos National Laboratory; Arrowsmith, Marie [Los Alamos National Laboratory; Arrowsmith, Stephen [Los Alamos National Laboratory; Baker, Diane [Los Alamos National Laboratory; Begnaud, Michael [Los Alamos National Laboratory; Harste, Hans [Los Alamos National Laboratory; Maceira, Monica [Los Alamos National Laboratory; Patton, Howard [Los Alamos National Laboratory; Phillips, Scott [Los Alamos National Laboratory; Randall, George [Los Alamos National Laboratory; Rowe, Charlotte [Los Alamos National Laboratory; Stead, Richard [Los Alamos National Laboratory; Steck, Lee [Los Alamos National Laboratory; Whitaker, Rod [Los Alamos National Laboratory; Yang, Xiaoning ( David ) [Los Alamos National Laboratory

2009-09-21

These proceedings contain papers prepared for the Monitoring Research Review 2009: Ground -Based Nuclear Explosion Monitoring Technologies, held 21-23 September, 2009 in Tucson, Arizona,. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, Comprehensive Test Ban Treaty Organization (CTBTO), and other invited sponsors. The scientific objectives of the research are to improve the United States’ capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

Proceedings of the 2010 Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies

International Nuclear Information System (INIS)

Wetovsky, Marvin A.; Patterson, Eileen F.

2010-01-01

These proceedings contain papers prepared for the Monitoring Research Review 2010: Ground-Based Nuclear Explosion Monitoring Technologies, held 21-23 September, 2010 in Orlando, Florida,. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, National Science Foundation (NSF), Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), and other invited sponsors. The scientific objectives of the research are to improve the United States capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

PingER: Internet performance monitoring -- How do collisions make better physics

International Nuclear Information System (INIS)

Matthews, W.

2000-01-01

Internet connectivity is critical infrastructure for modern high energy nuclear and particle physics experiments at laboratories around the world. Achieving the ambitious computing goals is dependent on reliable and fast connections between collaborators in geographically separate regions. The ambitious computing goals of experiments such as BaBar, RHIC and the LHC place internet connectivity in a highly critical position. More over the ability to monitor performance and identify weak points for upgrades has become pivotal to recruiting collaborators not only overseas from the location of the experiment but in locations previously considered remote. The methodology of the Internet End-to-End Performance Monitoring (IEPM) project and long-term trends in regional and trans-oceanic performance measured by the PingER tools has previously been described. The project has grown significantly and now 593 nodes at 424 sites in 72 countries are monitored by 28 monitoring sites in 15 countries. A total of 2,138 end-to-end pairs are monitored, making PingER probably the largest performance monitoring project in the world. Recently particular effort has been made to extend the monitoring of locations in East Europe and the former USSR and to Central and South America and the Middle East, reflecting the increasing reach of high energy nuclear and particle physics research

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.

Design of a particulate-monitoring network for the Y-12 plant

International Nuclear Information System (INIS)

Hougland, E.S.; Oakes, T.W.; Underwood, J.N.

1982-01-01

An Air Quality Monitoring Network Design (AQMND) with multiple objectives is being developed for the Y-12 Plant production facilities. The objectives are: Y-12 facility surveillance; monitoring the transport of Y-12 generated airborne effluents towards either the Oak Ridge National Laboratory or the developed region of the City of Oak Ridge; and monitoring population exposure in residential areas close to the Y-12 Plant. A two step design process was carried out, using the Air Quality Monitor Network Design Model (AQMND) previously used for the Oak Ridge National Laboratory network. In the first step of the design we used existing air quality monitor locations, subjectively designated locations, and grid intersections as a set of potential monitor sites. The priority sites from the first step (modified to account for terrain and accessibility), and subjectively designated sites, were used as the potential monitor sites for the second step of the process which produced the final design recommendations for the monitor network

Economics important in selecting monitoring techniques

International Nuclear Information System (INIS)

Moore, D.P.; Byars, H.G.

1990-01-01

Failure/risk costs need to be considered when deciding on the type of corrosion monitoring and inspection. Locations with high-pressure, high-velocity streams need closer monitoring. This article discusses the risks associated with different types of fluid streams and the various inspection techniques that can range from a low-cost visual examination to mechanical calipers and electromagnetic, radiographic, and ultrasonic tools

Large-Scale Brain Networks Supporting Divided Attention across Spatial Locations and Sensory Modalities.

Science.gov (United States)

Santangelo, Valerio

2018-01-01

Higher-order cognitive processes were shown to rely on the interplay between large-scale neural networks. However, brain networks involved with the capability to split attentional resource over multiple spatial locations and multiple stimuli or sensory modalities have been largely unexplored to date. Here I re-analyzed data from Santangelo et al. (2010) to explore the causal interactions between large-scale brain networks during divided attention. During fMRI scanning, participants monitored streams of visual and/or auditory stimuli in one or two spatial locations for detection of occasional targets. This design allowed comparing a condition in which participants monitored one stimulus/modality (either visual or auditory) in two spatial locations vs. a condition in which participants monitored two stimuli/modalities (both visual and auditory) in one spatial location. The analysis of the independent components (ICs) revealed that dividing attentional resources across two spatial locations necessitated a brain network involving the left ventro- and dorso-lateral prefrontal cortex plus the posterior parietal cortex, including the intraparietal sulcus (IPS) and the angular gyrus, bilaterally. The analysis of Granger causality highlighted that the activity of lateral prefrontal regions were predictive of the activity of all of the posteriors parietal nodes. By contrast, dividing attention across two sensory modalities necessitated a brain network including nodes belonging to the dorsal frontoparietal network, i.e., the bilateral frontal eye-fields (FEF) and IPS, plus nodes belonging to the salience network, i.e., the anterior cingulated cortex and the left and right anterior insular cortex (aIC). The analysis of Granger causality highlights a tight interdependence between the dorsal frontoparietal and salience nodes in trials requiring divided attention between different sensory modalities. The current findings therefore highlighted a dissociation among brain networks

Large-Scale Brain Networks Supporting Divided Attention across Spatial Locations and Sensory Modalities

Directory of Open Access Journals (Sweden)

Valerio Santangelo

2018-02-01

Full Text Available Higher-order cognitive processes were shown to rely on the interplay between large-scale neural networks. However, brain networks involved with the capability to split attentional resource over multiple spatial locations and multiple stimuli or sensory modalities have been largely unexplored to date. Here I re-analyzed data from Santangelo et al. (2010 to explore the causal interactions between large-scale brain networks during divided attention. During fMRI scanning, participants monitored streams of visual and/or auditory stimuli in one or two spatial locations for detection of occasional targets. This design allowed comparing a condition in which participants monitored one stimulus/modality (either visual or auditory in two spatial locations vs. a condition in which participants monitored two stimuli/modalities (both visual and auditory in one spatial location. The analysis of the independent components (ICs revealed that dividing attentional resources across two spatial locations necessitated a brain network involving the left ventro- and dorso-lateral prefrontal cortex plus the posterior parietal cortex, including the intraparietal sulcus (IPS and the angular gyrus, bilaterally. The analysis of Granger causality highlighted that the activity of lateral prefrontal regions were predictive of the activity of all of the posteriors parietal nodes. By contrast, dividing attention across two sensory modalities necessitated a brain network including nodes belonging to the dorsal frontoparietal network, i.e., the bilateral frontal eye-fields (FEF and IPS, plus nodes belonging to the salience network, i.e., the anterior cingulated cortex and the left and right anterior insular cortex (aIC. The analysis of Granger causality highlights a tight interdependence between the dorsal frontoparietal and salience nodes in trials requiring divided attention between different sensory modalities. The current findings therefore highlighted a dissociation among

Environmental radiation monitoring of Vizag City

International Nuclear Information System (INIS)

Sreekanth, B.; Narsaiah, M.V.R.; Saindane, Shashank; Pujari, Raju; Krishna, N.S.; Sambamurthy, T.; Chaudhury, Probal; Pradeepkumar, K.S.

