WorldWideScience

Sample records for ambulances

  1. Ambulance 3G.

    Science.gov (United States)

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

    2005-01-01

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

  2. A Theory of Ambulance Chasing

    CERN Document Server

    Backović, Mihailo

    2016-01-01

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

  3. Riding Third: Social Work in Ambulance Work

    Science.gov (United States)

    Campbell, Hilary; Rasmussen, Brian

    2012-01-01

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

  4. 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...

  5. Robotic Assistance During Ambulation by Older Adults

    OpenAIRE

    Matthews, Judith; Engberg, Sandra; Montemerlo, Michael; Pineau, Joelle; Roy, Nicholas; Rogers, Joan; Thrun, Sebastian

    2002-01-01

    Some older adults require assistance with ambulation due to physical mobility limitations. Others lack the cognitive ability, either alone or in combination with physical impairment, to get where they need to go. Investigation of older adults' gait speed, social interaction, and responsiveness to a robot during ambulation is part of the Nursebot Project, a unique collaboration of health care professionals and technologists focused on developing a personal robotic assistant for frail elderly a...

  6. Ambulance officers' use of online clinical evidence

    Directory of Open Access Journals (Sweden)

    Westbrook Mary T

    2006-07-01

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

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

    CERN Multimedia

    2000-01-01

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

  8. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus

    2010-01-01

    Much information is shared, interpreted and recreated between caller, emergency dispatch personnel and ambulance crew during an emergency call. This paper studies the use of reflection in the ambulance control center based on the information an ambulance crew produces during patient treatment in ...... understand and use the feedback delivered through the system. The paper argues for broadening the scope of telemedicine use outside the boundaries of communication between ambulance and emergency department....

  9. Post-traumatic stress among Swedish ambulance personnel

    OpenAIRE

    Jonsson, A; Segesten, K; Mattsson, B

    2003-01-01

    Objective: Emergency workers, including ambulance personnel, must cope with a variety of duty related stressors including traumatic incident exposures. Little is known about the variables that might be associated with post-traumatic stress symptom in high risk occupational groups such as ambulance personnel. This study investigated the prevalence of post-traumatic stress disorder among Swedish ambulance personnel.

  10. Rushing Roulette: The State of Canada's Ambulance Services.

    Science.gov (United States)

    Scanlan, L

    1976-02-01

    In a Canada-wide survey, CANADIAN FAMILY PHYSICIAN found a startling divergence in provincial standards for ambulance crews and vehicles.While some provinces had developed a well-integrated ambulance system with central dispatching, rigorous standards for attendants and advanced paramedical training programs, in some the ambulances are run almost entirely by local undertakers. PMID:21308032

  11. Leg Spasticity and Ambulation in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Sosnoff, Jacob J.; Pula, John H.; Brian M. Sandroff; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW)...

  12. Leg Spasticity and Ambulation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Swathi Balantrapu

    2014-01-01

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

  13. Leg Spasticity and Ambulation in Multiple Sclerosis

    Science.gov (United States)

    Balantrapu, Swathi; Sosnoff, Jacob J.; Pula, John H.; Sandroff, Brian M.; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P = 0.0001, d = −0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = −0.45), and walking velocity (P < 0.05, d = −0.53) and cadence (P < 0.05, d = −0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking. PMID:24999434

  14. Actively-controlled Beds for Ambulances

    Institute of Scientific and Technical Information of China (English)

    Takahiko Ono; Hikaru Inooka

    2009-01-01

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

  15. Design of an Efficient Integrated System for Ambulance Management

    Directory of Open Access Journals (Sweden)

    Raid S. Sarhan

    2015-08-01

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

  16. 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 questionn

  17. Ambulation after femoral sheath removal in percutaneous coronary intervention: a prospective comparison of early vs. late ambulation.

    NARCIS (Netherlands)

    Schiks, I.E.J.M.; Schoonhoven, L.J.; Aengevaeren, W.R.M.; Nogarede-Hoekstra, C.; Achterberg, T. van; Verheugt, F.W.A.

    2009-01-01

    AIM AND OBJECTIVES: To investigate if ambulation four hours after sheath removal can replace ambulation 10 hours or more after sheath removal with regard to puncture site complications after percutaneous coronary interventions and to examine patient comfort in both groups. BACKGROUND: Early ambulati

  18. Understanding the factors that influence patient satisfaction with ambulance services.

    Science.gov (United States)

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

    2016-01-01

    The quality of ambulance services has an immense impact on patients' future well-being and quality of life. Patient satisfaction is one of the key metrics for evaluating the quality of this service. Yet, the patient satisfaction measurement may be limited in its ability to accurately reflect this service quality, and even reflect factors beyond the patient experiences. We analyze 10 years of survey data to reveal a number of factors that systematically bias ambulance satisfaction ratings. Taking into account these biases provides more robust comparison of ambulance performance over time or across different jurisdictions. PMID:27295008

  19. Older people's use of ambulance services: a population based analysis.

    OpenAIRE

    Clark, M J; Fitzgerald, G

    1999-01-01

    OBJECTIVE: To investigate the use of emergency and non-urgent ambulance transport services by people aged 65 years and over. SETTING: The study was undertaken in Queensland where the Queensland Ambulance Services (QAS) is the sole provider of emergency pre-hospital and non-urgent ambulance services for the entire state. METHODS: The age and sex of 351,000 emergency and non-urgent cases treated and transported by the QAS from July 1995 to June 1996 were analysed. RESULTS: People aged 65 years ...

  20. Superior Ambulance Call Out Rate Forecasting Using Meteorological Data

    Science.gov (United States)

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

    2015-12-01

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

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

    Data.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Baba M. DEROS

    2016-03-01

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

  3. 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 ...

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered...... by ambulance personnel. METHODS: Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival....... Secondary outcomes included the number of patients with reduction in pain intensity during transport (NRS ≥ 2), the number of patients with NRS > 3 at hospital arrival, and potential fentanyl-related side effects. RESULTS: Fentanyl reduced pain from before treatment (8, IQR 7-9) to hospital arrival (4, IQR...

  6. A framework for the design of ambulance sirens.

    Science.gov (United States)

    Catchpole, K; McKeown, D

    2007-08-01

    Ambulance sirens are essential for assisting the safe and rapid arrival of an ambulance at the scene of an emergency. In this study, the parameters upon which sirens may be designed were examined and a framework for emergency vehicle siren design was proposed. Validity for the framework was supported through acoustic measurements and the evaluation of ambulance transit times over 240 emergency runs using two different siren systems. Modifying existing siren sounds to add high frequency content would improve vehicle penetration, detectability and sound localization cues, and mounting the siren behind the radiator grill, rather than on the light bar or under the wheel arch, would provide less unwanted noise while maintaining or improving the effective distance in front of the vehicle. Ultimately, these considerations will benefit any new attempt to design auditory warnings for the emergency services. PMID:17558670

  7. Role of Nurses in Early Ambulation of Living Donor Liver Transplant Recipients

    OpenAIRE

    Sato, Orie; Osanai, Yumiko; Urushidate, Chie; Yamaguchi, Tomoko; Narumi, Shunji; Umehara, Minoru; Toyoki, Yoshikazu; Sugai, Michihiro; Hakamada, Kenichi; Kimura, Toshiko

    2013-01-01

    [Introduction] Liver transplant recipients suffer more complications than do patients undergoing other gastroenterological surgeries. Many factors inhibit ambulation in liver transplant patients, such as the level of restriction to bed rest and length of stay in the intensive care unit( ICU). Patients thus face ambulation difficulties. Support for ambulation is one of the major daily tasks of nurses. We reviewed the ambulation situations of patients who underwent living donor liver transplant...

  8. Mathematical model of ambulance resources in Saint-Petersburg

    Science.gov (United States)

    Shavidze, G. G.; Balykina, Y. E.; Lejnina, E. A.; Svirkin, M. V.

    2016-06-01

    Emergency medical system is one of the main elements in city infrastructure. The article contains analysis of existing system of ambulance resource distribution. Paper considers the idea of using multiperiodicity as a tool to increase the efficiency of the Emergency Medical Services. The program developed in programming environment Matlab helps to evaluate the changes in the functioning of the system of emergency medical service.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  10. 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…

  11. Masculinity and Lifting Accidents among Danish Ambulance Personnel

    DEFF Research Database (Denmark)

    Hansen, Claus D.; Nielsen, Kent J

    alone. Aim This presentation investigates whether failure to use AT is linked to male ambulance workers’ gender identity? Is lifting patients alone a way of performing masculinity for AP’s? Method Data is taken from MARS, a panel study of AP workers in Denmark (n = 1606). Information from questionnaires...... measuring traditional male role norms (MRNI), safety attitudes and safety behavior will be linked to company register information on work injuries categorized as lifting accidents. Logistic regression is used to analyse associations between masculinity, lifting behavior, and lifting accidents. Results...... alone. For those 5% scoring lowest on MRNI the probability of reporting lifting alone was 6% while this figure was 17% for those scoring above the 95th percentile. Conclusion This study suggests that male ambulance workers performance of masculinity might pose a threat to their safety. AP...

  12. 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.

  13. Corticosteroid Treatments in Males With Duchenne Muscular Dystrophy: Treatment Duration and Time to Loss of Ambulation

    OpenAIRE

    Kim, Sunkyung; Campbell, Kimberly A.; Fox, Deborah J.; Matthews, Dennis J.; Valdez, Rodolfo

    2014-01-01

    This population-based study examines the association between corticosteroid treatment and time to loss of ambulation, stratifying by treatment duration (short: 0.25–3 years, long: >3 years), among 477 Duchenne muscular dystrophy cases identified by the Muscular Dystrophy Surveillance Tracking and Research Network (MDSTARnet). Those cases who received short-term corticosteroid treatment had a time to loss of ambulation that was 0.8 years shorter (t test) and an annual risk of losing ambulation...

  14. 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...... received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing....

  15. Physical fitness and occupational demands of the Belfast ambulance service.

    Science.gov (United States)

    Gamble, R P; Stevens, A B; McBrien, H; Black, A; Cran, G W; Boreham, C A

    1991-09-01

    The objectives of this study were to evaluate the current fitness of an area ambulance service based in Belfast and to quantify the physiological demands of accident and emergency work. From a total staff of 230, 105 (46%) volunteered to undergo a series of fitness tests subject to health state. Results based on body mass indices showed that 52% of subjects could be classified as overweight and 10% of subjects as obese. Fitness levels were similar to other comparable samples and showed the expected but not inevitable decrease with age. A simple work related task (walking at 6 km/h) performed in the laboratory showed that 54% of men over 40 years of age and 24% under 40 found it taxing. This would favour selection for accident and emergency work on the basis of functional capacity rather than chronological age. Accident and emergency work consisted of long periods of inactivity interspersed with shorter periods of relatively intense activity, often above the anaerobic threshold. Lactate concentrations measured during a staged emergency incident also suggested that personnel may work at intensities exceeding their anaerobic threshold. The incorporation of physical fitness standards in the ambulance service may be appropriate and consideration should be given to a reduced age of retirement. PMID:1911401

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

    Ebben, R.H.A.; Vloet, L.C.M.; Schalk, D.M.; Mintjes-de Groot, J.; Achterberg, T. van

    2014-01-01

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

  18. The use and abuse of the emergency ambulance service: some of the factors affecting the decision whether to call an emergency ambulance.

    OpenAIRE

    Gardner, G J

    1990-01-01

    Over a 1-month period all patients arriving in the accident and emergency department by ambulance following a '999' call were questioned using a standard proforma. They were assessed as to whether their medical condition warranted ambulance transfer. A number of social and practical points were analyzed to see whether they would identify any group of patients who used the emergency service without medical need. Overall 289 patients were questioned. Of these 178 (62%) were considered to have m...

  19. Prognostic Predictors for Ambulation in Thai Children With Cerebral Palsy Aged 2 to 18 Years.

    Science.gov (United States)

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

    2015-11-01

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

  20. Development of Training Programs to Optimize Planetary Ambulation

    Science.gov (United States)

    Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Cohen, H. S.; Miller, C. A.; Brady, R.; Warren, L. E.; Rutley, T. M.; Kozlovskaya, I. B.

    2007-01-01

    Astronauts experience disturbances in functional mobility following their return to Earth due to adaptive responses that occur during exposure to the microgravity conditions of space flight. Despite significant time spent performing in-flight exercise routines, these training programs have not been able to mitigate postflight alterations in postural and locomotor function. Therefore, the goal of our two inter-related projects (NSBRI-ground based and ISS flight study, "Mobility") is to develop and test gait training programs that will serve to optimize functional mobility during the adaptation period immediately following space flight, thereby improving the safety and efficiency of planetary ambulation. The gait training program entails manipulating the sensory conditions of treadmill exercise to systematically challenge the balance and gait control system. This enhances the overall adaptability of locomotor function enabling rapid reorganization of gait control to respond to ambulation in different gravitational environments. To develop the training program, we are conducting a series of ground-based studies evaluating the training efficacy associated with variation in visual flow, body loading, and support surface stability during treadmill walking. We will also determine the optimal method to present training stimuli within and across training sessions to maximize both the efficacy and efficiency of the training procedure. Results indicate that variations in both visual flow and body unloading during treadmill walking leads to modification in locomotor control and can be used as effective training modalities. Additionally, the composition and timing of sensory challenges experienced during each training session has significant impact on the ability to rapidly reorganize locomotor function when exposed to a novel sensory environment. We have developed the capability of producing support surface variation during gait training by mounting a treadmill on a six

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

    Directory of Open Access Journals (Sweden)

    Enrico Ferri

    2010-03-01

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

  2. 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...

  3. 75 FR 62639 - Air Ambulance and Commercial Helicopter Operations, Part 91 Helicopter Operations, and Part 135...

    Science.gov (United States)

    2010-10-12

    ...). SUMMARY: This proposed rule addresses air ambulance and commercial helicopter operations, part 91... and commercial helicopter operations. The proposal aims to address safety concerns arising from an... factors that are addressed in this proposal. These accidents involving commercial helicopter...

  4. [Design of a mechanical system for the balanceable system of ambulance].

    Science.gov (United States)

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

    2010-08-01

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

  5. Weather factors in the short-term forecasting of daily ambulance calls.

    Science.gov (United States)

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

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

  6. Weather factors in the short-term forecasting of daily ambulance calls

    Science.gov (United States)

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

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

  7. Demand Forecast Using Data Analytics for the Preallocation of Ambulances.

    Science.gov (United States)

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

    2016-07-01

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

  8. Weather and Age-Gender Effects on the Projection of Future Emergency Ambulance Demand in Hong Kong

    OpenAIRE

    Lai, PC; Wong, FHT

    2012-01-01

    An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structu...

  9. Ambulation following spinal cord injury and its correlates

    Directory of Open Access Journals (Sweden)

    Nitin Menon

    2015-01-01

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

  10. Ambulation speed and corresponding mechanics are associated with changes in serum cartilage oligomeric matrix protein.

    Science.gov (United States)

    Denning, W Matt; Becker Pardo, Michael; Winward, Jason G; Hunter, Iain; Ridge, Sarah; Hopkins, J Ty; Reese, C Shane; Parcell, Allen C; Seeley, Matthew K

    2016-02-01

    Because serum cartilage oligomeric matrix protein (COMP) has been used to reflect articular cartilage condition, we aimed to identify walking and running mechanics that are associated with changes in serum COMP. Eighteen subjects (9 male, 9 female; age=23 ± 2 yrs.; mass=68.3 ± 9.6 kg; height=1.70 ± 0.08 m) completed 4000 steps on an instrumented treadmill on three separate days. Each day corresponded to a different ambulation speed: slow (preferred walking speed), medium (+50% of slow), and fast (+100% of slow). Synchronized ground reaction force and video data were collected to evaluate walking mechanics. Blood samples were collected pre-, post-, 30-minute post-, and 60-minute post-ambulation to determine serum COMP concentration at these times. Serum COMP increased 29%, 18%, and 5% immediately post ambulation for the fast, medium, and slow sessions (p<0.01). When the speeds were pooled, peak ankle inversion, knee extension, knee abduction, hip flexion, hip extension, and hip abduction moment, and knee flexion angle at impact explained 61.4% of total variance in COMP concentration change (p<0.001). These results indicate that (1) certain joint mechanics are associated with acute change in serum COMP due to ambulation, and (2) increased ambulation speed increases serum COMP concentration. PMID:27004646

  11. Availability of ambulance patient care reports in the emergency department.

    Science.gov (United States)

    Shelton, Dominick; Sinclair, Paul

    2016-01-01

    Clinical handovers of patient care among healthcare professionals is vulnerable to the loss of important clinical information. A verbal report is typically provided by paramedics and documented by emergency department (ED) triage nurses. Paramedics subsequently complete a patient care report which is submitted electronically. This emergency medical system (EMS) patient care report often contains details of paramedic assessment and management that is not all captured in the nursing triage note. EMS patient care reports are often unavailable for review by emergency physicians and nurses. Two processes occur in the distribution of EMS patient care reports. The first is an external process to the ED that is influenced by the prehospital emergency medical system and results in the report being faxed to the ED. The second process is internal to the ED that requires clerical staff to distribute the fax report to accompany patient charts. A baseline audit measured the percentage of EMS patient care reports that were available to emergency physicians at the time of initial patient assessments and showed a wide variation in the availability of EMS reports. Also measured were the time intervals from patient transfer from EMS to ED stretcher until the EMS report was received by fax (external process measure) and the time from receiving the EMS fax report until distribution to patient chart (internal process measure). These baseline measures showed a wide variation in the time it takes to receive the EMS reports by fax and to distribute reports. Improvement strategies consisted of: 1. Educating ED clerical staff about the importance of EMS reports 2. Implementing a new process to minimize ED clerical staff handling of EMS reports for nonactive ED patients 3. Elimination of the automatic retrieval of old hospital charts and their distribution for ED patients 4. Introduction of an electronic dashboard for patients arriving by ambulance to facilitate more efficient distribution of

  12. [An ambulance helicopter in Jamtland. A survival necessity in a county of tourism].

    Science.gov (United States)

    Ek, B; Zetterström, H

    2000-03-22

    The county of Jämtland is a sparsely populated area in which an ambulance-helicopter has been in use since the middle of the 1970's. A prospective study was undertaken during a six month period with the aim of evaluating the benefits of the helicopter as compared with the use of road-ambulance transport alone. Total number of patients involved was n = 249. Both flight nurses and receiving doctors found that in most cases, patients transported by helicopter manned with a flight nurse were given higher quality care. A follow-up study by specialists from the receiving departments confirmed that for 3% (n = 8), transport by ambulance-helicopter resulted in "probably better prognosis", and that for 2% (n = 6) the result was "lifesaving". PMID:10765625

  13. Tuning approximate dynamic programming policies for ambulance redeployment via direct search

    Directory of Open Access Journals (Sweden)

    Matthew S. Maxwell

    2014-01-01

    Full Text Available In this paper we consider approximate dynamic programming methods for ambulance redeployment. We first demonstrate through simple examples how typical value function fitting techniques, such as approximate policy iteration and linear programming, may not be able to locate a high-quality policy even when the value function approximation architecture is rich enough to provide the optimal policy. To make up for this potential shortcoming, we show how to use direct search methods to tune the parameters in a value function approximation architecture so as to obtain high-quality policies. Direct search is computationally intensive. We therefore use a post-decision state dynamic programming formulation of ambulance redeployment that, together with direct search, requires far less computation with no noticeable performance loss. We provide further theoretical support for the post-decision state formulation of the ambulance-deployment problem by showing that this formulation can be obtained through a limiting argument on the original dynamic programming formulation.

  14. Early ambulation following 6 French diagnostic left heart catheterization: a prospective randomized trial.

    Science.gov (United States)

    Wood, R A; Lewis, B K; Harber, D R; Kovack, P J; Bates, E R; Stomel, R J

    1997-09-01

    Outpatient cardiac catheterization is frequently performed, but the optimal recovery time after sheath removal has not been defined. Left heart catheterization was performed via the femoral artery utilizing 6 French catheters on 323 outpatients. One hundred thirty-five patients were randomized to ambulate at a mean of 2.5 hr (group 1) after puncture site compression, whereas 188 patients were randomized to ambulate at a mean of 4.1 hr (group 2). Telephone follow-up occurred within 48 hr. A small hematoma (< 5 cm) occurred in 2 (1.6%) patients in group 1 and in 4 (2.4%) patients in group 2. These results indicate that it is safe to ambulate patients 2.5 hr following 6 French diagnostic heart catheterization. PMID:9286529

  15. A Prevalence and Management Study of Acute Pain in Children Attending Emergency Departments by Ambulance.

    Science.gov (United States)

    Murphy, Adrian; McCoy, Siobhan; O'Reilly, Kay; Fogarty, Eoin; Dietz, Jason; Crispino, Gloria; Wakai, Abel; O'Sullivan, Ronan

    2016-01-01

    Pain is the most common symptom in the emergency setting and remains one of the most challenging problems for emergency care providers, particularly in the pediatric population. The primary objective of this study was to determine the prevalence of acute pain in children attending emergency departments (EDs) in Ireland by ambulance. In addition, this study sought to describe the prehospital and initial ED management of pain in this population, with specific reference to etiology of pain, frequency of pain assessment, pain severity, and pharmacological analgesic interventions. A prospective cross-sectional study was undertaken over a 12-month period of all pediatric patients transported by emergency ambulance to four tertiary referral hospitals in Ireland. All children (management of acute pain in children transferred by ambulance to the ED in Ireland is currently poor, with documentary evidence of only 26% receiving prehospital analgesic agents. PMID:26024309

  16. 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.

  17. Prognostische Indices bei älteren Patienten mit ambulant erworbener Pneumonie

    OpenAIRE

    Niklaus, David

    2010-01-01

    Problem: Die Studie prüft, ob der CURBA-Index dem Pneumonie-Schwere-Index (PSI) bei älteren Patienten mit ambulant erworbener Pneumonie gleichwertig ist für die Abschätzung der Intrahospitalmortalität. Methode: Eine retrospektive Kohortenstudie wertet Daten stationärer Patienten ≥ 65 Jahre mit ambulant erworbener Pneumonie des Marienhospital Herne aus. Die Indices werden daraus generiert und evaluiert. Alle Patienten sind ≥ 65 Jahre, so wird der kürzere CURB-Score verwendet. Er...

  18. The Analysis of Vibration Characteristics and Motion Stability of the Tracked Ambulance Nonlinear Damping System

    Directory of Open Access Journals (Sweden)

    Meng Yang

    2013-01-01

    Full Text Available Considering the impact of the nonlinear stiffness, a 2 DOF dynamic nonlinear vibration model with cubic terms was established according to the structural feature and nonlinear behavior of the tracked ambulance. In the case of primary resonance and 1: 1 internal resonance, multiple scale method was used to obtain a first-order approximate solution for this model. Taking the parameters of the tracked ambulance for instance, the approximate solution was verified and the influence of the parameters on damping effect was investigated. Finally, the motion stability of the damping system was analyzed with singularity theory and the theoretical bases for improving efficiency of the damping system were provided.

  19. Assessing Pesticide Impact on Human Health in Nebraska: A Survey of Ambulance Services and Rescue Squads. Department Report No. 7.

    Science.gov (United States)

    Vitzthum, Edward F.; And Others

    A study examined the employment qualifications, job content, training, and training needs of ambulance service and rescue squad workers in Nebraska. Based on the 268 mail questionnaires that were completed and returned out of a total of 338 sent out, it was concluded that the strengths of the various ambulance and rescue services vary widely. The…

  20. 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.

    2009-01-01

    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 nurs

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  2. Necessities detected in patients derived to sanitary center in an ambulance of the urgent transport network after being treated by the 061 emergency team

    OpenAIRE

    Sixto Cámara Anguita; Antonio J. Valenzuela Rodríguez

    2007-01-01

    The integral systems of urgencies and sanitary emergencies has, as resources for the urgent transport of patients, with nonwelfare ambulances, ambulances of basic life support and ambulances of advanced life support. In the two first, due to the ambiguity of the norm, the presence of a nurse to give care is not compulsory. Nevertheless, in the present study, it is detected that, the patients of this study, transferred in nonwelfare ambulance of the urgent transport network to a useful hospita...

  3. Telemedicin - en mulighed til kvinder der føder ambulant?

    DEFF Research Database (Denmark)

    Danbjørg, Dorthe Boe; Clemensen, Jane; Wagner, Lis;

    2009, s.36). Det overordnede formål er at udforske om telemedicin kan være en mulig løsning, når kvinder udskrives ambulant. Design og metoder: Projektet er et aktionsforskningsprojekt, nærmere bestemt arbejdes der ud fra Participartory Design. Metodologien er baseret på deltagelse af brugerne, og det...

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

    International Nuclear Information System (INIS)

    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)

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    1998-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

    GerritsmaBleeker, CLE; Heeg, M; VosNiel, H

    1997-01-01

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

  10. Præhospital behandling. Ambulance-projektet Odense. En prospektiv undersøgelse

    DEFF Research Database (Denmark)

    Larsen, C F; Jørgensen, H R; Nielsen, J R;

    1990-01-01

    by the Danish National Board of Health was also tested. Experience from abroad and recent Danish trial arrangements demonstrate the positive effect of extended professional prehospital treatment. The authors consider, therefore, that an ambulance law is required as this would ensure better and more...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-01

    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.

  12. Promoting Ambulation Responses among Children with Multiple Disabilities through Walkers and Microswitches with Contingent Stimuli

    Science.gov (United States)

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Oliva, Doretta; Smaldone, Angela; La Martire, Maria L.; Stasolla, Fabrizio; Castagnaro, Francesca; Groeneweg, Jop

    2010-01-01

    Children with severe or profound intellectual and motor disabilities often present problems of balance and ambulation and spend much of their time sitting or lying, with negative consequences for their development and social status. Recent research has shown the possibility of using a walker (support) device and microswitches with preferred…

  13. 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...

  14. Ambulance services at hospital universiti sains malaysia and hospital kota bharu: a retrospective study of calls.

    Science.gov (United States)

    Shah Che Hamzah, Mohd Shaharudin; Ahmad, Rashidi; Nik Abdul Rahman, Nik Hisamuddin; Pardi, Kasmah Wati; Jaafar, Naimah; Wan Adnan, Wan Aasim; Jaalam, Kamaruddin; Sahil Jamalullail, Syed Mohsin

    2005-07-01

    This retrospective study attempted to identify the pattern of ambulance calls for the past two years at the Hospital Universiti Sains Malaysia (HUSM) and Hospital Kota Bharu (HKB). This study will provide a simple method of acquiring information related to ambulance response time (ART) and to test whether it met the international standards and needs of the client. Additionally, this paper takes into account the management of emergency calls. This included ambulance response time, which was part of Emergency Medical Services (EMS) episode: onset of ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint had been noted. ART ended when the emergency team arrived at the scene of incident. Information regarding ambulance calls from the record offices of HUSM and HKB was recorded for the year 2001 and 2002, tabulated and analyzed. There was a significant difference in the total number of calls managed by HUSM and HKB in the year 2001. It was noted that 645 calls were managed by HUSM while 1069 calls were recorded at HKB. In the year 2002, however, HUSM led with 613 extra numbers of calls as compare to HKB with 1193 numbers of calls. The pattern of ambulance calls observed is thought to possibly be influenced by social activities like local festivities, school holidays and the seasons. Further, it is observed that no studies were previously undertaken to compare the ART at both the HUSM and HKB to that of the international standards. In fact, a literature review undertaken so far showed no similar studies have been done for the whole Malaysia. PMID:22605956

  15. 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 ambulation after only 10 minutes training. The ability to achieve such BCI control with minimal training indicates that the implementation of future BCI-lower extremity prosthesis systems may be feasible.

  16. Weather and age-gender effects on the projection of future emergency ambulance demand in Hong Kong.

    Science.gov (United States)

    Lai, Poh-Chin; Wong, Ho-Ting

    2015-03-01

    An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structure between 2008 and 2036. The quadratic relation between average daily temperature and daily ambulance demand in 2036 was further explored by including and excluding age-gender demographic changes. Without accounting for changes in the age-gender structure, the 2036 ambulance demand for age groups of 65 and above were consistently underestimated (by 38%-65%), whereas those of younger age groups were overestimated (by 6%-37%). Moreover, changes in the 2008 to 2036 age-gender structure also shift upward and emphasize relationships between average daily temperature and daily ambulance demand at both ends of the quadratic U-shaped curve. Our study reveals a potential societal implication of ageing population on the demand for ambulance services. PMID:23070758

  17. 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

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

  18. Prosthetic ambulation in a paraplegic patient with a transfemoral amputation and radial nerve palsy.

    Science.gov (United States)

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

    2000-08-01

    Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side. The difficulties of fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed. PMID:10992814

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

    Science.gov (United States)

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

    2010-01-01

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

  20. 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

  1. 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...... 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....

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

    OpenAIRE

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

    2004-01-01

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

  3. 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.

  4. Reducing Time to First on Scene: An Ambulance-Community First Responder Scheme.

    Science.gov (United States)

    Campbell, Alan; Ellington, Matt

    2016-01-01

    The importance of early access to prehospital care has been demonstrated in many medical emergencies. This work aims to describe the potential time benefit of implementing a student Community First Responder scheme to support ambulance services in an inner-city setting in the United Kingdom. Twenty final and penultimate year medical students in the UK were trained in the "First Person on Scene" Business and Technology Education Council (BTEC) qualification. Over 12 months, they attended 89 emergency calls in an inner-city setting as Community First Responders (CFRs), alongside the West Midlands Ambulance Service, UK. At the end of this period, a qualitative survey investigated the perceived educational value of the scheme. The mean CFR response time across all calls was an average of 3 minutes and 8 seconds less than ambulance crew response times. The largest difference was to calls relating to falls (12 min). The difference varied throughout the day, peaking between 16:00 and 18:00. All questionnaire respondents stated that they felt more prepared in assessing and treating acutely unwell patients. In this paper, the authors present a symbiotic solution which has both reduced time to first on scene and provided training and experience in medical emergencies for senior medical students. PMID:27119024

  5. 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. PMID:25909398

  6. Design and validation of a platform robot for determination of ankle impedance during ambulation.

    Science.gov (United States)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Laetitia Yperzeele

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

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

    Directory of Open Access Journals (Sweden)

    Sergei N. Drachev

    2012-11-01

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

  9. 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.

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

    Science.gov (United States)

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

    2016-04-01

    Patient delivery time is no longer considered as the only critical factor, in ambulatory services. Presently, five clinical performance indicators are used to decide patient satisfaction. Unfortunately, the emergency ambulance services in rapidly growing metropolitan areas do not meet current satisfaction expectations; because of human errors in the management of the objects onboard the ambulances. But, human involvement in the information management of emergency interventions can be reduced by electronic tracking of personnel, assets, consumables and drugs (PACD) carried in the ambulances. Electronic tracking needs the support of automation software, which should be integrated to the overall hospital information system. Our work presents a complete solution based on a centralized database supported by radio frequency identification (RFID) and bluetooth low energy (BLE) identification and tracking technologies. Each object in an ambulance is identified and tracked by the best suited technology. The automated identification and tracking reduces manual paper documentation and frees the personnel to better focus on medical activities. The presence and amounts of the PACD are automatically monitored, warning about their depletion, non-presence or maintenance dates. The computerized two way hospital-ambulance communication link provides information sharing and instantaneous feedback for better and faster diagnosis decisions. A fully implemented system is presented, with detailed hardware and software descriptions. The benefits and the clinical outcomes of the proposed system are discussed, which lead to improved personnel efficiency and more effective interventions. PMID:26777434

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

    Directory of Open Access Journals (Sweden)

    Ann M Simon

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

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

    Science.gov (United States)

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

    2014-01-01

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

  13. 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

  14. Emerging organizational structures in the ambulance industry in the United States.

    Science.gov (United States)

    Narad, R A

    2000-01-01

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

  15. Lightweight physiologic sensor performance during pre-hospital care delivered by ambulance clinicians.

    Science.gov (United States)

    Mort, Alasdair J; Fitzpatrick, David; Wilson, Philip M J; Mellish, Chris; Schneider, Anne

    2016-02-01

    The aim of this study was to explore the impact of motion generated by ambulance patient management on the performance of two lightweight physiologic sensors. Two physiologic sensors were applied to pre-hospital patients. The first was the Contec Medical Systems CMS50FW finger pulse oximeter, monitoring heart rate (HR) and blood oxygen saturation (SpO2). The second was the RESpeck respiratory rate (RR) sensor, which was wireless-enabled with a Bluetooth(®) Low Energy protocol. Sensor data were recorded from 16 pre-hospital patients, who were monitored for 21.2 ± 9.8 min, on average. Some form of error was identified on almost every HR and SpO2 trace. However, the mean proportion of each trace exhibiting error was <10 % (range <1-50 % for individual patients). There appeared to be no overt impact of the gross motion associated with road ambulance transit on the incidence of HR or SpO2 error. The RESpeck RR sensor delivered an average of 4.2 (±2.2) validated breaths per minute, but did not produce any validated breaths during the gross motion of ambulance transit as its pre-defined motion threshold was exceeded. However, this was many more data points than could be achieved using traditional manual assessment of RR. Error was identified on a majority of pre-hospital physiologic signals, which emphasised the need to ensure consistent sensor attachment in this unstable and unpredictable environment, and in developing intelligent methods of screening out such error. PMID:25804608

  16. The use of intraluminal strain gauges for recording ambulant small bowel motility.

    Science.gov (United States)

    Gill, R C; Kellow, J E; Browning, C; Wingate, D L

    1990-04-01

    Perfused-tube manometry has hitherto been the standard technique for recording intraluminal intestinal pressure in humans, but it is unsuitable for ambulant use. The aim of our study was to evaluate the ability of resistive strain gauge transducers attached to a fine catheter to detect pressure change. Simultaneous strain gauge and perfused-tube manometry was performed on six fasting subjects; in four, strain gauge activation was continuous and in two, the transducers were activated in a pulsed mode with data encoded as a pulse train with an approximate frequency of 20 Hz. Eight thousand eight hundred eighty-eight pressure waves were recorded by strain gauge, of which 96% were detected by perfused-tube manometry. There was good agreement in both phases II and III of the migrating motor complex. The amplitude of pressure waves recorded by strain gauge was slightly but significantly greater. A proportion (14-17%) of pressure waves recorded by strain gauge were bifid; this was not seen with the perfused tube. These differences are best explained by the greater sensitivity and more rapid rise time of the strain gauges. There was no loss of fidelity in the pulse-interval recording mode. A seventh subject underwent a continuous 72-h recording with the strain gauge catheter attached to a battery-operated encoder and magnetic tape cassette recorder and was freely ambulant during this period. The procedure was well tolerated and motility patterns could be clearly identified. We conclude that intraluminal strain gauge catheters are suitable for prolonged use in ambulant subjects and produce data that are closely comparable to the data acquired from perfused-tube manometry under laboratory conditions. PMID:2333973

  17. Operational implementation and lessons learned from Haiti's first helicopter air ambulance.

    Science.gov (United States)

    DeGennaro, Vincent; Owen, Jordan; Chandler, Jerry; McDaniel, Ralph

    2016-05-01

    Critical-care helicopter transport has demonstrated improvements in morbidity and mortality to those patients who utilise the service, but this has largely excluded developing country populations due to set up costs. Haiti Air Ambulance is the first completely publicly-available helicopter ambulance service in a developing country. US standards were adopted for both aviation and aeromedical care in Haiti due to proximity and relationships. In order to implement properly, standards for aviation, critical care, and insurance reimbursement had to be put in place with local authorities. Haiti Air Ambulance worked with the Ministry of Health to author standards for medical procedures, medication usage, and staff training for aeromedical programs in the country. Utilisation criteria for the helicopter were drafted, edited, and constantly updated to ensure the program adapted to the clinical situation while maintaining US standard of care. During the first year, 76 patients were transferred; 13 of whom were children and 3 pregnant women. Three patients were intubated and two required bi-level mask ventilation. Traumatic injury and non-emergency interfacility transfers were the two most common indications for service. More than half of the transfers (54%) originated at one of six hospitals, mostly as a result of highly-involved staff. The program was limited by weather and the lack of weather reporting, radar, visual flight recognition, thus also causing an inability to fly at night. In partnership with the government and other non-governmental organisations, we seek to implement a more robust pre-hospital system in Haiti over the next 12-24 months, including more scene call capabilities. PMID:26739767

  18. Samarbeid og kompetanseutveksling mellom sykehus og kommune : evaluering av prosjektet "Ambulant team"

    OpenAIRE

    Lorentzen, Catherine

    2008-01-01

    Rapporten er en evaluering av prosjektet ”Ambulant team” som innbefattet ambulerende virksomhet fra Geriatrisk seksjon ved Sykehuset i Vestfold og ut i Horten, Nøtterøy og Sandefjord kommuner i forbindelse med hjemsending av pasienter. Hovedmålene med inneværende undersøkelse har vært å evaluere effekten av den ambulerende virksomheten på samhandlingen og kompetanseutvekslingen behandlingsnivåene imellom, samt å ta stilling til prosjektets videre- og overføringsverdi.

