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Sample records for norwegian ambulance personnel

  1. Occupational stressors and its organizational and individual correlates: A nationwide study of Norwegian ambulance personnel

    Directory of Open Access Journals (Sweden)

    Ekeberg Øivind

    2008-12-01

    Full Text Available Abstract Background High levels of stress among ambulance personnel have been attributed to the conditions of ambulance work. However, there is little research to support this notion, and it has been questioned whether ambulance work is inherently stressful. We compared the severity and frequency level of organizational and ambulance-specific stressors, and studied their relationship to organizational conditions and individual differences Methods A comprehensive nationwide questionnaire survey of ambulance personnel (n = 1180 in operational duty. The questionnaire included the Job Stress Survey, the Norwegian Ambulance Stress Survey, the Basic Character Inventory, General Self-Efficacy Scale, and questions addressing organizational conditions. Results Serious operational tasks and physical demands were identified as the two most severe stressors. Lack of support from co-workers was the most severe and frequent organizational stressor. Higher frequency of stressors was most strongly associated with size of service districts (beta ranging between .18 and .30, p p p p p Conclusion Ambulance-specific stressors were reported as both more severe and more frequently occurring stressors than were organizational stressors. Organizational working conditions were more strongly related to frequency of job stressors than were individual differences. In general, the relationship between occupational stressors and individual differences was weak.

  2. Occupational stressors and its organizational and individual correlates: a nationwide study of Norwegian ambulance personnel.

    Science.gov (United States)

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

    2008-12-02

    High levels of stress among ambulance personnel have been attributed to the conditions of ambulance work. However, there is little research to support this notion, and it has been questioned whether ambulance work is inherently stressful. We compared the severity and frequency level of organizational and ambulance-specific stressors, and studied their relationship to organizational conditions and individual differences A comprehensive nationwide questionnaire survey of ambulance personnel (n = 1180) in operational duty. The questionnaire included the Job Stress Survey, the Norwegian Ambulance Stress Survey, the Basic Character Inventory, General Self-Efficacy Scale, and questions addressing organizational conditions. Serious operational tasks and physical demands were identified as the two most severe stressors. Lack of support from co-workers was the most severe and frequent organizational stressor. Higher frequency of stressors was most strongly associated with size of service districts (beta ranging between .18 and .30, p exposure to critical event (beta ranging from .11 to .24, p organizational conditions. Ambulance-specific stressors were reported as both more severe and more frequently occurring stressors than were organizational stressors. Organizational working conditions were more strongly related to frequency of job stressors than were individual differences. In general, the relationship between occupational stressors and individual differences was weak.

  3. Health problems and help-seeking in a nationwide sample of operational Norwegian ambulance personnel

    Directory of Open Access Journals (Sweden)

    Ekeberg Øivind

    2008-01-01

    Full Text Available Abstract Background To estimate the prevalence of anxiety and depression symptoms, and their association with professional help-seeking, among operational ambulance personnel and a general working population, and to study the symptoms of musculoskeletal pain and disturbed sleep among ambulance personnel. Methods The results of a comprehensive nationwide questionnaire survey of operational ambulance personnel (n = 1180 were compared with the findings of a population-based Norwegian health study of working people (n = 31,987. The questionnaire included measures of help-seeking, the Hospital Anxiety and Depression Scale, the Subjective Health Complaints Questionnaire, the Karolinska Sleep Questionnaire and the Need for Recovery after Work Scale. Results Compared with those in the reference population, the mean of level anxiety symptoms in the ambulance sample was lower for men (3.5 vs. 3.9, P 0.001 and women (4.0 vs. 4.4, P 0.05, and the mean level of depression symptoms in ambulance workers was lower for men (2.3 vs. 2.8, P 0.05 but not for women (2.9 vs. 3.1, P = 0.22. A model adjusted for anxiety and depression symptoms indicated that ambulance personnel had lower levels of help-seeking except for seeing a chiropractor (12% vs. 5%, P 0.01. In the ambulance sample, symptoms of musculoskeletal pain were most consistently associated with help-seeking. In the adjusted model, only symptoms of disturbed sleep were associated with help-seeking from a psychologist/psychiatrist (total sample = 2.3%. Help-seeking was more often reported by women but was largely unaffected by age. Conclusion The assumption that ambulance personnel have more anxiety and depression symptoms than the general working population was not supported. The level of musculoskeletal pain and, accordingly, the level of help-seeking from a chiropractor were higher for ambulance workers. More research should address the physical strains among ambulance personnel.

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

    Science.gov (United States)

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

    2008-01-01

    This is the first paper on suicidal ideation and attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and suicide attempts among ambulance personnel, and to identify important correlates and the factors to which ambulance personnel attribute their serious suicidal ideation. A comprehensive nationwide questionnaire survey of 1,180 operational ambulance personnel was conducted. Measurements included: Paykel's Suicidal Feelings in the General Population questionnaire, the Hospital Anxiety and Depression scale, the Subjective Health Complaints Questionnaire, the Maslach Burnout Inventory, the Job Satisfaction Scale, the Basic Character Inventory, and the Rosenberg Self-Esteem Scale. Lifetime prevalence ranged from 28% for feelings that life was not worth living to 10.4% for seriously considered suicide and 3.1% for a suicide attempt. Serious suicidal ideation was independently associated with job-related emotional exhaustion (feelings of being overextended and depleted of resources) (OR 1.5, 95% CI 1.1-2.0) and bullying at work (OR 1.7, 95% CI 1.02-2.7), younger age, not married/cohabitant, depression symptoms, low self-esteem and the personality trait reality weakness. In general, suicidal thoughts were hardly attributable to working conditions, since only 1.8% of ambulance personnel attributed suicidal ideation to work problems alone. In conclusion, ambulance personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-related factors like emotional exhaustion and bullying may be of importance.

  5. Occupational stressors and its organizational and individual correlates: a nationwide study of Norwegian ambulance personnel

    National Research Council Canada - National Science Library

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

    2008-01-01

    .... We compared the severity and frequency level of organizational and ambulance-specific stressors, and studied their relationship to organizational conditions and individual differences A comprehensive...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered...... by ambulance personnel. METHODS: Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival...... patients (1.3%) and hypotension observed in 71 patients (3.0%). CONCLUSION: Intravenous fentanyl caused clinically meaningful pain reduction in most patients and was safe in the hands of ambulance personnel. Many patients had moderate to severe pain at hospital arrival. As the protocol allowed higher doses...

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

    Science.gov (United States)

    Friesgaard, K D; Nikolajsen, L; Giebner, M; Rasmussen, C-H; Riddervold, I S; Kirkegaard, H; Christensen, E F

    2016-04-01

    Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered by ambulance personnel. Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival. Secondary outcomes included the number of patients with reduction in pain intensity during transport (NRS ≥ 2), the number of patients with NRS > 3 at hospital arrival, and potential fentanyl-related side effects. Fentanyl reduced pain from before treatment (8, IQR 7-9) to hospital arrival (4, IQR 3-6) (NRS reduction: 3, IQR 2-5; P = 0.001), 79.3% of all patients had a reduction in > 2 on the NRS during transport, and 58.4% of patients experienced pain at hospital arrival (NRS > 3). Twenty-one patients (0.9%) had oxygen saturation ambulance personnel. Many patients had moderate to severe pain at hospital arrival. As the protocol allowed higher doses of fentanyl, feedback on effect and safety should be part of continuous education of ambulance personnel. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  8. Masculinity and Lifting Accidents among Danish Ambulance Personnel

    DEFF Research Database (Denmark)

    Hansen, Claus D.; Nielsen, Kent J

    Background Work injuries related to lifting are the most prevalent among ambulance personnel (AP) despite the introduction of ‘assistive technologies’ (AT) that help reduce situations of manual lifting. One third of the AP report using AT only ‘sometimes’ and 10% report having lifted a patient...... alone. For those 5% scoring lowest on MRNI the probability of reporting lifting alone was 6% while this figure was 17% for those scoring above the 95th percentile. Conclusion This study suggests that male ambulance workers performance of masculinity might pose a threat to their safety. AP...

  9. Telemedicine-based physician consultation results in more patients treated and released by ambulance personnel

    DEFF Research Database (Denmark)

    Raaber, Nikolaj; Bøtker, Morten T; Riddervold, Ingunn S

    2016-01-01

    . In the intervention period, the EMCC was manned 24/7 with physicians experienced in emergency care. Eligible participants included all patients with nonurgent conditions receiving an ambulance after a medical emergency call. Ambulance personnel assessed patients and subsequently performed a telephone consultation...... a physician at the EMCC and ambulance personnel and noncritically ill 1-1-2 patients results in an increased rate of patients treated and released with high satisfaction. The approach does not seem to compromise patient safety....

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island....

  11. Fatigue and mental health in Australian rural and regional ambulance personnel.

    Science.gov (United States)

    Pyper, Zoe; Paterson, Jessica L

    2016-02-01

    Australian ambulance personnel experience stress, fatigue and exposure to traumatic events. These risks have been extensively researched in metropolitan paramedics. However, there has been limited research in rural and regional personnel. Rural and regional ambulance personnel make up a significant proportion of the Australian ambulance workforce and may be exposed to unique stressors. The aim of the current study was to investigate levels of fatigue, stress, and emotional trauma in rural and regional ambulance personnel. A sample of 134 (103 male, 31 female) rural and regional ambulance personnel completed a mixed methods survey assessing fatigue, stress and emotional trauma. Data were analysed using a combination of descriptive analysis and qualitative, deductive analysis that involved data immersion, coding, and categorisation. Participants reported high levels of fatigue and emotional trauma. Qualitative data revealed stressors including community expectations and 'office politics'. Participants also reported negative effects of fatigue including errors in drug administration and falling asleep while driving. The majority of participants reported normal levels of stress. It may be the case that working with known individuals in a community offers some degree of 'protective' impact for stress in rural and regional ambulance personnel. This is one of the first studies to investigate fatigue, stress, and emotional trauma in a rural and regional ambulance population. Results indicate a complex and unique profile of risks and challenges for this critical and understudied community resource. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. Associations between organizational and incident factors and emotional distress in emergency ambulance personnel.

    Science.gov (United States)

    Bennett, Paul; Williams, Yvette; Page, Nicola; Hood, Kerenza; Woollard, Malcolm; Vetter, Norman

    2005-06-01

    This study examined the prevalence and correlates of post-traumatic stress disorder (PTSD), anxiety and depression among emergency ambulance personnel. A questionnaire and reminder were sent anonymously to 1029 emergency ambulance personnel in a large ambulance service. Among the 617 respondents, levels of PTSD symptoms did not differ according to grade, but men had a higher prevalence rate than women. Key predictors of the severity of symptoms were organizational stress, the frequency of experiencing potentially traumatic incidents, length of service, and dissociation in response to an index incident. The degree of organizational, but not incident-related, stress discriminated between 'cases' and 'non-cases'. Nine and 23% of recorded scores indicated clinical levels of depression and anxiety respectively. Several work factors were associated with these emotions, explaining 38% of anxiety and 31% of depression scores. Both organizational and individually based interventions may be necessary to minimize PTSD and other emotional disorders among ambulance personnel.

  13. Ambulance personnel adherence to hygiene routines: still protecting ourselves but not the patient.

    Science.gov (United States)

    Emanuelsson, Lena; Karlsson, Lena; Castrèn, Maaret; Lindström, Veronica

    2013-08-01

    It is well known that adherence to hygiene routines leads to increased quality of care and safety for patients and personnel in hospitals. However, there have been few studies describing hygiene in ambulances, despite the fact that many patients receive advanced medical care and treatment from ambulance services before arriving at an emergency department. Therefore, the purpose of this study was to describe the adherence of ambulance personnel to hygiene routines in the ambulances. A participant observation study in the County of Värmland (Sweden) was conducted over 1 day in November 2010. Seven hygiene-related variables were collected during the observations: disinfection of hands before and after patient contact; correct use of gloves, gowns and short-sleeved uniforms; no rings, watches, or bracelets; and short or tied back hair during patient care. A total of 68 observed ambulance assignments were analyzed in terms of the adherence of personnel to hygiene routines. In 34% of the observed cases, hand rub was used before patient care and, in 72% of the observed cases, the ambulance personnel used hand rub after patient care. Correct adherence to the rule requiring use of a short-sleeved uniform was found in 28% of the observations. Correct adherence to the rule regarding short or tied back hair was found in 91% of the observations. The ambulance personnel were found to have relatively good adherence to some hygiene routines, but not all. The adherence by ambulance personnel to all of the seven observed variables was correct in only 3% of the assignments.

  14. Guidance for ambulance personnel on decisions and situations related to out-of-hospital CPR.

    Science.gov (United States)

    Ågård, Anders; Herlitz, Johan; Castrén, Maaret; Jonsson, Lars; Sandman, Lars

    2012-01-01

    Ethical guidelines on out-of-hospital cardio-pulmonary resuscitation (CPR) are designed to provide substantial guidance for the people who have to make decisions and deal with situations in the real world. The crucial question is whether it is possible to formulate practical guidelines that will make things somewhat easier for ambulance personnel. The aims of this article are to address the ethical aspects related to out-of-hospital CPR, primarily to decisions on not starting or terminating resuscitation attempts, using the views and experience of ambulance personnel as a starting point, and to summarise the key points in a practice guideline on the subject. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    2012-01-01

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

  16. Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting

    Directory of Open Access Journals (Sweden)

    Nielsen Anne

    2012-05-01

    Full Text Available Abstract Background Ambulance personnel play an essential role in the ‘Chain of Survival’. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island. Methods The Basic Life Support (BLS and Automated External Defibrillator (AED skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given. Results On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2 was used by 80%. A mean compression depth of 40–50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm. The mean compression rate was 123 per min (SD 15/min. The mean tidal volume was 746 ml (SD 221 ml. Only the mean tidal volume deviated significantly from the recommended (p = 0.01. During the rhythm analysis, 65% did not perform any visual or verbal safety check. Conclusion The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor...... personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1......-rated health compared to the core work force (5 % vs. 10 %). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands...

  18. A Survey of the Competency of Ambulance Service Personnel in the Diagnosis and Management of Sepsis.

    Science.gov (United States)

    Shime, Nobuaki

    2015-08-01

    Few studies have evaluated the current status of knowledge of sepsis in ambulance service personnel. Our aim was to ascertain the levels of competency and proficiency of ambulance service personnel in the diagnosis and management of severe sepsis. A questionnaire was submitted to a sample of 208 participants in a professional ambulance service conference, and was recovered on site. The study probed eight areas of sepsis diagnosis and management based on modifications of a questionnaire used in a previous study. The term sepsis in Japanese, Haiketsushou, was familiar to 99% of Japanese certified emergency life-saving technicians (ELST) (Group I) and to 92% of noncertified ambulance service personnel (Group II), although 15% of participants in Group I and 44% in Group II ignored the meaning of sepsis. The definition of sepsis as "body's response to infection," "blood poisoning," or "shock due to bacteria in blood" were selected by 17%, 16%, and 37%, respectively, in Group I, and 4%, 6%, and 22%, respectively, in Group II. The mortality associated with sepsis was underestimated by 57% in Group I and 78% in Group II. Vital signs raising a suspicion for sepsis and their pertinent ranges were correctly chosen by only 50% of certified ELST. Hypothermia was prominently undervalued as a sign raising the suspicion of sepsis. Insufficient knowledge and perception for sepsis in Japanese ambulance services is revealed. A higher level of onsite or formal postgraduate education needs to be provided with a view to improve the prehospital management of sepsis. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Hansen Claus D

    2012-07-01

    Full Text Available Abstract Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691 and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%. Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%. The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal

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

    Science.gov (United States)

    2012-01-01

    Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence

  1. Interventions for post-traumatic stress disorder and psychological distress in emergency ambulance personnel: a review of the literature.

    Science.gov (United States)

    Smith, A; Roberts, K

    2003-01-01

    A literature review was carried out to establish the extent of the literature on interventions for psychological distress and post-traumatic stress disorder in emergency ambulance personnel. A total of 292 articles were identified. Of these, 10 were relevant to this review. The primary intervention used with this population was critical incident stress debriefing, although there was some debate in the literature about the effectiveness of this intervention and the quality of the research conducted. More high quality research is needed on critical incident stress debriefing before being confident of its effectiveness.

  2. Symbolic and systemic violence in media representations of aggression towards ambulance personnel in the Netherlands

    NARCIS (Netherlands)

    Cuijpers, N.; Brown, P.R.

    2016-01-01

    Violence towards public sector employees is perceived as a growing problem in a number of societies, attracting the attention of mass media, politicians and social scientists alike. In this article we discuss how national newspapers have reported aggression towards ambulance workers in the Netherlan

  3. Symbolic and systemic violence in media representations of aggression towards ambulance personnel in the Netherlands

    NARCIS (Netherlands)

    Cuijpers, N.; Brown, P.R.

    2016-01-01

    Violence towards public sector employees is perceived as a growing problem in a number of societies, attracting the attention of mass media, politicians and social scientists alike. In this article we discuss how national newspapers have reported aggression towards ambulance workers in the

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

    LENUS (Irish Health Repository)

    Gallagher, Sharon

    2007-01-01

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

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

    Science.gov (United States)

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

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

  6. Resource distribution in mental health services: changes in geographic location and use of personnel in Norwegian mental health services 1979-1994.

    Science.gov (United States)

    Pedersen, Per Bernhard; Lilleeng, Solfrid

    2000-03-01

    BACKGROUND: During the last decades, a central aim of Norwegian health policy has been to achieve a more equal geographical distribution of services. Of special interest is the 1980 financial reform. Central government reimbursements for the treatment of in-patients were replaced by a block grant to each county, based on indicators of relative "need". AIMS OF THE STUDY: The aim of this paper is to assess whether the distribution of specialized mental health services did take the course suggested by the proponents of the reform (i.e. a more equal distribution), or the opposite (i.e. a more unequal distribution) as claimed by the opponents. METHODS: Man year per capita ratios were used as indicators for the distribution of mental health services by county. Ratios were estimated for "all personnel", and for MDs and psychologists separately. Man years were assigned to counties by location of services (i.e. in which county the services were produced), and by residence of users (i.e. in which county the services were consumed). Indicators of geographic variation were estimated using the standard deviation (STD) as a measure of absolute variation, and the coefficient of variation (CV) and the Gini index as indicators of relative variation. Indicators were estimated for 1979, 1984, 1989 and 1994, based on data for all specialized adult mental health services in the country. Changes in distributions over the period were tested, using Levene's test of homogeneity. RESULTS: Relative variations in the distribution of personnel by location of services were substantially reduced over the period, the CV being reduced by more than 50% for all groups. Variations in the personnel ratios by residence of users were smaller at the start of the period, and the reductions were also smaller. Still, relative variations were reduced by 20-35, 40 and 60% approximately for "all personnel", MDs and psychologists respectively. In spite of a major increase in the supply of MDs and psychologists

  7. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus

    2010-01-01

    Much information is shared, interpreted and recreated between caller, emergency dispatch personnel and ambulance crew during an emergency call. This paper studies the use of reflection in the ambulance control center based on the information an ambulance crew produces during patient treatment in ...... to understand and use the feedback delivered through the system. The paper argues for broadening the scope of telemedicine use outside the boundaries of communication between ambulance and emergency department....... in the ambulance. The study is based on an ethnographical single case study of a Danish ambulance control center that uses a system called “amPHI” to monitor outgoing and homebound ambulance runs from scene of injury to arrival at the emergency department. The paper finds that the control center uses...

  8. Optimal ambulance dispatching

    NARCIS (Netherlands)

    C.J. Jagtenberg (Caroline); S. Bhulai (Sandjai); R.D. van der Mei (Rob)

    2017-01-01

    textabstractThis chapter considers the ambulance dispatch problem, in which one must decide which ambulance to send to an incident in real time. In practice as well as in literature, it is commonly believed that the closest idle ambulance is the best choice. This chapter describes alternatives to

  9. Norwegian Deepwater Programme; Norwegian deepwater program

    Energy Technology Data Exchange (ETDEWEB)

    Melling, Kristian [Statoil, Stavanger (Norway)

    1999-07-01

    This presentation describes in some detail the Norwegian Deepwater Programme (NDP), its use as a cooperation model, current projects and plans, and further perspectives. The conclusions are: (1) On cost-effectiveness: double work avoided, coordinated and joint operations substantially save cost; (2) On the dialog between parties: a high degree of openness and transfer of experience, good relations between colleges and cooperation with external institutions; (3) On participating companies and personnel: increased competence and knowledge, improved communication between the companies involved, personal relations; (4) On participating licenses: very useful database for further work, reduced working load and costs.

  10. Ambulance Crash Characteristics in the US Defined by the Popular Press: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Teri L. Sanddal

    2010-01-01

    Full Text Available Ambulance crashes are a significant risk to prehospital care providers, the patients they are carrying, persons in other vehicles, and pedestrians. No uniform national transportation or medical database captures all ambulance crashes in the United States. A website captures many significant ambulance crashes by collecting reports in the popular media (the website is mentioned in the introduction. This report summaries findings from ambulance crashes for the time period of May 1, 2007 to April 30, 2009. Of the 466 crashes examined, 358 resulted in injuries to prehospital personnel, other vehicle occupants, patients being transported in the ambulance, or pedestrians. A total of 982 persons were injured as a result of ambulance crashes during the time period. Prehospital personnel were the most likely to be injured. Provider safety can and should be improved by ambulance vehicle redesign and the development of improved occupant safety restraints. Seventy-nine (79 crashes resulted in fatalities to some member of the same groups listed above. A total of 99 persons were killed in ambulance crashes during the time period. Persons in other vehicles involved in collisions with ambulances were the most likely to die as a result of crashes. In the urban environment, intersections are a particularly dangerous place for ambulances.

  11. Trajectories For Space Ambulance

    Science.gov (United States)

    Nelson, Walter C.; Furakawa, Shiro

    1988-01-01

    Report presents concept for space ambulance that moves as quickly and economically as possible between orbits. Describes variety of rendezvous maneuvers between space stations in geocentric orbits at altitudes ranging from 200 km to geosynchronous altitude. Analyzes minimum times to complete rendezvous with orbiting medical station.

  12. Ambulance transport of noncritical children: emergency medical service providers' knowledge, opinions, and practice.

    Science.gov (United States)

    O'Neil, Joseph; Steele, Gregory K; Weinstein, Elizabeth; Collins, Robert; Talty, Judith; Bull, Marilyn J

    2014-03-01

    Safe ambulance transport of children presents unique challenges. Our study describes child passenger restraint practices during ambulance transport, Emergency Medical Service (EMS) providers' knowledge, training, and use of child passenger restraint devices (CRD). A child passenger safety technician (CPST) recorded restraint used for pediatric ambulance transport. The CPST assessed and documented type of CRD used, securement, and whether the child was properly restrained. EMS providers' knowledge, training, and CRD use for ambulance transport were assessed. The study period spanned July 2009 to July 2010; 63 EMS personnel were interviewed and 40 children were observed. Approximately 75% of emergency medical technicians surveyed felt their knowledge of pediatric transport was adequate. Fourteen percent allowed a stable patient to be transported via parent's lap. Twelve percent were transported unrestrained. None of the 11 patients, birth to 3 years, were found to be transported correctly. Study findings supports education and training of EMS personnel to improve the safe ambulance transport of children.

  13. Ambulance need at mass gatherings.

    Science.gov (United States)

    Meites, Elissa; Brown, John F

    2010-01-01

    Scant evidence exists to guide policy-making around public health needs during mass gatherings. In 2006, the City and County of San Francisco began requiring standby ambulances at all mass gatherings with attendance of >15,500 people. The objectives were to evaluate needs for ambulances at mass gatherings, and to make evidence-based recommendations for public health policy-makers. The hypothesis was that the needs for ambulances at mass gatherings can be estimated using community baseline data. Emergency medical services plans were reviewed for all public events with an anticipated attendance of >1,000 people in San Francisco County during the 12-month period 01 August 2006 through 31 July 2007. Ambulance transport data were confirmed by event coordinators and ambulance company records, and the rate was calculated by dividing ambulance transports by event attendance. Baseline ambulance transport rate was calculated by dividing the annual ambulance transports in the county's computer-aided dispatch system by the census population estimate. The risk ratio was calculated using the risk of transport from a mass gathering compared with the baseline risk of ambulance transport for the local community. Significance testing and confidence intervals were calculated. Descriptive information was available for 100% of events and ambulance transport data available for 97% of events. The majority of the mass gatherings (47 unique events; 59 event days) were outdoor, weekend festivals, parades, or concerts, though a large proportion were athletic events. The ambulance transport rate from mass gatherings was 1 per 59,000 people every six hours. Baseline ambulance transport rate in San Francisco was 1 per 20,000 people every six hours. The transport rate from mass gatherings was significantly lower than the community baseline (risk ratio [RR]=0.15, 95% CI=0.10-0.22, pambulance, 46% of ambulances were unused. San Francisco mass gatherings appear to present a lower risk of ambulance

  14. Ambulance 3G.

    Science.gov (United States)

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

    2005-01-01

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

  15. Norwegian Fashion Institute

    OpenAIRE

    Heggli, Karolina; Soraas, Nina Cathrine; Thorstensen, Nina Fredrikke; Thorso, Mia

    2010-01-01

    This report has been conducted in cooperation with Norwegian Fashion Institute (hereinafter NFI). NFI is a non-profit organisation that represents the participants within the Norwegian fashion Industry. It seeks to make Norwegian fashion brands recognized at home and overseas. There are 90 members in the organisation that represents the wide spectrum of Norwegian fashion. Obtaining knowledge of the market will help NFI promote Norwegian fashion brands in the UK and identify the...

  16. Norwegian Fashion Institute

    OpenAIRE

    Heggli, Karolina; Soraas, Nina Cathrine; Thorstensen, Nina Fredrikke; Thorso, Mia

    2010-01-01

    This report has been conducted in cooperation with Norwegian Fashion Institute (hereinafter NFI). NFI is a non-profit organisation that represents the participants within the Norwegian fashion Industry. It seeks to make Norwegian fashion brands recognized at home and overseas. There are 90 members in the organisation that represents the wide spectrum of Norwegian fashion. Obtaining knowledge of the market will help NFI promote Norwegian fashion brands in the UK and identify the...

  17. Health status in the ambulance services: a systematic review

    Directory of Open Access Journals (Sweden)

    Hem Erlend

    2006-07-01

    Full Text Available Abstract Background Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services. Methods We identified the relevant empirical literature by searching several electronic databases including Medline, EMBASE, PsychINFO, CINAHL, and ISI Web of Science. Other relevant sources were identified through reference lists and other relevant studies known by the research group. Results Forty-nine studies are included in this review. Our analysis shows that ambulance workers have a higher standardized mortality rate, higher level of fatal accidents, higher level of accident injuries and a higher standardized early retirement on medical grounds than the general working population and workers in other health occupations. Ambulance workers also seem to have more musculoskeletal problems than the general population. These conclusions are preliminary at present because each is based on a single study. More studies have addressed mental health problems. The prevalence of post-traumatic stress symptom caseness was > 20% in five of seven studies, and similarly high prevalence rates were reported for anxiety and general psychopathology in four of five studies. However, it is unclear whether ambulance personnel suffer from more mental health problems than the general working population. Conclusion Several indicators suggest that workers in the ambulance services experience more health problems than the general working population and workers in other health occupations. Several methodological challenges, such as small sample sizes, non-representative samples, and lack of comparisons with normative data limit the interpretation of many studies. More coordinated research and replication are needed to compare data across studies. We discuss some strategies for

  18. Intelligent Ambulance Traffic Assistance System

    Directory of Open Access Journals (Sweden)

    RONOJOY GHOSH

    2013-09-01

    Full Text Available With the increase in traffic road density, several causalities occur due to delay in taking a patient to the hospital in an ambulance. In this paper, we have developed an algorithm to find the shortest path to reach the required destination. As required the software will identify the present location of the vehicle and ask the user for the destination. Then it will show all the available paths, highlighting the shortest one or in several cases the most optimum one. Further we made the traffic signals automated for special vehicles like an ambulance or a fire-engine such that the signals will go green for the ambulance as it comes in the vicinity of the traffic signal, thus providing them with a clear path to reach its destination. The original signal is restored as soon as the ambulance goes undetected by the Bluetooth scanner of the traffic signal.

  19. [Ambulant treatment of alcohol withdrawal].

    Science.gov (United States)

    Nüstedt, Volker

    2016-07-01

    Most of the patients addicted to alcohol are socially well integrated. The offer of a low threshold ambulant withdrawal therapy opens an opportunity to build a sustainable therapeutic relationship. The so started empathic addiction therapy will be well accepted and will lead to a satisfying outcome. Using Clomethiazole or Oxazepam in a daily reduced dose and with daily personal contacts, the ambulant withdrawal in patients without seizures or delir in medical history is a secure and successful therapeutic option.

  20. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services.

    Science.gov (United States)

    Karlsen, Anders M; Thomassen, Oyvind; Vikenes, Bjarne H; Brattebø, Guttorm

    2013-08-12

    Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids. Throughout the services, hospital duvets, cotton blankets and plastic "bubble-wrap" were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols. The most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic "bubble wrap", and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units.

  1. [Status of Ambulant Geriatrics].

    Science.gov (United States)

    Kraft, Johannes W

    2017-06-01

    Ambulante Gesundheitsversorgung im Alter Aktuelle Bedarfsplanung und Versorgungsrealität weichen zunehmend auseinander. Geriatrie erfolgt idealerweise als abgestufte Versorgung in einem regionalen Netzwerk. Hausärztlich-geriatrische Grundversorgung Das Basisassessment ermöglicht die Integration geriatrischer Screening-Diagnostik in den Praxisalltag. Ein vernetztes Konzept haus- und fachärztlicher Versorgung mit einer spezialisierten ambulanten Versorgung hat das Potenzial, stationäre Einweisungen zu vermeiden und die Qualität der ambulanten Versorgung geriatrischer Patienten zu steigern. KBV-Entwurf „Spezifische geriatrische Versorgung“ Die Kassenärztliche Bundesvereinigung (KBV) hat im ambulanten kassenärztlichen Bereich eine Zwischenstufe zwischen spezialisierter Versorgung durch Geriater an Kliniken und niedergelassenen Kassenärzten skizziert. Spezialisierte Versorgung nach EBM-Abschnitt 30.13 Seit dem 1.7.2016 können Hausärzte Patienten die Chance auf spezialisierte geriatrische Beratung und Diagnostik eröffnen. Sie wird in Verbindung mit kooperierenden Therapieteams von zugelassenen niedergelassenen Geriatern oder an geriatrischen Institutsambulanzen auf Zuweisung erbracht. Neue Modelle erweiterter geriatrischer Institutsambulanzen/Ausblick Die kooperative Zusammenarbeit von Hausärzten mit ambulant tätigen Geriatern eröffnet Chancen, präventive, akutmedizinische, rehabilitative und palliative Leistungen regional abgestimmt und bedarfsgerecht weiter zu entwickeln.

  2. Norwegian Armed Forces Personnel Recovery Network

    Science.gov (United States)

    2016-12-01

    Nashville: W Publishing Group, 2014); and Richard Phillips and Stephan Talty, A Captain’s Duty: Somali Pirates, Navy SEALs, and Dangerous Days at Sea (New...recommendations to future escapers, see War Office, MI9 Evasion Reports; and War Office, MI9 Bulletin. 140 Georg Galdorisi and Tom Phillips , Leave No Man Behind...Washington, DC: Center for Air Force History, 1992); and Galdorisi and Phillips , Leave No Man Behind. 51 communications between survivors and

  3. The carbon footprint of Australian ambulance operations.

    Science.gov (United States)

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

    2012-12-01

    To determine the greenhouse gas emissions associated with the energy consumption of Australian ambulance operations, and to identify the predominant energy sources that contribute to those emissions. A two-phase study of operational and financial data from a convenience sample of Australian ambulance operations to inventory their energy consumption and greenhouse gas emissions for 1 year. State- and territory-based ambulance systems serving 58% of Australia's population and performing 59% of Australia's ambulance responses provided data for the study. Emissions for the participating systems totalled 67 390 metric tons of carbon dioxide equivalents. For ground ambulance operations, emissions averaged 22 kg of carbon dioxide equivalents per ambulance response, 30 kg of carbon dioxide equivalents per patient transport and 3 kg of carbon dioxide equivalents per capita. Vehicle fuels accounted for 58% of the emissions from ground ambulance operations, with the remainder primarily attributable to electricity consumption. Emissions from air ambulance transport were nearly 200 times those for ground ambulance transport. On a national level, emissions from Australian ambulance operations are estimated to be between 110 000 and 120 000 tons of carbon dioxide equivalents each year. Vehicle fuels are the primary source of emissions for ground ambulance operations. Emissions from air ambulance transport are substantially higher than those for ground ambulance transport. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. Physical workload of ambulance assistants.

    Science.gov (United States)

    Doormaal, M T; Driessen, A P; Landeweerd, J A; Drost, M R

    1995-02-01

    The physical workload of ambulance assistants was assessed by means of the Ovako Working posture Analysis System (OWAS) observation method and a Work and Health Questionnaire (WHQ) for measuring perceived workload. In addition, a biomechanical model was applied to several specifically strenuous conditions that were simulated in a laboratory situation. Bad postures were identified for a number of activities: 16% to 29% of a work shift was spent in harmful positions. Strenuous situations occur particularly during rides in emergency situations. The results of observed and perceived workload are generally in agreement. A number of practical recommendations are made. They concern, for example, the equipment in ambulance cars, training of ambulance assistants and adaptations in working procedures.

  5. The relationship between hepatitis serology of ambulance attendants and duration of education.

    Science.gov (United States)

    Güçlü, Ertuğrul; Öğütlü, Aziz; Karabay, Oğuz

    2015-01-01

    Healthcare workers (HCWs) run the risk of hepatitis B virus (HBV) infection. Studies investigating the HBV and hepatitis C virus (HCV) serology of HCWs have been generally conducted in secondary or tertiary hospitals. In this study we aimed to determine the relationships between education level and HBV and HCV serology and HBV vaccination status of ambulance attendants. The data of this study were obtained by retrospective review of ambulance personnel files in Sakarya Province, Turkey. Out of 314 ambulance attendants, 216 (68.7%; 78 males, 138 females) were enrolled in this study. The mean length of employment in the province's ambulance service was 5.22 years. While hepatitis B surface antigen positivity was found in 3 (1.4%) workers, 147 (68%) of them were positive for hepatitis B surface antibodies (anti-HBs). The lowest HBV vaccination rate was 12.5%, in drivers. Naturally acquired immunity against HBV was again the highest in drivers (17.5%; P ambulance service attendants, and positive anti-HBs status related to vaccination is associated with vocational training. Training should be performed to increase HBV awareness of ambulance attendants. Nonvaccinated personnel should be determined on the first day of employment, and regulations should be put in place to ensure their vaccination.

  6. Targeted response? An exploration of why ambulance services find government targets particularly challenging.

    Science.gov (United States)

    Durham, Mark; Faulkner, Mark; Deakin, Charles

    2016-12-01

    Ambulance services have historically found their targets particularly challenging. This article explores some areas of this multifaceted problem. Research articles, government publications and published audit data. Demand is increasing in many areas of healthcare, but whilst hospitals saw a 7% increase in demand in recent times, ambulance services saw nearly double that. The services ambulance trusts provide have evolved from that of a transport service to that of a mobile health provider, and they have become victims of their own success. Ambulance targets have never evolved to match evolving care. Ambulance personnel strive to avoid hospital attendance where appropriate, but this can be difficult for a 24-hour service, when not all referral pathways have 24-hour referral systems. We discuss why demand might be growing disproportionately for ambulance services, and challenge the appropriateness of the targets themselves. Possible formats for revised ambulance targets are discussed. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Canadian ground ambulance services: provincial funding and standards for equipment and training.

    Science.gov (United States)

    Goldstein, D H

    1980-01-01

    There is an increasing demand for improved, up-to-date training and equipment for ground ambulance services across Canada. This paper presents the results of a survey of ambulance operations and their funding by the provinces, as well as a comparison of provincial legislation and recommendations on standards for equipment and the training of ambulance personnel. The training standards were found to be very diverse, and the legislated or recommended equipment standards did not meet those of the American College of Surgeons committee on trauma (ACSCT). The cost of ambulance services per capita and the cost to the user of an average 43-km run varied widely between the provinces. There was no correlation between the second cost and how well the province met the ACSCT's equipment standards. PMID:7260779

  8. Basic Training Program for Emergency Medical Technician: Ambulance Concepts and Recommendations.

    Science.gov (United States)

    Fucigna, Joseph T.; And Others

    The main objective was to develop and pilot test a basic course for ambulance personnel with emphasis on the medical aspect of training. This included the identification of a medically acceptable text or manual, and determining the prerequisites for selecting students and instructors. Secondary objectives were to outline the requirements for…

  9. Lobotomy in Norwegian psychiatry.

    Science.gov (United States)

    Tranøy, Joar; Blomberg, Wenche

    2005-03-01

    Lobotomy is still a hidden chapter in the history of Norwegian psychiatry. The main reasons, which are discussed here, may have been the role of Ørnulv Ødegård at Gaustad Hospital in Oslo and the links between health authorities and the power élite in Norwegian psychiatry.

  10. The Norwegian Twin Registry.

    Science.gov (United States)

    Nilsen, Thomas S; Brandt, Ingunn; Magnus, Per; Harris, Jennifer R

    2012-12-01

    Norway has a long-standing tradition in twin research, but the data collected in several population-based twin studies were not coordinated centrally or easily accessible to the scientific community. In 2009, the Norwegian Twin Registry was established at the Norwegian Institute of Public Health (NIPH) in Oslo with the purpose of creating a single research resource for Norwegian twin data. As of today, the Norwegian Twin Registry contains 47,989 twins covering birth years 1895-1960 and 1967-1979; 31,440 of these twins consented to participate in health-related research. In addition, DNA from approximately 4,800 of the twins is banked at the NIPH biobank and new studies are continually adding new data to the registry. The value of the Norwegian twin data is greatly enhanced by the linkage opportunities offered by Norway's many nationwide registries, spanning a broad array of medical, demographic, and socioeconomic information.

  11. A Theory of Ambulance Chasing

    CERN Document Server

    Backović, Mihailo

    2016-01-01

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

  12. Emergency ambulance service involvement with residential care homes in the support of older people with dementia: an observational study.

    Science.gov (United States)

    Amador, Sarah; Goodman, Claire; King, Derek; Machen, Ina; Elmore, Natasha; Mathie, Elspeth; Iliffe, Steve

    2014-08-28

    Older people resident in care homes have a limited life expectancy and approximately two-thirds have limited mental capacity. Despite initiatives to reduce unplanned hospital admissions for this population, little is known about the involvement of emergency services in supporting residents in these settings. This paper reports on a longitudinal study that tracked the involvement of emergency ambulance personnel in the support of older people with dementia, resident in care homes with no on-site nursing providing personal care only. 133 residents with dementia across 6 care homes in the East of England were tracked for a year. The paper examines the frequency and reasons for emergency ambulance call-outs, outcomes and factors associated with emergency ambulance service use. 56% of residents used ambulance services. Less than half (43%) of all call-outs resulted in an unscheduled admission to hospital. In addition to trauma following a following a fall in the home, results suggest that at least a reasonable proportion of ambulance contacts are for ambulatory care sensitive conditions. An emergency ambulance is not likely to be called for older rather than younger residents or for women more than men. Length of residence does not influence use of emergency ambulance services among older people with dementia. Contact with primary care services and admission route into the care home were both significantly associated with emergency ambulance service use. The odds of using emergency ambulance services for residents admitted from a relative's home were 90% lower than the odds of using emergency ambulance services for residents admitted from their own home. Emergency service involvement with this vulnerable population merits further examination. Future research on emergency ambulance service use by older people with dementia in care homes, should account for important contextual factors, namely, presence or absence of on-site nursing, GP involvement, and access to

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

    African Journals Online (AJOL)

    2 Aeromedical Division, ER24 Emergency Medical Services, Johannesburg, South Africa ... training needs. S Afr J Crit ... objective of this preliminary study was to determine the accuracy .... Table 5 presents the factors on which stroke diagnoses were .... Clinical reasoning and decision-making may be improved by way of.

  14. Riding Third: Social Work in Ambulance Work

    Science.gov (United States)

    Campbell, Hilary; Rasmussen, Brian

    2012-01-01

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

  15. Riding Third: Social Work in Ambulance Work

    Science.gov (United States)

    Campbell, Hilary; Rasmussen, Brian

    2012-01-01

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

  16. Hourly associations between heat and ambulance calls.

    Science.gov (United States)

    Guo, Yuming

    2017-01-01

    The response speed of ambulance calls is very crucial to rescue patients suffering immediately life threatening conditions. The serious health outcomes might be caused by exposing to extreme heat only several hours before. However, limited evidence is available on this topic. This study aims to examine the hourly association between heat and ambulance calls, to improve the ambulance services and to better protect health. Hourly data on ambulance calls for non-accidental causes, temperature and air pollutants (PM10, NO2, and O3) were collected from Brisbane, Australia, during 2001 and 2007. A time-stratified case-crossover design was used to examine the associations between hourly ambulance calls and temperature during warm season (Nov, Dec, Jan, Feb, and Mar), while adjusting for potential confounders. Stratified analyses were performed for sex and age groups. Ambulance calls peaked at 10am for all groups, except those aged heat-ambulance calls relationships were non-linear for all groups, with thresholds between 27 °C and 31 °C. The associations appeared immediately, and lasted for about 24 h. There were no significant modification effect by sex and age. The findings suggest that hot hourly temperatures (>27 °C) increase the demands of ambulance. This information is helpful to increase the efficiency of ambulance service then save lives, for example, preparing more ambulance before appearance of extremely hot temperature in combination with weather forecast. Also, people should better arrange their time for outdoor activities to avoid exposing to extreme hot temperatures. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Ambulance demand: random events or predicable patterns?

    Science.gov (United States)

    Cantwell, Kate; Dietze, Paul; Morgans, Amee E; Smith, Karen

    2013-11-01

    Occupational, social and recreational routines follow temporal patterns, as does the onset of certain acute medical diseases and injuries. It is not known if the temporal nature of injury and disease transfers into patterns that can be observed in ambulance demand. This review examines eligible study findings that reported temporal (time of day, day of week and seasonal) patterns in ambulance demand. Electronic searches of Medline and Cumulative Index of Nursing and Allied Health Literature were conducted for papers published between 1980 and 2011. In addition, hand searching was conducted for unpublished government and ambulance service documents and reports for the same period. 38 studies examined temporal patterns in ambulance demand. Six studies reported trends in overall workload and 32 studies reported trends in a subset of ambulance demand, either as a specific case type or demographic group. Temporal patterns in overall demand were consistent between jurisdictions for time of day but varied for day of week and season. When analysed by case type, all jurisdictions reported similar time of day patterns, most jurisdictions had similar day of week patterns except for out-of-hospital cardiac arrest and similar seasonal patterns, except for trauma. Temporal patterns in case types were influenced by age and gender. Temporal patterns are present in ambulance demand and importantly these populations are distinct from those found in hospital datasets suggesting that variation in ambulance demand should not be inferred from hospital data alone. Case types seem to have similar temporal patterns across jurisdictions; thus, research where demand is broken down into case types would be generalisable to many ambulance services. This type of research can lead to improvements in ambulance service deliverables.

  18. Air ambulance medical transport advertising and marketing.

    Science.gov (United States)

    2011-01-01

    The National Association of EMS Physicians (NAEMSP), the American College of Emergency Physicians (ACEP), the Air Medical Physician Association (AMPA), the Association of Air Medical Services (AAMS), and the National Association of State EMS Officials (NASEMSO) believe that patient care and outcomes are optimized by using air medical transport services that are licensed air ambulance providers with robust physician medical director oversight and ongoing quality assessment and review. Only air ambulance medical transport services with these credentials should advertise/market themselves as air ambulance services.

  19. 42 CFR 410.41 - Requirements for ambulance suppliers.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements for ambulance suppliers. 410.41... § 410.41 Requirements for ambulance suppliers. (a) Vehicle. A vehicle used as an ambulance must meet the... ALS services. (c) Billing and reporting requirements. An ambulance supplier must comply with...

  20. Swedish ambulance managers' descriptions of crisis support for ambulance staff after potentially traumatic events.

    Science.gov (United States)

    Hugelius, Karin; Berg, Sara; Westerberg, Elin; Gifford, Mervyn; Adolfsson, Annofie

    2014-12-01

    Ambulance staff face complex and sometimes stressful or potentially traumatic situations, not only in disasters but also in their routine daily work. The aim of this study was to survey ambulance managers' descriptions of crisis support interventions for ambulance staff after potential traumatic events (PTEs). Semistructured interviews with a qualitative descriptive design were conducted with six ambulance managers in a health care region in central Sweden. The data was analyzed using content analysis. Five categories were found in the result: (1) description of a PTE; (2) description and performance of crisis support interventions; (3) impact of working in potentially traumatic situations; (4) the ambulance managers' role in crisis support interventions; and (5) the ambulance managers' suggestions for improvement. Ambulance managers described crisis support interventions after a PTE as a single, mandatory group meeting with a structure reminiscent of debriefing. The ambulance managers also expressed doubts about the present structures for crisis support and mentioned an alternative approach which is more in line with present evidence-based recommendations. The results indicated a need for increased understanding of the importance of the managers' attitudes for ambulance staff; a need for further implementation of evidence-based recommendations for crisis support interventions was also highlighted.

  1. Ambulance Reasonable Charge Public Use Files

    Data.gov (United States)

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

  2. Occupational hazards in a public ambulance service.

    Science.gov (United States)

    Constantin, Brânduşa; Morariu, S; Duma, Olga Odetta

    2013-01-01

    To identify the occupational risks in an ambulance service and to assess their impact on the health of employees. Two marched groups (number, sex, age, length of exposure) from two different work sectors were selected. A 60 item questionnaire was used. The 60 items were grouped into four categories related to work organization, work environment, neuropsychosensorial risk factors and health system and occupational safety-related risk factors and hazards. The data were statistically processed, significant correlations between the risk factors and the associated symptoms being found. Compared to the control group, significantly higher values (pground, carrying weight, vicious postures) were found in ambulance service staff; cervical and lumbar spine problems were the most common complaints of ambulance service staff. The specific risk factors for ambulance service employees directly related to musculoskeletal disorders have been established.

  3. Patients' experience of being badly treated in the ambulance service: A qualitative study of deviation reports in Sweden.

    Science.gov (United States)

    Ahlenius, Marie; Lindström, Veronica; Vicente, Veronica

    2017-01-01

    The Swedish healthcare system aims to provide the best care possible, thus fulfilling legal and program requirements despite the need for reducing costs. This study's aim has been to acquire deeper understanding of the factors underlying patients' experience of inappropriate treatment and care or personnel's problematical attitudes during their contact with the Emergency Medical Services (EMS) (Ambulance Services). This study used a care science perspective. It applied qualitative content analysis, analyzing data for meaning. Data comprised 32 deviation reports or complaints from patients in Stockholm, Sweden in 2014. Patients at the limits of their self-help experienced acute need for speedy transfer to hospital. Lack of recognition for their suffering caused them to feel badly treated by ambulance personnel. Patients in this study felt objectified and not treated as individual human beings, i.e. they "suffered from care". Ambulance personnel should avoid patient objectification by establishing an engaged relationship with attentiveness and committal, thus supporting patients' health processes. The aim of this study has been to draw attention to patients' experiences of the healthcare they received, in order to be able to improve and maintain healthcare standards, thus guaranteeing continued quality of care. This may be achieved by increasing the awareness of personnel concerning how their attitudes and treatment can influence patient well-being. Information, education and follow-up lead to increased awareness in personnel. The intended result of personnel's increased awareness is greater well-being and feelings of security for patients. Copyright © 2016. Published by Elsevier Ltd.

