[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

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.

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.

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

Science.gov (United States)

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

2013-02-01

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

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.

Occupational injury rates in personnel of emergency medical services

Directory of Open Access Journals (Sweden)

Robert Gałązkowski

2015-12-01

Full Text Available [i][/i][b]Introduction and objectives. [/b]The system of emergency medical services (EMS in Poland was established in 2006. The risk of occupational injuries to EMS personnel is very high, irrespective of the country where they operate, as they face many hazards in their everyday work. The aim of this study is to describe the type, incidence and consequences of occupational accidents among the personnel of the National Emergency Medical Services in Poland (NEMS – land and air ambulance crews in 2008–2012. [b]Material and methods:[/b] The study reviewed all occupational accidents among the EMS personnel reported to the National Labour Inspectorate in 2008–2012. [b]Results[/b]: In the period reported, the number of accidents decreased from 32 in 2008 to just 6 in 2012. Traffic accidents predominated and most of the victims were male paramedics under 30 years of age. The most common injuries included multiple organ injuries and injuries of the cervical spine, chest and trunk. [b]Conclusions:[/b] The growing professional experience of the EMS personnel has a beneficial effect on occupational injury rates as they tend to decrease with longer employment. Occupational accidents are definitely more common among ambulance crews than in the personnel of other organizational units of the National Emergency Medical Services.

Emergency Victim Care. A Textbook for Emergency Medical Personnel.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

This textbook for emergency medical personnel should be useful to fire departments, private ambulance companies, industrial emergency and rescue units, police departments, and nurses. The 30 illustrated chapters cover topics such as: (1) Emergency Medical Service Vehicles, (2) Safe Driving Practices, (3) Anatomy and Physiology, (4) Closed Chest…

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

Science.gov (United States)

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

2015-10-01

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

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

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.)

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...

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.

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.

Energy expenditure during ambulation with ortho crutches and axillary crutches.

Science.gov (United States)

Hinton, C A; Cullen, K E

1982-06-01

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

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

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

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.

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

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.

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...

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

Science.gov (United States)

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

2016-08-01

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

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.

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2015-12-01

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

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

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.

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.

Ambulance Reasonable Charge Public Use Files

Data.gov (United States)

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

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

NARCIS (Netherlands)

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

2011-01-01

Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers' health

Preparations for Severe Winter Conditions by Emergency Health Personnel in Turkey.

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Calışkan, Cüneyt; Algan, Aysun; Koçak, Hüseyin; Biçer, Burcu Küçük; Sengelen, Meltem; Cakir, Banu

2014-04-23

Emergency and core ambulance personnel work under all environmental conditions, including severe weather condtions. We evaluated emergency medical personnel in Çanakkale, Turkey, for their degree of preparedness. A descriptive study was conducted in Çanakkale, Turkey, within 112 emergency service units and their 17 district stations. Surveys were developed to measure the level of preparedness for serious winter conditions that individual workers made for themselves, their homes, and their cars. Of the 167 survey participants, the mean age was 29.8 ± 7.9 years; 52.7% were women; more than half (54.75%) were emergency medical technicians; and 53.3% were married. Only 10.4% of those who heated their homes with natural gas had carbon monoxide detectors. Scores relating to household and individual preparation for severe winter conditions increased by participants' age (P tires (P winter conditions (P = .016). Many of the surveyed emergency health personel demonstrated insufficient preparations for serious winter conditions. To increase the safety and efficiency of emergency medical personnel, educational training programs should be rountinely conducted. (Disaster Med Public Health Preparedness. 2014;0:1-4).

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

Science.gov (United States)

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

2012-08-01

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

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…

[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

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.

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...

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

Science.gov (United States)

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

2009-11-01

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

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

CSIR Research Space (South Africa)

Baloyi, Ethel

2017-08-01

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

The approach of prehospital health care personnel working at emergency stations towards forensic cases.

Science.gov (United States)

Asci, Ozlem; Hazar, Guleser; Sercan, Isa

2015-09-01

The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 2013 and February 2014. Of 141 health personnel that constituted sample of the study, 48.9% were nurses, 9.9% emergency medicine technicians, and 41.1% ambulance and emergency care technicians. The rate of feeling sufficient in coping with forensic cases and incidents was 20.6%. There was a lower rate of receiving education about the approach towards forensic cases (15.6%). In the study, the frequency of encountering with at least one forensic case was 88.7%. Traffic accidents (72.5%), suicides (41.5%) and assaults (41.5%) were among the most frequent reasons of forensic cases. The practices of nurses were more successful in woundings by firearms compared to other health personnel (p forensic cases. The personnel with higher educational level and nurses have more successful practices in forensic cases. Health personnel have approaches that may negatively affect the solution of forensic cases.

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

An integration of Emergency Department Information and Ambulance Systems.

Science.gov (United States)

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

2012-01-01

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

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.

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....

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.

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

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.

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

Directory of Open Access Journals (Sweden)

Suzuki Hiroshi

2010-01-01

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

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.

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.

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

Science.gov (United States)

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

2015-05-01

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

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

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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

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

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

Directory of Open Access Journals (Sweden)

Lazim Abdullah

2018-01-01

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

Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues

Science.gov (United States)

Ward, C L; Lombard, C J; Gwebushe, N

2006-01-01

Objectives To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. Methods We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post‐traumatic stress disorder (PTSD), and psychological and physical aggression between co‐workers. Open ended questions addressed additional stressors. Results Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co‐workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. Conclusions Service organisations should be alert to the possibility that their personnel are experiencing work ‐related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger. PMID:16498167

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

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)

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.

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”.

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

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?

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

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

Directory of Open Access Journals (Sweden)

Ana Paula Iannoni

2008-01-01

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

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.

Optimizing the location of ambulances in Tijuana, Mexico.

Science.gov (United States)

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

2017-01-01

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

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...

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.

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.

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.

Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel

Directory of Open Access Journals (Sweden)

Alexander Wolkow

2015-04-01

Full Text Available Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation.

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.

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.

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.

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

Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel.

Science.gov (United States)

Wolkow, Alexander; Ferguson, Sally; Aisbett, Brad; Main, Luana

2015-01-01

Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

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.

[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.

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

Science.gov (United States)

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

2017-10-16

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

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

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%.

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.

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

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

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.

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

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.

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.

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

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...

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

Personnel monitoring

International Nuclear Information System (INIS)

1965-01-01

This film stresses the need for personnel monitoring in work areas where there is a hazard of exposure to radiation. It illustrates the use of personnel monitoring devices (specially the film dosimeter), the assessment of exposure to radiation and the detailed recording of the results on personnel filing cards

Personnel monitoring

Energy Technology Data Exchange (ETDEWEB)

NONE

1966-12-31

This film stresses the need for personnel monitoring in work areas where there is a hazard of exposure to radiation. It illustrates the use of personnel monitoring devices (specially the film dosimeter), the assessment of exposure to radiation and the detailed recording of the results on personnel filing cards

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.

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.

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.

Personnel Selection Method Based on Personnel-Job Matching

OpenAIRE

Li Wang; Xilin Hou; Lili Zhang

2013-01-01

The existing personnel selection decisions in practice are based on the evaluation of job seeker's human capital, and it may be difficult to make personnel-job matching and make each party satisfy. Therefore, this paper puts forward a new personnel selection method by consideration of bilateral matching. Starting from the employment thoughts of ¡°satisfy¡±, the satisfaction evaluation indicator system of each party are constructed. The multi-objective optimization model is given according to ...

Emergency medical service systems in Japan : Past, present, and future

OpenAIRE

Tanigawa, Koichi; Tanaka, Keiichi

2006-01-01

Emergency medical services are provided by the fire defense headquarter of the local government in Japan. We have a one-tiered EMS system. The ambulance is staffed by three crews trained in rescue, stabilization, transportation, and advanced care of traumatic and medical emergencies. There are three levels of care provided by ambulance personnel including a basic-level ambulance crew (First Aid Class one, FAC-1), a second level (Standard First Aid Class, SFAC), and the highest level (Emergenc...

The accuracy of Johannesburg-based ambulance personnel in ...

African Journals Online (AJOL)

1 Department of Emergency Medical Care, Faculty of Health Sciences, ... 2 Aeromedical Division, ER24 Emergency Medical Services, Johannesburg, South Africa ..... Facilitating stroke management using modern information technology.

Den præhospitale service i Danmark

DEFF Research Database (Denmark)

Trier, H; Larsen, C F

1993-01-01

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

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.

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.

Personnel preferences in personnel planning and scheduling

OpenAIRE

van der Veen, Egbert

2013-01-01

Summary The personnel of an organization often has two conflicting goals. Individual employees like to have a good work-life balance, by having personal preferences taken into account, whereas there is also the common goal to work efficiently. By applying techniques and methods from Operations Research, a subfield of applied mathematics, we show that operational efficiency can be achieved while taking personnel preferences into account. In the design of optimization methods, we explicitly con...

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

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.

Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

DEFF Research Database (Denmark)

Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C

2017-01-01

BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...

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.

Neutron personnel dosimetry

International Nuclear Information System (INIS)

Griffith, R.V.

1981-01-01

The current state-of-the-art in neutron personnel dosimetry is reviewed. Topics covered include dosimetry needs and alternatives, current dosimetry approaches, personnel monitoring devices, calibration strategies, and future developments

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...

Avancerad hjärt-lungräddning med mekaniska eller manuella kompressioner : Uppfattningar hos ambulanspersonal om kompetens, övning, patientrisk och överlevnad

OpenAIRE

Andersson, Isabell

2010-01-01

Study objectives: Examine ambulance personnel’s perceptions of skills / training and knowledge with regards to the existing mechanical / manual compressions and frequency of training during a work shift. Do ambulance personnel think that mechanical compressions increase survival? Are there concerns that the device could damage the patient? Design: A cross-sectional study, quantitative approach with qualitative elements was conducted. Methods: Questionnaire form, which was answered by 44 amb...

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.

Personnel Monitoring Department - DEMIN

International Nuclear Information System (INIS)

1989-01-01

The activities and purposes of the Personnel Monitoring Dept. of the Institute of Radioprotection and Dosimetry of the Brazilian CNEN are presented. A summary of the personnel monitoring service is given, such as dosemeters supply, laboratorial inspections, and so on. The programs of working, publishing, courses and personnel interchange are also presented. (J.A.M.M.)

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.

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.

Fire Engine Support and On-scene Time in Prehospital Stroke Care - A Prospective Observational Study.

Science.gov (United States)

Puolakka, Tuukka; Väyrynen, Taneli; Erkkilä, Elja-Pekka; Kuisma, Markku

2016-06-01

Introduction On-scene time (OST) previously has been shown to be a significant component of Emergency Medical Services' (EMS') operational delay in acute stroke. Since stroke patients are managed routinely by two-person ambulance crews, increasing the number of personnel available on the scene is a possible method to improve their performance. Hypothesis Using fire engine crews to support ambulances on the scene in acute stroke is hypothesized to be associated with a shorter OST. All patients transported to hospital as thrombolysis candidates during a one-year study period were registered by the ambulance crews using a case report form that included patient characteristics and operational EMS data. Seventy-seven patients (41 [53%] male; mean age of 68.9 years [SD=15]; mean Glasgow Coma Score [GCS] of 15 points [IQR=14-15]) were eligible for the study. Forty-five cases were managed by ambulance and fire engine crews together and 32 by the ambulance crews alone. The median ambulance response time was seven minutes (IQR=5-10) and the fire engine response time was six minutes (IQR=5-8). The number of EMS personnel on the scene was six (IQR=5-7) and two (IQR=2-2), and the OST was 21 minutes (IQR=18-26) and 24 minutes (IQR=20-32; P =.073) for the groups, respectively. In a following regression analysis, using stroke as the dispatch code was the only variable associated with short (engine crews to support ambulances in acute stroke care was not associated with a shorter on-scene stay when compared to standard management by two-person ambulance crews alone. Using stroke as the dispatch code was the only variable that was associated independently with a short OST. Puolakka T , Väyrynen T , Erkkilä E-P , Kuisma M . Fire engine support and on-scene time in prehospital stroke care - a prospective observational study. Prehosp Disaster Med. 2016;31(3):278-281.

Personnel dose assignment practices

International Nuclear Information System (INIS)

Fix, J.J.

1993-04-01

Implementation of DOE N 5480.6 Radiological Control Manual Article 511(3) requirements, to minimize the assignment of personnel dosimeters, should be done only under a broader context ensuring that capabilities are in place to monitor and record personnel exposure both for compliance and for potential litigation. As noted in NCRP Report No. 114, personnel dosimetry programs are conducted to meet four major objectives: radiation safety program control and evaluation; regulatory compliance; epidemiological research; and litigation. A change to Article 511(3) is proposed that would require that minimizing the assignment of personnel dosimeters take place only following full evaluation of overall capabilities (e.g., access control, area dosimetry, etc.) to meet the NCRP objectives

Testing the START Triage Protocol: Can It Improve the Ability of Nonmedical Personnel to Better Triage Patients During Disasters and Mass Casualties Incidents ?

Science.gov (United States)

Badiali, Stefano; Giugni, Aimone; Marcis, Lucia

2017-06-01

START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group). The START group received last-minute START training. Each group examined 6000 patients, obtained from the Emergo Train System (ETS Italy, Bologna, Italy) victims database, and assigned patients a triage code (black-red-yellow-green) along with a reason for the assignment. Each rescuer triaged 30 patients within a 30-minute time frame. Results were analyzed according to Fisher's exact test for a P valueSTART group completed the evaluations in 15 minutes, whereas the non-START group took 30 minutes. The START group correctly triaged 94.2% of their patients, as opposed to 59.83% of the non-START group (PSTART group versus 13.67% and 26.5% for the non-START group. The non-START group had 458 "preventable deaths" on 6000 cases because of incorrect triage, whereas the START group had 91. Even a "last-minute" training on the START triage protocol allows nonmedical personnel to better identify and triage the victims of a disaster or MCI, resulting in more effective and efficient medical intervention. (Disaster Med Public Health Preparedness. 2017;11:305-309).

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

Science.gov (United States)

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

2018-05-24

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

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.

Qualification of NPP operations personnel

International Nuclear Information System (INIS)

Wang Jiao.

1987-01-01

Competence of personnel is one of the important problems for safety operation of nuclear power plant. This paper gives a description of some aspects, such as the administration of NPP, posts, competence of personnel, training, assessing the competence and personnel management

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.

Basis scheme of personnel training system

International Nuclear Information System (INIS)

Rerucha, F.; Odehnal, J.

1998-01-01

Basic scheme of the training system for NPP personnel of CEZ-EDU personnel training system is described in detail. This includes: specific training both basic and periodic, and professional training meaning specialized and continuous training. The following schemes are shown: licence acquisition and authorisation for PWR-440 Control Room Personnel; upgrade training for job positions of Control Room personnel; maintaining and refresh training; module training for certificate acquisition of servicing shift and operating personnel

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

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

Personnel Investigations and Clearance Tracking (OPI)

Data.gov (United States)

Office of Personnel Management — Security file-related information for the U.S. Office of Personnel Management (OPM)'s employee and contractor personnel. The data is OPM-specific, not government-wide.

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...

THEORETICAL BASIS FOR MANAGEMENT OF PERSONNEL RISKS

OpenAIRE

Haliashova, Katsiaryna

2017-01-01

Necessity of personnel risks management is based on research results. The authors' approaches to the determination of personnel risks and to their management have been explored. The author's definition of the concept of "personnel risks" is proposed. A classification of personnel risks is developed depending on the stage of origin and the tasks of the personnel policy, as well as the methods of management personnel risks in the organization. The article presents a methodical approach to perso...

Personnel radiation dosimetry

International Nuclear Information System (INIS)

1987-01-01

The book contains the 21 technical papers presented at the Technical Committee Meeting to Elaborate Procedures and Data for the Intercomparison of Personnel Dosimeters organizaed by the IAEA on 22-26 April 1985. A separate abstract was prepared for each of these papers. A list of areas in which additional research and development work is needed and recommendations for an IAEA-sponsored intercomparison program on personnel dosimetry is also included

Some problems of NPP personnel training

International Nuclear Information System (INIS)

Vajshnis, P.P.; Kumkov, L.P.; Omel'chuk, V.V.

1984-01-01

Shortcomings of NPP personnel training are discussed. Development of full-scale training systems is necessary for qualitative training operative personnel. Primary problems that should be necessarily solved for ensuring effective training NPP personnel are considered

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

Ethnic Minority Personnel Careers: Hindrances and Hopes

OpenAIRE

Ross, Catharine

2004-01-01

Personnel departments often have particular responsibility for equal opportunities within their organizations. This paper explores equal opportunities within personnel departments themselves, in relation to the careers of ethnic minority personnel practitioners. Through primary research, it identifies a range of criteria which can affect personnel careers, of which ethnic origin is often one. However, although being categorized as of ethnic minority origin often hinders personnel careers, the...

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.

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.

Special training of shift personnel

International Nuclear Information System (INIS)

Martin, H.D.

1981-01-01

The first step of on-the-job training is practical observation phase in an operating Nuclear Plant, where the participants are assigned to shift work. The simulator training for operating personnel, for key personnel and, to some extent, also for maintenance personnel and specialists give the practical feeling for Nuclear Power Plant behaviour during normal and abnormal conditions. During the commissioning phase of the own Nuclear Power Plant, which is the most important practical training, the participants are integrated into the commissioning staff and assisted during their process of practical learning by special instructors. The preparation for the licensing exams is vitally important for shift personnel and special courses are provided after the first non-nuclear trial operation of the plant. Personnel training also includes performance of programmes and material for retraining, training of instructors and assistance in building up special training programmes and material as well as training centers. (orig./RW)

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....

76 FR 81359 - National Security Personnel System

Science.gov (United States)

2011-12-28

... Security Personnel System AGENCY: Department of Defense; Office of Personnel Management. ACTION: Final rule... concerning the National Security Personnel System (NSPS). Section 1113 of the National Defense Authorization... National Security Personnel System (NSPS) in regulations jointly prescribed by DOD and OPM (Office of...

Personnel Policy and Profit

DEFF Research Database (Denmark)

Bingley, Paul; Westergård-Nielsen, Niels Chr.

2004-01-01

personnel structure variation. It is found that personnel policy is strongly related to economic performance. At the margin, more hires are associated with lower profit, and more separations with higher profit. For the average firm, one new job, all else equal, is associated with ?2680 (2000 prices) lower...

49 CFR 193.2711 - Personnel health.

Science.gov (United States)

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Personnel health. 193.2711 Section 193.2711 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2711 Personnel health. Each operator...

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

Going beyond "highly-qualified personnel" to "value-added personnel"

Science.gov (United States)

Nantel, Marc; Fox, Bradley; Gelsthorpe, Leanne; Hamilton, Roxy; Marshall, Robert; Williamson, Guida

2005-10-01

Employers clamour for more "Highly-Qualified Personnel" (HQP) to hire, and photonics is no exception. The challenge facing all new graduates lies in what actually constitutes a Highly-Qualified Person. Yesterday, an HQP was often understood to be a graduate with a Bachelor's, Master's or Ph.D. degree. Today, industry is demanding that an HQP be either a university or college graduate with strong academic standing AND a sound business and communications skill set. In this paper, we introduce the concept of "Value-Added Personnel" (VAP), which marries both scientific and "soft-skills" aspects, and we present a new program in Ontario to produce VAPs.

10 CFR 36.55 - Personnel monitoring.

Science.gov (United States)

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Personnel monitoring. 36.55 Section 36.55 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation of Irradiators § 36.55 Personnel monitoring. (a) Irradiator operators shall wear a personnel dosimeter that is...

Individual protection of NPP personnel

International Nuclear Information System (INIS)

Koshcheev, V.S.; Gol'dshtejn, D.S.; Chetverikova, Z.S.

1983-01-01

Specific features of NPP personnel individual protection are considered, mainly with respect to maintenance and repair works on various type reactors. The major concern is given to the selection and application reglamentations of the individual protection system (IPS), employment of sanitary locks, the organization of individual protection under the conditions of a heating microclimate. The ways are specified to the development and introduction of the most effective IPS and improvement of the entire NPP personnel individual protection system with respect to providing the necessary protection effect for maintaining high working capability of the personnel and minimizing the IPS impact on human organism functional systems. The accumulated experience in the personnel individual protection can be applied during construction and operation of NPP's in CMEA member-countries [ru

Personnel monitoring in geologic fields

International Nuclear Information System (INIS)

Romanova, I.N.; Seredin, Yu.V.

1981-01-01

State of radiation safety for the personnel of geologic crews carrying out neutron logging of wells using Po-Be sources has been evaluated. Given are results of development of methods for the evaluation of individual radiation loads for personnel when working with Po-Be neutron sources useful for the application in practice by a geologic logging crew as well as a quantitative evaluation of profissional radiation loads during this kind of work. The following methods are recommended for personnel monitoring: 1) calculation of whole-body irradiation doses and hands from averaged values of radiation dose rate; 2) calculational tabulated determination of irradiation doses during recharging of shanks of well instruments. Personnel monitoring by means of instrumental methods is not necessary in the considered case [ru

Personnel preferences in personnel planning and scheduling

NARCIS (Netherlands)

van der Veen, Egbert

2013-01-01

Summary The personnel of an organization often has two conflicting goals. Individual employees like to have a good work-life balance, by having personal preferences taken into account, whereas there is also the common goal to work efficiently. By applying techniques and methods from Operations

Cytogenic Investigations in Flight Personnel

International Nuclear Information System (INIS)

Wolf, G.; Obe, G.; Bergau, L.

1999-01-01

During long-distance flights at high altitudes flight personnel are exposed to cosmic radiation. In order to determine whether there are biological effects of such low dose radiation exposure in aircrew, chromosomal aberrations were investigated in 59 female cabin attendants and a matched control group of 31 members of station personnel. The mean number of dicentric chromosomes amounts to 1.3 (95% CI 1.0-1.6) per 1,000 cells in cabin attendants and 1.4 (95% CI 1.0-1.9) per 1,000 cells in controls. In an additional control group of 56 female clerks from Berlin the mean frequency of dicentric chromosomes was 1.3 (95% CI 1.0-1.6). Neither in dicentric frequency and distribution nor in other aberrations was a significant difference between the groups of flight and station personnel found. The high frequency of multi-aberrant cells was remarkable in flight personnel as well as in station personnel. The reason for this phenomenon is unknown and needs further investigation. (author)

Electronic Official Personnel Folder System

Data.gov (United States)

US Agency for International Development — The eOPF is a digital recreation of paper personnel folder that stores electronic personnel data spanning an individual's Federal career. eOPF allows employees to...