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

    Directory of Open Access Journals (Sweden)

    Ronald J. Triolo, PhD

    2010-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Sherene E. Sharath, MPH

    2015-11-01

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

  1. Using HSPA to improve the telemedical links on a moving ambulance.

    Science.gov (United States)

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

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

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

    Science.gov (United States)

    Kannenberg, Andreas; Zacharias, Britta; Pröbsting, Eva

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Andreas Kannenberg, MD, PhD

    2015-03-01

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

  5. Assessing post-anterior cruciate ligament reconstruction ambulation using wireless wearable integrated sensors.

    Science.gov (United States)

    Arosha Senanayake, S M N; Ahmed Malik, Owais; Mohammad Iskandar, Pg; Zaheer, Dansih

    2013-11-01

    Abstract A hardware/software co-design for assessing post-Anterior Cruciate Ligament (ACL) reconstruction ambulation is presented. The knee kinematics and neuromuscular data during walking (2-6 km h(-1)) have been acquired using wireless wearable motion and electromyography (EMG) sensors, respectively. These signals were integrated by superimposition and mixed signals processing techniques in order to provide visual analyses of bio-signals and identification of the recovery progress of subjects. Monitoring overlapped signals simultaneously helps in detecting variability and correlation of knee joint dynamics and muscles activities for an individual subject as well as for a group. The recovery stages of subjects have been identified based on combined features (knee flexion/extension and EMG signals) using an adaptive neuro-fuzzy inference system (ANFIS). The proposed system has been validated for 28 test subjects (healthy and ACL-reconstructed). Results of ANFIS showed that the ambulation data can be used to distinguish subjects at different levels of recuperation after ACL reconstruction. PMID:24117351

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Moriwaki Yoshihiro

    2009-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Lau Bjørn

    2011-03-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  11. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Science.gov (United States)

    2010-10-01

    ... representative instructs an enrollee to seek emergency services within or outside the plan; and (v) With a limit... pre-approved ends when— (i) A plan physician with privileges at the treating hospital assumes... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for ambulance services, emergency...

  12. 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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  14. [The evaluation of health of medical personnel of ambulance care and impacting factors].

    Science.gov (United States)

    2012-01-01

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

  15. The Effect of Early Ambulation on Patient Outcomes for Total Joint Replacement.

    Science.gov (United States)

    Yager, Melissa; Stichler, Jaynelle

    2015-01-01

    The National Association of Orthopaedic Nurses published clinical practice guidelines in 2010 to improve outcomes with day of surgery mobilization in the total joint replacement patient (). With the cost of healthcare skyrocketing and reimbursement marginally covering costs, healthcare professionals must look for ways to reduce length of stay for elective procedures. The purpose of this change project was to provide and measure the effectiveness of an educational intervention on the benefits of day of surgery mobility for nurses and physical therapy staff. Acquisition of caregivers' knowledge, attitudes, and practice was measured along with three patient outcomes (length of stay, discharge destination, and day of ambulation). The findings from this change project resulted in improvements in structure (new practice protocol), processes (nursing and physical therapy care processes), and patient and organization outcomes. PMID:26213872

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

    Directory of Open Access Journals (Sweden)

    Rachid Merzougui

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Arnaud Gouelle, PhD

    2014-09-01

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

  18. A Study on Vibration Characteristics and Stability of the Ambulance Nonlinear Damping System

    Directory of Open Access Journals (Sweden)

    Meng Yang

    2013-01-01

    Full Text Available Considering the impact of the nonlinear stiffness, a 2-DOF vibration model with cubic terms was established according to the structural feature and nonlinear behavior. Ignoring the impact of nonlinear terms, the system was linearly analyzed. In the case of primary resonance and 1 : 1 internal resonance, a multiscale method was used to obtain a first-order approximate solution. Taking the parameters of one tracked ambulance for instance, the approximate solution was corroborated and the influence of the parameters on damping effect was investigated. Finally, motion stability of the damping system was analyzed with singularity theory. The theoretical bases for improving efficiency of the damping system were provided.

  19. The effects of liberal versus restrictive transfusion thresholds on ambulation after hip fracture surgery

    DEFF Research Database (Denmark)

    Foss, Nicolai B; Kristensen, Morten Tange; Jensen, Pia Søe;

    2009-01-01

    BACKGROUND: Perioperative anemia leads to increased morbidity and mortality and potentially inhibits rehabilitation after hip fracture surgery. As such, the optimum transfusion threshold after hip fracture surgery is unknown. PATIENTS AND METHODS: A total of 120 elderly, cognitively intact hip...... fracture patients admitted from their own home were randomly assigned to receive transfusion at a hemoglobin threshold of 10.0 g per dL (liberal) versus 8.0 g per dL (restrictive) in the entire perioperative period. Patients were treated according to a well-defined multimodal rehabilitation program....... Primary outcome was postoperative functional mobility measured with the cumulated ambulation score (CAS). RESULTS: Patients in the liberal group received transfusions more frequently than those in the restrictive group (44 patients vs. 22 patients; p transfusions during...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Hip fractures are common in elderly patients, and walking impairment is a frequent complication. The Cumulated Ambulation Score (CAS) is a validated functional scale used to monitor easily three basic mobility activities in patients with hip fracture. The aim of this study was to translate, cross...... was determined by comparing the total CAS-I (0-6 points) with the Index of Independence in Activities of Daily Living score (0-4 points). Internal consistency and inter-rater reliability of the CAS, evaluated with Cronbach's α and κ, respectively, were above 0.84 and 0.94. The SE of measurement for the total CAS......-I (0-6 points) 2 days and 3 months after surgery were 0.03 and 0.13 points, respectively. The CAS-I showed a significant correlation with the first four items of the Activities of Daily Living score scale (r≥0.85, P

  1. Evaluation of Bacterial Contamination on Pre Hospital Ambulances in Qom University of Medical Sciences of Iran in 2015

    Directory of Open Access Journals (Sweden)

    Roohollah Farhadloo

    2016-07-01

    Full Text Available Abstract Background & Aims of the Study: When the issue of the quality of the patient's care is addressed, determination of infection degrees in reference to the quality of such cares has gained a high priority. Therefore, infections in ambulance equipment might play a significant role in reduction of the quality of the hospital cares. This study was conducted wishing to determine bacterial infection degrees in ambulances servicing in pre-hospital emergency medical services of Qom University of Medical Sciences, Iran. Materials and Methods: In this analytical cross-sectional study, 132 sampling of the equipments of 12 ambulances were done. Samples were stored on BHI broth as an amplifier for 24 hours. Then, they were introduced to blood agar and Eosin Methylene Blue (EMB agar culture environments. After 24 hours, negative staphylococcus coagulase and bacillus were specified by different environments, solutions, diagnostic discs, gram staining, catalase test, oxidase test and coagulase test. Then data were analyzed by SPSS16. Results: The results showed that the highest infection prevalence rate was observed in stretchers (12 samples, 100% and the lowest in oxygenation moisturizers (1 sample, 8.4%. From infected equipments, in addition, four instruments (37% were mobile and eight of them (63% were immobile. Conclusion: Results indicated that an infection degree of the utensils and instruments which were used in ambulances employed servicing in the Qom Province Medical Emergency Response Center of Iran is high, that might have their roots in non-application of disinfectants for disinfecting ambulance surfaces and equipment. This is a mandatory for healthcare agents to utilize the protective covers, especially medical gloves.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Melih Yuksel

    2015-06-01

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

  4. 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.

  5. 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. PMID:26248957

  6. Necessities detected in patients derived to sanitary center in an ambulance of the urgent transport network after being treated by the 061 emergency team

    Directory of Open Access Journals (Sweden)

    Sixto Cámara Anguita

    2007-03-01

    Full Text Available The integral systems of urgencies and sanitary emergencies has, as resources for the urgent transport of patients, with nonwelfare ambulances, ambulances of basic life support and ambulances of advanced life support. In the two first, due to the ambiguity of the norm, the presence of a nurse to give care is not compulsory. Nevertheless, in the present study, it is detected that, the patients of this study, transferred in nonwelfare ambulance of the urgent transport network to a useful hospitable center with urgency character, once they have been attended by the 061 emergency team, presented/displayed a group of altered basic human necessities, medical levels of dependency as far as autonomy, nurse diagnoses, medical diagnoses, and necessities of pursuit of the restored evolution of the therapeutic technique and that cause the necessity of benefit of nursing care during this transfer.

  7. Use of the emergency ambulance service to an inner city accident and emergency department--a comparison of general practitioner and '999' calls.

    OpenAIRE

    Pennycook, A. G.; Makower, R M; Morrison, W G

    1991-01-01

    Over a 2-week period a prospective study was undertaken of patients brought to an inner city accident and emergency department by the emergency ambulance service. Criteria for assessing the appropriateness of use of the emergency ambulance service are not well defined and at worst entirely subjective. The author's finding that, of patients attending after a '999' call, 49.8% were discharged with no follow-up suggests that many of these journeys represented inappropriate use of the emergency a...

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Schaffer Andrea

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lagarde Emmanuel

    2011-03-01

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

  11. 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. PMID:20634072

  12. Does a waist-worn ActiGraph accelerometer quantify community ambulation in persons with multiple sclerosis?

    OpenAIRE

    Jacob J. Sosnoff, PhD; Michael J. Socie, MS; Morgan K. Boes, MS; Brian M. Sandroff, MS; Robert W. Motl, PhD

    2012-01-01

    Accelerometry has been recognized as a method of objectively measuring community ambulation in persons with multiple sclerosis (MS). However, the assumption that walking itself serves as a major contributor to the accelerometer signal has yet to be tested. This study examined the assumption that community-based walking is a primary contributor to accelerometer output in MS. Ambulatory persons (5 males/17 females; 13 without aid/9 with aid) with MS wore a triaxial accelerometer (ActiGraph GT3X...

  13. Strategies to reduce the configuration time for a powered knee and ankle prosthesis across multiple ambulation modes.

    Science.gov (United States)

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

    2013-06-01

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

  14. 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. PMID:16438775

  15. Resource planning for ambulance services in mass casualty incidents: a DES-based policy model.

    Science.gov (United States)

    Rauner, Marion S; Schaffhauser-Linzatti, Michaela M; Niessner, Helmut

    2012-09-01

    Due to an increasing number of mass casualty incidents, which are generally complex and unique in nature, we suggest that decision makers consider operations research-based policy models to help prepare emergency staff for improved planning and scheduling at the emergency site. We thus develop a discrete-event simulation policy model, which is currently being applied by disaster-responsive ambulance services in Austria. By evaluating realistic scenarios, our policy model is shown to enhance the scheduling and outcomes at operative and online levels. The proposed scenarios range from small, simple, and urban to rather large, complex, remote mass casualty emergencies. Furthermore, the organization of an advanced medical post can be improved on a strategic level to increase rescue quality, including enhanced survival of injured victims. In particular, we consider a realistic mass casualty incident at a brewery relative to other exemplary disasters. Based on a variety of such situations, we derive general policy implications at both the macro (e.g., strategic rescue policy) and micro (e.g., operative and online scheduling strategies at the emergency site) levels. PMID:22653522

  16. 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.

  17. Reliability and validity of the modified functional ambulation category scale in patients with hemiparalysis.

    Science.gov (United States)

    Park, Chang Sik; An, Seung Heon

    2016-08-01

    [Purpose] This study aimed to examine the inter- and intra-rater reliability and validity of the modified functional ambulation category (mFAC) scale. [Subjects and Methods] The participants were 66 stroke patients with hemiparalysis. The inter- and intra-rater validity of the mFAC was calculated using the Spearman correlation coefficient. A score comparison of the stable or maximum gait speed with regard to mFAC and modified Rivermead Mobility Index (mRMI) performances was performed as a univariate linear regression analysis to determine how the Kruskal-Wallis test affects the mRMI and stable/maximum gait speed with regard to mFAC. [Results] The inter-rater reliability of the mFAC (intraclass coefficient [ICC]) was 0.982 (0.971-0.989), with a kappa coefficient of 0.923 and a consistency ratio of 94%. In contrast, the intra-rater reliability of the mFAC (ICC) was 0.991 (0.986-0.995), with a kappa coefficient of 0.961 and a consistency ratio of 96%, showing higher reliability. Moreover, there was a significant difference in stable/maximum gait speed between the mFAC and the mRMI. [Conclusion] Since the mFAC has sufficient inter- and intra-reliability and high validity, it can be used as an assessment tool that reflects the gait performance and mobility of stroke patients. PMID:27630410

  18. Treadmill measures of ambulation rates in ovine models of spinal cord injury and neuropathic pain.

    Science.gov (United States)

    Safayi, S; Miller, J W; Wilson, S; Shivapour, S K; Oelfke, T F; Ford, A L; Klarmann Staudt, A; Abode-Iyamah, K; Reddy, C G; Jeffery, N D; Fredericks, D C; Gillies, G T; Howard, M A

    2016-01-01

    Our laboratories are developing treadmill-based gait analysis employing sheep to investigate potential efficacy of intra-dural spinal cord stimulation in the treatment of spinal cord injury and neuropathic pain. As part of efforts to establish the performance characteristics of the experimental arrangement, this study measured the treadmill speed via a tachometer, video belt-marker timing and ambulation-rate observations of the sheep. The data reveal a 0.1-0.3% residual drift in the baseline (unloaded) treadmill speed which increases with loading, but all three approaches agree on final speed to within 1.7%, at belt speeds of ≈ 4 km/h. Using the tachometer as the standard, the estimated upper limit on uncertainty in the video belt-marker approach is ± 0.18 km h(-1) and the measured uncertainty is ± 0.15 km h(-1). Employment of the latter method in determining timing differences between contralateral hoof strikes by the sheep suggests its utility in assessing severity of SCI and responses to therapeutic interventions. PMID:26785329

  19. Ambulation and independence among Veterans with nontraumatic bilateral lower-limb loss.

    Science.gov (United States)

    Sharath, Sherene; Henson, Helene; Flynn, Stacy; Pisimisis, George; Kougias, Panos; Barshes, Neal R

    2015-01-01

    In describing functional outcomes and independent living in a cohort of bilateral major amputees, we sought to provide current estimates of function and independence after a second major amputation in an elderly Veteran population with peripheral arterial disease and/or diabetes. After retrospectively reviewing and excluding the electronic health records of those failing to meet the inclusion criteria, we identified 40 patients with a history of unilateral major amputation who underwent a second major amputation during the defined study period. Of these, 43% (17) were bilateral transfemoral amputations (TFAs); bilateral transtibial amputations (TTAs) and TFA-TTA accounted for the rest (33% and 25%, respectively). Of the 19 (48%) patients who were ambulatory prior to bilateral amputation, only 2 (11%) remained ambulatory after the second amputation, while 17 (89%) patients lost ambulatory capabilities. Compared with those who were amputation (p = 0.03). All patients with bilateral TFA were nonambulatory. Independence postcontralateral amputation decreased from 88% (35) to 53% (21). When data were available (58%), pre and post Functional Independence Measure scores showed a decrease in 74% of patients, while 22% showed an increase. In conclusion, bilateral lower-limb amputation among dysvascular Veterans is highly associated with a loss of ambulation. PMID:26745753

  20. Calls Forecast for the Moscow Ambulance Service. The Impact of Weather Forecast

    Science.gov (United States)

    Gordin, Vladimir; Bykov, Philipp

    2015-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Marika Pane

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

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

    Science.gov (United States)

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

    2014-01-01

    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3) m at 12 months, of -58.9 (SD 125.7) m at 24 months and -104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available. PMID:25271887

  3. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations. Extension, implementation, and lifting of temporary moratoria.

    Science.gov (United States)

    2016-08-01

    This document announces the extension of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare home health agencies (HHAs), subunits, and branch locations in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. It also announces the implementation of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare HHAs, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey on a statewide basis. In addition, it announces the lifting of the moratoria on all Part B emergency ground ambulance suppliers. These moratoria, and the changes described in this document, also apply to the enrollment of HHAs and non-emergency ground ambulance suppliers in Medicaid and the Children's Health Insurance Program.

  4. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations. Extension, implementation, and lifting of temporary moratoria.

    Science.gov (United States)

    2016-08-01

    This document announces the extension of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare home health agencies (HHAs), subunits, and branch locations in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. It also announces the implementation of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare HHAs, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey on a statewide basis. In addition, it announces the lifting of the moratoria on all Part B emergency ground ambulance suppliers. These moratoria, and the changes described in this document, also apply to the enrollment of HHAs and non-emergency ground ambulance suppliers in Medicaid and the Children's Health Insurance Program. PMID:27487581

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

    Directory of Open Access Journals (Sweden)

    J.K. Marcus

    2009-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Alvaro eCosta

    2016-02-01

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

  7. 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.

  8. Model application for rapid detection of the exact location when calling an ambulance using OGC Open GeoSMS Standards

    Science.gov (United States)

    Sukic, Enes; Stoimenov, Leonid

    2016-02-01

    The web has penetrated just about every sphere of human interest and using information from the web has become ubiquitous among different categories of users. Medicine has long being using the benefits of modern technologies and without them it cannot function. This paper offers a proposal of use and mutual collaboration of several modern technologies within facilitating the location and communication between persons in need of emergency medical assistance and the emergency head offices, i.e., the ambulance. The main advantage of the proposed model is the technical possibility of implementation and use of these technologies in developing countries and low implementation cost.

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

    Energy Technology Data Exchange (ETDEWEB)

    Mariss, P.; Haubold, E.

    1988-02-01

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

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands.......,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self......-rated health compared to the core work force (5 % vs. 10 %). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands...

  12. Case Studies of Technology-aided Interventions to Promote Hand Reaching and Standing or Basic Ambulation in Persons with Multiple Disabilities.

    Science.gov (United States)

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Alberti, Gloria; Campodonico, Francesca

    2016-02-01

    Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts. PMID:27420316

  13. 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.

  14. [Ambulance helicopters in the mountains. An evaluation of the 1-year activity at the Dombås base].

    Science.gov (United States)

    Karper, S; Stokstad, I; Hjort, P F; Indrebø, T

    1991-01-20

    On 1 January 1988 the Norwegian Air Ambulance Plan was put into effect. The operational base for the regional counties Oppland, parts of South Trøndelag, Møre and Romsdal and Hedmark was established in the township of Dombås. The base had a helicopter staffed with a specialist in emergency medicine. The operation of this base was evaluated for the period 1 February 1988 to 1 February 1989. 242 missions were undertaken. In 27 of 184 primary missions (15%) and in 11 of 32 secondary missions (33%) the service was judged to have given health benefit. It may have prevented the death of 13 patients. The service costs during the year were approximately NOK 10 million. The cost-benefit ratio is judged to be too high. In inland-Norway, with a widely scattered population, it is probably better to improve the quality of the emergency services offered by general practitioners and ordinary road ambulances than to use a helicopter staffed with a specialist in emergency medicine.

  15. 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

    2016-06-01

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

  16. Does a waist-worn ActiGraph accelerometer quantify community ambulation in persons with multiple sclerosis?

    Directory of Open Access Journals (Sweden)

    Jacob J. Sosnoff, PhD

    2012-12-01

    Full Text Available Accelerometry has been recognized as a method of objectively measuring community ambulation in persons with multiple sclerosis (MS. However, the assumption that walking itself serves as a major contributor to the accelerometer signal has yet to be tested. This study examined the assumption that community-based walking is a primary contributor to accelerometer output in MS. Ambulatory persons (5 males/17 females; 13 without aid/9 with aid with MS wore a triaxial accelerometer (ActiGraph GT3X, Health One Technologies; Fort Walton Beach, Florida as well as an IDEEA system (MiniSun, Inc; Fresno, Florida over the course of a single day. Outcome measures for the accelerometer included movement counts/hour for the vertical, anterior-posterior, and mediolateral axes. Outcomes for the IDEEA system included percent time walking, sitting, and standing, as well as walking speed. Pearson product correlations (r were used to examine the associations between outcomes from the accelerometer and IDEEA system. Significant correlations were observed between percent walking time and movement counts/hour along the vertical (r = 0.84 and anterior-posterior (r = 0.69 axes. Significant correlations were further noted between movement counts/hour along the vertical axis and walking speed (r = 0.45 and self-report walking impairment (r = −0.50 and disability (r = −0.46. Such observations further support accelerometry as an objective marker of community ambulation in persons with MS.

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

    LENUS (Irish Health Repository)

    Gallagher, Sharon

    2007-01-01

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

  18. Pre-hospital assessment by a single responder: The Swedish ambulance nurse in a new role: A pilot study.

    Science.gov (United States)

    Magnusson, Carl; Källenius, Christofer; Knutsson, Susanne; Herlitz, Johan; Axelsson, Christer

    2016-05-01

    When a person with vague symptoms calls 112, the dispatchers often have difficulty prioritising the severity of the call. Their only alternative has been to send an ambulance. In Gothenburg, Sweden, a nurse-manned single responder (SR) was initiated to assess this patient group. The study aims to describe patient characteristics and assessment level made by the SR nurse among patients assessed by the dispatcher as low priority and/or vague symptoms. A consecutive journal review was conducted. During six months, 529 patients were assessed; 329 (62%) attended the emergency department (ED) or inpatient care (IC). Of these, 85 patients (26%) were assessed as high priority. Only 108 were assessed as being in need of ambulance transport. ED/IC patients were significantly older. Two hundred (38%) stayed at the scene (SS) (n = 142) or were referred to primary care (PC) (n = 58). Of the 200 SS/PC patients, 38 (19%) attended the ED within 72 hrs with residual symptoms, 20 of whom were admitted to a ward. Nine patients (4% of 200 SS/PC patients) required inpatient treatment and 11 patients stayed overnight for observation. These results suggest a relatively high level of patient safety and the usefulness of an SR among patients assessed by the dispatcher as low priority. PMID:26472522

  19. Gaps between policy, protocols and practice: a qualitative study of the views and practice of emergency ambulance staff concerning the care of patients with non-urgent needs

    OpenAIRE

    Snooks, H.; Kearsley, N; Dale, J; Halter, M; Redhead, J; Foster, J.

    2005-01-01

    Aim: To describe emergency ambulance crews' views about (1) how they make decisions on whether to convey patients to hospital; (2) an intervention enabling them to triage patients to non-conveyance; and (3) their experience of using new protocols for undertaking such triage.

  20. The NSW Ambulance Service healthy lifestyle program--a case study in the evaluation of a health promotion program.

    Science.gov (United States)

    Gomel, M; Oldenburg, B

    1990-01-01

    A variety of approaches have been used to reduce Cardiovascular Disease (CVD) risk in the community, including programs based in the workplace. To date, it has been difficult to draw accurate conclusions on the effectiveness of worksite CVD risk reduction programs. Typically, such programs suffer from poor participation and high attrition rates and most lack physical and biochemical validation of self-reported lifestyle changes. The present paper describes an evaluation of four health promotion worksite interventions (screening, education, incentive and lifestyle change) conducted in the NSW Ambulance Service. The study achieved very high participation and low attrition rates. Self-reported changes in lifestyle were validated with physical and biochemical measures. The results suggest greater change in some risk factors for those individuals receiving the incentive and lifestyle change programs compared to screening alone or education. PMID:10109119

  1. Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology.

    Science.gov (United States)

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

    2008-06-01

    We report the testing of a mobile Robotic Tele-echo system that was placed in an ambulance and successfully transmitted clear real time echo imaging of a patient's abdomen to the destination hospital from where this device was being remotely operated. Two-way communication between the paramedics in this vehicle and a doctor standing by at the hospital was undertaken. The robot was equipped with an ultrasound probe which was remotely controlled by the clinician at the hospital and ultrasound images of the patient were transmitted wirelessly. The quality of the ultrasound images that were transmitted over the public mobile telephone networks and those transmitted over the Multimedia Wireless Access Network (a private networks) were compared. The transmission rate over the public networks and the private networks was approximately 256 Kbps, 3 Mbps respectively. Our results indicate that ultrasound images of far higher definition could be obtained through the private networks. PMID:18444361

  2. Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

    Science.gov (United States)

    Nishikawa, Tomofumi; Okamura, Tomonori; Nakayama, Hirofumi; Miyamatsu, Naomi; Morimoto, Akiko; Toyoda, Kazunori; Suzuki, Kazuo; Toyota, Akihiro; Hata, Takashi; Yamaguchi, Takenori

    2016-01-01

    Background An immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services. Methods The present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study. Results After the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P < 0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009). Conclusions Our results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance. PMID:26441211

  3. Advanced glycation end-products in the peritoneal fluid and in the peritoneal membrane of continuous ambulant peritoneal dialysis patients.

    Science.gov (United States)

    Mahiout, A; Ehlerding, G; Brunkhorst, R

    1996-01-01

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

  4. An art therapy intervention for cancer patients in the ambulant aftercare - results from a non-randomised controlled study.

    Science.gov (United States)

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

    2013-05-01

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

  5. Pilot Field Test: The Ability to Ambulate After Landing as Assessed with Seat Egress, Walk, and Obstacle Test

    Science.gov (United States)

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

    2016-01-01

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

  6. Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan.

    Science.gov (United States)

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

    2016-10-01

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

  7. Development of an implanted intramuscular EMG-triggered FES system for ambulation after incomplete spinal cord injury.

    Science.gov (United States)

    Dutta, Anirban; Kobetic, Rudi; Triolo, Ronald

    2009-01-01

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

  8. Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan.

    Science.gov (United States)

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

    2016-10-01

    Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7μg/m(3). In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10μg/m(3) increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in 3weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being. PMID:27235903

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

    Directory of Open Access Journals (Sweden)

    Akihito Hagihara

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

  10. 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

  11. 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)

    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. Trial Registration

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

    Directory of Open Access Journals (Sweden)

    Freeman Jennifer

    2012-04-01

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

  13. Préambule

    Directory of Open Access Journals (Sweden)

    Emmanuel Grimaud

    2011-06-01

    Full Text Available Courses à la virtuosité Nombreuses sont les pratiques qui ont généré, parfois en leur cœur et souvent en leurs marges, des programmes acrobatiques. Ces programmes ont généralement des finalités comparables. Il s’agit d’apprécier et d’évaluer l’excellence technique, d’explorer plus ou moins librement les possibilités d’un instrument ou de mettre à l’épreuve ses limites. De la musique à la jonglerie, de la prestidigitation à la voltige aérienne ou encore à la cascade à moto, rares sont les arts...

  14. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    OpenAIRE

    Thorley Megan; Donaghey Samantha; Edwards Priya; Copeland Lisa; Kentish Megan; McLennan Kim; Lindsley Jayne; Gascoigne-Pees Laura; Sakzewski Leanne; Boyd Roslyn N

    2012-01-01

    Abstract Background Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A) combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V), compared with standard therapy alo...

  15. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    OpenAIRE

    Thorley, Megan; Donaghey, Samantha; Edwards, Priya; Copeland, Lisa; Kentish, Megan; McLennan, Kim; Lindsley, Jayne; Gascoigne-Pees, Laura; Sakzewski, Leanne; Boyd, Roslyn N.

    2012-01-01

    Background Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A) combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V), compared with standard therapy alone (cycle...

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

    Institute of Scientific and Technical Information of China (English)

    杨丽萍

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Scott A. Bloch

    2013-01-01

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

  18. The Loyal Customer Phenomenon as a Social Relationship: A Study with Ambulant Coffee Salesmen in the City of Ibagué

    Directory of Open Access Journals (Sweden)

    Lady Grey Javela**

    2009-12-01

    Full Text Available The purpose of this research was to study the relationship established between an ambulant coffee salesman (ACSM and his loyal client, in the frame of Michael Argyle’s social relationships model. Thirty couples were interviewed about the ACSM and loyal clients relationship; also interactions among 183 ACSM – loyal clients and 117 ACS M –sporadic clients were registered. Our research found that the commercial relationship between an ACSM and his/her loyal client is a social relationship, taking into account that it brought evidence about the constitutive elements of a relationship of this nature under Argyle’s perspective; and coincidences were observed in the declarations that the actors of the relationship made about it. Additionally, we found that the ACSM’s behavior is different depending on the type of client that he/she is attending –loyal or sporadic–.

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

    Directory of Open Access Journals (Sweden)

    Andreea Mihaela Seferian

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

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

    Directory of Open Access Journals (Sweden)

    Forberg Jakob L

    2012-02-01

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

  1. 中美救护车车载物品比较%Comparison with the Supplies and Equipment Carried on Ambulance between the United State and China

    Institute of Scientific and Technical Information of China (English)

    郑进

    2013-01-01

    The supplies and equipment carried on ambulance is the foundation and guarantee of pre--hospital emergency care,it is significant for the efficiency and result of pre-hospital emergency care.This paper made a summary and analysis of the characteristic for the supplies and equipment carried on ambulance and the pre-hospital emergency care in American:pay more attention to the personal safety of prehospital emergency personal; pay more attention to the extrication for patient; pay more attention to the utilizing of cardiopulmonary resuscitation (CPR)board; pay more attention to the scientificalness of allocation for the jump kit; pay more attention to the using of ordinary goods; pay more attention to the patient transfer.The emergency medical personal rescued 5,120 sudden death patients out hospital in Seattle of the United States in 1970s,and the rate of successful resuscitation was 28.9%; the emergency medical personal of Shanghai emergency medical center rescued 4,374 sudden death patients out hospital in Shanghai in 1999,and the rate of successful resuscitation was 1.35%; Obviously,the rate of successful resuscitation for sudden death patients out hospital in China is much lower than that in the United States.It is probably related with the difference in ambulance equipment between the United States and China.Knowing this could be beneficial and referential for the pre-hospital emergency care in our country.%救护车车载物品是院前急救的基础和保障,对院前急救的效率和质量具有十分重要的意义.本文总结并分析了美国救护车车载物品和院前急救的特点:更加注重院前急救人员的个人防护;更加注重对患者的救出;更加注重心脏按压板的运用;更加注重急救箱物品配置的科学性;更加注重对普通物品的利用;更加注重患者的转运.美国西雅图20世纪70年代抢救5 120例院外猝死患者,复苏成功至康复出院者达28.9%;

  2. Intervention to prevent further falls in older people who call an ambulance as a result of a fall: a protocol for the iPREFER randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background An increasing number of falls result in an emergency call and the subsequent dispatch of paramedics. In the absence of physical injury, abnormal physiological parameters or change in usual functional status, it could be argued that routine conveyance by ambulance to the Emergency Department (ED) is not the most effective or efficient use of resources. Further, it is likely that non-conveyed older fallers have the potential to benefit from timely access to fall risk assessment and intervention. The aim of this randomised controlled trial is to evaluate the effect of a timely and tailored falls assessment and management intervention on the number of subsequent falls and fall-related injuries for non-conveyed older fallers. Methods Community dwelling people aged 65 years or older who are not conveyed to the ED following a fall will be eligible to be visited at home by a research physiotherapist. Consenting participants will receive individualised intervention strategies based on risk factors identified at baseline. All pre-test measures will be assessed prior to randomisation. Post-test measures will be undertaken by a researcher blinded to group allocation 6 months post-baseline. Participants in the intervention group will receive individualised pro-active fall prevention strategies from the clinical researcher to ensure that risk factors are addressed adequately and interventions carried out. The primary outcome measure will be the number of falls recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the subsequent use of medical and emergency services and uptake of recommendations. Data will be analysed using the intention-to-treat principle. Discussion As there is currently little evidence regarding the effectiveness or feasibility of alternate models of care following ambulance non-conveyance of older fallers, there is a need to explore assessment and intervention programs to

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

    Science.gov (United States)

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

    2012-01-01

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

  4. Integrated Suit Test 1 - A Study to Evaluate Effects of Suit Weight, Pressure, and Kinematics on Human Performance during Lunar Ambulation

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Brandon Jesse Goff

    2014-01-01

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

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

    Science.gov (United States)

    Goff, Brandon Jesse; Naber, Jeremy Wingseng; McCallin, John Patrick; Lopez, Edward Michael; Guthmiller, Kevin Brant; Lautenschlager, Karl Alan; Lai, Tristan Toll; Hommer, Dean Harry; Marin, Gonzalez Raul

    2014-01-01

    Complex regional pain syndrome (CRPS) is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS) has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervical disc fusion. This condition resulted in severe pain and functional impairment that was unresponsive to pharmacological management. The patient's rehabilitation was severely stymied by her excruciating pain. However, with the initiation of spinal cord stimulation, her pain was adequately controlled allowing for progression to full unassisted ambulation, advancing functional capacity, and improving quality of life. This case report supports the concept that rapid progression to neuromodulation, rather than delays that occur due to attempts at serial sympathetic blocks, may better control symptoms leading allowing for a more meaningful recovery. PMID:25525522

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

    Institute of Scientific and Technical Information of China (English)

    张艳; 陈剑苹; 蒋辛

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. The Intelligence PID Control of the Ambulation Track of the Robot%机械人移动轨迹的智能PID控制

    Institute of Scientific and Technical Information of China (English)

    周巨青

    2014-01-01

    过程控制系统广泛的采用PID控制,它的系统直接关系到生产过程的平稳和产品的最终质量,因而其优化设计十分重要。常规PID控制得到了广泛的应用,但是不难满足高精度要求。智能PID控制吸取了智能控制和常规PID控制的优点,能够满足很多场合的高精度的要求。用于机械人移动控制取得了很好的效果。采用神经网络,可实现对机器人动力学方程中未知部分的精确逼近,从而实现无需建模的控制。%PID control is widely used in proces control systems. The performance of the controllers is dirrectly related to the sta⁃bility of the processes and the quality of product, so it is very valuable for their optimai design.The normal regulations PID con⁃trol have already been applied extensively,but can't satisfy a high accuracy request.The intelligence PID control absorb the advan⁃tage of the intelligence control and the normal regulations PID control,can satisfy the request of the high accuracy of a lot of situa⁃tions.Used for the robot ambulation control obtained good result.Adopt the nerve network, can carry out to approach to the pre⁃cision that didn't know part, carried out and don't need a control of set up the mold thus.

  11. An observational study of hand hygiene in 120 ambulance service%“120”救护车手卫生相关状况的观察研究

    Institute of Scientific and Technical Information of China (English)

    杨珊; 王丽媛; 刘茜; 臧渝梨

    2014-01-01

    Objective To investigate into hand hygiene facilities and worker's practice of hand hygiene during 120 ambulance services in a capital city.Methods With the standard Observation Form publicized by the World Health Organization,field observation was carried out to monitor hand hygiene facilities and the practice of hand hygiene in workers during ambulance services provided by four service centers.Results A total of seven ambulances and 80 times of services were observed across a span of 21 days.The provision and position of hand hygiene facilities were found very limited in these ambulances.Of 656 times of presence of indictors for hand hygiene,the overall compliance rate was 3.04% reflecting the practice of hand hygiene in ambulance workers.The compliance rate was found to be 0 (0/291),1.96% (1/51),13.64% (3/22),5.21% (16/307) and 0(0/2) before touching patients,after body fluids exposure risk,before clean/aseptic procedures and after touching patients' surroundings respectively.Conclusions Poor practice of hand hygiene which was revealed in 120 ambulance services suggests the great need for education and training to improve patient safety and occupational health.%目的 深入了解某省会城市“120”救护车的手卫生设施及出诊工作者的手卫生执行情况.方法 采用世界卫生组织标准监督观察表,跟车对某省会城市4所急救分中心“120”救护车的手卫生设施及出车工作者的手卫生行为进行现场观察.结果 21 d观察7辆救护车80次出诊发现,救护车手卫生设施配置与摆放有限;出现手卫生机会656次,总体依从性3.04%,接触患者前、清洁无菌操作前、可能接触患者体液后、接触患者后及接触患者周围环境后的依从性分别为0(0/291)、1.96%(1/51)、13.64%(3/22)、5.21%(16/307)、0(0/2).结论 “120”院前急救手卫生状况不容乐观,亟待加强培训,促进患者安全和职业防护.