  4. Improving community ambulation after stroke: the AMBULATE trial

    Directory of Open Access Journals (Sweden)

    Lindley Richard

    2009-02-01

    Full Text Available Abstract Background It has been reported that following rehabilitation, only 7% of stroke survivors are able to walk at a level commensurate with community participation. Previous research indicates that treadmill and overground walking training can improve walking capacity in people living in the community after stroke. The main objectives of the AMBULATE trial are to determine (i whether a 4-month treadmill walking program is more effective than a 2-month program, compared to control, in improving walking capacity, health and community participation and (ii the "threshold" walking speed that results in sufficient walking capacity that makes walking self-sustaining. Methods/Design A prospective randomised controlled trial of unsupported treadmill training with a 12 month follow-up with concealed allocation and blinded assessment will be conducted. 210 community-dwelling people after stroke who are able to walk independently but slowly will be recruited and randomly allocated to either a 4 month training group, 2 month training group or the control (no intervention group. Intervention for the two training groups will occur 3 days per week for 30 minutes each session. Measurements of walking, health and community participation will be taken at baseline, 2 months, 4 months, 6 months and 12 months. This study has obtained ethical approval from the relevant Human Research Ethics Committees. Discussion By improving stroke survivors' walking ability, it is likely also to improve their general wellbeing by promoting better health and greater community participation. Furthermore, if stroke survivors can reach a point where their walking and community participation is self-sustaining, this will reduce the burden of care on family and friends as well as the economic burden on the health system. Given the major demographic shift in developed nations involving significant growth in the aged population, this research will make an important evidence

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

    Science.gov (United States)

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

    2013-02-01

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

  6. Are overdoses treated by ambulance services an opportunity for additional interventions? A prospective cohort study.

    Science.gov (United States)

    Gjersing, Linn; Bretteville-Jensen, Anne Line

    2015-11-01

    To assess whether people who inject drugs (PWID) and who are treated for overdose by ambulance services have a greater mortality risk compared with other PWID, and to compare mortality risk within potentially critical time-periods (1 week, 1 month, 3 months, 6 months, 1 year, 5 years) after an overdose attendance with the mortality risk within potentially non-critical time-periods (time before and/or after critical periods). A prospective cohort study. Oslo, Norway. A total of 172 PWID street-recruited in 1997 and followed-up until the end of 2004. Interview data linked to data from ambulance records, Norwegian Correctional Services, Opioid Substitution Treatment records and National Cause of Death Registry. Separate Cox regression models (one for each critical time-period) were estimated. Ambulance services treated 54% of the participants for an overdose during follow-up. The mortality rate was 2.8 per 100 person-years for those with an overdose and 3.3 for those without; the adjusted hazard ratio (HR) was 1.3 (95% CI = 0.6, 2.6, P = 0.482). Mortality risk was greater in all but the shortest critical time-period following ambulance attendance than in the non-critical periods. The mortality risk remained significantly elevated during critical periods, even when adjusted for total time spent in prison and substitution treatment. The HR ranged from 9.4 (95% CI = 3.5, 25.4) in the month after an overdose to 13.9 (95% CI = 6.4, 30.2) in the 5-year period. Mortality risk among people who inject drugs is significantly greater in time-periods after an overdose attendance than outside these time-periods. © 2015 Society for the Study of Addiction.

  7. Ambulance officers' use of online clinical evidence

    Directory of Open Access Journals (Sweden)

    Westbrook Mary T

    2006-07-01

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

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

    CERN Multimedia

    2000-01-01

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

  9. 29 CFR 553.215 - Ambulance and rescue service employees.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Ambulance and rescue service employees. 553.215 Section 553... Protection and Law Enforcement Employees of Public Agencies Exemption Requirements § 553.215 Ambulance and rescue service employees. (a) Ambulance and rescue service employees of a public agency other than a fire...

  10. Emergency Victim Care. A Textbook for Emergency Medical Personnel.

    Science.gov (United States)

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

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

  11. Norwegian mastitis control programme.

    Science.gov (United States)

    Osterås, O; Sølverød, L

    2009-04-01

    This paper describes the methods and results of the Norwegian Mastitis Control Program implemented in 1982. The program has formed an integral part of the Norwegian Cattle Health Services (NCHS) since 1995. The NCHS also have specific programs for milk fever, ketosis, reproduction and calf diseases. The goal of the program is to improve udder health by keeping the bulk milk somatic cell count (BMSCC) low, to reduce the use of antibiotics, to keep the cost of mastitis low at herd level and improve the consumers' attitude to milk products. In 1996, a decision was made to reduce the use of antibiotics in all animal production enterprises in Norway by 25% within five years. Relevant data has been collected through the Norwegian Cattle Herd Recording System (NCHRS); including health records since 1975 and somatic cell count (SCC) data since 1980. These data have been integrated within the NCHRS. Since 2000, mastitis laboratory data have also been included in the NCHRS. Data on clinical disease, SCC and mastitis bacteriology have been presented to farmers and advisors in monthly health periodicals since 1996, and on the internet since 2005. In 1996, Norwegian recommendations on the treatment of mastitis were implemented. Optimal milking protocols and milking machine function have been emphasised and less emphasis has been placed on dry cow therapy. A selective dry cow therapy program (SDCTP) was implemented in 2006, and is still being implemented in new areas. Research demonstrates that the rate of clinical mastitis could be reduced by 15% after implementing SDCTP. The results so far show a 60% reduction in the clinical treatment of mastitis between 1994 and 2007, a reduction in BMSCC from 250,000 cells/ml to 114,000 cells/ml, and a total reduction in the mastitis cost from 0.23 NOK to 0.13 NOK per litre of milk delivered to the processors, corresponding to a fall from 9.2% to 1.7% of the milk price, respectively. This reduction is attributed to changes in attitude and

  12. Norwegian mastitis control programme

    Science.gov (United States)

    2009-01-01

    This paper describes the methods and results of the Norwegian Mastitis Control Program implemented in 1982. The program has formed an integral part of the Norwegian Cattle Health Services (NCHS) since 1995. The NCHS also have specific programs for milk fever, ketosis, reproduction and calf diseases. The goal of the program is to improve udder health by keeping the bulk milk somatic cell count (BMSCC) low, to reduce the use of antibiotics, to keep the cost of mastitis low at herd level and improve the consumers' attitude to milk products. In 1996, a decision was made to reduce the use of antibiotics in all animal production enterprises in Norway by 25% within five years. Relevant data has been collected through the Norwegian Cattle Herd Recording System (NCHRS); including health records since 1975 and somatic cell count (SCC) data since 1980. These data have been integrated within the NCHRS. Since 2000, mastitis laboratory data have also been included in the NCHRS. Data on clinical disease, SCC and mastitis bacteriology have been presented to farmers and advisors in monthly health periodicals since 1996, and on the internet since 2005. In 1996, Norwegian recommendations on the treatment of mastitis were implemented. Optimal milking protocols and milking machine function have been emphasised and less emphasis has been placed on dry cow therapy. A selective dry cow therapy program (SDCTP) was implemented in 2006, and is still being implemented in new areas. Research demonstrates that the rate of clinical mastitis could be reduced by 15% after implementing SDCTP. The results so far show a 60% reduction in the clinical treatment of mastitis between 1994 and 2007, a reduction in BMSCC from 250,000 cells/ml to 114,000 cells/ml, and a total reduction in the mastitis cost from 0.23 NOK to 0.13 NOK per litre of milk delivered to the processors, corresponding to a fall from 9.2% to 1.7% of the milk price, respectively. This reduction is attributed to changes in attitude and

  13. Norwegian mastitis control programme

    Directory of Open Access Journals (Sweden)

    Østerås O

    2009-04-01

    Full Text Available Abstract This paper describes the methods and results of the Norwegian Mastitis Control Program implemented in 1982. The program has formed an integral part of the Norwegian Cattle Health Services (NCHS since 1995. The NCHS also have specific programs for milk fever, ketosis, reproduction and calf diseases. The goal of the program is to improve udder health by keeping the bulk milk somatic cell count (BMSCC low, to reduce the use of antibiotics, to keep the cost of mastitis low at herd level and improve the consumers' attitude to milk products. In 1996, a decision was made to reduce the use of antibiotics in all animal production enterprises in Norway by 25% within five years. Relevant data has been collected through the Norwegian Cattle Herd Recording System (NCHRS; including health records since 1975 and somatic cell count (SCC data since 1980. These data have been integrated within the NCHRS. Since 2000, mastitis laboratory data have also been included in the NCHRS. Data on clinical disease, SCC and mastitis bacteriology have been presented to farmers and advisors in monthly health periodicals since 1996, and on the internet since 2005. In 1996, Norwegian recommendations on the treatment of mastitis were implemented. Optimal milking protocols and milking machine function have been emphasised and less emphasis has been placed on dry cow therapy. A selective dry cow therapy program (SDCTP was implemented in 2006, and is still being implemented in new areas. Research demonstrates that the rate of clinical mastitis could be reduced by 15% after implementing SDCTP. The results so far show a 60% reduction in the clinical treatment of mastitis between 1994 and 2007, a reduction in BMSCC from 250,000 cells/ml to 114,000 cells/ml, and a total reduction in the mastitis cost from 0.23 NOK to 0.13 NOK per litre of milk delivered to the processors, corresponding to a fall from 9.2% to 1.7% of the milk price, respectively. This reduction is attributed to

  14. Dynamic ambulance reallocation for the reduction of ambulance response times using system status management.

    Science.gov (United States)

    Lam, Sean Shao Wei; Zhang, Ji; Zhang, Zhong Cheng; Oh, Hong Choon; Overton, Jerry; Ng, Yih Yng; Ong, Marcus Eng Hock

    2015-02-01

    Dynamically reassigning ambulance deployment locations throughout a day to balance ambulance availability and demands can be effective in reducing response times. The objectives of this study were to model dynamic ambulance allocation plans in Singapore based on the system status management (SSM) strategy and to evaluate the dynamic deployment plans using a discrete event simulation (DES) model. The geographical information system-based analysis and mathematical programming were used to develop the dynamic ambulance deployment plans for SSM based on ambulance calls data from January 1, 2011, to June 30, 2011. A DES model that incorporated these plans was used to compare the performance of the dynamic SSM strategy against static reallocation policies under various demands and travel time uncertainties. When the deployment plans based on the SSM strategy were followed strictly, the DES model showed that the geographical information system-based plans resulted in approximately 13-second reduction in the median response times compared to the static reallocation policy, whereas the mathematical programming-based plans resulted in approximately a 44-second reduction. The response times and coverage performances were still better than the static policy when reallocations happened for only 60% of all the recommended moves. Dynamically reassigning ambulance deployment locations based on the SSM strategy can result in superior response times and coverage performance compared to static reallocation policies even when the dynamic plans were not followed strictly. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Nosocomial infections in ambulances and effectiveness of ambulance fumigation techniques in Saudi Arabia. Phase I study.

    Science.gov (United States)

    Alrazeeni, Daifallah; Al Sufi, Mohammed S

    2014-11-01

    To evaluate infection control and the incidence of bacterial pathogens in Emergency Medical Service (EMS) ambulances in Riyadh, Saudi Arabia. The effectiveness of fumigation techniques used for these ambulances to minimize the spread of infection to transported patients and pre-hospital care providers was also assessed. Based on previous literature review indicating a higher propensity of microbial load, 3 areas within the ambulance, such as, stretcher handle, oxygen flow meter knob, and interior handle of the rear door were selected for specimen collection. Swab samples were collected both in the day and night shift, after the intended disinfection and cleaning (before and after fumigation). Micro-organisms were identified using standard procedures. This phase-I study was conducted at the Emergency Medical Services Department, Prince Sultan Bin AbdulAziz College of Emergency Medical Services, Al Malaz, King Saud University, Riyadh, Saudi Arabia between October and November 2013, wherein a total of 10 ambulances from the Saudi Red Crescent Authority in Riyadh were selected for inclusion in the study. The specimens from all 10 ambulances showed similar results. In post disinfection and before fumigation, swab samples showed positive cultures that grew moderate to large quantities of environmental and skin flora. However, almost all organisms were susceptible to the fumigation technique. This study confirms the importance of evaluating the frequency and efficiency of various fumigation techniques as an ambulance is a potential reservoir for microbial transmission to patients and staff.

  16. Nosocomial infections in ambulances and effectiveness of ambulance fumigation techniques in Saudi Arabia

    Science.gov (United States)

    Alrazeeni, Daifallah; Al Sufi, Mohammed S.

    2014-01-01

    Objectives: To evaluate infection control and the incidence of bacterial pathogens in Emergency Medical Service (EMS) ambulances in Riyadh, Saudi Arabia. The effectiveness of fumigation techniques used for these ambulances to minimize the spread of infection to transported patients and pre-hospital care providers was also assessed. Methods: Based on previous literature review indicating a higher propensity of microbial load, 3 areas within the ambulance, such as, stretcher handle, oxygen flow meter knob, and interior handle of the rear door were selected for specimen collection. Swab samples were collected both in the day and night shift, after the intended disinfection and cleaning (before and after fumigation). Micro-organisms were identified using standard procedures. This phase-I study was conducted at the Emergency Medical Services Department, Prince Sultan Bin Abdulaziz College of Emergency Medical Services, Al Malaz, King Saud University, Riyadh, Saudi Arabia between October and November 2013, wherein a total of 10 ambulances from the Saudi Red Crescent Authority in Riyadh were selected for inclusion in the study. Results: The specimens from all 10 ambulances showed similar results. In post disinfection and before fumigation, swab samples showed positive cultures that grew moderate to large quantities of environmental and skin flora. However, almost all organisms were susceptible to the fumigation technique. Conclusion: This study confirms the importance of evaluating the frequency and efficiency of various fumigation techniques as an ambulance is a potential reservoir for microbial transmission to patients and staff. PMID:25399212

  17. Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study.

    Science.gov (United States)

    Grusd, Eystein; Kramer-Johansen, Jo

    2016-05-06

    The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, freeing up highly trained ambulance staff to attend patients in greater need. A cross-sectional observational study was used, drawing on all electronic and paper records in our ambulance service from four random days in 2012. The patients were classified into acuity groups, based on Emergency Medical Dispatch codes, and pre-hospital interventions were extracted from the Patient Report Forms. Of the 1489 ambulance call-outs included in this study, 82 PRFs (5 %) were missing. A highly significant association was found between acuity group and recorded pre-hospital intervention (p ≤ 0.001). We found no correlation between gender, distance to hospital, age and pre-hospital interventions. Ambulances staffed by paramedics performed more interventions (234/917, 26 %) than those with emergency medical technicians (42/282, 15 %). The strongest predictor for needing pre-hospital interventions was found to be the emergency medical dispatch acuity descriptor. This study has demonstrated that the Norwegian dispatch system is able to correctly identify patients who do not need pre-hospital interventions. Patients with a low acuity code had a very low level of pre-hospital interventions. Evaluation of adherence to protocol in the Emergency Medical Dispatch is not possible due to the inherent need for medical experience in the triage process. This study validates the Norwegian dispatch tool (Norwegian index) as a predictor of patients who do not need pre-hospital interventions.

  18. Injuries in Norwegian Early Childhood and Care (ECEC Institutions

    Directory of Open Access Journals (Sweden)

    Ole Johan Sando

    2017-02-01

    Full Text Available Children’s play and exploration involves risk and a possibility for being injured. Early childhood and care institutions (ECECs should provide children with physical challenges in a safe environment. Over the past years, the attention towards playground safety and injuries in ECECs has increased. Norwegian practitioners have a liberal approach to children’s risk taking in play, raising questions on injury prevalence in Norwegian ECECs. The aim for this study was to gain knowledge about the injury prevalence and characteristics of the injuries in Norwegian ECECs. Managers from 2105 institutions completed an electronic questionnaire retrospectively asking the managers to report injuries and accidents the past year. The results indicate that injuries are rare in Norwegian ECECs, and that most of the injuries are minor and do not require a follow-up from professional medical personnel. The moderate and severe injuries are very rare, and often mishaps. There are some indications that boys experience injuries more often than girls do. The main cause of moderate injuries is falling, both outdoors and indoors.

  19. Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

    Directory of Open Access Journals (Sweden)

    Hansen Elisabeth

    2009-07-01

    Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

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

    Science.gov (United States)

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

    2015-10-01

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

  1. 42 CFR 414.615 - Transition to the ambulance fee schedule.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Transition to the ambulance fee schedule. 414.615... Ambulance Services § 414.615 Transition to the ambulance fee schedule. The fee schedule for ambulance... the fee schedule payment for ambulance services and the amount the program would have paid absent the...

  2. 42 CFR 424.124 - Conditions for payment for physician services and ambulance services.

    Science.gov (United States)

    2010-10-01

    ... ambulance services. 424.124 Section 424.124 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... and ambulance services. (a) Basic rules. Medicare Part B pays for physician and ambulance services if... furnishes the services. (c) Ambulance services. The ambulance services are— (1) Necessary because the use of...

  3. Computer assisted assessment and advice for "non-serious" 999 ambulance service callers: the potential impact on ambulance despatch

    OpenAIRE

    Dale, Jeremy; Higgins, J.; Williams, S.; Foster, T.; Snooks, Helen; Crouch, R; Hartley-Sharpe, C; Glucksman, E; Hooper, R.; George, S.

    2003-01-01

    Objective: To investigate the potential impact for ambulance services of telephone assessment and\\ud triage for callers who present with non-serious problems (Category C calls) as classified by ambulance\\ud service call takers.\\ud Design: Pragmatic controlled trial. Calls identified using priority dispatch protocols as non-serious\\ud were allocated to intervention and control groups according to time of call. Ambulance dispatch\\ud occurred according to existing procedures. During intervention...

  4. Leg Spasticity and Ambulation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Swathi Balantrapu

    2014-01-01

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

  5. Shoes versus sneakers in toddler ambulation.

    Science.gov (United States)

    Gould, N

    1985-10-01

    The purpose of this study was to determine the relative values and differences between shoes and sneakers for young children just learning to walk. In phase 1 of the study, 79 toddlers (47 females and 32 males), ranging in age from 11 months to 3 years, were carefully measured for footwear. Only 15 toddlers (19%) could be properly fitted in the medium-width sneakers that are currently available on the market. The majority of the measured toddlers required widths greater than D, and to accommodate these wider feet, it was necessary to fit them with longer sneakers than they actually needed otherwise, thus making ambulation a bit more difficult and clumsy. In phase 2, eight toddlers, randomly selected except for sex (four male and four female), ranging in age from 11 to 16 months who had been ambulating 2 weeks to 5 months, were tagged with an identifying letter and videotaped in four walking situations: sneakers on tile, shoes on tile, sneakers on rugging, and shoes on rugging. Four hours of video taping was edited down to one-half hour. Twenty-three observers (orthopaedic surgeons, pediatricians, and shoe fitters) carefully reviewed the tape on multiple occasions and came to the following conclusions: better fit, stance, gait, cadence, and stability were noted with shoes in all the toddlers and in all situations. Falls were three times more frequent in sneakers as compared to shoes on tile surfaces and five times more frequent on rugging. It was concluded that the slight economic advantage of sneakers over shoes was not that great to warrant jeopardizing the capabilities of the toddler in the earliest stages of ambulation.

  6. Ambulance nurses' experiences of nursing critically ill and injured children: A difficult aspect of ambulance nursing care.

    Science.gov (United States)

    Nordén, Charlotte; Hult, Karin; Engström, Åsa

    2014-04-01

    Ambulance nurses work daily in both emergency and non-emergency situations that can be demanding. One emotionally demanding situation for ambulance nurses is to nurse children who are ill. The aim of this study was to describe ambulance nurses' experiences of nursing critically ill or injured children. Eight specialist ambulance nurses were interviewed and the interviews were analyzed using qualitative content analysis. The analysis resulted in one theme, a difficult aspect of ambulance nursing care, with five categories. The security of both child and parents was considered to be paramount. Ambulance nurses felt relieved when they handed over the responsibility and the child to the receiving unit. The ambulance nurses felt that more training, education and follow-up was desirable in order to increase their security when nursing children. Ambulance nurses are subject to stressful feelings while nursing children. As providing reassurance to the child and its parents is a cornerstone of the treatment, it is important for the ambulance nurses to take the time to build up a trusting relationship in such an encounter. Skill development in the area might lead to increased security and reduce the mental burden resulting from negative stress. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Infradian rhythms in medical ambulance team dispatches

    Science.gov (United States)

    Dudin, S. A.

    2012-12-01

    We describe the results of a spectral and correlation analysis of changes in the daily dispatches of ambulance teams over 3 years. The results show fluctuations with periods of 7, 41, 50-51, 68-82, 136, 227, and 310-365 days and small-amplitude fluctuations with periods of 11, 13-14, 17-18, 23, 29, 31, 36, and 58 days. Some of these coincide with the predictions of Tibetan medical sources. The periods under observation closely match the changes in the gradient of the Earth's electric field potential.

  8. Facts 2011 - The Norwegian petroleum sector

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-15

    The publication provides a general overview of information regarding the petroleum activities on the Norwegian continental shelf. Content; Foreword; The petroleum sector - Norway's largest industry; Organisation of Norwegian petroleum activity; Government petroleum revenues; Exploration activities; Development and operations; Norwegian gas exports; Decommissioning; Research, technology and industrial development; Environmental considerations in the Norwegian petroleum sector; Petroleum resources; Fields in production; Fields under development; Future developments; Fields where production has ceased; Pipelines and onshore facilities. (AG)

  9. Facts 2010 - The Norwegian petroleum sector

    Energy Technology Data Exchange (ETDEWEB)

    2010-07-01

    The publication provides a general overview of information regarding the petroleum activities on the Norwegian continental shelf. Content; Foreword; The petroleum sector - Norway's largest industry; Organisation of Norwegian petroleum activity; Government petroleum revenues; Exploration activities; Development and operations; Norwegian gas exports; Decommissioning; Research, technology and industrial development; Environmental considerations in the Norwegian petroleum sector; Petroleum resources; Fields in production; Fields under development; Future developments; Fields where production has ceased; Pipelines and onshore facilities. (AG)

  10. Facts 2009 - The Norwegian petroleum sector

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-01

    The publication provides a general overview of information regarding the petroleum activities on the Norwegian continental shelf. Contents: Foreword; The petroleum sector; Norwegian resource management; Government petroleum revenues; Exploration activities; Development and operations; Norwegian gas exports; Decommissioning; Research, technology; Environmental considerations; Petroleum resources; Fields in production; Fields under development; Future developments; Fields where production has ceased; Pipelines and onshore facilities. (AG)

  11. Actively-controlled Beds for Ambulances

    Institute of Scientific and Technical Information of China (English)

    Takahiko Ono; Hikaru Inooka

    2009-01-01

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

  12. Personnel scheduling

    OpenAIRE

    Vanden Berghe, Greet

    2012-01-01

    Personnel scheduling can become a particularly difficult optimisation problem due to human factors. And yet: people working in healthcare, transportation and other round the clock service regimes perform their duties based on a schedule that was often manually constructed. The unrewarding manual scheduling task deserves more attention from the timetabling community so as to support computation of fair and good quality results. The present abstract touches upon a set of particular characterist...

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

    NARCIS (Netherlands)

    Laan, Corine M.; Vanberkel, Peter T.; Boucherie, Richard J.; Carter, Alix J.E.

    2016-01-01

    Emergency department overcrowding is a widespread problem and often leads to ambulance offload delay. If no bed is available when a patient arrives, the patient has to wait with the ambulance crew. A recent Canadian innovation is the offload zone—an area where multiple patients can wait with a singl

  14. Design of an Efficient Integrated System for Ambulance Management

    Directory of Open Access Journals (Sweden)

    Raid S. Sarhan

    2015-08-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

    Emergency department overcrowding is a widespread problem and often leads to ambulance offload delay. If no bed is available when a patient arrives, the patient has to wait with the ambulance crew. A recent Canadian innovation is the offload zone—an area where multiple patients can wait with a

  16. Medical Requirements for Ambulance Design and Equipment. Emergency Health Series.

    Science.gov (United States)

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

    A vehicle must meet certain specific requirements to be classified as an ambulance if it is to satisfy the demands of the physician in terms of emergency care for which properly trained ambulance attendants can be held responsible. Developed by professional and lay experts for use by automotive designers and manufacturing, this publication would…

  17. Reducing ambulance response times using discrete event simulation.

    Science.gov (United States)

    Wei Lam, Sean Shao; Zhang, Zhong Cheng; Oh, Hong Choon; Ng, Yih Ying; Wah, Win; Hock Ong, Marcus Eng

    2014-01-01

    The objectives of this study are to develop a discrete-event simulation (DES) model for the Singapore Emergency Medical Services (EMS), and to demonstrate the utility of this DES model for the evaluation of different policy alternatives to improve ambulance response times. A DES model was developed based on retrospective emergency call data over a continuous 6-month period in Singapore. The main outcome measure is the distribution of response times. The secondary outcome measure is ambulance utilization levels based on unit hour utilization (UHU) ratios. The DES model was used to evaluate different policy options in order to improve the response times, while maintaining reasonable fleet utilization. Three policy alternatives looking at the reallocation of ambulances, the addition of new ambulances, and alternative dispatch policies were evaluated. Modifications of dispatch policy combined with the reallocation of existing ambulances were able to achieve response time performance equivalent to that of adding 10 ambulances. The median (90th percentile) response time was 7.08 minutes (12.69 minutes). Overall, this combined strategy managed to narrow the gap between the ideal and existing response time distribution by 11-13%. Furthermore, the median UHU under this combined strategy was 0.324 with an interquartile range (IQR) of 0.047 versus a median utilization of 0.285 (IQR of 0.051) resulting from the introduction of additional ambulances. Response times were shown to be improved via a more effective reallocation of ambulances and dispatch policy. More importantly, the response time improvements were achieved without a reduction in the utilization levels and additional costs associated with the addition of ambulances. We demonstrated the effective use of DES as a versatile platform to model the dynamic system complexities of Singapore's national EMS systems for the evaluation of operational strategies to improve ambulance response times.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  19. Board Certification. Registered EMT-Paramedic. Registered EMT-Intermediate. Registered EMT-Ambulance. Registered EMT-Non-Ambulance.

    Science.gov (United States)

    National Registry of Emergency Medical Technicians, Columbus, OH.

    These three brochures outline entry requirements and certification information for: (1) emergency medical technician (EMT)-ambulance and EMT-non-ambulance; (2) EMT-intermediate; and (3) EMT-paramedic. Each brochure provides information on entry requirements, including provisional registration and expiration date; lapsed registration; examination…

  20. [Job satisfaction among Norwegian doctors].

    Science.gov (United States)

    Nylenna, Magne; Aasland, Olaf Gjerløw

    2010-05-20

    Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.

  1. Orbit design for a space ambulance vehicle

    Science.gov (United States)

    Nelson, Walter C.

    A number of rendezvous maneuvers between space stations in geocentric orbits at altitudes ranging between 200 km and geosynchronous altitude are examined. Minimum time to complete rendezvous is studied for purposes of expediting crew patient transfer to an orbiting medical base station (MBS) for the stabilization of trauma and definitive care. The vehicle to be used for the crew patient transfer to the MBS is the space ambulance vehicle (SAV). The SAV is assumed to use two velocity impulses to complete rendezvous maneuvers between an SS and the MBS: an accelerating impulse when departing the SS and a second decelerating impulse prior to docking with the MBS. Recommendations are made concerning the planning of space operations which will reduce both time and propulsive energy for rendezvous maneuvers. It is suggested that throttleable engines be used when transferring a crew patient whose trauma could be exacerbated by excessive acceleration of the carrier vehicle.

  2. Emergency Department Overcrowding and Ambulance Turnaround Time.

    Science.gov (United States)

    Lee, Yu Jin; Shin, Sang Do; Lee, Eui Jung; Cho, Jin Seong; Cha, Won Chul

    2015-01-01

    The aims of this study were to describe overcrowding in regional emergency departments in Seoul, Korea and evaluate the effect of crowdedness on ambulance turnaround time. This study was conducted between January 2010 and December 2010. Patients who were transported by 119-responding ambulances to 28 emergency centers within Seoul were eligible for enrollment. Overcrowding was defined as the average occupancy rate, which was equal to the average number of patients staying in an emergency department (ED) for 4 hours divided by the number of beds in the ED. After selecting groups for final analysis, multi-level regression modeling (MLM) was performed with random-effects for EDs, to evaluate associations between occupancy rate and turnaround time. Between January 2010 and December 2010, 163,659 patients transported to 28 EDs were enrolled. The median occupancy rate was 0.42 (range: 0.10-1.94; interquartile range (IQR): 0.20-0.76). Overcrowded EDs were more likely to have older patients, those with normal mentality, and non-trauma patients. Overcrowded EDs were more likely to have longer turnaround intervals and traveling distances. The MLM analysis showed that an increase of 1% in occupancy rate was associated with 0.02-minute decrease in turnaround interval (95% CI: 0.01 to 0.03). In subgroup analyses limited to EDs with occupancy rates over 100%, we also observed a 0.03 minute decrease in turnaround interval per 1% increase in occupancy rate (95% CI: 0.01 to 0.05). In this study, we found wide variation in emergency department crowding in a metropolitan Korean city. Our data indicate that ED overcrowding is negatively associated with turnaround interval with very small practical significance.

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

    Science.gov (United States)

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

    2016-01-01

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

  4. 42 CFR 414.617 - Transition from regional to national ambulance fee schedule.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Transition from regional to national ambulance fee... SERVICES Fee Schedule for Ambulance Services § 414.617 Transition from regional to national ambulance fee... the ground ambulance base rate is subject to a floor amount determined by establishing nine fee...

  5. 42 CFR 414.620 - Publication of the ambulance fee schedule.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Publication of the ambulance fee schedule. 414.620... Ambulance Services § 414.620 Publication of the ambulance fee schedule. Changes in payment rates resulting... to the fee schedule for ambulance services that result from any factors other than the inflation...

  6. Using Discrete Event Simulation To Analyze Personnel Requirements For The Malaysian Armys New Utility Helicopter Fleet

    Science.gov (United States)

    2016-06-01

    Government. IRB Protocol number ____N/A____. 12a. DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution is unlimited 12b...personnel transport, air ambulance services, firefighting, and search and rescue. Figure 1. Agusta A109 LOH Source: A. Westland. Agusta A109LOH

  7. A symbiotic relationship: Norwegian diplomacy and Norwegian journalism on war and peace in Guatemala

    Directory of Open Access Journals (Sweden)

    Roy Krøvel

    2011-04-01

    Full Text Available This article deals with Norwegian journalism on the Guatemalan civil war and the peace process from 1990 to 1997. The author has examined all documents regarding the peace process in Guatemala registered in the archive of the Norwegian Ministry of Foreign Affairs from the late 1980s to 1995 and interviewed most of the relevant Norwegian and Guatemalan sources. The results of the study show that Norwegian sources consistently dominated the reporting on Guatemala. The constructed understandings of Norwegian engagement with war and peace in Guatemala resonated with deep sentiments within Norwegian society. Norwegian journalists came to rely heavily on Norwegian diplomats and facilitators, not only for information, but also for the interpretation of the information.

  8. A symbiotic relationship: Norwegian diplomacy and Norwegian journalism on war and peace in Guatemala

    OpenAIRE

    Roy Krøvel

    2011-01-01

    This article deals with Norwegian journalism on the Guatemalan civil war and the peace process from 1990 to 1997. The author has examined all documents regarding the peace process in Guatemala registered in the archive of the Norwegian Ministry of Foreign Affairs from the late 1980s to 1995 and interviewed most of the relevant Norwegian and Guatemalan sources. The results of the study show that Norwegian sources consistently dominated the reporting on Guatemala. The constructed understand...

  9. Norwegian Petroleum Policy; Norsk petroleumspolitikk

    Energy Technology Data Exchange (ETDEWEB)

    Froeiland, Ranveig

    1997-12-31

    This presentation discusses the environment, the petroleum fortune and future generations, licence policy, and regional issues. A principal aim for the Norwegian government is to combine the role as a major energy producer with the desire to be a leading country in environmental issues. Norway is now a major oil and gas producer that produces effectively, profitably and more environmentally friendly than other petroleum countries. The MILJOESOK process was started to strengthen the cooperation between Norwegian authorities and the industry in the environmental sector. The emissions of greenhouse gases per unit produced have been reduced. The emissions to sea of oil and chemicals are also being reduced. Another principle aim is that the oil and gas resources should give the highest possible value creation and secure welfare and employment. With the present production level the reserves of oil will last for 15 years and the reserves of gas for 110 years. The state income generated by the petroleum production is expected to peak around the turn of the millennium, then to decline gradually toward 2050. The petroleum fund is established to be a buffer till long into the future. In 2010, the yield from this fund is expected to be twice the amount of oil money used over the state budget today. Compared with the UK, Norway has chosen to exploit the resources in a step by step fashion at a moderate rate. This policy can be seen in the granting of concession. New concessions will be granted at a rate suitable for smoothing out the activity level and strengthening onshore employment. The North Sea, the Norwegian Sea and the Barents Sea are quite different as to mapping and maturity and hence require different concession policies. The new deep-sea fields in the Norwegian Sea offer technological challenges and it is important that offshore activities in this area create opportunities for regional development on land

  10. BALANCING AMBULANCE CREW WORKLOADS VIA A TIERED DISPATCH POLICY

    National Research Council Canada - National Science Library

    Li, Xun; Saydam, Cem

    2016-01-01

    ... relocations to ensure high demand zones are covered adequately. In this paper we propose a tiered dispatch policy to balance the ambulance crew workloads while meeting fast response times for priority 1 calls...

  11. Would You Feel Safe in A Driverless Ambulance?

    Science.gov (United States)

    ... configuration, while they had mixed feelings about the autopilot configuration," said Rice, an associate professor of human ... people's emotional responses to it because ambulances on autopilot aren't a part of our everyday lives ...

  12. Superior Ambulance Call Out Rate Forecasting Using Meteorological Data

    Science.gov (United States)

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

    2015-12-01

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

  13. Cardiac arrest: comparison of paramedic and conventional ambulance services.

    OpenAIRE

    1983-01-01

    A prospective study conducted in the Greater Vancouver area compared survival rates in prehospital cardiac arrest managed by an advanced life support (paramedic) service with those in cardiac arrest managed by conventional ambulance service. Management by the paramedic service was associated with higher survival rates for patients found in cardiac arrest but not for patients who suffered the arrest while the ambulance was present. Cardiopulmonary resuscitation by bystanders was associated wit...

  14. Ambulance referral for emergency obstetric care in remote settings.

    Science.gov (United States)

    Tsegaye, Ademe; Somigliana, Edgardo; Alemayehu, Tadesse; Calia, Federico; Maroli, Massimo; Barban, Paola; Manenti, Fabio; Putoto, Giovanni; Accorsi, Sandro

    2016-06-01

    To evaluate the functionality of an ambulance service dedicated to emergency obstetric care (EmOC) that referred pregnant women to health centers for delivery assistance or to a hospital for the management of obstetric complications. A retrospective study investigated an ambulance referral system for EmOC in a rural area of Ethiopia between July 1 and December 31, 2013. The service was available 24h a day and was free of charge. Women requesting referral were transported to nearby health centers. Assistance was provided locally for uncomplicated deliveries. Women with obstetric complications were referred from health centers to a hospital. A total of 528 ambulance referrals were recorded. The majority of patients (314 [59.5%]) were transported from villages to health centers. The remaining individuals were brought to a hospital, having been referred from health centers (179 [33.9%]) or were referred directly from villages owing to hospital proximity (35 [6.6%]). Of the 179 patients referred to the hospital from health centers, 84 (46.9%) were diagnosed with major direct obstetric complications. No maternal deaths were recorded among patients using the ambulance service. The cost of the ambulance service was US$ 18.47 per referred patient. An ambulance service dedicated to EmOC that interconnected health centers and a hospital facilitated referrals and better utilized local resources. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Should parents accompany pediatric interfacility ground ambulance transports? The parent's perspective.

    Science.gov (United States)

    Woodward, G A; Fleegler, E W

    2000-12-01

    Parental accompaniment can be a positive experience for the parent and the patient, as perceived by the parent. It can also be accomplished effectively without hindering the delivery of intratransport medical care by a nurse/nurse or nurse/physician transport team. This survey, along with the responses from other parents, led our team to adopt the position that a parent is welcome and encouraged to accompany the transport team if he or she wishes to. The team has recognized the importance of the family unit during the stressful period surrounding an acute medical issue and interfacility transport. The transport team reserves the option to ask that a parent not ride along if they suspect the parent might not function as a supportive team member (ie, the parent is belligerent, inebriated, or hostile). The parent normally rides in the passenger seat of the ambulance, and we encourage him or her to interact with the patient as much as possible. Occasionally parents ride in the back of the ambulance if the patient's situation allows for that option (ie, no anticipated need for potential interventions, number of team personnel, etc.).

  16. Mechanical versus manual chest compression CPR under ground ambulance transport conditions.

    Science.gov (United States)

    Fox, Julia; Fiechter, René; Gerstl, Peter; Url, Alfons; Wagner, Heinz; Lüscher, Thomas F; Eriksson, Urs; Wyss, Christophe A

    2013-03-01

    Novel mechanical chest compression devices offer the possibility to transport cardiac arrest patients with ongoing CPR and might shorten significantly the time delay to post-resuscitation care. We simulated an eight-minute cardiac resuscitation situation during ambulance transport using CPR training manikins. We compared teams consisting of two experienced resuscitators with the performance of a mechanical chest compression device (LUCAS). CPR-performance by two experienced resuscitators demonstrated ambivalent results. Whereas mean compression rate was within the recommended range (103/min, 95% CI: 93-113/min), mean compression depth was closely below the actually recommended compression depth of >5 cm (49.7 mm, 95% CI: 46.1-53.3mm). Nevertheless, only a mean of two thirds (67%) of all compressions were classified as manually correct (defined as sternal compression depth >5 cm). In contrast, the LUCAS device showed a constant and reliable CPR performance (99.96% correctly applied chest compressions correctly applied within the device programmed parameters, P = 0.0162) with almost no variance between the different sequences. The LUCAS CPR device represents a reliable alternative to manual CPR in a moving ambulance vehicle during emergency evacuation. Furthermore, it needs less human resources and is safer for the EMS personnel.

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

    Data.gov (United States)

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    OBJECTIVE: The objective of this study was to evaluate the prediction of ambulation in adults with myelomeningocele from muscle strength testing and ambulation in early life. MATERIALS AND METHODS: Fifty-two myelomeningocele (MMC) individuals at the age 18-37 years at follow-up were studied...... with muscle strength within the first year of life, 7 achieved the predicted ambulatory function, 6 had a better, and 7 a poorer function. Of 32 individuals with known muscle strength at the age of 5-8 years, 10 had function as predicted, 5 a better ambulatory function, and 17 had a poorer ambulation in adult...... life than predicted. Good strength in quadriceps muscles gave significant better prospect for adult walking. Of the 52 participants, 41 retained their ambulation status from 5-8 years of age. CONCLUSION: For MMC individuals with motor levels L3-L5, adult ambulatory function cannot be determined from...

  19. The effect of an ambulance diversion ban on emergency department length of stay and ambulance turnaround time.

    Science.gov (United States)

    Burke, Laura G; Joyce, Nina; Baker, William E; Biddinger, Paul D; Dyer, K Sophia; Friedman, Franklin D; Imperato, Jason; King, Alice; Maciejko, Thomas M; Pearlmutter, Mark D; Sayah, Assaad; Zane, Richard D; Epstein, Stephen K

    2013-03-01

    Massachusetts became the first state in the nation to ban ambulance diversion in 2009. It was feared that the diversion ban would lead to increased emergency department (ED) crowding and ambulance turnaround time. We seek to characterize the effect of a statewide ambulance diversion ban on ED length of stay and ambulance turnaround time at Boston-area EDs. We conducted a retrospective, pre-post observational analysis of 9 Boston-area hospital EDs before and after the ban. We used ED length of stay as a proxy for ED crowding. We compared hospitals individually and in aggregate to determine any changes in ED length of stay for admitted and discharged patients, ED volume, and turnaround time. No ED experienced an increase in ED length of stay for admitted or discharged patients or ambulance turnaround time despite an increase in volume for several EDs. There was an overall 3.6% increase in ED volume in our sample, a 10.4-minute decrease in length of stay for admitted patients, and a 2.2-minute decrease in turnaround time. When we compared high- and low-diverting EDs separately, neither saw an increase in length of stay, and both saw a decrease in turnaround time. After the first statewide ambulance diversion ban, there was no increase in ED length of stay or ambulance turnaround time at 9 Boston-area EDs. Several hospitals actually experienced improvements in these outcome measures. Our results suggest that the ban did not worsen ED crowding or ambulance availability at Boston-area hospitals. Copyright © 2012. Published by Mosby, Inc.

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

    Science.gov (United States)

    Ebben, Remco H A; Vloet, Lilian C M; van Grunsven, Pierre M; Breeman, Wim; Goosselink, Ben; Lichtveld, Rob A; Mintjes-De Groot, Joke A J; van Achterberg, Theo

    2015-06-01

    Adherence to prehospital guidelines and protocols is suboptimal. Insight into influencing factors is necessary to improve adherence. The aim of this study was to identify factors that influence ambulance nurses' adherence to a National Protocol Ambulance Care (NPAC). A questionnaire was developed using the literature, a questionnaire and expert opinion. Ambulance nurses (n=452) from four geographically spread emergency medical services (EMSs) in the Netherlands were invited to fill out the questionnaire. The questionnaire included questions on influencing factors and self-reported adherence. Questionnaires were returned by 248 (55%) of the ambulance nurses. These ambulance nurses' adherence to the NPAC was 83.4% (95% confidence interval 81.9-85.0). Bivariate correlations showed 23 influencing factors that could be related to the individual professional, organization, protocol characteristics and social context. Multilevel regression analysis showed that 21% of the variation in adherence (R=0.208) was explained by protocol characteristics and social influences. Ambulance nurses' self-reported adherence to the NPAC seems high. To improve adherence, protocol characteristics (complexity, the degree of support for diagnosis and treatment, the relationship of the protocol with patient outcomes) and social influences (expectance of colleagues to work with the national protocol) should be addressed.

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

    Science.gov (United States)

    Vloet, Lilian C.M.; van Grunsven, Pierre M.; Breeman, Wim; Goosselink, Ben; Lichtveld, Rob A.; Mintjes-De Groot, Joke A.J.; van Achterberg, Theo

    2015-01-01

    Objectives Adherence to prehospital guidelines and protocols is suboptimal. Insight into influencing factors is necessary to improve adherence. The aim of this study was to identify factors that influence ambulance nurses’ adherence to a National Protocol Ambulance Care (NPAC). Methods A questionnaire was developed using the literature, a questionnaire and expert opinion. Ambulance nurses (n=452) from four geographically spread emergency medical services (EMSs) in the Netherlands were invited to fill out the questionnaire. The questionnaire included questions on influencing factors and self-reported adherence. Results Questionnaires were returned by 248 (55%) of the ambulance nurses. These ambulance nurses’ adherence to the NPAC was 83.4% (95% confidence interval 81.9–85.0). Bivariate correlations showed 23 influencing factors that could be related to the individual professional, organization, protocol characteristics and social context. Multilevel regression analysis showed that 21% of the variation in adherence (R2=0.208) was explained by protocol characteristics and social influences. Conclusion Ambulance nurses’ self-reported adherence to the NPAC seems high. To improve adherence, protocol characteristics (complexity, the degree of support for diagnosis and treatment, the relationship of the protocol with patient outcomes) and social influences (expectance of colleagues to work with the national protocol) should be addressed. PMID:24595355

  2. Comparison of ambulance dispatch protocols for nontraumatic abdominal pain.

    Science.gov (United States)

    Lammers, R L; Roth, B A; Utecht, T

    1995-11-01

    To compare rates of undertriage and overtriage of six ambulance dispatch protocols for the presenting complaint of nontraumatic abdominal pain, and to identify the optimal protocol. Retrospective prehospital and emergency department chart review to classify patients' conditions as "emergency" or "nonemergency." Utility analysis was used to identify the preferred protocol and monetary cost-effectiveness analysis to identify the least expensive protocol. County emergency medical services (EMS) system with five receiving hospitals serving a mainly urban population of approximately 350,000. Records of 902 patients who called 911 for nontraumatic abdominal pain were reviewed; patients not transported were excluded. Twenty-seven county EMS medical directors completed questionnaires. Six ambulance dispatch protocols for nontraumatic abdominal pain were developed: indiscriminate-dispatch, four selective protocols, and no-dispatch. A dichotomous classification system was derived prospectively from the prehospital and medical records of patients who had activated the EMS system before the study period to define "emergency" and "nonemergency" conditions associated with nontraumatic abdominal pain. Emergency criteria identified patients with conditions requiring medical treatment within 1 hour. Reviewers determined, for each patient, whether an ambulance would have been dispatched by each of the protocols. Undertriage and overtriage rates were calculated for each protocol. County EMS medical directors assigned utility values to four potential outcomes of ambulance dispatch by the direct scaling method. The outcomes comprised correct and incorrect decisions to dispatch ambulances to patients with and without emergencies. The protocols were compared by decision analysis. A cost analysis was also performed, using an estimated marginal cost per transport of $302. Sensitivity analysis demonstrated the effect of varying the cost of an undertriage error and the cost per response. Of

  3. The Technical Student Programme draws Norwegians

    CERN Multimedia

    Maria Martin Sanchez

    2005-01-01

    Erik Hejne, second from left, Chairman of the Technical Students Committee, and Jens Vigen, who is concerned spefically with Norwegian students at CERN, with some of the Norwegian technical students who arrived at CERN in spring 2005, together with their teachers.

  4. Can Parallelingualism Save Norwegian from Extinction?

    Science.gov (United States)

    Linn, Andrew R.

    2010-01-01

    Language extinction is one of the most pressing issues in linguistics today, and the literature is full of discussion about how to combat it. Statements that Norwegian is amongst the languages that are already extinct are merely examples of a widespread tendency in the literature towards erroneous information about Norwegian. Nonetheless, there is…

  5. Homotolerance and Heterosexuality as Norwegian Values

    Science.gov (United States)

    Rothing, Ase; Svendsen, Stine Helena Bang

    2010-01-01

    In recent years, equality between homosexual and heterosexual relationships has increasingly been presented as a marker for Norwegian values. Norwegian schooling encourages tolerance toward homosexuals, and the state shows active interest in counteracting bullying against LGBT (lesbian, gay, bisexual, and transgender) youth by supporting research…

  6. Homotolerance and Heteronormativity in Norwegian Classrooms

    Science.gov (United States)

    Rothing, Ase

    2008-01-01

    This article is based on classroom observations and discusses sexual education that addresses homosexuality. Tolerance of queer lifestyles as well as support for judicial equality between heterosexual and homosexual couples is generally perceived as being high in the Norwegian political context. Norwegian sexual politics is, however, based on a…

  7. Homotolerance and Heterosexuality as Norwegian Values

    Science.gov (United States)

    Rothing, Ase; Svendsen, Stine Helena Bang

    2010-01-01

    In recent years, equality between homosexual and heterosexual relationships has increasingly been presented as a marker for Norwegian values. Norwegian schooling encourages tolerance toward homosexuals, and the state shows active interest in counteracting bullying against LGBT (lesbian, gay, bisexual, and transgender) youth by supporting research…

  8. Stereotypes of Norwegian social groups.

    Science.gov (United States)

    Bye, Hege H; Herrebrøden, Henrik; Hjetland, Gunnhild J; Røyset, Guro Ø; Westby, Linda L

    2014-10-01

    We present a pilot study and two main studies that address the nature of stereotypes of social groups in Norway within the framework of the Stereotype Content Model (SCM). The first study focused on stereotypes of a wide range of groups across categories such as gender, age, religious conviction, socioeconomic and health status. The second study focused on stereotypes of immigrant groups. Participants (n = 244 and n = 63, respectively) rated the groups on perceived warmth, competence, status, and competition. Results from both studies support the applicability of the SCM in Norway and provides a unique insight into stereotypes of Norwegian social groups.

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

    Directory of Open Access Journals (Sweden)

    Baba M. DEROS

    2016-03-01

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

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

    CERN Multimedia

    2000-01-01

    The arrival of a new vehicle is always an important moment in the life of a fire station. So when a new ambulance was delivered to the CERN Fire Brigade on Wednesday 16 September 2000, it was given a warm welcome, attended by staff of the different divisions involved in its purchase. It took a year from the first administrative moves to the day of acquisition. On the one hand there were the calls for tender needed for such a purchase and on the other the development of this custom-designed ambulance with its unique features. Three visits to the manufacturer had to be made, including two to the head office of the Miesen factory at Bonn to study and incorporate in the ambulance the special requirements called for by its future users. These requirements, born from the past experience of CERN’s ambulance crews, concerned not only interior arrangements but also included a new side panel, opening up a stowage compartment where everything will be put that gets dirty during ambulance operations. This will minimize ...