Training of nonlicensed personnel

International Nuclear Information System (INIS)

Hetrick, D.E.

1975-01-01

The safety and efficiency with which a station operates is a function of the competence and proficiency of all personnel. This includes the nonlicensed personnel who make up the bulk of the station staff. Thus the training of these members of the station complement is an important function in overall station performance. Standards, regulations, regulatory guides, and codes provide guidance to the training requirements for such personnel. Training needs and objectives must be established, a plan prepared and then all incorporated into a training program. A well planned and operated training program will stimulate effective communications between the different groups within the station and between the station and off site support groups

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.

Absence and Need for Fatigue Risk Management in Emergency Medical Services

Science.gov (United States)

2018-01-11

Fatigue in the Emergency Medical Services (EMS) workplace is widespread. Reports of fatigue-related events that involve ambulance crashes, personnel injury, patient death, and other negative outcomes are on the rise (1-7). There is growing evidence t...

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.

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

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

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....

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,…

Technical guidelines for personnel dosimetry calibrations

International Nuclear Information System (INIS)

Roberson, P.L.; Fox, R.A.; Hadley, R.T.; Holbrook, K.L.; Hooker, C.D.; McDonald, J.C.

1983-01-01

A base of technical information has been acquire and used to evaluate the calibration, design, and performance of selected personnel systems in use at Department of Energy (DOE) facilites. A technical document was prepared to guide DOE and DOE contractors in selecting and evaluating personnel dosimetry systems and calibration. A parallel effort was initiated to intercompare the adiological calibrations standards used to calibrate DOE personnel dosimeters

Personnel Officers: Judging Their Qualifications.

Science.gov (United States)

Webb, Gisela

1988-01-01

Discusses the backgrounds and qualifications appropriate for a library personnel administrator, including (1) a master's degree in library science; (2) library work experience; (3) additional training in administration, personnel management, organizational development, and psychology; and (4) personal attributes such as good communication skills,…

Personnel Preparation.

Science.gov (United States)

Fair, George, Ed.; Stodden, Robert, Ed.

1981-01-01

Three articles comprise a section on personnel preparation in vocational education. Articles deal with two inservice programs in career/vocational education for the handicapped and a project to train paraprofessionals to assist special educators in vocational education. (CL)

Educating personnel for nuclear technology in Czechoslovakia

International Nuclear Information System (INIS)

Otcenasek, P.

1980-01-01

The basic preconditions are discussed of educating personnel for nuclear power and nuclear technology in Czechoslovakia. In educating specialists, the high societal significance of nuclear power and the need to obtain qualified personnel for safeguarding safety and reliability of nuclear facilities operation should primarily be borne in mind. The system of training applies not only to operating and maintenance personnel of nuclear power plants but also to fuel and power generation, transport, engineering, building industry, health care, education and other personnel. (J.B.)

Personnel Practices for Small Colleges.

Science.gov (United States)

Bouchard, Ronald A.

Personnel administration in higher education is the focus of this "hands-on, how-to-do-it" guide that provides fundamental materials for developing and maintaining a sound personnel program. Part One (Employment) examines government regulations, employee recruitment and selection, pre-employment inquiries and screening, post-employment process,…

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.

Adaptação para a língua portuguesa do Questionário de Experiências Dissociativas Peritraumáticas (QEDP numa amostra de bombeiros Portuguese adaptation of the Peritraumatic Dissociation Experiences Questionnaire (PDEQ in a sample of ambulance personal

Directory of Open Access Journals (Sweden)

Ângela Costa Maia

2009-01-01

Full Text Available CONTEXTO: A dissociação peritraumática é uma resposta no momento da exposição a uma situação ameaçadora que tem se mostrado um preditor significativo de perturbação psicológica a longo prazo, nomeadamente perturbação pós-estresse traumático. OBJETIVOS: Fazer a adaptação para português do Peritraumatic Dissociation Experiences Questionnaire numa população altamente exposta a situações traumáticas, como é o caso dos bombeiros. MÉTODO: Após a tradução e o estudo dos itens, fizeram-se a aplicação e a análise psicométrica com uma amostra de 170 bombeiros, que relataram exposição traumática e que também preencheram uma escala de Perturbação de Pós-Estresse Traumático. RESULTADOS: Os dados indicam que se trata de um instrumento com uma boa consistência interna (alfa de Cronbach = 0,87 e cuja validade de construto o torna adequado para a avaliação das respostas dessa população no exercício da sua profissão. Para além disso, a correlação elevada com os sintomas de perturbação pós-estresse traumático sugere ainda uma boa validade convergente. DISCUSSÃO: Atendendo ao fato de que a dissociação peritraumática prevê PPST, o recurso a um instrumento que revela boas capacidades psicométricas pode ajudar a identificar as pessoas que desenvolverão perturbação após exposição a trauma.BACKGROUND: Peritraumatic dissociation is a reaction that occurs in the moment someone is exposed to a threatening situation and has shown to be an important predictor of long term psychological disorder, including post traumatic stress disorder. OBJECTIVES: To make the psychometric adaptation of Peritraumatic Dissociation Experiences Questionnaire in Portuguese ambulance personnel that report high exposure to trauma. The instrument has been widely used in research, and was initially designed to analyse peritraumatic dissociation in emergency personnel. METHODS: After items translation and study, 170 ambulance

Development of NPP personnel training system in Ukraine

Energy Technology Data Exchange (ETDEWEB)

Tarykin, V. [Operation Personnel Training Department, Khmelnitsky NPP, Training Center, Neteshin 30100, Khmelnitsky region (Ukraine)]. E-mail: tarykinv@ukr.net

2005-07-01

Modern personnel training and retraining system is a guarantee of NPPs safe reliable operation. Since the time when independence of Ukraine was proclaimed personnel training system was created directly at NPPs. This system is based on the latest legislation framework, developed subject to IAEA recommendations, gained international experience in the field of personnel training in view of increased demands to personnel qualification. Training Centers, formed at each plant, form one of the main components of NPP personnel training. Personnel training at Training Centers is performed in accordance with standard programmes. Simulator training base was created by joint efforts of specialists from the USA, Russia and Ukraine. Establishing manager training system and replacement reserves for National Nuclear Energy Generating Company 'ENERGOATOM' (NNEGC 'ENERGOATOM') managerial personnel, including training programme and training materials development, teacher selection and training, is under way. (author)

34 CFR 361.18 - Comprehensive system of personnel development.

Science.gov (United States)

2010-07-01

... implementation of a plan to address the current and projected needs for personnel who are qualified in accordance... accordance with paragraph (c) of this section, including personnel from minority backgrounds and personnel... retraining, recruiting, and hiring personnel; (B) The specific time period by which all State unit personnel...

49 CFR 1542.217 - Law enforcement personnel.

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Law enforcement personnel. 1542.217 Section 1542... Law enforcement personnel. (a) Each airport operator must ensure that law enforcement personnel used... the criminal laws of the State and local jurisdictions in which the airport is located— (1) A crime...

49 CFR 1544.217 - Law enforcement personnel.

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Law enforcement personnel. 1544.217 Section 1544... AND COMMERCIAL OPERATORS Operations § 1544.217 Law enforcement personnel. (a) The following applies to... for law enforcement personnel meeting the qualifications and standards specified in §§ 1542.215 and...

Personnel Development Practices in Turkish Education System

Science.gov (United States)

Ozdemir, Tuncay Yavuz

2016-01-01

Nowadays everything develops and changes very quickly and sustainability of organizational goals will be possible only when personnel can keep up with these changes. From administrative aspect it is important to enhance personnel's potential and prompt them to achieve organizational goals. Personnel development is a process which influences and…

[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

National Finance Center Personnel/Payroll System

Data.gov (United States)

US Agency for International Development — The NFC system is an USDA system used for processing transactions for payroll/personnel systems. Personnel processing is done through EPIC/HCUP, which is web-based....

Conditions for selection, training and placement of personnel

International Nuclear Information System (INIS)

Chrkavy, L.

1983-01-01

Methods applied in the choice of personnel include: the assessment of personnel files, references, interviews, examinations, long-term observation of the respective person. Investment intents go hand in hand with the concept of labour demands. The planned employment of personnel takes place from the very beginning of the construction of the power plant. At the Bohunice V-1 nuclear power plant 23 university graduates, 29 secondary school graduates and 64 graduates of vocational schools were employed every year. Social measures and complex care are being implemented. Personnel is being selected also on the basis of an assessment of their psychic qualities which are very important in view of the high personal and social responsibility of nuclear power plant personnel. The high technical standard of the equipment places high demands on the education level of all personnel, high demands on training, high remuneration and high level of allround care of personnel. (M.D.)

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

Science.gov (United States)

Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Abe, Tetsuya; Ueno, Tomoyuki; Soma, Yuichiro; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

2017-01-01

Patients with complete paraplegia after spinal cord injury (SCI) are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL) in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman) were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20-67) years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS) grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60-90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG) was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad) in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs) score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention. These findings

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

Musculoskeletal disorders in main battle tank personnel

DEFF Research Database (Denmark)

Nissen, Lars Ravnborg; Guldager, Bernadette; Gyntelberg, Finn

2009-01-01

PURPOSE: To compare the prevalence of musculoskeletal disorders of personnel in the main battle tank (MBT) units in the Danish army with those of personnel in other types of army units, and to investigate associations between job function in the tank, military rank, and musculoskeletal problems......, and ankle. RESULTS AND CONCLUSIONS: There were only 4 women in the MBT group; as a consequence, female personnel were excluded from the study. The participation rate was 58.0% (n = 184) in the MBT group and 56.3% (n = 333) in the reference group. The pattern of musculoskeletal disorders among personnel...

IAEA activities on NPP personnel training and qualification

International Nuclear Information System (INIS)

Kossilov, A.

1998-01-01

Activities of IAEA concerning training and qualification of NPP personnel consider the availability of sufficient number of competent personnel which is one of the most critical requirements for safe and reliable NPP operation and maintenance. Competence of personnel is essential for reducing the frequency of events connected to human errors and equipment failures. The IAEA Guidebook on Nuclear Power Plant Personnel Training and its Evaluation incorporates the experience gained worldwide and provides recommendations on the use of SAT being the best practice for attaining and maintaining the qualification and competence of NPP personnel and for quality assurance of training

Site security personnel training manual

International Nuclear Information System (INIS)

1978-10-01

As required by 10 CFR Part 73, this training manual provides guidance to assist licensees in the development of security personnel training and qualifications programs. The information contained in the manual typifies the level and scope of training for personnel assigned to perform security related tasks and job duties associated with the protection of nuclear fuel cycle facilities and nuclear power reactors

An effective support system of emergency medical services with tablet computers.

Science.gov (United States)

Yamada, Kosuke C; Inoue, Satoshi; Sakamoto, Yuichiro

2015-02-27

There were over 5,000,000 ambulance dispatches during 2010 in Japan, and the time for transportation has been increasing, it took over 37 minutes from dispatch to the hospitals. A way to reduce transportation time by ambulance is to shorten the time of searching for an appropriate facility/hospital during the prehospital phase. Although the information system of medical institutions and emergency medical service (EMS) was established in 2003 in Saga Prefecture, Japan, it has not been utilized efficiently. The Saga Prefectural Government renewed the previous system in an effort to make it the real-time support system that can efficiently manage emergency demand and acceptance for the first time in Japan in April 2011. The objective of this study was to evaluate if the new system promotes efficient emergency transportation for critically ill patients and provides valuable epidemiological data. The new system has provided both emergency personnel in the ambulance, or at the scene, and the medical staff in each hospital to be able to share up-to-date information about available hospitals by means of cloud computing. All 55 ambulances in Saga are equipped with tablet computers through third generation/long term evolution networks. When the emergency personnel arrive on the scene and discern the type of patient's illness, they can search for an appropriate facility/hospital with their tablet computer based on the patient's symptoms and available medical specialists. Data were collected prospectively over a three-year period from April 1, 2011 to March 31, 2013. The transportation time by ambulance in Saga was shortened for the first time since the statistics were first kept in 1999; the mean time was 34.3 minutes in 2010 (based on administrative statistics) and 33.9 minutes (95% CI 33.6-34.1) in 2011. The ratio of transportation to the tertiary care facilities in Saga has decreased by 3.12% from the year before, 32.7% in 2010 (regional average) and 29.58% (9085

Training of maintenance personnel

International Nuclear Information System (INIS)

Rabouhams, J.

1986-01-01

This lecture precises the method and means developed by EDF to ensure the training of maintenance personnel according to their initial educational background and their experience. The following points are treated: General organization of the training for maintenance personnel in PWR and GCR nuclear power stations and in Creys Malville fast breeder reactor; Basic nuclear training and pedagogical aids developed for this purpose; Specific training and training provided by contractors; complementary training taking into account the operation experience and feedback; Improvement of velocity, competence and safety during shut-down operations by adapted training. (orig.)

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.

Personnel external dose monitoring system

International Nuclear Information System (INIS)

Zhao Hengyuan

1989-01-01

The status and trend of personnel external dose monitoring system are introduced briefly. Their characteristics, functions and TLD bedges of some commercially available automatic TLD system, including UD-710A (Matsushita, Japan), Harshaw-2271, 2276 (Harshaw, USA), Harshaw-8000 (Harshaw/Filtrol), Studsvik-1313 (Sweden) and Pitman-800 (UK) were depicted in detail. Finally, personnel dose management and record keeping system were presented and two examples were given

32 CFR 720.20 - Service of process upon personnel.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Service of process upon personnel. 720.20... DELIVERY OF PERSONNEL; SERVICE OF PROCESS AND SUBPOENAS; PRODUCTION OF OFFICIAL RECORDS Service of Process and Subpoenas Upon Personnel § 720.20 Service of process upon personnel. (a) General. Commanding...

Verbetering van de hulpverlening aan slachtoffers van verkeersongevallen : een zwartboek.

NARCIS (Netherlands)

Flury, F.C.

1989-01-01

Since the beginning of the nineteen eighties people working in the assistance to traffic accident victims (traumatologists as well as ambulance personnel) have declared that the assistance can be improved much on the basis of existing knowledge. Improvements are thought to be possible in every phase

Improving human performance in maintenance personnel

International Nuclear Information System (INIS)

Gonzalez Anez, Francisco; Agueero Agueero, Jorge

2010-01-01

The continuous evolution and improvement of safety-related processes has included the analysis, design and development of training plans for the qualification of maintenance nuclear power plant personnel. In this respect, the international references in this area recommend the establishment of systematic qualification programmes for personnel performing functions or carrying out safety related tasks. Maintenance personnel qualification processes have improved significantly, and training plans have been designed and developed based on Systematic Approach to Training methodology to each job position. These improvements have been clearly reflected in recent training programmes with new training material and training facilities focused not only on developing technical knowledge and skills but also on improving attitudes and safety culture. The objectives of maintenance training facilities such as laboratories, mock-ups real an virtual, hydraulic loops, field simulators and other training material to be used in the maintenance training centre are to cover training necessities for initial and continuous qualification. Evidently, all these improvements made in the qualification of plant personnel should be extended to include supplemental personnel (external or contracted) performing safety-related tasks. The supplemental personnel constitute a very spread group, covering the performance of multiple activities entailing different levels of responsibility. Some of these activities are performed permanently at the plant, while others are occasional or sporadic. In order to establish qualification requirements for these supplemental workers, it is recommended to establish a rigorous analysis of job positions and tasks. The objective will be to identify the qualification requirements to assure competence and safety. (authors)

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

Occupational exposure of nuclear medicine personnel

International Nuclear Information System (INIS)

Roessler, M.

1982-01-01

The results are given of measurements of the radiation burden of personnel in departments of nuclear medicine in the years 1979 to 1981 using film dosemeters and ring thermoluminescence dosemeters evaluated by the national personnel dosemeter service. The relations are examined of the exposure of hands and the preparation of radiopharmaceuticals and especially their use for examinations. Certain organizational measures are indicated for reducina radiation burden in a laboratory for the preparation of radiopharmaceuticals. The results of measurements and evaluations of radiation burden of personnel of nuclear medicine departments are confronted with conclusions published in the literature. (author)

Employment of security personnel

International Nuclear Information System (INIS)

Anon.

1990-01-01

If a company or institution hires personnel of a security service company to protect its premises, this kind of employment does not mean the company carries on temporary employment business. Within the purview of section 99, sub-section 1 of the BetrVG (Works Constitution Act), the security service personnel is not 'employed' in the proper sense even if the security tasks fulfilled by them are done at other times by regular employees of the company or institution. The court decision also decided that the Works Council need not give consent to employment of foreign security personnel. The court decision was taken for settlement of court proceedings commenced by Institute of Plasma Physics in Garching. In his comments, W. Hunold accedes to the court's decision and discusses the underlying reasons of this decision and of a previous ruling in the same matter by putting emphasis on the difference between a contract for services and a contract for work, and a contract for temporary employment. The author also discusses the basic features of an employment contract. (orig./HP) [de

Personnel neutron dosimetry

International Nuclear Information System (INIS)

Hankins, D.

1982-04-01

This edited transcript of a presentation on personnel neutron discusses the accuracy of present dosimetry practices, requirements, calibration, dosemeter types, quality factors, operational problems, and dosimetry for a criticality accident. 32 figs

10 CFR 34.47 - Personnel monitoring.

Science.gov (United States)

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Personnel monitoring. 34.47 Section 34.47 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Radiation Safety Requirements § 34.47 Personnel monitoring. (a) The licensee may not...

10 CFR 26.155 - Laboratory personnel.

Science.gov (United States)

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Laboratory personnel. 26.155 Section 26.155 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Laboratories Certified by the Department of Health and Human... ensure the continued competency of laboratory personnel by documenting their in-service training...

[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)

Competency assessments for nuclear industry personnel

International Nuclear Information System (INIS)

2004-04-01

In 1996, the IAEA published Technical Reports Series No. 380, Nuclear Power Plant Personnel Training and its Evaluation: A Guidebook. This publication provides guidance for the development, implementation and evaluation of training programmes for all nuclear power plant personnel using the systematic approach to training (SAT) methodology. The SAT methodology has since been adopted and used for the development and implementation of training programmes for all types of nuclear facility and activities in the nuclear industry. The IAEA Technical Working Group on Training and Qualification of Nuclear Power Plant Personnel recommended that an additional publication be prepared to provide further guidance concerning competency assessments used for measuring the knowledge, skills and attitudes of personnel as the result of training. This publication has been prepared in response to that recommendation. A critical component of SAT (as part of the implementation phase) is the assessment of whether personnel have achieved the standards identified in the training objectives. The nuclear industry spends a significant amount of resources conducting competency assessments. Competency assessments are used for employee selection, trainee assessment, qualification, requalification and authorization (in some Member States the terminology may be 'certification' or 'licensing'), and job advancement and promotion. Ineffective testing methods and procedures, or inappropriate interpretation of test results, can have significant effects on both human performance and nuclear safety. Test development requires unique skills and, as with any skill, training and experience are needed to develop and improve them. Test item and examination development, use, interpretation of results and examination refinement, like all other aspects of SAT, should be part of an ongoing, systematic process. This publication is primarily intended for use by personnel responsible for developing and administering

The impact of post-resuscitation feedback for paramedics on the quality of cardiopulmonary resuscitation.

Science.gov (United States)

Bleijenberg, Eduard; Koster, Rudolph W; de Vries, Hendrik; Beesems, Stefanie G

2017-01-01

The Guidelines place emphasis on high-quality cardiopulmonary resuscitation (CPR). This study aims to measure the impact of post-resuscitation feedback on the quality of CPR as performed by ambulance personnel. Two ambulances are dispatched for suspected cardiac arrest. The crew (driver and paramedic) of the first arriving ambulance is responsible for the quality of CPR. The crew of the second ambulance establishes an intravenous access and supports the first crew. All resuscitation attempts led by the ambulance crew of the study region were reviewed by two research paramedics and structured feedback was given based on defibrillator recording with impedance signal. A 12-months period before introduction of post-resuscitation feedback was compared with a 19-months period after introduction of feedback, excluding a six months run-in interval. Quality parameters were chest compression fraction (CCF), chest compression rate, longest peri-shock pause and longest non-shock pause. In the pre-feedback period 55 cases were analyzed and 69 cases in the feedback period. Median CCF improved significantly in the feedback period (79% vs 86%, presuscitation feedback improves the quality of resuscitation, significantly increasing CCF and decreasing the duration of longest non-shock pauses. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

5 CFR 9901.363 - Premium pay for health care personnel.

Science.gov (United States)

2010-01-01

... health care personnel. (1) Health care personnel working a tour of duty, any part of which falls between....362(c). (2) Health care personnel are entitled to pay for night duty for a period of paid absence only... excused from work. (d) Pay for weekend duty for health care personnel. (1) Health care personnel who work...

32 CFR 537.6 - Identification of recovery incidents.

Science.gov (United States)

2010-07-01

... personnel to ensure that inpatient and outpatient records and emergency room and clinic logs are properly screened to identify potential cases. The RJA or recovery attorney will screen the MTF comptroller records database and division records as well as ambulance logs to identify potential medical care recovery cases...

10 CFR 39.65 - Personnel monitoring.

Science.gov (United States)

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Personnel monitoring. 39.65 Section 39.65 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR WELL LOGGING Radiation Safety Requirements § 39.65 Personnel monitoring. (a) The licensee may not permit an individual to act as a logging...