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

    Science.gov (United States)

    2016-08-01

    This notice announces the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in 6 states. The demonstration is being implemented in accordance with section 402 of the Social Security Amendments of 1967 and gives CMS the authority to grant waivers to the statewide enrollment moratoria on a case-by-case basis in response to access to care issues, and to subject providers and suppliers enrolling via such waivers to heightened screening, oversight, and investigations. PMID:27487580

  13. Ambulation and spinal cord injury.

    Science.gov (United States)

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

    2013-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    舒艳; 杨建国; 李素英; 王梅; 陈明

    2011-01-01

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

  15. Effects of weight relieving ambulator on walking function of hemiplegic patients with cerebral stroke%减重步态机器人对脑卒中偏瘫患者步行功能的影响

    Institute of Scientific and Technical Information of China (English)

    程明; 崔微; 王雪梅; 余茜

    2013-01-01

    目的 研究步态机器人训练对脑卒中偏瘫患者运动功能的影响.方法 将50例偏瘫患者分为2组,综合康复组行常规康复及减重步态机器人治疗,普通康复组行单纯康复治疗,疗程均为一个月,采用Carr-Shepherd运动功能评定(MAS)中的步行评定法对两组步行能力及临床疗效进行评定并且比较.结果 综合康复组患者步行能力较普通康复组改善明显,总有效率明显高于普通康复组(P<0.05).结论 减重步态机器人对偏瘫患者的恢复步行能力及改善异常步态有积极的作用.%Objective To study the effects of weight relieving ambulator on walking function of hemiplegic patients suffered from cerebral stroke. Methods Fifty hemiplegic patients were randomly divided into two groups: the comprehensive rehabilitation group and the general rehabilitation group. The comprehensive rehabilitation group was treated in the conventional method combined with weight relieving ambulator, while the general rehabilitation group was treated with the conventional method only. The period of treatment was one month. After treatment, the Carr-Shepherd assessment of motor function ( MAS ) was used to compare the walking function between the two groups. Results Patients of the comprehensive rehabilitation group had more improvements in walking ability than those of the general rehabilitation group did. Conclusion It is concluded that the weight relieving ambulator has a positive effect on the improvement of walking ability and abnormal gait of hemiplegic patients.

  16. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Thorley Megan

    2012-08-01

    Full Text Available Abstract Background Children with cerebral palsy (CP whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V, compared with standard therapy alone (cycle I, and whether repeated injections with the same regime of adjunctive therapy results in greater benefits compared with a single injecting episode (cycle II. The regime of therapy will include serial casting, splinting and/or provision of orthoses, as indicated, combined with four sessions of goal directed occupational therapy or physiotherapy. Method/design This study is a double blind randomized controlled trial. Forty participants will be recruited. In cycle I, participants will be randomized to either a treatment group who will receive BoNT-A injections into selected upper and/or lower limb muscles, or a control group who will undergo sham injections. Both groups will receive occupational therapy and /or physiotherapy following injections. Groups will be assessed at baseline then compared at 4 and 16 weeks following injections or sham control. Parents, treating clinicians and assessors will be masked to group allocation. In cycle II, all participants will undergo intramuscular BoNT-A injections to selected upper and/or lower limb muscles, followed by therapy. The primary outcome measure will be change in parent ratings in identified areas of concern for their child’s care and comfort, using the Canadian Occupational Performance Measure (COPM. Secondary measures will include the Care and Comfort Hypertonicity Scale (ease of care, the Cerebral Palsy Quality of Life Questionnaire (CP QoL–Child (quality of life, the Caregiver Priorities and Child

  17. Direct ambulance transport to catheterization laboratory reduces door-to-balloon time in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the DIRECT-STEMI study

    Institute of Scientific and Technical Information of China (English)

    QIU Jian-ping; ZHANG Qi; LU Ji-de; WANG Hai-rong; LIN Jie; GE Zhi-ru; ZHANG Rui-yan; SHEN Wei-feng

    2011-01-01

    Background Primary percutaneous coronary intervention (PCI) has been clearly identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI). The importance of reducing door-to-balloon (D2B) time has gained increased recognition. This study aimed to assess the feasibility, safety and efficacy of the strategy of direct ambulance transportation of patients with acute STEMI to catheterization lab to receive primary PCI.Methods The study population included 141 consecutive patients with chest pain and ST-segment elevation who were admitted to the catheterization laboratory directly by the ambulance and underwent primary PCI (DIRECT group).Another 145 patients with STEMI randomly selected from the PCI database, were served as control group (conventional group); they were transported to catheterization laboratory from emergency room (ER). The primary endpoint of D2B time,and secondary endpoint of in-hospital and 30-day major adverse cardiac events (MACE, including death, non-fatal reinfarction, and target vessel revascularization) were compared.Results Baseline and procedural characteristics between the two groups were comparable, except more patients in the DIRECT group presented TIMI 0-1 flow in culprit vessel at initial angiogram (80.1% and 73.8%, P=0.04). Comparing to conventional group, the primary endpoint of D2B time was reduced ((54±18) minutes and (112±55) minutes, P <0.0001)and the percentage of patients with D2B <90 minutes was increased in the DIRECT group (96.9% and 27.0%, P<0.0001).The success rate of primary PCI with stent implantation with final Thrombolysis in Myocardial Infarction (TIMI) 3 flow was significantly higher in the DIRECT group (93.8% and 85.2%, P=0.03). Although no significant difference was found at 30-day MACE free survival rate between the two groups (95.0% and 89.0%, P=0.06), a trend in improving survival status in the DIRECT group was demonstrated by Kaplan-Meier analysis

  18. 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;

    2015-01-01

    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...... with electrocardiographic data available in 824 patients (95%). Residual ST-segment deviation one hour after PCI was 3.8±4.9 mm versus 3.9±5.2 mm for bivalirudin and heparin+GPI, respectively (p=0.0019 for non-inferiority). Overall, there were no differences between randomized treatments in any measures of ST......-segment resolution either before or after the index procedure. CONCLUSIONS: Pre-hospital treatment with bivalirudin is non-inferior to pre-hospital heparin + GPI with regard to residual ST-segment deviation or ST-segment resolution, reflecting comparable myocardial reperfusion with the two strategies....

  19. Characteristics analysis of pneumatic artificial muscle isolation system of vehicle-mounted stretcher on ambulance%救护车载 PAM担架缓冲系统特性分析

    Institute of Scientific and Technical Information of China (English)

    孙大刚; 高蓬; 宋勇; 梁培根; 沈毅

    2015-01-01

    Based on the analysis of the vibration isolation system of ambulance stretcher and the study on its dynamic model,a new buffer system of stretcher based on pneumatic artificial muscle was proposed.Then a vehicle-stretcher-human vibration model was built up,and a semi-active neural network PID controller for stretcher vibration control based on pneumatic artificial muscle was designed.The vibration isolation system performances were simulated by using the Simulation software,and the simulation results were analysed.The results show that compared with traditional system,the pneumatic artificial muscle buffer system using neural network PID control has more obvious isolation effect on stretcher and patient vibration,indicating the feasibility of using pneumatic artificial muscle in buffer system of ambulance stretcher.%经对救护车担架隔振系统及动力学模型研究分析,提出气动人工肌肉(PAM)救护车担架隔振系统。建立车体-担架-分段人体振动模型,设计基于该系统的半主动神经网络 PID 控制器,并用 Simulink 对隔振系统进行性能仿真分析。仿真结果表明,与被动系统相比,采用神经网络 PID 控制的气动人工肌肉隔振系统对担架及人体有明显隔振效果,气动人工肌肉用于救护车担架隔振系统具有可行性。

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

    Institute of Scientific and Technical Information of China (English)

    魏华; 黄敬堂; 申培红

    2016-01-01

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

  1. Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

    OpenAIRE

    Roberts Stephen; Phillips Judith; Phillips Ceri; Peconi Julie; Merali Yasmin; Mason Suzanne; Lyons Ronan; Humphreys Ioan; Gaze Sarah; Dale Jeremy; Close Jacqueline; Cheung Wai-Yee; Snooks Helen; Russell Ian; Sánchez Antonio

    2010-01-01

    Abstract Background Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS) software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community fall...

  2. Effect of High-Dose Vitamin D3 Intake on Ambulation, Muscular Pain and Bone Mineral Density in a Woman with Multiple Sclerosis: A 10-Year Longitudinal Case Report

    Directory of Open Access Journals (Sweden)

    François Feron

    2012-10-01

    Full Text Available Mounting evidence correlate vitamin D3 (cholecalciferol supplementation or higher serum levels of vitamin D (25(OHD with a lower risk of developing multiple sclerosis (MS, reduced relapse rate, slower progression or fewer new brain lesions. We present here the case of a woman who was diagnosed with MS in 1990. From 1980 to 2000, her ability to walk decreased from ~20 to 1 km per day. Since January 2001, a vitamin D3 supplement was ingested daily. The starting dose was 20 mcg (800 IU/day and escalated to 100 mcg (4000 IU/day in September 2004 and then to 150 mcg (6000 IU/day in December 2005. Vitamin D3 intake reduced muscular pain and improved ambulation from 1 (February 2000 to 14 km/day (February 2008. Vitamin D intake over 10 years caused no adverse effects: no hypercalcaemia, nephrolithiasis or hypercalciuria were observed. Bowel problems in MS may need to be addressed as they can cause malabsorption including calcium, which may increase serum PTH and 1,25(OH2D levels, as well as bone loss. We suggest that periodic assessment of vitamin D3, calcium and magnesium intake, bowel problems and the measurement of serum 25(OHD, PTH, Ca levels, UCa/Cr and bone health become part of the integral management of persons with MS.

  3. Optimal Design of Vibration Reduction for the Integrated Airborne Aid Unit on Ambulance Helicopter%救护直升机机载急救单元减振优化设计

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    According to the vibration characteristics of an ambulance helicopter, the optimum design for vibration isolation of integrated airborne aid unit was done using the tunable metal dry-friction damping. Within the adjustment range of the isolator’s dry friction damping, curves of the friction force of the vibration isolator were obtained by testing, and the harmonic-wave superposition method was used to simulate the cabin-floor excitation of the helicopter. Meanwhile, the optimum curve of the friction force was made based on the optimization simulation, and then the best working condition of the isolator damping was determined. Results of the optimization show that the RMS of the acceleration can be reduced by 78.755 % with the use of the isolator in the airborne aid unit, the isolator has a good vibration isolation damping performance and is suitable for the airborne vibration environment of the helicopter.%  针对某型救护直升机振动特点,采用金属干摩擦阻尼可调式隔振器对机载综合急救单元进行隔振优化设计,在隔振器干摩擦阻尼调节范围内,测试多组隔振器摩擦力曲线,应用谐波叠加法模拟直升机客舱底板激励,并通过仿真优化计算确定最佳摩擦力曲线,进而确定隔振器阻尼最佳工作状态。优化结果表明机载综合急救单元采用该型隔振器,能使加速度均方根响应降低78.75%,说明该隔振器具有良好的隔振减振性能,适用于直升机机载振动环境。

  4. Measuring physical strain during ambulation with accelerometry

    NARCIS (Netherlands)

    Bussmann, J B; Hartgerink, I; van der Woude, L H; Stam, H J

    2000-01-01

    PURPOSE: To study the feasibility of ambulatory accelerometry in the evaluation of physical strain in walking at different speeds and different levels of economy. METHODS: Twelve able-bodied subjects performed a walking test on a treadmill with increasing walking speed. After a 6-wk period, these me

  5. Upper extremity joint stresses during walkerassisted ambulation in post-surgical patients Estresse articular no membro superior durante marcha assistida por andador em pacientes pós-cirúrgicos

    Directory of Open Access Journals (Sweden)

    Kevin J. Mcquade

    2011-08-01

    Full Text Available BACKGROUND: A walker is a common device prescribed for ambulatory assistance for individuals with balance difficulties or to reduce lower extremity demands following injury or surgery. The long-term use of a walker imposes significant demands on the patient's upper extremities that may lead to increased risk for development of secondary conditions such as wrist, elbow or shoulder pain. OBJECTIVE: To describe the joint kinematics, forces and moments of the wrist, elbow and shoulder in a sample of twenty patients that were using a walker as a result of total joint surgery of the hips and knees. METHODS: Three-dimensional upper extremity kinematics were recorded using a motion capture system synchronized with forces and torques transmitted through a walker instrumented with force transducers in the handles. RESULTS: Compressive forces were found to be nearly 20% of the body weight at each of the upper extremity joints, both surgical and non-surgical sides, being the greatest force at the wrist and decreasing proximally. Compression forces were greater in the non-surgical side limb at the wrist and at the elbow. CONCLUSION: Our findings indicated that loads on upper extremity joints associated with the use of a walker for assisted ambulation are high and further studies are needed to address the cause-effect relationship between the actual joint loading and the development of secondary musculoskeletal upper extremity complaints in more frail patients.CONTEXTUALIZAÇÃO: Um andador é um dispositivo frequentemente prescrito para auxiliar a marcha de indivíduos com dificuldades de equilíbrio ou para reduzir demandas à extremidade inferior após cirurgia ou lesão. O uso prolongado de um andador impõe significante demanda para a extremidade superior do paciente, o que pode levar a um risco aumentado de desenvolver condições secundárias, como dor no punho, cotovelo e ombro. OBJETIVO: Descrever a cinemática articular, forças e momentos do punho

  6. Support and Assessment for Fall Emergency Referrals (SAFER 1 trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Roberts Stephen

    2010-01-01

    Full Text Available Abstract Background Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services. Methods/Design Pragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters' at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial. Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders. The primary outcome is the interval to the first subsequent reported fall (or death. We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically. Discussion Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services. In conclusion this complex emergency care

  7. Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

    Science.gov (United States)

    2010-01-01

    Background Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS) software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services. Methods/Design Pragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters') at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial. Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders. The primary outcome is the interval to the first subsequent reported fall (or death). We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically. Discussion Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services. In conclusion this complex emergency care trial will provide

  8. Perfil funcional de locomoção em um grupo de pacientes com lesão medular atendidos em um centro de reabilitação Perfil funcional de locomoción en un grupo de pacientes con lesión medular atendidos en un centro de rehabilitación Functional ambulation profile in a group of spinal cord injured patients attended at a rehabilitation center

    Directory of Open Access Journals (Sweden)

    Ana Cristina Franzoi

    2009-12-01

    Full Text Available OBJETIVO: descrever o perfil de locomoção de um grupo de pacientes com lesão medular (LM, correlacionando-o com as características da amostra. MÉTODOS: setenta pacientes (50 com LM traumática e 20 com LM não-traumática. Instrumentos: Classificação Funcional da Marcha Modificada (CFMM, WISCI-II, Escala de Ashworth Modificada (EAM, Classificação AIS, Lower Extremities Muscle Score (AIS-LEMS. Estatística: descritiva, comparação entre grupos, testes de correlação considerando pOBJETIVO: describir el perfil de locomoción de un grupo de pacientes con lesión medular (LM, correlacionándolo con las características de la muestra. MÉTODOS: setenta pacientes (50 con LM traumática y 20 con LM no traumática. Instrumentos: Clasificación Funcional de la Marcha Modificada (CFMM, WISCI-II, Escala de Ashworth Modificada (EAM, Clasificación AIS, AIS Lower Extremities Muscle Score (AIS-LEMS. Estadística: descriptiva, comparación entre grupos, testes de correlación considerando un pOBJECTIVE: to describe the locomotion profile of a group of spinal cord injured (SCI patients and its correlation with the sample features. METHODS: seventy patients (50 with traumatic SCI and 20 non-traumatic were assessed. Instruments: Modified Functional Ambulation Classification (MFAC, Walking Index for Spinal Cord Injury II (WISCI-II, Modified Ashworth Scale (MAS, American Spinal Injury Association Impairment Scale (AIS and AIS Lower Extremities Muscle Score (AIS-LEMS. Statistics: descriptive, comparison between groups, correlation tests (considering p<0,05. RESULTS: average values were: age: 36 years, 72.9% males, average time of lesion 4.7 years. AIS A, 38.6%; AIS B, 10%; AIS C, 22.8%; AIS D, 28.6%. Level of lesion: 32.8% cervical, 52.9% thoracic, 14.3% lumbar. More prevalent etiologies: gunshot wounds 30% and car accidents 18%. MFAC: Non-ambulation, 34.3%; Therapeutic ambulation 20%, Household ambulation 12.8%, community ambulation (32.9%; WISCI-II: 7

  9. 新入职院前急救护士职业应激、心理资本与共情疲劳感的关系分析%Relationship of compassion fatigue, occupational stress and psychological capital among new graduate ambulance nurses

    Institute of Scientific and Technical Information of China (English)

    魏华; 董越娟; 邹涛; 王永革; 陈妍; 段梅艳

    2015-01-01

    目的:探讨新入职院前急救护士职业应激、心理资本与共情疲劳感的关系。方法选取入职1个月的253名院前急救护士为研究对象,采用护士专业生活品质量表( ProQOL-V)、心理资本问卷(PCQ-24)和护士应激源量表(CNSS)进行测评,入职后3,6个月进行追踪测评。结果入职后6个月院前急救护士CNSS得分、CNSS-4得分、CNSS-6得分分别为(100.21±14.82),(185.54±50.54),(165.54±51.87)分,分别优于入职后1,3个月,差异有统计学意义(F值分别为14.53,17.41,14.89;P<0.05)。新入职院前急救护士 CNSS得分与 PCQ-24得分呈负相关(r=-0.45,P<0.05),与 CNSS-1、CNSS-2、CNSS-4、CNSS-6得分呈正相关(r=0.28,0.15,0.37,0.36;P<0.05);PCQ-24得分与 CNSS-1、CNSS-2、CNSS-3、CNSS-4、CNSS-6得分呈负相关(r=-0.30,-0.30,-0.27,-0.34,-0.23;P<0.05)。结论新入职院前急救护士共情疲劳感症状严重,可能与职业应激及心理资本的消耗有关。%Objective To explore the relationship of compassion fatigue, occupational stress and psychological capital among new graduate ambulance nurses. Methods A total of 253 new graduate nurses were selected and followed-up in ambulance department. They were assessed by Professional Quality of Life(ProQOL-V), Chinese Nursing Stressor Scale (CNSS) and Psychological Capital Questionnaire-24 (PCQ-24). Results After six months, the scores of CNSS, CNSS-4 and CNSS-6 were (100. 21 ± 14. 82), (185. 54 ± 50. 54) and (165. 54 ± 51. 87), which were significantly higher than those at the first and third month (F=14. 53, 17. 41, 14. 89, respectively;P<0. 05). The score of CNSS was negatively correlated with the score of PCQ-24 (r=-0. 45,P<0. 05) and was positively correlated with the scores of CNSS-1, CNSS-2, CNSS-4 and CNSS-6 (r=0. 28, 0. 15, 0. 37, 0. 36, respectively;P<0. 05). The score of PCQ-24 was negatively correlated with the scores of CNSS-1, CNSS-2, CNSS-3, CNSS-4 and CNSS-6 (r= -0. 30, -0. 30, -0. 27, -0. 34, -0

  10. Effect of Electroacupuncture at the Balance Area on Ambulation and Quality of Life in Patients with Cerebral Stroke%电针平衡区对脑卒中患者步行能力及生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    朱敏; 楚佳梅; 曾友华

    2016-01-01

    目的:观察电针平衡区对卒中患者步行能力及生活质量的影响。方法将100例脑卒中患者随机分为治疗组和对照组,每组50例。治疗组采用电针平衡区配合康复治疗,对照组采用常规针刺配合康复治疗。两组治疗前后分别采用 Berg平衡量表评分、Holden步行能力分级评分及改良Barthel指数评分对患者步行能力及生活质量进行评定。结果两组治疗1、2个疗程后Berg平衡量表评分、Holden步行能力分级评分及改良Barthel指数评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗1个疗程后Berg平衡量表评分、Holden步行能力分级评分及改良Barthel指数评分与对照组比较,差异均具有统计学意义(P<0.05)。结论电针平衡区能有效提高脑卒中患者平衡功能,增加步行能力,提高生活质量。%Objective To observe the effect of electroacupuncture at the Balance Area on ambulation and quality of life in patients with cerebral stroke.Method A hundred patients with cerebral stroke were randomized into a treatment group and a control group, 50 cases in each group. The treatment group was intervened by electroacupuncture at the Balance Area plus rehabilitation, while the control group was by conventional acupuncture plus rehabilitation. The Berg Balance Scale (BBS), Holden ambulation grading score, and modified Barthel Index (BI) were adopted to evaluate the walk ability and quality of life.Result The BBS score, Holden grading score, and modified BI score respectively after 1 treatment course and 2 treatment courses were significantly different from that before intervention in both groups (P<0.01). After 1 treatment course, the BBS score, Holden grading score, and BI score of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Electroacupuncture at the Balance Area can effectively enhance the balance function of cerebral stroke

  11. 院内专业化救护路径在高原地区批量地震伤员救治中的应用%Application of Plateau Specialized Hospital Ambulance Transport Path in Batch of Wounded Rescue in the Earthquake

    Institute of Scientific and Technical Information of China (English)

    乔够梅; 杏玲芝; 李娟; 汉瑞娟; 陆皓

    2014-01-01

    Objective To explore organization and management of the plateau specialized hospital ambu-lance transport path in batch of wounded rescue in the earthquake.Methods 3 1 patients were selected and explicitly checked by using a unified classification system,and responsible by rescue teams,open green life channel,earthquakes bulk of wounded patients transport,provide personalized specialist treatment plan,psychological support and other hospital professionalize rescue path to perform emergency surgery and postoperative treatment and clinical outcomes.Results The survival rate was 100% with no adverse outcome due to no one rescue was not timely,lack of prompt rescue and triage was not timely,no doctor-patient conflict,3 1 patients were all covered and stable and had continues treatment in the local hospital.Conclusion Plateau specialization hospital ambulance transport path mode can enhance the plateau nursing care ability and disaster nursing care ability to ensure the quality and efficiency of the plateau emergency care.%目的:探讨院内专业化救护路径在高原地区批量地震伤员救治中的应用。方法2013年7月批量收治31例地震伤员,采用统一明确检查分类、实施救护小组负责制、开放绿色生命通道、批量地震伤员转运、提供个性化专科救治方案、对伤员有效心理支持等院内专业化救护路径对其进行院内急救、手术与术后处理及临床治疗。结果31例伤员的抢救成功率为100%,无一例伤员因抢救不及时或接诊、分诊不及时而造成不良后果,无一起医患纠纷,31例伤员均康复出院或病情稳定后回当地医院继续治疗。结论院内专业化救护路径模式提高了医疗团队的高原护理能力及灾后护理能力,确保了高原地区的应急救护质量和效率。

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

    赵秀国; 徐新喜; 刘亚军; 崔向东

    2011-01-01

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

  14. Préambule. Interactions dans le groupe et apprentissages

    OpenAIRE

    Hugon, Marie-Anne; Cunff, Catherine Le

    2014-01-01

    Les échanges oraux entre élèves en classe au sein de travaux de groupes suscitent depuis longtemps l’intérêt des pédagogues ainsi que celui des chercheurs en sciences humaines concernés par les apprentissages à l’école. C’est ainsi qu’aujourd’hui les connaissances sur l’apprentissage coopératif commencent à être bien diffusées comme le montrent des publications récentes. Mais en France pour des raisons d’histoire institutionnelle, les recherches sur les interactions dans les groupes d’apprent...

  15. Rationality, religion and refusal of treatment in an ambulance revisited.

    Science.gov (United States)

    McMahon-Parkes, Kate

    2013-09-01

    In their recent article, Erbay et al considered whether a seriously injured patient should be able to refuse treatment if the refusal was based on a (mis)interpretation of religious doctrine. They argued that in such a case 'what is important…is whether the teaching or philosophy used as a reference point has been in fact correctly perceived' (p 653). If it has not been, they asserted that this eroded the patient's capacity to make an autonomous decision and that therefore, in such cases, it is the role of the healthcare professional (HCP) to 'assist patients to think more clearly and rationally' (p 653). There are, however, a number of problems with the reasons why Erbay et al suggest we should help patients to rationalise their decisions and how HCPs should go about this. In this article, the author explores some of their main arguments regarding consent and rationality (particularly in relation to religious beliefs), as well as Erbay et al's normative claim that HCPs have an obligation to promote autonomy by helping patients to come to a 'rational' decision. Ultimately, the author agrees that the (temporary) solution to the dilemma presented in this scenario (which was to insert an intravenous cannula into the patient in order to allow an infusion of fluids in the event that he changed his mind) seemed both pragmatic and ethically permissible. However, it is suggested that the arguments which underpin this conclusion in Erbay et al's article are largely unsound.

  16. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus

    2010-01-01

    the documented and shared information to support organizational learning, increase effectiveness of interaction with callers and support social practice in the control center. The reflections are a result of the health professional backgrounds of the emergency medical dispatch staff that enable them...

  17. Fractal analysis of the ambulation pattern of Japanese quail.

    Science.gov (United States)

    Kembro, J M; Perillo, M A; Pury, P A; Satterlee, D G; Marín, R H

    2009-03-01

    1. The study examined the practicality and usefulness of fractal analyses in evaluating the temporal organisation of avian ambulatory behaviour by using female Japanese quail in their home boxes as the model system. To induce two locomotion activity levels, we tested half of the birds without disturbance (Unstimulated) and the other half when food was scattered on the floor of the home box after 3 h of feeder withdrawal (Stimulated). 2. Ambulatory activity was recorded during 40 min at a resolution of 1 s and evaluated by: (1) detrended fluctuation analyses (DFA), (2) the frequency distribution of the duration of the walking or non-walking events (FDD-W or FDD-NW, respectively), and (3) the transition probabilities between walking/non-walking states. Conventional measures of total time spent walking and average duration of the walking/non-walking events were also employed. 3. DFA showed a decreased value of the self-similarity parameter (alpha; indicative of a more complex ambulatory pattern) in Stimulated birds compared to their Unstimulated counterparts. The FDD-NW showed a more negative scaling factor in Stimulated than in Unstimulated birds. Stimulated birds also had more transitions between non-walking and walking states, consistent with stimulated exploratory activity. No differences were found between groups in the FDD-W, in percentage of total time spent walking, or in average duration of the walking events. 4. The temporal walking pattern of female Japanese quail has a fractal structure and its organisation and complexity is altered when birds are stimulated to explore. The fractal analyses detected differences between the Unstimulated and Stimulated groups that went undetected by the traditional measurements of the percentage of total time spent walking and the duration of the walking events suggesting its usefulness as a tool for behavioural studies. PMID:19373715

  18. 42 CFR 410.41 - Requirements for ambulance suppliers.

    Science.gov (United States)

    2010-10-01

    ... certified as an emergency medical technician by the State or local authority where the services are... following requirements: (1) Be specially designed to respond to medical emergencies or provide acute medical..., emergency medical supplies, oxygen equipment, and other lifesaving emergency medical equipment as...

  19. `Stop' that ambulance! New physics at the LHC?

    CERN Document Server

    Kim, Jong Soo; Sakurai, Kazuki; Tattersall, Jamie

    2014-01-01

    A number of LHC searches now display intriguing excesses. Most prominently, the measurement of the $W^+W^-$ cross-section has been consistently $\\sim 20\\%$ higher than the theoretical prediction across both ATLAS and CMS for both 7 and 8 TeV runs. More recently, supersymmetric searches for final states containing two or three leptons have also seen more events than predicted in certain signal regions. We show that a supersymmetric model containing a light stop, winos and binos can consistently match the data. We perform a fit to all measurements and searches that may be sensitive to our model and find a reduction in the log-likelihood of 13.3 compared to the Standard Model which corresponds to 3.2-$\\sigma$ once the extra degrees of freedom in the fit are considered.

  20. Exposure to human tragedy, empathy, and trauma in ambulance paramedics.

    Science.gov (United States)

    Regehr, Cheryl; Goldberg, Gerald; Hughes, Judy

    2002-10-01

    Paramedics are exposed to events involving human pain and suffering on a daily basis, many of which are the result of violence perpetrated by 1 individual on another. For the most part, these emergency workers have learned to deal with such events and take them in stride. At times, however, certain circumstances lead workers to develop an emotional connection with the victim or his or her family. When this occurs, paramedics report increased symptoms of traumatic stress. Aspects that can trigger this connection include the victim's alienation from others, profound loss, or the abuse of an innocent child. One of the coping strategies described in these circumstances is to manage the events on a cognitive and technical level while maintaining an emotional distance. Although such a strategy may be protective, it may also have long-term negative effects in terms of interpersonal relationships. This mixed-methods study attempts to better understand factors that lead to higher levels of distress among paramedics within the theoretical framework of emotional and cognitive empathy. PMID:15792036

  1. Reflexões sobre deambulação e posição materna no trabalho de parto e parto Reflexiones sobre deambulación y posición materna en el trabajo de parto y parto Reflection on ambulation and maternal position during labor and delivery

    Directory of Open Access Journals (Sweden)

    Fabiana Villela Mamede

    2007-06-01

    place to other ones that valued the technology, the medicalization and the intervention. Such changes didn't make possible a significant reduction in the mother mortality and neonatal, in other way, they promoted the lack of humanization in the assistance. A new look on the ambulation effect and the position during labor and delivery is been encouraged and giving opportunity to became evident a variety of vantages and benefits to the mother and child.

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

    Directory of Open Access Journals (Sweden)

    Célia Maria Sales Vieira

    2008-12-01

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

  3. 不同频率电针对脑卒中下肢痉挛患者肌电图及步行能力的影响:随机对照研究%Effect of electroacupuncture in different frequencies on electromyography and ambulation in stroke patients with lower-extremity spasticity: a randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    王芗斌; 陈剑; 李天骄; 陶静; 陈立典; 何坚; 陈岚榕

    2011-01-01

    Objective To assess the effect of electroacupuncture in different frequencies by electromyography and walking function measure in post-stroke patients with lower-extremity (LE) spasticity and hemiparesis.Methods Fifty cases of post-stroke whose motor deficit was classified into Brunnstrom stage Ⅱ - Ⅳ were randomly divided into a 100 Hz group, a 50 Hz group and a 2 Hz group. They were accepted 100 Hz, 50 Hz or 2 Hz of electroacupuncture (EA) therapy combined with standard rehabilitation program. Main outcome measures included integrated electromyography (IEMG) score during maximum isometric voluntary contraction (MIVC) of the knee flexors and extensors, ankle dorsiflexors and planterflexors in the affected LE recorded by surface EMG, Co-contraction ratio calculated by IEMG score of the antagonist over that of the agonist plus antagonist, Composite Spas ticity Scale (CSS), Fugl-Meyer Motor Scale (FMS) and Functional Ambulation Categories (FAC) on LE. All out-comes were assessed at the baseline and after treatment by the professional practitioners who blinded to the treatment. Results After EA treatment, IEMG of rectus femoris were decreased in 100 Hz and 50 Hz groups (P< 0. 01, P<0.05), and better than that in 2 Hz group (both P<0.05); gastrocnemius IEMG were decreased in 100 Hz and 50 Hz groups (P<0. 05, P<0. 01); but IEMG of tibialis anterior muscle was increased only in 50 Hz group (P<0.05). During knee flexion, EMG co-contraction ratioin MIVC declimed in 100 Hz and 50 Hz groups were decreased significantly (P< 0. 05, P< 0. 01 ), and the co-contraction ratio between the non-affected and affected side were increased significantly in all the 3 groups after treatment (P<0. 01, P<0.05). During ankle dorsiflexion, co-contraction ratio were decreased significantly in all the 3 groups (P< 0. 05, P< 0. 01 ), and cocontraction ratio between the non-affected and affected side was increased significantly only in 100 Hz after treatment (P<0. 01

  4. Dual-energy X-ray absorptiometry, skinfold thickness and waist circumference for assessing body composition in ambulant and non-ambulant wheelchair games players

    Directory of Open Access Journals (Sweden)

    Annika eWillems

    2015-11-01

    Full Text Available Field-based assessments provide a cost–effective and accessible alternative to dual-energy X-ray absorptiometry (DXA for practitioners determining body composition in athletic populations. It remains unclear how the range of physical impairments classifiable in wheelchair sports may affect the utility of field-based body composition techniques. The present study assessed body composition using DXA in 14 wheelchair games players who were either wheelchair dependent (non-walkers; n =7 or relied on a wheelchair for sports participation only (walkers; n =7. Anthropometric measurements were used to predict body fat percentage with existing regression equations established for able-bodied persons by Sloan & Weir, Durnin & Womersley, Lean et al, Gallagher et al and Pongchaiyakul et al. In addition, linear regression analysis was performed to calculate the association between body fat percentage and BMI, waist circumference, sum of 6 skinfold thicknesses and sum of 8 skinfold thicknesses. Results showed that non-walkers had significantly lower total lean tissue mass (46.2±=6.6 kg vs. 59.4±8.2 kg, P =.006 and total body mass (65.8 ±4.2 kg vs. 79.4 ±14.9 kg; P =0.05 than walkers. Body fat percentage calculated from most existing regression equations was significantly lower than that from DXA, by 2 to 9% in walkers and 8 to14% in non-walkers. Of the anthropometric measurements, the sum of 8 skinfold thicknesses had the lowest standard error of estimation in predicting body fat content. In conclusion, existing anthropometric equations developed in able-bodied populations substantially underestimated body fat content in wheelchair athletes, particularly non-walkers. Impairment specific equations may be needed in wheelchair athletes.

  5. Dual-Energy X-Ray Absorptiometry, Skinfold Thickness, and Waist Circumference for Assessing Body Composition in Ambulant and Non-Ambulant Wheelchair Games Players

    Science.gov (United States)

    Willems, Annika; Paulson, Thomas A. W.; Keil, Mhairi; Brooke-Wavell, Katherine; Goosey-Tolfrey, Victoria L.

    2015-01-01

    Field-based assessments provide a cost–effective and accessible alternative to dual-energy X-ray absorptiometry (DXA) for practitioners determining body composition in athletic populations. It remains unclear how the range of physical impairments classifiable in wheelchair sports may affect the utility of field-based body composition techniques. The present study assessed body composition using DXA in 14 wheelchair games players who were either wheelchair dependent (non-walkers; n = 7) or relied on a wheelchair for sports participation only (walkers; n = 7). Anthropometric measurements were used to predict body fat percentage with existing regression equations established for able-bodied persons by Sloan and Weir, Durnin and Womersley, Lean et al, Gallagher et al, and Pongchaiyakul et al. In addition, linear regression analysis was performed to calculate the association between body fat percentage and BMI, waist circumference, sum of 6 skinfold thickness and sum of 8 skinfold thickness. Results showed that non-walkers had significantly lower total lean tissue mass (46.2 ± 6.6 kg vs. 59.4 ± 8.2 kg, P = 0.006) and total body mass (65.8 ± 4.2 kg vs. 79.4 ± 14.9 kg; P = 0.05) than walkers. Body fat percentage calculated from most existing regression equations was significantly lower than that from DXA, by 2 to 9% in walkers and 8 to 14% in non-walkers. Of the anthropometric measurements, the sum of 8 skinfold thickness had the lowest standard error of estimation in predicting body fat content. In conclusion, existing anthropometric equations developed in able-bodied populations substantially underestimated body fat content in wheelchair athletes, particularly non-walkers. Impairment specific equations may be needed in wheelchair athletes. PMID:26640442

  6. Possibility of leg muscle hypertrophy by ambulation in older adults: a brief review

    Directory of Open Access Journals (Sweden)

    Ozaki H

    2013-03-01

    Full Text Available Hayao Ozaki,1 Jeremy P Loenneke,2 Robert S Thiebaud,2 Joel M Stager,3 Takashi Abe31Juntendo University, Inzai, Chiba, Japan; 2Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA; 3Department of Kinesiology, Indiana University, Bloomington, IN, USAAbstract: It is known that ambulatory exercises such as brisk walking and jogging are potent stimuli for improving aerobic capacity, but it is less understood whether ambulatory exercise can increase leg muscle size and function. The purpose of this brief review is to discuss whether or not ambulatory exercise elicits leg muscle hypertrophy in older adults. Daily ambulatory activity with moderate (>3 metabolic equivalents [METs], which is defined as the ratio of the work metabolic rate to the resting metabolic rate intensity estimated by accelerometer is positively correlated with lower body muscle size and function in older adults. Although there is conflicting data on the effects of short-term training, it is possible that relatively long periods of walking, jogging, or intermittent running for over half a year can increase leg muscle size among older adults. In addition, slow-walk training with a combination of leg muscle blood flow restriction elicits muscle hypertrophy only in the blood flow restricted leg muscles. Competitive marathon running and regular high intensity distance running in young and middle-aged adults may not produce leg muscle hypertrophy due to insufficient recovery from the damaging running bout, although there have been no studies that have investigated the effects of running on leg muscle morphology in older subjects. It is clear that skeletal muscle hypertrophy can occur independently of exercise mode and load.Keywords: aerobic exercise, muscle mass, aging, strength, sarcopenia

  7. Clinical algorithm for improved prediction of ambulation and patient stratification after incomplete spinal cord injury.