2014-01-01

Radiological impact assessment is to be carried out following any radiological emergency to implement the required counter measures. A ground based environmental radiation monitoring of Vizag city has been carried out by installing various radiation monitoring instruments in a vehicle to generate the base line radiation data. It also helps to check the illicit trafficking of radioactive sources and also identifying the orphan sources. The average background radiation level observed in Vizag city was 80 nGy/h. Database of baseline radiation level with GPS location at all important locations of the whole city has been developed. No illicit trafficking of radioactive materials and orphan sources were detected during the survey. All the detectors used in the survey shown good correlation in their response. The study showed that mobile monitoring methodology will be useful in the quick assessment of radiological impact and strengthens the decision makers in reducing consequences by initiating immediate counter measures

Attention to multiple locations is limited by spatial working memory capacity.

Science.gov (United States)

Close, Alex; Sapir, Ayelet; Burnett, Katherine; d'Avossa, Giovanni

2014-08-21

What limits the ability to attend several locations simultaneously? There are two possibilities: Either attention cannot be divided without incurring a cost, or spatial memory is limited and observers forget which locations to monitor. We compared motion discrimination when attention was directed to one or multiple locations by briefly presented central cues. The cues were matched for the amount of spatial information they provided. Several random dot kinematograms (RDKs) followed the spatial cues; one of them contained task-relevant, coherent motion. When four RDKs were presented, discrimination accuracy was identical when one and two locations were indicated by equally informative cues. However, when six RDKs were presented, discrimination accuracy was higher following one rather than multiple location cues. We examined whether memory of the cued locations was diminished under these conditions. Recall of the cued locations was tested when participants attended the cued locations and when they did not attend the cued locations. Recall was inaccurate only when the cued locations were attended. Finally, visually marking the cued locations, following one and multiple location cues, equalized discrimination performance, suggesting that participants could attend multiple locations when they did not have to remember which ones to attend. We conclude that endogenously dividing attention between multiple locations is limited by inaccurate recall of the attended locations and that attention poses separate demands on the same central processes used to remember spatial information, even when the locations attended and those held in memory are the same. © 2014 ARVO.

Coupling a Neural Network with Atmospheric Flow Simulations to Locate and Quantify CH4 Emissions at Well Pads

Science.gov (United States)

Travis, B. J.; Sauer, J.; Dubey, M. K.

2017-12-01

Methane (CH4) leaks from oil and gas production fields are a potentially significant source of atmospheric methane. US DOE's ARPA-E office is supporting research to locate methane emissions at 10 m size well pads to within 1 m. A team led by Aeris Technologies, and that includes LANL, Planetary Science Institute and Rice University has developed an autonomous leak detection system (LDS) employing a compact laser absorption methane sensor, a sonic anemometer and multiport sampling. The LDS system analyzes monitoring data using a convolutional neural network (cNN) to locate and quantify CH4 emissions. The cNN was trained using three sources: (1) ultra-high-resolution simulations of methane transport provided by LANL's coupled atmospheric transport model HIGRAD, for numerous controlled methane release scenarios and methane sampling configurations under variable atmospheric conditions, (2) Field tests at the METEC site in Ft. Collins, CO., and (3) Field data from other sites where point-source surface methane releases were monitored downwind. A cNN learning algorithm is well suited to problems in which the training and observed data are noisy, or correspond to complex sensor data as is typical of meteorological and sensor data over a well pad. Recent studies with our cNN emphasize the importance of tracking wind speeds and directions at fine resolution ( 1 second), and accounting for variations in background CH4 levels. A few cases illustrate the importance of sufficiently long monitoring; short monitoring may not provide enough information to determine accurately a leak location or strength, mainly because of short-term unfavorable wind directions and choice of sampling configuration. Length of multiport duty cycle sampling and sample line flush time as well as number and placement of monitoring sensors can significantly impact ability to locate and quantify leaks. Source location error at less than 10% requires about 30 or more training cases.

Radiation area monitoring by wireless-communicating area monitor with surveillance camera

International Nuclear Information System (INIS)

Shimura, Mitsuo; Kobayashi, Hiromitsu; Kitahara, Hideki; Kobayashi, Hironobu; Okamoto, Shinji

2004-01-01

Aiming at a dose reduction and a work efficiency improvement for nuclear power plants that have high dose regions, we have developed our system of wireless-communicating Area Monitor with Surveillance Camera, and have performed an on-site test. Now we are implementing this Area Monitor with Surveillance Camera for a use as a TV camera in the controlled-area, which enables a personal computer to simultaneously display two or more dose values and site live images on the screen. For the radiation detector of this Area Monitor System, our wireless-communicating dosimeter is utilized. Image data are transmitted via a wireless Local Area Network (LAN). As a test result, image transmission of a maximum of 20 frames per second has been realized, which shows that this concept is a practical application. Remote-site monitoring also has been realized from an office desk located within the non-controlled area, adopting a Japan's wireless phone system, PHS (Personal Handy Phone) for the transmission interface. (author)

Environmental monitoring at the Savannah River Plant. Annual report for 1978

International Nuclear Information System (INIS)

Ashley, C.; Zeigler, C.C.

1981-01-01

The environmental monitoring program at the Savannah River Plant (SRP) provides reliable measurement of radioactive materials released at the source (approximately 40 locations) and present in the environment (approximately 500 locations). In recent years, the environmental monitoring program has been expanded to include measurements of nonradioactive materials released by SRP. A brief discussion of plant releases to the environment and radioactive and nonradioactive materials detected in the environment are presented. The appendices contain data analysis and quality control information, sensitivities of laboratory analyses, tables of environmental sample analyses, and maps of sampling locations

Burrowing Owl Monitoring Report for Calendar Year 2012

Energy Technology Data Exchange (ETDEWEB)

Wilde, Justin W.; Lindsey, Cole T.; Nugent, John J.

2013-03-14

The monitoring during 2012 focused on documenting the status of known burrows. Newly identified burrows were documented while examining historical locations, during ecological resource reviews, or discovered during other monitoring efforts. The timing of the monitoring effort allowed staff to perform the surveys without disrupting any breeding or hatching, while also allowing for easy discernment of adults from juveniles, which helped in determining burrow-use type.

Combination of Robot Simulation with Real-time Monitoring and Control

Directory of Open Access Journals (Sweden)

Jianyu YANG

2014-08-01

Full Text Available The paper mainly focuses in combining virtual reality based operation simulation with remote real-time monitoring and control method for an experimental robot. A system composition framework was designed and relative arm-wheel experimental robot platform was also built. Virtual robots and two virtual environments were developed. To locate the virtual robot within numerical environments, relative mathematical methods is also discussed, including analytic locating methods for linear motion and self-rotation, as well as linear transformation method with homogeneous matrices for turning motion, in order to decrease division calculations. Several experiments were carried out, trajectory errors were found because of relative slides between the wheel and the floor, during the locating experiments. Writing-monitoring experiments were also performed by programming the robotic arm to write a Chinese character, and the virtual robot in monitoring terminal perfectly followed all the movements. All the experiment results confirmed that virtual environment can not only be used as a good supplement to the traditional video monitoring method, but also offer better control experience during the operation.

Interactive Inventory Monitoring

Science.gov (United States)

Garud, Sumedha

2013-01-01

Method and system for monitoring present location and/or present status of a target inventory item, where the inventory items are located on one or more inventory shelves or other inventory receptacles that communicate with an inventory base station through use of responders such as RFIDs. A user operates a hand held interrogation and display (lAD) module that communicates with, or is part of the base station to provide an initial inquiry. lnformation on location(s) of the larget invenlory item is also indicated visibly and/or audibly on the receptacle(s) for the user. Status information includes an assessment of operation readiness and a time, if known, that the specified inventory item or class was last removed or examined or modified. Presentation of a user access level may be required for access to the target inventgory item. Another embodiment provides inventory informatin for a stack as a sight-impaired or hearing-impaired person adjacent to that stack.