Assuring the competence of nuclear power plant contractor personnel

International Nuclear Information System (INIS)

2001-07-01

This report was prepared in response to a recommendation by the IAEA International Working Group on Training and Qualification of NPP Personnel (JWG-T and Q) and supported by a number of IAEA meetings on NPP personnel training. IAEA publications on NPP training are the only international documents available to all Member States with nuclear programmes. This report complements the following IAEA publications on NPP personnel training: Technical Reports Series No. 380, Nuclear Power Plant Personnel Training and its Evaluation, A Guidebook; IAEA-TECDOC-1057, Experience in the Use of Systematic Approach to Training (SAT) for Nuclear Power Plant Personnel and IAEA-TECDOC-1063, IAEA World Survey on Nuclear Power Plant Personnel Training. This TECDOC also supplements the IAEA Safety Guide 50-SG-O1 (Rev. 1), Staffing of Nuclear Power Plants and the Recruitment Training and Authorization of Operating Personnel and Safety Standards Series No. NS-R-2, Safety of Nuclear Power Plants. Operation. Within the context of this report NPP contractors are defined as any personnel working for a nuclear power plant who are not directly employed by the nuclear power plant. Competence is the ability to perform to identified standards; it comprises skills, knowledge and attitudes and may be developed through education, experience and training. Qualification is a formal statement of achievement, resulting from an auditable assessment; if competence is assessed, the qualification becomes a formal statement of competence and may be shown on a certificate, diploma, etc. It is recognized that personnel are used to perform tasks that are of a specialised or temporary nature where it is not feasible to hire or maintain a full-time NPP employee. Accordingly, contractors may be used in a variety of situations to support NPPs. Typical situations include: supplies and services being delivered by the contractors that are subject to different quality standards based on a graded approach to assuring

Assuring the competence of nuclear power plant contractor personnel

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

This report was prepared in response to a recommendation by the IAEA International Working Group on Training and Qualification of NPP Personnel (JWG-T and Q) and supported by a number of IAEA meetings on NPP personnel training. IAEA publications on NPP training are the only international documents available to all Member States with nuclear programmes. This report complements the following IAEA publications on NPP personnel training: Technical Reports Series No. 380, Nuclear Power Plant Personnel Training and its Evaluation, A Guidebook; IAEA-TECDOC-1057, Experience in the Use of Systematic Approach to Training (SAT) for Nuclear Power Plant Personnel and IAEA-TECDOC-1063, IAEA World Survey on Nuclear Power Plant Personnel Training. This TECDOC also supplements the IAEA Safety Guide 50-SG-O1 (Rev. 1), Staffing of Nuclear Power Plants and the Recruitment Training and Authorization of Operating Personnel and Safety Standards Series No. NS-R-2, Safety of Nuclear Power Plants. Operation. Within the context of this report NPP contractors are defined as any personnel working for a nuclear power plant who are not directly employed by the nuclear power plant. Competence is the ability to perform to identified standards; it comprises skills, knowledge and attitudes and may be developed through education, experience and training. Qualification is a formal statement of achievement, resulting from an auditable assessment; if competence is assessed, the qualification becomes a formal statement of competence and may be shown on a certificate, diploma, etc. It is recognized that personnel are used to perform tasks that are of a specialised or temporary nature where it is not feasible to hire or maintain a full-time NPP employee. Accordingly, contractors may be used in a variety of situations to support NPPs. Typical situations include: supplies and services being delivered by the contractors that are subject to different quality standards based on a graded approach to assuring

30 CFR 77.1400 - Personnel hoists and elevators.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Personnel hoists and elevators. 77.1400 Section 77.1400 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Personnel Hoisting § 77.1400 Personnel...

45 CFR 201.11 - Personnel merit system review.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Personnel merit system review. 201.11 Section 201... STATES FOR PUBLIC ASSISTANCE PROGRAMS Review and Audits § 201.11 Personnel merit system review. A personnel merit system review is carried out by the Office of State Merit Systems of the Office of the...

21 CFR 211.28 - Personnel responsibilities.

Science.gov (United States)

2010-04-01

... apparel, such as head, face, hand, and arm coverings, shall be worn as necessary to protect drug products... observation) to have an apparent illness or open lesions that may adversely affect the safety or quality of... medical personnel not to jeopardize the safety or quality of drug products. All personnel shall be...

Guidelines for the calibration of personnel dosimeters

International Nuclear Information System (INIS)

Roberson, P.L.; Holbrook, K.L.

1984-01-01

This guide describes minimum acceptable performance levels for personnel dosimetry systems used at Department of Energy (DOE) facilities. The goal is to improve both the quality of radiological calibrations and the methods of comparing reported occupational doses between DOE facilities. Reference calibration techniques are defined. A standard for evaluation of personnel dosimetry systems and recommended design parameters for personnel dosimeters are also included. Approximate intervals for the radiation energies for which these guidelines are appropriate are 15 keV to 2 MeV for photons; above 0.3 MeV for beta particles; and 1 keV to 2 MeV for neutrons. An analysis of ANSI N13.11 was completed using performance evaluations of selected personnel dosimetry systems in use at DOE facilities. The results of this analysis are incorporated in the guidelines

Maintenance Personnel Performance Simulation (MAPPS) model

International Nuclear Information System (INIS)

Siegel, A.I.; Bartter, W.D.; Wolf, J.J.; Knee, H.E.; Haas, P.M.

1984-01-01

A stochastic computer model for simulating the actions and behavior of nuclear power plant maintenance personnel is described. The model considers personnel, environmental, and motivational variables to yield predictions of maintenance performance quality and time to perform. The mode has been fully developed and sensitivity tested. Additional evaluation of the model is now taking place

Health-physics personnel: a need unfulfilled

International Nuclear Information System (INIS)

Kathren, R.E.

1983-06-01

Current trends and conditions in the health physics profession are discussed. The need for health physics personnel in academia, nuclear power plants, other nuclear industry, national laboratories, and other sectors and the shortfall in qualified personnel to fill the available positions is described. Reasons for the present situation and recommendations for alleviating it are presented

LANSCE personnel access control system (PACS)

International Nuclear Information System (INIS)

Sturrock, J.C.; Gallegos, F.R.; Hall, M.J.

1997-01-01

The Radiation Security System (RSS) at the Los Alamos Neutron Science Center (LANSCE) provides personnel protection from prompt radiation due to accelerated beam. The Personnel Access Control System (PACS) is a component of the RSS that is designed to prevent personnel access to areas where prompt radiation is a hazard. PACS was designed to replace several older personnel safety systems (PSS) with a single modem unified design. Lessons learned from the operation over the last 20 years were incorporated into a redundant sensor, single-point failure safe, fault tolerant, and tamper-resistant system that prevents access to the beam areas by controlling the access keys and beam stoppers. PACS uses a layered philosophy to the physical and electronic design. The most critical assemblies are battery backed up, relay logic circuits; less critical devices use Programmable Logic Controllers (PLCs) for timing functions and communications. Outside reviewers have reviewed the operational safety of the design. The design philosophy, lessons learned, hardware design, software design, operation, and limitations of the device are described

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.

Innovative activity of personnel of organization

Directory of Open Access Journals (Sweden)

V. N.Belkin

2010-09-01

Full Text Available This article deals with transition way of economic of the Russian Federation on an innovative way of development. The special attention is given the internal social and economic environment of the organizations which, as a rule, counteracts development of innovative activity of the personnel. Ways of increase of innovative activity of the personnel are offered.

Perspectives of NPP personnel training in the future?

International Nuclear Information System (INIS)

Khess, R.E.

1996-01-01

Problems of the NPP personnel education are discussed during radical reorganization of the state regulation of energy production and distribution when nuclear energetics will appears in the market conditions. Effective methods of the NPP personnel training developed by the corporation GPU Nuclear are given. Potentials of the application of simulators and computerized programs for increasing the NPP personnel education efficiency are considered

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.

Personnel Management theories and applications

Institute of Scientific and Technical Information of China (English)

Yanni Feng

2010-01-01

@@ 1.Introduction Many new businesses are opened in the whole world every day.Unfortunately,only a minor part of them has success and continues its activity.There is a variety of reasons which determine the hankruptcy of companies.Most of them are included in running a business,and more and more people come to realize the significance of management,especially personnel management,as personnel represents the relationship between people in the company,which is a key point for the development of enterprise.

Occupational stress among police personnel in India

Directory of Open Access Journals (Sweden)

G Ragesh

2017-06-01

Full Text Available Background: Occupational stress and associated physical and mental health related issues are not addressed in Indian police personnel with adequate importance. Methods: Cross-sectional survey was conducted among police personnel (both male and female in Calicut urban police district, Kerala state, India. Police personnel from all designations (ranks, except from the all India services (Indian Police Service were included in the study. Data were collected using a specifically designed datasheet covering socio-demographic profile, physical and mental health related details which was prepared by researchers. Occupational stress was measured using Operational Police Stress Questionnaire (PSQ-OP and Organisational Police Stress Questionnaire (PSQ-ORG. Result: The study found that both operational and organisational stress was significant among the police officers. Organisational stress was experienced in moderate level by 68% and in high level by 14%. Operational stress scores were in the moderate range in 67% and in high range in 16.5%. The younger age group (21-35 years and lower level rank police personnel had higher stress. Stress was higher among female police personnel compared to males. While 23% of them had been diagnosed with physical illnesses, a significant four per cent of them with mental illness, and 29% of them reported substance abuse. Conclusion: The results point to the high level of stress among Indian police personnel and the need for urgent interventions from the government to address the occupational stress.

5 CFR 792.104 - Responsibilities of the Office of Personnel Management.

Science.gov (United States)

2010-01-01

... § 792.104 Responsibilities of the Office of Personnel Management. OPM shall provide overall leadership... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Responsibilities of the Office of Personnel Management. 792.104 Section 792.104 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT...

Work performed by the nuclear industry - personnel structure and personnel requirement

International Nuclear Information System (INIS)

Simon, M.

1984-01-01

The development of the nuclear industry in the Federal Republic of Germany can be phased as follows: Phase 1 (1956-1968): initial stage, Phase 2 (1968-1975): expansion of the business volume, Phase 3 (1975-1982): decreasing business volume, more conditions and technical requirements, Phase 4 (after 1982): consolidation of technologies and project management. Accordingly, the requirements made on the personnel employed in the nuclear industry had to change. Between 1982 and today, there has been a decrease of personnel employed in nuclear industry to about 35.000. This decrease is mainly due to the supplying industry. Adding to this figure the number of people employed in research centres, authorities and experts, there are over 40.000 nuclear technology jobs, a figure which, taking into account indirect employment effect, could be in the range of 100.000 to 150.000. (orig./HSCH) [de

Directory of personnel responsible for radiological health programs

International Nuclear Information System (INIS)

1977-01-01

This is a directory of professional personnel who administer the radiological health program activities in state and local governmental agencies. Included in the directory is a listing of each state health officer or the head of the agency responsible for the radiological health program. The name, address, and telephone number of the radiological health personnel are listed, followed by the alternate contact who, in many instances, may be chief of a larger administrative unit of which the radiological health program is a subunit. The address for the program is also included if it differs from the official health department or agency. Generally, the titles of the personnel listed will indicate the administrative status of the radiological health program. The directory also includes a list of key professional personnel in the Bureau of Radiological Health, Radiation Operations Staff, Regional Radiological Health Representatives, Winchester Engineering and Analytical Center, Food and Drug Administration; Office of Radiation Programs, Regional Radiation Representatives, National Environmental Research Center, and Eastern Environmental Radiation Laboratory, Environmental Protection Agency; selected personnel in the U.S. Nuclear Regulatory Commission; and selected personnel in the National Bureau of Standards

Monitoring of overalls and personnel skin contamination

International Nuclear Information System (INIS)

Turkin, N.F.

1980-01-01

Organization of monitoring of overalls and personnel skin contamination wastes is considered. The devices used for this purpose are enumerated. In sanitary sluices through which the personnel leaving the repair zone it is recommended to particularly thoroughly control hand skin contamination and most contaminated parts of overalls (sleeves, breeches lower parts, pockets, stomack region). In sanitary check points during personnel leaving the operator zone monitoring of overalls and skin contamination is performed. The overalls and other individual protective clothing are subjected to control in a special loundry before and after washing (decontamination) [ru

Training of research reactor personnel

International Nuclear Information System (INIS)

Cherruau, F.

1980-01-01

Research reactor personnel operate the reactor and carry out the experiments. These two types of work entail different activities, and therefore different skills and competence, the number of relevant staff being basically a function of the size, complexity and versatility of the reactor. Training problems are often reactor-specific, but the present paper considers them from three different viewpoints: the training or retraining of new staff or of personnel already employed at an existing facility, and training of personnel responsible for the start-up and operation of a new reactor, according to whether local infrastructure and experience already exist or whether they have to be built up from scratch. On-the-spot experience seems to be an essential basis for sound training, but requires teaching abilities and aids often difficult to bring together, and the availability of instructors that does not always fit in smoothly with current operational and experimental tasks. (author)

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

An independent safety assessment of Department of Energy nuclear reactor facilities: Training of operating personnel and personnel selection

International Nuclear Information System (INIS)

Drain, J.F.

1981-02-01

This study has been prepared for the Department of Energy's Nuclear Facilities Personnel Qualification and Training (NFPQT) Committee. Its purpose is to provide the Committee with background information on, and assessment of, the selection, training, and qualification of nuclear reactor operating personnel at DOE-owned facilities

Training of nuclear facility personnel: boon or boondoggle

International Nuclear Information System (INIS)

Remick, F.J.

1975-01-01

The training of nuclear facility personnel has been a requirement of the reactor licensing process for over two decades. However, the training of nuclear facility personnel remains a combination of boon and boondoggle. The opportunity to develop elite, well trained, professionally aggressive reactor operation staffs is not being realized to its full potential. Improvements in the selection of personnel, training programs, operational tools and professional pride can result in improved plant operation and contribute to improved plant capacity factors. Industry, regulatory agencies, professional societies and universities can do much to improve standards and quality of the training of nuclear facility personnel and to improve the professional level of plant operation

Education and training for security personnel

International Nuclear Information System (INIS)

Chida, Toshiya

2015-01-01

It is said that Physical Protection (PP) has two purposes. One is to prevent from occurring risks of threat and terrorism and the other is to minimize damages which will be happened in case of unusual conditions or emergency situation. To achieve this goal, personnel who perform their duties should have professional knowledge and skills concerning security. However, since newcomers rarely satisfy their knowledge and skill for nuclear security in most cases. Therefore, we have to provide adequate education and training after they joined to our company. To this end, our company, located in Aomori Prefecture focused on security and physical protection for nuclear related facilities. In this paper, personnel training and challenges in order to bring up security personnel at our company will be introduced. (author)

32 CFR 154.42 - Evaluation of personnel security information.

Science.gov (United States)

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Evaluation of personnel security information... SECURITY DEPARTMENT OF DEFENSE PERSONNEL SECURITY PROGRAM REGULATION Adjudication § 154.42 Evaluation of personnel security information. (a) The criteria and adjudicative policy to be used in applying the...

45 CFR 1388.5 - Program criteria-preparation of personnel.

Science.gov (United States)

2010-10-01

..., DEVELOPMENTAL DISABILITIES PROGRAM THE UNIVERSITY AFFILIATED PROGRAMS § 1388.5 Program criteria—preparation of personnel. (a) Introduction to preparation of personnel: UAP interdisciplinary training programs reflect... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program criteria-preparation of personnel. 1388.5...

An On-Line Computerized Personnel-Payroll Dream.

Science.gov (United States)

Francis, E. E.

1979-01-01

Niles Township School District 219, Skokie, Illinois, has rebuilt its personnel and payroll program. The new system provides a data bank for storage of any and all information required by both the personnel and payroll departments on each district employee. (Author/MLF)

Training of nuclear power facility personnel. Part 1

International Nuclear Information System (INIS)

1989-06-01

The proceedings of the conference entitled ''Training of Nuclear Power Facility Personnel'' and held in Tale, Czechoslovakia, on 24 - 27 April 1989, contain full texts of 58 contributions, 57 of which fall in the INIS subject scope. The aim of the conference was to summarize experience gained during the training and education of Czechoslovak nuclear power plants operating personnel, to put forth new suggestions for increasing the safety and reliability of nuclear power plants, and to establish the needs and new trends in the training and education of nuclear power plants personnel. The topics treated at the conference can be divided into three basic groups as follows: 1. professional qualification of nuclear power plant staff members; 2. development of technical means for the nuclear power plants personnel training; and 3. training of maintenance personnel, the system and organization of this training and education. The proceedings are published in two volumes. Part 1 contains the texts of 25 papers falling in the INIS subject scope. (Z.M.)

Automatic personnel contamination monitor

International Nuclear Information System (INIS)

Lattin, Kenneth R.

1978-01-01

United Nuclear Industries, Inc. (UNI) has developed an automatic personnel contamination monitor (APCM), which uniquely combines the design features of both portal and hand and shoe monitors. In addition, this prototype system also has a number of new features, including: micro computer control and readout, nineteen large area gas flow detectors, real-time background compensation, self-checking for system failures, and card reader identification and control. UNI's experience in operating the Hanford N Reactor, located in Richland, Washington, has shown the necessity of automatically monitoring plant personnel for contamination after they have passed through the procedurally controlled radiation zones. This final check ensures that each radiation zone worker has been properly checked before leaving company controlled boundaries. Investigation of the commercially available portal and hand and shoe monitors indicated that they did not have the sensitivity or sophistication required for UNI's application, therefore, a development program was initiated, resulting in the subject monitor. Field testing shows good sensitivity to personnel contamination with the majority of alarms showing contaminants on clothing, face and head areas. In general, the APCM has sensitivity comparable to portal survey instrumentation. The inherit stand-in, walk-on feature of the APCM not only makes it easy to use, but makes it difficult to bypass. (author)

5 CFR 532.705 - Appeal to the Office of Personnel Management.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Appeal to the Office of Personnel Management. 532.705 Section 532.705 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PREVAILING RATE SYSTEMS Job Grading Reviews and Appeals § 532.705 Appeal to the Office of Personnel Management. (a)(1) An employee may...

Anaphylaxis in family practice

African Journals Online (AJOL)

not squeeze the venom sac when attempting to remove the stinger; instead of using your fingers, rather use a credit card or blunt end of a knife to scrape the stinger off the ... Oxygen therapy, airway protection and other life-support procedures can be provided by ambulance personnel in accordance with their qualifications.

Nuclear power plant personnel training and its evaluation. A guidebook

International Nuclear Information System (INIS)

1996-01-01

The Guidebook will prove especially useful for, and is addressed primarily to: nuclear power operating organizations establishing or upgrading their NPP personnel training systems; regulatory personnel responsible for setting requirements and/or evaluating NPP personnel training; and organizations (within or outside the operating organization) responsible for the development, implementation and evaluation of training programmes for NPP personnel. Figs, tabs

9 CFR 590.560 - Health and hygiene of personnel.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Health and hygiene of personnel. 590.560 Section 590.560 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., Processing, and Facility Requirements § 590.560 Health and hygiene of personnel. (a) Personnel facilities...

Health physics personnel: a need unfulfilled

International Nuclear Information System (INIS)

Kathren, R.L.

1983-01-01

For the past decade, the demand for health physics personnel, at both the professional and technical levels, has been increasing, and indeed has become quite acute in recent years. The need for health physics personnel is demonstrated by a summary of projected requirements and potential candidates by the year 1991. Suggestions made for ensuring the availability of qualified health physics personnel includes: 1) a characterization study of health physicists should be conducted, with emphasis on industry, to determine qualifications, job satisfaction factors, and other data pertinent to entry and retention in the field; 2) the curricula currently offered by post-secondary schools should be evaluated for quality and relevance; and 3) an industry standard or protocol for qualification and training of health physics should be developed and implemented

Investigation of Shift Work Disorders among Security Personnel

OpenAIRE

Zahra Zamanian; Mansooreh Dehghani; Heidar Mohammady; Mohammadtaghi Rezaeiani; Hadi Daneshmandi

2012-01-01

In today’s advanced world resulting from the improvement of technology, societies tend to encounter a large number of problems and accidents. As we know, university’s security personnel are classified as shift workers and are exposed to health disturbing factors. The aim of this study was investigation of shiftwork disorders among security personnel of the hospitals Affiliated to Shiraz University of Medical Sciences, Central. This case-control study was conducted among 130 security personnel...

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

THE IMPORTANCE OF PERSONNEL MOTIVATION IN THE MANAGEMENT PROCESS

Directory of Open Access Journals (Sweden)

NĂSTASIE MIHAELA – ANDREEA

2015-07-01

Full Text Available General research area of this article is the motivation of personnel, essential tool in the management process, and also a component derived from human resource management. In economic activity, personnel motivation should be regarded as an internal process, not as an imperative that can be imposed from outside the economic entity. Managers of economic entities must, first, understand personnel motivation strategies, how they influence positively or negatively the internal motivations of employees. Personnel motivation by itself attracts an end, just as profitable and moral, individual and social welfare making.

25 CFR 38.12 - Leave system for education personnel.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Leave system for education personnel. 38.12 Section 38.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION EDUCATION PERSONNEL § 38.12 Leave system for education personnel. (a) Full-time school-term employees. Employees on a full-time school-term...

34 CFR 76.659 - Use of public school personnel.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Use of public school personnel. 76.659 Section 76.659... Be Met by the State and Its Subgrantees? Participation of Students Enrolled in Private Schools § 76.659 Use of public school personnel. A subgrantee may use program funds to make public personnel...

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.

Harmonious personnel scheduling

NARCIS (Netherlands)

Fijn van Draat, Laurens; Post, Gerhard F.; Veltman, Bart; Winkelhuijzen, Wessel

2006-01-01

The area of personnel scheduling is very broad. Here we focus on the ‘shift assignment problem’. Our aim is to discuss how ORTEC HARMONY handles this planning problem. In particular we go into the structure of the optimization engine in ORTEC HARMONY, which uses techniques from genetic algorithms,

Incidence, characteristics and management of pain in one operational area of medical emergency teams.

Science.gov (United States)

Kosiński, Sylweriusz; Bryja, Magdalena; Wojtaszowicz, Rafał; Górka, Andrzej

2014-01-01

Experience of pain associated with both chronic as well as acute medical conditions is a main cause for call for ambulance. The aim of this study was to establish both frequency and characteristics of pain reported by patients treated in pre-hospital environment in a single operational area. The supplementary goal was an analysis of methods of pain alleviation applied by medical personnel in the above described scenario. The written documentation of 6 months of year 2009 provided by doctor-manned as well as paramedic-only ambulances operating in Tatra county, Małopolska, Poland was analyzed. Medical personnel inquired about pain experienced in 57.4% of cases, 10-point numerical rating scale was used in 22.3% of patients. Pain was reported by 43.8% of patients, the most frequent reasons of experienced pain were trauma and cardiovascular diseases. In almost half of the cases pain was referred to the areas of chest and abdomen. Non-traumatic pain was reported by 47.7% of patients, post-traumatic in 41.3% of cases, 11% of subjects reported ischemic chest pain. 42.3% of pain-reporting patients received some form of analgesia, yet only 3% of subjects in this group received opiates. Personnel of paramedic-only ambulances tended to use pain intensity scale more often (P < 0.01), yet administered pain alleviating drugs noticeably less often than the doctor-manned teams (P < 0.01). The use of pain alleviating drugs, opiates especially, was inadequate in proportion to frequency and intensity of pain reported by patients. General, nation-wide standards of pain measurement and treatment in pre-hospital rescue are suggested as a means to improve the efficacy of pain reduction treatment.

SAPLE: Sandia Advanced Personnel Locator Engine.