  11. Moral distress among Norwegian doctors.

    Science.gov (United States)

    Førde, R; Aasland, O G

    2008-07-01

    Medicine is full of value conflicts. Limited resources and legal regulations may place doctors in difficult ethical dilemmas and cause moral distress. Research on moral distress has so far been mainly studied in nurses. To describe whether Norwegian doctors experience stress related to ethical dilemmas and lack of resources, and to explore whether the doctors feel that they have good strategies for the resolution of ethical dilemmas. Postal survey of a representative sample of 1497 Norwegian doctors in 2004, presenting statements about different ethical dilemmas, values and goals at their workplace. The response rate was 67%. 57% admitted that it is difficult to criticize a colleague for professional misconduct and 51% for ethical misconduct. 51% described sometimes having to act against own conscience as distressing. 66% of the doctors experienced distress related to long waiting lists for treatment and to impaired patient care due to time constraints. 55% reported that time spent on administration and documentation is distressing. Female doctors experienced more stress that their male colleagues. 44% reported that their workplace lacked strategies for dealing with ethical dilemmas. Lack of resources creates moral dilemmas for physicians. Moral distress varies with specialty and gender. Lack of strategies to solve ethical dilemmas and low tolerance for conflict and critique from colleagues may obstruct important and necessary ethical dialogues and lead to suboptimal solutions of difficult ethical problems.

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

    DEFF Research Database (Denmark)

    Hansen, Claus D.

    2013-01-01

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

  13. Norwegian climate research. An evaluation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-06-15

    [English] In early 2011, the Norwegian Research Council (RCN) appointed a committee to review Norwegian climate research. The aim of the evaluation was to provide a critical review of Norwegian climate research in an international perspective and to recommend measures to enhance the quality, efficiency and relevance of future climate research. The Evaluation Committee met three times: in August and December 2011, and March 2012. RCN sent an invitation to 140 research organisations to participate by delivering background information on their climate research. Based on the initial response, 48 research units were invited to submit self-assessments and 37 research units responded. These were invited to hearings during the second meeting of the Evaluation Committee in December. In our judgement, a great majority of the most active research units are covered by this evaluation report. It should be emphasised that the evaluation concerned the Norwegian landscape of climate research rather than individual scientists or research units. Bibliometric analyses and social network analyses provided additional information. We are aware of problems in making comparisons across disciplinary publishing traditions, especially with regard to the differences between the natural and social sciences and the humanities. The Evaluation Committee also reviewed a number of governmental and RCN policy documents and conducted interviews with the chairs of the NORKLIMA Programme Steering Board and the Norwegian IPY Committee, as well as with staff members of RCN. Additional information was received from hearings organised by RCN with the science communities and various stakeholders in January 2012. For the purpose of this evaluation, climate research was divided into three broad thematic areas: 1. The climate system and climate change: research on climate variability and change in order to improve our capability of understanding climate and of projecting climate change for different time

  14. Ambulance use in Pakistan: an analysis of surveillance data from emergency departments in Pakistan.

    Science.gov (United States)

    Zia, Nukhba; Shahzad, Hira; Baqir, Syed; Shaukat, Shahab; Ahmad, Haris; Robinson, Courtland; Hyder, Adnan A; Razzak, Junaid

    2015-01-01

    The utilization of ambulances in low- and middle-income countries is limited. The aim of this study was to ascertain frequency of ambulance use and characteristics of patients brought into emergency departments (EDs) through ambulance and non-ambulance modes of transportation. The Pakistan National Emergency Departments Surveillance (Pak-NEDS) was a pilot active surveillance conducted in seven major tertiary-care EDs in six main cities of Pakistan between November 2010 and March 2011. Univariate and multivariate logistic regression was performed to investigate the factors associated with ambulance use. Out of 274,436 patients enrolled in Pak-NEDS, the mode of arrival to the ED was documented for 94. 9% (n = 260,378) patients, of which 4.1% (n = 10,546) came to EDs via ambulances. The mean age of patients in the ambulance group was significantly higher compared to the mean age of the non-ambulance group (38 ± 18.4 years versus 32.8 ± 14.9 years, p-value ambulance group was head injury (12%) while among non-ambulance users it was fever (12%). Patients of all age groups were less likely to use an ambulance compared to those >45 years of age (p-value ambulances for those with injuries was 3.5 times higher than those with non-injury complaints (p-value ambulance were 7.2 times more likely to die in the ED than non-ambulance patients after adjustment for other variables in the model. Utilization of ambulances is very low in Pakistan. Ambulance use was found to be more among the elderly and those presenting with injuries. Patients presenting via ambulances were more likely to die in the ED.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  16. Community-acquired pneumonia; Ambulant erworbene Pneumonien

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-15

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

  17. Face Arm Speech Time Test use in the prehospital setting, better in the ambulance than in the emergency medical communication center.

    Science.gov (United States)

    Berglund, Annika; Svensson, Leif; Wahlgren, Nils; von Euler, Mia

    2014-01-01

    Prehospital identification of acute stroke increases the possibility of early treatment and good outcome. To increase identification of stroke, the Face Arm Speech Time (FAST) test was introduced in the Emergency Medical Communication Center (EMCC). This substudy aims to evaluate the implementation of the FAST test in the EMCC and the ambulance service. The study was conducted in the region of Stockholm, Sweden during 6 months. The study population consisted of all calls to the EMCC concerning patients presenting at least one FAST symptom or a history/finding making the EMCC or ambulance personnel to suspect stroke within 6 h. Positive FAST was compared to diagnosis at discharge. Positive predictive values (PPV) for a stroke diagnosis at discharge were calculated. In all, 900 patients with a median age of 71 years were enrolled, 667 (74%) by the EMCC and 233 (26%) by the ambulances. At discharge, 472 patients (52%) were diagnosed with stroke/transient ischemic attack (TIA), 337 identified by the EMCC (71%) and 135 (29%) by the ambulances. The PPV for a discharge diagnosis of stroke/TIA was 51% (CI 47-54%) in EMCC-enrolled and 58% (CI 52-64%) in ambulance-enrolled patients. With a positive FAST the PPV of a correct stroke/TIA diagnosis increased to 56% (CI 52-61%) and 73% (CI 66-80%) in EMCC- and ambulance-enrolled patients, respectively. Positive FAST from EMCC was also found in 44% of patients with a nonstroke diagnosis at discharge. A stroke/TIA diagnosis at discharge but negative FAST was found in 58 and 27 patients enrolled by the EMCC and ambulances, respectively. The PPV of FAST is higher when used on the scene by ambulance than by EMCC. FAST may be a useful prehospital tool to identify stroke/TIA but has limitations as the test can be negative in true strokes, can be positive in nonstrokes, and FAST symptoms may be present but not identified in the emergency call. For the prehospital care situation better identification tools are needed. © 2014 S. Karger AG

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

    Science.gov (United States)

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

    2013-06-06

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

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

    Science.gov (United States)

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

    2012-01-01

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

  20. Perspectives on Norwegian-Russian energy cooperation

    Energy Technology Data Exchange (ETDEWEB)

    Bourmistrov, Anatoli; Mellemvik, Frode; Vasiliev, Sergey Vasiliev (eds.)

    2011-07-01

    Review from publisher: Perspectives on Norwegian#Hyphen#Russian Energy Cooperation, September 2011 NAREC : Norwegian#Hyphen# Russian Education and Research Consortium for International Business Development in the field of Energy The book illustrates the kind of knowledge and competence possessed by the NAREC partner academic institutions: Part I highlights and discusses opportunities and barriers for the Norwegian#Hyphen#Russian energy cooperation in the High North. Part II considers and exemplifies the High North as an arena for increasing modernization and innovations. Part III devoted to advanced technologies for developing the High North.(Author)

  1. The Norwegian hydrogen guide 2010

    Energy Technology Data Exchange (ETDEWEB)

    2010-07-01

    Hydrogen technologies are maturing at rapid speed, something we experience in Norway and around the globe every day as demonstration projects for vehicles and infrastructure expand at a rate unthinkable of only a few years ago. An example of this evolution happened in Norway in 2009 when two hydrogen filling stations were opened on May the 11th, making it possible to arrange the highly successful Viking Rally from Oslo to Stavanger with more than 40 competing teams. The Viking Rally demonstrated for the public that battery and hydrogen-electric vehicles are technologies that exist today and provide a real alternative for zero emission mobility in the future. The driving range of the generation of vehicles put into demonstration today is more than 450 km on a full hydrogen tank, comparable to conventional vehicles. As the car industry develops the next generation of vehicles for serial production within the next 4-5 years, we will see vehicles that are more robust, more reliable and cost effective. Also on the hydrogen production and distribution side progress is being made, and since renewable hydrogen from biomass and electrolysis is capable of making mobility basically emission free, hydrogen can be a key component in combating climate change and reducing local emissions. The research Council of Norway has for many years supported the development of hydrogen and fuel cell technologies, and The Research Council firmly believes that hydrogen and fuel cell technologies play a crucial role in the energy system of the future. Hydrogen is a flexible transportation fuel, and offers possibilities for storing and balancing intermittent electricity in the energy system. Norwegian companies, research organisations and universities have during the last decade developed strong capabilities in hydrogen and fuel cell technologies, capabilities it is important to further develop so that Norwegian actors can supply high class hydrogen and fuel cell technologies to global markets

  2. Norwegian Ocean Observatory Network (NOON)

    Science.gov (United States)

    Ferré, Bénédicte; Mienert, Jürgen; Winther, Svein; Hageberg, Anne; Rune Godoe, Olav; Partners, Noon

    2010-05-01

    The Norwegian Ocean Observatory Network (NOON) is led by the University of Tromsø and collaborates with the Universities of Oslo and Bergen, UniResearch, Institute of Marine Research, Christian Michelsen Research and SINTEF. It is supported by the Research Council of Norway and oil and gas (O&G) industries like Statoil to develop science, technology and new educational programs. Main topics relate to ocean climate and environment as well as marine resources offshore Norway from the northern North Atlantic to the Arctic Ocean. NOON's vision is to bring Norway to the international forefront in using cable based ocean observatory technology for marine science and management, by establishing an infrastructure that enables real-time and long term monitoring of processes and interactions between hydrosphere, geosphere and biosphere. This activity is in concert with the EU funded European Strategy Forum on Research Infrastructures (ESFRI) roadmap and European Multidisciplinary Seafloor Observation (EMSO) project to attract international leading research developments. NOON envisions developing towards a European Research Infrastructure Consortium (ERIC). Beside, the research community in Norway already possesses a considerable marine infrastructure that can expand towards an international focus for real-time multidisciplinary observations in times of rapid climate change. PIC The presently established cable-based fjord observatory, followed by the establishment of a cable-based ocean observatory network towards the Arctic from an O&G installation, will provide invaluable knowledge and experience necessary to make a successful larger cable-based observatory network at the Norwegian and Arctic margin (figure 1). Access to large quantities of real-time observation from the deep sea, including high definition video, could be used to provide the public and future recruits to science a fascinating insight into an almost unexplored part of the Earth beyond the Arctic Circle

  3. Ambulance or taxi? High acuity prehospital transports in the Ashanti region of Ghana

    Directory of Open Access Journals (Sweden)

    C. Nee-Kofi Mould-Millman

    2014-03-01

    Conclusion: Although a minority of patients were transported by ambulance, they represented the most acute patients arriving at the KATH EC. Given the limited availability of EMS resources and ambulances in Ashanti, selective ambulance use appears warranted and should inform prehospital care planning.

  4. Managing stress in prehospital care: Strategies used by ambulance nurses.

    Science.gov (United States)

    Bohström, Dan; Carlström, Eric; Sjöström, Nils

    2017-05-01

    Ambulance nurses display stress symptoms, resulting from their work with patients in an emergency service. Certain individuals seem, however, to handle longstanding stress better than others and remain in exposed occupations such as ambulance services for many years. This paper examines stress inducing and stress defusing factors among ambulance nurses. A qualitative descriptive design using critical incident technique was used. A total of 123 critical incidents were identified, and a total of 61 strategies dealing with stress were confirmed. In all, 13 sub-categories (seven stress factors and five stress reducing factors) were merged into four categories (two stress categories and two stress reducing categories). The study shows that ambulance nurses in general experience emergency calls as being stressful. Unclear circumstances increase the stress level, with cases involving children and childbirth being especially stressful. Accurate information and assistance from the dispatch centre reduced the stress. Having discussions with colleagues directly after the assignment were particularly stress reducing. Advanced team collaboration with teammates was viewed as effective means to decrease stress, in addition to simple rituals to defuse stress such as taking short breaks during the workday. The study confirmed earlier studies that suggest the benefits of defusing immediately after stress reactions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Recommendations on ambulance cardiopulmonary resuscitation in basic life support systems.

    Science.gov (United States)

    Hock Ong, Marcus Eng; Shin, Sang Do; Sung, Soon Swee; Tanaka, Hideharu; Huei-Ming, Matthew; Song, Kyoung Jun; Nishiuchi, Tatsuya; Leong, Benjamin Sieu-Hon; Karim, Sarah Abdul; Lin, Chih-Hao; Ryoo, Hyun Wook; Ryu, Hyun Ho; Iwami, Taku; Kajino, Kentaro; Ko, Patrick Chow-In; Lee, Kyung Won; Sumetchotimaytha, Nathida; Swor, Robert; Myers, Brent; Mackey, Kevin; McNally, Bryan

    2013-01-01

    Cardiopulmonary resuscitation (CPR) during ambulance transport can be a safety risk for providers and can affect CPR quality. In many Asian countries with basic life support (BLS) systems, patients experiencing out-of-hospital cardiac arrest (OHCA) are routinely transported in ambulances in which CPR is performed. This paper aims to make recommendations on best practices for CPR during ambulance transport in BLS systems. A panel consisting of 20 experts (including 4 North Americans) in emergency medical services (EMS) and resuscitation science was selected, and met over two days. We performed a literature review and selected 33 candidate issues in five core areas. Using Delphi methodology, the issues were classified into dichotomous (yes/no), multiple choice, and ranking questions. Primary consensus between experts was reached when there was more than 70% agreement. Questions with 60-69% agreement were made more specific and were submitted for a second round of voting. The panel agreed upon 24 consensus statements with more than 70% agreement (2 rounds of voting). The recommendations cover the following: length of time on the scene; advanced airway at the scene; CPR prior to transport; rhythm analysis and defibrillation during transport; prehospital interventions; field termination of resuscitation (TOR); consent for TOR; destination hospital; transport protocol; number of staff members; restraint systems; mechanical CPR; turning off of the engine for rhythm analysis; alternative CPR; and feedback for CPR quality. Recommendations for CPR during ambulance transport were developed using the Delphi method. These recommendations should be validated in clinical settings.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  8. [Emergency ambulance call-outs often provide primary care

    NARCIS (Netherlands)

    Smits, M.; Francissen, O.; Weerts, M.; Janssen, K.; Grunsven, P. van; Giesen, P.

    2014-01-01

    OBJECTIVE: To examine patient and care characteristics of emergency ambulance call-outs and to determine how many of them were, in retrospect, effectively providing primary care. DESIGN: Retrospective cross-sectional study. METHOD: We charted patient and care characteristics of 598 emergency

  9. Mathematical model of ambulance resources in Saint-Petersburg

    Science.gov (United States)

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

    2016-06-01

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

  10. A biomechanical and subjective comparison of two powered ambulance cots.

    Science.gov (United States)

    Sommerich, Carolyn M; Lavender, Steven A; Radin Umar, Radin Zaid; Li, Jing; Park, SangHyun; Dutt, Mohini

    2015-01-01

    This study investigated biomechanical effects of different leg folding/unfolding mechanisms used for loading/unloading two powered cots (Cots A and B) into and from a simulated ambulance. Sixteen experienced emergency medical service (EMS) workers loaded and unloaded cots with weights of 45, 68 and 91 kg placed on the cots to simulate patients. Peak back and shoulder/arm muscle activity was reduced 52-87% when using Cot A in comparison to Cot B. Peak ground reaction force (PGRF) was reduced by 74% with Cot A. Adding weight resulted in increased muscle activity and PGRF when using Cot B, but had little effect when using Cot A. Task time was longer with Cot A, though was not perceived unfavourably by participants. This study confirmed that it is possible to substantially reduce physical stress imposed on EMS workers when loading and unloading a cot to and from an ambulance through improvements in cot design. This study compared two powered ambulance cots, one that lifts/lowers the front and rear wheels independently and one that lifts/lowers the four wheels simultaneously during ambulance loading and unloading. Measured muscle activity, ground reaction forces and operator perceptions support using cot designs that lift/lower the front and rear wheels independently.

  11. Characteristics of Fixed Wing Air Ambulance Transports in Victoria, Australia.

    Science.gov (United States)

    Delorenzo, Ashleigh J; Abetz, Jeremy W; Andrew, Emily; de Wit, Anthony; Williams, Brett; Smith, Karen

    Air medical transport is important for the transfer of patients in the prehospital and interhospital environment. Few studies have described the services provided by fixed wing ambulances or the broader clinical profiles of patients they transport. Such information may be useful for the planning and allocation of resources, assistance with training, and refining clinical protocols. We sought to describe the characteristics of patients transported by fixed wing aircraft at Air Ambulance Victoria (AAV) and the service AAV provides in Victoria, Australia. A retrospective data review of patients transported by AAV fixed wing aircraft between January 1, 2011, and June 30, 2015, was performed. Data were sourced from the Ambulance Victoria data warehouse. Retrievals involving physicians were excluded. A total of 16,579 patients were transported during the study period, with a median age of 66 years. Most patients were male (58.7%), and cardiovascular/hematologic conditions (27.2%) were most common. Overall, 51.7% of cases were prebooked routine transfers, 47.4% were interhospital routine transfers, and 0.9% were primary responses. Caseloads were largest in the regions furthest from the capital city. The AAV fixed wing service in Victoria enables regional and remote patients to be transported to definitive care without major disruption to ground ambulances. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  12. Marine Habitat Mapping for the Norwegian Sea

    OpenAIRE

    Noji, Thomas; Thorsnes, Terje; Fosså, Jan Helge

    2000-01-01

    An initiative is currently being taken by several Norwegian organizations to obtain funds to intensify ongoing investigations on marine sea-floor mapping off Norway. Led by the Geological Survey of Norway and Institute of Marine Research, planning during the last two years has led to the inception of a large-scale mapping project entitled “MAREANO - Marine Areal Database for the Norwegian Sea”. The investigation area covers 270 000 km2 of the shelf and deep sea off the central ...

  13. The efficiency of Norwegian road toll companies

    OpenAIRE

    Welde, Morten; Odeck, James

    2009-01-01

    This paper deals with the efficiency of Norwegian toll companies. Efficiency and productivity are compared using different efficiency measurement approaches. The focus of the paper is to demonstrate differences in efficiency and productivity among Norwegian toll companies employing methodologies such as Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA). DEA and SFA both represent alternative methods of estimating frontier functions and measuring efficiency of ...

  14. Fact sheet. Norwegian petroleum activity 1996

    Energy Technology Data Exchange (ETDEWEB)

    Westgaard, T. [ed.

    1996-02-01

    The present report from the Royal Ministry of Industry and Energy deals with the Norwegian petroleum activity. Main topics are as follow: Historical overview; state organisation of petroleum activities; the economic impact of Norwegian oil and gas; state revenues; mainland activities; petroleum resources; production; marketing situation for petroleum products; environmental aspects; the legal and licence framework; licensing rounds; exploration; fields in production; fields under development; discoveries with development plan under consideration; transportation systems; licence interests; company interests. 36 refs., 24 figs., 15 tabs.

  15. Using ambulance data to reduce community violence: critical literature review.

    Science.gov (United States)

    Taylor, Alexander; Boyle, Adrian; Sutherland, Alex; Giacomantonio, Chris

    2016-08-01

    Previous work has demonstrated that much violence requiring medical help is not recorded by the police. Sharing emergency department data on victims of violence is associated with reductions in community violence and is well established throughout the UK. We undertook a critical literature review to determine whether sharing ambulance data was useful to identify violence hotspots and offered unique information for violence prevention. A search of the major medical and criminological databases was undertaken using search terms related to the ambulance service, violence and assault, as well as data collection. The search was conducted within the NICE Evidence, Cochrane Library, Google Scholar, Criminal Justice Abstracts, Scopus and National Criminal Justice Reference Service databases, along with the websites of various relevant institutions. Overall, 36 papers were identified by abstract scanning and bibliography search, of which 10 were considered relevant. A further nine papers were detected in the grey literature, and two were considered to be useful in providing evidence for use of ambulance data in violence surveillance. Two of the identified papers were interventional studies, and the other 10 were observational studies. Although the standard of evidence was generally low, most studies demonstrated that ambulance services detected a substantial proportion of assaults that were not recorded by the police or the emergency departments. We identified only two interventional studies, but they were of low quality. Although the interventional evidence base is currently weak, ambulance data provide a unique source of information about the epidemiology of community violence and have the potential to improve current violent crime surveillance methods.

  16. Physical stressors during neonatal transport: helicopter compared with ground ambulance.

    Science.gov (United States)

    Bouchut, Jean-Christophe; Van Lancker, Eric; Chritin, Vincent; Gueugniaud, Pierre-Yves

    2011-01-01

    This study was undertaken to assess concurrent mechanical stresses from shock, vibration, and noise to which a critically ill neonate is exposed during emergency transfer. For neonates transported by a French specialized emergency medical service, we measured and analyzed 27 physical parameters recorded during typical transport by ambulance and by helicopter. The noninvasive sensors were placed to allow better representation of the exposure of the newborn to the physical constraints. Based on 10 hours of transport by ambulance and 2 hours by helicopter, noise, whole body vibration, rate of turn, acceleration, and pitch were extracted as the five most representative dynamic harshness indicators. A helicopter produces a higher-level but more stable (lower relative dispersion) whole body dynamic exposure than an ambulance, with a mean noise level of 86 ± 1 dBA versus 67 ± 3 dBA, mean whole body vibration of 1 ± 0.1 meter per second squared (m/s(2)) versus 0.4 6 0.2 m/s(2), and acceleration of 1 6 0.05 m/s(2) versus 0.4 6 0.1 m/s(2). A ground ambulance has many more dynamic effects in terms of braking, shock, and impulsive noise than a helicopter (1 impulsive event per 2 minutes vs. 1 per 11 minutes). Our results show significant exposure of the sick neonate to both stationary and impulsive dynamic physical stressors during transportation, particularly in a ground ambulance. The study suggests opportunities to reduce physical stressors during neonatal transport. Copyright © 2011 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-11-01

    Among Hungary's health sector workers the presence of a high level of stress is known, which can affect the individual. The aim of the authors was to uncover major risk factors causing work-related stress, as well as its extent, and positive and negative coping strategies among ground and aerial rescue workers. From June until October 2015, a national survey was conducted among Hungarian rescue workers. An own questionnaire and Rahe Stress and coping validated short questionnaire online form were used. A total of 141 persons took part in the survey. As compared to air-ambulance workers, ground rescue workers were exposed to higher work-related stress effects (p<0.01), resulting in a much larger variety of physical and psychological symptoms (p<0.05). Based on Global Stress and Coping Index effective coping mechanisms were observed among air rescue workers (p<0.01). It is important to perform regular professional theoretical and practical training. Human resource management should pay attention on occupational stress reduction. Orv. Hetil., 2016, 157(45), 1802-1808.

  18. The School Personnel Administrator.

    Science.gov (United States)

    Knox, Rodney F.

    This paper provides an overview of the development of the school-personnel administrator role. It first describes the influence of the science-management and human-relations movements and the behavioral sciences on personnel administration and human resource management. It next discusses the role of the personnel-performance-appraisal system and…

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

    Science.gov (United States)

    Krause, James S.

    2010-01-01

    The author compares current employment status after spinal cord injury between participants who were independent in ambulation (required no assistance from others) and those who were dependent in ambulation (required assistance from at least one other person to ambulate). Those who were independent of assistance from others in ambulation were…

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

    Science.gov (United States)

    Krause, James S.

    2010-01-01

    The author compares current employment status after spinal cord injury between participants who were independent in ambulation (required no assistance from others) and those who were dependent in ambulation (required assistance from at least one other person to ambulate). Those who were independent of assistance from others in ambulation were…

  1. Impacts of temperature change on ambulance dispatches and seasonal effect modification

    Science.gov (United States)

    Cheng, Jian; Xu, Zhiwei; Zhao, Desheng; Xie, Mingyu; Yang, Huihui; Wen, Liying; Li, Kesheng; Su, Hong

    2016-12-01

    Ambulance dispatch is a proxy of acute health outcomes, and growing epidemiological evidence documented its relation to extreme temperature events. Research, however, on short-term temperature change and ambulance dispatches is scarce. We aimed to investigate the effect of short-term temperature change on ambulance dispatches and potential modification by season. Daily data on ambulance dispatch and weather factors were collected in Huainan, a Chinese inland city from December 2011 through December 2013. A Poison generalized linear regression model combined with distributed lag nonlinear model was constructed to examine the association of temperature change between neighboring days (TCN) with ambulance dispatches. The effect modification by season was also examined. There were 48,700 ambulance attendances during the study period. A statistically significant association of TCN with ambulance dispatches was observed. Temperature rise between neighboring days (TCN > 0) was associated with elevated adverse risk of ambulance dispatches, and the effects appeared to be acute (lag0, on the current day) and could last for at least a week, while temperature drop between neighboring days (TCN ambulance dispatches increased by 2 % (95 % CI 1-3 %) and 7 (95 % CI 1-13 %), respectively. Extreme TCN increase (95th percentile, 3.3 °C vs. 0 °C) at lag0 and lag05 was accompanied by 6 (95 % CI 3-8 %) and 27 % (95 % CI 12-44 %) increase in ambulance dispatches. Ambulance dispatches were more vulnerable to extremely great temperature rise in summer and autumn. TCN was adopted for the first time to quantify the impact of short-term temperature change on ambulance dispatches. Temperature drop between neighboring days (TCN ambulance dispatches, while temperature rise between neighboring days (TCN > 0) could acutely trigger the increase in ambulance dispatches, and TCN effect differs by season.

  2. Personnel preferences in personnel planning and scheduling

    OpenAIRE

    Veen, van der, M.Q.

    2013-01-01

    The personnel of an organization often has seemingly conflicting goals. On the one hand, the common goal is to achieve operational efficiency and to be available for work when needed in the organization. On the other hand, individual employees like to have a good work-life balance, by having personal working hour preferences taken into account. We develop and apply Operations Research methods and tools and show that operational efficiency can be achieved while taking personnel preferences int...

  3. Norwegian midwives' perceptions of empowerment.

    Science.gov (United States)

    Lukasse, Mirjam; Pajalic, Zada

    2016-03-01

    Midwives are educated to care for women during pregnancy, birth and the postnatal period. For midwives to be able to fulfill their professional role they need to be empowered to do so. To investigate Norwegian midwives' perception of empowerment in practice. A cross-sectional study. In September 2014, a random sample of 1500 midwives was sent a questionnaire, which included the Perception of Empowerment in Midwifery Practice Scale (PEMS). Of 1458 eligible midwives, 595 (41%) completed the PEMS. Exploratory factor analyses and comparative analyses were done. Exploratory factor analyses identified three factors (subscales): Supportive management, Autonomous professional role, and Equipped for practice. Midwives working in a hospital setting scored significantly lower on the factors Supportive management and Autonomous professional role compared to midwives not working in a hospital setting (p empowerment at work differed according to midwives' education, role at work, duration of work experience, working situation and environment. This study supports the psychometric qualities of the PEMS. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Facts 2000. The Norwegian Petroleum Sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-02-01

    Petroleum production on the Norwegian continental shelf (NCS) in the North Sea, the Norwegian Sea and the Barents Sea totalled 2.7 bn scm oil equivalents (oe) up to 1998. Per December 1999, remaining reserves totalled 1.5 bn scm of oil, 1.2 bn scm oe gas and 0.2 bn scm oe of NGL/condensate. Twenty-eight exploration wells were completed or temporarily abandoned on the NCS in 1999. By 31 December 1999, 967 exploration wells had been completed or temporarily abandoned off Norway. Discoveries totalled 45-60 mill scm of oil and 45-70 bn scm of gas. Governmental approval was given in 1999 for the Tune, Borg and Sygna developments. Investment in exploration, field development and pipeline transport totalled about NOK 67 bn in 1998. Oil and gas production in 1999 was roughly on the par with 1998, while NGL/condensate sales rose by 19 per cent. The Balder, Gullfaks South, Jotun, Oseberg East, Visund and Aasgard projects came on stream during 1999. It is estimated that, with the present production rate, Norway's remaining discovered oil resources will last for 17 years, and gas, 93 years. The estimated value of Norwegian petroleum export in 1999 was NOK 168 bn, which is about 36% of the country's total earnings from foreign sales. Published by the Norwegian Ministry of Petroleum and Energy, the book is a major source of information on the Norwegian offshore petroleum activities.

  5. Determinants of ambulance response time: A study in Sabah, Malaysia

    Science.gov (United States)

    Chin, Su Na; Cheah, Phee Kheng; Arifin, Muhamad Yaakub; Wong, Boh Leng; Omar, Zaturrawiah; Yassin, Fouziah Md; Gabda, Darmesah

    2017-04-01

    Ambulance response time (ART) is one of the standard key performance indicators (KPI) in measuring the emergency medical services (EMS) delivery performances. When the mean time of ART of EMS system reaches the KPI target, it shows that the EMS system performs well. This paper considers the determinants of ART, using data sampled from 967 ambulance runs in a government hospital in Sabah. Multiple regression analysis with backward elimination was proposed for the identification of significant factors. Amongst the underlying factors, travel distance, age of patients, type of treatment and peak hours were identified to be significantly affecting ART. Identifying factors that influence ART helps the development of strategic improvement planning for reducing the ART.

  6. Facts 2011 - The Norwegian petroleum sector; Fakta 2011 - norsk petroleumsverksemd

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-15

    The publication provides a general overview of information regarding the petroleum activities on the Norwegian continental shelf. Content; Foreword; The petroleum sector - Norway's largest industry; Organisation of Norwegian petroleum activity; Government petroleum revenues; Exploration activities; Development and operations; Norwegian gas exports; Decommissioning; Research, technology and industrial development; Environmental considerations in the Norwegian petroleum sector; Petroleum resources; Fields in production; Fields under development; Future developments; Fields where production has ceased; Pipelines and onshore facilities. (AG)

  7. Facts 2010 - The Norwegian petroleum sector; Fakta 2010 - norsk petroleumsverksemd

    Energy Technology Data Exchange (ETDEWEB)

    2010-07-01

    The publication provides a general overview of information regarding the petroleum activities on the Norwegian continental shelf. Content; Foreword; The petroleum sector - Norway's largest industry; Organisation of Norwegian petroleum activity; Government petroleum revenues; Exploration activities; Development and operations; Norwegian gas exports; Decommissioning; Research, technology and industrial development; Environmental considerations in the Norwegian petroleum sector; Petroleum resources; Fields in production; Fields under development; Future developments; Fields where production has ceased; Pipelines and onshore facilities. (AG)

  8. Clinical characteristics affecting motor recovery and ambulation in stroke patients

    Science.gov (United States)

    Yetisgin, Alparslan

    2017-01-01

    [Purpose] To describe the clinical characteristics affecting motor recovery and ambulation in stroke patients. [Subjects and Methods] Demographic and clinical characteristics of 53 stroke patients (31 M, 22 F), such as age, gender, etiology, hemiplegic side, Brunnstrom stage, functional ambulation scale scores, history of rehabilitation, and presence of shoulder pain and complex regional pain syndrome were evaluated. [Results] The etiology was ischemic in 79.2% of patients and hemorrhagic in 20.8%. Brunnstrom hand and upper extremity values in females were lower than in males. Complex regional pain syndrome was observed at a level of 18.9% in all patients (more common in females). Brunnstrom hand stage was lower in complex regional pain syndrome patients than in those without the syndrome. Shoulder pain was present in 44.4% of patients. Brunnstrom lower extremity values and functional ambulation scale scores were higher in rehabilitated than in non-rehabilitated cases. [Conclusion] Brunnstrom stages of hand and upper extremity were lower and complex regional pain syndrome was more common in female stroke patients. Shoulder pain and lower Brunnstrom hand stages were related to the presence of complex regional pain syndrome. PMID:28265142

  9. Approach to decreasing emergency department ambulance diversion hours.

    Science.gov (United States)

    Vilke, Gary M; Brown, Lana; Skogland, Patty; Simmons, Charles; Guss, David A

    2004-02-01

    Analysis between two local Emergency Departments (EDs) suggested an oscillatory phenomenon for ambulance diversion: When one hospital went on diversion it led to a disproportionate flow of ambulance traffic to a neighboring facility that subsequently was forced to go on divert. We hypothesized if one hospital could avoid diversion status, the need for diversion could be averted in the neighboring facility. ED A secured additional resources and made a commitment to no diversion for 1 week. No changes in operations occurred in hospital B. We found no differences in ambulance runs or ED census at either facility comparing the week before, during, and after the trial. There was a dramatic decline in diversion hours from 19.7 to 1.4 and 27.7 to 0 at hospitals A and B, respectively, during the trial period (p < 0.05) compared to the weeks before and after. We conclude that reciprocating effects can be decreased with one institution's commitment to avoid diversion, thus decreasing the need for diversion at a neighboring facility.

  10. Informing clinical policy decision-making practices in ambulance services.

    Science.gov (United States)

    Muecke, Sandy; Curac, Nada; Binks, Darryn

    2013-12-01

    This study aims to identify the processes and frameworks that support an evidence-based approach to clinical policy decision-making practices in ambulance services. This literature review focused on: (i) the setting (pre-hospital); and (ii) the process of evidence translation, for studies published after the year 2000. Searches of Medline, CINAHL and Google were undertaken. Reference lists of eligible publications were searched for relevant articles. A total of 954 articles were identified. Of these, 20 full text articles were assessed for eligibility and seven full text articles met the inclusion criteria. Three provided detailed descriptions of the evidence-based practice processes used to inform ambulance service protocol or guideline development or review. There is little published literature that describes the processes involved, and frameworks required, to inform clinical policy decision making within ambulance services. This review found that processes were iterative and involved collaborations across many internal and external stakeholders. In several jurisdictions, these were coordinated by a dedicated team. Success appears dependent on committed leadership and purposive human and structural resources. Although time consuming, structured processes have been developed in some jurisdictions to assist decision-making processes. Further insight is likely to be obtained from literature published by those from other disciplines. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

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

    Directory of Open Access Journals (Sweden)

    Sherwin E. Phillips

    2012-01-01

    Full Text Available Objectives. There are no published studies on the Barbados Emergency Ambulance Service and no assessment of the calls that end in nontransported individuals. We describe reasons for the nontransport of potential clients. Methods. We used the Emergency Medical Dispatch (Medical Priority Dispatch System instrument, augmented with five local call types, to collect information on types of calls. The calls were categorised under 7 headings. Correlations between call types and response time were calculated. Results. Most calls were from the category medical (54%. Nineteen (19% percent of calls were in the non-transported category. Calls from call type Cancelled accounted for most of these and this was related to response time, while Refused service was inversely related (. Conclusions. The Barbados Ambulance Service is mostly used by people with a known illness and for trauma cases. One-fifth of calls fall into a category where the ambulance is not used often due to cancellation which is related to response time. Other factors such as the use of alternative transport are also important. Further study to identify factors that contribute to the non-transported category of calls is necessary if improvements in service quality are to be made.

  12. Mobile-Based Medical Emergency Ambulance Scheduling System

    Directory of Open Access Journals (Sweden)

    Bassey Isong

    2016-11-01

    Full Text Available Effective and efficient public service delivery like healthcare services are very important in today's society, especially in the rural areas. People in rural areas are expected to have access to public facilities at all times. However, these services are not always available when they are needed. This paper discusses the problems faced by rural areas of Mafikeng in South Africa (SA when public and basic healthcare facilities like medical ambulance transports are needed during emergency situation. The challenges ranges from poor communication, poor road network and unstructured address to non-arrival of ambulances leading loss of lives that are preventable. This paper designed and implemented a system prototype using mobile application technologies to offer cost-effective services to patients during emergencies. It is intended to reduce long queues in hospitals and long waiting periods for an ambulance via location-based services. By using this application, lives in the rural areas can be made easier and loss of lives prevented by providing timely response from the appropriate healthcare providers during emergencies.

  13. Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns

    Science.gov (United States)

    Doyle, Joseph; Graves, John; Gruber, Jonathan

    2014-01-01

    Medicare spending exceeds 4% of GDP in the US each year, and there are concerns that moral hazard problems have led to overspending. This paper considers whether hospitals that treat patients more aggressively and receive higher payments from Medicare improve health outcomes for their patients. An innovation is a new lens to compare hospital performance for emergency patients: plausibly exogenous variation in ambulance-company assignment among patients who live near one another. Using Medicare data from 2002–2010, we show that ambulance company assignment importantly affects hospital choice for patients in the same ZIP code. Using data for New York State from 2000–2006 that matches exact patient addresses to hospital discharge records, we show that patients who live very near each other but on either side of ambulance service area boundaries go to different types of hospitals. Both identification strategies show that higher-cost hospitals achieve better patient outcomes for a variety of emergency conditions. Using our Medicare sample, the estimates imply that a one standard deviation increase in Medicare reimbursement leads to a 4 percentage point reduction in mortality (10% compared to the mean). Taking into account one-year spending after the health shock, the implied cost per at least one year of life saved is approximately $80,000. These results are found across different types of hospitals and patients, as well across both identification strategies. PMID:25750459

  14. Facts 2009 - The Norwegian petroleum sector; Fakta 2009 - norsk petroleumsverksemd

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-01

    The publication provides a general overview of information regarding the petroleum activities on the Norwegian continental shelf. Contents: Foreword; The petroleum sector; Norwegian resource management; Government petroleum revenues; Exploration activities; Development and operations; Norwegian gas exports; Decommissioning; Research, technology; Environmental considerations; Petroleum resources; Fields in production; Fields under development; Future developments; Fields where production has ceased; Pipelines and onshore facilities. (AG)

  15. Environment 2000. The Norwegian Petroleum Sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    How much of the total Norwegian emissions to air comes from the petroleum sector? What is the Norwegian petroleum industry's contribution to the discharges to sea? How do the Norwegian authorities manage the environmental aspects relating to the petroleum industry? What does nmVOC mean? In co-operation with the Norwegian Petroleum Directorate the Norwegian Ministry of Petroleum and Energy issues this publication to answer questions such as these. We furthermore wish to provide comprehensive information about the environmental aspects relating to the Norwegian oil and gas operations. It is also important to demonstrate that the efforts to improve environmental efficiency in this industry is a continuous process and that measures have already been implemented to this effect. Each year we take a closer look at one topic which is of concern to the petroleum industry. In light of the new protocol under the Convention of Long-range Transboundary Air Pollution, we wish to focus on the offshore sectors emission of NO{sub x} in this issue and on the possibilities and challenges we face in this context. This publication also contains a section containing factual data, which i.a. describes the status of discharges and emissions, environmental effects and measures to reduce the emission of CO{sub 2}, NO{sub x}, nmVOC and the discharge of oil and chemicals. We hope that a publication like this will increase the public's general knowledge of how the petroleum industry addresses environmental issues. An important task of the Ministry of Petroleum and Energy is to help formulate general guidelines and measures in areas where energy policy and environmental policy interact. It is furthermore our aim to help Norway combine her role as a major oil producer of energy with the role of being a leader in the protection of the environment.

  16. Norwegian Petroleum Activity 97. Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    This report is the official governmental review of the offshore operations on the Norwegian Continental Shelf in 1996. It covers the following topics: (1) Summary, (2) Historical overview, (3) State organization of petroleum activities, (4) The economic impact of Norwegian oil and gas, (5) State revenues, (6) Mainland activities, (7) Petroleum resources, (8) Production, (9) Marketing situation for petroleum products, (10) Environmental aspects, (11) The legal and license framework, (12) Licensing rounds, (13) Exploration, (14) Fields in production, (15) Fields under development, (16) Discoveries with development plan under consideration, (17) Transportation systems, (18) License interests, (19) Company interests, (20) White papers, (21) Useful postal addresses. 24 figs., 16 tabs.

  17. How the context of ambulance care influences learning to become a specialist ambulance nurse a Swedish perspective.

    Science.gov (United States)

    Axelsson, Christer; Herrera, Maria Jimenez; Bång, Angela

    2016-02-01

    Ambulance emergency care is multifaceted with extraordinary challenges to implement accurate assessment and care. A clinical learning environment providing opportunities for mastering these essential skills is a key component in ensuring that prehospital emergency nurse (PEN) students acquire the necessary clinical competence. The aim is to understand how PEN students experience their clinically based training, focusing on their learning process. We applied content analysis with its qualitative method to our material that consisted of three reflections each by 28 PEN students over their learning process during their 8 weeks of clinical ambulance practice. The research was carried out at the Center for Prehospital Care, University of Borås, Sweden. The broad spectrum of ambulance assignments seems to awaken great uncertainty and excessive respect in the students. Student vulnerability appears to decrease when the clinical supervisor behaves calmly, knowledgeably, confidently and reflectively. Early traumatic incidents on the other hand may increase the students' anxiety. Each student is offered a unique opportunity to learn how to approach patients and relatives in their own environments, and likewise an opportunity to gather information for assessment. Infrequency of missions seems to make PEN students less active in their student role, thereby preventing them from availing themselves of potential learning situations. Fatigue and hunger due to lack of breaks or long periods of transportation also inhibit learning mode. Our findings suggest the need for appraisal of the significance of the clinical supervisor, the ambulance environment, and student vulnerability. The broad spectrum of conditions in combination with infrequent assignments make simulation necessary. However, the unique possibilities provided for meeting patients and relatives in their own environments offer the PEN student excellent opportunities for learning how to make assessments. Copyright

  18. Insights on the effects of patient perceptions and awareness on ambulance usage in Karachi, Pakistan.

    Science.gov (United States)

    Chandran, Aruna; Ejaz, Kiran; Karani, Rabia; Baqir, Muhammad; Razzak, Junaid; Hyder, Adnan A

    2014-12-01

    Prehospital care is a vital part of emergency medical care. Countries with decentralised ambulance systems, such as Pakistan, require patient knowledge as to when to call an ambulance and which service to call. Little is known about how patient perceptions of ambulance services affect ambulance usage in most low- and middle-income countries (LMIC). The purpose of our study was to analyse patient perspectives of the ambulance system in Karachi to understand how to improve ambulance use. Indepth interviews were conducted with 30 individuals selected by convenience sampling representing patients who came to the emergency department by private transport versus one of two of the main ambulance service providers in Karachi. Similar to what has been shown in some LMIC contexts, two of the major themes that emerged which affect patient decision making with regard to ambulance use were a mistrust of the ambulance system or providers and a sense of inadequacy of the local system as compared with international standards. In addition, which has not been shown in previous studies, there was a fundamental misunderstanding of the role of ambulance services in the healthcare infrastructure. Insight into the main issues affecting patient decisions to use an ambulance service offers possible targets for patient education that could result in an increase in the proper usage of ambulances and thus optimise outcomes from serious injury and illness in an LMIC context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Ambulance use is associated with higher self-rated illness seriousness: user attitudes and perceptions.

    Science.gov (United States)

    Toloo, Ghasem Sam; FitzGerald, Gerry J; Aitken, Peter J; Ting, Joseph Y S; McKenzie, Kirsten; Rego, Joanna; Enraght-Moony, Emma

    2013-06-01

    The objective was to study the role and effect of patients' perceptions on reasons for using ambulance services in Queensland, Australia. A cross-sectional survey was conducted of patients (n = 911) presenting via ambulance or self-transport at eight public hospital emergency departments (EDs). The survey included perceived illness severity, attitudes toward ambulance, and reasons for using ambulance. A theoretical framework was developed to inform this study. Ambulance users had significantly higher self-rated perceived seriousness, urgency, and pain than self-transports. They were also more likely to agree that ambulance services are for everyone to use, regardless of the severity of their conditions. In compared to self-transports, likelihood of using an ambulance increased by 26% for every unit increase in perceived seriousness; and patients who had not used an ambulance in the 6 months prior to the survey were 66% less likely to arrive by ambulance. Patients who had presented via ambulance stated they considered the urgency (87%) or severity (84%) of their conditions as reasons for calling the ambulance. Other reasons included requiring special care (76%), getting higher priority at the ED (34%), not having a car (34%), and financial concerns (17%). Understanding patients' perceptions is essential in explaining their actions and developing safe and effective health promotion programs. Individuals use ambulances for various reasons and justifications according to their beliefs, attitudes, and sociodemographic conditions. Policies to reduce and manage demand for such services need to address both general opinions and specific attitudes toward emergency health services to be effective. © 2013 by the Society for Academic Emergency Medicine.

  20. Personnel preferences in personnel planning and scheduling

    NARCIS (Netherlands)

    van der Veen, Egbert

    2013-01-01

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

  1. Personnel preferences in personnel planning and scheduling

    NARCIS (Netherlands)

    van der Veen, Egbert

    2013-01-01

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

  2. Personnel preferences in personnel planning and scheduling

    NARCIS (Netherlands)

    Veen, van der Egbert

    2013-01-01

    The personnel of an organization often has seemingly conflicting goals. On the one hand, the common goal is to achieve operational efficiency and to be available for work when needed in the organization. On the other hand, individual employees like to have a good work-life balance, by having persona

  3. Feasibility of a computer-assisted feedback system between dispatch centre and ambulances.

    Science.gov (United States)

    Lindström, Veronica; Karlsten, Rolf; Falk, Ann-Charlotte; Castrèn, Maaret

    2011-06-01

    The aim of the study was to evaluate the feasibility of a newly developed computer-assisted feedback system between dispatch centre and ambulances in Stockholm, Sweden. A computer-assisted feedback system based on a Finnish model was designed to fit the Swedish emergency medical system. Feedback codes were identified and divided into three categories; assessment of patients' primary condition when ambulance arrives at scene, no transport by the ambulance and level of priority. Two ambulances and one emergency medical communication centre (EMCC) in Stockholm participated in the study. A sample of 530 feedback codes sent through the computer-assisted feedback system was reviewed. The information on the ambulance medical records was compared with the feedback codes used and 240 assignments were further analyzed. The used feedback codes sent from ambulance to EMCC were correct in 92% of the assignments. The most commonly used feedback code sent to the emergency medical dispatchers was 'agree with the dispatchers' assessment'. In addition, in 160 assignments there was a mismatch between emergency medical dispatchers and ambulance nurse assessments. Our results have shown a high agreement between medical dispatchers and ambulance nurse assessment. The feasibility of the feedback codes seems to be acceptable based on the small margin of error. The computer-assisted feedback system may, when used on a daily basis, make it possible for the medical dispatchers to receive feedback in a structural way. The EMCC organization can directly evaluate any changes in the assessment protocol by structured feedback sent from the ambulance.