Radiological monitoring. Controlling surface water pollution

International Nuclear Information System (INIS)

Morin, Maxime

2018-01-01

Throughout France, surface waters (from rivers to brooks) located at the vicinity of nuclear or industrial sites, are subject to regular radiological monitoring. An example is given with the radiological monitoring of a small river near La Hague Areva's plant, where contaminations have been detected with the help of the French IRSN nuclear safety research organization. The sampling method and various measurement types are described

An autonomous structural health monitoring solution

Science.gov (United States)

Featherston, Carol A.; Holford, Karen M.; Pullin, Rhys; Lees, Jonathan; Eaton, Mark; Pearson, Matthew

2013-05-01

Combining advanced sensor technologies, with optimised data acquisition and diagnostic and prognostic capability, structural health monitoring (SHM) systems provide real-time assessment of the integrity of bridges, buildings, aircraft, wind turbines, oil pipelines and ships, leading to improved safety and reliability and reduced inspection and maintenance costs. The implementation of power harvesting, using energy scavenged from ambient sources such as thermal gradients and sources of vibration in conjunction with wireless transmission enables truly autonomous systems, reducing the need for batteries and associated maintenance in often inaccessible locations, alongside bulky and expensive wiring looms. The design and implementation of such a system however presents numerous challenges. A suitable energy source or multiple sources capable of meeting the power requirements of the system, over the entire monitoring period, in a location close to the sensor must be identified. Efficient power management techniques must be used to condition the power and deliver it, as required, to enable appropriate measurements to be taken. Energy storage may be necessary, to match a continuously changing supply and demand for a range of different monitoring states including sleep, record and transmit. An appropriate monitoring technique, capable of detecting, locating and characterising damage and delivering reliable information, whilst minimising power consumption, must be selected. Finally a wireless protocol capable of transmitting the levels of information generated at the rate needed in the required operating environment must be chosen. This paper considers solutions to some of these challenges, and in particular examines SHM in the context of the aircraft environment.

Proceedings of the 29th Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies

Energy Technology Data Exchange (ETDEWEB)

Wetovsky, Marvin A. [Editor; Benson, Jody [Editor; Patterson, Eileen F. [Editor

2007-09-25

These proceedings contain papers prepared for the 29th Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies, held 25-27 September, 2007 in Denver, Colorado. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Air Force Technical Applications Center (AFTAC), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), and other invited sponsors. The scientific objectives of the research are to improve the United States capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

Proceedings of the 29th Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies

International Nuclear Information System (INIS)

Wetovsky, Marvin A.; Benson, Jody; Patterson, Eileen F.

2007-01-01

These proceedings contain papers prepared for the 29th Monitoring Research Review: Ground-Based Nuclear Explosion Monitoring Technologies, held 25-27 September, 2007 in Denver, Colorado. These papers represent the combined research related to ground-based nuclear explosion monitoring funded by the National Nuclear Security Administration (NNSA), Air Force Technical Applications Center (AFTAC), Air Force Research Laboratory (AFRL), US Army Space and Missile Defense Command, Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), and other invited sponsors. The scientific objectives of the research are to improve the United States capability to detect, locate, and identify nuclear explosions. The purpose of the meeting is to provide the sponsoring agencies, as well as potential users, an opportunity to review research accomplished during the preceding year and to discuss areas of investigation for the coming year. For the researchers, it provides a forum for the exchange of scientific information toward achieving program goals, and an opportunity to discuss results and future plans. Paper topics include: seismic regionalization and calibration; detection and location of sources; wave propagation from source to receiver; the nature of seismic sources, including mining practices; hydroacoustic, infrasound, and radionuclide methods; on-site inspection; and data processing.

Priming With 1-Hz Repetitive Transcranial Magnetic Stimulation Over Contralesional Leg Motor Cortex Does Not Increase the Rate of Regaining Ambulation Within 3 Months of Stroke: A Randomized Controlled Trial.

Science.gov (United States)

Huang, Ying-Zu; Lin, Li-Fong; Chang, Kwang-Hwa; Hu, Chaur-Jong; Liou, Tsan-Hon; Lin, Yen-Nung

2018-05-01

The potential benefits of repetitive transcranial magnetic stimulation (rTMS), applied either alone or as a combination treatment, on recovery of lower limbs after stroke have been insufficiently studied. The aim of the study was to evaluate the effect of priming with 1-Hz repetitive transcranial magnetic stimulation over contralesional leg motor area with a double-cone coil before physical therapy on regaining ambulation. Thirty-eight subacute stroke patients with significant leg disabilities were randomly assigned into the experimental group or control group to receive a 15-min real or sham 1-Hz repetitive transcranial magnetic stimulation, respectively, over the contralesional motor cortex representing the quadriceps muscle followed by 45-min physical therapy for 15 sessions for 3 wks. Functional measures, motor evoked potentials, and quality of life were assessed. There was no significant difference between experimental group and control group regarding the recovery in ambulation, balance, motor functions, and activity of daily living. No significant difference was found in other functional measures and the quality of life. Only the control group displayed significantly increased cortical excitability of the contralesional hemisphere after the intervention. The present study found that insufficient evidence that contralesional priming with 1-Hz repetitive transcranial magnetic stimulation improves ambulatory and other motor functions among patients with a severe leg dysfunction in subacute stroke.

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.

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.

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...

Environmental Monitoring Plan: Environmental Monitoring Section. Appendix A, Procedures

International Nuclear Information System (INIS)

1995-02-01

This document presents information about the environmental monitoring program at Lawrence Livermore National Laboratory. Topics discussed include: air sampling; air tritium calibrations; storm water discharge; non-storm water discharge; sampling locations; ground water sampling; noise and blast forecasting; analytical laboratory auditing; document retention; procedure writing; quality assurance programs for sampling; soil and sediment sampling; sewage sampling; diversion facility tank sampling; vegetation and foodstuff sampling; and radiological dose assessments

Environmental Monitoring Plan: Environmental Monitoring Section. Appendix A, Procedures

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-02-01

This document presents information about the environmental monitoring program at Lawrence Livermore National Laboratory. Topics discussed include: air sampling; air tritium calibrations; storm water discharge; non-storm water discharge; sampling locations; ground water sampling; noise and blast forecasting; analytical laboratory auditing; document retention; procedure writing; quality assurance programs for sampling; soil and sediment sampling; sewage sampling; diversion facility tank sampling; vegetation and foodstuff sampling; and radiological dose assessments.

[Research and design for optimal position of electrocardio-electrodes in monitoring clothing for men].

Science.gov (United States)

Liang, Lijun; Hu, Yao; Liu, Hao; Li, Xiaojiu; Li, Jin; He, Yin

2017-04-01

In order to reduce the mortality rate of cardiovascular disease patients effectively, improve the electrocardiogram (ECG) accuracy of signal acquisition, and reduce the influence of motion artifacts caused by the electrodes in inappropriate location in the clothing for ECG measurement, we in this article present a research on the optimum place of ECG electrodes in male clothing using three-lead monitoring methods. In the 3-lead ECG monitoring clothing for men we selected test points. Comparing the ECG and power spectrum analysis of the acquired ECG signal quality of each group of points, we determined the best location of ECG electrodes in the male monitoring clothing. The electrode motion artifacts caused by improper location had been significantly improved when electrodes were put in the best position of the clothing for men. The position of electrodes is crucial for ECG monitoring clothing. The stability of the acquired ECG signal could be improved significantly when electrodes are put at optimal locations.

Multidimensional evaluation of a radio frequency identification wi-fi location tracking system in an acute-care hospital setting.

Science.gov (United States)

Okoniewska, Barbara; Graham, Alecia; Gavrilova, Marina; Wah, Dannel; Gilgen, Jonathan; Coke, Jason; Burden, Jack; Nayyar, Shikha; Kaunda, Joseph; Yergens, Dean; Baylis, Barry; Ghali, William A

2012-01-01

Real-time locating systems (RTLS) have the potential to enhance healthcare systems through the live tracking of assets, patients and staff. This study evaluated a commercially available RTLS system deployed in a clinical setting, with three objectives: (1) assessment of the location accuracy of the technology in a clinical setting; (2) assessment of the value of asset tracking to staff; and (3) assessment of threshold monitoring applications developed for patient tracking and inventory control. Simulated daily activities were monitored by RTLS and compared with direct research team observations. Staff surveys and interviews concerning the system's effectiveness and accuracy were also conducted and analyzed. The study showed only modest location accuracy, and mixed reactions in staff interviews. These findings reveal that the technology needs to be refined further for better specific location accuracy before full-scale implementation can be recommended.

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…

UHV photoelectron x-ray beam position monitor

International Nuclear Information System (INIS)

Johnson, E.D.; Oversluizen, T.

