Introduction:
Providing patient care in a moving ambulance can be difficult due to various transport-related factors, (e.g., accelerations, lateral forces, and noise). Previous research has primarily ...focused on cardiopulmonary resuscitation (CPR) performance effects but has neglected to investigate other care interventions.
Aim:
To test a range of different care interventions during different driving scenarios.
Methods:
A workshop with ambulance practitioners was held to create a list of care interventions to be tested. Two ambulance practitioners were recruited to drive an ambulance on a closed test-track while performing care interventions on simulation models. Three driving scenarios of differing difficulty were used. Main outcome measures were estimates of workload using the NASA Task Load Index (TLX) and task difficulty. G-forces and video-data were also collected.
Results:
Estimated workload increased overall as the difficulty of the driving scenario increased, as did task difficulty estimates. However, some care scenarios and interventions were affected less. For example, placing intravenous access increased greatly in difficulty, whereas saturation and blood pressure measurements had more modest increases. TLX scores showed that the primarily estimated physical workload and effort that increased, but also mental and temporal demands for some care scenarios. The more difficult driving scenarios primarily increased the variability of measured G-forces but not necessarily the overall driving speed, indicating that force variability is an important factor to study further.
Discussion:
The study was intended as an initial pilot test of a wide range of care interventions. It will serve as input to future, larger studies of specific interventions and transport-related factors. Overall, this small pilot indicates that more interventions than only CPR should be studied in moving ambulances to investigate potential performance effects. This is important for traffic, patient, and work safety for ambulance workers and patients.
In the Hemispheric Transport of Air Pollution Phase 2 (HTAP2) exercise, a range of global atmospheric general circulation and chemical transport models performed coordinated perturbation experiments ...with 20% reductions in emissions of anthropogenic aerosols, or aerosol precursors, in a number of source regions. Here, we compare the resulting changes in the atmospheric load and vertically resolved profiles of black carbon (BC), organic aerosols (OA) and sulfate (SO4/ from 10 models that include treatment of aerosols. We use a set of temporally, horizontally and vertically resolved profiles of aerosol forcing efficiency (AFE) to estimate the impact of emission changes in six major source regions on global radiative forcing (RF) pertaining to the direct aerosol effect, finding values between. 51.9 and 210.8mW/sq m/Tg for BC, between -2.4 and -17.9mW/sq m/Tg for OA and between -3.6 and -10.3W/sq m/Tg for SO4. In most cases, the local influence dominates, but results show that mitigations in south and east Asia have substantial impacts on the radiative budget in all investigated receptor regions, especially for BC. In Russia and the Middle East, more than 80 % of the forcing for BC and OA is due to extra-regional emission reductions. Similarly, for North America, BC emissions control in east Asia is found to be more important than domestic mitigations, which is consistent with previous findings. Comparing fully resolved RF calculations to RF estimates based on vertically averaged AFE profiles allows us to quantify the importance of vertical resolution to RF estimates. We find that locally in the source regions, a 20% emission reduction strengthens the radiative forcing associated with SO4 by 25% when including the vertical dimension, as the AFE for SO4 is strongest near the surface. Conversely, the local RF from BC weakens by 37% since BC AFE is low close to the ground. The fraction of BC direct effect forcing attributable to intercontinental transport, on the other hand, is enhanced by one-third when accounting for the vertical aspect, because long-range transport primarily leads to aerosol changes at high altitudes, where the BC AFE is strong. While the surface temperature response may vary with the altitude of aerosol change, the analysis in the present study is not extended to estimates of temperature or precipitation changes.
Posed 16 years ago in a much-cited editorial by gerontologist, Alan Walker, "Why involve older people in research?" is a question that has since inspired researchers in many countries and from ...diverse disciplines. In Sweden, researchers and older people have been collaborating in the 6-year UserAge research programme, focusing on user involvement in research on ageing and health, UserAge aims at contributing to an in-depth understanding of the challenges and benefits of user involvement in different phases of the research process. Approaching programme completion, the authors take the opportunity to dwell upon current reasons for and modes of user involvement in ageing research in light of the argument originally put forward by Alan Walker back in 2007.