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

    Science.gov (United States)

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

    2014-07-01

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

  5. Ambulance Transport of the Oldest Old in Tokyo: A Population-Based Study

    Science.gov (United States)

    Tokuda, Yasuharu; Abe, Toshikazu; Ishimatsu, Shinichi; Hinohara, Shigeaki

    2010-01-01

    Background Few studies have investigated ambulance utilization in people aged 85 years or older, ie, the oldest old. Methods We conducted a 1-year population-based observational study of patients transported by ambulance to emergency departments in Tokyo, Japan, which has a population of about 12 million. Demographic data, symptoms/events associated with ambulance transport, and the proportion of hospital admissions were recorded. Transport rates by age and sex were calculated using data for the background population and ambulance transports, and the 10 most frequent symptoms/events requiring transport were compared between the oldest old and those aged 65 to 84 years. Results Of the 642 764 patients who were transported to hospitals by ambulances, 59 570 (9%) were aged ≥85 years; 64% were women. The annual ambulance transport rate for this population was 250 per 1000/year and was significantly greater than the rate (90 per 1000/year) for those aged 65 to 84 years. The highest rate was for men aged 85 to 99 years (292 per 1000/year). Among the oldest old, the most frequent reason for ambulance transport was fall (38.5 per 1000/year), and the symptom most likely to result in hospital admission was dyspnea. Conclusions The ambulance transport rate for the oldest old was high, particularly among men aged ≥95 years. To reduce the need for ambulance transport among the oldest old, preventive care is needed to reduce falls and acute exacerbations of cardiac and respiratory disorders. PMID:20814165

  6. Norwegian crusted scabies: an unusual case presentation.

    Science.gov (United States)

    Maghrabi, Michael M; Lum, Shireen; Joba, Ameha T; Meier, Molly J; Holmbeck, Ryan J; Kennedy, Kate

    2014-01-01

    Scabies is a contagious condition that is transmitted through direct contact with an infected person and has been frequently associated with institutional and healthcare-facility outbreaks. The subtype Norwegian crusted scabies can masquerade as other dermatologic diseases owing to the heavy plaque formation. Successful treatment has been documented in published reports, including oral ivermectin and topical permethrin. Few case studies documenting the treatment of Norwegian crusted scabies have reported the use of surgical debridement as an aid to topical and/or oral treatment when severe plaque formation has been noted. A nursing home patient was admitted to the hospital for severe plaque formation of both feet. A superficial biopsy was negative for both fungus and scabies because of the severity of the plaque formation on both feet. The patient underwent a surgical, diagnostic biopsy of both feet, leading to the diagnosis of Norwegian crusted scabies. A second surgical debridement was then performed to remove the extensive plaque formation and aid the oral ivermectin and topical permethrin treatment. The patient subsequently made a full recovery and was discharged back to the nursing home. At 2 and 6 months after treatment, the patient remained free of scabies infestation, and the surgical wound had healed uneventfully. The present case presentation has demonstrated that surgical debridement can be complementary to the standard topical and oral medications in the treatment of those with Norwegian crusted scabies infestation.

  7. Being "Neutral"? English Pronunciation among Norwegian Learners

    Science.gov (United States)

    Rindal, Ulrikke; Piercy, Caroline

    2013-01-01

    This study investigates the pronunciation of English among Norwegian adolescents by applying sociolinguistic methods in a second language context. Results from an auditory analysis of seven phonological variables show a blended use of linguistic features from American English and British English, with some additional pronunciations, forming a…

  8. Norwegian Superintendents as Mediators of Change Initiatives

    Science.gov (United States)

    Paulsen, Jan Merok

    2014-01-01

    The underlying theoretical argument in this article views municipal school superintendents in the Nordic context as middle managers in organizational theory terminology. Empirical support for this discussion emerges from national data collected among Norwegian school superintendents in 2009. Findings show that the actual work and leadership…

  9. NORWEGIAN CONVERSATIONAL POLITENESS. BETWEEN LANGUAGE AND CULTURE

    Directory of Open Access Journals (Sweden)

    Paulina Horbowicz

    2011-01-01

    Full Text Available The paper analyses the concept of politeness in the context of Norwegian everyday conversation. Instead of following the widely accepted concept of universality of politeness structures, it refers the theoretical background for considering politeness as realising culturally preconditioned communication patterns. Such patterns consist both of adequate face work, and of obligations connected to speaker/listener role, the latter realised through the system of adjacency pairs. The basic rules prevailing in Norwegian conversations are discussed, such as maintaining a clear and harmonious fl ow of talk or non-imposing on one’s conversational partner. These rules are exemplified on extracts from interethnic dialogues between Poles using Norwegian as a second language, and native speakers of Norwegian. The conclusions of the paper are twofold; it calls for the concept of politeness to be considered on the broader level of discourse rather than the level of single speech acts. Additionally, it stresses the role of ethnic communication pattern in second/foreign language teaching. The realisation of communication patterns allows for a legitimate participation in conversation, which in turn is vital for a successful construction of identity in second/foreign language.

  10. Patient safety culture in Norwegian nursing homes.

    Science.gov (United States)

    Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter

    2017-06-20

    Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values homes. In multiple linear regression analysis, we found that increasing age and job position among the healthcare providers were associated with significantly increased mean scores for the patient safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture

  11. Association between ambulance dispatch priority and patient condition.

    Science.gov (United States)

    Ball, Stephen J; Williams, Teresa A; Smith, Karen; Cameron, Peter; Fatovich, Daniel; O'Halloran, Kay L; Hendrie, Delia; Whiteside, Austin; Inoue, Madoka; Brink, Deon; Langridge, Iain; Pereira, Gavin; Tohira, Hideo; Chinnery, Sean; Bray, Janet E; Bailey, Paul; Finn, Judith

    2016-12-01

    To compare chief complaints of the Medical Priority Dispatch System in terms of the match between dispatch priority and patient condition. This was a retrospective whole-of-population study of emergency ambulance dispatch in Perth, Western Australia, 1 January 2014 to 30 June 2015. Dispatch priority was categorised as either Priority 1 (high priority), or Priority 2 or 3. Patient condition was categorised as time-critical for patient(s) transported as Priority 1 to hospital or who died (and resuscitation was attempted by paramedics); else, patient condition was categorised as less time-critical. The χ(2) statistic was used to compare chief complaints by false omission rate (percentage of Priority 2 or 3 dispatches that were time-critical) and positive predictive value (percentage of Priority 1 dispatches that were time-critical). We also reported sensitivity and specificity. There were 211 473 cases of dispatch. Of 99 988 cases with Priority 2 or 3 dispatch, 467 (0.5%) were time-critical. Convulsions/seizures and breathing problems were highlighted as having more false negatives (time-critical despite Priority 2 or 3 dispatch) than expected from the overall false omission rate. Of 111 485 cases with Priority 1 dispatch, 6520 (5.8%) were time-critical. Our analysis highlighted chest pain, heart problems/automatic implanted cardiac defibrillator, unknown problem/collapse, and headache as having fewer true positives (time-critical and Priority 1 dispatch) than expected from the overall positive predictive value. Scope for reducing under-triage and over-triage of ambulance dispatch varies between chief complaints of the Medical Priority Dispatch System. The highlighted chief complaints should be considered for future research into improving ambulance dispatch system performance. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. Modeling of patient's blood pressure variation during ambulance transportation

    Science.gov (United States)

    Sakatani, Kenji; Ono, Takahiko; Kobayasi, Yasuhide; Hikita, Shinichi; Saito, Mitsuyuki

    2007-12-01

    In an emergency transportation by ambulance, a patient is transported in a supine position. In this position, a patient's blood pressure (BP) variation depending on an inertial force which occurs when an ambulance accelerates or decelerates. This BP variation causes a critical damage for a patent with brain disorder. In order to keep a patient stable during transportation, it is required to maintain small BP variation. To analyze the BP variation during transportation, a model of the BP variation has so far been made. But, it can estimate the BP variation only in braking. The purpose of this paper is to make a dynamical model of the BP variation which can simulate it in both braking and accelerating. First, to obtain the data to construct the model, we used a tilting bed to measure a head-to-foot acceleration and BP of fingertip. Based on this data, we build a mathematical model whose input is the head-to-foot acceleration and output is the Mean BP variation. It is a switched model which switches two models depending on the jerk. We add baroreceptor reflex to the model as a offset value.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Science.gov (United States)

    2010-10-12

    ...--Nautical mile NTSB--National Transportation Safety Board NVG--Night vision goggles NVIS--Night-vision... ambulances have varying situational- awareness technology (such as night vision goggles, HTAWS, radio... during night conditions as four common factors in helicopter air ambulance accidents. A review...

  17. Ambulance patients with nondocumented sepsis have a high mortality risk: a retrospective study.

    Science.gov (United States)

    Roest, Asselina A; Stoffers, Judith; Pijpers, Evelien; Jansen, Jochen; Stassen, Patricia M

    2017-02-01

    Sepsis is a serious disease leading to high mortality. Early recognition is important because treatment is most effective when started quickly.The primary aim of this retrospective cohort study was to assess how many sepsis patients are documented as septic by ambulance staff. The secondary aims were to investigate how many sepsis patients are transported by ambulance, to compare them with patients transported otherwise, to investigate which factors influence documentation of sepsis and to assess whether documentation influences mortality. We retrieved all data from ambulance and emergency department charts of patients who visited the internist in the emergency department from March 2011 to July 2012. In total, 47.4% (n=363) sepsis patients were transported by ambulance. These patients were older (71.5 vs. 55.7 years, Pambulance patients, sepsis was not documented by ambulance staff. Measurement of temperature was important for documentation of sepsis (odds ratio 11.2, 95% confidence interval 5.2-24.4). In 32.1% of ambulance patients, sepsis could have been identified by assessing vital signs. Mortality in these nondocumented patients was higher than that in documented patients (25.7 vs. 12.9%, P=0.003). Ambulance patients are seriously ill, but sepsis is often not documented by ambulance staff. Nondocumentation is associated with high mortality and could be resolved by assessing vital signs, particularly the temperature.

  18. Resilience of urban ambulance services under future climate, meteorology and air pollution scenarios

    Science.gov (United States)

    Pope, Francis; Chapman, Lee; Fisher, Paul; Mahmood, Marliyyah; Sangkharat, Kamolrat; Thomas, Neil; Thornes, John

    2017-04-01

    Ambulances are an integral part of a country's infrastructure ensuring its citizens and visitors are kept healthy. The impact of weather, climate and climate change on ambulance services around the world has received increasing attention in recent years but most studies have been area specific and there is a need to establish basic relationships between ambulance data (both response and illness data) and meteorological parameters. In this presentation, the effects of temperature, other meteorological and air pollution variables on ambulance call out rates for different medical categories will be investigated. We use ambulance call out obtained from various ambulance services worldwide which have significantly different meteorologies, climatologies and pollution conditions. A time-series analysis is utilized to understand the relation between meteorological conditions, air pollutants and different call out categories. We will present findings that support the opinion that ambulance attendance call outs records are an effective and well-timed source of data and can be used for health early warning systems. Furthermore the presented results can much improve our understanding of the relationships between meteorology, climate, air pollution and human health thereby allowing for better prediction of ambulance use through the application of long and short-term weather, climate and pollution forecasts.

  19. [Comparison between alcoholic patients and primary care patients for the use of the ambulance].

    Science.gov (United States)

    Ino, Aro; Yoshimoto, Hisashi; Mizutani, Naomi; Kato, Naohisa; Hirohuji, Hideo; Takemura, Yousuke C

    2013-10-01

    Though heavy drinkers and patients with alcohol dependence make use of the ambulance more frequently as compared with the general population, there are few data on the alcohol-related use of the emergency department (ED) in Japan. A cross sectional study was conducted. 170 patients with alcohol dependence in one clinic and 306 primary care patients across two clinics provided demographic data and answered some questions about the use of emergency ambulance services over the age of 20. The questions asked included whether use of the ambulance caused injuries, as well as AUDIT-C (primary care patients only). In this study, multiple logistic regression analysis was used. The use of emergency ambulance services by patients with alcohol dependence was 4.68 times more than primary care patients, and the occurrence of ambulance-caused injuries was 6.03 times higher, as determined by multiple logistic regression. Among primary care patients, AUDIT-C positive patients (male; 5 points or more, female; 3 points or more) were 37 (12.2%), and the occurrence of ambulance-caused injuries was 3.32 times higher. Like with other countries, in Japan, heavy drinkers and patients with alcohol dependence lead to a significant increase in the use of emergency ambulance services as well as ambulance-caused injuries.

  20. Variations in Ambulance Use in the United States: the Role of Health Insurance

    Science.gov (United States)

    Meisel, Zachary F.; Pines, Jesse M.; Polsky, Daniel E.; Metlay, Joshua P.; Neuman, Mark D.; Branas, Charles C.

    2011-01-01

    Objectives The purpose of this study was to describe the associations between individual health insurance and ambulance utilization using a national sample of patients who receive emergency department (ED) care. Methods The data source was the National Hospital Ambulatory Medical Care Survey, years 2004 through 2006. Non-institutionalized patients between ages 18 and 65 years were included. The primary dependant variable was ambulance use. Multivariable logistic regression methods were used to assess the associations between health insurance status and ambulance use, and to adjust for confounders. Results A total of 61,013 ED visits were included, representing a national sample of approximately 70 million annual ED visits over three years. Ambulance transport was used in 11% of private insurance visits, 16% of Medicaid visits, and 13% of uninsured visits. In the adjusted model, visits by patients with Medicaid (aOR 1.60, 99% confidence interval (CI) = 1.37 to 1.86) and the uninsured (aOR 1.43, 99% CI = 1.23 to 1.66) were more likely to arrive by ambulance than visits by patients with private insurance. Ambulance use among the uninsured was most pronounced in metropolitan areas. Conclusions Ambulance use varies by health insurance status. Medicaid coverage and lack of insurance are each independently associated with increased odds of ambulance use, suggesting a disproportionate role for EMS in the care of patients with limited financial resources. PMID:21996068

  1. Dynamic ambulance dispatching: is the closest-idle policy always optimal?

    NARCIS (Netherlands)

    C.J. Jagtenberg (Caroline); S. Bhulai (Sandjai); R.D. van der Mei (Rob)

    2016-01-01

    htmlabstractWe address the problem of ambulance dispatching, in which we must decide which ambulance to send to an incident in real time. In practice, it is commonly believed that the ‘closest idle ambulance’ rule is near-optimal and it is used throughout most literature. In this paper, we present

  2. Determinants of Personnel Practices.

    Science.gov (United States)

    1987-05-01

    headquartered in Japan, Singapore, Malaysia , Indonesia, or India, and 48 were local companies with all their establishments in Singapore. 4.w V jm , i...appraisal data, a well developed 2ILM, and written job descriptions and HRM philosophy will be considered to represent sophisticated personnel...resources management( HRM ) or personnel department with at least one professional staff member. Seventy two percent of responding organizations did

  3. The Effect of Ambulance Staffing Models in a Metropolitan, Fire-Based EMS System.

    Science.gov (United States)

    Cortez, Eric J; Panchal, Ashish R; Davis, James E; Keseg, David P

    2017-04-01

    Introduction The staffing of ambulances with different levels of Emergency Medical Service (EMS) providers is a difficult decision with evidence being mixed on the benefit of each model. Hypothesis/Problem The objective of this study was to describe a pilot program evaluating alternative staffing on two ambulances utilizing the paramedic-basic (PB) model (staffed with one paramedic and one emergency medical technician[EMT]). This was a retrospective study conducted from September 17, 2013 through December 31, 2013. The PB ambulances were compared to geographically matched ambulances staffed with paramedic-paramedic (PP ambulances). One PP and one PB ambulance were based at Station A; one PP and one PB ambulance were based at Station B. The primary outcome was total on-scene time. Secondary outcomes included time-to-electrocardiogram (EKG), time-to-intravenous (IV) line insertion, IV-line success rate, and percentage of protocol violations. Inclusion criteria were all patients requesting prehospital services that were attended to by these teams. Patients were excluded if they were not attended to by the study ambulance vehicles. Descriptive statistics were reported as medians and interquartile ranges (IQR). Proportions were reported with 95% confidence intervals (CI). The Mann-Whitley U test was used for significance testing (Pambulance were shorter than the PB ambulance team (PP: 10.1 minutes, IQR 6.0-15; PB: 13.0 minutes, IQR 8.1-18; P=.01). This finding also was noted at Station B (PP: 13.5 minutes, IQR 8.5-19; PB: 14.3 minutes, IQR 9.9-20; P=.01). There were no differences between PP and PB ambulance teams at Station A or Station B in time-to-EKG, time-to-IV insertion, IV success rate, and protocol violation rates. In the setting of a well-developed EMS system utilizing an all-Advanced Life Support (ALS) response, this study suggests that PB ambulance teams may function well when compared to PP ambulances. Though longer scene times were observed, differences in

  4. Comparison of different intubation techniques performed inside a moving ambulance: a manikin study.

    Science.gov (United States)

    Wong, K B; Lui, C T; Chan, William Y W; Lau, T L; Tang, Simon Y H; Tsui, K L

    2014-08-01

    OBJECTIVE. Airway management and endotracheal intubation may be required urgently when a patient deteriorates in an ambulance or aircraft during interhospital transfer or in a prehospital setting. The objectives of this study were: (1) to compare the effectiveness of conventional intubation by Macintosh laryngoscope in a moving ambulance versus that in a static ambulance; and (2) to compare the effectiveness of inverse intubation and GlideScope laryngoscopy with conventional intubation inside a moving ambulance. DESIGN. Comparative experimental study. SETTING. The experiment was conducted in an ambulance provided by the Auxiliary Medical Service in Hong Kong. PARTICIPANTS. A group of 22 doctors performed endotracheal intubation on manikins with Macintosh laryngoscope in a static and moving ambulance. In addition, they performed conventional Macintosh intubation, inverse intubation with Macintosh laryngoscope, and GlideScope intubation in a moving ambulance in both normal and simulated difficult airways. MAIN OUTCOME MEASURES. The primary outcome was the rate of successful intubation. The secondary outcomes were time taken for intubation, subjective glottis visualisation grading, and eventful intubation (oesophageal intubation, intubation time >60 seconds, and incisor breakage) with different techniques or devices. RESULTS. In normal airways, conventional Macintosh intubation in a static ambulance (95.5%), conventional intubation in a moving ambulance (95.5%), as well as GlideScope intubation in a moving ambulance (95.5%) were associated with high success rates; the success rate of inverse intubation was comparatively low (54.5%; P=0.004). In difficult airways, conventional Macintosh intubation in a static ambulance (86.4%), conventional intubation in a moving ambulance (90.9%), and GlideScope intubation in a moving ambulance (100%) were associated with high success rates; the success rate of inverse intubation was comparatively lower (40.9%; P=0.034). CONCLUSIONS

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

    Science.gov (United States)

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

    2015-11-01

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

  6. Critical care paramedics in England: a national survey of ambulance services.

    Science.gov (United States)

    von Vopelius-Feldt, Johannes; Benger, Jonathan

    2014-08-01

    Critical care paramedics (CCPs) have been introduced by individual ambulance trusts in England, but there is a lack of national coordination of training and practice. We conducted an online survey of NHS ambulance services to provide an overview of the current utilization and role of CCPs in England. The survey found significant variations in training, competencies and the working patterns of the ∼90 CCPs working in five ambulance services. All ambulance trusts currently employing CCPs are planning on increasing CCP numbers, whereas 'insufficient financial means' and 'insufficient scientific evidence' are the two major barriers to CCP utilization. The CCP model established in five ambulance services in England is unique within Europe. With increasing numbers of CCPs, concerns about lack of supportive scientific evidence and clinical need should be addressed. Optimal delivery of prehospital critical care in England remains controversial.

  7. The Norwegian Sounding Rocket and Balloon Program

    Science.gov (United States)

    Skatteboe, Rolf

    2001-08-01

    The status and recent developments of the Norwegian Sounding Rocket and Balloon Program are presented with focus on national activities and recent achievements. The main part of the Norwegian program is sounding rocket launches conducted by Andøya Rocket Range from the launch facilities on Andøya and at Svalbard. For the majority of the programs, the scientific goal is investigation of processes in the middle and upper atmosphere. The in situ measurements are supplemented by a large number of ground-based support instruments located at the ALOMAR Observatory. The ongoing and planned projects are described and the highlights of the latest completed projects are given. The scientific program for the period 2001-2003 will be reviewed. Several new programs have been started to improve the services available to the international science comunity. The Hotel Payload project and MiniDusty are important examples that will be introduced in the paper. Available space related infrastructure is summarized.

  8. Tanker spills Norwegian crude oil off Shetlands

    Energy Technology Data Exchange (ETDEWEB)

    1993-01-11

    This paper reports that crude oil was spilling last week from the U.S. owned Braer tanker after the 89,000 dwt vessel ran aground on the south end of Scotland's Shetland Islands. Workers were trying to assess the extent of damage to the tanker, shoreline, and wildlife after the January 5 accident. Braer's cargo amounted to 607,000 bbl of Norwegian oil bound for Canada. Braer loaded its cargo and sailed January 3 from Den norske stats oljeselskap AS's Mongstad, Norway, terminal with crude from Gullfaks field in the Norwegian North Sea. The $11 million shipment was destined for Ultramar Canada Inc.'s 125,000 b/d refinery at St. Romuald, Que.

  9. Norwegian police students' attitudes towards armament

    OpenAIRE

    Fekjær, Silje Bringsrud; Strype, Jon

    2015-01-01

    Whether the police should routinely carry firearms is an ongoing debate in Norway. Although the police can carry weapons under special circumstances, the normal situation for the police in Norway is to store firearms in sealed cases in the police cars until armament orders are given by the police chief. In the present study, we examine attitudes towards routine police armament among Norwegian police students. First, we investigate the distribution of these attitudes among the students, and th...

  10. Written Language Shift among Norwegian Youth

    Science.gov (United States)

    Özerk, Kamil; Todal, Jon

    2013-01-01

    In Norway there are two written Norwegian languages, Bokmâl and Nynorsk. Of these two written languages Bokmâl is being used by the majority of the people, and Bokmâl has the highest prestige in the society. This article is about the shift of written language from Nynorsk to Bokmâl among young people in a traditional Nynorsk district in the…

  11. Fact Sheet 1999. Norwegian Petroleum Activity

    Energy Technology Data Exchange (ETDEWEB)

    Breivik, Jan

    1999-10-01

    As discussed in this publication, petroleum resources in the order of 9.5 billion (bn) standard cubic metres (scm) oil equivalents (oe) have been discovered on the Norwegian continental shelf (NCS), 77 per cent in the North Sea, 19 per cent in the Norwegian Sea and four per cent in the Barents Sea. By the end of 1998, remaining reserves on the NCS totalled 1.6 bn scm of oil, 1.2 bn scm oe gas and 160 mill scm oe of natural gas liquids. Thirty-two exploration wells, including 21 wildcats and 11 for appraisal, were completed or temporarily abandoned on the NCS in 1998. 939 exploration wells had been completed or temporarily abandoned off Norway. In 1998 governmental approval was given for the Huldra, Snorre B phase II, Gullfaks satellites phase II and Yme Beta West. Norwegian offshore petroleum production in 1998 totalled 222.5 scm oe, including 168.9 mill scm oe of oil, 43.6 mill scm oe of gas and 10 mill scm oe of NGL/condensate. Oil production declined by 4 per cent compared with 1997, while gas sales rose by 2 per cent. The estimated value of Norwegian petroleum exports in 1998 was NOK 123 bn, or about 30 per cent of the country`s total earnings from foreign sales. Petroleum production and pipeline transport accounted for 12 per cent of Norway`s gross national product. Net government revenues from taxes and royalties on petroleum operations is put at 27.6 billion NOK. The publication also includes a list of white papers and a list of useful postal addresses. 23 figs., 14 tabs.

  12. Online consumer behavior among Norwegian business students

    OpenAIRE

    Møller-Hansen, Tor Ragnar

    2013-01-01

    E-commerce is an ever growing phenomenon which merits further research. This study conducts a literature review in the field of online consumer behavior, focusing on online consumer purchase intention and online consumer loyalty in the context of Norwegian business students. We also conduct a survey with 196 business students in Norway, and go on to identify three important variables impacting online consumer purchase intention; online trust, previous online purchase experience and social med...

  13. Factors influencing ambulance use in patients with ST-elevation myocardial infarction in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing; HU Da-yi; SONG Li; CHEN Hui; ZHANG Jian; LI Shi-ying; LI Qing-xiang; CHENG Shu-juan; WANG Jian; ZHAO Han-jun

    2009-01-01

    Background Emergency medical service plays a key role in the early recognition and treatment of ST-elevation myocardial infarction (STEMI), but studies indicate that the patients experiencing STEMI symptoms often fail to call an ambulance as recommended. This study aimed to examine the current ambulance transport frequency and ascertain predictors and reasons for not choosing ambulance transportation by the patients with STEMI in Beijing.Methods A prospective, cross-sectional survey was conducted from January 1,2006 through until June 30, 2007 in two tertiary hospitals in Beijing and included consecutive patients with STEMI admitted within 24 hours of onset of symptoms. Data were collected by structured interviews and medical records review.Results Of the 572 patients, only 172 (30.1%) used an ambulance, and the remaining 400 (69.9%) presented by self-transport. Multivariate analysis showed that age <65 years (OR: 1.220; 95% CI: 1.001-2.043), lower education level (OR: 1.582; 95% CI: 1.003-2.512), presence of pre-infarction angina (OR: 1.595; 95% CI: 1.086-2.347), and attribution of symptoms to non-cardiac origin (OR: 1.519; 95% CI: 1.011-2.284) were independent predictors for not using an ambulance. However, history of coronary artery disease (CAD), dyspnea, perceiving symptoms to be serious, and knowing the meaning of cardiopulmonary resuscitation appeared to be independent predictors of ambulance use. The main reasons for not using an ambulance were convenience and quickness of self-transport and the decreased severity of symptoms.Conclusions A large proportion of patients in Beijing do not call for an ambulance after onset of STEMI symptoms. Several factors including demographics, previous CAD, symptoms and cognitive factors of patients are associated with the ambulance use. The public should be educated that an ambulance is not merely a transportation modality and that it also provides rapid diagnosis and treatment.

  14. Written Language Shift among Norwegian Youth

    Directory of Open Access Journals (Sweden)

    Kamil ÖZERK

    2013-07-01

    Full Text Available In Norway there are two written Norwegian languages, Bokmål and Nynorsk. Of these two written languages Bokmål is being used by the majority of the people, and Bokmål has the highest prestige in the society. This article is about the shift of written language from Nynorsk to Bokmål among young people in a traditional Nynorsk district in the country. Drawing on empirical data we conclude that many adolescents are experiencing written language shift. We discuss various reasons for this phenomenon in the linguistic landscape of Norway. In our discussions we emphasize the importance of the school with regard to language maintenance and language revitalization. We call for a new language policy in the educational system that can prevent language shift. Having several dialects and two officially written forms of Norwegian in the country, creates a special linguistic landscape in Norway. Despite the fact that the Norwegian language situation is in several ways unique, it’s done very little research on how the existing policy works in practice. Our research reveals that the existing language policy and practice in the school system is not powerful enough to prevent language shift and language decay among the youngsters. The school system functions like a fabric for language shift.

  15. Beverage Consumption Patterns among Norwegian Adults.

    Science.gov (United States)

    Paulsen, Mari Mohn; Myhre, Jannicke Borch; Andersen, Lene Frost

    2016-09-13

    Beverages may be important contributors for energy intake and dietary quality. The purpose of the study was to investigate how beverage consumption varies between different meals (breakfast, lunch, dinner, supper/evening meal, snacks) and between weekdays and weekend-days in Norwegian adults. A cross-sectional dietary survey was conducted among Norwegian adults (n = 1787) in 2010-2011. Two telephone-administered 24 h recalls were used for dietary data collection. Breakfast was the most important meal for milk and juice consumption, dinner for sugar-sweetened beverages and wine, and snacks for water, coffee, artificially sweetened beverages, and beer. Consumption of sugar-sweetened and artificially sweetened beverages did not differ between weekdays and weekend-days among consumers. The average intake of wine and beer (men only) was higher on weekend-days. Higher age was positively associated with wine consumption and negatively associated with consumption of water, sugar-sweetened, and artificially sweetened beverages. Higher education was associated with consumption of water, beer, and wine, whereas lower education was associated with sugar-sweetened beverage consumption. Beverage consumption patterns among Norwegian adults vary between different meal types and in subgroups of the population. Alcohol consumption was higher on weekend-days. Knowledge regarding beverage consumption patterns in the population should be considered when revising dietary guidelines in the future.

  16. The Technical Student Programme draws Norwegians

    CERN Multimedia

    2005-01-01

    Erik Hejne, second from left, Chairman of the Technical Students Committee, and Jens Vigen, who is concerned spefically with Norwegian students at CERN, with some of the Norwegian technical students who arrived at CERN in spring 2005, together with their teachers. From mid-April, CERN's PH and IT Departments are hosting ten Norwegian students from Bergen University College, the Sør-Trøndelag University College and the University of Science and Technology in Trondheim to take part in the Laboratory's Technical Student Programme. The Technical Student Programme is open to students of universities and technical higher education establishments in the Member States who, in the course of their studies, are required to complete a period of professional training in industry or in a laboratory. Around 70 Technical Students come to work at CERN each year. Selected by a committee, they spend between six months and one year with the Organization. The programme is funded by CERN. However, once the Laboratory's quota of...

  17. [Norwegian scabies, a rare diagnosis in Tunisia].

    Science.gov (United States)

    Mebazaa, Amel; Bedday, Bouraoui; Trabelsi, Sabiha; Denguezli, Mohamed; Ben Said, Moncef; Belajouza, Colandane; Nouira, Rafiaa

    2006-10-01

    Norwegian scabies is a particular form of scabies, rarely reported in Tunisia. It habitually occurs in immunocompromised hosts, with prolonged immunosuppressive therapy, congenital immune disease, HIV-1 infection or neoplasm. We report an observation of norwegian scabies, occuring in a woman with prolounged systemic corticosteroid therapy. A 65-year-old woman, with a long history of obstructive bronchoneumopathy and bronchiectasis, treated with systemic corticosteroids for 5 years, was referred with a mild pruriginous and scaly erythroderma. This dermatosis developed within 5 months, with fever and impairing of health. Skin parasitological exams showed a massive infestation by sarcoptes. Histologic findings revealed multiple sarcoptes scabiei and eggs in the stratum corneum. The patient was treated with benzyl benzoate during 48 hours. She died rapidly with acute respiratory distress. basing on this observation of norwegian scabies occuring in an old immunocompromised woman, we put the accent on this particular form of scabies, often misappreciated, and incite to practice skin and nail parasitological exams in case of mild pruriginous, chronic scaly erythroderma. developing in immunocompromised patients.

  18. Discoveries on the Norwegian continental shelf

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    As discussed in this document, there are 108 discoveries on the Norwegian continental shelf which so far have not been approved for development. The oil and gas resources of the Norwegian Sea and the Barents Sea are mostly found in discoveries containing large volumes of gas. Eighty-one of the discoveries which are not approved for development are located in the North Sea and more than 60% of the discoveries in this province contain less than 5 mill Sm{sup 3} oil equivalents. In the Norwegian Sea and the Barents Sea there are 27 discoveries which are not approved for development and whose total resources are estimated at 500 mill Sm{sup 3} oil equivalents. About 60% of the oil resources is expected to be comprised by development plans in 1997 or 1998. Another 20% is in new discoveries currently being evaluated or in discoveries containing large volumes of gas. Production forecasts indicate substantial vacant oil processing capacity after 2000. Vacant gas processing capacity will mainly arise after 2005. 23 figs., 3 tabs.

  19. Beverage Consumption Patterns among Norwegian Adults

    Directory of Open Access Journals (Sweden)

    Mari Mohn Paulsen

    2016-09-01

    Full Text Available Beverages may be important contributors for energy intake and dietary quality. The purpose of the study was to investigate how beverage consumption varies between different meals (breakfast, lunch, dinner, supper/evening meal, snacks and between weekdays and weekend-days in Norwegian adults. A cross-sectional dietary survey was conducted among Norwegian adults (n = 1787 in 2010–2011. Two telephone-administered 24 h recalls were used for dietary data collection. Breakfast was the most important meal for milk and juice consumption, dinner for sugar-sweetened beverages and wine, and snacks for water, coffee, artificially sweetened beverages, and beer. Consumption of sugar-sweetened and artificially sweetened beverages did not differ between weekdays and weekend-days among consumers. The average intake of wine and beer (men only was higher on weekend-days. Higher age was positively associated with wine consumption and negatively associated with consumption of water, sugar-sweetened, and artificially sweetened beverages. Higher education was associated with consumption of water, beer, and wine, whereas lower education was associated with sugar-sweetened beverage consumption. Beverage consumption patterns among Norwegian adults vary between different meal types and in subgroups of the population. Alcohol consumption was higher on weekend-days. Knowledge regarding beverage consumption patterns in the population should be considered when revising dietary guidelines in the future.

  20. Characteristics of hospitals diverting ambulances in a California EMS system.

    Science.gov (United States)

    Kahn, Christopher A; Stratton, Samuel J; Anderson, Craig L

    2014-02-01

    While several reports discuss controversies regarding ambulance diversion from acute care hospitals and the mortality, financial, and resource effects, there is scant literature related to the effect of hospital characteristics. The objective of this study was to describe specific paramedic receiving center characteristics that are associated with ambulance diversion rates in an Emergency Medical Services system. A retrospective observational study design was used. The study was performed in a suburban EMS system with 27 paramedic receiving centers studied; one additional hospital present at the beginning of the study period (2000-2008) was excluded due to lack of recent data. Hospital-level and population-level characteristics were gathered, including diversion rate (hours on diversion/total hours open), for-profit status, number of specialty services (including trauma, burn, cardiovascular surgery, renal transplant services, cardiac catheterization capability [both interventional and diagnostic], and burn surgery), average inpatient bed occupancy rate (total patient days/licensed bed days), annual emergency department (ED) volume (patients per year), ED admission rate (percent of ED patients admitted), and percent of patients leaving without being seen. Demographic characteristics included percent of persons in each hospital's immediate census tract below the 100% and 200% poverty lines (each considered separately), and population density within the census tract. Bivariate and regression analyses were performed. Diversion rates for the 27 centers ranged from 0.3%-14.5% (median 4.5%). Average inpatient bed occupancy rate and presence of specialty services were correlated with an increase in diversion rate; occupancy rate showed a 0.08% increase in diversion hours per 1% increase in occupancy rate (95% CI, 0.01%-0.16%), and hospitals with specialty services had, on average, a 4.1% higher diversion rate than other hospitals (95% CI, 1.6%-6.7%). Other characteristics

  1. Fifty Years of Sino-Norwegian Cooperation——An Interview with Norwegian Ambassador

    Institute of Scientific and Technical Information of China (English)

    QiuJianghong

    2004-01-01

    Geographical distance has not hindered friendly relations, ongoing for more than two centuries, between China and Norway. Norway recognized the People's Republic of China on January 7, 1950 and diplomatic relations were established on October 5, 1954. In 1955, the two countries began to exchange ambassadors. Since then their political, economic and cultural cooperation has steadily advanced. The year 2004 marks the 50th anniversary of establishment of Sino-Norwegian diplomatic relations. In honor of the occasion, China Today spoke with Norwegian Ambassador Tor Chr. Hildan on bilateral trade and economic cooperation.

  2. Stylistic analysis of the poem "Ambulance" by Philip Larkin

    Directory of Open Access Journals (Sweden)

    Muhammad Yasir Khan

    2016-09-01

    Full Text Available Philip Larkin is known as a movement poet, because there are many poems which were published in the book of poetic movement, New Lines. This movement was started in 1950, against the unreasonable, inflated and extortionate romanticism of 1930's and 1940's. The common features of movement poetry are; the use of irony and wit, an element of satire, the loneliness of modern man, pessimistic outlook on life, realism, use of ordinary diction, use of symbols, and loss of religious faith. Robert Conquest is known as the representative poet of this movement. The poets of this movement believed that the language of poetry should be simple, lucid and intelligible. The poem Ambulance deals with the important features of movement poetry. Through the stylistics study of this poem the researchers will show the loneliness and concept of death in modern man.

  3. [Treatment of liver cirrhosis - actually possibility of ambulant internist].

    Science.gov (United States)

    Ehrmann, Jiří; Aiglová, Květa; Konečný, Michal; Procházka, Vlastimil; Vrzalová, Drahomíra

    There are 40 000-60 000 patients with cirrhosis in the Czech Republic. 2 000 die of this disease yearly. This group of patients needs a complex treatment and it is mostly an internist cooperating with other specialists. The most important for an ambulant internist is to diagnose the disease as soon as possible and start with treatment of chronic liver disease that could lead to a cirrhosis. It means especially chronic viral hepatitis, alcoholic or non-alcoholic steatosis/steatohepatitis, auto-immune liver damage and metabolic disease. The next step is to diagnose the cirrhosis in time when it is in no manifest stage. The third step is to diagnose and treat the liver decompensation. It means consequences of the portal hypertension, it is ascit, esophageal or gastric varices, hepatorenal syndrome. Next there are consequences of the metabolic insufficiency, it is icterus, coagulopathy and hepatic encephalopathy. It is necessary to diagnose and cure cholestasis from the very first extrahepatic causes. For a successful treatment of the hepatocellular carcinoma originated almost exclusively in the grounds of the cirrhosis must be early diagnosed. The ambulant internist respective hepatologist must diagnose the stage of the cirrhosis and decide when a hospitalization is necessary. Also a close cooperation with other specialists is urgent if it is about a liver transplantation. The treatment of successive stages of the cirrhosis is a topic of the showed educational article. compensated/decompensated liver cirrhosis - diet/nutrition in liver cirrhosis - etiology and diagnose of liver cirrhosis - treatment of liver insufficiency/failure - treatment of portal hypertension and its complications.

  4. Speed and distance requirements for community ambulation: a systematic review.

    Science.gov (United States)

    Salbach, Nancy M; O'Brien, Kelly; Brooks, Dina; Irvin, Emma; Martino, Rosemary; Takhar, Pam; Chan, Sylvia; Howe, Jo-Anne

    2014-01-01

    To provide an overview of the research literature on distance and speed requirements for adults to walk outside the home. We conducted a systematic review and searched PubMed, MEDLINE (Ovid), EMBASE, CINAHL, Scopus, PEDro, and The Cochrane Library from 1948 to May 2012, and other sources. Search terms included communities, walk, ambulation, and neighborhood. Full-text peer-reviewed articles written in English, French, or Spanish reporting distance and/or speed requirements for individuals walking outside the home were considered eligible. Two authors independently screened titles and abstracts. One author reviewed full-text articles to determine inclusion. Of the 3191 titles and abstracts screened, 15 studies (.47%) were selected for detailed review. One author appraised methodological quality. Inadequate description of the reliability of the measurement methods and the population of the town/city assessed was noted. One author extracted data from included studies. A second reviewer independently verified extracted data for accuracy. Seven studies examining 24 community sites and crosswalks in the United States, Australia, and Singapore were included. Three sites with the largest mean distance requirements for adults to walk were club warehouses (677m), superstores (183-607m), and hardware stores (566m). Three sites with the lowest mean distance requirements were walking at the front (16m) and back (19m) of the house, and at cemeteries (18m). The average speed required to cross the street in the time of a walk signal varied from .44 to 1.32m/s. Distance and speed requirements for adults to walk in the community environment vary widely. Findings are relevant to judging capacity for community ambulation to carry out essential activities of daily living, educating patients, and setting rehabilitation goals. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Personnel Policy and Profit

    DEFF Research Database (Denmark)

    Bingley, Paul; Westergård-Nielsen, Niels Chr.

    2004-01-01

    of the firm. Here we follow the population of 7118 medium-to-large sized private sector Danish firms over the period 1992-95. In an instrumental variables framework, we use changes in the personnel composition of different firms operating in the same local labour market to provide exogenous identifying...... personnel structure variation. It is found that personnel policy is strongly related to economic performance. At the margin, more hires are associated with lower profit, and more separations with higher profit. For the average firm, one new job, all else equal, is associated with ?2680 (2000 prices) lower...... annual profit. Higher wage level and lower wage growth is associated with higher profit. A workforce that has less tenure, all else equal, is more profitable....

  6. Personnel Policy and Profit

    DEFF Research Database (Denmark)

    Bingley, Paul; Westergård-Nielsen, Niels Chr.

    2004-01-01

    personnel structure variation. It is found that personnel policy is strongly related to economic performance. At the margin, more hires are associated with lower profit, and more separations with higher profit. For the average firm, one new job, all else equal, is associated with ?2680 (2000 prices) lower......There is a growing awareness of large differences in worker turnover and pay between firms. However, there is little knowledge about the effects of this on firm performance. This paper describes how personnel policies with respect to pay, tenure and worker flows are related to economic performance...... annual profit. Higher wage level and lower wage growth is associated with higher profit. A workforce that has less tenure, all else equal, is more profitable....

  7. INTRODUKSI TEKNOLOGI INOVASI AMBUL UNTUK BUDIDAYA TANAMAN SAYURAN DI KALIMANTAN TENGAH

    Directory of Open Access Journals (Sweden)

    HASTIN ERNAWATI NUR CHUSNUL CHOTIMAH

    2014-04-01

    Full Text Available Arut Bawah is a settlement that is always flooded every year due to Kahayan river run off . Residents perform various activities on the water, and transportation between housing residents with one another, using wooden boards. The conditions is not possible if it is used to grow crops. It is certainly limiting factor for household food needs, including the need for vegetables. Flooded land use around residential has not been done because the technology is not yet known. Through these activities, the community is expected to implement one of the local knowledges of the environment-friendly cultivation in swampy areas with ambul system so that people can still grow crops to sustain life. It consists of meeting nutritional needs, as well as improving food security in water-saturated soil conditions. This community service was conducted by the various stages of 1 outreach and dissemination of technology ambul 2 training of making ambul and 3 planting a variety of vegetables in ambul. The results showed that ambul can be used as a technology for cultivation in flooded areas. The introduction of technology ambul got a positive response from residents Arut Bawah Palangkaraya Central Kalimantan. Keywords: ambul, vegetables and flooded areas.

  8. The desired competence of the Swedish ambulance nurse according to the professionals - a Delphi study.

    Science.gov (United States)

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

    2014-07-01

    Nursing is evolving into new fields of health care including ambulance care, where a branch of specialist nursing is growing. Various views exist on the desired competence for the ambulance nurse and valid guidelines are lacking in Sweden. To increase knowledge of the field, professionals were asked to describe what competences an ambulance nurse should possess. The aim of this study was therefore to elucidate the desired professional competence of the specialist ambulance nurse, according to the professionals. A modified Delphi technique was used, where a panel of professional experts expressed their views on the desired competence of the ambulance nurse. This study reports, at a high level of agreement among the panel experts, that the desired competence of the specialist ambulance nurse consist of forty-four separate competences creating ten areas of competences: execute leadership, generic abilities, interpersonal communication, institutional collaboration, pedagogic skills, possession of relevant knowledge, professional judgement, professional skills, research activities, and technical skills. The high level of agreement among the professionals as well as the large number of competences reflects the high demands placed on the ambulance nurse by the professionals themselves. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Route less travelled? Ambulance use for children with high-acuity acute illness.

    Science.gov (United States)

    Hopgood, Timothy; Shepherd, Michael

    2014-04-01

    Ambulance transportation offers important supportive care and treatment en route to definitive treatment. However, children may be at risk of under-utilising ambulance transportation, where private vehicle is possible. This study aims to determine how many of the sickest children present to hospitals in Auckland via ambulance and whether certain population groups are lower users of ambulance services. Transportation, demographic and outcome data were collected and analysed for children presenting to Starship Children's Health (Starship) from 1 January to 31 December 2011), who were 'self referrals' to hospital, less than 15 years of age, and assigned triage category 1 and 2 on presentation. There were 1047 presentations to Starship identified that met inclusion criteria. Of these, 256 of the 341 triage one presentations (75.1%) and 217 of the 706 triage two presentations (30.7%) were transported by ambulance.Ambulance use was higher among older children (P ambulance, particularly those aged less than 1 year. This has the potential to result in worse health outcomes. There were no identified associations with patient demographics, and further research is required to better understand this problem and develop solutions. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  10. Fact 2004. The Norwegian petroleum sector

    Energy Technology Data Exchange (ETDEWEB)

    Gooderham, Rolf E. (ed.)

    2004-07-01

    The oil and gas sector is Norway's largest industry by value creation and has been a key driving force in Norwegian economic development for several decades. Developments in the petroleum industry are crucial for the future progress of Norwegian society and will remain so. While the petroleum sector has so far been characterised by growth, we can now see the beginning of a gradual reduction in the level of activity. This will have significant spin-offs for other industries and consequences for the Norwegian economy as a whole. Thus, it is important to ensure that profitable petroleum activities are pursued in order to moderate the pace of decline. This publication provides a broad picture of Norway's petroleum activities, and covers most aspects of the industry. It presents useful information and statistics on the sector both for those already familiar with this business and for readers who know less about it. Since petroleum production began on the Norwegian continental shelf (NCS) in 1971, a total of 3.8 bn standard cubic metres of oil equivalent (scm oe) has been produced. This corresponds to just under 30 per cent of the original recoverable reserves, and so substantial oil and gas resources remain. The government's Report no 38 (2001-2002) to the Storting (the Norwegian Parliament) described a long-term scenario for the NCS in which estimates for recoverable reserves from the Norwegian Petroleum Directorate are recovered. It is very important to ensure that the long-term scenario is achieved based on due consideration of environmental and safety issues. Norway's role as a major energy producer must be reconciled with the ambition to be a pioneer in the environmental area. This goal has always characterized government policy towards the petroleum industry. The strong focus on the environment has created a positive trend in safeguarding environmental concerns on the NCS. Production of oil and natural gas liquids averaged 3.3 mill barrels a

  11. Audit of oxygen use in emergency ambulances and in a hospital emergency department.

    Science.gov (United States)

    Hale, K E; Gavin, C; O'Driscoll, B R

    2008-11-01

    Oxygen is widely used but poorly studied in emergency medicine, with a limited evidence base for its use in specific conditions. There are safety concerns about the underuse of oxygen in patients with critical illness and its overuse in conditions such as chronic obstructive pulmonary disease (COPD). A baseline audit was required to assess current practice prior to the introduction of new national emergency oxygen guidelines in late 2008. The use of pulse oximetry and oxygen therapy was audited in patients brought by ambulance to the "majors" section of the emergency department (ED) in a university hospital. Oxygen therapy in the ambulance and the ED was subsequently documented. Oxygen use in ambulances was compared with Joint Royal Colleges Ambulance Liaison Committee (JRCALC) guidance and with subsequent patient management. The ambulance and ED records of 1022 patients were audited manually. Oxygen saturation (SpO(2)) was recorded for 90% of patients, 17% of whom had SpO(2) ambulance and almost half of these had oxygen discontinued in the ED. Only 62% of ambulance oxygen use was in accordance with JRCALC guidance, but most "undertreated" patients were stable normoxaemic patients for whom guidance recommends high-flow oxygen. Only 58% of patients with COPD were correctly identified in the ambulance and 73% of these patients were treated with flow rates >4 l/min (equivalent to >35% oxygen). Oxygen use in ambulances is very common, equivalent to 2.2 million episodes annually in the UK. The quality of oxygen use is suboptimal, especially for patients with COPD. Emergency oxygen therapy will become simpler when new evidence-based UK emergency oxygen guidelines are published, and it is hoped that future audits will show better protocol adherence.

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

    Directory of Open Access Journals (Sweden)

    Enrico Ferri

    2010-03-01

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

  13. English in Norwegian Academia: A Step Towards Diglossia?

    Science.gov (United States)

    Ljosland, Ragnhild

    2007-01-01

    This paper examines the role of English in relation to Norwegian in the higher education and research sector in Norway. English has gained influence in this sector at the expense of Norwegian, something which is described as a "domain loss." Two main questions are asked: (1) Can domain loss be explained as a consequence of the linguistic…

  14. Personnel Management. Universities.

    Science.gov (United States)

    Ohio Board of Regents, Columbus. Management Improvement Program.

    This manual is one of 10 completed in the Ohio Management Improvement Program (MIP) during the 1971-73 biennium. In this project, Ohio's 34 public universities and colleges, in an effort directed and staffed by the Ohio Board of Regents, have developed manuals of management practices, in this case, concerning personnel management. Emphasis in this…

  15. Personnel Scheduling in Laboratories

    NARCIS (Netherlands)

    Franses, Philip; Post, Gerhard; Burke, Edmund; De Causmaecker, Patrick

    2003-01-01

    We describe an assignment problem particular to the personnel scheduling of organisations such as laboratories. Here we have to assign tasks to employees. We focus on the situation where this assignment problem reduces to constructing maximal matchings in a set of interrelated bipartite graphs. We d

  16. Evaluating School Personnel Today.

    Science.gov (United States)

    Poliakoff, Lorraine L.