1989-01-01

As part of our research program to develop viable beam position monitors for both the X-ray and VUV beamlines at the NSLS, we have constructed vertical photon beam position monitors which are presently mounted in two front-ends in the X-ray ring. These area-type detectors are located before the safety shutters and are, therefore, able to monitor the beam position even during injection. The features of this type of monitor which contribute to its long-term stability, position sensitivity, and immunity to horizontal beam motion have been examined and will be discussed. 6 refs., 4 figs

Interactive monitoring portal for fusion simulations

International Nuclear Information System (INIS)

Abla, G.; Schissel, D.P.; Kim, E.N.; Flanagan, S.M.; Lee, X.

2012-01-01

Highlights: ► We designed a web-based monitoring system that tracks the status of fusion simulations. ► Our system is scalable to monitor the simulations running on distributed supercomputers and clusters located at multiple geographical locations. ► The monitoring portal provides a web-based interface for post-run analysis, such as visualizing the results, logging the user comments, and rating the simulation quality. ► Our system utilizes the open source software, such as Python, Django, MySQL, Apache, and MDSplus. - Abstract: The Center for Simulation of RF Wave Interactions with Magnetohydrodynamics (SWIM) Project is a proto-Fusion Simulation Program (FSP) whose goal is to study high-performance fusion plasmas and perform comprehensive simulations that are essential to the development of fusion. SWIM team members are geographically distributed and utilize distributed supercomputers for computational simulations. Due to the highly distributed computational work environment, the SWIM team has the difficulty of monitoring code runs and discovering historical runs. To alleviate this difficulty a web-based monitoring portal has been developed and deployed. The monitoring portal tracks the progress of simulations and automatically collects metadata in real-time. This capability helps scientists to effectively utilize precious computer resources. Furthermore, the portal provides a web-based interface for post-run analysis, such as visualizing the results, logging the user comments, and rating the simulation quality. The user interface provides rapid discovery capability via multi-field searching and sorting. The development of the monitoring portal used open source software, such as Python, Django, MySQL, and Apache. It uses MDSplus for data management, Memcached for data caches, and OpenID for single sign-on security. This paper describes the software architecture, related technologies and deployment experiences of the monitoring portal.

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.

Web design and development for centralize area radiation monitoring system in Malaysian Nuclear Agency

Science.gov (United States)

Ibrahim, Maslina Mohd; Yussup, Nolida; Haris, Mohd Fauzi; Soh @ Shaari, Syirrazie Che; Azman, Azraf; Razalim, Faizal Azrin B. Abdul; Yapp, Raymond; Hasim, Harzawardi; Aslan, Mohd Dzul Aiman

2017-01-01

One of the applications for radiation detector is area monitoring which is crucial for safety especially at a place where radiation source is involved. An environmental radiation monitoring system is a professional system that combines flexibility and ease of use for data collection and monitoring. Nowadays, with the growth of technology, devices and equipment can be connected to the network and Internet to enable online data acquisition. This technology enables data from the area monitoring devices to be transmitted to any place and location directly and faster. In Nuclear Malaysia, area radiation monitor devices are located at several selective locations such as laboratories and radiation facility. This system utilizes an Ethernet as a communication media for data acquisition of the area radiation levels from radiation detectors and stores the data at a server for recording and analysis. This paper discusses on the design and development of website that enable all user in Nuclear Malaysia to access and monitor the radiation level for each radiation detectors at real time online. The web design also included a query feature for history data from various locations online. The communication between the server's software and web server is discussed in detail in this paper.

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

Optical wear monitoring

Science.gov (United States)

Kidane, Getnet S; Desilva, Upul P.; He, Chengli; Ulerich, Nancy H.

2016-07-26

A gas turbine includes first and second parts having outer surfaces located adjacent to each other to create an interface where wear occurs. A wear probe is provided for monitoring wear of the outer surface of the first part, and includes an optical guide having first and second ends, wherein the first end is configured to be located flush with the outer surface of the first part. A fiber bundle includes first and second ends, the first end being located proximate to the second end of the optical guide. The fiber bundle includes a transmit fiber bundle comprising a first plurality of optical fibers coupled to a light source, and a receive fiber bundle coupled to a light detector and configured to detect reflected light. A processor is configured to determine a length of the optical guide based on the detected reflected light.

Exhaust stack monitoring issues at the Waste Isolation Pilot Plant

International Nuclear Information System (INIS)

Rodgers, J.C.

1987-11-01

This report outlines the problems of obtaining valid, representative samples of, and continuously monitoring for, radioactive particulates in the discharge air from the underground disposal facilities at WIPP. There appears to be serious problems with the presently installed systems. Chapter 1 of the report provides an overview of current perspective on the major issues. Principal conclusions of the overview are that the present sampling locations are not optimum for the intended purpose; that the chosen probe design is not capable of meeting requirements for delivery of a representative sample to the detectors; and that the proposed test plan for the flow conditioning and monitoring system is seriously flawed. Chapter 2 is a summary of the major findings and recommendations of a peer review. The review suggested that the proposed flow conditioning concepts were likely to be an unworkable substitute for having adequate duct length between major disturbances in flow and the sampling or monitoring locations; that the use of probes of simpler design with large diameter inlet nozzles feeding short transmission lines would provide superior performance; and that conditions for monitoring discharge air would be far better ahead of the collar in the exhaust shaft than any location downstream. Chapter 3 contains the detailed technical basis for a conceptual design, and a proposed sample extraction system for the stack discharge location. 36 refs., 23 figs., 4 tabs

Water monitoring and its information management system in China; Chugoku ni okeru suishitsu monitoring to joho kanri system

Energy Technology Data Exchange (ETDEWEB)

Quan, H.

1996-01-10

This paper summarizes the water monitoring system (WMS) in China applied mainly to surface water and operated within the competence of the Environmental Protection Agency. The WMS consists of a national water monitoring network and a water information system that monitors surface water periodically. The WMS comprises water monitoring stations classified from class 1 to class 4, which are located in 2,222 locations. Stations from class 1 to class 3 are operated by using computers, but class 4 stations are still incapable to use floppy disks to perform information transmission. When an information management system is completed at the China-Japan Friendship Environmental Protection Center being constructed by gratis assistance from the Japanese Government, transmission of water quality data will become possible by means of the cable line system in addition to the table system and the floppy system. The water quality data are published to general people in the forms of Chinese gazette for the environmental conditions, the environment yearbook, and the reports on environmental quality. However, the more important is to publish more publications to make people aware of the actual state of water pollution and have them cooperate in environment preservation. 4 refs., 1 fig.

An FBG acoustic emission source locating system based on PHAT and GA

Science.gov (United States)

Shen, Jing-shi; Zeng, Xiao-dong; Li, Wei; Jiang, Ming-shun

2017-09-01

Using the acoustic emission locating technology to monitor the health of the structure is important for ensuring the continuous and healthy operation of the complex engineering structures and large mechanical equipment. In this paper, four fiber Bragg grating (FBG) sensors are used to establish the sensor array to locate the acoustic emission source. Firstly, the nonlinear locating equations are established based on the principle of acoustic emission, and the solution of these equations is transformed into an optimization problem. Secondly, time difference extraction algorithm based on the phase transform (PHAT) weighted generalized cross correlation provides the necessary conditions for the accurate localization. Finally, the genetic algorithm (GA) is used to solve the optimization model. In this paper, twenty points are tested in the marble plate surface, and the results show that the absolute locating error is within the range of 10 mm, which proves the accuracy of this locating method.

Remote Arrhythmia Monitoring System Developed

Science.gov (United States)

York, David W.; Mackin, Michael A.; Liszka, Kathy J.; Lichter, Michael J.