Energy Technology Data Exchange (ETDEWEB)

Procopio, Michael J.

2010-04-01

We present the Sandia Advanced Personnel Locator Engine (SAPLE) web application, a directory search application for use by Sandia National Laboratories personnel. SAPLE's purpose is to return Sandia personnel 'results' as a function of user search queries, with its mission to make it easier and faster to find people at Sandia. To accomplish this, SAPLE breaks from more traditional directory application approaches by aiming to return the correct set of results while placing minimal constraints on the user's query. Two key features form the core of SAPLE: advanced search query interpretation and inexact string matching. SAPLE's query interpretation permits the user to perform compound queries when typing into a single search field; where able, SAPLE infers the type of field that the user intends to search on based on the value of the search term. SAPLE's inexact string matching feature yields a high-quality ranking of personnel search results even when there are no exact matches to the user's query. This paper explores these two key features, describing in detail the architecture and operation of SAPLE. Finally, an extensive analysis on logged search query data taken from an 11-week sample period is presented.

Return to work: Police personnel and PTSD

NARCIS (Netherlands)

Plat, Marie-Christine J.; Westerveld, Gre J.; Hutter, Renée C.; Olff, Miranda; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2013-01-01

This study i) describes the number of police personnel with PTSD who are working and those who are on sick leave before and after an out-patient-clinic treatment program and ii) examines which factors are related to return to work. Police personnel treated for PTSD (n=121). In this retrospective

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...

Personnel neutron dosimetry at Department of Energy facilities

International Nuclear Information System (INIS)

Brackenbush, L.W.; Endres, G.W.R.; Selby, J.M.; Vallario, E.J.

1980-08-01

This study assesses the state of personnel neutron dosimetry at DOE facilities. A survey of the personnel dosimetry systems in use at major DOE facilities was conducted, a literature search was made to determine recent advances in neutron dosimetry, and several dosimetry experts were interviewed. It was concluded that personnel neutron dosimeters do not meet current needs and that serious problems exist now and will increase in the future if neutron quality factors are increased and/or dose limits are lowered

Civilian Personnel: Career Management

National Research Council Canada - National Science Library

2001-01-01

This revision; (1) Contains changes required by the establishment of a consolidated and realigned management structure for civilian personnel, manpower, and related functions in the Office of the Assistant Secretary of the Army...

39 CFR 211.4 - Interim personnel regulations.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Interim personnel regulations. 211.4 Section 211.4... under the Postal Reorganization Act. (b) Continuation of Personnel Provisions of Former title 39, U.S.C... collective bargaining agreement under the Postal Reorganization Act, all provisions of former title 39, U.S.C...

49 CFR 1546.211 - Law enforcement personnel.

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Law enforcement personnel. 1546.211 Section 1546... § 1546.211 Law enforcement personnel. (a) At airports within the United States not governed by part 1542...) When using a screening system required by § 1546.101(a), (b), or (c), provide for law enforcement...

Selected references on thermoluminescent dosemeters for personnel monitoring

International Nuclear Information System (INIS)

Lawson, Helen

1976-08-01

This bibliography contains references on: specific thermoluminescent dosemeters used for personnel dosimetry; comparisons of thermoluminescent and other dosemeters for personnel monitoring and read-out apparatus for thermoluminescent dosemeters. An appendix contains selected foreign language references. (author)

Personnel radiation safety in nuclear power plants

International Nuclear Information System (INIS)

Elkert, J.

1979-05-01

The principal contributions to the radiation doses of the Swedish power reactor personnel are identified. The possi bilities to reduce these doses are examined. The radiation doses are analyzed according to different personnel categories, specific maintenance operations or inspections and to different radiation activities. Suggestions are given for reducing the radiation doses. (L.E.)

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

Personality, personnel selection, and job performance

OpenAIRE

Linden, Dimitri; Pelt, Dirk; Dunkel, Curtis; Born, Marise

2017-01-01

markdownabstractJob Performance: The term job performance can either refer to the objective or subjective outcomes one achieves in a specific job (e.g., the profit of a sales persons, the number of publications of a scientist, the number of successful operations of a surgeon) or to work-related activities (e.g., writing an article, conducting specific surgical acts). In the majority of research on this topic, job performance as an outcome is used. Personnel selection: Personnel selection refe...

TLD personnel dosimetry and its relationship with the radiodiagnostic training

International Nuclear Information System (INIS)

Gaona, E.; Franco E, J.G.; Gaona C, E.

2002-01-01

The personnel dosimetry and the training in radiological protection in radiodiagnostic in Mexico before 1997 were almost nonexistent except few services of public and private radiology, we can to say that the personnel dosimetry and the obligatory training was born in the year 1997, together with the present Mexican Official Standards in radiology. This study has the purpose to make an evaluation of the personnel dosimetry of 110 radiology services distributed in the Mexican Republic for the year 2001 and to estimate the annual and bimonthly mean doses, as well as its trust intervals and its relationships with the personnel training in radiological protection by means of a sampling that was realized in two stages (1997 and 2000) in the metropolitan area of Mexico City. The results show that the received doses by the medical and technical personnel in the participating radiology services are in the 0.03 mSv and 0.94 mSv interval and the mean is 0.25 mSv. The estimated annual personnel dose would be in the 0.18 mSv to 5.64 mSv interval, which are values very lower to the annual dose limit that is 50 mSv and its magnitude is similar to the effective annual dose by natural background radiation. In the first stage in training was found that there is not a significant difference in the response frequencies among the medical and technical personnel with a p < 0.05. The 52% of the occupational exposure personnel of radiology uses dosemeter, but only 17% of them know the dose reports. the 15.8% of personnel considers that dosemeter protects against radiation and only 16.5% knows the annual maximum permissible dose for stochastic effects. The second stage, the results shown that there is a significant difference in the response of frequencies among medical and technical personnel, the same results which are obtained for members and non members of a professional association with a p < 0.05. The 38% has personnel dosimetry, the 19% knows the principles of radiological

DoD Nuclear Weapons Personnel Reliability Assurance

Science.gov (United States)

2016-04-27

systems, positive control material (PCM) and equipment, and special nuclear material (SNM) and subject to a nuclear weapons personnel reliability...assurance implementation guidance for consistency and compliance with this issuance. c. Conducts programmatic reviews, manages audits , and directs...personnel reliability assurance education and training materials . 2.4. ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS (ASD(HA)). Under the authority

A relational database for personnel radiation exposure management

International Nuclear Information System (INIS)

David, W.; Miller, P.D.

1993-01-01

In-house utility personnel developed a relational data base for personnel radiation exposure management computer system during a 2 1/2 year period. The (PREM) Personnel Radiation Exposure Management System was designed to meet current Nuclear Regulatory Commission (NRC) requirements related to radiological access control, Radiation Work Permits (RWP) management, automated personnel dosimetry reporting, ALARA planning and repetitive job history dose archiving. The system has been operational for the past 18 months which includes a full refueling outage at Clinton Power Station. The Radiation Protection Department designed PREM to establish a software platform for implementing future revisions to 10CFR20 in 1993. Workers acceptance of the system has been excellent. Regulatory officials have given the system high marks as a radiological tool because of the system's ability to track the entire job from start to finish

The LHC personnel safety system

International Nuclear Information System (INIS)

Ninin, P.; Valentini, F.; Ladzinski, T.

2011-01-01

Large particle physics installations such as the CERN Large Hadron Collider require specific Personnel Safety Systems (PSS) to protect the personnel against the radiological and industrial hazards. In order to fulfill the French regulation in matter of nuclear installations, the principles of IEC 61508 and IEC 61513 standard are used as a methodology framework to evaluate the criticality of the installation, to design and to implement the PSS.The LHC PSS deals with the implementation of all physical barriers, access controls and interlock devices around the 27 km of underground tunnel, service zones and experimental caverns of the LHC. The system shall guarantee the absence of personnel in the LHC controlled areas during the machine operations and, on the other hand, ensure the automatic accelerator shutdown in case of any safety condition violation, such as an intrusion during beam circulation. The LHC PSS has been conceived as two separate and independent systems: the LHC Access Control System (LACS) and the LHC Access Safety System (LASS). The LACS, using off the shelf technologies, realizes all physical barriers and regulates all accesses to the underground areas by identifying users and checking their authorizations.The LASS has been designed according to the principles of the IEC 61508 and 61513 standards, starting from a risk analysis conducted on the LHC facility equipped with a standard access control system. It consists in a set of safety functions realized by a dedicated fail-safe and redundant hardware guaranteed to be of SIL3 class. The integration of various technologies combining electronics, sensors, video and operational procedures adopted to establish an efficient personnel safety system for the CERN LHC accelerator is presented in this paper. (authors)

Training of personnel

International Nuclear Information System (INIS)

1997-01-01

Selected staffs (in the area of NPPs) are examined by the State Examining Committee established by Nuclear Regulatory Authority of the Slovak Republic (NRA SR's) chairman. The committee consists of representatives of NRA SR , Bohunice NPPs, Mochovce NPP, Research Institute of Nuclear Energy and experts from the Faculty of Electrical Engineering and Information Technology of the Slovak Technical University. The review of selected personnel of NPP V-1, V-2 and Mochovce NPP which passed exams in 1996 is given. NRA SR paid attention to the upgrading training process of individual categories of staff for V-1, V-2 and Mochovce NPPs, simulator training and training with computerized simulation system according to the United criteria of nuclear installation personnel training that started in 1992. During the year, an inspection was performed focused on examination of technical equipment of the simulator of Mochovce NPP, professional eligibility and overall preparation of simulator training including simulator software. Throughout the year launching works continued at the simulator with the deadline of commissioning to trial use operation in the first half of 1997

Personnel exposures in industrial radiography

International Nuclear Information System (INIS)

Shenoy, K.S.; Patel, P.H.

1979-01-01

The manifold increase in production, and ease of availability of radioisotopes in India have been responsible for a tremendous increase in use of radioisotopes in industrial radiography during past fifteen years. Among various applications of radioisotopes the industrial radiography involves a large potential risk of occupational radiation exposures. The dose records of past fifteen years in respect of all radiation workers maintained by the Personnel Monitoring Group of Division of Radiological Protection of the Bhabha Atomic Research Centre, Bombay, have been analysed. Analysis of excessive exposure (exceeding 400 mrem/fortnight) reveals that this figure is increasing at an alarming rate among the radiation workers of this category. In spite of various regulatory controls the dose per person per week has remained higher as compared to the same in other categories. This combined with the increase in number of radiation workers every year would soon contribute significantly to the per capita dose for radiation workers. Use of adequately shielded fool-proof remote control equipment and training of all personnel in safe handling of radiation sources seem to be the only solution to arrest the rate of increase in personnel exposures of this category. (auth.)

Personnel economics: A research field comes of age

DEFF Research Database (Denmark)

Grund, Christian; Bryson, Alex; Dur, Robert

2017-01-01

The application of economic theory and principles to firms’ human resource problems is commonplace today. Personnel economics has come a long way since its early days in the late 1970s and 1980s, when scholars developed its theoretical foundations. In this contribution and introduction...... to the Special Issue ‘Advances in personnel economics’ of the German Journal of Human Resource Management, we would like to illustrate the origins of the field, outline how personnel economics relates to other research areas, describe major developments in the field and address its future challenges....

Personnel radiation monitoring by thermoluminescence dosimetry (2000-2001)

International Nuclear Information System (INIS)

Mi-Cho-Cho, Daw; Hla-Hla-Win, Daw; Thin-Thin-Kraing

2001-01-01

Thermoluminescence dosimetry service was introduced in 1991. Personnel who exposed directly or indirectly to radiation is monitored by thermoluminescent dosimeter. TL materials used for thermoluminescent dosimeter are in the form of thin disc. Personnel whole-body and extremity doses are measured by thermoluminescence dosimetry. The Harshaw Model 4500 TLD reader and Vinten 654E TLD reader are used for TLD evaluation. At present about 600 radiation workers are provided with TLD for routine monitoring. It was found that most personnel had received within permissible dose recommended by the International Commission on Radiological Protection (ICRP). (author)

Stress, Sleep and Depressive Symptoms in Active Duty Military Personnel.

Science.gov (United States)

Chou, Han-Wei; Tzeng, Wen-Chii; Chou, Yu-Ching; Yeh, Hui-Wen; Chang, Hsin-An; Kao, Yu-Chen; Huang, San-Yuan; Yeh, Chin-Bin; Chiang, Wei-Shan; Tzeng, Nian-Sheng

2016-08-01

The military is a unique occupational group and, because of this, military personnel face different kinds of stress than civilian populations. Sleep problems are an example. The purpose of this study was to investigate the relationship between sleep problems, depression level and coping strategies among military personnel. In this cross-sectional study, military personnel completed the Beck Depression Inventory, the Pittsburgh Sleep Quality Index and the Jalowiec Coping Scale. An evaluation of the test scores showed that officers had better sleep quality and fewer depressive symptoms than enlisted personnel. Military personnel with higher educational levels and less physical illness also had fewer depressive symptoms. Officers and noncommissioned officers preferred problem-focused strategies. Those with higher Beck Depression Inventory and Pittsburgh Sleep Quality Index scores and those who drank alcohol frequently preferred affective-focused strategies. Our results revealed that sleep quality, physical illness and alcohol consumption were associated with the mental health of military personnel. Treating these factors may improve the mental health of military personnel and enhance effective coping strategies. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Personnel Risks in Ensuring Safety of Medical Activity

Directory of Open Access Journals (Sweden)

O. L. Zadvornaya

2017-01-01

Full Text Available Purpose: modern strategies of management of the organization require the formation of special management approaches based on the analysis of the mechanisms and processes of the organization of medical activities related to possible risks in activity of medical personnel. Based on international experience and own research the authors have identified features of a system of management of personnel risk in medical activities, examined approaches showing the sequence and contents of the main practical activities of the formation, maintenance and development of the system of management of personnel risks. Emphasized is the need for further research and implementation of the system of management of personnel risk in health care organizations. Study and assessment of personnel risks affecting the security of medical activities aimed at the development of the system of personnel risk management, development of a system of identification and monitoring of HR risk indicators with a purpose to improve institutional management and increase efficiency of activity of medical organizations. Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews, comparative analysis, method of expert evaluations, method of statistical processing of information. Results: approaches to predict the occurrence and development of personnel risks have been reviewed and proposed. Conclusions and Relevance: patient safety is a global issue affecting countries at all levels of development. Each year, the WHO identifies a number of systemic and technical aspects and trends in the field of patient safety related to actions of medical workers. Existing imbalances in the staffing of the health system of the Russian Federation increase the probability of potential risks in medical practice. The personnel policy of healthcare of the Russian Federation requires further improvement and

Modernization of personnel training

International Nuclear Information System (INIS)

Haferburg, M.; Rehn, H.

1997-01-01

Personnel training in German nuclear power plants adheres to high standards complying with government regulations. The development of PC technology allows the introduction of new training methods, e.g. computer based training (CBT), as well as their integration into existing systems. In Germany, the operators of nuclear power plants have developed their own computer based standards with a screen design, a hardware platform and an assessment standard. 25% of the theoretical training of the shift personnel is covered by CBT. The CBT-Programmes offer multimedia features: videos, photographs, sound, graphs and switching diagrams of existing systems, practice oriented simulations and 3-D animations. Interaction is the most important attribute of an efficient self-learning-programme. A typical example of such an appropriate theme is the CBT-Lesson ''Pressure Surges in Pipes and Components of Power Plants''. (author)

Attention and Related Factors in Tehran Night Shift Prehospital Emergency Personnel

Directory of Open Access Journals (Sweden)

Abbasali Ebrahimian

2015-10-01

Full Text Available Background:  Emergency  medical  services  (EMS  staff  can  play  an  important  role  in  the survival and prevention of serious injuries to patients if they are in good physical and mental health and focus on doing their jobs with sufficient attention. Therefore, a study was conducted to  investigate  attention  level  and  its  related  factors  in  night  shift  prehospital  emergency personnel. Materials and Methods: This research is a descriptive-analytic study. A total of 114 Tehran prehospital emergency staff participated in this study. Pen and paper Bonnardel test and a questionnaire was used to collect information. The attention of the participants was assessed around 10-11 PM and 4-5 AM. The data were analyzed by using the Spearman correlation coefficient and independent t test. Results:  Mean  attention  level  of  EMS  staff  was  0.490±0.237  around  10-11  PM  and 0.456±0.252  around 4-5 AM. There  was  no  statistically  significant  difference  between  the attention level of prehospital emergency staff around 10-11 PM and 4-5 AM (P˃0.01. Also, there was significant difference between age and the night attention (P<0.01. Conclusion: The mean level of night attention of EMS staff was moderate. Therefore, based on the average number of daily missions in different bases, we recommend increasing the number of ambulances in the base or the number of bases in the crowded emergency areas. It is also necessary to increase welfare and nutritional facilities in prehospital emergency bases so that those who are older and experienced carry out fewer missions.

A system for measuring and processing personnel dosimetric data

International Nuclear Information System (INIS)

Neetzel, C.R.; Rochetti, Luis

1981-01-01

An operative system for the measurement and on-line processing of personnel dosimetry data is described. The aim is to organize and rationalize the work involved in a personnel dosimetry service. The method considers the application to other areas of radiation protection, as well as the connection and exchange of files among the different personnel monitoring groups. The system can be interfaced with different computers (M.E.L.) [es

Systematic approach to personnel neutron monitoring

International Nuclear Information System (INIS)

Griffith, R.V.; Hankins, D.E.

1980-01-01

NTA film and albedo detectors represent the major portion of personnel dosimeters now used for occupational neutron monitoring. However, recent attention to the spectral response of these systems has demonstrated the need for detectors that have a better match to the fields being monitored. Recent developments in direct recoil track etch dosimeters present some intriguing alternatives, and careful use of 237 Np fission fragment detectors offers the advantage of a good dose equivalent spectral match. Work continues on a number of other new detector mechanisms, but problems with sensitivity, energy response, gamma interference, etc., continue to prevent development of most mechanisms into viable personnel dosimeters. Current dosimeter limitations make a systematic approach to personnel neutron monitoring particularly important. Techniques have been developed and tested, using available portable survey instruments, that significantly improve the quality of dosimeter interpretation. Even simple spectrometry can be done with modest effort, significantly improving the health physicists ability to provide accurate neutron monitoring

Assessing the Personal Financial Problems of Junior Enlisted Personnel

National Research Council Canada - National Science Library

Buddin, Richard

2002-01-01

.... Surveys of military personnel show that, particularly for junior personnel, financial problems constitute a major source of stress, subordinate only to increased workload and family separation...

21 CFR 111.105 - What must quality control personnel do?

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What must quality control personnel do? 111.105..., LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Production and Process Control System: Requirements for Quality Control § 111.105 What must quality control personnel do? Quality control personnel must...

A Global Perspective of Vaccination of Healthcare Personnel against Measles: Systematic Review

Science.gov (United States)

Fiebelkorn, Amy Parker; Seward, Jane F.; Orenstein, Walter

2015-01-01

Measles transmission has been well documented in healthcare facilities. Healthcare personnel who are unvaccinated and who lack other evidence of measles immunity put themselves and their patients at risk for measles. We conducted a systematic literature review of measles vaccination policies and their implementation in healthcare personnel, measles seroprevalence among healthcare personnel, measles transmission and disease burden in healthcare settings, and impact/costs incurred by healthcare facilities for healthcare-associated measles transmission. Five database searches yielded 135 relevant articles; 47 additional articles were found through cross-referencing. The risk of acquiring measles is estimated to be 2 to 19 times higher for susceptible healthcare personnel than for the general population. Fifty-three articles published worldwide during 1989–2013 reported measles transmission from patients to healthcare personnel; many of the healthcare personnel were unvaccinated or had unknown vaccination status. Eighteen articles published worldwide during 1982–2013 described examples of transmission from healthcare personnel to patients or to other healthcare personnel. Half of European countries have no measles vaccine policies for healthcare personnel. There is no global policy recommendation for the vaccination of healthcare personnel against measles. Even in countries such as the United States or Finland that have national policies, the recommendations are not uniformly implemented in healthcare facilities. Measles serosusceptibility in healthcare personnel varied widely across studies (median 6.5%, range 0%-46%) but was consistently higher among younger healthcare personnel. Deficiencies in documentation of two doses of measles vaccination or other evidence of immunity among healthcare personnel presents challenges in responding to measles exposures in healthcare settings. Evaluating and containing exposures and outbreaks in healthcare settings can be

Experience with training of operating and maintenance personnel of nuclear power plants

International Nuclear Information System (INIS)

Pospisil, M.; Cencinger, F.

1988-01-01

The system is described of the specialist training of personnel for Czechoslovak nuclear power plants. Training consists of basic training, vocational training and training for the respective job. Responsible for the training is the Research Institute for Nuclear Power Plants; actual training takes place at three training centres. Personnel are divided into seven categories for training purposes: senior technical and economic staff, shift leaders, whose work has immediate effect on nuclear safety, engineering and technical personnel of technical units, shift leaders of technical units, personnel in technical units, shift service personnel and operating personnel, maintenance workers. Experience with training courses run at the training centre is summed up. Since 1980 the Centre has been training personnel mainly for the Dukovany nuclear power plant. Recommendations are presented for training personnel for the Temelin nuclear power plant. (Z.M.)

Personnel photographic film dosimetry

International Nuclear Information System (INIS)

Keirim-Markus, I.B.

1981-01-01

Technology of personnel photographic film dosimetry (PPD) based on the photographic effect of ionizing radiation is described briefly. Kinds of roentgen films used in PPD method are enumerated, compositions of a developer and fixing agents for these films are given [ru

Nuclear Test Personnel Review

Science.gov (United States)

FOIA Electronic Reading Room Privacy Impact Assessment DTRA No Fear Act Reporting Nuclear Test Personnel Review NTPR Fact Sheets NTPR Radiation Dose Assessment Documents US Atmospheric Nuclear Test History Documents US Underground Nuclear Test History Reports NTPR Radiation Exposure Reports Enewetak

Critical Uses of College Resources. Part I: Personnel Utilization System.