    This document, an evaluation of school personnel, is based on a review of the literature on evaluation in the ERIC system. Emphasis is placed on the evaluation of school administrators, teacher evaluation by students, and the teacher's role in evaluation. A 23-item bibliography is included. (MJM)

  17. Harmonious personnel scheduling

    NARCIS (Netherlands)

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

    2006-01-01

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

  18. Harmonious personnel scheduling

    NARCIS (Netherlands)

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

    2006-01-01

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

  19. Environment 2002. The Norwegian petroleum sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    The Ministry of Petroleum and Energy produces an annual environmental review in cooperation with the Norwegian Petroleum Directorate. The purpose of this publication is threefold: (1) to increase knowledge about the environmental aspects of Norwegian oil and gas activities, (2) to take a more detailed look at a specific topic which particularly concerns both the industry and the authorities, and identify the challenges and options faced, (3) to emphasise the governments goal of ensuring that Norway reconciles its role as a large energy producer with a pioneering position on environmental issues. This year's edition focuses on the topic of ''oil and fish - common sea''. Both the petroleum and fishing industries depend on the waters off Norway. Ever since petroleum activities began on the Norwegian continental shelf more than 30 years ago, the authorities have been keen to ensure that these two sectors can work in the same sea areas. What challenges and opportunities face the petroleum industry over discharges to the sea and living marine resources? How can the authorities ensure that this sector is able to coexist with the fisheries? These and similar questions about the relationship between the petroleum and fishing industries in their shared seas are covered in section two of this publication. Environment 2002 also incorporates a factual section, which covers the status of emissions/discharges, environmental impacts and measures to reduce discharges to the sea and emissions to the air from petroleum activities. The MPE hopes that a publication of this kind can enhance basic knowledge about petroleum activities and environmental issues.

  20. NOM removal technologies – Norwegian experiences

    Directory of Open Access Journals (Sweden)

    H. Ødegaard

    2009-10-01

    Full Text Available The paper gives an overview of the methods for removal of natural organic matter (NOM, particularly humic substances (HS, in water with focus on the Norwegian experiences. It is demonstrated that humic substances may be removed by a variety of methods, such as; molecular sieving through nanofiltration membranes, coagulation with subsequent floc separation (including granular media or membrane filtration, oxidation followed by biofiltration and sorption processes including chemisorption (ion exchange and physical adsorption (activated carbon. All these processes are in use in Norway and the paper gives an overview of the operational experiences.

  1. NOM removal technologies – Norwegian experiences

    Directory of Open Access Journals (Sweden)

    H. Ødegaard

    2010-01-01

    Full Text Available The paper gives an overview of the methods for removal of natural organic matter (NOM in water, particularly humic substances (HS, with focus on the Norwegian experiences. It is demonstrated that humic substances may be removed by a variety of methods, such as; molecular sieving through nanofiltration membranes, coagulation with subsequent floc separation (including granular media or membrane filtration, oxidation followed by biofiltration and sorption processes including chemisorption (ion exchange and physical adsorption (activated carbon. All these processes are in use in Norway and the paper gives an overview of the operational experiences.

  2. Evaluating benchmarks for Norwegian exchange rate forecasting

    OpenAIRE

    Adrik, Samir

    2016-01-01

    In this thesis, we compare the out-of-sample forecasting abilities of three fundamental exchange rate models (EqCM) against the random walk (without drift), RW. The objective of the thesis is to see how well the RW model preforms against fundamental exchange rate models that in the literature have proven to be better at forecasting the Norwegian exchange rate. These models were tested on an out-of-sample period (2009:1-2015:4) that include two characteristic exchange rate regimes. The models ...

  3. Norwegian scabies - rare case of atypical manifestation*

    Science.gov (United States)

    Ebrahim, Karina Corrêa; Alves, Júlia Barazetti; Tomé, Lísias de Araújo; de Moraes, Carlos Floriano; Gaspar, Arianne Ditzel; Franck, Karin Fernanda; Hussein, Mohamad Ali; da Cruz, Lucas Raiser; Ebrahim, Leonardo Duque; Sidney, Luis Felipe de Oliveira

    2016-01-01

    Human scabies affects all social classes and different races around the world. It is highly contagious, but the exact figures on its prevalence are unknown. A 19-year-old male patient was admitted to the emergency room reporting fever (38°C) and multiple lesions throughout the body, except face, soles, and palms. Lesions were non-pruritic, which hampered the initial diagnostic suspicion. Skin biopsy was performed, and the final diagnosis was crusted scabies (Norwegian). It was concluded that human scabies is a significant epidemic disease, due to its different clinical manifestations, and because it is extremely contagious. PMID:28099611

  4. Facts 2002. The Norwegian petroleum sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    The petroleum sector is highly significant for the Norwegian economy. Its share of gross domestic product, exports and total government revenues has been substantial over the past two decades, reaching a particularly high level in 2000 and 2001. The principal reason why revenues were so high in these two years is a combination of high oil prices, a strong USD against the NOK and historically high petroleum production. The share of petroleum investment in total capital spending in the Norwegian economy was at its highest in the early 1990s. Total investment in the petroleum sector has been above NOK 40 bn every year since 1992, and peaked in 1998 at roughly NOK 80 bn. Capital spending declined to around NOK 56.9 bn in 2001. The government's most important revenue sources in recent years have been cash flow from the state's direct financial interest (SDFI) and from taxes. Production of crude oil has averaged around three mill barrels per day since 1996. The figure for 2001 was 3.1 mill barrels. Including natural gas liquids (NGL) and condensate raises the 2001 average to 3.4 mill barrels oe per day. At 53 mill scm oe, gas production was also high in 2001. Oil production is expected to remain more or less unchanged over the next few years, and then to go into a gradual decline. Gas output, on the other hand, should expand substantially over the coming decade and is expected to be increasingly significant in Norwegian petroleum output in future. The petroleum sector is also a substantial player internationally. Norway ranks as the world's sixth largest producer and third largest net exporter of oil. It is also the world's third largest exporter of pipeline gas, and Norwegian foreign sales of this commodity accounted for about two per cent of global consumption in 2001. Roughly 10 per cent of west European gas consumption is covered from Norway. Several changes were made to state participation in the petroleum sector during 2001. The government sold

  5. The Norwegian Climate and Ozone Research Programme

    Energy Technology Data Exchange (ETDEWEB)

    Dahlin, E. [ed.

    1996-03-01

    This report includes abstracts from a workshop arranged by the Norwegian Climate and Ozone Research Programme 11-12 March 1996. The abstracts are organized according to the sessions: (1) Regional effects of climate change with emphasis on ecology, (2) Climate research related to the North Atlantic, (3) What lessons can be drawn from paleoclimatology about changes in the current climate?, (4) Changes in the ozone layer and their effect on UV and biology. Abstracts of a selection of papers presented at the workshop can be found elsewhere in the present data base. 70 refs., 19 figs., 2 tabs.

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

    Science.gov (United States)

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

    2010-08-01

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

  7. Occupant accelerations and injury potential during an ambulance-to-curb impact.

    Science.gov (United States)

    Lee, Ellen L; Hayes, Wilson C

    2014-04-01

    This paper presents real world acceleration data for an ambulance driving up and over a curb. A full scale reenactment was performed for a litigated case in which a patient on a gurney in an ambulance claimed a variety of bodily injuries after the ambulance struck a curb. A height and weight matched surrogate rode on the gurney during the tests. Results demonstrated that peak vehicle and occupant accelerations never exceeded 1.1g's. To address the claimed injuries, the accelerations likely sustained by the patient were compared to those experienced during daily life. Since ambulances are wide vehicles that travel fast on potentially narrow arterial, collector or local roadways, curb or median impacts may occur during the normal course of driving. Thus, these results may be useful for forensic experts in dealing with similar cases involving claimed injuries following curb impacts.

  8. Early Access to Patients with Life-threatening Cardiovascular Disease by an Air Ambulance Service

    National Research Council Canada - National Science Library

    Imaizumi, Takahiro; Hata, Noritake; Kobayashi, Nobuaki; Yokoyama, Shinya; Shinada, Takuro; Tokuyama, Kenichi; Ishikawa, Masahiro; Shiiba, Kunito; Matsumoto, Hisashi; Takuhiro, Kitoji; Mashiko, Kunihiro

    2004-01-01

    ... (doctor helicopter service; DHS) could shorten the prehospital delay. We evaluated the initial treatment time and the transport time in 30 patients transported by DHS and 30 patients transported by ground ambulance service (GAS...

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

    CERN Multimedia

    Anaïs Schaeffer

    2012-01-01

    On 19 April the Fire Brigade unveiled its latest acquisition: a brand-new ambulance specially designed for CERN.   One of the Fire Brigade's two ambulances has just been replaced by a state-of-the-art vehicle tailor-made to meet CERN's unique requirements. At 4.6 metres long it's much more spacious than its predecessors, providing plenty of room for patient, doctor and paramedic. The ambulance's design and manufacture are the result of a successful collaboration between the Fire Brigade and the technicians from Profile Vehicles, the Finnish company that won the contract following a call for tenders launched in June 2011. "It took us six months to finalise the specification for our new ambulance," explains Patrick Berlinghi, who is responsible for the Fire Brigade's logistics. "We wanted it to be spacious enough for us to be able to work comfortably and to have the latest safety and patient care equipment.  We also reques...

  10. Environmental monitoring of Norwegian water resources

    Energy Technology Data Exchange (ETDEWEB)

    Tollan, A.

    1980-01-01

    A national environmental monitoring program was started in Norway in 1980, under the auspices of the Norwegian State Pollution Control Authority. Within this program The Norwegian Institute for Water Research is responsible for: (1) Chemical and biological monitoring of selected rivers and fjord areas. Typically, the monitoring of a particular river or fjord starts with a basic investigation of 1-3 years, comprising physiography, human impacts on the water quality and a broad description of the present water quality status. This stage is followed by a permanent monitoring of carefully selected variables at a limited number of stations. Special water quality problems may be studied separately. (2) Participation in a coordinated monitoring of long-range transported atmospheric pollution, and its effects on water chemistry, aquatic life and soil properties. (3) Methodological development, standardization of analytical procedures and evaluation techniques for water quality assessment, and assistance as a national reference laboratory for water analyses. (4) Depository for environmental data collected within the national monitoring program.

  11. Promoting coordination in Norwegian health care

    Directory of Open Access Journals (Sweden)

    Tor I. Romøren

    2011-10-01

    Full Text Available   Introduction: The Norwegian health care system is well organized within its two main sectors - primary health and long term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures.Policy practice: Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term "Coordination Reform". These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented.Discussion: The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.

  12. Promoting coordination in Norwegian health care

    Directory of Open Access Journals (Sweden)

    Tor I. Romøren

    2011-10-01

    Full Text Available   Introduction: The Norwegian health care system is well organized within its two main sectors - primary health and long term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures. Policy practice: Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term "Coordination Reform". These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented. Discussion: The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.

  13. The acquisition of compositional definiteness in Norwegian

    Directory of Open Access Journals (Sweden)

    Merete Anderssen

    2008-02-01

    Full Text Available This paper aim to explain why the prenominal definiteness marker found in modified structures only is acquired much later than the suffixal definite article in Norwegian. The coexistence of the two definiteness markers is the result of the so-called double definiteness phenomenon in Norwegian which occurs in definite structures involving an attributive adjective. As the prenominal determiner only occurs in modified contexts, one obvious explanation that presents itself is that the omission of the prenominal determiner is related to the fact that it is much less frequent in the input than the suffixal article. However, if we consider the form of this determiner, it is clear that the form itself must be very frequent in the input, as it is homophonous with the demonstrative and with inanimate third person pronouns, which are all frequent in use. Consequently, a lexical insertion approach to the double definiteness phenomenon is proposed according to which the discrepancy in the order of acquisition is argued to be due to a combination of prosodic saliency and the lexicalisation of semantic features, the latter of which will be dealt with here.

  14. Design considerations to enhance the safety of patient compartments in ambulance transporters.

    Science.gov (United States)

    Byran, Eyal; Gilad, Issachar

    2012-01-01

    The safety of the interior of ambulances is dubious and, in the event of sudden impact during emergency transport, potentially perilous to patients they carry. The workplace ergonomics of the interior of the passenger cabin is lacking. This article discusses an improved ergonomic interior design based on study findings, observations and subjective perception. It suggests design aspects and safety concepts aimed at increasing the safety of patients and paramedic staff inside the ambulance as a mobile workstation.

  15. To surrender in dependence of another: the relationship with the ambulance clinicians as experienced by patients.

    Science.gov (United States)

    Holmberg, Mats; Forslund, Kerstin; Wahlberg, Anna Carin; Fagerberg, Ingegerd

    2014-09-01

    Historically, the ambulance care has focused on acute transports and medical treatment, although ambulance care has also been reported as complex, encompassing more than just medical treatment and transports. Previous studies, on ambulance clinicians, have pointed out the importance of interpersonal caring activities complementary to the medical treatment. Those activities can be understood as taking part in the relationship between patients and ambulance clinicians, earlier described as essential and a core component of care. The aim of this study was to elucidate the meaning of the relationship with the ambulance clinicians as experienced by patients. Twenty ambulance patients were interviewed in the study. The interviews were transcribed verbatim and analysed with a phenomenological hermeneutical method to grasp meanings in the patients' experiences. The regional ethical committee approved the study. In the result emerged one main theme: To surrender in dependence of another. The main theme includes four themes: Being in the hands of another, Being in a caring temporary presence, Being important while involved and Being powerless while insignificant, and the themes comprise eleven subthemes. The main theme meant to have no other option than to surrender and to put their life into the hand of another. This surrender also meant to adapt to the clinicians' views even if not shared. This is experienced as excessive care. Summarised, the patients' experiences were both positive and negative and the findings provide a complex understanding of the relationship between the patient and the ambulance clinicians. Overall, the relationship embraces the whole person without reducing the patient to be a recipient of an objectified ambulance care. © 2013 Nordic College of Caring Science.

  16. Patient characteristics and patterns of intoxication: one-time and repeated use of emergency ambulance services.

    Science.gov (United States)

    Holzer, Barbara M; Minder, Christoph E; Rosset, Nina; Schaetti, Gabriela; Battegay, Edouard; Mueller, Stefan; Zimmerli, Lukas

    2013-05-01

    The aim of this study was to investigate the utilization of ambulance services that resulted from alcohol and drug intoxication over a period of 1 year in a metropolitan area, with an emphasis on characteristic differences between patients with one-time versus repeated use. All ambulance-service report forms filed in 2010 were systematically screened for utilizations in which alcohol intoxication or intoxication resulting from consumption of illicit or legal drugs other than alcohol was the chief complaint (N = 2,341 patients; 65% male). Repeat users differed from persons with one-time use in their characteristics and patterns of intoxication. On average, patients with repeated ambulance use were almost 8 years older and had a different pattern of ambulance use over the course of the week with no clear peak on any specific day. The mean number of ambulance services in patients with repeated use was 2.8 (SD = 1.517) in the 1-year study period. Repeat users were less likely to be injured than patients with one-time ambulance-service use and more often showed aggression or uncooperative behavior toward paramedics. All cases of death associated with intoxication involved patients with one-time ambulance use. The ambulance-service users' generally slight impairment of consciousness and the high proportion of intoxicated patients without any injuries raise the question of how many of these patients could be adequately cared for in a sobering center. Sobering centers might relieve hospital emergency departments of patients not requiring acute emergency care and, in addition, could provide intervention services to prevent relapses.

  17. Electronic Official Personnel Folder System

    Data.gov (United States)

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

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

    Science.gov (United States)

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

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

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

    Science.gov (United States)

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

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

  20. Effect of public awareness campaigns on calls to ambulance across Australia.

    Science.gov (United States)

    Bray, Janet E; Straney, Lahn; Barger, Bill; Finn, Judith

    2015-05-01

    The National Stroke Foundation of Australia has run 12 public awareness campaigns since 2004. Campaign exposure and funding has varied annually and regionally during this time. The aim of this study was to measure the effect of campaigns on calls to ambulance for stroke across Australia in exposed regions (paid or pro bono advertising). All ambulance services in Australia provided monthly ambulance dispatch data between January 2003 and June 2014. We performed multivariable regression to measure the effect of campaign exposure on the volume of stroke-related emergency calls, after controlling for confounders. The final model indicated that 11 of the 12 National Stroke Foundation campaigns were associated with increases in the volume of stroke-related calls (varying between 1% and 9.9%) in regions with exposure to advertising. This increase lasted ≈3 months, with an additional 10.2% relative increase in the volume of the calls in regions with paid advertising. We found no significant additional effect of the campaigns on stroke calls where ambulance services are publicly funded. The National Stroke Foundation stroke awareness campaigns are associated with increases to calls to ambulance for stroke in regions receiving advertising and promotion. Research is now required to examine whether this increased use in ambulance is for appropriate emergencies. © 2015 American Heart Association, Inc.

  1. The lived experiences of patients and ambulance ramping in a regional Australian emergency department: An interpretive phenomenology study.

    Science.gov (United States)

    Kingswell, Chris; Shaban, Ramon Z; Crilly, Julia

    2015-11-01

    Internationally, the workload of emergency departments (ED) has increased, resulting in overcrowding and frequent delays in the offloading of patients arriving via ambulance--referred to in Australia as 'ambulance ramping'. Using interpretive phenomenology, this study sought to understand the experience of ambulance ramping from the perspective of patients. Semi-structured interviews were undertaken with seven patients who presented to a regional Queensland ED via ambulance, and experienced an ambulance offload delay of >30 min. Ambulance ramping in the ED was described as 'Being a patient, patient', and three major themes emerged: Understanding the emergency healthcare system; Making do within the emergency healthcare system; and Being 'in the dark' during ambulance ramping. Most participants did not understand the antecedents to ambulance ramping, but understood some of the consequences. Most were happy to wait with paramedics for a bed and, although without privacy, felt safe. However, most participants felt 'in the dark' during ambulance ramping, due to communication difficulties regarding bed availability, and this led to frustration. In light of the Australian Charter of Healthcare Rights, service improvement opportunities exist for patients arriving to the ED by ambulance to ensure delays are minimised and quality care is delivered. Copyright © 2015 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-07-01

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

  3. Assessing a Norwegian translation of the Organizational Climate Measure.

    Science.gov (United States)

    Bernstrøm, Vilde Hoff; Lone, Jon Anders; Bjørkli, Cato A; Ulleberg, Pål; Hoff, Thomas

    2013-04-01

    This study investigated the Norwegian translation of the Organizational Climate Measure developed by Patterson and colleagues. The Organizational Climate Measure is a global measure of organizational climate based on Quinn and Rohrbaugh's competing values model. The survey was administered to a Norwegian branch of an international service sector company (N = 555). The results revealed satisfactory internal reliability and interrater agreement for the 17 scales, and confirmatory factor analysis supported the original factor structure. The findings gave preliminary support for the Organizational Climate Measure as a reliable measure with a stable factor structure, and indicated that it is potentially useful in the Norwegian context.

  4. Emergency nursing workload and patient dependency in the ambulance bay: A prospective study.

    Science.gov (United States)

    Varndell, Wayne; Ryan, Elizabeth; Jeffers, Alison; Marquez-Hunt, Nadya

    2016-11-01

    The purpose of this prospective observational study was to characterise patients occupying the ambulance bay and to determine the ensuing nursing workload. The number of patients presenting to ED by ambulance is increasing. During periods of peak demand and access block in the ED, patients with ongoing care needs, requiring continual assessment and symptom management by emergency nurses can remain in the ambulance bay for extended periods of time. The profile of these patients and on the related nursing workload is not well known. A prospective observational study design based upon a convenience sample of patients was conducted over a randomly selected four-week period. Nursing workload was assessing using the Jones Dependency Tool. A modified Work Observation Method By Activity Timing technique was used to estimate direct nursing care time. Of 4068 presentations to ED, 640 (16%) occupied the ambulance bay following triage, of which the majority (n=408; 64%) had arrived by ambulance. Of those occupying the ambulance bay 205 (32%) were evaluated using the JDT. The majority of patients had potentially life-threatening symptoms (ATS 3, n=424; 66%), were moderately dependent (n=134; 65%), and consumed approximately 152.1h of direct nursing care time. A large proportion of direct nursing care time was spent on patient reassessment (60.4h) and pain management (29.6h). Patients occupying the ambulance bay had an average ED length of stay of 5.6h (4.6h), of which 1.8h (SD 1.8h) was spent delayed in the ambulance bay. Early detailed assessment and symptom management of patients occupying the ambulance bay is extensively undertaken by emergency nurses. The frequency and number of patients off-loaded into non-clinical areas is not currently monitored or reported upon. This study has demonstrated that patients managed in the ambulance bay consume large amounts of nursing resources, commonly require acute level care and hospital admission. Copyright © 2016 College of Emergency

  5. Reduction in STEMI transfer times utilizing a municipal "911" ambulance service.

    Science.gov (United States)

    Tennyson, Joseph C; Quale, Mark R

    2014-02-01

    The time interval from diagnosis to reperfusion therapy for patients experiencing ST-segment elevation myocardial infarction (STEMI) has a significant impact on morbidity and mortality. It is hypothesized that the time required for interfacility patient transfers from a community hospital to a regional percutaneous coronary intervention (PCI) center using an Advanced Life Support (ALS) transfer ambulance service is no different than utilizing the "911" ALS ambulance. Quality assurance data collected by a tertiary care center cardiac catheterization program were reviewed retrospectively. Data were collected on all patients with STEMI requiring interfacility transfer from a local community hospital to the tertiary care center's PCI suite, approximately 16 miles away by ground, 12 miles by air. In 2009, transfers of patients with STEMI were redirected to the municipal ALS ambulance service, instead of the hospital's contracted ALS transfer service. Data were collected from January 2007 through May 2013. Temporal data were compared between transports initiated through the contracted ALS ambulance service and the municipal ALS service. Data points included time of initial transport request and time of ambulance arrival to the sending facility and the receiving PCI suite. During the 4-year study period, 63 patients diagnosed with STEMI and transferred to the receiving hospital's PCI suite were included in this study. Mean times from the transport request to arrival of the ambulance at the sending hospital's emergency department were six minutes (95% CI, 4-7 minutes) via municipal ALS and 13 minutes (95% CI, 9-16 minutes) for the ALS transfer service. The mean times from the ground transport request to arrival at the receiving hospital's PCI suite when utilizing the municipal ALS ambulance and hospital contracted ALS ambulance services were 48 minutes (95% CI, 33-64 minutes) and 56 minutes (95% CI 52-59 minutes), respectively. This eight-minute period represented a 14% (P

  6. Enlisted Personnel Allocation System

    Science.gov (United States)

    1990-07-01

    0 0 0 0 0 0 0 CSP/AD DATE[: 11/iS/SB TIMH MAGIU: EC01G MAP: EC011IO2 HSL: 0~3401 1 2 2 4 5 6 7 ] 11102 IELI~STED PERSONNEL ALL.OCATION SYS TD ...DD4OGRAPIC GROUP #1] 10 J j9>>>)>>>>>>> Z’<<<<<<<<’((<t Jt>>>>>F Z•<<<<t 3 1 11 I II II .III 1 . ] I I IIIA IIIB .11 3 T; 1/1 HZj 2/3 REUNT3ANMEU

  7. Personnel Audit Process

    Directory of Open Access Journals (Sweden)

    Wojciech Pająk

    2012-06-01

    Full Text Available Audit is one of the basic issues in organisation and management. It consists of a number of constituent problems. One of them is the problem of research methodology. On the other hand, internal audit plays an increasingly important role in improvement of the functioning of an organisation . An attempt to apply the concept of internal audit for the purposes of diagnosing human resource management is the subject matter of this paper. Apart from the problems strictly related to the essence of methodology of personnel audit, an attempt was made to determine the problem range determined by this audit.

  8. Food safety practices among Norwegian consumers.

    Science.gov (United States)

    Røssvoll, Elin Halbach; Lavik, Randi; Ueland, Øydis; Jacobsen, Eivind; Hagtvedt, Therese; Langsrud, Solveig

    2013-11-01

    An informed consumer can compensate for several potential food safety violations or contaminations that may occur earlier in the food production chain. However, a consumer can also destroy the work of others in the chain by poor food handling practices, e.g., by storing chilled ready-to-eat foods at abusive temperatures. To target risk-reducing strategies, consumer groups with high-risk behavior should be identified. The aim of this study was to identify demographic characteristics associated with high-risk food handling practices among Norwegian consumers. More than 2,000 randomly selected Norwegian consumers were surveyed, and the results were analyzed with a risk-based grading system, awarding demerit points for self-reported food safety violations. The violations were categorized into groups, and an ordinary multiple linear regression analysis was run on the summarized demerit score for each group and for the entire survey group as a whole. Young and elderly men were identified as the least informed consumer groups with the most unsafe practices regarding food safety. Single persons reported poorer practices than those in a relationship. People with higher education reported poorer practices than those with lower or no education, and those living in the capital of Norway (Oslo) reported following more unsafe food practices than people living elsewhere in Norway. Men reported poorer food safety practices than women in all categories with two exceptions: parboiling raw vegetables before consumption and knowledge of refrigerator temperature. These findings suggest that risk-reducing measures should target men, and a strategy is needed to change their behavior and attitudes.

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

    Directory of Open Access Journals (Sweden)

    Rinku Girija

    2017-01-01

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

  10. Circumstances surrounding non-fatal opioid overdoses attended by ambulance services.

    Science.gov (United States)

    Madah-Amiri, Desiree; Clausen, Thomas; Myrmel, Lars; Brattebø, Guttorm; Lobmaier, Philipp

    2017-05-01

    Opioid overdose fatalities are a significant concern globally. Non-fatal overdoses have been described as a strong predictor for future overdoses, and are often attended by the ambulance services. This paper explores characteristics associated with non-fatal overdoses and aims to identify possible trends among these events in an urban area in Norway. This is a retrospective analysis of non-fatal overdoses from Bergen ambulance services from 2012 to 2013. Demographic, temporal and geographic data were explored. During the two years, 463 non-fatal opioid overdoses were attended by ambulance services. Ambulance call-outs occurred primarily during the late afternoon and evening hours of weekdays. Summer months had more overdoses than other seasons, with a peak in August. Overdoses were nearly twice as likely to occur in a public location in August (risk ratio 1.92, P = 0.042). Ambulance response times were more likely to be longer to private locations, and these victims were more likely to be treated and left at the scene. There was no difference in arrival time for drug-related and non-drug related dispatch. The temporal patterns suggest that non-fatal overdoses occur during non-recreational time periods. The longer ambulance response time and disposition for private addresses indicate potential opportunities for peer interventions. Our analysis describes circumstances surrounding non-fatal overdoses and can be useful in guiding relevant, targeted prevention interventions. [Madah-Amiri D, Clausen T, Myrmel L, Brattebø G, Lobmaier P. Circumstances surrounding non-fatal opioid overdoses attended by ambulance services. Drug Alcohol Rev 2017;36:288-294]. © 2016 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

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

    Science.gov (United States)

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

    2016-01-01

    Pain is the most common symptom in the emergency setting and remains one of the most challenging problems for emergency care providers, particularly in the pediatric population. The primary objective of this study was to determine the prevalence of acute pain in children attending emergency departments (EDs) in Ireland by ambulance. In addition, this study sought to describe the prehospital and initial ED management of pain in this population, with specific reference to etiology of pain, frequency of pain assessment, pain severity, and pharmacological analgesic interventions. A prospective cross-sectional study was undertaken over a 12-month period of all pediatric patients transported by emergency ambulance to four tertiary referral hospitals in Ireland. All children (ambulance, of which 2,635 (41.4%, 95% confidence interval 40.2-42.3%) had pain as a documented symptom on the ambulance patient care report (PCR) form. Overall 32% (n = 856) of children who complained of pain were subject to a formal pain assessment during the prehospital phase of care. Younger age, short transfer time to the ED, and emergency calls between midnight and 6 am were independently associated with decreased likelihood of having a documented assessment of pain intensity during the prehospital phase of care. Of the 2,635 children who had documented pain on the ambulance PCR, 26% (n = 689) received some form of analgesic agent prior to ED arrival. Upon ED arrival 54% (n = 1,422) of children had a documented pain assessment and some form of analgesic agent was administered to 50% (n = 1,324). Approximately 41% of children who attend EDs in Ireland by ambulance have pain documented as their primary symptom. This study suggests that the management of acute pain in children transferred by ambulance to the ED in Ireland is currently poor, with documentary evidence of only 26% receiving prehospital analgesic agents.

  12. Improved outcomes for emergency department patients whose ambulance off-stretcher time is not delayed.

    Science.gov (United States)

    Crilly, Julia; Keijzers, Gerben; Tippett, Vivienne; O'Dwyer, John; Lind, James; Bost, Nerolie; O'Dwyer, Marilla; Shiels, Sue; Wallis, Marianne

    2015-06-01

    To describe and compare characteristics and outcomes of patients who arrive by ambulance to the ED. We aimed to (i) compare patients with a delayed ambulance offload time (AOT) >30 min with those who were not delayed; and (ii) identify predictors of an ED length of stay (LOS) of >4 h for ambulance-arriving patients. A retrospective, multi-site cohort study was undertaken in Australia using 12 months of linked health data (September 2007-2008). Outcomes of AOT delayed and non-delayed presentations were compared. Logistic regression analysis was undertaken to identify predictors of an ED LOS of >4 h. Of the 40 783 linked, analysable ambulance presentations, AOT delay of >30 min was experienced by 15%, and 63% had an ED LOS of >4 h. Patients with an AOT ambulance time at hospital; time to see healthcare professional; proportion seen within recommended triage time frame; and ED LOS for both admitted and non-admitted patients. In-hospital mortality did not differ. Strong predictors of an ED LOS >4 h included: hospital admission, older age, triage category, and offload delay >30 min. Patients arriving to the ED via ambulance and offloaded within 30 min experience better outcomes than those delayed. Given that offload delay is a modifiable predictor of an ED LOS of >4 h, targeted improvements in the ED arrival process for ambulance patients might be useful. © 2015 The Authors. Emergency Medicine Australasia published by Wiley Publishing Asia Pty Ltd on behalf of Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  13. A comparison of actual versus predicted emergency ambulance journey times using generic Geographic Information System software.

    Science.gov (United States)

    McMeekin, Peter; Gray, Jo; Ford, Gary A; Duckett, Jay; Price, Christopher I

    2014-09-01

    The planning of regional emergency medical services is aided by accurate prediction of urgent ambulance journey times, but it is unclear whether it is appropriate to use Geographical Information System (GIS) products designed for general traffic. We examined the accuracy of a commercially available generic GIS package when predicting emergency ambulance journey times under different population and temporal conditions. We undertook a retrospective cohort study of emergency ambulance admissions to three emergency departments (ED) serving differing population distributions in northeast England (urban/suburban/rural). The transport time from scene to ED for all the highest priority dispatches between 1 October 2009 and 30 September 2010 was compared with predictions made by generic GIS software. For 10,156 emergency ambulance journeys, the mean prediction discrepancy between actual and predicted journey times across all EDs was an underprediction of 1.6 min (SD 4.9). Underprediction was statistically significant at all population densities, but unlikely to be of clinical significance. Ambulances in urban areas were able to exceed general traffic speed, whereas, the opposite effect was seen in suburban and rural road networks. There were minor effects due to travel outside the busiest traffic times (mean overprediction 0.8 min) and during winter months (mean underprediction 0.4 min). It is reasonable to estimate emergency ambulance journey times using generic GIS software, but in order to avoid insufficient regional ambulance provision it would be necessary to make small adjustments because of the tendency towards systematic underprediction. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Ambulance telephone triage using 'NHS Pathways' to identify adult cardiac arrest.

    Science.gov (United States)

    Deakin, Charles D; England, Simon; Diffey, Debbie

    2017-05-01

    UK ambulance services are called to 30 000 cardiac arrests (CAs) annually where resuscitation is attempted. Correct identification by the ambulance service trebles survival by facilitating bystander-cardiopulmonary resuscitation (CPR) and immediate ambulance dispatch. Identification of CA by telephone is challenging and involves algorithms to identify key features. 'NHS Pathways' is now used for triage by six of 12 UK ambulance services, covering a population of 20 million. With the significant improvements in survival when CA is accurately identified, it is vital that 'NHS Pathways' is able to identify CA correctly. All '999' emergency calls to South Central Ambulance Service (SCAS) over a 12-month period screened by NHS Pathways v9.04 were identified. All actual or presumed CAs identified by the emergency call taker were cross-referenced with the ambulance crew's Patient Report Form to identify all confirmed CAs. A total of 469 400 emergency (999) calls were received by SCAS. Of the 3119 CA identified by ambulance crew, 753 were not initially classified as CA by NHS Pathways (24.1%). Overall, sensitivity=0.759 (95% CI 0.743 to 0.773); specificity=0.986 (95% CI 0.9858 to 0.98647); and positive predictive value=26.80% (95% CI 25.88 to 27.73%). NHS Pathways accurately identifies 75.9% of adult CAs. The remainder represents approximately 7500 treatable CAs in the UK annually where the diagnosis is missed, with significant implications for patient outcome. Further work is required to improve this first link in the chain of survival. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

    Science.gov (United States)

    2010-01-01

    Background Ambulance response time is a crucial factor in patient survival. The number of emergency cases (EMS cases) requiring an ambulance is increasing due to changes in population demographics. This is decreasing ambulance response times to the emergency scene. This paper predicts EMS cases for 5-year intervals from 2020, to 2050 by correlating current EMS cases with demographic factors at the level of the census area and predicted population changes. It then applies a modified grouping genetic algorithm to compare current and future optimal locations and numbers of ambulances. Sets of potential locations were evaluated in terms of the (current and predicted) EMS case distances to those locations. Results Future EMS demands were predicted to increase by 2030 using the model (R2 = 0.71). The optimal locations of ambulances based on future EMS cases were compared with current locations and with optimal locations modelled on current EMS case data. Optimising the location of ambulance stations locations reduced the average response times by 57 seconds. Current and predicted future EMS demand at modelled locations were calculated and compared. Conclusions The reallocation of ambulances to optimal locations improved response times and could contribute to higher survival rates from life-threatening medical events. Modelling EMS case 'demand' over census areas allows the data to be correlated to population characteristics and optimal 'supply' locations to be identified. Comparing current and future optimal scenarios allows more nuanced planning decisions to be made. This is a generic methodology that could be used to provide evidence in support of public health planning and decision making. PMID:20109172

  16. Language barriers and professional identity: A qualitative interview study of newly employed international medical doctors and Norwegian colleagues.

    Science.gov (United States)

    Skjeggestad, Erik; Gerwing, Jennifer; Gulbrandsen, Pål

    2017-08-01

    To explore how language barriers influence communication and collaboration between newly-employed international medical doctors and Norwegian health personnel. Interviews were conducted with 16 doctors who had recently started working in Norway and 12 Norwegian born health personnel who had extensive experience working with international medical doctors. Analyses were consistent with principles of systematic text condensation. All participants experienced that language barriers caused difficulties in their everyday collaboration. Furthermore, the participants' descriptions of "language barriers" encompassed a wide range of topics, including semantics (e.g., specialized professional vocabulary, system knowledge), pragmatics (e.g., using language in doctor-patient and interprofessional interactions), and specific culturally sensitive topics. All participants described that language barriers provoked uncertainty about a doctor's competence. Newly employed international medical doctors and their colleagues are concerned by ineffective communication due to language barriers. Experiences of language barriers threaten professional identity as a competent and effective doctor. Newly employed doctors who are non-native speakers could benefit from support in understanding and handling the array of barriers related to language. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Ambulation following spinal cord injury and its correlates

    Directory of Open Access Journals (Sweden)

    Nitin Menon

    2015-01-01

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

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

    Science.gov (United States)

    Coleman, Gill; Wiggins, Liz

    2017-08-21

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

  19. Heroes and Nomads in Norwegian Polar Explorer Literature

    Directory of Open Access Journals (Sweden)

    Jørgen Alnæs

    2008-02-01

    Full Text Available In 1888 six Norwegians crossed the Greenland-ice on skis. Two years after, the expedition leader Fridtjof Nansen published the book På ski over Grønland (English title: The First Crossing of Greenland about the expedition. In Norway, this book has had an enormous influence and for modern Norwegian travel authors, it has become a kind of centre from which they organise their travels and their writing. This paper will focus on how På ski over Grønland has been read and its impact on the travel genre. Also, I will look briefly at another book published by the Norwegian Bjørn Staib, about 85 years after Nansen's. This book too is importatant in the Norwegian polar explorer discourse.

  20. Meat and masculinity in the Norwegian Armed Forces.

    Science.gov (United States)

    Kildal, Charlotte Lilleby; Syse, Karen Lykke

    2017-05-01

    In 2013, the Norwegian Armed Forces decided to introduce a meat reduction scheme in its military mess halls, for both health reasons and environmental concerns. This article explores Norwegian soldiers' reactions to the introduction of Meat free Monday, and their attitudes towards reducing meat consumption. As of yet, Meat free Monday has not been implemented due to both structural and contextual challenges. We explore both the process and potential of the Norwegian military's Meat free Monday initiative to promote sustainable and climate friendly diets. We found significant barriers preventing the military from implementing Meat free Monday. The main reason behind the resistance to reduce meat consumption among Norwegian soldiers was meat's associations with protein, masculinity and comfort. Our results underline the importance of acknowledging the social and cultural role of food. The study is qualitative and uses focus group interviews as its main methodology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Greenland-Iceland-Norwegian Seas Regional Climatology (NODC Accession 0112824)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — To provide an improved oceanographic foundation and reference for multi-disciplinary studies of the Greenland-Iceland-Norwegian Seas (GINS), NODC developed a new set...

  2. Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres--a cross-sectional study.

    Science.gov (United States)

    Ellensen, Eirin N; Hunskaar, Steinar; Wisborg, Torben; Zakariassen, Erik

    2014-01-08

    The 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number and the operators' self-reported use of Index as a first step towards a validation study. We registered all medical emergency calls to the EMCCs during a 72 h period in a national cross sectional study. We subsequently sent a questionnaire to all EMCC operators in Norway, asking how they use Index. A combined outcome variable "use of Index" was computed through a Likert scale, range 1-5. Regression models were used to examine factors influencing use. 2 298 contacts were included. National contact rate was 56/1,000 inhabitants per year, range between EMCCs 34 - 119. Acute contact (life-threatening situations) rate was 21/1,000 per year, range between EMCCs 5 - 31. Index criteria 6 - 'Unresolved problem' accounts for 20% of the 113 contacts, range between EMCCs 10 - 42%. The mean use of Index was 3.95 (SD 0.39), corresponding to "more than 75% of emergency calls". There were differences in use of Index on EMCC level, range 3.7 - 4.4, and a multi regression model explained 23.4% of the variation in use. Operators working rotation with ground ambulance services reported reduced use of Index compared to operators not working in rotation, while distinct EMCC focus on Index increased use of Index compared to EMCCs with no focus on Index. Use of electronic records and operators experience were the main reasons given for not using Index. There is a large variation between the EMCCs with regard to both contact patterns and use of Index. There is a relatively high overall self-reported use of Index by the operators, with variations on both individual and EMCC level.

  3. Ambulance diversion and emergency department offload delay: resource document for the National Association of EMS Physicians position statement.

    Science.gov (United States)

    Cooney, Derek R; Millin, Michael G; Carter, Alix; Lawner, Benjamin J; Nable, Jose Victor; Wallus, Harry J

    2011-01-01

    The emergency medical services (EMS) system is a component of a larger health care safety net and a key component of an integrated emergency health care system. EMS systems, and their patients, are significantly impacted by emergency department (ED) crowding. While protocols designed to limit ambulance diversion may be effective at limiting time on divert status, without correcting overall hospital throughput these protocols may have a negative effect on ED crowding and the EMS system. Ambulance offload delay, the time it takes to transfer a patient to an ED stretcher and for the ED staff to assume the responsibility of the care of the patient, may have more impact on ambulance turnaround time than ambulance diversion. EMS administrators and medical directors should work with hospital administrators, ED staff, and ED administrators to improve the overall efficiency of the system, focusing on the time it takes to get ambulances back into service, and therefore must monitor and address both ambulance diversions and ambulance offload delay. This paper is the resource document for the National Association of EMS Physicians position statement on ambulance diversion and ED offload time. Key words: ambulance; EMS; diversion; bypass; offload; delay.

  4. Reducing inappropriate emergency department attendances--a review of ambulance service attendances at a regional teaching hospital in Scotland.

    Science.gov (United States)

    Patton, Gareth Gordon; Thakore, Shobhan

    2013-06-01

    Emergency Departments (ED) in the UK have seen increasing attendance rates in recent years. Departments are now seeking strategies to reduce their attendances. A review of all ambulance attendances to the ED at Ninewells Hospital was conducted to identify if patients presenting by ambulance could be seen and treated more appropriately in other parts of the health service. A retrospective review of ambulance attendances to the ED at Ninewells Hospital over 7 non-consecutive days. The ambulance patient report form and the ED notes were reviewed by the duty consultant to deem whether it was appropriate for the patient to be presented to the ED. If inappropriate, an alternative destination was suggested. Additional data was collected on the source of the ambulance call. There were 910 attendances in the 7 days. 295 (32%) presented by ambulance. 32 had incomplete data and were excluded. 185 (70%) and 179 (68%) of the 263 were deemed appropriate from review of the patient report form and notes respectively. Of the inappropriate, 74.4% and 79.7% had primary care suggested as an alternative. Patients who call for their own ambulance and NHS24 had higher rates of inappropriate attendances. The ambulance services present one-third of the patients to the ED at Ninewells Hospital. 30%-32% were found to be attending inappropriately and 74%-80% of these could have been managed in primary care. Reducing inappropriate ambulance attendances could reduce the departmental patient load by 11%.

  5. Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey.

    Science.gov (United States)

    Demirkan, Burcu; Ege, Meltem Refiker; Doğan, Pınar; İpek, Esra Gücük; Güray, Umit; Güray, Yeşim

    2013-09-01

    In this study, we aimed to identify the factors influencing the use of ambulance among patients admitted to two Turkish hospitals with acute coronary syndrome (ACS). Overall, 330 with a mean age of 55±13 years, hospitalized patients with ACS at 2 different hospitals were included in this prospective cohort study. The factors influencing the use of ambulance hospital were investigated through a questionnaire. The comparisons were made between two groups regarding use of ambulance. The predictors of the use of ambulance were determined using multiple logistic regression analysis. Despite the high rate of knowing the emergency service number of "112", of the 330 patents, only 96 (29%) used ambulance. Ambulance users had shorter arrival duration with median of 60 min vs 120 min (p=0.03). Presenting with ST elevation myocardial infarction (OR=3.127, 95% CI: 1.555-6.2877, pambulance (OR= 4.184, 95% CI: 2.528-6.926, pambulance use. Using ambulance was in a very low rate among our study patients with ACS. Severity of symptoms, type of ACS and knowledge are seemed to be related with increased ambulance use. Informative health educational programs can be organized to achieve a behavioral change in using of ambulance.

  6. Facts 2000. Norwegian petroleum activities; Fakta 2000. Norsk petroleumsvirksomhet

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    The petroleum resources discovered on the Norwegian Continental Shelf amounts to about 9,6 billion Sm{sup 3} oil equivalents, 76 percent in the North Sea, 20 percent in the Norwegian Sea and 4 percent in the Barents Sea. The present publication gives a summary of the resources, the exploration, the field development, the production of oil and gas, and the revenue from petroleum sale for the year 1999.

  7. CO2-emissions from Norwegian oil and gas extraction

    OpenAIRE

    2015-01-01

    Emissions from oil and gas extraction matter for the lifecycle emissions of fossil fuels, and account for significant shares of domestic emissions in many fossil fuel exporting countries. In this study we investigate empirically the driving forces behind CO2-emission intensities of Norwegian oil and gas extraction, using detailed field-specific data that cover all Norwegian oil and gas activity. We find that emissions per unit extraction increase significantly as a field’s extraction declines...

  8. CO2-emissions form Norwegian oil and gas extraction

    OpenAIRE

    2015-01-01

    Emissions from oil and gas extraction matter for the lifecycle emissions of fossil fuels, and account for significant shares of domestic emissions in many fossil fuel exporting countries. In this study we investigate empirically the driving forces behind CO2-emission intensities of Norwegian oil and gas extraction, using detailed field-specific data that cover all Norwegian oil and gas activity. We find that emissions per unit extraction increase significantly as a field's extraction declines...

  9. Factors associated with ambulance use among patients with low-acuity conditions.

    Science.gov (United States)

    Durant, Edward; Fahimi, Jahan

    2012-01-01

    The use of ambulances for low-acuity medical complaints depletes emergency medical services (EMS) resources that could be used for higher-acuity conditions and contributes to emergency department (ED) overcrowding and ambulance diversion. Objective. We sought to understand the characteristics of patients who use ambulances for low-acuity conditions. We hypothesized that patients who arrive to the ED by ambulance for low-acuity conditions are more likely to be members of vulnerable populations. A secondary analysis was performed on the National Hospital Ambulatory Medical Care Survey (NHAMCS). We included only patients aged 18 years or older who were triaged to the "nonurgent" category upon presentation to the ED. To compare patients who arrived by ambulance with those who arrived by all other modes, multivariate logistic regression was performed using a generalized linear model, and adjusted relative risks (ARRs) were calculated. A total of 16,109 records from 1997 to 2008 (excluding 2001-2002) were included in the analysis. Significantly higher rates of ambulance use for low-acuity conditions were associated with: 1) older age (ARR 1.30, 95% confidence interval [CI]: 1.18-1.43; per 10 years); 2) Medicare or Medicaid insurance (ARR 1.81, 95% CI: 1.36-2.41, and ARR 1.46, 95% CI: 1.12-1.91, respectively); 3) homelessness (ARR 3.30, 95% CI: 1.61-6.78); 4) arrival between 11 pm and 6:59 am (ARR 1.80, 95% CI: 1.43-2.27); and 5) certain chief complaint categories: psychiatric (ARR 1.78, 95% CI: 1.03-3.07), toxicologic/poisoning (ARR 3.26, 95% CI: 1.85-5.76), and neurologic/psychological (ARR 1.71, 95% CI: 1.34-2.18). Patients who arrived by ambulance were more likely than nonambulance patients to receive laboratory diagnostic tests (ARR 3.50, 95% CI: 2.80-4.39), radiographic imaging (ARR 2.26, 95% CI: 1.91-2.68), and admission to the hospital (ARR 3.99, 95% CI: 3.03-5.27). Our study builds on a body of work highlighting the factors associated with ambulance transport to

  10. The petroleum resources on the Norwegian continental shelf

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    In this document the Norwegian Petroleum Directorate estimates the total recoverable petroleum resources on the Norwegian continental shelf to be 12.5 billion Sm{sup 3} oil equivalents. There is considerable uncertainty regarding the undiscovered resources, the expected value being 3.5 billion Sm{sup 3} oil equivalents. The new estimates signify an increase of 14% since the calculations made last year. This increase is chiefly due to an upward adjustment of the expectations for a future increase in the recovery factor for the in place resources on the continental shelf. In 1995, the Norwegian oil production accounted for 4.3% of the global oil production. It is estimated that Norway has a total of about 1.3% of the discovered recoverable oil resources and about 1.8% of the discovered recoverable gas resources in the world. The Norwegian annual oil production is expected to reach a maximum of 3.7 million barrels per day in the year 2000. Many new discoveries are still being made on the Norwegian continental shelf. In the last two years, 20 new discoveries have been made, giving a resources growth of about 260 million Sm{sup 3} oil equivalents. Great technological progress has been made on the Norwegian continental shelf during the last five years concerning exploration, development and production. As for mapping, the introduction of 3D seismic data and the development of interpolation tools have helped to provide a much better understanding of the substratum. 88 figs.

  11. The petroleum resources on the Norwegian continental shelf

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    In this document the Norwegian Petroleum Directorate estimates the total recoverable petroleum resources on the Norwegian continental shelf to be 12.5 billion Sm{sup 3} oil equivalents. There is considerable uncertainty regarding the undiscovered resources, the expected value being 3.5 billion Sm{sup 3} oil equivalents. The new estimates signify an increase of 14% since the calculations made last year. This increase is chiefly due to an upward adjustment of the expectations for a future increase in the recovery factor for the in place resources on the continental shelf. In 1995, the Norwegian oil production accounted for 4.3% of the global oil production. It is estimated that Norway has a total of about 1.3% of the discovered recoverable oil resources and about 1.8% of the discovered recoverable gas resources in the world. The Norwegian annual oil production is expected to reach a maximum of 3.7 million barrels per day in the year 2000. Many new discoveries are still being made on the Norwegian continental shelf. In the last two years, 20 new discoveries have been made, giving a resources growth of about 260 million Sm{sup 3} oil equivalents. Great technological progress has been made on the Norwegian continental shelf during the last five years concerning exploration, development and production. As for mapping, the introduction of 3D seismic data and the development of interpolation tools have helped to provide a much better understanding of the substratum. 88 figs.