2004-01-01

Telemedicine is taking a step forward with the efforts of team members from the NASA Glenn Research Center, the MetroHealth campus of Case Western University, and the University of Akron. The Arrhythmia Monitoring System is a completed, working test bed developed at Glenn that collects real-time electrocardiogram (ECG) signals from a mobile or homebound patient, combines these signals with global positioning system (GPS) location data, and transmits them to a remote station for display and monitoring. Approximately 300,000 Americans die every year from sudden heart attacks, which are arrhythmia cases. However, not all patients identified at risk for arrhythmias can be monitored continuously because of technological and economical limitations. Such patients, who are at moderate risk of arrhythmias, would benefit from technology that would permit long-term continuous monitoring of electrical cardiac rhythms outside the hospital environment. Embedded Web Technology developed at Glenn to remotely command and collect data from embedded systems using Web technology is the catalyst for this new telemetry system (ref. 1). In the end-to-end system architecture, ECG signals are collected from a patient using an event recorder and are transmitted to a handheld personal digital assistant (PDA) using Bluetooth, a short-range wireless technology. The PDA concurrently tracks the patient's location via a connection to a GPS receiver. A long distance link is established via a standard Internet connection over a 2.5-generation Global System for Mobile Communications/General Packet Radio Service (GSM/GPRS)1 cellular, wireless infrastructure. Then, the digital signal is transmitted to a call center for monitoring by medical professionals.

Awakening the BALROG: BAyesian Location Reconstruction Of GRBs

Science.gov (United States)

Burgess, J. Michael; Yu, Hoi-Fung; Greiner, Jochen; Mortlock, Daniel J.

2018-05-01

The accurate spatial location of gamma-ray bursts (GRBs) is crucial for both accurately characterizing their spectra and follow-up observations by other instruments. The Fermi Gamma-ray Burst Monitor (GBM) has the largest field of view for detecting GRBs as it views the entire unocculted sky, but as a non-imaging instrument it relies on the relative count rates observed in each of its 14 detectors to localize transients. Improving its ability to accurately locate GRBs and other transients is vital to the paradigm of multimessenger astronomy, including the electromagnetic follow-up of gravitational wave signals. Here we present the BAyesian Location Reconstruction Of GRBs (BALROG) method for localizing and characterizing GBM transients. Our approach eliminates the systematics of previous approaches by simultaneously fitting for the location and spectrum of a source. It also correctly incorporates the uncertainties in the location of a transient into the spectral parameters and produces reliable positional uncertainties for both well-localized sources and those for which the GBM data cannot effectively constrain the position. While computationally expensive, BALROG can be implemented to enable quick follow-up of all GBM transient signals. Also, we identify possible response problems that require attention and caution when using standard, public GBM detector response matrices. Finally, we examine the effects of including the uncertainty in location on the spectral parameters of GRB 080916C. We find that spectral parameters change and no extra components are required when these effects are included in contrast to when we use a fixed location. This finding has the potential to alter both the GRB spectral catalogues and the reported spectral composition of some well-known GRBs.

Environmental monitoring for krypton-85

International Nuclear Information System (INIS)

Barber, D.E.

1973-01-01

85 Kr presents unique environmental monitoring problems because it does not react with other elements and compounds at normal ambient temperatures and pressures. However, elaborate means are available to manage the 85 Kr problem, but a simpler, inexpensive approach is required if monitoring is to be accomplished at many sampling locations. This work shows that environmental monitoring for 85 Kr is possible by collecting air samples in thin plastic bags, and counting the bags for beta particle activity. The direct counting of contained samples of this type makes it possible to detect concentrations less than the public MPC for 85 Kr. The bagged-sample technique is readily adaptable to any environmental monitoring station with power to run a low-volume air pump. The idea of counting the bagged-sample directly is a new, low-cost, approach to environmental gas monitoring which may have application in environmental, clinical, and industrial situations

Air quality monitoring Edson and Hinton area September 1999 to June 2000 : Final report

International Nuclear Information System (INIS)

2002-01-01

The Edson and Hinton areas of Alberta were the subject of a mobile, ambient air quality monitoring survey. The monitoring involved four surveys of a week each, over four seasons, for one year. This area had been selected for monitoring to meet three major objectives: the determination of concentrations of air pollutants representative of the monitored locations in the survey area, to establish a comparison of air pollutant levels to data from other locations in the province of Alberta, and to provide a comparison of air pollutant levels to Alberta's air quality guidelines. These surveys formed an integral part of the air quality monitoring program of Alberta Environment. Using the Mobile Air Monitoring Laboratory (MAML), personnel from Alberta Environment appear on location unannounced. Carbon monoxide, oxides of nitrogen, ozone, particulates, hydrocarbons, sulphur dioxide, hydrogen sulphide, total reduced sulphur and ammonia are the substances measured and monitored. Eighteen sites in the Edson and Hinton area were selected, as well as downwind of industrial facilities in the Edson area, and air quality was monitored using the mobile lab for twenty days. To allow comparison to the air quality guidelines, monitoring was conducted for a minimum of one hour at each location. As a result, approximately 152 hours of air quality monitoring information was obtained, providing data in the vicinity of both populated and industrial areas. The periods comprised September 13-16, 1999 (Fall), February 7-9, 2000 (Winter), April 18-19, 25-27, 2000 (Spring), and June 4-5, 13-16, 2000 (Summer). The results were provided in this report. Most results were below the Alberta Ambient Air Quality Guidelines. refs., 16 tabs., 18 figs

Automatically processed alpha-track radon monitor

International Nuclear Information System (INIS)

Langner, G.H. Jr.

1993-01-01

An automatically processed alpha-track radon monitor is provided which includes a housing having an aperture allowing radon entry, and a filter that excludes the entry of radon daughters into the housing. A flexible track registration material is located within the housing that records alpha-particle emissions from the decay of radon and radon daughters inside the housing. The flexible track registration material is capable of being spliced such that the registration material from a plurality of monitors can be spliced into a single strip to facilitate automatic processing of the registration material from the plurality of monitors. A process for the automatic counting of radon registered by a radon monitor is also provided

EMon: Embodied Monitorization

Science.gov (United States)

Carneiro, Davide; Novais, Paulo; Costa, Ricardo; Gomes, Pedro; Neves, José

The amount of seniors in need of constant care is rapidly rising: an evident consequence of population ageing. There are already some monitorization environments which aim to monitor these persons while they remain at home. This, however, although better than delocalizing the elder to some kind of institution, may not still be the ideal solution, as it forces them to stay inside the home more than they wished, as going out means lack of accompaniment and a consequent sensation of fear. In this paper we propose EMon: a monitorization device small enough to be worn by its users, although powerful enough to provide the higher level monitorization systems with vital information about the user and the environment around him. We hope to allow the representation of an intelligent environment to move with its users, instead of being static, mandatorily associated to a single physical location. The first prototype of EMon, as presented in this paper, provides environmental data as well as GPS coordinates and pictures that are useful to describe the context of its user.

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)

Robotics for Long-Term Monitoring

International Nuclear Information System (INIS)

Shahin, Sarkis; Duran, Celso

2002-01-01

While long-term monitoring and stewardship means many things to many people, DOE has defined it as The physical controls, institutions, information, and other mechanisms needed to ensure protection of people and the environment at sites where DOE has completed or plans to complete cleanup (e.g., landfill closures, remedial actions, and facility stabilization). Across the United States, there are thousands of contaminated sites with multiple contaminants released from multiple sources where contaminants have transported and commingled. The U.S. government and U.S. industry are responsible for most of the contamination and are landowners of many of these contaminated properties. These sites must be surveyed periodically for various criteria including structural deterioration, water intrusion, integrity of storage containers, atmospheric conditions, and hazardous substance release. The surveys, however, are intrusive, time-consuming, and expensive and expose survey personnel to radioactive contamination. In long-term monitoring, there's a need for an automated system that will gather and report data from sensors without costly human labor. In most cases, a SCADA (Supervisory Control and Data Acquisition) unit is used to collect and report data from a remote location. A SCADA unit consists of an embedded computer with data acquisition capabilities. The unit can be configured with various sensors placed in different areas of the site to be monitored. A system of this type is static, i.e., the sensors, once placed, cannot be moved to other locations within the site. For those applications where the number of sampling locations would require too many sensors, or where exact location of future problems is unknown, a mobile sensing platform is an ideal solution. In many facilities that undergo regular inspections, the number of video cameras and air monitors required to eliminate the need for human inspections is very large and far too costly. HCET's remote harsh

47 CFR 73.158 - Directional antenna monitoring points.

Science.gov (United States)

2010-10-01

... construction or other disturbances to the measured field, an application to change the monitoring point location, including FCC Form 302-AM, is to be promptly submitted to the FCC in Washington, DC. (1) If the..., the licensee shall select a new monitoring point from the points measured in the last full proof of...