    Science.gov (United States)

    Zörner, Björn; Blanckenhorn, Wolf U; Dietz, Volker; Curt, Armin

    2010-01-01

    The extent of ambulatory recovery after motor incomplete spinal cord injury (miSCI) differs considerably amongst affected persons. This makes individual outcome prediction difficult and leads to increased within-group variation in clinical trials. The aims of this study on subjects with miSCI were: (1) to rank the strongest single predictors and predictor combinations of later walking capacity; (2) to develop a reliable algorithm for clinical prediction; and (3) to identify subgroups with only limited recovery of walking function. Correlation and logistic regression analyses were performed on a dataset of 90 subjects with tetra- or paraparesis, recruited in a prospective European multicenter study. Eleven measures obtained in the subacute injury period, including clinical examination, tibial somatosensory evoked potentials (tSSEP), and demographic factors, were related to ambulatory outcome (WISCI II, 6minWT) 6 months after injury. The lower extremity motor score (LEMS) alone and in combination was identified as most predictive for later walking capacity in miSCI. Ambulatory outcome of subjects with tetraparesis was correctly predicted for 92% (WISCI II) or 100% (6minWT) of the cases when LEMS was combined with either tSSEP or the ASIA Impairment Scale, respectively. For individuals with paraparesis, prediction was less distinct, mainly due to low prediction rates for individuals with poor walking outcome. A clinical algorithm was generated that allowed for the identification of a subgroup composed of individuals with tetraparesis and poor ambulatory recovery. These data provide evidence that a combination of predictors enables a reliable prediction of walking function and early patient stratification for clinical trials in miSCI.

  8. Fluid and salt supplementation effect on body hydration and electrolyte homeostasis during bed rest and ambulation

    Science.gov (United States)

    Zorbas, Yan G.; Kakurin, Vassily J.; Kuznetsov, Nikolai A.; Yarullin, Vladimir L.

    2002-06-01

    Bed rest (BR) induces significant urinary and blood electrolyte changes, but little is known about the effect of fluid and salt supplements (FSS) on catabolism, hydration and electrolytes. The aim was to measure the effect of FSS on catabolism, body hydration and electrolytes during BR. Studies were done during 7 days of a pre-bed rest period and during 30 days of a rigorous bed rest period. Thirty male athletes aged, 24.6±7.6 years were chosen as subjects. They were divided into three groups: unsupplemented ambulatory control subjects (UACS), unsupplemented bed rested subjects (UBRS) and supplemented bed rested subjects (SBRS). The UBRS and SBRS groups were kept under a rigorous bed rest regime for 30 days. The SBRS daily took 30 ml water per kg body weight and 0.1 sodium chloride per kg body weight. Plasma sodium (Na), potassium (K), calcium (Ca) and magnesium (Mg) levels, urinary Na, K, Ca and Mg excretion, plasma osmolality, plasma protein level, whole blood hemoglobin (Hb) and hematocrit (Hct) level increased significantly ( p≤0.05), while plasma volume (PV), body weight, body fat, peak oxygen uptake, food and fluid intake decreased significantly ( p≤0.05) in the UBRS group when compared with the SBRS and UACS groups. In contrast, plasma and urinary electrolytes, osmolality, protein level, whole blood Hct and Hb level decreased significantly ( p≤0.05), while PV, fluid intake, body weight and peak oxygen uptake increased significantly ( p≤0.05) in the SBRS group when compared with the UBRS group. The measured parameters did not change significantly in the UACS group when compared with their baseline control values. The data indicate that FSS stabilizes electrolytes and body hydration during BR, while BR alone induces significant changes in electrolytes and body hydration. We conclude that FSS may be used to prevent catabolism and normalize body hydration status and electrolyte values during BR.

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

    DEFF Research Database (Denmark)

    Hansen, Claus D.

    2013-01-01

    levels of self-rated health (OR: 1.79), higher levels of musculoskeletal pain (OR: 1.16) but was unrelated to mental health. In addition, increasing work load was associated with higher levels of emotional demands and work pace (p

  10. Ambulant neuropsykologisk opfølgning af patienter indlagt med aseptisk meningitis

    DEFF Research Database (Denmark)

    Damsgaard Gunst, Jesper; Klostergaard, Kirsten Rose; Leutscher, Peter Derek Christian

    2014-01-01

    Aseptic meningitis is considered to be a benign illness with mild symptoms, and the prognosis is usually good. However, retrospective studies have demonstrated that these patients may experience cognitive sequelae. A neuropsychologist was affiliated to the Department of Infectious Diseases......, and neuropsychological findings in patients with aseptic meningitis were assessed. In conclusion, at twelve months of follow-up cognitive dysfunction persist among the majority of patients; 75% had mental fatigue and 45% had changed their work status....

  11. Energy expenditure estimation during normal ambulation using triaxial accelerometry and barometric pressure

    International Nuclear Information System (INIS)

    Energy expenditure (EE) is an important parameter in the assessment of physical activity. Most reliable techniques for EE estimation are too impractical for deployment in unsupervised free-living environments; those which do prove practical for unsupervised use often poorly estimate EE when the subject is working to change their altitude by walking up or down stairs or inclines. This study evaluates the augmentation of a standard triaxial accelerometry waist-worn wearable sensor with a barometric pressure sensor (as a surrogate measure for altitude) to improve EE estimates, particularly when the subject is ascending or descending stairs. Using a number of features extracted from the accelerometry and barometric pressure signals, a state space model is trained for EE estimation. An activity classification algorithm is also presented, and this activity classification output is also investigated as a model input parameter when estimating EE. This EE estimation model is compared against a similar model which solely utilizes accelerometry-derived features. A protocol (comprising lying, sitting, standing, walking, walking up stairs, walking down stairs and transitioning between activities) was performed by 13 healthy volunteers (8 males and 5 females; age: 23.8 ± 3.7 years; weight: 70.5 ± 14.9 kg), whose instantaneous oxygen uptake was measured by means of an indirect calorimetry system (K4b2, COSMED, Italy). Activity classification improves from 81.65% to 90.91% when including barometric pressure information; when analyzing walking activities alone the accuracy increases from 70.23% to 98.54%. Using features derived from both accelerometry and barometry signals, combined with features relating to the activity classification in a state space model, resulted in a .VO2 estimation bias of −0.00 095 and precision (1.96SD) of 3.54 ml min−1 kg−1. Using only accelerometry features gives a relatively worse performance, with a bias of −0.09 and precision (1.96SD) of 5.99 ml min−1 kg−1, with the largest errors due to an underestimation of .VO2 when walking up stairs. (paper)

  12. Musculoskeletal neck-shoulder pain : a new ambulant myofeedback intervention approach

    NARCIS (Netherlands)

    Voerman, Gerritje Evelien

    2007-01-01

    Persisting musculoskeletal complaints in the neck-shoulder region are highly prevalent and associated with high health care and community costs in industrialized countries. The mechanisms underlying the development and perpetuation of these complaints have not fully been identified yet, but explanat

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

    Directory of Open Access Journals (Sweden)

    Chien-Chia Huang

    2016-01-01

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

  14. Interface shear stresses during ambulation with a below-knee prosthetic limb.

    Science.gov (United States)

    Sanders, J E; Daly, C H; Burgess, E M

    1992-01-01

    Shear stresses on a residual limb in a prosthetic socket are considered clinically to contribute to tissue breakdown in below-knee amputees. When applied simultaneously with normal stresses, they can cause injury within the skin or can generate an abrasion on the surface. To gain insight into shear stresses and parameters that affect them, interface stresses were recorded on below-knee amputee subjects during walking trials. On the tibial flares, resultant shear ranged from 5.6 kPa to 39.0 kPa, while on the posterior surface it ranged from 5.0 kPa to 40.7 kPa. During stance phase, anterior resultant shears on a socket were directed toward the apex while posterior resultant shears were directed downward approximately perpendicular to the ground. Waveform shapes were usually double-peaked, with the first peak at 25% to 40% into stance phase and the second peak at 65% to 85% into stance. Application of these results to residual limb tissue mechanics and prosthetic design is discussed.

  15. Optimal Control and Biomechanics of Ambulation with Spring-Loaded Crunches

    Directory of Open Access Journals (Sweden)

    Guangyu Liu

    2011-08-01

    Full Text Available Standard underarm or forearm crutches have some drawbacks induced by their rigid legs. Sping‐ loaded crutches can reduce the impact effect. However, whether or not they also improve propulsion is an open problem. We formulate a problem of the optimal performance of spring‐loaded crutches and propose a numerical approach to solve the problem. Then, the numerical optimal values are incorporated to the innovative design of a pair of spring‐loaded crutches. To evaluate the crutchesʹ performance, we have conducted standard biomechanical experiments for a number of male subjects under two conditions: walking with standard crutches and with spring‐loaded crutches. Three dimensional kinematic data and ground reaction force were recorded and analysed. It was observed that optimized spring‐loaded crutches can efficiently propel the crutch walkers, which conforms to the theory.

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

    Directory of Open Access Journals (Sweden)

    Patel Alka B

    2012-10-01

    Full Text Available Abstract Background Evaluating geographic access to health services often requires determining the patient travel time to a specified service. For urgent care, many research studies have modeled patient pre-hospital time by ground emergency medical services (EMS using geographic information systems (GIS. The purpose of this study was to determine if the modeling assumptions proposed through prior United States (US studies are valid in a non-US context, and to use the resulting information to provide revised recommendations for modeling travel time using GIS in the absence of actual EMS trip data. Methods The study sample contained all emergency adult patient trips within the Calgary area for 2006. Each record included four components of pre-hospital time (activation, response, on-scene and transport interval. The actual activation and on-scene intervals were compared with those used in published models. The transport interval was calculated within GIS using the Network Analyst extension of Esri ArcGIS 10.0 and the response interval was derived using previously established methods. These GIS derived transport and response intervals were compared with the actual times using descriptive methods. We used the information acquired through the analysis of the EMS trip data to create an updated model that could be used to estimate travel time in the absence of actual EMS trip records. Results There were 29,765 complete EMS records for scene locations inside the city and 529 outside. The actual median on-scene intervals were longer than the average previously reported by 7–8 minutes. Actual EMS pre-hospital times across our study area were significantly higher than the estimated times modeled using GIS and the original travel time assumptions. Our updated model, although still underestimating the total pre-hospital time, more accurately represents the true pre-hospital time in our study area. Conclusions The widespread use of generalized EMS pre-hospital time assumptions based on US data may not be appropriate in a non-US context. The preference for researchers should be to use actual EMS trip records from the proposed research study area. In the absence of EMS trip data researchers should determine which modeling assumptions more accurately reflect the EMS protocols across their study area.

  17. And why not thrombolysis in the ambulance (at least for some)?

    Science.gov (United States)

    Rosenberg, Gilad; Steiner, Israel

    2016-07-12

    The fear that alteplase may aggravate primary intracerebral hemorrhages has led to the mandatory prerequisite for prealteplase imaging in all acute stroke patients in order to exclude such hemorrhages. Consequently, in a situation in which "time is brain," administration of alteplase is delayed until the patients are transferred to a hospital where such imaging is available, at the cost of additional ischemic damage to the brain parenchyma. Yet, theoretical considerations and empirical data suggest that alteplase's effects on primary intracerebral hemorrhages may not be that detrimental. Moreover, at least some of the patients who are at a high risk of having primary cerebral bleeds, or at a high risk of developing symptomatic secondary bleeds, can be excluded from alteplase therapy on clinical grounds, and using nonimaging point-of-care devices, before their hospital arrival. We propose that clinical research should be initiated to define a population of stroke patients in whom alteplase may be administered preimaging, resulting in a greater benefit than harm and in improved functional outcome compared to deferred, postimaging, alteplase treatment. PMID:27306629

  18. Activation of catheterization lab in ambulance: new direction in ST-elevation myocardial infarction care

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing

    2011-01-01

    @@ Primary percutaneous coronary intervention (PPCI) is the cornerstone of treatment to reduce infarct size and improve outcomes in patients with ST-elevation myocardial infarction (STEMI).1 The optimal site for initiation of reperfusion strategies is the patient's home or place where the infarction occurs.

  19. Svær dehydrering hos nyfødt efter ambulant fødsel

    DEFF Research Database (Denmark)

    Thøstesen, Lisbeth Marianne; Fenger-Grøn, Jesper

    2011-01-01

    A nine day-old girl was hospitalised because of breast-feeding problems and life-threatening hypernatremic dehydration; weight loss was 30% of birth weight and s-Na 187 mmol/l. The question is raised whether there could be an association to the current changes in the perinatal health care in Denm...

  20. The Relationship between Manual Ability and Ambulation in Adolescents with Cerebral Palsy

    Science.gov (United States)

    Majnemer, Annette; Shikako-Thomas, Keiko; Shevell, Michael; Poulin, Chantal; Lach, Lucyna; Law, Mary; Schmitz, Norbert

    2013-01-01

    This study examined the relationship between gross motor function and manual ability in 120 adolescents with cerebral palsy (CP) (15.2, SD 2.1 years, 59.8% male). Adolescents were evaluated using the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). A neurologist classified CP subtype. Most…

  1. Decompression Sickness During Simulated Low Pressure Exposure is Increased with Mild Ambulation Exercise

    Science.gov (United States)

    Pollock, N. W.; Natoli, M. J.; Martina, S. D.; Conkin, J.; Wessel, J. H., III; Gernhardt, M. L.

    2016-01-01

    Musculoskeletal activity accelerates inert gas elimination during oxygen breathing prior to decompression (prebreathe), but may also promote bubble formation (nucleation) and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity are likely critical to the net effect. The NASA Prebreathe Reduction Program (PRP) combined oxygen prebreathe and exercise preceding a 4.3 psia exposure in non-ambulatory subjects (a microgravity analog) to produce two protocols now used by astronauts preparing for extravehicular activity - one employing cycling and non-cycling exercise (CEVIS: 'cycle ergometer vibration isolation system') and one relying on non-cycling exercise only (ISLE: 'in-suit light exercise'). Current efforts investigate whether light exercise normal to 1 G environments increases the risk of DCS over microgravity simulation.

  2. Possibility of leg muscle hypertrophy by ambulation in older adults: a brief review

    OpenAIRE

    Ozaki H; Loenneke JP; Thiebaud RS; Stager JM; Abe T

    2013-01-01

    Hayao Ozaki,1 Jeremy P Loenneke,2 Robert S Thiebaud,2 Joel M Stager,3 Takashi Abe31Juntendo University, Inzai, Chiba, Japan; 2Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA; 3Department of Kinesiology, Indiana University, Bloomington, IN, USAAbstract: It is known that ambulatory exercises such as brisk walking and jogging are potent stimuli for improving aerobic capacity, but it is less understood whether ambulatory exercise can increase leg muscle size and...

  3. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo;

    2011-01-01

    Aims: To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device. Methods and results: First, a randomised controlled trial of immediate mobilisation vs. delayed a...

  4. 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

    ) walking ability - was assessed by two independent physiotherapists at postoperative median day 3. Each activity was assessed on a three-point ordinal scale from 0 (not able to) to 2 (independent of human assistance). The cumulated score for each activity provides a total CAS from 0 to 6, with 6 indicating...

  5. Successful trans-Atlantic air ambulance transfer of a patient supported by a bi-ventricular assist device.

    Science.gov (United States)

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

    2011-08-01

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

  6. Threshold electrical stimulation (TES) in ambulant children with CP: a randomized double-blind placebo-controlled clinical trial

    DEFF Research Database (Denmark)

    Dali, Christine í; Hansen, Flemming Juul; Pedersen, Søren Anker;

    2002-01-01

    A randomized double-blind placebo-controlled clinical trial was carried out to determine whether a group of stable children with cerebral palsy (36 males, 21 females; mean age 10 years 11 months, range 5 to 18 years) would improve their motor skills after 12 months of threshold electrical stimula...

  7. Controlled Study of the Effects of Continuous Intrathecal Baclofen Infusion in Non-Ambulant Children with Cerebral Palsy

    Science.gov (United States)

    Morton, Richard E.; Gray, Natalie; Vloeberghs, Michael

    2011-01-01

    Aim: To measure changes in children with severe spastic cerebral palsy (CP) after continuous intrathecal baclofen (ITB) infusion over 18 months and to compare the results with those of a comparison group awaiting treatment. Method: Thirty-eight children with severe spastic CP considered suitable for ITB were assessed when first seen, just before…

  8. Threshold electrical stimulation (TES) in ambulant children with CP: a randomized double-blind placebo-controlled clinical trial

    DEFF Research Database (Denmark)

    Dali, Christine í; Hansen, Flemming Juul; Pedersen, Søren Anker;

    2002-01-01

    A randomized double-blind placebo-controlled clinical trial was carried out to determine whether a group of stable children with cerebral palsy (36 males, 21 females; mean age 10 years 11 months, range 5 to 18 years) would improve their motor skills after 12 months of threshold electrical...... stimulation (TES). Two thirds received active and one third received inactive stimulators. For the primary outcome we constructed a set of plausible motor function tests and studied the change in summary indices of the performance measurements. Tests were videotaped and assessed blindly to record qualitative...

  9. Úloha sestry v péči o klienty s Parkinsonovou chorobou v ambulanci neurologa

    OpenAIRE

    Motlová, Eva

    2014-01-01

    Abstract The task of the nurse in care of Parkinson patients at neurology clinic This bachelor thesis focuses on the task of nurses in care of Parkinson patients at neurology clinic. Parkinson disease is a progressive degenerative illness of central nervous system affecting extrapyramidal pathways. It leads mainly to movement problems, stance and gait disorder, muscle rigidity and tremor. It is caused by dopamine insufficiency in basal ganglia. This disease has been described by a London phys...

  10. Pilot Field Test: The Ability to Ambulate Following Landing as Assessed with Seat Egress, Walk and Obstacle Testing

    Science.gov (United States)

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

    2016-01-01

    To date, changes in functional performance have been systematically studied after short-duration space flight. As important as the postflight functional changes have been, full functional recovery has never been investigated or established for long-duration flights. The Pilot Field Test (PFT) experiment, conducted with participation of ISS crewmembers traveling on Soyuz expeditions 34S - 41S, is comprised of several tasks designed to study the recovery of sensorimotor abilities of astronauts during the first 24 hours after landing and beyond. The objective of the Seat Egress - Walk and Obstacle Test, developed by NASA's Russian collaborators at the Institute for Biomedical Problems, is to address this gap in knowledge. This will allow us to characterize the ability of crewmembers to perform critical mission requirements that they will be expected to perform after an unassisted landing following 6 to 12 months in microgravity.

  11. Using Surveillance Data to Inform Community Action: The Effect of Alcohol Sale Restrictions on Intentional Injury-related Ambulance Pickups

    OpenAIRE

    Masho, Saba W.; Bishop, Diane L.; Edmonds, Torey; Farrell, Albert D.

    2013-01-01

    Youth violence disproportionately affects inner city, urban minority communities in the USA. This article illustrates the use of surveillance data to inform and evaluate community action directed at this serious problem. Community efforts in response to surveillance data indicating high rates of violence surrounding convenience stores with unrestricted alcohol beverage licenses provided a natural experiment to examine the impact of imposing licensing restrictions on intentional injury rates. ...

  12. Interobserver Agreement of the Gross Motor Function Classification System in an Ambulant Population of Children with Cerebral Palsy

    Science.gov (United States)

    McDowell, Brona C.; Kerr, Claire; Parkes, Jackie

    2007-01-01

    Gross Motor Function Classification System (GMFCS) level was reported by three independent assessors in a population of children with cerebral palsy (CP) aged between 4 and 18 years (n=184; 112 males, 72 females; mean age 10y 10mo [SD 3y 7mo]). A software algorithm also provided a computed GMFCS level from a regional CP registry. Participants had…

  13. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo;

    2011-01-01

    To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device.......To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device....

  14. Fire and EMS Districts, ESN Districts, Ambulance Districts, Published in 2008, 1:24000 (1in=2000ft) scale, Lafayette County Land Records.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Fire and EMS Districts dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Hardcopy Maps information as of 2008. It is described...

  15. Patients' priorities for ambulant hospital care centres: a survey and discrete choice experiment among elderly and chronically ill patients of a Dutch hospital.

    NARCIS (Netherlands)

    Albada, A.; Triemstra, M.

    2009-01-01

    Objective: This study established patients' preferences regarding the facilities in an adjacent centre for ambulatory hospital care. It also identified determinants of patients' choice to visit this centre instead of the regional hospital. Methods: A questionnaire survey among 1477 elderly and chron

  16. Autonomous regulation mode moderates the effect of actual physical activity on affective states : an ambulant assessment approach to the role of self-determination

    OpenAIRE

    Kanning, Martina; Ebner-Priemer, Ulrich; Brand, Ralf

    2012-01-01

    Studies have shown that physical activity influences affective states. However, studies have seldom depicted these associations in ongoing real-life situations, and there is no investigation showing that motivational states (i.e., more or less autonomously regulated) would moderate these effects in situ. To investigate the interaction of autonomous regulation and actual physical activity (aPA) with affective states, we use an ambulatory assessment approach. The participants were 44 university...

  17. Normal and shear stresses on a residual limb in a prosthetic socket during ambulation: comparison of finite element results with experimental measurements.

    Science.gov (United States)

    Sanders, J E; Daly, C H

    1993-01-01

    Interface stresses on a below-knee amputee residual limb during the stance phase of gait calculated using an analytical finite element model were compared with experimental interface stress measurements. The model was quasi-static and linear. Qualitatively, shapes of analytical and experimental interface stress waveforms were similar in that they were double-peaked with some distinct features apparent. However, quantitatively analytical resultant shear stress magnitudes were less than experimental values at all transducer measurement sites. Analytical normal stresses were less than experimental values at postero-proximal, postero-distal, and anteromedial proximal sites, but were greater than experimental values at antero-lateral distal and antero-lateral proximal sites. Anterior resultant shear angles were directed more distally in the model than in clinical data, an expected result since there was no relief for the tibial crest in the model. Model sensitivity analyses to shank loads showed interface normal and resultant shear stresses were most sensitive to axial force, sagittal bending moment, or sagittal shear force. The finite element model presented in this paper is significant because it contributes toward development of an analytical modeling technique to predict interface stress distributions for proposed prosthetic designs, provides insight into physical explanations of features apparent in interface stress waveforms (thereby enhancing understanding of interface mechanics), and provides insight into nonlinear characteristics that need to be added to improve the model.

  18. Functional performance, nutritional status, and body composition in ambulant community-dwelling individuals 1–3 years after suffering from a cerebral infarction or intracerebral bleeding

    OpenAIRE

    Vahlberg, Birgit; Zetterberg, Lena; Hellström, Karin; Lindmark, Birgitta; Cederholm, Tommy

    2016-01-01

    Background Muscle wasting and obesity may complicate the post-stroke trajectory. We investigated the relationships between nutritional status, body composition, and mobility one to 3 years after stroke. Methods Among 279 eligible home-dwelling individuals who had suffered a stroke (except for subarachnoid bleeding) 1–3 years earlier, 134 (74 ± 5 years, 69 % men) were examined according to the Mini Nutritional Assessment-Short Form (MNA-SF, 0–14 points), including body mass index (BMI, kg/m2),...

  19. Farmacevtske kognitivne storitve pri zdravljenju z zdravili - pogled farmacevta svetovalca v ambulanti: Pharmaceutical cognitive services in pharmacotherapy - pharmacist's consultant perspective at an ambulance:

    OpenAIRE

    Premuš Marušič, Alenka

    2013-01-01

    Pharmacist cognitive services in different countries in Europe and around the world are carried out in various ways. The range of responsibilities of clinical pharmacists is ranging from prescribing medicine in the United Kingdom and the United States, to pharmacotherapy groups and pharmacist consultant in the Netherlands. Pharmacotherapy Groups and Clinical Pharmacist's Consultation is a currently ongoing development program in Slovenia. Within the program, the clinical pharmacist reviews th...

  20. [Post-traumatic stress disorder in the Ares 118 voluntary ambulance staff in the Latina area: preliminary study to validate the PTSS-10].

    Science.gov (United States)

    Capodilupo, Antonio; Danieli, Micaela; Sansoni, Julita

    2012-01-01

    The study investigates and describes post-traumatic stress testing for the Italian validation of the abbreviated form of the Scale for the Symptoms of Post Traumatic Stress Disorder (PTSS-10). It's a scale comprising 10 items and the article takes into consideration the German version, derived from the original Norwegian. The scale is based on the concept of multidirectional stress supported by Lazarus. Its validation and testing was conducted on a group of 60 ARES 118 volunteers of Latina. The study reports the internal reliability of the translated instrument, calculated using Cronbach's alpha and compared to German study. 'Factor Analysis is calculated and the results are discussed. Some remarks, also, are made by relating scores indicating a suspected PTSD with socio-demographic variables. The results demonstrate the reliability of the instrument, but for a generalization, it should be tested on a larger sample and apply the test -retest. PMID:22463753

  1. 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...

  2. L’arrivée des centres commerciaux dans les marges urbaines de Rabat : Des lieux inédits de sociabilité et de déambulation urbaine

    OpenAIRE

    Harroud, Tarik

    2015-01-01

    La contribution porte sur l’analyse des recompositions spatiales et socioculturelles induites par la multiplication des centres commerciaux dans la périphérie de Rabat. Apparus au cours de la décennie 90, ces espaces marchands se sont fortement multipliés au cours de ces dernières années au point de constituer l’un des pôles les plus attractifs à l’échelle de la capitale. Il suffit d’observer l’importance des flux qui y convergent à la fin de la semaine pour attester de l’importance qu’ils oc...

  3. 脑卒中偏瘫患者下肢功能与ADL移动动作能力的关系%Relationship between the function of the paretic lower limb and ambulation of ADL function in hemiparetic stroke patients

    Institute of Scientific and Technical Information of China (English)

    瓮长水; 毕胜; 杨娟; 刘忠文; 任学军; 秦茵; 于增志

    2004-01-01

    目的:改善ADL能力是脑卒中康复主要目标.本文通过对脑卒中偏瘫患者ADL移动动作能力与患侧下肢功能之间关系的研究,判别影响ADL移动动作能力的下肢功能因素.方法:对55例患者用功能独立性测量中的转移和行进项目来评价患者的ADL移动动作能力,用简式Fugl-Meyer评价法评价下肢运动功能,用Motricity指数评价患侧下肢肌力,用Berg平衡量表评价患者的平衡能力.用Pearson相关分析方法来确定ADL移动动作能力和下肢功能之间的相关性;然后以ADL移动动作能力作为因变量用多元回归分析法的逐步回归法和路径分析法来确定影响ADL移动动作能力的下肢功能因素.结果:患者患侧下肢功能与ADL移动动作能力之间呈高度相关(r=0.54l-0.670,P<0.001);其中平衡功能是影响ADL移动动作能力最重要的直接因素(R2=0.45,P<0.05).结论:脑卒中偏瘫患者的下肢功能尤其是平衡功能是影响ADL移动动作能力的重要因素.

  4. Fire and EMS Districts, Ambulance and first responder territories are combined to create emergency medical service boundaries for use in dispatching., Published in 2013, 1:2400 (1in=200ft) scale, Manitowoc County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Fire and EMS Districts dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Hardcopy Maps information as of 2013. It is described...

  5. Fire and EMS Districts, Areas defining emergency response assignments for fire, ambulance, first responders, and law enforcement., Published in 2008, 1:2400 (1in=200ft) scale, Portage County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Fire and EMS Districts dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Published Reports/Deeds information as of 2008. It is...

  6. ENERGY-COST DURING AMBULATION IN TRANSFEMORAL AMPUTEES - A KNEE-JOINT WITH A MECHANICAL SWING PHASE-CONTROL VS A KNEE-JOINT WITH A PNEUMATIC SWING PHASE-CONTROL

    NARCIS (Netherlands)

    BOONSTRA, AM; SCHRAMA, J; FIDLER, [No Value; EISMA, WH

    1995-01-01

    The aim of the study was (i) to evaluate the preference of transfemoral amputees for a 4-bar linked knee joint with either a mechanical swing phase control or a pneumatic swing phase control, and (ii) to compare the energy expenditure in transfemoral amputees using a prosthesis with a mechanical swi

  7. Screening Education And Recognition in Community pHarmacies of Atrial Fibrillation to prevent stroke in an ambulant population aged ≥65 years (SEARCH-AF stroke prevention study): a cross-sectional study protocol

    OpenAIRE

    Lowres, Nicole; Freedman, Saul Benedict; Redfern, Julie; McLachlan, Andrew; Krass, Ines; Bennett, Alexandra; Briffa, Thomas; Bauman, Adrian; Neubeck, Lis

    2012-01-01

    Background Atrial fibrillation (AF) is associated with a high risk of stroke and may often be asymptomatic. AF is commonly undiagnosed until patients present with sequelae, such as heart failure and stroke. Stroke secondary to AF is highly preventable with the use of appropriate thromboprophylaxis. Therefore, early identification and appropriate evidence-based management of AF could lead to subsequent stroke prevention. This study aims to determine the feasibility and impact of a community ph...

  8. Effect of High-Dose Vitamin D3 Intake on Ambulation, Muscular Pain and Bone Mineral Density in a Woman with Multiple Sclerosis: A 10-Year Longitudinal Case Report

    OpenAIRE

    François Feron; van Amerongen, Barbara M.

    2012-01-01

    Mounting evidence correlate vitamin D3 (cholecalciferol) supplementation or higher serum levels of vitamin D (25(OH)D) with a lower risk of developing multiple sclerosis (MS), reduced relapse rate, slower progression or fewer new brain lesions. We present here the case of a woman who was diagnosed with MS in 1990. From 1980 to 2000, her ability to walk decreased from ~20 to 1 km per day. Since January 2001, a vitamin D3 supplement was ingested daily. The starting dose was 20 mcg (800 IU)/day ...

  9. Case management in oncology rehabilitation (CAMON: The effect of case management on the quality of life in patients with cancer after one year of ambulant rehabilitation. A study protocol for a randomized controlled clinical trial in oncology rehabilitation

    Directory of Open Access Journals (Sweden)

    Bardheci Katarina

    2011-04-01

    Full Text Available Abstract Background Cancer diseases and their therapies have negative effects on the quality of life. The aim of this study is to assess the effectiveness of case management in a sample of oncological outpatients with the intent of rehabilitation after cancer treatment. Case management wants to support the complex information needs of the patients in addition to the segmented structure of the health care system. Emphasis is put on support for self-management in order to enhance health - conscious behaviour, learning to deal with the burden of the illness and providing the opportunity for regular contacts with care providers. We present a study protocol to investigate the efficacy of a case management in patients following oncology rehabilitation after cancer treatment. Methods The trial is a multicentre, two-arm randomised controlled study. Patients are randomised parallel in either 'usual care' plus case management or 'usual care' alone. Patients with all types of cancer can be included in the study, if they have completed the therapy with chemo- and/or radiotherapy/surgery with curative intention and are expected to have a survival time >1 year. To determine the health-related quality of life the general questionnaire FACT G is used. The direct correlation between self-management and perceived self-efficacy is measured with the Jerusalem & Schwarzer questionnaire. Patients satisfaction with the care received is measured using the Patient Assessment of Chronic Illness Care 5 As (PACIC-5A. Data are collected at the beginning of the trial and after 3, 6 and 12 months. The power analysis revealed a sample size of 102 patients. The recruitment of the centres began in 2009. The inclusion of patients began in May 2010. Discussion Case management has proved to be effective regarding quality of life of patients with chronic diseases. When it comes to oncology, case management is mainly used in cancer treatment, but it is not yet common in the rehabilitation of cancer patients. Case management in oncology rehabilitation is not well-established in Switzerland. A major challenge of the study will therefore probably be the recruitment of the patients due to the physicians' and patients' scarcely existing awareness of this issue. Trial registration ISRCTN41474586

  10. Intensivering af præhospital hjertestopbehandling øger antallet af overlevende med god cerebral funktion

    DEFF Research Database (Denmark)

    Nielsen, J R; Gram, L; Larsen, C F;

    1990-01-01

    Psychological assessment in the form of a test for dementia was carried out in 69 individuals. Thirty of these were survivors of cardiac arrest outside hospital. Seven of these were brought to hospital in ordinary emergency ambulances, 14 in heart ambulances and nine in medically staffed ambulances...

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

    Directory of Open Access Journals (Sweden)

    Mohd Hafiz Azizan

    2013-06-01

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

  12. 38 CFR 21.240 - Medical treatment, care and services.

    Science.gov (United States)

    2010-07-01

    ... AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under... ambulation, and one-hand typewriting; (ii) Orientation, adjustment, mobility and related services;...

  13. 7 CFR 1739.3 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Community Center and every public school or education center, public library, public medical clinic, public hospital, community college, public university, or law enforcement, fire and ambulance stations in...

  14. 重复经颅磁刺激对不完全性脊髓损伤患者运动和步行功能的疗效%Effect of Repetitive Transcranial Magnetic Stimulation on Motor and Ambulation Function for Incomplete Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    潘钰; 郄淑燕; 刘畅; 甄巧霞; 刘晓磊; 丁永红; 杨等; 邰志红

    2013-01-01

    Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) on motor and ambulatory function in incomplete spinal cord injury (SCI) patients. Methods 18 incomplete SCI patients (AIS D) were randomized to treatment group (n=10) and control group (n=8). The treatment group received rTMS while the control group received sham stimulation for 2 weeks. All the patients re-ceived routine rehabilitation. They were assessed with Lower Extremity Motor Score (LEMS), 10 m Walking Test for Walking Speed, modi-fied Ashworth scale (MAS), Walking Index for SCI Scale II(WISCI II), and Spinal Cord Independence Measure (SCIM) before and after treatment, and followed up for 2 weeks after treatment. Results The treatment group significantly improved in LEMS, walking speed, and SCIM after treatment and during follow up (P0.05)。结论 rTMS可进一步改善不完全性脊髓损伤患者的下肢运动功能。

  15. The effects of training abductors of hip on balance function and ambulation safety in hemiplegic patients%强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响

    Institute of Scientific and Technical Information of China (English)

    郭京伟; 谢欲晓; 黄学英; 孙启良

    2008-01-01

    目的:探讨强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响.方法:将符合入选标准的脑卒中偏瘫患者随机分为观察组(20例)和对照组(20例),两组患者均采用以Bobath为主的现代康复技术进行平衡训练和步行训练,在此基础上,观察组加入强化髋外展肌群的训练方法,在治疗前和6周治疗结束后,分别用Berg平衡评分量表和Holden功能步行分类对两组患者进行平衡功能和步行能力的评定.随访并统计治疗结束后半年期间两组患者的跌倒发生率.结果:6周治疗后,两组的BBS和Holden功能步行分类的级别均较治疗前有明显提高(P<0.01).观察组的BBS和Holden功能步行分类的级别均优于对照组,差异具有显著性意义(P<0.05,P<0.01).通过随访,治疗结束半年内观察组的跌倒发生率比对照组低,差异有非常显著性意义(19<0.01).结论:在常规平衡训练的基础上,强化患侧髋外展肌群的训练.能更有效地提高脑卒中偏瘫患者的平衡功能,增加步行的安全性.

