•Extended version of the SEMA4A ontology with concepts about evacuation.•Improved methodology for identifying, acquiring, creating and organizing knowledge.•Implementation of the ontology using the ...standard Web Ontology Language (OWL).•Evaluation of the ontology with both a quantitative and a qualitative method.•Deployment of a use case demonstrating the usage of SEMA4A in a real scenario.
Providing alert communication in emergency situations is vital to reduce the number of victims. However, this is a challenging goal for researchers and professionals due to the diverse pool of prospective users, e.g. people with disabilities as well as other vulnerable groups. Moreover, in the event of an emergency situation, many people could become vulnerable because of exceptional circumstances such as stress, an unknown environment or even visual impairment (e.g. fire causing smoke). Within this scope, a crucial activity is to notify affected people about safe places and available evacuation routes. In order to address this need, we propose to extend an ontology, called SEMA4A (Simple EMergency Alert 4 for All), developed in a previous work for managing knowledge about accessibility guidelines, emergency situations and communication technologies. In this paper, we introduce a semi-automatic technique for knowledge acquisition and modeling on accessible evacuation routes. We introduce a use case to show applications of the ontology and conclude with an evaluation involving several experts in evacuation procedures.
Providing alert communication in emergency situations is vital to reduce the number of victims. Reaching this goal is challenging due to users’ diversity: people with disabilities, elderly and ...children, and other vulnerable groups. Notifications are critical when an emergency scenario is going to happen (e.g. a typhoon approaching) so the ability to transmit notifications to different kind of users is a crucial feature for such systems. In this work an ontology was developed by investigating different sources: accessibility guidelines, emergency response systems, communication devices and technologies, taking into account the different abilities of people to react to different alarms (e.g. mobile phone vibration as an alarm for deafblind people). We think that the proposed ontology addresses the information needs for sharing and integrating emergency notification messages over distinct emergency response information systems providing accessibility under different conditions and for different kind of users.
Background
We established cohorts to assess associations between viral influenza and cognitive development to inform the value proposition of vaccination.
Methods
From 2014 through 2017, we called ...women seeking care at four prenatal clinics in Panama and El Salvador to identify acute respiratory illnesses (ARIs). Within 2 weeks of childbirth, mothers were asked to enroll their neonates in the cognitive development study. Staff obtained nasopharyngeal swabs from children with febrile ARIs for real‐time reverse transcription polymerase chain reaction (rtPCR) detection of viral RNA. Toddlers were administered Bayley developmental tests at ages 12 and 18–24 months. We used multilevel linear regression to explore associations between Bayley scores, ARIs, fever, and laboratory‐confirmed influenza, controlling for maternal respiratory or Zika illnesses, infant influenza vaccination, birth during influenza epidemics, and the number of children in households.
Results
We enrolled 1567 neonates of which 68% (n = 1062) underwent developmental testing once and 40% (n = 623) twice. Children with previous ARIs scored an average of 3 points lower on their cognitive scores than children without ARIs (p = 0.001). Children with previous fevers scored an average of 2.1 points lower on their cognitive scores than afebrile children (p = 0.02). In the second year, children with previous laboratory‐confirmed influenza scored 4 points lower on their cognitive scores than children without influenza (p = 0.04, after controlling for first Bayley cognitive scores).
Conclusions
ARIs and fever during infancy were associated with lower Bayley scores at 12 months, and laboratory‐confirmed influenza was associated with lower cognitive scores at 24 months suggesting the potential value of vaccination to prevent non‐respiratory complications of influenza.
AIMSTo identify commonly used intravenous drugs that may produce endothelial damage. METHODSAn experimental research study was performed using a sample of 62 intravenous drugs commonly used in ...emergency care, pH and osmolarity were measured. Subsequently, based on these values, the theoretical capacity to cause irritation or endovascular damage was determined and classified as high, moderate, and low. RESULTSSamples from 19 drugs for fluid therapy, 21 antibiotics and 22 drugs for intravenous use were studied. Glucose solutions, sodium bicarbonate 1M and mannitol 10% showed a high capacity to cause venous irritation. Vancomycin, ciprofloxacin, amiodarone, haloperidol, and labetalol solution presented a high capacity for irritation based on their acidic pH. The antibiotics, dexketoprofen, diazepam, digoxin, etomidate, phenytoin, levetiracetam and metamizole also showed high osmotic values in their reconstituted or undiluted presentations. Moreover, osmolarity of diazepam, digoxin and phenytoin remained high despite being diluted in 100 ml of saline. CONCLUSIONSKnowing the pH and osmolarity of intravenous drugs allows their capacity to cause endothelial damage to be assessed. The use of comprehensive tables based on the chemical properties of the drugs can be a useful tool to help prevent chemically-induced phlebitis.