A shared awareness of other teams’ roles and tasks has been linked to successful performance in joint ventures. However, emergency management organizations responding to incidents do not always share ...critical information necessary for maintaining shared awareness. An instrument called Shared Priorities has previously been applied to measure aspects of shared situation awareness at level 2 and 3 in Endsley’s (1995) model. This paper reports on a shared awareness instrument focused on level 1 situation awareness and its associated level of team shared awareness. Participants in a large emergency response exercise were asked to locate and rank geographical locations based on importance for overall mission success. The results show that organizations tended to rank locations relevant for their own work higher than positions relevant to other organization’s tasks. The different organizations displayed different levels of inter-rater agreement within themselves concerning the ranking of these positions.
Biosensor-based immunochemical screening assays for the detection of sulfadiazine (SDZ) and sulfamethazine (SMT) in muscle extract from pigs were developed. Samples were extracted with aqueous buffer ...and then centrifuged. This simple and straightforward preparation allowed up to 40 samples to be processed and analysed in 1 d. The limits of detection for the assays were found to be 5.6 ng g-1 for SDZ and 7.4 ng g-1 for SMT. These figures were well below the European and US legal limits for sulfonamides (100 ng g-1). The precision (RSD) between runs was < 8% and the recovery was between 91 and 98%. The validation proved the assays to be accurate and the analysis of routine field samples showed good correlation with an established TLC screening procedure. No false negative or positive results were obtained with blank and spiked samples. The influence of cross-reacting metabolites on immunoassays was demonstrated by testing incurred tissue samples, collected from sulfonamide treated pigs after only a short withdrawal period. The quantitative results obtained by biosensor analysis were a combination of parent sulfonamide plus N4-acetyl metabolite while the HPLC method used for confirmatory analysis detected only the parent sulfonamide. This gave rise to some false positive results and highlighted the need to use real samples in evaluating any assay thoroughly. False negative results were not obtained.
Clenbuterol (CBL) is an orally active beta2-adrenoceptor agonist which has been used in veterinary medicine as a broncodilator and an agent of uterine relaxation. It has however become better known ...as a drug used illegally to promote growth in farm animals. A rapid and sensitive biosensor assay was developed to detect CBL residues in bovine urine. The method involved a simple extraction procedure using tert-butyl methyl ether followed by analysis on the biosensor with results obtained against a buffer calibration curve. The assay allowed up to 88 samples to be analyzed per working day, with each cycle on the biosensor taking approximately 7 min to complete. The limit of detection (LOD) was determined as 0.27 ng/mL using 20 EU reference blank urine samples. The intra-assay Sr ranged from 4.7-7.6% for 3 control samples while the interassay Sr ranged from 9.2-12.7%. The recovery was found to be approximately 95%. A series of incurred urine samples were assayed and the results compared by Enzyme immunoassay (EIA), radio-immunoassay (RIA), and gas chromatography/mass spectrometry (GC/MS) analysis. Urine samples taken from local abattoirs were also analyzed by the biosensor method and by EIA analysis. The antibody used in the biosensor test exhibited high cross reactivity with at least 7 other beta-agonists allowing detection of these compounds at less than 1 ng/mL in bovine urine.
We have calculated the self-consistent effective potential for an electron tunneling through a square barrier while interacting with surface plasmons. This potential reduces to the classical image ...potential in the static limit. In the opposite limit, when the velocity'' of the tunneling electron is large, it reduces to the unperturbed square-barrier potential. For a wide variety of parameters the dynamic effects on the transmission coefficient {ital T}={vert bar}{ital t}{sup 2}{vert bar} can, for instance, be related to the Buettiker-Landauer traversal time for tunneling, given by {tau}{sup BL}={h bar}{vert bar}{ital d} ln{ital t}/{ital dV}{vert bar}.
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