Lami, Mariam; Nair, Pooja; Gadhvi, Karishma
Questions have been raised about basic life support (BLS) training in medical education. This article addresses the research evidence behind why BLS training is inadequate and suggests recommendations for improving BLS training for medical students.
Lami, Mariam; Nair, Pooja; Gadhvi, Karishma
Mariam Lami, Pooja Nair, Karishma GadhviFaculty of Medicine, Imperial College, London, London, UKAbstract: Questions have been raised about basic life support (BLS) training in medical education. This article addresses the research evidence behind why BLS training is inadequate and suggests recommendations for improving BLS training for medical students.Keywords: medical education, basic life support
Srivilaithon, Winchana; Amnaumpatanapon, Kumpon; Limjindaporn, Chitlada; Imsuwan, Intanon; Daorattanachai, Kiattichai
To study about attitude and knowledge regarding basic-life-support among college students outside medical system. The cross-sectional study in the emergency department of Thammasat Hospital. The authors included college students at least aged 18 years old and volunteers to be study subjects. The authors collected data about attitudes and knowledge in performing basic-life-support by using set of questionnaires. 250 college students participated in the two hours trainingprogram. Most ofparticipants (42.4%) were second-year college students, of which 50 of 250 participants (20%) had trained in basic-life-support program. Twenty-seven of 250 participants (10.8%) had experience in basic-life-support outside the hospital. Most of participants had good attitude for doing basic-life-support. Participants had a significant improved score following training (mean score 8.66 and 12.34, respectively, pbasic-life-support to cardiac arrest patient. The training program in basic-life-support has significant impact on knowledge after training.
Vestergaard, L. D.; Løfgren, Bo; Jessen, C.
Pediatric Basic Life Support Self-training is comparable to Instructor-led Training: A randomized manikin study.......Pediatric Basic Life Support Self-training is comparable to Instructor-led Training: A randomized manikin study....
Aloush, Sami; Tubaishat, Ahmad; ALBashtawy, Mohammed; Suliman, Mohammad; Alrimawi, Intima; Al Sabah, Ashraf; Banikhaled, Yousef
Bystander cardiopulmonary resuscitation improves survival after out-of-hospital cardiac arrest. This study aimed to assess the effectiveness of a basic life support (BLS) educational course given to 110 middle school children, using a pretest posttest design. In the pretest, students were asked to demonstrate BLS on a manikin to simulate a real-life scenario. After the pretest, a BLS training course of two sessions was provided, followed by posttest on the same manikin. Students were assessed using an observational sheet based on the American Heart Association's BLS guidelines. In the pretest, students showed significant weakness in the majority of guidelines. In the posttest, they demonstrated significant improvement in their BLS skills. BLS training in the middle school was effective, considering the lack of previous skills. It is recommended that BLS education be compulsory in the school setting.
This document serves as a support paper to the "Work-Life Issues and Participation in Education and Training" report. This support document contains tables that show: (1) participation in education and training; (2) participation in education and training and work-life interaction; (3) future participation in education or training; (4) perceptions…
Serwetnyk, Tara M; Filmore, Kristi; VonBacho, Stephanie; Cole, Robert; Miterko, Cindy; Smith, Caitlin; Smith, Charlene M
Basic Life Support certification for nursing staff is achieved through various training methods. This study compared three American Heart Association training methods for nurses seeking Basic Life Support renewal: a traditional classroom approach and two online options. Findings indicate that online methods for Basic Life Support renewal deliver cost and time savings, while maintaining positive learning outcomes, satisfaction, and confidence level of participants.
Full Text Available Abstract Objective The quality of external chest compressions (ECC is of primary importance within basic life support (BLS. Recent guidelines delineate the so-called 4“-step approach” for teaching practical skills within resuscitation training guided by a certified instructor. The objective of this study was to evaluate whether a “media-supported 4-step approach” for BLS training leads to equal practical performance compared to the standard 4-step approach. Materials and methods After baseline testing, 220 laypersons were either trained using the widely accepted method for resuscitation training (4-step approach or using a newly created “media-supported 4-step approach”, both of equal duration. In this approach, steps 1 and 2 were ensured via a standardised self-produced podcast, which included all of the information regarding the BLS algorithm and resuscitation skills. Participants were tested on manikins in the same mock cardiac arrest single-rescuer scenario prior to intervention, after one week and after six months with respect to ECC-performance, and participants were surveyed about the approach. Results Participants (age 23 ± 11, 69% female reached comparable practical ECC performances in both groups, with no statistical difference. Even after six months, there was no difference detected in the quality of the initial assessment algorithm or delay concerning initiation of CPR. Overall, at least 99% of the intervention group (n = 99; mean 1.5 ± 0.8; 6-point Likert scale: 1 = completely agree, 6 = completely disagree agreed that the video provided an adequate introduction to BLS skills. Conclusions The “media-supported 4-step approach” leads to comparable practical ECC-performance compared to standard teaching, even with respect to retention of skills. Therefore, this approach could be useful in special educational settings where, for example, instructors’ resources are sparse or large-group sessions
Masoud, Asaad N.
Pharmacists have a unique role to play in providing basic life-support since they are the health professionals who are most available and who enjoy the greatest contact with the public. Training procedures are described. (LBH)
Matsubara, Hiroki; Enami, Miki; Hirose, Keiko; Kamikura, Takahisa; Nishi, Taiki; Takei, Yutaka; Inaba, Hideo
To determine the effect of Japanese obligatory basic life support training for new driver's license applicants on their willingness to carry out basic life support. We distributed a questionnaire to 9,807 participants of basic life support courses in authorized driving schools from May 2007 to April 2008 after the release of the 2006 Japanese guidelines. The questionnaire explored the participants' willingness to perform basic life support in four hypothetical scenarios: cardiopulmonary resuscitation on one's own initiative; compression-only cardiopulmonary resuscitation following telephone cardiopulmonary resuscitation; early emergency call; and use of an automated external defibrillator. The questionnaire was given at the beginning of the basic life support course in the first 6-month term and at the end in the second 6-month term. The 9,011 fully completed answer sheets were analyzed. The training significantly increased the proportion of respondents willing to use an automated external defibrillator and to perform cardiopulmonary resuscitation on their own initiative in those with and without prior basic life support training experience. It significantly increased the proportion of respondents willing to carry out favorable actions in all four scenarios. In multiple logistic regression analysis, basic life support training and prior training experiences within 3 years were associated with the attitude. The analysis of reasons for unwillingness suggested that the training reduced the lack of confidence in their skill but did not attenuate the lack of confidence in detection of arrest or clinical judgment to initiate a basic life support action. Obligatory basic life support training should be carried out periodically and modified to ensure that participants gain confidence in judging and detecting cardiac arrest.
Glerup Lauridsen, Kasper; Mygind-Klausen, Troels; Stærk, Mathilde
Introduction: Advanced life support (ALS) training may increase survival from in-hospital cardiac arrest. Efficient ALS training includes practice of both technical and non-technical skills in a realistic setting with frequent retraining to avoid decay in ALS skills. ALS training strategies among...... hospitals are currently unknown. This study aimed to investigate ALS training strategies in Danish hospitals.Methods: We included all public, somatic hospitals in Denmark with a cardiac arrest team (n=46). Online questionnaires were distributed to resuscitation officers in each hospital. Questionnaires...... inquired information on: A) Course duration and retraining interval, B) Training methods and setting, C) Scenario training and practicing non-technical skills.Results: In total, 44 hospitals replied (response rate: 96%). ALS training was conducted in 43 hospitals (98%). Median (range) ALS course duration...
Berland, Noah; Fox, Aaron; Tofighi, Babak; Hanley, Kathleen
Opioid overdose deaths have reached epidemic proportions in the United States. This problem stems from both licit and illicit opioid use. Prescribing opioids, recognizing risky use, and initiating prevention, including opioid overdose prevention training (OOPT), are key roles physicians play. The American Heart Association (AHA) modified their basic life support (BLS) algorithms to consider naloxone in high-risk populations and when a pulse is appreciated; however, the AHA did not provide OOPT. The authors' intervention filled this training deficiency by teaching medical students opioid overdose resuscitation with a Train-the-Trainer model as part of mandatory BLS training. The authors introduced OOPT, following a Train-the-Trainer model, into the required basic life support (BLS) training for first-year medical students at a single medical school in a large urban area. The authors administered pre- and post-evaluations to assess the effects of the training on opioid overdose knowledge, self-reported preparedness to respond to opioid overdoses, and attitudes towards patients with substance use disorders (SUDs). In the fall 2014, 120 first-year medical students received OOPT. Seventy-three students completed both pre- and posttraining evaluations. Improvements in knowledge about and preparedness to respond to opioid overdoses were statistically significant (P support dissemination of OOPT as a part of BLS training for all medical students, and potentially all BLS providers.
Rasmussen, M.B.; Dieckmann, Peter; Issenberg, Berry
Highly structured simulation-based training (SBT) on managing emergency situations can have a significant effect on immediate satisfaction and learning. However, there are some indications of problems when applying learned skills to practice. The aim of this study was to identify long-term intended...... and unintended learner reactions, experiences and reflections after attending a simulation based Advanced Life Support (ALS) course....
Kelle, Sebastian; Klemke, Roland; Specht, Marcus
Based on a previous analysis of game design patterns and related effects in an educational scenario, the following paper presents an experimental study. In the study a course for Basic Life Support training has been evaluated and two game design patterns have been applied to the course. The hypotheses evaluated in this paper relate to game design…
Abbas, Fatima; Sawaf, Bisher; Hanafi, Ibrahem; Hajeer, Mohammad Younis; Zakaria, Mhd Ismael; Abbas, Wafaa; Alabdeh, Fadi; Ibrahim, Nazir
Peer training has been identified as a useful tool for delivering undergraduate training in basic life support (BLS) which is fundamental as an initial response in cases of emergency. This study aimed to (1) Evaluate the efficacy of peer-led model in basic life support training among medical students in their first three years of study, compared to professional-led training and (2) To assess the efficacy of the course program and students' satisfaction of peer-led training. A randomized controlled trial with blinded assessors was conducted on 72 medical students from the pre-clinical years (1st to 3rd years in Syria) at Syrian Private University. Students were randomly assigned to peer-led or to professional-led training group for one-day-course of basic life support skills. Sixty-four students who underwent checklist based assessment using objective structured clinical examination design (OSCE) (practical assessment of BLS skills) and answered BLS knowledge checkpoint-questionnaire were included in the analysis. There was no statistically significant difference between the two groups in delivering BLS skills to medical students in practical (P = 0.850) and BLS knowledge questionnaire outcomes (P = 0.900). Both groups showed statistically significant improvement from pre- to post-course assessment with significant statistical difference in both practical skills and theoretical knowledge (P-Value life support for medical students was beneficial and it provided a quality of education which was as effective as training conducted by professionals. This method is applicable and desirable especially in poor-resource countries and in crisis situation.
Lim, K G; Lum, S K; Burud, I A S
In the course of their undergraduate training at the International Medical University, students receive a Basic Trauma Life Support course. We wanted to test the long-term retention of knowledge (after 16 months) of third year medical students who had received training in Basic Trauma Life Support Method: To assess the retention of knowledge one cohort of students who received the training course were tested again 16 months later using the same 30 question One Best Answer quiz. Seventy-three students who underwent the course sat for the Retention test. The number of students who passed the Retention test was not significantly different from the test taken immediately after the course. The mean scores, 62.5% and 59.5% respectively, were however significantly different. Our study involves a relatively long interval between the course and retention of knowledge test shows encouraging results.
Pillow, Malford Tyson; Stader, Donald; Nguyen, Matthew; Cao, Dazhe; McArthur, Robert; Hoxhaj, Shkelzen
Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS) are integral parts of emergency resuscitative care. Although this training is usually reserved for residents, introducing the training in the medical student curriculum may enhance acquisition and retention of these skills. We developed a survey to characterize the perceptions and needs of graduating medical students regarding BLS, ACLS, and PALS training. This was a study of graduating 4th-year medical students at a U.S. medical school. The students were surveyed prior to participating in an ACLS course in March of their final year. Of 152 students, 109 (71.7%) completed the survey; 48.6% of students entered medical school without any prior training and 47.7% started clinics without training; 83.4% of students reported witnessing an average of 3.0 in-hospital cardiac arrests during training (range of 0-20). Overall, students rated their preparedness 2.0 (SD 1.0) for adult resuscitations and 1.7 (SD 0.9) for pediatric resuscitations on a 1-5 Likert scale, with 1 being unprepared. A total of 36.8% of students avoided participating in resuscitations due to lack of training; 98.2%, 91.7%, and 64.2% of students believe that BLS, ACLS, and PALS, respectively, should be included in the medical student curriculum. As per previous studies that have examined this topic, students feel unprepared to respond to cardiac arrests and resuscitations. They feel that training is needed in their curriculum and would possibly enhance perceived comfort levels and willingness to participate in resuscitations. Copyright © 2014 Elsevier Inc. All rights reserved.
Li, Qi; Zhou, Rong-hua; Liu, Jin; Lin, Jing; Ma, Er-Li; Liang, Peng; Shi, Ting-wei; Fang, Li-qun; Xiao, Hong
Pre-training evaluation and feedback have been shown to improve medical students' skills acquisition of basic life support (BLS) immediately following training. The impact of such training on BLS skills retention is unknown. This study was conducted to investigate effects of pre-training evaluation and feedback on BLS skills retention in medical students. Three hundred and thirty 3rd year medical students were randomized to two groups, the control group (C group) and pre-training evaluation and feedback group (EF group). Each group was subdivided into four subgroups according to the time of retention-test (at 1-, 3-, 6-, 12-month following the initial training). After a 45-min BLS lecture, BLS skills were assessed (pre-training evaluation) in both groups before training. Following this, the C group received 45 min training. 15 min of group feedback corresponding to students' performance in pre-training evaluation was given only in the EF group that was followed by 30 min of BLS training. BLS skills were assessed immediately after training (post-test) and at follow up (retention-test). No skills difference was observed between the two groups in pre-training evaluation. Better skills acquisition was observed in the EF group (85.3 ± 7.3 vs. 68.1 ± 12.2 in C group) at post-test (p<0.001). In all retention-test, better skills retention was observed in each EF subgroup, compared with its paired C subgroup. Pre-training evaluation and feedback improved skills retention in the EF group for 12 months after the initial training, compared with the control group. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Laharnar, Naima; Glass, Nancy; Perrin, Nancy; Hanson, Ginger; Kent Anger, W.
Background Effective policy implementation is essential for a healthy workplace. The Ryan-Kossek 2008 model for work-life policy adoption suggests that supervisors as gatekeepers between employer and employee need to know how to support and communicate benefit regulations. This article describes a workplace intervention on a national employee benefit, Family and Medical Leave Act (FMLA), and evaluates the effectiveness of the intervention on supervisor knowledge, awareness, and experience with FMLA. Methods The intervention consisted of computer-based training (CBT) and a survey measuring awareness and experience with FMLA. The training was administered to 793 county government supervisors in the state of Oregon, USA. Results More than 35% of supervisors reported no previous training on FMLA and the training pre-test revealed a lack of knowledge regarding benefit coverage and employer responsibilities. The CBT achieved: (1) a significant learning effect and large effect size of d = 2.0, (2) a positive reaction to the training and its design, and (3) evidence of increased knowledge and awareness regarding FMLA. Conclusion CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA. PMID:24106648
Altintaş, Kerim Hakan; Aslan, Dilek; Yildiz, Ali Naci; Subaşi, Nüket; Elçin, Melih; Odabaşi, Orhan; Bilir, Nazmi; Sayek, Iskender
In Turkey, the first aiders are few in quantity and yet they are required in many settings, such as earthquakes. It was thought that training first year university students in first aid and basic life support (FA-BLS) techniques would serve to increase the number of first aiders. It was also thought that another problem, the lack of first aid trainers, might be addressed by training medical students to perform this function. A project aimed at training first year university students in FA-BLS was conducted at Hacettepe University. In the first phase, medical student first aid trainers (MeSFAT) were trained in FA-BLS training techniques by academic trainers and in the second phase, first year university students were trained in FA-BLS techniques by these peer trainers under the academic trainers' supervision. The purpose of this study was to assess the participants' evaluation of this project and to propose a new program to increase the number of first aiders in the country. In total, 31 medical students were certified as MeSFATs and 12 of these trained 40 first year university students in FA-BLS. Various questionnaires were applied to the participants to determine their evaluation of the training program. Most of the participants and the authors considered the program to be successful and effective. This method may be used to increase the number of first aid trainers and first aiders in the community.
Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17\\/25 (68%) were trained and 13\\/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2\\/13 (15%) of children. Non-medical grade monitors were in use by 10\\/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge
Macken, W L; Clarke, N; Nadeem, M; Coghlan, D
Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2/13 (15%) of children. Non-medical grade monitors were in use by 10/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge.
Toubasi, Samar; Alosta, Mohammed R; Darawad, Muhammad W; Demeh, Waddah
Providing efficient basic life support (BLS) training is crucial for practicing nurses who provide direct patient care. Nevertheless, data addressing the impact of BLS courses on the skills and performance of Jordanian nurses are scarce. This study aimed to assess the effectiveness of a BLS simulation training on Jordanian nurses' skill improvement in cardiopulmonary resuscitation. A prospective quasi-experimental, single group pretest-posttest design was used to study the effect of BLS simulation; using a 9-item checklist; on the spot training; American Heart Association, on a group of Jordanian nurses. A pre-test was conducted following a CPR scenario to test the skills using 9-item checklist extrapolated from the American Heart Association guidelines. After debriefing, an interactive on spot training was provided. Later, participants undertook an unscheduled post-test after four weeks that included the same nine items. Thirty registered nurses with a mean clinical experience of 6.1years participated in the study. Comparing pre-test (M=4.6, SD=2.9, range=0 to 9) with post-test results (M=7.5, SD=1.7, range=4 to 9) showed an overall improvement in skills and BLS scores after the simulation training program (t=7.4, df=29, pskills and performance among Jordanian nurses. A refreshment BLS training session for nurses is highly recommended to guarantee nurses' preparedness in actual CPR scenarios. Copyright © 2015 Elsevier Ltd. All rights reserved.
Khanal, Prabal; Vankipuram, Akshay; Ashby, Aaron; Vankipuram, Mithra; Gupta, Ashish; Drumm-Gurnee, Denise; Josey, Karen; Tinker, Linda; Smith, Marshall
Advanced Cardiac Life Support (ACLS) is a series of team-based, sequential and time constrained interventions, requiring effective communication and coordination of activities that are performed by the care provider team on a patient undergoing cardiac arrest or respiratory failure. The state-of-the-art ACLS training is conducted in a face-to-face environment under expert supervision and suffers from several drawbacks including conflicting care provider schedules and high cost of training equipment. The major objective of the study is to describe, including the design, implementation, and evaluation of a novel approach of delivering ACLS training to care providers using the proposed virtual reality simulator that can overcome the challenges and drawbacks imposed by the traditional face-to-face training method. We compare the efficacy and performance outcomes associated with traditional ACLS training with the proposed novel approach of using a virtual reality (VR) based ACLS training simulator. One hundred and forty-eight (148) ACLS certified clinicians, translating into 26 care provider teams, were enrolled for this study. Each team was randomly assigned to one of the three treatment groups: control (traditional ACLS training), persuasive (VR ACLS training with comprehensive feedback components), or minimally persuasive (VR ACLS training with limited feedback components). The teams were tested across two different ACLS procedures that vary in the degree of task complexity: ventricular fibrillation or tachycardia (VFib/VTach) and pulseless electric activity (PEA). The difference in performance between control and persuasive groups was not statistically significant (P=.37 for PEA and P=.1 for VFib/VTach). However, the difference in performance between control and minimally persuasive groups was significant (P=.05 for PEA and P=.02 for VFib/VTach). The pre-post comparison of performances of the groups showed that control (P=.017 for PEA, P=.01 for VFib/VTach) and
Choi, Hyung Soo; Lee, Dong Hoon; Kim, Chan Woong; Kim, Sung Eun; Oh, Je Hyeok
The inclusion of cardiopulmonary resuscitation (CPR) in formal education has been a useful approach to providing basic life support (BLS) services. However, because not all students have been able to learn directly from certified instructors, we studied the educational efficacy of the use of peer-assisted learning (PAL) to train high-school students to perform BLS services. This study consisted of 187 high-school students: 68 participants served as a control group and received a 1-hour BLS training from a school nurse, and 119 were included in a PAL group and received a 1-hour CPR training from a PAL leader. Participants' BLS training was preceded by the completion of questionnaires regarding their background. Three months after the training, the participants were asked to respond to questionnaires about their willingness to perform CPR on bystander CPR and their retention of knowledge of BLS. We found no statistically significant difference between the control and PAL groups in their willingness to perform CPR on bystanders (control: 55.2%, PAL: 64.7%, P=0.202). The PAL group was not significantly different from the control group (control: 60.78±39.77, PAL: 61.76±17.80, P=0.848) in retention of knowledge about BLS services. In educating high school students about BLS, there was no significant difference between PAL and traditional education in increasing the willingness to provide CPR to bystanders or the ability to retain knowledge about BLS.
Pande, Sushma; Pande, Santosh; Parate, Vrushali; Pande, Sanket; Sukhsohale, Neelam
Poor awareness among medical graduates about basic life support (BLS) is a matter of great concern. The presence of a trained rescuer is the key determinant of ultimate survival from life-threatening emergencies. To achieve this goal, early exposure to such life-saving skills is the right decision to foster these skills for medical students, which…
Pichel López, María; Martínez-Isasi, Santiago; Barcala-Furelos, Roberto; Fernández-Méndez, Felipe; Vázquez Santamariña, David; Sánchez-Santos, Luis; Rodríguez-Nuñez, Antonio
Teachers may have an essential role in basic life support (BLS) training in schoolchildren. However, few data are available about their BLS learning abilities. To quantitatively assess the quality of BLS when performed by school teachers after a brief and simple training program. A quasi-experimental study with no control group, and involving primary and secondary education teachers from four privately managed and public funded schools was conducted in 3 stages: 1st. A knowledge test, 2nd: BLS training, and 3rd: Performance test. Training included a 40minutes lecture and 80minutes hands-on session with the help feedback on the quality of the chest compressions. A total of 81 teachers were included, of which 60.5% were women. After training, the percentage of subjects able to perform the BLS sequence rose from 1.2% to 46% (P<.001). Chest compression quality also improved significantly in terms of: correct hands position (97.6 vs. 72.3%; P<.001), mean depth (48.1 vs. 38.8mm; P<.001), percentage that reached recommended depth (46.5 vs. 21.5%; P<.001), percentage of adequate decompression (78.7 vs. 61.2%; P<.05), and percentage of compressions delivered at recommended rate (64.2 vs. 26.9%; P<.001). After and brief and simple training program, teachers of privately managed public funded schools were able to perform the BLS sequence and to produce chest compressions with a quality similar to that obtained by staff with a duty to assist cardiac arrest victims. The ability of schoolteachers to deliver good-quality BLS is a pre-requisite to be engaged in BLS training for schoolchildren. Copyright © 2017. Publicado por Elsevier España, S.L.U.
Altintaş, Kerim Hakan; Yildiz, Ali Naci; Aslan, Dilek; Ozvariş, Sevkat Bahar; Bilir, Nazmi
We developed 24 and 12-h programs for first aid and basic life support (FA-BLS) training for first-year medical students and evaluated the opinions of both the trainers and trainees on the effectiveness of the programs. The trainees were the first-year students of academic years 2000-2001 (316 students) and 2001-2002 (366 students). The evaluations of the participants were collected from short questionnaires created specifically for the study. For the 24-h training program, most of the students stated that FA-BLS sessions met their expectations (85.9%) and they were satisfied with the training (91.1%). Of the participants, 75.6% stated that they could apply FA confidently in real situations simulating the topics they learned in the FA-BLS sessions. For the 12-h training program, 84.4% of the students felt themselves competent in FA-BLS applications. The trainers considered both of the programs as effective.
Vankipuram, Akshay; Khanal, Prabal; Ashby, Aaron; Vankipuram, Mithra; Gupta, Ashish; DrummGurnee, Denise; Josey, Karen; Smith, Marshall
The use of virtual reality (VR) training tools for medical education could lead to improvements in the skills of clinicians while providing economic incentives for healthcare institutions. The use of VR tools can also mitigate some of the drawbacks currently associated with providing medical training in a traditional clinical environment such as scheduling conflicts and the need for specialized equipment (e.g., high-fidelity manikins). This paper presents the details of the framework and the development methodology associated with a VR-based training simulator for advanced cardiac life support, a time critical, team-based medical scenario. In addition, we also report the key findings of a usability study conducted to assess the efficacy of various features of this VR simulator through a postuse questionnaire administered to various care providers. The usability questionnaires were completed by two groups that used two different versions of the VR simulator. One version consisted of the VR trainer with it all its features and a minified version with certain immersive features disabled. We found an increase in usability scores from the minified group to the full VR group.
González-Salvado, Violeta; Abelairas-Gómez, Cristian; Peña-Gil, Carlos; Neiro-Rey, Carmen; Barcala-Furelos, Roberto; González-Juanatey, José Ramón; Rodríguez-Núñez, Antonio
Early basic life support is crucial to enhance survival from out-of-hospital cardiac arrest but rates remain low, especially in households. High-risk groups' training has been advocated, but the optimal method is unclear. The CArdiac REhabilitation and BAsic life Support (CAREBAS) project aims to compare the effectiveness of two basic life support educational strategies implemented in a cardiac rehabilitation program. A community intervention study including consecutive patients enrolled on an exercise-based cardiac rehabilitation program after acute coronary syndrome or revascularization was conducted. A standard basic life support training (G-Stan) and a novel approach integrating cardiopulmonary resuscitation hands-on rolling refreshers (G-CPR) were randomly assigned to each group and compared. Basic life support performance was assessed by means of simulation at baseline, following brief instruction and after the 2-month program. 114 participants were included and 108 completed the final evaluation (G-Stan:58, G-CPR:50). Basic life support performance was equally poor at baseline and significantly improved following a brief instruction. A better skill retention was found after the 2-month program in G-CPR, significantly superior for safety and sending for an automated external defibrillator. Confidence and self-perceived preparation were also significantly greater in G-CPR after the program. Integrating cardiopulmonary resuscitation hands-on rolling refreshers in the training of an exercise-based cardiac rehabilitation program is feasible and improves patients' skill retention and confidence to perform a basic life support sequence, compared to conventional training. Exporting this formula to other programs may result in increased numbers of trained citizens, enhanced social awareness and bystander resuscitation. Copyright © 2018 Elsevier B.V. All rights reserved.
Isbye, Dan L; Meyhoff, Christian S; Lippert, Freddy K
As 70-80% of cardiac arrests occur at home, widespread training is needed to increase the likelihood of basic life support (BLS) being performed before the arrival of Emergency Medical Services personnel. Teaching BLS in public schools has been recommended to achieve this.......As 70-80% of cardiac arrests occur at home, widespread training is needed to increase the likelihood of basic life support (BLS) being performed before the arrival of Emergency Medical Services personnel. Teaching BLS in public schools has been recommended to achieve this....
Conclusion: CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA.
Full Text Available The cardiopulmonary resuscitation (CPR guideline of comprehensive cardiopulmonary life support (CCLS for management of the patient with cardiopulmonary arrest in adults provides an algorithmic step-wise approach for optimal outcome of the patient inside the hospital by trained medics and paramedics. This guideline has been developed considering the infrastructure of healthcare delivery system in India. This is based on evidence in the international and national literature. In the absence of data from the Indian population, the extrapolation has been made from international data, discussed with Indian experts and modified accordingly to ensure their applicability in India. The CCLS guideline emphasise the need to recognise patients at risk for cardiac arrest and their timely management before a cardiac arrest occurs. The basic components of CPR include chest compressions for blood circulation; airway maintenance to ensure airway patency; lung ventilation to enable oxygenation and defibrillation to convert a pathologic 'shockable' cardiac rhythm to one capable to maintaining effective blood circulation. CCLS emphasises incorporation of airway management, drugs, and identification of the cause of arrest and its correction, while chest compression and ventilation are ongoing. It also emphasises the value of organised team approach and optimal post-resuscitation care.
Full Text Available The cardiopulmonary resuscitation guideline of Basic Cardiopulmonary Life Support (BCLS for management of adult victims with cardiopulmonary arrest outside the hospital provides an algorithmic stepwise approach for optimal outcome of the victims by trained medics and paramedics. This guideline has been developed considering the need to have a universally acceptable practice guideline for India and keeping in mind the infrastructural limitations of some areas of the country. This guideline is based on evidence elicited in the international and national literature. In the absence of data from Indian population, the excerpts have been taken from international data, discussed with Indian experts and thereafter modified to make them practically applicable across India. The optimal outcome for a victim with cardiopulmonary arrest would depend on core links of early recognition and activation; early high-quality cardiopulmonary resuscitation, early defibrillation and early transfer to medical facility. These links are elaborated in a stepwise manner in the BCLS algorithm. The BCLS also emphasise on quality check for various steps of resuscitation.
Meissner, Theresa M; Kloppe, Cordula; Hanefeld, Christoph
Immediate bystander cardiopulmonary resuscitation (CPR) significantly improves survival after a sudden cardiopulmonary collapse. This study assessed the basic life support (BLS) knowledge and performance of high school students before and after CPR training. This study included 132 teenagers (mean age 14.6 ± 1.4 years). Students completed a two-hour training course that provided theoretical background on sudden cardiac death (SCD) and a hands-on CPR tutorial. They were asked to perform BLS on a manikin to simulate an SCD scenario before the training. Afterwards, participants encountered the same scenario and completed a questionnaire for self-assessment of their pre- and post-training confidence. Four months later, we assessed the knowledge retention rate of the participants with a BLS performance score. Before the training, 29.5% of students performed chest compressions as compared to 99.2% post-training (P training, respectively, P training, 99.2% stated that they felt confident about performing CPR, as compared to 26.9% (P training. BLS training in high school seems highly effective considering the minimal amount of previous knowledge the students possess. We observed significant improvement and a good retention rate four months after training. Increasing the number of trained students may minimize the reluctance to conduct bystander CPR and increase the number of positive outcomes after sudden cardiopulmonary collapse.
Isbye, Dan L; Meyhoff, Christian S; Lippert, Freddy K
As 70-80% of cardiac arrests occur at home, widespread training is needed to increase the likelihood of basic life support (BLS) being performed before the arrival of Emergency Medical Services personnel. Teaching BLS in public schools has been recommended to achieve this....
Toner, P; Connolly, M; Laverty, L; McGrath, P; Connolly, D; McCluskey, D R
The 'ABC for life' programme was designed to facilitate the wider dissemination of basic life support (BLS) skills and knowledge in the population. A previous study demonstrated that using this programme 10-12-year olds are capable of performing and retaining these vital skills when taught by medical students. There are approximately 25,000 year 7 school children in 900 primary schools in Northern Ireland. By using a pyramidal teaching approach involving medical students and teachers, there is the potential to train BLS to all of these children each year. To assess the effectiveness of a programme of CPR instruction using a three-tier training model in which medical students instruct primary school teachers who then teach school children. School children and teachers in the Western Education and Library Board in Northern Ireland. A course of instruction in cardiopulmonary resuscitation (CPR)--the 'ABC for life' programme--specifically designed to teach 10-12-year-old children basic life support skills. Medical students taught teachers from the Western Education and Library Board area of Northern Ireland how to teach basic life support skills to year 7 pupils in their schools. Pupils were given a 22-point questionnaire to assess knowledge of basic life support immediately before and after a teacher led training session. Children instructed in cardiopulmonary resuscitation using this three-tier training had a significantly improved score following training (57.2% and 77.7%, respectively, p<0.001). This study demonstrates that primary school teachers, previously trained by medical students, can teach BLS effectively to 10-12-year-old children using the 'ABC for life' programme.
Rasmussen, Ditte K; Glerup Lauridsen, Kasper; Staerk, Mathilde
Introduction: High-quality chest compressions and early defibrillation is essential to improve survival following in-hospital cardiac arrest. Efficient training in basic life support (BLS) for clinical staff is therefore important. This study aimed to investigate duration, training methods...... and retraining intervals for BLS training of clinical staff in Danish hospitals.Methods: We included all public, somatic hospitals in Denmark with a cardiac arrest team. Online questionnaires were distributed to resuscitation officers in each hospital. Questionnaires inquired information on: A) Course duration...... and retraining interval, and B) Training methods and setting.Results: In total, 44 hospitals replied (response rate: 96%). BLS training for clinical staff was conducted in 41 hospitals (93%). Median (Q1;Q3) course duration was 1.5 (1;2.5) hours. Retraining was conducted every year (17%), every second year (56...
Vestergaard, Lone D; Løfgren, Bo; Jessen, Casper L; Petersen, Christina B; Wolff, Anne; Nielsen, Henrik V; Krarup, Niels H V
Pediatric cardiac arrest carries a poor prognosis. Basic life support improves survival. Studies on pediatric basic life support (PBLS) training are sparse. The aim of our study was to investigate the effect of self-training in PBLS. We conducted a prospective controlled trial enrolling nurses from pediatric and maternity wards (n=29 in each group). Self-training, including a manikin and access to a web-based video on PBLS, was compared with a 2-h instructor-led course. Two weeks after training, all participants were tested in a mock scenario of pediatric cardiac arrest. Fifteen parameters equivalent to the steps in the PBLS algorithm - for example, effective ventilations, effective chest compressions, calling for help, and correct sequence of actions, were evaluated and rated dichotomously (1=approved or 0=not approved). No difference was observed in the baseline demographics between the self-training group and the instructor-led group. The participants in the self-training group accessed the website 2±1.5 times (mean±SD) and spent 41±25 min on the site. There was no significant difference between the two groups in the overall average score (10.5 in the self-training group vs. 10.0 in the instructor-led group, P=0.51) or in any of the 15 parameters. After the study, all participants felt that they had improved their skills and felt capable of performing PBLS. Self-training is not statistically different to instructor-led training in teaching PBLS. Self-evaluated confidence improved, but showed no difference between groups. PBLS may be disseminated through self-training.
Brewster, D J; Barrett, J A; Gherardin, E; O'Neill, J A; Sage, D; Hanlon, G
Recent focus on national standards within Australian hospitals has prompted a focus on the training of our staff in advanced life support (ALS). Research in critical care nursing has questioned the traditional annual certification of ALS competence as the best method of delivering this training. Simulation and team-based training may provide better ALS education to intensive care unit (ICU) staff. Our new inter-professional team-based advanced life support program involved ICU staff in a large private metropolitan ICU. A prospective observational study using three standardised questionnaires and two multiple choice questionnaire assessments was conducted. Ninety-nine staff demonstrated a 17.8% (95% confidence interval 4.2-31, P =0.01) increase in overall ICU nursing attendance at training sessions. Questionnaire response rates were 93 (94%), 99 (100%) and 60 (61%) respectively; 51 (52%) staff returned all three. Criteria were assessed by scores from 0 to 10. Nurses reported improved satisfaction with the education program (9.4 to 7.1, P versus 7.9 and 8.2, P versus 7.4 and 7.8, P versus 8.1, P =0.04). The new program cost approximately an extra $16,500 in nursing salaries. We concluded that team-based, inter-professional ALS training produced statistically significant improvements in nursing attendance, satisfaction with ALS education, confidence and role understanding compared to traditional ALS training.
Lippmann, John; Livingston, Patricia; Craike, Melinda J.
Aims: Flexible-learning first aid courses are increasingly common due to reduced classroom contact time. This study compared retention of first aid knowledge and basic life support (BLS) skills three months after a two-day, classroom-based first aid course (STD) to one utilizing on-line theory learning at home followed by one day of classroom…
Meissner Theresa M
Full Text Available Abstract Background Immediate bystander cardiopulmonary resuscitation (CPR significantly improves survival after a sudden cardiopulmonary collapse. This study assessed the basic life support (BLS knowledge and performance of high school students before and after CPR training. Methods This study included 132 teenagers (mean age 14.6 ± 1.4 years. Students completed a two-hour training course that provided theoretical background on sudden cardiac death (SCD and a hands-on CPR tutorial. They were asked to perform BLS on a manikin to simulate an SCD scenario before the training. Afterwards, participants encountered the same scenario and completed a questionnaire for self-assessment of their pre- and post-training confidence. Four months later, we assessed the knowledge retention rate of the participants with a BLS performance score. Results Before the training, 29.5% of students performed chest compressions as compared to 99.2% post-training (P P Conclusions BLS training in high school seems highly effective considering the minimal amount of previous knowledge the students possess. We observed significant improvement and a good retention rate four months after training. Increasing the number of trained students may minimize the reluctance to conduct bystander CPR and increase the number of positive outcomes after sudden cardiopulmonary collapse.
Mardegan, Karen J; Schofield, Margot J; Murphy, Gregory C
Basic Life Support (BLS) is a life-saving and fundamental skill in resuscitation. However, studies have reported limitations in BLS training outcomes for both health professional and lay populations, and noted the resource and time-intensive nature of traditional training approaches. This exploratory study evaluated the effectiveness of an interactive CD-based BLS training programme that included unsupervised manikin practice compared with a traditional instructor-led BLS training programme involving demonstration and supervised practice. A quasi-experimental post-test with follow-up design was used. The sample was comprised of two cohorts: Novice second-year undergraduate Nursing students (n=187) and Practising Nurses (n=107) in their first year of hospital employment. BLS skill outcomes were assessed at one week and again at eight weeks post training. No statistically significant differences were found between the CD and traditional instructor-led BLS training methods in BLS skills of Novice and Practising Nurses at one week and eight weeks post training. However, there was a decrement in skill between one week and eight weeks post-training across both groups and an overall low level of competence. The failure to find a difference between the CD-based BLS programme with unsupervised manikin practice and a resource-intensive traditional instructor-led BLS training programme may indicate equivalence of the programmes or, even study design limitations. It is concerning that competence displayed by trainees from both groups was less than optimal and suggests the need for renewed efforts to develop and evaluate BLS training programmes which can achieve high rates of competence with acceptable skill retention over time. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
Kuhls, Deborah A; Chestovich, Paul J; Coule, Phillip; Carrison, Dale M; Chua, Charleston M; Wora-Urai, Nopadol; Kanchanarin, Tavatchai
Medical response to mass-casualty incidents (MCIs) requires specialized training and preparation. Basic Disaster Life Support (BDLS) is a course designed to prepare health care workers for a MCI. The purpose of this study was to evaluate the confidence of health care professionals in Thailand to face a MCI after participating in a BDLS course. Basic Disaster Life Support was taught to health care professionals in Thailand in July 2008. Demographics and medical experience were recorded, and participants rated their confidence before and after the course using a five-point Likert scale in 11 pertinent MCI categories. Survey results were compiled and compared with PBasic Disaster Life Support significantly improves confidence to respond to MCI situations, but nurses and active duty military benefit the most from the course. Future courses should focus on these groups to prepare for MCIs. Kuhls DA , Chestovich PJ , Coule P , Carrison DM , Chua CM , Wora-Urai N , Kanchanarin T . Basic Disaster Life Support (BDLS) training improves first responder confidence to face mass-casualty incidents in Thailand. Prehosp Disaster Med. 2017;32(5):492-500 .
Prior to beginning a 90-day test of a regenerative life support system, a need was identified for a training and certification program to qualify an operating staff for conducting the test. The staff was responsible for operating and maintaining the test facility, monitoring and ensuring crew safety, and implementing procedures to ensure effective mission performance with good data collection and analysis. The training program was designed to ensure that each operating staff member was capable of performing his assigned function and was sufficiently cross-trained to serve at certain other positions on a contingency basis. Complicating the training program were budget and schedule limitations, and the high level of sophistication of test systems.
Abolfotouh, Mostafa A; Alnasser, Manal A; Berhanu, Alamin N; Al-Turaif, Deema A; Alfayez, Abdulrhman I
Cardiopulmonary resuscitation (CPR) increases the probability of survival of a person with cardiac arrest. Repeating training helps staff retain knowledge in CPR and in use of automated external defibrillators (AEDs). Retention of knowledge and skills during and after training in CPR is difficult and requires systematic training with appropriate methodology. The aim of this study was to determine the effect of basic life-support (BLS) training on the attitudes of health-care providers toward initiating CPR and on use of AEDs, and to investigate the factors that influence these attitudes. A quasi-experimental study was conducted in two groups: health-care providers who had just attended a BLS-AED course (post-BLS group, n = 321), and those who had not (pre-BLS group, n = 421). All participants had previously received BLS training. Both groups were given a validated questionnaire to evaluate the status of life-support education and certification, attitudes toward use of CPR and AED and concerns regarding use of CPR and AED. Multiple linear regression analyses were applied to identify significant predictors of the attitude and concern scores. Overall positive attitudes were seen in 53.4% of pre-BLS respondents and 64.8% of post-BLS respondents (χ 2 = 9.66, p = 0.002). Positive attitude was significantly predicted by the recent completion of BLS training (β = 5.15, p attitudes toward CPR performance and the use of AEDs. Training that addressed the concerns of health-care workers could further improve these attitudes.
Kang, Ku Hyun; Song, Keun Jeong; Lee, Chang Hee
Background. Basic life support (BLS) training with hands-on practice can improve performance during simulated cardiac arrest, although the optimal duration for BLS training is unknown. This study aimed to assess the effectiveness of various BLS training durations for acquiring cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skills. Methods. We randomised 485 South Korean nonmedical college students into four levels of BLS training: level 1 (40 min), level 2 (80 min), level 3 (120 min), and level 4 (180 min). Before and after each level, the participants completed questionnaires regarding their willingness to perform CPR and use AEDs, and their psychomotor skills for CPR and AED use were assessed using a manikin with Skill-Reporter™ software. Results. There were no significant differences between levels 1 and 2, although levels 3 and 4 exhibited significant differences in the proportion of overall adequate chest compressions (p CPR and use AEDs (all, p training provided a moderate level of skill for performing CPR and using AEDs. However, high-quality skills for CPR required longer and hands-on training, particularly hands-on training with AEDs. PMID:27529066
Jin Hyuck Lee
Full Text Available Background. Basic life support (BLS training with hands-on practice can improve performance during simulated cardiac arrest, although the optimal duration for BLS training is unknown. This study aimed to assess the effectiveness of various BLS training durations for acquiring cardiopulmonary resuscitation (CPR and automated external defibrillator (AED skills. Methods. We randomised 485 South Korean nonmedical college students into four levels of BLS training: level 1 (40 min, level 2 (80 min, level 3 (120 min, and level 4 (180 min. Before and after each level, the participants completed questionnaires regarding their willingness to perform CPR and use AEDs, and their psychomotor skills for CPR and AED use were assessed using a manikin with Skill-Reporter™ software. Results. There were no significant differences between levels 1 and 2, although levels 3 and 4 exhibited significant differences in the proportion of overall adequate chest compressions (p<0.001 and average chest compression depth (p=0.003. All levels exhibited a greater posttest willingness to perform CPR and use AEDs (all, p<0.001. Conclusions. Brief BLS training provided a moderate level of skill for performing CPR and using AEDs. However, high-quality skills for CPR required longer and hands-on training, particularly hands-on training with AEDs.
Sanders, C; Rogers, A; Gardner, C; Kennedy, A
Previous research has demonstrated how the Internet can foster emotional support and provide a 'private' space for discussing sensitive issues. Whilst the family has been located as a primary source of support, empirical research on the dynamics of close personal relationships in chronic illness experience remains a challenge. To explore the role of family relationships in supporting self-care and the nature of social support exchanged within an online self-management training course. Qualitative thematic and narrative analysis of online discussion boards. Postings for 218 participants, divided between 11 groups were included for a course section that focused on 'difficult emotions'. Participants exchanged a high degree of emotional support and revealed much about their 'real life' relationships. The latter highlighted the complexities of managing illness within family contexts alongside additional pressures of daily life such as caring commitments and work roles. The private interactive space created within the course allowed insights into the dynamics of family life associated with illness management that are challenging to research. Simultaneously, collective support was developed amongst this group of predominantly working women. The article points to the implications for such interventions and associated evaluative research beyond this selective group.
Durak, Halil Ibrahim; Certuğ, Agah; Calişkan, Ayhan; van Dalen, Jan
Although the Basic Life Support (BLS) ability of a medical student is a crucial competence, poor BLS training programs have been documented worldwide. Better training designs are needed. This study aims to share detailed descriptions and the test results of two cognitive-constructivist training models for the BLS skills in the first year of medical curriculum. A BLS skills training module was implemented in the first year curriculum in the course of 6 years (1997-2003). The content was derived from the European Resuscitation Council Guidelines. Initially, a competence-based model was used and was upgraded to a cognitive apprenticeship model in 2000. The main performance-content type that was expected at the end of the course was: competent application of BLS procedures on manikins and peers at an OSCE as well as 60% achievement in a test consisting of 25 MCQ items. A retrospective cohort survey design using exam results and a self-completed anonymous student ratings' questionnaire were used in order to test models. Training time for individual students varied from 21 to 29 hours. One thousand seven hundred and sixty students were trained. Fail rates were very low (1.0-2.2%). The students were highly satisfied with the module during the 6 years. In the first year of the medical curriculum, a competence-based or cognitive apprenticeship model using cognitive-constructivist designs of skills training with 9 hours theoretical and 12-20 hours long practical sessions took place in groups of 12-17 students; medical students reached a degree of competence to sufficiently perform BLS skills on the manikins and their peers. The cognitive-constructivist designs for skills training are associated with high student satisfaction. However, the lack of controls limits the extrapolation of this conclusion.
Fonseca Del Pozo, Francisco Javier; Valle Alonso, Joaquin; Canales Velis, Nancy Beatriz; Andrade Barahona, Mario Miguel; Siggers, Aidan; Lopera, Elisa
To examine the effectiveness of a "cardiopulmonary resuscitation song" in improving the basic life support skills of secondary school students. This pre-test/post-test control design study enrolled secondary school students from two middle schools randomly chosen in Córdoba, Andalucia, Spain. The study included 608 teenagers. A random sample of 87 students in the intervention group and 35 in the control group, aged 12-14 years were selected. The intervention included a cardiopulmonary resuscitation song and video. A questionnaire was conducted at three-time points: pre-intervention, one month and eight months post-intervention. On global knowledge of cardiopulmonary resuscitation, there were no significant differences between the intervention group and the control group in the trial pre-intervention and at the month post-intervention. However, at 8 months there were significant differences with a p-value = 0.000 (intervention group, 95% CI: 6.39 to 7.13 vs. control group, 95% CI: 4.75 to 5.92), F(1,120)=16.644, p=0.000). In addition, significant differences about students' basic life support knowledge about chest compressions at eight months post-intervention (F(1,120)=15.561, p=0.000) were found. Our study showed that incorporating the song component in the cardiopulmonary resuscitation teaching increased its effectiveness and the ability to remember the cardiopulmonary resuscitation algorithm. Our study highlights the need for different methods in the cardiopulmonary resuscitation teaching to facilitate knowledge retention and increase the number of positive outcomes after sudden cardiac arrest.
Løfgren, Bo; Petersen, Christina Børlum; Mikkelsen, Ronni
Peer-led training has been identified as a useful tool for delivering undergraduate healthcare training. In this paper we describe the implementation of the European Resuscitation Council BLS/AED Course as a peer-led training program for medical students....
Cartledge, Susie; Bray, Janet E; Leary, Marion; Stub, Dion; Finn, Judith
Targeting basic life support (BLS) training to bystanders who are most likely to witness an out of hospital cardiac arrest (OHCA) is an important public health intervention. We performed a systematic review examining the evidence of the effectiveness of providing BLS training to family members of high-risk cardiac patients. A search of Ovid MEDLINE, CINAL, EMBASE, Informit, Cochrane Library, Web of Science, Scopus, ERIC and ProQuest Dissertations and Theses Global was conducted. We included all studies training adult family members of high-risk cardiac patients regardless of methods used for cardiopulmonary resuscitation (CPR) or BLS training. Two reviewers independently extracted data and evaluated the quality of evidence using GRADE (Grades of Recommendation, Assessment, Development and Evaluation). We included 26 of the 1172 studies identified. The majority of studies were non-randomised controlled trials (n=18), of very low to moderate quality. Currently, there is insufficient evidence to indicate a benefit of this intervention for patients; largely because of low numbers of OHCA events and high loss to follow-up. However, the majority of trained individuals were able to competently perform BLS skills, reported a willingness to use these skills and experienced lower anxiety. Whilst there is no current evidence for improvement in patient outcomes from targeted BLS training for family members, this group are willing and capable to learn these skills. Future research may need to examine longer periods of follow-up using alternate methods (e.g. cardiac arrest registries), and examine the effectiveness of training in the modern era. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Cook, Neal F; McAloon, Toni; O'Neill, Philip; Beggs, Richard
The delivery of effective life support measures is highly associated with the quality, design and implementation of the education that underpins it. Effectively responding to a critical event is a requirement for all nurses illustrating the need for effective educational approaches from pre-registration training through to enhancing and maintaining life support skills after qualification. This paper reports the findings of utilising a web-based multimedia simulation game PULSE (Platform for Undergraduate Life Support Education). The platform was developed to enhance the student experience of life support education, to motivate on-going learning and engagement and to improve psychomotor skills associated with the provision of Intermediate Life Support (ILS) training. Pre training participants played PULSE and during life support training data was collected from an intervention and a control group of final year undergraduate nursing students (N=34). Quantitative analysis of performance took place and qualitative data was generated from a questionnaire assessing the learning experience. A statistically significant difference was found between the competence the groups displayed in the three skills sets of checking equipment, airway assessment and the safe/effective use of defibrillator at ILS level, and PULSE was positively evaluated as an educational tool when used alongside traditional life support training. Copyright © 2011 Elsevier Ltd. All rights reserved.
Objective: Survival after cardiac arrest is related to time taken for resuscitation, and defibrillation, to commence. At many hospitals, the healthcare worker most likely to be present when a patient suffers a cardiac arrest is a nurse. This study was performed to assess BLS knowledge and training of nurses, and thus to ...
Jones Christopher M
Full Text Available Abstract Introduction Effective delivery of cardiopulmonary resuscitation (CPR and prompt defibrillation following sudden cardiac arrest (SCA is vital. Updated guidelines for adult basic life support (BLS were published in 2010 by the European Resuscitation Council (ERC in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p Conclusions The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.
Jones, Christopher M; Owen, Andrew; Thorne, Christopher J; Hulme, Jonathan
Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital. Updated guidelines for adult basic life support (BLS) were published in 2010 by the European Resuscitation Council (ERC) in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p < 0.05), reflecting a significantly greater proportion of lay-rescuers performing chest compressions at too fast a rate when trained and assessed with the 2010 rather than 2005 guidelines (6.04% vs. 2.67%; p < 0.05). Error rates for other skills did not differ between guideline groups. The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.
Stefan, Mihaela S.; Belforti, Raquel K.; Langlois, Gerard; Rothberg, Michael B.