Science.gov (United States)

Vlahos, Mantha

A Personnel Utilization System has been designed at Broward Community College, which combines payroll, personnel, course, and function information in order to determine the actual duties performed by personnel for the amount of remuneration received. Objectives of the system are (1) to define the tasks being performed by faculty, staff, and…

The Patient Safety Attitudes among the Operating Room Personnel

Directory of Open Access Journals (Sweden)

Cherdsak Iramaneerat

2016-07-01

Full Text Available Background: The first step in cultivating the culture of safety in the operating room is the assessment of safety culture among operating room personnel. Objective: To assess the patient safety culture of operating room personnel at the Department of Surgery, Faculty of Medicine Siriraj Hospital, and compare attitudes among different groups of personnel, and compare them with the international standards. Methods: We conducted a cross-sectional survey of safety attitudes among 396 operating room personnel, using a short form of the Safety Attitudes Questionnaire (SAQ. The SAQ employed 30 items to assess safety culture in six dimensions: teamwork climate, safety climate, stress recognition, perception of hospital management, working conditions, and job satisfaction. The subscore of each dimension was calculated and converted to a scale score with a full score of 100, where higher scores indicated better safety attitudes. Results: The response rate was 66.4%. The overall safety culture score of the operating room personnel was 65.02, higher than an international average (61.80. Operating room personnel at Siriraj Hospital had safety attitudes in teamwork climate, safety climate, and stress recognition lower than the international average, but had safety attitudes in the perception of hospital management, working conditions, and job satisfaction higher than the international average. Conclusion: The safety culture attitudes of operating room personnel at the Department of Surgery, Siriraj Hospital were comparable to international standards. The safety dimensions that Siriraj Hospital operating room should try to improve were teamwork climate, safety climate, and stress recognition.

School Personnel Responses to Children Exposed to Violence

Science.gov (United States)

Kenemore, Thomas; Lynch, John; Mann, Kimberly; Steinhaus, Patricia; Thompson, Theodore

2010-01-01

Authors explored the experiences of school personnel in their responses to children's exposure to violence. Thirty-one school personnel, including administrators, teachers, counselors, school social workers, and psychologists, were interviewed to obtain data on their experiences related to violence exposure in their schools and the surrounding…

Risks and health effects in operating room personnel

NARCIS (Netherlands)

van den Berg-Dijkmeijer, Marleen L.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2011-01-01

The objective was to find the factors that pose a possible health risk to OR personnel. Work-related health problems of operating room (OR) personnel were signalled by an occupational physician and preparations for the development of new Worker's Health Surveillance (WHS) were started with a

Energy response study of modified CR-39 neutron personnel dosimeter

International Nuclear Information System (INIS)

Sathian, Deepa; Bakshi, A.K.; Datta, D.; Nair, Sreejith S.; Sathian, V.; Mishra, Jitendra; Sen, Meghnath

2018-01-01

Personnel neutron dosimetry is an integral part of radiation protection. No single dosimeter provides the satisfactory energy response, sensitivity, angular dependence characteristics and accuracy necessary to meet the requirement of an ideal personnel neutron dosimeter. The response of a personnel neutron dosimeter is critically dependent upon the energy distribution of the neutron field. CR-39 personnel neutron dosimeters were typically calibrated in the standard neutron field of 252 Cf and 241 Am-Be in our laboratory, although actual neutron fields may vary from the calibration neutron spectrum. Recently the badge cassette of the personnel neutron dosimeter was changed due to frequent damage of the PVC badge used earlier. This paper discusses energy response of CR-39 solid state nuclear track detector loaded in this modified badge cassette as per latest ISO recommendation

Personnel monitoring system by thermoluminescence dosimeter - a study and review

International Nuclear Information System (INIS)

Iyer, V.S.; Alok, M.; Chandel, B.S.

2018-01-01

The principle objective of personnel monitoring system is to prevent overexposure and avoid unnecessary exposure of personnel working with various sources of radiation. The adequate system of personnel monitoring must provide for the measurement. evaluation and recording of significant doses accumulated by individuals together with a recording of conditions under which these doses are received

Role of the State Office for Nuclear Safety in testing special professional competence of selected personnel of nuclear facilities and selected personnel handling ionizing radiation sources

International Nuclear Information System (INIS)

Kovar, P.

2003-01-01

The laws and regulations governing the title topic are identified. The following terms are defined and their context highlighted: professional competence; special professional competence; selected personnel; requirements for selected personnel; requirements for selected personnel training; examination boards; and licensing procedure. (P.A.)

Detection of Early lung Cancer Among Military Personnel (DECAMP)

Science.gov (United States)

2017-10-01

Award Number: W81XWH-11-2-0161 TITLE: Detection of Early lung Cancer Among Military Personnel (DECAMP) PRINCIPAL INVESTIGATOR: Avrum E. Spira...W81XWH-11-2-0161 Detection of Early lung Cancer Among Military Personnel (DECAMP) 5b. GRANT NUMBER W81XWH-11-2-0161 5c. PROGRAM ELEMENT NUMBER 6...biomarkers found in blood, tissues, or other bodily fluids, which may be used for the early detection of lung cancer among military personnel and

The training of the operation personnel

International Nuclear Information System (INIS)

Martin, H.D.

1975-01-01

A survey about training places and the volume of the training program for reactor personnel in the Federal Republic of Germany is given. Paragraph 7 of the atomic energy act, which imposes on the operators of nuclear energy plants the qualifired training of the personnel, is refered to. Positive experiences with the use of simulation equipment for training have led to the planning of a simulator-centre which is expected to be ready for operation in 1977. The versatile program of this centre is briefly reported. (ORU) [de

Automating the personnel dosimeter monitoring program

International Nuclear Information System (INIS)

Compston, M.W.

1982-12-01

The personnel dosimetry monitoring program at the Portsmouth uranium enrichment facility has been improved by using thermoluminescent dosimetry to monitor for ionizing radiation exposure, and by automating most of the operations and all of the associated information handling. A thermoluminescent dosimeter (TLD) card, worn by personnel inside security badges, stores the energy of ionizing radiation. The dosimeters are changed-out periodically and are loaded 150 cards at a time into an automated reader-processor. The resulting data is recorded and filed into a useful form by computer programming developed for this purpose

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.

Pulmonary function test in traffic police personnel in Pondicherry.

Science.gov (United States)

Pal, Pravati; John, Robert A; Dutta, T K; Pal, G K

2010-01-01

Traffic policemen working in the busy traffic signal areas get exposed to the vehicular emissions for years together. The fumes, chemicals and particles present in the emission are reported to be damaging to the lung functions of these individuals. Since there were no data available on the PFT parameters of traffic police personnel of Pondicherry, this study was taken up to assess the effect of traffic air pollution on their pulmonary functions. PFT parameters were recorded in age- and BMI-matched 30 traffic police personnel (study group) and 30 general police personnel (control group) of male gender. As chronic smoking is known to be a critical factor in altering lung function, PFT parameters were compared between the smokers as well as nonsmokers of both the groups. In nonsmokers, there was significant decrease in VC (P traffic police personnel compared to the general police personnel. This may be due to exposure to vehicular pollution for several hours in a day for many years causing decreased functional capacity of the lungs and chronic smoking worsens the condition.

Personnel training at EDF's nuclear and fossil generation division and its application for the personnel of a nuclear power station abroad

International Nuclear Information System (INIS)

Rabouhams, J.

1991-01-01

Safety in nuclear power stations relies so much upon human competence that the training of the personnel has to respond to the basic need of having personnel who are competent in their job permanently available. EDF has designed, organized and managed a large volume of training in order to provide its personnel involved in the operation of nuclear power station with initial training, training, retraining and improvement within the framework of quality organization. To deal with this training in the most efficient way EDF has developed various training aids ranging from booklets to fullscope simulator or fullscope mockups which are continually updated. All EDF experience has been used to train Daya Bay nuclear power plant personnel who have been monitored throughout the training programmes. Adequate safety conduct and attitudes including the socio-cultural background have been developed during the training. The principle teaching method was shadow training in other words the transfer in situ of knowledge, know how, and conduct from an experienced engineer. (author)

Personnel Audit Using a Forensic Mining Technique

OpenAIRE

Adesesan B. Adeyemo; Oluwafemi Oriola

2010-01-01

This paper applies forensic data mining to determine the true status of employees and thereafter provide useful evidences for proper administration of administrative rules in a Typical Nigerian Teaching Service. The conventional technique of personnel audit was studied and a new technique for personnel audit was modeled using Artificial Neural Networks and Decision Tree algorithms. Atwo-layer classifier architecture was modeled. The outcome of the experiment proved that Radial Basis Function ...

Personnel radiation dosimetry laboratory accreditation programme for thermoluminescent dosimeters : a proposal

International Nuclear Information System (INIS)

Bhatt, B.C.; Srivastava, J.K.; Iyer, P.S.; Venkatraman, G.

1993-01-01

Accreditation for thermoluminescent dosimeters is the process of evaluating a programme intending to use TL personnel dosimeters to measure, report and record dose equivalents received by radiation workers. In order to test the technical competence for conducting personnel dosimetry service as well as to decentralize personnel monitoring service, it has been proposed by Radiological Physics Division (RPhD) to accredit some of the laboratories, in the country. The objectives of this accreditation programme are: (i) to give recognition to competent dosimetry processors, and (ii) to provide periodic evaluation of dosimetry processors, including review of internal quality assurance programme to improve the quality of personnel dosimetry processing. The scientific support for the accreditation programme will be provided by the scientific staff from Radiological Physics Division (RPhD) and Radiation Protection Services Division (RPSD). This paper describes operational and technical requirements for the Personnel Radiation Dosimetry Laboratory Accreditation Programme for Thermoluminescent Dosimeters for Personnel Dosimetry Processors. Besides, many technical documents dealing with the TL Personnel Dosimeter System have been prepared. (author). 5 refs., 2 figs

Nuclear power plant personnel training process management system

International Nuclear Information System (INIS)

Arjona Vazquez, Orison; Venegas Bernal, Maria del Carmen; Armeteros Lopez, Ana L.

1996-01-01

The system in charge the management of the training process personnel from a nuclear power plant was designed taking into account all the requirements stated in the training guide for nuclear power plant personnel and their evaluation, which were prepared by the IAEA in 1995 in order to implement the SAT in the training programs for nuclear plant personnel. In the preparations of formats and elements that shape the system, account has been taken of the views expressed in such a guide, in some other bibliography that was consulted, and in the authors own opinion mainly with regard to those issues which the guide does not go deeper into

The Personnel Function Today--Trends for the Future.

Science.gov (United States)

Cox, Arne

The personnel function in industrial society has been marked by crisis, reappraisals, struggles for power, and guilty conscience. The profession is again under pressure; company management often questions its contribution to the solution of strategic personnel matters, while employees and their unions question its values, and wish to place its…

21 CFR 1314.35 - Training of sales personnel.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Training of sales personnel. 1314.35 Section 1314.35 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Sales by Regulated Sellers § 1314.35 Training of sales personnel. Each regulated...

HEALTH BEHAVIOURS OF THE PERSONNEL OF PRIMARY SCHOOLS IN ANKARA

Directory of Open Access Journals (Sweden)

Serife AK

2006-04-01

Full Text Available The main purpose of study is to define the health behaviour profile of the personnel of primary schools as well as to define the topics to be given priority in health education activities. The research population consisted of all personnel of 564 primary schools in Ankara province. The study group (30 schools was estimated by cluster sampling method. The Health Behaviours Questionnaire, which consists of 47 items on health behaviours and demographic characteristics, was used for data collection. In the study, 849 school workers (67,5% female were interviewed. Teachers constituted the largest group (82,3% while the cleaning staff (7.0%, school administrators (6.3%, and other personnel (4.4% were sharing the rest in small proportions. Of the study group 41,7 % are cigarette smokers and of them 67.3% smoke every time and 11,9% sometime in school. Very few school personnel (14,8% do physical exercise regularly. Majority of school personnel (71,3% stated that they brush their teeth at least twice a day regularly. However, only 23,7% of school personnel go to have regular dental control. All results were discussed in details considering the effects of health behaviours of school personnel on students, and some recommendations were developed for health education activities in schools. [TAF Prev Med Bull 2006; 5(2.000: 83-93

TO ALL MEMBERS OF THE PERSONNEL

CERN Multimedia

2003-01-01

Temporary work for children of members of the personnel During the period mid-June to mid-September 2003, there will be a limited number of vacancies for temporary work at CERN (normally unskilled work of routine nature) which will be made available to children of members of the personnel (i.e. anyone holding an employment or association contract with CERN). It should be noted that candidates must be aged between 18 and 24 inclusive on the first day of the contract, and that they must have insurance cover for both illness and accident. In view of the limited number of vacancies available, no children previously appointed at CERN under this scheme can be considered. The duration of all appointments will be 4 weeks, the allowance being CHF 1582.- for this period. Application form can be obtained from Martine PLAZA, HR Division (by using the slip in the bulletin or by electronic mail to Martine.Plaza@cern.ch) or at http://cern.ch/hr-web/internal/general/HN-personnel/ Completed application forms must be returne...

TO ALL MEMBERS OF THE PERSONNEL

CERN Multimedia

2003-01-01

Temporary work for children of members of the personnel During the period mid-June to mid-September 2003, there will be a limited number of vacancies for temporary work at CERN (normally unskilled work of routine nature) which will be made available to children of members of the personnel (i.e. anyone holding an employment or association contract with CERN). It should be noted that candidates must be aged between 18 and 24 inclusive on the first day of the contract, and that they must have insurance cover for both illness and accident. In view of the limited number of vacancies available, no children previously appointed at CERN under this scheme can be considered. The duration of all appointments will be 4 weeks, the allowance being CHF 1582.- for this period. Application form can be obtained from Martine PLAZA, HR Division (by electronic mail to Martine.Plaza@cern.ch) or at http://cern.ch/hr-web/internal/general/HN-personnel/ Completed application forms must be returned to this service by 2 May 2003 at th...

TO ALL MEMBERS OF THE PERSONNEL

CERN Multimedia

2003-01-01

Temporary work for children of members of the personnel During the period mid-June to mid-September 2003, there will be a limited number of vacancies for temporary work at CERN (normally unskilled work of routine nature) which will be made available to children of members of the personnel (i.e. anyone holding an employment or association contract with CERN). It should be noted that candidates must be aged between 18 and 24 inclusive on the first day of the contract, and that they must have insurance cover for both illness and accident. In view of the limited number of vacancies available, no children previously appointed at CERN under this scheme can be considered. The duration of all appointments will be 4 weeks, the allowance being CHF 1582.- for this period. Application form can be obtained from Martine PLAZA, HR Division (by electronic mail to Martine.Plaza@cern.ch) or at http://cern.ch/hr-web/internal/general/HN-personnel/ Completed application forms must be returned to this service by 2 May 2003 at t...

To all members of the personnel

CERN Multimedia

2005-01-01

Temporary work for children of members of the personnel During the period mid-June to mid-September 2005, a limited number of vacancies for temporary work at CERN (normally unskilled work of a routine nature) will be available to children of members of the personnel (i.e. anyone holding an employment or association contract with CERN). It should be noted that candidates must be aged between 18 and 24 inclusive on the first day of the contract, and that they must have insurance cover for both illness and accident. In view of the limited number of vacancies available, no children having previously worked at CERN under this scheme can be considered. The duration of all appointments will be 4 weeks and the allowance for the period will be CHF 1621.- net. Candidates should apply via the HR Department's electronic recruitment system (E-rt) : http://humanresources.web.cern.ch/humanresources/internal/personnel/pmd/cr/Staff-kids-05.pdf Completed application forms must be returned to this Service by 8 April 2005 ...

Annual individual doses for personnel dealing with ionizing radiation sources

International Nuclear Information System (INIS)

Poplavskij, K.K.

1982-01-01

Data on annual individual doses for personnel of national economy enterprises, research institutes, high schools, medical establishments dealing with ionizing radiation sources are presented. It is shown that radiation dose for the personnel constitutes only shares of standards established by sanitary legislation. Numeral values of individual doses of the personnel are determined by the type, character and scope of using ionizing radiation sources

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.

Licensing requirements regarding the qualification of operating personnel in nuclear power plants

International Nuclear Information System (INIS)

Fechner, J.B.

1981-01-01

The legal requirements regarding the qualifications of operating personnel in nuclear power plants in the Federal Republic of Germany are outlined as in article 7 of the Atomic Energy Act. For the responsible operating personnel the requisite competence and reliability are legally required; for subordinate personnel the law requires only the necessary knowledge. The requisite competence and the necessary knowledge have been further specified in a set of guidelines by the authorities; work on specification of reliability requirements is under way. Essential elements of the requisite competence of responsible operating personnel are their professional qualification, their safety-related knowledge, their abilities, their practical experience, and - for the responsible shift personnel - their nuclear, plant-related training as well as a written and oral examination. Requalification is indispensible for keeping the requisite competence on a level in accordance with the current state of science and technology. Facts concerning the personal reliability of the responsible operating personnel are assessed by the competent authorities on the basis of information available at other state institutions. For the responsible shift personnel, physical and psychological fitness are important factors contributing to their reliability. The necessary knowledge subordinate operating personnel must possess with respect to plant safety and safety of the personnel is assured via instruction on safety and via special briefings at the working place. Lack of safety-related knowledge has to be compensated for by assigning an experienced permanent supervisor for each activity in question. Current work on qualification of operating personnel concentrates on training, including simulator training, of responsible shift personnel. (author)

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.

Personnel Recruitment and Retention Strategies in Lagos State Civil ...

African Journals Online (AJOL)

Personnel Recruitment and Retention Strategies in Lagos State Civil Service of Nigeria. ... The results show that the strategy for personnel recruitment into the CS is based on mixtures of merit and political ... AJOL African Journals Online.

Personnel monitoring of radiations with thermoluminescent dosemeters

International Nuclear Information System (INIS)

Miano, S.C.

1987-01-01

The basics of personnel dosimetry technics, used by the Radiologic Protetion and Assessorie Service (SAPRA) are presented, consisting on use of thermoluminescent and CaSO 4 :Dy monitors in aggregated pellets by Teflon. The characteristics of this dosemeters, relating to the sensitivity, energetic dependence, spike temperature, characteristic emission curve, decay and light effect are shown. The thermoluminescent dosemeter measure system and the personnel monitoring system are also described. (C.G.C.) [pt

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.

[Trends and perspectives in health personnel research in the Americas].

Science.gov (United States)

Nogueira, R P

1985-01-01

It is paradoxical that the lion's share (60 to 80%) of the health budgets of the countries is invested in meeting the personnel costs of the system, and yet few studies have been done to assess the production of that personnel. The importance of personnel as a basic constituent of the sector and its presence at all levels of medical care (from physicians to auxiliaries) makes it vitally important to know how it has evolved over time so that trends can be anticipated and policies guided accordingly. This work seeks to fill, at least partly, the information gap on this subject. The method by which the author has chosen to make this evaluation is to examine the published literature on health personnel, inasmuch as the situation is reflected in articles and documents on the subject. He therefore examined the general trends observed in the following specific areas: increase of personnel and medical schools, the upsurge in the international migration of physicians, changes in the pace of personnel production, emphasis on the integration of services and education, etc. After a detailed analysis of the articles in Educación médica y salud and the Index Medicus Latinoamericano classified by subjects, the author concludes that, although much has been written on health personnel, little in-depth research has been done in primary data sources, and what is done is predominantly surveys. Besides, this research is concerned essentially with the curriculum and organization of university instruction, and betrays a great concern with coverage extension and primary care and with the training and use of auxiliary personnel, planning, and continuing education.

Office of Personnel Management (OPM)

Data.gov (United States)

Social Security Administration — The purpose of this agreement is for SSA to verify SSN information for the Office of Personnel Management. OPM will use the SSN verifications in its investigative...

Evaluation of a real-time personnel and material tracking system

International Nuclear Information System (INIS)

Trujillo, A.A.; Hoover, C.E.; Garcia, B.A.

1988-01-01

Past experience in addressing the insider threat has led to the development of general principles for mitigating the insider threat while minimizing adverse impacts on site operations. Among the general principles developed was the requirement of a real-time personnel and material tracking system. A real-time system for personnel and material tracking will aid in mitigating the insider threat by providing critical information regarding the movement and location of personnel and material. In addition, this system can provide an early detection mechanism for potential insider actions. A system integrating Radio Frequency (RF) transmitters for real-time personnel and material tracking has been developed. This system was installed and tested in an operational environment. This test was intended to demonstrate the system's ability to successfully control access to material and areas by personnel, as well as providing information regarding the status of materials in transit and storage

Personnel management and job satisfaction in academic libraries: a ...

African Journals Online (AJOL)

Personnel management and job satisfaction in academic libraries: a case study of ... the level of staff development, identify the motivational factors of the library personnel, ... Questionnaire was used for this research as the main data collection ...

Proficiency evaluation of maintenance personnel: Training equivalency determination

International Nuclear Information System (INIS)

Price, W.J.

1991-01-01

The nuclear industry has recognized the importance of safe, quality, productive maintenance practices and has taken a number of initiatives that have generally improved maintenance programs. Because proficient maintenance practices are critical to plant safety and reliability, most plants have also recognized the need for reliable, valid testing techniques that demonstrate and assure the competence of their maintenance personnel. Until now, resource demands were too great to develop in-plant testing programs. In the past, maintenance supervisors have exempted personnel from training, using informal judgment of the employees' previous training and experience and informal observation of the employee on the job. While this procedure may have some degree of validity, it fails to provide the documentation for training equivalency that is required to satisfy the US Nuclear Regulatory Commission (NRC) regulations and Institute of Nuclear Power Operations (INPO) guidelines. To assess and demonstrate the proficiency levels of personnel, Calvert Cliffs needed to establish an objective, reliable, time-saving, and valid system to evaluate the competency levels of personnel. This was done in a joint effort with the Electric Power Research Institute

Nuclear power plant personnel training and its evaluation. A guidebook. Executive summary

International Nuclear Information System (INIS)

1997-05-01

The Guidebook will prove especially useful for, and is addressed primarily to: nuclear power operating organizations establishing or upgrading their NPP personnel training systems; regulatory personnel responsible for setting requirements and/or evaluating NPP personnel training; and organizations (within or outside the operating organization) responsible for the development, implementation and evaluation of training programmes for NPP personnel. Figs

IAEA world survey on nuclear power plant personnel training

International Nuclear Information System (INIS)

1999-01-01

Training of personnel is acknowledged to be essential for safe and reliable operation of nuclear power plants. The preparation of this TECDOC was recommended by the IAEA International Working group on Nuclear Power Plant Personnel Training and Qualification and represents a unique compilation of information including all aspects of NPP personnel training from 23 Member States and 129 training organizations. The basic aims of this survey are: to provide a worldwide overview of all aspects of NPP personnel training; to foster both national and international cooperation between organizations involved in nuclear training; to provide the means of exchange of experiences and practices in systematic approach to training (SAT). The survey provides information for each corresponding country on the: national system and organization of training; job positions for which SAT is used; training programmes for key operations, maintenance, instructor and other jobs; role of management and the regulatory body; training facilities; recommended training practices; availability of training personnel from organizations outside the country; and contact points. The three main parts of the publication are the summary, the analysis of training programmes for each job position and the analysis of training resources, and the country reports

Performing personnel dosimetry investigations and records quality assurance

International Nuclear Information System (INIS)

Perle, S.C.