  12. Assessment of climate vulnerability in the Norwegian built environment

    Science.gov (United States)

    Hygen, H. O.; Øyen, C. F.; Almâs, A. J.

    2010-09-01

    The main trends expected for the change of Norwegian climate for this century are increasing temperatures, precipitation and wind. This indicates a probable increase of climate related risks to the Norwegian built environment. Previous assessments of climate vulnerability of the built environment have been based on general terms and experiences. The report "Climate and vulnerability analysis for Norwegian built environment; Basis elucidation for the Official Norwegian Report (NOU) on climate adaptation (in Norwegian only)" has used previously defined indexes to quantify the future vulnerability and thus estimated the impact of future climate strain to the existing built environment. The method used to do this assessment has been to create national geolocated maps of relevant climate indexes. Climate indexes for this analysis are: * Wood decay, * Temperature and heating degree days, * Snow load and wet winter precipitation, * Precipitation, flood and extreme precipitation * Wind and wind-driven rain * Frost decay * Frost amount * Perma frost Most of these indexes have been established both for the normal period 1961 - 1990 and projected climate of 2071 - 2100. To compensate for uncertainties in the projection, a set of three projections has been used. These indexes have been combined with geolocated information for Norway's 3.9 million buildings, by imposing GIS digitalized building information to the geolocated maps. The result of this combination is a synopsis of the number of buildings in Norway vulnerable to the displayed present climate parameters and to the projected changes. Consequenses for the Norwegian buildings stock and actions to be taken by the government are also discussed.

  13. Ontogeny of sex differences in open-field ambulation in the rat.

    Science.gov (United States)

    Slob, A K; Huizer, T; Van der Werff ten Bosch, J J

    1986-01-01

    The effects of age and gonads were studied in rats subjected to open-field tests, during which ambulation behavior was recorded. Subjects were three groups of male and female rats: sham-operation on day 1 and day 21; gonadectomy on day 1 and sham-operation on day 21; and sham-operation on day 1 and gonadectomy on day 21. Half of each group were tested in a circular open field (3 min/day, 3 consecutive days) on days 28-30; the others were tested on days 47-49. Representatives of both batches were tested again in a square open field on days 76-78. There was a sex difference in ambulation at 77 days, but not at earlier ages. In animals gonadectomized on day 1 or day 21 the sex difference in adulthood failed to occur, because castration caused the males to ambulate as much as sham-operated and ovariectomized females. On the basis of our results and reports in the literature it is suggested that testicular secretions around puberty have an organizing effect on ambulation behavior. The intact adult male rat ambulates less than the adult female and this difference persists after castration in adulthood. Castration well before puberty prevents the development of the adult sex difference.

  14. Diversity of Norwegian sea slugs (Nudibranchia: new species to Norwegian coastal waters and new data on distribution of rare species

    Directory of Open Access Journals (Sweden)

    Jussi Evertsen

    2013-02-01

    Full Text Available A total of 5 nudibranch species are reported from the Norwegian coast for the first time (Doridoxa ingolfiana, Goniodoris castanea, Onchidoris sparsa, Eubranchus rupium and Proctonotus mucroniferus. In addition 10 species that can be considered rare in Norwegian waters are presented with new information (Lophodoris danielsseni, Onchidoris depressa, Palio nothus, Tritonia griegi, Tritonia lineata, Hero formosa, Janolus cristatus, Cumanotus beaumonti, Berghia norvegica and Calma glaucoides, in some cases with considerable changes to their distribution. These new results present an update to our previous extensive investigation of the nudibranch fauna of the Norwegian coast from 2005, which now totals 87 species. An increase in several new species to the Norwegian fauna and new records of rare species, some with considerable updates, in relatively few years results mainly from sampling effort and contributions by specialists on samples from poorly sampled areas.

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

    Science.gov (United States)

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

    2017-01-01

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

  16. Variation in ambulance call rates for care homes in Torbay, UK.

    Science.gov (United States)

    Hancock, Jason; Matthews, Justin; Ukoumunne, Obioha C; Lang, Iain; Somerfield, David; Wenman, James; Dickens, Chris

    2017-05-01

    Emergency ambulance calls represent one of the routes of emergency hospital admissions from care homes. We aimed to describe the pattern of ambulance call rates from care homes and identify factors predicting those homes calling for an ambulance most frequently. We obtained data from South Western Ambulance Service NHS Foundation Trust on 3138 ambulance calls relating to people aged 65 and over from care homes in the Torbay region between 1 April 2012 and 31 July 2013. We supplemented this with data from the Care Quality Commission (CQC) website on home characteristics and outcomes of CQC inspections. We used descriptive statistics to identify variation in ambulance call rates for residential and nursing homes and fitted negative binomial regression models to determine if call rates were predicted by home type (nursing versus residential), the five standards in the CQC reports, dementia care status or travel time to hospital. One hundred and forty-six homes (119 residential and 27 nursing) were included in the analysis. The number of calls made ranged from 1 to 99. The median number (IQR; range) of calls per resident per year was 0.51 (0.21-0.89; 0.03-2.45). Nursing homes had a lower call rate than residential homes [adjusted rate ratio (ARR) 0.29; 95% CI: 0.22-0.40; P homes failing the quality and suitability of management standard had a lower call rate compared to those who passed (ARR 0.67; 95% CI: 0.50-0.90; P = 0.006); and homes specialising in dementia had a higher call rate compared to those not specialising (ARR 1.56; 95% CI: 1.23-1.96; P home policies and practice. © 2016 John Wiley & Sons Ltd.

  17. Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Kristensen, Morten Tange; Kehlet, Henrik

    2006-01-01

    fracture patients with an independent walking function admitted from their own home. Rehabilitation followed a well-defined multimodal rehabilitation regimen and discharge criteria. MAIN OUTCOME MEASURE: Admission tests with a new mobility score to assess prefracture functional mobility and a short mental...... score for cognitive dysfunction were performed. On the first three postoperative days patients were assessed with the cumulated ambulation score consisting of a cumulated assessment of simple ambulation characteristics with a score from 0 to 18 (fully mobile). The three assessments were correlated...

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

    Science.gov (United States)

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

    2015-05-01

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

  19. Impact of short-term exposure to fine particulate matter on emergency ambulance dispatches in Japan.

    Science.gov (United States)

    Michikawa, Takehiro; Ueda, Kayo; Takeuchi, Ayano; Kinoshita, Makoto; Hayashi, Hiromi; Ichinose, Takamichi; Nitta, Hiroshi

    2015-01-01

    Evidence of an association between fine particulate matter (PM2.5) and morbidity is limited in Asia. We used a case-crossover design to evaluate the association between short-term exposure to PM2.5 and emergency ambulance dispatches (as a proxy of acute health outcomes), and to calculate the extent to which a 10 μg/m(3) decrease in PM2.5 concentrations would reduce the number of ambulance dispatches. We used data on emergency ambulance dispatches in Fukuoka City, Japan between 2005 and 2010. Emergency ambulance services are publicly funded and cover the entire city. After excluding ambulance dispatches related to external injuries and pregnancy/childbirth, we analysed data on the remaining 176 123 dispatches. We also collected records of daily concentrations of PM2.5 from one ambient air pollution monitoring station. ORs per 10 μg/m(3) increase in PM2.5 were estimated using conditional logistic regression controlled for ambient temperature and relative humidity. During the study period, the average daily concentration of PM2.5 was 20.3 μg/m(3). Exposure to PM2.5 was associated with emergency ambulance dispatches in general (lag0-1; OR=1.008 (95% CI 1.002 to 1.014)) and with dispatches due to respiratory diseases (lag0-1; OR=1.027 (1.007 to 1.048)). No association was observed for dispatches due to cardiovascular diseases. We estimated that a 10 μg/m(3) decrease in PM2.5 concentrations would have led to approximately 260 (estimated range=70-460) fewer ambulance dispatches in Fukuoka for 2012. Providing further evidence on the short-term health effects of PM2.5 exposure, we found that exposure was associated with an increased number of emergency ambulance dispatches. The effect was, however, relatively small. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Directory of Open Access Journals (Sweden)

    M. Kuhn*

    2013-12-01

    These principles have been applied to our air ambulance system based from Lanseria International Airport. By combining preventative and control measures, there has been no breach in our infection control strategies, as evidenced by no growth noted on specific and random swabs even when more and more ”super bugs” are being identified in hospital. As an air ambulance service flying patients from various African countries, we have the responsibility to conduct our own ”Border Security” to keep our hospitals, patients, aircraft and crews clean and safe. In this presentation we will share our ”Border Security” principles and experiences with the audience.

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

    Science.gov (United States)

    Vitzthum, Edward F.; And Others

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

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

  4. Safety and tolerance of the ReWalk™ exoskeleton suit for ambulation by people with complete spinal cord injury: a pilot study

    National Research Council Canada - National Science Library

    Zeilig, Gabi; Weingarden, Harold; Zwecker, Manuel; Dudkiewicz, Israel; Bloch, Ayala; Esquenazi, Alberto

    2012-01-01

    ...™ exoskeleton ambulation system in people with spinal cord injury. Measures of functional ambulation were also assessed and correlated to neurological spinal cord level, age, and duration since injury...

  5. Environment 98. The Norwegian Petroleum Sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    This report gives a comprehensive, detailed statistical survey of the oil and gas activity on the Norwegian Continental Shelf. In the 4th quarter survey the investments for field development in 1998 are estimated to NOK 64 billion, which is 6.7 billion higher than the corresponding figures in the 1997 estimate. The increase is mainly due to the fact that more fields were approved for development throughout 1997. Even though the investments in 1998 will increase the most for field development, increases are also registered for exploration, fields on stream, onshore activities and pipeline transport. The investments for fields on stream are estimated at NOK 11.5 billion for 1998. Investments onshore for 1998 are estimated at NOK 3.6 billion, which is NOK 2.6 billion more than the estimate for 1997 from the 4th quarter 1996. The total investments for 1998 are estimated at NOK 7.4 for the pipeline transport sector, which is 1.6 billion higher than the corresponding estimate for 1997. The year 1997 appears to be a peak year for oil investments. 12 figs., 38 tabs.

  6. Zooplankton Distribution in Four Western Norwegian Fjords

    Science.gov (United States)

    Gorsky, G.; Flood, P. R.; Youngbluth, M.; Picheral, M.; Grisoni, J.-M.

    2000-01-01

    A multi-instrumental array constructed in the Laboratoire d'Ecologie du Plancton Marin in Villefranche sur mer, France, named the Underwater Video Profiler (UVP), was used to investigate the vertical distribution of zooplankton in four western Norwegian fjords in the summer 1996. Six distinct zoological groups were monitored. The fauna included: (a) small crustaceans (mainly copepods), (b) ctenophores (mainly lobates), (c) siphonophores (mainly physonects), (d) a scyphomedusa Periphylla periphylla, (e) chaetognaths and (f) appendicularians. The use of the non-disturbing video technique demonstrated that the distribution of large zooplankton is heterogeneous vertically and geographically. Furthermore, the abundance of non-migrating filter feeders in the deep basins of the fjords indicates that there is enough food (living and non-living particulate organic matter) to support their dietary needs. This adaptation may be considered as a strategy for survival in fjords. Specifically, living in dark, deep water reduces visual predation and population loss encountered in the upper layer due to advective processes.

  7. Characterization of Norwegian women eating wholegrain bread.

    Science.gov (United States)

    Bakken, Toril; Braaten, Tonje; Olsen, Anja; Lund, Eiliv; Skeie, Guri

    2015-10-01

    To investigate dietary and non-dietary characteristics of wholegrain bread eaters in the Norwegian Women and Cancer study. Cross-sectional study using an FFQ. Women were divided into two groups according to wholegrain bread consumption. Adult women (n 69 471). Median daily consumption of standardized slices of wholegrain bread was 2·5 in the low intake group and 4·5 in the high intake group. The OR for high wholegrain bread consumption was 0·28, 2·19 and 4·63 for the first, third and fourth quartile of energy intake, respectively, compared with the second quartile. Living outside Oslo or in East Norway and having a high level of physical activity were associated with high wholegrain bread consumption. BMI and smoking were inversely associated with wholegrain bread consumption. Intake of many food items was positively associated with wholegrain bread consumption (P trend bread consumption (P trend bread consumption, even after taking energy intake into account. Energy intake was strongly positively associated with wholegrain bread consumption. Geographical differences in wholegrain bread consumption were observed. Our study suggests that women with high wholegrain bread consumption do not generally have a healthier diet than those who eat less wholegrain bread, but that they tend to be healthier in regard to other lifestyle factors.

  8. The Norwegian immunisation register--SYSVAK.

    Science.gov (United States)

    Trogstad, L; Ung, G; Hagerup-Jenssen, M; Cappelen, I; Haugen, I L; Feiring, B

    2012-04-19

    The Norwegian immunisation register, SYSVAK, is a national electronic immunisation register. It became nationwide in 1995. The major aim was to register all vaccinations in the Childhood Immunisation Programme to ensure that all children are offered adequate vaccination according to schedule in the programme, and to secure high vaccination coverage. Notification to SYSVAK is mandatory, based on personal identification numbers. This allows follow up of individual vaccination schedules and linkage of SYSVAK data to other national health registers for information on outcome diagnoses, such as the surveillance system for communicable diseases. Information from SYSVAK is used to determine vaccine coverage in a timely manner. Coverage can be broken down to regional/local levels and used for active surveillance of vaccination coverage and decisions about interventions. During the 2009 influenza A(H1N1)pdm09 pandemic, an adaptation of SYSVAK enabled daily surveillance of vaccination coverage on national and regional levels. Currently, data from SYSVAK are used, among others, in studies on adverse events related to pandemic vaccination. Future challenges include maximising usage of collected data in surveillance and research, and continued improvement of data quality. Immunisation registers are rich sources for high quality surveillance of vaccination coverage, effectiveness, vaccine failure and adverse events, and gold mines for research.

  9. Visions and Expectations for the Norwegian Bioeconomy

    Directory of Open Access Journals (Sweden)

    Lillian Hansen

    2017-02-01

    Full Text Available Developing a future bioeconomy has become critical for three main reasons: (1 The need for sustainability of resource use; (2 The growing demand for both food and energy; and (3 The need to decouple economic growth from environmental degradation. As Zilberman observes, a transition to bioeconomy “is a continuing evolutionary process of transition from systems of mining non-renewable resources to farming renewable ones”. Hence, to meet the challenges created by a growing dependence on non-renewable resources, radical changes are needed that involve more than development of or changes within the individual bio-based sectors. In line with emerging attention to the bioeconomy in Europe and elsewhere, great expectations towards the bioeconomy have been launched in high level industry and policy fora, as well as in resource-based economies such as Norway's. Grounded in theories of transition and transition management, this paper discusses the Norwegian biosector's expectations regarding a bioeconomy. Analyses are based on empirical survey data from biosector representatives. Findings suggest that there are clear differences between sectors in motivation for a future bioeconomy. A transition into a complete bioeconomy will demand a system shift and more cross-sectoral integration between these regimes than currently exists.

  10. Psychological Distress Among Young Norwegian Health Professionals

    Directory of Open Access Journals (Sweden)

    Per Nerdrum

    2014-03-01

    Full Text Available In this study, we present longitudinal data on psychological distress among 169 young Norwegian health professionals. Psychological distress was measured at the end of their studies, and three years later on, when being professional nurses, physiotherapists and occupational therapists. Psychological distress was assessed by applying the 12-item version of the General Health Questionnaire (GHQ 12. Twenty-seven percent of the nursing students scored higher than the GHQ 12 case score at the end of the study, but as nurses, they became significantly less distressed three years later (13 percent. The other two professions showed relatively small and non-significant reductions in psychological distress during the first three years as a professional. Hierarchical multiple analyses showed that the level of psychological distress when finishing the study, the young professionals’ experience of personal support from colleagues, the experience of work-home conflicts and the experience of methodological coping at work were significant predictors of psychological distress three years after working as young health professionals. These four predictors explained together 29 percent in the variance in GHQ 12 three years after graduation. Belonging to any of the three professions did not contribute to the explained variance in psychological distress three years after graduation.

  11. Personnel Practices for Small Colleges.

    Science.gov (United States)

    Bouchard, Ronald A.

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

  12. Personnel Officers: Judging Their Qualifications.

    Science.gov (United States)

    Webb, Gisela

    1988-01-01

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

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

    Science.gov (United States)

    Chen, Yuqiang; Lai, Yucheng; Ke, Jiajie; Chen, Yuefeng; Xu, Yuling; Ma, Yuqin; Yuan, Jiayin; Liang, Tian; Mai, Pengzhan; Lin, Changmin; Xie, Yang; Huang, Keng

    2015-01-01

    To explore the impact of subtropical maritime monsoon climate on the frequency of ambulance use for trauma patients in a coastal region in China. Statistical analysis of data on ambulance use from the 120 Emergency Command Center in Shantou City, Guangdong Province, from January to December 2012 as well as daily meteorological data from a Shantou observatory was performed to determine how climatic factors (seasons, time, and weather) affect the frequency of ambulance use for trauma patients. The daily ambulance use for trauma patients differed between spring and summer or autumn (pambulance use for trauma patients (R² =0.103, pambulance use between good and bad weather (pambulance use for trauma patients is affected by the subtropical maritime monsoon climate in the coastal region. Better weather contributes to increased daily frequency of ambulance use, which is the highest in autumn and lowest in spring.

  14. Norwegian resource policy: The production rate for Norwegian petroleum resources; Norsk ressurspolitikk: Utvinningstempoet for norske petroleumsressurser

    Energy Technology Data Exchange (ETDEWEB)

    Schreiner, P.

    1995-12-31

    Petroleum activities have become a large industry in Norway. This has led to extensive changes in Norwegian economy and society. In the public debate on this activity there has been little discussion of what would be the most profitable production rate. However, it is generally agreed that the great wealth implied by the petroleum resources must be managed in ways suitable to both present and coming generations. This report discusses the production rate based on the following questions: (1) How high can the production rate be before the petroleum activities and the expenditure of the income from them influence the remaining Norwegian economy too strongly? (2) How much of this wealth should reasonably be used by present generations and how much should be left for future generations? There is much to gain from a high tempo and from relocating some of the petroleum wealth. The possibilities of influencing the production rate are mainly connected with the allotments of production licences. The consequences of uncertainties in the petroleum activities for the choice of exploitation tempo are unclear. The environment is not much affected by the production rate. The contractor activity has become Norway`s largest industry. 42 refs., 14 figs., 2 tabs.

  15. 75 FR 74768 - Culturally Significant Objects Imported for Exhibition Determinations: “Norwegian Painters”

    Science.gov (United States)

    2010-12-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Culturally Significant Objects Imported for Exhibition Determinations: ``Norwegian Painters'' SUMMARY: Notice..., I hereby determine that the objects to be included in the exhibition ``Norwegian...

  16. Categorization of speech sounds by Norwegian/English bilinguals

    Science.gov (United States)

    Dypvik, Audny T.; Slawinski, Elzbieta B.

    2005-04-01

    Bilinguals who learned English late in life (late bilinguals) as opposed to those who learned English early in life (early bilinguals) differ in their perception of phonemic distinctions. Age of acquisition of a second language as well as depth of immersion into English is influenced by perceptual differences of phonemic contrasts between monolinguals and bilinguals, with consequences for speech production. The phonemes /v/ and /w/ are from the same category in Norwegian, rendering them perceptually indistinguishable to the native Norwegian listener. In English, /v/ and /w/ occupy two categories. Psychoacoustic testing on this phonemic distinction in the current study will compare perceptual abilities of monolingual English and bilingual Norwegian/English listeners. Preliminary data indicates that Norwegian/English bilinguals demonstrate varying perceptual abilities for this phonemic distinction. A series of speech sounds have been generated by an articulatory synthesizer, the Tube Resonance Model, along a continuum between the postures of /v/ and /w/. They will be presented binaurally over headphones in an anechoic chamber at a sound pressure level of 75 dB. Differences in the perception of the categorical boundary between /v/ and /w/ among English monolinguals and Norwegian/English bilinguals will be further delineated.

  17. Ambulance services as part of the district health system in low-income countries: a feasibility study from Cambodia.

    Science.gov (United States)

    Jacobs, Bart; Men, Cheanrithy; Sam, Oeun Sam; Postma, Sjoerd

    2016-10-01

    Emergency referral care is considered an essential component of the district health system. Nevertheless, the establishment of effective and durable transport arrangements of such referral care by use of an ambulance is considered controversial in low-income countries. We aim to assess the extent to which an ambulance service as part of the district health system is feasible in rural Cambodia. In a rural health district, we assessed the population's perception of the ambulance service, its recurrent costs requirements, government financial contribution to its operations, profile and medical conditions of ambulance (non)users, reasons for (non)use of the ambulance and contextual factors required for the ambulance services to operate. This observation was obtained through nine key informant interviews, five focus group discussions, structured interviews with 225 caretakers of admitted patients, a 1-month census of admitted emergency cases and assessment of annual recurrent costs for the ambulance services. The ambulance services were well received by the population and authorities and appeared to reinforce an appreciation of the hospital. Ambulance services were mainly used by the poor and by women, especially for emergency obstetric care. Less than half the number of transported patients, 44%, was considered a medical emergency. The direct cost to the hospital per collected emergency case was $34.4. When certain conditions are met, effective ambulance services can be an integral part of the district health system and positively contribute to the population's appreciation of the hospital services and respective district health system. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Hip fractures are common in elderly patients, and walking impairment is a frequent complication. The Cumulated Ambulation Score (CAS) is a validated functional scale used to monitor easily three basic mobility activities in patients with hip fracture. The aim of this study was to translate, cross...

  19. Nursing students' perceptions of learning nursing skills in the ambulance service.

    Science.gov (United States)

    Nilsson, Tomas; Lindström, Veronica

    2017-05-01

    Several previous studies have explored nursing students' perceptions of clinical learning at hospitals and in other health care facilities, but there are few studies exploring nursing students' perceptions of the clinical learning in the ambulance service. Therefore, the aim of this study was to explore nursing students' perceptions of learning nursing skills in the ambulance service. An inductive qualitative study design with two focus group interviews and content analysis was used. Two themes were identified. The first theme, professional skills, included: Assessment, Prioritizing and initiating care, and Medical treatment and evaluation of interventions. The second theme, a holistic approach to the care included: Cultural, social, and ethical aspects of caring, Decision-making in collaboration with patients, and Care provided in the patients' home. The ambulance service provides a learning environment where the students face a multifaceted picture of health and illness. This learning environment helps nursing students to learn independently how to use professional nursing skills and how to care by employing a holistic approach. However, further research is needed to explore if and how this knowledge about nursing and caring in the ambulance service is useful when working as a Registered Nurse in other health care settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Knee disarticulation : Survival, wound healing and ambulation. A historic cohort study

    NARCIS (Netherlands)

    Ten Duis, K.; Bosmans, J. C.; Voesten, H. G. J.; Geertzen, J. H. B.; Dijkstra, P. U.

    2009-01-01

    The aim of this study was to analyze survival, wound healing and ambulation after knee disarticulation (KD). A historic cohort study using medical records and nursing home records was performed. Data included demographics, reason for amputation, concomitant diseases, survival, wound healing, re-ampu

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

    Science.gov (United States)

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

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

  2. Nurses and advanced airway management: the experience of the Piacenza ambulance service

    Directory of Open Access Journals (Sweden)

    Fabio Mozzarelli

    2015-10-01

    Full Text Available The study examined the intubation manoeuvres performed by Piacenza local health authority ambulance service nurses in patients with sudden cardiac arrest of nontraumatic origin. The study has a retrospective observational design and analyzes all the intubation manoeuvres performed by ambulance service nurses in patients with non-traumatic cardiac arrest between January 2010 and December 2013. The success of the procedure with subglottic tubes was 97.7% (P>0.60, while it was 100% (P>0.50 with supraglottic devices. The success rate of the procedures is encouraging and the statistical analysis showed that there are no significant differences between literature data and the experience of Piacenza ambulance system crews. An increase in the use of supraglottic devices was also observed. The results show that the Piacenza ambulance service nursing staff has a good level of skills and competence in advanced airway management. A future development of this ability could involve intubation also in situations other than cardiac arrest using specific medication.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

    Tolboom, N; Cats, EA; Helders, PJM; Pruijs, JEH; Engelbert, RHH

    2004-01-01

    We studied the effects of spondylodesis on spinal curvature, functional outcome, level of ambulation and perceived competence in 11 children with osteogenesis imperfecta (OI). Mean age at surgical intervention was 13.1 years (SD 2.5 years) and follow-up amounted to 3.4 years (SD 2.3 years). Spinal c

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

    Science.gov (United States)

    Ebben, Remco H A; Vloet, Lilian C M; Schalk, Donna M J; Mintjes-de Groot, Joke A J; van Achterberg, Theo

    2014-03-01

    Adherence to ambulance and ED protocols is often suboptimal. Insight into factors influencing adherence is a requisite for improvement of adherence. This study aims to gain an in-depth understanding of factors that influence ambulance and emergency nurses' adherence to protocols. Semi-structured interviews were held with ambulance nurses, emergency nurses, and physicians (N = 20) with medical end responsibility in the Netherlands to explore influencing factors. Content analysis was used to identify influencing factors. The main influencing factors for adherence were individual factors, including individual (clinical) experience, awareness, and the preference of following local protocols instead of national protocols. Organizational or external factors were involvement in protocol development, training and education, control mechanisms for adherence, and physicians' interest. Also of influence were protocol characteristics including integration of the advanced trauma life support approach, being in accordance with daily practice, and the generality of the content. Influencing factors could be a barrier as well as a facilitator for adherence. Factors influencing ambulance and emergency nurses' protocol adherence could be assigned to individual, organizational, and external categories, as well as to protocol characteristics. To improve adherence, implementation strategies should be tailored to identified factors. Multifaceted implementation strategies will be needed to improve adherence. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

    Tolboom, N; Cats, EA; Helders, PJM; Pruijs, JEH; Engelbert, RHH

    2004-01-01

    We studied the effects of spondylodesis on spinal curvature, functional outcome, level of ambulation and perceived competence in 11 children with osteogenesis imperfecta (OI). Mean age at surgical intervention was 13.1 years (SD 2.5 years) and follow-up amounted to 3.4 years (SD 2.3 years). Spinal c

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

    NARCIS (Netherlands)

    GerritsmaBleeker, CLE; Heeg, M; VosNiel, H

    1997-01-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  12. Iterative optimization algorithm with parameter estimation for the ambulance location problem.

    Science.gov (United States)

    Kim, Sun Hoon; Lee, Young Hoon

    2016-12-01

    The emergency vehicle location problem to determine the number of ambulance vehicles and their locations satisfying a required reliability level is investigated in this study. This is a complex nonlinear issue involving critical decision making that has inherent stochastic characteristics. This paper studies an iterative optimization algorithm with parameter estimation to solve the emergency vehicle location problem. In the suggested algorithm, a linear model determines the locations of ambulances, while a hypercube simulation is used to estimate and provide parameters regarding ambulance locations. First, we suggest an iterative hypercube optimization algorithm in which interaction parameters and rules for the hypercube and optimization are identified. The interaction rules employed in this study enable our algorithm to always find the locations of ambulances satisfying the reliability requirement. We also propose an iterative simulation optimization algorithm in which the hypercube method is replaced by a simulation, to achieve computational efficiency. The computational experiments show that the iterative simulation optimization algorithm performs equivalently to the iterative hypercube optimization. The suggested algorithms are found to outperform existing algorithms suggested in the literature.

  13. Time-dependent ambulance allocation considering data-driven empirically required coverage.

    Science.gov (United States)

    Degel, Dirk; Wiesche, Lara; Rachuba, Sebastian; Werners, Brigitte

    2015-12-01

    Empirical studies considering the location and relocation of emergency medical service (EMS) vehicles in an urban region provide important insight into dynamic changes during the day. Within a 24-hour cycle, the demand, travel time, speed of ambulances and areas of coverage change. Nevertheless, most existing approaches in literature ignore these variations and require a (temporally and spatially) fixed (double) coverage of the planning area. Neglecting these variations and fixation of the coverage could lead to an inaccurate estimation of the time-dependent fleet size and individual positioning of ambulances. Through extensive data collection, now it is possible to precisely determine the required coverage of demand areas. Based on data-driven optimization, a new approach is presented, maximizing the flexible, empirically determined required coverage, which has been adjusted for variations due to day-time and site. This coverage prevents the EMS system from unavailability of ambulances due to parallel operations to ensure an improved coverage of the planning area closer to realistic demand. An integer linear programming model is formulated in order to locate and relocate ambulances. The use of such a programming model is supported by a comprehensive case study, which strongly suggests that through such a model, these objectives can be achieved and lead to greater cost-effectiveness and quality of emergency care.

  14. Emergency Medical Technician-Ambulance: National Standard Curriculum. Course Guide (Third Edition).

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This course guide is intended to assist course coordinators in planning and managing a course to train emergency medical technicians to work with ambulance or other specialized rescue services. Materials are presented to enable students to perform the following functions: recognize the nature and seriousness of the patient's condition or extent of…

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

    Science.gov (United States)

    Chae, Hee Dong; Choi, Seung-Bok

    2015-01-01

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

  16. An Action Learning Approach to the Question: Are Ambulance Response Time Targets Achievable?

    Science.gov (United States)

    Slater, Alan

    2017-01-01

    In recent years, NHS Ambulance Trusts throughout the UK have consistently failed to achieve their response time targets for both actual and potential life-threatening calls. To avoid a media and public outcry, the NHS response has been to change the basic parameters upon which the response time targets are calculated. An action learning study,…

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-01

    The radiology trainer for surgical ambulance includes informative X-ray imaging examples for the following issues: zygoma, nasal bone, spinal cord, clavicle, shoulder, upper arms, elbow, forearms, wrist, hand, phalanx, thorax, sternum, pelvis, abdomen, hips, femur, knee, lower leg, ankle, feet.

  18. Design and methods of European Ambulance Acute Coronary Syndrome Angiography Trial (EUROMAX)

    DEFF Research Database (Denmark)

    Steg, Philippe Gabriel; van 't Hof, Arnoud; Clemmensen, Peter

    2013-01-01

    In patients with ST-segment elevation myocardial infarction (STEMI) triaged to primary percutaneous coronary intervention (PCI), anticoagulation often is initiated in the ambulance during transfer to a PCI site. In this prehospital setting, bivalirudin has not been compared with standard-of-care ...

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

    Science.gov (United States)

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

    2012-01-01

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

  20. Language Planning Confronted by Everyday Communication in the International University: The Norwegian Case

    Science.gov (United States)

    Ljosland, Ragnhild

    2014-01-01

    Having been the scene of language planning for more than a century in relation to the two competing written standards of Norwegian, Norwegian language planners are now facing a new challenge: how to deal with what has been termed "domain loss" where Norwegian is perceived as losing out to English in important sectors of society,…

  1. Centralized Decentralization or Decentralized Centralization? A Review of Newer Norwegian Research on Schools and Their Communities

    Science.gov (United States)

    Kvalsund, Rune

    2009-01-01

    In this paper, Norwegian research on the relationship between the school and the local community during the past 30 years is reviewed. The Norwegian context of schooling is briefly described, pointing out the rural-urban conflict. The review is organized into two phases: research in the expansive and contractive phases of the Norwegian welfare…

  2. Formation waters of the Norwegian Continental Shelf

    Energy Technology Data Exchange (ETDEWEB)

    McCartney, R. A.; Rein, E.

    2006-03-15

    New and previously published analyses of formation waters for the Norwegian Continental Shelf (NCS) have been evaluated and interpreted to determine the compositional distribution of formation waters in the region and factors controlling their compositions, and also to obtain information on subsurface fluid flow. Formation waters in the region are Na-Cl and Na-Ca-Cl-type waters that display a wide range of salinity (2500-212000 mg/kg Cl). Generally, the concentrations of most dissolved constituents are positively correlated with Cl so that their distribution in formation waters largely reflects the variations shown by salinity. Exceptions are SO4 which is generally low (less than 40 mg/l) regardless of Cl, and HCO3 and in-situ pH which are negatively correlated with Cl. The main factors determining the compositions of the formation waters are mixing of meteoric water (probably late-Jurassic to Eocene), ancient seawater and primary brine together with diagenetic reactions that have affected each of these components individually as well as mixtures of them. Evaluation of the distribution of salinity has helped us identify where vertical and/or lateral migration of brine from the evaporites has occurred. This has in turn provided us with information on the presence of leak-points and vertical mixing, although further investigation of the location of evaporites and basin palaeohydrogeology are required to determine whether regional lateral advection has occurred in the past. The results of this study may benefit oil exploration and production activities in the NCS including constraint of hydrocarbon migration models, economic evaluation of undrilled prospects, scale management and compartmentalisation studies. (Author)

  3. Mortality among Norwegian doctors 1960-2000

    Directory of Open Access Journals (Sweden)

    Hem Erlend

    2011-03-01

    Full Text Available Abstract Background To study the mortality pattern of Norwegian doctors, people in human service occupations, other graduates and the general population during the period 1960-2000 by decade, gender and age. The total number of deaths in the study population was 1 583 559. Methods Census data from 1960, 1970, 1980 and 1990 relating to education were linked to data on 14 main causes of death from Statistics Norway, followed up for two five-year periods after census, and analyzed as stratified incidence-rate data. Mortality rate ratios were computed as combined Mantel-Haenzel estimates for each sex, adjusting for both age and period when appropriate. Results The doctors had a lower mortality rate than the general population for all causes of death except suicide. The mortality rate ratios for other graduates and human service occupations were 0.7-0.8 compared with the general population. However, doctors have a higher mortality than other graduates. The lowest estimates of mortality for doctors were for endocrine, nutritional and metabolic diseases, diseases in the urogenital tract or genitalia, digestive diseases and sudden death, for which the numbers were nearly half of those for the general population. The differences in mortality between doctors and the general population increased during the periods. Conclusions Between 1960 and 2000 mortality for doctors converged towards the mortality for other university graduates and for people in human service occupations. However, there was a parallel increase in the gap between these groups and the rest of the population. The slightly higher mortality for doctors compared with mortality for other university graduates may be explained by the higher suicide rate for doctors.

  4. Norwegian Retroflexion − Licensing by Cue or Prosody?

    Directory of Open Access Journals (Sweden)

    Silke Hamann

    2004-01-01

    Full Text Available This article deals with the class of retroflex segments in Norwegian. The question is handled whether the phonotactic restrictions on retroflexes to occur mainly only in coda position cannot be better described in terms of the availability of the retroflex cues in post-vocalic position instead of refering to their syllable-position. The latter approach, the so-called prosodic licensing (Lombardi 1995, is shown to be insufficient in cases of retroflexion across word-boundaries, where retroflexes appear in onset-position. The so-called lincensing by cue-approach (Steriade 1995, on the other hand, is shown to be able to cover all the instances of retroflex occurrences: retroflexes in Norwegian occur only when a vowel precedes, which enhances their strong transitional cues from vowel to retroflex. In addition to this, licensing by cue can account for the progressive assimilation of retroflexion also found in Norwegian.

  5. Grammatical Gender in American Norwegian Heritage Language: Stability or Attrition?

    Science.gov (United States)

    Lohndal, Terje; Westergaard, Marit

    2016-01-01

    This paper investigates possible attrition/change in the gender system of Norwegian heritage language spoken in America. Based on data from 50 speakers in the Corpus of American Norwegian Speech (CANS), we show that the three-gender system is to some extent retained, although considerable overgeneralization of the masculine (the most frequent gender) is attested. This affects both feminine and neuter gender forms, while declension class markers such as the definite suffix remain unaffected. We argue that the gender category is vulnerable due to the lack of transparency of gender assignment in Norwegian. Furthermore, unlike incomplete acquisition, which may result in a somewhat different or reduced gender system, attrition is more likely to lead to general erosion, eventually leading to complete loss of gender.

  6. Grammatical Gender in American Norwegian Heritage Language: Stability or attrition?

    Directory of Open Access Journals (Sweden)

    Terje eLohndal

    2016-03-01

    Full Text Available This paper investigates possible attrition/change in the gender system of Norwegian heritage language spoken in America. Based on data from 50 speakers in the Corpus of American Norwegian Speech (CANS, we show that the three-gender system is to some extent retained, although considerable overgeneralization of the masculine (the most frequent gender is attested. This affects both feminine and neuter gender forms, while declension class markers such as the definite suffix remain unaffected. We argue that the gender category is vulnerable due to the lack of transparency of gender assignment in Norwegian. Furthermore, unlike incomplete acquisition, which may result in a somewhat different or reduced gender system, attrition is more likely to lead to general erosion, eventually leading to complete loss of gender.

  7. DETERMINANTS OF ENTREPRENEURIAL INTENTION: The Case of Norwegian Students

    Directory of Open Access Journals (Sweden)

    Nurul Indarti

    2003-01-01

    Full Text Available This paper aims to identify determinants of entrepreneurial intentions among young people. The empirical basis is Norwegian students, while an objective is also to create a basis for comparative studies among different economic and cultural contexts. Independent variables in the study include demographic factors and individual background, personality traits, and contextual elements like access to capital and information. The individual perceptions of self-efficacy and instrumental readiness are the variables that affect entrepreneurial intentions most significantly. Age, gender and educational background have no statistically significant impact. Generally, the level of the entrepreneurial intentions among Norwegian students is relatively low, which may be explained by social status and economic remuneration of entrepreneurs compared with employees in the Norwegian context.

  8. Assessment of climate vulnerability in the Norwegian built environment

    Science.gov (United States)

    Hygen, H. O.; Øyen, C. F.; Almås, A. J.

    2011-05-01

    The main trends expected for the change of Norwegian climate for this century are increasing temperatures, precipitation and wind. This indicates a probable increase of climate-related risks to the Norwegian built environment. Through co-operation between the Norwegian Meteorological Institute and SINTEF Building and Infrastructure, building and climate information have been combined to estimate changes in strain to the built environment due to climate change. The results show that the risk of wood decay will increase for the whole country. Almost two million buildings will be subject to an increase in risk of wood decay from medium to high level. Similar analyses have been performed for other climate indices, demonstrating a clear increase in potential damages due to water and humidity, while frost damage probably will decrease.

  9. Personnel Investigations and Clearance Tracking (OPI)

    Data.gov (United States)

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

  10. Prehospital advanced airway management by ambulance technicians and paramedics: is clinical practice sufficient to maintain skills?

    Science.gov (United States)

    Deakin, C D; King, P; Thompson, F

    2009-12-01

    Ambulance paramedics are now trained routinely in advanced airway skills, including tracheal intubation. Initial training in this skill requires the insertion of 25 tracheal tubes, and further ongoing training is attained through clinical practice and manikin-based practice. In contrast, training standards for hospital-based practitioners are considerably greater, requiring approximately 200 tracheal intubations before practice is unsupervised. With debate growing regarding the efficacy of paramedic intubation, there is a need to assess current paramedic airway practice in order to review whether initial training and maintenance of skills provide an acceptable level of competence with which to practice advanced airway skills. All ambulance patient report forms (anonymised) for the period 1 January 2007 to 31 December 2007 were reviewed, and data relating to airway management were collected. Paramedic and technician identification codes were used to determine the number of airway procedures undertaken on an individual basis. Of the 269 paramedics, 128 (47.6%) had undertaken no intubation and 204 (75.8%) had undertaken one or less intubation in the 12-month study period. The median number of intubations per paramedic during the 12-month period was 1.0 (range 0-11). A total of 76 laryngeal mask insertion attempts were recorded by 41 technicians and 30 paramedics. The median number of laryngeal mask insertions per paramedic/technician during the 12-month period was 0 (range 0-2). A survey of ongoing continuing professional development across all ambulance trusts demonstrated no provision for adequate training to compensate for the lack of clinical exposure to advanced airway skills. Paramedics use advanced airway skills infrequently. Continuing professional development programmes within ambulance trusts do not provide the necessary additional practice to maintain tracheal intubation skills at an acceptable level. Advanced airway management delivered by ambulance crews

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

    Science.gov (United States)

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

    2012-10-01

    Objective. Spinal cord injury (SCI) often leaves affected individuals unable to ambulate. Electroencephalogram (EEG) based brain-computer interface (BCI) controlled lower extremity prostheses may restore intuitive and able-body-like ambulation after SCI. To test its feasibility, the authors developed and tested a novel EEG-based, data-driven BCI system for intuitive and self-paced control of the ambulation of an avatar within a virtual reality environment (VRE). Approach. Eight able-bodied subjects and one with SCI underwent the following 10-min training session: subjects alternated between idling and walking kinaesthetic motor imageries (KMI) while their EEG were recorded and analysed to generate subject-specific decoding models. Subjects then performed a goal-oriented online task, repeated over five sessions, in which they utilized the KMI to control the linear ambulation of an avatar and make ten sequential stops at designated points within the VRE. Main results. The average offline training performance across subjects was 77.2±11.0%, ranging from 64.3% (p = 0.001 76) to 94.5% (p = 6.26×10-23), with chance performance being 50%. The average online performance was 8.5±1.1 (out of 10) successful stops and 303±53 s completion time (perfect = 211 s). All subjects achieved performances significantly different than those of random walk (p ambulation after only 10 minutes training. The ability to achieve such BCI control with minimal training indicates that the implementation of future BCI-lower extremity prosthesis systems may be feasible.

  12. Design and trial of a new ambulance-to-emergency department handover protocol: 'IMIST-AMBO'.

    Science.gov (United States)

    Iedema, Rick; Ball, Chris; Daly, Barbara; Young, Jacinta; Green, Tim; Middleton, Paul M; Foster-Curry, Catherine; Jones, Marea; Hoy, Sarah; Comerford, Daniel

    2012-08-01

    Information communicated by ambulance paramedics to Emergency Department (ED) staff during handover of patients has been found to be inconsistent and incomplete, and yet has major implications for patients' subsequent hospital treatment and trajectory of care. The study's aims were to: (1) identify the existing structure of paramedic-to-emergency staff handovers by video recording and analysing them; (2) involve practitioners in reflecting on practice using the footage; (3) combine those reflections with formal analyses of these filmed handovers to design a handover protocol; (4) trial-run the protocol; and (5) assess the protocol's enactment. The study was a 'video-reflexive ethnography' involving: structured analysis of videoed handovers (informed by ED clinicians' and ambulance paramedics' comments); ED clinicians and ambulance paramedics viewing their own practices; and rapid at-work training and feedback for paramedics. A five-question pre- and post-survey measured ED triage nurses' perceptions of the new protocol's impact. In total, 137 pre- and post-handovers were filmed involving 291 staff, and 368 staff were educated in the use of the new protocol. There was agreement that Identification of the patient, Mechanism/medical complaint, Injuries/information relative to the complaint, Signs, vitals and GCS, Treatment and trends/response to treatment, Allergies, Medications, Background history and Other (social) information (IMIST-AMBO) was the preferred protocol for non-trauma and trauma handovers. Uptake of IMIST-AMBO showed improvements: a greater volume of information per handover that was more consistently ordered; fewer questions from ED staff; a reduction in handover duration; and fewer repetitions by both paramedics and ED clinicians that may suggest improved recipient comprehension and retention. IMIST-AMBO shows promise for improving the ambulance-ED handover communication interface. Involving paramedics and ED clinicians in its development enhanced the

  13. Treadmill-based locomotor training with leg weights to enhance functional ambulation in people with chronic stroke: a pilot study.

    Science.gov (United States)

    Lam, Tania; Luttmann, Kathryn; Houldin, Adina; Chan, Catherine

    2009-09-01

    Novel locomotor training strategies for individuals with disorders of the central nervous system have been associated with improved locomotor function. The purpose of this study was to investigate the effects of treadmill-based locomotor training combined with leg weights on functional ambulation in individuals with chronic stroke. We assessed functional ambulation and muscle activity in ambulatory individuals with chronic stroke. We used a pre/posttest design. Six individuals with chronic stroke who were community ambulators were recruited. Participants underwent a 30-minute treadmill-based locomotor training sessions three times per week for four to 12 weeks. The training program involved treadmill walking for 30 minutes with partial body weight support as needed. Leg weights, equivalent to 5% of body weight, were affixed around the paretic leg. Outcome measures consisted of the 10-m walk test, the modified Emory Functional Ambulation Profile, and temporal gait parameters. Improvements were observed in functional ambulation measures, particularly the stairs subscore of the modified Emory Functional Ambulation Profile. Participants also exhibited an increase in the proportion of time the paretic leg spent in swing. No significant improvements were observed in the 10-m walk test. This pilot study demonstrates that the combination of leg weights and treadmill training is a feasible approach, that is well tolerated by participants. This approach may have the potential to improve some aspects of functional ambulation and the performance of activities requiring hip and knee flexion.

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

    Science.gov (United States)

    Lai, Poh-Chin; Wong, Ho-Ting

    2015-03-01

    An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structure between 2008 and 2036. The quadratic relation between average daily temperature and daily ambulance demand in 2036 was further explored by including and excluding age-gender demographic changes. Without accounting for changes in the age-gender structure, the 2036 ambulance demand for age groups of 65 and above were consistently underestimated (by 38%-65%), whereas those of younger age groups were overestimated (by 6%-37%). Moreover, changes in the 2008 to 2036 age-gender structure also shift upward and emphasize relationships between average daily temperature and daily ambulance demand at both ends of the quadratic U-shaped curve. Our study reveals a potential societal implication of ageing population on the demand for ambulance services. © 2012 APJPH.

  15. Ambulance call-outs and response times in Birmingham and the impact of extreme weather and climate change.

    Science.gov (United States)

    Thornes, John Edward; Fisher, Paul Anthony; Rayment-Bishop, Tracy; Smith, Christopher

    2014-03-01

    Although there has been some research on the impact of extreme weather on the number of ambulance call-out incidents, especially heat waves, there has been very little research on the impact of cold weather on ambulance call-outs and response times. In the UK, there is a target response rate of 75% of life threatening incidents (Category A) that must be responded to within 8 min. This paper compares daily air temperature data with ambulance call-out data for Birmingham over a 5-year period (2007-2011). A significant relationship between extreme weather and increased ambulance call-out and response times can clearly be shown. Both hot and cold weather have a negative impact on response times. During the heat wave of August 2003, the number of ambulance call-outs increased by up to a third. In December 2010 (the coldest December for more than 100 years), the response rate fell below 50% for 3 days in a row (18 December-20 December 2010) with a mean response time of 15 min. For every reduction of air temperature by 1°C there was a reduction of 1.3% in performance. Improved weather forecasting and the take up of adaptation measures, such as the use of winter tyres, are suggested for consideration as management tools to improve ambulance response resilience during extreme weather. Also it is suggested that ambulance response times could be used as part of the syndromic surveillance system at the Health Protection Agency.

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

    Science.gov (United States)

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

    2013-11-01

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

  17. Office of Personnel Management (OPM)

    Data.gov (United States)

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

  18. Outplacement: An Established Personnel Function

    Science.gov (United States)

    Scherba, John

    1978-01-01

    Every professional personnel department has the basic skills to provide at least minimum outplacement services such as resume preparation, resume typing and reproduction, counseling, and suggestions of job leads. (Author)

  19. Outplacement: An Established Personnel Function

    Science.gov (United States)

    Scherba, John

    1978-01-01

    Every professional personnel department has the basic skills to provide at least minimum outplacement services such as resume preparation, resume typing and reproduction, counseling, and suggestions of job leads. (Author)

  20. Suitability of Norwegian short-tail lambs, Norwegian dairy goats and Cashmere goats for meat production - Carcass, meat, chemical and sensory characteristics.

    Science.gov (United States)

    Mushi, D E; Eik, L O; Thomassen, M S; Sørheim, O; Dnøy, T

    2008-11-01

    Six female Norwegian lambs (29kg body weight, 8 months old), six castrated Norwegian goats (27kg body weight, 10 months old) and six castrated Cashmere goats (20kg body weight, 8 months old) were used to study the relative potential of Norwegian lambs, Norwegian goats and Cashmere goats for meat production. Animals were fattened on silage and commercial concentrate before slaughter. Lamb meat had 4 % lower (PNorwegian goats. Sensory panellists scored lamb meat fattier, juicier and more tender than goat meats. Meat from Cashmere goats scored highest (PNorwegian lamb and Cashmere goats, meats from them are nutritionally comparable to that from Norwegian goats. However, the higher proportion of SFA in Norwegian lambs and Cashmere goats may increase hardness of fat and being easily solidified upon cooling, may influence meat palatability.