Background Medical residents are often responsible for leading and performing cardiopulmonary resuscitation; however, their levels of expertise and comfort as leaders of advanced cardiovascular life support (ACLS) teams vary widely. While the current American Heart Association ACLS course provides education in recommended resuscitative protocols, training in leadership skills is insufficient. In this article, we describe the design and implementation in our institution of a formative curriculum aimed at improving residents’ readiness for being leaders of ACLS teams using human patient simulation. Human patient simulation refers to a variety of technologies using mannequins with realistic features, which allows learners to practice through scenarios without putting patients at risk. We discuss the limitations of the program and the challenges encountered in implementation. We also provide a description of the initiation and organization of the program. Case scenarios and assessment tools are provided. Description of the Institutional Training Program Our simulation-based training curriculum consists of 8 simulated patient scenarios during four 1-hour sessions. Postgraduate year–2 and 3 internal medicine residents participate in this program in teams of 4. Assessment tools are utilized only for formative evaluation. Debriefing is used as a teaching strategy for the individual resident leader of the ACLS team to facilitate learning and improve performance. To evaluate the impact of the curriculum, we administered a survey before and after the intervention. The survey consisted of 10 questions answered on a 5-point Likert scale, which addressed residents’ confidence in leading ACLS teams, management of the equipment, and management of cardiac rhythms. Respondents’ mean presimulation (ie, baseline) and postsimulation (outcome) scores were compared using a 2-sample t test. Residents’ overall confidence score improved from 2.8 to 3.9 (P simulation-based training
Owen, Andrew; Kocierz, Laura; Aggarwal, Naresh; Hulme, Jonathan
The importance of immediate cardiopulmonary resuscitation (CPR) and defibrillation after cardiac arrest is established. The 2005 European Resuscitation Council (ERC) guidelines were altered to try to improve survival after cardiac arrest. This observational study compares the errors in basic life support (BLS) performance after training using the 2000 or 2005 guidelines. First-year healthcare students at the University of Birmingham, United Kingdom, were taught adult BLS in a standardised 8-h course: an historical group with previous ERC guidelines (Old), the other with 2005 ERC guidelines (New). 2537 (Old 1773; New 764) students were trained and assessed in BLS. There was no difference in overall error rate between Old and New (5.53% vs. 6.70% (p>0.05)) or adherence to the sequence of the respective BLS algorithm. The New group ("hands in centre of the chest") had significantly more erroneous hand positions compared to the Old group (5.23% vs. 1.64%, pERC guidelines do not significantly improve correct BLS performance. Removal of hand placement measurement results in a significant increase in hand position errors. The clinical benefit of an increased number of compressions impaired by worsened hand positioning is unknown and requires further study. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background: For several years, educators have criticized the lecture-based approach to teaching and learning. Experts have rightly stressed on acquisition of a number of critical skills rather than focusing on lectures. Purpose. To compare students' pe1jormance after self-education with VCD and manikin, with thei performance after standard BLS training.Methods: In this randomized controlled study, twenty first-year nursing students were divided into two groups randomly, and were provided with basic life support (BLS instruction either in the traditional format of lecturing or with VCD and manikin without tutor. The students’ Performance was evaluated on a manikin with a checklist including all steps in BLS.Results: With traditional instruction, students' mean score was 42.2±3.91, while it was 46.3±3.86 with self-education, showing no significant difference.Conclusion: In nursing students with no previous BLS training, access to VCD and manikin facilitates immediate achievement of educational objectives similar to those of a standard BLS course. Self learning BLS with VCD should be enhanced with a short period of hands-on practice.Keywords: cardiopulmonary resuscitation (CPR, nursing students, cpr skills, education
Perkins, Gavin D; Fullerton, James N; Davis-Gomez, Nicole; Davies, Robin P; Baldock, Catherine; Stevens, Harry; Bullock, Ian; Lockey, Andrew S
The role of e-learning in contemporary healthcare education is quickly developing. The aim of this study was to examine the relationship between the use of an e-learning simulation programme (Microsim, Laerdal, UK) prior to attending an Advanced Life Support (ALS) course and the subsequent relationship to candidate performance. An open label, multi-centre randomised controlled study was conducted. The control group received a course manual and pre-course MCQ four weeks prior to the face to face course. The intervention group in addition received the Microsim programme on a CD. The primary outcome was performance during a simulated cardiac arrest at the end of the course. Secondary outcomes were performance during multiple choice exams, resuscitation skills assessments and feedback to Microsim programme. 572 participants were randomised (287 Microsim, 285 control). There were no significant differences in the primary outcome (performance during a standard cardiac arrest simulation) or secondary outcomes. User evaluations were favorable. 79% would recommend it to colleagues. 9% stated Microsim could replace the entire ALS course, 25% parts. Over 70% of participants' perceived that Microsim improved their understanding of the key learning domains of the ALS course. Distributing Microsim to healthcare providers prior to attending an ALS courses did not improve either cognitive or psychomotor skills performance during cardiac arrest simulation testing. The challenge that lies ahead is to identify the optimal way to use e-learning as part of a blended approach to learning for this type of training programme.
E. Y. Ilaltdinova
Full Text Available The article reveals the peculiarities of the organization of graduate support of graduates of the targeted training program in the context of supporting the life cycle of the teacher's profession. Important stages of the life cycle of the pedagogical profession are described. The model of the teacher's special training and contract employment is offered, the mechanisms of its implementation in the context of the trajectory of the entrance, promotion and exit after the completion of the targeted training program are defined. The mechanism of graduate support of graduates as one of the elements of the model of targeted training of teachers is presented, its priority goals and tasks are described, as well as the fundamental principles that determine the logic of the graduate's graduate support process. The tools of the mechanism of postgraduate accompaniment are developed, among which the defining role is played by the electronic interactive multifunctional online support service. The article describes the results obtained during the approbation of the developed mechanism for graduate support of graduates of the targeted training program and their impact on the solution of the problem of updating the teaching staff.
Conclusion According to achieved results, eight weeks body weight supported treadmill training can improve the balance of the patients with spinal cord injury. It was observed that the gait training with stimulation and use of proprioceptors and increase of patient’s confidence in walking and standing positions improve the patient’s balance. The patients were also able to control the internal and external perturbations and maintain the better balance. But eight weeks gait training had no significant effect on the quality of life in patients with spinal cord injury which suggest that more extended rehabilitation is required.
M. Hassanvand Amouzadeh
Full Text Available The aim of this study was to investigate the effect of life-skills training on social anxiety symptoms and stress coping methods in teens with social anxiety that are supported by welfare department. The research method was semi-empirical with two group's pretest-posttest design. The subjects of this study were socially anxious teens in families supported by welfare organization in Darreh shahr town. So, after first administration of Social Phobia Inventory (SPIN, 30 persons with highest scores were selected and randomly assigned in to an experimental group (15 persons and a control group (15 persons. The experimental group received “life-skills” training through thirteen two hour sessions twice a week. During this period no intervention was given to the control group. The instrument for this study, social phobia inventory Conver and etal (2000 (SPIN and parker & ender questionnaire of coping with stress (1991 were administered at the pretest and post-test stage to all participations. The result of multiple covariance analysis indicated that “life-skills” training significantly decreased the amount of social anxiety, emotion-based coping and evasion-based coping and so significant increase in the scores of problem-based coping in the experimental group as compared the control group (p=0.0001. The result of the study revealed that “life-skills” training could be used as a useful intervention for teens in families that are supported by welfare organization.
Rose, Martin Høyer; Løkkegaard, Annemette; Sonne-Holm, Stig
OBJECTIVE: To evaluate the effect of body weight-supported progressive high-intensity locomotor training in Parkinson's disease (PD) on (1) clinical status; (2) quality of life; and (3) gait capacity. DESIGN: Open-label, fixed sequence crossover study. SETTING: University motor control laboratory......±93 to 637±90m. CONCLUSIONS: Body weight-supported progressive high-intensity locomotor training is feasible and well tolerated by patients with PD. The training improved clinical status, quality of life, and gait capacity significantly....... were found in all outcome measures compared with the control period. Total MDS-UPDRS score changed from (mean ± 1SD) 58±18 to 47±18, MDS-UPDRS motor part score changed from 35±10 to 29±12, PDQ-39 summary index score changed from 22±13 to 13±12, and the six-minute walking distance changed from 576...
Navarro-Patón, R; Freire-Tellado, M; Basanta-Camiño, S; Barcala-Furelos, R; Arufe-Giraldez, V; Rodriguez-Fernández, J E
To evaluate the learning of basic life support (BLS) measures on the part of laypersons after 3different teaching programs. A quasi-experimental before-after study involving a non-probabilistic sample without a control group was carried out. Primary school teacher students from the University of Santiago (Spain). A total of 124 students (68.8% women and 31.2% men) aged 20-39 years (M=22.23; SD=3.79), with no previous knowledge of BLS, were studied. Three teaching programs were used: a traditional course, an audio-visual approach and feedback devices. Chest compressions as sole cardiopulmonary resuscitation skill evaluation: average compression depth, compression rate, chest recoil percentage and percentage of correct compressions. Automated external defibrillator: time needed to apply a shock before and after the course. There were significant differences in the results obtained after 2minutes of chest compressions, depending on the training program received, with feedback devices having a clear advantage referred to average compression depth (p<0.001), compression rate (p<0.001), chest recoil percentage (p<0.001) and percentage of correct compressions (p<0.001). Regarding automated external defibrillator, statistically significant differences were found in T after (p=0.025). The teaching course using feedback devices obtained the best results in terms of the quality of chest compressions, followed by the traditional course and audio-visual approach. These favorable results were present in both men and women. All 3teaching methods reached the goal of reducing defibrillation time. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
Bittencourt, Hugo Souza; Cruz, Cristiano Gonçalves; David, Bruno Costa; Rodrigues, Erenaldo; Abade, Camille Magalhães; Junior, Roque Aras; Carvalho, Vitor Oliveira; Dos Reis, Francisco Borges Faria; Gomes Neto, Mansueto
To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. A randomized, single-blind, controlled study. Cardiac rehabilitation center. A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support ( n = 23) or combined aerobic and resistance training alone ( n = 23). Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire. Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change: 4.8 vs. 1.3, p = 0.004), and quality of life (mean change: 19.3 vs. 6.8, p = 0.017 ). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 vs. 44.1, p = 0.924), but without a statistically significant difference. Non-invasive ventilatory support combined with combined aerobic and resistance training provides additional benefits for dyspnea and quality of life in moderate heart failure patients. ClinicalTrials.gov identifier: NCT02384798. Registered 03 April 2015.
Kirkwood Community Coll., Cedar Rapids, IA.
This document contains materials for an advanced college course in cardiac life support developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, six references, evaluation criteria, course objectives by units, course…
Jones, Harry W.
The design and mass cost of a starship and its life support system are investigated. The mission plan for a multi generational interstellar voyage to colonize a new planet is used to describe the starship design, including the crew habitat, accommodations, and life support. Only current technology is assumed. Highly reliable life support systems can be provided with reasonably small additional mass, suggesting that they can support long duration missions. Bioregenerative life support, growing crop plants that provide food, water, and oxygen, has been thought to need less mass than providing stored food for long duration missions. The large initial mass of hydroponics systems is paid for over time by saving the mass of stored food. However, the yearly logistics mass required to support a bioregenerative system exceeds the mass of food solids it produces, so that supplying stored dehydrated food always requires less mass than bioregenerative food production. A mixed system that grows about half the food and supplies the other half dehydrated has advantages that allow it to breakeven with stored dehydrated food in about 66 years. However, moderate increases in the hydroponics system mass to achieve high reliability, such as adding spares that double the system mass and replacing the initial system every 100 years, increase the mass cost of bioregenerative life support. In this case, the high reliability half food growing, half food supplying system does not breakeven for 389 years. An even higher reliability half and half system, with three times original system mass and replacing the system every 50 years, never breaks even. Growing food for starship life support requires more mass than providing dehydrated food, even for multigeneration voyages of hundreds of years. The benefits of growing some food may justify the added mass cost. Much more efficient recycling food production is wanted but may not be possible. A single multigenerational interstellar voyage to
Rose, Martin H; Løkkegaard, Annemette; Sonne-Holm, Stig; Jensen, Bente R
To evaluate the effect of body weight-supported progressive high-intensity locomotor training in Parkinson's disease (PD) on (1) clinical status; (2) quality of life; and (3) gait capacity. Open-label, fixed sequence crossover study. University motor control laboratory. Patients (N=13) with idiopathic PD (Hoehn and Yahr stage 2 or 3) and stable medication use. Patients completed an 8-week (3 × 1h/wk) training program on a lower-body positive-pressure treadmill. Body weight support was used to facilitate increased intensity and motor challenges during treadmill training. The training program contained combinations of (1) running and walking intervals, (2) the use of sudden changes (eg, in body weight support and speed), (3) different types of locomotion (eg, chassé, skipping, and jumps), and (4) sprints at 50 percent body weight. The Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parkinson's Disease Questionnaire-39 items (PDQ-39), and the six-minute walk test were conducted 8 weeks before and pre- and posttraining. At the end of training, statistically significant improvements were found in all outcome measures compared with the control period. Total MDS-UPDRS score changed from (mean ± 1SD) 58±18 to 47±18, MDS-UPDRS motor part score changed from 35±10 to 29±12, PDQ-39 summary index score changed from 22±13 to 13±12, and the six-minute walking distance changed from 576±93 to 637±90m. Body weight-supported progressive high-intensity locomotor training is feasible and well tolerated by patients with PD. The training improved clinical status, quality of life, and gait capacity significantly. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Poulos, Roslyn G; Harkin, Damian; Poulos, Christopher J; Cole, Andrew; MacLeod, Rod
Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs). An evaluation of the service was undertaken, focussing on the self-reported impact of the service on family carers (FCs), with triangulation of findings from community palliative care teams and CCWs. Service evaluation data were obtained through postal surveys and/or qualitative interviews with FCs, community palliative care teams and CCWs. FCs also reported the experience of their loved one based on 10 items drawn from the Quality of Death and Dying Questionnaire (QODD). Thematic analysis of surveys and interviews found that the support provided by CCWs was valued by FCs for: enabling choice (i.e. to realise end-of-life care in the home); providing practical assistance ("hands-on"); and for emotional support and reassurance. This was corroborated by community palliative care teams and CCWs. Responses by FCs on the QODD items indicated that in the last week of life, effective control of symptoms was occurring and quality of life was being maintained. This study suggests that satisfactory outcomes for patients and their families who wish to have end-of-life care in the home can be enabled with the additional support of specially trained CCWs. A notable benefit of the PCHSP model, which provided specific palliative care vocational training to an existing community care workforce, was a relatively rapid increase in the palliative care workforce across the state. © 2017 John Wiley & Sons Ltd.
Shaikh, A; Robinson, P N; Hasan, M
We performed a randomised, controlled, cross-over study of lung ventilation by Basic Life Support-trained providers using either the Tulip GT® airway or a facemask with a Guedel airway in 60 anaesthetised patients. Successful ventilation was achieved if the provider produced an end-tidal CO2 > 3.5 kPa and a tidal volume > 250 ml in two of the first three breaths, within 60 sec and within two attempts. Fifty-seven (95%) providers achieved successful ventilation using the Tulip GT compared with 35 (58%) using the facemask (p Basic Life Support-trained airway providers. © 2015 The Association of Anaesthetists of Great Britain and Ireland.
Kim, Tae Han; Lee, Yu Jin; Lee, Eui Jung; Ro, Young Sun; Lee, KyungWon; Lee, Hyeona; Jang, Dayea Beatrice; Song, Kyoung Jun; Shin, Sang Do; Myklebust, Helge; Birkenes, Tonje Søraas
For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation. Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.
Cho, Youngsuk; Je, Sangmo; Yoon, Yoo Sang; Roh, Hye Rin; Chang, Chulho; Kang, Hyunggoo; Lim, Taeho
Students are largely providing feedback to one another when instructor facilitates peer feedback rather than teaching in group training. The number of students in a group affect the learning of students in the group training. We aimed to investigate whether a larger group size increases students' test scores on a post-training test with peer feedback facilitated by instructor after video-guided basic life support (BLS) refresher training. Students' one-rescuer adult BLS skills were assessed by a 2-min checklist-based test 1 year after the initial training. A cluster randomized controlled trial was conducted to evaluate the effect of student number in a group on BLS refresher training. Participants included 115 final-year medical students undergoing their emergency medicine clerkship. The median number of students was 8 in the large groups and 4 in the standard group. The primary outcome was to examine group differences in post-training test scores after video-guided BLS training. Secondary outcomes included the feedback time, number of feedback topics, and results of end-of-training evaluation questionnaires. Scores on the post-training test increased over three consecutive tests with instructor-led peer feedback, but not differ between large and standard groups. The feedback time was longer and number of feedback topics generated by students were higher in standard groups compared to large groups on the first and second tests. The end-of-training questionnaire revealed that the students in large groups preferred the smaller group size compared to their actual group size. In this BLS refresher training, the instructor-led group feedback increased the test score after tutorial video-guided BLS learning, irrespective of the group size. A smaller group size allowed more participations in peer feedback.
Vityazev, Vsevolod; Ushakov Artem
The structure and key elements of the ROSATOM education and training system are presented. Educational and training services and technical support are provided during the NPP lifetime, including nuclear Infrastructure, nuclear power plant personnel training, equipment and post-warranty spare parts, nuclear power plant operation support, maintenance and repair, modernization and lifetime extension
Full Text Available Learning and training basic life support (BLS-especially external chest compressions (ECC within the BLS-algorithm-are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training.A study group of first-year medical students (n = 334 without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Students' BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree. The recorded points of measurement were the time to start, depth, and frequency of ECC.The study population was categorized according to learning styles: diverging (5%, n = 16, assimilating (36%, n = 121, converging (41%, n = 138, and accommodating (18%, n = 59. Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency.The findings of this work show that the four
Schröder, Hanna; Henke, Alexandra; Stieger, Lina; Beckers, Stefan; Biermann, Henning; Rossaint, Rolf; Sopka, Saša
Learning and training basic life support (BLS)-especially external chest compressions (ECC) within the BLS-algorithm-are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training. A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Students' BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. The findings of this work show that the four-step-approach for
Henke, Alexandra; Stieger, Lina; Beckers, Stefan; Biermann, Henning; Rossaint, Rolf; Sopka, Saša
Background Learning and training basic life support (BLS)—especially external chest compressions (ECC) within the BLS-algorithm—are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton’s four-step approach for BLS training. Methods A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb’s Learning Styles Inventory. Students’ BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. Results The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. Conclusions The findings
Brown, M; Tucker, P; Rapport, F; Hutchings, H; Dahlgren, A; Davies, G; Ebden, P
The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Four main themes were identified. Under "Doctors shift rotas", doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. "Education and training" focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. "Work/life balance" reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. "Social support structures" focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.
Kubota, Rhuji; Iyadomi, Motomi.
In order to train the specialist such as operator or maintenance stuff of large scale plant such as nuclear power plant or thermal power plant, a high grade teaching and training support system is required as well as in training pilot of aeroplane. The specialist in such large scale plant is also a researcher in the field of machinery, electricity and physics at first, and is grown up a expert operator or maintenance stuff through learning of CAI system or OTJ used training material for teaching tool in addition of training used operating or maintenance training device imitating actual plant after acquiring determined knowledges by receiving fundamental education on nuclear and thermal power plants. In this paper, the teaching and training support systems of the nuclear and thermal power plants for a system supporting such teaching and training, respectively, were introduced. (G.K.)
"Booster" training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.
Sutton, Robert M; Niles, Dana; Meaney, Peter A; Aplenc, Richard; French, Benjamin; Abella, Benjamin S; Lengetti, Evelyn L; Berg, Robert A; Helfaer, Mark A; Nadkarni, Vinay
To investigate the effectiveness of brief bedside "booster" cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Prospective, randomized trial. General pediatric wards at Children's Hospital of Philadelphia. Sixty-nine Basic Life Support-certified hospital-based providers. CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min(-1) and 38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p CPR compliance, 35% to 96% [p training combined with automated feedback: rate 48% to 100% [p CPR compliance, 30% to 100% [p CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests.
Gruber, Elisabeth; Oberhammer, Rosmarie; Balkenhol, Karla; Strapazzon, Giacomo; Procter, Emily; Brugger, Hermann; Falk, Markus; Paal, Peter
In some emergency situations resuscitation and ventilation may have to be performed by basic life support trained personnel, especially in rural areas where arrival of advanced life support teams can be delayed. The use of advanced airway devices such as endotracheal intubation has been deemphasized for basically-trained personnel, but it is unclear whether supraglottic airway devices are advisable over traditional mask-ventilation. In this prospective, randomized clinical single-centre trial we compared airway management and ventilation performed by nurses using facemask, laryngeal mask Supreme (LMA-S) and laryngeal tube suction-disposable (LTS-D). Basic life support trained nurses (n=20) received one-hour practical training with each device. ASA 1-2 patients scheduled for elective surgery were included (n=150). After induction of anaesthesia and neuromuscular block nurses had two 90-second attempts to manage the airway and ventilate the patient with volume-controlled ventilation. Ventilation failed in 34% of patients with facemask, 2% with LMA-S and 22% with LTS-D (P<0.001). In patients who could be ventilated successfully mean tidal volume was 240±210 ml with facemask, 470±120 ml with LMA-S and 470±140 ml with LTS-D (P<0.001). Leak pressure was lower with LMA-S (23.3±10.8 cm H2O, 95% CI 20.2-26.4) than with LTS-D (28.9±13.9 cm·H2O, 95% CI 24.4-33.4; P=0.047). After one hour of introductory training, nurses were able to use LMA-S more effectively than facemask and LTS-D. High ventilation failure rates with facemask and LTS-D may indicate that additional training is required to perform airway management adequately with these devices. High-level trials are needed to confirm these results in cardiac arrest patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
“Booster” training: Evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest
Sutton, Robert M.; Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay
Objective To investigate the effectiveness of brief bedside “booster” cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Design Prospective, randomized trial. Setting General pediatric wards at Children’s Hospital of Philadelphia. Subjects Sixty-nine Basic Life Support–certified hospital-based providers. Intervention CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Measurements and Main Results Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min−1 and 38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p CPR compliance, 35% to 96% [p training combined with automated feedback: rate 48% to 100% [p CPR compliance, 30% to 100% [p CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests. PMID:20625336
Beck, Stefanie; Ruhnke, Bjarne; Issleib, Malte; Daubmann, Anne; Harendza, Sigrid; Zöllner, Christian
Training of lay-rescuers is essential to improve survival-rates after cardiac arrest. Multiple campaigns emphasise the importance of basic life support (BLS) training for school children. Trainings require a valid assessment to give feedback to school children and to compare the outcomes of different training formats. Considering these requirements, we developed an assessment of BLS skills using MiniAnne and tested the inter-rater reliability between professionals, medical students and trained school children as assessors. Fifteen professional assessors, 10 medical students and 111-trained school children (peers) assessed 1087 school children at the end of a CPR-training event using the new assessment format. Analyses of inter-rater reliability (intraclass correlation coefficient; ICC) were performed. Overall inter-rater reliability of the summative assessment was high (ICC = 0.84, 95 %-CI: 0.84 to 0.86, n = 889). The number of comparisons between peer-peer assessors (n = 303), peer-professional assessors (n = 339), and peer-student assessors (n = 191) was adequate to demonstrate high inter-rater reliability between peer- and professional-assessors (ICC: 0.76), peer- and student-assessors (ICC: 0.88) and peer- and other peer-assessors (ICC: 0.91). Systematic variation in rating of specific items was observed for three items between professional- and peer-assessors. Using this assessment and integrating peers and medical students as assessors gives the opportunity to assess hands-on skills of school children with high reliability.
Van Raemdonck, Veerle; Monsieurs, Koenraad G; Aerenhouts, Dirk; De Martelaer, Kristine
Cardiopulmonary resuscitation (CPR) training at school is recommended. Limited school resources prevent implementation. The learning efficacy of low-cost training strategies is unknown. To evaluate the efficacy of different CPR learning strategies using low-cost didactic tools. Children (n=593, 15-16 years) were randomized to four training conditions: (1) manikin+teacher instruction (control group), (2) manikin+video instruction, (3) foam dice+plastic bag+peer training+teacher instruction, and (4) foam dice+plastic bag+peer training+video instruction. After a 50 min training, a 3 min CPR test on a manikin was performed using SkillReporting Software (Laerdal, Norway), and repeated after 6 months. The data of children without previous CPR training were analysed. Analysis of variance and the χ-test assessed differences between groups. Complete data sets were available for 165 pupils. Initially, group 3 scored lower on the mean ventilation volume (Pbasics of CPR can be taught with alternative equipment if manikins are not available.
Nefedov, Iu G; Adamovich, B A
This paper discusses various aspects of space vehicle habitability and life support systems. It describes variations in the chemical and microbial composition of an enclosed atmosphere during prolonged real and simulated flights. The paper gives a detailed description of life support systems and environmental investigations onboard the Mir station. It also outlines the development of space vehicle habitability and life support systems as related to future flights.
Goddard, Kara B; Eppert, Heather D; Underwood, Elizabeth L; McLean, Katie Maxwell; Finks, Shannon W; Rogers, Kelly C
To create a self-sufficient, innovative method for providing cardiopulmonary resuscitation (CPR) education within a college of pharmacy using a student-driven committee, and disseminating CPR education into the community through a service learning experience. A CPR committee comprised of doctor of pharmacy (PharmD) students at the University of Tennessee College of Pharmacy provided CPR certification to all pharmacy students. The committee developed a service learning project by providing CPR training courses in the community. Participants in the course were required to complete an evaluation form at the conclusion of each training course. The CPR committee successfully certified more than 1,950 PharmD students and 240 community members from 1996 to 2009. Evaluations completed by participants were favorable, with 99% of all respondents (n = 351) rating the training course as either "excellent" or "good" in each of the categories evaluated. A PharmD student-directed committee successfully provided CPR training to other students and community members as a service learning experience.
Thorne, Christopher J; Jones, Christopher M; Harvey, Philip; Hulme, Jonathan; Owen, Andrew
Existing ERC BLS/AED accreditation procedures allow BLS instructors to assess the capability of BLS/AED providers, without undergoing additional training as an assessor. The reliability of instructor-based assessment has been questioned. This study sought to determine the efficacy of a simple training programme for BLS/AED instructors aimed at standardising assessment decisions. An Assessment Training Programme (ATP) which provides additional, assessment-focused tuition for BLS instructors was introduced. Eighteen ERC accredited instructors participated in the study. Nine received standard ERC training (instructors); nine received additional training through the ATP (assessors). The assessment of 73 students' BLS/AED capabilities was carried out by an assessor, ERC instructor and ERC instructor trainer concurrently. Participants independently completed an ERC assessment form. Decisions for instructors and assessors were compared to the instructor trainers' decisions; those not agreeing were deemed to be incorrect. Instructors (49.3%) had lower raw pass rates than assessors (67.1%) and instructor trainers (64.4%). There was a significant difference in overall decisions between instructors and instructor trainers (p=0.035), and instructors and assessors (p=0.015). There was no difference between assessors and instructor trainers (p=0.824). Instructors were more prone to incorrectly failing candidates than assessors (sensitivities of 80.5% and 63.8% respectively, p=0.077). AED-capability decisions were significantly different from instructor trainers in both the instructor (p=0.007) and assessor groups (p=0.031). BLS instructors incorrectly fail candidates for reasons that should not normally constitute a true assessment failure. The ATP is an effective intervention to reduce false-failure rates and improve compliance with an experienced instructor trainer's decision. Consideration should be made to integrate such programmes into current BLS instructor accreditation
Baldwin, Lydia J L; Jones, Christopher M; Hulme, Jonathan; Owen, Andrew
Feedback is vital for the effective delivery of skills-based education. We sought to compare the sandwich technique and learning conversation structured methods of feedback delivery in competency-based basic life support (BLS) training. Open randomised crossover study undertaken between October 2014 and March 2015 at the University of Birmingham, United Kingdom. Six-hundred and forty healthcare students undertaking a European Resuscitation Council (ERC) BLS course were enrolled, each of whom was randomised to receive teaching using either the sandwich technique or the learning conversation. Fifty-eight instructors were randomised to initially teach using either the learning conversation or sandwich technique, prior to crossing-over and teaching with the alternative technique after a pre-defined time period. Outcome measures included skill acquisition as measured by an end-of-course competency assessment, instructors' perception of teaching with each feedback technique and candidates' perception of the feedback they were provided with. Scores assigned to use of the learning conversation by instructors were significantly more favourable than for the sandwich technique across all but two assessed domains relating to instructor perception of the feedback technique, including all skills-based domains. No difference was seen in either assessment pass rates (80.9% sandwich technique vs. 77.2% learning conversation; OR 1.2, 95% CI 0.85-1.84; p=0.29) or any domain relating to candidates' perception of their teaching technique. This is the first direct comparison of two feedback techniques in clinical medical education using both quantitative and qualitative methodology. The learning conversation is preferred by instructors providing competency-based life support training and is perceived to favour skills acquisition. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Müller, Michael P; Richter, Torsten; Papkalla, Norbert; Poenicke, Cynthia; Herkner, Carsten; Osmers, Anne; Brenner, Sigrid; Koch, Thea; Schwanebeck, Uta; Heller, Axel R
Many hospitals have basic life support (BLS) training programmes, but the effects on the quality of chest compressions are unclear. This study aimed to evaluate the no-flow fraction (NFF) during BLS provided by standard care nursing teams over a five-year observation period during which annual participation in the BLS training was mandatory. All healthcare professionals working at Dresden University Hospital were instructed in BLS and automated external defibrillator (AED) use according to the current European Resuscitation Council guidelines on an annual basis. After each cardiac arrest occurring on a standard care ward, AED data were analyzed. The time without chest compressions during the period without spontaneous circulation (i.e., the no-flow fraction) was calculated using thoracic impedance data. For each year of the study period (2008-2012), a total of 1454, 1466, 1487, 1432, and 1388 health care professionals, respectively, participated in the training. The median no-flow fraction decreased significantly from 0.55 [0.42; 0.57] (median [25‰; 75‰]) in 2008 to 0.3 [0.28; 0.35] in 2012. Following revision of the BLS curriculum after publication of the 2010 guidelines, cardiac arrest was associated with a higher proportion of patients achieving ROSC (72% vs. 48%, P=0.025) but not a higher survival rate to hospital discharge (35% vs. 19%, P=0.073). The NFF during in-hospital cardiac resuscitation decreased after establishment of a mandatory annual BLS training for healthcare professionals. Following publication of the 2010 guidelines, more patients achieved ROSC after in-hospital cardiac arrest. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Castillo, Jordi; Gallart, Aberto; Rodríguez, Encarnación; Castillo, Jorge; Gomar, Carmen
The objective of this study was to compare the immediate and 6-month efficacy of basic life support (BLS) and automatic external defibrillation (AED) training using standard or blended methods. First-year students of medicine and nursing (n = 129) were randomly assigned to a control group (face-to-face training based on the European Resuscitation Council [ERC] Guidelines) or to an experimental group that trained with a self-training video, a new website, a Moodle platform, an intelligent manikin, and 45 min of instructor presence. Both groups were homogeneous and were evaluated identically. Theoretical knowledge was evaluated using a multi-choice questionnaire (MCQ). Skill performance was evaluated by the instructor's rubric and on a high-fidelity Resusci Anne QCPR manikin. Immediately after the course, there were no statistically significant differences in knowledge between the two groups. The median score of practical evaluation assessed by the instructor was significantly better in the experimental group (8.15, SD 0.93 vs 7.7, SD 1.18; P = 0.02). No differences between groups were found when using a high-fidelity manikin to evaluate chest compressions and lung inflations. At six months, the scores in knowledge and skill performance were significantly lower compared to the evaluations at the end of the instruction, but they remained still higher compared to baseline. The experimental group had higher scores in practical skills evaluated by the instructor than the control group (7.44, SD 1.85 vs 6.10, SD 2.6; P = 0.01). The blended method provides the same or even higher levels of knowledge and skills than standard instruction both immediately after the course and six months later. Copyright © 2018 Elsevier Ltd. All rights reserved.
Marton, József; Pandúr, Attila; Pék, Emese; Deutsch, Krisztina; Bánfai, Bálint; Radnai, Balázs; Betlehem, József
Better knowledge and skills of basic life support can save millions of lives each year in Europe. The aim of this study was to measure the knowledge about basic life support in European students. From 13 European countries 1527 volunteer participated in the survey. The questionnaire consisted of socio-demographic questions and knowledge regarding basic life support. The maximum possible score was 18. Those participants who had basic life support training earned 11.91 points, while those who had not participated in lifesaving education had 9.6 points (pbasic life support between students from different European countries. Western European youth, and those who were trained had better performance.
Calvo Macías, A; Manrique Martínez, I; Rodríguez Núñez, A; López-Herce Cid, J
Basic life support (BLS) is the combination of maneuvers that identifies the child in cardiopulmonary arrest and initiates the substitution of respiratory and circulatory function, without the use of technical adjuncts, until the child can receive more advanced treatment. BLS includes a sequence of steps or maneuvers that should be performed sequentially: ensuring the safety of rescuer and child, assessing unconsciousness, calling for help, positioning the victim, opening the airway, assessing breathing, ventilating, assessing signs of circulation and/or central arterial pulse, performing chest compressions, activating the emergency medical service system, and checking the results of resuscitation. The most important changes in the new guidelines are the compression: ventilation ratio and the algorithm for relieving foreign body airway obstruction. A compression/ ventilation ratio of 30:2 will be recommended for lay rescuers of infants, children and adults. Health professionals will use a compression: ventilation ratio of 15:2 for infants and children. If the health professional is alone, he/she may also use a ratio of 30:2 to avoid fatigue. In the algorithm for relieving foreign body airway obstruction, when the child becomes unconscious, the maneuvers will be similar to the BLS sequence with chest compressions (functioning as a deobstruction procedure) and ventilation, with reassessment of the mouth every 2 min to check for a foreign body, and evaluation of breathing and the presence of vital signs. BLS maneuvers are easy to learn and can be performed by anyone with adequate training. Therefore, BLS should be taught to all citizens.
Mitchell, C. A.
Long-duration future habitation of space involving great distances from Earth and/or large crew sizes (eg, lunar outpost, Mars base) will require a controlled ecological life-support system (CELSS) to simultaneously revitalize atmosphere (liberate oxygen and fix carbon dioxide), purify water (via transpiration), and generate human food (for a vegetarian diet). Photosynthetic higher plants and algae will provide the essential functions of biomass productivity in a CELSS, and a combination of physicochemical and bioregenerative processes will be used to regenerate renewable resources from waste materials. Crop selection criteria for a CELSS include nutritional use characteristics as well as horticultural characteristics. Cereals, legumes, and oilseed crops are used to provide the major macronutrients for the CELSS diet. A National Aeronautics and Space Administration (NASA) Specialized Center of Research and Training (NSCORT) was established at Purdue University to establish proof of the concept of the sustainability of a CELSS. The Biosphere 2 project in Arizona is providing a model for predicted and unpredicted situations that arise as a result of closure in a complex natural ecosystem.
National Aeronautics and Space Administration — The Advanced Exploration Systems (AES) Life Support Systems project Environmental Monitoring (EM) systems task objectives are to develop and demonstrate onboard...
This course provides an introduction to the design and development of life support systems to sustain humankind in the harsh environment of space. The life support technologies necessary to provide a respirable atmosphere and clean drinking water are emphasized in the course. A historical perspective, beginning with open loop systems employed aboard the earliest crewed spacecraft through the state-of-the-art life support technology utilized aboard the International Space Station today, will provide a framework for students to consider applications to possible future exploration missions and destinations which may vary greatly in duration and scope. Development of future technologies as well as guiding requirements for designing life support systems for crewed exploration missions beyond low-Earth orbit are also considered in the course.
Harvey, P R; Higenbottam, C V; Owen, A; Hulme, J; Bion, J F
In 1995, the University of Birmingham, UK, School of Medicine and Dentistry replaced lecture-based basic life support (BLS) teaching with a peer-led, practical programme. We present our 15-yr experience of peer-led healthcare undergraduate training and examination with a literature review. A literature review of healthcare undergraduate peer-led practical skills teaching was performed though Pubmed. The development of the Birmingham course is described, from its inception in 1995-2011. Training methods include peer-led training and assessment by senior students who complete an European Resuscitation Council-endorsed instructor course. Student assessors additionally undergo training in assessment and communication skills. The course has been developed by parallel research evaluation and peer-reviewed publication. Course administration is by an experienced student committee with senior clinician support. Anonymous feedback from the most recent courses and the current annual pass rates are reported. The literature review identified 369 publications of which 28 met our criteria for inclusion. Largely descriptive, these are highly positive about peer involvement in practical skills teaching using similar, albeit smaller, courses to that described below. Currently approximately 600 first year healthcare undergraduates complete the Birmingham course; participant numbers increase annually. Successful completion is mandatory for students to proceed to the second year of studies. First attempt pass rate is 86%, and close to 100% (565/566 students, 99.8%) following re-assessment the same day. 97% of participants enjoyed the course, 99% preferred peer-tutors to clinicians, 99% perceived teaching quality as "good" or "excellent", and felt they had sufficient practice. Course organisation was rated "good" or "excellent" by 91%. Each year 3-4 student projects have been published or presented internationally. The annual cost of providing the course is currently £15,594.70 (Eur 18
Seong, Baek Seok; Lee, J. S.; Sim, C. M. [KAERI, Daejeon (Korea, Republic of)
The purpose of this project is to support external users to promote shared-use of HANARO effectively. To this end, external manpower was recruited and trained. Also, in order to broaden HANARO user-base, practice-oriented training was given. The total number of projects selected as a part of this program was 20 this year. These composed of four broad fields: neutron beam utilization, materials and nuclear fuel irradiation test, neutron activation analysis and radioisotope production. In each field, the number of projects was 11, 1, 3 and 2 respectively. In addition, considering the time spent on support, total supporting ratio has reached to an average of 14% over three fields. It was 23% for neutron beam utilization, 11% for materials/nuclear materials irradiation test, and 8% for neutron activation analysis. In order to broaden HANARO's potential user-base and increase the utilization of the HANARO experimental facility, practice-oriented HANARO user training was given. All participants from industry, academia, and national labs trained on working instruments of various fields such as neutron beam applications, materials and nuclear fuel irradiation test, and neutron activation analysis. 'HANARO (utilization and research) information management system' has been developed in an effort to create a single database. By having it available on the net, it will serve as HANARO's important 'Information Platform' along with HANARO web site
Seong, Baek Seok; Lee, J. S.; Sim, C. M. [KAERI, Daejeon (Korea, Republic of)
The purpose of this project is to support external users to promote shared-use of HANARO effectively. To this end, external manpower was recruited and trained. Also, in order to broaden HANARO user-base, practice-oriented training was given. The total number of projects selected as a part of this program was 36 this year. These composed of four broad fields: neutron beam utilization, materials and nuclear fuel irradiation test, neutron activation analysis and radioisotope production. In each field, the number of projects was 22, 4, 6 and 4 respectively. The HANARO user supports used for these projects were carried out 40 events with 355 samples for neutron beam utilization, 16 events with 1,404 hr for materials and nuclear fuel irradiation test, 8 events with 369 samples and 4 events for radioisotope production. In order to broaden HANARO's potential user-base and increase the utilization of the HANARO experimental facility, practice-oriented HANARO user training was given. All participants from industry, academia, and national labs trained on working instruments of various fields such as neutron beam applications, materials and nuclear fuel irradiation test, and neutron activation analysis. 'HANARO (utilization and research) information management system' has been developed in an effort to create a single database. By having it available on the net, it will serve as HANARO's important 'Information Platform' along with HANARO web site
Life support systems are an enabling technology and have become integral to the success of living and working in space. As NASA embarks on human exploration and development of space to open the space frontier by exploring, using and enabling the development of space and to expand the human experience into the far reaches of space, it becomes imperative, for considerations of safety, cost, and crew health, to minimize consumables and increase the autonomy of the life support system. Utilizing advanced life support technologies increases this autonomy by reducing mass, power, and volume necessary for human support, thus permitting larger payload allocations for science and exploration. Two basic classes of life support systems must be developed, those directed toward applications on transportation/habitation vehicles (e.g., Space Shuttle, International Space Station (ISS), next generation launch vehicles, crew-tended stations/observatories, planetary transit spacecraft, etc.) and those directed toward applications on the planetary surfaces (e.g., lunar or Martian landing spacecraft, planetary habitats and facilities, etc.). In general, it can be viewed as those systems compatible with microgravity and those compatible with hypogravity environments. Part B of the Appendix defines the technology development 'Roadmap' to be followed in providing the necessary systems for these missions. The purpose of this Project Plan is to define the Project objectives, Project-level requirements, the management organizations responsible for the Project throughout its life cycle, and Project-level resources, schedules and controls.
Nambiar, Madavan; Nedungalaparambil, Nisanth Menon; Aslesh, Ottapura Prabhakaran
Healthcare professionals are expected to have knowledge of current basic and advanced cardiac life support (BLS/ACLS) guidelines to revive unresponsive patients. A cross-sectional study was conducted to evaluate the current practices and knowledge of BLS/ACLS principles among healthcare professionals of North-Kerala using pretested self-administered structured questionnaire. Answers were validated in accordance with American Heart Association's BLS/ACLS teaching manual and the results were analysed. Among 461 healthcare professionals, 141 (30.6%) were practicing physicians, 268 (58.1%) were nurses and 52 (11.3%) supporting staff. The maximum achievable score was 20 (BLS 15/ACLS 5). The mean score amongst all healthcare professionals was 8.9±4.7. The mean score among physicians, nurses and support staff were 8.6±3.4, 9±3.6 and 9±3.3 respectively. The majority of healthcare professionals scored ≤50% (237, 51.4%); 204 (44.3%) scored 51%-80% and 20 (4.34%) scored >80%. Mean scores decreased with age, male sex and across occupation. Nurses who underwent BLS/ACLS training previously had significantly higher mean scores (10.2±3.4) than untrained (8.2±3.6, P =0.001). Physicians with <5 years experience ( P =0.002) and nurses in the private sector ( P =0.003) had significantly higher scores. One hundred and sixty three (35.3%) healthcare professionals knew the correct airway opening manoeuvres like head tilt, chin lift and jaw thrust. Only 54 (11.7%) respondents were aware that atropine is not used in ACLS for cardiac arrest resuscitation and 79 (17.1%) correctly opted ventricular fibrillation and pulseless ventricular tachycardia as shockable rhythms. The majority of healthcare professionals (356, 77.2%) suggested that BLS/ACLS be included in academic curriculum. Inadequate knowledge of BLS/ACLS principles amongst healthcare professionals, especially physicians, illuminate lacunae in existing training systems and merit urgent redressal.
Kim, Shin Ae; Kim, K. Y.; Kim, B. K. (and others)
This project is aimed to support external users for the effective use of HANARO. The total number of projects selected as the beneficiary of the supporting program by MEST was 21 including this project in this year. We supported 2,339 hr measurements for the 31 requests of the 14 projects selected on the field of neutron beam utilization. In the field of materials and nuclear fuel irradiation test the 3 projects were selected and supported for 80 samples. In the fields of neutron activation analysis and radioisotope production the number of selected and supported projects were 1 and 2 respectively. In order to broaden potential user base, maximize instrument utilization, and enhance cooperation with industries, universities and institutes, practice-oriented HANARO user training courses were held for neutron beam utilization and materials and nuclear fuel irradiation fields. In the fields of neutron activation analysis 3 times training courses were held for the university students. The online neutron beam time allocation system was developed and applied successfully for the HRPD in this year. We are planing to apply this system to other neutron beam instruments in the near future. This project is a kind of the user-based supporting program for the maximize of HANARO utilization. The development products and the ideas and suggestions of users obtained through this projects will be collected and applied to the development of next new facilities. Also, by using the 'HANARO utilization and research information management system(HANARO4U)' we construct the research network among users at industries, universities and institutes. This network is expected to increase HANARO utilization and enhance productivity of the facilities.
Nogami, Kentaro; Taniguchi, Shogo; Ichiyama, Tomoko
The aim of this study was to investigate the correlation between basic life support skills in dentists who had completed the American Heart Association's Basic Life Support (BLS) Healthcare Provider qualification and time since course completion. Thirty-six dentists who had completed the 2005 BLS Healthcare Provider course participated in the study. We asked participants to perform 2 cycles of cardiopulmonary resuscitation on a mannequin and evaluated basic life support skills. Dentists who had previously completed the BLS Healthcare Provider course displayed both prolonged reaction times, and the quality of their basic life support skills deteriorated rapidly. There were no correlations between basic life support skills and time since course completion. Our results suggest that basic life support skills deteriorate rapidly for dentists who have completed the BLS Healthcare Provider. Newer guidelines stressing chest compressions over ventilation may help improve performance over time, allowing better cardiopulmonary resuscitation in dental office emergencies. Moreover, it may be effective to provide a more specialized version of the life support course to train the dentists, stressing issues that may be more likely to occur in the dental office.
Shin, Eun Joo; Kim, K. Y.; Kim, B. K.
This project is aimed to support external users for the effective use of HANARO. The total number of projects selected as the beneficiary of the supporting program by MEST was 21 including this project in this year. We supported 1,850 hr measurements for the 24 requests of the 16 projects selected on the field of neutron beam utilization. In the field of materials and nuclear fuel irradiation test the 2 projects were selected and supported for 108 samples. In the fields of neutron activation analysis and radioisotope production the number of selected and supported projects was 1 respectively. In order to broaden potential user base, maximize instrument utilization, and enhance cooperation with industries, universities and institutes, practice-oriented HANARO user training courses were held for neutron beam utilization and materials and nuclear fuel irradiation fields. The online neutron beam time allocation system was developed and applied successfully for the HRPD in this year. We are planing to apply this system to other neutron beam instruments in the near future. This project is a kind of the user-based supporting program for the maximize of HANARO utilization. The development products and the ideas and suggestions of users obtained through this projects will be collected and applied to the development of next new facilities. Also, by using the 'HANARO utilization and research information management system(HANARO4U)' we construct the research network among users at industries, universities and institutes. This network is expected to increase HANARO utilization and enhance productivity of the facilities
Aaberg, Anne Marie Roust; Larsen, Caroline Emilie Brenner; Rasmussen, Bodil Steen
BACKGROUND: Early recognition and immediate bystander cardiopulmonary resuscitation are critical determinants of survival after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate current knowledge on basic life support (BLS) in Danish high school students and benefits of a single...... training session run by junior doctors. METHODS: Six-hundred-fifty-one students were included. They underwent one 45-minute BLS training session including theoretical aspects and hands-on training with mannequins. The students completed a baseline questionnaire before the training session and a follow...... areas of BLS is poor among high school students. One hands-on training session run by junior doctors seems to be efficient to empower the students to be first responders to OHCA....
DiGiovanni, Lisa Marie
The American Heart Association's HeartCode[TM] Healthcare Provider (HCP) Basic Life Support (BLS) e-learning program with voice-advisory manikins was implemented in an acute care hospital as the only teaching method offered for BLS certification. On course evaluations, healthcare provider staff commented that the VAM technology for skills practice…
Yamnill, Siriporn; McLean, Gary N.
Reviews theories about factors affecting the transfer of training, including theories on motivation (expectancy, equity, goal setting), training transfer design (identical elements, principle, near and far), and transfer climate (organizational). (Contains 36 references.) (SK)
Perez-Schindler, Joaquin; Hamilton, D Lee; Moore, Daniel R; Baar, Keith; Philp, Andrew
Concurrent training (the combination of endurance exercise to resistance training) is a common practice for athletes looking to maximise strength and endurance. Over 20 years ago, it was first observed that performing endurance exercise after resistance exercise could have detrimental effects on strength gains. At the cellular level, specific protein candidates have been suggested to mediate this training interference; however, at present, the physiological reason(s) behind the concurrent training effect remain largely unknown. Even less is known regarding the optimal nutritional strategies to support concurrent training and whether unique nutritional approaches are needed to support endurance and resistance exercise during concurrent training approaches. In this review, we will discuss the importance of protein supplementation for both endurance and resistance training adaptation and highlight additional nutritional strategies that may support concurrent training. Finally, we will attempt to synergise current understanding of the interaction between physiological responses and nutritional approaches into practical recommendations for concurrent training.
Stewart, Warren; Lovely, Rachel
To undertake a service evaluation to assess the effect of peer social support training using two separate learning programmes, which were designed to assist prisoners to support older prisoners and prisoners with disabilities. The service evaluation used an action research approach to support planning, delivery and data collection. Eleven interviews with nine prisoners who had undertaken the peer social support training programmes and two members of prison staff (one nurse manager and one prison officer) were recorded and transcribed by the researchers. This data was coded and thematically analysed to evaluate the findings. Recommendations were made regarding the format and content of the training. The training was well received by the peer social support worker trainees and had several positive outcomes, including increased peer social support, improved relationships between peer social support workers and older prisoners and prisoners with disabilities, increased self-esteem, measured as 'social capital', among peer social support workers, and effective teamworking. The peer social support training programmes were considered to be a positive intervention and were effective in supporting peer social support roles. Recommendations for future training of prisoner peer support workers include involving existing peer social support workers in training and recruitment, and enhancing the role of peer social support workers in prisons by providing them with job descriptions. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
Sasaki, Makoto; Onishi, Kohei; Nakayama, Atsushi; Kamata, Katsuhiro; Stefanov, Dimitar; Yamaguchi, Masaki
In this paper, we introduce a new tongue-training system that can be used for improvement of the tongue's range of motion and muscle strength after dysphagia. The training process is organized in game-like manner. Initially, we analyzed surface electromyography (EMG) signals of the suprahyoid muscles of five subjects during tongue-training motions. This test revealed that four types tongue training motions and a swallowing motion could be classified with 93.5% accuracy. Recognized EMG signals during tongue motions were designed to allow control of a mouse cursor via intentional tongue motions. Results demonstrated that simple PC games could be played by tongue motions, achieving in this way efficient, enjoyable and pleasant tongue training. Using the proposed method, dysphagia patients can choose games that suit their preferences and/or state of mind. It is expected that the proposed system will be an efficient tool for long-term tongue motor training and maintaining patients' motivation.