  16. Prehospital care in Indonesia

    OpenAIRE

    Pitt, E.; Pusponegoro, A

    2005-01-01

    Current system: Hospitals of varying standards are widespread but have no system of emergency ambulance or patient retrieval. Indonesia's only public emergency ambulance service, 118, is based in five of the biggest cities and is leading the way in paramedic training and prehospital care.

  17. 42 CFR 412.23 - Excluded hospitals: Classifications.

    Science.gov (United States)

    2010-10-01

    .... (A) Stroke. (B) Spinal cord injury. (C) Congenital deformity. (D) Amputation. (E) Major multiple... arthropathies resulting in significant functional impairment of ambulation and other activities of daily living... inflammation, resulting in significant functional impairment of ambulation and other activities of daily...

  18. Striding Towards Better Physical Therapy

    Science.gov (United States)

    2003-01-01

    This paper presents a discussion on a new rehabilitative device that promises to improve physical therapy for patients working to regain the ability to walk after facing traumatic injuries or a degenerative illness. Produced by Enduro Medical Technology, of East Hartford, Connecticut, the Secure Ambulation Module (S.A.M.) creates a stable and secure environment for patients as they stand during ambulation therapy.

  19. Ergonomics

    Science.gov (United States)

    ... moving patients. These devices allow ambulance technicians or emergency evacuation personnel to safely move a loaded hospital cot or gurney down stairs or any steep decline. The Device easily attaches to any ambulance cot currently in the pre-hospital care market. When not in use, the DCS simply ...

  20. Balancing Machine Work, Comfort Work, and Sentimental Work

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  1. Balancing Machine Work, Comfort Work, and Sentimental Work

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  2. The role of pain for early rehabilitation in fast track surgery.

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten Tange; Myhrmann, Lis;

    the clinical pathway for fast track programs, including transfer and ambulation from day one, with further physiotherapy daily. Patients were discharged, according to the following discharge criteria: Independence in transfer and ambulation, able to walk with crutches, independence in toileting and dressing...... relationship between TUG and VAS in connection with transfer and ambulation on POD 1 (Spearman´s Rho= 0.303-0.332). On DOD no significant correlations was found. Conclusion: Using the LIA technique in fast-track programs for TKA patients, pain intensity reached a low level postoperatively, and pain...... is not a restricting factor for early rehabilitation....

  3. GPS Tracking System Coupled With Image Processing in Traffic Signals to Enhance Life Security

    Directory of Open Access Journals (Sweden)

    Manoj Prabhakar k

    2013-08-01

    Full Text Available In modern and crowded traffic life, it becomes mandatory to save the human life by reaching the hospitalvery sooner than possible. This paper explains about the advancement in tracking the ambulance presenceamidst the traffic with the usage of GPS tracking system calculating the position of the ambulance from thetraffic signal which replaces the RF transmitter receiver circuitry. This paper also retains the use of theimage capturing technology available from the base paper (IMPACT OF IMAGE PROCESSING INSAVING THE HUMAN LIFE BY AUTOMATING TRAFFIC SIGNALS to identify the presence of theambulance, thereby changing the signalto green automatically in favour of ambulance

  4. Hjertestop uden for hospital. Retrospektiv undersøgelse i Odense

    DEFF Research Database (Denmark)

    Frandsen, F; Nielsen, J R; Gram, L;

    1989-01-01

    arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement of...... treatment include: 1. Information to the population. 2. Training of first-aid staff in treatment of cardiac arrest. 3. Quicker arrival of ambulances and 4. Better staffing and training of ambulance staff in the use of a defibrillator possibly with participation of a doctor....

  5. Mass Psychogenic Illness

    Science.gov (United States)

    ... been exposed to something harmful. An outbreak of mass psychogenic illness is a time of anxiety and worry. During an outbreak, a lot of media coverage and the presence of ambulances or emergency ...

  6. 49 CFR 325.1 - Scope of the rules in this part.

    Science.gov (United States)

    2010-10-01

    ... valid noise emission measurement; (4) An emergency motor vehicle, such as a fire engine, an ambulance, a....1 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GENERAL REGULATIONS COMPLIANCE WITH INTERSTATE...

  7. 38 CFR 21.6240 - Medical treatment, care and services.

    Science.gov (United States)

    2010-07-01

    ... AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Temporary Program of Vocational Training for.... (a) General. A participant in a vocational training program or receiving employment assistance shall... and voice correction, training in ambulation, and one-hand typewriting; (ii) Orientation,...

  8. Drawing the Line. Cross-Boundary Coordination Processes in Emergency Management

    NARCIS (Netherlands)

    Wolbers, J.J.

    2016-01-01

    How do emergency responders coordinate the response operation across theboundaries of their organizations in fast-paced environments? Coordinationis a key aspect of emergency management that addresses how crisismanagers from police, ambulance services and fire department align theirmutual interdepen

  9. 42 CFR 410.10 - Medical and other health services: Included services.

    Science.gov (United States)

    2010-10-01

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

  10. Acute stent thrombosis after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Wiberg, Sebastian; Van't Hof, Arnoud;

    2015-01-01

    OBJECTIVES: This study sought to determine clinical, procedural, and treatment factors associated with acute stent thrombosis (AST) in the EUROMAX (European Ambulance Acute Coronary Syndrome Angiography) trial. BACKGROUND: Bivalirudin started during transport for primary percutaneous coronary int...

  11. [Emergency medical services for the elderly: present fact and future challenge].

    Science.gov (United States)

    Aruga, Yuichiro

    2013-06-01

    The Tokyo Fire Department (TFD) ambulance units are transporting more people than ever before with elderly patients on the increase. The TFD then set up the Emergency Telephone Consultation Center in 2007 to help citizens properly use EMS services, asking non-emergency cases to go to the hospital by themselves or sending the ambulance to serious cases. Transportation of all "home patients" (receiving medical services at home, not in the hospital) by fire department ambulances would leave really serious patients behind. Consequently, it is important to make the most of private sector ambulances and hospital ones. For community life safety, making the most of local resources, as well as the fire department-hospital cooperation, is much more needed now. PMID:23855196

  12. The Walk to Save: Benefits of Inpatient Cardiac Rehabilitation.

    Science.gov (United States)

    Rion, Joann H; Kautz, Donald D

    2016-01-01

    Hospital immobilization after a cardiac event can cause complications. The pathophysiology of complications, research concerning benefits of early ambulation, and recommendations from the American College of Sports Medicine are discussed. PMID:27522842

  13. Kolmekesi ühest Peipsi-äärsest asjast / Tiit Lepp

    Index Scriptorium Estoniae

    Lepp, Tiit

    2007-01-01

    Annika Haasi, Birgit Püve ja Age Petersoni fotonäitus "Prichudie, Revisited" Peipsiääre valla inimestest ja elust-olust kunstikeskuses AmbulARToorium Tartumaaal. Kommenteerinud Annika Haas, Birgit Püve, Age Peterson

  14. 29 CFR 779.369 - Funeral home establishments may qualify as exempt 13(a)(2) establishments.

    Science.gov (United States)

    2010-07-01

    ... described in paragraph (e) below. (b) Burial insurance operations. There is no retail concept applicable to..., long distance calls, newspaper notices, flowers, livery service, honoraria to participating personnel... concept in the transportation industry, such ambulance service establishments cannot qualify for...

  15. 75 FR 41923 - Public Meeting on Draft Recommendations for Safely Transporting Children in Specific Situations...

    Science.gov (United States)

    2010-07-19

    ... National Association of Emergency Medical Technicians, the American Ambulance Association, the National... matter experts to provide guidance to local, State, and national emergency medical services (EMS... ground emergency medical services (EMS) responds to approximately 30 million emergency calls each...

  16. 29 CFR 541.3 - Scope of the section 13(a)(1) exemptions.

    Science.gov (United States)

    2010-07-01

    ..., paramedics, emergency medical technicians, ambulance personnel, rescue workers, hazardous materials workers... fighters, paramedics, emergency medical technicians and similar employees have college degrees, a... professional employees such as medical doctors, architects and archeologists. Thus, for example,...

  17. 76 FR 54917 - National Preparedness Month, 2011

    Science.gov (United States)

    2011-09-02

    ..., Missouri, pickup trucks became ambulances, doors served as stretchers, and a university transformed itself.... (Presidential Sig.) [FR Doc. 2011-22768 Filed 9-1-11; 11:15 am] Billing code 3195-W1-P...

  18. Praehospital-hjertestopbehandling med semiautomatisk defibrillator--Heartstart 2000

    DEFF Research Database (Denmark)

    Fonsmark, L; Sandøe, E; Kastrup, J;

    1989-01-01

    In order to test the efficacy of a semiautomatic defibrillator (Heartstart 2000) in connection with cardiac arrest outside hospital, the apparatus was installed in two of the ambulances belonging to the Copenhagen Fire Service. The ambulance district involved was also equipped with an ambulance...... staffed by a doctor. A total of 48 patients with cardiac arrest were found and 16 of these had ventricular fibrillation. Six of the 16 patients have since been discharged from hospital (37.5%). The defibrillator had a high diagnostic certainty with a sensitivity of 96.5% and a specificity of 100%. No...... practical problems of note occurred in connection with employment of the defibrillator. The ambulance staffs underwent six hours of training and this appeared to be adequate. It is concluded that Heartstart 2000 functions well and effectively in connection with revival of patients with cardiac arrest...

  19. An Integer Programming Model for the Dynamic Location and Relocation of Emergency Vehicles: A Case Study

    OpenAIRE

    Moeini, Mahdi; Jemai, Zied; Sahin, Evren

    2014-01-01

    In this paper, we address the dynamic Emergency Medical Service (EMS) systems. A dynamic location model is presented that tries to locate and relocate the ambulances. The proposed model controls the movements and locations of ambulances in order to provide a better coverage of the demand points under different fluctuation patterns that may happen during a given period of time. Some numerical experiments have been carried out by using some real-world data sets that have been collected through ...

  20. Foot Deformities in Patients with Cerebral Palsy

    OpenAIRE

    E Ameri; A. Yeganeh

    2007-01-01

    Introduction & Objective: In patients with cerebral palsy (CP) the most common presentation is lower extremity deformity specially foot deformity. Inability to ambulation is the one of the most important disabilities, that dependent to the variety of factors such as severity of disease, kind of CP, etc. This study was aimed to assess prevalence of kinds of foot deformity in CP and communication between kind of CP and foot deformity and another hand inability to ambulation.Materials & Methods...

  1. Disability and quality of life in Charcot-Marie-Tooth disease type 1

    OpenAIRE

    PFEIFFER, G; Wicklein, E; Ratusinski, T; Schmitt, L; Kunze, K

    2001-01-01

    OBJECTIVES—Charcot-Marie-Tooth disease type I (CMT1) is a hereditary sensorimotor neuropathy causing variable degrees of handicap. The risk for relevant disability in respect to genetic counselling is unknown. An attempt was made to define it.
METHODS—Disability and ambulation of 50 patients with CMT1 were scored by the Hauser ambulation index score and the Rankin scale. Rankin score 2 was subdivided into 2a (independent without relevant slowness) and 2b (independent, ...

  2. Optimizing Bone Health in Duchenne Muscular Dystrophy

    OpenAIRE

    Buckner, Jason L.; Bowden, Sasigarn A.; Mahan, John D

    2015-01-01

    Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serio...

  3. Support and Assessment for Fall Emergency Referrals (SAFER 1): Cluster Randomised Trial of Computerised Clinical Decision Support for Paramedics

    OpenAIRE

    Helen Anne Snooks; Ben Carter; Jeremy Dale; Theresa Foster; Ioan Humphreys; Philippa Anne Logan; Ronan Anthony Lyons; Suzanne Margaret Mason; Ceri James Phillips; Antonio Sanchez; Mushtaq Wani; Alan Watkins; Bridget Elizabeth Wells; Richard Whitfield; Ian Trevor Russell

    2014-01-01

    Objective To evaluate effectiveness, safety and cost-effectiveness of Computerised Clinical Decision Support (CCDS) for paramedics attending older people who fall. Design Cluster trial randomised by paramedic; modelling. Setting 13 ambulance stations in two UK emergency ambulance services. Participants 42 of 409 eligible paramedics, who attended 779 older patients for a reported fall. Interventions Intervention paramedics received CCDS on Tablet computers to guide patient care. Control parame...

  4. Organisationsprofile und Gesundheit im bundesdeutschen Rettungsdienst

    OpenAIRE

    Hering, Thomas

    2016-01-01

    Introduction. Research into the stress and demands of ambulance services is dominated by studies which mainly focus on psychologically highly stressful traumatizing emergencies and their pathological consequences such as posttraumatic stress disorder. Little research has been done on specific aspects of working conditions that the ambulance services are enduring and their importance for the characteristics of work-related health as well as for the indicators of commitment. So far, research ai...

  5. A method to reduce response times in prehospital care: the motorcycle experience.

    Science.gov (United States)

    Lin, C S; Chang, H; Shyu, K G; Liu, C Y; Lin, C C; Hung, C R; Chen, P H

    1998-11-01

    This study compared the response times of a motorcycle and a standard ambulance in a congested urban emergency medical services (EMS) setting. The study was performed in Taipei, Taiwan, a densely populated urban area. A basic life support (BLS) motorcycle (without defibrillation capability) and an advanced life support (ALS) ambulance were based at three study hospitals and simultaneously dispatched when there was a perceived need for ALS ambulance transport. Over a 3-month period, prehospital personnel evaluated 307 medical and trauma emergencies. Time data were insufficient for analysis in 33 cases, leaving a study population of 274. Response times of the motorcycle and the ambulance were prospectively assessed and compared. During rush hours, the response times of the motorcycle and ambulance were 4.9+/-3.0 minutes and 6.3+/-3.4 minutes (P motorcycles to transport EMTs to the emergency scene significantly reduced response time compared with a standard ambulance in a congested urban setting. Large prospective studies are required to determine the impact on patient outcome of shorter EMS response times using motorcycles. EMS motorcycles appear feasible and deserve consideration to help expedite prehospital care in other systems in densely populated cities. PMID:9827757

  6. Association between Bone Mineral Density and Clinical Parameters in Traumatic Brain Injury Patients

    Directory of Open Access Journals (Sweden)

    Murat Ersöz,

    2016-04-01

    Full Text Available Objective: Determine the association between the bone mineral density and traumatic brain injury (TBI. Materials and Methods: Twenty-two patients with TBI included to the study. Dual energy X-ray absorptiometry measurements which determines the femur neck and L1-4 vertebrate T scores in patients was performed via Lunar Prodigy DPX system. Clinical parameters such as types of involvements (plegia, upper-lower extremity spasticity values, presence of heterotypic ossification, ambulation levels were determined and their relations with femur neck and L1-4 vertebrate T scores were examined with Mann-Whitney U Test. Results: In the comparison of sub groups of type of plegia (tetraplegic/hemi-paraplegic, lower extremity spasticity values [Ascworth score 0/1-2-3-4, presence of heterotopic ossification no statistically significant (p>0.05 difference was found in the femur neck and L1-4 vertebrate T scores. On the other hand, in the subgroups determined according to ambulatory levels of the patients (confined to bed-wheelchair/ ambulated (orthesis-hand support-independent] significant difference was observed in the femur neck T scores (p=0.044. Femur neck T scores were significantly high in ambulated patients (p=0.044. Conclusion: In TBI cases ambulation level is a factor which significantly affect bone mineral density. It is necessary to ambulate patients with potential as soon as possible and to plan alternative approaches in patient could not be ambulated.

  7. Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana

    Science.gov (United States)

    Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Zakariah, Ahmed N; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Campbell, Thomas B

    2015-01-01

    Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana’s national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. Methods: A survey instrument was developed using Pechansky and Thomas’s model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. Results: 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18–35 years were more likely than older respondents to prefer an ambulance (odds

  8. Outdoor dynamic subject-specific evaluation of internal stresses in the residual limb: hydraulic energy-stored prosthetic foot compared to conventional energy-stored prosthetic feet.

    Science.gov (United States)

    Portnoy, Sigal; Kristal, Anat; Gefen, Amit; Siev-Ner, Itzhak

    2012-01-01

    The prosthetic foot plays an important role in propelling, breaking, balancing and supporting body loads while the amputee ambulates on different grounds. It is therefore important to quantify the effect of the prosthetic foot mechanism on biomechanical parameters, in order to prevent pressure ulcers and deep tissue injury. Our aim was to monitor the internal stresses in the residuum of transtibial amputation (TTA) prosthetic-users ambulating on different terrains, which the amputees encounter during their daily activities, i.e. paved floor, grass, ascending and descending stairs and slope. We specifically aimed to compare between the internal stresses in the TTA residuum of amputees ambulating with a novel hydraulic prosthetic foot compared to conventional energy storage and return (ESR) prosthetic feet. Monitoring of internal stresses was accomplished using a portable subject-specific real-time internal stress monitor. We found significant decrease (phydraulic foot, compared to walking with ESR feet. The loading rate calculated while ambulating with the hydraulic foot was at least three times lower than the loading rate calculated while ambulating with the ESR foot. Although the average decrease in internal stresses was ≈ 2-fold larger when replacing single-toe ESR feet with the hydraulic foot than when replacing split-toed ESR feet with the hydraulic foot, the differences were statistically insignificant. Our findings suggest that using a hydraulic prosthetic foot may protect the distal tibial end of the TTA residuum from high stresses, therefore preventing pressure-related injury and pain.

  9. The Emergency Medical Service personnel's perception of the transportation of young children.

    Science.gov (United States)

    Öberg, Marjut; Vicente, Veronica; Wahlberg, Anna C

    2015-04-01

    To our knowledge no previous studies have been made which describe the Emergency Medical Service (EMS) personnel's perceptions of transporting children and the care encounter between the child, the parent and the EMS personnel when separating the child and the parent specifically in an ambulance. The aim of this study was to gain an understanding of how EMS personnel perceive ambulance transport of children. The study was carried out in 2012 at one of three ambulance contractors in Stockholm. Twelve semi-structured interviews were conducted and the content analysis showed that transporting children induces stress and is deemed a precarious task by EMS personnel mainly because children are considered more vulnerable than adults and because of the necessity to separate the child from the parent during transport. There is a conflict between medical- and emotional wellbeing and traffic-safety during the transportation of children and a fear of insufficient ability to care for the child. The EMS personnel's vulnerability is evident in the complicated care situation associated with transporting children in an ambulance. These findings may be considered a first step in assessing if action is needed to improve care and patient safety during ambulance transportation of children. PMID:25082416

  10. Clinical usefulness of Adeli suit therapy for improving gait function in children with spastic cerebral palsy: a case study

    Science.gov (United States)

    Lee, Byoung-Hee

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of Adeli suit therapy (AST) on gross motor function and gait function in children with cerebral palsy. [Subjects and Methods] Two participants with spastic cerebral palsy were recruited to undergo AST. AST was applied in 60-minute sessions, five times per week, with 20 sessions total over 4 weeks. Assessments of gross motor function, spatiotemporal parameters, and functional ambulation performance for gait were conducted. [Results] Gross motor function, cadence, and functional ambulation performance improved after the intervention in both cases. [Conclusion] Although additional follow-up studies are required, the results demonstrated improved gross motor function and functional ambulation performance in the children with cerebral palsy. These findings suggest a variety of applications for conservative therapeutic methods that require future clinical trials in children with cerebral palsy. PMID:27390453

  11. Relaxation and music reduce pain following intestinal surgery.

    Science.gov (United States)

    Good, Marion; Anderson, Gene Cranston; Ahn, Sukhee; Cong, Xiaomei; Stanton-Hicks, Michael

    2005-06-01

    Three nonpharmacological nursing interventions, relaxation, chosen music, and their combination, were tested for pain relief following intestinal (INT) surgery in a randomized clinical trial. The 167 patients were randomly assigned to one of three intervention groups or control and were tested during ambulation and rest on postoperative days 1 and 2. Pain sensation and distress were measured with visual analog scales (VAS). Multivariate analysis of covariance showed significantly less post-test pain in the intervention groups than in the control group on both days after rest and at three of six ambulation post-tests (p = .024-.001), resulting in 16-40% less pain. Mixed effects after ambulation were due to the large variation in pain and difficulty relaxing while returning to bed; but post hoc explorations showed effects for those with high and low pain. These interventions are recommended along with analgesics for greater postoperative relief without additional side effects. PMID:15884029

  12. Age effects on the social interaction test in early adulthood male rats.

    Science.gov (United States)

    Garau, A; Martí, M A; Sala, J; Balada, F

    2000-01-01

    The effects of age on active and passive social interaction were studied in Wistar rats using the social interaction test (S.I.T.). Individual behaviors such as ambulation, rearing, and defecation were also studied. Despite the widespread use of the S.I.T. in anxiety research, the effects of age on the S.I.T. have not been studied thoroughly. Male Wistar rats of 75, 135, and 180 days old were used. Our results showed age effects on active social contact, passive social contact, ambulation, rearing, and defecation. At 135 days old, animals presented the lowest scores on active social behavior and the highest scores on defecation. Moreover, exploratory behavior measured by ambulation and rearing decreased with age. These results suggest that age could be a relevant variable in the social interaction test.

  13. [Long-haul intensive care transports by air].

    Science.gov (United States)

    Graf, Jürgen; Seiler, Olivier; Pump, Stefan; Günther, Marion; Albrecht, Roland

    2013-03-01

    The need for inter-hospital transports over long distances aboard air ambulances or airlines has increased in recent years, both in the civil as well as the military sector. More often severely ill intensive care patients with multiple organ failure and appropriate supportive care (e.g. mechanical ventilation, catecholamines, dialysis, cardiac assist devices) are transported by air. Despite the fact that long-haul intensive care transports by air ambulance and airlines via Patient Transport Compartment (PTC) are considered established modes of transport they always provide a number of challenges. Both modes of transport have distinct logistical and medical advantages and disadvantages. These-as well as the principal risks of an air-bound long-haul intensive care transport -have to be included in the risk assessment and selection of means of transport. Very often long-haul intensive care transports are a combination of air ambulance and scheduled airlines utilizing the PTC. PMID:23504461

  14. EMS in Mauritius.

    Science.gov (United States)

    Ramalanjaona, Georges; Brogan, Gerald X

    2009-02-01

    Mauritius lies in the southwest Indian Ocean about 1250 miles from the African coast and 500 miles from Madagascar. Mauritius (estimated population 1,230,602) became independent from the United Kingdom in 1968 and has one of the highest GDP per capita in Africa. Within Mauritius there is a well established EMS system with a single 999 national dispatch system. Ambulances are either publicly or privately owned. Public ambulances are run by the Government (SAMU). Megacare is a private subscriber only ambulance service. The Government has recently invested in new technology such as telemedicine to further enhance the role of EMS on the island. This article describes the current state of EMS in Mauritius and depicts its development in the context of Government effort to decentralise and modernise the healthcare system.

  15. How do patients come to the Accident and Emergency Department of RIPAS Hospital?

    Directory of Open Access Journals (Sweden)

    Po Thaw DA

    2012-06-01

    Full Text Available Introduction: The mode and speed of transportation to the Accident and Emergency Department (AED of hospitals is very important for critically ill patients. This study looked at the mode of transportation to the AED at the Raja Isteri Pengiran Anak Saleha (RIPAS Hospital. Materials and Methods: Three different time periods: Period A from 15th May to 31st May 2004, (17 days, n=2,170 without prioritising, Period B from 1st January 2004 to 31st July 2006 (31 months, n=235 dead on arrival and resuscitation cases, and Period C from 20th to 26th November 2006 (7 days, all Priority Cases 1 to 3 were reviewed. Data on mode of transportation and triage categories were extracted from the ambulance response sheets. Results: During Period A, the main mode of transportation to the AED was private vehicles (90.7% followed by ambulance (7.9%, and other transportation (1.4%. During study Period B, the main mode of transportation was also private transports (50.2% followed closely by ambulance (48.5% and other transportation (1.3%. During Period C, Priority 1 cases (life-threatening conditions, n=7, most were transported with private transport (71.4% followed by ambulance (28.6%; Priority 2 (n=232 cases, majority were transported with private transport (89.2%, followed by ambulance (10.3%, and one case used police transportation; and in Priority 3 cases (non-life threatening conditions, n=1,010, almost all were transported with private transport (98.7%, followed by police (0.9% and ambulance (0.4% respectively. Conclusion: Utilisation of designated emergency transportation is low especially for the moderate to seriously ill (Priority 1 and 2 patients when compared to other well developed countries. More needs to be done to improve the usage of emergency transportations especially for the seriously ill cases.

  16. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

    Directory of Open Access Journals (Sweden)

    Staff Trine

    2011-03-01

    Full Text Available Abstract Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs. Methods Records from police, Emergency Medical Communication Centers (EMCC, ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS, respiratory rate (RR, and systolic blood pressure (SBP was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend. Results 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p Conclusion EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our finding indicates a need for improved procedures, training, and tools for EMS documentation. Documentation is in itself a quality criterion for appropriate care and is crucial to trauma research.

  17. Ambulantage et métropolisation

    Directory of Open Access Journals (Sweden)

    Jérôme Monnet

    2007-04-01

    Full Text Available « L’ambulantage » renvoie bien sûr au commerce ambulant, mais ce néologisme a pour but de dépasser la vision trop restrictive qui se concentre exclusivement sur les vendeurs ambulants en les associant le plus souvent à l’économie dite informelle ou souterraine. Cependant, il ne s’agit pas ici de nier l’importance de cette économie, que les conditions de la globalisation postfordiste et du capitalisme flexible semblent favoriser. De fait, les articles réunis dans ce dossier parlent tous de ven...

  18. Evaluation Of Gait Symmetry In Amputees Who Use Below Knee Prosthesis With Dynamic Foot

    Directory of Open Access Journals (Sweden)

    Yasin Yurt

    2012-06-01

    Full Text Available Purpose: To assess inter limb symmetry while walking in unilateral transtibial amputees which use dynamic foot. Method: Gait velocity, cadence, step length, stance percentages and ambulation index results of amputees (n=20 were recorded. Comparison was made with control group. (n=21 Results: Gait velocity, cadence and ambulation index results were greater for control group. Cases had longer stance time on their intact limb than amputated side. Stance time difference between limbs were higher for amputee group than control group. Conclusion: Amputees had higher stance percentage on their intact limb than sound limb with regard to healthy people.

  19. Hjertestop uden for hospital. Prospektiv undersøgelse af forskellige typer af udvidet præhospital behandling i Odense

    DEFF Research Database (Denmark)

    Nielsen, J R; Lybecker, H; Andersen, C;

    1990-01-01

    Danish National Board of Health (6 months]. Out of 28 patients brought in by the medically staffed ambulance, two (7%) were discharged alive. Out of 57 patients brought in the phase with the motorized doctor nine (16%) were discharged alive. Out of 78 patients brought in by heart ambulance one (1%) was...... discharged alive. The results of this investigation reveal that the prehospital treatment of cardiac arrest in Odense can be improved by participation of a doctor in the treatment, (particularly the rendezvous model). Suggested improvements consist of 1) improved alarm system, 2) intensification of training...

  20. Ambulanceservice til patienter med akutte hjertelidelser i Danmark - en status

    DEFF Research Database (Denmark)

    Lybecker, H; Larsen, C F; Nielsen, J R;

    1990-01-01

    In 1985, the Danish Board of Health published a review of the therapeutic value of heart ambulances. A report is presented here concerning the extent to which prehospital treatment of cardiac arrest recommended by the Board of Health has been intensified after publication of the review. The preho......In 1985, the Danish Board of Health published a review of the therapeutic value of heart ambulances. A report is presented here concerning the extent to which prehospital treatment of cardiac arrest recommended by the Board of Health has been intensified after publication of the review...

  1. Why and when citizens call for emergency help

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Ersbøll, Annette Kjær; Tolstrup, Janne Schurmann;

    2015-01-01

    BACKGROUND: A medical emergency call is citizens' access to pre-hospital emergency care and ambulance services. Emergency medical dispatchers are gatekeepers to provision of pre-hospital resources and possibly hospital admissions. We explored causes for access, emergency priority levels, and temp......, and ultimately development of best practice in the area of emergency medicine.......BACKGROUND: A medical emergency call is citizens' access to pre-hospital emergency care and ambulance services. Emergency medical dispatchers are gatekeepers to provision of pre-hospital resources and possibly hospital admissions. We explored causes for access, emergency priority levels...

  2. Custom-made footwear in diabetes: Offloading, usability and ulcer recurrence

    NARCIS (Netherlands)

    M.L.J. Arts

    2013-01-01

    Foot ulceration is a serious long term complication in patients with diabetes mellitus and polyneuropathy, which increases the risk of infection and lower limb amputation. Loss of protective sensation and high levels of plantar foot pressure during ambulation are the main causative factors. These pa

  3. Effects of acarbose (Glucobay) in persons with type 1 diabetes : a multicentre study

    NARCIS (Netherlands)

    Sels, J P; Verdonk, H E; Wolffenbuttel, B H

    1998-01-01

    The aim of this multicentre study was to investigate the effect--in everyday life--of long term administration of acarbose on parameters of glycaemic control, daily insulin requirements, lipid parameters and tolerability in ambulant type 1 diabetic subjects insufficiently controlled with diet and in

  4. The assisted 6-minute cycling test to assess endurance in children with a neuromuscular disorder

    NARCIS (Netherlands)

    Jansen, M.; Jong, M. de; Coes, H.M.; Eggermont, F.; Alfen, N. van; Groot, I.J. de

    2012-01-01

    Introduction: For late- or non-ambulant children with a neuromuscular disorder no suitable endurance tests are currently available. We developed the assisted 6-minute cycling test (A6MCT) for the legs and arms and investigated its psychometric properties in healthy boys and boys with Duchenne muscul

  5. Emergency Room Use Among Adults Aged 18-64

    Science.gov (United States)

    ... ambulance Lack of access to other providers Doctor's office not open No other place to go Emergency room is ... a hospital could help (54.5%), the doctor’s office was not open (48.0%), or there was no other place ...

  6. Die Therapie schlafbezogener Atmungsstörungen mit Hilfe eines den Unterkiefer protrudierenden Schienensystems

    OpenAIRE

    Klisch, Nico

    2015-01-01

    50 Patienten wurden mit einem herausnehmbaren unterkiefervorverlagernden Schienensystem im Zeitraum der Jahre 2000 bis 2002 behandelt. Die schlafmedizinisch-diagnostischen Untersuchungen vor Therapiebeginn erfolgten bei 25 Patienten ambulant und bei den anderen 25 Patienten stationär. Es wurden schlafmedizinischen Parameter zur Diagnosestellung herangezogen. Hälftig bestanden bei diesen Patienten die schlafmedizinische Diagnosen einer Rhonchopathie (reine Schnarcher, ohne internistische Beson...

  7. The association between submaximal quadriceps force steadiness and the knee adduction moment during walking in patients with knee osteoarthritis

    DEFF Research Database (Denmark)

    Sørensen, Tina Juul; Langberg, Henning; Aaboe, Jens;

    2011-01-01

    in this population. METHODS: Forty-one patients with knee OA (34 females and 7 males) were included in the study. Submaximal isometric quadriceps force steadiness was measured during a force target-tracking task. Peak knee adduction moments during ambulation were measured using a 3-dimensional gait analysis system...

  8. Dyspnea is a dangerous symptom in the pre-hospital setting

    DEFF Research Database (Denmark)

    Bøtker, Morten Thingemann; Kirkegaard, Hans; Christensen, Erika Frischknecht;

    ABSTRACT: Background Electrocardiogram (ECG) based telemedicine is a cornerstone in pre-hospital triage of patients with suspected ST-elevation myocardial infarction (STEMI). An ECG transmitted from the ambulance is reviewed by a cardiologist on-call in case of ongoing or recent chest pain, resus...

  9. Coaching Communication Partners: A Preliminary Investigation of Communication Intervention during Mealtime in Rett Syndrome

    Science.gov (United States)

    Bartolotta, Theresa E.; Remshifski, Patricia A.

    2013-01-01

    Rett syndrome (RTT) occurs primarily in females and is characterized by deficits in cognition, communication, hand use and ambulation. This quasi-experimental study explored the use of a coaching program to increase communicative interactions between girls with RTT and their communication partners. Communication coaching strategies were provided…

  10. A CLINICAL STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE (LCP - PF) IN THE MANAGEMENT OF COMMUNITED INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF THE FEMUR

    OpenAIRE

    Hari Babu; Satish; Suresh Babu; Anand

    2015-01-01

    Fractures of proximal femur and hip are relatively common injuries in elderly individuals . The incidence of peritrochanteric and intertrochanteric fracture is also increasing among young population, who sustain high energy trauma Rigid Internal fixation and early mobilization has been the standard method of treatment. A combination of orthopaedic surgery and early postoperative physiotherapy and ambulation is the bes...

  11. Handcycling : different modes and gear ratios

    NARCIS (Netherlands)

    van der Woude, L H; Bosmans, I; Bervoets, B; Veeger, DirkJan (H. E. J.)

    2001-01-01

    Handrim wheelchair propulsion is a straining form of ambulation. In contrast, arm crank exercise in laboratory settings has shown a higher degree of gross mechanical efficiency and increased levels of peak power output. Moreover, arm crank exercise can be conducted at different gear ratios and in as

  12. Hartbewaking in de pre-hospitale fase : onderzoek naar de activiteiten van de ambulanceverpleegkundigen van de G. G. en G.D. Rotterdam voor en tijdens het vervoer van patiënten met een vermoedelijk acuut ischaemisch hartlijden

    NARCIS (Netherlands)

    H.N. Hart

    1978-01-01

    textabstractHet feit, dat 50-60% van alle sterfgevallen tengevolge van een acuut myocardinfarct buiten het ziekenhuis plaatsvond, werd voor het eerst door Pantridge et al. (1967, 1971) in Belfast vastgelegd. Op grond daarvan veranderden zij enkele ambulances in rijdende coronary care units en noemde

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

    Science.gov (United States)

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

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-01

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

  15. 75 FR 7370 - Federal Motor Vehicle Safety Standards; Door Locks and Door Retention Components

    Science.gov (United States)

    2010-02-19

    ... Federal Specifications for the Star-of-Life Ambulance.\\13\\ Section 3.10.9 of the GSA standard states... Safety Standard (FMVSS) No. 206, Door Locks and Door Retention Components (49 CFR 571.206) (72 FR 5385.... NHTSA's Part I Response To accommodate manufacturers' design and production cycles while allowing...

  16. Selected contents in J Head Trauma Rehabilitation%精 选 目 次 :

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Supported treadmill ambulation training after spinal cord injury: A pilot study. 2001 Jun;82(6):825-831   脊 髓 损 伤 后 的 支 持 性 踏 车 运 动 训 练 : 实 验 性 研 究   

  17. Is determination between complete and incomplete traumatic spinal cord injury clinically relevant? Validation of the ASIA sacral sparing criteria in a prospective cohort of 432 patients.

    NARCIS (Netherlands)

    Middendorp, J.J. van; Hosman, A.J.F.; Pouw, M.H.; Meent, H. van de

    2009-01-01

    STUDY DESIGN: Prospective multicenter longitudinal cohort study. OBJECTIVE: To validate the prognostic value of the acute phase sacral sparing measurements with regard to chronic phase-independent ambulation in patients with traumatic spinal cord injury (SCI). SETTING: European Multicenter Study of

  18. 38 CFR 52.120 - Quality of care.

    Science.gov (United States)

    2010-07-01

    ...) Transfer and ambulate; (iii) Toilet; and (iv) Eat. (2) A participant is given the appropriate treatment and... pressure ulcers receives necessary treatment and services to promote healing, prevent infection and prevent... identified and reviewed on a timely basis; and (2) Strategies for preventing medication errors and...