2002-01-01

Radiation Safety Officers (RSOs) sometimes face situations in which personnel dosimetry estimates are required after dosimeters issued to radiation workers (film or TLD badges, extremity dosimeters, etc.) are lost or damaged before processing. This article was prepared to help those involved with personnel dosimetry investigations became aquatinted with this process. A factor that contributes to the anxiety of those unfamiliar with dosimetry investigations is the lack of published guidance available in this subject. More printed resources are needed to help radiation safety professionals familiarize themselves and understand personnel dosimetry investigations. Topics discussed in this presentation include the justification of performing dosimetry investigations, recommendations on how to perform them and the advantages of performing such investigations

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...

Severe accident testing of a personnel airlock

International Nuclear Information System (INIS)

Clauss, D.B.; Parks, M.B.; Julien, J.T.; Peters, S.W.

1988-01-01

Sandia National Laboratories (Sandia) is investigating the leakage potential of mechanical penetrations as part of a research program on containment integrity under severe accident loads for the U.S. Nuclear Regulatory Commission (NRC). Barnes et al. (1984) and Shackelford et al. (1985) identified leakage from personnel airlocks as an important failure mode of containments subject to severe accident loads. However, these studies were based on relatively simple analysis methods. The complex structural interaction between the door, gasket, and bulkhead in personnel airlocks makes analytical evaluation of leakage difficult. In order to provide data to validate methods for evaluating the leakage potential, a full-size personnel airlock was subject to simulated severe accident loads consisting of pressure and temperature up to 300 psig and 800 degrees F. The test was conducted at Chicago Bridge and Iron under contract to Sandia. The authors provide a detailed report on the test program

Prehospital care in Hong Kong.

Science.gov (United States)

Lo, C B; Lai, K K; Mak, K P

2000-09-01

A quick and efficient prehospital emergency response depends on immediate ambulance dispatch, patient assessment, triage, and transport to hospital. During 1999, the Ambulance Command of the Hong Kong Fire Services Department responded to 484,923 calls, which corresponds to 1329 calls each day. Cooperation between the Fire Services Department and the Hospital Authority exists at the levels of professional training of emergency medical personnel, quality assurance, and a coordinated disaster response. In response to the incident at the Hong Kong International Airport in the summer of 1999, when an aircraft overturned during landing, the pre-set quota system was implemented to send patients to designated accident and emergency departments. Furthermore, the 'first crew at the scene' model has been adopted, whereby the command is established and triage process started by the first ambulance crew members to reach the scene. The development of emergency protocols should be accompanied by good field-to-hospital and interhospital communication, the upgrading of decision-making skills, a good monitoring and auditing structure, and commitment to training and skills maintenance.

French nuclear tests: the medical follow up of Cea participating personnel

International Nuclear Information System (INIS)

2004-01-01

For the personnel exposed to the risk of ionizing radiations, two types of examinations, in the aim of detecting any track of internal contamination were practiced at regular interval, at the arrival and at the departure from the site. A gamma spectrometry, and radio toxicological examination of feces and urines were practiced. furthermore, the exposed personnel received a specific film devoted to measure their external dosimetry. The same examinations were made for the local personnel and for the personnel of intervening societies. (N.C.)

Training of personnel for nuclear power in Ceske Energeticke Zavody Concern

International Nuclear Information System (INIS)

Hodny, J.; Krestan, J.

1983-01-01

The projects of training of personnel and recruitment of apprentices have to be started 10 years prior to the commissioning of a nuclear power plant. Training starts three years prior to the physical start-up. The education and training of personnel in the nuclear programme including the implementation of their social background is an equivalent component of nuclear safety. The most important aspects are presented of personnel training with regard to organization, recruitment, theoretical and practical education and training, material and technical provisions and social programme. At present personnel training and the education of specialists have reached a high standard but the problem of social care of personnel in future plants is serious and has not been solved. (M.D.)

Personnel Safety for Future Magnetic Fusion Power Plants

Energy Technology Data Exchange (ETDEWEB)

Lee Cadwallader

2009-07-01

The safety of personnel at existing fusion experiments is an important concern that requires diligence. Looking to the future, fusion experiments will continue to increase in power and operating time until steady state power plants are achieved; this causes increased concern for personnel safety. This paper addresses four important aspects of personnel safety in the present and extrapolates these aspects to future power plants. The four aspects are personnel exposure to ionizing radiation, chemicals, magnetic fields, and radiofrequency (RF) energy. Ionizing radiation safety is treated well for present and near-term experiments by the use of proven techniques from other nuclear endeavors. There is documentation that suggests decreasing the annual ionizing radiation exposure limits that have remained constant for several decades. Many chemicals are used in fusion research, for parts cleaning, as use as coolants, cooling water cleanliness control, lubrication, and other needs. In present fusion experiments, a typical chemical laboratory safety program, such as those instituted in most industrialized countries, is effective in protecting personnel from chemical exposures. As fusion facilities grow in complexity, the chemical safety program must transition from a laboratory scale to an industrial scale program that addresses chemical use in larger quantity. It is also noted that allowable chemical exposure concentrations for workers have decreased over time and, in some cases, now pose more stringent exposure limits than those for ionizing radiation. Allowable chemical exposure concentrations have been the fastest changing occupational exposure values in the last thirty years. The trend of more restrictive chemical exposure regulations is expected to continue into the future. Other issues of safety importance are magnetic field exposure and RF energy exposure. Magnetic field exposure limits are consensus values adopted as best practices for worker safety; a typical

Personnel Safety for Future Magnetic Fusion Power Plants

International Nuclear Information System (INIS)

Cadwallader, Lee

2009-01-01

The safety of personnel at existing fusion experiments is an important concern that requires diligence. Looking to the future, fusion experiments will continue to increase in power and operating time until steady state power plants are achieved; this causes increased concern for personnel safety. This paper addresses four important aspects of personnel safety in the present and extrapolates these aspects to future power plants. The four aspects are personnel exposure to ionizing radiation, chemicals, magnetic fields, and radiofrequency (RF) energy. Ionizing radiation safety is treated well for present and near-term experiments by the use of proven techniques from other nuclear endeavors. There is documentation that suggests decreasing the annual ionizing radiation exposure limits that have remained constant for several decades. Many chemicals are used in fusion research, for parts cleaning, as use as coolants, cooling water cleanliness control, lubrication, and other needs. In present fusion experiments, a typical chemical laboratory safety program, such as those instituted in most industrialized countries, is effective in protecting personnel from chemical exposures. As fusion facilities grow in complexity, the chemical safety program must transition from a laboratory scale to an industrial scale program that addresses chemical use in larger quantity. It is also noted that allowable chemical exposure concentrations for workers have decreased over time and, in some cases, now pose more stringent exposure limits than those for ionizing radiation. Allowable chemical exposure concentrations have been the fastest changing occupational exposure values in the last thirty years. The trend of more restrictive chemical exposure regulations is expected to continue into the future. Other issues of safety importance are magnetic field exposure and RF energy exposure. Magnetic field exposure limits are consensus values adopted as best practices for worker safety; a typical

Demands on power plant personnel and personnel organisation from the authorities' point of view

International Nuclear Information System (INIS)

Pfaffelhuber, J.K.

1980-01-01

A survey is given about those essential aspects of qualification and organization of personnel in nuclear power plants, that are already regulated in laws or guidelines. The considerations of the BMI concerning further developments of these requirements are outlined. (orig.) [de

5 CFR 250.202 - Office of Personnel Management responsibilities.

Science.gov (United States)

2010-01-01

... REGULATIONS PERSONNEL MANAGEMENT IN AGENCIES Strategic Human Capital Management § 250.202 Office of Personnel... to which human capital management strategies are integrated into agency strategic plans and..., managers and human resources officers accountable for efficient and effective human capital management, in...

18 CFR 701.79 - Selection policy for professional personnel.

Science.gov (United States)

2010-04-01

... following criteria: (a) Outstanding character and competence—both personal and professional. (b) Spread and... professional personnel. 701.79 Section 701.79 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Headquarters Organization § 701.79 Selection policy for professional personnel. In...

A seamless ubiquitous emergency medical service for crisis situations.

Science.gov (United States)

Lin, Bor-Shing

2016-04-01

In crisis situations, a seamless ubiquitous communication is necessary to provide emergency medical service to save people's lives. An excellent prehospital emergency medicine provides immediate medical care to increase the survival rate of patients. On their way to the hospital, ambulance personnel must transmit real-time and uninterrupted patient information to the hospital to apprise the physician of the situation and provide options to the ambulance personnel. In emergency and crisis situations, many communication channels can be unserviceable because of damage to equipment or loss of power. Thus, data transmission over wireless communication to achieve uninterrupted network services is a major obstacle. This study proposes a mobile middleware for cognitive radio (CR) for improving the wireless communication link. CRs can sense their operating environment and optimize the spectrum usage so that the mobile middleware can integrate the existing wireless communication systems with a seamless communication service in heterogeneous network environments. Eventually, the proposed seamless mobile communication middleware was ported into an embedded system, which is compatible with the actual network environment without the need for changing the original system architecture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Energy Requirements of Military Personnel

National Research Council Canada - National Science Library

Tharion, William J; Lieberman, Harris R; Montain, Scott J; Young, Andrew J; Baker-Fulco, Carol J

2005-01-01

...) have been measured while training under various conditions. Group mean total energy expenditures for 424 male military personnel from various units engaged in diverse missions ranged from 13.0 to 29.8 MJ per day...

Transportation security personnel training manual

International Nuclear Information System (INIS)

1978-11-01

Objective of this manual is to train security personnel to protect special nuclear materials and nuclear facilities against theft and sabotage as required by 10 CFR Part 73. This volume contains the introduction and rationale

Calibration of instrument and personnel monitoring in radiological protection

International Nuclear Information System (INIS)

Abdul Aziz Mohamad Ramli; Wan Saffiey Wan Abdullah

1987-01-01

It is difficult to choose radioprotection equipments that are not too expensive and suit the purpose. Some of the dosimetric characteristics of good dosemeters outlined by ISO 4071-1978 (E) namely scale linearity, energy dependence, radiation quality dependence and angular dependence for some of the commercially available dosemeters are discussed. The calibration procedures practised at the National Secondary Standard Dosimetry Laboratory (SSDL), of the Nuclear Energy Unit (NEU) is also explained. The radiological equipments for personnel monitoring such as film badge and TLD are widely used to estimate the radiation dose delivered to the whole or partial body of a personnel. Both of the personnel monitoring procedures have been established at the NEU. The objective, use and maintenance of the devices are also discussed in detail. The evaluation of the monthly dose received by a personnel from various establishments in the country are also presented. (author). 17 figs

Education in logistics and training of non-logistic personnel

Directory of Open Access Journals (Sweden)

Marko D. Andrejić

2011-01-01

Full Text Available The significance of education in logistics and education and training of cadets who belong to non-logistic services (non-logistic personnel will be presented. The logistical aspects of education of non-logistic personnel are elaborated as well as the knowledge in the area of logistics which is necessary to be transferred through the educational process to non-logistic personnel for the successful accomplishment of their functional duties. A general approach and the methods of logistics education and improvement of non-logistic personnel are presented as well as the institutional prerequisites necessary for improving the quality of logistics education and training. The quality of the knowledge in this area and its implementation into the methods of thinking and decision making of non-logistic personnel affect the cooperation between the non-logistic and the logistic personnel, directly contributing to the quality of life and working conditions of units and institutions as well as to the quality and synergy in task accomplishments in the framework defined by the missions of the Army of Serbia. The necessary content and means of its transfer to cadets are discussed since they are supposed to be available at all levels and forms of education, depending on the previous cadet education levels. The theoretical bases and experiences shown are of general character and they have a universal application in the process of education. Introduction In our recent defense theory and operational practice, logistics education of non-logistic personnel is not sufficiently analyzed either in organizational or technological aspects, considering the concept and the logic of a systematic and a situational approach. The analysis of the experiences gained from operational practice shows a slight decrease in the quality of task accomplishment due to the lack of necessary logistic knowledge and habits as well as an increased communication gap between logistic and non

Experience from training of personnel abroad

International Nuclear Information System (INIS)

Otcenasek, P.

1983-01-01

In the first period of the development of nuclear technology specialists received mainly theoretical training in brief study courses and training sessions. These courses did not place high demands on training methods. In the subsequent period long-term, well-conceived and costly systems of training were developed placing emphasis on specialized knowledge and especially on practical training. The third stage has now been launched which is characterized by the departure from classical control rooms to data collection and processing in centralized information systems, selective recording according to situation and choice, etc. This stage is passing on to the system of the minimization of the human factor error. A significant problem of the human factor in nuclear technology is the time aspect. Schools specializing in the education and training of specialists, technical personnel and workers for the nuclear programme have been established. Following such education personnel are selected for specialized training in training centres which have been equipped with costly training equipment including simulators. With regard to the importance of the human factor in nuclear installations, control computers are being introduced to an increasing extent and individuals and groups of workers and personnel are trained in operation. (E.S.)

Requirements on qualification, competence and sufficient number of personnel for NPP operation

International Nuclear Information System (INIS)

Simon, M.

2004-01-01

The safe operation of NPPs presupposes qualified personnel on site in sufficient numbers. While the acquisition and preservation of technical expertise and the qualification of the shift personnel and other staff is well regulated by regulatory guidelines in Germany, there is a lack of such regulations with the exception for shift personnel - for the minimum number of technical personnel required for safe operation of a NPP. By order of the BMU, an attempt was made with this study to work out the requirements for qualification, competence and number of personnel to be maintained at the plant, representing the minimum requirements for safe operation of a NPP. The scope of the project was restricted to requirements for technical plant personnel. The aim was to work out requirements which would be as independent as possible of the existing organisation in a particular power plant. This study therefore does not assume a given organisational structure but was rather more oriented on the work processes in a NPP which are the basis for planning and performing routine work in the plant. For the study a work process model of typical tasks in a NPP had to be developed. Then, the tasks to be performed within the so defined work processes were described (task profiles) on the basis of existing manuals for plant organisation. From these task profiles such tasks were defined or selected which shall not be delegated to external personnel for specific reasons, and which were called vital competences. To keep these vital competences at the plant, an assessment and/or calculation of the necessary number of plant technical personnel was made using the task profiles for responsible personnel, but also by the evaluation of thousands of work orders for maintenance personnel. On the basis of these data, a proposal was made for the minimal number of technical personnel which is necessary to operate a NPP unit safely. Beside of this number, general criteria were developed which should be

Role and responsibilities of management in NPP personnel training and competence. Working material

International Nuclear Information System (INIS)

1994-01-01

The main aim and result of this seminar was imparting knowledge to various levels of Paks NPP management on their special tasks and responsibilities to achieve personnel competence, which include: meeting relevant regulatory and other requirements; defining the qualifications for NPP personnel jobs; training using systematic approach to training to attain the required level of qualification and competence of all NPP personnel, which includes management, operations, maintenance and technical support personnel and others; recruiting and retaining qualified personnel, including career development; supporting the training of all personnel on their responsibilities for introducing, maintaining and improving safety. Refs, figs and tabs

From personnel dose to personal dose

International Nuclear Information System (INIS)

Hoefert, M.; Raffnsoe, R.C.; Tuyn, J.W.N.; Wittekind, D.

1985-01-01

From following the development of personnel doses at CERN over the past six years it has become evident that work in areas of induced radioactivity is the principal cause of exposure. The results of photon dose measurements free-in-air and around a phantom are presented and discussed in the light of new quantities in individual monitoring. The importance of these results, with respect to the practical situation, is discussed and the problem of phantom size is mentioned. Finally, the results of dose measurements in the phantom are presented, since such information is important in cases where it becomes necessary to transform personnel doses into personal doses. (author)

New Employee Orientation, Division of Personnel and Labor Relations,

Science.gov (United States)

understanding work rules and procedures, provide you with the resources you need, as well as guide you through Employee Training Exit Survey HR Forms New Employee Orientation For Admin Staff Classification Form Packets Personnel Memoranda Personnel Rules Policies and Procedures Recruitment Services Reports Sections Director's

Principles for enhancing professionalism of nuclear personnel

Energy Technology Data Exchange (ETDEWEB)

NONE

1989-03-01

The management principles in this publication were developed by a committee of senior utility officials with assistance by the staff of the Institute of Nuclear Power Operations (INPO) and with input from virtually all U.S. nuclear utilities. The principles are aimed at creating an environment within a nuclear power plant that promotes a healthy respect for the unique technology that nuclear electric power represents and, thus, to promote great care and conservative, thoughtful decision-making by the nuclear plant staff. The scope of the principles includes all nuclear personnel and gives guidance in the selection and development of management and supervisory personnel and other key individuals in the areas of operations, maintenance, technical support and engineering. Utility managers are encouraged to make in-depth comparisons between these principles and their day-to-day policies and practices, and to use such efforts as opportunities to communicate their organization's management philosophy to all nuclear personnel.

Principles for enhancing professionalism of nuclear personnel

International Nuclear Information System (INIS)

1989-01-01

The management principles in this publication were developed by a committee of senior utility officials with assistance by the staff of the Institute of Nuclear Power Operations (INPO) and with input from virtually all U.S. nuclear utilities. The principles are aimed at creating an environment within a nuclear power plant that promotes a healthy respect for the unique technology that nuclear electric power represents and, thus, to promote great care and conservative, thoughtful decision-making by the nuclear plant staff. The scope of the principles includes all nuclear personnel and gives guidance in the selection and development of management and supervisory personnel and other key individuals in the areas of operations, maintenance, technical support and engineering. Utility managers are encouraged to make in-depth comparisons between these principles and their day-to-day policies and practices, and to use such efforts as opportunities to communicate their organization's management philosophy to all nuclear personnel

3. national conference on training of personnel for nuclear power

International Nuclear Information System (INIS)

Jacko, J.

1983-01-01

A national conference with international participation was held in Podbanske to evaluate the results and experiences with the training of personnel for nuclear power in training centres of the sector of fuel and energy, within the educational system and at other workplaces. The rational development of the system of personnel training must contribute towards reducing the hazards of nuclear power caused by the human factor. The results and experiences were evaluated gained in the process of the unified system of training personnel for nuclear power plants, namely training centres of various institutions, institutions of higher education and in-operation training of personnel. In 1984, the first Czechoslovak simulator of a WWER 440 unit will be put into operation. (M.D.)

48 CFR 2452.237-75 - Clearance of contractor personnel.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Clearance of contractor... Clauses 2452.237-75 Clearance of contractor personnel. As prescribed in 2437.110(e), insert the following clause in solicitations and contracts. Clearance of Contractor Personnel (OCT 1999) (a) General. This...

Regionalizing the Recruitment of Health Personnel in Burkina Faso ...

International Development Research Centre (IDRC) Digital Library (Canada)

Human resources are essential to attaining the objectives of the Millennium development goals with respect to national health systems. In low-income countries, human health resources are characterized by a deficit of qualified personnel and an unequal distribution of existing personnel. To address these problems, the ...

Motivational Monitoring as a Tool of Managing Fluctuation of Personnel

OpenAIRE

Darchenko Nataliya D.

2013-01-01

The goal of the article lies in the study of a possibility to manage fluctuation of personnel at a modern enterprise through application of the motivational monitoring and in identification of some methodical aspects of formation of the system of monitoring the fluctuation of personnel. The article considers the essence, tasks and main directions of motivational monitoring at an enterprise and offers its classification. It proves urgency of the problem of fluctuation of personnel at enterpris...

21 CFR 212.10 - What personnel and resources must I have?

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What personnel and resources must I have? 212.10 Section 212.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES.... 12-12-2011) Personnel and Resources § 212.10 What personnel and resources must I have? You must have...

Department of Defense Civilian Personnel Manual

National Research Council Canada - National Science Library

1996-01-01

.... It implements policy, establishes uniform DoD-wide procedures, provides guidelines and model programs, delegates authority, and assigns responsibilities regarding civilian personnel management within...

Quo vadis, personnel monitoring

International Nuclear Information System (INIS)

Becker, K.

1975-01-01

With the increasing use of nuclear power and radiation sources, the selection of optimum systems for personnel monitoring is becoming a matter of worldwide concern. The present status of personnel dosimetry, sometimes characterized by unstable and inaccurate detectors and oversimplified interpretation of the results, leaves much to be desired. In particular, photographic film, although having certain advantages with regard to economics and information content, undergoes rapid changes in warm and humid climates. Careful sealing reduces, but does not prevent, these problems. The replacement of film by solid-state dosimeters, primarily thermoluminescence dosimeters, is in progress or being considered by an increasing number of institutions and requires a number of decisions concerning the choice of the optimum detector(s), badge design, and evaluation system; organizational matters, such as the desirability of automation and computerized bookkeeping; etc. The change also implies the potential use of such advanced concepts as different detectors and monitoring periods for the large number of low-risk persons and the small number of high-risk radiation workers. (auth)

The use of film badges for personnel monitoring

International Nuclear Information System (INIS)

Ehrlich, M.

1962-01-01

Photographic film is fairly inexpensive and durable and as a result of irradiation its radiosensitive components undergo relatively permanent changes. With proper calibration the optical density of the development and fixed photographic film can be related to radiation exposure. Personnel monitoring with photographic film is the method of choice in many laboratories, and this manual gives guidelines for the use of photographic film in personnel dosimetry.

Training of nuclear power plant personnel in Canada

International Nuclear Information System (INIS)

Tennant, D.

1993-01-01

All of the utilities, Ontario Hydro, Hydro Quebec and New Brunswick Power, operating Nuclear Power Plants in Canada have Training Centres which provide training for all of their plant personnel whose job activities could affect plant and personnel safety. This report points out the methods used for training, which generally conform to that described by the IAEA as a Systematic Approach to Training (SAT)

Using Gait Dynamics to Estimate Load from a Body-Worn Accelerometer

Science.gov (United States)

2016-02-05

dynamics, ambulation, correlation structure, musculoskeletal injury I. INTRODUCTION ilitary personnel commonly engage in training and operational...according to their load estimation accuracy, which is defined by the Pearson correlation , r, of its load estimates with the true loads (see Tables...method. In Table IV are shown the mean absolute error, MAE, and Pearson correlation , r, of the load estimates using estimates from GS alone, PLS alone

Automated Scheduling of Personnel to Staff Operations for the Mars Science Laboratory

Science.gov (United States)

Knight, Russell; Mishkin, Andrew; Allbaugh, Alicia

2014-01-01

Leveraging previous work on scheduling personnel for space mission operations, we have adapted ASPEN (Activity Scheduling and Planning Environment) [1] to the domain of scheduling personnel for operations of the Mars Science Laboratory. Automated scheduling of personnel is not new. We compare our representations to a sampling of employee scheduling systems available with respect to desired features. We described the constraints required by MSL personnel schedulers and how each is handled by the scheduling algorithm.