  1. Personnel Aspects of Library Automation

    Directory of Open Access Journals (Sweden)

    David C. Weber

    1971-03-01

    Full Text Available Personnel of an automation project is discussed in terms of talents needed in the design team, their qualifications and organization, the attitudes to be fostered, and the communication and documentation that is important for effective teamwork. Discussion is based on Stanford University's experience with Protect BALLOTS and includes comments on some specific problems which have personnel importance and may be faced in major design efforts.

  2. Ambulance Transfer in Case of Postpartum Hemorrhage after Birth in Primary Midwifery Care in The Netherlands: A Prospective Cohort Study.

    Science.gov (United States)

    Stolp, Ineke; Smit, Marrit; Luxemburg, Sanne; van den Akker, Thomas; de Waard, Jan; van Roosmalen, Jos; de Vos, Rien

    2015-09-01

    The objective of this prospective cohort study was to assess whether the 45-minute prehospital limit for ambulance transfer is met in case of postpartum hemorrhage (PPH) after midwifery-supervised home birth in The Netherlands and evaluate the process of ambulance transfer, maternal condition during transfer, and outcomes in relation to whether this limit was met. Using ambulance report forms and medical charts, ambulance intervals, urgency coding, clinical condition (using the lowest Revised Trauma Score, [RTS]), and maternal outcomes were collected. From April 2008 to April 2010, midwives reported 72 cases of PPH. Associations between duration of the ambulance transfer, maternal condition during ambulance transfer and outcomes were analyzed. The main outcome measures were duration of ambulance transfer, RTS, blood loss, surgical procedures, and blood transfusions. Seventy-two cases were reported, 18 (25%) were excluded: 54 cases were analyzed. In 63 percent, the 45-minute prehospital limit was met, 75.9 percent received a RTS of 12, indicating optimal Glasgow Coma Scale, systolic blood pressure, and respiratory frequency. In 24.1 percent a decrease in systolic blood pressure was found (RTS 10 or 11). We found no difference in outcomes between women with different RTS or in whom the 45-minute prehospital limit was or was not met. We found no relation between the duration of ambulance transfer and maternal condition or outcomes. All women fully recovered. The low-risk profile of women in primary care, well-organized midwifery, and ambulance care in The Netherlands are likely to contribute to these findings. © 2015 Wiley Periodicals, Inc.

  3. Norwegian hydropower a valuable peak power source

    Energy Technology Data Exchange (ETDEWEB)

    Brekke, Hermod

    2010-07-01

    given on a possible increase of the Norwegian hydropower peak power production to meet the growing the European demand for peak power caused by the growing non stationary production from wind mills and ocean energy from waves and sea current. Also building of reversible pump turbine power plants will be discussed even if approximately 10% power will be consumed by loss in the pumping phase compared to direct use of the water from reservoirs. (Author)

  4. Ultrahigh Pressure Metamorphic Terrane Evolution; Norwegian Caledonides

    Science.gov (United States)

    Rodda, C. I.; Koons, P. O.; Terry, M.; Robinson, P.

    2007-12-01

    Rocks in Norway's Western Gneiss Region (WGR) experienced high pressure and ultrahigh pressure (UHPM) (4GPa., 800C) peak metamorphic conditions during the Scandian orogeny at 410Ma. Thermobarometric studies of exhumed ultramafic eclogite pods from the Nordfjord, Soroyane and Nordoyane areas place tight time constraints on subduction, UHP metamorphism and exhumation, with all but the final phase of exhumation occurring in ca. 12 million years. However, few structures apparently related to the descent phase of terrane evolution were observed during field studies. Rather, ubiquitous quartz-rod lineation and pervasive minor folding indicate top-to-the-west, relatively shallow unroofing of the subducted margin as indicated in a new bedrock map of a portion of the Norwegian coast. Many of the mapped units have been redescribed, with emphasis put on those features that are of interest to the geophysical community.. To address the ambiguous kinematics of UHPM evolution, numerical models are employed in this study to consider the trajectory of crustal materials during continental collision that concentrate on the delicate balance of forces driving and resisting the subduction of buoyant continental materials as a function of kinetically-controlled equilibration.. In the WGR, past stability of coesite and rarely, of diamond, is preserved in robust mafic eclogites as inclusions within zircon and garnet grains. However, the extent of UHPM equilibration of the volumetrically dominant quartzo-feldspathic gneisses and consequently the contribution of these lithologies to the overall subduction suystemare unclear. . As such, simple equilibrium- defined strength and density parameters are insufficient to define natural model behavior. (Meaning of this next sentence escapes me. How does the following sound?) Rather, numerical solutions involving end member and intermediate states between equilibrium and non-equilibrium assemblages are explored While UHP metamorphic reactions in the

  5. Exploration of Norwegian Student Teachers' Relational Concerns during Internships

    Science.gov (United States)

    Haugan, Jan Arvid; Moen, Torill; Karlsdottir, Ragnheidur

    2012-01-01

    This study builds on and contributes to research on student teachers' relational concerns in teacher education, as four Grade 3 Norwegian student teachers were followed during their internship for two periods of two weeks each. The article presents and discusses data from interviews and student teachers' logs, while the aim of the study is to…

  6. Predicting Intentions to Perform Protective Sexual Behaviours among Norwegian Adolescents

    Science.gov (United States)

    Myklestad, Ingri; Rise, Jostein

    2008-01-01

    This paper examines the socio-cognitive processes underlying intentions to use condoms and contraceptive pills, using the Theory of Planned Behaviour extended with prototypes in a group of young Norwegian adolescents. The data are derived from a questionnaire survey comprising all pupils in Grade Nine at three schools in Oslo (n = 196). Using…

  7. Requirements to a Norwegian national automatic gamma monitoring system

    DEFF Research Database (Denmark)

    Lauritzen, B.; Jensen, Per Hedemann; Nielsen, F.

    2005-01-01

    An assessment of the overall requirements to a Norwegian gamma-monitoring network is undertaken with special emphasis on the geographical distribution of automatic gamma monitoring stations, type of detectors in such stations and the sensitivity of thesystem in terms of ambient dose equivalent rate...

  8. The Limitations of Multiculturalism in Norwegian Early Childhood Education

    Science.gov (United States)

    Hovdelien, Olav

    2014-01-01

    In Norway, 9 out of 10 children between the ages of one and five participate in an educational formation programme which, despite around half of the kindergartens being privately owned, is regulated by a common law and relatively detailed regulations describing what the content of kindergartens should be. Norwegian kindergartens therefore…

  9. Cascading Norwegian co-streams for bioeconomic transition

    DEFF Research Database (Denmark)

    Egelyng, Henrik; Romsdal, A.; Hansen, Henning Otte

    2017-01-01

    of Norwegian food industry cases involving processing of fish, meat, fruit, and vegetable co-streams aiming to capture or even increase use and value of residues from processing. It shows that while objectives of avoiding food losses and transforming co-streams to new products of higher value characterizes...

  10. Future challanges for the maturing Norwegian salmon aquaculture industry

    DEFF Research Database (Denmark)

    Asche, Frank; Guttormsen, Atle G.; Nielsen, Rasmus

    2013-01-01

    In this paper, we analyze total factor productivity change in the Norwegian salmon aquaculture sector from 1996 to 2008. During this period, the production has on average been growing with 8% per year. At the same time, the price of salmon has stabilized indicating that an increase in demand is d...

  11. Highly variable Pliocene sea surface conditions in the Norwegian Sea

    Science.gov (United States)

    Bachem, Paul E.; Risebrobakken, Bjørg; De Schepper, Stijn; McClymont, Erin L.

    2017-09-01

    The Pliocene was a time of global warmth with small sporadic glaciations, which transitioned towards the larger-scale Pleistocene glacial-interglacial variability. Here, we present high-resolution records of sea surface temperature (SST) and ice-rafted debris (IRD) in the Norwegian Sea from 5.32 to 3.14 Ma, providing evidence that the Pliocene surface conditions of the Norwegian Sea underwent a series of transitions in response to orbital forcing and gateway changes. Average SSTs are 2 °C above the regional Holocene mean, with notable variability on millennial to orbital timescales. Both gradual changes and threshold effects are proposed for the progression of regional climate towards the Late Pliocene intensification of Northern Hemisphere glaciation. Cooling from 4.5 to 4.3 Ma may be linked to the onset of poleward flow through the Bering Strait. This cooling was further intensified by a period of cool summers due to weak obliquity forcing. A 7 °C warming of the Norwegian Sea at 4.0 Ma suggests a major increase in northward heat transport from the North Atlantic, leading to an enhanced zonal SST gradient in the Nordic Seas, which may be linked to the expansion of sea ice in the Arctic and Nordic Seas. A warm Norwegian Sea and enhanced zonal temperature gradient between 4.0 and 3.6 Ma may have been a priming factor for increased glaciation around the Nordic Seas due to enhanced evaporation and precipitation at high northern latitudes.

  12. Seroprevalence of Toxoplasma gondii infection in Norwegian dairy goats

    Directory of Open Access Journals (Sweden)

    Stormoen Marit

    2012-12-01

    Full Text Available Abstract Background Toxoplasma gondii is a major problem for the sheep industry as it may cause reproduction problems. The importance of T. gondii in Norwegian goat herds is uncertain, but outbreaks of toxoplasmosis in dairy goat farms have been recorded. The aim of this study was to describe the prevalence of T. gondii infection in Norwegian dairy goats by using serology. Findings Goat serum originally collected as part of two nationwide surveillance and control programmes between 2002 and 2008 were examined for T. gondii antibodies by using direct agglutination test. In total, 55 of 73 herds (75% had one or more serologically positive animals, while 377 of 2188 (17% of the individual samples tested positive for T. gondii antibodies. Conclusions This is the first prevalence study of T. gondii infection in Norwegian goats. The results show that Norwegian goat herds are commonly exposed to T. gondii. Nevertheless, the majority of goat herds have a low prevalence of antibody positive animals, which make them vulnerable to infections with T. gondii during the gestation period.

  13. Teaching Immigrants Norwegian Culture to Support Their Language Learning

    Science.gov (United States)

    Alhassan, Awal Mohammed; Kuyini, Ahmed Bawa

    2013-01-01

    This study was conducted with 48 adult immigrant students studying Norwegian under basic education program of the Ski Municipality Adult Education Unit between 2009-2011. Using the framework of Genc and Bada (2005), we tried to replicate their study in a new setting--Norway. The study investigated migrant students' perceptions learning Norwegian…

  14. New creativity in Norwegian research; Ny giv i norsk forskning

    Energy Technology Data Exchange (ETDEWEB)

    Gaudernac, B. [Institutt for Energiteknikk, Kjeller (Norway)

    1996-03-01

    The article deals briefly with the IEA (International Energy Agency) research program on cost beneficial large scale hydrogen production by direct conversion of solar energy. The Norwegian participation in this program covers photobiological, photochemical, and photoelectrochemical hydrogen production, and storage of energy. 1 fig.

  15. Jens Glad Balchen: A Norwegian Pioneer in Engineering Cybernetics

    Directory of Open Access Journals (Sweden)

    Morten Breivik

    2009-07-01

    Full Text Available This paper tells the story of Jens Glad Balchen (1926-2009, a Norwegian research scientist and engineer who is widely regarded as the father of Engineering Cybernetics in Norway. In 1954, he founded what would later become the Department of Automatic Control at the Norwegian Institute of Technology in Trondheim. This name was changed to the Department of Engineering Cybernetics in 1972 to reflect the broader efforts being made, not only within the purely technical disciplines, but also within biology, oceanography and medicine. Balchen established an advanced research community in cybernetics in postwar Norway, whose applications span everything from the process industry and positioning of ships to control of fish and lobster farming. He was a chief among the tribe of Norwegian cybernetics engineers and made a strong impact on his colleagues worldwide. He planted the seeds of a whole generation of Norwegian industrial companies through his efforts of seeking applications for every scientific breakthrough. His strength and his wisdom in combination with his remarkable stubbornness gave extraordinary results.

  16. Typing of Pseudomonas aeruginosa strains in Norwegian cystic fibrosis patients

    DEFF Research Database (Denmark)

    Fluge, G; Ojeniyi, B; Høiby, N

    2001-01-01

    OBJECTIVES: Typing of Pseudomonas aeruginosa isolates from Norwegian cystic fibrosis (CF) patients with chronic Pseudomonas lung infection in order to see whether cross-infection might have occurred. METHODS: Isolates from 60 patients were collected during the years 1994-98, and typed by pulsed...

  17. The Limitations of Multiculturalism in Norwegian Early Childhood Education

    Science.gov (United States)

    Hovdelien, Olav

    2014-01-01

    In Norway, 9 out of 10 children between the ages of one and five participate in an educational formation programme which, despite around half of the kindergartens being privately owned, is regulated by a common law and relatively detailed regulations describing what the content of kindergartens should be. Norwegian kindergartens therefore…

  18. Stratigraphic guide to the Rogaland Group, Norwegian North Sea

    NARCIS (Netherlands)

    Brunstad, H.; Gradstein, F.; Lie, J.E.; Hammer, O.; Munsterman, D.K.; Ogg, G.; Hollerbach, M.

    2013-01-01

    This guide provides a major revision and update of the lithostratigraphy of the Rogaland Group for the Norwegian North Sea. An abundance of recent well and seismic data sheds new light on lithology, biostratigraphy, provenance, geographic distribution and terminology of all Rogaland rock units, used

  19. Observations of shifts in cetacean distribution in the Norwegian Sea

    Directory of Open Access Journals (Sweden)

    Leif eNøttestad

    2015-01-01

    Full Text Available This study aimed to assess possible shifts in distributional patterns of cetaceans residing in the Norwegian Sea, and if possible relate the distribution to their feeding ecology during the summer seasons of 2009, 2010 and 2012. During this same period, historically large abundances in the order of 15 million tonnes pelagic planktivorous fish such as Norwegian spring-spawning herring (Clupea harengus, northeast Atlantic mackerel (Scomber scombrus and blue whiting (Micromesistius poutassou, have been reported feeding in the Norwegian Sea during the summer. There is also observed elevated average surface temperatures and a reduction in zooplankton biomasses. Such changes might influence species composition, distribution patterns and feeding preferences of cetaceans residing the region. Our results show higher densities of toothed whales, killer whales (Orcinus orca and pilot whales (Globicephala melas, than the previous norm for these waters. Baleen whales, such as minke whales (Balaenoptera acutorostrata and fin whales (Balaenoptera physalus, which is often associated with zooplankton, displayed a distribution overlap with pelagic fish abundances. Humpback whales (Megaptera novaeangliae were observed in low numbers, indicating shift in habitat preference, compared to sighting data collected only few years earlier. Our study illustrate that both small and large cetaceans that reside in the Norwegian Sea have the capability to rapidly perform shifts in distribution and abundance patterns dependent of the access to different types and behaviour of prey species.

  20. Educating Voters: Political Education in Norwegian Upper-Secondary Schools

    Science.gov (United States)

    Borhaug, Kjetil

    2008-01-01

    Research on political education in schools suggests that an emphasis on formal structure, constitutional principles, formal citizen rights, and debates on current issues is common. The Norwegian national curriculum on political education envisions a different political education emphasizing that students should be critical of political life and…

  1. Implementation of New Public Management in Norwegian Universities

    Science.gov (United States)

    Frolich, Nicoline

    2005-01-01

    This article analyses the implementation of market-type mechanisms in the management of universities. The question of which cultural biases have been used in the implementation of New Public Management (NPM) in Norwegian universities is discussed. Cultural theory, institutional theory, and public policy studies are applied to the analysis of a…

  2. The Norwegian "Christianity, Religion and Philosophy" Subject "KRL" in Strasbourg

    Science.gov (United States)

    Lied, Sidsel

    2009-01-01

    This article presents the judgement and dissent of the European Court of Human Rights in the "Case of Folgero and others v. Norway" regarding the subject "Christianity, Religion and Philosophy (KRL)" in Norwegian state schools. The verdict, reached with dissenting votes of 9-8, states that parents' freedom of ensuring their children an education…

  3. Syllable reduction and articulation rates in Danish, Norwegian and Swedish

    NARCIS (Netherlands)

    Hilton, N.H.; Schüppert, Anja; Gooskens, C.S.

    2011-01-01

    This investigation compares articulation rates of phonological and phonetic syllables in Norwegian, Swedish and Danish to investigate differences in degrees of syllable deletion (reduction) among these three languages. For the investigation two sets of data are used: one consisting of recorded speec

  4. Non-audit services and auditor independence: Norwegian evidence

    DEFF Research Database (Denmark)

    Zhang, Yu (Elli); Hay, David; Holm, Claus

    2016-01-01

    We examine the effect on auditor independence of auditors providing non-audit services in the Norwegian audit market. We report the results of three tests of independence of mind and one test of independence in appearance. These tests find that there is a positive relationship between audit fees...

  5. The Prevalence and Nature of Intellectual Disability in Norwegian Prisons

    Science.gov (United States)

    Sondenaa, E.; Rasmussen, K.; Palmstierna, T.; Nottestad, J.

    2008-01-01

    Background: The objective of the study was to calculate the prevalence of inmates with intellectual disabilities (ID), and identify historical, medical and criminological characteristics of a certain impact. Methods: A random sample of 143 inmates from a Norwegian prison cross sectional sample was studied. The Hayes Ability Screening Index (HASI)…

  6. Translation and "Myth": Norwegian Children's Literature in English.

    Science.gov (United States)

    Rudvin, Mette

    1994-01-01

    Argues that books from minor language communities/cultures are selected not only according to merit but also according to whether the literature in question conforms with the myths about these smaller nations in the dominant culture. Illustrates this point by examining translations of Norwegian children's literature into English, noting in…

  7. 76 FR 47516 - Personnel Management in Agencies

    Science.gov (United States)

    2011-08-05

    ... MANAGEMENT 5 CFR PART 250 RIN 3206-AL98 Personnel Management in Agencies AGENCY: U.S. Office of Personnel Management. ACTION: Proposed rule. SUMMARY: The U.S. Office of Personnel Management is issuing proposed... and Veterans Support, U.S. Office of Personnel Management, Room 7460, 1900 E Street, NW., Washington...

  8. 21 CFR 606.20 - Personnel.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Personnel. 606.20 Section 606.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Organization and Personnel § 606.20 Personnel. (a) (b) The personnel responsible for...

  9. 48 CFR 752.7007 - Personnel compensation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Personnel compensation... Personnel compensation. The following clause shall be used in all USAID cost-reimbursement contracts. Personnel Compensation (JUL 2007) (a) Direct compensation of the Contractor's personnel will be...

  10. Exemplary Educational Programs in Norwegian Prisons: A Case Study of Norwegian Educators' Attitudes and Humanitarian Practices

    Science.gov (United States)

    Pettit, Michelle D.

    2012-01-01

    The purpose of this study was to explore how Norwegian correctional educators' attitudes and working environments influenced successful inmate outcomes. Success for incarcerated students was defined by the ability to enroll in and do well in prison classes, develop life skills, and gain the knowledge and skills to become productive members of…

  11. The Rhetoric of the Norwegian Constitution Day: A Topos Analysis of Young Norwegian Students' May 17 Speeches, 2011 and 2012

    Science.gov (United States)

    Tønnesson, Johan Laurits; Sivesind, Kirsten

    2016-01-01

    National Day, or Constitution Day, in Norway, May 17, is often referred to as Children's Day. On this day, thousands of young Norwegian students march in parades and participate in celebrations in schoolyards and similar meeting places. Some students are selected to give speeches, performed in front of family members, neighbors, classmates, and…

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

    van Bergen, Leo

    2010-01-01

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

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

    LENUS (Irish Health Repository)

    Feeney, A

    2016-04-01

    Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten ‘door to needle time’. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face Arm Speech Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014. The final clinical diagnosis was acute stroke in 57.1% (n=101) of patients. Of these, 76 were ischaemic strokes of whom 56.5% (n=43) were thrombolysed. In the pre-hospital setting Ambulance Paramedics can identify, with reasonable accuracy, acute stroke using the FAST test. Over half of the ischaemic stroke patients presenting via this pathway can be treated with intravenous thrombolysis

  15. Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Kristensen, Morten Tange; Kehlet, Henrik

    2006-01-01

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

  16. The role of physician-staffed ambulances:the outcome of a pilot study

    Institute of Scientific and Technical Information of China (English)

    A Haner; P rninge; A Khorram-Manesh

    2015-01-01

    Objective:To evaluate the outcome of physician-staffed ambulances in a pilot study. Methods:All physician-staffed ambulance missions conducted in Gothenburg, Sweden, in 2013 were retrospectively reviewed and evaluated for the type of missions and the need of a physician. Results:Out of 1 381 physician-staffed missions, 511 were cancelled or managed by telephone. Around 239 (17%) missions required active intervention, of which only one was considered directly life-saving. Conclusions: Most of the missions neither required the interventional skills of a physician, nor could they be performed at distance. However, the added medical value of physicians was found to be in other prehospital situations, such as critical decision-making, staff education and research.

  17. Contributing factors and issues associated with rural ambulance crashes: literature review and annotated bibliography.

    Science.gov (United States)

    Sanddal, Nels D; Albert, Steve; Hansen, Joseph D; Kupas, Douglas F

    2008-01-01

    Ambulance crashes occur with greater frequency and severity than crashes involving vehicles of similar size and weight characteristics. Crashes in rural areas tend to be more severe in terms of injury or death to vehicle occupants. The purpose of this article was to examine the extant literature, as well as summarize and discuss the overlapping findings of that body of literature. A stepwise literature search was conducted using the following MeSH search terms ambulance; accident, traffic; emergency medical technician; occupational health; and rural in descending combination. MEDLINE was used as the primary database but was augmented by searches of Academic Search Premier, Comprehensive Index of Nursing, Allied Health Literature, and ProQuest Dissertation International. The search resulted in 32 article citations, and of these, 28 were included. An annotated bibliography is followed by a discussion and conclusion that identify opportunities for prevention activities in the areas of education, enforcement, and engineering.

  18. 10-year experience of CO2-laser application in ambulance gynecology

    Science.gov (United States)

    Stachanov, Michael L.; Masychev, Victor I.; Velsher, Leonid Z.; Kirkin, Vladimir V.; Zhashkov, Roman V.; Kocharian, Emilia A.

    2000-10-01

    CO2-laser surgical systems have come to stay in everyday practice of modern physicians and are successfully used in colposcopic and laparoscopic surgery. Results, obtained in ambulance gynecology are especially impressing. CO2- laser provides high medical- and cost-effective treatment. Presented work describes many-years experience of CO2- laser application. 439 patients with various vulvaric and cervix diseases were operated within this period. Laser beam parameters were selected according to requirements ((tau) =4 J/cm2) treatment without carbonization. Analyses of the results showed that the laser successfully destructs uterine cervix erosion, endocervicosis, dysplasia, leukoplakia, eritoplakia of uterine cervix, various benignant pathologies and focus degenerative process in ambulate conditions.

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

    Science.gov (United States)

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

    2000-08-01

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

  20. Proposal for periodic verifications of electromedical devices integrated to terrestrial Technical Ambulance Inspection (TAI)

    Science.gov (United States)

    Del Aguila Heidenreich, R.; Vanella, O.; Bruni, R.; Taborda, R.

    2011-12-01

    In Argentina, electromedical devices may only be commercialized if they meet safety and performance requirements established by current regulations, ensuring their safety and intended performance when leaving the Factory. However, during usage, natural wearing and overloading may change this condition, especially if used in extra hospital services performed by ambulances, which are likely to be subjected to rough handling conditions and hitting. This proposal explains the chosen methodology to address the periodic verification activities of electro medical devices within the process of terrestrial Technical Ambulance Inspection (TAI). Among the results stand out the set of methods for verification and the lists used to record the outcome of this evaluation. Outstanding conclusions include that the operations meet the conditions of an analogous mechanism to that of a Technical Vehicle Inspection (existing for other vehicles), and that the same working structure can be used as a basis for making a manual of procedures for a TAI.

  1. When is the helicopter faster? A comparison of helicopter and ground ambulance transport times.

    Science.gov (United States)

    Diaz, Marco A; Hendey, Gregory W; Bivins, Herbert G

    2005-01-01

    A retrospective analysis of 7,854 ground ambulance and 1,075 helicopter transports was conducted. The 911-hospital arrival intervals for three transport methods were compared: ground, helicopter dispatched simultaneously with ground unit, and helicopter dispatched nonsimultaneously after ground unit response. Compared with ground transports, simultaneously dispatched helicopter transports had significantly shorter 911-hospital arrival intervals at all distances greater than 10 miles from the hospital. Nonsimultaneously dispatched helicopter transport was significantly faster than ground at distances greater than 45 miles, and simultaneous helicopter dispatch was faster than nonsimultaneous at virtually all distances. Ground transport was significantly faster than either air transport modality at distances less than 10 miles from the hospital. Ground ambulance transport provided the shortest 911-hospital arrival interval at distances less than 10 miles from the hospital. At distances greater than 10 miles, simultaneously dispatched air transport was faster. Nonsimultaneous dispatched helicopter transport was faster than ground if greater than 45 miles from the hospital.

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

    DEFF Research Database (Denmark)

    Jenstrup, M T; Jæger, P; Lund, J;

    2012-01-01

    Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We...... hypothesized that the adductor-canal-blockade may reduce morphine consumption (primary endpoint), improve pain relief, enhance early ambulation ability, and reduce side effects (secondary endpoints) after TKA compared with placebo....

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

    OpenAIRE

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

    2004-01-01

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

  4. A Statistical Analysis of Santa Barbara Ambulance Response in 2006: Performance Under Load

    Directory of Open Access Journals (Sweden)

    Chang, Joshua C

    2009-02-01

    Full Text Available Ambulance response times in Santa Barbara County for 2006 are analyzed using point process techniques, including kernel intensity estimates and K-functions. Clusters of calls result in significantly higher response times, and this effect is quantified. In particular, calls preceded by other calls within 20 km and within the previous hour are significantly more likely to result in violations. This effect appears to be especially pronounced within semi-rural neighborhoods.[WestJEM. 2009;10:42-47.

  5. Emergency ambulance assistance in The Netherlands: is the Dutch situation optimal?

    Science.gov (United States)

    van Vugt, A B; van Olden, G D; Edwards, M J

    1995-12-01

    The system of prehospital trauma care in the Netherlands is the subject of great concern. Although many improvements have been achieved in the last decade, there are still some deficits. Legislation concerning the minimal level of education for ambulance attendants was recently upgraded to 'registered nurse', a standard which must be achieved by 1997. Standardization with regard to extrication techniques, equipment and methods of treatment in prehospital trauma care does not yet exist. Although aware of the fact that large regional differences exist throughout the USA, a system of care in accordance with the advanced trauma life support (ATLS) standard of the American College of Surgeons (ACS) and by means of prehospital and advanced trauma life support (PHTLS) given according to the standards of the National Association of Emergency Medical Technicians (NAEMS) was considered to be the 'golden standard'. Nineteen ground ambulance and two helicopter services in different states of the USA, working according to ACS/NAEMS standard, were visited to analyse the system of care, with special reference to (para)medical education, communication, logistics, and immobilization materials and techniques. In the Netherlands all 41 central post ambulance services (CPAs) were asked to return a questionnaire. This resulted in a 90% (37 out of 41) response. The deficits of the Dutch system of care related to the PHTLS/ATLS standard are pointed out, resulting in recommendations to improve the Dutch system. The requirements of the dispatcher are far inferior to the optimal situation, which, together with the lack of technical equipment, results in serious communication problems. The Dutch ambulance attendant education, in which in the present system the education level reaches 'registered nurse' in only 91% and specialized courses are not mandatory, should be upgraded to the PHTLS level of care.

  6. Relation Between Objectively Measured Growth Determinants and Ambulation in Children with Cerebral Palsy

    OpenAIRE

    GÖKKAYA, N. Kutay ORDU; ÇALIŞKAN, Aslı; KARAKUŞ, Dilek; Uçan, Halil

    2009-01-01

    Aims: Cerebral palsy (CP) is a well-known neurodevelopmental condition beginning in early childhood and persisting throughout one´s life span. Feeding problems and eating impairments in CP children are well documented in the literature. The aims of our study were to determine the prevalence of linear growth retardation and the other growth determinants in this patient group and to identify the contributing factors and their relationship with ambulation. Materials and Methods: A cross-section...

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2016-11-01

    The aim of this study is to determine whether short-term exposure to fine particulate matter (PM2.5) is associated with emergency ambulance dispatches for cardiovascular diseases in Japan. The nationwide data on emergency dispatches of ambulance for cardiovascular diseases classified as I00-I99 by International Classification of Diseases-10th revision in 30 Japanese prefectures between April 1 and December 31, in 2010 were analyzed. Data on weather variability including PM2.5, temperature and relative humidity were acquired from ambient air pollution monitoring stations. Conditional Poisson regression models were used to estimate the prefecture-specific effects of PM2.5 on morbidity, and adjust for confounding factors. A meta-analysis was then applied to pool estimates at the 30-prefecture level. A total of 160,566 emergency ambulance dispatches for cardiovascular diseases were reported during the study period. The risk of emergency ambulance dispatch for cardiovascular diseases significantly increased with an increase in the exposure to PM2.5 in Fukuoka and Iwate Prefectures. However, we found no statistically significant associations between PM2.5 and emergency ambulance dispatches in the pooled analysis (odds ratio 1.00, 95 % confidence interval 0.99-1.00). Heterogeneity was not observed between prefectures (Cochran Q test, p = 0.187, I (2) = 18.4 %). Exposure to PM2.5 is not associated with overall emergency ambulance dispatches for cardiovascular diseases in Japan.

  9. Personnel Management theories and applications

    Institute of Scientific and Technical Information of China (English)

    Yanni Feng

    2010-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  11. A coproduced patient and public event: An approach to developing and prioritizing ambulance performance measures.

    Science.gov (United States)

    Irving, Andy; Turner, Janette; Marsh, Maggie; Broadway-Parkinson, Andrea; Fall, Dan; Coster, Joanne; Siriwardena, A Niroshan

    2017-08-25

    Patient and public involvement (PPI) is recognized as an important component of high-quality health services research. PPI is integral to the Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) programme. The PPI event described in detail in this article focusses on the process of involving patients and public representatives in identifying, prioritizing and refining a set of outcome measures that can be used to support ambulance service performance measurement. To obtain public feedback on little known, complex aspects of ambulance service performance measurement. The event was codesigned and coproduced with the PhOEBE PPI reference group and PhOEBE research team. The event consisted of brief researcher-led presentations, group discussions facilitated by the PPI reference group members and electronic voting. Data were collected from eighteen patient and public representatives who attended an event venue in Yorkshire. The results of the PPI event showed that this interactive format and mode of delivery was an effective method to obtain public feedback and produced a clear indication of which ambulance performance measures were most highly favoured by event participants. The event highlighted valuable contributions the PPI reference group made to the design process, supporting participant recruitment and facilitation of group discussions. In addition, the positive team working experience of the event proved a catalyst for further improvements in PPI within the PhOEBE project. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2016-02-01

    The aim of this study was to explore the impact of motion generated by ambulance patient management on the performance of two lightweight physiologic sensors. Two physiologic sensors were applied to pre-hospital patients. The first was the Contec Medical Systems CMS50FW finger pulse oximeter, monitoring heart rate (HR) and blood oxygen saturation (SpO2). The second was the RESpeck respiratory rate (RR) sensor, which was wireless-enabled with a Bluetooth(®) Low Energy protocol. Sensor data were recorded from 16 pre-hospital patients, who were monitored for 21.2 ± 9.8 min, on average. Some form of error was identified on almost every HR and SpO2 trace. However, the mean proportion of each trace exhibiting error was ambulance transit on the incidence of HR or SpO2 error. The RESpeck RR sensor delivered an average of 4.2 (±2.2) validated breaths per minute, but did not produce any validated breaths during the gross motion of ambulance transit as its pre-defined motion threshold was exceeded. However, this was many more data points than could be achieved using traditional manual assessment of RR. Error was identified on a majority of pre-hospital physiologic signals, which emphasised the need to ensure consistent sensor attachment in this unstable and unpredictable environment, and in developing intelligent methods of screening out such error.

  13. Ambulation monitoring of transtibial amputation subjects with patient activity monitor versus pedometer.

    Science.gov (United States)

    Dudek, Nancy L; Khan, Omar D; Lemaire, Edward D; Marks, Meridith B; Saville, Leyana

    2008-01-01

    Our study aimed to compare the accuracy of step count and ambulation distance determined with the Yamax Digi-Walker SW-700 pedometer (DW) and the Ossur patient activity monitor (PAM) in 20 transtibial amputation subjects who were functioning at the K3 Medicare Functional Classification Level. Subjects completed four simulated household tasks in an apartment setup and a gymnasium walking course designed to simulate outdoor walking without the presence of environmental barriers or varied terrain. The mean step count accuracy of the DW and the PAM was equivalent for both the household activity (75.3% vs 70.6%) and the walking course (93.8% vs 94.0%). The mean distance measurement accuracy was better with the DW than with the PAM (household activity: 72.8% vs 0%, walking course: 92.5% vs 86.3%; p < 0.05). With acceptable step count accuracy, both devices are appropriate for assessing relatively continuous ambulation. The DW may be preferred for its more accurate distance measurements. Neither device is ideal for monitoring in-home ambulation.

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

    Science.gov (United States)

    Nordby, Halvor

    2015-01-01

    Managers of ambulance stations face many communicative challenges in their interaction with employees working in prehospital first-line services. The article presents an exploratory study of how paramedics experience these challenges in communication with station leaders. On the basis of a dialogue perspective in qualitative method, 24 paramedics were interviewed in one-to-one and focus group settings. Naturalistic and phenomenological approaches were used to analyze the interviews. All the paramedics said that they wished to be more involved in decision processes and that station managers should provide better explanations of information "from above." The paramedics understood that it was difficult for the managers to find time for extensive dialogue, but many thought that the managers should give more priority to communication. The paramedics' views correspond to theoretical assumptions in human resource management. According to this model, employees should be involved in decision processes on management levels, as long as it is realistically possible to do so. Furthermore, expressing emotional support and positive attitudes does not take much time, and the study suggests that many ambulance managers should focus more on interpersonal relations to employees. It has been extensively documented that management communication affects organizational performance. The study indicates that managers of ambulance stations should be more aware of how their leadership style affects professional commitment and motivation in the first-line services.

  15. Effect of a mass media campaign on ambulance use for chest pain.

    Science.gov (United States)

    Nehme, Ziad; Cameron, Peter A; Akram, Muhammad; Patsamanis, Harry; Bray, Janet E; Meredith, Ian T; Smith, Karen

    2017-01-16

    To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use. Monthly ambulance attendances. The median number of monthly ambulance attendances for chest pain was 3609 (IQR, 3011-3891), but was higher in campaign months than in non-campaign months (3880 v 3234, Pambulance use for chest pain, and a 15.4% increase (95% CI, 10.1-20.9%; Pambulance increased by 10.0% (95% CI, 6.1-14.2%; P<0.001) during campaign months, the number of patients not transported to hospital also increased, by 13.9% (95% CI, 8.3-19.8%; P<0.001). A public awareness campaign about responding to prodromal acute myocardial infarction symptoms was associated with an increase in EMS use by people with chest pain and suspected acute coronary syndromes. Campaign activity may also lead to increased EMS use in low risk populations.

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

    DEFF Research Database (Denmark)

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

    Formål og baggrund: Længden af hospitalsophold efter fødsel er afkortet i løbet af de sidste 10-20 år. Udfordringen bliver at sikre ’at den observation og understøttelse af mor og barn, der tidligere fandt sted under indlæggelse, fortsat sikres efter ambulant fødsel eller tidlig udskrivelse’ (SST...... 2009, s.36). Det overordnede formål er at udforske om telemedicin kan være en mulig løsning, når kvinder udskrives ambulant. Design og metoder: Projektet er et aktionsforskningsprojekt, nærmere bestemt arbejdes der ud fra Participartory Design. Metodologien er baseret på deltagelse af brugerne, og det......-løsningen med fokus på hvordan sygeplejerskerne og de nybagte familier oplever brug af en app efter ambulant fødsel. Foreløbige resultater: Den første fase af undersøgelsen understreger behovet for et individuelt barselsforløb, hvor der er opfølgende støtte efter udskrivelsen og hvor familierne oplever, at de...

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

    Directory of Open Access Journals (Sweden)

    Alan Campbell

    2016-01-01

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

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

    Science.gov (United States)

    Campbell, Alan; Ellington, Matt

    2016-01-01

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

  19. Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres - a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background The 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number and the operators’ self-reported use of Index as a first step towards a validation study. Methods We registered all medical emergency calls to the EMCCs during a 72 h period in a national cross sectional study. We subsequently sent a questionnaire to all EMCC operators in Norway, asking how they use Index. A combined outcome variable “use of Index” was computed through a Likert scale, range 1–5. Regression models were used to examine factors influencing use. Results 2 298 contacts were included. National contact rate was 56/1 000 inhabitants per year, range between EMCCs 34 – 119. Acute contact (life-threatening situations) rate was 21/1 000 per year, range between EMCCs 5 – 31. Index criteria 6 – ’Unresolved problem’ accounts for 20% of the 113 contacts, range between EMCCs 10 – 42%. The mean use of Index was 3.95 (SD 0.39), corresponding to “more than 75% of emergency calls”. There were differences in use of Index on EMCC level, range 3.7 – 4.4, and a multi regression model explained 23.4% of the variation in use. Operators working rotation with ground ambulance services reported reduced use of Index compared to operators not working in rotation, while distinct EMCC focus on Index increased use of Index compared to EMCCs with no focus on Index. Use of electronic records and operators experience were the main reasons given for not using Index. Conclusions There is a large variation between the EMCCs with regard to both contact patterns and use of Index. There is a relatively high overall self-reported use of Index by the operators, with variations on both individual and EMCC level. PMID:24398290

  20. "Almost at War". The Mohammed Cartoon Crisis in Norwegian Media

    Directory of Open Access Journals (Sweden)

    Solveig Steien

    2008-04-01

    Full Text Available In January and February 2006, Norwegians witnessed the burning of their national flag in Palestine, the burning of Norwegian embassies and consulates in Syria, Lebanon and Iran; all simply because twelve Danish Mohammed cartoons from Jyllands-Posten had been reprinted in Norway; the cartoons were published in a marginal Christian conservative weekly newspaper, Magazinet, three months after their original appearance in Denmark. In February 2006 the Norwegian ISAF-forces in Afghanistan were attacked. This conflict had a surprising impact on domestic and foreign policy, and the Norwegian publication of the cartoons triggered a global escalation of the controversy; Norwegian newspapers wrote that the country was "almost at war". I have focused on how some leading Norwegian newspapers (Aften, Aftenposten, Dagbladet, Dagens Næringsliv, Dagsavisen and VG covered this unexpected crisis and studied the different discourses that became a substantial part of the media coverage. In my analysis I have used an overall approach of War versus Peace journalism. War and Peace journalism was not created as a concept for analysing media texts or photographs, but to provide practical tools for journalists in the field of conflict and war situations. Nevertheless, this approach gives an opportunity to examine the results of journalistic work and compare them with the press'es ideals and ethical codes. At the same time, the occurrence of discourses like "clash of civilisations", freedom of speech, "us" versus "them", i.e., "us" versus the Muslims, and the newspapers' choice of sources for their stories, seem to fit with a model of War and Peace journalism. The focus is on opinion materials like editorials and comments, as well as on domestic reports and reportage by correspondents. By analysing samples of articles I have tried to outline some areas where the concept of Peace versus War journalism still needs to be developed, in order to become a comprehensive or more

  1. The Birth and Growth of the National Ambulance Service in Ghana.

    Science.gov (United States)

    Zakariah, Ahmed; Stewart, Barclay T; Boateng, Edmund; Achena, Christiana; Tansley, Gavin; Mock, Charles

    2017-02-01

    Introduction This study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified. Data routinely collected by the Ghana NAS from 2004-2014 were described, including: patient demographics, reason for the call, response location, target destination, and ti1mes of service. Additionally, the organizational structure and challenges encountered during the development and maturation of the NAS were reported. In 2004, the NAS piloted operations with 69 newly trained emergency medical technicians (EMTs), nine ambulances, and seven stations. The NAS expanded service delivery with 199 ambulances at 128 stations operated by 1,651 EMTs and 47 administrative and maintenance staff in 2014. In 2004, nine percent of the country was covered by NAS services; in 2014, 81% of Ghana was covered. Health care transfers and roadside responses comprised the majority of services (43%-80% and 10%-57% by year, respectively). Increased mean response time, stable case holding time, and shorter vehicle engaged time reflect greater response ranges due to increased service uptake and improved efficiency of ambulance usage. Specific internal and external challenges with regard to NAS operations also were described. The steady growth of the NAS is evidence of the need for Emergency Medical Services and the effects of sound planning and timely responses to changes in program indicators. The way forward includes further capacity building to increase the number of scene responses, strengthening ties with local health facilities to ensure timely emergency medical care and appropriateness of transfers, assuring a more stable funding stream, and improving public awareness of NAS services

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

    Directory of Open Access Journals (Sweden)

    Laetitia Yperzeele

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

  3. The Medical Duty Officer: An Attempt to Mitigate the Ambulance At-Hospital Interval.

    Science.gov (United States)

    Halliday, Megan H; Bouland, Andrew J; Lawner, Benjamin J; Comer, Angela C; Ramos, Daniel C; Fletcher, Mark

    2016-09-01

    A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time. The MDO was implemented on November 11, 2013. A senior EMS paramedic was assigned to the position and was placed in the fire communication bureau from 9 a.m. to 9 p.m., seven days a week. We defined the pre-intervention period as August 2013 - October 2013 and the post-intervention period as December 2013 - February 2014. We also compared the post-intervention period to the "seasonal match control" one year earlier to adjust for seasonal variation in EMS volume. The MDO was tasked with the prospective management of city EMS resources through intensive monitoring of unit availability and hospital ED traffic. The MDO could suggest alternative transport destinations in the event of ED crowding. We collected and analyzed data from BCFD computer-aided dispatch (CAD) system for the following: ambulance response times, ambulance at-hospital interval, hospital diversion and alert status, and "suppression wait time" (defined as the total time suppression units remained on scene until ambulance arrival). The data analysis used a pre/post intervention design to examine the MDO impact on the BCFD EMS system. There were a total of 15,567 EMS calls during the pre-intervention period, 13,921 in the post-intervention period and 14,699 in the seasonal match control period one year earlier. The average at-hospital time decreased by 1.35 minutes from pre- to post-intervention periods and 4.53 minutes from the pre- to seasonal match control, representing a statistically significant decrease

  4. Project Management Personnel Competencies Evaluation

    Directory of Open Access Journals (Sweden)

    Paul POCATILU

    2006-01-01

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

  5. Health Instruction Packages: Dental Personnel.

    Science.gov (United States)

    Hayes, Gary E.; And Others

    Text, illustrations, and exercises are utilized in this set of four learning modules designed to instruct non-professional dental personnel in selected job-related skills. The first module, by Gary E. Hayes, describes how to locate the hinge axis point of the jaw, place and secure a bitefork, and perform a facebow transfer. The second module,…

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

    Science.gov (United States)

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

    2014-02-01

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

  7. Norwegian actors in the fields of energy and climate change in China

    Energy Technology Data Exchange (ETDEWEB)

    Buan, Inga Fritzen

    2008-02-15

    Written for and funded by the Norwegian Ministry of Foreign Affairs and StatoilHydro, this report is a descriptive inventory of Norwegian involvement and Sino-Norwegian cooperation in the fields of energy and climate change-related issues in China. Part 1 is a brief, general introduction to the relevant topics, providing both typical and atypical examples of Norwegian involvement and cooperation and partnerships between actors from the two countries. Many valuable cooperative relationships in science and business have been established. The report also comments on areas in which Norwegian involvement is falling behind the other Nordic countries. Parts 2, 3 and 4 consist of lists of the relevant Norwegian governmental bodies, research institutions and private businesses including descriptions of their partnerships, projects and expertise. (author). 57 refs

  8. The petroleum resources on the Norwegian continental shelf. 2007

    Energy Technology Data Exchange (ETDEWEB)

    2007-07-01

    The petroleum resources will not last for ever. It is therefore important for Norway to look ahead so as to be prepared for the changes that will come. In this report, the Norwegian Petroleum Directorate presents the current status of the petroleum resources on the Norwegian continental shelf. This is the basis on which the authorities can lay plans for the future. Since no-one can predict the future with certainty, on this occasion the Directorate is presenting four alternative scenarios for the future of Norwegian petroleum activities if the basic scenario proves incorrect. This will enable us to prepare ourselves for changes that may come, and to view the consequences of the various choices we can make. In this report, the Directorate also describes the various plays on the continental shelf, and explains the techniques used and the evaluations made when it estimates the undiscovered resources. This information is important for exploration work, particularly for new companies which need to get acquainted with the geology and the possibilities for finding oil and gas in Norway. Significant volumes remain to be produced and found on the Norwegian continental shelf. Only a third of the total resources have so far been produced, and a quarter of them have still not been discovered. Oil and gas prices are high at the moment, giving the industry and society in general good incentives to produce at a maximum rate. Oil production reached its peak a couple of years ago, but gas production is still increasing. However, the industry is finding less than it produces, which places demands on both it and the authorities. The industry must actively explore the acreage it has been allocated. The Petroleum Directorate believes that substantial resources can still be discovered in areas where production licences have been awarded. At the same time, the industry must gain access to new areas for exploration. The authorities must find an appropriate balance between concern for the

  9. Status of Norwegian climate policy 2011; Statusrapport for norsk klimapolitikk

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    Norwegians are generally little impressed what Norway as a society has achieved in the climate policy. This is consistent with the actual situation as it is mapped in this year's edition of the Status of Norwegian climate policy. The results obtained in a survey by TNS Gallup which was commissioned by BI Centre for Climate Strategy in connection with the disclosure of the agency's annual status report for the Norwegian climate policy. 1000 Norwegians have been asked about how good or bad they perceive the overall results in various areas of climate policy. Even for climate-friendly heating, which is the area where most perceive that there has been progress, only 39% of the population consider the results as very good or good. In addition to heating, energy efficiency in buildings, Norway's international efforts, research on climate technology and information to the public areas where most Norwegians still think the results are good, and which are the least dissatisfied.Year Status Report on Norwegian climate policy is a joint project between the organization Holder de ord (Do they keep promises) and BI Centre for Climate Strategy. The report shows that people have a fairly accurate picture of climate policy. In most areas, there is little substantial progress since the Low Emission submitted its recommendations in 2006. It is symptomatic that climate policy was recently delayed again - now to 2012. While it is a positive development in the areas that are at the top of people's list. Since 2006, for example, there has been a substantial expansion of district heating in Norway, and building standards have become much stricter when it comes to energy use. Motor vehicle taxes are changed and greenhouse emissions from new cars is 25% lower than in 2006. Norway also play a constructive role, both in relation to the negotiations at the UN on a new climate deal, but also for example in relation to a global sectoral agreement for shipping that was signed

  10. Organising Ethics: The Case of the Norwegian Army

    Directory of Open Access Journals (Sweden)

    Ellen-Marie Forsberg

    2012-05-01

    Full Text Available This article shows how institutionalism, a theory in organisational social science, provides a model for diagnosing organisational challenges that influence the ethical practices and integration in the Norwegian Army. Institutionalism provides tools for analysing the differences between expressed values and actual practices and for understanding the organisational dynamics that unfold at the crossroads of the organisation's formal structure, informal culture and stakeholder relations. In this article we present and discuss such differences and dynamics in the Norwegian Army based on findings from a survey and a number of workshops. We also provide some suggestions for effective implementation of strategies for strengthening ethics in such an organisation. We argue that the perspective taken in this project is also relevant for other highly professionalised complex organisations and that such interdisciplinary research will strengthen practical ethics' potential for real impact.http://dx.doi.org/10.5324/eip.v6i1.1779

  11. Temporal Variation of Mycotoxin Producing Fungi in Norwegian Cereals

    Directory of Open Access Journals (Sweden)

    Leif Sundheim

    2013-12-01

    Full Text Available Spring barley is grown on about half of the Norwegian cereal area. The rest of the area is equally divided between wheat and oats. Most years the domestic production provides 70%–80% of the domestic market for bread wheat. Barley and oats are mainly grown for animal feed. During the years 2008–2012, severe epidemics of Fusarium head blight have led to increased mycotoxin contamination of cereals. During that period, precipitation was above normal during anthesis and grain maturation. The most important mycotoxin producers have been F. avenaceum, F. culmorum, F. graminearum and F. langsethiae. Increased deoxynivalenol contamination of Norwegian cereals during recent years is due to severe F. graminearum epidemics.