Екатерина Александровна Лежнева
Full Text Available The article explains the importance of the development of motive to succeed in adolescence. It is determined the value of the motive to achieve success in the further development of the teenager: a motive to achieve effective internal forces mobilized for the implementation of successful operation ensures the active involvement of teenagers in social and interpersonal relationships. As the primary means of motive development success is considered training. The author provides a definition of "training for success in life," creates a model of training for success in life, and describes its units (targeted, informative, technological, productive, reveals the successful development of the technology life strategy used during the training (self-presentation, targets, incentives, subject-orientation. The author pays attention to the need for a future psychologist to develop teenagers’ motive to achieve success through the mastery of competence in constructing a model of training for success in life, and its implementation in the course of professional activities. The main means of training students of psychology to the use of training success in life identified the additional educational programs and psychological section.DOI: http://dx.doi.org/10.12731/2218-7405-2013-9-77
Coren, Esther; Hutchfield, Jemeela; Thomae, Manuela; Gustafsson, Carina
Intellectual disability may impact on an individual's capacity to parent a child effectively. Research suggests that the number of intellectually disabled people with children is increasing. Children of parents with intellectual disabilities may be at increased risk of neglectful care which could lead to health, developmental and behavioural problems, or increased risk of intellectual disability.However, there is some indication that some parents with intellectual disabilities are able to provide adequate child care if they are given appropriate training and support to do so. To assess the effectiveness of parent training interventions to support the parenting of parents with intellectual disabilities We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, Sociological Abstracts, Dissertation Abstracts International, MetaRegister of Controlled Trials, and ZETOC. Randomised controlled trials comparing parent training interventions for parents with intellectual disabilities with usual care or with a control group. Outcomes of interest were: the attainment of parenting skills specific to the intervention, safe home practices and the understanding of child health. Two review authors independently assessed risk of bias and undertook data extraction. Three trials met the inclusion criteria for this review but no meta-analysis was possible. One study reported improved maternal-child interaction following group parent training compared with the control group. The second study reported some improvements in parents knowledge of life threatening emergencies, ability to recognise dangers and identify precautions and smaller improvements in their ability to implement precautions, use medicines safely and recognise child illness and symptoms. The third study reported improvement in child care and safety skills following the intervention. There is some risk of bias in the
Sakaguchi, Junichi; Komatsu, Yasuki
The importance of operator training using operator training simulator has been recognized intensively. Since 1986, we have been developing and providing many PWR simulators in Japan. We also have developed some training support systems connected with the simulator and the integrated training support system to improve training effect and to reduce instructor's workload. This paper describes the concept and the effect of the integrated training support system and of the following sub-systems. We have PES (Performance Enhancement System) that evaluates training performance automatically by analyzing many plant parameters and operation data. It can reduce the deviation of training performance evaluation between instructors. PEL (Parameter and Event data Logging system), that is the subset of PES, has some data-logging functions. And we also have TPES (Team Performance Enhancement System) that is used aiming to improve trainees' ability for communication between operators. Trainee can have conversation with virtual trainees that TPES plays automatically. After that, TPES automatically display some advice to be improved. RVD (Reactor coolant system Visual Display) displays the distributed hydraulic-thermal condition of the reactor coolant system in real-time graphically. It can make trainees understand the inside plant condition in more detail. These sub-systems have been used in a training center and have contributed the improvement of operator training and have gained in popularity. (author)
Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.
Saskatchewan NewStart, Inc., Prince Albert.
Ways of helping coaches to counsel unemployed adults in the solving of their personal problems are explored in this manual. Originally printed as two separate volumes, this reprinting of the study has bound the two together. Volume I involves a general discussion of life's problems and of the need to solve them. This volume contains four parts.…
Thomas, Evan A.
Sustainable spacecraft life support concepts may allow the development of more reliable technologies for long duration space missions. Currently, life support technologies at different levels of development are not well evaluated against each other, and evaluation methods do not account for long term reliability and sustainability of the hardware. This paper presents point-of-departure sustainability evaluation criteria for life support systems, that may allow more robust technology development, testing and comparison. An example sustainable water recovery system concept is presented.
Training programs at DOE facilities should provide well-trained, qualified personnel to safely and efficiently operate the facilities in accordance with DOE requirements. A need has been identified for guidance regarding analysis, design, development, implementation, and evaluation of consistent and reliable performance-based training programs. Accreditation of training programs at Category A reactors and high-hazard and selected moderate-hazard nonreactor nuclear facilities will assure consistent, appropriate, and cost-effective training of personnel responsible for the operation, maintenance, and technical support of these facilities. Training programs that are designed and based on systematically determined job requirements, instead of subjective estimation of trainee needs, yield training activities that are consistent and develop or improve knowledge, skills, and abilities that can be directly related to the work setting. Because the training is job-related, the content of these programs more efficiently and effectively meets the needs of the employee. Besides a better trained work force, a greater level of operational reactor safety can be realized. This manual is intended to provide an overview of the accreditation process and a brief description of the elements necessary to construct and maintain training programs that are based on the requirements of the job. Two companion manuals provide additional information to assist contractors in their efforts to accredit training programs
Oude Lansink-Hartgring, Annemieke; van den Hengel, Berber; van der Bij, Wim; Erasmus, Michiel E.; Mariani, Massimo A.; Rienstra, Michiel; Cernak, Vladimir; Vermeulen, Karin M.; van den Bergh, Walter M.
Objectives: To conduct an exploration of the hospital costs of extracorporeal life support therapy. Extracorporeal life support seems an efficient therapy for acute, potentially reversible cardiac or respiratory failure, when conventional therapy has been inadequate, or as bridge to transplant, but
Full Text Available OBJECTIVES: To examine the association of life events and social support in the broadly defined category of depression in late life. INTRODUCTION: Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil. METHODS: We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. ''Old age symptomatic depression'' was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed ''late subthreshold depression''. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE inventory. RESULTS: ''Old age symptomatic depression'' occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, ''old age symptomatic depression'' was associated with a perceived lack of social support in men and life events in women. DISCUSSION: Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance. CONCLUSIONS: We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.
Anderson, Molly S.; Ewert, Michael K.; Keener, John F.
The Baseline Values and Assumptions Document (BVAD) provides analysts, modelers, and other life support researchers with a common set of values and assumptions which can be used as a baseline in their studies. This baseline, in turn, provides a common point of origin from which many studies in the community may depart, making research results easier to compare and providing researchers with reasonable values to assume for areas outside their experience. This document identifies many specific physical quantities that define life support systems, serving as a general reference for spacecraft life support system technology developers.
Flynn, Eleanor; Woodward-Kron, Robyn; Hu, Wendy
Front-line administrative, academic and clinical teaching staff often find themselves providing pastoral and learning support to students, but they are often not trained for this role, and this aspect of their work is under-acknowledged. Staff participating in an action research study at two medical schools identified common concerns about the personal impact of providing student support, and of the need for professional development to carry out this responsibility. This need is magnified in clinical placement settings that are remote from on-campus services. Informed by participatory action research, brief interactive workshops with multimedia training resources were developed, conducted and evaluated at eight health professional student training sites. These workshops were designed to: (1) be delivered in busy clinical placement and university settings; (2) provide a safe and inclusive environment for administrative, academic and clinical teaching staff to share experiences and learn from each other; (3) be publicly accessible; and (4) promote continued development and roll-out of staff training, adapted to each workplace (see http://www.uws.edu.au/meusupport). The workshops were positively evaluated by 97 participants, with both teaching and administrative staff welcoming the opportunity to discuss and share experiences. Staff supporting health professional students have shared, often unmet, needs for support themselves Staff supporting health professional students have shared, often unmet, needs for support themselves. Participatory action research can be a means for producing and maintaining effective training resources as well as the conditions for change in practice. In our workshops, staff particularly valued opportunities for guided discussion using videos of authentic cases to trigger reflection, and to collaboratively formulate student support guidelines, customised to each site. © 2015 John Wiley & Sons Ltd.
This paper considers some of the common assumptions and engineering rules of thumb used in life support system design. One general design rule is that the longer the mission, the more the life support system should use recycling and regenerable technologies. A more specific rule is that, if the system grows more than half the food, the food plants will supply all the oxygen needed for the crew life support. There are many such design rules that help in planning the analysis of life support systems and in checking results. These rules are typically if-then statements describing the results of steady-state, "back of the envelope," mass flow calculations. They are useful in identifying plausible candidate life support system designs and in rough allocations between resupply and resource recovery. Life support system designers should always review the design rules and make quick steady state calculations before doing detailed design and dynamic simulation. This paper develops the basis for the different assumptions and design rules and discusses how they should be used. We start top-down, with the highest level requirement to sustain human beings in a closed environment off Earth. We consider the crew needs for air, water, and food. We then discuss atmosphere leakage and recycling losses. The needs to support the crew and to make up losses define the fundamental life support system requirements. We consider the trade-offs between resupplying and recycling oxygen, water, and food. The specific choices between resupply and recycling are determined by mission duration, presence of in-situ resources, etc., and are defining parameters of life support system design.
National Aeronautics and Space Administration — The Advanced Exploration Systems (AES) Life Support Systems project Oxygen Generation and Recovery technology development area encompasses several sub-tasks in an...
National Aeronautics and Space Administration — NextSTEP Phase I Hybrid Life Support Systems (HLSS) effort assessed options, performance, and reliability for various mission scenarios using contractor-developed...
Morrow, R. C.; Wetzel, J. P.; Richter, R. C.
Demonstration of plant-based hybrid life support technologies in deep space will validate the function of these technologies for long duration missions, such as Mars transit, while providing dietary variety to improve habitability.
Jones, Harry W.; Hodgson, Edward W.; Kliss, Mark H.
How should life support for deep space be developed? The International Space Station (ISS) life support system is the operational result of many decades of research and development. Long duration deep space missions such as Mars have been expected to use matured and upgraded versions of ISS life support. Deep space life support must use the knowledge base incorporated in ISS but it must also meet much more difficult requirements. The primary new requirement is that life support in deep space must be considerably more reliable than on ISS or anywhere in the Earth-Moon system, where emergency resupply and a quick return are possible. Due to the great distance from Earth and the long duration of deep space missions, if life support systems fail, the traditional approaches for emergency supply of oxygen and water, emergency supply of parts, and crew return to Earth or escape to a safe haven are likely infeasible. The Orbital Replacement Unit (ORU) maintenance approach used by ISS is unsuitable for deep space with ORU's as large and complex as those originally provided in ISS designs because it minimizes opportunities for commonality of spares, requires replacement of many functional parts with each failure, and results in substantial launch mass and volume penalties. It has become impractical even for ISS after the shuttle era, resulting in the need for ad hoc repair activity at lower assembly levels with consequent crew time penalties and extended repair timelines. Less complex, more robust technical approaches may be needed to meet the difficult deep space requirements for reliability, maintainability, and reparability. Developing an entirely new life support system would neglect what has been achieved. The suggested approach is use the ISS life support technologies as a platform to build on and to continue to improve ISS subsystems while also developing new subsystems where needed to meet deep space requirements.
Smith, Marianne; Stolder, Mary Ellen; Liu, Megan Fang
This paper describes evaluation findings associated with an innovative, CD-based, self-directed training program that was designed to improve general practice nurses' abilities to identify and care for older adults with depression. A voluntary sample of nurses completed an evaluation that focused on participants' perceptions of changes in their knowledge and skills and usefulness of the program. Quantitative items received high ratings, and narrative responses to open-ended questions were largely positive. Many opportunities exist for psychiatric nurses to facilitate, support, and extend training principles to promote late-life depression recognition and treatment. © 2013 Wiley Periodicals, Inc.
Seshan, Panchalam K.; Ganapathi, Balasubramanian; Jan, Darrell L.; Ferrall, Joseph F.; Rohatgi, Naresh K.
Generic hierarchical model of life-support system developed to facilitate comparisons of options in design of system. Model represents combinations of interdependent subsystems supporting microbes, plants, fish, and land animals (including humans). Generic model enables rapid configuration of variety of specific life support component models for tradeoff studies culminating in single system design. Enables rapid evaluation of effects of substituting alternate technologies and even entire groups of technologies and subsystems. Used to synthesize and analyze life-support systems ranging from relatively simple, nonregenerative units like aquariums to complex closed-loop systems aboard submarines or spacecraft. Model, called Generic Modular Flow Schematic (GMFS), coded in such chemical-process-simulation languages as Aspen Plus and expressed as three-dimensional spreadsheet.
Sejerø Pedersen, Birgitte; Jeberg, Kirsten Ann; Koerner, Christian
In this study we analyzed how IT support can be established for the treatment and documentation of advanced life support (ALS) in a hospital. In close collaboration with clinical researchers, a running prototype of an IT solution to support the clinical decisions in ALS was developed and tried out...... in a full scale simulation environment. We have named this IT solution the CardioData Prototype....
Cheng, Adam; Rodgers, David L; van der Jagt, Élise; Eppich, Walter; O'Donnell, John
To describe the history of the Pediatric Advanced Life Support course and outline the new developments in instructor training that will impact the way debriefing is conducted during Pediatric Advanced Life Support courses. The Pediatric Advanced Life Support course, first released by the American Heart Association in 1988, has seen substantial growth and change over the past few decades. Over that time, Pediatric Advanced Life Support has become the standard for resuscitation training for pediatric healthcare providers in North America. The incorporation of high-fidelity simulation-based learning into the most recent version of Pediatric Advanced Life Support has helped to enhance the realism of scenarios and cases, but has also placed more emphasis on the importance of post scenario debriefing. We developed two new resources: an online debriefing module designed to introduce a new model of debriefing and a debriefing tool for real-time use during Pediatric Advanced Life Support courses, to enhance and standardize the quality of debriefing by Pediatric Advanced Life Support instructors. In this article, we review the history of Pediatric Advanced Life Support and Pediatric Advanced Life Support instructor training and discuss the development and implementation of the new debriefing module and debriefing tool for Pediatric Advanced Life Support instructors. The incorporation of the debriefing module and debriefing tool into the 2011 Pediatric Advanced Life Support instructor materials will help both new and existing Pediatric Advanced Life Support instructors develop and enhance their debriefing skills with the intention of improving the acquisition of knowledge and skills for Pediatric Advanced Life Support students.
Anguita, Davide; Ridella, Sandro; Rivieccio, Fabio; Zunino, Rodolfo
Refined concepts, such as Rademacher estimates of model complexity and nonlinear criteria for weighting empirical classification errors, represent recent and promising approaches to characterize the generalization ability of Support Vector Machines (SVMs). The advantages of those techniques lie in both improving the SVM representation ability and yielding tighter generalization bounds. On the other hand, they often make Quadratic-Programming algorithms no longer applicable, and SVM training cannot benefit from efficient, specialized optimization techniques. The paper considers the application of Quantum Computing to solve the problem of effective SVM training, especially in the case of digital implementations. The presented research compares the behavioral aspects of conventional and enhanced SVMs; experiments in both a synthetic and real-world problems support the theoretical analysis. At the same time, the related differences between Quadratic-Programming and Quantum-based optimization techniques are considered.
Bazanova, O M; Kholodina, N V; Nikolenko, E D; Payet, J
We have recently shown a diminishing of the Menopause Index in old-aged women who underwent special training directed at the enhancement of support afferentation by increasing the plantar forefoot sensitivity (Bazanova et al., 2015). Based on these results we hypothesized, that purposeful training of support afferentation through stimulation of plantar graviceptors by Aikido practice will decrease excessive postural and psychoemotional tension not only in rest condition, but during cognitive and manual task performance too. Fluency of cognitive and motor task performance, EEG alpha power as an index of neuronal efficiency of cognitive control, amount of alpha power suppression as a visual activation measure and EMG power of forehead muscles as a sign of psychoemotional tension were compared in three groups of post-menopausal women: i) 8years training with forefeet support afferentation with Aikido practice (A), ii) 8years fitness training (F) and iii) no dedicated fitness training for past 8years (N). Simultaneous stabilometry, EEG, and frontal EMG recording were performed in sitting and standing up position in eyes closed and eyes open condition. Recording done at rest and while performing cognitive and finger motor tasks. We compared studied parameters between groups with one- and two-way analyses of variance (ANOVAs) with Bonferroni correction for multiple comparisons, followed by post hoc two-tailed unpaired t-tests. The fluency of tasks performance, EMG and alpha-EEG-activity displayed similar values in all groups in a sitting position. Center of pressure (CoP) sway length, velocity and energy demands for saving balance increased when standing up, more in group N than in groups F and A (all contrasts p values0.89). Post hoc t-tests showed increased fluency in standing in both Aikido (p0.77). Fluency in motor task and alpha EEG power decreased, but frontal EMG power increased in response to standing in untrained women (group N) and did not change in F group
Astronaut Tamara E. Jernigan, STS-67 payload commander, deploys a life raft during a session of emergency bailout training. The training took place in the 25-feet deep pool at JSC's Weightless Environment Training Facility (WETF). Jernigan was joined by her crew mates for the training session. Several SCUBA-equipped divers who assisted in the training can be seen in this photograph.
Advanced life support systems have many interacting processes and limited resources. Controlling and optimizing advanced life support systems presents unique challenges. In particular, advanced life support systems are nonlinear coupled dynamical systems and it is difficult for humans to take all interactions into account to design an effective control strategy. In this project. we developed several reinforcement learning controllers that actively explore the space of possible control strategies, guided by rewards from a user specified long term objective function. We evaluated these controllers using a discrete event simulation of an advanced life support system. This simulation, called BioSim, designed by Nasa scientists David Kortenkamp and Scott Bell has multiple, interacting life support modules including crew, food production, air revitalization, water recovery, solid waste incineration and power. They are implemented in a consumer/producer relationship in which certain modules produce resources that are consumed by other modules. Stores hold resources between modules. Control of this simulation is via adjusting flows of resources between modules and into/out of stores. We developed adaptive algorithms that control the flow of resources in BioSim. Our learning algorithms discovered several ingenious strategies for maximizing mission length by controlling the air and water recycling systems as well as crop planting schedules. By exploiting non-linearities in the overall system dynamics, the learned controllers easily out- performed controllers written by human experts. In sum, we accomplished three goals. We (1) developed foundations for learning models of coupled dynamical systems by active exploration of the state space, (2) developed and tested algorithms that learn to efficiently control air and water recycling processes as well as crop scheduling in Biosim, and (3) developed an understanding of the role machine learning in designing control systems for
de Oliveira, Laura Alice Santos; Martins, Camilla Polonini; Horsczaruk, Carlos Henrique Ramos; da Silva, Débora Cristina Lima; Vasconcellos, Luiz Felipe; Lopes, Agnaldo José; Meira Mainenti, Míriam Raquel; Rodrigues, Erika de Carvalho
The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance.
Guey, C.N.; Arrieta, L.; Youngblood, R.
Once the gross features of a frontline fluid system have been defined, one must consider what support system configuration will provide the best overall system performance. This paper considers different dc bus configurations for a given emergency feedwater system. Results indicate that a four-train support system (i.e., 4 dc buses) gives a lower system unavailability for transients, but a higher system unavailability for Anticipated Transients Without Scram (ATWS), than a two-train support system (i.e., two dc buses). This serves to illustrate that more trains do not necessarily provide higher reliability, and that a configuration choice which is better for one mission success criterion may be worse for another. Because of the small characteristic unreliability of dc buses, the numerical comparisons made here are not dramatic, but the underlying topological point is nevertheless broadly applicable. The EFWS selected in this study consists of two turbine-driven pumps, and two motor-driven pumps, with associated piping, instruments, and valves. There are two divisions of EFWS, each division including one turbine-driven pump train, and one motor-driven pump train with a crosstie that can provide an alternate flow path in case one train is not available. Each of the motor-driven pumps has one ac power bus associated with it. No ac power is required for the turbine-driven trains
Gooding, Lori F; Abner, Erin L; Jicha, Gregory A; Kryscio, Richard J; Schmitt, Fredrick A
This study investigated the effects of early- to midlife musical training on cognition in older adults. A musical training survey examined self-reported musical experience and objective knowledge in 237 cognitively intact participants. Responses were classified into low-, medium-, and high-knowledge groups. Linear mixed models compared the groups' longitudinal performance on the Animal Naming Test (ANT; semantic verbal fluency) and Logical Memory Story A Immediate Recall (LMI; episodic memory) controlling for baseline age, time since baseline, education, sex, and full-scale IQ. Results indicate that high-knowledge participants had significantly higher LMI scores at baseline and over time compared to low-knowledge participants. The ANT scores did not differ among the groups. Ability to read music was associated with higher mean scores for both ANT and LMI over time. Early- to midlife musical training may be associated with improved late-life episodic and semantic memory as well as a useful marker of cognitive reserve. © The Author(s) 2013.
The life support system for long duration missions will recycle oxygen and water to reduce the material resupply mass from Earth. The impact of life support failures was investigated by dynamic simulation of a lunar outpost habitat life support model. The model was modified to simulate resupply delays, power failures, recycling system failures, and storage failures. Many failures impact the lunar outpost water supply directly or indirectly, depending on the water balance and water storage. Failure effects on the water supply are reduced if Extra Vehicular Activity (EVA) water use is low and the water supply is ample. Additional oxygen can be supplied by scavenging unused propellant or by production from regolith, but the amounts obtained can vary significantly. The requirements for oxygen and water can also vary significantly, especially for EVA. Providing storage buffers can improve efficiency and reliability, and minimize the chance of supply failing to meet demand. Life support failures and supply variations can be survivable if effective solutions are provided by the system design
Noback, C.R.; Murphy, C.H.
The radiographic and physical principles involved in interpreting films, and some of the altered anatomy and pathology that may be seen on such films, are discussed. This chapter considers the radiographic appearances of monitoring and life-support devices. Appropriate positioning and function are shown, as are some of the complications associated with their placement and/or function
Barta, Daniel J.; Chullen, Cinda; Pickering, Karen D.; Cox, Marlon; Towsend, Neil; Campbell, Colin; Flynn, Michael; Wheeler, Raymond
Next Generation Life Support (NGLS) is one of several technology development projects sponsored by NASA s Game Changing Development Program. The NGLS Project is developing life support technologies (including water recovery and space suit life support technologies) needed for humans to live and work productively in space. NGLS has three project tasks: Variable Oxygen Regulator (VOR), Rapid Cycle Amine (RCA) swing bed, and Alternative Water Processor (AWP). The RCA swing bed and VOR tasks are directed at key technology needs for the Portable Life Support System (PLSS) for an Advanced Extravehicular Mobility Unit, with focus on test article development and integrated testing in an Advanced PLSS in cooperation with the Advanced Extra Vehicular Activity (EVA) Project. An RCA swing-bed provides integrated carbon dioxide removal and humidity control that can be regenerated in real time during an EVA. The VOR technology will significantly increase the number of pressure settings available to the space suit. Current space suit pressure regulators are limited to only two settings whereas the adjustability of the advanced regulator will be nearly continuous. The AWP effort, based on natural biological processes and membrane-based secondary treatment, will result in the development of a system capable of recycling wastewater from sources expected in future exploration missions, including hygiene and laundry water. This paper will provide a status of technology development activities and future plans.
National Aeronautics and Space Administration — Advanced Exploration Systems (AES) Life Support Systems project Wastewater Processing and Water Management task: Within an integrated life support system, water...
Bush, David R.
KSC has used cryogenic life support (liquid air based) technology successfully for many years to support spaceflight operations. This technology has many benefits unique to cryogenics when compared to traditional compressed gas systems: passive cooling, lighter, longer duration, and lower operating pressure. However, there are also several limiting factors that have prevented the technology from being commercialized. The National Institute of Occupational Safety and Health, Office of Mine Safety and Health Research (NIOSH-OMSHR) has partnered with NASA to develop a complete liquid air based life support solution for emergency mine escape and rescue. The project will develop and demonstrate various prototype devices and incorporate new technological innovations that have to date prevented commercialization.
Guey, C.N.; Arrieta, L.; Youngblood, R.
Once the gross features of a frontline fluid system have been defined, one must consider what support system configuration will provide the best overall system performance. This paper considers different direct-current (dc) bus configurations for a given emergency feedwater system (EFWS). Results indicate that a four-train support system (i.e., 4 dc buses) gives a lower system unavailability for transients, but a higher system unavailability for anticipated transients without scram (ATWSs), than a two-train support system (i.e., two dc buses). This serves to illustrate that more trains do not necessarily provide higher reliability, and that a configuration choice which is better for one emission success criterion may be worse for another. Because of the small characteristic unreliability of dc buses, the numerical comparisons made here are not dramatic, but the underlying topological point is nevertheless broadly applicable
Jones, Harry W.
Systems engineering is an organized way to design and develop systems, but the initial system design concepts are usually seen as the products of unexplained but highly creative intuition. Axiomatic design is a mathematical approach to produce and compare system architectures. The two axioms are:- Maintain the independence of the functional requirements.- Minimize the information content (or complexity) of the design. The first axiom generates good system design structures and the second axiom ranks them. The closed system human life support architecture now implemented in the International Space Station has been essentially unchanged for fifty years. In contrast, brief missions such as Apollo and Shuttle have used open loop life support. As mission length increases, greater system closure and increased recycling become more cost-effective.Closure can be gradually increased, first recycling humidity condensate, then hygiene wastewater, urine, carbon dioxide, and water recovery brine. A long term space station or planetary base could implement nearly full closure, including food production. Dynamic systems theory supports the axioms by showing that fewer requirements, fewer subsystems, and fewer interconnections all increase system stability. If systems are too complex and interconnected, reliability is reduced and operations and maintenance become more difficult. Using axiomatic design shows how the mission duration and other requirements determine the best life support system design including the degree of closure.
Next Generation Life Support (NGLS) is one of over twenty technology development projects sponsored by NASA's Game Changing Development Program. The NGLS Project develops selected life support technologies needed for humans to live and work productively in space, with focus on technologies for future use in spacecraft cabin and space suit applications. Over the last three years, NGLS had five main project elements: Variable Oxygen Regulator (VOR), Rapid Cycle Amine (RCA) swing bed, High Performance (HP) Extravehicular Activity (EVA) Glove, Alternative Water Processor (AWP) and Series-Bosch Carbon Dioxide Reduction. The RCA swing bed, VOR and HP EVA Glove tasks are directed at key technology needs for the Portable Life Support System (PLSS) and pressure garment for an Advanced Extravehicular Mobility Unit (EMU). Focus is on prototyping and integrated testing in cooperation with the Advanced Exploration Systems (AES) Advanced EVA Project. The HP EVA Glove Element, new this fiscal year, includes the generation of requirements and standards to guide development and evaluation of new glove designs. The AWP and Bosch efforts focus on regenerative technologies to further close spacecraft cabin atmosphere revitalization and water recovery loops and to meet technology maturation milestones defined in NASA's Space Technology Roadmaps. These activities are aimed at increasing affordability, reliability, and vehicle self-sufficiency while decreasing mass and mission cost, supporting a capability-driven architecture for extending human presence beyond low-Earth orbit, along a human path toward Mars. This paper provides a status of current technology development activities with a brief overview of future plans.
Via, Allegra; Blicher, Thomas; Bongcam-Rudloff, Erik; Brazas, Michelle D; Brooksbank, Cath; Budd, Aidan; De Las Rivas, Javier; Dreyer, Jacqueline; Fernandes, Pedro L; van Gelder, Celia; Jacob, Joachim; Jimenez, Rafael C; Loveland, Jane; Moran, Federico; Mulder, Nicola; Nyrö nen, Tommi; Rother, Kristian; Schneider, Maria Victoria; Attwood, Teresa K
concepts. Providing bioinformatics training to empower life scientists to handle and analyse their data efficiently, and progress their research, is a challenge across the globe. Delivering good training goes beyond traditional lectures and resource
Tredinnick, Gerlind; Cocks, Naomi
This study investigated the effectiveness of a 1-day dysphagia training package delivered to support workers who work with adults with a learning disability. Thirty-eight support staff took part in this study. Twenty-five support staff received training, and 13 did not receive training and therefore acted as a control group. Three questionnaires…
Harris, Roger; Simons, Michele; McCarthy, Carmel
This document was produced by the authors based on their research for the report, "Private Training Providers: Their Characteristics and Training Activities," [ED495181] and is an added resource for further information. That study examined the nature of the training activity of private registered training organisations (RTOs) offered to…
Jones, Harry W.
A human mission to Mars will require highly reliable life support systems. Mars life support systems may recycle water and oxygen using systems similar to those on the International Space Station (ISS). However, achieving sufficient reliability is less difficult for ISS than it will be for Mars. If an ISS system has a serious failure, it is possible to provide spare parts, or directly supply water or oxygen, or if necessary bring the crew back to Earth. Life support for Mars must be designed, tested, and improved as needed to achieve high demonstrated reliability. A quantitative reliability goal should be established and used to guide development t. The designers should select reliable components and minimize interface and integration problems. In theory a system can achieve the component-limited reliability, but testing often reveal unexpected failures due to design mistakes or flawed components. Testing should extend long enough to detect any unexpected failure modes and to verify the expected reliability. Iterated redesign and retest may be required to achieve the reliability goal. If the reliability is less than required, it may be improved by providing spare components or redundant systems. The number of spares required to achieve a given reliability goal depends on the component failure rate. If the failure rate is under estimated, the number of spares will be insufficient and the system may fail. If the design is likely to have undiscovered design or component problems, it is advisable to use dissimilar redundancy, even though this multiplies the design and development cost. In the ideal case, a human tended closed system operational test should be conducted to gain confidence in operations, maintenance, and repair. The difficulty in achieving high reliability in unproven complex systems may require the use of simpler, more mature, intrinsically higher reliability systems. The limitations of budget, schedule, and technology may suggest accepting lower and
Jauch, Edward C; Pineda, Jose A; Hemphill, J Claude
Intracerebral hemorrhage (ICH) is a subset of stroke due to bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, reversal of coagulopathy, and proper diagnosis. ICH was chosen as an Emergency Neurological Life Support protocol because intervention within the first critical hour may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.
Seagrave, Richard C. (Principal Investigator)
This report covers the seventeen months of work performed under an extended one year NASA University Grant awarded to Iowa State University to perform research on topics relating to the development of closed-loop long-term life support systems with the initial principal focus on space water management. In the first phase of the program, investigators from chemistry and chemical engineering with demonstrated expertise in systems analysis, thermodynamics, analytical chemistry and instrumentation, performed research and development in two major related areas; the development of low-cost, accurate, and durable sensors for trace chemical and biological species, and the development of unsteady-state simulation packages for use in the development and optimization of control systems for life support systems. In the second year of the program, emphasis was redirected towards concentrating on the development of dynamic simulation techniques and software and on performing a thermodynamic systems analysis, centered on availability or energy analysis, in an effort to begin optimizing the systems needed for water purification. The third year of the program, the subject of this report, was devoted to the analysis of the water balance for the interaction between humans and the life support system during space flight and exercise, to analysis of the cardiopulmonary systems of humans during space flight, and to analysis of entropy production during operation of the air recovery system during space flight.
Awang, Sakinah; Ahmad, Shamsuria; Alias, Norlidah; DeWitt, Dorothy
Basic Life Support (BLS) can increase a victim's chances of survival when administered promptly and correctly. Cardiac and respiratory arrests occur more frequently when the victim is at home far from clinical support. Hence, prompt action by family members trained in BLS can save the victim's life. In this study, the requirements for the design…
The NPP engineering support functional area comprises seven common positions: reactor engineer, in-service inspection engineer, performance reliability engineer, system-maintenance engineer, station modification engineer, quality assurance engineer, and regulatory compliance engineer. The primary duties and tasks of each was presented. In Spain, a simplified SAT approach was used to analyze the training needs of these positions. The basic difference between the comprehensive SAT and the simplified method is that the simplified approach uses no taxonomy codes and the task elements are not analyzed to obtain the knowledge and skills. Resulting in an economy of time and personnel resources, this process makes use of job competencies and a top table analysis conducted by subject matter experts. An example of a JPM prepared using the simplified SAT approach was shown. Examples of the simplified approaches used in Russia, France, and USA were also discussed
Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency ...
Full Text Available Flexible Training's Intrusion on Work/Life Balance Seema TAKIYAJennifer ARCHBOLDZane BERGEBaltimore, USA Learning interventions should be aligned with the human learning system. To be effective, they have to support human learning, not work against it. Thalheimer, 2004 ABSTRACT With more companies allowing flextime, more access to elearning, and telecomuting, the line between workplace flexibility and work-life balance begins to blur. Companies sell to employees the flexibility of being able to complete training programs from the comfort of the participant's home, allowing them to learn at their own speed. In many ways, this solution is of great value to many employees. What also must be considered with the flexibility such training offers, is the unintentional consequences. This article explores questions such as does this flexibility create a 24-hour work day where the employee is continually accessible to work? Does it result in less family, personal and leisure time to the detriment of the worker?
Sullivan, D J; Hansen-Flaschen, J
As the population continues to age, greater numbers and more severely injured elderly patients require care in ICUs. With the attendant increase in the medical complexity of such patients, investigators anticipate that trauma and critical care resources will become increasingly stretched. Because of economic and societal forces, it will become increasingly important for trauma surgeons to appropriately counsel patients and their families regarding the outcome from their injuries and to become comfortable approaching families about withdrawal of support when medical futility is recognized. The authors propose the following guidelines for discussing limitation or termination of life support with patients and their families. Physicians should (1) discuss the patient's wishes regarding life support on admission or early in the hospital course; (2) at the initial discussion, establish who the decision maker will be if the patient is or becomes incapacitated; (3) maintain regular communication and continuity of care; and (4) inevitably, when conflict occurs, involve consultants and a hospital ethics committee for assistance in its resolution.
Wheeler, Raymond M.
NASA and other space agencies and around the world have had long-standing interest in using plants and biological approaches for regenerative life support. In particular, NASA's Kennedy Space Center, has conducted research in this area for over 30 years. One unique aspect to this testing was NASA's Biomass Production Chamber, which had four vertically stacked growing shelves inside a large, 113 cubic meter chamber. This was perhaps one of the first working examples of a vertical agriculture system in the world. A review of some of this research along with some of the more salient findings will be presented.
Brandy Viera Valdés; Paula Aguila Solis; Francisco Valladares Carvajal; Marcos D. Iraola Ferrer; Pablo. A. Rodríguez
Background: Title: Basic vital cardiac support. Training to relatives of patients with acute miocardial infarction. The cardiorespiratory reanimation is a proved procedure that can save a human life in case of a cardiorespiratory stop. For three years it is imparted in the University Hospital of Cienfuegos, a training for this procedure, to the family of patients with sharp myocardic infarction. Objective: To evaluate the knowledge acquired by the relatives of the patients during the training...
Borron, S. W.; Walter, F. G.
A prospective, descriptive, feasibility study aimed to determine whether an interdisciplinary group of health care experts could design and successfully deliver an international, life support, continuing education program that teaches the medical management of hazardous materials (hazmat) patients. The American Academy of Clinical Toxicology and the University of Arizona College of Medicine, Arizona Emergency Medicine Research Center partnered on July 1, 1998 to develop a two-day Advanced Hazmat Life Support (AHLS) Provider Course. Interdisciplinary expert clinicians designed and then delivered the first AHLS Provider Course in 1999. Prior to this, other courses focused on the management of hazmat incidents and almost exclusively on the prehospital care of hazmat victims by firefighters, hazardous materials technicians, and emergency medical technicians (EMTs), not on the medical management of patients from these incidents. Therefore, AHLS was developed for a broader interdisciplinary group of health care professionals, including both prehospital health care professionals and hospital-based, poison center-based, clinic-based, public health care-based, and other health care professionals. From 1999 through 2006, the AHLS Provider Course has trained 7,142 health care professionals from 48 countries. Of the 7,142 health care professionals worldwide, 43% are paramedics, 24% are physicians, 21% are nurses, 2% are pharmacists, 1% are physician assistants, and 9% are other professionals. Of the professionals trained, 88% are from the United States, 5% from Hong Kong, 2% from Canada, 2% from Australia, 1% from Mexico, and the remainder come from 43 other countries. The Advanced Hazmat Life Support Program is feasible and meets the continuing education needs of health care professionals around the world.(author)
Cash, Stefan; Shinnick-Page, Andrea
Nurses and other carers of people with learning disabilities must be able to manage choking events and perform basic life support effectively. UK guidelines for assessment of airway obstruction and for resuscitation do not take account of the specific needs of people with profound multiple learning disability. For example, they fail to account for inhibited gag and coughing reflexes, limited body movements or chest deformity. There are no national guidelines to assist in clinical decisions and training for nurses and carers. Basic life support training for students of learning disability nursing at Birmingham City University is supplemented to address these issues. The authors ask whether such training should be provided for all nurses including those caring for children and young people. They also invite comment and discussion on questions related to chest compression and training in basic life support for a person in a seated position.
Matteo Di NARDO
Full Text Available Extracorporeal Life Support (ECLS is a valuable tool in the management of neonates and older children with severe cardiac or respiratory failure. In this review, we focus on ECLS when used for neonatal and pediatric cardiac disease. Strict selection of patients and timely deployment are necessary to optimize outcomes. Although every attempt should be made to deploy ECLS urgently rather than emergently, extracorporeal cardiopulmonary resuscitation (ECPR is being increasingly used and reasonable survival rates have been achieved after initiation of ECLS during active compressions of the chest following in-hospital cardiac arrest. Contraindications to ECLS are falling over time, although lethal chromosomal abnormalities, severe irreversible brain injury, and extremely low gestational age and weight (<32 weeks gestation or <1.5 kg remain firm contraindications.
Schwartzkopf, S. H.
The requirements for a human life support system for long-duration space missions are reviewed. The system design of a controlled ecological life support system is briefly described, followed by a more detailed account of the study of the conceptual design of a Lunar Based CELSS. The latter is to provide a safe, reliable, recycling lunar base life support system based on a hybrid physicochemical/biological representative technology. The most important conclusion reached by this study is that implementation of a completely recycling CELSS approach for a lunar base is not only feasible, but eminently practical. On a cumulative launch mass basis, a 4-person Lunar Base CELSS would pay for itself in approximately 2.6 years relative to a physicochemical air/water recycling system with resupply of food from the Earth. For crew sizes of 30 and 100, the breakeven point would come even sooner, after 2.1 and 1.7 years, respectively, due to the increased mass savings that can be realized with the larger plant growth units. Two other conclusions are particularly important with regard to the orientation of future research and technology development. First, the mass estimates of the Lunar Base CELSS indicate that a primary design objective in implementing this kind of system must be to minimized the mass and power requirement of the food production plant growth units, which greatly surpass those of the other air and water recycling systems. Consequently, substantial research must be directed at identifying ways to produce food more efficiently. On the other hand, detailed studies to identify the best technology options for the other subsystems should not be expected to produce dramatic reductions in either mass or power requirement of a Lunar Base CELSS. The most crucial evaluation criterion must, therefore, be the capability for functional integration of these technologies into the ultimate design of the system. Secondly, this study illustrates that existing or near
Drysdale, A. E.; Ewert, M. K.; Hanford, A. J.
Life support approaches for Mars missions are evaluated using an equivalent system mass (ESM) approach, in which all significant costs are converted into mass units. The best approach, as defined by the lowest mission ESM, depends on several mission parameters, notably duration, environment and consequent infrastructure costs, and crew size, as well as the characteristics of the technologies which are available. Generally, for the missions under consideration, physicochemical regeneration is most cost effective. However, bioregeneration is likely to be of use for producing salad crops for any mission, for producing staple crops for medium duration missions, and for most food, air and water regeneration for long missions (durations of a decade). Potential applications of in situ resource utilization need to be considered further.
Full Text Available To predict the remaining life of ball screw, a screw remaining life prediction method based on quantum genetic algorithm (QGA and support vector machine (SVM is proposed. A screw accelerated test bench is introduced. Accelerometers are installed to monitor the performance degradation of ball screw. Combined with wavelet packet decomposition and isometric mapping (Isomap, the sensitive feature vectors are obtained and stored in database. Meanwhile, the sensitive feature vectors are randomly chosen from the database and constitute training samples and testing samples. Then the optimal kernel function parameter and penalty factor of SVM are searched with the method of QGA. Finally, the training samples are used to train optimized SVM while testing samples are adopted to test the prediction accuracy of the trained SVM so the screw remaining life prediction model can be got. The experiment results show that the screw remaining life prediction model could effectively predict screw remaining life.
Li, Timmy; Jones, Courtney M C; Shah, Manish N; Cushman, Jeremy T; Jusko, Todd A
Determining the most appropriate level of care for patients in the prehospital setting during medical emergencies is essential. A large body of literature suggests that, compared with Basic Life Support (BLS) care, Advanced Life Support (ALS) care is not associated with increased patient survival or decreased mortality. The purpose of this special report is to synthesize the literature to identify common study design and analytic challenges in research studies that examine the effect of ALS, compared to BLS, on patient outcomes. The challenges discussed in this report include: (1) choice of outcome measure; (2) logistic regression modeling of common outcomes; (3) baseline differences between study groups (confounding); (4) inappropriate statistical adjustment; and (5) inclusion of patients who are no longer at risk for the outcome. These challenges may affect the results of studies, and thus, conclusions of studies regarding the effect of level of prehospital care on patient outcomes should require cautious interpretation. Specific alternatives for avoiding these challenges are presented. Li T , Jones CMC , Shah MN , Cushman JT , Jusko TA . Methodological challenges in studies comparing prehospital Advanced Life Support with Basic Life Support. Prehosp Disaster Med. 2017;32(4):444-450.
Chilkoti, Geetanjali; Mohta, Medha; Wadhwa, Rachna; Saxena, Ashok Kumar; Sharma, Chhavi Sarabpreet; Shankar, Neelima
Students are exposed to basic life support (BLS) and advanced cardiac life support (ACLS) training in the first semester in some medical colleges. The aim of this study was to compare students' satisfaction between lecture-based traditional method and hybrid problem-based learning (PBL) in BLS/ACLS teaching to undergraduate medical students. We conducted a questionnaire-based, cross-sectional survey among 118 1 st -year medical students from a university medical college in the city of New Delhi, India. We aimed to assess the students' satisfaction between lecture-based and hybrid-PBL method in BLS/ACLS teaching. Likert 5-point scale was used to assess students' satisfaction levels between the two teaching methods. Data were collected and scores regarding the students' satisfaction levels between these two teaching methods were analysed using a two-sided paired t -test. Most students preferred hybrid-PBL format over traditional lecture-based method in the following four aspects; learning and understanding, interest and motivation, training of personal abilities and being confident and satisfied with the teaching method ( P < 0.05). Implementation of hybrid-PBL format along with the lecture-based method in BLS/ACLS teaching provided high satisfaction among undergraduate medical students.
Douglas, Sarah N.; Nordquist, Erica; Kammes, Rebecca; Gerde, Hope
Parent training can help support the development of communication skills for young children with complex communication needs (CCN). Online delivery of such training may alleviate some of the burden on families, thereby increasing participation and outcomes. To determine the effectiveness of online parent training in communication partner…
Kusy, Mitchell E., Jr.
A study was conducted to determine which type of training evaluation method elicited the most management support of the training function among corporate managers. The investigator designed and distributed a case study survey instrument called the Training Evaluation Methods Survey (TEMS) to assess the extent of management support for each type of…
Haaren, Birte von
The current thesis investigated the effects of a 20-week aerobic exercise training on physiological and emotional responses to real-life stress using a randomized, controlled trial and an inactive sample. To assess participants' physiological and psychological responses during everyday life, ambulatory assessment was used. In summary, the present thesis provides empirical support that regular exercise can lead to improved emotional and physiological responses during real-life stress.
Anne D Souza
Full Text Available Background: Out of hospital deaths due to cardiac arrest would commonly occur because of the lack of awareness about the quick and right action to be taken. In this context the healthcare students undergo training in basic life support. However the lay persons are not exposed to such training. The present study was intended to train the auto drivers, the basic skills of basic life support by the medical and nursing students. Students got an opportunity to learn and teach the skills under the supervision of faculty. Methods: A total of fourteen students, 20 auto drivers of Manipal were included in the study population. The session on one and two rescuer cardio pulmonary resuscitation and relieving foreign body airway obstruction was conducted by the trained students for the auto drivers under the observation of the faculty. Prior knowledge of the study population was assessed by the pre-session questionnaire followed by a post-session questionnaire at the end of the session. The skill evaluation was carried out using a checklist. Results: The auto drivers participated in the session, gained required skills of providing basic life support. The students who trained the study population opined that they got an opportunity to teach basic life support which would help them build their teaching skills and confidence. Conclusion: The lay persons attaining basic life support skills have a high impact on the management of out of hospital cardiac arrest victims. Involving the healthcare students as instructors makes an innovation in learning.
The 40-year-long experience in devising ecological systems with a significantly closed material cycling (CES), which are intended for human life support outside the Earth's biosphere, allows us to state that this problem has been largely solved technically. To test the terrestrial prototypes of these systems: Bios in Krasnoyarsk, the Terrestrial Ecological System (TES) in Moscow, and Bioplex in Houston, crews of humans stayed inside them over long periods of time. In Bios-3 humans could be fully (100%) provided with regenerated air and water and with a vegetable part (80%) of their diet. One human requires 4.5 kW of light energy, which is equal to the light energy incident on an 8-m2 surface perpendicular to solar rays in the Earth's orbit. The regeneration of air and water can be alternatively performed by a 17-L2 microalgal cultivator with a light-receiving surface of 8 m at 2 kW of light energy or by a conveyer culture of agricultural plants. To regenerate the vegetable part of2 the diet to the full, the area must increase to 31.5 m per person. Similar values have been obtained in the TES and in Bioplex. It can be concluded that the system is ready to be implemented in the engineering-technical designs of specific versions: for orbital flights, for missions to Mars and other planets, and for stations on the Moon and Mars. To improve the CES further, a number of new key problems should be resolved. The first of them are: to robotize the technological processes and to establish an optimized system of the internal control of the CES by the crew working in it; to develop a hybrid physicochemical-biological technology for returning the dead-end products of biosynthesis into the system's cycling; to solve the fundamental problem of regenerating the human ration completely inside the CES by the autotrophic chemo - and photosynthesis. Once this problem is solved, the energy requirements for life support in space will be significantly reduced. This will also considerably
The mountains of data thrusting from the new landscape of modern high-throughput biology are irrevocably changing biomedical research and creating a near-insatiable demand for training in data management and manipulation and data mining and analysis. Among life scientists, from clinicians to environmental researchers, a common theme is the need not just to use, and gain familiarity with, bioinformatics tools and resources but also to understand their underlying fundamental theoretical and practical concepts. Providing bioinformatics training to empower life scientists to handle and analyse their data efficiently, and progress their research, is a challenge across the globe. Delivering good training goes beyond traditional lectures and resource-centric demos, using interactivity, problem-solving exercises and cooperative learning to substantially enhance training quality and learning outcomes. In this context, this article discusses various pragmatic criteria for identifying training needs and learning objectives, for selecting suitable trainees and trainers, for developing and maintaining training skills and evaluating training quality. Adherence to these criteria may help not only to guide course organizers and trainers on the path towards bioinformatics training excellence but, importantly, also to improve the training experience for life scientists.
Mehrholz, Jan; Thomas, Simone; Elsner, Bernhard
Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of the Cochrane review first published in 2003 and updated in 2005 and 2014. To determine if treadmill training and body weight support, individually or in combination, improve walking ability, quality of life, activities of daily living, dependency or death, and institutionalisation or death, compared with other physiotherapy gait-training interventions after stroke. The secondary objective was to determine the safety and acceptability of this method of gait training. We searched the Cochrane Stroke Group Trials Register (last searched 14 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Reviews of Effects (DARE) (the Cochrane Library 2017, Issue 2), MEDLINE (1966 to 14 February 2017), Embase (1980 to 14 February 2017), CINAHL (1982 to 14 February 2017), AMED (1985 to 14 February 2017) and SPORTDiscus (1949 to 14 February 2017). We also handsearched relevant conference proceedings and ongoing trials and research registers, screened reference lists, and contacted trialists to identify further trials. Randomised or quasi-randomised controlled and cross-over trials of treadmill training and body weight support, individually or in combination, for the treatment of walking after stroke. Two review authors independently selected trials, extracted data, and assessed risk of bias and methodological quality. The primary outcomes investigated were walking speed, endurance, and dependency. We included 56 trials with 3105 participants in this updated review. The average age of the participants was 60 years, and the studies were carried out in both inpatient and outpatient settings. All participants had at least some walking difficulties and many could not walk without assistance. Overall, the use of treadmill training did not increase the chances of walking
Havlik , Denis; Deri , Oren; Rannat , Kalev; Warum , Manuel; Rafalowski , Chaim; Taveter , Kuldar; Kutschera , Peter; Meriste , Merik
Part 3: Decision Support Tools and Systems; International audience; This paper presents a methodology and a prototypic software implementation of a simple system supporting resource management training for crisis managers. The application that is presented supports the execution and assessment of a desktop training for decision makers on a tactical and strategic level. It introduces elements of turn-based strategic “serious gaming”, with a possibility to roll back in time and re-try new decis...
Hansen, Camilla; Rasmussen, Stinne E; Kristensen, Mette Amalie
Introduction: High-quality cardiopulmonary resuscitation (CPR) improves survival from cardiac arrest. During basic life support (BLS) training, instructors assess CPR skills to enhance learning outcome. Emergency department staff and senior residents have been shown to assess chest compression...... quality poorly. Currently no studies have evaluated CPR assessment among certified BLS instructors. The aim of this study was to investigate certified BLS instructors’ assessment of chest compressions and rescue breathing.Methods: Data were collected at BLS courses for medical students at Aarhus...... of CPR skills may be beneficial to ensure high-quality learning outcome.Author Disclosures: C. Hansen: None. S.E. Rasmussen: None. M.A. Nebsbjerg: None. M. Stærk: None. B. Løfgren: None....
To facilitate analysis, ALS systems are often assumed to be linear and time invariant, but they usually have important nonlinear and dynamic aspects. Nonlinear dynamic behavior can be caused by time varying inputs, changes in system parameters, nonlinear system functions, closed loop feedback delays, and limits on buffer storage or processing rates. Dynamic models are usually cataloged according to the number of state variables. The simplest dynamic models are linear, using only integration, multiplication, addition, and subtraction of the state variables. A general linear model with only two state variables can produce all the possible dynamic behavior of linear systems with many state variables, including stability, oscillation, or exponential growth and decay. Linear systems can be described using mathematical analysis. Nonlinear dynamics can be fully explored only by computer simulations of models. Unexpected behavior is produced by simple models having only two or three state variables with simple mathematical relations between them. Closed loop feedback delays are a major source of system instability. Exceeding limits on buffer storage or processing rates forces systems to change operating mode. Different equilibrium points may be reached from different initial conditions. Instead of one stable equilibrium point, the system may have several equilibrium points, oscillate at different frequencies, or even behave chaotically, depending on the system inputs and initial conditions. The frequency spectrum of an output oscillation may contain harmonics and the sums and differences of input frequencies, but it may also contain a stable limit cycle oscillation not related to input frequencies. We must investigate the nonlinear dynamic aspects of advanced life support systems to understand and counter undesirable behavior.
Schneider, M.V.; Watson, J.; Attwood, T.
As bioinformatics becomes increasingly central to research in the molecular life sciences, the need to train non-bioinformaticians to make the most of bioinformatics resources is growing. Here, we review the key challenges and pitfalls to providing effective training for users of bioinformatics...... services, and discuss successful training strategies shared by a diverse set of bioinformatics trainers. We also identify steps that trainers in bioinformatics could take together to advance the state of the art in current training practices. The ideas presented in this article derive from the first...
Gonzalez-Morales, M Gloria; Kernan, Mary C; Becker, Thomas E; Eisenberger, Robert
Although much is known about the antecedents and consequences of abusive supervision, scant attention has been paid to investigating procedures to reduce its frequency. We conducted a quasiexperiment to examine the effects of supervisor support training on subordinate perceptions of abusive supervision and supervisor support. Supervisors (n = 23) in 4 restaurants were trained in 4 supportive supervision strategies (benevolence, sincerity, fairness, and experiential processing) during 4 2-hr sessions over a period of 2 months. We compared perceived supervisor support and abusive supervision before and 9 months after training for 208 employees whose supervisors received support training and 241 employees in 4 similar control restaurants. Compared to employees in the control restaurants, employees whose supervisors received the support training reported higher levels of perceived supervisor support and less abusive supervision. These findings suggest that a relatively brief training program can help managers become more supportive and less abusive. Theoretical and practical implications for effectively managing abusive supervision are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Lavenburg, Philip; Bernt, Frank M
We surveyed volunteers from 8 hospices in the Delaware Valley regarding training, perceived needs, and role satisfaction. Results were consistent with previous studies: satisfaction with preservice training and with volunteering was very high; respondents reported feeling very prepared and confident about doing hospice work as a result of their volunteer training. In addition, longer volunteer preservice training was associated with higher levels of overall satisfaction with training; levels of volunteer satisfaction and fulfillment tended to be lower during the first year of volunteering; and participation in volunteer support teams was associated with finding volunteer work rewarding and with feeling a part of the hospice team. Implications for preservice training and ongoing support and education of hospice volunteers are discussed.