Quarterly seismic monitoring report 96B

International Nuclear Information System (INIS)

Reidel, S.P.

1996-01-01

This report summarizes the location, magnitude, and other pertinent information on earthquakes recorded on and near the Hanford Site by Westinghouse Seismic Monitoring during the period encompassing January 1, 1996 to March 31, 1996

Locating Leaks with TrustRank Algorithm Support

Directory of Open Access Journals (Sweden)

Luísa Ribeiro

2015-03-01

Full Text Available This paper presents a methodology to quantify and to locate leaks. The original contribution is the use of a tool based on the TrustRank algorithm for the selection of nodes for pressure monitoring. The results from these methodologies presented here are: (I A sensitivity analysis of the number of pressure transducers on the quality of the final solution; (II A reduction of the number of pipes to be inspected; and (III A focus on the problematic pipes which allows a better office planning of the inspection works to perform atthe field. To obtain these results, a methodology for the identification of probable leaky pipes and an estimate of their leakage flows is also presented. The potential of the methodology is illustrated with several case studies, considering different levels of water losses and different sets of pressure monitoring nodes. The results are discussed and the solutions obtained show the benefits of the developed methodologies.

Photon beam position monitor

Science.gov (United States)

Kuzay, Tuncer M.; Shu, Deming

1995-01-01

A photon beam position monitor for use in the front end of a beamline of a high heat flux and high energy photon source such as a synchrotron radiation storage ring detects and measures the position and, when a pair of such monitors are used in tandem, the slope of a photon beam emanating from an insertion device such as a wiggler or an undulator inserted in the straight sections of the ring. The photon beam position monitor includes a plurality of spaced blades for precisely locating the photon beam, with each blade comprised of chemical vapor deposition (CVD) diamond with an outer metal coating of a photon sensitive metal such as tungsten, molybdenum, etc., which combination emits electrons when a high energy photon beam is incident upon the blade. Two such monitors are contemplated for use in the front end of the beamline, with the two monitors having vertically and horizontally offset detector blades to avoid blade "shadowing". Provision is made for aligning the detector blades with the photon beam and limiting detector blade temperature during operation.

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

Idaho National Laboratory Cultural Resource Monitoring Report for FY 2010

Energy Technology Data Exchange (ETDEWEB)

INL Cultural Resource Management Office

2010-10-01

This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during fiscal year 2010 (FY 2010). Throughout the year, thirty-three cultural resource localities were revisited, including somethat were visited more than once, including: two locations with Native American human remains, one of which is a cave, two additional caves, twenty-six prehistoric archaeological sites, two historic stage stations, and Experimental Breeder Reactor-I, which is a designated National Historic Landmark. The resources that were monitored included seventeen that are routinely visited and sixteen that are located in INL project areas. Although impacts were documented at a few locations and one trespassing incident (albeit sans formal charges) was discovered, no significant adverse effects that would threaten the National Register eligibility of any resources were observed. Monitoring also demonstrated that several INL projects generally remain in compliance with recommendations to protect cultural resources.

Detection, Source Location, and Analysis of Volcano Infrasound

Science.gov (United States)

McKee, Kathleen F.

The study of volcano infrasound focuses on low frequency sound from volcanoes, how volcanic processes produce it, and the path it travels from the source to our receivers. In this dissertation we focus on detecting, locating, and analyzing infrasound from a number of different volcanoes using a variety of analysis techniques. These works will help inform future volcano monitoring using infrasound with respect to infrasonic source location, signal characterization, volatile flux estimation, and back-azimuth to source determination. Source location is an important component of the study of volcano infrasound and in its application to volcano monitoring. Semblance is a forward grid search technique and common source location method in infrasound studies as well as seismology. We evaluated the effectiveness of semblance in the presence of significant topographic features for explosions of Sakurajima Volcano, Japan, while taking into account temperature and wind variations. We show that topographic obstacles at Sakurajima cause a semblance source location offset of 360-420 m to the northeast of the actual source location. In addition, we found despite the consistent offset in source location semblance can still be a useful tool for determining periods of volcanic activity. Infrasonic signal characterization follows signal detection and source location in volcano monitoring in that it informs us of the type of volcanic activity detected. In large volcanic eruptions the lowermost portion of the eruption column is momentum-driven and termed the volcanic jet or gas-thrust zone. This turbulent fluid-flow perturbs the atmosphere and produces a sound similar to that of jet and rocket engines, known as jet noise. We deployed an array of infrasound sensors near an accessible, less hazardous, fumarolic jet at Aso Volcano, Japan as an analogue to large, violent volcanic eruption jets. We recorded volcanic jet noise at 57.6° from vertical, a recording angle not normally feasible

40 CFR 141.622 - Subpart V monitoring plan.

Science.gov (United States)

2010-07-01

... procedures; and (iv) Monitoring plans for any other systems in the combined distribution system if the State... current distribution system locations with expected high TTHM or HAA5 levels. The State may also require modifications in your monitoring plan. If you are a subpart H system serving > 3,300 people, you must submit a...

Quality assurance of environmental gamma radiation monitoring in Slovenia

International Nuclear Information System (INIS)

Stuhec, M.; Zorko, B.; Mitic, D.; Miljanic, S.; Ranogajec-Komor, M.

2006-01-01

Environmental gamma radiation monitoring established in Slovenia consists of a network of multifunctional gamma monitors (MFMs) based on pairs of Geiger-Mueller counters and a network of measuring sites with high-sensitive thermoluminescence dosemeters. The measuring points are evenly spread across Slovenia, located at the meteorological stations and more densely on additional locations around the Krsko NPP. The MFM network has a 2-fold function with one sensor used for the purpose of early warning system in near surroundings of the NPP and the other, more sensitive, for natural radiation monitoring. The paper summarises activities to establish quality assurance of the environmental gamma radiation measurements in Slovenia, with a critical view of the results in comparison with the international standards and recommendations. While the results of linearity and energy dependence tests were satisfying, on-field intercomparison showed that the inherent signal of one of the monitors (MFM) has to be taken into account in the range of environmental background radiation. (authors)

Wireless LAN security management with location detection capability in hospitals.

Science.gov (United States)

Tanaka, K; Atarashi, H; Yamaguchi, I; Watanabe, H; Yamamoto, R; Ohe, K

2012-01-01

In medical institutions, unauthorized access points and terminals obstruct the stable operation of a large-scale wireless local area network (LAN) system. By establishing a real-time monitoring method to detect such unauthorized wireless devices, we can improve the efficiency of security management. We detected unauthorized wireless devices by using a centralized wireless LAN system and a location detection system at 370 access points at the University of Tokyo Hospital. By storing the detected radio signal strength and location information in a database, we evaluated the risk level from the detection history. We also evaluated the location detection performance in our hospital ward using Wi-Fi tags. The presence of electric waves outside the hospital and those emitted from portable game machines with wireless communication capability was confirmed from the detection result. The location detection performance showed an error margin of approximately 4 m in detection accuracy and approximately 5% in false detection. Therefore, it was effective to consider the radio signal strength as both an index of likelihood at the detection location and an index for the level of risk. We determined the location of wireless devices with high accuracy by filtering the detection results on the basis of radio signal strength and detection history. Results of this study showed that it would be effective to use the developed location database containing radio signal strength and detection history for security management of wireless LAN systems and more general-purpose location detection applications.

Corrosion Monitoring System

Energy Technology Data Exchange (ETDEWEB)

Dr. Russ Braunling

2004-10-31

The Corrosion Monitoring System (CMS) program developed and demonstrated a continuously on-line system that provides real-time corrosion information. The program focused on detecting pitting corrosion in its early stages. A new invention called the Intelligent Ultrasonic Probe (IUP) was patented on the program. The IUP uses ultrasonic guided waves to detect small defects and a Synthetic Aperture Focusing Technique (SAFT) algorithm to provide an image of the pits. Testing of the CMS demonstrated the capability to detect pits with dimensionality in the sub-millimeter range. The CMS was tested in both the laboratory and in a pulp and paper industrial plant. The system is capable of monitoring the plant from a remote location using the internet.