75 FR 77379 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Project...

Science.gov (United States)

2010-12-10

... Personnel Management Demonstration Project, Department of Navy, Office of Naval Research; Notice #0;#0..., authorizes the Secretary of Defense (SECDEF) to conduct personnel management demonstration projects at... to execute a process and plan to employ the Department's personnel management demonstration project...

32 CFR 644.396 - Assignment of personnel to administer.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Assignment of personnel to administer. 644.396... PROPERTY REAL ESTATE HANDBOOK Disposal Predisposal Action § 644.396 Assignment of personnel to administer... responsible representative to each installation, or group of installations, to act under his staff supervision...

professional status and the personnel functionary in the sadf

African Journals Online (AJOL)

PROFESSIONAL STATUS AND THE. PERSONNEL FUNCTIONARY IN THE SADF. By R Adm R. Eberlein*. Introduction. During the last year or so there has developed an increasing awareness among personnel functionaries in the SA Defence Force of a move- ment aimed at obtaining recognition of the pro- fessional ...

Motorcycle Training for California Driver Licensing Personnel. Final Report.

Science.gov (United States)

California State Dept. of Motor Vehicles, Sacramento.

The development of a 6-hour motorcycle course of instruction for personnel responsible for motorcycle licensing is described in this project report. The primary goals are stated and include (1) training driver licensing personnel in motorcycle safety and principles of operation, and (2) purchasing and installing appropriate motorcycle skill…

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.

Nuclear security. DOE actions to improve the personnel clearance program

International Nuclear Information System (INIS)

Fultz, Keith O.; Bannerman, Carl J.; Daniel, Beverly A.

1988-11-01

The status of the Department of Energy's (DOE) implementation of recommendations in our two reports on DOE's personnel security clearance program was determined. The recommendations were aimed at improving the timeliness, accuracy, and efficiency of personnel security clearance decisions. Specifically, the objective was to determine and report on steps DOE is taking to implement these recommendations. In summary, it was found that DOE has either initiated action or is studying ways to address all the recommendations, but none of the recommendations have been completely implemented. The effectiveness of the DOE actions will depend, in part, on the adequacy of its internal control system for overseeing and evaluating program operations. DOE's personnel security clearance program is intended to provide reasonable assurance that personnel with access to classified information and materials are trustworthy. The Department requests that the Office of Personnel Management or the Federal Bureau of Investigation collect personal data on each person who requires such access to do his or her job. Based on these background investigations, DOE officials authorize individuals whose personal histories indicate that they are trustworthy to have access to classified information, secured facilities, and controlled materials as needed to perform their jobs. DOE has five types of these authorizations or personnel security clearances and must update information on personnel holding each type at 5-year intervals to confirm their continuing reliability. The five types are based on the types of security interests to which the person needs access, e.g., persons needing nuclear weapons-related data must have a Q clearance, and persons with a top secret clearance can have access to national security data classified as top secret

Military personnel recognition system using texture, colour, and SURF features

Science.gov (United States)

Irhebhude, Martins E.; Edirisinghe, Eran A.

2014-06-01

This paper presents an automatic, machine vision based, military personnel identification and classification system. Classification is done using a Support Vector Machine (SVM) on sets of Army, Air Force and Navy camouflage uniform personnel datasets. In the proposed system, the arm of service of personnel is recognised by the camouflage of a persons uniform, type of cap and the type of badge/logo. The detailed analysis done include; camouflage cap and plain cap differentiation using gray level co-occurrence matrix (GLCM) texture feature; classification on Army, Air Force and Navy camouflaged uniforms using GLCM texture and colour histogram bin features; plain cap badge classification into Army, Air Force and Navy using Speed Up Robust Feature (SURF). The proposed method recognised camouflage personnel arm of service on sets of data retrieved from google images and selected military websites. Correlation-based Feature Selection (CFS) was used to improve recognition and reduce dimensionality, thereby speeding the classification process. With this method success rates recorded during the analysis include 93.8% for camouflage appearance category, 100%, 90% and 100% rates of plain cap and camouflage cap categories for Army, Air Force and Navy categories, respectively. Accurate recognition was recorded using SURF for the plain cap badge category. Substantial analysis has been carried out and results prove that the proposed method can correctly classify military personnel into various arms of service. We show that the proposed method can be integrated into a face recognition system, which will recognise personnel in addition to determining the arm of service which the personnel belong. Such a system can be used to enhance the security of a military base or facility.

Performance estimates for personnel access control systems

International Nuclear Information System (INIS)

Bradley, R.G.

1980-10-01

Current performance estimates for personnel access control systems use estimates of Type I and Type II verification errors. A system performance equation which addresses normal operation, the insider, and outside adversary attack is developed. Examination of this equation reveals the inadequacy of classical Type I and II error evaluations which require detailed knowledge of the adversary threat scenario for each specific installation. Consequently, new performance measures which are consistent with the performance equation and independent of the threat are developed as an aid in selecting personnel access control systems

Analysis of Specific Features of International Standards of Personnel Security of an Enterprise

Directory of Open Access Journals (Sweden)

Otenko Iryna P.

2014-03-01

Full Text Available The article marks out components of personnel security of an enterprise, outlines processes of personnel management, which correspond with conditions of security of life and labour, competent, socially protected professional activity, availability of the acting system of motivation and stimulation, and possibilities for corporate conflicts resolution. The article presents basic standards, rules and legislative acts that regulate ensuring personnel security. It analyses specific features of application of standards with respect to: life security and labour protection culture at an enterprise, including managerial systems and practice, behaviour of personnel at working places and also intellectual component of personnel security, which envisages that personnel has knowledge and competences that assist in achievement of strategic goals of an enterprise.

The Macro- and Micropolitics of Personnel Evaluation: A Framework.

Science.gov (United States)

Bridges, Edwin M.; Groves, Barry R.

1999-01-01

Explicates a conceptual framework for analyzing the politics of personnel evaluation in an educational context. Using several elements of the framework, discusses the politics of teacher evaluation in California in relation to the types of personnel evaluation decisions, the actors, their access to these decisions, sources and levels of power, and…

7 CFR 56.77 - Health and hygiene of personnel.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Health and hygiene of personnel. 56.77 Section 56.77 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... EGGS Grading of Shell Eggs Facility Requirements § 56.77 Health and hygiene of personnel. (a) No person...

Perception of quality control by personnel in diagnostic radiology ...

African Journals Online (AJOL)

This situation may be due to the perceived lack of interest and lack of cooperation from management of their facilities.The personnel also felt that they did not have sufficient training to implement QC and that QC results were difficult to analyse. Keywords: perception, quality control, personnel, management, diagnostic ...

Effects of Personnel Injuries on Cinc Mission Readiness

Science.gov (United States)

1997-09-01

activities in which injury may be sustained: ACTSPEC (activity specific): 1 =N/A 5 = 0 Course 9 = Fastrope 13 = Patrolling 2 = Running 6 = Weightlifting 10...NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS EFFECTS OF PERSONNEL INJURIES ON CINC MISSION READINESS by Erin G. Snow September, 1997...Thesis 4. TITLE AND SUBTITLE EFFECTS OF PERSONNEL INJURIES ON CINC MISSION READINESS 6. AUTHOR(S) Snow, Erin G. 5. FUNDING NUMBERS 7. PERFORMING

Hydrogen sulfide suicide: a new trend and threat to healthcare providers.

Science.gov (United States)

Ruder, John B; Ward, Jeanette G; Taylor, Scott; Giles, Karon; Higgins, Thomas; Haan, James M

2015-01-01

First popularized in Japan, hydrogen sulfide (H2S) gas suicide is an underreported form of suicide with known risk for secondary disaster. Mortality rate commonly exceeds 90% because of the gas's lethal, noncontained nature. Instances in the United States are increasing, up from 2 cases in 2008 to 18 in 2010. Because H2S poisonings remain rare, there exists a lack of knowledge regarding the residual effects of gas venting after victim extrication. Identifying instances of the efficacious use of personal protection equipment (PPE) is critical in the effort to alleviate risks faced by hospital and rescue personnel. The current case demonstrates the effective use of PPEs after prolonged H2S exposure. In 2011, a 20-year-old man threatened suicide using H2S gas inside a vehicle on a remote rural highway. First responders identified a "rotten egg smell" and subsequently experienced low poisoning symptoms. After prolonged Hazmat-assisted extrication (4 hours) the patient was unconscious and experiencing seizures. He was decontaminated on-scene (20 minutes) and transported to the closest hospital (22 minutes). Ambulance personnel who wore PPE and used the ambulance's reverse ventilation system (RVS)reported no adverse effects. The patient was transferred to the authors' burn facility by helicopter (38 minutes). Life-flight personnel, who did not wear PPE (no ventilatory system available), complained of watery eyes, headache, and dizziness. Hospital personnel, who did not use PPE (or RVS), complained of watery eyes or headache. Exposed personnel demonstrated no deficits or residual effects. In spite of spontaneous movement, the patient began to seize and died. This case is unique given the multiple primary and secondary H2S gas exposures involved. Exposed personnel without RVS and not using PPE demonstrated moderate H2S symptoms. PPE (self-contained breathing apparatuses) and RVS were shown to be effective during an H2S emergency; however, there are currently limited data

Demonstration personnel and material tracking system at ANL-W

International Nuclear Information System (INIS)

Roybal, J.A.; Ortiz, S.; Henslee, S.P.

1988-01-01

A Personnel and Material Tracking System (PMTS) was demonstrated in the Fuel Manufacturing Facility (FMF) at Argonne National Laboratories-West (ANL-W) in July, 1987. The PMTS is intended to aid in the transfer of inventory materials from area to area within a facility such as FMF. It is also intended to assure that only those personnel who are authorized to do so may conduct these transfer operations. The PMTS Personnel Movement (PM) subsystem uses portals installed between areas to alert the system to the movement of personnel between areas. The portals are composed to two sensors, one on either side of a proximity badge reader, to detect the presence of personnel entering the portal area. However, a restricted area can be assigned to any badge holder which will cause the system to issue an alert if the badge holder passes into his/her restricted area. The PM subsystem is intended to be transparent when in use. The PMTS Inventory Material Access (IMA) subsystem provides two functions: material control and material access. The material control is provided by the Wireless Alarm Transmission of Container Handling (WATCH) system which is a sensor rf transmitter system that detects item movements. Material access is provided by the Mobile Accountability Verification Inventory Station (MAVIS) system which is a self-powered smart barcode reader

78 FR 64204 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Project...

Science.gov (United States)

2013-10-28

... Personnel Management Demonstration Project, Department of Navy, Office of Naval Research (ONR); Amendment... ONR Personnel Management Demonstration Project (75 FR 77380-77447, December 10, 2010). SUMMARY: On December 10, 2010 (75 FR 77380-77447), DoD published a notice of approval of a personnel management...

Towards harmonized qualifications for radiation exposed personnel

International Nuclear Information System (INIS)

Briso, Hugo A.

2008-01-01

The accelerated process of globalization affecting mankind doesn't exclude safety matters. Indeed, some trans national corporations are increasingly offering specialized engineering services such as industrial radiography or well lodging. As well, a growing scientific exchange involves the mobility of nuclear researchers in different areas, for instance radiochemistry, nuclear medicine and radiotherapy. Such a breakdown in the technological frontiers must necessarily be reflected by the regulatory solutions. Particularly, diverse levels of theoretical-practical training for radiation exposed personnel coexist in the Latin-American Region, being an especially sensitive problem for radiation protection matters. The spectrum goes from post-graduate courses required for radiation protection officers in some countries, while in others only basic recommendations are required for the operating personnel. Another scheme consists of medium level course for the operating personnel, while radiation protection officers don't have special requirements. Many educational private institutions teach non standardized courses which only give broad concepts of radiation protection. On the other hand, usually nothing is said about the operational training, or else its certification is entrusted to the employer itself. In some countries multiple Regulatory Authorities apply dissimilar criteria to assess safety matters, including the evaluation of workers applications. The necessary regional integration makes indispensable to establish common standards for granting authorizations. Having similar or homogeneous requirements for the universe of radiation exposed personnel, i.e. source operators, radiation protection officers, qualified experts and technical support people would be easier for the Regulatory Authorities to have common methodologies of evaluation for the applicants. An IAEA supported technical cooperation project related to this paper seeks to establish standardized

Khmelnitsky NPP personnel training system improvement

International Nuclear Information System (INIS)

Sapronov, V.G.; Issupov, V.I.

1996-01-01

Khmelnitsky nuclear power plant personnel training system improvement is described, including creation of Training center, development of training courses based on SAT methodology, development of training hardware

Sources of personnel for multinuclear companies

International Nuclear Information System (INIS)

Guppy, W.H.

1975-01-01

Included are comments and statistics on current employment levels, projected requirements for future stations, sources of personnel for current and projected stations, and methods of employee selection

IAEA activities in nuclear power plant personnel training and qualification

International Nuclear Information System (INIS)

Mautner-Markhof, F.

1993-01-01

Training to achieve and maintain the qualification and competence of nuclear power personnel is essential for safe and economic nuclear power. Technical Cooperation Meeting on Training-Related Activities for Nuclear Power Plant (NPP) Personnel in the countries of Central and Eastern Europe (CEEC) and of the former Soviet Union (FSU) has as its main objective the identification, through information exchange and discussion, of possible Technical Cooperation (TC) projects to assist Member States in meeting NPP personnel training needs and priorities, including the enhancing of training capabilities

32 CFR 634.33 - Training of law enforcement personnel.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Training of law enforcement personnel. 634.33 Section 634.33 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.33 Training of law enforcement personnel. (a) A...

21 CFR 606.20 - Personnel.

Science.gov (United States)

2010-04-01

... GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Organization and Personnel § 606.20... testing, storage or distribution of blood or blood components shall be adequate in number, educational... areas where the collection, processing, compatibility testing, storage or distribution of blood or blood...

Qualification of NDE personnel in the nuclear industry

International Nuclear Information System (INIS)

Epps, T.N.

1984-01-01

There has been evidence of ineffective programs for certifying nondestructive examination (NDE) personnel who conduct periodic inservice examinations in nuclear power plants under ASME Section XI Code requirements. This was brought to the attention of a group from the electric utility industry, the Electric Power Research Institute (EPRI), some NDE consultants and representatives from the American Society of Mechanical Engineers (ASME) by the Nuclear Regulatory Commission (NRC) in a May, 1982 meeting in Bethesda, Maryland. One problem pointed out by the NRC was the lack of a clear definition of qualification requirements for certification of NDE personnel who conduct ASME Section XI Inservice Inspection work in nuclear power plants. The NRC requested that the nuclear industry resolve this problem by formulating definitive qualification requirements for personnel certification that could be made an industry requirement. In June, 1982 the EPRI NDE Subcommittee held a general meeting for utility representatives to discuss the results of the May, 1982 meeting to develop a plan for industry response to the issue. The consensus was that an Ad Hoc Committee of utility representatives be convened to develop a document outlining qualification requirements for vertification of NDE personnel. The Ad Hoc Committee was formally convened on September 29, 1982

Оrganization of anti-crisis personnel management in agricultural enterprises

Directory of Open Access Journals (Sweden)

Mylyar T.S.

2017-06-01

Full Text Available The research deals with the basic principles of the use of anti-crisis personnel management in enterprises of agriculture. The paper theoretically proves the implementation efficiency of anti-crisis personnel management in enterprises of agriculture. Nowadays many enterprises are constantly faced with the impact of crises of different nature. HR management is urgent and a priority to improve the efficiency of the administrative process for all organizations. The actual basis for the introduction of anti-crisis management in enterprises is timely detection and correct response to crisis situations by human resources. The basis of anti-crisis personnel management is an organization work with the staff, aimed at creating conditions for the effective activity planning at the company, the selection of strategies for implementation, development of anti-crisis program, selection of appropriate instruments to use. However, it is important to take into account the human factor, based on the psychological readiness of skilled company personnel to work in conditions of stress and crisis. Much attention is paid to the overview of main factors that are necessary for personnel in the organization of anti-crisis management. The principles of anti-crisis personnel management are systematized. It should be noted that the principles can be individual, that is specific to the crisis in the enterprises, as the staff in this case is in serious social and psychological environment. It is determined that anti-crisis management has specific characteristics. The article studies the place of the personnel policy in the anti-crisis management system. The paper gives the valuable information on the way of improving the effectiveness of anti-crisis management, which is the implementation of the internal anti-crisis control group, and the functions of the group are the ability to anticipate crises in the future and provide everything necessary to prevent their appearance.

Hand dermatitis and symptoms from the fingers among Swedish dental personnel.

Science.gov (United States)

Lönnroth, E C; Shahnavaz, H

1998-01-01

Hand dermatitis among dental personnel has been an issue in recent years. Dental personnel manually handle polymer materials which are known to irritate skin, and also cause allergy. In addition, dental personnel wash their hands frequently, and use latex gloves, and are therefore at risk to develop hand dermatitis. To survey the occurrence of hand dermatitis among dental personnel, questionnaires were sent to all dental teams (dentist + chair assistant) working in the two northern Swedish counties. Referents were; researchers, teachers, and secretaries from a university and high schools, from the same geographical area. The response rate was 76% for dental teams, and 66% for referents. The results show that male dentists reported a significantly higher prevalence of hand dermatitis than male reference. In contrast to chair assistants and referents, dentists (both male and female) reported a higher extent of hand dermatitis on the left than on the right hand. There was an association between hand dermatitis among dental personnel and; age, eczema in childhood, and hay fever but, not with; sex, asthma, frequent washing of the hands, and glove use. Whitening of the fingers increased with increasing age among dental personnel. Pricking was also associated with frequent glove use. Pricking of the fingers was associated with sex, and 3.5 times more common among female dental personnel than male dentists. Numbness of the fingers, and finger pain was reported by more dentists than chair assistants and referents.

Strategic directions of personnel potential forming of a building complex

Directory of Open Access Journals (Sweden)

Simonova Marina

2016-01-01

Full Text Available The analysis of directions of strategic approach forming of labor potential management of a building complex is carried out in this paper. On the basis of this analysis the system of actions for strategy forming divided into consecutive stages is offered. The development of the personnel forecast is a strategic planning basis. One of personnel forecast variants is the correlation of needs estimates in personnel of a building complex with available allowances. On the basis of the personnel forecast strategic analysis it is possible to compose working programs for the stated goals of implementation. Operational assessment of personnel requirements of a building complex is proved to be combined with strategic objectives. Some assessment approaches to qualitative and quantitative need for specialists of a building complex are offered. The fact that high-quality labor power supply system of a building complex with should be based on industry development forecast and increase in construction products competitiveness is revealed in the article. Strategic management priority will allow to react immediately to the current situation changes, to introduce amendments both into tactical, and operational management.

Risk perception among nuclear power plant personnel: A survey

International Nuclear Information System (INIS)

Kivimaeki, M.; Kalimo, R.

1993-01-01

This study investigated risk perception, well-being, and organizational commitment among nuclear power plant personnel. The study group, 428 employees from a nuclear power plant, completed a questionnaire which included the same questions as those in previous surveys on risk perception of lay persons and industrial workers. Hazards at work were not seen as a sizable problem by nuclear power plant personnel. The study group estimated the safety of nuclear power plants better and the possibility of a serious nuclear accident as more unlikely than the general public. Compared to employees in other industrial companies, the overall perceived risks at work among plant personnel did not exceed the respective perceptions of the reference groups. Risk-related attitudes did not explain well-being among plant personnel, but the relationship between the perceived probability of a serious nuclear accident at work and organizational commitment yielded to a significant correlation: Those plant workers who estimated the likelihood of an accident higher were less committed to the organization. 21 refs., 2 tabs

Study of the adequacy of personnel for the US nuclear program

International Nuclear Information System (INIS)

1981-11-01

The report will emphasize fission topics relative to fusion because of the relative number of personnel involved. However, the commonality of types of personnel and their required educational background are such that the health of the fission educational infrastructure will affect the future supply of fusion technologists. Alternatively, the attractive aspects of some closely related fusion research in universities can help attract the high quality personnel needed in the fission field. The report's recommendations are therefore based on the needs of both programs. A separate study of the detailed requirements for fusion scientific and engineering personnel has been prepared by the Office of Fusion Energy. In this report, the present status of nuclear power, historic personnel requirements, future requirements, and constraints on future supply are analyzed. The intent of this report is to provide a context for conclusions and recommendation of Government actions leading to an adequate supply of nuclear manpower both for the industrial and Government components of the nuclear enterprise

Comparison of elective lumbar discectomy outcomes between civilians and military personnel

International Nuclear Information System (INIS)

Farzanegan, G.; Mohebbi, H.A.; Moharamzad, Y.

2007-01-01

To determine the results of discectomy surgery for lumbar disc herniation in military personnel and compare it with civilians. One-hundred and seventeen military patients (54 subjects as combat forces and 63 as office personnel) and 115 civilians, who underwent discectomy surgery were included. In a mean duration of 50.8 months, the ability to return to full duty and resolution of complaints were assessed and satisfaction was measured using a Visual Analog Scale. Inability to return to previous duty was significantly higher in military personnel compared to civilians (p = 0.002); and in combat forces compared to office personnel (p 0.05). Surgical intervention had relatively poor outcomes in military personnel, specifically in combat forces. Prevention of injury to back region should be considered in military training programs and in case of presence of disc herniation related symptoms, efforts should be made to save patients effective function by conservation and medical therapies. (author)

The Phasing of the Process of Diagnosing the Personnel Potential at Trade Enterprise

Directory of Open Access Journals (Sweden)

Peniuk Valeriia O.