Wallace, Charles J; Tauber, Robert
Introduction by the column editors: Supported employment, as designed for persons with serious and persistent mental illness, has been termed individual placement and support. In two randomized controlled trials (1,2), clients who received individual placement and support services were more likely to obtain at least one job in the competitive sector, to work more hours, and to have a higher total income than their counterparts who received more traditional types of vocational rehabilitation. However, individual placement and support did not improve the length of time the employed participants kept their jobs. An adjunctive or additional element of individual placement and support, aimed at improving the job tenure of individuals with mental illness, would be a constructive contribution to the vocational rehabilitation for this population. In a previous Rehab Rounds column, Wallace and colleagues (3) described the development of the workplace fundamental skills module, a highly structured and user-friendly curriculum designed to teach workers with mental illness the social and workplace skills needed to keep their jobs. The workplace fundamental skills module supplements individual placement and support by conveying specific skills that enable workers to learn the requirements of their jobs, anticipate the stressors associated with their jobs, and cope with stressors by using a problem-solving process. The earlier report described the production and validation of the module's content. The purpose of this month's column is to present the preliminary results of a randomized comparison of the module's effects on job retention, symptoms, and community functioning when coupled with individual placement and support. To enable wide generalization of the findings of the study, the program was conducted in a typical community mental health center.
Shull, Sarah A.; Schneider, Walter F.
The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA’s Habitability Architecture Team.
Ethiopian Journal of Business and Economics (The) ... Two Principle Component Analysis factors related to these hypotheses were described as a training factor TFAC1(I need training in data analysis and research report writing ) and a support factor TFAC2 (Internet access is essential and research class would not ...
This quantitative, quasi-experimental study examined the application of a business simulation against training in support of an Enterprise Resource Planning (ERP) system. Defining more effective training strategies is a critical concern for organizational leaders and stakeholders concerned by today's economic challenges. The scope of this…
This interactive workshop session introduces mobile serious games as situated, contextualized learning games. Example cases for mobile serious games for decision support training are introduced and discussed. Participants will get to know contextualization techniques used in modern mobile devices
Klemke, Roland; Börner, Dirk; Suarez, Angel; Schneider, Jan; Antonaci, Alessandra
This interactive workshop session introduces mobile serious games as situated, contextualized learning games. Example cases for mobile serious games for decision support training are introduced and discussed. Participants will get to know contextualization techniques used in modern mobile
Baduni, Neha; Prakash, Prem; Srivastava, Dhirendra; Sanwal, Manoj Kumar; Singh, Bijender Pal
It is important that every member of our community should be trained in effective BLS technique to save lives. At least doctors including dental practitioners, and medical and paramedical staff should be trained in high quality CPR, as it is a basic medical skill which can save many lives if implemented timely. Our aim was to study the awareness of Basic Life Support (BLS) among dental students and practitioners in New Delhi. This cross sectional study was conducted by assessing responses to 20 selected questions pertaining to BLS among dental students, resident doctors/tutors, faculty members and private practitioners in New Delhi. All participants were given a printed questionnaire where they had to mention their qualifications and clinical experience, apart from answering 20 questions. Data was collected and evaluated using commercially available statistical package for social sciences (SPSS version 12). One hundred and four responders were included. Sadly, none of our responders had complete knowledge about BLS. The maximum mean score (9.19 ± 1.23) was obtained by dentists with clinical experience between 1-5 years. To ensure better and safer healthcare, it is essential for all dental practitioners to be well versed with BLS.
Elvira Mikhailovna Rebko
The article discloses experience networking of universities (Herzen State Pedagogical University and Sakhalin State University) in the development and implementation of joint training programs for master’s education in the field of life safety «Social security in the urban environment». The novelty of the work is to create a schematic design of basic educational training program for master’s education in the mode of networking, and to identify effective instructional techniques and conditions...
Full Text Available Abstract Background - Prehospital care is classified into ALS- (advanced life support and BLS- (basic life support levels according to the methods used. ALS-level prehospital care uses invasive methods, such as intravenous fluids, medications and intubation. However, the effectiveness of ALS care compared to BLS has been questionable. Aim - The aim of this systematic review is to compare the effectiveness of ALS- and BLS-level prehospital care. Material and methods - In a systematic review, articles where ALS-level prehospital care was compared to BLS-level or any other treatment were included. The outcome variables were mortality or patient's health-related quality of life or patient's capacity to perform daily activities. Results - We identified 46 articles, mostly retrospective observational studies. The results on the effectiveness of ALS in unselected patient cohorts are contradictory. In cardiac arrest, early cardiopulmonary resuscitation and defibrillation are essential for survival, but prehospital ALS interventions have not improved survival. Prehospital thrombolytic treatment reduces mortality in patients having a myocardial infarction. The majority of research into trauma favours BLS in the case of penetrating trauma and also in cases of short distance to a hospital. In patients with severe head injuries, ALS provided by paramedics and intubation without anaesthesia can even be harmful. If the prehospital care is provided by an experienced physician and by a HEMS organisation (Helicopter Emergency Medical Service, ALS interventions may be beneficial for patients with multiple injuries and severe brain injuries. However, the results are contradictory. Conclusions - ALS seems to improve survival in patients with myocardial infarction and BLS seems to be the proper level of care for patients with penetrating injuries. Some studies indicate a beneficial effect of ALS among patients with blunt head injuries or multiple injuries. There is
ONeil, Daniel A.; Young, Lawrence R.
This section describes the key issues, barriers, opportunities, and potential trip packages related to the needs and expectations of initial space adventure travelers. A variety of ideas to overcome barriers is presented that address financial, psychological, and sociological problems expected to be encountered in establishing a general PST and tourism business. Tour package descriptions range from near-term surface training facilities to far-term lunar ones. Recommendations include requirements pertaining to human factors in design and needed technology.
Via, Allegra; Blicher, Thomas; Bongcam-Rudloff, Erik
their data efficiently, and progress their research, is a challenge across the globe. Delivering good training goes beyond traditional lectures and resource-centric demos, using interactivity, problem-solving exercises and cooperative learning to substantially enhance training quality and learning outcomes...... to environmental researchers, a common theme is the need not just to use, and gain familiarity with, bioinformatics tools and resources but also to understand their underlying fundamental theoretical and practical concepts. Providing bioinformatics training to empower life scientists to handle and analyse...
One such major concern pertains to the very general experiences of life of the elderly and associated factors. The purpose of this study was then to specifically assess the subjective quality of life and perceived adequacy of social support and the possible socio-demographic factors making differences in quality of life.
Subjects with late-stage HIV infection reported a lower social adjustment to the disease, a lower quality of life and more severe lifestyle changes. Satisfaction with social support correlated significantly with quality of life and social adjustment. It is therefore concluded that the higher the level of satisfaction with social support, ...
This article contends that theological training supported by effective mentoring can contribute to the shaping of theology students in terms of their spiritual growth, character development and ministry formation. It is further argued that mentoring as a supportive pedagogy needs to be an essential element of theological ...
Tan, E.C.T.H.; Hekkert, K.D.; Vugt, A.B. van; Biert, J.
PURPOSE: Adequate education in first aid and basic life support (BLS) should be considered as an essential aspect of the medical curriculum. The objective of this study was to investigate the current medical training in first aid and BLS at all 8 medical schools in the Netherlands. SUMMARY: An
Ruijter, P.A. de; Biersteker, H.A.; Biert, J.; Goor, H. van; Tan, E.C.T.H.
BACKGROUND: Undergraduate medical students follow a compulsory first aid (FA) and basic life support (BLS) course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in
Doctors are generally unacceptably poor at resuscitation and this has been shown to lead to unnecessary mortality. This problem has led to the development of structured resuscitation training in the form of life-support courses, which have become very popular and are widely advocated, but which are
Zhou, Mi; Lin, Weipeng
The purpose of this study was to investigate the moderating role of social support in the relationship between adaptability and life satisfaction. Data were collected from 99 undergraduate freshmen in a Chinese university using a lagged design with a 1-month interval. Results demonstrated that social support moderated the relation between adaptability and life satisfaction, such that the positive relation between adaptability and life satisfaction was stronger for individuals with higher levels of social support than for individuals with lower levels of social support. The theoretical and practical implications of this result are discussed. PMID:27516753
Zhou, Mi; Lin, Weipeng
The purpose of this study was to investigate the moderating role of social support in the relationship between adaptability and life satisfaction. Data were collected from 99 undergraduate freshmen in a Chinese university using a lagged design with a 1-month interval. Results demonstrated that social support moderated the relation between adaptability and life satisfaction, such that the positive relation between adaptability and life satisfaction was stronger for individuals with higher levels of social support than for individuals with lower levels of social support. The theoretical and practical implications of this result are discussed.
Barta, Daniel; Henninger, D.; Edeen, M.; Lewis, J.; Smth, F.; Verostko, C.
Future long duration human exploration missions away from Earth will require closed-loop regenerative life support systems to reduce launch mass, reduce dependency on resupply and increase the level of mission self sufficiency. Such systems may be based on the integration of biological and physiocochemical processes to produce potable water, breathable atmosphere and nutritious food from metabolic and other mission wastes. Over the period 1995 to 1998 a series of ground-based tests were conducted at the National Aeronautics and Space Administration, Johnson Space Center, to evaluate the performance of advanced closed-loop life support technologies with real human metabolic and hygiene loads. Named the Lunar-Mars Life Support Test Project (LMLSTP), four integrated human tests were conducted with increasing duration, complexity and closure. The first test, LMLSTP Phase I, was designed to demonstrate the ability of higher plants to revitalize cabin atmosphere. A single crew member spent 15 days within an atmospherically closed chamber containing 11.2 square meters of actively growing wheat. Atmospheric carbon dioxide and oxygen levels were maintained by control of the rate of photosynthesis through manipulation of light intensity or the availability of carbon dioxide and included integrated physicochemical systems. During the second and third tests, LMLSTP Phases II & IIa, four crew members spent 30 days and 60 days, respectively, in a larger sealed chamber. Advanced physicochemical life support hardware was used to regenerate the atmosphere and produce potable water from wastewater. Air revitalization was accomplished by using a molecular sieve and a Sabatier processor for carbon dioxide absorption and reduction, respectively, with oxygen generation performed by water hydrolysis. Production of potable water from wastewater included urine treatment (vapor compression distillation), primary treatment (ultrafiltration/reverse osmosis and multi-filtration) and post
Takiya, Seema; Archbold, Jennifer; Berge, Zane
With more companies allowing "flextime", more access to elearning, and telecomuting, the line between workplace flexibility and work-life balance begins to blur. Companies "sell" to employees the flexibility of being able to complete training programs from the comfort of the participant's home, allowing them to learn at their own speed. In many…
Department of Education, Washington, DC.
This participant's guide includes: "Introduction: Welcome to Cash Management Life Cycle Training"; "Module 1: Review of Cash Management Principles" (cash management overview and activity); "Module 2: Common Origination and Disbursement (COD) System Overview" (e.g., full participants and phase-in participants, COD…
Shuaishuai WANG; Caichao ZHU; Chaosheng SONG; Huali HAN
The reliability and service life of wind turbines are influenced by the complex loading applied on the hub,especially amidst a poor external wind environment.A three-point elastic support,which includes the main bearing and two torque arms,was considered in this study.Based on the flexibilities of the planet carrier and the housing,a coupled dynamic model was developed for a wind turbine drive train.Then,the dynamic behaviors of the drive train for different elastic support parameters were computed and analyzed.Frequency response functions were used to examine how different elastic support parameters influence the dynamic behaviors of the drive train.Results showed that the elastic support parameters considerably influenced the dynamic behaviors of the wind turbine drive train.A large support stiffness of the torque arms decreased the dynamic response of the planet carrier and the main bearing,whereas a large support stiffness of the main bearing decreased the dynamic response of planet carrier while increasing that of the main bearing.The findings of this study provide the foundation for optimizing the elastic support stiffness of the wind turbine drive train.
Mikkola, Leena; Suutala, Elina; Parviainen, Heli
ABSTRACT When becoming a specialist, learning-through-service plays a significant role. The workplace affords good opportunities for learning, but the service-learning period may also impose stress on phycisians in specialization training. In medical work, social support has proved to be a very important factor in managing stress. Social support may afford advantages also for learning and professional identity building. However, little was known about how social support is perceived by doctors in specialization training. This study aimed to understand the perceptions of physicians in specialization training regarding social support communication in their workplace during their learning-through-service period. The study was conducted qualitatively by inductively analyzing the physicians’ descriptions of workplace communication. The dataset included 120 essays, 60 each from hospitals and primary healthcare centres. Physicians in specialization training explained the need of social support with the responsibilities and demands of their clinical work and the inability to control and manage their workloads. They perceived that social support works well for managing stress, but also for strengthening relational ties and one’s professional identity. A leader’s support was perceived as being effective, and both senior and junior colleagues were described as an important source of social support. Also co-workers, such as the individual nurse partner with whom one works, was mentioned as an important source of social support. The results of this study indicate that social support works at the relational and identity levels, which is due to the multi-functional nature of workplace communication. For example, consultation functions as situational problem-solving, but also the tone of social interaction is meaningful. Thus, strengthening one’s professional identity or collegial relationships requires further attention to workplace communication. Abbreviations Pi
Mikkola, Leena; Suutala, Elina; Parviainen, Heli
When becoming a specialist, learning-through-service plays a significant role. The workplace affords good opportunities for learning, but the service-learning period may also impose stress on phycisians in specialization training. In medical work, social support has proved to be a very important factor in managing stress. Social support may afford advantages also for learning and professional identity building. However, little was known about how social support is perceived by doctors in specialization training. This study aimed to understand the perceptions of physicians in specialization training regarding social support communication in their workplace during their learning-through-service period. The study was conducted qualitatively by inductively analyzing the physicians' descriptions of workplace communication. The dataset included 120 essays, 60 each from hospitals and primary healthcare centres. Physicians in specialization training explained the need of social support with the responsibilities and demands of their clinical work and the inability to control and manage their workloads. They perceived that social support works well for managing stress, but also for strengthening relational ties and one's professional identity. A leader's support was perceived as being effective, and both senior and junior colleagues were described as an important source of social support. Also co-workers, such as the individual nurse partner with whom one works, was mentioned as an important source of social support. The results of this study indicate that social support works at the relational and identity levels, which is due to the multi-functional nature of workplace communication. For example, consultation functions as situational problem-solving, but also the tone of social interaction is meaningful. Thus, strengthening one's professional identity or collegial relationships requires further attention to workplace communication. Abbreviations PiST: Physician in
Cone, D C; Wydro, G C
To determine whether firefighter/emergency medical technicians-basic (FF/EMT-Bs) staffing basic life support (BLS) ambulances in a two-tiered emergency medical services (EMS) system can safely determine when advanced life support (ALS) is not needed. This was a prospective, observational study conducted in two academic emergency departments (EDs) receiving patients from a large urban fire-based EMS system. Runs were studied to which ALS and BLS ambulances were simultaneously dispatched, with the patient transported by the BLS unit. Prospectively established criteria for potential need for ALS were used to determine whether the FF/EMT-B's decision to cancel the ALS unit was safe, and simple outcomes (admission rate, length of stay, mortality) were examined. In the system studied, BLS crews may cancel responding ALS units at their discretion; there are no protocols or medical criteria for cancellation. A convenience sample of 69 cases was collected. In 52 cases (75%), the BLS providers indicated that they cancelled the responding ALS unit because they did not feel ALS was needed. Of these, 40 (77%) met study criteria for ALS: 39 had potentially serious chief complaints, nine had abnormal vital signs, and ten had physical exam findings that warranted ALS. Forty-five (87%) received an intervention immediately upon ED arrival that could have been provided in the field by an ALS unit, and 16 (31%) were admitted, with a median length of stay of 3.3 days (range 1.1-73.4 days). One patient died. Firefighter/EMT-Bs, working without protocols or medical criteria, cannot always safely determine which patients may require ALS intervention.
Beck, Stefanie; Meier-Klages, Vivian; Michaelis, Maria; Sehner, Susanne; Harendza, Sigrid; Zöllner, Christian; Kubitz, Jens Christian
The "kids save lives" joint-statement highlights the effectiveness of training all school children worldwide in cardiopulmonary resuscitation (CPR) to improve survival after cardiac arrest. The personnel requirement to implement this statement is high. Until now, no randomised controlled trial investigated if medical students benefit from their engagement in the BLS-education of school children regarding their later roles as physicians. The objective of the present study is to evaluate if medical students improve their teaching behaviour and CPR-skills by teaching school children in basic life support. The study is a randomised, single blind, controlled trial carried out with medical students during their final year. In total, 80 participants were allocated alternately to either the intervention or the control group. The intervention group participated in a CPR-instructor-course consisting of a 4h-preparatory seminar and a teaching-session in BLS for school children. The primary endpoints were effectiveness of teaching in an objective teaching examination and pass-rates in a simulated BLS-scenario. The 28 students who completed the CPR-instructor-course had significantly higher scores for effective teaching in five of eight dimensions and passed the BLS-assessment significantly more often than the 25 students of the control group (Odds Ratio (OR): 10.0; 95%-CI: 1.9-54.0; p=0.007). Active teaching of BLS improves teaching behaviour and resuscitation skills of students. Teaching school children in BLS may prepare medical students for their future role as a clinical teacher and support the implementation of the "kids save lives" statement on training all school children worldwide in BLS at the same time. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Life Support is a basic issue since manned space flight began. Not only to support astronauts and cosmonauts with the essential things to live, however, also animals which were carried for research to space etc together with men need support systems to survive under space conditions. Most of the animals transported to space participate at the life support system of the spacecraft. However, aquatic species live in water as environment and thus need special developments. Research with aquatic animals has a long tradition in manned space flight resulting in numerous life support systems for them starting with simple plastic bags up to complex support hardware. Most of the recent developments have to be identified as part of a technological oriented system and can be described as small technospheres. As the importance arose to study our Earth as the extraordinary Biosphere we live in, the modeling of small ecosystems began as part of ecophysiological research. In parallel the investigations of Bioregenerative Life Support Systems were launched and identified as necessity for long-term space missions or traveling to Moon and Mars and beyond. This paper focus on previous developments of Life Support Systems for aquatic animals and will show future potential developments towards Bioregenerative Life Support which additionally strongly benefits to our Earth's basic understanding.
Jones, Harry W.
A hardware system's failure rate often increases over time due to wear and aging, but not always. Some systems instead show reliability growth, a decreasing failure rate with time, due to effective failure analysis and remedial hardware upgrades. Reliability grows when failure causes are removed by improved design. A mathematical reliability growth model allows the reliability growth rate to be computed from the failure data. The space shuttle was extensively maintained, refurbished, and upgraded after each flight and it experienced significant reliability growth during its operational life. In contrast, the International Space Station (ISS) is much more difficult to maintain and upgrade and its failure rate has been constant over time. The ISS Carbon Dioxide Removal Assembly (CDRA) reliability has slightly decreased. Failures on ISS and with the ISS CDRA continue to be a challenge.
Ergh, Tanya C; Hanks, Robin A; Rapport, Lisa J; Coleman, Renee D
Social support is an important determinant of adjustment following traumatic brain injury (TBI) sustained by a family member. The present study examined the extent to which social support moderates the influence of characteristics of the person with injury on caregiver subjective well-being. Sixty pairs of individuals who had sustained a moderate to severe TBI and their caregivers (N=120) participated. Years postinjury ranged from 0.3 to 9.9 ( M=4.8, SD=2.6). Cognitive, functional, and neurobehavioral functioning of participants with TBI were assessed using neuropsychological tests and rating scales. Caregiver life satisfaction and perceived social support were assessed using self-report questionnaires. Results indicated that time since injury was unrelated to life satisfaction. Neurobehavioral disturbances showed an inverse relation with life satisfaction. Social support emerged as an important moderator of life satisfaction. Only among caregivers with low social support was cognitive dysfunction adversely related to life satisfaction. Similarly, a trend suggested that patient unawareness of deficit was associated with caregiver life dissatisfaction only among caregivers with low social support. In contrast, these characteristics were unrelated to life satisfaction among caregivers with adequate social support.
Bourassa, J.; Clark, C.R.; Kazennov, A.; Laraia, M.; Rodriguez, M.; Scott, A.; Yoder, J.
Adequate numbers of competent personnel must be available during any phase of a nuclear facility life cycle, including the decommissioning phase. While a significant amount of attention has been focused on the technical aspects of decommissioning and many publications have been developed to address technical aspects, human resource management issues, particularly the training and qualification of decommissioning personnel, are becoming more paramount with the growing number of nuclear facilities of all types that are reaching or approaching the decommissioning phase. One of the keys to success is the training of the various personnel involved in decommissioning in order to develop the necessary knowledge and skills required for specific decommissioning tasks. The operating organisations of nuclear facilities normally possess limited expertise in decommissioning and consequently rely on a number of specialized organisations and companies that provide the services related to the decommissioning activities. Because of this there is a need to address the issue of assisting the operating organisations in the development and implementation of human resource management policies and training programmes for the facility personnel and contractor personnel involved in various phases of decommissioning activities. The lessons learned in the field of ensuring personnel competence are discussed in the paper (on the basis of information and experiences accumulated from various countries and organizations, particularly, through relevant IAEA activities). Particularly, the following aspects are addressed: transition of training from operational to decommissioning phase; knowledge management; target groups, training needs analysis, and application of a systematic approach to training (SAT); content of training for decommissioning management and professional staff, and for decommissioning workers; selection and training of instructors; training facilities and tools; and training as
Dauber, V.; Scheffer, N.; Schoenfelder, C.
In recent years AREVA has conducted several measures to enhance the effectiveness and efficiency of configuration management-related activities within a nuclear power plant (NPP) new build as well as modernization projects, thereby further strengthening its commitment to achieving the highest level of safety in nuclear facilities. This paper describes a new training course that shall support the standardization and improvement of configuration management activities. Recommendations will be given that should be considered when designing and developing comparable training programs to support change processes within engineering units. (Author)
Mayrhofer, Andrea; Goodman, Claire; Smeeton, Nigel; Handley, Melanie; Amador, Sarah; Davies, Sue
The ABC End of Life Education Programme trained approximately 3000 care home staff in End of Life (EoL) care. An evaluation that compared this programme with the Gold Standards Framework found that it achieved equivalent outcomes at a lower cost with higher levels of staff satisfaction. To consolidate this learning, a facilitated peer education model that used the ABC materials was piloted. The goal was to create a critical mass of trained staff, mitigate the impact of staff turnover and embed EoL care training within the organisations. The aim of the study was to evaluate the feasibility of using a train the trainer (TTT) model to support EoL care in care homes. A mixed method design involved 18 care homes with and without on-site nursing across the East of England. Data collection included a review of care home residents' characteristics and service use (n = 274), decedents' notes n = 150), staff interviews (n = 49), focus groups (n = 3), audio diaries (n = 28) and observations of workshops (n = 3). Seventeen care homes participated. At the end of the TTT programme 28 trainers and 114 learners (56% of the targeted number of learners) had been trained (median per home 6, range 0-13). Three care homes achieved or exceeded the set target of training 12 learners. Trainers ranged from senior care staff to support workers and administrative staff. Results showed a positive association between care home stability, in terms of leadership and staff turnover, and uptake of the programme. Care home ownership, type of care home, size of care home, previous training in EoL care and resident characteristics were not associated with programme completion. Working with facilitators was important to trainers, but insufficient to compensate for organisational turbulence. Variability of uptake was also linked to management support, programme fit with the trainers' roles and responsibilities and their opportunities to work with staff on a daily basis. When
Full Text Available Background: Patients with breast cancer are predisposed to some psychiatric symptoms and mental disorders as a result of their diagnosis or lifestyle. These problems cause patients to have daily stress, feelings of guilt, anxiety, a dysphoric mood, and impaired social relations. Such problems will lead to serious mental disorders.Therefore, life skills training may enable patients to cope better with these problems and improve their mental health.Methods: In an experimental study 50 breast cancer patients were randomly selected and assigned to two groups, experimental and control. The experimental group attended life skills training classes continuously for ten weeks. The duration of each class was two hours. Participants in both groups completed a General Health Questionnaire-28 form before the commencement of classes, after two weeks of training, and again at two months after course completion. The statistical method used in this study was the t-test.Results: In the life skills training group, patients' depressive and anxiety symptoms, somatization disorders, sleep disorders, and disorders of social functioning significantly decreased (P<0.0001. There was no change in the control group.Conclusion: The results show that life skills training can be considered a supportive method for symptoms of depression, anxiety, sleep, and somatic disorders in patients with breast cancer.
LaValley, Susan A; Gage-Bouchard, Elizabeth A
Caregivers of terminally ill patients are at risk for anxiety, depression, and social isolation. Social support from friends, family members, neighbors, and health care professionals can potentially prevent or mitigate caregiver strain. While previous research documents the importance of social support in helping end-of-life caregivers cope with caregiving demands, little is known about differences in social support experiences among caregivers at different life course stages. Using life course theory, this study analyzes data from in-depth interviews with 50 caregivers of patients enrolled in hospice services to compare barriers to mobilizing social support among caregivers at two life course stages: midlife caregivers caring for parents and older adult caregivers caring for spouses/partners. Older adult caregivers reported different barriers to mobilizing social support compared with midlife caregivers. Findings enhance the understanding of how caregivers' life course stage affects their barriers to mobilization of social support resources.
Sharman, Mahesh; Meert, Kathleen L; Sarnaik, Ashok P
Decisions to forgo life support from critically ill children are commonly faced by parents and physicians. Previous research regarding parents' perspectives on the decision-making process has been limited by retrospective methods and the use of closed-ended questionnaires. We prospectively identified and described parents' self-reported influences on decisions to forgo life support from their children. Deeper understanding of parents' views will allow physicians to focus end-of-life discussions on factors important to parents and help resolve conflicts. Prospective, qualitative pilot study. Pediatric intensive care unit of a university-affiliated children's hospital. A total of 14 parents of ten children whose pediatric intensive care unit physician had made a recommendation to limit or withdraw life support. : In-depth, semistructured interviews were conducted with parents during their decision-making process. Factors influencing the parents in this study in their decision to forgo life support included their previous experience with death and end-of-life decision making for others, their personal observations of their child's suffering, their perceptions of their child's will to survive, their need to protect and advocate for their child, and the family's financial resources and concerns regarding life-long care. Parents in this study expressed the desire to do what is best for their child but struggled with feelings of selfishness, guilt, and the need to avoid agony and sorrow. Physician recommendations, review of options, and joint formulation of a plan helped parents gain a sense of control over their situation. Parents of eight children agreed to forgo life support and parents of two did not. Prospective interviews with open-ended questions identified factors influencing parents' decision making not previously described in the critical care literature such as parents' past experiences with end-of-life decisions and their anticipated emotional adjustments and
National Aeronautics and Space Administration — The innovation is to utilize ionic liquids with the Bosch process to achieve closed-loop life support. Specific tasks are to: 1) Advance the technology readiness of...
National Aeronautics and Space Administration — WATER WALLS (WW) takes an approach to providing a life support system, Forward Osmosis (FO), that is biologically and chemically passive, using mechanical systems...
National Aeronautics and Space Administration — Advanced Exploration Systems (AES) Life Support Systems project Trace Contaminant and Particulate Control task: Work in the area of trace contamination and...
National Aeronautics and Space Administration — Space life-supporting systems require effective removal of metabolic CO2 from the cabin atmosphere with minimal loss of O2. Conventional techniques, using either...
Brummelhuis, L.L. ten; Lippe, T. van der
Today’s workforce encompasses a wide variety of employees with specifi c needs and resources when it comes to balancing work and life roles. Our study explores whether various types of work-life balance support measures improve employee helping behavior and performance among single employees,
Martin, Harry J.
Although billions of dollars are spent annually on training and development, much about the transfer processes is not well understood. This study investigated the interaction of workplace climate and peer support on the transfer of learning in a corporate field setting. Supervisor ratings of performance on several skill dimensions were obtained…
Messerschmid, E; Haignere, J P; Damian, K; Damann, V
The operation of the International Space Station (ISS) will be a global multilateral endeavour. Each International Partner will be responsible for the operation of its elements and for providing a crew complement proportional to its share of the overall resources. The preparations of the European Astronaut Centre to furnish training and medical support for the ISS astronauts are described.
This column explores how peer support provider training is enhanced through collaborative learning. Collaborative learning is an approach that draws upon the "real life" experiences of individual learners and encompasses opportunities to explore varying perspectives and collectively construct solutions that enrich the practice of all participants. This description draws upon published articles and examples of collaborative learning in training and communities of practice of peer support providers. Similar to person-centered practices that enhance the recovery experience of individuals receiving services, collaborative learning enhances the experience of peer support providers as they explore relevant "real world" issues, offer unique contributions, and work together toward improving practice. Three examples of collaborative learning approaches are provided that have resulted in successful collaborative learning opportunities for peer support providers. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Loyaga-Rendon, Renzo Y; Plaisance, Eric P; Arena, Ross; Shah, Keyur
The left ventricular assist device (LVAD) is an accepted treatment alternative for the management of end-stage heart failure. As we move toward implantation of LVADs in less severe cases of HF, scrutiny of functional capacity and quality of life becomes more important. Patients demonstrate improvements in exercise capacity after LVAD implantation, but the effect is less than predicted. Exercise training produces multiple beneficial effects in heart failure patients, which would be expected to improve quality of life. In this review, we describe factors that are thought to participate in the persistent exercise impairment in LVAD-supported patients, summarize current knowledge about the effect of exercise training in LVAD-supported patients, and suggest areas for future research. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Jones, Harry W.; Anderson, Grant
As the nation plans manned missions that go far beyond Earth orbit to Mars, there is an urgent need for a robust, disciplined systems engineering methodology that can identify an optimized Environmental Control and Life Support (ECLSS) architecture for long duration deep space missions. But unlike the previously used Equivalent System Mass (ESM), the method must be inclusive of all driving parameters and emphasize the economic analysis of life support system design. The key parameter for this analysis is Life Cycle Cost (LCC). LCC takes into account the cost for development and qualification of the system, launch costs, operational costs, maintenance costs and all other relevant and associated costs. Additionally, an effective methodology must consider system technical performance, safety, reliability, maintainability, crew time, and other factors that could affect the overall merit of the life support system.
Full Text Available Questions of increase of efficiency of a supply with information of creation and support in operation of modern aviation engines are considered. The revealed most perspective directions of development of complex systems of support of life cycle aviation technics.
Rask, Jon; Gibbs, Kristina; Ray, Hami; Bridges, Desireemoi; Bailey, Brad; Smith, Jeff; Sato, Kevin; Taylor, Elizabeth
The NASA Space Life Sciences Training Program (SLSTP) provides undergraduate students entering their junior or senior years with professional experience in space life science disciplines. This challenging ten-week summer program is held at NASA Ames Research Center. The primary goal of the program is to train the next generation of scientists and engineers, enabling NASA to meet future research and development challenges in the space life sciences. Students work closely with NASA scientists and engineers on cutting-edge research and technology development. In addition to conducting hands-on research and presenting their findings, SLSTP students attend technical lectures given by experts on a wide range of topics, tour NASA research facilities, participate in leadership and team building exercises, and complete a group project. For this presentation, we will highlight program processes, accomplishments, goals, and feedback from alumni and mentors since 2013. To date, 49 students from 41 different academic institutions, 9 staffers, and 21 mentors have participated in the program. The SLSTP is funded by Space Biology, which is part of the Space Life and Physical Sciences Research and Application division of NASA's Human Exploration and Operations Mission Directorate. The SLSTP is managed by the Space Biology Project within the Science Directorate at Ames Research Center.
Full Text Available Educational games may improve learning by taking advantage of the new knowledge and skills of todayÃ¢Â€Â™s students obtained from extensive use of interactive games. This paper describes how interactive dynamic simulators of advanced technical systems and phenomena can be shaped and adapted as games and competitions supporting technical education and training. Some selected examples at different educational levels are shown, from vocational training to university level courses. The potential benefit and perceived learning effect of this approach is also described and underpinned from comprehensive user feedback.
Qi, Bin; Guo, Linli; Zhang, Zhixian
Space life science and life support engineering are prominent problems in manned deep space exploration mission. Some typical problems are discussed in this paper, including long-term life support problem, physiological effect and defense of varying extraterrestrial environment. The causes of these problems are developed for these problems. To solve these problems, research on space life science and space medical-engineering should be conducted. In the aspect of space life science, the study of space gravity biology should focus on character of physiological effect in long term zero gravity, co-regulation of physiological systems, impact on stem cells in space, etc. The study of space radiation biology should focus on target effect and non-target effect of radiation, carcinogenicity of radiation, spread of radiation damage in life system, etc. The study of basic biology of space life support system should focus on theoretical basis and simulating mode of constructing the life support system, filtration and combination of species, regulation and optimization method of life support system, etc. In the aspect of space medical-engineering, the study of bio-regenerative life support technology should focus on plants cultivation technology, animal-protein production technology, waste treatment technology, etc. The study of varying gravity defense technology should focus on biological and medical measures to defend varying gravity effect, generation and evaluation of artificial gravity, etc. The study of extraterrestrial environment defense technology should focus on risk evaluation of radiation, monitoring and defending of radiation, compound prevention and removal technology of dust, etc. At last, a case of manned lunar base is analyzed, in which the effective schemes of life support system, defense of varying gravity, defense of extraterrestrial environment are advanced respectively. The points in this paper can be used as references for intensive study on key
Partiprajak, Suphamas; Thongpo, Pichaya
This study explored the retention of basic life support knowledge, self-efficacy, and chest compression performance among Thai nursing students at a university in Thailand. A one-group, pre-test and post-test design time series was used. Participants were 30 nursing students undertaking basic life support training as a care provider. Repeated measure analysis of variance was used to test the retention of knowledge and self-efficacy between pre-test, immediate post-test, and re-test after 3 months. A Wilcoxon signed-rank test was used to compare the difference in chest compression performance two times. Basic life support knowledge was measured using the Basic Life Support Standard Test for Cognitive Knowledge. Self-efficacy was measured using the Basic Life Support Self-Efficacy Questionnaire. Chest compression performance was evaluated using a data printout from Resusci Anne and Laerdal skillmeter within two cycles. The training had an immediate significant effect on the knowledge, self-efficacy, and skill of chest compression; however, the knowledge and self-efficacy significantly declined after post-training for 3 months. Chest compression performance after training for 3 months was positively retaining compared to the first post-test but was not significant. Therefore, a retraining program to maintain knowledge and self-efficacy for a longer period of time should be established after post-training for 3 months. Copyright © 2015 Elsevier Ltd. All rights reserved.
Peld, N.D.; Ridikas, D.
Full-text: Through the provision of neutrons for experiments and their historical association with universities, research reactors have played a prominent role in nuclear education and training of students, scientists and radiation workers. Today education and training remains the foremost application of research reactors, involving close to 160 facilities out of 246 operational. As part of its mandate to facilitate and expand the contribution of atomic energy to peace, health and prosperity throughout the world, the IAEA administers a number of activities intended to promote nuclear research and enable access to nuclear technology for peaceful purposes, one of which is the support of various education and training measures involving research reactors. In the last 5 years, education and training has formed one pillar for the creation of research reactor coalitions and networks to pool their resources and offer joint programmes, such as the on-going Group Fellowship Training Course. Conducted mainly through the Eastern European Research Reactor Initiative, this programme is a periodic sic week course for young scientists and engineers on nuclear techniques and administration jointly conducted at several member research reactor institutes. Organization of similar courses is under consideration in Latin America and the Asia-Pacific Region, also with support from the IAEA. Additionally, four research reactor institutes have begun offering practical education courses through virtual reactor experiments and operation known as the Internet Reactor Laboratory. Through little more than an internet connection and projection screens, university science departments can be connected regionally or bilaterally with the control room o a research reactor for various training activities. Finally, two publications are being prepared, namely Hands-On Training Courses Using Research Reactors and Accelerators, and Compendium on Education and training Based on Research Reactors. These
Elvira Mikhailovna Rebko
Full Text Available The article discloses experience networking of universities (Herzen State Pedagogical University and Sakhalin State University in the development and implementation of joint training programs for master’s education in the field of life safety «Social security in the urban environment». The novelty of the work is to create a schematic design of basic educational training program for master’s education in the mode of networking, and to identify effective instructional techniques and conditions of networking.Purpose – present the results of the joint development of a network of the basic educational program (BEP, to identify the stages of networking, to design a generalized scheme of development and implementation of a network of educational training program for master’s education in the field of life safety.Results generalized model of networking partner institutions to develop and implement the basic educational program master.Practical implications: the education process for Master of Education in the field of health and safety in Herzen State Pedagogical University and Sakhalin State University.
Brummelhuis, L.L. ten; Lippe, T. van der
Today’s workforce encompasses a wide variety of employees with specifi c needs and resources when it comes to balancing work and life roles. Our study explores whether various types of work-life balance support measures improve employee helping behavior and performance among single employees, employees with a partner, and employees with a partner and children. Using a sample of 482 employees at 24 organizations, the results showed that the organization’s work-family culture improved work perf...
Pim A. de Ruijter; Heleen A. Biersteker; Jan Biert; Harry van Goor; Edward C. Tan
Background: Undergraduate medical students follow a compulsory first aid (FA) and basic life support (BLS) course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in undergraduate medical students.Methods: One hundred and twenty students were randomly selected from first year (n=349) medical students who successfully followed a compulsory FA and BLS course. From thes...
Al-Mohaissen, Maha A
Awareness of basic life support (BLS) is paramount to ensure the provision of essential life-saving medical care in emergency situations. This study aimed to measure knowledge of BLS and attitudes towards BLS training among female health students at a women's university in Saudi Arabia. This prospective cross-sectional study took place between January and April 2016 at five health colleges of the Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. All 2,955 students attending the health colleges were invited to participate in the study. Participants were subsequently asked to complete a validated English-language questionnaire which included 21 items assessing knowledge of BLS and six items gauging attitudes to BLS. A total of 1,349 students completed the questionnaire (response rate: 45.7%). The mean overall knowledge score was very low (32.7 ± 13.9) and 87.9% of the participants had very poor knowledge scores. A total of 32.5% of the participants had never received any BLS training. Students who had previously received BLS training had significantly higher knowledge scores ( P supported mandatory BLS training. Overall knowledge about BLS among the students was very poor; however, attitudes towards BLS training were positive. These findings call for an improvement in BLS education among Saudi female health students so as to ensure appropriate responses in cardiac arrest or other emergency situations.
In the UK, voluntary organisations such as the British Red Cross and St John Ambulance have been advocating the compulsory inclusion of first aid education in the school curricula as a way of improving the outcomes for casualties following accidents or emergencies occurring in non-hospital settings. This article focuses on the rationale for teaching first aid to children, including potential benefits of and barriers to providing such education. Commencing first aid training in primary school children and updating skills regularly throughout life may give individuals the confidence to respond to emergency situations.
Gazenko, O G; Grigor'ev, A I; Meleshko, G I; Shepelev, E Ia
This paper discusses general concepts and specific details of the habitability of space stations and planetary bases completely isolated from the Earth for long periods of time. It emphasizes inadequacy of the present-day knowledge about natural conditions that provide a biologically acceptable environment on the Earth as well as lack of information about life support systems as a source of consumables (oxygen, water, food) and a tool for waste management. The habitability of advanced space vehicles is closely related to closed bioregenerative systems used as life support systems.
Bamsey, M.; Graham, T.; Stasiak, M.; Berinstain, A.; Scott, A.; Vuk, T. Rondeau; Dixon, M.
Canada began research on space-relevant biological life support systems in the early 1990s. Since that time Canadian capabilities have grown tremendously, placing Canada among the emerging leaders in biological life support systems. The rapid growth of Canadian expertise has been the result of several factors including a large and technically sophisticated greenhouse sector which successfully operates under challenging climatic conditions, well planned technology transfer strategies between the academic and industrial sectors, and a strong emphasis on international research collaborations. Recent activities such as Canada's contribution of the Higher Plant Compartment of the European Space Agency's MELiSSA Pilot Plant and the remote operation of the Arthur Clarke Mars Greenhouse in the Canadian High Arctic continue to demonstrate Canadian capabilities with direct applicability to advanced life support systems. There is also a significant latent potential within Canadian institutions and organizations with respect to directly applicable advanced life support technologies. These directly applicable research interests include such areas as horticultural management strategies (for candidate crops), growth media, food processing, water management, atmosphere management, energy management, waste management, imaging, environment sensors, thermal control, lighting systems, robotics, command and data handling, communications systems, structures, in-situ resource utilization, space analogues and mission operations. With this background and in collaboration with the Canadian aerospace industry sector, a roadmap for future life support contributions is presented here. This roadmap targets an objective of at least 50% food closure by 2050 (providing greater closure in oxygen, water recycling and carbon dioxide uptake). The Canadian advanced life support community has chosen to focus on lunar surface infrastructure and not low Earth orbit or transit systems (i.e. microgravity
Massenberg, Ann-Christine; Spurk, Daniel; Kauffeld, Simone
Supervisor support, peer support and transfer motivation have been identified as important predictors of training transfer. Transfer motivation is thought to mediate the support-training transfer relationship. Especially after team training interventions that include all team members (i.e. whole-team training), individual perception of these…
Madera, Juan M.; Steele, Stacey T.; Beier, Margaret
The current study examined the temporal effect of perceived training utility on adoption of a trained method and how perceived organizational support influences the relationship between perceived training utility perceptions and adoption of a trained method. With the use of a correlational-survey-based design, this longitudinal study required…
Ewert, Michael K.; Barta, Daniel J.; McQuillan, Jeffrey
Exploration Life Support (ELS) is one of NASA's Exploration Technology Development Projects. ELS plans, coordinates and implements the development of new life support technologies for human exploration missions as outlined in NASA's Vision for Space Exploration. ELS technology development currently supports three major projects of the Constellation Program - the Orion Crew Exploration Vehicle (CEV), the Altair Lunar Lander and Lunar Surface Systems. ELS content includes Air Revitalization Systems (ARS), Water Recovery Systems (WRS), Waste Management Systems (WMS), Habitation Engineering, Systems Integration, Modeling and Analysis (SIMA), and Validation and Testing. The primary goal of the ELS project is to provide different technology options to Constellation which fill gaps or provide substantial improvements over the state-of-the-art in life support systems. Since the Constellation missions are so challenging, mass, power, and volume must be reduced from Space Shuttle and Space Station technologies. Systems engineering analysis also optimizes the overall architecture by considering all interfaces with the life support system and potential for reduction or reuse of resources. For long duration missions, technologies which aid in closure of air and water loops with increased reliability are essential as well as techniques to minimize or deal with waste. The ELS project utilizes in-house efforts at five NASA centers, aerospace industry contracts, Small Business Innovative Research contracts and other means to develop advanced life support technologies. Testing, analysis and reduced gravity flight experiments are also conducted at the NASA field centers. This paper gives a current status of technologies under development by ELS and relates them to the Constellation customers who will eventually use them.
The Effect of Instructional Method on Cardiopulmonary Resuscitation Skill Performance: A Comparison Between Instructor-Led Basic Life Support and Computer-Based Basic Life Support With Voice-Activated Manikin.
Wilson-Sands, Cathy; Brahn, Pamela; Graves, Kristal
Validating participants' ability to correctly perform cardiopulmonary resuscitation (CPR) skills during basic life support courses can be a challenge for nursing professional development specialists. This study compares two methods of basic life support training, instructor-led and computer-based learning with voice-activated manikins, to identify if one method is more effective for performance of CPR skills. The findings suggest that a computer-based learning course with voice-activated manikins is a more effective method of training for improved CPR performance.
Chunxiao, Xu; Hong, Liu
The use of plants for life support applications in space is appealing because of the multiple life support functions by the plants. Research on crops that were grown in the life support system to provide food and oxygen, remove carbon dioxide was begun from 1960. To select possible crops for research on the bioregenerative life support systems in China, criteria for the selection of potential crops were made, and selection of crops was carried out based on these criteria. The results showed that 14 crops including 4 food crops (wheat, rice, soybean and peanut) and 7 vegetables (Chinese cabbage, lettuce, radish, carrot, tomato, squash and pepper) won higher scores. Wheat ( Triticum aestivum L.), rice ( Oryza sativa L.), soybean ( Glycine max L.) and peanut ( Arachis hypogaea L.) are main food crops in China. Chinese cabbage ( Brassica campestris L. ssp. chinensis var. communis), lettuce ( Lactuca sativa L. var. longifolia Lam.), radish ( Raphanus sativus L.), carrot ( Daucus carota L. var. sativa DC.), tomato ( Lycopersicon escalentum L.), squash ( Cucurbita moschata Duch.) and pepper ( Capsicum frutescens L. var. longum Bailey) are 7 vegetables preferred by Chinese. Furthermore, coriander ( Coriandum sativum L.), welsh onion ( Allium fistulosum L. var. giganteum Makino) and garlic ( Allium sativum L.) were selected as condiments to improve the taste of space crew. To each crop species, several cultivars were selected for further research according to their agronomic characteristics.
Anderson, Molly; Curley, Su; Rotter, Henry; Stambaugh, Imelda; Yagoda, Evan
Life support systems are a critical part of human exploration beyond low earth orbit. NASA s Altair Lunar Lander team is pursuing efficient solutions to the technical challenges of human spaceflight. Life support design efforts up through Design Analysis Cycle (DAC) 4 focused on finding lightweight and reliable solutions for the Sortie and Outpost missions within the Constellation Program. In DAC-4 and later follow on work, changes were made to add functionality for new requirements accepted by the Altair project, and to update the design as knowledge about certain issues or hardware matured. In DAC-5, the Altair project began to consider mission architectures outside the Constellation baseline. Selecting the optimal life support system design is very sensitive to mission duration. When the mission goals and architecture change several trade studies must be conducted to determine the appropriate design. Finally, several areas of work developed through the Altair project may be applicable to other vehicle concepts for microgravity missions. Maturing the Altair life support system related analysis, design, and requirements can provide important information for developers of a wide range of other human vehicles.
Park, Jisung; Roh, Soonhee; Yeo, Younsook
Purpose: The present study tested Smith's (2003. Theorizing religious effects among American adolescents. "Journal for the Scientific Study of Religion, 42", 17-30. doi:10.1111/1468-5906.t01-1-00158) theory of religious effects to explore the relationship of religiosity, social support, and life satisfaction among elderly Korean…
Wheeler, Raymond M.
Use of a phase change permeation membrane (Dutyion [Trademark]) to passively and selectively mobilize water in microgravity to enable improved water recovery from urine/brine for Environment Control and Life Support Systems (ECLSS) and water delivery to plans for potential use in microgravity.
Source apportionment of social support and quality of life index among drug abuse inmates using multiple linear regression. ... The data from 12 prisons selected in Peninsular Malaysia was collected during the period April and June 2015. The 1753 respondents were selected using simple random sampling. The method of ...
Born out of a 1981 murder, Buffalo (New York) Public Schools' EPIC (Effective Parenting Information for Children) program successfully combines parenting, effective teaching, and community programs to help family and school life support each other. Under EPIC, teachers are advised to help students acquire 23 skills involving self-esteem, rules,…
Been, Wike M.; van der Lippe, Tanja; den Dulk, Laura; Das Dores Horta Guerreiro, Maria; Kanjuo Mrčela, Aleksandra; Niemistö, Charlotta
Top managers—defined as CEOs, CFOs and members of boards of directors—decide to what degree their organization offers employees work-life arrangements. This study focuses on the conditions under which they support such arrangements. A factorial survey of 202 top managers in five European countries
Netjes, M.; Reijers, H.A.; Aalst, van der W.M.P.
Business Process Management (BPM) systems provide a broad range of facilities to enact and manage operational business processes. Ideally, these systems should provide support for the complete BPM life-cycle: (re)design, configuration, execution, control, and diagnosis of processes. In the research
Tawa, Hiroki; Yonezawa, Yoshiharu; Maki, Hiromichi; Ogawa, Hidekuni; Ninomiya, Ishio; Sada, Kouji; Hamada, Shingo; Caldwell, W Morton
We have developed a new wireless breathing-training support system for kinesitherapy. The system consists of an optical sensor, an accelerometer, a microcontroller, a Bluetooth module and a laptop computer. The optical sensor, which is attached to the patient's chest, measures chest circumference. The low frequency components of circumference are mainly generated by breathing. The optical sensor outputs the circumference as serial digital data. The accelerometer measures the dynamic acceleration force produced by exercise, such as walking. The microcontroller sequentially samples this force. The acceleration force and chest circumference are sent sequentially via Bluetooth to a physical therapist's laptop computer, which receives and stores the data. The computer simultaneously displays these data so that the physical therapist can monitor the patient's breathing and acceleration waveforms and give instructions to the patient in real time during exercise. Moreover, the system enables a quantitative training evaluation and calculation the volume of air inspired and expired by the lungs.
Sargusingh, Miriam J.; Perry, Jay L.
Many advanced human space exploration missions being considered by the National Aeronautics and Space Administration (NASA) include concepts in which in-space systems cycle between inhabited and uninhabited states. Managing the life support system (LSS) may be particularly challenged during these periods of intermittent dormancy. A study to identify LSS management challenges and considerations relating to dormancy is described. The study seeks to define concepts suitable for addressing intermittent dormancy states and to evaluate whether the reference LSS architectures being considered by the Advanced Exploration Systems (AES) Life Support Systems Project (LSSP) are sufficient to support this operational state. The primary focus of the study is the mission concept considered to be the most challenging-a crewed Mars mission with an extensive surface stay. Results from this study are presented and discussed.
Mohammad Reza Zarbakhsh Bahri
Full Text Available Introduction: This study aims to evaluate the effectiveness of stress management training and problem-solving training on quality of life and life expectancy of infertile women was conducted.Material and Methods: The method of this study was experimental with pretest – posttest design with a control group. population of 400 infertile women who referred to infertility center in Rasht were randomized to 250 of them were selected and the quality of life and life expectancy of the study were the 45 members of the quality of life and life expectancy lower were more randomly in three groups of 15 people, including two experimental groups and one control group were replaced. Each experimental groups were trained for 10 sessions of 90 minutes, respectively, stress management and problem-solving. Upon completion of the training program, participants were assessed again.Results: The result of present study showed that there was a significant difference between the experimental groups and control group in the scores of quality of life and life expectancy (p0.05.Conclusion: Stress management and problem solving training were effective on life expectancy and quality of life of infertile women but there was no significant difference between the effectiveness of these two methods on life expectancy and quality of life of infertile women.