A real-time stack radioactivity monitoring system and dose projection program

Energy Technology Data Exchange (ETDEWEB)

Hull, A.P.; Michael, P.A. [Brookhaven National Laboratory, Upton, NY (United States); Bernstein, H.J. [Bernstein & Sons, Bellport, NY (United States)

1995-02-01

At Brookhaven National Laboratory, a commercial Low- and High-Range Air Effluent Monitor has become operational at the 60 Mw (t) High Flux Beam Reactor. Its output data is combined with that from ground-level and elevated meteorological sensors to provide a real-time projection of the down-wind dose rates from noble gases and radioiodines released from the HFBR`s 100 m stack. The output of the monitor, and the meteorological sensors and the dose projections can be viewed at emergency response terminals located in the Reactor Control Room, its Technical Support Center and at the laboratory`s separately located Meteorological Station and Monitoring and Assessment Center.

Anual Report of Groundwater Monitoring at Centralia, Kansas, in 2015

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States)

2016-10-01

The KDHE (2012) agreed to annual sampling at all locations, beginning with the 2013 monitoring documented previously (Argonne 2014a). This present report documents the results of the annual sampling of the approved monitoring well network on September 27-30, 2015.

Technical note: Evaluation of standard ultraviolet absorption ozone monitors in a polluted urban environment

Directory of Open Access Journals (Sweden)

E. J. Dunlea

2006-01-01

Full Text Available The performance of the EPA Federal Equivalent Method (FEM technique for monitoring ambient concentrations of O3 via ultraviolet absorption (UV has been evaluated using data from the Mexico City Metropolitan Area field campaign (MCMA-2003. Comparisons of UV O3 monitors with open path Differential Optical Absorption Spectroscopy (DOAS and open path Fourier Transform Infrared (FTIR spectroscopy instruments in two locations revealed average discrepancies in the measured concentrations between +13% to −18%. Good agreement of two separate open path DOAS measurements at one location indicated that spatial and temporal inhomogeneities were not substantially influencing comparisons of the point sampling and open path instruments. The poor agreement between the UV O3 monitors and the open path instruments was attributed to incorrect calibration factors for the UV monitors, although interferences could not be completely ruled out. Applying a linear correction to these calibration factors results in excellent agreement of the UV O3 monitors with the co-located open path measurements; regression slopes of 0.94 to 1.04 and associated R2 values of >0.89. A third UV O3 monitor suffered from large spurious interferences, which were attributed to extinction of UV radiation within the monitor by fine particles (3 monitors and recommendations for future testing are made.

Design Of Pump Monitoring Of Primary Cooling System

International Nuclear Information System (INIS)

Indrakoesoema, Koes; Sujarwono

2000-01-01

Monitoring of 3 primary cooling pumps done visually by operator on the spot. The operator must be check oil in a sight glass, oil leakage during pump operation and water leakage. If reaktor power increase about more than 3 MW, the radiation exposure also increase in the primary cell and that's way the operator can not check the pumps. To continuing monitor all pump without delay, one system has been added I.e Closed Circuit Television (CCTV). This system using 3 video camera to monitor 3 pumps and connected to one receiver video monitor by coaxial cable located in Main Control Room. The sequence monitoring can be done by sequential switcher

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.

What fluids are given during air ambulance treatment of patients with trauma in the UK, and what might this mean for the future? Results from the RESCUER observational cohort study

Science.gov (United States)

Naumann, David N; Hancox, James M; Raitt, James; Smith, Iain M; Crombie, Nicholas; Doughty, Heidi; Perkins, Gavin D; Midwinter, Mark J

2018-01-01

Objectives We investigated how often intravenous fluids have been delivered during physician-led prehospital treatment of patients with hypotensive trauma in the UK and which fluids were given. These data were used to estimate the potential national requirement for prehospital blood products (PHBP) if evidence from ongoing trials were to report clinical superiority. Setting The Regional Exploration of Standard Care during Evacuation Resuscitation (RESCUER) retrospective observational study was a collaboration between 11 UK air ambulance services. Each was invited to provide up to 5 years of data and total number of taskings during the same period. Participants Patients with hypotensive trauma (systolic blood pressure 1 type. The most common fluid was 0.9% saline, given to 486/537 (90.5%) of patients who received fluids, at a median volume of 750 (IQR 300–1500) mL. Three per cent of patients received PHBP. Estimated projections for patients eligible for PHBP at these 11 services and in the whole UK were 313 and 794 patients per year, respectively. Conclusions One in 40 air ambulance taskings were manned by physicians to retrievepatients with hypotensive trauma. The most common fluid delivered was 0.9% saline. If evidence justifies universal provision of PHBP, approximately 800 patients/year would be eligible in the UK, based on our data combined with others published. Prospective investigations are required to confirm or adjust these estimations. PMID:29362272

Power monitoring in space nuclear reactors using silicon carbide radiation detectors

Science.gov (United States)

Ruddy, Frank H.; Patel, Jagdish U.; Williams, John G.

2005-01-01

Space reactor power monitors based on silicon carbide (SiC) semiconductor neutron detectors are proposed. Detection of fast leakage neutrons using SiC detectors in ex-core locations could be used to determine reactor power: Neutron fluxes, gamma-ray dose rates and ambient temperatures have been calculated as a function of distance from the reactor core, and the feasibility of power monitoring with SiC detectors has been evaluated at several ex-core locations. Arrays of SiC diodes can be configured to provide the required count rates to monitor reactor power from startup to full power Due to their resistance to temperature and the effects of neutron and gamma-ray exposure, SiC detectors can be expected to provide power monitoring information for the fill mission of a space reactor.

Developments in radioactive scrap monitoring

International Nuclear Information System (INIS)

Bellian, J.G.

1997-01-01

Over the past ten years there have been major developments in radiation monitoring systems used for detecting shielded radioactive sources in scrap metal. The extent of the problem and industry's awareness of the problem have both grown significantly during that time. The multimillion dollar expenses associated with decontamination after a source passes into the melt and the potential health hazard to employees and the public have added further impetus to the development of monitoring systems. Early attempts at scrap monitoring could detect some radiation, but testing with real life situations showed them to be virtually incapable of detecting shielded sources of radioactivity in incoming vehicles. More sophisticated detector technology and the development of advanced software made useful by more powerful microprocessors led to successive generations of monitoring systems with order-of-magnitude improvement in detection capability. The next generation includes larger detectors and more complex algorithms offering further improvement in truck and rail car monitoring. Complete solutions require monitoring at additional locations within the site, such as the charge bucket and conveyor lines, and at the scrap processor's site

Experimental constraints on forecasting the location of volcanic eruptions from pre-eruptive surface deformation

Science.gov (United States)

Guldstrand, Frank; Galland, Olivier; Hallot, Erwan; Burchardt, Steffi

2018-02-01

Volcanic eruptions pose a threat to lives and property when volcano flanks and surroundings are densely populated. The local impact of an eruption depends firstly on its location, whether it occurs near a volcano summit, or down on the flanks. Then forecasting, with a defined accuracy, the location of a potential, imminent eruption would significantly improve the assessment and mitigation of volcanic hazards. Currently, the conventional volcano monitoring methods based on the analysis of surface deformation assesses whether a volcano may erupt but are not implemented to locate imminent eruptions in real time. Here we show how surface deformation induced by ascending eruptive feeders can be used to forecast the eruption location through a simple geometrical analysis. Our analysis builds on the results of 33 scaled laboratory experiments simulating magma intrusions in a brittle crust, during which the intrusion-induced surface deformation was systematically monitored at high spatial and temporal resolution. In all the experiments, surface deformation preceding the eruptions resulted in systematic uplift, regardless of the intrusion shape. The analysis of the surface deformation patterns leads to the definition of a vector between the centre of the uplifted zone and the point of maximum uplift, which systematically acted as a precursor to the eruption’s location. The temporal evolution of this vector indicated the direction in which the subsequent eruption would occur and ultimately the location itself, irrespective of the feeder shapes. Our findings represent a new approach on how surface deformation on active volcanoes could be analysed and used prior to an eruption with a real potential to improve hazard mitigation.

Near-Facility Environmental Monitoring Quality Assurance Project Plan

International Nuclear Information System (INIS)

MCKINNEY, S.M.