  19. A Novel Human Autonomy Assessment System

    Directory of Open Access Journals (Sweden)

    Torsten Stevens

    2012-06-01

    Full Text Available This article presents a novel human autonomy assessment system for generating context and discovering the behaviors of older people who use ambulant services. Our goal is to assist caregivers in assessing possibly abnormal health conditions in their clients concerning their level of autonomy, thus enabling caregivers to take countermeasures as soon as possible.

  20. Manual wheelchairs : Research and innovation in rehabilitation, sports, daily life and health

    NARCIS (Netherlands)

    van der Woude, Lucas H V; de Groot, Sonja; Janssen, Thomas W J

    2006-01-01

    Those with lower limb disabilities are often dependent on manually propelled wheelchairs for their mobility, in Europe today some 3.3 million people. This implies a transfer from leg to arm work for ambulation and all other activities of daily living (ADL). Compared to the legs, arm work is less eff

  1. The Right Son at the Right Time

    Institute of Scientific and Technical Information of China (English)

    崔礼山

    2004-01-01

    The story began on a downtown Brooklyn street corner.An elderly man had collapsed while crossing the street.and an ambulance rushed him to Kings County Hospital.There.when he came to now and again.the man repeatedly called for his son.

  2. Music as support and challenge

    DEFF Research Database (Denmark)

    Bonde, Lars Ole

    2010-01-01

    Første del af forskningsrapport om gruppemusikterapi med psykiatriske patienter i ambulant behandling. Metoden kaldes "Musiklytning og indre billeder" og der anvendes klassisk musik med såvel støttende som udfordrende elementer. Den artikel opridser den teoretiske baggrund for anvendelsen af denn...

  3. Førstehjælp ved observeret hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Lybecker, H; Andersen, C; Frandsen, F;

    1990-01-01

    In connection with participation of doctors in the emergency ambulance service in Odense, the number of cases of observed cardiac arrest outside hospital was registered during a period of six months. The object was to assess how often primary treatment for cardiac arrest was instituted by passers...

  4. Initial experience in setting up a medical student first responder scheme in South Central England.

    Science.gov (United States)

    Seligman, William H; Ganatra, Sameer; England, David; Black, John J M

    2016-02-01

    Prehospital emergency medicine (PHEM) is a recently recognised subspecialty of emergency medicine, and anaesthetics, intensive care and acute medicine, in the UK, and yet it receives little to no mention in many undergraduate medical curricula. However, there is growing interest in PHEM among medical students and junior doctors. Several programmes are in existence across the UK that serve to provide teaching and exposure of prehospital care to medical students and junior doctors. However, relatively few students are able to gain significant first-hand experience of treating patients in the prehospital phase. In this short report, we discuss our experience of launching the student first responder (SFR) scheme across three counties in the Thames Valley. Medical students are trained by the regional ambulance service and respond to life-threatening medical emergencies in an ambulance response vehicle. The scheme is likely to benefit the ambulance service by providing a wider pool of trained volunteer first responders able to attend to emergency calls, to benefit patients by providing a quick response at their time of need, and to benefit medical students by providing first-hand experience of medical emergencies in the community. In its first 15 months of operation, SFRs were dispatched to 343 incidents. This scheme can serve as a training model for other ambulance services and medical schools across the UK. PMID:26253147

  5. 48 CFR 22.1003-5 - Some examples of contracts covered.

    Science.gov (United States)

    2010-10-01

    ... CFR 4.130 for additional examples): (a) Motor pool operation, parking, taxicab, and ambulance services... services. (f) Snow, trash, and garbage removal. (g) Aerial spraying and aerial reconnaissance for fire..., stenographic reporting, or mortuary services. (j) Electronic equipment maintenance and operation...

  6. Ambulanceudrykning i København, Odense og Ringkøbing Amt. Resultater fra Sundhedsministeriets og Amtsrådsforeningens stikprøveundersøgelse 1990. 2. Ambulancemandskabets behandling, lægestøtte og diagnosemønster

    DEFF Research Database (Denmark)

    Larsen, C F; Trier, H

    1992-01-01

    district with smaller towns (the County of Ringkøbing). The conditions of the patients were assessed by the ambulance staff: 7-12% of the patients transported had visible haemorrhage, 5-8% were unconscious, 4-7% were cyanotic, 2-3% had seizures and 1-2% had pareses. The serious cases tended to be most...

  7. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery.

    Science.gov (United States)

    McCaffrey, Ruth; Locsin, Rozzano

    2006-01-01

    The purpose of this study was to examine the effects of music listening in older adults following hip or knee surgery. Acute confusion and pain after surgery can increase length of stay and reduce function. Study results demonstrate a reduction in acute confusion and pain and improved ambulation and higher satisfaction scores in older adults who listened to music. PMID:16974175

  8. Analgesic effect of perioperative escitalopram in high pain catastrophizing patients after total knee arthroplasty

    DEFF Research Database (Denmark)

    Lunn, Troels H; Frokjaer, Vibe G; Hansen, Torben Bæk;

    2015-01-01

    = 0.20. Overall pain upon ambulation and at rest from days 2 to 6 was lower in the escitalopram versus placebo group, as was depression score at day 6 (all P ≤ 0.01 in analyses uncorrected for multiple tests). Side effects were nonsignificant except for reduced tendency to sweat and prolonged sleep...

  9. DIAGNOSTIC SIGNIFICATION OF EXANTHEMA IN THE PREHOSPITAL CARE IN INFECTIOUS DISEASES

    Directory of Open Access Journals (Sweden)

    N. F. Plavunov

    2016-01-01

    Full Text Available Disease, with exanthema, pose a significant differential diagnostic difficulty for physicians multidisciplinary hospitals and require the consultation of an infectious disease physician. The article highlights the problem of early diagnostics of acute infectious diseases proceeding with exanthema. The analysis of quality of diagnostics of infectious disease on the outcomes of the consultative infectious ambulance team for 2013-2014.

  10. Prednisone Therapy for Duchenne Dystrophy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-02-01

    Full Text Available The effects of prednisone on muscle function and the extent of steroid-related adverse effects were studied in 17 ambulant children with Duchenne muscular dystrophy (DMD at University Hospital, Groningen; Rehabilitation Centre, Utrecht; and Leiden University Medical Centre, the Netherlands.

  11. Walking facilitates positive affect (even when expecting the opposite).

    Science.gov (United States)

    Miller, Jeffrey Conrath; Krizan, Zlatan

    2016-08-01

    Across 3 experiments, we rely on theoretical advancements that connect movement, embodiment, and reward-seeking behavior to test the proposal that walking incidental to routine activity (heretofore referred to as "incidental ambulation")-not specifically "exercise"-is a robust facilitator of positive affect. Experiment 1 reveals that ambulation facilitates positive affect even when participants are blind to the purpose of this activity. Experiment 2 further demonstrates the robustness of this effect of incidental ambulation by documenting its operation under conditions of low interest, as well as its power to override expectations of mood worsening. Experiment 3 replicates the main finding while eliminating the possibility that posture, ambient events, or experimenter bias account for the results. Taken together, the experiments demonstrate that incidental ambulation systematically promotes positive affect regardless of the focus on such movement, and that it can override the effects of other emotionally relevant events such as boredom and dread. The findings hold key implications for understanding the role of movement in shaping affect as well as for clarifying the embodied nature of emotion. (PsycINFO Database Record PMID:27100368

  12. The effects of orthoses, footwear, and walking aids on the walking ability of children and adolescents with spina bifida : A systematic review using International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a reference framework

    NARCIS (Netherlands)

    Ivanyi, Barbara; Schoenmakers, Marja; van Veen, Natasja; Maathuis, Karel; Nollet, Frans; Nederhand, Marc

    2015-01-01

    BACKGROUND: To date no review has been published that analyzes the efficacy of assistive devices on the walking ability of ambulant children and adolescents with spina bifida and, differentiates between the effects of treatment on gait parameters, walking capacity, and walking performance. OBJECTIVE

  13. Recreational nitrous oxide use: Prevalence and risks

    NARCIS (Netherlands)

    J. van Amsterdam; T. Nabben; W. van den Brink

    2015-01-01

    Nitrous oxide (N2O; laughing gas) is clinically used as a safe anesthetic (dentistry, ambulance, childbirth) and appreciated for its anti-anxiety effect. Since five years, recreational use of N2O is rapidly increasing especially in the dance and festival scene. In the UK, N2O is the second most popu

  14. Periarticular regional analgesia in total knee arthroplasty: a review of the neuroanatomy and injection technique.

    Science.gov (United States)

    Guild, George N; Galindo, Rubin P; Marino, Joseph; Cushner, Fred D; Scuderi, Giles R

    2015-01-01

    Postoperative pain control after total knee arthroplasty may be insufficient, resulting in insomnia, antalgic ambulation, and difficulty with rehabilitation. Current strategies, including the use of femoral nerve catheters, may control pain but have been associated with falls, motor blockade, and quadriceps inhibition. Periarticular infiltration using the appropriate technique and knowledge of intraarticular knee anatomy may increase pain control and maximize rehabilitation. PMID:25435030

  15. Neuroprotection in acute ischemic stroke

    NARCIS (Netherlands)

    De Keyser, Jacques; Uyttenboogaart, Maarten; Koch, Marcus W; Elting, Jan Willem; Sulter, Geert; Vroomen, Patrick C; Luijckx, Gert Jan

    2005-01-01

    Neuroprotection of patients with acute ischemic stroke should start at the scene and continue in the ambulance with the assessment and treatment of the airway, breathing, circulation, body temperature, and blood glucose. The key goal in eligible patients should be fast vessel recanalization with int

  16. The management of acute asthma.

    Science.gov (United States)

    Cross, S

    1997-04-01

    Health professionals likely to come into contact with people experiencing an acute episode of asthma, such as school nurses, ambulance personnel and A&E staff, need clear guidelines on management. The British Thoracic Society guidelines, revised this year, advise on the categorisation of asthma, assessment and treatment.

  17. Prolonged cardiopulmonary resuscitation and outcomes after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Rajan, Shahzleen; Folke, Fredrik; Kragholm, Kristian;

    2016-01-01

    of spontaneous circulation (ROSC). METHODS: We included 1316 adult OHCA individuals with pre-hospital ROSC (2005-2011) handled by the largest nationwide ambulance provider in Denmark. Patients were stratified into 0-5, 6-10, 11-15, 16-20, 21-25 and >25min of cardiopulmonary resuscitation (CPR) by emergency...

  18. Impact of arterial access site on outcomes after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hamon, Martial; Coste, Pierre; Van't Hof, Arnoud;

    2015-01-01

    BACKGROUND: In European Ambulance Acute Coronary Syndrome Angiography (EUROMAX), bivalirudin improved 30-day clinical outcomes with reduced major bleeding compared with heparins plus optional glycoprotein IIb/IIIa inhibitors. We assessed whether choice of access site (radial or femoral) had an im...

  19. 49 CFR 571.10 - Designation of seating positions.

    Science.gov (United States)

    2010-10-01

    ... No. 208 (49 CFR 571.208), firefighting vehicles, ambulances, or motor homes. To determine the number of passenger seating positions in school buses, see S4.1 of Standard No. 222 (49 CFR 571.222). (b... 49 Transportation 6 2010-10-01 2010-10-01 false Designation of seating positions. 571.10...

  20. SU-SP3 Semesterprojekt 3

    DEFF Research Database (Denmark)

    Sørensen, John Aasted; Holst-Christensen, Bo; Munck-Fairwood, Roger;

    2010-01-01

    1. At planlægge videreførelsen af en prototype til et system, der hånd-terer patientkontakt før, mellem og efter indlæggelser samt ambulant behandling. 2. At planlægge og konstruere en Matlab baseret simulator til et patient monitoreringssystem for fysiologiske parametre. Simulatoren skal sætte e...

  1. The influence of low dystrophin levels on disease pathology in mouse models for Duchenne Muscular Dystrophy

    NARCIS (Netherlands)

    Putten, Maaike van

    2013-01-01

    Duchenne muscular dystrophy (DMD) is the most prevalent neuromuscular disorder, caused by mutations in the DMD gene that prevent synthesis of dystrophin. Fibers that lack dystrophin are sensitive to exercise-induced damage, resulting in progressive muscle wasting, loss of ambulation and premature de

  2. Muscular Dystrophy: Hope Through Research

    Science.gov (United States)

    ... more severe and result in functional disability and loss of ambulation. Life expectancy often depends on the degree of muscle ... growth or mitigating damage due to inflammation Progressive loss of ... quality and length of life in MD. Drug treatment strategies designed to slow ...

  3. Quantitative magnetic resonance imaging in limb-girdle muscular dystrophy 2I

    DEFF Research Database (Denmark)

    Willis, Tracey A; Hollingsworth, Kieren G; Coombs, Anna;

    2014-01-01

    We conducted a prospective multinational study of muscle pathology using magnetic resonance imaging (MRI) in patients with limb-girdle muscular dystrophy 2I (LGMD2I). Thirty eight adult ambulant LGMD2I patients (19 male; 19 female) with genetically identical mutations (c.826C>A) in the fukutin-re...

  4. Burnout and Connectedness among Australian Volunteers: A Test of the Job Demands-Resources Model

    Science.gov (United States)

    Lewig, Kerry A.; Xanthopoulou, Despoina; Bakker, Arnold B.; Dollard, Maureen F.; Metzer, Jacques C.

    2007-01-01

    This study used the Job Demands-Resources (JD-R) model, developed in the context of occupational well-being in the paid workforce, to examine the antecedents of burnout and connectedness in the formal volunteer rural ambulance officer vocation (N=487). Structural equation modeling using self-reports provide strong evidence for the central…

  5. Healthcare PANs: Personal Area Networks for trauma care and home care

    NARCIS (Netherlands)

    Jones, V.M.; Bults, R.G.A.; Konstantas, D.; Vierhout, P.A.M.

    2001-01-01

    The first hour following the trauma is of crucial importance in trauma care. The sooner treatment begins, the better the ultimate outcome for the patient. Generally the initial treatment is handled by paramedical personnel arriving at the site of the accident with an ambulance. There is evidence to

  6. Initial experience in setting up a medical student first responder scheme in South Central England.

    Science.gov (United States)

    Seligman, William H; Ganatra, Sameer; England, David; Black, John J M

    2016-02-01

    Prehospital emergency medicine (PHEM) is a recently recognised subspecialty of emergency medicine, and anaesthetics, intensive care and acute medicine, in the UK, and yet it receives little to no mention in many undergraduate medical curricula. However, there is growing interest in PHEM among medical students and junior doctors. Several programmes are in existence across the UK that serve to provide teaching and exposure of prehospital care to medical students and junior doctors. However, relatively few students are able to gain significant first-hand experience of treating patients in the prehospital phase. In this short report, we discuss our experience of launching the student first responder (SFR) scheme across three counties in the Thames Valley. Medical students are trained by the regional ambulance service and respond to life-threatening medical emergencies in an ambulance response vehicle. The scheme is likely to benefit the ambulance service by providing a wider pool of trained volunteer first responders able to attend to emergency calls, to benefit patients by providing a quick response at their time of need, and to benefit medical students by providing first-hand experience of medical emergencies in the community. In its first 15 months of operation, SFRs were dispatched to 343 incidents. This scheme can serve as a training model for other ambulance services and medical schools across the UK.

  7. Community-dwelling people with chronic stroke need disproportionate attention while walking and negotiating obstacles

    NARCIS (Netherlands)

    Swart, Bert de; Smulders, K.; Swigchem, R. van; Geurts, Alexander; Weerdesteyn, V.

    2012-01-01

    The objective of the present study was to examine the attentional demands of gait adaptations required to walk over irregular terrain in community-dwelling people with chronic stroke. Eight community ambulators (>6 months post-stroke, aged 57 ± 15 years) and eight age-matched healthy controls partic

  8. Community-dwelling people with chronic stroke need disproportionate attention while walking and negotiating obstacles.

    NARCIS (Netherlands)

    Smulders, K.; Swigchem, R. van; Swart, B.J.M. de; Geurts, A.C.H.; Weerdesteijn, V.G.M.

    2012-01-01

    The objective of the present study was to examine the attentional demands of gait adaptations required to walk over irregular terrain in community-dwelling people with chronic stroke. Eight community ambulators (>6 months post-stroke, aged 57 +/- 15 years) and eight age-matched healthy controls p

  9. Caring about the young

    NARCIS (Netherlands)

    John Stevens; Evert Pommer; Hetty van Kempen; Elke Zeijl; Isolde Woittiez; Klarita Sadiraj; Rob Gilsing; Saskia Keuzenkamp

    2009-01-01

    Original title: De jeugd een zorg. Youth care services are going through major changes. This has created a need for a better insight into the demand that is likely to be placed on these services in the future at both national and regional level. This report suggests that the use of ambulant care w

  10. Swivel walkers in Duchenne muscular dystrophy.

    OpenAIRE

    Sibert, J R; Williams, V; Burkinshaw, R; Sibert, S

    1987-01-01

    Swivel walkers were used to provide low energy ambulation in 11 boys with Duchenne muscular dystrophy in schools for the physically handicapped in South Glamorgan. Our preliminary experience suggests that these walkers improve the quality of life and provide a useful part of the physical treatment of the condition.

  11. Heart rate and oxygen demand of powered exoskeleton–assisted walking in persons with paraplegia

    Directory of Open Access Journals (Sweden)

    Pierre Asselin, MS

    2015-06-01

    Full Text Available Historically, persons with paralysis have limited options for overground ambulation. Recently, powered exoskeletons, which are systems that translate the user’s body movements to activate motors that move the lower limbs through a predetermined gait pattern, have become available. As part of an ongoing clinical study (NCT01454570, eight nonambulatory persons with paraplegia were trained to ambulate with a powered exoskeleton. Measurements of oxygen uptake (VO2 and heart rate (HR were recorded for 6 min each during each maneuver while sitting, standing, and walking. The average value of VO2 during walking (11.2 +/– 1.7 mL/kg/min was significantly higher than for sitting and standing (3.5 +/– 0.4 and 4.3 +/– 0.9 mL/kg/min, respectively; p < 0.001. The HR response during walking was significantly greater than that of either sitting or standing (118 +/– 21 vs 70 +/– 10 and 81 +/– 12 beats per minute, respectively; p < 0.001. Persons with paraplegia were able to ambulate efficiently using the powered exoskeleton for overground ambulation, providing the potential for functional gain and improved fitness.

  12. Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis

    Directory of Open Access Journals (Sweden)

    Shimpei Miyamoto, MD

    2014-03-01

    Conclusions: This study demonstrates that early mobilization after free-flap transfer to the lower extremity is made possible by flow-through anastomosis for both arteries and veins. Flow-through flaps have stable circulation from the acute phase and can tolerate early dangling and ambulation.

  13. VehiHealth: An Emergency Routing Protocol for Vehicular Ad Hoc Network to Support Healthcare System.

    Science.gov (United States)

    Bhoi, S K; Khilar, P M

    2016-03-01

    Survival of a patient depends on effective data communication in healthcare system. In this paper, an emergency routing protocol for Vehicular Ad hoc Network (VANET) is proposed to quickly forward the current patient status information from the ambulance to the hospital to provide pre-medical treatment. As the ambulance takes time to reach the hospital, ambulance doctor can provide sudden treatment to the patient in emergency by sending patient status information to the hospital through the vehicles using vehicular communication. Secondly, the experienced doctors respond to the information by quickly sending a treatment information to the ambulance. In this protocol, data is forwarded through that path which has less link breakage problem between the vehicles. This is done by calculating an intersection value I v a l u e for the neighboring intersections by using the current traffic information. Then the data is forwarded through that intersection which has minimum I v a l u e . Simulation results show VehiHealth performs better than P-GEDIR, GyTAR, A-STAR and GSR routing protocols in terms of average end-to-end delay, number of link breakage, path length, and average response time. PMID:26696419

  14. Elastomeer-infuuspompen getest voor de praktijk

    NARCIS (Netherlands)

    Woerdenbag, Herman J.; Dillingh, Jan H.; Wanders, Jacquelien T. M.; Boer, E. Jildau; Frijlink, Henderik W.; Kosterink, Jos G. W.; Schellekens, Reinout C. A.

    2011-01-01

    OBJECTIVE: To test short-term and long-term elastomeric infusion pumps for applicability in hospital practice and for ambulant patients at home. DESIGN AND METHODS: Four short-term elastomeric infusion pumps (Accufuser C1000M, Easypump ST 100-1, Infusor Intermate SV-100, Surefuser Plus 100 ml) and f

  15. The Rescue911 Emergency Response Information System (ERIS): A Systems Development Project Case

    Science.gov (United States)

    Cohen, Jason F.; Thiel, Franz H.

    2010-01-01

    This teaching case presents a systems development project useful for courses in object-oriented analysis and design. The case has a strong focus on the business, methodology, modeling and implementation aspects of systems development. The case is centered on a fictitious ambulance and emergency services company (Rescue911). The case describes that…

  16. Treadmill Training with Partial Body-Weight Support in Children with Cerebral Palsy: A Systematic Review

    Science.gov (United States)

    Mutlu, Akmer; Krosschell, Kristin; Spira, Deborah Gaebler

    2009-01-01

    OKAim: The aim of this systematic review was to examine the literature on the effects of partial body-weight support treadmill training (PBWSTT) in children with cerebral palsy (CP) on functional outcomes and attainment of ambulation. Method: We searched the relevant literature from 1950 to July 2007. We found eight studies on the use of PWSBTT on…

  17. Developing a Framework and Priorities to Promote Mobility among Older Adults

    Science.gov (United States)

    Anderson, Lynda A.; Slonim, Amy; Yen, Irene H.; Jones, Dina L.; Allen, Peg; Hunter, Rebecca H.; Goins, R. Turner; Leith, Katherine H.; Rosenberg, Dori; Satariano, William A.; McPhillips-Tangum, Carol

    2014-01-01

    Mobility, broadly defined as movement in all of its forms from ambulation to transportation, is critical to supporting optimal aging. This article describes two projects to develop a framework and a set of priority actions designed to promote mobility among community-dwelling older adults. Project 1 involved a concept-mapping process to solicit…

  18. Functional Grouping in Residential Homes for People with Intellectual Disabilities.

    Science.gov (United States)

    Mansell, Jim; Beadle-Brown, Julie; Macdonald, Susan; Ashman, Bev

    2003-01-01

    The effects of functional grouping of 303 people with intellectual disabilities on care practices in English group homes were investigated. Residents who were non-ambulant were rated as receiving care with less interpersonal warmth and residents with severe challenging behavior were rated as receiving care with less interpersonal warmth and…

  19. Deficits in motor response to avoid sudden obstacles during gait in functional walkers poststroke

    NARCIS (Netherlands)

    Swigchem, R. van; Duijnhoven, H.J. van; Boer, J. den; Geurts, A.C.H.; Weerdesteijn, V.G.

    2013-01-01

    BACKGROUND: . Safe community ambulation requires the capacity to adapt gait to environmental changes on short notice. Reduced adaptability may contribute to an increased risk for falls. OBJECTIVE: . This study investigated gait adaptability in community-dwelling persons poststroke and sought to unde

  20. Integration in stroke services: the challenges for primary and community care services

    OpenAIRE

    Baeza, Juan I; Fraser, Alec; Boaz, Dr Annette

    2012-01-01

    Objectives A number of evidence-based interventions are now available for stroke patients. Good quality stroke care involves a range of health professionals located across ambulance, hospital, community and primary care services. This study examined the perspectives of healthcare workers involved in stroke care in two different English case study sites on the integration challenges stroke care presents.

  1. Prehospital Unassisted Assessment of Stroke Severity Using Telemedicine A Feasibility Study

    NARCIS (Netherlands)

    Van Hooff, Robbert-Jan; Cambron, Melissa; Van Dyck, Rita; De Smedt, Ann; Moens, Maarten; Espinoza, Alexis Valenzuela; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; De Keyser, Jacques; Brouns, Raf

    2013-01-01

    Background and Purpose We evaluated the feasibility and the reliability of remote stroke severity quantification in the prehospital setting using the Unassisted TeleStroke Scale (UTSS) via a telestroke ambulance system and a fourth-generation mobile network. Methods The technical feasibility and the

  2. 76 FR 18831 - Updating Regulations Issued Under the Fair Labor Standards Act

    Science.gov (United States)

    2011-04-05

    ..., paramedic, emergency medical technician, rescue worker, ambulance personnel, or hazardous material worker... they `spend one hundred percent of their time responding to medical emergencies.' '' They suggested that the Department add a sentence in Sec. 553.210 providing that emergency medical personnel who...

  3. 42 CFR 414.605 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... (ALS) personnel means an individual trained to the level of the emergency medical technician... local laws as an emergency medical technician-basic (EMT-Basic). These laws may vary from State to State... PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedule for Ambulance Services §...

  4. Public Access Defibrillation

    DEFF Research Database (Denmark)

    Agerskov, Marianne; Nielsen, Anne Møller; Hansen, Carolina Malta;

    2015-01-01

    BACKGROUND: In Copenhagen, a volunteer-based Automated External Defibrillator (AED) network provides a unique opportunity to assess AED use. We aimed to determine the proportion of Out-of-Hospital Cardiac Arrest (OHCA) where an AED was applied before arrival of the ambulance, and the proportion o...

  5. Frostbite

    Science.gov (United States)

    ... the child walk on frostbitten feet. Get your child into dry clothing in a warm environment. If you cannot get to a hospital right away or must wait for an ambulance, give your child a warm drink and begin first-aid treatment: ...

  6. Development of a cosmetic knee disarticulation prosthesis : A single-patient case study

    NARCIS (Netherlands)

    de Laat, Fred A.; de Vos, Wouter; Geertzen, Jan; Roorda, Leo D.

    2015-01-01

    Background and aim: If a person does not become ambulant after an amputation, a knee disarticulation (KD) shouldbe considered and the person may then benefit from a cosmetic KD prosthesis. The features of a cosmetic KD prosthesis are, however, seldom described. The aim of this clinical note is to de

  7. Cutting down on the cutdown: Time to remove the training wheels for transfemoral access for TAVR.

    Science.gov (United States)

    Turi, Zoltan G

    2015-09-01

    Percutaneous transfemoral access is replacing cutdowns, even in the absence of a high level evidence base The evolution of smaller profile TAVR sheaths will make cutdowns largely obsolete Patient comfort, early ambulation, and shorter length of stay, along with improved methodologies will continue to drive the move to percutaneous access and closure for TAVR. PMID:26276237

  8. Ambulanceudrykning i København, Odense og Ringkøbing Amt. Resultater fra Sundhedsministeriets og Amtsrådsforeningens stikprøveundersøgelse 1990. 1. Epidemiologiske data

    DEFF Research Database (Denmark)

    Trier, H; Larsen, C F

    1992-01-01

    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...

  9. Upper Limb Evaluation in Duchenne Muscular Dystrophy: Fat-Water Quantification by MRI, Muscle Force and Function Define Endpoints for Clinical Trials

    Science.gov (United States)

    Ricotti, Valeria; Evans, Matthew R. B.; Sinclair, Christopher D. J.; Butler, Jordan W.; Ridout, Deborah A.; Hogrel, Jean-Yves; Emira, Ahmed; Morrow, Jasper M.; Reilly, Mary M.; Hanna, Michael G.; Janiczek, Robert L.; Matthews, Paul M.; Yousry, Tarek A.; Muntoni, Francesco; Thornton, John S.

    2016-01-01

    Objective A number of promising experimental therapies for Duchenne muscular dystrophy (DMD) are emerging. Clinical trials currently rely on invasive biopsies or motivation-dependent functional tests to assess outcome. Quantitative muscle magnetic resonance imaging (MRI) could offer a valuable alternative and permit inclusion of non-ambulant DMD subjects. The aims of our study were to explore the responsiveness of upper-limb MRI muscle-fat measurement as a non-invasive objective endpoint for clinical trials in non-ambulant DMD, and to investigate the relationship of these MRI measures to those of muscle force and function. Methods 15 non-ambulant DMD boys (mean age 13.3 y) and 10 age-gender matched healthy controls (mean age 14.6 y) were recruited. 3-Tesla MRI fat-water quantification was used to measure forearm muscle fat transformation in non-ambulant DMD boys compared with healthy controls. DMD boys were assessed at 4 time-points over 12 months, using 3-point Dixon MRI to measure muscle fat-fraction (f.f.). Images from ten forearm muscles were segmented and mean f.f. and cross-sectional area recorded. DMD subjects also underwent comprehensive upper limb function and force evaluation. Results Overall mean baseline forearm f.f. was higher in DMD than in healthy controls (pfat transformation of muscle with loss of muscle force and function. PMID:27649492

  10. When bystanders become bothersome: The negative consequences of bystander conflict and the moderating role of resilience

    NARCIS (Netherlands)

    Erp, van Kim J.P.M; Rispens, Sonja; Gevers, Josette M.P.; Demerouti, Evangelia

    2014-01-01

    Bystander conflict is a situation in which employees are hindered in their work by parties not involved in the primary process. Public service employees and emergency care workers, such as ambulance employees and firefighters, often encounter this kind of conflict with potentially far-reaching detri

  11. International EMS Systems

    DEFF Research Database (Denmark)

    Langhelle, Audun; Lossius, Hans Morten; Silfvast, Tom;

    2004-01-01

    is the only country that has emergency medicine (EM) as a recognised speciality but there is a need for more fully trained specialists in EM; (4) Norway: the ordinary ground ambulance is pointed out as the weakest link in the EM chain and a health reform demands extensive co-operation between the new health...

  12. Indoor fire in a nursing home : evaluation of the medical response to a mass casualty incident based on a standardized protocol

    NARCIS (Netherlands)

    Koning, S. W.; Ellerbroek, P. M.; Leenen, L. P. H.

    2015-01-01

    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent res

  13. Emergency care center turnaround time--an improvement story.

    Science.gov (United States)

    Gelrud, Joan; Burroughs, Helen; Koterwas, Joanne

    2008-01-01

    Emergency department overcrowding is a nationally recognized barrier to patient safety. Other obstacles to efficiency and adequate care in emergency rooms include lengthy patient waits and side-tracked ambulances. This article explores one community hospital's approach to significantly decreasing emergency visit turnaround times while increasing patient satisfaction.

  14. Muscular Dystrophy: Data and Statistics

    Science.gov (United States)

    ... duration and time to loss of ambulation. J Child Neurol. 2015 Sept;30(10):1275-80. Fox DJ, Kumar A, West N, DiRienzo AG, James KA, Oleszek J; Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STAR net ). Trends with corticosteroid use in males with ...

  15. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    Buuren, M. van; Kommer, G.J.; Mei, R.D. van der; Bhulai, S.

    2015-01-01

    In pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response time to the

  16. Experiential Learning in Pre-Hospital Emergency Care: A Qualitative Study.

    Science.gov (United States)

    Melby, Vidar

    2000-01-01

    Analysis of 141 nursing students' diaries and focus group interviews about their work with an ambulance service revealed the following: holistic nursing played a role; they developed appreciation for paramedics' skills; and experiential learning helped them understand the complete care process from the emergency call to patient discharge. (SK)

  17. De verkeersonveiligheid van hulpverleningsvoertuigen. Consult ten behoeve van de Koninklijke Nederlandse Toeristenbond ANWB.

    NARCIS (Netherlands)

    Oei, H.-l.

    1986-01-01

    Drivers on emergency vehicles (ambulances, fire engines, police cars) which have to fulfil an urgent task and which make use of particular competencies, show often a driving behaviour with an increased risk. Each year more than hundred victims are killed or injured in accidents in which emergency ve

  18. Idling Reduction for Emergency and Other Service Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-07

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

  19. Human Performance in Simulated Reduced Gravity Environments

    Science.gov (United States)

    Cowley, Matthew; Harvill, Lauren; Rajulu, Sudhakar

    2014-01-01

    NASA is currently designing a new space suit capable of working in deep space and on Mars. Designing a suit is very difficult and often requires trade-offs between performance, cost, mass, and system complexity. Our current understanding of human performance in reduced gravity in a planetary environment (the moon or Mars) is limited to lunar observations, studies from the Apollo program, and recent suit tests conducted at JSC using reduced gravity simulators. This study will look at our most recent reduced gravity simulations performed on the new Active Response Gravity Offload System (ARGOS) compared to the C-9 reduced gravity plane. Methods: Subjects ambulated in reduced gravity analogs to obtain a baseline for human performance. Subjects were tested in lunar gravity (1.6 m/sq s) and Earth gravity (9.8 m/sq s) in shirt-sleeves. Subjects ambulated over ground at prescribed speeds on the ARGOS, but ambulated at a self-selected speed on the C-9 due to time limitations. Subjects on the ARGOS were given over 3 minutes to acclimate to the different conditions before data was collected. Nine healthy subjects were tested in the ARGOS (6 males, 3 females, 79.5 +/- 15.7 kg), while six subjects were tested on the C-9 (6 males, 78.8 +/- 11.2 kg). Data was collected with an optical motion capture system (Vicon, Oxford, UK) and was analyzed using customized analysis scripts in BodyBuilder (Vicon, Oxford, UK) and MATLAB (MathWorks, Natick, MA, USA). Results: In all offloaded conditions, variation between subjects increased compared to 1-g. Kinematics in the ARGOS at lunar gravity resembled earth gravity ambulation more closely than the C-9 ambulation. Toe-off occurred 10% earlier in both reduced gravity environments compared to earth gravity, shortening the stance phase. Likewise, ankle, knee, and hip angles remained consistently flexed and had reduced peaks compared to earth gravity. Ground reaction forces in lunar gravity (normalized to Earth body weight) were 0.4 +/- 0.2 on

  20. Assesment of Osteoporosis in Medulla Spinalis Injured Patients

    Directory of Open Access Journals (Sweden)

    Zuhal Bayırlı Karakoyun

    2011-12-01

    Full Text Available Aim: To investigate the relationship between osteoporosis and demographic features, clinical characteristics,risk factors in younger SCI patients. Materials and Methods: Between January-June 2009, all SCI patients admitted to our hospital evaluated and 58 patients who were younger than 50 years who had osteoporosis were enrolled.Patients age, gender, educational status, duration of injury, smoking, sunlight exposure and dietary habits were questioned. Neurological level, completeness, ambulation status and spasticity were assessed. Relationship between these findings with the severity of osteoporosis has been viewed. Results: There were 19 women. Mean age was 35,7 years. The mean time since injury were 117.7 months. 42 patients were paraplegia (17 complete, 16 were tetraplegia (4 complete.The most common osteoporotic site where the legs. There was no correlation between BMD values with age. In men, the legs and total body BMD were significantly lower.The effect of educational level on BMD was not found. No significant correlation was found between time since injury and BMD. In paraplegics, femoral neck and total femur Z-scores were significantly lower. In tetraplegics, Z scores of the arms were lower, but was not significant. Lumbar BMD values of complete patients were significantly lower than incompletes. Sunlight exposure and consumption of milk/milk products had not a significant positive effect on BMD. 8 patients had therapeutic ambulation, whereas 23 of them had community ambulation. Ambulation status of patients and the presence of spasticity was no effect on BMD. There was no significant correlation between BMD and the severity of spasticity. Smokers (n=19, bone density was lower in all regions except for femoral neck but were not significantly. Conclusion: Male gender, paraplegia, and incompleteness negatively effects the bone density. Age, time since injury, education level, spasticity, ambulation level, smoking, sunlight exposure and

  1. EMS adaptation for climate change

    Science.gov (United States)

    Pan, C.; Chang, Y.; Wen, J.; Tsai, M.

    2010-12-01

    The purpose of this study was to find an appropriate scenario of pre-hospital transportation of an emergency medical service (EMS) system for burdensome casualties resulting from extreme climate events. A case of natural catastrophic events in Taiwan, 88 wind-caused disasters, was reviewed and analyzed. A sequential-conveyance method was designed to shorten the casualty transportation time and to promote the efficiency of ambulance services. A proposed mobile emergency medical center was first constructed in a safe area, but nearby the disaster area. The Center consists of professional medical personnel who process the triage of incoming patients and take care of casualties with minor injuries. Ambulances in the Center were ready to sequentially convey the casualties with severer conditions to an assigned hospital that is distant from the disaster area for further treatment. The study suggests that if we could construct a spacious and well-equipped mobile emergency medical center, only a small portion of casualties would need to be transferred to distant hospitals. This would reduce the over-crowding problem in hospital ERs. First-line ambulances only reciprocated between the mobile emergency medical center and the disaster area, saving time and shortening the working distances. Second-line ambulances were highly regulated between the mobile emergency medical center and requested hospitals. The ambulance service of the sequential-conveyance method was found to be more efficient than the conventional method and was concluded to be more profitable and reasonable on paper in adapting to climate change. Therefore, additional practical work should be launched to collect more precise quantitative data.