Chiang, Hsu-Min; Ni, Xinyu; Lee, Young-Sun
This study investigated the extent to which life skills training was offered to middle and high school students with autism and life skills training needs after high school. A secondary analysis of the National Longitudinal Training Study-2 (NLTS-2) data was conducted in this study. This study found that the majority of the middle and high school…
Pilutti, Lara A; Paulseth, John E; Dove, Carin; Jiang, Shucui; Rathbone, Michel P; Hicks, Audrey L
Background: There is evidence of the benefits of exercise training in multiple sclerosis (MS); however, few studies have been conducted in individuals with progressive MS and severe mobility impairment. A potential exercise rehabilitation approach is total-body recumbent stepper training (TBRST). We evaluated the safety and participant-reported experience of TBRST in people with progressive MS and compared the efficacy of TBRST with that of body weight-supported treadmill training (BWSTT) on outcomes of function, fatigue, and health-related quality of life (HRQOL). Methods: Twelve participants with progressive MS (Expanded Disability Status Scale scores, 6.0-8.0) were randomized to receive TBRST or BWSTT. Participants completed three weekly sessions (30 minutes) of exercise training for 12 weeks. Primary outcomes included safety assessed as adverse events and patient-reported exercise experience assessed as postexercise response and evaluation of exercise equipment. Secondary outcomes included the Multiple Sclerosis Functional Composite, the Modified Fatigue Impact Scale, and the Multiple Sclerosis Quality of Life-54 questionnaire scores. Assessments were conducted at baseline and after 12 weeks. Results: Safety was confirmed in both exercise groups. Participants reported enjoying both exercise modalities; however, TBRST was reviewed more favorably. Both interventions reduced fatigue and improved HRQOL (P ≤ .05); there were no changes in function. Conclusions: Both TBRST and BWSTT seem to be safe, well tolerated, and enjoyable for participants with progressive MS with severe disability. Both interventions may also be efficacious for reducing fatigue and improving HRQOL. TBRST should be further explored as an exercise rehabilitation tool for patients with progressive MS.
Shaku, Fumio; Tsutsumi, Madoka
Decision making in terminal illness has recently received increased attention. In Japan, patients and their families typically make decisions without understanding either the severity of illness or the efficacy of life-supporting treatments at the end of life. Japanese culture traditionally directs the family to make decisions for the patient. This descriptive study examined the influence of the experiences of 391 Japanese nurses caring for dying patients and family members and how that experience changed their decision making for themselves and their family members. The results were mixed but generally supported the idea that the more experience nurses have in caring for the dying, the less likely they would choose to institute lifesupport measures for themselves and family members. The results have implications for discussions on end-of-life care. © The Author(s) 2016.
Eckelman, Matthew J.
In our rapidly urbanizing world, sustainable transportation presents a major challenge. Transportation decisions have considerable direct impacts on urban society, both positive and negative, for example through changes in transit times and economic productivity, urban connectivity, tailpipe emissions and attendant air quality concerns, traffic accidents, and noise pollution. Much research has been dedicated to quantifying these direct impacts for various transportation modes. Transportation planning decisions also result in a variety of indirect environmental and human health impacts, a portion of which can accrue outside of the transit service area and so outside of the local decision-making process. Integrated modeling of direct and indirect impacts over the life cycle of different transportation modes provides decision support that is more comprehensive and less prone to triggering unintended consequences than a sole focus on direct tailpipe emissions. The recent work of Chester et al (2013) in this journal makes important contributions to this research by examining the environmental implications of introducing bus rapid transit and light rail in Los Angeles using life cycle assessment (LCA). Transport in the LA region is dominated by automobile trips, and the authors show that potential shifts to either bus or train modes would reduce energy use and emissions of criteria air pollutants, on an average passenger mile travelled basis. This work compares not just the use of each vehicle, but also upstream impacts from its manufacturing and maintenance, as well as the construction and maintenance of the entire infrastructure required for each mode. Previous work by the lead author (Chester and Horvath 2009), has shown that these non-operational sources and largely non-local can dominate life cycle impacts from transportation, again on an average (or attributional) basis, for example increasing rail-related GHG emissions by >150% over just operational emissions
Cripe, Larry D; Perkins, Susan M; Cottingham, Ann; Tong, Yan; Kozak, Mary Ann; Mehta, Rakesh
Palliative sedation for refractory existential distress (PS-ED) is ethically troubling but potentially critical to quality end-of-life (EOL) care. Physicians' in postgraduate training support toward PS-ED is unknown nor is it known how empathy, hope, optimism, or intrinsic religious motivation (IRM) affect their support. These knowledge gaps hinder efforts to support physicians who struggle with patients' EOL care preferences. One hundred thirty-four postgraduate physicians rated their support of PS for refractory physical pain (PS-PP) or PS-ED, ranked the importance of patient preferences in ethically challenging situations, and completed measures of empathy, hope, optimism, and IRM. Predictors of PS-ED and PS-PP support were examined using binary and multinomial logistic regression. Only 22.7% of residents were very supportive of PS-ED, and 82.0% were very supportive of PS-PP. Support for PS-PP or PS-ED did not correlate with levels of empathy, hope, optimism, or IRM; however, for residents with lower IRM, greater optimism was associated with greater PS-ED support. In contrast, among residents with higher IRM, optimism was not associated with PS-ED support. Comparing current results to published surveys, a similar proportion of residents and practicing physicians support PS-ED and PS-PP. In contrast to practicing physicians, however, IRM does not directly influence residents' supportiveness. The interaction between optimism and IRM suggests residents' beliefs and characteristics are salient to their EOL decisions. End-of-life curricula should provide physicians opportunities to reflect on the personal and ethical factors that influence their support for PS-ED.
Pocnet, Cornelia; Antonietti, Jean-Philippe; Strippoli, Marie-Pierre F; Glaus, Jennifer; Preisig, Martin; Rossier, Jérôme
The aim of this study was to investigate the relationship between major recent life events that occurred during the last 5 years, social and personal resources, and subjective quality of life (QoL). A total of 1801 participants from the general population (CoLaus/PsyCoLaus study) completed the Life Events Questionnaire, the Social Support Questionnaire, the NEO Five-Factor Inventory Revised, and the Manchester Short Assessment of Quality of Life. Major life events were modestly associated with the QoL (about 5 % of the explained variance). However, QoL was significantly related to perceived social support and personality traits (about 37 % of the explained variance). Particularly, perceived social support, extraversion and conscientiousness personality dimensions were positively linked to life satisfaction, whereas a high level of neuroticism was negatively associated with QoL. This study highlights the negative but temporary association between critical events and QoL. However, a combination of high conscientiousness and extraversion, and positive social support may explain better variances for a high-perceived QoL.
Li, Yajie; Chen, Huanguo; Cai, Li; Chen, Pei; Qian, Jiacheng; Wu, Jianwei
It is a common phenomenon that fatigue crack initiation occurs frequently in the inclusions of wheel rims. Research on the fatigue life of wheel rims with spherical inclusions is of great significance on the reliability of wheels. To find the danger point and working condition of a wheel, the stress state of the wheel rim with spherical inclusions was analyzed using the finite element method. Results revealed that curve conditions are dangerous. The critical plane method, based on the cumulative fatigue damage theory, was used to predict the fatigue life of the wheel rim and whether it contained spherical inclusions or not under curve conditions. It was found that the fatigue life of the wheel rim is significantly shorter when the wheel rim contains spherical inclusions. Analysis of the results can provide a theoretical basis and technical support for train operations and maintenance.
R K Mani
Full Text Available Appropriate treatment limitations towards the end of life to reduce unwanted burdens require ethical clarity that is supported by appropriate legislation. The lack of knowledge of enabling legal provisions, physicians feel vulnerable to legal misinterpretation of treatment limiting decisions. In India the lack of societal awareness, inadequate exploration of the gray areas of bio-ethics and unambiguous legal position relating to terminal illness have resulted in poor quality end of life care. Much of the perceived vulnerability by the physician is attributable to insufficient knowledge and understanding of existing constitutional and legal position in India. While we await informed legal and legislative opinion, this paper highlights possible legal liabilities arising from treatment limitation decisions with available defense. It is hoped that such clarity would lead to more confident ethical decisions and improved end of life care for patients.
Sullivan, D.J.; Hubbard, L.B.; Broadbent, M.V.; Stewart, P.; Jaeger, M.
Advanced life support medications stored in emergency department stretcher areas, diagnostic radiology rooms, and radiotherapy suites are exposed to ionizing radiation. We hypothesized that radiation may decrease the potency and thus the shelf life of medications stored in these areas. Atropine, dopamine, epinephrine, and isoproterenol were exposed to a wide range of ionizing radiation. The potency of the four drugs was unaffected by levels of radiation found in ED stretcher areas and high-volume diagnostic radiograph rooms (eg, chest radiograph, computed tomography, fluoroscopy). The potency of atropine may be reduced by gamma radiation in high-use radiotherapy suites. However, dopamine, epinephrine, and isoproterenol were unaffected by high doses of gamma radiation. Atropine, dopamine, epinephrine, and isoproterenol may be safely kept in ED stretcher areas and diagnostic radiology rooms without loss of potency over the shelf life of the drugs
Gd. Harry Kurnia Prawedana
Full Text Available Indonesia is a popular tourist destination which has potential for drowning cases. Therefore, required knowledge of adult basic life support to be able to deal with such cases in the field. Basic life support in an act to maintain airway and assist breathing and circulation without the use of tools other than simple breathing aids. The most important factor that determines the outcome of drowning event is the duration and severity of hypoxia induced. The management of near drowning at the scene include the rescue of victim from the water, rescue breathing, chest compression, cleaning the vomit substances which allowing blockage of the airway, prevent loss of body heat, and transport the victim to nearest emergency department for evaluation and monitoring.
Hogan, John A. (Editor); Race, Margaret S. (Editor); Fisher, John W. (Editor); Joshi, Jitendra A. (Editor); Rummel, John D. (Editor)
A workshop entitled "Life Support and Habitation and Planetary Protection Workshop" was held in Houston, Texas on April 27-29, 2005 to facilitate the development of planetary protection guidelines for future human Mars exploration missions and to identify the potential effects of these guidelines on the design and selection of related human life support, extravehicular activity and monitoring and control systems. This report provides a summary of the workshop organization, starting assumptions, working group results and recommendations. Specific result topics include the identification of research and technology development gaps, potential forward and back contaminants and pathways, mitigation alternatives, and planetary protection requirements definition needs. Participants concluded that planetary protection and science-based requirements potentially affect system design, technology trade options, development costs and mission architecture. Therefore early and regular coordination between the planetary protection, scientific, planning, engineering, operations and medical communities is needed to develop workable and effective designs for human exploration of Mars.
Russell, James F.; Lewis, John F.
Orion is the next vehicle for human space travel. Humans will be sustained in space by the Orion subystem, environmental control and life support (ECLS). The ECLS concept at the subsystem level is outlined by function and technology. In the past two years, the interface definition with other subsystems has increased through different integrated studies. The paper presents the key requirements and discusses three recent studies (e.g., unpressurized cargo) along with the respective impacts on the ECLS design moving forward.
Knott, W. M.
The Controlled Ecological Life Support System (CELSS) Breadboard Project, NASA's effort to develop the technology required to produce a functioning bioregenerative system, is discussed. The different phases of the project and its current status are described. The relationship between the project components are shown, and major project activities for fiscal years 1989-1993 are listed. The biomass production chamber to be used by the project is described.
Knott, W. M.
The Closed Ecological Life Support System (CELSS) Breadboard Project, NASA's effort to develop the technology required to produce a functioning bioregenerative system, is discussed. The different phases of the project and its current status are described. The relationship between the project components are shown, and major project activities for fiscal years 1989 to 1993 are listed. The Biomass Production Chamber (BPC) became operational and tests of wheat as a single crop are nearing completion.
Kinnane, Nicole Anne; Waters, Trish; Aranda, Sanchia
Volunteers from Peter MacCallum Cancer Centre (Peter Mac) Patient Information and Support Centre (PISC) assist the Cancer Support Nurse by helping patients and families/carers find information and provide face-to-face peer support. Benefits of shared personal experiences between volunteer and patient are clearly different from professional support. Volunteers require specific skill sets and detailed preparation for this role. Volunteers completed a 3-day training programme adapted from the Cancer Council Victoria's 'Cancer Connect Telephone Peer Support Volunteer' training programme. The focus was role expectations and boundaries for peer support volunteers, debriefing, communication skills training, support services, complementary and alternative therapies and internet information. Assessment included a quiz and observation for a range of competencies. Role-play with simulated patients developed appropriate support skills. Eight volunteers participated. Pre-training questionnaires revealed all volunteers highly self-rated existing skills supporting people affected by cancer. During training, volunteers recognised these skills were inadequate. All agreed that role-play using an actor as a 'simulated patient' helped develop communication skills; however, the experience proved challenging. Post-training all reported increased knowledge of role definition and boundaries, supportive communication skills, supports available for patients and families/carers and importance of self-care. Facilitators recommended seven of the eight participants be accredited PISC Peer Support Volunteers. One volunteer was assessed unsuitable for consistently overstepping the boundaries of the peer support role and withdrew from training. Success of the programme resulted in a trained 'face-to-face peer support volunteer' group better equipped for their role. Sixteen months following training, all who completed the programme remain active volunteers in the PISC. Planned educational updates
...) microworld training. RAND developed and piloted microworld training for distribution management skills as a part of a larger project that entailed making changes to the current structure, content, and methods of CSS training...
Van Scoy, Lauren Jodi; Watson-Martin, Elizabeth; Bohr, Tiffany A; Levi, Benjamin H; Green, Michael J
Discussing end-of-life issues with patients is an essential role for chaplains. Few tools are available to help chaplains-in-training develop end-of-life communication skills. This study aimed to determine whether playing an end-of-life conversation game increases the confidence for chaplain-in-trainings to discuss end-of-life issues with patients. We used a convergent mixed methods design. Chaplains-in-training played the end-of-life conversation game twice over 2 weeks. For each game, pre- and postgame questionnaires measured confidence discussing end-of-life issues with patients and emotional affect. Between games, chaplains-in-training discussed end-of-life issues with an inpatient. One week after game 2, chaplains-in-training were individually interviewed. Quantitative data were analyzed using descriptive statistics and Wilcoxon rank-sum t tests. Content analysis identified interview themes. Quantitative and qualitative data sets were then integrated using a joint display. Twenty-three chaplains-in-training (52% female; 87% Caucasian; 70% were in year 1 of training) completed the study. Confidence scores (scale: 15-75; 75 = very confident) increased significantly after each game, increasing by 10.0 points from pregame 1 to postgame 2 ( P game, and shyness subscale scores decreased significantly after each game. Content analysis found that chaplains-in-training found the game to be a positive, useful experience and reported that playing twice was beneficial (not redundant). Mixed methods analysis suggest that an end-of-life conversation game is a useful tool that can increase chaplain-in-trainings' confidence for initiating end-of-life discussions with patients. A larger sample size is needed to confirm these findings.
PSI Associates, Inc., Washington, DC.
The cross-cultural training module and support services for Peace Corps volunteers en route to Liberia make trainees more aware of and sensitive to cultural differences in human behavior and human interaction. In this part of the Peace Corps Stateside Teacher Training Model, the approach to training is both generic and specific, and both native…
Gitelson, Josef I.
The advent of man-made closed ecosystems (CES) is a solution of the fundamental problem-egress of humans beyond the Earth's biosphere, providing biological basis for exploitation of Space and celestial bodies. Yet, before proceeding to these ambitious project elements of closed life-support biotechnologies, there can be found diverse applications on Earth in human settlements providing for high quality of life under extreme environment conditions: high latitudes, deserts, mountains and industrially polluted areas. This presentation considers these variations of terrestrial applications of CELSS technologies. The version of CES under development is based on making direct use of the light energy in plant photosynthesis. In this case life support of one man on the Earth orbit requires solar light collected from 5-10m2. Among terrestrial applications of prime importance is the development of an ecohome designed to provide people with a high quality of life in Arctic and Antarctic territories. The developed technology of cascade employment of energy makes possible (expending 10-15 kw of installed power per a house-3-5 member family) to provide for: permanent supply of fresh vitamin-full vegetables, absorption and processing oaf excreta, purification of water and air in the living quarters, habitual colour and light conditions in the premises in winter making up to sensorial deprivation and, finally, psychological comfort of close contact with the plants during the long polar night. Ecohabitat based on the technology described in realistic today and depends only on the energy available and the resolution and readiness (sagacity) of the decision-makers to be committed with ecohome assigning. The ecological and economical significance of construction of ecohabitats for the northern territories of Canada, Alaska and Russia is apparent. This principle can be used (with considerable economy of energy and construction costs) to maintain normal partial pressure of oxygen inside
Valladares, Angel Felix; Aebersold, Michelle; Tschannen, Dana; Villarruel, Antonia Maria
A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is an important contribution to developing cost
Perry Lattimore, L; Parsons, Marsha B; Reid, Dennis H; Ahearn, William
Currently recommended practice in supported work emphasizes training job skills to workers with severe disabilities while on the job. Early behavioral research indicated that skills needed in natural environments could also be trained in simulated settings. We compared job-site plus simulation training for teaching job skills to supported workers with autism to provision of training exclusively on the job. Job-site training occurred in a small publishing company during the regular work routin...
Laffan, Amanda J; Daniels, Jo; Osborn, Michael
The importance of training non-psychology healthcare professionals to offer psychological support to people with cancer is becoming increasingly recognized. This small-scale pilot project sought to identify the training and support needs of oncology staff and to evaluate the effectiveness of a Level 2 Psychological Support Training Program workshop. Semi-structured interviews with five members of multidisciplinary oncology staff identified that training needs were primarily around communication skills, recognizing and dealing with emotions, offering support and empathy, and self-care. Pre and post-training questionnaires developed with these themes in mind revealed that the Level 2 Training Program workshops run in this network of hospitals are effective in increasing participants' levels of perceived knowledge and confidence across each of these domains. Recommendations are made for further enhancing this effectiveness.
Diggs, Leigh Ann; Sheth-Chandra, Manasi; De Leo, Gianluca
Children have unique medical needs compared to adults. Emergency medical services personnel need proper equipment and training to care for children. The purpose of this study is to characterize emergency medical services pediatric basic life support to help better understand the needs of children transported by ambulance. Pediatric basic life support patients were identified in this retrospective descriptive study. Descriptive statistics were used to examine incident location, possible injury, cardiac arrest, resuscitation attempted, chief complaint, primary symptom, provider's primary impression, cause of injury, and procedures performed during pediatric basic life support calls using the largest aggregate of emergency medical services data available, the 2013 National Emergency Medical Services Information System (NEMSIS) Public Release Research Data Set. Pediatric calls represented 7.4% of emergency medical services activations. Most pediatric patients were male (49.8%), White (40.0%), and of non-Hispanic origin (56.5%). Most incidents occurred in the home. Injury, cardiac arrest, and resuscitation attempts were highest in the 15 to 19 year old age group. Global complaints (37.1%) predominated by anatomic location and musculoskeletal complaints (26.9%) by organ system. The most common primary symptom was pain (30.3%) followed by mental/psychiatric (13.4%). Provider's top primary impression was traumatic injury (35.7%). The most common cause of injury was motor vehicle accident (32.3%). The most common procedure performed was patient assessment (27.4%). Median EMS system response time was 7 minutes (IQR: 5-12). Median EMS scene time was 12 minutes (IQR: 8-19). Median transport time was 14 minutes (IQR: 8-24). Median EMS total call time was 51 minutes (IQR: 33-77). The epidemiology of pediatric basic life support can help to guide efforts in both emergency medical services operations and training.
Full Text Available Objective: This research aimed to study the effect of life skill training on mental health of Iranian middle school students.Method: This experimental study was conducted In 2015 on 100 students of city of Ghaemshahr (North of Iran, who were randomly selected and divided into two equal groups of intervention (n = 50 and control (n = 50. Qualified trainers provided eight sessions (two sessions a week for 2 hours of life skills training to the intervention group for one month. The control group did not participate in any training sessions during the same period. Mental health in both groups was assessed by a questionnaire pre- and post-training. Data were analyzed using descriptive and infernal (ANCOVA and paired t-test statistic tests.Results: The average age of the participants in both groups was 13.5±1.01. ANCOVA test results revealed that the average score of violence, addiction, stress and sensation-seeking before and after the training was statistically significant in the intervention group and control groups (p<0.001.Conclusion: Life skills training had positive effects on mental health of the participants. Given the importance of mental health in modern societies, it is necessary for schools to incorporate life skills in their curriculum to support the mental health of adolescents.
Straight, Christian L.; Bubenheim, David L.; Bates, Maynard E.; Flynn, Michael T.
CELSS Antarctic Analog Project (CAAP) represents a logical solution to the multiple objectives of both the NASA and the National Science Foundation (NSF). CAAP will result in direct transfer of proven technologies and systems, proven under the most rigorous of conditions, to the NSF and to society at large. This project goes beyond, as it must, the generally accepted scope of CELSS and life support systems including the issues of power generation, human dynamics, community systems, and training. CAAP provides a vivid and starkly realistic testbed of Controlled Ecological Life Support System (CELSS) and life support systems and methods. CAAP will also be critical in the development and validation of performance parameters for future advanced life support systems.
Acharya, Rija; Badhu, Angur; Shah, Tara; Shrestha, Sharmila
An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers. Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method. Self- constructed observation checklist and semi structured interview schedule was used for data collection. More than half of the respondents had less than five years of experience and were not trained in first aid. About two-third of the respondents had adequate knowledge on first aid. About 90% of the ambulance had oxygen cylinder and adult oxygen mask which was 'usually' used equipment. More than half of ambulance had equipment less than 23% as compared to that of national guidelines. There was significant association of knowledge with the experience (p = 0.004) and training (p = 0.001). Availability of equipment was associated with training received (p = 0.007),organization (p= 0.032)and district (p = 0.023) in which the ambulance is registered. The study concludes that maximum ambulance linked to BPKIHS, Nepal did not have even one fourth of the equipment for basic life support. Equipment usually used was oxygen cylinder and oxygen mask. Majority of driver had adequate knowledge on first aid and it was associated with training and experience.
Roshana, Shrestha; Kh, Batajoo; Rm, Piryani; Mw, Sharma
Basic life support (BLS), a key component of the chain of survival decreases the arrest - cardiopulmonary resuscitation interval and increases the rate of hospital discharge. The study aimed to explore the knowledge of and attitude towards basic life support (BLS) among medical/paramedical professionals. An observational study was conducted by assessing response to self prepared questionnaire consisting of the demographic information of the medical/paramedical staff, their personnel experience/attitude and knowledge of BLS based on the 2005 BLS Guidelines of European Resuscitation Council. After excluding incomplete questionnaires, the data from 121 responders (27 clinical faculty members, 21 dental and basic sciences faculty members, 29 house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4%) of the 121 responders answered ≥11, 53 (43%) answered 7-10, and 58 (48%) answered basic sciences faculty members attained a least mean score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary resuscitation (CPR) training within 5 years obtained a highest mean score of 8.62±2.49, whereas those who had the training more than 5 years back or no training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001). Those who were involved in resuscitation frequently had a higher median score of 8 in comparison to those who were seldom involved or not involved at all (P<0.001). The average health personnel in our hospital lack adequate knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of these personnel. Thus standard of CPR/BLS training and assessment are recommended at our hospital.
Shull, Sarah A.; Schneider, Walter F.
The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA's Habitability Architecture Team (HAT). The LSS project is focused on four areas: architecture and systems engineering for life support systems, environmental monitoring, air revitalization, and wastewater processing and water management. Starting with the international space station (ISS) LSS systems as a point of departure (where applicable), the mission of the LSS project is three-fold: 1. Address discrete LSS technology gaps 2. Improve the reliability of LSS systems 3. Advance LSS systems towards integrated testing on the ISS. This paper summarized the work being done in the four areas listed above to meet these objectives. Details will be given on the following focus areas: Systems Engineering and Architecture- With so many complex systems comprising life support in space, it is important to understand the overall system requirements to define life support system architectures for different space mission classes, ensure that all the components integrate well together and verify that testing is as representative of destination environments as possible. Environmental Monitoring- In an enclosed spacecraft that is constantly operating complex machinery for its own basic functionality as well as science experiments and technology demonstrations, it's possible for the environment to become compromised. While current environmental monitors aboard the ISS will alert crew members and mission control if there is an emergency, long-duration environmental monitoring cannot be done in-orbit as current methodologies
Kalz, Marco; Lenssen, Niklas; Felzen, Marc; Rossaint, Rolf; Tabuenca, Bernardo; Specht, Marcus; Skorning, Max
No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the perspective of medical experts and end-users. The study aims to assess the quality of current mobile apps for cardiopulmonary resuscitation (CPR) training and real incident support from expert as well as end-user perspective. Two independent medical experts evaluated the medical content of CPR apps from the Google Play store and the Apple App store. The evaluation was based on pre-defined minimum medical content requirements according to current Basic Life Support (BLS) guidelines. In a second phase, non-medical end-users tested usability and appeal of the apps that had at least met the minimum requirements. Usability was assessed with the System Usability Scale (SUS); appeal was measured with the self-developed ReactionDeck toolkit. Out of 61 apps, 46 were included in the experts' evaluation. A consolidated list of 13 apps resulted for the following layperson evaluation. The interrater reliability was substantial (kappa=.61). Layperson end-users (n=14) had a high interrater reliability (intraclass correlation 1 [ICC1]=.83, Ptraining and real incident support are available, very few are designed according to current BLS guidelines and offer an acceptable level of usability and hedonic quality for laypersons. The results of this study are intended to optimize the development of CPR mobile apps. The app ranking supports the informed selection of mobile apps for training situations and CPR campaigns as well as for real incident support.
Palmer, I P; Baskett, P J; McCabe, S E
Many studies have drawn attention to deficiencies in the management of major trauma, both in the UK and elsewhere. One area that has received little attention is the documentation of such cases in the Emergency Room. When outcome may be sub-optimal, documentation assumes greater importance if advances are to be made in the organisation of trauma care. Based upon the American College of Surgeons Advanced Trauma Life Support (ATLS) protocols, the authors have designed a document that records dynamically what happens to the multiply injured victim on arrival in the Emergency Room. It unifies the recording of vital signs, whilst acting as an assessment and resuscitation template. By ensuring no life-threatening illness is missed it is likely to improve patient survival. The document can act as a basis for teaching and a medico-legal record, whilst providing the necessary data for quality assurance and outcome audit.
Barta, Daniel J.; Edeen, Marybeth A.; Henninger, Donald L.
The Lunar-Mars Life Support Test Project (LMLSTP) was conducted from 1995 through 1997 at the National Aeronautics and Space Administration s (NASA) Johnson Space Center (JSC) to demonstrate increasingly longer duration operation of integrated, closed-loop life support systems that employed biological and physicochemical techniques for water recycling, waste processing, air revitalization, thermal control, and food production. An analog environment for long-duration human space travel, the conditions of isolation and confinement also enabled studies of human factors, medical sciences (both physiology and psychology) and crew training. Four tests were conducted, Phases I, II, IIa and III, with durations of 15, 30, 60 and 91 days, respectively. The first phase focused on biological air regeneration, using wheat to generate enough oxygen for one experimental subject. The systems demonstrated in the later phases were increasingly complex and interdependent, and provided life support for four crew members. The tests were conducted using two human-rated, atmospherically-closed test chambers, the Variable Pressure Growth Chamber (VPGC) and the Integrated Life Support Systems Test Facility (ILSSTF). Systems included test articles (the life support hardware under evaluation), human accommodations (living quarters, kitchen, exercise equipment, etc.) and facility systems (emergency matrix system, power, cooling, etc.). The test team was managed by a lead engineer and a test director, and included test article engineers responsible for specific systems, subsystems or test articles, test conductors, facility engineers, chamber operators and engineering technicians, medical and safety officers, and science experimenters. A crew selection committee, comprised of psychologists, engineers and managers involved in the test, evaluated male and female volunteers who applied to be test subjects. Selection was based on the skills mix anticipated for each particular test, and utilized
Jones, Harry W.; Ewert, Michael K.
Spacecraft human life support systems can achieve ultra reliability by providing sufficient spares to replace all failed components. The additional mass of spares for ultra reliability is approximately equal to the original system mass, provided that the original system reliability is not too low. Acceptable reliability can be achieved for the Space Shuttle and Space Station by preventive maintenance and by replacing failed units. However, on-demand maintenance and repair requires a logistics supply chain in place to provide the needed spares. In contrast, a Mars or other long space mission must take along all the needed spares, since resupply is not possible. Long missions must achieve ultra reliability, a very low failure rate per hour, since they will take years rather than weeks and cannot be cut short if a failure occurs. Also, distant missions have a much higher mass launch cost per kilogram than near-Earth missions. Achieving ultra reliable spacecraft life support systems with acceptable mass will require a well-planned and extensive development effort. Analysis must determine the reliability requirement and allocate it to subsystems and components. Ultra reliability requires reducing the intrinsic failure causes, providing spares to replace failed components and having "graceful" failure modes. Technologies, components, and materials must be selected and designed for high reliability. Long duration testing is needed to confirm very low failure rates. Systems design should segregate the failure causes in the smallest, most easily replaceable parts. The system must be designed, developed, integrated, and tested with system reliability in mind. Maintenance and reparability of failed units must not add to the probability of failure. The overall system must be tested sufficiently to identify any design errors. A program to develop ultra reliable space life support systems with acceptable mass should start soon since it must be a long term effort.
Jones, Harry W.
Recycling life support systems can achieve ultra reliability by using spares to replace failed components. The added mass for spares is approximately equal to the original system mass, provided the original system reliability is not very low. Acceptable reliability can be achieved for the space shuttle and space station by preventive maintenance and by replacing failed units, However, this maintenance and repair depends on a logistics supply chain that provides the needed spares. The Mars mission must take all the needed spares at launch. The Mars mission also must achieve ultra reliability, a very low failure rate per hour, since it requires years rather than weeks and cannot be cut short if a failure occurs. Also, the Mars mission has a much higher mass launch cost per kilogram than shuttle or station. Achieving ultra reliable space life support with acceptable mass will require a well-planned and extensive development effort. Analysis must define the reliability requirement and allocate it to subsystems and components. Technologies, components, and materials must be designed and selected for high reliability. Extensive testing is needed to ascertain very low failure rates. Systems design should segregate the failure causes in the smallest, most easily replaceable parts. The systems must be designed, produced, integrated, and tested without impairing system reliability. Maintenance and failed unit replacement should not introduce any additional probability of failure. The overall system must be tested sufficiently to identify any design errors. A program to develop ultra reliable space life support systems with acceptable mass must start soon if it is to produce timely results for the moon and Mars.
Sorensen, Bjarke Lund; Rasch, Vibeke; Massawe, Siriel
Objective. To evaluate the impact of Advanced Life Support in Obstetrics (ALSO) training on staff performance and the incidences of postpartum hemorrhage (PPH) at a regional hospital in Tanzania. Design. Prospective intervention study. Setting. A regional, referral hospital. Population. A total...... of 510 delivered women before and 505 after the intervention. Methods. All high- and midlevel providers involved in childbirth at the hospital attended a two day ALSO provider course. Staff management was observed and postpartum bleeding assessed at all vaginal deliveries for seven weeks before and seven...
Full Text Available Answers to the questions of how and in what way the quality of life of students, resilience and ICT support affects the quality of high education we will get through this work where main objective is to define a network of processes and process management ensuring more quality and more innovative managing and service provision, therefore satisfying the needs of service users - in this case the students of the university. To collect the relevant data in the thematic analysis of this paper, the method of interviewing by questionnaires was applied. The sample survey was conducted among undergraduate students, teachers and staff of the Teacher Training Faculty in Uzice.
Hallas, Peter; Lauridsen, Johnny; Brabrand, Mikkel
well known in organizational studies. It refers to the collaborative effort among members in a dialogue to create meaning in an ambiguous situation, often by using subtle variations in the sentences in the dialogue. Sentences with high degrees of "sensemaking" activity can be thematized as "co......-orientation", "re-presentation" and/or "subordination" (among others). We sought to establish if elements of "sensemaking" occur in the formation of in-hospital cardiac arrest teams. METHODS: Videos of ten simulations of unannounced in-hospital cardiac arrests treated by basic life support (BLS) providers. We...
Miller, C. W.; Heppner, D. B.
The present paper is concerned with a systems engineering study which has provided an understanding of the overall Space Station ECLSS (Environmental Control and Life Support System). ECLSS/functional partitioning is considered along with function criticality, technology alternatives, a technology description, single thread systems, Space Station architectures, ECLSS distribution, mechanical schematics per space station, and Space Station ECLSS characteristics. Attention is given to trade studies and system synergism. The Space Station functional description had been defined by NASA. The ECLSS will utilize technologies which embody regenerative concepts to minimize the use of expendables.
Rudolph, Søren Steemann; Isbye, Dan Lou; Pfeiffer, Peter
In an advanced emergency medical service all parts of the advanced life support (ALS) algorithm can be provided. This evidence-based algorithm outlines resuscitative efforts for the first 10-15 minutes after cardiac arrest, whereafter the algorithm repeats itself. Restoration of spontaneous...... circulation fails in most cases, but in some circumstances the patient may benefit from additional interventional approaches, in which case transport to hospital with ongoing cardiopulmonary resuscitation is indicated. This paper has summarized treatments outside the ALS algorithm, which may be beneficial...
Liu, H.; Wang, J.; Manukovsky, N. S.; Kovalev, V. S.; Gurevich, Yu. L.
We have studied a modular approach to construction of bioregenerative life support system BLSS for a lunar base using soil-like substrate SLS for plant cultivation Calculations of massflow rates in BLSS were based mostly on a vegetarian diet and biological conversion of plant residues in SLS Plant candidate list for lunar BLSS includes the following basic species rice Oryza sativa soy Glycine max sweet potato Ipomoea batatas and wheat Triticum aestivum To reduce the time necessary for transition of the system to steady state we suggest that the first seeding and sprouting could be made on Earth
Perry, Jay L.; Sargusingh, Miriam J.; Toomarian, Nikzad
As notional life support system (LSS) architectures are developed and evaluated, myriad options must be considered pertaining to process technologies, components, and equipment assemblies. Each option must be evaluated relative to its impact on key functional interfaces within the LSS architecture. A leading notional architecture has been developed to guide the path toward realizing future crewed space exploration goals. This architecture includes atmosphere revitalization, water recovery and management, and environmental monitoring subsystems. Guiding requirements for developing this architecture are summarized and important interfaces within the architecture are discussed. The role of environmental monitoring within the architecture is described.
Life Support Systems are critical to sustain human habitation of space over long time periods. As orbiting space habitats become operational in the future, support systems such as atmo-sphere, food, water etc. will play a very pivotal role in sustaining life. To design a long-duration space habitat, it's important to consider the full gamut of human experience of the environment. Long-term viability depends on much more than just the structural or life support efficiency. A space habitat isn't just a machine; it's a life experience. To be viable, it needs to keep the inhabitants satisfied with their condition. This paper provides conceptual research on several key factors that influence the growth and sustainability of humans in a space habitat. Apart from the main life support system parameters, the architecture (both interior and exterior) of the habitat will play a crucial role in influencing the liveability in the space habitat. In order to ensure the best possible liveability for the inhabitants, a truncated (half cut) torus is proposed as the shape of the habitat. This structure rotating at an optimum rpm will en-sure 1g pseudo gravity to the inhabitants. The truncated torus design has several advantages over other proposed shapes such as a cylinder or a sphere. The design provides minimal grav-ity variation (delta g) in the living area, since its flat outer pole ensures a constant gravity. The design is superior in economy of structural and atmospheric mass. Interior architecture of the habitat addresses the total built environment, drawing from diverse disciplines includ-ing physiology, psychology, and sociology. Furthermore, factors such as line of sight, natural sunlight and overhead clearance have been discussed in the interior architecture. Substantial radiation shielding is also required in order to prevent harmful cosmic radiations and solar flares from causing damage to inhabitants. Regolith shielding of 10 tons per meter square is proposed for the
This report provides an analysis of employer-supported training in Australia. Employer-supported training is the largest share of adult education and training in all Organisation for Economic Co-operation and Development (OECD) countries. It has benefits for individuals, firms, and society. Cross-country studies have shown a positive association…
Herrmann, Ivan Tengbjerg; Hauschild, Michael Zwicky; Sohn, Michael D.
the decision maker (DM) in making the best possible choice for the environment. At present, some DMs do not trust the LCA to be a reliable decisionsupport tool—often because DMs consider the uncertainty of an LCA to be too large. The standard evaluation of uncertainty in LCAs is an ex-post approach that can...... regarding which type of LCA study to employ for the decision context at hand. This taxonomy enables the derivation of an LCA classification matrix to clearly identify and communicate the type of a given LCA. By relating the LCA classification matrix to statistical principles, we can also rank the different......The aim of this article is to help confront uncertainty in life cycle assessments (LCAs) used for decision support. LCAs offer a quantitative approach to assess environmental effects of products, technologies, and services and are conducted by an LCA practitioner or analyst (AN) to support...
Senthilvelkumar, Thangavelu; Magimairaj, Henry; Fletcher, Jebaraj; Tharion, George; George, Jacob
To compare the effectiveness of body weight-supported treadmill training and body weight-supported overground training for improving gait and strength in people with traumatic incomplete tetraplegia. Assessor blinded randomized trial. Rehabilitation institute of a tertiary care teaching hospital in India. Sixteen participants with traumatic motor incomplete tetraplegia and within two years of injury. Participants were randomised to one of two groups: body weight-supported overground training on level ground and body weight-supported treadmill training. Both groups received 30 minutes of gait training per day, five days a week for eight weeks. In addition, both groups received regular rehabilitation which included flexibility, strength, balance, self care and functional training. The primary outcome measure was the Walking Index for Spinal Cord Injury (/20 points) and the secondary outcome was the Lower Extremity Muscle Score (/50 points). There was no statistically significant between group differences in the Walking Index for Spinal Cord Injury [mean difference=0.3points; 95% CI (-4.8 to 5.4); p=0.748] or the Lower Extremity Muscle Score [mean difference=0.2 points; 95% CI (-3.8 to 5.1); p=0.749]. Gait training with body weight-supported overground training is comparable to treadmill training for improving locomotion in people with traumatic incomplete tetraplegia. © The Author(s) 2014.
Kang, K.; Hezoucky, F.; Clark, R. C.; )
For the past couple of decades there has been a change of emphasis in the world nuclear power from that of building new Nuclear Power Plants (NPP) to that of taking measures to optimize the life cycle of operational plants. National approaches in many countries showed an increase of interest in Plant Life Management (PLiM), both in terms of plant service life assurance and in optimizing the service or operational life of NPP. The safety considerations of a NPP are paramount and those requirements have to be met to obtain and to extend/renew the operating license. To achieve the goal of the long term safe, economic and reliable operation of the plant, PLiM programme is essential. Some countries already have advanced PLiM programmes while others still have none. The PLiM objective is to identify all that factors and requirements for the overall plant life cycle. The optimization of these requirements would allow for the minimum period of the investment return and maximum of the revenue from the sell of the produced electricity. Recognizing the importance of this issue and in response to the requests of the Member States the IAEA Division of Nuclear Power implements the Sub-programme on 'Engineering and Management Support for Competitive Nuclear Power'. Three projects within this sub-programme deal with different aspects of the NPP life cycle management with the aim to increase the capabilities of interested Member States in implementing and maintenance of the competitive and sustainable nuclear power. Although all three projects contain certain issues of PLiM, there is one specific project on guidance on engineering and management practices for optimization of NPP service life. This particular project deals with different specific issues of PLiM including aspects of ageing phenomena and their monitoring, issues of control and instrumentation, maintenance and operation issues, economic evaluation of PLiM including guidance on its earlier shut down and decommissioning
A life skills and HIV/AIDS education programme was implemented in secondary schools as a strategy to combat the spread of HIV/AIDS among school-going young people in South Africa. As part of a joint effort of the Departments of Health and Education, two teachers per school were trained to implement life skills training ...
Selm, Mariette van
Presentation for session 4 of RDM Support. RDM Support is a basic training course in research data management (support) for information specialists. The training course was developed by Mariëtte van Selm for the information specialists of the Library of the University of Amsterdam (UvA), within the framework of the RDM Support project (2013-2015). The training course was held from January to April 2014.
Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil
Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and
Starkey, Kerry J; Lyon, J; Sigman, E; Pynn, H J; Nordmann, G
Airborne operations enable large numbers of military forces to deploy on the ground in the shortest possible time. This however must be balanced by an increased risk of injury. The aim of this paper is to review the current UK military drop zone medical estimate process, which may help to predict the risk of potential injury and assist in planning appropriate levels of medical support. In spring 2015, a British Airborne Battlegroup (UKBG) deployed on a 7-week overseas interoperability training exercise in the USA with their American counterparts (USBG). This culminated in a 7-day Combined Joint Operations Access Exercise, which began with an airborne Joint Forcible Entry (JFE) of approximately 2100 paratroopers.The predicted number of jump-related injuries was estimated using Parachute Order Number 8 (PO No 8). Such injuries were defined as injuries occurring from the time the paratrooper exited the aircraft until they released their parachute harness on the ground. Overall, a total of 53 (2.5%) casualties occurred in the JFE phase of the exercise, lower than the predicted number of 168 (8%) using the PO No 8 tool. There was a higher incidence of back (30% actual vs 20% estimated) and head injuries (21% actual vs 5% estimated) than predicted with PO No 8. The current method for predicting the incidence of medical injuries after a parachute drop using the PO No 8 tool is potentially not accurate enough for current requirements. Further research into injury rate, influencing factors and injury type are urgently required in order to provide an evidence base to ensure optimal medical logistical and clinical planning for airborne training and operations in the future. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Busch, Jacob; Rodogno, Raffaele
It has recently been suggested by Shaw (2007) that the distinction between voluntary active euthanasia, such as giving a patient a lethal overdose with the intention of ending that patient's life, and voluntary passive euthanasia, such as removing a patient from a ventilator, is much less obvious than is commonly acknowledged in the literature. This is argued by suggesting a new perspective that more accurately reflects the moral features of end-of-life situations. The argument is simply that if we consider the body of a mentally competent patient who wants to die, a kind of 'unwarranted' life support, then the distinction collapses. We argue that all Shaw has provided is a perspective that makes the conclusion that there is little distinction between voluntary active euthanasia and voluntary passive euthanasia only seemingly more palatable. In doing so he has yet to convince us that this perspective is superior to other perspectives and thus more accurately reflects the moral features of the situations pertaining to this issue.
O'Connor, Debra L.; Menaker, Ellen S.
Instructional games are created when training is deliberately added to a gaming environment or when gaming aspects are deliberately incorporated into training. One type of game that is currently attracting the attention of the education and training field is the massively multiplayer online game (MMOG). Because evidence about learning outcomes…
STS-77 TRAINING VIEW --- Astronaut Curtis L. Brown, Jr., pilot, works with his life raft during emergency bailout training for crew members in the Johnson Space Centers (JSC) Weightless Environment Training Facility (WET-F). Brown will join five other astronauts for nine days aboard the Space Shuttle Endeavour next month.
Haque, Anwarul; Arif, Fehmina; Abass, Qalab; Ahmed, Khalid
Acute neurological emergencies (ANEs) in children are common life-threatening illnesses and are associated with high mortality and severe neurological disability in survivors, if not recognized early and treated appropriately. We describe our experience of teaching a short, novel course "Pediatric Neurologic Emergency Life Support" to pediatricians and trainees in a resource-limited country. This course was conducted at 5 academic hospitals from November 2013 to December 2014. It is a hybrid of pediatric advance life support and emergency neurologic life support. This course is designed to increase knowledge and impart practical training on early recognition and timely appropriate treatment in the first hour of children with ANEs. Neuroresuscitation and neuroprotective strategies are key components of this course to prevent and treat secondary injuries. Four cases of ANEs (status epilepticus, nontraumatic coma, raised intracranial pressure, and severe traumatic brain injury) were taught as a case simulation in a stepped-care, protocolized approach based on best clinical practices with emphasis on key points of managements in the first hour. Eleven courses were conducted during the study period. One hundred ninety-six physicians including 19 consultants and 171 residents participated in these courses. The mean (SD) score was 65.15 (13.87%). Seventy percent (132) of participants were passed (passing score > 60%). The overall satisfaction rate was 85%. Pediatric Neurologic Emergency Life Support was the first-time delivered educational tool to improve outcome of children with ANEs with good achievement and high satisfaction rate of participants. Large number courses are required for future validation.
Krogh, Lise Qvirin; Bjørnshave, Katrine; Vestergaard, Lone Due; Sharma, Maja Bendtsen; Rasmussen, Stinne Eika; Nielsen, Henrik Vendelbo; Thim, Troels; Løfgren, Bo
Dissemination of pediatric basic life support (PBLS) skills is recommended. E-learning is accessible and cost-effective, but it is currently unknown whether laypersons can learn PBLS through e-learning. The hypothesis of this study was to investigate whether e-learning PBLS is non-inferior to instructor-led training. Participants were recruited among child-minders and parents of children aged 0-6 years. Participants were randomized to either 2-h instructor-led training or e-learning using an e-learning program (duration 17 min) including an inflatable manikin. After training, participants were assessed in a simulated pediatric cardiac arrest scenario. Tests were video recorded and PBLS skills were assessed independently by two assessors blinded to training method. Primary outcome was the pass rate of the PBLS test (≥8 of 15 skills adequately performed) with a pre-specified non-inferiority margin of 20%. In total 160 participants were randomized 1:1. E-learning was non-inferior to instructor-led training (difference in pass rate -4%; 95% CI -9:0.5). Pass rates were 100% among instructor-led trained (n=67) and 96% among e-learned (n=71). E-learners median time spent on the e-learning program was 30 min (range: 15-120 min) and the median number of log-ons was 2 (range: 1-5). After the study, all participants felt that their skills had improved. E-learning PBLS is non-inferior to instructor-led training among child-minders and parents with children aged 0-6 years, although the pass rate was 4% (95% CI -9:0.5) lower with e-learning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Salisbury, F. B.; Dempster, W. F.; Allen, J. P.; Alling, A.; Bubenheim, D.; Nelson, M.; Silverstone, S.
Regardless of how well other growing conditions are optimized, crop yields will be limited by the available light up to saturation irradiances. Considering the various factors of clouds on Earth, dust storms on Mars, thickness of atmosphere, and relative orbits, there is roughly 2/3 as much light averaged annually on Mars as on Earth. On Mars, however, crops must be grown under controlled conditions (greenhouse or growth rooms). Because there presently exists no material that can safely be pressurized, insulated, and resist hazards of puncture and deterioration to create life support systems on Mars while allowing for sufficient natural light penetration as well, artificial light will have to be supplied. If high irradiance is provided for long daily photoperiods, the growing area can be reduced by a factor of 3-4 relative to the most efficient irradiance for cereal crops such as wheat and rice, and perhaps for some other crops. Only a small penalty in required energy will be incurred by such optimization. To obtain maximum yields, crops must be chosen that can utilize high irradiances. Factors that increase ability to convert high light into increased productivity include canopy architecture, high-yield index (harvest index), and long-day or day-neutral flowering and tuberization responses. Prototype life support systems such as Bios-3 in Siberia or the Mars on Earth Project need to be undertaken to test and further refine systems and parameters.
Agui, Juan H.; Perry, Jay L.
The National Aeronautics and Space Administrations (NASA) technical developments for highly reliable life support systems aim to maximize the viability of long duration deep space missions. Among the life support system functions, airborne particulate matter filtration is a significant driver of launch mass because of the large geometry required to provide adequate filtration performance and because of the number of replacement filters needed to a sustain a mission. A trade analysis incorporating various launch, operational and maintenance parameters was conducted to investigate the trade-offs between the various particulate matter filtration configurations. In addition to typical launch parameters such as mass, volume and power, the amount of crew time dedicated to system maintenance becomes an increasingly crucial factor for long duration missions. The trade analysis evaluated these parameters for conventional particulate matter filtration technologies and a new multi-stage particulate matter filtration system under development by NASAs Glenn Research Center. The multi-stage filtration system features modular components that allow for physical configuration flexibility. Specifically, the filtration system components can be configured in distributed, centralized, and hybrid physical layouts that can result in considerable mass savings compared to conventional particulate matter filtration technologies. The trade analysis results are presented and implications for future transit and surface missions are discussed.
Barta, Daniel J.
As NASA looks beyond the International Space Station toward long-duration, deep space missions away from Earth, the current practice of supplying consumables and spares will not be practical nor affordable. New approaches are sought for life support and habitation systems that will reduce dependency on Earth and increase mission sustainability. To reduce launch mass, further closure of Environmental Control and Life Support Systems (ECLSS) beyond the current capability of the ISS will be required. Areas of particular interest include achieving higher degrees of recycling within Atmosphere Revitalization, Water Recovery and Waste Management Systems. NASA is currently investigating advanced carbon dioxide reduction processes that surpass the level of oxygen recovery available from the Sabatier Carbon Dioxide Reduction Assembly (CRA) on the ISS. Candidate technologies will potentially improve the recovery of oxygen from about 50% (for the CRA) to as much as 100% for technologies who's end product is solid carbon. Improving the efficiency of water recycling and recovery can be achieved by the addition of advanced technologies to recover water from brines and solid wastes. Bioregenerative technologies may be utilized for water reclaimation and also for the production of food. Use of higher plants will simultaneously benefit atmosphere revitalization and water recovery through photosynthesis and transpiration. The level at which bioregenerative technologies are utilized will depend on their comparative requirements for spacecraft resources including mass, power, volume, heat rejection, crew time and reliability. Planetary protection requirements will need to be considered for missions to other solar system bodies.
Overland, David; Hoo, Karlene; Ciskowski, Marvin
The Advanced Integration Matrix (AIM) project at the Johnson Space Center (JSC) was chartered to study and solve systems-level integration issues for exploration missions. One of the first issues identified was an inability to conduct trade studies on control system architectures due to the absence of mature evaluation criteria. Such architectures are necessary to enable integration of regenerative life support systems. A team was formed to address issues concerning software and hardware architectures and system controls.. The team has investigated what is required to integrate controls for the types of non-linear dynamic systems encountered in advanced life support. To this end, a water processing bioreactor testbed is being developed which will enable prototyping and testing of integration strategies and technologies. Although systems such as the water bioreactors exhibit the complexities of interactions between control schemes most vividly, it is apparent that this behavior and its attendant risks will manifest itself among any set of interdependent autonomous control systems. A methodology for developing integration requirements for interdependent and autonomous systems is a goal of this team and this testbed. This paper is a high-level summary of the current status of the investigation, the issues encountered, some tentative conclusions, and the direction expected for further research.
Schneider, Maria Victoria; Griffin, Philippa C; Tyagi, Sonika; Flannery, Madison; Dayalan, Saravanan; Gladman, Simon; Watson-Haigh, Nathan; Bayer, Philipp E; Charleston, Michael; Cooke, Ira; Cook, Rob; Edwards, Richard J; Edwards, David; Gorse, Dominique; McConville, Malcolm; Powell, David; Wilkins, Marc R; Lonie, Andrew
EMBL Australia Bioinformatics Resource (EMBL-ABR) is a developing national research infrastructure, providing bioinformatics resources and support to life science and biomedical researchers in Australia. EMBL-ABR comprises 10 geographically distributed national nodes with one coordinating hub, with current funding provided through Bioplatforms Australia and the University of Melbourne for its initial 2-year development phase. The EMBL-ABR mission is to: (1) increase Australia's capacity in bioinformatics and data sciences; (2) contribute to the development of training in bioinformatics skills; (3) showcase Australian data sets at an international level and (4) enable engagement in international programs. The activities of EMBL-ABR are focussed in six key areas, aligning with comparable international initiatives such as ELIXIR, CyVerse and NIH Commons. These key areas-Tools, Data, Standards, Platforms, Compute and Training-are described in this article. © The Author 2017. Published by Oxford University Press.