2000-01-01

This Quality Assurance Project Plan addresses the quality assurance requirements for the activities associated with the preoperational and near-facility environmental monitoring directed by Waste Management Technical Services and supersedes HNF-EP-0538-4. This plan applies to all sampling and monitoring activities performed by Waste Management Technical Services in implementing near-facility environmental monitoring at the Hanford Site. This Quality Assurance Project Plan is required by U.S. Department of Energy Order 5400.1 (DOE 1990) as a part of the Environmental Monitoring Plan (DOE-RL 1997) and is used to define: Environmental measurement and sampling locations used to monitor environmental contaminants near active and inactive facilities and waste storage and disposal sites; Procedures and equipment needed to perform the measurement and sampling; Frequency and analyses required for each measurement and sampling location; Minimum detection level and accuracy; Quality assurance components; and Investigation levels. Near-facility environmental monitoring for the Hanford Site is conducted in accordance with the requirements of U.S. Department of Energy Orders 5400.1 (DOE 1990), 5400.5 (DOE 1993), 5484.1 (DOE 1990), and 435.1 (DOE 1999), and DOE/EH-O173T (DOE 1991). It is Waste Management Technical Services' objective to manage and conduct near-facility environmental monitoring activities at the Hanford Site in a cost-effective and environmentally responsible manner that is in compliance with the letter and spirit of these regulations and other environmental regulations, statutes, and standards

Multipurpose Health Care Telemedicine System

National Research Council Canada - National Science Library

Kyriacou, E

2001-01-01

.... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...

Techniques for monitoring pileated woodpeckers.

Science.gov (United States)

Evelyn L Bull; Richard S. Holthausen; Marie G. Henjum

1990-01-01

Methods of locating pileated woodpeckers (Dryocopus pileatus) are described, including imitating pileated woodpecker vocalizations, identifying nest and roost trees, and finding foraging signs. Populations of pileated woodpeckers can be monitored by using (1) density of breeding pairs, (2) reproduction, and (3) presence or absence of birds. The...

A blade deflection monitoring system

DEFF Research Database (Denmark)

2017-01-01

A wind turbine blade comprising a system for monitoring the deflection of a wind turbine blade is described. The system comprises a wireless range-measurement system, having at least one wireless communication device located towards the root end of the blade and at least one wireless communication...

Fuel rod puncturing and fission gas monitoring system examination techniques

International Nuclear Information System (INIS)

Song, Woong Sup

1999-02-01

Fission gas products accumulated in irradiated fuel rod is 1-2 cm 3 in CANDU and 40-50 cm 3 in PWR fuel rod. Fuel rod puncturing and fission gas monitoring system can be used for both CANDU and PWR fuel rod. This system comprises puncturing device located at in cell part and monitoring device located at out cell part. The system has computerized 9 modes and can calculate both void volume and mass volume only single puncturing. This report describes techniques and procedure for operating fuel rod puncturing and gas monitoring system which can be play an important role in successful operation of the devices. Results obtained from the analysis can give more influence over design for fuel rods. (Author). 6 refs., 9 figs

Technology of remote monitoring for nuclear activity monitoring

International Nuclear Information System (INIS)

Kwack, Ehn Ho; Kim, Jong Soo; Yoon, Wan Ki; Park, Sung Sik; Na, Won Woo; An, Jin Soo; Cha, Hong Ryul; Kim, Jung Soo

2000-05-01

In a view of safeguards monitoring at nuclear facilities, the monitoring is changing to remote method so that this report is described to remote monitoring(RM) applying on commercial NPP in Korea. To enhance IAEA safeguards efficiency and effectiveness, IAEA is taking into account of remote monitoring system(RMS) and testing as a field trial. IRMP(International Remote Monitoring Project) in participating many nations for development of RMS is proceeding their project such as technical exchange and research etc. In case of our country are carrying out the research relevant RM since acceptance RMS at 7th ROK-IAEA safeguards implementation review meeting. With a view to enhancement the RMS, installation location and element technology of the RM equipment are evaluated in a view of safeguards in Korea LWRs, and proposed a procedure for national inspection application through remote data evaluation from Younggwang-3 NPP. These results are large valuable to use of national inspection at time point extending installation to all Korea PWR NPP. In case of CANDU, neutron, gamma measurement and basic concept of network using optical fiber scintillating detector as remote verification method for dry storage canister are described. Also RM basic design of spent fuel transfer campaign is described that unattended RM without inspector instead of performing in participating together with IAEA and national inspector. The transfer campaign means the spent fuel storage pond to dry storage canister for about two months every year. Therefore, positively participation of IAEA strength safeguards project will be increased transparency for our nuclear activity as well as contributed to national relevant industry

Technology of remote monitoring for nuclear activity monitoring

Energy Technology Data Exchange (ETDEWEB)

Kwack, Ehn Ho; Kim, Jong Soo; Yoon, Wan Ki; Park, Sung Sik; Na, Won Woo; An, Jin Soo; Cha, Hong Ryul; Kim, Jung Soo

2000-05-01

In a view of safeguards monitoring at nuclear facilities, the monitoring is changing to remote method so that this report is described to remote monitoring(RM) applying on commercial NPP in Korea. To enhance IAEA safeguards efficiency and effectiveness, IAEA is taking into account of remote monitoring system(RMS) and testing as a field trial. IRMP(International Remote Monitoring Project) in participating many nations for development of RMS is proceeding their project such as technical exchange and research etc. In case of our country are carrying out the research relevant RM since acceptance RMS at 7th ROK-IAEA safeguards implementation review meeting. With a view to enhancement the RMS, installation location and element technology of the RM equipment are evaluated in a view of safeguards in Korea LWRs, and proposed a procedure for national inspection application through remote data evaluation from Younggwang-3 NPP. These results are large valuable to use of national inspection at time point extending installation to all Korea PWR NPP. In case of CANDU, neutron, gamma measurement and basic concept of network using optical fiber scintillating detector as remote verification method for dry storage canister are described. Also RM basic design of spent fuel transfer campaign is described that unattended RM without inspector instead of performing in participating together with IAEA and national inspector. The transfer campaign means the spent fuel storage pond to dry storage canister for about two months every year. Therefore, positively participation of IAEA strength safeguards project will be increased transparency for our nuclear activity as well as contributed to national relevant industry.

Stack monitor for the Proof-of-Breeding Project

International Nuclear Information System (INIS)

Fergus, R.W.

1985-01-01

This stack monitor system is a coordinated arrangement of hardware and software to monitor four hot cells (8 stacks) during the fuel dissection for the Proof-of-Breeding Project. The cell monitors, which are located in fan lofts, contain a microprocessor, radiation detectors, air flow sensors, and air flow control equipment. Design criteria included maximizing microprocessor control while minimizing the hardware complexity. The monitors have been programmed to produce concentration and total activity release data based on several detector measurements and flow rates. Although each monitor can function independently, a microcomputer can also be used to control each cell monitor including reprogramming if necessary. All programming is software, as opposed to firmware, with machine language for compactness in the cell monitors and Basic language for adaptability in the microcomputer controller

Inventory of current environmental monitoring projects in the US-Canadian transboundary region

Energy Technology Data Exchange (ETDEWEB)

Glantz, C.S.; Ballinger, M.Y.; Chapman, E.G.

1986-05-01

This document presents the results of a study commissioned to survey and summarize major environmental monitoring projects in the US-Canadian transboundary region. Projects with field sites located within 400 km (250 mi) of the border and active after 1980 were reviewed. The types of projects included: ambient air-quality monitoring, ambient water-quality monitoring, deposition monitoring, forest/vegetation monitoring and research, soil studies, and ecosystem studies. Ecosystem studies included projects involving the measurement of parameters from more than one monitoring category (e.g., studies that measured both water and soil chemistry). Individual descriptions were formulated for 184 projects meeting the spatial and temporal criteria. Descriptions included the official title for the project, its common abbreviation, program emphasis, monitoring site locations, time period conducted, parameters measured, protocols employed, frequency of sample collection, data storage information, and the principal contact for the project. A summary inventory subdivided according to the six monitoring categories was prepared using a computerized data management system. Information on major centralized data bases in the field of environmental monitoring was also obtained, and summary descriptions were prepared. The inventory and data base descriptions are presented in appendices to this document.