  2. Pre-hospital treatment of acute poisonings in Oslo

    Directory of Open Access Journals (Sweden)

    Nore Anne K

    2008-11-01

    Full Text Available Abstract Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. Methods A one-year multi-centre study with prospective inclusion of all acutely poisoned patients ≥ 16 years of age treated in ambulances, an outpatient clinic, and hospitals in Oslo. Results A total of 3757 health service contacts from 2997 poisoning episodes were recorded: 1860 were treated in ambulances, of which 15 died and 750 (40% were discharged without transfer; 956 were treated in outpatient clinic, of which 801 (84% were discharged without transfer; and 941 episodes were treated in hospitals. Patients discharged alive after ambulance treatment were mainly poisoned by opiates (70%, were frequently comatose (35%, had respiratory depression (37%, and many received naloxone (49%. The majority of the patients discharged from the outpatient clinic were poisoned by ethanol (55%, fewer were comatose (10%, and they rarely had respiratory depression (4%. Among the hospitalized, pharmaceutical poisonings were most common (58%, 23% were comatose, and 7% had respiratory depression. Male patients comprised 69% of the pre-hospital discharges, but only 46% of the hospitalized patients. Except for one patient, who died of a new heroin overdose two days following discharge from an ambulance, there were no deaths during the first week after the poisonings in the 90% of the pre-hospital discharged patients with known identity. Conclusion More than half of the poisoned patients treated in pre-hospital treatment settings were discharged without transfer to higher levels. These poisonings were more often

  3. Anaesthesiologists in prehospital care make a difference to certain groups of patients

    DEFF Research Database (Denmark)

    Christensen, Erika Frischknecht; Melchiorsen, Hanne; Kilsmark, J.;

    2003-01-01

    and (2) to evaluate the impact of one mobile emergency care unit (MECU) staffed by an anesthesiologist. DESIGN AND METHODS: A descriptive and quasi-experimental study of consecutive emergency ambulance users during two 3-month periods: before the MECU (Period 1) and after (Period 2). Hospitalization......, diagnostic and 0-180-day mortality data were requested from national registers. Diagnoses were according to the International Classification of Diseases (ICD). RESULTS: Periods 1 and 2 included 2950 and 2869 users, respectively. The MECU attended 27.7% in Period 2. Fewer users were brought to hospital......ACKGROUND: Knowledge of the population using prehospital emergency services is scarce except for selected subgroups. Interventions are often made without evaluation. The aim of this study was (1) to describe mortality, hospitalization and the diagnostic pattern among emergency ambulance users...

  4. Preoperative teaching and hysterectomy outcomes.

    Science.gov (United States)

    Oetker-Black, Sharon L; Jones, Susan; Estok, Patricia; Ryan, Marian; Gale, Nancy; Parker, Carla

    2003-06-01

    This study used a theoretical model to determine whether an efficacy-enhancing teaching protocol was effective in improving immediate postoperative behaviors and selected short- and long-term health outcomes in women who underwent abdominal hysterectomies. The model used was the self-efficacy theory of Albert Bandura, PhD. One hundred eight patients in a 486-bed teaching hospital in the Midwest who underwent hysterectomies participated. The participation rate was 85%, and the attrition rate was 17% during the six-month study. The major finding was that participants in the efficacy-enhancing teaching group ambulated significantly longer than participants in the usual care group. This is an important finding because the most prevalent postoperative complications after hysterectomy are atelectasis, pneumonia, paralytic ileus, and deep vein thrombosis, and postoperative ambulation has been shown to decrease or prevent all of these complications. This finding could affect the overall health status of women undergoing hysterectomies. PMID:12817743

  5. 基于CATIA软件平台的人机工程应用研究%Man-machine engineering applications research based on CATIA software platform

    Institute of Scientific and Technical Information of China (English)

    李付星

    2012-01-01

    Based on the analysis of CATIA software platform for the ambulance man-machine module, the rescue capsule digital model was introduced to virtual model of the human body so as to create a virtual man-machine relationship, and ergonomics theory was applied to guide the ambulance rescue capsule, and the optimization design based on the analysis of CATIA software module was explained in man-machine application method of product design.%基于CATIA软件平台的人机分析模块,对救护车的救护舱数字模型引入虚拟人体模型,建立虚拟人机关系,应用人机工程学理论来指导救护舱的优化设计,以探讨CATIA软件的人机分析模块,在产品开发设计中的应用方法.

  6. Isochrones as Indicators of the Influence of Traffic in Public Health: A Visual Simulation Application in Ávila, Spain.

    Science.gov (United States)

    Otamendi, F Javier; García-Heredia, David

    2015-10-01

    It is well known that excessive rescue times after traffic accidents negatively affect the health of those injured. There is a need to quantitatively measure the impact of unexpected events like ambulance availability, weather, floating population and congestion in those rescue times. A family of indicators based on isochrones is disguised and proposed to understand the risk of the whole population as the probability of not being assisted on time. Indicators of health risk for local towns are also defined. The indicators are calculated using a simulation model and visualized in web format. The framework of analysis is validated using Ávila (Spain) and the problem of the optimal deployment of ambulances as a test-bench. PMID:26473894

  7. Retirement Policies and Support for Emergency Service Personnel: The Transition to Retirement.

    Science.gov (United States)

    Bracken-Scally, Mairéad; McGilloway, Sinéad; Mitchell, Jeffrey T

    2016-06-01

    The aim of this study was to explore policies and procedures to support employees who retire from the emergency services. Interviews were conducted with participants who were familiar with existing policies and procedures in a large ambulance (n = 8) and fire (n = 6) service in Ireland. Four key themes were identified: (1) "I don't think it's a job at 65 to be running out on an emergency ambulance"; (2) "They do genuinely feel a wee bit isolated"; (3) improving the "cultural shock"; and (4) "I just keep going and hope for the best". Findings point towards retirement as a major life change and highlight a need for more structured, effective pre-retirement preparation. Factors unique to emergency service personnel include the physical and emotional stress involved in emergency service; a strong identification with the service; and a lack of clarity about rules and entitlements, requiring better information and preparation. PMID:27112913

  8. Fracture in Duchenne Muscular Dystrophy: Natural History and Vitamin D Deficiency.

    Science.gov (United States)

    Perera, Nadia; Sampaio, Hugo; Woodhead, Helen; Farrar, Michelle

    2016-08-01

    The present study examined the natural history of fracture and vitamin D levels in Duchenne muscular dystrophy patients, who are vulnerable to osteoporosis and fractures. Retrospective analysis of a cohort of 48 Duchenne muscular dystrophy patients revealed that 43% of patients experienced ≥1 fracture. Fracture probabilities at ages 6, 9, 12, and 15 years were 4%, 9%, 31%, and 60% respectively, accelerating around the time of ambulation loss (mean age 11.8 ± 2.7 years). Chronic corticosteroid therapy was utilized in 69% of patients and was associated with all vertebral fractures. A history of vitamin D deficiency occurred in 84%, and 35% were currently deficient. Despite chronic vitamin D supplementation, 38% remained deficient. These results demonstrate that osteoporosis and fracture remain major concerns in Duchenne muscular dystrophy. Bone health should be optimized well before loss of ambulation, however current levels of vitamin D supplementation may be inadequate given high levels of deficiency. PMID:27221372

  9. MCLP and SQM models for the emergency vehicle districting and location problem

    Directory of Open Access Journals (Sweden)

    Mohammad Mohammadi

    2014-08-01

    Full Text Available Over time, the number of unexpected earthy, oceanic and atmospheric events is rising each year. Hence, disaster management is considered as one of the most important scientific and practical issues in developed and developing countries. Therefore, in this study, we review and develop the problem of locating the emergency units with constraints including the number of available ambulances, limited budget for deployment of ambulances and the minimum acceptable level of covering. The proposed model improves the spatial queuing model (SQM and Maximal Covering Location Problem (MCLP by considering the cost of the deployment of the emergency units, which makes it closer to real-world conditions. Because the proposed model is NP-hard, the model is solved using three heuristics including Simulated Annealing (SA, Genetic Algorithm (GA and a hybrid of both. The preliminary results indicate that the hybrid method had better performance to achieve the optimal or close to optimal solution.

  10. Evaluation of a temporary prosthetic insert in the rehabilitation of elderly ischaemic below-knee amputees: a pilot study.

    Science.gov (United States)

    Hallam, F M; Jull, G A

    1988-01-01

    The physiotherapy management of elderly, ischaemic below knee amputees is often compromised by delayed and/or complicated wound healing. Such patients are often unable to ambulate on a prosthesis for prolonged periods. Problems concommitant with immobilization such as weakness, contractures, and decreased morale tend to arise. This pilot study investigated the efficacy of incorporating a shaped Dunlopillo insert into a temporary prosthetic socket to allow the at risk group to ambulate as soon as the sutures were removed regardless of the state of wound healing. Two parameters were evaluated, namely wound healing and stump maturation. A total of eighteen subjects were observed in a control and an experimental group. Both wound healing (p < 0.05) and stump maturation (p < 0.05) were significantly enhanced by the inclusion of a Dunlopillo insert.

  11. Rehabilitation in limb deficiency. 1. Gait and motion analysis.

    Science.gov (United States)

    Czerniecki, J M

    1996-03-01

    This self-directed learning module highlights new advances in this topic area. It is part of the chapter on rehabilitation in limb deficiency in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses normal gait, the influence of prosthetic alignment on amputee function, and the effects of prosthetic components on the metabolic costs and the biomechanical function of the amputee. The biomechanics of normal ambulation are presented as a background to enable the practitioner to gain an understanding of the typical gait adaptations that occur in below-knee and above-knee amputees. The effects of newer prosthetic components and socket designs on the biomechanical adaptations are reviewed. The metabolic costs of amputee ambulation are significantly greater than normal. The theoretical mechanisms for this are discussed, and the effects of newer socket designs, ultra-light-weight components, and energy-storing prosthetic components are presented.

  12. Using a business rule management system to improve disposition of traumatized patients.

    Science.gov (United States)

    Neuhaus, Philipp; Noack, Oliver; Majchrzak, Tim; Uckert, Frank

    2010-01-01

    We propose a business rule management system that is used to optimize the dispatchment on a mass casualty incident. Using geospatial information from available ambulances and rescue helicopters, a business rule engine calculates an optimized transportation plan for injured persons. It automatically considers special needs like ambulances equipped for baby transportation or special decontamination equipment, e.g. to deal with an accident in a chemical factory. The rules used in the system are not hardcoded; thus, it is possible to redefine them on the fly without changing the program's source code. It is possible to load and save a rule set in case of a catastrophe. Furthermore, it is possible to automatically recalculate an already planned operation if it becomes clear that the rescue vehicles assigned are needed by a person with life-threatening injuries.

  13. Praehospitalt hjertestop i Danmark. Er beredskabet effektivt?

    DEFF Research Database (Denmark)

    Hallas, P

    2000-01-01

    The chain-of-survival concept is an established principle in the treatment of out-of-hospital cardiac arrest. Survival is improved when out-of-hospital cardiac arrest is followed by a sequence of events: early access to help, early cardiopulmonary resuscitation, early defibrillation and early adv...... is the time between the emergency call and the start of adequate treatment. Options for defibrillation and--in some cities--advanced life support are good, but hard to exploit as ambulances frequently arrive too late for treatment to be effective....... advanced care. The Danish emergency medical system is only to some extent in accordance with the standards of the chain-of-survival concept. The current way of evaluating the efficiency of the system is based mainly upon the driving time for the ambulance, but the time that counts for the patient...

  14. Bilateral Ankle and Subtalar Joint Fusion Secondary to Guillain Barré-Induced Foot Drop.

    Science.gov (United States)

    Seidel, Jay; Mathew, Bindu; Marks, Jeffrey

    2016-01-01

    Guillain-Barré syndrome is a serious disorder that occurs when the body's immune system mistakenly attacks the peripheral nervous system. This leads to nerve inflammation and damage that can cause muscle weakness and/or paralysis, including foot drop. Therapy ranges from supportive measures, such as physical therapy, to surgical intervention. It appears from the published data that these patients, generally, have been left to their own devices, because no known cure is available, necessitating reliance on others for their daily activities and ambulation. We present a unique surgical option, with a follow-up period of 24 months, in which bilateral subtalar and ankle fusion allowed unassisted ambulation to a patient who might otherwise have never walked again. PMID:25128306

  15. Prehospital transported patients

    DEFF Research Database (Denmark)

    Bech, Camilla Louise Nørgaard; Brabrand, M.; Lassen, Annmarie Touborg

    2015-01-01

    in the period of inclusion. Overall 7-day mortality was 4.3% (95% CI = 4.0 to 4.6). Univariate analysis showed increasing age, Charlson Comorbidity Index >2, vital parameters outside the normal reference range and summoned physician-assisted mobile emergency care units to be associated with 7-day mortality...... for assessing potential risk factors associated with adverse outcomes and mortality. Our aim was to describe ambulance transports to the ED and identify prognostic factors accessible in the prehospital phase and associated with 7-day mortality. Methods We included all adult patients (>18 years) with a first......-based healthcare registers in order to identify comorbid conditions and information on mortality. Demographic factors and first registered vital sign were analysed by univariate logistic regression analysis, with 7-day mortality as outcome. Results In total, 18,572 first-time ambulance contacts were identified...

  16. On the influence of space storms on the frequency of infarct-myocardial, brain strokes, and hard car accidents; possible using of CR for their forecasting

    Science.gov (United States)

    Dorman, L. I.; Iucci, N.; Ptitsyna, N. G.; Villoresi, G.

    We consider the influence of space storms as strong interplanetary shock waves causing great cosmic ray Forbush-decreases and big geomagnetic storms on the people health at the ground level We used data of more than 7 millions ambulance cases in Moscow and St Petersburg included information on daily numbers of the hard traffic accidents infarctions and brain strokes We found that during space storms the average daily numbers of hard traffic accidents with using ambulances as well as infarctions and brain strokes confirmed by medical personal increase by 17 4 pm 3 1 10 5 pm 1 2 and 7 0 pm 1 7 respectively We show that the forecasting of these dangerous apace phenomena can be done partly by using cosmic ray data on pre-increase and pre-decrease effects as well as on the change of 3-D cosmic ray anisotropy

  17. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: analyses using four severity metrics

    Science.gov (United States)

    Cripton, Peter A; Shen, Hui; Brubacher, Jeff R; Chipman, Mary; Friedman, Steven M; Harris, M Anne; Winters, Meghan; Reynolds, Conor C O; Cusimano, Michael D; Babul, Shelina; Teschke, Kay

    2015-01-01

    Objective To examine the relationship between cycling injury severity and personal, trip, route and crash characteristics. Methods Data from a previous study of injury risk, conducted in Toronto and Vancouver, Canada, were used to classify injury severity using four metrics: (1) did not continue trip by bike; (2) transported to hospital by ambulance; (3) admitted to hospital; and (4) Canadian Triage and Acuity Scale (CTAS). Multiple logistic regression was used to examine associations with personal, trip, route and crash characteristics. Results Of 683 adults injured while cycling, 528 did not continue their trip by bike, 251 were transported by ambulance and 60 were admitted to hospital for further treatment. Treatment urgencies included 75 as CTAS=1 or 2 (most medically urgent), 284 as CTAS=3, and 320 as CTAS=4 or 5 (least medically urgent). Older age and collision with a motor vehicle were consistently associated with increased severity in all four metrics and statistically significant in three each (both variables with ambulance transport and CTAS; age with hospital admission; and motor vehicle collision with did not continue by bike). Other factors were consistently associated with more severe injuries, but statistically significant in one metric each: downhill grades; higher motor vehicle speeds; sidewalks (these significant for ambulance transport); multiuse paths and local streets (both significant for hospital admission). Conclusions In two of Canada's largest cities, about one-third of the bicycle crashes were collisions with motor vehicles and the resulting injuries were more severe than in other crash circumstances, underscoring the importance of separating cyclists from motor vehicle traffic. Our results also suggest that bicycling injury severity and injury risk would be reduced on facilities that minimise slopes, have lower vehicle speeds, and that are designed for bicycling rather than shared with pedestrians. PMID:25564148

  18. Emotion regulation, physiological arousal and PTSD symptoms in trauma-exposed individuals

    OpenAIRE

    Shepherd, Laura; Wild, Jennifer

    2014-01-01

    Objectives Retrospective studies suggest a link between PTSD and difficulty regulating negative emotions. This study investigated the relationship between PTSD symptoms and the ability to regulate negative emotions in real-time using a computerised task to assess emotion regulation. Method Trauma-exposed ambulance workers (N = 45) completed self-report measures of trauma exposure, PTSD symptoms and depression. Participants then completed a computer task requiring them to enhance, decrease or ...

  19. Social Looking, Social Referencing and Humor Perception in 6-and-12-month-old Infants

    OpenAIRE

    Mireault, Gina C.; Crockenberg, Susan C.; Sparrow, John E.; Pettinato, Christine A.; Woodard, Kelly C.; Malzac, Kirsten

    2014-01-01

    Social referencing refers to infants' use of caregivers as emotional referents in ambiguous situations (Walden, 1993). Studies of social referencing typically require ambulation, thereby over-looking younger, non-ambulatory infants (i.e., ≤ 8-mos) and resulting in a widespread assumption that young infants do not employ this strategy. Using a novel approach that does not require mobility, we found that when parents provided unsolicited affective cues during an ambiguous-absurd (i.e., humorous...

  20. Custom-made footwear in diabetes: Offloading, usability and ulcer recurrence

    OpenAIRE

    Nollet, F.; Bus, S.A.; Haart, de, M.; Arts, M.L.J.

    2013-01-01

    Foot ulceration is a serious long term complication in patients with diabetes mellitus and polyneuropathy, which increases the risk of infection and lower limb amputation. Loss of protective sensation and high levels of plantar foot pressure during ambulation are the main causative factors. These patients are often prescribed with custom-made therapeutic footwear, which aims to offload high-risk plantar foot sites through pressure redistribution, however, scientific evidence for its use is me...

  1. Consequences of insecurity in emergency telephone consultations: an experimental study in medical students.

    OpenAIRE

    Barth, Jürgen; Ahrens, Regina; Schaufelberger, Mireille

    2014-01-01

    QUESTION UNDER STUDY Handling emergency telephone consultations (ETCs) is a challenging and very important task for doctors. The aims of the study were to document insecurity in medical students during ETCs and to identify the reasons for that insecurity. We hypothesised that insecurity is associated with advising more urgent action (e.g. advice to call for an ambulance) in ETCs. METHODS We used ETCs with simulated patients (SPs), with each student randomly allocated two of four p...

  2. Ošetřovatelská péče u dětí s bolestmi hlavy

    OpenAIRE

    Želinská, Kateřina

    2016-01-01

    Introduction into the topic: This bachelor thesis is focused on nursing care of children with headaches. The nursing care itself is usually done at children GP surgeries and paediatric neurological ambulances. Theoretical part: The theoretical part of the thesis is divided into two larger chapters headaches among children and headaches among adults. In the first chapter, headaches among children, the original mechanism which commences the headache, types of headaches, evaluation and the treat...

  3. The RAPID protocol enhances patient recovery after both laparoscopic and open colorectal resections.

    LENUS (Irish Health Repository)

    Lloyd, G M

    2010-06-01

    Enhanced recovery after surgery (ERAS) programs can accelerate recovery and shorten the hospital stay after colorectal resections. The RAPID (remove, ambulate, postoperative analgesia, introduce diet) protocol is a simplified ERAS program that consists of a simplified, user-friendly single-page pro forma schedule. This study aimed to evaluate the impact of the RAPID protocol on patients undergoing both laparoscopic and open colorectal resections in two specialized colorectal units.

  4. An update on the management of chronic inflammatory demyelinating polyneuropathy

    OpenAIRE

    Gorson, Kenneth C.

    2012-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune mediated disorder of the peripheral nervous system with clinical features that include weakness, sensory loss, imbalance, pain and impaired ambulation which may lead to substantial disability. This review highlights current treatment strategies for CIDP, how best to utilize proven therapies such as intravenous immunoglobulin, oral prednisone, pulse dexamethasone, and plasma exchange, and when and how to use alternative immu...

  5. Search Engine Advertising: Channel Substitution when Pricing Ads to Context

    OpenAIRE

    Avi Goldfarb; Catherine Tucker

    2010-01-01

    We explore substitution patterns across advertising platforms. Using data on the advertising prices paid by lawyers for 139 Google search terms in 195 locations, we exploit a natural experiment in "ambulance-chaser" regulations across states. When lawyers cannot contact clients by mail, advertising prices per click for search engine advertisements are 5%-7% higher. Therefore, online advertising substitutes for offline advertising. This substitution toward online advertising is strongest in ma...

  6. Informationssystem Versorgungsdaten bei DIMDI nimmt Pilotbetrieb auf

    OpenAIRE

    Müller, W.

    2014-01-01

    Am 17. Februar 2014 nimmt das neue Informationssystem Versorgungsdaten (Datentransparenz) des DIMDI den Pilotbetrieb auf. Damit werden erstmals aggregierte Versorgungsdaten der gesetzlichen Krankenkassen für Analysen nutzbar. Das System eröffnet insbesondere der Versorgungsforschung neue Möglichkeiten: Zugänglich werden unter anderem ambulante und stationäre Diagnosen sowie Daten über ambulant verordnete und abgerechnete Arzneimittel. In dieser Vollständigkeit - über die verschiedenen gesetzl...

  7. Sonographische Diagnostik beim akuten Abdomen bei Kindern und Erwachsenen

    OpenAIRE

    Vauth, C; ENGLERT, H; Fischer, T.; Kulp, W; Greiner, W; Willich, SN; Stroever, B; Graf von der Schulenburg, JM

    2005-01-01

    Introduction The acute abdomen is the main term for an at first unclear emergency situation of the abdominal cavity. The acute abdomen belongs to the three most important reasons for the admission of patients into the emergency room. Further, this illness ranks 40% of all consultations in the ambulant care sector. The acute abdomen requires an early and direct diagnosis because of its potential of having a life threatening differential diagnosis. This HTA report aimed to assess the ultrasoun...

  8. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

    OpenAIRE

    Karlsen, Anders M; Thomassen, Øyvind; Vikenes, Bjarne H.; Brattebø, Guttorm

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air...

  9. Pre-hospital non-invasive ventilation for acute respiratory failure: a systematic review and cost-effectiveness evaluation.

    OpenAIRE

    Pandor, A; Thokala, P.; Goodacre, S; Poku, E.; Stevens, J.W.; Ren, S.; Cantrell, A.; Perkins, G.D.; Ward, M.; Penn-Ashman, J.

    2015-01-01

    BACKGROUND: Non-invasive ventilation (NIV), in the form of continuous positive airway pressure (CPAP) or bilevel inspiratory positive airway pressure (BiPAP), is used in hospital to treat patients with acute respiratory failure. Pre-hospital NIV may be more effective than in-hospital NIV but requires additional ambulance service resources. OBJECTIVES: We aimed to determine the clinical effectiveness and cost-effectiveness of pre-hospital NIV compared with usual care for adults presenting to t...

  10. Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    M C Mandal

    2011-01-01

    Full Text Available Background: Inguinal hernia repair can be performed under satisfactory anaesthetic conditions using general, regional and peripheral nerve block anaesthesia. Unilateral spinal anaesthesia provides optimal anaesthesia, with stable haemodynamics and minimal adverse events. The paravertebral block, being segmental in nature, can be expected to produce some advantages regarding haemodynamic stability and early ambulation and may be a viable alternative. Methods: Fifty-four consenting male patients posted for inguinal hernia repair were randomized into two groups, to receive either the two-segment paravertebral block (group-P, n=26 at T10 and L1 or unilateral spinal anaesthesia (group-S, n=28, respectively. The time to ambulation (primary outcome, time to the first analgesic, total rescue analgesic consumption in the first 24-hour period and adverse events were noted. Results: Block performance time and time to reach surgical anaesthesia were significantly higher in the patients of group-P (P<0.001. Time to ambulation was significantly shorter in group-P compared to group-S (P<0.001, while postoperative sensory block was prolonged in patients of group-S; P<0.001. A significantly higher number of patients could bypass the recovery room in group-P compared to group-S, (45% versus 0%, respectively, P<0.001. No statistically significant difference in adverse outcomes was recorded. Conclusion: Both the paravertebral block and unilateral spinal anaesthesia are effective anaesthetic techniques for uncomplicated inguinal hernia repair. However, the paravertebral block can be an attractive alternative as it provides early ambulation and prolonged postoperative analgesia with minimal adverse events.

  11. Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana

    OpenAIRE

    Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Ahmed N. Zakariah; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Thomas B. Campbell

    2015-01-01

    Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana’s national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. Methods: A survey instrument was developed using Pechansky and Thomas’s model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability....

  12. Kinetic Relationships between the Hip and Ankle Joints during Gait in Children with Cerebral Palsy: A Pilot Study

    OpenAIRE

    Ishihara, Misako; Higuchi, Yumi

    2014-01-01

    [Purpose] The purpose of this study was to evaluate kinetic relationships between the ankle and hip joints during gait, in the late stance, in children with spastic cerebral palsy (CP). [Subjects] The subjects were 3 ambulant children with spastic hemiplegic CP (aged 10, 13, and 14: CP group) and 3 typically developing children with the same ages (control). [Methods] A three-dimensional gait analysis including force data was performed to compare the peak moment, power, and ankle/hip power rat...

  13. Long-term Survival of the Juvenile Lethal Arginase-deficient Mouse With AAV Gene Therapy

    OpenAIRE

    Lee, Eun K.; Hu, Chuhong; Bhargava, Ragini; Rozengurt, Nora; Stout, David; Grody, Wayne W.; Cederbaum, Stephen D.; Lipshutz, Gerald S

    2012-01-01

    Arginase deficiency is characterized by hyperargininemia and infrequent episodes of hyperammonemia. Human patients suffer from neurological impairment with spasticity, loss of ambulation, seizures, and severe mental and growth retardation. In a murine model, onset of the phenotypic abnormality is heralded by weight loss beginning around day 15 with death occurring typically by postnatal day 17 with hyperargininemia and markedly elevated ammonia. The goal of this study was to address the devel...

  14. Are the 10 meter and 6 minute walk tests redundant in patients with spinal cord injury?

    Directory of Open Access Journals (Sweden)

    Gail F Forrest

    Full Text Available OBJECTIVE: To evaluate the relationship and redundancy between gait speeds measured by the 10 Meter Walk Test (10MWT and 6 Minute Walk Test (6MWT after motor incomplete spinal cord injury (iSCI. To identify gait speed thresholds supporting functional ambulation as measured with the Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI. DESIGN: Prospective observational cohort. SETTING: Seven outpatient rehabilitation centers from the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN. PARTICIPANTS: 249 NRN patients with American Spinal Injury Association Impairment Scale (AIS level C (n = 20, D (n = 179 and (n = 50 iSCI not AIS evaluated, from February 2008 through April 2011. INTERVENTIONS: Locomotor training using body weight support and walking on a treadmill, overground and home/community practice. MAIN OUTCOME MEASURE(S: 10MWT and 6MWT collected at enrollment, approximately every 20 sessions, and upon discharge. RESULTS: The 10MWT and 6MWT speeds were highly correlated and the 10MWT speeds were generally faster. However, the predicted 6MWT gait speed from the 10MWT, revealed increasing error with increased gait speed. Regression lines remained significantly different from lines of agreement, when the group was divided into fast (≥0.44 m/s and slow walkers (<0.44 m/s. Significant differences between 6MWT and 10MWT gait speeds were observed across SCI-FAI walking mobility categories (Wilcoxon sign rank test p<.001, and mean speed thresholds for limited community ambulation differed for each measure. The smallest real difference for the 6MWT and 10MWT, as well as the minimally clinically important difference (MCID values, were also distinct for the two tests. CONCLUSIONS: While the speeds were correlated between the 6MWT and 10MWT, redundancy in the tests using predictive modeling was not observed. Different speed thresholds and separate MCIDs were defined for community ambulation for each test.

  15. Biomarkers of basic activities of daily living in Alzheimer’s disease

    OpenAIRE

    Hall, James R.; Johnson, Leigh A; Robert C Barber; Vo, Hoa T.; Winter, A. Scott; O’Bryant, Sid E.

    2012-01-01

    Functional impairment is common in Alzheimer’s disease, and related to increased caregiver burden and institutionalization. There is a dearth of research investigating the relationship between specific biomarkers and basic activities of daily living such as toileting, feeding, dressing, grooming, bathing, and ambulating. The present study examined the relationship between serum based biomarkers and specific activities of daily living in a sample of Alzheimer’s disease patients

  16. 完形填空专项练习

    Institute of Scientific and Technical Information of China (English)

    王国军

    2010-01-01

    @@ An 1 woman died and several other passengers wore critically injured when a 2 Virgin express train crashed in Cumbria last night. A huge rescue operation involving BAF helicopters and 3 ambulances arrived after passengers were trapped in the train 4 mole than four hours because 5 power line poles made acceess for emergency workers difficult. Authorities reported 6 80 injuries.Thirteen people were taken to hospital in a "critical 7 serious condition".

  17. Balancing intrusive illness : the experiences of people with musculoskeletal problems

    OpenAIRE

    Wiitavaara, Birgitta

    2007-01-01

    The overall aim of the present thesis was to explore and describe the health experiences of men and women with musculoskeletal problems. The specific aims of the four papers were: (I) to explore the experience of illness and wellness among ambulance personnel with musculoskeletal symptoms; (II) to explore the experience of illness and wellness among female health care personnel with musculoskeletal symptoms; (III) to explore the experience of bodily illness among people with musculoskeletal p...

  18. Epidural labour analgesia using Bupivacaine and Clonidine

    OpenAIRE

    Syal, K; R K Dogra; A Ohri; Chauhan, G.; Goel, A.

    2011-01-01

    Background: To compare the effects of addition of Clonidine (60 μg) to Epidural Bupivacaine (0.125%) for labour analgesia, with regard to duration of analgesia, duration of labour, ambulation, incidence of instrumentation and caesarean section, foetal outcome, patient satisfaction and side effects. Patients & Methods: On demand, epidural labour analgesia was given to 50 nulliparous healthy term parturients (cephalic presentation), divided in two groups randomly. Group I received bupivacain...

  19. Femoroacetabular impingement: A classic case of cam-type impingement in a 21-year-old soldier

    Directory of Open Access Journals (Sweden)

    Eric Royston, DO, MPH, CPT, MC

    2014-01-01

    Full Text Available We describe a case of femoroacetabular impingement (FAI in a 21-year-old male U.S. Army Private. Pre-operative radiographs demonstrated a dysplastic bump at the right head-neck junction. The patient underwent arthroscopy and resection of the bump, resulting in a improved contour of the femoral head-neck junction. After standard recovery, he is now able to ambulate and flex his right hip without pain and has returned to full duty.

  20. Emergency care of older people who fall: a missed opportunity

    Science.gov (United States)

    Snooks, Helen A; Halter, Mary; Close, Jacqueline C T; Cheung, Wai‐Yee; Moore, Fionna; Roberts, Stephen E

    2006-01-01

    Introduction A high number of emergency (999) calls are made for older people who fall, with many patients not subsequently conveyed to hospital. Ambulance crews do not generally have protocols or training to leave people at home, and systems for referral are rare. The quality and safety of current practice is explored in this study, in which for the first time, the short‐term outcomes of older people left at home by emergency ambulance crews after a fall are described. Results will inform the development of care for this population. Methods Emergency ambulance data in London were analysed for patterns of attendance and call outcomes in 2003–4. All older people who were attended by emergency ambulance staff after a fall in September and October 2003, within three London areas, were identified. Those who were not conveyed to hospital were followed up; healthcare contacts and deaths within the following 2 weeks were identified. Results During 2003–4, 8% of all 999 calls in London were for older people who had fallen (n = 60 064), with 40% not then conveyed to hospital. Of 2151 emergency calls attended in the study areas during September and October 2003, 534 were for people aged ⩾65 who had fallen. Of these, 194 (36.3%) were left at home. 86 (49%) people made healthcare contacts within the 2‐week follow‐up period, with 83 (47%) people calling 999 again at least once. There was an increased risk of death (standard mortality ratio 5.4) and of hospital admission (4.7) compared with the general population of the same age in London. Comment The rate of subsequent emergency healthcare contacts and increased risk of death and hospitalisation for older people who fall and who are left at home after a 999 call are alarming. Further research is needed to explore appropriate models for delivery of care for this vulnerable group. PMID:17142584

  1. Metastatic spinal cord compression: radiotherapy outcome and dose fractionation

    International Nuclear Information System (INIS)

    Background and purpose: No standard dose fractionation has been defined for metastatic spinal cord compression. This retrospective analysis was undertaken to explore the impact of hypo fractionated treatment compared to conventional multi fraction treatment. Materials and methods: One hundred and two consecutive patients referred to Mount Vernon Cancer Centre with metastatic spinal canal compression confirmed on MR scan in 95% with median age 68 years (range 32-90) and main primary tumour types breast (28%), prostate (28%) and lung (20%); 51% of patients were fully ambulant at diagnosis, 41% ambulant but with paraparesis and 9% had complete paraplegia. Spinal radiotherapy was given delivering a single dose in 32% and 20 Gy in five fractions in 64%. Results: The median survival was 3.5 months; survival was significantly related to primary site and motor function at presentation. Normal ambulation was achieved in 58% at 2 weeks and 71% up to 2 months after treatment. No patient who presented with paraplegia regained function. At presentation 59% of patients had severe pain, which fell to 8% at 2 weeks. Comparing those patients who received one or two dose treatments with those who received protracted fractionation, the two groups were matched for age, sex, primary site and site of compression. Relatively more patients treated with one or two doses had paraplegia; 19% vs. 3%. Despite this outcome in the two groups was equivalent for motor and sphincter function and pain control. Conclusions: Metastatic spinal canal compression carries a poor prognosis. Urgent treatment will maintain and improve motor function in patients presenting ambulant but those who have paraplegia at presentation do not improve and have a very short survival. In this series no difference in outcome was seen between patients treated with one or two radiation doses compared to multi fraction treatment; a randomised trial comparing fractionation schedules would be justified

  2. Gene Therapy for Muscular Dystrophy: Moving the Field Forward

    OpenAIRE

    Al-Zaidy, Samiah; Rodino-Klapac, Louise; Mendell, Jerry R.

    2014-01-01

    Gene therapy for the muscular dystrophies has evolved as a promising treatment for this progressive group of disorders. While corticosteroids and/or supportive treatments remain standard of care for Duchenne muscular dystrophy (DMD), loss of ambulation, respiratory failure and compromised cardiac function is the inevitable outcome. Recent developments in genetically mediated therapies have allowed for personalized treatments that strategically target individual muscular dystrophy subtypes bas...

  3. Aortic valve replacement in a patient with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Bhuvnesh Kansara

    2013-01-01

    Full Text Available Valvular heart disease in systemic lupus erythematosus (SLE is associated with substantial morbidity and mortality. Current therapy includes symptomatic measures and valve replacement. SLE can present major challenges because of accrued organ damage, coagulation defects and complex management regimes. The peri-operative goals are to maintain strict asepsis, avoid use of nephrotoxic drugs and thereby renal insult, and to promote early ambulation post-operatively.

  4. Why nursing care is missed?

    OpenAIRE

    Wiwanitkit V

    2014-01-01

    Nursing care is an important part for success of clinical therapeutics and diagnosis. The problem of nursing care can be seen elsewhere. An important consideration is on missed nursing care. The common elements of missed nursing care usually lie on these scopes: “ambulation, turning, delayed or missed feedings, patient teaching, discharge planning, emotional support, hygiene, intake and output documentation, and surveillance.”

  5. The use of out of hours health services: a cross sectional survey.

    OpenAIRE

    Brogan, C.; Pickard, D.; Gray, A; Fairman, S; Hill, A.