De Faoite, D.; Henry, C.; Johnston, K.; van der Sijde, Peter
Increasingly, academics, practitioners and governments recognise the need to examine the role and effectiveness of entrepreneurship training and support. Studies to date have examined the importance of training and other skil development opportunities in promoting entrepreneurship in the context of
Somaraj, Vinej; Shenoy, Rekha P; Panchmal, Ganesh Shenoy; Jodalli, Praveen S; Sonde, Laxminarayan; Karkal, Ravichandra
This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences ( P <0.05) between assessed knowledge and anxiety. Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant ( P =0.983). There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.
Noji, K.; Suzuki, K.; Kobayashi, A.
Operation training with full-scope simulators is effective to improve trainees operation competency. To obtain more effective results of simulator training, roles of the ''classroom operation training'' closely cooperated to simulator training are important. The ''classroom operation training'' is aimed at pre- and post-studies for operation knowledge related to operation training using full-scope simulators. We have been developing computer-based operation training tools which are used in classroom training sessions. As the first step, we developed the Simulator Training Replay System. This is an aiding tool in the classroom used to enhance trainees operation performance. This system can synchronously replay plant behavior on CRT display with operators action on a video monitor in the simulator training sessions. This system is used to review plant behavior - trainees response after simulator training sessions and to understand plant behavior - operation procedure before operation training. (author)
Turner, S.; Scott, K.
The Training Department at the Point Lepreau GS has been developing and improving its training for technical support staff. A generic set of objectives are being used as the basis for a systematic approach to training. The program covers general and job specific knowledge and skills using a mix of classroom instruction, mentoring and continuing training seminars. This paper describes experience, success and the challenges in the development, delivery and evaluation of the training program. (author)
Verseux, Cyprien; Baqué, Mickael; Lehto, Kirsi; de Vera, Jean-Pierre P.; Rothschild, Lynn J.; Billi, Daniela
Even though technological advances could allow humans to reach Mars in the coming decades, launch costs prohibit the establishment of permanent manned outposts for which most consumables would be sent from Earth. This issue can be addressed by in situ resource utilization: producing part or all of these consumables on Mars, from local resources. Biological components are needed, among other reasons because various resources could be efficiently produced only by the use of biological systems. But most plants and microorganisms are unable to exploit Martian resources, and sending substrates from Earth to support their metabolism would strongly limit the cost-effectiveness and sustainability of their cultivation. However, resources needed to grow specific cyanobacteria are available on Mars due to their photosynthetic abilities, nitrogen-fixing activities and lithotrophic lifestyles. They could be used directly for various applications, including the production of food, fuel and oxygen, but also indirectly: products from their culture could support the growth of other organisms, opening the way to a wide range of life-support biological processes based on Martian resources. Here we give insights into how and why cyanobacteria could play a role in the development of self-sustainable manned outposts on Mars.
Wessels, Monique; Lucas, Cees; Eriks, Inge; de Groot, Sonja
To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Cochrane, MEDLINE, EMBASE, CINAHL, PEDro, DocOnline were searched and identified studies were assessed for eligibility and methodological quality and described regarding population, training protocol, and effects on walking ability, activities of daily living and quality of life. A descriptive and quantitative synthesis was conducted. Eighteen articles (17 studies) were included. Two randomized controlled trials showed that subjects with injuries of less than one year duration reached higher scores on the locomotor item of the Functional Independence Measure (range 1-7) in the over-ground training group compared with the body weight-supported treadmill training group. Only for persons with an American Spinal Injury Association Impairment Scale C or D was the mean difference significant, with 0.80 (95% confidence interval 0.04-1.56). No differences were found regarding walking velocity, activities of daily living or quality of life. Subjects with subacute motor incomplete spinal cord injury reached a higher level of independent walking after over-ground training, compared with body weight-supported treadmill training. More randomized controlled trials are needed to clarify the effectiveness of body weight-supported gait training on walking, activities of daily living, and quality of life for subgroups of persons with an incomplete spinal cord injury.
Full Text Available In this article, an improved grey prediction model is proposed to address low-accuracy prediction issue of grey forecasting model. The first step is using a trigonometric function to transform the original data sequence to smooth the data, which is called smoothness of grey prediction model, and then a grey support vector machine model by integrating the improved grey model with support vector machine is introduced. At the initial stage of the model, trigonometric functions and accumulation generation operation can be used to preprocess the data, which enhances the smoothness of the data and reduces the associated randomness. In addition, support vector machine is implemented to establish a prediction model for the pre-processed data and select the optimal model parameters via genetic algorithms. Finally, the data are restored through the ‘regressive generate’ operation to obtain the forecasting data. To prove that the grey support vector machine model is superior to the other models, the battery life data from the Center for Advanced Life Cycle Engineering are selected, and the presented model is used to predict the remaining useful life of the battery. The predicted result is compared to that of grey model and support vector machines. For a more intuitive comparison of the three models, this article quantifies the root mean square errors for these three different models in the case of different ratio of training samples and prediction samples. The results show that the effect of grey support vector machine model is optimal, and the corresponding root mean square error is only 3.18%.
Ahmadi, Koorosh; Sedaghat, Mohammad; Safdarian, Mahdi; Hashemian, Amir-Masoud; Nezamdoust, Zahra; Vaseie, Mohammad; Rahimi-Movaghar, Vafa
Since appropriate and time-table methods in trauma care have an important impact on patients'outcome, we evaluated the effect of Advanced Trauma Life Support (ATLS) program on medical interns' performance in simulated trauma patient management. A descriptive and analytical study before and after the training was conducted on 24 randomly selected undergraduate medical interns from Imam Reza Hospital in Mashhad, Iran. On the first day, we assessed interns' clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre- and post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant. Our findings showed that interns'ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns' clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P less than 0.001, P equal to 0.016 and P equal to 0.01 respectively). ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.
Takamura, Akiteru; Ito, Sayori; Maruyama, Kaori; Ryo, Yusuke; Saito, Manami; Fujimura, Shuhei; Ishiura, Yuna; Hori, Ariyuki
Automated external defibrillators (AED) have been installed in schools in Japan since 2004, and the government strongly recommends teaching basic life support (BLS). We therefore examined the quality of BLS education and AED installation in schools. We conducted a prefecture-wide questionnaire survey of all primary and junior high schools in 2016, to assess BLS education and AED installation against the recommendations of the Japan Circulation Society. The results were analyzed using descriptive statistics and chi-squared test. In total, 195 schools out of 315 (62%) responded, of which 38% have introduced BLS education for children. BLS training was held in a smaller proportion of primary schools (18%) than junior high schools (86%). More than 90% of primary school staff had undergone BLS training in the previous 2 years. The most common locations of AED were the gymnasium (32%) followed by entrance hall (28%), staffroom (25%), and infirmary (12%). The reasons given for location were that it was obvious (34%), convenient for staff (32%), could be used out of hours (17%), and the most likely location for a heart attack (15%). Approximately 18% of schools reported that it takes >5 min to reach the AED from the furthest point. BLS training, AED location, and understanding of both are not sufficient to save children's lives efficiently. Authorities should make recommendations about the correct number of AED, and their location, and provide more information to improve the quality of BLS training in schools. © 2016 Japan Pediatric Society.
Combs-Miller, Stephanie A; Kalpathi Parameswaran, Anu; Colburn, Dawn; Ertel, Tara; Harmeyer, Amanda; Tucker, Lindsay; Schmid, Arlene A
To compare the effects of body weight-supported treadmill training and overground walking training when matched for task and dose (duration/frequency/intensity) on improving walking function, activity, and participation after stroke. Single-blind, pilot randomized controlled trial with three-month follow-up. University and community settings. A convenience sample of participants (N = 20) at least six months post-stroke and able to walk independently were recruited. Thirty-minute walking interventions (body weight-supported treadmill training or overground walking training) were administered five times a week for two weeks. Intensity was monitored with the Borg Rating of Perceived Exertion Scale at five-minute increments to maintain a moderate training intensity. Walking speed (comfortable/fast 10-meter walk), walking endurance (6-minute walk), spatiotemporal symmetry, and the ICF Measure of Participation and ACTivity were assessed before, immediately after, and three months following the intervention. The overground walking training group demonstrated significantly greater improvements in comfortable walking speed compared with the body weight-supported treadmill training group immediately (change of 0.11 m/s vs. 0.06 m/s, respectively; p = 0.047) and three months (change of 0.14 m/s vs. 0.08 m/s, respectively; p = 0.029) after training. Only the overground walking training group significantly improved comfortable walking speed (p = 0.001), aspects of gait symmetry (p = 0.032), and activity (p = 0.003) immediately after training. Gains were maintained at the three-month follow-up (p training was more beneficial than body weight-supported treadmill training at improving self-selected walking speed for the participants in this study. © The Author(s) 2014.
example, simulation-aided performance improvement was shown during the Royal Australian Air Forces live training event, Pitch Black (Francis, Best...behind Black Skies was to prepare trainees for the more expensive live training of the Pitch Black exercise. Results demonstrated a twenty percent...evaluation of the system by subject matter experts suggests that a training simulation such as the prototype developed in the course of this work could
Volk, Tyler; Rummel, John D.
Design decisions to aid the development of future space based biological life support systems (BLSS) can be made with simulation models. The biochemistry stoichiometry was developed for: (1) protein, carbohydrate, fat, fiber, and lignin production in the edible and inedible parts of plants; (2) food consumption and production of organic solids in urine, feces, and wash water by the humans; and (3) operation of the waste processor. Flux values for all components are derived for a steady state system with wheat as the sole food source. The large scale dynamics of a materially closed (BLSS) computer model is described in a companion paper. An extension of this methodology can explore multifood systems and more complex biochemical dynamics while maintaining whole system closure as a focus.
Petersen, Gene R.
The use of yeasts in controlled ecological life support systems (CELSS) for microbial food regeneration in space required the accurate and reproducible analysis of intracellular carbohydrate and protein levels. The reproducible analysis of glycogen was a key element in estimating overall content of edibles in candidate yeast strains. Typical analytical methods for estimating glycogen in Saccharomyces were not found to be entirely aplicable to other candidate strains. Rigorous cell lysis coupled with acid/base fractionation followed by specific enzymatic glycogen analyses were required to obtain accurate results in two strains of Candida. A profile of edible fractions of these strains was then determined. The suitability of yeasts as food sources in CELSS food production processes is discussed.
Block, Roger F.
The Automated Subsystem Control for Life Support Systems (ASCLSS) program has successfully developed and demonstrated a generic approach to the automation and control of space station subsystems. The automation system features a hierarchical and distributed real-time control architecture which places maximum controls authority at the lowest or process control level which enhances system autonomy. The ASCLSS demonstration system pioneered many automation and control concepts currently being considered in the space station data management system (DMS). Heavy emphasis is placed on controls hardware and software commonality implemented in accepted standards. The approach demonstrates successfully the application of real-time process and accountability with the subsystem or process developer. The ASCLSS system completely automates a space station subsystem (air revitalization group of the ASCLSS) which moves the crew/operator into a role of supervisory control authority. The ASCLSS program developed over 50 lessons learned which will aide future space station developers in the area of automation and controls..
Koenig, D. W.; Bruce, R. J.; Mishra, S. K.; Barta, D. J.; Pierson, D. L.
A Variable Pressure Plant Growth Chamber (VPGC), at the Johnson Space Center's (JSC) ground based Regenerative Life Support Systems (RLSS) test bed, was used to produce crops of soil-grown lettuce. The crops and chamber were analyzed for microbiological diversity during lettuce growth and after harvest. Bacterial counts for the rhizosphere, spent nutrient medium, heat exchanger condensate, and atmosphere were approximately 10(exp 11) Colony Forming Units (CFU)/g, 10(exp 5) CFU/ml, 10(exp 5)CFU/ml, and 600 CFU/m sq, repectively. Pseudomonas was the predominant bacterial genus. Numbers of fungi were about 10(exp 5) CFU/g in the rhizosphere, 4-200 CFU/ml in the spent nutient medium, 110 CFU/ml in the heat exchanger condensate, and 3 CFU/cu m in the atmosphere. Fusarium and Trichoderma were the predominant fungal genera.
I Wayan Ade Punarbawa
Full Text Available Chest injury is one injury that often occurs and need immediate and precise handling that prevent people from death. Chest trauma 1/4 of the trauma that caused the death and 1/3 of those deaths occur in hospitals. One chest injury that often we get to the health center is pneumothorax. WHO declared in 2020 the level of morbidity and mortality from chest injuries will increase, to become the second leading cause of death in the world. From this data that need to know the signs and symptoms of peneumotoraks, identify the signs and symptoms so we can provide basic life support to the patient before the patient was referred to a medical center nearby so as to reduce the morbidity and mortality in patients with pneumothorax.
Muhammad Alishahdani Ibrahim
Full Text Available Reputation is a key construct in organizational sciences since reputation signals its past behavior and its prospect in the future. The purpose of this paper is to explore the development and influence of both personal and organizational reputation and its impact to customer support. The organiza-tion life cycle theory is applied to the “SM” foundation, one of Indonesian largest Islamic social enterprise which experienced fast growth and decline due to the decline of its leader reputation. The case shows that personal reputation of leader is very important in the start-up and early development phase of the organization but it may threaten the organizational sustainability at a later stage when the leader’s personal reputation is conveyed into the organization reputation.
Full Text Available Economic development has always been a moving target. Both the national and local governments have been facing the challenge of implementing the effective and efficient economic policy and program in order to best utilize their limited resources. One of the recent approaches in this area is called cluster-based economic analysis and strategy development. This study reviews key literature and some of the cluster based economic policies adopted by different governments. Based on this review, it proposes “the cluster life cycle” as a determining factor to identify the support requirements of clusters. A survey, designed based on literature review of International Cluster support programs, was conducted with 30 participants from 3 clusters with different maturity stage. This paper discusses the results of this study conducted among the cluster members in Eskişehir- Bilecik-Kütahya Region in Turkey on the requirement of the support to foster the development of related clusters.
Gao, Ni; Dolce, Joni; Rio, John; Heitzmann, Carma; Loving, Samantha
This column describes a goal-oriented, time-limited in vivo coaching/training approach for skills building among peer veterans vocational rehabilitation specialists of the Homeless Veteran Supported Employment Program (HVSEP). Planning, implementing, and evaluating the training approach for peer providers was intended, ultimately, to support veterans in their goal of returning to community competitive employment. The description draws from the training experience that aimed to improve the ability of peer providers to increase both rates of employment and wages of the homeless veterans using their services. Training peers using an in vivo training approach provided a unique opportunity for the veterans to improve their job development skills with a focus to support employment outcomes for the service users. Peers who received training also expressed that learning skills through an in vivo training approach was more engaging than typical classroom trainings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Callaghan, M; Doyle, Y; O'Hare, B; Healy, M; Nölke, L
Extra corporeal membrane oxygenation (ECMO) is a form of life support, which facilitates gas exchange outside the body via an oxygenator and a centrifugal pumping system. A paediatric cardiac ECMO programme was established in 2005 at Our Lady's Children's Hospital, Crumlin (OLCHC) and to date 75 patients have received ECMO, the majority being post operative cardiac patients. The outcome data compares favourably with international figures. ECMO has been most successful in the treatment of newborn infants with life threatening respiratory failure from conditions such as meconium aspiration, respiratory distress syndrome and respiratory infections. There is no formal paediatric respiratory ECMO programme at OLCHC, or anywhere else in Ireland. Currently, neonates requiring respiratory ECMO are transferred to centres in Sweden or the UK at an average cost of 133,000 Euros/infant, funded by the Health Service Executive E112 treatment abroad scheme. There is considerable morbidity associated with the transfer of critically ill infants, as well as significant psycho-social impact on families. OLCHC is not funded to provide respiratory ECMO, although the equipment and expertise required are similar to cardiac ECMO and are currently in place. The average cost of an ECMO run at OLCHC is 65,000 Euros. There is now a strong argument for a fully funded single national cardiac and respiratory paediatric ECMO centre, similar to that for adult patients.
Oleson, Melvin; Olson, Richard L.
Results are given of a study to explore options for the development of a Controlled Ecological Life Support System (CELSS) for a future Space Station. In addition, study results will benefit the design of other facilities such as the Life Sciences Research Facility, a ground-based CELSS demonstrator, and will be useful in planning longer range missions such as a lunar base or manned Mars mission. The objectives were to develop weight and cost estimates for one CELSS module selected from a set of preliminary plant growth unit (PGU) design options. Eleven Space Station CELSS module conceptual PGU designs were reviewed, components and subsystems identified and a sensitivity analysis performed. Areas where insufficient data is available were identified and divided into the categories of biological research, engineering research, and technology development. Topics which receive significant attention are lighting systems for the PGU, the use of automation within the CELSS system, and electric power requirements. Other areas examined include plant harvesting and processing, crop mix analysis, air circulation and atmosphere contaminant flow subsystems, thermal control considerations, utility routing including accessibility and maintenance, and nutrient subsystem design.
Ariyani, Nur Anisa Eka; Kismartini
The Karimunjawa National Park as the only one marine protected area in Central Java, managed by zonation system has decreased natural resources in the form of decreasing mangrove forest area, coral cover, sea biota population such as clams and sea cucumbers. Conservation has been done by Karimunjawa National Park Authority through protection of life support system activities in order to protect the area from degradation. The objective of the research is to know the implementation of protection and security activities of Karimunjawa National Park Authority for the period of 2012 - 2016. The research was conducted by qualitative method, processing secondary data from Karimunjawa National Park Authority and interview with key informants. The results showed that protection and security activities in The Karimunjawa National Park were held with three activities: pre-emptive activities, preventive activities and repressive activities. Implementation of conservation policy through protection of life support system is influenced by factors of policy characteristic, resource factor and environmental policy factor. Implementation of conservation policy need support from various parties, not only Karimunjawa National Park Authority as the manager of the area, but also need participation of Jepara Regency, Central Java Provinces, communities, NGOs, researchers, developers and tourism actors to maintain and preserve existing biodiversity. Improving the quality of implementors through education and training activities, the availability of the state budget annually and the support of stakeholders is essential for conservation.
One of the best-known and most widely used ways to improve employee performance in organisations is the use of corporate training. As a consequence, the effects of training are of major interest to both scholars and scientists in the field of human resource development. The results of research
Mastenbroek, A.; Chebet, A.; Muwanika, C.T.; Adong, C.J.; Okot, F.; Otim, G.; Birungi, J.; Kansiime, M.; Oyee, P.; Ninsiima, P.
The training manual is developed in Uganda to train partner organisations in coaching farmer groups to become sustainable local seed businesses. It introduces the Integrated Seed Sector Development Programme in Uganda and the concept of local seed businesses (LSBs). The manual has 5 modules covering
This document was produced by the author(s) based on their research for the report "Cross- Cultural Training and Workplace Performance" (ED503402). It contains the following materials related to the report: (1) Primary approach letters; (2) Tests for statistical significance; (3) Survey of current cross-cultural training practice; (4)…
Howe, Robert; Diep, Chuong; Barnett, Bob; Thomas, Gretchen; Rouen, Michael; Kobus, Jack
This paper discusses the Portable Life Support Subsystem (PLSS) packaging design work done by the NASA and Hamilton Sundstrand in support of the 3 future space missions; Lunar, Mars and zero-g. The goal is to seek ways to reduce the weight of PLSS packaging, and at the same time, develop a packaging scheme that would make PLSS technology changes less costly than the current packaging methods. This study builds on the results of NASA s in-house 1998 study, which resulted in the "Flex PLSS" concept. For this study the present EMU schematic (low earth orbit) was used so that the work team could concentrate on the packaging. The Flex PLSS packaging is required to: protect, connect, and hold the PLSS and its components together internally and externally while providing access to PLSS components internally for maintenance and for technology change without extensive redesign impact. The goal of this study was two fold: 1. Bring the advanced space suit integrated Flex PLSS concept from its current state of development to a preliminary design level and build a proof of concept mockup of the proposed design, and; 2. "Design" a Design Process, which accommodates both the initial Flex PLSS design and the package modifications, required to accommodate new technology.
Livezey, M. M.; Herring, D.; Keck, J.; Meyers, J. C.
The Climate Resilience Toolkit (CRT) is a Federal government effort to address the U.S. President's Climate Action Plan and Executive Order for Climate Preparedness. The toolkit will provide access to tools and products useful for climate-sensitive decision making. To optimize the user experience, the toolkit will also provide access to training materials. The National Oceanic and Atmospheric Administration (NOAA) has been building a climate training capability for 15 years. The target audience for the training has historically been mainly NOAA staff with some modified training programs for external users and stakeholders. NOAA is now using this climate training capacity for the CRT. To organize the CRT training section, we collaborated with the Association of Climate Change Officers to determine the best strategy and identified four additional complimentary skills needed for successful decision making: climate literacy, environmental literacy, risk assessment and management, and strategic execution and monitoring. Developing the climate literacy skills requires knowledge of climate variability and change, as well as an introduction to the suite of available products and services. For the development of an environmental literacy category, specific topics needed include knowledge of climate impacts on specific environmental systems. Climate risk assessment and management introduces a process for decision making and provides knowledge on communication of climate information and integration of climate information in planning processes. The strategic execution and monitoring category provides information on use of NOAA climate products, services, and partnership opportunities for decision making. In order to use the existing training modules, it was necessary to assess their level of complexity, catalog them, and develop guidance for users on a curriculum to take advantage of the training resources to enhance their learning experience. With the development of this CRT
Seamon, Mark J; Doane, Stephen M; Gaughan, John P; Kulp, Heather; D'Andrea, Anthony P; Pathak, Abhijit S; Santora, Thomas A; Goldberg, Amy J; Wydro, Gerald C
Advanced Life Support (ALS) providers may perform more invasive prehospital procedures, while Basic Life Support (BLS) providers offer stabilisation care and often "scoop and run". We hypothesised that prehospital interventions by urban ALS providers prolong prehospital time and decrease survival in penetrating trauma victims. We prospectively analysed 236 consecutive ambulance-transported, penetrating trauma patients an our urban Level-1 trauma centre (6/2008-12/2009). Inclusion criteria included ICU admission, length of stay >/=2 days, or in-hospital death. Demographics, clinical characteristics, and outcomes were compared between ALS and BLS patients. Single and multiple variable logistic regression analysis determined predictors of hospital survival. Of 236 patients, 71% were transported by ALS and 29% by BLS. When ALS and BLS patients were compared, no differences in age, penetrating mechanism, scene GCS score, Injury Severity Score, or need for emergency surgery were detected (p>0.05). Patients transported by ALS units more often underwent prehospital interventions (97% vs. 17%; p<0.01), including endotracheal intubation, needle thoracostomy, cervical collar, IV placement, and crystalloid resuscitation. While ALS ambulance on-scene time was significantly longer than that of BLS (p<0.01), total prehospital time was not (p=0.98) despite these prehospital interventions (1.8 ± 1.0 per ALS patient vs. 0.2 ± 0.5 per BLS patient; p<0.01). Overall, 69.5% ALS patients and 88.4% of BLS patients (p<0.01) survived to hospital discharge. Prehospital resuscitative interventions by ALS units performed on penetrating trauma patients may lengthen on-scene time but do not significantly increase total prehospital time. Regardless, these interventions did not appear to benefit our rapidly transported, urban penetrating trauma patients. Copyright © 2013 Elsevier Ltd. All rights reserved.
Yun, Seok-Min; Park, Sang-Kyoon; Lim, Hee Sung
[Purpose] This study was to observe the influence of Pilates training on the quality of life in chronic stoke patients. [Subjects and Methods] Forty chronic stroke patients participated in this study. They were divided into same number of experimental group (EG) and control group (CG). EG participated in a 60-min Pilates training program, twice a week for 12 weeks, while the CG did not participate in any exercise-related activities for the duration and participating in general occupational therapy without any exercise-related activities. Then the MMSE-K was performed before and after Pilates training to observe the influence of Pilates training on the quality of life in chronic stroke patients. [Results] Statistically significant improvement in the physical, social, and psychological domains was found in EG after the training. No statistically significant difference was found in all three quality of life domains for the CG. EG experienced a statistically significant improvement in all quality of life domains compared with that of CG. [Conclusion] Therefore, participation in Pilates training was found to effectively improve the quality of life in stroke patients. Pilates training involves low and intermediate intensity resistance and repetition that match the patient's physical ability and can be a remedial exercise program that can improve physical ability and influence quality of life.
Körber, Maria Isabel; Köhler, Thomas; Weiss, Verena; Pfister, Roman; Michels, Guido
Poor survival rates after cardiac arrest can partly be explained by poor basic life support skills in medical professionals. This study aimed to assess quality of basic life support in medical students and paramedics. We conducted a prospective observational study with 100 early medical students (group A), 100 late medical students (group B) and 100 paramedics (group C), performing a 20-minute basic life support simulation in teams of two. Average frequency and absolute number of chest compressions per minute (mean (±SD)), chest decompression (millimetres of compression remaining, mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching positions between ventilation and chest compression (per 20 minutes) and rate of sufficient compressions (depth ≥50mm) were assessed as quality parameters of CPR. In groups A, B and C the rates of sufficiently deep chest compressions were 56%, 42% and 52%, respectively, without significant differences. Male gender and real-life CPR experience were significantly associated with deeper chest compression. Frequency and number of chest compressions were within recommended goals in at least 96% of all groups. Remaining chest compressions were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and 4s/min (±1), which was significantly different across all three groups. Overall, paramedics tended to show better quality of CPR compared to medical students. Though, chest compression depth as an important quality characteristic of CPR was insufficient in almost 50% of participants, even in well trained paramedics. Therefore, we suggest that an effort should be made to find better ways to educate health care professionals in BLS.
Hesse, Stefan; Werner, Cordula; von Frankenberg, Sophie; Bardeleben, Anita
Treadmill therapy with partial BWS is a promising new approach to improve gait ability after stroke. This task-specific approach enables nonambulatory patients the repetitive practice of complex gait cycles instead of single-limb gait-preparatory maneuvers. Patients walk more symmetrically with less spasticity and better cardiovascular efficiency on the treadmill than with floor walking. Several controlled, clinical studies have shown the potential of treadmill training as a therapeutic intervention for nonambulatory patients with chronic stroke-related hemiplegia. Furthermore, controlled trials in acute stroke survivors have shown that treadmill training is as effective as other physiotherapy approaches that stress the repetitive practice of gait. Controlled multicenter trials comparing locomotor training with conventional therapy will be forthcoming. An electromechanical gait trainer that relieves the strenuous effort of the therapists and provides control of the trunk in a phase-dependent manner is a new technical alternative for gait training in severely impaired stroke patients.
... associated with military training exercises. The model combines the business practice of Material Requirements Planning and the commercial spreadsheet software capabilities of Lotus 1-2-3 to calculate the requirements for food, consumable...
Polyakov, Yuriy S.; Musaev, Ibrahim; Polyakov, Sergey V.
Water scarcity in hot deserts, which cover about one-fifth of the Earth's land area, along with rapid expansion of hot deserts into arable lands is one of the key global environmental problems. As hot deserts are extreme habitats characterized by the availability of solar energy with a nearly complete absence of organic life and water, space technology achievements in designing closed ecological systems may be applicable to the design of sustainable settlements in the deserts. This review discusses the key space technology findings for closed biogenerative life support systems (CBLSS), which can simultaneously produce food, water, nutrients, fertilizers, process wastes, and revitalize air, that can be applied to hot deserts. Among them are the closed cycle of water and the acceleration of the cycling times of carbon, biogenic compounds, and nutrients by adjusting the levels of light intensity, temperature, carbon dioxide, and air velocity over plant canopies. Enhanced growth of algae and duckweed at higher levels of carbon dioxide and light intensity can be important to provide complete water recycling and augment biomass production. The production of fertilizers and nutrients can be enhanced by applying the subsurface flow wetland technology and hyper-thermophilic aerobic bacteria for treating liquid and solid wastes. The mathematical models, optimization techniques, and non-invasive measuring techniques developed for CBLSS make it possible to monitor and optimize the performance of such closed ecological systems. The results of long-duration experiments performed in BIOS-3, Biosphere 2, Laboratory Biosphere, and other ground-based closed test facilities suggest that closed water cycle can be achieved in hot-desert bioregenerative systems using the pathways of evapotranspiration, condensation, and biological wastewater treatment technologies. We suggest that the state of the art in the CBLSS design along with the possibility of using direct sunlight for
This report documents the methodology and lessons learned in the development of the Innovative Tools and Techniques for Brigade and Below Staff Training II - Battle Staff Training System II (ITTBBST-BSTS II...
Glass, Nancy; Hanson, Ginger C; Laharnar, Naima; Anger, W Kent; Perrin, Nancy
As Intimate Partner Violence (IPV) affects the workplace, a supportive workplace climate is important. The study evaluated the effectiveness of an "IPV and the Workplace" training on workplace climate towards IPV. IPV training was provided to 14 intervention counties and 13 control counties (receiving training 6 months delayed). Measures included workplace climate surveys, IPV knowledge test, and workplace observations. (i) Training significantly improved supervisor knowledge on IPV and received positive evaluations, (ii) training improved workplace climate towards IPV significantly which was maintained over time, and (iii) after the training, supervisors provided more IPV information to employees and more IPV postings were available in the workplace. The study provides evidence to support on-site interactive, computer based training as a means for improved workplace safety. IPV and the Workplace training effectively increased knowledge and positively changed workplace climate. Am. J. Ind. Med. 59:538-548, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Mao, Yurong; Chen, Peiming; Li, Lifang; Li, Le; Huang, Dongfeng
Gait recovery is very important to stroke survivors to regain their independence in activity of daily life. This study aimed to investigate the effects of virtual reality (VR) coupled body weight support treadmill training (BWSTT) on pelvic control at the early stage of stroke. Kinematic and kinetic changes of pelvic motion were evaluated by a 3D gait analysis system and were compared to the results from over-ground walking training. Twenty-four patients having unilateral hemiplegia with subacute stroke were recruited to a VR coupled BWSTT group (n= 12) and a conventional therapy (CT) group (n= 12). Both of the groups received training of 20-40 min/day, 5 days/week, for 3 weeks. The results showed the tilt of pelvis in sagittal plane improved significantly (P= 0.038) after treatment in the BWSTT+VR group, in terms of decreased amplitude of anterior peak (mean, from 10.99° to 6.25°), while there were no significant differences in the control group. The findings suggested that VR coupled BWSTT gait training could decrease anterior tilt of pelvis in early hemiparetic persons following a modest intervention dose, and the training may have advantages over conventional over-ground gait training and can assist the therapists in correcting abnormal gait pattern of stroke survivors.
Jones, Harry W.
Goodhart's law states that metrics do not work. Metrics become distorted when used and they deflect effort away from more important goals. These well-known and unavoidable problems occurred when the closure and system mass metrics were used to manage life support research. The intent of life support research should be to develop flyable, operable, reliable systems, not merely to increase life support system closure or to reduce its total mass. It would be better to design life support systems to meet the anticipated mission requirements and user needs. Substituting the metrics of closure and total mass for these goals seems to have led life support research to solve the wrong problems.
Weiner, Scott G; Mitchell, Patricia M; Temin, Elizabeth S; Langlois, Breanne K; Dyer, K Sophia
Intranasal delivery of naloxone to reverse the effects of opioid overdose by Advanced Life Support (ALS) providers has been studied in several prehospital settings. In 2006, in response to the increase in opioid-related overdoses, a special waiver from the state allowed administration of intranasal naloxone by Basic Life Support (BLS) providers in our city. This study aimed to determine: 1) if patients who received a 2-mg dose of nasal naloxone administered by BLS required repeat dosing while in the emergency department (ED), and 2) the disposition of these patients. This was a retrospective review of patients transported by an inner-city municipal ambulance service to one of three academic medical centers. We included patients aged 18 and older that were transported by ambulance between 1/1/2006 and 12/12/2012 and who received intranasal naloxone by BLS providers as per a state approved protocol. Site investigators matched EMS run data to patients from each hospital's EMR and performed a chart review to confirm that the patient was correctly identified and to record the outcomes of interest. Descriptive statistics were then generated. A total of 793 patients received nasal naloxone by BLS and were transported to three hospitals. ALS intervened and transported 116 (14.6%) patients, and 11 (1.4%) were intubated in the field. There were 724 (91.3%) patients successfully matched to an ED chart. Hospital A received 336 (46.4%) patients, Hospital B received 210 (29.0%) patients, and Hospital C received 178 (24.6%) patients. Mean age was 36.2 (SD 10.5) years and 522 (72.1%) were male; 702 (97.1%) were reported to have abused heroin while 21 (2.9%) used other opioids. Nasal naloxone had an effect per the prehospital record in 689 (95.2%) patients. An additional naloxone dose was given in the ED to 64 (8.8%) patients. ED dispositions were: 507 (70.0%) discharged, 105 (14.5%) admitted, and 112 (15.5%) other (e.g., left against medical advice, left without being seen, or
Bubenheim, David L.
The problems of obtaining adequate pure drinking water and disposing of liquid and solid waste in the U.S Arctic, a region where virtually all water is frozen solid for much of the year, has led to unsanitary solutions. Sanitation and a safe water supply are particularly problems in rural villages. These villages are without running water and use plastic buckets for toilets. The outbreak of diseases is believed to be partially attributable to exposure to human waste and lack of sanitation. Villages with the most frequent outbreaks of disease are those in which running water is difficult to obtain. Waste is emptied into open lagoons, rivers, or onto the sea coast. It does not degrade rapidly and in addition to affecting human health, can be harmful to the fragile ecology of the Arctic and the indigenous wildlife and fish populations. Current practices for waste management and sanitation pose serious human hazards as well as threaten the environment. NASA's unique knowledge of water/wastewater treatment systems for extreme environments, identified in the Congressional Office of Technology Assessment report entitled An Alaskan Challenge: Native Villagt Sanitation, may offer practical solutions addressing the issues of safe drinking water and effective sanitation practices in rural villages. NASA's advanced life support technologies are being combined with Arctic science and engineering knowledge to address the unique needs of the remote communities of Alaska through the Advanced Life Systems for Extreme Environments (ALSEE) project. ALSEE is a collaborative effort involving the NASA, the State of Alaska, the University of Alaska, the North Slope Borough of Alaska, Ilisagvik College in Barrow and the National Science Foundation (NSF). The focus is a major issue in the State of Alaska and other areas of the Circumpolar North; the health and welfare of its people, their lives and the subsistence lifestyle in remote communities, economic opportunity, and care for the
Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M
Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases). Propensity score methods were used to compare the effects of ALS and BLS on patient survival, neurological performance, and medical spending after cardiac arrest. Survival to hospital discharge, to 30 days, and to 90 days; neurological performance; and incremental medical spending per additional survivor to 1 year. Survival to hospital discharge was greater among patients receiving BLS (13.1% vs 9.2% for ALS; 4.0 [95% CI, 2.3-5.7] percentage point difference), as was survival to 90 days (8.0% vs 5.4% for ALS; 2.6 [95% CI, 1.2-4.0] percentage point difference). Basic life support was associated with better neurological functioning among hospitalized patients (21.8% vs 44.8% with poor neurological functioning for ALS; 23.0 [95% CI, 18.6-27.4] percentage point difference). Incremental medical spending per additional survivor to 1 year for BLS relative to ALS was $154,333. Patients with out-of-hospital cardiac arrest who received BLS had higher survival at hospital discharge and at 90 days compared with those who received ALS and were less likely to experience poor neurological functioning.
Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M
Most Medicare patients seeking emergency medical transport are treated by ambulance providers trained in advanced life support (ALS). Evidence supporting the superiority of ALS over basic life support (BLS) is limited, but some studies suggest ALS may harm patients. To compare outcomes after ALS and BLS in out-of-hospital medical emergencies. Observational study with adjustment for propensity score weights and instrumental variable analyses based on county-level variations in ALS use. Traditional Medicare. 20% random sample of Medicare beneficiaries from nonrural counties between 2006 and 2011 with major trauma, stroke, acute myocardial infarction (AMI), or respiratory failure. Neurologic functioning and survival to 30 days, 90 days, 1 year, and 2 years. Except in cases of AMI, patients showed superior unadjusted outcomes with BLS despite being older and having more comorbidities. In propensity score analyses, survival to 90 days among patients with trauma, stroke, and respiratory failure was higher with BLS than ALS (6.1 percentage points [95% CI, 5.4 to 6.8 percentage points] for trauma; 7.0 percentage points [CI, 6.2 to 7.7 percentage points] for stroke; and 3.7 percentage points [CI, 2.5 to 4.8 percentage points] for respiratory failure). Patients with AMI did not exhibit differences in survival at 30 days but had better survival at 90 days with ALS (1.0 percentage point [CI, 0.1 to 1.9 percentage points]). Neurologic functioning favored BLS for all diagnoses. Results from instrumental variable analyses were broadly consistent with propensity score analyses for trauma and stroke, showed no survival differences between BLS and ALS for respiratory failure, and showed better survival at all time points with BLS than ALS for patients with AMI. Only Medicare beneficiaries from nonrural counties were studied. Advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS. National Science Foundation, Agency for
psychological processes, socio-demographic factors and subjective quality of life have often .... function of religious involvement, spirituality and personal meaning in life ...... Unpublished MA Thesis: Department of Psychology, AAU. Baarsen ...
Jones, Harry W.
Brief human space missions supply all the crew's water and oxygen from Earth. The multiyear International Space Station (ISS) program instead uses physicochemical life support systems to recycle water and oxygen. This paper compares the Life Cycle Cost (LCC) of recycling to the LCC of resupply for potential future long duration human space missions. Recycling systems have high initial development costs but relatively low durationdependent support costs. This means that recycling is more cost effective for longer missions. Resupplying all the water and oxygen requires little initial development cost but has a much higher launch mass and launch cost. The cost of resupply increases as the mission duration increases. Resupply is therefore more cost effective than recycling for shorter missions. A recycling system pays for itself when the resupply LCC grows greater over time than the recycling LCC. The time when this occurs is called the recycling breakeven date. Recycling will cost very much less than resupply for long duration missions within the Earth-Moon system, such as a future space station or Moon base. But recycling would cost about the same as resupply for long duration deep space missions, such as a Mars trip. Because it is not possible to provide emergency supplies or quick return options on the way to Mars, more expensive redundant recycling systems will be needed.
Ahmet Akýn; Serhat Arslan; Eyüp Çelik; Çýnar Kaya; Nihan Arslan
The purpose of this study is to examine the relationship between Academic Support and Life Satisfaction. Participants were 458 university students who voluntarily filled out a package of self-report instruments. Student Academic Support Scale and Satisfaction with Life Scale were used as measures. The relationships between student academic support and life satisfaction were examined using correlation analysis and stepwise regression analysis. Life satisfaction was predicted positively by info...
Full Text Available Abstract Background Part-time training (PTT is accessed by approximately 10% of Australian obstetrics and gynaecology trainees, a small but increasing minority which reflects the growing demand for improved work/life balance amongst the Australian medical workforce. This survey reports the attitudes and experiences of both full-time and part-time trainees to PTT. Methods An email-based anonymous survey was sent to all Australian obstetrics and gynaecology trainees in April 2009, collecting demographic and training status data, data on personal experiences of PTT and/or trainees, and attitudes towards PTT. Results 105 responses were received (20% response rate. These indicated strong support (90% from both full-time (FT and part-time (PT trainees for the availability of PTT. PT trainees were significantly more likely than FT trainees to be female with children. Improved morale was seen as a particular advantage of PTT; decreased continuity of care as a disadvantage. Conclusions Although limited by poor response rate, both PT and FT Australian obstetric trainees were supportive of part-time training. Both groups recognised important advantages and disadvantages of this mode of training. Currently, part-time training is accessed primarily by female trainees with family responsibilities, with many more trainees considering part-time training than the number that access it.
Henry, Amanda; Clements, Sarah; Kingston, Ashley; Abbott, Jason
Part-time training (PTT) is accessed by approximately 10% of Australian obstetrics and gynaecology trainees, a small but increasing minority which reflects the growing demand for improved work/life balance amongst the Australian medical workforce. This survey reports the attitudes and experiences of both full-time and part-time trainees to PTT. An email-based anonymous survey was sent to all Australian obstetrics and gynaecology trainees in April 2009, collecting demographic and training status data, data on personal experiences of PTT and/or trainees, and attitudes towards PTT. 105 responses were received (20% response rate). These indicated strong support (90%) from both full-time (FT) and part-time (PT) trainees for the availability of PTT. PT trainees were significantly more likely than FT trainees to be female with children. Improved morale was seen as a particular advantage of PTT; decreased continuity of care as a disadvantage. Although limited by poor response rate, both PT and FT Australian obstetric trainees were supportive of part-time training. Both groups recognised important advantages and disadvantages of this mode of training. Currently, part-time training is accessed primarily by female trainees with family responsibilities, with many more trainees considering part-time training than the number that access it.
Wojtowicz, Marek A.; Cosgrove, Joseph E.; Serio, Michael A.; Jennings, Mallory A.
Results are presented on the development of regenerable trace-contaminant (TC) sorbent for use in Extravehicular Activities (EVAs), and more specifically in the Primary Life Support System (PLSS). Since ammonia is the most important TC to be captured, data presented in this paper are limited to ammonia sorption, with results relevant to other TCs to be reported at a later time. The currently available TC-control technology involves the use of a packed bed of acid-impregnated granular charcoal. The sorbent is non-regenerable, and its use is associated with appreciable pressure drop, i.e. power consumption. The objective of this work is to demonstrate the feasibility of using vacuum-regenerable sorbents for PLSS application. In this study, several carbon sorbent monoliths were fabricated and tested. Multiple adsorption/vacuum-regeneration cycles were demonstrated at room temperature, as well as carbon surface conditioning that enhances ammonia sorption without impairing sorbent regeneration. Depending on sorbent monolith geometry, the reduction in pressure drop with respect to granular sorbent was found to be between 50% and two orders of magnitude. Resistive heating of the carbon sorbent monolith was demonstrated by applying voltage to the opposite ends of the monolith.
Discussion: Pre-hospital acute pain management in the Western Cape does not appear to conform to best practice as Advanced Life Support providers in the Western Cape use low doses of morphine. Chest pain is an important reason for drug administration in acute pre-hospital pain. Multimodal analgesia is not a feature of care in this pre-hospital service. The development of a Clinical Practice Guideline for and training in pre-hospital pain should be viewed as imperative.
you identify any additional Life Cycle training or training improvements? The theme of the responses centered on there is not one magic formula to...prepare a future PSM. One participant’s answer was: “PSMs MUST have experience in a PM shop . That experience needs to include having provided...TRAINING 33 shop only deepens an already steep learning curve for that PSM and frustrates the PMs as they don’t understand what a PSM does and CAN do
White-Schwoch, Travis; Woodruff Carr, Kali; Anderson, Samira; Strait, Dana L; Kraus, Nina
Aging results in pervasive declines in nervous system function. In the auditory system, these declines include neural timing delays in response to fast-changing speech elements; this causes older adults to experience difficulty understanding speech, especially in challenging listening environments. These age-related declines are not inevitable, however: older adults with a lifetime of music training do not exhibit neural timing delays. Yet many people play an instrument for a few years without making a lifelong commitment. Here, we examined neural timing in a group of human older adults who had nominal amounts of music training early in life, but who had not played an instrument for decades. We found that a moderate amount (4-14 years) of music training early in life is associated with faster neural timing in response to speech later in life, long after training stopped (>40 years). We suggest that early music training sets the stage for subsequent interactions with sound. These experiences may interact over time to sustain sharpened neural processing in central auditory nuclei well into older age.
А. П. Власов
Full Text Available The objective is to ground the ways of improving the level of technical preparedness of highly-qualified archers by means of video and multimedia technologies. Materials and methods: The research studied motor actions of 25 athletes of the national team of Ukraine in archery when they were performing training exercises indoors (exercising area and outdoors (archery range. Each athlete’s technique of executing shooting exercises was video recorded in sequence from different angles (from above, from behind, from the front, from the left and the right sides depending on the shooting line with a digital video camera Sony DCR-XR150E. The processing of the video materials was done with the Dartfish Connekt software package. Results: The research grounds the need to use video and multimedia technologies in the process of training of highly-qualified archers. Such methods aim at improving the skills of both coaches and athletes by helping them better understand all aspects of the training exercises execution. Multimedia means offer a delayed-in-time opportunity to watch the video recording of the training after its preliminary computer processing. It enables the coach and the athlete to focus on the analysis of the execution of the entire exercise and its elements. The paper provides examples of the use of video technologies in archers’ training practice. Conclusions: Prospects of the use of the state-of-the-art computer technologies in sports training are infinite. Computer software and hardware systems should be available for most coaches. The task of the latter is to learn to use and implement them for the benefit of themselves and athletes. The task of the scientific groups and experts is to find a most convenient way for the coach to use the innovative technologies. The task of the software developer is to model intellectual programs to help the coach effectively analyze and evaluate his archers or team when preparing them for the most
Kreimeier, U; Dirks, B; Arntz, R; Bahr, J; Goldschmidt, P; Roessler, M; Sasse, M; Toursarkissian, M
Basic life support (BLS) refers to maintaining airway patency and supporting breathing and the circulation, without the use of equipment other than infection protection measures. The scientific advisory committee of the American Heart Association (AHA) published recommendations (online-first) on March 31 2008, which promote a call to action for bystanders who are not or not sufficiently trained in cardiopulmonary resuscitation (CPR) and witness an adult out-of-hospital sudden collapse probably of cardiac origin. These bystanders should provide chest compression without ventilation (so-called compression-only CPR). If bystanders were previously trained and thus confident with CPR, they should decide between conventional CPR (chest compression plus ventilation at a ratio of 30:2) and chest compression alone. However, considering current evidence-based medicine and latest scientific data both the European Resuscitation Council (ERC) and the German Resuscitation Council (GRC) do not at present intend to change or supplement the current resuscitation guidelines "Basic life support for adults". Both organisations do not see any need for change or amendments in central European practice and continue to recommend that only those lay rescuers that are not willing or unable to give mouth-to-mouth ventilation should provide CPR solely by uninterrupted chest compressions until professional help arrives. It is also stressed that the training of young people especially teenagers as lay rescuers should be promoted and the establishment of training programs through emergency medical organizations and in schools should be encouraged.
Markstaller, Klaus; Rudolph, Annette; Karmrodt, Jens; Gervais, Hendrik W; Goetz, Rolf; Becher, Anja; David, Matthias; Kempski, Oliver S; Kauczor, Hans-Ulrich; Dick, Wolfgang F; Eberle, Balthasar
The importance of ventilatory support during cardiac arrest and basic life support is controversial. This experimental study used dynamic computed tomography (CT) to assess the effects of chest compressions only during cardiopulmonary resuscitation (CCO-CPR) on alveolar recruitment and haemodynamic parameters in porcine model of ventricular fibrillation. Twelve anaesthetized pigs (26+/-1 kg) were randomly assigned to one of the following groups: (1) intermittent positive pressure ventilation (IPPV) both during basic life support and advanced cardiac life support, or (2) CCO during basic life support and IPPV during advanced cardiac life support. Measurements were acquired at baseline prior to cardiac arrest, during basic life support, during advanced life support, and after return of spontaneous circulation (ROSC), as follows: dynamic CT series, arterial and central venous pressures, blood gases, and regional organ blood flow. The ventilated and atelectatic lung area was quantified from dynamic CT images. Differences between groups were analyzed using the Kruskal-Wallis test, and a pbasic life support in the CCO-CPR group remained clinically relevant throughout the subsequent advanced cardiac life support period and following ROSC, and was associated with prolonged impaired haemodynamics. No inter-group differences in myocardial and cerebral blood flow were observed. A lack of ventilation during basic life support is associated with excessive atelectasis, arterial hypoxaemia and compromised CPR haemodynamics. Moreover, these detrimental effects remain evident even after restoration of IPPV.
Mendis, Kumara; Greenhill, Jennene; Walker, Judi; Bailey, Jannine; Croft, Amanda; Doyle, Zelda; McCrossin, Timothy; Stevens, Wendy
The Rural Clinical Training and Support (RCTS) program is an Australian Government initiative to address the shortage of medical practitioners within rural and remote Australia. There is a large amount of published information about the RCTS program and rural medical student cohorts who have undertaken short- and long-term rotations. However, very little is known about the academic and professional staff involved in the program, a knowledge gap that may impact workforce and succession planning. To address this, the Federation of Rural Australian Medical Educators (FRAME) initiated the pilot 2014 RCTS Snapshot survey to obtain data on the current RCTS workforce. All professional, academic and clinical academic staff (fixed-term and continuing, regardless of fraction) employed through the RCTS program were invited to complete a short, web-based survey. The survey was conducted from March to June 2014. The quantitative variables in the survey included demographics (age and gender), rural background and exposure, employment history in rural/regional areas and at rural clinical schools (RCS), experience and expertise, reasons for working at RCS, and future employment intentions. The last three questions also were of a qualitative open-ended format to allow respondents to provide additional details regarding their reasons for working at RCSs and their future intentions. The estimated total RCTS workforce was 970. A total of 413 responses were received and 316 (40.9%) complete responses analysed. The majority of respondents were female (71%), the 40-60-year age group was predominant (28%), and professional staff constituted the majority (62%). The below 40-year age group had more professionals than academics (21% vs 12%) and more than 62% of academics were aged above 50 years. Notably, there were no academics aged less than 30 years. The percentage of professional staff with a rural background was higher (62%) than that of academics with a rural background (42%). However
Grootveld, M.J.; Verbakel, E.
At the end of 2011 a Data Intelligence 4 Librarians course was developed to provide online resources and training for digital preservation practitioners, specifically library staff. Lessons learned during the first rounds of the course and developments in the Research Data Management landscape have
Federal Laboratory Consortium — The Virtual Training Devices (VTD) Laboratory at the Life Cycle Software Engineering Center, Picatinny Arsenal, provides a software testing and support environment...
Conclusion: Romance and quality of life were significantly influenced by the pattern of medical training in female residents. Setting duty-hour limits and initiating a new hobby were determined to be potentially beneficial to their quality of life and attitudes toward romance.
Estratégias tecnológicas de ensino associadas ao treinamento em Suporte Básico de Vida Estrategias tecnológicas de enseñanza asociadas al entrenamiento en Soporte Básico de Vida Technological strategies associated with training in Basic Life Support
Full Text Available Neste estudo objetivou-se analisar a eficácia e as vantagens do uso dos recursos tecnológicos para o ensino em Suporte Básico de Vida (SBV por meio de revisão narrativa. Foram analisados 29 artigos publicados e indexados nas bases de dados MedLine, PubMed e LILACS que utilizaram vídeo, CD-ROM, DVD, websites e programas computacionais para o ensino em SBV. Observou-se que a utilização desses recursos pode favorecer a aquisição de conhecimento em níveis similares ou superiores aos métodos tardicionais de ensino. Dentre as vantagens observadas citam-se a redução dos custos de treinamento, a facilidade de acesso e padronização das informações.En este estudio se tuvo como objetivo analizar la eficacia y las ventajas del uso de los recursos tecnológicos para la enseñanza del Soporte Básico de Vida (SBV por medio de revisión narrativa. Se analizaron 29 artículos publicados e indexados en las bases de datos MedLine, PubMed y LILACS que utilizaron video, CD-ROM, DVD, websites y programas de informática para la enseñanza en SBV. Se observó que la utilización de esos recursos puede favorecer en la adquisición de conocimientos en niveles similares o superiores a los métodos tradicionales de enseñanza. Entre las ventajas observadas se citan la reducción de los costos de entrenamiento, la facilidad de acceso y patronización de las informaciones.This study aimed to analyze the effectiveness and advantages of the use of technological resources for teaching Basic Life Support (SBV through a narrative review. We analyzed 29 articles published and indexed in these sources: Medline, PubMed and LILACS that used video, CD-ROM, DVD, websites and computer programs for teaching SBV. It was observed that the use of these resources may favor the acquisition of knowledge at levels similar or superior to methods of traditional teaching. Among the observed advantages cited were the reduction in training costs, ease of access and standardization
Maxwell, Whitney D; Mohorn, Phillip L; Haney, Jason S; Phillips, Cynthia M; Lu, Z Kevin; Clark, Kimberly; Corboy, Alex; Ragucci, Kelly R
Objective. To assess the impact of an advanced cardiac life support (ACLS) simulation on pharmacy student confidence and knowledge. Design. Third-year pharmacy students participated in a simulation experience that consisted of team roles training, high-fidelity ACLS simulations, and debriefing. Students completed a pre/postsimulation confidence and knowledge assessment. Assessment. Overall, student knowledge assessment scores and student confidence scores improved significantly. Student confidence and knowledge changes from baseline were not significantly correlated. Conversely, a significant, weak positive correlation between presimulation studying and both presimulation confidence and presimulation knowledge was discovered. Conclusions. Overall, student confidence and knowledge assessment scores in ACLS significantly improved from baseline; however, student confidence and knowledge were not significantly correlated.