2017-03-01

Full Text Available The article is aimed at carrying out phasing of the process of diagnosing the personnel potential at trade enterprise, taking into consideration the possible restrictions of a structural nature. The article determines the main causes for unequal attitude by the directors of differently sized trade enterprises of Ukraine towards diagnosing the personnel potential and personnel evaluation. The author’s vision of the phasing of the process of diagnosing the personnel potential has been submitted. An economic-mathematical model of the optimal implementation of the stages of diagnostics of the personnel potential at trade enterprise has been built. A list of principles has been compiled, along with clarifying their contents, on the basis of which diagnosing the personnel potential at trade enterprise should be carried out. The author’s definition of the concept of «desired status of the personnel potential» for trade enterprise has been formulated. Examples of endogenous and exogenous factors that impact the desired status of the personnel potential of trading enterprise and cause its changing have been provided. Prospects for further research in this direction can be research on the diagnostics of other constituents of the strategic potential of trade enterprise, as well as improvement or development of a new methodological instrumentarium to carry out diagnostics of the personnel potential at enterprises.

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.

Selection, qualification and training of personnel for nuclear power plants

International Nuclear Information System (INIS)

Anon.

1981-01-01

This standard provides criteria for the selection, qualification and training of personnel for stationary nuclear power plants. Qualifications, responsibilities, and training of personnel in operating and support organizations appropriate for the safe and efficient operation of nuclear power plants are addressed

42 CFR 484.4 - Personnel qualifications.

Science.gov (United States)

2010-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES General Provisions § 484.4 Personnel... baccalaureate degree in social work, psychology, sociology, or other field related to social work, and has had...

Training, education and qualification of NPP operating personnel in the Netherlands

International Nuclear Information System (INIS)

de Vrey, G.A.

1987-01-01

This paper outlines the organization and the requirements of the training, education and qualification of NPP operating personnel in the Netherlands. It describes the implementation of a formally required scheme of personnel qualification after TMI, and the current practice as developed by the training staff of both Dutch nuclear power plants. Attention is given to the specific circumstances and problems in the Netherlands, and the resulting program. The licensing criteria for control room operating personnel are discussed, including the level of government involvement. Measures are described to improve the approach to training of NPP personnel involved in safety relevant activities. Finally, some ideas are given for strategies to cope with adverse stress situations

Radiation exposure of personnel in nuclear fuel facilities in fiscal 1981

International Nuclear Information System (INIS)

1983-01-01

The owners of refining enterprises, fabrication enterprises and reprocessing enterprises and users are obligated by the law to keep the radiation exposure dose of personnel below the permissible level. In fiscal 1981 (from April, 1981, to March, 1982), the personnel exposure was far below this level. Exposure dose distribution, total exposure dose and average in the fiscal year are given for the personnel of the following enterprises and other personnel, respectively: refining enterprise - Power Reactor and Nuclear Fuel Development Corporation; fabrication enterprises - Mitsubishi Nuclear Fuel Co., Ltd., and four others; reprocessing enterprise - Power Reactor and Nuclear Fuel Development Corporation; users - Power Reactor and Nuclear Fuel Development Corporation, Japan Atomic Energy Research Institute, and four others. (Mori, K.)

Dosimetry of the Occupational Exposure Personnel and not exposure of the INNSZ

International Nuclear Information System (INIS)

Ruiz J, A.

1999-01-01

In this work, was measured the equivalent dose of all the personnel of Nuclear medicine and personnel of the Institute which by its activities remain in the Department, by time determined, through thermoluminescent dosemeters and the results were that the personnel presents variable equivalent dose and it is proportional to the time and radionuclide type which use for their work. By this it is allowed to secure what the work watched with respect to radiological protection to fulfil with the International Standards standing for personnel in the Institute. (Author)

PAMTRAK: A personnel and material tracking system

International Nuclear Information System (INIS)

Anspach, D.A.; Anspach, J.P.; Crain, B. Jr.

1996-01-01

There is a need for an automated system for protecting and monitoring sensitive or classified parts and material. Sandia has developed a real-time personnel and material tracking system (PAMTRAK) that has been installed at selected DOE facilities. It safeguards sensitive parts and material by tracking tags worn by personnel and by monitoring sensors attached to the parts or material. It includes remote control and alarm display capabilities and a complementary program in Keyhole to display measured material attributes remotely. This paper describes the design goals, the system components, current installations, and the benefits a site can expect when using PAMTRAK

Unmasking the health problems faced by the police personnel

Directory of Open Access Journals (Sweden)

G.Jahnavi

2012-11-01

Full Text Available Aim: To assess the health problems of the police personnel under Vijayawada police commisionerate 2. To make the health check ups regular and 3. To make the physical fitness programme mandatory for them.Study design: cross sectional study Methodology: Health check up was done for 617 police personnel from 12.11.09 to 4.12.09. In the morning hours, a group of junior doctors, paramedical staff and technicians visited the police dispensary to do the general check up, take blood samples and ECG. The following afternoon a group of specialists visited to check the same patients along with their reports to make the final diagnosis. Results: Out of 617 police personnel 259 (42% were overweight/obese, lack of physical activity was found in 397 (64% of them, alcohol consumption was present in 148 (24% and smoking in 136 (22% of the police personnel. Diabetes was diagnosed in 229 (37% and hypertension in 203 (33%. Anemia was detected in 154 (25%, visual abnormalities in 59 (10%, lipid abnormalities in 185 (30%, liver function test abnormalities in 31 (5%, ECG abnormalities in 25 (4%, renal function abnormalities in 6 (1%. Conclusion: A Physical fitness Schedule along with Stress alleviation techniques to be made mandatory for the police personnel to keep them physically and mentally fit, to perform critical job functions, to alleviate stress, and to improve their quality of life. Routine health checkups should be done to detect lurking dangers.

Office of Personnel Management (OPM) Earnings

Data.gov (United States)

Social Security Administration — Each year the Office of Personnel Management (OPM) sends SSA a file to be verified and matched against the Master Earnings File (MEF) and Employer Information File...

THE ASSESMENT CENTER, A NEW „FASHION” IN PERSONNEL SELECTION

Directory of Open Access Journals (Sweden)

Popa Luminita

2009-05-01

Full Text Available The Assessment Center is a relatively new method for personnel selection that becomes more and more popular among the Human Resources Managers. It has proven to have efficiency both in personnel selection and training needs identification. This paper refe

50 CFR 260.104 - Personnel.

Science.gov (United States)

2010-10-01

... belongings, eat food, drink beverages, chew gum, or use tobacco in any form in areas where food or food... FOOD PRODUCTS INSPECTION AND CERTIFICATION Inspection and Certification of Establishments and Fishery... Basis 1 § 260.104 Personnel. The establishment management shall be responsible for taking all...

Work environment, overtime and sleep among offshore personnel.

Science.gov (United States)

Parkes, Katharine R

2017-02-01

Personnel working on North Sea oil/gas installations are exposed to remote and potentially hazardous environments, and to extended work schedules (typically, 14×12h shifts). Moreover, overtime (additional to the standard 84-h week) is not uncommon among offshore personnel. Evidence from onshore research suggests that long work hours and adverse environmental characteristics are associated with sleep impairments, and consequently with health and safety risks, including accidents and injuries. However, little is known about the extent to which long hours and a demanding work environment combine synergistically in relation to sleep. The present study sought to address this issue, using survey data collected from offshore day-shift personnel (N=551). The multivariate analysis examined the additive and interactive effects of overtime and measures of the psychosocial/physical work environment (job demands, job control, supervisor support, and physical stressors) as predictors of sleep outcomes during offshore work weeks. Control variables, including age and sleep during leave weeks, were also included in the analysis model. Sleep duration and quality were significantly impaired among those who worked overtime (54% of the participants) relative to those who worked only 12-h shifts. A linear relationship was found between long overtime hours and short sleep duration; personnel who worked >33h/week overtime reported job demands, and positively related to supervisor support, only among personnel who worked overtime. Poor sleep quality was predicted by the additive effects of overtime, low support and an adverse physical environment. These findings highlight the need to further examine the potential health and safety consequences of impaired sleep associated with high overtime rates offshore, and to identify the extent to which adverse effects of overtime can be mitigated by favourable physical and psychosocial work environment characteristics. Copyright © 2015 Elsevier Ltd

Essence of the «Enterprise Management through Personnel Management» Paradigm

OpenAIRE

Vashchenko Natalia V.

2013-01-01

The article proves a necessity of consideration of personnel as a driving force of enterprise development. It studies and generalises the existing approaches of scientists to understanding the "enterprise management" and "personnel management" processes. It marks out problem and positive points of view of scientists with respect to identification of the role of personnel in the process of enterprise management and ensuring its development. It reveals the essence of the "management" and "enter...

Evaluation of factors associated with the difficulty in finding receiving hospitals for traffic accident patients at the scene treated by emergency medical services: a population-based study in Osaka City, Japan.

Science.gov (United States)

Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Hayashida, Sumito; Ogura, Hiroshi; Shimazu, Takeshi

2017-10-01

Although the prolongation of the time between injury and hospital arrival of traffic accident patients can influence their prognosis, factors associated with the difficulty in hospital acceptance of these patients have not been sufficiently evaluated in Japan. We retrospectively analyzed the population-based ambulance records of all traffic accident patients for whom the Osaka Municipal Fire Department (Osaka City, Japan) dispatched an ambulance in 2013. We defined "cases with difficulty in hospital acceptance" as cases that required ≥4 calls by emergency medical service personnel at the scene before receiving hospital acceptance. We included patient characteristics (age, sex, coma status, and trauma severity judged by emergency medical service personnel), time factors (day/night or weekday/holiday and weekends), and accident location for multivariable logistic regression analysis to assess factors associated with the difficulty in hospital acceptance. Among 13,427 traffic accident patients, 2,033 (15.1%) were cases with difficulty in hospital acceptance. Pediatric patients (adjusted odds ratio [OR], 1.265; 95% confidence interval [CI], 1.060-1.509), male sex (adjusted OR, 1.260; 95% CI, 1.135-1.398), moderate-grade trauma (adjusted OR, 2.241; 95% CI, 1.972-2.547), severe-grade trauma (adjusted OR, 2.057; 95% CI, 1.249-3.388), holidays and weekends (adjusted OR, 1.702; 95% CI, 1.539-1.882), and night-time (adjusted OR, 2.720; 95% CI, 2.443-3.027) were positively associated with difficulty in hospital acceptance. Using population-based ambulance records from a large urban community in Japan, we showed that the difficulty in hospital acceptance of patients at the scene of traffic accidents was positively associated with several prehospital factors.

Personnel neutron dose assessment upgrade: Volume 1, Personnel neutron dosimetry assessment: [Final report

International Nuclear Information System (INIS)

Hadlock, D.E.; Brackenbush, L.W.; Griffith, R.V.; Hankins, D.E.; Parkhurst, M.A.; Stroud, C.M.; Faust, L.G.; Vallario, E.J.

1988-07-01

This report provides guidance on the characteristics, use, and calibration criteria for personnel neutron dosimeters. The report is applicable for neutrons with energies ranging from thermal to less than 20 MeV. Background for general neutron dosimetry requirements is provided, as is relevant federal regulations and other standards. The characteristics of personnel neutron dosimeters are discussed, with particular attention paid to passive neutron dosimetry systems. Two of the systems discussed are used at DOE and DOE-contractor facilities (nuclear track emulsion and thermoluminescent-albedo) and another (the combination TLD/TED) was recently developed. Topics discussed in the field applications of these dosimeters include their theory of operation, their processing, readout, and interpretation, and their advantages and disadvantages for field use. The procedures required for occupational neutron dosimetry are discussed, including radiation monitoring and the wearing of dosimeters, their exchange periods, dose equivalent evaluations, and the documenting of neutron exposures. The coverage of dosimeter testing, maintenance, and calibration includes guidance on the selection of calibration sources, the effects of irradiation geometries, lower limits of detectability, fading, frequency of calibration, spectrometry, and quality control. 49 refs., 6 figs., 8 tabs

Crossing Borders with Personnel Selection: From Expatriates to Multicultural Teams

NARCIS (Netherlands)

S.T. Mol (Stefan)

2007-01-01

textabstractPersonnel selection is one of the main activities of the industrial and organizational psychologist. Yet, little is known about whether principles of personnel selection that have been developed in domestic and mainly Western (i.e., North American and European) contexts will apply in

Automated personnel data base system specifications, Task V. Final report

International Nuclear Information System (INIS)

Bartley, H.J.; Bocast, A.K.; Deppner, F.O.; Harrison, O.J.; Kraas, I.W.

1978-11-01

The full title of this study is 'Development of Qualification Requirements, Training Programs, Career Plans, and Methodologies for Effective Management and Training of Inspection and Enforcement Personnel.' Task V required the development of an automated personnel data base system for NRC/IE. This system is identified as the NRC/IE Personnel, Assignment, Qualifications, and Training System (PAQTS). This Task V report provides the documentation for PAQTS including the Functional Requirements Document (FRD), the Data Requirements Document (DRD), the Hardware and Software Capabilities Assessment, and the Detailed Implementation Schedule. Specific recommendations to facilitate implementation of PAQTS are also included

Personnel Selection Influences on Remotely Piloted Aircraft Human-System Integration.

Science.gov (United States)

Carretta, Thomas R; King, Raymond E

2015-08-01

Human-system integration (HSI) is a complex process used to design and develop systems that integrate human capabilities and limitations in an effective and affordable manner. Effective HSI incorporates several domains, including manpower, personnel and training, human factors, environment, safety, occupational health, habitability, survivability, logistics, intelligence, mobility, and command and control. To achieve effective HSI, the relationships among these domains must be considered. Although this integrated approach is well documented, there are many instances where it is not followed. Human factors engineers typically focus on system design with little attention to the skills, abilities, and other characteristics needed by human operators. When problems with fielded systems occur, additional training of personnel is developed and conducted. Personnel selection is seldom considered during the HSI process. Complex systems such as aviation require careful selection of the individuals who will interact with the system. Personnel selection is a two-stage process involving select-in and select-out procedures. Select-in procedures determine which candidates have the aptitude to profit from training and represent the best investment. Select-out procedures focus on medical qualification and determine who should not enter training for medical reasons. The current paper discusses the role of personnel selection in the HSI process in the context of remotely piloted aircraft systems.

A Review of Mercury Exposure and Health of Dental Personnel

Directory of Open Access Journals (Sweden)

Natasha Nagpal

2017-03-01

Full Text Available Considerable effort has been made to address the issue of occupational health and environmental exposure to mercury. This review reports on the current literature of mercury exposure and health impacts on dental personnel. Citations were searched using four comprehensive electronic databases for articles published between 2002 and 2015. All original articles that evaluated an association between the use of dental amalgam and occupational mercury exposure in dental personnel were included. Fifteen publications from nine different countries met the selection criteria. The design and quality of the studies showed significant variation, particularly in the choice of biomarkers as an indicator of mercury exposure. In several countries, dental personnel had higher mercury levels in biological fluids and tissues than in control groups; some work practices increased mercury exposure but the exposure levels remained below recommended guidelines. Dental personnel reported more health conditions, often involving the central nervous system, than the control groups. Clinical symptoms reported by dental professionals may be associated with low-level, long-term exposure to occupational mercury, but may also be due to the effects of aging, occupational overuse, and stress. It is important that dental personnel, researchers, and educators continue to encourage and monitor good work practices by dental professionals.

Project Management Personnel Competencies Evaluation

Directory of Open Access Journals (Sweden)

Paul POCATILU

2006-01-01

Full Text Available An important factor for the success management of IT projects is the human resource. People involved in the project management process have to be evaluated. In order to do that, same criteria has to be specified. This paper describes some aspects regarding the personnel evaluation.

Programmes design for Bohunice NPP personnel other than control room operators

International Nuclear Information System (INIS)

Kalincik, L.

2002-01-01

This paper deals with project development of training programmes for non-licenced NPP personnel-masters, field operators, maintenance and technical supporting personnel. The programme development focuses on the part stage and on the job training at NPP. Bohunice NPP belongs to plants with higher specific number of personnel per installed power capacity. This factor also influenced the choice of programmes design. Undermentioned procedure is one of various approaches to SAT exploitation for training programmes design. (author)

R&D Personnel Career Routes: An Exploratory Study

OpenAIRE

Barbara Bigliardi; Alberto Ivo Dormio

2009-01-01

This study, aiming at investigate the alternative modes of career development for personnel belonging to R&D staff, addresses the extent to which career anchors are applicable to R&D staff and to examine the relationship among career anchors, gender and age, with the final purpose to add elements of discussion to the long-lasting debate about this matter. With this purpose in mind, we developed a questionnaire survey among 309 R&D personnel employed at firms belonging to the food machinery in...

Personnel training and patient education in medical marijuana dispensaries in Oregon.

Science.gov (United States)

Linares, Roberto; Choi-Nurvitadhi, Jo; Cooper, Svetlana; Ham, YoungYoon; Ishmael, Jane E; Zweber, Ann

2016-01-01

To determine the knowledge and training of Oregon Medical Marijuana Dispensary (OMMD) personnel and describe the information and type of advice provided to patients who use Oregon dispensaries. Statewide cross-sectional email survey of OMMD personnel. Of the 141 surveys, 47 were initiated. The most frequently referenced types of training were on-the-job training and the Internet. Dispensary personnel most commonly used patients' preferences and symptoms as well as personal experiences to determine appropriate strains for patients. The majority of respondents advised patients about precautions and expected effects. Respondents were least likely to advise on drug interactions, or recommend a patient talk to a pharmacist or prescriber. Dispensary personnel in Oregon use a variety of resources to learn about medical marijuana. Although formal health or medical training was not indicated, personnel advise on marijuana's effects, use, and product selection. Further study is needed to assess the current training and advising on patients' ability to use medical marijuana safely and effectively. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Personnel Replacements Operations during Operations Desert Storm and Desert Shield

Science.gov (United States)

2015-06-12

virtue of huge purchases from international arms markets .”5 The Iraqi Army was also battle hardened from its eight year war with Iran, and it had...timelines for CRCs as well as the communication responsibilities to inform the Theater Personnel Command of inbound personnel. These doctrinal

Civil Service Evaluation. The Evolving Role of the U.S. Office of Personnel Management. A Report concerning Significant Actions of the U.S. Office of Personnel Management

National Research Council Canada - National Science Library

Erdreich, Ben

1998-01-01

The Government's program to oversee Federal personnel systems has existed in some form since World War II when rapid expansion of the civil service necessitated the delegation of personnel authorities...

Multicriteria Personnel Selection by the Modified Fuzzy VIKOR Method

Directory of Open Access Journals (Sweden)

Rasim M. Alguliyev

2015-01-01

Full Text Available Personnel evaluation is an important process in human resource management. The multicriteria nature and the presence of both qualitative and quantitative factors make it considerably more complex. In this study, a fuzzy hybrid multicriteria decision-making (MCDM model is proposed to personnel evaluation. This model solves personnel evaluation problem in a fuzzy environment where both criteria and weights could be fuzzy sets. The triangular fuzzy numbers are used to evaluate the suitability of personnel and the approximate reasoning of linguistic values. For evaluation, we have selected five information culture criteria. The weights of the criteria were calculated using worst-case method. After that, modified fuzzy VIKOR is proposed to rank the alternatives. The outcome of this research is ranking and selecting best alternative with the help of fuzzy VIKOR and modified fuzzy VIKOR techniques. A comparative analysis of results by fuzzy VIKOR and modified fuzzy VIKOR methods is presented. Experiments showed that the proposed modified fuzzy VIKOR method has some advantages over fuzzy VIKOR method. Firstly, from a computational complexity point of view, the presented model is effective. Secondly, compared to fuzzy VIKOR method, it has high acceptable advantage compared to fuzzy VIKOR method.

Selecting public relations personnel of hospitals by analytic network process.

Science.gov (United States)

Liao, Sen-Kuei; Chang, Kuei-Lun

2009-01-01

This study describes the use of analytic network process (ANP) in the Taiwanese hospital public relations personnel selection process. Starting with interviewing 48 practitioners and executives in north Taiwan, we collected selection criteria. Then, we retained the 12 critical criteria that were mentioned above 40 times by theses respondents, including: interpersonal skill, experience, negotiation, language, ability to follow orders, cognitive ability, adaptation to environment, adaptation to company, emotion, loyalty, attitude, and Response. Finally, we discussed with the 20 executives to take these important criteria into three perspectives to structure the hierarchy for hospital public relations personnel selection. After discussing with practitioners and executives, we find that selecting criteria are interrelated. The ANP, which incorporates interdependence relationships, is a new approach for multi-criteria decision-making. Thus, we apply ANP to select the most optimal public relations personnel of hospitals. An empirical study of public relations personnel selection problems in Taiwan hospitals is conducted to illustrate how the selection procedure works.

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.

WebPASS Explorer (HR Personnel Management)

Data.gov (United States)

US Agency for International Development — WebPass Explorer (WebPASS Framework): USAID is partnering with DoS in the implementation of their WebPass Post Personnel (PS) Module. WebPassPS does not replace...

Problems of medical personnel deontology during radiation emergency response

International Nuclear Information System (INIS)

Poplavskij, K.K.; Popov, A.O.

1990-01-01

Problems of deontology in the process of liquidation of radiation accident consequences are considered in the article. It is noted, that shortages of ethical nature in the activities of physicians are related to insufficient qualification of medical personnel in the area of radiation medicine. Problems of medical personnel participation in the large scale propaganda activities among various groups of population are considered. 5 refs

Training of fire protection personnel in nuclear power plants

International Nuclear Information System (INIS)

Blaser, W.

1980-01-01

Training of fire protection personnel in nuclear power plants is divided up in three categories: training of fire protection commissioners which is mostly carried out externally; training of fire fighting personnel in the form of basic and repeated training usually by the fire protection commissioner; training of other employers with regard to behaviour in case of fire and during work involving a fire hazard. (orig.) [de

Quality assurance for external personnel monitoring in nuclear industrial facilities, CNNC

International Nuclear Information System (INIS)

Zhang Yansheng; Dai Jun; Li Taosheng

1993-01-01

More than 6000 personnel are currently being monitored for occupational exposure in CNNC, China. Personnel monitoring is one of the important items of radiation protection. The data of individual dose are not only indispensable for radiation safety assessment but also the basis for radiation protection measures to be taken. Possibly, it could provide basic information for epidemiological studies, optimization procedure of radiation protection (risk/benefit analyses) and medical or legal purposes. Obviously, personnel monitoring and its quality assurance are very significant

Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review.

Science.gov (United States)

Rasoal, Dara; Skovdahl, Kirsti; Gifford, Mervyn; Kihlgren, Annica

2017-12-01

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a "bottom-up" perspective might give healthcare personnel opportunities to think and reflect more than a "top-down" perspective. A "bottom-up" approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a "top-down" approach risks removing such moral responsibility.