  12. Sexual socialization and motives for intercourse among Norwegian adolescents.

    Science.gov (United States)

    Traeen, B; Kvalem, I L

    1996-06-01

    The impact of gender differences in sexual socialization on early sexual experiences among Norwegian adolescents is discussed. The material comprises a stratified sample of 920 adolescents ages 16-20 years in a Norwegian county. Data were collected by means of questionnaires. Of the respondents, 55.5% were girls and 44.5% were boys. 52.3% of girls and 41.4% of the boys had coital experience. The most common reasons for having had the first sexual intercourse were being in love, curiosity or excitement, and sexual arousal. Findings from a discriminant analysis showed that emotional reasons were more important to girls, whereas boys seemed more practical in sexual matters. More boys than girls reported that the reason for having had their most recent intercourse was that the partner wanted it. This indicates that if girls do not want sex, boys seldom use pressure. Girls set the premises for sexual interaction but are not as sexually skilled as boys.

  13. Counselling for burnout in Norwegian doctors: one year cohort study

    OpenAIRE

    Rø, Karin E Isaksson; Gude, Tore; Tyssen, Reidar; Aasland, Olaf G

    2008-01-01

    Objective To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors. Design Cohort study followed by self reported assessment at one year. Setting Norwegian resource centre. Participants 227 doctors participating in counselling intervention, 2003-5. Interventions Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors’ situation and personal needs. Main ou...

  14. Highly variable Pliocene sea surface conditions in the Norwegian Sea

    Directory of Open Access Journals (Sweden)

    P. E. Bachem

    2017-09-01

    Full Text Available The Pliocene was a time of global warmth with small sporadic glaciations, which transitioned towards the larger-scale Pleistocene glacial–interglacial variability. Here, we present high-resolution records of sea surface temperature (SST and ice-rafted debris (IRD in the Norwegian Sea from 5.32 to 3.14 Ma, providing evidence that the Pliocene surface conditions of the Norwegian Sea underwent a series of transitions in response to orbital forcing and gateway changes. Average SSTs are 2 °C above the regional Holocene mean, with notable variability on millennial to orbital timescales. Both gradual changes and threshold effects are proposed for the progression of regional climate towards the Late Pliocene intensification of Northern Hemisphere glaciation. Cooling from 4.5 to 4.3 Ma may be linked to the onset of poleward flow through the Bering Strait. This cooling was further intensified by a period of cool summers due to weak obliquity forcing. A 7 °C warming of the Norwegian Sea at 4.0 Ma suggests a major increase in northward heat transport from the North Atlantic, leading to an enhanced zonal SST gradient in the Nordic Seas, which may be linked to the expansion of sea ice in the Arctic and Nordic Seas. A warm Norwegian Sea and enhanced zonal temperature gradient between 4.0 and 3.6 Ma may have been a priming factor for increased glaciation around the Nordic Seas due to enhanced evaporation and precipitation at high northern latitudes.

  15. Crusted (Norwegian) Scabies Following Systemic and Topical Corticosteroid Therapy

    OpenAIRE

    Binić, Ivana; Janković, Aleksandar; Jovanović, Dragan; Ljubenović, Milanka

    2009-01-01

    It is a case study of a 62-yr-old female with crusted (Norwegian) scabies, which appeared during her treatment with systemic and topical corticosteroid therapy, under the diagnosis of erythroderma. In the same time, the patient had been suffered from hypothyoidism, and her skin changes were misdiagnosed, because it was thought that they are associated with her endocrine disorder. Suddenly, beside the erythema, her skin became hyperkeratotic, with widespread scaling over the trunk and limbs, a...

  16. GHG abatement welfare cost curves for Norwegian agriculture

    OpenAIRE

    Blandford, David; Gaasland, Ivar; Vårdal, Erling

    2014-01-01

    Agriculture makes a significant contribution to Norway’s emissions of greenhouse gases (GHG). Although the sector accounts for only 0.3 per cent of GDP, it accounts for roughly 9 per cent of total GHG emissions. Norwegian agriculture is dominated by livestock production; ruminants (cattle and sheep) are particularly important. There are opportunities for GHG mitigation under existing technology through changes in agricultural practices. Analytically we derive abatement cost curves for Norway ...

  17. Non-pruritic granuloma in Norwegian forest cats.

    Science.gov (United States)

    Leistra, W H G; van Oost, B A; Willemse, T

    2005-04-30

    The eosinophilic granuloma complex is a group of skin disorders common in cats. This paper describes the clinical, haematological and histopathological features of 17 related Norwegian forest cats, six of which had a linear granuloma on the caudal thigh, three of which also had a granuloma on the lower lip, and one of which had a granuloma in combination with an indolent ulcer. The high prevalence of the disease in this population is suggestive of a genetic background.

  18. Perceived barriers to consumption of fish among Norwegian women

    DEFF Research Database (Denmark)

    Trondsen, Torbjørn; Scholderer, Joachim; Lund, Eiliv

    2003-01-01

    This study aimed to characterize constraints on consumption of fish perceived by consumers in Norway. A random sample of Norwegian women aged 45-69 years answered a self-administered mail questionnaire in 1996 about eating habits, perceived barriers to fish consumption, socioeconomic status, and ...... products that satisfy (a) children's wishes, (b) health-oriented family members, and (c) convenience-oriented consumers, will significantly increase at-home consumption of fish. Udgivelsesdato: DEC...

  19. Knowledge for Sale: Norwegian Encyclopaedias in the Marketplace

    Directory of Open Access Journals (Sweden)

    Siv Frøydis Berg

    2014-06-01

    Full Text Available Encyclopedias present and contain knowledge, but historically they have also been commercial commodities, produced for sale. In this article, we study the self-presentations of a selection of Norwegian encyclopedias, as these are expressed in the form of commercial images, advertising texts and slogans. We thus present a brief but detailed study of what might be called a number of paratextual matters associated with 20th-century Norwegian encyclopedias, with the aim of identifying the most significant or recurring topoi in the material. Our analysis shows that claims about speed and modernization are among the most conspicuous ingredients in these self-presentations, claims which, we argue, feed into a particular logic of a particular version of 20th-century modernity. The article begins with an analysis of the commercially successful Konversationslexicon, the first Norwegian encyclopedia, published in 1906 and for a long time market leader of the bourgeois tradition. The Konversationslexicon was produced with the explicit aim of providing a source of conversation for the educated classes, a new and expanding group of readers. We also show how the publisher Aschehoug went on to strengthen its own position in this market through a sophisticated process of differentiation. Seen as a contrast to these market leaders, we explore the Norwegian tradition of counter-encyclopaedias, with the radical PaxLeksikon as our main example. This encyclopaedia came into existence as a result of a strong ideological motivation and was run by left-wing idealists. Nevertheless, and perhaps inevitably, it ended up situating itself within the same market mechanisms and the same commercial logic as the bourgeois encyclopaedias. The article ends by a brief consideration of the change from commercial print encyclopaedias to internet-based encyclopaedias, and of the new challenges this poses in a small nation, rhetorically and in the struggle for funding.

  20. Norwegian Hydrological Reference Dataset for Climate Change Studies

    Energy Technology Data Exchange (ETDEWEB)

    Magnussen, Inger Helene; Killingland, Magnus; Spilde, Dag

    2012-07-01

    Based on the Norwegian hydrological measurement network, NVE has selected a Hydrological Reference Dataset for studies of hydrological change. The dataset meets international standards with high data quality. It is suitable for monitoring and studying the effects of climate change on the hydrosphere and cryosphere in Norway. The dataset includes streamflow, groundwater, snow, glacier mass balance and length change, lake ice and water temperature in rivers and lakes.(Author)

  1. A case study of feedback to written English in a Norwegian upper secondary school

    OpenAIRE

    Nyvoll Bø, Elisabeth

    2014-01-01

    This thesis is about a study of English writing and feedback in an upper secondary school in Norway. The ability to express oneself in writing is one of the five basic skills in the Norwegian LK06 English subject curriculum. However, some Norwegian studies (e.g. Lehmann 1999; Nygaard 2010) indicate that Norwegian students’ writing skills in English are inadequate. How teachers teach English writing is therefore important to investigate, and feedback is one important factor of teaching and dev...

  2. The Swedish-Norwegian Electricity Certificate Market - Annual Report 2012

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-07-01

    The first joint annual report from the Swedish Energy Agency and the Norwegian Water Resources and Energy Directorate (NVE) about the Swedish-Norwegian electricity certificate market has now been completed. With this report, we wish to present a picture of the most important events and key figures for the electricity certificate market during 2012. For further information about the electricity certificate system and the electricity certificate market, please see the web sites of either public authority. Since 1 January 2012, Sweden and Norway have had a common market for electricity certificates. It is based on the Swedish electricity certificate market, which has been in existence since 2003. The goal of the electricity certificate market is to increase the renewable electricity production in both countries combined by 26.4 TWh by the end of 2020. Sweden and Norway are responsible for financing half of the increase each, but it is up to the market to decide where and when the new production is to take place. In addition to information about fulfilment of the common goal, this report also includes a summary of approved production in the Swedish electricity certificate system up to the end of 2011 and approved plants in the Norwegian transitional settlement. The Agency and NVE are happy to receive feedback about the annual report. Please contact us if you wish to put forward your views on how to make next year's report even better.

  3. Explaining the appeal of militant Salafism in a Norwegian context

    Directory of Open Access Journals (Sweden)

    Ida Nord Holmer

    2016-04-01

    Full Text Available By drawing upon existing literature on Islamic radicalisation, this article empirically explores why some Norwegian Muslims come to accept the use of violence in the name of Islam. Based on primary internet research and interviews with individuals who either call for violent jihad, or who have travelled to Syria to engage in armed struggle, this study identifies several complaints and grievances which may result in individuals adopting extreme positions. These grievances relate to Norwegian and Western foreign policies, feelings of being alienated and stigmatised in the public debate, a sense of not belonging, actual or perceived discrimination, and socio-economic deprivation. Interestingly, the findings in this study suggest that these factors are not significantly different in Norway than in other European countries facing the general trend of Islamic radicalisation. Rather, the ideological positions and statements identified in the data collection reflect the broader literature on the radicalisation of young Muslims living in Europe. In line with theories of Wiktorowicz (2005 and Roy (2004, this article therefore argues that Norwegian Muslims may become attracted to militant Salafism because it responds to their individual grievances, and provides an alternative worldview that offers meaning, community and justice based on shared religion and ideology. 

  4. [Nosocomial outbreak of scabies from a Norwegian scabies case].

    Science.gov (United States)

    Fajardo-Velázquez, Ramón; Urdez-Hernández, Elena; Ysita-Morales, Antonio

    2004-01-01

    To describe a nosocomial outbreak of scabies occurred in August 1999, resulting from exposure to an undiagnosed Norwegian scabies case, in Mexico City. After reviewing the index case, we isolated the patient and identified secondary scabies cases among employees working in the affected ward, their relatives, and inpatients. Only individuals complaining from skin lesions and pruritus were included as infested cases. Control measures as contact isolation, proper handling of contaminated clothes, and topical treatment were implemented. A patient with AIDS (index case) with a severe water and electrolyte imbalance was admitted to the Hospital de Infectologia (Infectious Diseases Hospital) of the Centro Medico Nacional La Raza (La Raza National Medical Center) in Mexico City from July 19 to August 20, 1999. Twenty-eight days after the index case admission, scabies cases occurred among health workers. Norwegian scabies was suspected and confirmed by microscopic evidence of the mites on a specimen of scabs from the index case. We identified 48 secondary cases with clinical scabies: 71% health workers, mainly nurses (79%); 23% health workers' relatives; and 6% inpatients. The mean incubation period was 15 days (range 12 to 27). Skin rashes commonly involved the upper extremities (60%) but not the hands. This paper highlights the difficulties in diagnosing Norwegian scabies in an immunosuppressed host, as well as the importance of ensuring that health workers follow standard precautions at all times. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

  5. The Norwegian version of the Severe Respiratory Insufficiency Questionnaire.

    Science.gov (United States)

    Markussen, Heidi; Lehmann, Sverre; Nilsen, Roy M; Natvig, Gerd K

    2015-06-01

    The aims of this study were to translate and adapt the Severe Respiratory Insufficiency (SRI) questionnaire into Norwegians and to test its reliability and validity.Data were collected from a cross-sectional survey and were linked to the Norwegian Registry of patients receiving long-term mechanical ventilation (LTMV). Of 193 potential participants, 127 responded to the SRI questionnaire. Reliability as measured with Cronbach's α varied between 0.68 and 0.88 for the subscales and was 0.94 for SRI-sum score. Construct validity was obtained with high correlations between subscales in SF-36 and SRI. The SRI questionnaire discriminated well between universally accepted clinical differences among categories of patients receiving LTMV by significant dissimilarities in SRI-sum score and SRI subscales. The Norwegian version of SRI has well-documented psychometric properties regarding reliability and validity. It might be used in clinical practice and in international studies for assessing health-related quality of life in patients receiving LTMV.

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

    Directory of Open Access Journals (Sweden)

    Sergei N. Drachev

    2012-11-01

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

  7. Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zhenlei Liu

    Full Text Available Bed rest has been considered as the cornerstone of management of deep vein thrombosis (DVT for a long time, though it is not evidence-base, and there is growing evidence favoring early ambulation.Electronic databases including Medline, PubMed, Cochrane Library and three Chinese databases were searched with key words of "deep vein thrombosis", "pulmonary embolism", "venous thrombosis", "bed rest", "immobilization", "mobilization" and "ambulation". We considered randomized controlled trials, prospective or retrospective cohort studies that compared the outcomes of acute DVT patients managed with early ambulation versus bed rest, in addition to standard anticoagulation. Meta-analysis pertaining to the incidence of new pulmonary embolism (PE, progression of DVT, and DVT related deaths were conducted, as well as the extent of remission of pain and edema.13 studies were included with a total of 3269 patients. Compared to bed rest, early ambulation was not associated with a higher incidence of new PE, progression of DVT, or DVT related deaths (RD -0.03, 95% CI -0.05∼ -0.02; Z = 1.24, p = 0.22; random effect model, Tau2 = 0.01. Moreover, if the patients suffered moderate or severe pain initially, early ambulation was related to a better outcome, with respect to remission of acute pain in the affected limb (SMD 0.42, 95%CI 0.09∼0.74; Z = 2.52, p = 0.01; random effect model, Tau2 = 0.04. Meta-analysis of alleviation of edema cannot elicit a solid conclusion because of significant heterogeneity among the few studies.Compared to bed rest, early ambulation of acute DVT patients with anticoagulation was not associated with a higher incidence of new PE, progression of DVT, and DVT related deaths. Furthermore, for the patients suffered moderate or severe pain initially, a better outcome can be seen in early ambulation group, regarding to the remission of acute pain in the affected limb.

  8. Stock structure of Atlantic herring Clupea harengus in the Norwegian Sea and adjacent waters

    DEFF Research Database (Denmark)

    Pampoulie, Christophe; Slotte, Aril; Oskarsson, Guomundur J.;

    2015-01-01

    The genetic structure of Atlantic herring Clupea harengus L. was investigated in its north-easterly distribution in the Norwegian Sea and adjacent waters, using 23 neutral and one non-neutral (Cpa111) microsatellite loci. Fish from the suspected 2 main populations-the Norwegian spring-spawning he......The genetic structure of Atlantic herring Clupea harengus L. was investigated in its north-easterly distribution in the Norwegian Sea and adjacent waters, using 23 neutral and one non-neutral (Cpa111) microsatellite loci. Fish from the suspected 2 main populations-the Norwegian spring...

  9. Personnel Management: A J/A Perspective

    Science.gov (United States)

    Tasca, A. J.

    1974-01-01

    Recently, personnel executives and their staffs are being asked to help management solve an increasing number of human resource and business problems. Personnel management must undergo some changes if it is to achieve its full potential. (Author/AJ)

  10. National Finance Center Personnel/Payroll System

    Data.gov (United States)

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

  11. Fifth personnel dosimetry intercomparison study

    Energy Technology Data Exchange (ETDEWEB)

    Sims, C.S.

    1980-02-01

    The fifth Personnel Dosimetry Intercomparison Study (PDIS) was conducted at the Oak Ridge National Laboratory's (ORNL) Dosimetry Applications Research (DOSAR) facility on March 20-22, 1979. This study is the latest PDIS in the continuing series started at the DOSAR facility in 1974. The PDIS is a three day study, typically in March, where personnel dosimeters are mailed to the DOSAR facility, exposed to a range of low-level neutron radiation doses (1 to 15 mSv or equivalently, 100 to 1500 mrem) and neutron-to-gamma ratios (1:1-10:1) using the Health Physics Research Reactor (HPRR) as the radiation source, and returned to the participants for evaluation. This report is a summary and analysis of the results reported by the various participants. The participants are able to intercompare their results with those of others who made dose measurements under identical experimental conditions.

  12. Contact dermatitis in military personnel.

    Science.gov (United States)

    Dever, Tara T; Walters, Michelle; Jacob, Sharon

    2011-01-01

    Military personnel encounter the same allergens and irritants as their civilian counterparts and are just as likely to develop contact dermatitis from common exposures encountered in everyday life. In addition, they face some unique exposures that can be difficult to avoid owing to their occupational duties. Contact dermatitis can be detrimental to a military member's career if he or she is unable to perform core duties or avoid the inciting substances. An uncontrolled contact dermatitis can result in the member's being placed on limited-duty (ie, nondeployable) status, needing a job or rate change, or separation from military service. We present some common causes of contact dermatitis in military personnel worldwide and some novel sources of contact dermatitis in this population that may not be intuitive.

  13. Personnel

    CERN Multimedia

    Schopper,H; Andersen

    1985-01-01

    Le président du conseil M.Doran explique la décision que le conseil du Cern vient de prendre sur la 4.étape du régime complémentaire des pensions. Le président du comité des finances le Dr.Andersen ainsi que le Prof.Connor(?) prennent aussi la parole

  14. Dietary patterns and lifestyle factors in the Norwegian EPIC cohort: the Norwegian Women and Cancer (NOWAC) study.

    Science.gov (United States)

    Engeset, D; Alsaker, E; Ciampi, A; Lund, E

    2005-05-01

    To identify different dietary patterns in Norway using a combination of cluster and factor analysis. Cross-sectional study. Nation-wide, population-based study. The Norwegian EPIC cohort is a subcohort of the Norwegian Women and Cancer study (NOWAC), and consist 37.226 women aged 41-56 y who answered a food frequency questionnaire (FFQ) in 1998. The associations among 50 food variables were first investigated by using principal component analysis. Five important factors were found. The five principal components were then used as input in the cluster analysis. Different socioeconomic and lifestyle variables were examined. Six clusters of dietary patterns were found, and were labelled accordingly: 'traditional fish eaters', 'healthy eaters', 'average, less fish, less healthy', 'Western', 'traditional bread eaters', and 'alcohol users'. The traditional fish eaters and the traditional bread eaters were both highly represented in the north and west of Norway and were more likely to be present among persons with lower income and lower education. The healthy and the alcohol drinkers were found mostly in the south and east and were more likely to have higher income. Persons in the alcohol group were more likely to be current smokers. The western group had the highest percentage of three or more persons in the household and the shortest time since last birth, indicating that families with children dominate this group. Our data indicate six different dietary patterns in Norway, each with different socio-demographic and lifestyle characteristics. The Norwegian Cancer Society (E 04038/006).

  15. 5 CFR 293.302 - Establishment of Official Personnel Folder.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Establishment of Official Personnel Folder. 293.302 Section 293.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Official Personnel Folder § 293.302 Establishment of Official Personnel Folder...

  16. Personnel marketing focused on graduates' attraction

    OpenAIRE

    Solovská, Petra

    2012-01-01

    This diploma thesis refers to the topic of personnel marketing focused on graduates' attraction. In theoretical part it describes concepts of personnel marketing, its components, tools and parts, then it focuses on personnel marketing in a context of social system of organization and on specifics of graduates. The empirical part is searching for answers why is it important for organizations to attract graduates, which methods of personnel marketing are used to attract them, what is the strate...

  17. PERSONNEL DEMOTIVATING: THE REASONS, FACTORS, ELIMINATION METHODS

    OpenAIRE

    Kuznetsova Ekaterina Andreevna

    2012-01-01

    The motivation of the personnel in any economic conditions remains a leading link in an enterprise control system. At creation of system of motivation tracking of extent of its impact on productivity of work of the personnel is important. The boomerang effect which is shown in a demotivating of separate groups of the personnel is often observed. In article features of manifestation of demotivating factors at various stages of work of the personnel are analyzed, the circle of the reasons bring...

  18. Control for occupationally exposed personnels

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Hiroyuki [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Momose, Takuma

    1999-03-01

    The present status of the technology for the measurement of personnel exposure dose was reviewed based on the basic concept of ICRP Recommendation on new assessment of exposure dose. The personnel dosimeter which has been mostly used by occupationally exposed personnels in Japan is film badge or thermoluminescence dosimeter. Now, photoluminescent glass dosimeter has been paid attention because pulse excitation method by UV laser has been developed. Measurement at an accuracy of 0.1 mSv or more became possible by using this dosimeter at present. In addition, characteristic studies for practical application of electronic, photostimulated luminescence and neutron dosimeters are progressing now. Revision of kinetic model of in vivo metabolism of radioactive substances is progressing based on the recent findings since ICRP Recommendation in 1990. Monitoring an individual internal exposure is made by two methods; direct measurement of the radiation emitted from the body and indirect one by radioanalysis of excretes etc. The latter is inferior to the former in respect of the accuracy of dose assessment, but the direct method is more suitable to detect a little amount of radioactive substance incorporated because of its high sensitivity. In future, it is needed to provide a considerable number of whole body counters against a large-scale nuclear accident. (M.N.)

  19. 16 October 2012 - Norwegian University of Science and Technology Rector Digernes in the ATLAS visitor centre with Senior Norwegian S. Stapnes and J. Vigen; signing the guest book with Director for Accelerators and Technology S. Myers.

    CERN Multimedia

    Jacques Fichet

    2012-01-01

    16 October 2012 - Norwegian University of Science and Technology Rector Digernes in the ATLAS visitor centre with Senior Norwegian S. Stapnes and J. Vigen; signing the guest book with Director for Accelerators and Technology S. Myers.

  20. Preoperative Predictors of Ambulation Ability at Different Time Points after Total Hip Arthroplasty in Patients with Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Akiko Kamimura

    2014-01-01

    Full Text Available The aims of this study were to identify the preoperative factors influencing ambulation ability at different postoperative time points after total hip arthroplasty (THA and to examine the cutoff values of predictive preoperative factors by receiver operating characteristic (ROC curves. Forty-eight women with unilateral THA were measured for hip extensor, hip abductor, and knee extensor muscle strength in both legs; hip pain (visual analog scale, VAS; and the Timed Up and Go (TUG test pre- and postoperatively. Multiple regression analysis indicated that preoperative knee extensor strength (β=-0.379,R2=0.409 at 3 weeks, hip abductor strength (β=-0.572,R2=0.570 at 4 months, and age (β=0.758,R2= 0.561 at 7 months were strongly associated with postoperative ambulation, measured using the TUG test. Optimal preoperative cutoff values for ambulation ability were 0.56 Nm/kg for knee extensor strength, 0.24 Nm/kg for hip abductor strength, and 73 years of age. Our results suggest that preoperative factors predicting ambulation ability vary by postoperative time point. Preoperative knee extensor strength, hip abductor strength, and age were useful predictors of ambulation ability at the early, middle, and late time points, respectively, after THA.

  1. Striving for balance - A qualitative study to explore the experiences of nurses new to the ambulance service in Sweden.

    Science.gov (United States)

    Hörberg, Anna; Lindström, Veronica; Kalén, Susanne; Scheja, Max; Vicente, Veronica

    2017-08-19

    New nurses and nurses new to a professional practice go through a transition where they adopt a new professional identity. This has been described as a challenging time where peer support and limited responsibility are considered necessary. Little is known about the experience of nurses being new to the ambulance service where support is limited and the nurse holds full responsibility of patient care. The aim of this study has therefore been to explore nurses' experiences during their first year of employment in the Swedish ambulance service. Data was generated from semi-structured interviews with 13 nurses having less than 12 months of experience of work in the ambulance service. The nurses represented nine different districts in Sweden. Analysis was a latent inductive qualitative content analysis. The analysis resulted in the main category, "Striving for balance during the transition process in the ambulance context". Transition in the ambulance service was experienced as a balance act between emotions, expectations and a strive for professional development. The balance was negatively affected by harsh, condescending attitudes among colleagues and the lack of structured support and feedback. In striving for balance in their new professional practice, the nurses described personal, unsupervised strategies for professional development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study

    Science.gov (United States)

    2014-01-01

    Background Acute asthma is a common reason for patients to seek care from ambulance services. Although better care of acute asthma can prevent avoidable morbidity and deaths, there has been little research into ambulance clinicians’ adherence to national guidelines for asthma assessment and management and how this might be improved. Our research aim was to explore paramedics’ attitudes, perceptions and beliefs about prehospital management of asthma, to identify barriers and facilitators to guideline adherence. Methods We conducted three focus group interviews of paramedics in a regional UK ambulance trust. We used framework analysis supported by NVivo 8 to code and analyse the data. Results Seventeen participants, including paramedics, advanced paramedics or paramedic operational managers at three geographical sites, contributed to the interviews. Analysis led to five themes: (1) guidelines should be made more relevant to ambulance service care; (2) there were barriers to assessment; (3) the approach needed to address conflicts between clinicians’ and patients’ expectations; (4) the complexity of ambulance service processes and equipment needed to be taken into account; (5) and finally there were opportunities for improved prehospital education, information, communication, support and care pathways for asthma. Conclusions This qualitative study provides insight into paramedics’ perceptions of the assessment and management of asthma, including why paramedics may not always follow guidelines for assessment or management of asthma. These findings provide opportunities to strengthen clinical support, patient communication, information transfer between professionals and pathways for prehospital care of patients with asthma. PMID:25086749

  3. The association between the first locating emergency ambulance being single crewed and cardiac arrest outcomes in New Zealand.

    Science.gov (United States)

    Dicker, Bridget; Davey, Paul; Smith, Tony

    2017-09-01

    This study investigated the association between the first locating emergency ambulance being single crewed on outcomes following out-of-hospital cardiac arrest in New Zealand. Using data from the St John cardiac arrest registry for the period of 1 October 2013 to 30 June 2015, cases were included if a resuscitation attempt was made and the patient was an adult. Logistic regression modelling was used to account for confounding factors. The primary outcome was survival to hospital discharge. A total of 2,347 cases were included. There was no difference in the rate of return of spontaneous circulation sustained to hospital handover in patients attended by either single-crewed (27%) or double-crewed ambulances (32%); p=0.059. However, patients were significantly less likely to survive to hospital discharge when attended by single-crewed (12%) compared to double-crewed ambulances (17%) with an OR of 0.533, 95% confidence interval 0.320-0.888 and p=0.016. Patients had lower survival to hospital discharge outcomes when the first locating ambulance was single crewed than those where the first locating ambulance was double crewed.

  4. Characterizing demographics, injury severity, and intubation status for patients transported by air or ground ambulance to a rural burn center.

    Science.gov (United States)

    Ahmed, Azeemuddin; Van Heukelom, Paul; Harland, Karisa; Denning, Gerene; Liao, Junlin; Born, Janelle; Latenser, Barbara

    2014-01-01

    Our study was designed to characterize intubation status among patients transported by air or ground ambulance to a rural burn center. A retrospective chart review of patients arriving at our burn center from January 1, 2005 to December 31, 2009 was completed. Descriptive and multivariate analyses were performed. During the study period, 259 air and 590 ground ambulance patients met inclusion criteria. Air ambulance patients were older and had higher total body surface area burned, lower Glasgow Coma scores, longer lengths of stay, and more frequent inhalation injuries. Approximately 10% of patients arriving by air were intubated after burn center admission, and 49% of intubated patients were extubated within 24 hours of admission. These values were 2% and 40%, respectively, for patients transported by ground. Increasing age and air ambulance transport increased the overall likelihood of change in intubation status. The likelihood of intubation by burn center providers increased with age, with suspicion of inhalation injury, and for patients transported by air. The likelihood of extubation within 24 hours of burn center admission increased with age, decreased with suspected inhalation injury, and was independent of transport mode. Among our patient population, more severely injured patients were being transported by air ambulance. However, age, suspicion of inhalation injury, and mode of transport showed a complex pattern of associations with changes in intubation status, and illustrate the need to develop better prehospital guidelines for intubation in burn patients.

  5. The Changing World of Personnel Management.

    Science.gov (United States)

    Anderson, Eileen R.

    Although personnel management in the public sector has become increasingly difficult because of recent social changes, more worker and middle management involvement in decision-making processes can improve all levels of personnel management. The social changes affecting personnel management have assumed three forms: (1) the entrance into the work…

  6. 46 CFR 107.113 - Industrial personnel.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Industrial personnel. 107.113 Section 107.113 Shipping... CERTIFICATION General § 107.113 Industrial personnel. Industrial personnel are all persons, exclusive of the... unit for the sole purpose of carrying out the industrial business or functions of the unit....

  7. 49 CFR 193.2711 - Personnel health.

    Science.gov (United States)

    2010-10-01

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

  8. 33 CFR 157.154 - Assistant personnel.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Assistant personnel. 157.154 Section 157.154 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED... Crude Oil Washing (COW) System on Tank Vessels Personnel § 157.154 Assistant personnel. The owner...

  9. 14 CFR 91.1049 - Personnel.

    Science.gov (United States)

    2010-01-01

    ... scheduling or flight release personnel are on duty to schedule and release program aircraft during all hours... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Personnel. 91.1049 Section 91.1049... Management § 91.1049 Personnel. (a) Each program manager and each fractional owner must use in...

  10. 40 CFR 264.16 - Personnel training.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Personnel training. 264.16 Section 264... Facility Standards § 264.16 Personnel training. (a)(1) Facility personnel must successfully complete a program of classroom instruction or on-the-job training that teaches them to perform their duties in a...

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

    Science.gov (United States)

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

    2016-06-16

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment.

  12. Prehospital Trauma Life Support (PHTLS) training of ambulance caregivers and impact on survival of trauma victims.

    Science.gov (United States)

    Johansson, Jakob; Blomberg, Hans; Svennblad, Bodil; Wernroth, Lisa; Melhus, Håkan; Byberg, Liisa; Michaëlsson, Karl; Karlsten, Rolf; Gedeborg, Rolf

    2012-10-01

    The Prehospital Trauma Life Support (PHTLS) course has been widely implemented and approximately half a million prehospital caregivers in over 50 countries have taken this course. Still, the effect on injury outcome remains to be established. The objective of this study was to investigate the association between PHTLS training of ambulance crew members and the mortality in trauma patients. A population-based observational study of 2830 injured patients, who either died or were hospitalized for more than 24 h, was performed during gradual implementation of PHTLS in Uppsala County in Sweden between 1998 and 2004. Prehospital patient records were linked to hospital-discharge records, cause-of-death records, and information on PHTLS training and the educational level of ambulance crews. The main outcome measure was death, on scene or in hospital. Adjusting for multiple potential confounders, PHTLS training appeared to be associated with a reduction in mortality, but the precision of this estimate was poor (odds ratio, 0.71; 95% confidence interval, 0.42-1.19). The mortality risk was 4.7% (36/763) without PHTLS training and 4.5% (94/2067) with PHTLS training. The predicted absolute risk reduction is estimated to correspond to 0.5 lives saved annually per 100,000 population with PHTLS fully implemented. PHTLS training of ambulance crew members may be associated with reduced mortality in trauma patients, but the precision in this estimate was low due to the overall low mortality. While there may be a relative risk reduction, the predicted absolute risk reduction in this population was low. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Ambulance diversion reduction and elimination: the 3-2-1 plan.

    Science.gov (United States)

    Patel, Pankaj B; Vinson, David R

    2012-11-01

    The diversion of ambulances from their intended emergency departments (EDs) occurs frequently, compromising patient care. Previously, we reduced ambulance diversion (AD) by 74% in a large urban area with 17 EDs. In this follow-up program, we sought to further reduce and eliminate AD by progressively reducing the duration of each AD event. Using tight diversion criteria, AD at each ED was limited by protocol to 3h at a stretch, after which incoming ambulances had to be accepted at that ED for at least 1h. After 6 months, AD was limited to 2h per diversion event; after another 6 months, AD was limited to 1h. The monitoring for AD was programmed into a region-wide, Internet-based Emergency Medical Services (EMS) program. Total annual AD decreased from 8469 h in 2006 (pre-implementation) to 4592 h in 2007 (during implementation), and finally to 2439 h and 2306 h in 2008 and 2009 (post-implementation), respectively, an 87.4% (95% confidence interval 64.6-95.5%) reduction, and one county within the region eliminated AD altogether. From 2006 to 2009, overall increases were noted in EMS arrivals (7.8%), ED census (13.0%), hospital admissions (6.6%), Intensive Care Unit admissions (17.1%), and overall Sacramento population (1.9%). By limiting the duration of AD events to progressively shorter periods of time using a region-wide, Internet-based EMS program, we reduced AD hours in 17 EDs by 87.4% and eliminated AD in one entire county. This original, collaborative 3-2-1 Plan may be readily reproduced across the country to progressively reduce and eliminate AD. Copyright © 2012 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ann M Simon

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment. PMID:27340808

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Gajanan Bhalerao

    2016-06-01

    Full Text Available Background: Stroke subjects face reduced tolerance to activity and sedentary lifestyle due to various impairments, such as muscle weakness, pain, spasticity, and poor balance. Thus, loss of independent ambulation especially outdoors is generally observed in them. Methods: Chronic stroke patients (> 6 months with Functional Ambulation Category score > 2 and able to walk at least 10 meters of distance with and without assistance from a tertiary healthcare centre were selected and treated. Subjects were randomly divided into 2 groups control group (n=14 and experimental group (n=13. Each group received Motor Relearning Programme for 60 minutes, 6 times a week for 4 weeks. The experimental group received an additional shoe-raise of 1 cm on the unaffected side along with while ambulating during therapy as well as at home. Pre and post treatment the patients were assessed for spatio-temporal parameters using foot print analysis method and Rivermead Visual Gait Assessment (RVGA Score using RVGA scale. Results: There was significant improvement seen in almost all the spatio-temporal gait parameters and RVGA score in within group analysis. Whereas on between group the results from between group comparison suggests that subjects in MRP with shoe-raise group showed better results in spatio-temporal parameters of gait than subjects receiving MRPalone. But there was no additional benefit of shoe-raise seen on RGVA score and angle of toe-out parameter. Conclusion: Additional use of shoe-raise helps to improve spatio-temporal gait parameters. However, there was no additional change seen in RVGA score.

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

    Science.gov (United States)

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

    2017-01-01

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

  20. Trends in cannabis-related ambulance presentations from 2000 to 2013 in Melbourne, Australia.

    Science.gov (United States)

    Kaar, Stephen J; Gao, Caroline X; Lloyd, Belinda; Smith, Karen; Lubman, Dan I

    2015-10-01

    The current burden of cannabis-related presentations to emergency health services is largely unknown. This paper presents data collected over a 13-year period in metropolitan Melbourne, Australia as part of the Ambo Project, a unique surveillance system that analyses and codes paramedic records for drug-related trends and harms. Cannabis-related ambulance attendances involving 15-59 year olds in metropolitan Melbourne were analysed retrospectively from 2000 to 2013 (n=10,531). Trends and attendance characteristics were compared among cannabis only (CO)-, cannabis and alcohol (CA)- and cannabis with polydrug use (CP)-related attendances. Changes in alcohol and drug involvements in cannabis-related attendances were explored. Rates of cannabis-related ambulance attendances increased significantly over the study period. Increasing rate of attendances per 100,000 population per year changed from 0.6 (2000-2010) to 5.5 (2010-2013). This sharp change was driven by CO- and CP-related attendances (rate of CA-related attendance increased steadily). The highest increasing rate (15.6) was for CO-related attendances among 15-29 years old males (2010-2013). Crystal methamphetamine became the most common illicit co-intoxicant amongst cannabis presentations in 2013. Relative to the total drug-related burden on ambulance services, cannabis-related presentations appear to be a small but significant and increasing problem. Significant changes in trends across other drug involvement and demographic subgroups suggest a possible shift in the cannabis using population and/or a change in using behaviours. Public health strategies should raise awareness of the increased risk posed by cannabis polydrug use and high attendance subpopulations should be determined. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. The equestrian sport-related injury workload of a regional doctor-led air ambulance unit.

    Science.gov (United States)

    Bleetman, David

    2012-12-01

    The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load. Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport-related injuries occur in areas inaccessible to land crews. We conducted a retrospective analysis of the ASU mission database from July 2008 to December 2009 (18 months) and identified 29 patients that were attended to by the ASU. The patient cohort had a female majority with an average age of 31.9. 10 Patients (34.5%) were under the age of 20. The ISS ranged from 1 to 75 (mean, 4.8; median, 1) and injuries to the extremities were commonest. The location of the accident was inaccessible to land ambulance in 55.2% of missions. The average mission time was over 2h. Doctors delivered more advanced (medical) interventions in 20.7% of missions. In 41.4% of missions, there were no such interventions performed by the attending doctor and no access to land ambulance. We therefore conclude that a large proportion of ASU dispatches were due to limited access rather than for the delivery of advanced interventions. However, our results support the opinion that horse riding carries some risk of serious injury and when employed appropriately, HEMS doctors on the ASU are a useful resource for a minority of equestrian sport-related injuries.

  2. Prosthetic fitting and ambulation in a paraplegic patient with an above-knee amputation.

    Science.gov (United States)

    Herman, T; David, Y; Ohry, A

    1995-03-01

    The combination of paraplegia with an above-knee amputation is a complex injury that makes the rehabilitation process difficult. This article describes a case of T12 paraplegia and an above-knee amputation. After the rehabilitation course, the patient achieved full ambulatory independence with an ischial containment, contoured adducted trochanteric controlled alignment method (CATCAM) prosthesis and a knee ankle foot orthosis (KAFO). Difficulties in fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed.

  3. Risk Management Analysis of Air Ambulance Blood Product Administration in Combat Operations

    Science.gov (United States)

    2014-11-01

    Combat Operations 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Nicole Powell-Dunford, Jose F. Quesada , Robert F...Analysis of Air Ambulance Blood Product Administration in Combat Operations Nicole Powell-Dunford , Jose F. Quesada , Robert F. Malsby , Victoria...Schofi eld Barracks, Wahiawa, HI; Jose F. Quesada , M.S., M.D., 440th Blood Support Detachment, and Robert Gerhardt, M.D., M.P.H., FACEP, U.S. Army

  4. An improved video median noise reduction algorithm for ambulance vehicle terminal monitoring system

    Science.gov (United States)

    Ma, Xian-Min; Zhang, Hang

    2012-04-01

    An improved video median noise reduction algorithm is presented for 120 vehicle terminal monitoring system in this paper. The noise causes of the video images in many 120 ambulance vehicle video terminal monitor equipments are analyzed, and the space rigid body model of self-adaptive median noise reduction filter is established to decrease the noises of the video image transmission process. The noise reduction experiment of video images shows that the proposed video median noise reduction algorithm is superior to the traditional adaptive filtering method, because the new method has the superiority of space-time joint noise reduction.

  5. Why did the patient die? The relationship between ambulance accidents and death of patients: forensic medical issues.

    Science.gov (United States)

    Ersoy, Gokhan; Ersoy, Ozlem; Yuksekbas, Ozlem; Kurnaz, Gulay; Akyildiz, Elif Ulker; Ekemen, Suheyla

    2012-11-01

    This article's aim is investigating traumatic consequences of ambulance accident on patients and discussing difficulties to give a decision about the relation between death and accident at these cases. The cases were selected among the forensic medical reports concluded between 1996 and 2005 years. They were documented for age, sex, causes of urgent call, localization and extent of traumatic lesion, properties of events and board decisions. A total of 21 cases were found. 15 cases died on the day of the accident. Skin injuries at head (8 cases) and legs (6 cases) were most common traumatic lesions. Totally 6 deaths were found related with ambulance accident. Death of patient after ambulance accidents may not be associated easily to the accident. Delay due to accident or concomitant contributing medical conditions may also facilitate the death in this type of cases. Reliable medical records were needed for accurate medicolegal evaluation.

  6. Talent Development as an Ecology of Games: A Case Study of Norwegian Handball

    Science.gov (United States)

    Bjørndal, Christian Thue; Ronglan, Lars Tore; Andersen, Svein S.

    2017-01-01

    Structured talent identification and development, it has been argued, is one of the foundations of international sporting success and many modern elite sport systems have applied normative talent development (TD) models. The success of Norwegian handball, however, is based on an alternative approach to TD. Norwegian handball is characterized by a…

  7. Vocabulary Development in Norwegian L1 and L2 Learners in the Kindergarten-School Transition

    Science.gov (United States)

    Karlsen, Jannicke; Lyster, Solveig-Alma Halaas; Lervåg, Arne

    2017-01-01

    This study examined the vocabulary development of Norwegian second language (L2) learners with Urdu/Punjabi as their first language (L1) at two time-points from kindergarten to primary school, and compared it to the vocabulary development of monolingual Norwegian children. Using path models, the associations between number of picture books in the…

  8. Semantic Models of Host-Immigrant Relations in Norwegian Education Policies

    Science.gov (United States)

    Garthus-Niegel, Kristian; Oppedal, Brit; Vike, Halvard

    2016-01-01

    Education has continuously been regarded as a vital tool in Norwegian policymakers' immigrant integration agendas. This study analyzes semantic structures substantiating the policy language of historical Norwegian immigrant education policies from their inception in 1973 until today (2013). The analysis is framed by Kronenfeld's linguistic…

  9. Use of radiographic diagnostics among Norwegian dentists; Bruk av roentgendiagnostikk blant norske tannleger

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-01

    Norwegian Radiation Protection Authority has conducted a survey of X-ray use among Norwegian dentists as well as inspection and measurement technical control of x-ray equipment. Radiation protection regulations were not well known among dentists, only 53% had made periodic service agreement with the supplier and it was revealed deviations at entire 43% of the investigated X-ray machines. (AG)

  10. From Digital Divides to Digital Inequality -- The Emerging Digital Inequality in the Norwegian Unitarian School

    Science.gov (United States)

    Krumsvik, Rune J.

    2008-01-01

    This position paper highlights existing and emerging, prospective digital divides in Norwegian schools and asks whether we are now moving from traditional digital divides to digital inequality in our digitized society and schools. Despite very good technology density in Norwegian society and schools in general, there is the reason to pay attention…

  11. Work-Plan Heroes: Student Strategies in Lower-Secondary Norwegian Classrooms

    Science.gov (United States)

    Dalland, Cecilie P.; Klette, Kirsti

    2014-01-01

    This article explores how individualized teaching methods, such as the use of work plans, create new student strategies in Norwegian lower secondary classrooms. Work plans, which are frequently set up as instructional tools in Norwegian classrooms, outline different types of tasks and requirements that the students are supposed to do during a…

  12. A Revised Version of the Norwegian Adaptation of the Test Anxiety Inventory in a Heterogeneous Population

    Science.gov (United States)

    Oktedalen, Tuva; Hagtvet, Knut A.

    2011-01-01

    Confirmatory factor analysis and Multiple Indicators, Multiple Causes (MIMIC) modeling were employed to investigate psychometric properties of a revised adaptation of the Norwegian version of the Test Anxiety Inventory (RTAIN) in a sample of 456 students. The study supported the Norwegian version as a useful inventory for measuring the components…

  13. Academic English Reading Proficiency at the University Level: A Norwegian Case Study

    Science.gov (United States)

    Hellekjaer, Glenn Ole

    2009-01-01

    In this paper the academic English reading proficiency of 578 Norwegian university students was quantitatively examined. Self-assessment items were used to measure reading proficiency in Norwegian and English and validated using an International English Language Testing System Academic Reading Module. The study found that about 30% of the…

  14. Self-rated health among Greenlandic Inuit and Norwegian Sami adolescents

    DEFF Research Database (Denmark)

    Spein, Anna Rita; Pedersen, Cecilia Petrine; Silviken, Anne Cathrine;

    2013-01-01

    Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami.......Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami....

  15. Cross-Validation of the Norwegian Teacher's Self-Efficacy Scale (NTSES)

    Science.gov (United States)

    Avanzi, Lorenzo; Miglioretti, Massimo; Velasco, Veronica; Balducci, Cristian; Vecchio, Luca; Fraccaroli, Franco; Skaalvik, Einar M.

    2013-01-01

    The study assesses the psychometric properties of the Italian version of the Norwegian Teacher Self-Efficacy Scale--NTSES. Multiple group confirmatory factor analysis was used to explore the measurement invariance of the scale across two countries. Analyses performed on Italian and Norwegian samples confirmed a six-factor structure of the scale…

  16. Governance through concepts: The OECD and the construction of “competence” in Norwegian education policy

    OpenAIRE

    Mausethagen, Sølvi

    2013-01-01

    This article investigates how Norwegian policy documents construct the term competence in relation to policy initiatives exerted by the Organization of Economic Cooperation and Development (OECD). Recent Norwegian policy documents partially redefined student and teacher competence so that the concepts became more individual and performance-oriented. This departed from previous policy documents. Thus, the author argues, the OECD not only governs ...

  17. Ambulance Handbook

    Science.gov (United States)

    1976-01-01

    Johnson Space Center has devised a checklist for the skylab inflight medical support system that has been transferred for public emergencies. The checklist illustrates a procedure for diagnosis, treatment, and stabilization of a wide variety of emergencies. Handbook presents comprehensive ordered description of emergency medical equipment and its use in treating victims. Paramedics assigned to the Houston Fire Department are now using the checklist.

  18. The Norwegian Educational System, the Linguistic Diversity in the Country and the Education of Different Minority Groups

    Science.gov (United States)

    Özerk, Kamil

    2013-01-01

    Linguistic diversity has always been and still is one of the current issues in the Norwegian educational system. Norwegian is the official language of the country, but, there have been several distinct dialects and two official written Norwegian languages in the country since 1885. One of them is "Bokmål" and the other is…

  19. Climate cure 2020 measures and instruments to achieve Norwegian climate goals by 2020. Chapter 10 - the transport sector analysis

    Energy Technology Data Exchange (ETDEWEB)

    2010-11-15

    This document is a translation of Chapter 10, Sector analysis of transport, in the Norwegian report Climate Cure 2020, Measures and Instruments for Achieving Norwegian Climate Goals by 2020. The sector analysis has been prepared by an inter agency working group, conducted by the Norwegian Public Road Administration. (Author)

  20. Paraplegia and transtibial amputation: successful ambulation after dual disability: a retrospective case report.

    Science.gov (United States)

    Senthilvelkumar, Thangavelu; Chandy, Bobeena R

    2017-01-01

    This is a single-subject case report. The objective is to describe the unique rehabilitation outcome of an individual with motor complete T12 paraplegia and a right transtibial amputation. This study was conducted at the Department of Physical Medicine and Rehabilitation of Christian Medical College in India. A 42-year-old policeman presented to our rehabilitation centre with motor complete T12 paraplegia and right transtibial amputation, 3 months following a road traffic accident. As the patient's goal was to walk, he was given a trial of independent ambulation with a customized prosthesis on the right side and a regular knee ankle foot orthosis (KAFO) on the left side. At the end of 12 weeks of rehabilitation, the patient was able to walk independently with the prosthesis/orthosis and bilateral elbow crutches. His Walking Index for Spinal Cord Injury (WISCI) score improved from 0/20 to 12/20 points. The scope of functional ambulation should not get restricted for a person with low thoracic spinal cord injury even when there is concurrent transtibial amputation.