Cho, Gyu Chong; Sohn, You Dong; Kang, Ku Hyun; Lee, Won Woong; Lim, Kyung Soo; Kim, Won; Oh, Bum Jin; Choi, Dai Hai; Yeom, Seok Ran; Lim, Hoon
Recently, hands only CPR (cardiopulmonary resuscitation) has been proposed as an alternative to standard CPR for bystanders. The present study was performed to identify the effect of basic life support (BLS) training on laypersons' willingness in performing standard CPR and hands only CPR. The participants for this study were non-medical personnel who applied for BLS training program that took place in 7 university hospitals in and around Korea for 6 months. Before and after BLS training, all the participants were given questionnaires for bystander CPR, and 890 respondents were included in the final analyses. Self-assessed confidence score for bystander CPR, using a visual analogue scale from 0 to 100, increased from 51.5+/-30.0 before BLS training to 87.0+/-13.7 after the training with statistical significance (p 0.001). Before the training, 19% of respondents reported willingness to perform standard CPR on a stranger, and 30.1% to perform hands only CPR. After the training, this increased to 56.7% of respondents reporting willingness to perform standard CPR, and 71.9%, hands only CPR, on strangers. Before and after BLS training, the odds ratio of willingness to perform hands only CPR versus standard CPR were 1.8 (95% CI 1.5-2.3) and 2.0 (95% CI 1.7-2.6) for a stranger, respectively. Most of the respondents, who reported they would decline to perform standard CPR, stated that fear of liability and fear of disease transmission were deciding factors after the BLS training. The BLS training increases laypersons' confidence and willingness to perform bystander CPR on a stranger. However, laypersons are more willing to perform hands only CPR rather than to perform standard CPR on a stranger regardless of the BLS training. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Miles, Gaines E.; Krom, Kimberly J.
Controlled, Ecological Life Support Systems (CELSS) that utilize plants to provide food, water and oxygen could consume considerable amounts of labor unless crop production, recovery and processing are automated. Robotic manipulators equipped with special end-effectors and programmed to perform the sensing and materials handling tasks would minimize the amount of astronaut labor required. The Human Rated Test Facility (HRTF) planned for Johnson Space Center could discover and demonstrate techniques of crop production which can be reliably integrated with machinery to minimize labor requirements. Before the physical components (shelves, lighting fixtures, etc.) can be selected, a systems analysis must be performed to determine which alternative processes should be followed and how the materials handling tasks should be automated. Given that the current procedures used to grow crops in a CELSS may not be the best methods to automate, then what are the alternatives? How may plants be grown, harvested, processed for food, and the inedible components recycled? What commercial technologies current exist? What research efforts are underway to develop new technologies which might satisfy the need for automation in a CELSS? The answers to these questions should prove enlightening and provide some of the information necessary to perform the systems analysis. The planting, culturing, gathering, threshing and separation, food processing, and recovery of inedible portions of wheat were studied. The basic biological and materials handling processes of each task are defined and discussed. Current practices at Johnson Space Center and other NASA centers are described and compared to common production practices in the plant production industry. Technologies currently being researched which might be applicable are identified and illustrated. Finally, based on this knowledge, several scenarios are proposed for automating the tasks for wheat.
Izenson, Michael G.; Chen, Weibo; Anderson, Molly; Hodgson, Edward
Thermal and environmental control systems for future exploration spacecraft must meet challenging requirements for efficient operation and conservation of resources. Regenerative CO2 removal systems are attractive for these missions because they do not use consumable CO2 absorbers. However, these systems also absorb and vent water to space along with carbon dioxide. This paper describes an innovative device designed to minimize water lost from regenerative CO2 control systems. Design studies and proof-of-concept testing have shown the feasibility of a compact, efficient membrane water vapor exchanger (WVX) that will conserve water while meeting challenging requirements for operation on future spacecraft. Compared to conventional WVX designs, the innovative membrane WVX described here has the potential for high water recovery efficiency, compact size, and very low pressure losses. The key innovation is a method for maintaining highly uniform flow channels in a WVX core built from water-permeable membranes. The proof-of-concept WVX incorporates all the key design features of a prototypical unit, except that it is relatively small scale (1/23 relative to a unit sized for a crew of six) and some components were fabricated using non-prototypical methods. The proof-of-concept WVX achieved over 90% water recovery efficiency in a compact core in good agreement with analysis models. Furthermore the overall pressure drop is very small (less than 0.5 in. H2O, total for both flow streams) and meets requirements for service in environmental control and life support systems on future spacecraft. These results show that the WVX provides very uniform flow through flow channels for both the humid and dry streams. Measurements also show that CO2 diffusion through the water-permeable membranes will have negligible effect on the CO2 partial pressure in the spacecraft atmosphere.
Boisramé-Helms, Julie; Rahmani, Hassène; Stiel, Laure; Tournoud, Christine; Sauder, Philippe
Ingestions of Colchicum autumnale may lead to severe poisoning. It begins with gastrointestinal symptoms and leukocytosis, followed by multi-organ failure with shock and a possible late recovery phase. Mortality is highly dependent on the ingested dose. We report a case of accidental C. autumnale poisoning with refractory cardiogenic shock and eventual survival after extracorporeal life support (ECLS). A 68-year-old woman was admitted to the intensive care unit (ICU) on day 3 after ingestion of C. autumnale in a meal. She first suffered from nausea and vomiting leading to severe dehydration. She then developed multi-organ failure and refractory cardiogenic shock, with a mean arterial pressure nadir of 50 mmHg despite high doses of catecholamines and a left ventricular ejection fraction at 5-10%. Venous-arterial ECLS was therefore started at an initial rate of 3.5 L/min and 3,800 rev/min. Her symptoms also included pancytopenia on day 4 with diffuse bleeding requiring iterative blood product transfusion. Platelet and leukocyte count nadirs were 13 × 10(9)/L (normal range: 150-400 × 10(9)/L) and 0.77 × 10(9)/L (normal range: 4.2-10.7 × 10(9)/L), respectively. ECLS allowed good cardiac contractility recovery within a few days, with complications including bleeding made controllable. Indeed, because of hemostasis disorders, the patient presented hemoptysis and hematuria. She was treated with tranexamic acid and transfused with blood products. She received 15 erythrocyte concentrates, 13 platelet concentrates, and 7 fresh frozen plasma. ECLS was removed by day 10, with subsequent weaning from mechanical ventilation as well as from hemodialysis in the following days. This patient survives after the use of ECLS in Colchicum poisoning, with controllable complications. Thus, ECLS might be indicated to overcome the potentially refractory cardiogenic shock phase.
Mohammed, John L; Sorensen, Barbara; Ong, James C; Li, Jian
.... These systems use hierarchical, object-oriented task representations that enable rapid authoring by non-programmers while supporting sophisticated job aiding and student performance evaluation...
Stutts, Amy; Schloemann, Johanna
As medical knowledge and technology continue to increase, so will types of life-sustaining support as well as the public's expectations for use of this support with positive outcomes. Health care professionals will continue to be challenged by the issues surrounding the appropriate use of life-sustaining support and the issues it raises. This is especially apparent in the NICU. When parents' belief systems challenge the health care team's ethical commitment to beneficence and nonmaleficence, a shared decision-making model based on mutual understanding of and respect for different viewpoints can redirect the focus onto the baby's best interest. This article addresses three questions: 1. How do nonmaleficence, beneficence, and concern about quality of life guide the use of life-sustaining support? 2. To what extent should parental autonomy and spirituality influence treatment decisions? 3. What efforts can the health care team make to support the family?
Brasted, Ian D; Dailey, Michael W
Aggressive epinephrine administration has growing support in the treatment of anaphylaxis, a life-threatening allergic reaction. Emergency Medical Services (EMS) providers are frequently in a position to provide the first care to someone experiencing an anaphylactic reaction. Intramuscular injection of epinephrine is the definitive pharmacologic treatment for many associated symptoms. While easy to use, epinephrine autoinjectors (EAI) are prohibitively expensive, having increased in price ten-fold in ten years. Some states and EMS departments have begun expanding the scope of practice to allow Basic Life Support (BLS) providers, previously restricted to noninvasive therapies, to administer epinephrine by syringe. To compile a current and comprehensive list of how epinephrine is carried and used by EMS across the USA. An online survey focusing on anaphylaxis protocols and epinephrine administration was sent to state EMS medical directors and officials in all 50 states. Follow-up telephone calls were made to ensure compliance. Data were analyzed with descriptive statistics. Forty-nine of the 50 states in the USA provided a survey response. Texas responded but declined to participate in the survey because of practice variability across the state. In the other states, the form of epinephrine allowed or required on BLS ambulances was consistent with the scope of practice of their Basic Emergency Medical Technician (EMT). Thirteen states had training programs to allow BLS providers to inject epinephrine; 7 were considering it; 29 were not. Twenty-seven states specified EAI as the only form of epinephrine required or allowed on their BLS ambulances. No states reported allowing any level of EMS provider below EMT to use alternatives to EAI. This study confirms that many states have expanded the training of BLS providers to include the use of syringe injectable epinephrine. Even so, the majority of states relied on EAI in BLS ambulances.
Binkhorst, Mathijs; Coopmans, Michelle; Draaisma, Jos M T; Bot, Petra; Hogeveen, Marije
Retention of resuscitation skills is usually assessed at a predefined moment, which enables participants to prepare themselves, possibly introducing bias. In this multicenter study, we evaluated the retention of knowledge and skills in pediatric basic life support (PBLS) amongst 58 pediatricians and pediatric residents with an unannounced examination. Practical PBLS skills were assessed with a validated scoring instrument, theoretical knowledge with a 10-item multiple-choice test (MCQ). Participants self-assessed their PBLS capabilities using five-point Likert scales. Background data were collected with a questionnaire. Of our participants, 21% passed the practical PBLS exam: 29% failed on compressions/ventilations, 31% on other parts of the algorithm, 19% on both. Sixty-nine percent passed the theoretical test. Participants who more recently completed a PBLS course performed significantly better on the MCQ (p = 0.03). This association was less clear-cut for performance on the practical exam (p = 0.11). Older, attending pediatricians with more years of experience in pediatrics performed less well than their younger colleagues (p basic life support (PBLS) in daily practice. Poor retention of skills supposedly accounts for this incompetence. Without regular exposure, resuscitation skills usually deteriorate within 3 to 6 months after training. • Examination of resuscitation skills usually takes place after training. Also, in most studies evaluating retention of skills, participants are tested at a predefined moment. Inasmuch as participants are able to prepare themselves, these assessments do not reflect the ad hoc resuscitation capabilities of pediatricians and residents. What is New: • In this study, pediatricians and pediatric residents had to complete an unannounced PBLS exam at variable time intervals from last certification. Retention of PBLS skills was rather poor (pass rate 21%). • The PBLS skills of older, attending pediatricians with many
Rodriguez, A.; Paille, C.; Rebeyre, P.; Lamaze, B.; Lobo, M.; Lasseur, C.
Nowadays the Moon is not only a scientific exploration target but also potentially also a launch pad for deeper space exploration. Establishing an extended human presence on the Moon could reduce the cost of further space exploration, and gather the technical and scientific experience that would make possible the next steps of space exploration, namely manned-missions to Mars. To enable the establishment of such a Moon base, a reliable and regenerative life support system (LSS) is required: without any recycling of metabolic consumables (oxygen, water and food), a 6-person crew during the course of one year would require a supply of 12t from Earth (not including water for hygiene purposes), with a prohibitive associated cost! The recycling of consumables is therefore mandatory for a combination of economic, logistical and also safety reasons. Currently the main regenerative technologies used, namely water recycling in the ISS, are physical-chemical but they do not solve the issue of food production. In the European Space Agency, for the last 15 years, studies are being performed on several life support topics, namely in air revitalisation, food, water and waste management, contaminants, monitoring and control. Ground demonstration, namely the MELiSSA Pilot Plant and Concordia Station, and simulation studies demonstrated the studies feasibility and the recycling levels are promising. To be able to build LSS in a Moon base, the temperature amplitude, the dust and its 14-day night, which limits solar power supply, should be regarded. To reduce these technical difficulties, a landing site should be carefully chosen. Considering the requirements of a mission to the Moon and within the Aurora programme phase I, a preliminary configuration for a regenerative LSS can be proposed as an experiment for a precursor mission to the Moon. An overview of the necessary LSS to a Moon base will be presented, identifying Moon?s specific requirements and showing preliminary
Sutherland, Georgina; Andersen, Mark B; Morris, Tony
This study was a pilot project to explore the effect of an autogenic training program (AT; a relaxation intervention) on the health-related quality of life (HRQOL) and well-being for people with multiple sclerosis. Participants either met weekly for sessions in AT for 10 weeks (n = 11) or were assigned to the control group (n = 11). The AT group was also asked to practice the technique daily at home. Scales designed to measure HRQOL and aspects of well-being (mood and depressed affect) were taken preintervention and at week 8 of the 10-week program. ANCOVAs using a measure of social support and pretest scores as covariates revealed that at the posttest the AT group reported more energy and vigor than the control group and were less limited in their roles due to physical and emotional problems. Future research should involve studies conducted over an extended period, together with sufficiently sized samples to explore the effect of frequency of practice of relaxation training on HRQOL and well-being for people with multiple sclerosis.
Kurz, Max J; Stuberg, Wayne; Dejong, Stacey; Arpin, David J
The aim of this investigation was to determine if body-weight-supported (BWS) overground gait training has the potential to improve the walking abilities of children and youth with childhood onset motor impairments and intellectual disabilities. Eight participants (mean age of 16.3 years) completed 12 weeks of BWS overground gait training that was performed two times a week. BWS was provided during the training sessions by an overhead harness system that rolls overground. There was a significant improvement in the preferred walking speed after the training (p training may be an effective treatment strategy for improving the preferred walking speed of children and youth with motor impairments.
José Maria Gonçalves Fernandes
Full Text Available Background:Despite being recommended as a compulsory part of the school curriculum, the teaching of basic life support (BLS has yet to be implemented in high schools in most countries.Objectives:To compare prior knowledge and degree of immediate and delayed learning between students of one public and one private high school after these students received BLS training.Methods:Thirty students from each school initially answered a questionnaire on cardiopulmonary resuscitation (CPR and use of the automated external defibrillator (AED. They then received theoretical-practical BLS training, after which they were given two theory assessments: one immediately after the course and the other six months later.Results:The overall success rates in the prior, immediate, and delayed assessments were significantly different between groups, with better performance shown overall by private school students than by public school students: 42% ± 14% vs. 30.2% ± 12.2%, p = 0.001; 86% ± 7.8% vs. 62.4% ± 19.6%, p < 0.001; and 65% ± 12.4% vs. 45.6% ± 16%, p < 0.001, respectively. The total odds ratio of the questions showed that the private school students performed the best on all three assessments, respectively: 1.66 (CI95% 1.26-2.18, p < 0.001; 3.56 (CI95% 2.57-4.93, p < 0.001; and 2.21 (CI95% 1.69-2.89, p < 0.001.Conclusions:Before training, most students had insufficient knowledge about CPR and AED; after BLS training a significant immediate and delayed improvement in learning was observed in students, especially in private school students.
All physicians, dentists, nurses and health care personnel should be adequately and regularly trained in cardiopulmonary resuscitation. Guidelines for acquiring the necessary skills in basic and advanced life support are now available.
Benson, Angela D.; Bothra, Jashoda; Sharma, Priya
Performance support systems can play an important role in corporations by managing and allowing distribution of information more easily. These systems run the gamut from simple paper job aids to sophisticated computer- and web-based software applications that support the entire corporate supply chain. According to Gery (1991), a performance…
Høyer, Ellen; Jahnsen, Reidun; Stanghelle, Johan Kvalvik; Strand, Liv Inger
Treadmill training with body weight support (TTBWS) for relearning walking ability after brain damage is an approach under current investigation. Efficiency of this method beyond traditional training is lacking evidence, especially in patients needing walking assistance after stroke. The objective of this study was to investigate change in walking and transfer abilities, comparing TTBWS with traditional walking training. A single-blinded, randomized controlled trial was conducted. Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups, one received 30 sessions of TTBWS plus traditional training, the other traditional training alone. Daily training was 1 hr. Outcome measures were Functional Ambulation Categories (FAC), Walking, Functional Independence Measure (FIM); shorter transfer and stairs, 10 m and 6-min walk tests. Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention. Overall no statistical significant differences were found between the groups, but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach. Both training strategies provided significant improvements in the tested activities, suggesting that similar outcomes can be obtained in the two modalities by systematic, intensive and goal directed training.
National Aeronautics and Space Administration — Cryogenic life support technology, used by NASA to protect crews working around hazardous gases soon could be called on for a number of life-saving applications as...
Valcour, Monique; Ollier-Malaterre, Ariane; Matz-Costa, Christina; Pitt-Catsouphes, Marcie; Brown, Melissa
This study examined predictors of employee perceptions of organizational work-life support. Using organizational support theory and conservation of resources theory, we reasoned that workplace demands and resources shape employees' perceptions of work-life support through two mechanisms: signaling that the organization cares about their work-life…
Kresak, Karen E.; Gallagher, Peggy A.; Kelley, Susan J.
Sources of support and quality of life of 50 grandmother-headed families raising grandchildren with and without disabilities were examined. Comparative analyses revealed significant differences between grandmothers raising grandchildren with and without disabilities in regard to sources of support and family quality of life. Informal support was…
Bahri, Narjes; Yoshany, Nooshin; Morowatisharifabad, Mohammad Ali; Noghabi, Ali Delshad; Sajjadi, Moosa
Spouses' support during menopausal transition has an important role for improving the quality of life in postmenopausal women. Since the first step in providing support is having adequate knowledge, this study aimed to investigate the effects of an educational program on menopause health for spouses on women's quality of life during the menopausal transition. This clinical trial was conducted in Yazd, Iran. A hundred healthy women aged 45 to 60 years were recruited by random sampling. The spouses in the intervention group (n = 50) attended three training sessions about the management and health of menopausal transition. The spouses in the control group (n = 50) did not receive any intervention. Knowledge and performance about menopausal health were assessed in all spouses before and 3 months after intervention. All women were assessed by the Menopause Rating Scale, and the Menopause Quality of Life questionnaire before and 3 months after educational intervention. Analyses were carried out using SPSS 16 software. The level of significance was set at P less than 0.05. The knowledge and performance of spouses in the intervention group were significantly higher 3 months after intervention (P women in the intervention group was higher 3 months after intervention (P training of menopausal health for spouses improves the quality of life in women during menopausal transition. We suggest integrating such educational programs in menopausal management programs.
Jantzer, Amanda M; Anderson, Jenn; Kuehl, Rebecca A
Women are increasingly faced with decisions about how to combine breastfeeding with work, but few researchers have directly measured how breastfeeding relates to the work-life interface. Research aim: The authors examined how perceptions of work enhancement of personal life and work interference with personal life were influenced by workplace breastfeeding support, including organizational, manager, and coworker support, as well as adequate time to express human milk. Then, we examined how workplace breastfeeding support predicted work-life variables and job satisfaction. Using a self-report, survey design, the authors analyzed online surveys from 87 women in a rural, community sample who indicated that they had pumped at work or anticipated needing to pump in the future. According to regression results, provision of workplace breastfeeding support, particularly providing adequate time for human milk expression, predicted work enhancement of personal life. Conversely, we found that as workplace support diminished, employees perceived greater work interference with personal life. Results of path analysis further suggested that providing time for expressing milk improved job satisfaction via a partially mediated relationship where work enhancement of personal life acted as a mediator. These results suggest that employers can enhance the lives of their breastfeeding employees both at work and at home by providing workplace breastfeeding support, especially through providing time for expressing human milk in the workplace.
This thesis focuses on developing a spreadsheet decision support model that can be used by combat engineer platoon and company commanders in determining the material requirements and estimated costs...
This study conducted to determine the effect of vitamin E separate or combined with gamma ray in semi artificial diets on some biological aspects of the Greater wax moth, Galleria mellonella L. (Pyralidae : Lepidoptera). The increase in the average number of eggs per mated female for more than 70 % of the control in both treated male and female. Also, through the F1 generation (descendant of P1 progeny fed on artificial diet plus vitamin E) in either irradiated male or female at 100 and 300 Gy dose levels. The life supporter of vitamin E clearly demonstrates throughout F1 whose offspring fed on artificial diet plus Vitamin E, also more pronounced during the first generation treated with gamma irradiation (100 and 300 Gray) which descendant from the offspring were fed on the artificial diet containing Vitamin E (0.02%) than that treatments which treated with gamma irradiation only. The average weight of larvae and pupae significantly increase by using petroleum ether only or this may be abnormal. The average weight of larvae and pupae at the concentration 0.02% was 105.07 and 121.87 % from the control treatment, respectively then decreased to 67.86 and 75.12%, respectively from the control treatment at the concentration 0.04% and then increase at the two concentrations 0.06 and 0.08 %. The increase in weight gain in the case combined ( 100 Gy or 300 Gy with Vitamin E) more than in case using a single dose of gamma irradiation , the increase in case 300 Gy only or combined with Vitamin E more than the control treatment. The best result in case of Vitamin (E) only then when treated the pest with gamma radiation after Vitamin (E) and the effect at 100 Gy better than in case 300 Gy. The combined effect of sub sterilizing dose (300 Gy) and sterilizing doses (400 and 500 Gy) of gamma radiation and vitamin E on the mating competitiveness of F1 males G. Mellenella shows that the competitiveness values more than 1.0 at the combined VE and the two dose levels 400 and 500 Gy
Polonskiy, Vadim; Polonskaya, Janna
The perspective crops for the bioregenerative human life support systems V.I. Polonskiy, J.E. Polonskaya aKrasnoyarsk State Agrarian University, 660049, Krasnoyarsk, Russia In the nearest future the space missions will be too long. In this case it is necessary to provide the crew by vitamins, antioxidants, and water-soluble dietary fibers. These compounds will be produced by higher plants. There was not enough attention at present to increasing content of micronutrients in edible parts of crops candidates for CELSS. We suggested to add the new crops to this list. 1. Barley -is the best crop for including to food crops (wheat, rice, soybean). Many of the health effects of barley are connected to dietary fibers beta-glucan of barley grains. Bar-ley is the only seed from cereals including wheat with content of all eight tocopherols (vitamin E, important antioxidant). Barley grains contain much greater amounts of phenolic compounds (potential antioxidant activities) than other cereal grains. Considerable focus is on supplement-ing wheat-based breads with barley to introduce the inherent nutritional advantages of barley flour, currently only 20We have selected and tested during 5 generations two high productive barley lines -1-K-O and 25-K-O. Our investigations (special breeding program for improving grain quality of barley) are in progress. 2. Volatile crops. Young leaves and shoots of these crops are edible and have a piquant taste. A lot of organic volatile compounds, oils, vitamins, antioxidants are in their biomass. These micronutrients are useful for good appetite and health of the crew. We have investigated 11 species: basil (Ocimum basilicum), hyssop (Hyssopus officinalis), marjoram (Origanum majorana), sweet-Mary (Melissa officinalis), common thyme (Thymus vulgaris), creeping thyme (Thymus serpyllum), summer savory (Satureja hortensis), catnip (Nepeta cataria), rue (Ruta graveolens), coriander (Coriandrum Ativum), sulfurwort (Levisticum officinale). These
Anderson, Molly; Gatens, Robyn; Ikeda, Toshitami; Ito, Tsuyoshi; Hovland, Scott; Witt, Johannes
Human exploration of the solar system is an ambitious goal. Future human missions to Mars or other planets will require the cooperation of many nations to be feasible. Exploration goals and concepts have been gathered by the International Space Exploration Coordination Group (ISECG) at a very high level, representing the overall goals and strategies of each participating space agency. The Global Exploration Roadmap published by ISECG states that international partnerships are part of what drives the mission scenarios. It states "Collaborations will be established at all levels (missions, capabilities, technologies), with various levels of interdependency among the partners." To make missions with interdependency successful, technologists and system experts need to share information early, before agencies have made concrete plans and binding agreements. This paper provides an overview of possible ways of integrating NASA, ESA, and JAXA work into a conceptual roadmap of life support and environmental monitoring capabilities for future exploration missions. Agencies may have immediate plans as well as long term goals or new ideas that are not part of official policy. But relationships between plans and capabilities may influence the strategies for the best ways to achieve partner goals. Without commitments and an organized program like the International Space Station, requirements for future missions are unclear. Experience from ISS has shown that standards and an early understanding of requirements are an important part of international partnerships. Attempting to integrate systems that were not designed together can create many problems. Several areas have been identified that could be important to discuss and understand early: units of measure, cabin CO2 levels, and the definition and description of fluids like high purity oxygen, potable water and residual biocide, and crew urine and urine pretreat. Each of the partners is exploring different kinds of technologies
Torok, R.; Naser, J.
In response to the growing challenges of obsolescence and rising maintenance costs, utilities are increasingly upgrading or replacing their existing instrumentation and control (I and C) systems and components. In most cases, this involves analog-to-digital or digital-to-newer-digital replacements. However, the use of digital technology often raises new technical and licensing issues, particularly for safety-related applications. Examples include: new failure modes and the potential for common-mode failure of redundant components; electromagnetic compatibility (EMC); potential human-system interface problems; and software verification, validation, and configuration management. Successful implementation, operation and maintenance of digital systems depend to a great extent on having processes in place that are tailored for digital technology. Nuclear plants are therefore updating their processes as they start the migration to digital I and C. For several years, EPRI has been developing guidelines to address the key technical issues and interfacing with the U.S. NRC to ensure the acceptability of the approaches developed. A framework for implementing digital upgrades now exists, but practical experience under the current regulatory environment is sparse. Significant uncertainty exists in regard to both technical and licensing issues. Many utilities still need to prepare their staff and processes to properly handle the new technology. In recent years, this need has been exacerbated by staff reductions, changing job assignments, and declining training budgets. EPRI has responded by developing a training program to help utilities efficiently bring design and licensing engineers up to speed on the latest issues and guidance affecting the implementation of digital upgrades in nuclear plants. This paper describes the key technical issues in the context of the EPRI training program. (authors)
DUMITRU G. BADEA
Full Text Available Foundation Insurance Management Institute (IMI has implemented over three years period (2011-2013 a program for human resources development in insurance, co-financed from the SOP HRD programme. This project aimed tthe training of specialists and intermediaries in insurance. To ensure the quality required of such a program, Insurance Management Institute has partnered with a number of universities in the country and with two professional associations of the insurance domain. This project had important quantitative results - 8339 participants in 306 courses conducted in all counties of Romania
The picture used for simulation was the model of a power station control room designed by KWU for the German Museum, the cooling water circuit of which is illustrated, in order to avoid long training times by a manageable problem setting. A process video system equipped with a light pen made by KRUPP ATLAS was available for the VDU representation of simulation, which is used in industry, for the control and supervision of technical system. This process video system was controlled by a Digital PDP 11/40, which has several great advantages over stand-alone operation. (orig./DG) [de
Ferrall, J. F.; Seshan, P. K.; Rohatgi, N. K.; Ganapathi, G. B.
This paper describes a simulation model called the Life Support Systems Analysis Simulation Tool (LiSSA-ST), the spreadsheet program called the Life Support Systems Analysis Trade Tool (LiSSA-TT), and the Generic Modular Flow Schematic (GMFS) modeling technique. Results of using the LiSSA-ST and the LiSSA-TT will be presented for comparing life support systems and process technology options for a Lunar Base and a Mars Exploration Mission.
systems and the resources required for NET. TRAC-WSMR then integrated the NET resources into the final cost estimates for the system...unit with LW and MW expressed in terms of unit force effectiveness, impacts to the DOTMLPF domains, life cycle cost , and ability to mitigate Joint...exposed. This was referred to as indirect view fire ( IVF ). Rounds were the same as the baseline. The M249 firers only executed the IVF . They also
... they would otherwise spend observing, coaching, and facilitating the learning of exercise players. This study: (1) Identifies the impact of force modernization on future exercise control and training feedback functions...
National Aeronautics and Space Administration — NASA is evaluating Dutyion™, a phase change permeation membrane technology developed by Design Technology and Irrigation (DTI), for use in future advanced life...
National Aeronautics and Space Administration — Humidity is a critical variable for monitoring and control on extended duration missions because it can affect the operation and efficiency of closed loop life...
Mitchell, K. L.; Bagdigian, R. M.; Carrasquillo, R. L.; Carter, D. L.; Franks, G. D.; Holder, D. W., Jr.; Hutchens, C. F.; Ogle, K. Y.; Perry, J. L.; Ray, C. D.
NASA has been progressively learning the design and performance of the Russian life support systems utilized in their Mir space station. In 1992, a plan was implemented to assess the benefits of the Mir-1 life support systems to the Freedom program. Three primary tasks focused on: evaluating the operational Mir-1 support technologies and understanding if specific Russian systems could be directly utilized on the American space station and if Russian technology design information could prove useful in improving the current design of the planned American life support equipment; evaluating the ongoing Russian life support technology development activities to determine areas of potential long-term application to the U.S. space station; and utilizing the expertise of their space station life support systems to evaluate the benefits to the current U.S. space station program which included the integration of the Russian Mir-1 designs with the U.S. designs to support a crew of six.
Prolonged exercise and heavy training are associated with depressed immune function which can increase the risk of picking up minor infections. To maintain robust immunity, athletes should eat a well-balanced diet sufficient to meet their energy, carbohydrate, protein, and micronutrient requirements. Dietary deficiencies of protein and specific micronutrients have long been associated with immune dysfunction and an adequate intake of iron, zinc, and vitamins A, D, E, B6 and B12 is particularly important in the maintenance of immune function. Consuming carbohydrate during prolonged strenuous exercise attenuates rises in stress hormones and appears to limit the degree of exercise-induced immune depression. Similar effects can be seen with daily ingestion of high-dose antioxidant vitamin supplements, though concerns have been expressed that excessive antioxidant intake may impair exercise training adaptations. It is safe to say with reasonable confidence that individual amino acids, colostrum, Echinacea, and zinc are unlikely to boost immunity or reduce infection risk in athletes. The ingestion of carbohydrate during exercise and daily consumption of probiotic and plant polyphenol (e.g. quercetin)-containing supplements or foodstuffs (e.g. non-alcoholic beer) currently offer the best chance of success. This approach is likely to be most effective for individuals who are particularly prone to illness. Copyright © 2013 Nestec Ltd., Vevey/S. Karger AG, Basel.
Ferrall, J. F.; Seshan, P. K.; Rohatgi, N. K.; Ganapathi, G. B.
This paper describes a simulation model called the Life Support Systems Analysis Simulation Tool (LiSSA-ST), the spreadsheet program called the Life Support Systems Analysis Trade Tool (LiSSA-TT), and the Generic Modular Flow Schematic (GMFS) modeling technique. Results of using the LiSSA-ST and the LiSSA-TT will be presented for comparing life support system and process technology options for a Lunar Base with a crew size of 4 and mission lengths of 90 and 600 days. System configurations to minimize the life support system weight and power are explored.
Martel, Sara; Ives-Baine, Lori
To qualitatively explore neonatal intensive care nurses' experiences with end-of-life photography as part of their bereavement support work with families. An Interpretive Phenomenological Analysis with data collected through a focus group (n = 6) and one semi-structured interview (n = 1) with neonatal nurses from a Level 3/4 NICU in a Canadian pediatric hospital. Participants' comfort with EOL photography developed over time through exposure to bereavement scenarios and positive experiences with families. Participants' experienced a feeling of pressure to balance the photography with clinical responsibilities and find the right time to introduce photography while being sensitive to family experiences. Participants experienced EOL photography as something tangible to give families and were satisfied knowing the images might play an important role in the family's healing after the NICU. All participants had come to value EOL photography as a positive and meaningful part of their work with bereaved families. Identified challenges related to balancing the practice with the unpredictable flow and demands of critical care and to developing an appreciation for and comfort with the photography as part of their healing and the families' healing. Findings contribute insight into care-provider experience that can inform best practices, training, and staff support for palliative and bereavement work in neonatal and pediatric settings. The findings suggest a need to support nurses emotionally and clinically in carrying out this photography as part of their care for families. Copyright © 2018 Elsevier Inc. All rights reserved.
Sianturi, Elisabet Damayanti
121301107 Work-life balance merupakan suatu keadaan dimana individu merasa terikat dan puas terhadap kehidupan pekerjaan dan kehidupan keluarganya. Salah satu faktor yang mempengaruhi work-life balance adalah organizational support (dukungan organisasi). Dalam hal ini, dukungan organisasi sangat penting karena ketersediaan dukungan terhadap karyawan dalam menjalankan perannya di tempat kerja dan keluarga akan membuat karyawan merasa bahwa organisasi memperhatikan kesejaht...
Kircher, T; Stetter, F; Wormstall, H
23 multimorbid, geronto-psychiatric patients, aged 60 years or older, participated in a "supportive" course of autogenic training according to Schultz. Participating in the course an average of 7 +/- 3 weeks, 17 (76%) of the subjects were able to learn the training. In general, subjects reported a better general condition after the training sessions, measured with visual analogue scales (p training success was better in the psychopathological less affected than in the more severely ill (BPRS prior r = 0.64, p = 0.001, GDS prior r = 0.46, p training success and age, number of somatic diseases, number of medication, MMSE and the "Beschwerdenliste". Autogenic training is a useful component in psychotherapeutic and psychiatric therapy for elderly multimorbid in- and outpatients. A half-open group, two therapy sessions per week, reciting the training formulae aloud, a structured, simple setting and co-therapists proved to be worthwhile.
Rombouts, Ellen; Meuris, Kristien; Maes, Bea; De Meyer, Anne-Marie; Zink, Inge
Purpose: Research has demonstrated that formal training is essential for professionals to learn key word signing. Yet, the particular didactic strategies have not been studied. Therefore, this study compared the effectiveness of verbal and video feedback in a key word signing training for future direct support staff. Method: Forty-nine future…
Grebennikov, Valery V.; Grudtsina, Ludmila Yu.; Marchuk, Nikolay N.; Sangadgiev, Badma V.; Kudyashev, Nail K.
The research urgency is caused by the transition to the knowledge society and new demands for training and methodical provision of professional pedagogical education. The purpose of this paper is to develop practical recommendations to improve the quality of training and methodical support of professional pedagogical education. The leading…
Alvelos, Rita; Ferreira, Aristides I.; Bates, Reid
Purpose: The purpose of this study is to contribute to the understanding of factors that affect training effectiveness. According to the literature, social support, perceived content validity, transfer design, the motivation to improve work through learning and positive transfer, contribute to the effectiveness of training.…
Eldin, Ahmed Sharaf; ElNahry, Alaa H.; Elsayed, Adel; Ibrahim, Rania Elsayed
The current study seeks to introduce a new pedagogical design for geo-informatics courses using an e-training support system. Laurillard's conversational approach based on conceptual representation for both instructor and learner was used to form the framework. As the current study specifically interested in training as a special form for…
Mun, Y.; Hulst, A.H. van der; Oprins, E.A.P.B.; Schraagen, J.M.C.
Introduction: For effective decision making in the 21st century where operational environments are complex and uncertain, there is a strong need for training support and its practical application to naturalistic, real-world settings. In this contribution, we focus on training of adaptive performance
Hedlund, Eva R; Lundell, Bo; Söderström, Liselott; Sjöberg, Gunnar
Children after Fontan palliation have reduced exercise capacity and quality of life. Our aim was to study whether endurance training could improve physical capacity and quality of life in Fontan patients. Fontan patients (n=30) and healthy age- and gender-matched control subjects (n=25) performed a 6-minute walk test at submaximal capacity and a maximal cycle ergometer test. Quality of life was assessed with Pediatric Quality of Life Inventory Version 4.0 questionnaires for children and parents. All tests were repeated after a 12-week endurance training programme and after 1 year. Patients had decreased submaximal and maximal exercise capacity (maximal oxygen uptake 35.0±5.1 ml/minute per·kg versus 43.7±8.4 ml/minute·per·kg, pquality of life score (70.9±9.9 versus 85.7±8.0, pimproved their submaximal exercise capacity in a 6-minute walk test (from 590.7±65.5 m to 611.8±70.9 m, pquality of life (pimprove maximal exercise capacity. At follow-up, submaximal exercise capacity had increased further and improved quality of life was sustained. The controls improved their maximal exercise capacity (pquality of life after training. At follow-up, improvement of maximal exercise capacity was sustained. We believe that an individualised endurance training programme for Fontan patients improves submaximal exercise capacity and quality of life in Fontan patients and the effect on quality of life appears to be long-lasting.
Freund, Yonathan; Duchateau, François-Xavier; Baker, Elinor C; Goulet, Hélène; Carreira, Serge; Schmidt, Matthieu; Riou, Bruno; Rouby, Jean-Jacques; Duguet, Alexandre
Before implementing new workshops and teaching in our faculty for performing basic life support (BLS), we aimed to determine the level of self-confidence of medical students with regard to the management of cardiac arrest (CA). We conducted a preinterventional study. A questionnaire was sent to third-year to sixth-year medical students. We recorded sex, year of training, and personal witnessing of CA. We asked them about their theoretical knowledge on 10 main items of BLS and their self-perception of qualification to conduct a CA situation. We tested the respective influence of sex, year of training, and personal witnessing of CA. In total, 592 (37%) students completed the questionnaire, 42% of them were men. Less than a third of the students (30%) thought of themselves as being sufficiently qualified to conduct BLS. After the third year, the level of study did not influence their theoretical knowledge or their self-perception of qualification. Male sex and the number of CAs witnessed were the only factors positively associated with better self-confidence regarding qualification. Self-perception of qualification in BLS is poor in our faculty. In our study, personal witnessing of CA greatly influenced confidence, whereas level of study did not.
Kalz, Marco; Skorning, Max; Haberstroh, Max; Gorgels, Ton; Klerkx, Joris; Vergnion, Michel; Van Poucke, Sven; Lenssen, Niklas; Biermann, Henning; Schuffelen, Petra; Pijls, Ruud; Ternier, Stefaan; De Vries, Fred; Van der Baaren, John; Parra, Gonzalo; Specht, Marcus
Kalz, M., Skorning, M., Haberstroh, M., Gorgels, T., Klerkx, J., Vergnion, M., ...Specht, M. (2012). EMuRgency – New approaches for resuscitation support and training in the Euregio Meuse-Rhine. Resuscitation, 83 (S1). e37.
...) command and control (C2). These challenges and changes to how CSS management will occur in an increasingly information-rich and distributed environment provide the opportunity to reexamine training for support staffs...
Planning and management support for NPP personnel SAT-based training programmes is described for the following job positions: reactor operator; turbine operator; reactor maintenance worker; pump maintenance worker; chemistry foreman; health physics foreman; electric maintenance worker
Smeesters, Hannah; Skinner, Chas; Martin, Jo
A lack of knowledge in diabetes self management skills, such as insulin administration, glucose testing and diet, have been identified in a high percentage of adults with the condition ever since insulin treatment was first introduced (Watkins et al, 1967; Murata et al, 2003). Adult support weeke...
Thorne, C J; Lockey, A S; Kimani, P K; Bullock, I; Hampshire, S; Begum-Ali, S; Perkins, G D
To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect. Between 1 January 2013 and 30 June 2014, 8218 individuals participated in a Resuscitation Council (UK) e-learning Advanced Life Support (e-ALS) course. Participants completed 5-8h of online e-learning prior to attending a one day face-to-face course. e-Learning access data were collected through the Learning Management System (LMS). All participants were assessed by a multiple choice questionnaire (MCQ) before and after the face-to-face aspect alongside a practical cardiac arrest simulation (CAS-Test). Participant demographics and assessment outcomes were analysed. The mean post e-learning MCQ score was 83.7 (SD 7.3) and the mean post-course MCQ score was 87.7 (SD 7.9). The first attempt CAS-Test pass rate was 84.6% and overall pass rate 96.6%. Participants with previous ALS experience, ILS experience, or who were a core member of the resuscitation team performed better in the post-course MCQ, CAS-Test and overall assessment. Median time spent on the e-learning was 5.2h (IQR 3.7-7.1). There was a large range in the degree of access to e-learning content. Increased time spent accessing e-learning had no effect on the overall result (OR 0.98, P=0.367) on simulated learning outcome. Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs. Copyright © 2017 Elsevier B.V. All rights reserved.
Most of the literature demonstrates that multinational companies do not adequately train and support expatriates prior to and during overseas assignments. If expatriates do not sufficiently adjust to host-country conditions, this can have detrimental effects on expatriate managers themselves, the assignment and the sending organisation. This study examines the effectiveness of expatriate training and support practices of multinational companies in Cyprus. The dissertation builds on three them...
Gu, G Z; Yu, S F; Zhou, W H; Wu, H; Kang, L; Chen, R
Objective: To investigate the social support status of train drivers. Methods: Using cluster sampling, a cross-sectional study was conducted in 1 413 male train drivers (including 301 passenger train drivers, 683 freight train drivers, 85 guest scheduling train drivers, 265 cargo adjustable drivers, and 79 high-speed train drivers) from a railway bureau depot. The survey included individual factors, social support, occupational stressors, strains, personalities, and coping strategy using occupational stress instruments and effort-reward imbalance questionnaire. We compared the difference in social support scores between different drivers, who were divided according to job type and age. Additionally, the correlation between social support score and job strain-related factors was analyzed. The influence of depressive symptoms and job satisfaction were analyzed using a non-conditional logistic multivariate model. Results: The overall average age P (50) ( P (25), P (75)) of 1 413 train drivers was 33.92 (27.83,43.58) years. The overall average length of service 12.25 (5.25,22.75) years. A significant difference in social support scores was observed according to job type ( H =23.23, P40 years (27 (22,31)). Correlation analysis revealed that the social support score was negatively associated with job satisfaction ( r=- 0.43), reward ( r=- 0.22), working stability ( r=- 0.23), promotion opportunities ( r=- 0.12), positive affectivity ( r=- 0.31), esteem ( r=- 0.21), and self-esteem ( r=- 0.20) scores ( Pstress ( r= 0.29), negative affectivity ( r= 0.23), and depressive symptoms ( r= 0.44) scores ( Poccupational stress. High social support was related to reduction in the occurrence of occupational stress, depressive symptoms, and low job satisfaction. Social support is related to mental health of train drivers.
Full Text Available Life quality of diabetic patients is always affected by psychosocial problems, physical disorders, and life style changes. It seems that the perceived social support could intervene in improving the life quality of these patients. The present study was carried out aiming to examine the relation between family social support and life quality of female patients with diabetes. This was a cross-sectional study. The statistical population included 173 diabetic females who were randomly selected from patients referred to Kermanshah diabetes research center. Data were collected using life quality questionnaire (Short Form-36 as well as perceived social support scale. The data analysis indicated that there is a significant correlation between family support and life quality of patients. Furthermore, concerning the components of life quality, there is a significant correlation between family social support and physical performance, physical limitation, tiredness, emotional health, social performance, pain, and general health of patients. However, no significant relation was found between family support and limitation of patients. Results showed that there is a direct relation between family support and the life quality in females with diabetes. Hence, it can be concluded that giving the family support to the female diabetic patients can increase their quality of life.
Froes, Isabel Cristina G.; Laaksolahti, Jarmo Matti; Witzner Hansen, Dan
development. Our ongoing investigation of Interaction Design for a Good Life (http://itu.dk/IxDLab/) has uncovered a broad diversity of perspectives on how to unpack ‘a good life’ through research and design, and indeed what constitutes a good life to begin with. Through our investigations, time has surfaced...... as pivotal to our budding understanding of elements of a good life and a useful framing for future investigations. Time is also an important topic for interaction design, because it is at the core of interaction, the practice of design, and, in many ways, our use and relationships with technological......This position paper outlines a research program for the IxD Research Group at the IT University of Copenhagen. As such, it presents a range of questions addressing different corners of the question of time in IxD from the point of view of HCI, social interaction, material expressions, and software...
De Pascale, Stefania; De Micco, Veronica; Aronne, Giovanna; Paradiso, Roberta
For long time our research group has been involved in experiments aiming to evaluate the possibility to cultivate plants in Space to regenerate resources and produce food. Apart from investigating the response of specific growth processes (at morpho-functional levels) to space factors (namely microgravity and ionising radiation), wide attention has been dedicated to agro-technologies applied to ecologically closed systems. Based on technical and human dietary requirements, soybean [Glycine max (L.) Merr.] is studied as one of the candidate species for hydroponic (soilless) cultivation in the research program MELiSSA (Micro-Ecological Life Support System Alternative) of the European Space Agency (ESA). Soybean seeds show high nutritional value, due to the relevant content of protein, lipids, dietary fiber and biologically active substances such as isoflavones. They can produce fresh sprouts or be transformed in several edible products (soymilk and okara or soy pulp). Soybean is traditionally grown in open field where specific interactions with soil microrganisms occur. Most available information on plant growth, seed productivity and nutrient composition relate to cultivated varieties (cultivars) selected for soil cultivation. However, in a space outpost, plant cultivation would rely on soilless systems. Given that plant growth, seed yield and quality strictly depend on the environmental conditions, to make successful the cultivation of soybean in space, it was necessary to screen all agronomic information according to space constraints. Indeed, selected cultivars have to comply with the space growth environment while providing a suitable nutritional quality to fulfill the astronauts needs. We proposed an objective criterion for the preliminary theoretical selection of the most suitable cultivars for seed production, which were subsequently evaluated in bench tests in hydroponics. Several Space-oriented experiments were carried out in a closed growth chamber to
Kovalev, Vladimir; Tikhomirov, Alexander A.; Nickolay Manukovsky, D..
It is known that snail meat is a high quality food that is rich in protein. Hence, heliciculture or land snail farming spreads worldwide because it is a profitable business. The possibility to use the snails of Helix pomatia in Biological Life Support System (BLSS) was studied by Japanese Researches. In that study land snails were considered to be producers of animal protein. Also, snail breeding was an important part of waste processing, because snails were capable to eat the inedible plant biomass. As opposed to the agricultural snail farming, heliciculture in BLSS should be more carefully planned. The purpose of our work was to develop a model for snail breeding in BLSS that can predict mass flow rates in and out of snail facility. There are three linked parts in the model called “Stoichiometry”, “Population” and “Mass balance”, which are used in turn. Snail population is divided into 12 age groups from oviposition to one year. In the submodel “Stoichiometry” the individual snail growth and metabolism in each of 12 age groups are described with stoichiometry equations. Reactants are written on the left side of the equations, while products are written on the right side. Stoichiometry formulas of reactants and products consist of four chemical elements: C, H, O, N. The reactants are feed and oxygen, products are carbon dioxide, metabolic water, snail meat, shell, feces, slime and eggs. If formulas of substances in the stoichiometry equations are substituted with their molar masses, then stoichiometry equations are transformed to the equations of molar mass balance. To get the real mass balance of individual snail growth and metabolism one should multiply the value of each molar mass in the equations on the scale parameter, which is the ratio between mass of monthly consumed feed and molar mass of feed. Mass of monthly consumed feed and stoichiometry coefficients of formulas of meat, shell, feces, slime and eggs should be determined experimentally
Several prominent research strategy organizations recommend applying life cycle assessment (LCA) early in the development of emerging technologies. For example, the US Environmental Protection Agency, the National Research Council, the Department of Energy, and the National Nanotechnology Initiative identify the potential for LCA to inform research and development (R&D) of photovoltaics and products containing engineered nanomaterials (ENMs). In this capacity, application of LCA to emerging technologies may contribute to the growing movement for responsible research and innovation (RRI). However, existing LCA practices are largely retrospective and ill-suited to support the objectives of RRI. For example, barriers related to data availability, rapid technology change, and isolation of environmental from technical research inhibit application of LCA to developing technologies. This dissertation focuses on development of anticipatory LCA tools that incorporate elements of technology forecasting, provide robust explorations of uncertainty, and engage diverse innovation actors in overcoming retrospective approaches to environmental assessment and improvement of emerging technologies. Chapter one contextualizes current LCA practices within the growing literature articulating RRI and identifies the optimal place in the stage gate innovation model to apply LCA. Chapter one concludes with a call to develop anticipatory LCA---building on the theory of anticipatory governance---as a series of methodological improvements that seek to align LCA practices with the objectives of RRI. Chapter two provides a framework for anticipatory LCA, identifies where research from multiple disciplines informs LCA practice, and builds off the recommendations presented in the preceding chapter. Chapter two focuses on crystalline and thin film photovoltaics (PV) to illustrate the novel framework, in part because PV is an environmentally motivated technology undergoing extensive R&D efforts and
Wessels, Monique; Lucas, Cees; Eriks, Inge; de Groot, Sonja
Objective: To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Methods: Cochrane, MEDLINE, EM BASE, CINAHL, PEDro, DocOnline
Wessels, Monique; Lucas, Cees; Eriks, Inge; de Groot, Sonja
To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Cochrane, MEDLINE, EMBASE, CINAHL, PEDro, DocOnline were searched and
FOSTER (1) is about promoting and facilitating the adoption of Open Science by the European research community, and fostering compliance with the open access policies set out in Horizon 2020 (H2020). FOSTER aims to reach out and provide training to the wide range of disciplines and countries involved in the European Research Area (ERA) by offering and supporting face-to-face as well as distance training. Different stakeholders, mainly young researchers, are trained to integrate Open Science in their daily workflow, supporting researchers to optimise their research visibility and impact. Strengthening the institutional training capacity is achieved through a train-the-trainers approach. The two-and-half-year project started in February 2014 with identifying, enriching and providing training content on all relevant topics in the area of Open Science. One of the main elements was to support two rounds of trainings, which were conducted during 2014 and 2015, organizing more than 100 training events with around 3000 participants. The presentation will explain the project objectives and results and will look into best practice training examples, among them successful training series in the GeoSciences. The FOSTER portal that now holds a collection of training resources (e.g. slides and PDFs, schedules and design of training events dedicated to different audiences, video captures of complete events) is presented. It provides easy ways to identify learning materials and to create own e-learning courses based on the materials and examples. (1) FOSTER is funded through the European Union's Seventh Framework Programme for research, technological development and demonstration under grant agreement no 612425. http://fosteropenscience.eu
Marsh Anthony P
Full Text Available Abstract Background Although progressive resistance strength training (ST has been found to improve various measures of physical functioning in older adults, the benefit to quality of life is unclear. Additionally, recent evidence suggests that high velocity power training (PT may be more beneficial for physical functioning than ST, but it is not known whether this type of training impacts quality of life. The purpose of this study was to compare changes in multiple measures of quality of life resulting from ST vs. PT in older adults. A no exercise group was also included as control comparison condition. Methods Forty-five older adults (M age = 74.8 years; SD = 5.7 were randomly assigned to either a PT, b ST, or c control group (no exercise. Measures of self-efficacy (SE, satisfaction with physical function (SPF, and the Satisfaction with Life Scale (SWL were assessed at baseline and following training. The resistance training conditions met 3 times per week for 12 weeks at an intensity of 70% 1 repetition maximum. Results A series of ANCOVA's comparing between group differences in change and controlling for baseline values revealed significant group differences in all three measures: SE (F(2,31 = 9.77; p (2,32 = 3.36; p = .047; SWL (F(2,31 = 4.76; p = .016. Follow up analyses indicated that the PT group reported significantly more change in SE, SPF, and SWL than the control group whereas the ST group reported greater change than the control group only in SE. Conclusion These pilot data indicate that high velocity power training may influence multiple levels of quality of life over and above the benefits gained through traditional strength training.