    1998-01-01

    OBJECTIVES: To determine the use and costs of the principal out of hours health services in Buckinghamshire. DESIGN: Prospective cross sectional survey and cost description of patient contacts with out of hours services. SETTING: Buckinghamshire during March and April 1995. SUBJECTS: General practices, accident and emergency departments, ambulance services, and community nursing services. MAIN OUTCOME MEASURE: Contacts with patients and cost of out of hours services. RESULTS: 438 patient cont...

  6. Ambulatory Blood Pressure Monitoring and Circadian Rhythm of Blood Pressure in Diabetes Mellitus

    OpenAIRE

    Elena Matteucci; Ottavio Giampietro

    2013-01-01

    Systolic and diastolic blood pressures display a circadian rhythmicity that can be assessed by 24-hour ambulatory blood pressure monitoring and analysed using the cosinor procedure. Altered characteristics to the circadian rhythm of blood pressure, which may result in adverse health outcomes, have been observed in both prediabetes and diabetes. We have investigated the circadian variability of blood pressure in patients with type 1 and type 2 diabetes. Chronobiologically interpreted ambulator...

  7. Lymphoma of the Base of the Tongue: An Incidental Finding on the Preoperative Workup for a Spine Surgery

    OpenAIRE

    Walid, Mohammad Sami

    2009-01-01

    Lymphoma of the tongue is very rare and accounts for 1% of all malignant tumors of the oral cavity. We present a patient who presented with weakness and difficulties with ambulation who was a known cervical spine spondylosis and stenosis patient. During the preoperative workup for cervical spine surgery a tumor at the base of the tongue was discovered which was confirmed by pathology to be a lymphoma. Keywords Lymphoma; Tongue; Spine surgery; Preoperative workup

  8. Sir Geoffrey Marshall (1887-1982): respiratory physician, catalyst for anaesthesia development, doctor to both Prime Minster and King, and World War I Barge Commander.

    Science.gov (United States)

    Metcalfe, Neil H

    2011-02-01

    Sir Geoffrey Marshall was a remarkable, hard-working man who helped in the development of anaesthesia and respiratory medicine. Both were in someway helped by his military experiences in World War I, first when working on an ambulance barge and then in the Casualty Clearing Stations researching the increasing problem of surgical shock. Among a multitude of high-ranking medical posts he also acted as Physician to King George VI and Sir Winston Churchill when they developed respiratory conditions.

  9. [French military nurses during the First World War (1914-1918)].

    Science.gov (United States)

    Garcia, Julien; Lefort, Hugues; Lamache, Christophe; Tabbagh, Xavier; Olier, François

    2014-06-01

    In 1914, beingthe heirs of the ambulance soldiers who had been created during the time of the Empire, the military males-nurses were overwhelmed by the armies huge needs in paramedics. Facing both the callings of commandment which demanded the recruitment of soldiers and the necessity--which had been set up as a duty by the health service--to attend the doctors, the military male-nurse gave way, in 1918 to a new comer: the female military nurse.

  10. The Changes of Henry's Character in Hemingway's A FAREWELL TO ARMS

    Institute of Scientific and Technical Information of China (English)

    樊东辉

    2002-01-01

    During the First World War, Fredeik Henry isblindly moved by the American government's slogan-“save the world for democracy. ” He volunteers to jointhe Italian Army as an officer in the ambulance crops.He wants to search for some values and do some usefulthings for society, but the cruel reality of war disturbsthe quiet in his heart. He becomes void, and even loseshis aim of life.

  11. Transportation of the Critically Ill and Injured

    OpenAIRE

    Ailsby, R L

    1987-01-01

    The introduction of cookbook-style protocols to emergency treatment of critically ill and injured patients has significantly improved the quality of pre-hospital care and the organization of transportation of these patients. The systematic implementation of pre-planned protocols by physicians, nursing staff, and ambulance personnel, combined with regular post-incident performance evaluations, will enhance the level of medical care both in large and small community settings.

  12. Modelo hipercubo integrado a um algoritmo genético para análise de sistemas médicos emergenciais em rodovias The hypercube queuing model integrated to a genetic algorithm to analyze emergency medical systems on highways

    Directory of Open Access Journals (Sweden)

    Ana Paula Iannoni

    2006-04-01

    Full Text Available O modelo hipercubo, conhecido na literatura de problemas de localização de sistemas servidor para cliente, é um modelo baseado em teoria de filas espacialmente distribuídas e aproximações Markovianas. O modelo pode ser modificado para analisar os sistemas de atendimentos emergenciais (SAEs em rodovias, considerando as particularidades da política de despacho destes sistemas. Neste estudo, combinou-se o modelo hipercubo com um algoritmo genético para otimizar a configuração e operação de SAEs em rodovias. A abordagem é efetiva para apoiar decisões relacionadas ao planejamento e operação destes sistemas, por exemplo, em determinar o tamanho ideal para as áreas de cobertura de cada ambulância, de forma a minimizar o tempo médio de resposta aos usuários e o desbalanceamento das cargas de trabalho das ambulâncias. Os resultados computacionais desta abordagem foram analisados utilizando dados reais do sistema Anjos do Asfalto (rodovia Presidente Dutra.The hypercube model, well-known in the literature on problems of server-to-customer localization systems, is based on the spatially distributed queuing theory and Markovian analysis approximations. The model can be modified to analyze Emergency Medical Systems (EMSs on highways, considering the particularities of these systems' dispatching policies. In this study, we combine the hypercube model with a genetic algorithm to optimize the configuration and operation of EMSs on highways. This approach is effective to support planning and operation decisions, such as determining the ideal size of the area each ambulance should cover to minimize not only the average time of response to the user but also ambulance workload imbalances, as well as generating a Pareto efficient boundary between these measures. The computational results of this approach were analyzed using real data Anjos do Asfalto EMS (which covers the Presidente Dutra highway.

  13. Below knee prosthetic socket designs and suspension systems.

    Science.gov (United States)

    Edwards, M L

    2000-08-01

    The prosthetic socket must act as a customized connection between the residual limb's surrounding tissues and the prosthetic components. The socket must be designed to control weight bearing, suspension, and ambulation stability. When making a below-the-knee socket, the prosthetist attempts to maximize loading and minimize displacements, such as vertical, transverse, or rotational. This article discusses the engineering designs or shapes of the two basic forms of below-the-knee prosthetic sockets used today.

  14. Assessment on self-care, mobility and social function of children with spina biifda in Turkey

    Institute of Scientific and Technical Information of China (English)

    Hulya Sirzai; Beril Dogu; Selamet Demir; Figen Yilmaz; Banu Kuran

    2014-01-01

    The aim of the study was to investigate the functional performance in children with spina biifda, using the Pediatric Evaluation of Disability Inventory (PEDI) to look into capacity of twen-ty-eight children with spina biifda with lesions at different levels in different dimensions of self-care, mobility and social function. Mean age of the patients was 3.5 ± 2.3 (1-10) years. In the muscle test carried out, 13 patients (44.8%) had no movements including pelvic elevation in lower extremity muscles and they were at level 5. Sixteen patients (54%) were non-ambulatory according to the Hoofer ambulation classiifcation. Raw and scale scores in the self-care, mobil-ity and social function domains both in the functional skill scale and in the caregiver scale were found to be lower compared to the data of the normal population. A statistically significant correlation was observed in the self-care values of the Functional Skills Scales and the Caregiver Assistance Scale measurements, which was positive for age and negative for Functional Ambu-lation Scale and muscle test (P< 0.05). A positive relation was found between the Functional Skills Scales-mobility area and age while a negative relation was observed between Functional Ambulation Scale and muscle test (P < 0.005). A negative relation was also found between Care-giver Assistance Scale-mobility and Functional Ambulation Scale and muscle test (P < 0.005). In our study, the functional performance of the children was found to be low. Low-level lesions, encouraging muscular strength and independence in mobility are all very important factors for functional independence.

  15. Taking a PAWS to Reflect on How the Work of a Therapy Dog Supports a Trauma-Informed Approach to Prisoner Health

    OpenAIRE

    Dell Colleen Anne; Poole, Nancy

    2015-01-01

    Canada’s Correctional Investigator has found that mental health disorders, alone or in combination with alcohol and drug abuse, challenge public health and safety. Trauma is a key contributor among Canada’s inmate population. Therapy dogs can assist in supporting individuals with mental health, addiction, and trauma concerns. This case report presents the work of a St. John Ambulance therapy dog in a trauma-informed approach to prisoner health. The Substance Abuse and Mental Health Services A...

  16. Implementation of a pre-hospital decision rule in general practice. Triage of patients with suspected myocardial infarction

    OpenAIRE

    Grijseels, Els; Deckers, Jaap; Hoes, Arno; Boersma, Eric; Hartman, J.A.M.; van der Does, Emiel; Simoons, Maarten

    1996-01-01

    textabstractOBJECTIVE: To improve pre-hospital triage of patients with suspected acute cardiac disease. DESIGN: Prospective study. SUBJECTS. Patients with symptoms suggestive of acute cardiac pathology, who were seen by a general practitioner, for whom acute admission into hospital was requested, and in whom a pre-hospital electrocardiogram was recorded by the ambulance service. METHODS: The study consisted of two phases. In the first phase, a decision rule was developed based on clinical cha...

  17. Interdisciplinary Team Collaboration Within the Incident Command Post: A Case Study of Oslo and South-Eastern Norway

    OpenAIRE

    2012-01-01

    The Norwegian Emergency Response Service is built on collaboration between public, private and voluntary organizations, with the police, the fire and rescue service and the ambulance service outlining the primary response units. The emergency response work involves interdisciplinary team collaboration between different units and between the operational commanders within the Incident Command Post. A common language and shared understanding of the situation is essential for emergency response t...

  18. Bone marrow stem cells and their role in angiogenesis Células-tronco da medula óssea e seu papel na angiogênese

    OpenAIRE

    Paulo Eduardo Ocke Reis

    2005-01-01

    The degree of symptomatology of a patient with peripheral arterial disease dictates the kind of treatment. Despite the known therapies, some patients continue to have pain with ambulation, which affects their quality of life. The therapeutic implications of the angiogenic growth factors were identified by the pioneering studies of Folkman et al. 2 decades ago. Further investigations established the possibility of the use of formulations of recombinant angiogenic growth factors, with the objec...

  19. Hospital Admissions from Nursing Homes: Rates and Reasons

    OpenAIRE

    Geir Egil Eide; Kristian Jansen; Anders Grimsmo; Kjell Krüger; Jonn Terje Geitung

    2011-01-01

    Hospital admissions from nursing homes have not previously been investigated in Norway. During 12 months all hospital admissions (acute and elective) from 32 nursing homes in Bergen were recorded via the Norwegian ambulance register. The principal diagnosis made during the stay, length of stay, and the ward were sourced from the hospital's data register and data were merged. Altogether 1,311 hospital admissions were recorded during the 12 months. Admissions from nursing homes made up 6.1% of ...

  20. Porovnání činností Policie, Hasičského záchranného sboru a Zdravotnické záchranné služby ČR , Německa, Rakouska a Slovenska.

    OpenAIRE

    NÁVRATOVÁ, Šárka

    2012-01-01

    Comparing the operation of the Police, Fire Brigade and Ambulance Service in the Czech Republic, Germany, Austria and Slovakia. Various authorities and different assignments of the members evoked an impulse to make a coordinated progress at rescue and liquidation works in MU - the joint rescue service. Joint rescue service integrates the daily needs in the cooperation of firemen, medics, the police and other departments at solving MU, for example fires, disasters or traffic accidents. The pol...

  1. Burnout selected members of the Integrated Rescue System in South County

    OpenAIRE

    KUBOUŠEK, Ladislav

    2015-01-01

    The bachelor's thesis is concerning on the burnout syndrom in particular parts of integrated rescues system. In the theoretical part of the bachelor's thesis is defined the term of burnout syndrom, its causes, subsequent prevention, support and the treatment. The practical part is focused on findings of burnout syndrom among the components of the integrated rescues system, that is the Police, Fire Brigade and Ambulance Service, using the semi-standardized interview, questionnaire and qulitati...

  2. Effect of wearing a dorsiflexion assist orthosis on mobility, perceived fatigue and exertion during the six-minute walk test in people with multiple sclerosis: a randomised cross-over protocol

    OpenAIRE

    McLoughlin James; Barr Christopher; Sturnieks Daina; Lord Stephen; Crotty Maria

    2012-01-01

    Abstract Background Fatigue in combination with gait and balance impairments can severely limit daily activities in people with multiple sclerosis (PWMS). Generalised fatigue has a major impact on walking ability, with moderately disabled PWMS experiencing difficulty in walking extended distances. Localised motor fatigue in the ankle dorsiflexors can lead to foot drop, further reducing functional ambulation. The aim of this study is to evaluate the effect of a simple dynamic dorsiflexion assi...

  3. Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury

    OpenAIRE

    Varoqui, Deborah; Niu, Xun; Mirbagheri, Mehdi M

    2014-01-01

    Background In incomplete spinal cord injury (iSCI), sensorimotor impairments result in severe limitations to ambulation. To improve walking capacity, physical therapies using robotic-assisted locomotor devices, such as the Lokomat, have been developed. Following locomotor training, an improvement in gait capabilities—characterized by increases in the over-ground walking speed and endurance—is generally observed in patients. To better understand the mechanisms underlying these improvements, we...

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

    OpenAIRE

    Alexander Wolkow; Sally Ferguson; Brad Aisbett; Luana Main

    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 contextual...

  5. Barriers and facilitators for people from minority ethnic groups accessing prehospital care: a systematic review

    OpenAIRE

    Phung, Viet-Hai; Windle, Karen; Ortega, Marishona; Essam, Nadya; Barot, Mukesh; Kai, Joe; Johnson, Mark; Siriwardena, Niro

    2015-01-01

    ABSTRACT Background Despite its increasing importance, equity remains an unrealised aspiration in healthcare. People from minority ethnic groups are proportionately less likely to access emergency and hospital services than the majority White population, despite higher levels of need. Our systematic literature review and narrative synthesis aimed to identify the barriers or facilitators to accessing ambulance and paramedic care for minority ethnic patients. In doing so, the review expl...

  6. Semesterprojekt 3

    DEFF Research Database (Denmark)

    Sørensen, John Aasted; Holst-Christensen, Bo; Tolstrup Jensen, Jytte;

    2011-01-01

    Projektet er opdelt i følgende to mål: 1.At planlægge videreførelsen af en prototype til et system, der hånd-terer patientkontakt før, mellem og efter indlæggelser samt ambulant behandling. 2.At planlægge og konstruere en Matlab baseret simulator til et patient monitoreringssystem for fysiologisk...

  7. Endpoint measures in the mdx mouse relevant for muscular dystrophy pre-clinical studies

    OpenAIRE

    Kobayashi, Yvonne M.; Rader, Erik P; Crawford, Robert W.; Campbell, Kevin P.

    2011-01-01

    Loss of mobility influences the quality of life for patients with neuromuscular diseases. Common measures of mobility and chronic muscle damage are the six-minute walk test and serum creatine kinase. Despite extensive pre-clinical studies of therapeutic approaches, characterization of these measures is incomplete. To address this, a six-minute ambulation assay, serum creatine kinase, and myoglobinuria were investigated for the mdx mouse, a dystrophinopathy mouse model commonly used in pre-cli...

  8. “The Forgotten Helpers? Life After the Emergency Services”

    OpenAIRE

    Bracken-Scally, Mairead

    2015-01-01

    Background: The impact of emergency service work on the health and well-being of personnel has been well documented in the literature. Despite this, however, very little is known about the experiences of emergency service retirees and their Quality of Life (QoL). Aims: The principal aim of this study was to assess the overall QoL and wellbeing of retired emergency services (ambulance and fire) personnel. The specific objectives of the study were to: (1) ascertain the possible l...

  9. X-Ray or Computed Tomography Which Comes First?

    OpenAIRE

    Sancar Serbest

    2013-01-01

      The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 28-yearold man was brought to the emergency department by ambulance. At the time of admission he was suffering left shoulder pain. On local physical examination, there was severe pain on the proximal humerus. The left arm was in internal rotation in the adducted position. On local p...

  10. Persistent Left Superior Vena Cava, The View of a Rare Case

    OpenAIRE

    H.Volkan Kara

    2013-01-01

    The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 68-yearold woman was brought to the emergency department by ambulance  with shoulder pain following a fall from stairs. On local physical examination, there was severe pain on the left proximal humerus. The left arm was in internal rotation in the adducted position. Active and passive mo...

  11. "DETERMINANTS OF PREHOSPITAL DELAY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION"

    OpenAIRE

    Alidoosti, M

    2004-01-01

    Determination of pre-hospital delay time of patients with acute myocardial infarction and seeking ways of speeding up the time for reperfusion is an important factor to lower mortality in these patients. This is a cross-sectional study to determine pre-hospital delay time, its components, and related causes and conditions, obtained in 375 patients with prolonged chest pain referred to four hospitals of Tehran University of Medical Sciences. Means of transport to hospital, reasons of ambulance...

  12. The Myocardial Ischaemia National Audit Project (MINAP)

    OpenAIRE

    Herrett, Emily; Smeeth, Liam; Walker, Lynne; Weston, Clive; MINAP Academic Group; Fox, Keith

    2010-01-01

    AIMS OF MINAP: To audit the quality of care of patients with acute coronary syndrome and provide a resource for academic research. QUALITY OF CARE INTERVENTIONS: Feedback to hospitals, ambulance services and cardiac networks regarding benchmarking of performance against national standards and targets. SETTING: All 230 acute hospitals in England and Wales. Years: 2000-present. POPULATION: Consecutive patients, unconsented. Current number of records: 735 000. STARTPOINTS: Any acute coronary syn...

  13. 救护车

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    5GHz W-LAN Trials for High Speed Mobile Applications - Trials on An Express Train and on An Ambulance Car, Active noise control for sound of siren using the DXHS algorithm with frequency and secondary path delay estimation, Analytical study of emergency medical service rescue time, Application of distributed traffic simulation to evaluate traffic signal controller algorithms,Enterprise modeling and decision-support for automating the business rules lifecycle。

  14. Improvements in gait characteristics after intensive resistance and functional training in people with dementia: a randomised controlled trial

    OpenAIRE

    Schwenk, Michael; Zieschang, Tania; Englert, Stefan; Grewal, Gurtej; Najafi, Bijan; Hauer, Klaus

    2014-01-01

    Background Preventing and rehabilitating gait disorders in people with dementia during early disease stage is of high importance for staying independent and ambulating safely. However, the evidence gathered in randomized controlled trials (RCTs) on the effectiveness of exercise training for improving spatio-temporal gait parameters in people with dementia is scarce. The aim of the present study was to determine whether a specific, standardized training regimen can improve gait characteristics...

  15. Biochemical assessment of pancreatic disease in human immunodeficiency virus infected men.

    OpenAIRE

    Hancock, M R; N..A. Smith; Hawkins, D A; Gazzard, B; Ball, S G

    1997-01-01

    AIM: To determine the usefulness of measuring amylase activity as an indicator of pancreatic disease in human immunodeficiency virus (HIV) positive patients. METHODS: A prospective study of 129 ambulant HIV positive males. Total amylase, pancreatic amylase, and lipase activities were assayed using commercial test kits on an automated analyser. Samples with raised amylase were examined for the presence of macroamylasaemia using cellulose acetate electrophoresis. RESULTS: Thirty six (28%) of th...

  16. Surgical treatment of lymphedema of the penis and scrotum Tratamento cirúrgico do linfedema peno-escrotal

    OpenAIRE

    Miguel Modolin; Anuar Ibrahim Mitre; José Carlos Faes da Silva; Wilson Cintra; Ana Paula Quagliano; Sami Arap; Marcus Castro Ferreira

    2006-01-01

    PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by r...

  17. Accuracy of StepWatch™ and ActiGraph Accelerometers for Measuring Steps Taken among Persons with Multiple Sclerosis

    OpenAIRE

    Brian M. Sandroff; Motl, Robert W.; Pilutti, Lara A.; Learmonth, Yvonne C.; Ipek Ensari; Deirdre Dlugonski; Klaren, Rachel E; Swathi Balantrapu; Barry J Riskin

    2014-01-01

    INTRODUCTION: There has been increased interest in the objective monitoring of free-living walking behavior using accelerometers in clinical research involving persons with multiple sclerosis (MS). The current investigation examined and compared the accuracy of the StepWatch activity monitor and ActiGraph model GT3X+ accelerometer for capturing steps taken during various speeds of prolonged, over-ground ambulation in persons with MS who had mild, moderate, and severe disability. METHODS: Sixt...

  18. Integrity of the Anterior Visual Pathway and Its Association with Ambulatory Performance in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Brian M. Sandroff; Pula, John H.; Motl, Robert W.

    2013-01-01

    Background. Retinal nerve fiber layer thickness (RNFLT) and total macular volume (TMV) represent markers of neuroaxonal degeneration within the anterior visual pathway that might correlate with ambulation in persons with multiple sclerosis (MS). Objective. This study examined the associations between RNFLT and TMV with ambulatory parameters in MS. Methods. Fifty-eight MS patients underwent a neurological examination for generation of an expanded disability status scale (EDSS) score and measur...

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

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

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

  20. Overexpression of Latent TGFβ Binding Protein 4 in Muscle Ameliorates Muscular Dystrophy through Myostatin and TGFβ

    OpenAIRE

    Kay-Marie Lamar; Sasha Bogdanovich; Gardner, Brandon B.; Gao, Quan Q.; Tamari Miller; Earley, Judy U.; Michele Hadhazy; Vo, Andy H.; Lisa Wren; Molkentin, Jeffery D.; McNally, Elizabeth M.

    2016-01-01

    Latent TGFβ binding proteins (LTBPs) regulate the extracellular availability of latent TGFβ. LTBP4 was identified as a genetic modifier of muscular dystrophy in mice and humans. An in-frame insertion polymorphism in the murine Ltbp4 gene associates with partial protection against muscular dystrophy. In humans, nonsynonymous single nucleotide polymorphisms in LTBP4 associate with prolonged ambulation in Duchenne muscular dystrophy. To better understand LTBP4 and its role in modifying muscular ...

  1. Corticosteroid Treatment Impact on Spinal Deformity in Duchenne Muscular Dystrophy

    OpenAIRE

    Sanzarello, Ilaria; Merlini, Luciano; Traina, Francesco; Rosa, Michele Attilio; Faldini, Cesare

    2014-01-01

    Duchenne muscular dystrophy is a progressive disease with loss of ambulation at around 9-10 years of age, followed, if untreated, by development of scoliosis, respiratory insufficiency, and death in the second decade of life. This review highlights the natural history of the disease, in particular, with regard to the development of the spinal deformity and how this complication has been modified by surgical interventions and overall by corticosteroid treatment. The beneficial effect of cortic...

  2. The Canadian experience with long term deflazacort treatment in Duchenne muscular dystrophy

    OpenAIRE

    McADAM, LAURA C.; MAYO, AMANDA L.; Benjamin A Alman; Biggar, W. Douglas

    2012-01-01

    Deflazacort is the most commonly prescribed corticosteroid for the treatment of Duchenne muscular dystrophy in Canada. We review the long term experience with deflazacort treatment at two centers in Canada; Montreal and Toronto. Deflazacort has benefitted both cohorts by prolonged ambulation, preserved cardiac and respiratory function, less scoliosis and improved survival. Common side effects in both cohorts include weight gain, decreased height and cataract formation. The Canadian experience...

  3. Obstructive apnoeas in Duchenne muscular dystrophy.

    OpenAIRE

    Khan, Y.; Heckmatt, J Z

    1994-01-01

    BACKGROUND--In order to clarify the treatment of sleep hypoxaemias in Duchenne muscular dystrophy polysomnographic studies were performed on patients at home with the purpose of recruiting them into two clinical therapeutic trials. Observations concerning the nature of sleep hypoxaemia in these patients are presented. METHODS--Twenty one non-ambulant patients with Duchenne muscular dystrophy aged 13-23 years with no symptoms of sleep hypoventilation or apnoea were studied for two consecutive ...

  4. Health care in a unique setting: applying emergency medicine at music festivals

    OpenAIRE

    McQueen C; Davies C

    2012-01-01

    Carl McQueen,1 Charlotte Davies21The Air Ambulance Service, Coventry, Warwickshire, 2Yorkshire Deanery, Yorkshire, UKAbstract: The last 25 years has seen an explosion in the popularity of outdoor music festivals, especially in the UK. Coupled with this has been the development of the trend for major sporting events that were once confined to stadia to be accompanied by mass gatherings of spectators and fans in "fan parks" and public places. The majority of music festivals an...

  5. Reduced exercise capacity in persons with Down syndrome: cause, effect, and management

    OpenAIRE

    Mendonca, Goncalo

    2010-01-01

    Goncalo V Mendonca1, Fernando D Pereira1, Bo Fernhall21Center of Human Performance (CIPER), Faculty of Human Kinetics, Technical University of Lisbon, Lisbon, Portugal; 2Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, IL, USAAbstract: Persons with Down syndrome (DS) have reduced peak and submaximal exercise capacity. Because ambulation is one predictor of survival among adults with DS, a review of the current knowledge of the causes, effects, and manag...

  6. Andrographolide attenuates skeletal muscle dystrophy in mdx mice and increases efficiency of cell therapy by reducing fibrosis

    OpenAIRE

    Cabrera, Daniel; Gutiérrez, Jaime; Cabello-Verrugio, Claudio; Morales, Maria Gabriela; Mezzano, Sergio; Fadic, Ricardo; Casar, Juan Carlos; Hancke, Juan L.; Brandan, Enrique

    2014-01-01

    Background Duchenne muscular dystrophy (DMD) is characterized by the absence of the cytoskeletal protein dystrophin, muscle wasting, increased transforming growth factor type beta (TGF-β) signaling, and fibrosis. At the present time, the only clinically validated treatments for DMD are glucocorticoids. These drugs prolong muscle strength and ambulation of patients for a short term only and have severe adverse effects. Andrographolide, a bicyclic diterpenoid lactone, has traditionally been use...

  7. The Dark Side of Resilience and Burnout: A Moderation-Mediation Model

    OpenAIRE

    Treglown, Luke; Palaiou, Kat; Zarola, Anthony; Furnham, Adrian

    2016-01-01

    This study tested whether specific dark-side traits may be beneficial in manifesting and maintaining Resilience, whilst others are vulnerability factors for Burnout. Four hundred and fifty-one (50 female) ambulance personnel completed three questionnaires as a part of a selection and development assessment. The study utilised the Hogan Development survey as a measure of dark side personality, the Copenhagen Burnout Inventory to assess work-related burnout, and the Resilience Scale– 14 to meas...

  8. Hi-Tech Living

    Institute of Scientific and Technical Information of China (English)

    TANG YUANKAI

    2010-01-01

    @@ On a recent cold winter night,a child passed out at his home in Beijing.His mother pushed the button of an emergency alarm system installed in their home.The system immediately put her through to Beijing 999 Emergency Aid Center,but she was too panicked to remember her home address.Emergency aid staff quickly identified her exact location and an ambulance arrived quickly.

  9. Development and evaluation of a novel, real time mobile telesonography system in management of patients with abdominal trauma: study protocol

    Directory of Open Access Journals (Sweden)

    Ogedegbe Chinwe

    2012-12-01

    Full Text Available Abstract Background Despite the use of e-FAST in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted. The goal of this study is to develop a novel portable telesonography (TS system and evaluate the comparability of the quality of images obtained via this system among healthy volunteers who undergo e-FAST abdominal examination in a moving ambulance and at the ED. We hypothesize that: (1 real-time ultrasound images of acute trauma patients in the pre-hospital setting can be obtained and transmitted to the ED via the novel TS system; and (2 Ultrasound images transmitted to the hospital from the real-time TS system will be comparable in quality to those obtained in the ED. Methods Study participants are three healthy volunteers (one each with normal, overweight and obese BMI category. The ultrasound images will be obtained by two ultrasound-trained physicians The TS is a portable sonogram (by Sonosite interfaced with a portable broadcast unit (by Live-U. Two UTPs will conduct e-FAST examinations on healthy volunteers in moving ambulances and transmit the images via cellular network to the hospital server, where they are stored. Upon arrival in the ED, the same UTPs will obtain another set of images from the volunteers, which are then compared to those obtained in the moving ambulances by another set of blinded UTPs (evaluators using a validated image quality scale, the Questionnaire for User Interaction Satisfaction (QUIS. Discussion Findings from this study will provide needed data on the validity of the novel TS in transmitting live images from moving ambulances to images obtained in the ED thus providing opportunity to facilitate medical care of a patient located in a remote or austere setting.

  10. 美国提供急救设备等医疗设备

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ 种类:急救设备(EMS),经修复的二手医疗设备(REFURBISHED),担架床(AMBULANCE COT),除纤颤器(DEFIBRILLATORS),麻醉设备(ANESTHETIC EQUIP-MENT),脉冲血氧计(PULSE OWIMETER).联系人:CHARLES STANFORD联系单位:STANFORD WORLDWIDE地址:UNITED STATES,FLORIDA电话:(00011)+305-992-0913传真:(00011)+407-699-1767HTTP://STANFORD-WORLDWIDE.COM/

  11. De verkeersonveiligheid van hulpverleningsvoertuigen. Consult ten behoeve van de Koninklijke Nederlandse Toeristenbond ANWB.

    OpenAIRE

    Oei, H.-l.

    1986-01-01

    Drivers on emergency vehicles (ambulances, fire engines, police cars) which have to fulfil an urgent task and which make use of particular competencies, show often a driving behaviour with an increased risk. Each year more than hundred victims are killed or injured in accidents in which emergency vehicles are involved. A specialized driver training and an improvement in driving behaviour is stressed just as a more stringent application of the specifications.

  12. Influence of The Education and Training of Prehospital Medical Crews on Measures of Performance and Patient Outcomes

    OpenAIRE

    Blomberg, Hans

    2013-01-01

    Prehospital care has developed dramatically the last decades with the implementation of new devices and educational concepts. Clinical decisions and treatments have moved out from the hospitals to the prehospital setting. In Sweden this has been accompanied by an increase in the level of competence, i.e. by introducing nurses in the ambulances. With some exceptions the scientific support for these changes is poor. This thesis deals with such changes in three different subsets of prehospital c...

  13. Does the ‘diffusion of innovations’ model enrich understanding of research use? Case studies of the implementation of thrombolysis services for stroke

    OpenAIRE

    Boaz, Annette; Baeza, Juan; Fraser, Alec

    2016-01-01

    Objectives: To test the applicability of the model of diffusion of innovations as an analytical framework to explore the implementation of evidence based thrombolysis services for stroke patients. Methods: Four empirical case studies of the implementation of evidence into stroke services in England and Sweden. Data were drawn from 95 semi structured interviews with a range of clinical and managerial staff within four hospitals, working in stroke units, emergency medicine, radiology, the ambul...

  14. Guidelines for the early management of patients with myocardial infarction. British Heart Foundation Working Group.

    OpenAIRE

    Weston, C. F.; Penny, W J; Julian, D.G.

    1994-01-01

    In light of recent publications relating to resuscitation and pre-hospital treatment of patients suffering acute myocardial infarction of British Heart Foundation convened a working group to prepare guidelines outlining the responsibilities of general practitioners, ambulance services, and admitting hospitals. The guidelines emphasise the importance of the rapid provision of basic and advanced life support; adequate analgesia; accurate diagnosis; and, when indicted, thrombolytic treatment. Th...

  15. Current and emerging treatment strategies for Duchenne muscular dystrophy

    OpenAIRE

    Mah JK

    2016-01-01

    Jean K Mah Department of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Abstract: Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy in childhood. It is caused by mutations of the DMD gene, leading to progressive muscle weakness, loss of independent ambulation by early teens, and premature death due to cardiorespiratory complications. The diagnosis can usually be made after careful review of the...

  16. Mom

    Institute of Scientific and Technical Information of China (English)

    张明; 李晓芸

    2005-01-01

    I was only two and a half when my real mom died. One morning, My brothers and I went to wake her up, but sht wouldn't answer us. When she didn't tespond(应答;响应)to our calls, my oldest brother, Shane, got my dad. The last thing Iremember about my real mom was watching the ambulance(救护车) taking her away from us.

  17. STUDI KASUS HUBUNGAN SENAM NIFAS DENGAN STATUS KESEHATAN IBU NIFAS

    Directory of Open Access Journals (Sweden)

    Gurendro Putro

    2012-11-01

    Full Text Available Background: During pregnancy and birth period there are physical changes, some of muscle experiencing lengthening, especially uterus muscle and stomach muscle. After bearing, uterus was not back quickly like before, but through a process. Health recover process at post-partum was important thing for mother after birth period. Therefore, for turning back at early condition or recover period better so that body always health needed a exercise which popular as post-partum exercise. Methods: This research executed was prospective cohort design with quantitative approach. Interview was executed at 30 respondents post-partum mother. Subject got from population with simple random sampling. Depth interview was executed to get depth information about research which observed. Independent variables at this research were participation postparfum exercise and dependent variables are complication, narrow of uterus, swell oedema, treatment of stitching hurt loctation, early ambulation, urinate, defecate, drink and eat pattern. Results: Chi square result indicated difference health status between does exercise and neither was only early ambulation and defecates from other some variable. Variables early ambulation (p = 0.001 and deficate (p = 0.001 significant with exercise. But variables involution utery, oedema treatment of stitching hurt and drink and eat pattern not significant with exercise.Key words: post-parfum exercise, health status

  18. 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. PMID:11025847

  19. Comparison of a priori calibration models for respiratory inductance plethysmography during running.

    Science.gov (United States)

    Leutheuser, Heike; Heyde, Christian; Gollhofer, Albert; Eskofier, Bjoern M

    2014-01-01

    Respiratory inductive plethysmography (RIP) has been introduced as an alternative for measuring ventilation by means of body surface displacement (diameter changes in rib cage and abdomen). Using a posteriori calibration, it has been shown that RIP may provide accurate measurements for ventilatory tidal volume under exercise conditions. Methods for a priori calibration would facilitate the application of RIP. Currently, to the best knowledge of the authors, none of the existing ambulant procedures for RIP calibration can be used a priori for valid subsequent measurements of ventilatory volume under exercise conditions. The purpose of this study is to develop and validate a priori calibration algorithms for ambulant application of RIP data recorded in running exercise. We calculated Volume Motion Coefficients (VMCs) using seven different models on resting data and compared the root mean squared error (RMSE) of each model applied on running data. Least squares approximation (LSQ) without offset of a two-degree-of-freedom model achieved the lowest RMSE value. In this work, we showed that a priori calibration of RIP exercise data is possible using VMCs calculated from 5 min resting phase where RIP and flowmeter measurements were performed simultaneously. The results demonstrate that RIP has the potential for usage in ambulant applications.

  20. Medial opening wedge high tibial osteotomy alters knee moments in multiple planes during walking and stair ascent.

    Science.gov (United States)

    Leitch, Kristyn M; Birmingham, Trevor B; Dunning, Cynthia E; Giffin, J Robert

    2015-07-01

    Medial opening wedge high tibial osteotomy is a surgical procedure intended to redistribute loads on the knee in patients with medial compartment knee osteoarthritis (OA). The surgery may affect moments in multiple planes during ambulation, with potential beneficial or detrimental effects on joint loads. The objective of this study was to investigate three-dimensional external knee moments before and after medial opening wedge high tibial osteotomy during level walking and during stair ascent. Fourteen patients with varus alignment and osteoarthritis primarily affecting the medial compartment of the tibiofemoral joint were assessed. Three-dimensional motion analyses during level walking and stair ascent was evaluated using inverse dynamics before, 6 and 12 months after surgery. Mean changes at 12 months suggested decreases in the peak knee adduction, flexion and internal rotation moments, with standardized response means ranging from 0.15 to 2.54. These decreases were observed despite increases in speed. Changes in alignment were associated with changes in the adduction and internal rotation moments, but not the flexion moment. Both pre- and postoperatively, the peak knee adduction moment was significantly lower (p=0.001) during stair ascent than during level walking, while the flexion and internal rotation moments were significantly higher (pplanes of motion during ambulation, suggesting substantial alterations of the loads on the knee during ambulation.