Elías VIVED CONTE
Full Text Available In the context of an innovative teaching project approved by the Government of Aragon and the University of Zaragoza a study on professional training for young people with intellectual disabilities (ID was developed. The objective was to investigate the support system and to check the effectiveness of a design based on sources of natural and professional support. 9 young people with DI took part together with diverse support staff –parents, volunteers, university students through a service learning experience, professionals, adults with ID–. The theoretical bases of the project were linked to independent life projects, the supported employment and the supports model. The methodological references were the mediational teaching approach and cooperative learning. As evaluation tools, the Adaptive Skills Inventory (CALS, the questionnaire of social interaction skills (CHIS and the questionnaires of satisfaction were used. The results indicate a high achievement regarding the acquisition of skills by the participants,as well as a high degree of satisfaction from the experience. Despite several limitations present in our study, our results support the desirability of establishing new designs that enhance the effectiveness of the professional training of young people with DI and promote social and labor availability in inclusive environments.
Huang, Hong Zhong; Wang, Hai Kun; Li, Yan Feng; Zhang, Longlong; Liu, Zhiliang
Estimation of remaining useful life (RUL) is helpful to manage life cycles of machines and to reduce maintenance cost. Support vector machine (SVM) is a promising algorithm for estimation of RUL because it can easily process small training sets and multi-dimensional data. Many SVM based methods have been proposed to predict RUL of some key components. We did a literature review related to SVM based RUL estimation within a decade. The references reviewed are classified into two categories: improved SVM algorithms and their applications to RUL estimation. The latter category can be further divided into two types: one, to predict the condition state in the future and then build a relationship between state and RUL; two, to establish a direct relationship between current state and RUL. However, SVM is seldom used to track the degradation process and build an accurate relationship between the current health condition state and RUL. Based on the above review and summary, this paper points out that the ability to continually improve SVM, and obtain a novel idea for RUL prediction using SVM will be future works.
Germain, Alison; Nolan, Kate; Doyle, Rita; Mason, Stephen; Gambles, Maureen; Chen, Hong; Smeding, Ruthmarijke; Ellershaw, John
A training programme was developed and delivered to a cohort of volunteers who were preparing for a unique role to provide companionship to dying patients in the acute hospital setting. This comprehensive programme aimed to provide an opportunity for participants to fully understand the nature and responsibilities of the role, whilst also allowing sufficient time to assess the qualities and competencies of participants for their ongoing volunteering role. Participants completed reflective diaries throughout the training course to record their ongoing thoughts and feelings. The purpose of this paper is to present a phenomenological analysis of these entries to understand participants' experiences, perceptions and motivations. The wider study was structured into three phases. Phase 1 was the delivery of a 12 week, bespoke training programme; Phase 2 involved a 26 week pilot implementation of the Care of the Dying Volunteer Service and Phase 3 was the research evaluation of the training and implementation which would inform the further development of the training programme. Self-reflection is a common component of End of Life training programmes and volunteers in this study completed a reflective diary after participation in each of the training sessions. A thematic analysis was undertaken to explore and understand the participants' experience, perceptions and motivations in relation to their participation in the training. All 19 volunteers completed the reflective diaries. From a potential 228 diary entries over the 12 week training programme, 178 diary entries were submitted (78 %). The following key themes were identified: Dying Alone and the importance of being present, Personal loss and the reconstruction of meaning, Self-Awareness and Personal growth, Self-preservation and Coping strategies and group unity/cohesion. The participants in this study demonstrated that they were able to use the diaries as an appropriate medium for reflection. Their reflections were
Wilson, Michael E; Rhudy, Lori M; Ballinger, Beth A; Tescher, Ann N; Pickering, Brian W; Gajic, Ognjen
Our aim was to explore reasons for physician variability in decisions to limit life support in the intensive care unit (ICU) utilizing qualitative methodology. Single center study consisting of semi-structured interviews with experienced physicians and nurses. Seventeen intensivists from medical (n = 7), surgical (n = 5), and anesthesia (n = 5) critical care backgrounds, and ten nurses from medical (n = 5) and surgical (n = 5) ICU backgrounds were interviewed. Principles of grounded theory were used to analyze the interview transcripts. Eleven factors within four categories were identified that influenced physician variability in decisions to limit life support: (1) physician work environment-workload and competing priorities, shift changes and handoffs, and incorporation of nursing input; (2) physician experiences-of unexpected patient survival, and of limiting life support in physician's family; (3) physician attitudes-investment in a good surgical outcome, specialty perspective, values and beliefs; and (4) physician relationship with patient and family-hearing the patient's wishes firsthand, engagement in family communication, and family negotiation. We identified several factors which physicians and nurses perceived were important sources of physician variability in decisions to limit life support. Ways to raise awareness and ameliorate the potentially adverse effects of factors such as workload, competing priorities, shift changes, and handoffs should be explored. Exposing intensivists to long term patient outcomes, formalizing nursing input, providing additional training, and emphasizing firsthand knowledge of patient wishes may improve decision making.
Bates, Jason; Sharratt, Martin; King, John
This article examines the way that non-clinical support services are provided in healthcare settings through outsourcing partnerships. The integrated support services model and benefits to patient experience and safety as well as organizational efficiency and effectiveness are explored through an examination of services at a busy urban community hospital.
Lolaty, Hamideh A; Ghahari, Sharbanoo; Tirgari, Abdolhakim; Fard, Jabbar Heydari
Emotional intelligence has a major role in mental health and life skills training, and could be viewed as a bridge relating to emotional intelligence and mental health. The present study is aimed at determining the effect of life skills training on the emotional intelligence among the first year students of Mazandaran University of Medical Sciences. MATERIALS AND METHODS: IN THIS EXPERIMENTAL STUDY, THE SUBJECTS WERE SELECTED BY RANDOM SAMPLING AND ALLOCATED INTO TWO GROUPS: Case group (n=20) and control group (n=19); they matched for gender, experience of stressful life events in the past six months, level of interest in the field of study, and level of emotional intelligence. The two groups responded to Bar-on Emotional Quotient Inventory before starting the experiment. Subsequently, the case group underwent life skills training. After the training, Bar-on Emotional Quotient Inventory was responded by the case and control groups again. The data was analyzed using descriptive statistics including Chi-square test, paired and independent t-tests, using SPSS software version 15. In the case group, the scores of emotional intelligence after life skills training were significantly improved (t=11.703 df=19 P=0.001), while no significant difference was observed in the control group (t=0.683 df =18 P=0.503). By performing programs such as life skills training, the levels of emotional intelligence of the students could be increased, which itself could lead to academic success, reduced substance abuse, and increased stress tolerance in the students.
In recent decades, work-life arrangements increasingly became an integral part of the organization of work. Arrangements such as telecommuting, flextime, part-time hours, and various types of leave arrangements are available to employees in many organizations. Top managers, such as CEOs, CFOs and
Full Text Available Background: Life satisfaction and perceived social support been shown to improve the well-being of a person and also affect the outcome of treatment in somatization disorder. The phenomenon of somatization was explored in relation to the perceived social support and life satisfaction. Aim: This study aimed at investigating perceived social support and life satisfaction in people with somatization disorder. Materials and Methods: The study was conducted on persons having somatization disorder attending the outpatient unit of LGB Regional Institute of Mental Health, Tezpur, Assam. Satisfaction with life scale and multidimensional scale of perceived social support were used to assess life satisfaction and perceived social support respectively. Results: Women reported more somatic symptoms than men. Family perceived social support was high in the patient in comparison to significant others′ perceived social support and friends′ perceived social support. Perceived social support showed that a significant positive correlation was found with life satisfaction. Conclusion: Poor social support and low life satisfaction might be a stress response with regard to increased distress severity and psychosocial stressors rather than a cultural response to express psychological problems in somatic terms.
Chauhan, Ragini; Ghosh, Piyali; Rai, Alka; Shukla, Divya
This study aims to assess the individual impacts of two components of support at the workplace, namely, support from peers and supervisor, on transfer of training in a post-training environment. Mediation by motivation to transfer in the relationship of supervisor and peer support with transfer of training has also been examined. Data on 149…
Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C.; Weiner, Bryan J.; Kinsinger, Linda
Introduction The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. Methods We developed an MI peer counselor training program for volunteer veterans, the “Buddies” program, to provide one-on-one telephone support for veterans enrolled in MOVE!. Buddies were recruited at 5 VHA sites and trained to provide peer support for the 6-month MOVE! intervention. We used a DVD to teach MI skills and followed with 2 to 3 booster sessions. We observed training, conducted pre- and posttraining surveys, and debriefed focus groups to assess training feasibility. Results Fifty-six Buddies were trained. Results indicate positive receipt of the program (89% reported learning about peer counseling and 87% reported learning communication skills). Buddies showed a small improvement in MI self-efficacy on posttraining surveys. We also identified key challenges to learning MI and training implementation. Conclusions MI training is feasible to implement and acceptable to volunteer Buddies. Trainers must assess how effectively volunteers learn MI skills in order to enhance its effective use in health promotion. PMID:24199738
Claudia Josefina Arias
Full Text Available This paper aims to carry out an analysis of the importance of social support and participation in old age. Contributions are presented first that various international agencies concerned with old age and aging have been made to strengthen this support and increased participation of older people. Different sources of social support are described: formal and informal interventions that can be made with varied promotion and preventive-wellness-care objectives and action at various levels-individual, group, family, organizational and community-and is made an analysis of the impact on the well-being have the resources of social support available to older people. Finally we reflect on Certain negative assumptions about the availability of support and social participation of older people in relation to recent research findings on the subject. Problematize the importance of these negative stereotypes about aging in general and on the participation and the availability of social support in particular in order to achieve more supportive environments that promote the development of the potential of older persons is concluded.
Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne
Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as
Fagan Abigail A
Full Text Available Abstract Background Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. Methods This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Results Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers, ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence. Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage. Student behavior and use of interactive teaching techniques (quality of delivery were positively related. No variables were related to student participation (student responsiveness. Conclusion Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that
Tan, E.C.T.H.; Severien, I.; Metz, J.C.; Berden, H.J.J.M.; Biert, J.
According to the Dutch medical education guidelines junior doctors are expected to be able to perform first aid and basic life support. A prospective study was undertaken to assess the level of first aid and basic life support (BLS) competence of junior doctors at the Radboud University Nijmegen
Severien, I.; Tan, E.C.T.H.; Metz, J.C.; Biert, J.; Berden, H.J.J.M.
According to Dutch medical-education guidelines junior doctors are expected to be able to carry out first aid and basic life support. We determined the level of first aid and basic life support of junior doctors at the Radboud University Nijmegen Medical Centre, The Netherlands. Of the 300 junior
The purpose of this study was to investigate the predictive value of optimism, perceived support from family and perceived support from faculty in determining life satisfaction of college students in Turkey. One hundred and thirty three students completed the Satisfaction with Life Scale (Diener et al., Journal of Personality Assessment…
This dissertation considers the problem of process synthesis and design of life-support systems for manned space missions. A life-support system is a set of technologies to support human life for short and long-term spaceflights, via providing the basic life-support elements, such as oxygen, potable water, and food. The design of the system needs to meet the crewmember demand for the basic life-support elements (products of the system) and it must process the loads generated by the crewmembers. The system is subject to a myriad of uncertainties because most of the technologies involved are still under development. The result is high levels of uncertainties in the estimates of the model parameters, such as recovery rates or process efficiencies. Moreover, due to the high recycle rates within the system, the uncertainties are amplified and propagated within the system, resulting in a complex problem. In this dissertation, two algorithms have been successfully developed to help making design decisions for life-support systems. The algorithms utilize a simulation-based optimization approach that combines a stochastic discrete-event simulation and a deterministic mathematical programming approach to generate multiple, unique realizations of the controlled evolution of the system. The timelines are analyzed using time series data mining techniques and statistical tools to determine the necessary technologies, their deployment schedules and capacities, and the necessary basic life-support element amounts to support crew life and activities for the mission duration.
Jenkins, Sharon Rae; Belanger, Aimee; Connally, Melissa Londono; Boals, Adriel; Duron, Kelly M.
First-generation undergraduate students face challenging cross-socioeconomic cultural transitions into college life. The authors compared first- and non-first-generation undergraduate students' social support, posttraumatic stress, depression symptoms, and life satisfaction. First-generation participants reported less social support from family…
Akin, Ahmet; Arslan, Serhat; Çelik, Eyüp; Kaya, Çinar; Arslan, Nihan
The purpose of this study is to examine the relationship between Academic Support and Life Satisfaction. Participants were 458 university students who voluntarily filled out a package of self-report instruments. Student Academic Support Scale and Satisfaction with Life Scale were used as measures. The relationships between student academic support…
Paterson, Ashley D.; Hakim-Larson, Julie
Results from 98 Arab youth in Canada showed that having a positive Arab culture orientation was related to greater family life satisfaction with family social support as a mediator. A positive European Canadian orientation was related to greater school life satisfaction, but this relation was not mediated by friend social support. Implications for…
Beadle-Brown, J.; Leigh, J.; Whelton, B.; Richardson, L.; Beecham, J.; Baumker, T.; Bradshaw, J.
Background: People with severe and profound intellectual disabilities often spend substantial time isolated and disengaged. The nature and quality of the support appears to be important in determining quality of life. Methods: Structured observations and staff questionnaires were used to explore the quality of life and quality of support for 110…
Soman, S; Bhat, S M; Latha, K S; Praharaj, S K
To study the gender differences in perceived social support and life events in patients with depression. A total of 118 patients aged 18 to 60 years, with depressive disorder according to the DSM-IV-TR, were evaluated using the Multidimensional Scale of Perceived Social Support and Presumptive Stressful Life Events Scale. The perceived social support score was significantly higher in males than females (p friends than females (p life events as well as specific type of life events in males that became apparent after controlling for education (p life event in both males and females. Work-related problems were more commonly reported by males, whereas family and marital conflict were more frequently reported by females. Perceived social support and stressful life events were higher in males with depression than females.
Brand, Charles; Barry, Lorna; Gallagher, Stephen
The psychosocial pathways underlying associations between benefit finding and quality of life are poorly understood. Here, we examined associations between benefit finding, social support, optimism and quality of life in a sample of 84 caregivers. Results revealed that quality of life was predicted by benefit finding, optimism and social support. Moreover, the association between benefit finding and quality of life was explained by social support, but not optimism; caregivers who reported greater benefit finding perceived their social support be higher and this, in turn, had a positive effect on their overall quality of life. These results underscore the importance of harnessing benefit finding to enhance caregiver quality of life. © The Author(s) 2014.
Rose, Martin Høyer; Løkkegaard, Annemette; Sonne-Holm, Stig
The aim of this study was to investigate the effect of high-intensity locomotor training on knee extensor and flexor muscle activation and adaptability to increased body-weight (BW) support during walking in patients with Parkinson's disease (PD). Thirteen male patients with idiopathic PD and eight...... healthy participants were included. The PD patients completed an 8-week training program on a lower-body, positive-pressure treadmill. Knee extensor and flexor muscles activation during steady treadmill walking (3km/h) were measured before, at the mid-point, and after training. Increasing BW support...... decreased knee extensor muscle activation (normalization) and increased knee flexor muscle activation (abnormal) in PD patients when compared to healthy participants. Training improved flexor peak muscle activation adaptability to increased (BW) support during walking in PD patients. During walking without...
Hagovská, Magdaléna; Dzvoník, Oliver; Olekszyová, Zuzana
The aim of the current study was to compare the effectiveness of two types of cognitive training in 60 older adults with mild cognitive impairment by assessing the impact on functional activities, quality of life (QOL), and various cognitive functions. The primary outcomes were functional activity level and QOL. The secondary outcome was cognitive examination. Group assignment was random. Group A (n = 30) underwent CogniPlus, a computer-based, cognitive training. Group B (n = 30) underwent classical group-based cognitive training. Both programs comprised two 30-minute sessions per week for 10 weeks. After training, group A had better QOL (p effect size [ES] = 0.69) and better attention (increased load score, p functional activity level. Group A demonstrated larger improvements in QOL and attention than group B (i.e., classical cognitive training), but the transfer to functional activities was the same between groups. [Res Gerontol Nurs. 2017; 10(4):172-180.]. Copyright 2017, SLACK Incorporated.
Full Text Available An active life on the labour market implies, besides the existence of jobs, continuous education and training of adults. Regardless of age, every person needs new knowledge, which one can obtain either by self-teaching or by attending training courses. The development of technology and information influences lifelong learning, which is why, in recent years, greater emphasis has been put on the education and training of adults. In this respect numerous Centers of Professional Training of Adults have been established, some of them attracting their learners through the implementation of projects financed from European funds, which meant free participation of adults to various courses of specialization, training or (requalification. The article highlights the importance of continuous education and training of adults related to the economic and social benefits deriving from it. The article analyzes some of the aspects of continuous education and training of adults that fosters active participation of adults in the labour market, concluding that, for an active professional life, the establishment of relationships between employers, employees, trainers and learners is required.
Chamberlain, Douglas; Frenneaux, Michael; Fletcher, David
The standards required for optimal effect of chest compressions and the degree to which most practice falls short of ideal have not been widely appreciated. This review highlights some of the important data now available and offers a haemodynamic explanation that broadens current concepts. New techniques have permitted a detailed examination of how compressions are performed in practice. The implications of recent experimental work adds a new imperative to the need for improvement. In addition to highlighting the need for improved training and audit, the greater understanding of mechanisms in resuscitation suggest that guidelines for management of adult cardiac arrest of presumed cardiac origin need further revision and simplification.
Kim, Sook-Young; Sok, Sohyune R
The objective of this study was to examine the perceived health status, family support and life satisfaction of older Korean adults and the relationships among them. This study was designed to be a descriptive correlation study using questionnaire. Subjects were 246 older people who were over 65 years of age in Seoul and Daegu metropolitan city, Korea. Measures were the Cornell Medical Index-Simple Korean Form to measure the perceived health status, the Family Support Instrument to measure the family support and the Standard Life Satisfaction Instrument for Korean people to measure the life satisfaction. Perceived health state was worse as average 3.3, family support was good as average 3.4 and life satisfaction was low as average 3.1. There were statistically significant positive correlations among perceived health state, family support and life satisfaction and between family support and life satisfaction. The predictors of life satisfaction in elderly were family support, age, monthly allowance and perceived health state. These factors explained 37.5% of the total variance. The major influencing factor was family support. This cross-sectional study provides preliminary evidence that to develop nursing strategy to increase family support of older Korean adults is needed. © 2012 Blackwell Publishing Asia Pty Ltd.
Stone, Susan C; Abbott, Jean; McClung, Christian D; Colwell, Chris B; Eckstein, Marc; Lowenstein, Steven R
Paramedics often are asked to care for patients at the end of life. To do this, they must communicate effectively with family and caregivers, understand their legal obligations, and know when to withhold unwanted interventions. The objectives of this study were to ascertain paramedics' attitudes toward end-of-life (EOL) situations and the frequency with which they encounter them; and to compare paramedics' preparation during training for a variety of EOL care skills. A written survey was administered to a convenience sample of paramedics in two cities: Denver, Colorado and Los Angeles, California. Questions addressed: (1) attitudes toward EOL decision-making in prehospital settings; (2) experience (number of EOL situations experienced in the past two years); (3) importance of various EOL tasks in clinical practice (pronouncing and communicating death, ending resuscitation, honoring advance directives (ADs)); and (4) self-assessed preparation for these EOL tasks. For each task, importance and preparation were measured using a four-point Likert scale. Proportions were compared using McNemar chi-square statistics to identify areas of under- or over-preparation. Two hundred thirty-six paramedics completed the survey. The mean age was 39 years (range 22-59 years), and 222 (94%) were male. Twenty percent had >20 years of experience. Almost all participants (95%; 95% CI = 91-97%) agreed that prehospital providers should honor field ADs, and more than half (59%; 95% CI = 52-65%) felt that providers should honor verbal wishes to limit resuscitation at the scene. Ninety-eight percent of the participants (95% CI = 96-100%) had questioned whether specific life support interventions were appropriate for patients who appeared to have a terminal disease. Twenty-six percent (95% CI = 20-32%) reported to have used their own judgment during the past two years to withhold or end resuscitation in a patient who appeared to have a terminal disease. Significant discrepancies between the
Haughton, Betsy; Eppig, Kristen; Looney, Shannon M; Cunningham-Sabo, Leslie; Spear, Bonnie A; Spence, Marsha; Stang, Jamie S
Life course perspective, social determinants of health, and health equity have been combined into one comprehensive model, the life course model (LCM), for strategic planning by US Health Resources and Services Administration's Maternal and Child Health Bureau. The purpose of this project was to describe a faculty development process; identify strategies for incorporation of the LCM into nutrition leadership education and training at the graduate and professional levels; and suggest broader implications for training, research, and practice. Nineteen representatives from 6 MCHB-funded nutrition leadership education and training programs and 10 federal partners participated in a one-day session that began with an overview of the models and concluded with guided small group discussions on how to incorporate them into maternal and child health (MCH) leadership training using obesity as an example. Written notes from group discussions were compiled and coded emergently. Content analysis determined the most salient themes about incorporating the models into training. Four major LCM-related themes emerged, three of which were about training: (1) incorporation by training grants through LCM-framed coursework and experiences for trainees, and similarly framed continuing education and skills development for professionals; (2) incorporation through collaboration with other training programs and state and community partners, and through advocacy; and (3) incorporation by others at the federal and local levels through policy, political, and prevention efforts. The fourth theme focused on anticipated challenges of incorporating the model in training. Multiple methods for incorporating the LCM into MCH training and practice are warranted. Challenges to incorporating include the need for research and related policy development.
Hellweg, C. E.; Gerzer, R.; Reitz, G.
In the field of space life sciences, the demand of an interdisciplinary and specific training of young researchers is high due to the complex interaction of medical, biological, physical, technical and other questions. The Helmholtz Space Life Sciences Research School (SpaceLife) offers an excellent interdisciplinary training for doctoral students from different fields (biology, biochemistry, biotechnology, physics, psychology, nutrition or sports sciences and related fields) and any country. SpaceLife is coordinated by the Institute of Aerospace Medicine at the German Aerospace Center (DLR) in Cologne. The German Universities in Kiel, Bonn, Aachen, Regensburg, Magdeburg and Berlin, and the German Sports University (DSHS) in Cologne are members of SpaceLife. The Universities of Erlangen-Nürnberg, Frankfurt, Hohenheim, and the Beihang University in Beijing are associated partners. In each generation, up to 25 students can participate in the three-year program. Students learn to develop integrated concepts to solve health issues in human spaceflight and in related disease patterns on Earth, and to further explore the requirements for life in extreme environments, enabling a better understanding of the ecosystem Earth and the search for life on other planets in unmanned and manned missions. The doctoral candidates are coached by two specialist supervisors from DLR and the partner university, and a mentor. All students attend lectures in different subfields of space life sciences to attain an overview of the field: radiation and gravitational biology, astrobiology and space physiology, including psychological aspects of short and long term space missions. Seminars, advanced lectures, laboratory courses and stays at labs at the partner institutions or abroad are offered as elective course and will provide in-depth knowledge of the chosen subfield or allow to appropriate innovative methods. In Journal Clubs of the participating working groups, doctoral students learn
Motamed-Jahromi, Mohadeseh; Fereidouni, Zhila; Dehghan, Azizallah
Job stress is a part of nurses' professional life that causes the decrease of the nurses' job satisfaction and quality of work life. This study aimed to determine the effect of positive thinking via social media applications on the nurses' quality of work life. This was a pretest-posttest quasi-experimental study design with a control group. The samples were selected among the nurses in two hospitals in Fasa University of Medical Sciences and divided randomly into two interventional ( n = 50) and control ( n = 50) groups. Positive thinking training through telegrams was sent to the intervention group during a period of 3 months. Data were collected by using Brooks and Anderson's questionnaire of work life quality and analyzed by SPSS 18. The mean total scores of pretest and posttest in the intervention group improved noticeably and there were significant differences between mean scores of quality of work life in pretest and posttest scores in interventional groups ( p work life quality, home life ( p work design ( p work context ( p work world ( p = 0.003). This study concluded that positive thinking training via social media application enhanced nurses' quality of work life. This study is necessary to carry out on a larger sample size for generalizing findings better.
Tapping, R.L.; Holt, R.A.
One of the keys to the long-term success of CANDUs is a high capacity factor over the station design life. Considerable R and D in underway at AECL to develop technologies for assessing, monitoring and mitigating the effect of plant ageing and for improving plant performance and extending plant life. To achieve longer service life and to realize high capacity factor from CANDU stations, AECL is developing new technologies to enhance fuel channel and steam generator inspection capabilities, to monitor system health, and to allow preventive maintenance and cleaning (e.g., on-line chemical cleaning processes that produce small volumes of wastes). The life management strategy for fuel channels and steam generators requires a program to inspect components on a routine basis to identify mechanisms that could potentially affect fitness-for-service. In the case of fuel channels, the strategy includes inspections for dimensional changes, flaw detection, and deuterium concentration. New techniques are been developed to enhance these inspection capabilities; examples include accurate measurement of the gap between a pressure tube and its calandria tube and rapid full-length inspections of steam generator tubes for all known flaw types. Central to life management of components are Fitness-for-Service Guidelines (FFSG) that have been developed with the CANDU Owners Group (COG) that provide a standardized method to assess the potential for propagation of flaws detected during in-service inspections, and assessment of any change in fracture characteristics of the material. FFSG continue to be improved with the development of new technologies such as the capability to credit relaxation of stresses due to creep and non-rejectable flaws in pressure tubes. Effective management of plant systems throughout their lifetime requires much more than data acquisition and display - it requires that system health is continually monitored and managed. AECL has developed a system Health Monitor
Sarre, Sophie; Maben, Jill; Aldus, Clare; Schneider, Justine; Wharrad, Heather; Nicholson, Caroline; Arthur, Antony
Ever-growing demands on care systems have increased reliance on healthcare support workers. In the UK, their training has been variable, but organisation-wide failures in care have prompted questions about how this crucial section of the workforce should be developed. Their training, support and assessment has become a policy priority. This paper examines: healthcare support workers' access to training, support and assessment; perceived gaps in training provision; and barriers and facilitators to implementation of relevant policies in acute care. We undertook a qualitative study of staff caring for older inpatients at ward, divisional or organisational-level in three acute National Health Service hospitals in England in 2014. 58 staff working with older people (30 healthcare support workers and 24 staff managing or working alongside them) and 4 healthcare support worker training leads. One-to-one semi-structured interviews included: views and experiences of training and support; translation of training into practice; training, support and assessment policies and difficulties of implementing them. Transcripts were analysed to identify themes. Induction training was valued, but did not fully prepare healthcare support workers for the realities of the ward. Implementation of hospital policies concerning supervision and formal assessment of competencies varied between and within hospitals, and was subject to availability of appropriate staff and competing demands on staff time. Gaps identified in training provision included: caring for people with cognitive impairment; managing the emotions of patients, families and themselves; and having difficult conversations. Access to ongoing training was affected by: lack of time; infrequent provision; attitudes of ward managers to additional support workforce training, and their need to balance this against patients' and other staff members' needs; and the use of e-learning as a default mode of training delivery. With the
Dumitrache, Cristina G; Rubio, Laura; Rubio-Herrera, Ramona
The aim of this study was on one hand to examine the associations between health impairment and life satisfaction, as well as social support and life satisfaction, and on the other, to analyze the moderating effect of social support with regard to health impairment and life satisfaction in a sample of community-dwelling older adults from urban areas of Granada, southern Spain. This was a cross-sectional survey in which a sample of 406 older adults with ages between 65 and 99 years old (M age = 74.88, SD = 6.75) was selected. Multiple stepwise regression analysis was used to assess the impact of health impairment and perceived social support on life satisfaction. Moderation analysis was performed using the bias-corrected and accelerated bootstrapping approach. Significant differences in life satisfaction scores were found by number and type of disease, restrictions in daily life activities and subjective health. Perceived health and perceived social support predicted life satisfaction. Besides global social support, emotional and affectionate support moderated the link between perceived health and life satisfaction. Older people who do not rate their health status positively and indicate low levels of social support have a higher risk of being dissatisfied with their lives and due to this they should receive special attention from gerontologists.
Marquita R. Walker
Full Text Available This qualitative paper explores the lived experiences of one group of workers dislocated because of globalized trade policies who completed a hybrid Advanced Manufacturing Training Program (AMTP by taking advantage of Trade Adjustment Assistance (TAA, a federally-funded program for retraining workers dislocated because of trade policies. The research questions focus on how satisfied these workers are with the services and programs provided by TAA. Focus groups and survey instrument results indicate these workers found TAA services and processes cumbersome and time- consuming and actually had the effect of discouraging their education, training, and self- employment. The consequences of their dislocation as it relates to TAA experiences are increased frustration and dissatisfaction with the TAA program. Serious consideration for TAA policy changes should be deemed of utmost importance.
Mohr, Wanda K
Support groups have increased rapidly in number and become a viable alternative to formal treatment in the United States. However, little is known regarding how mental health advocacy or support groups start and develop, or about challenges that can threaten their survival. In this 2 1/2-year ethnography, the author studied the culture of a developing family support program associated with a system of care. Several phases emerged, reflecting an organizational dynamic. The group dynamics and response to challenges have implications for organizers and parent organizations about the need for technical assistance necessary for survival of the group. Participant observation and immersion in the culture of such groups can provide a deeper understanding of the ideologies and values around which they organize and the kinds of tensions that members can experience during the group's cycle.
Li, Tianyuan; Fok, Hung Kit; Fung, Helene H
Reciprocity in support exchanges is believed to be beneficial to psychological well-being. This study examined perceived emotional and instrumental support balance from either family or friends, and the relationship between each support balance and life satisfaction among young and older adults. The sample included 107 older adults and 96 young adults. They rated their life satisfaction, as well as the emotional and instrumental support they provided to and received from family members and friends. Consistent with the socioemotional selectivity theory, age differences were found in perceived emotional support balance with friends. Older adults reported more emotionally reciprocal friendships than did young adults. Moreover, contrary to the equity rule, emotionally over-benefited friendships were associated with higher life satisfaction for older adults than were reciprocal friendships. Age, type of support, and source of support should be considered when studying the relationships between support balance and psychological well-being.
Marquita R. Walker
This qualitative paper explores the lived experiences of one group of workers dislocated because of globalized trade policies who completed a hybrid Advanced Manufacturing Training Program (AMTP) by taking advantage of Trade Adjustment Assistance (TAA), a federally-funded program for retraining workers dislocated because of trade policies. The research questions focus on how satisfied these workers are with the services and programs provided by TAA. Focus groups and survey instrument results ...
Since the formation of health physics as a profession following the end of World War II, the federal government of the United States has played an active role in the support of education and training of health physicists. The purpose of this paper is to review the types of federal support that have been available from the federal government in the past and to examine the current status of support. Individuals trained in health physics through the nuclear navy programs have not been included in this discussion. (author)
Bohannon, J.R. Jr.
The sources of planning for the development of curricula for engineering support personnel for the nuclear industry in general and nuclear facilities in particular have included the deliberate acquisition of inputs from employers, feedback from past students, and the critique of curricula by the industry, students, and faculty. As a result, three principal courses were developed in the Department of Nuclear Engineering, namely, Reactor Systems which deals in terms of the design engineer's and owner's concerns with regard to functional requirements, design criteria, and objectives of reactor systems; Reactor Operations which applies the student's basic engineering education to the role of an engineer in nuclear facilities, with particular attention to power plant operations; and Quality Assurance which provides the student with the bases, engineering implications and engineer's role in quality assurance during the design, construction, delivery and operation of nuclear and other complex facilities. A summary of the results to date of this trinity of courses is presented, with particular attention to its acceptance by the industry
Nikutta, Robert; Fitzpatrick, Michael J.; NOAO Data Lab
The NOAO Data Lab (datalab.noao.edu) is a fully-fledged science data & analysis platform. However, simply building a science platform is notenough to declare it a success. Like any such system built for users, it needs actual users who see enough value in it to be willing toovercome the inertia of registering an account, studying the documentation, working through examples, and ultimately attempting tosolve their own science problems using the platform. The NOAO Data Lab has been open to users since June 2016. In this past year we haveregistered hundreds of users and improved the system, not least through the interaction with and feedback from our users. The posterwill delineate our efforts to recruit new users through conference presentations, platform demos and user workshops, and what we do toassure that users experience their first steps and their learning process with Data Lab as easy, competent, and inspiring. It will alsopresent our efforts in user retention and user support, from a human-staffed helpdesk, to one-on-one sessions, to regular"bring-your-own-problem (BYOP)" in-house sessions with interested users.
Impaired arm-hand performance is a serious consequence of stroke that is associated with reduced self-efficacy and poor quality of life. Task-oriented arm training is a therapy approach that is known to improve skilled arm-hand performance, even in chronic stages after stroke. At the start of this
Rose, Martin H; Løkkegaard, Annemette; Sonne-Holm, Stig; Jensen, Bente R
The aim of this study was to investigate the effect of high-intensity locomotor training on knee extensor and flexor muscle activation and adaptability to increased body-weight (BW) support during walking in patients with Parkinson's disease (PD). Thirteen male patients with idiopathic PD and eight healthy participants were included. The PD patients completed an 8-week training program on a lower-body, positive-pressure treadmill. Knee extensor and flexor muscles activation during steady treadmill walking (3 km/h) were measured before, at the mid-point, and after training. Increasing BW support decreased knee extensor muscle activation (normalization) and increased knee flexor muscle activation (abnormal) in PD patients when compared to healthy participants. Training improved flexor peak muscle activation adaptability to increased (BW) support during walking in PD patients. During walking without BW support shorter knee extensor muscle off-activation time and increased relative peak muscle activation was observed in PD patients and did not improve with 8 weeks of training. In conclusion, patients with PD walked with excessive activation of the knee extensor and flexor muscles when compared to healthy participants. Specialized locomotor training may facilitate adaptive processes related to motor control of walking in PD patients. Copyright © 2013 Elsevier Ltd. All rights reserved.
Dewberry, Brandon S.
The objective of the ECLSS Advanced Automation project includes reduction of the risk associated with the integration of new, beneficial software techniques. Demonstrations of this software to baseline engineering and test personnel will show the benefits of these techniques. The advanced software will be integrated into ground testing and ground support facilities, familiarizing its usage by key personnel.
Çimen, Mesut; Akbolat, Mahmut
Abstract: This study was conducted to identify the factors that affect the perception of social support and life satisfaction of selected nursing home residents in Turkey, using the Multidimensional Scale of Perceived Social Support (MSPSS) and the Satisfaction with Life Scale (SWLS). 80 residents participated in the study. Results of univariate analyses indicated that family-based perceived social support of nursing home residents is significantly higher in married residents and in residents...
Botvin, Gilbert J.; Griffin, Kenneth W.
Research concerning the etiology and prevention of substance misuse has led to the development of preventive interventions that are theory-based and effective. One such approach, Life Skills Training (LST), targets key etiologic factors using a conceptual framework derived from social learning theory and problem behavior theory. LST has been…
Roeder, A [Paul Scherrer Inst. (PSI), Villigen (Switzerland)
The method of life-cycle assessment (LCA) has been applied to cars with different power trains. As an example, the results for greenhouse gas (GHG) emissions are presented. They show possibilities and limits for the reduction of these emissions in the transportation sector by means of advanced technology. (author) 2 figs., 4 refs.
Barrett, Jessica L.; Mazerolle, Stephanie M.; Eason, Christianne M.
Context: The professional socialization process enables athletic training students (ATSs) to gain insights into behaviors, values, and attitudes that characterize their chosen profession. However, the process often focuses on skill development over professional issues. ATSs may be exposed to burnout and work-life conflict, which may impact their…
Hoorweg, J.C.; Niemeijer, R.
During the course of 1978, the three Family Life Training Centres studied admitted 273 women accompanied by 674 children. Women with malnourished children (and their siblings) are admitted to these centres for a 3-week course consisting primarily of nutrition and health education, but also covering
Wang, Yu-Jung; Hsu, Kan-Lin; Chang, Chin-Sung; Wu, Chih-Hsing
For the past 30 years, there has been a steady increase in the number of female physicians, but the relationship between their romantic lives and their pattern of training has been inadequately reported. This study was designed to investigate the interrelationships between medical training, quality of life, and the attitudes that female residents have toward romance. Of the 106 female medical residents at our medical center in 2009, a total of 78 residents (73.6%) were enrolled for the study. Structured questionnaires (Cronbach α = 0.878), which included questions about female resident quality of life, attitude toward spousal choice, and the impact of programmed professional medical training, were self-administered through an anonymous process. Female residents, especially ward-care specialists, were determined to have excessively long working hours (84.6% > 88 work hours/week), insufficient and irregular sleep (44.9%), and inadequate personal time (73.1% friends, differences in values, and work-related stress. Those presumptive factors influencing romance between the assumed partner being a doctor or a "nondoctor" were significantly different with regard to lack of time (p = 0.002), values (p work-related stress (p life were significantly influenced by the pattern of medical training in female residents. Setting duty-hour limits and initiating a new hobby were determined to be potentially beneficial to their quality of life and attitudes toward romance. Copyright © 2012. Published by Elsevier B.V.
Wolfe, Adam D; Frierdich, Sharon A; Wish, Joel; Kilgore-Carlin, Joyce; Plotkin, Julie A; Hoover-Regan, Margo
Abstract Background: Despite parent and physician reports of inadequate skill development, there are few guidelines for training the pediatric care team in sharing life-altering information (SLAI), i.e., "breaking bad news." The necessary skills for SLAI differ between pediatric and adult medical environments. We set out to establish evidence-based guidelines and multidisciplinary team training for SLAI in pediatrics, and to demonstrate an improvement in immediate self-efficacy of training participants. A multidisciplinary task force, which included parent participation and feedback, and which received input from parents of patients in multiple pediatric subspecialties, crafted children's hospitalwide guidelines for SLAI. A one-hour training module on the guidelines was presented to several multidisciplinary pediatric team audiences; 159 voluntary pre- and post-presentation self-efficacy surveys were collected. Responses were analyzed by paired t-test (within groups) and ANOVA (between groups). All evaluated groups of care team members reported significant improvements in self-efficacy among four learning objectives after the training. Medical trainees, newer physicians, and nonphysician (e.g., midlevel providers including nurses) team members reported the greatest improvements, regardless of whether they had received previous training in SLAI. We propose pediatric-focused SLAI guidelines based on a modified SPIKES protocol. Focus on patient- and family-centered, culturally sensitive pediatric practices should be the basis for development of training that can be periodically reinforced. Future comprehensive training will incorporate experiential learning. SLAI requires a skill set that benefits from lifelong learning.
Díaz-Castellanos, M A; Fernández-Carmona, A; Díaz-Redondo, A; Cárdenas-Cruz, A; García-del Moral, R; Martín-Lopez, J; Díaz-Redondo, T
The aim of this study was to investigate the rate at which the alumni of basic life support courses witnessed and intervened in out-of-hospital emergency situations, and to identify the variables characterizing those alumni associated with a greater number of witnessing events and interventions. An analysis of the efficiency of the courses was also carried out. A descriptive, cross-sectional study was made. A district in the province of Almería (Spain). Alumni of a mass basic life support training program targeted to the general population «Plan Salvavidas» conducted between 2003-2009. In 2010 the alumni were administered a telephone survey asking whether they had witnessed an emergency situation since attending the program, with the collection of information related to this emergency situation. Rate of out-of-hospital emergencies witnessed by the alumni. Rate of intervention of the alumni in emergency situations. Variables characterizing alumni with a greater likelihood of witnessing an emergency situation. A total of 3,864 trained alumni were contacted by telephone. Of 1,098 respondents, 63.9% were women, and the mean age was 26.61±10.6 years. Of these alumni, 11.75% had witnessed emergency situations, an average of three years after completing the course. Of these emergencies, 23.3% were identified as cardiac arrest. The alumni intervened in 98% of the possible cases. In 63% of the cases, there was no connection between the alumni and the victim. The majority of the emergency situations occurred in the street and in public spaces. A greater likelihood of witnessing an emergency situation was associated with being a healthcare worker and with being over 18 years of age. The rate of out-of-hospital emergencies witnessed by these alumni after the course was 11.75%. The level of intervention among the alumni was high. The most efficient target population consisted of healthcare workers. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
Rodrigues, Annette T.; Maese, A. Christopher
As this country prepares for exploration to other planets, the need to understand the affects of long duration exposure to microgravity is evident. The National Aeronautics and Space Administration (NASA) Ames Research Center's Space Life Sciences Payloads Office is responsible for a number of non-human life sciences payloads on NASA's Space Shuttle's Spacelab. Included in this responsibility is the training of those individuals who will be conducting the experiments during flight, the astronauts. Preparing a crew to conduct such experiments requires training protocols that build on simple tasks. Once a defined degree of performance proficiency is met for each task, these tasks are combined to increase the complexity of the activities. As tasks are combined into in-flight operations, they are subjected to time constraints and the crew enhances their skills through repetition. The science objectives must be completely understood by the crew and are critical to the overall training program. Completion of the in-flight activities is proof of success. Because the crew is exposed to the background of early research and plans for post-flight analyses, they have a vested interest in the flight activities. The salient features of this training approach is that it allows for flexibility in implementation, consideration of individual differences, and a greater ability to retain experiment information. This training approach offers another effective alternative training tool to existing methodologies.
This fall I was working on two different projects that culminated into a redesign of the spacesuit LLB (long life battery). I also did some work on the PLSS (personal life support system) battery with EC. My first project was redlining the work instruction for completing DPAs (destructive physical analysis) on battery cells in the department. The purpose of this document is to create a standard process and ensure that the data in the same way no matter who carries out the analysis. I observed three DPAs, conducted one with help, and conducted two on my own all while taking notes on the procedure. These notes were used to write the final work instruction that will become is the department standard. My second project continued the work of the summer co-op before me. I was testing aluminum heat sinks for their ability to provide good thermal conduction and structural support during a thermal runaway event. The heat sinks were designed by the summer intern but there was not much time for testing before he left. We ran tests with a heater on the bottom of a trigger cell to try to drive thermal runaway and ensure that it will not propagate to adjacent cells. We also ran heat-to-vent tests in an oven to see if the assembly provided structural support and prevented sidewall rupture during thermal runaway. These tests were carried out at ESTA (energy systems test area) and are providing very promising results that safe, high performing (greater than 180 Wh/kg) designs are possible. My main project was a redesign of the LLB battery. Another summer intern did some testing and concluded that there was no simple fix to mitigate thermal runaway propagation hazards in the current design. The only option was a clean sheet redesign of the battery. I was given a volume and ideal energy density and the rest of the design was up to me. First, I created new heat sink banks in Creo using the information gathered in the metal heat sink tests from the summer intern. After this, I made
Bekkema, Nienke; de Veer, Anke J E; Albers, Gwenda; Hertogh, Cees M P M; Onwuteaka-Philipsen, Bregje D; Francke, Anneke L
Nurses and social workers caring for people with intellectual disabilities are increasingly confronted with clients in need of end-of-life care. Previous studies, however, suggest that professionals in intellectual disability care services lack knowledge and experience concerning end-of-life care. Moreover, the proportion of nurses within the staff of intellectual disability services has declined in recent years, while the proportion of social workers has increased, which may have consequences for the quality of end-of-life care. To gain insight into the quality of end-of-life care, past vocational training, training needs and expert consultation opportunities of nurses and social workers working in intellectual disability care services. Survey questionnaire study conducted in the Netherlands. Intellectual disability care services. The study sample was recruited from an existing nationally representative research panel of care professionals. In 2011, all 181 nurses and social workers in the research panel who worked in intellectual disability care services were sent our survey questionnaire. Postal survey addressing education, views and needs regarding end-of-life care. The response was 71.8%. Respondents positively evaluated the quality of end-of-life care. However, most respondents felt inadequately trained in end-of-life care issues. Nurses had received more training in end-of-life care and had fewer training needs than social workers. Respondents wished for additional training, especially in supporting clients in dealing with the impending death and farewell process. Half of the respondents were unaware of the availability of external consultation facilities. This study shows that although nurses and social workers positively appraise the quality of end-of-life care for people with intellectual disabilities, the majority feel inadequately trained to provide good end-of-life care. As the number of people with intellectual disability in need of end-of-life care
Cousineau, Jean-Luc; Thévenin, Laurent
Therapeutic coordination apartments are medical-social structures which provide accommodation to desocilialized people. For the last 25 years, the association Cordia has been supporting people with debilitating chronic diseases in situations of precarity. The multi-disciplinary approach also ensures that terminally-ill residents are taken care of right up until their last moments. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Khan, Javaid Arif; Shafquat, Azam; Kundi, Asadullah
To assess the knowledge of basic cardiac life support (BCLS) before and after the institution of training among first degree relatives and spouses of patients with coronary disease. Quasi-experimental study. National Institute of Cardiovascular Diseases, Karachi, from April 2007 to May 2008. A total of 300 relatives of patients with coronary heart disease undertook a one day CPR course. Questionnaire assessing knowledge of CPR was administered before and after the course. Patients were studied in groups of 10-20 at a time. Proportion of correct knowledge was compared using chi-square test with significance at p educational levels (p educational groups showed equal learning abilities.
Full Text Available Abstract Background: Migraine is a chronic neurological disorder that leads patients to avoid any kind of activities. Since different factors are involved in migraine incidence and its triggers, so drugs are used to prevent or treat it are so variable. Also, combined medications are used to relieve migraine. This study examined the effectiveness of self-control training on quality of life in patients with migraine. Materials and Methods: Statistic population of this study included all migraine patients in Ardabil in 2014(Estimation: N=1150 that 40 patients were selected by convenience sampling. Demographic and disease information questionnaire and quality of life questionnaire (SF-36 were used to collect data in clinical centers. Multivariate analysis of variance (MANCOVA was used to analyze data, because present research was a experimental and clinical trial with pre-test and post-test with control group. Results: The results showed that there is a significant difference between mean in quality of life in migraine patients and control subjects. It means that physical health and mental health of quality of life was different between control and experimental groups after self- control training. Conclusion: Self-control training can be used to enhance quality of life in migraine patients. These results have important and effective applications in the treatment of migraine patients. Generally, specialists of clinical centers can use this method alongside other treatment interventions.
Full Text Available Background: Given the extent of asthma, the Emotional Intelligence Theory provides a new perspective about predicting effective factors for success and primary prevention of mental disorders as well. The main objective of this study was to evaluate the effectiveness of emotional intelligence training on the quality of life in patients with asthma. Method: Method of the project has been quasi-experimental that 30 asthmatic patients (confirmed by clinical tests were selected for sampling and divided into two experimental and control groups (each group had 15 persons randomly. The experimental group received training in emotional intelligence in 10 sessions of 90 minutes, but the control group did not receive this training. The World Health Organization Quality of Life (WHOQOL scales were performed in two stage pre- and post-test for both groups. After collecting, data, were analyzed using SPSS version 22. Results: The results showed that there was a significant positive correlation between emotional intelligence [EI] and quality of life, and also there was a significant difference between the mean scores of post-test experimental and control groups on measures of physical health and quality of life in asthmatic patients .(P<0.05 Conclusions: According to the results achieved in this study, emotional intelligence [EI] can be improved quality of life patients suffering from asthma.
A. S. Marchenko
Full Text Available Abstract. The article proposed the use of simulation methods for evaluating the effectiveness of a stepped fan engine speed control while maintaining the air flow volume in the set boundaries of the «fan-filter» system. A detailed algorithm of the program made on the basis of an Any Logic software package. Is analyzed the possibility of using the proposed method in the design of ventilation systems.The proposed method allows at the design stage to determine the maximum replacement intervals of the systems filter elements, as well as to predict the time to switch the fan motor speeds. Using of the technique allows to refuse the complex air flow systems and maximize the life of the filter elements set.Methods of logical processes modeling allows to reduce construction costs and improve energy efficiency of buildings.
Knott, Gillian; Crane, Linda; Heslop, Ian; Glass, Beverley D
Sessional staff is increasingly involved in teaching at universities, playing a pivotal role in bridging the gap between theory and practice for students, especially in the health professions, including pharmacy. Although sessional staff numbers have increased substantially in recent years, limited attention has been paid to the quality of teaching and learning provided by this group. This review will discuss the training and support of sessional staff, with a focus on Australian universities, including the reasons for and potential benefits of training, and structure and content of training programs. Although sessional staff views these programs as valuable, there is a lack of in-depth evaluations of the outcomes of the programs for sessional staff, students and the university. Quality assurance of such programs is only guaranteed, however, if these evaluations extend to the impact of this training and support on student learning.
Kondaurov, A.; Zaitseva, N.; Yunikova, A.; Artisiuk, V.
Conclusions: For prototype nuclear power reactor the development of training materials requires high level expertise from the R&D side. The First International Course focusing the SVBR technology was developed and piloted in ROSATOM Central Institute for Continuing Education&Training to support HRD for Open Joint-Stock Company «AKME-engineering» - owner and operator of SVBR-100. The Course is available for international participants
This paper deals with planning and management support for NPP personnel SAT based training programmes based on IAEA TC Project SLR/0/003 on upgrading NPP personnel training, with the aim of upgrading NPP safety and reliability of NPP operation and maintenance. The costs needed include both Slovak and IAEA sources. Five stages of the Project are defined: planning; organizing; motivating; implementation; control, review and accountability
Based on Man -machine Interface The views, opinions and/or findings contained in this report are those of the author(s) and should not contrued as an...ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 adaptive training, EEG, man -machine interface...non peer-reviewed journals: Final Report: Adaptive Training and Collective Decision Support Based on Man -machine Interface Report Title The existence of
Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael
When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management
Williams, David E.; Gentry, Gregory J.
The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the past year, covering the period of time between March 2010 and February 2011 and the continued permanent presence of six crew members on ISS. Work continues on the last of the Phase 3 pressurized elements, commercial cargo resupply vehicles, and extension of the ISS service life from 2015 to 2020 or beyond.
Williams, David E.; Dake, Jason R.; Gentry, Gregory J
The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the prior year, covering the period of time between March 2011 and February 2012. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the last of the Phase 3 pressurized elements, the commercial cargo resupply vehicles, and work to try and extend ISS service life from 2015 to at least 2028.