AIMTo analyse the caregivers' physical, anthropometrical and educational characteristics associated with adequate chest compression and full chest recoil during cardiopulmonary resuscitation (CPR). ...METHODSAn observational prospective research study was conducted. Emergency and critical care health professionals and students performed two minutes of chest compressions on a dummy. Depth and residual leaning after the compressions were assessed and their association with several variables (physical, anthropometrical, and educational) was analysed using logistic regression models. RESULTSTwo hundred thirty-eight volunteers participated. Previous experience of the rescuer in less than six CPRs (OR = 3.03; 95% CI 1.2-7.63) was related to a higher probability of not achieving an adequate depth of compressions. Greater height (OR: .93; 95% CI .87-.99) and grip strength (OR: .94; 95% CI .89-.99) were associated with correct performance of chest compression. We did not find any characteristic related to chest recoil. CONCLUSIONSThe caregiver's previous experience with CPR was the strongest factor associated with adequate performance of chest compressions. To a lesser extent, the professional's height and upper body muscle strength also have an influence. No factors associated with the adequacy of full chest recoil were identified.
There is growing interest, worldwide, in the link between education systems and the production of skills that are valued in the labor market. With growth stagnating and unemployment soaring in much ...of the world, educators are being asked to focus more on producing skills that feed into labor productivity and support the sustainable growth of employment and incomes. This timely volume contributes important new findings on the dynamics of education systems and labor market outcomes in Latin America and the Caribbean (LAC). It analyzes an important recent shift in labor market trends in LAC: the first decade of the 21st century has witnessed a marked decline in the earnings premia for university and secondary education. This, in turn, is contributing to reduced income inequality across the region. The recent trend contrasts with the sharp rise in tertiary earnings premia that was observed in the 1990s and that helped to reinforce high levels of income inequality in the region at that time. The authors recommend that, having achieved very large increases in secondary and tertiary enrollment, the region should now focus on improving the quality of its education systems and the pertinence of education curricula for the needs of the labor market. At age 15, the learning achievement of the average Latin American student still lags two years behind his or her Organization for Economic Co-operation and Development (OECD) contemporary. The study opens up an important agenda for future research. While the evidence presented on the trends in education earnings premia is clear, the conclusions about the causes and significance of those trends are largely based on suggestive evidence for a limited number of countries, and are not definitive because of data limitations. The findings call for further in-depth analysis of the nature of skill mismatches, to inform policies that can strengthen the region's future economic growth by enhancing the productivity and earnings potential of the workforce.
To explore the experiences, emotions and coping skills among emergency medical technicians and emergency nurses after performing out-of-hospital cardiopulmonary resuscitation manoeuvres resulting in ...death.
An exploratory qualitative research was performed. Seven emergency medical technicians and six emergency nurses were selected by non-probability sampling among emergency medical system workers. The meetings took place up to information saturation, achieved after six individual interviews and a focal group. The meetings were then transcribed and a manual and inductive analysis of the contents performed.
After a failed resuscitation several short and long-term reactions appear. They can be negatives, such as sadness or uncertainty, or positives, such as the feeling of having done everything possible to save the patient's life. Emotional stress increases when ambulance staff have to talk with the deceased's family or when the patient is a child. The workers don't know of a coping strategy other than talking about their emotions with their colleagues.
Death after a failed resuscitation can be viewed as a traumatic experience for rescuers. Being in contact with the suffering of others is an emotional, stress-generating factor with direct repercussions on the working and personal lives of emergency staff. Nevertheless, structured coping techniques are not common among those professionals.
To explore the training, ability and attitudes towards cardiopulmonary resuscitation and the use of automatic defibrillators among the population of the Basque Country (Spain).
A face-to-face survey.
...Capital cities of the Basque Country.
A total of 605 people between 15-64 years of age were randomly selected.
Information about the knowledge, perceptions and self-perceived ability to identify and assist cardiopulmonary arrest was requested.
A total of 56.4% of the responders were women, 61.8% were occupationally active, and 48.3% had higher education. Thirty-seven percent of the responders claimed to be trained in resuscitation techniques, but only 20.2% considered themselves able to apply such techniques. Public servants were almost 4 times more likely of being trained in defibrillation compared to the rest of workers (OR 3.7; P<.001), while people with elementary studies or no studies were almost 3 times more likely of not being trained in cardiopulmonary resuscitation, in comparison with the rest (OR 2.7; P=.001). A total of 94.7% of the responders considered it "quite or very important" for the general population to be able to apply resuscitation, though 55% considered themselves unable to identify an eye witnessed cardiac arrest, and 40.3% would not recognize a public-access defibrillator.
Citizens of the Basque Country consider the early identification and treatment of cardiorespiratory arrest victims to be important, though their knowledge in cardiopulmonary resuscitation and defibrillation is limited.
So far, the mechanisms underlying the action of selective serotonin reuptake inhibitors, such as fluoxetine, are not completely understood. Thus, to clarify if fluoxetine has any effect on ...noradrenergic transmission, we measured the spontaneous firing rate of noradrenergic neurons in the locus coeruleus both in vivo and in vitro using single-unit extracellular recordings. In anesthetized rats, fluoxetine (2.5-20 mg/kg, i.v.) reduced the firing rate in a dose-dependent manner, reaching a maximal inhibition of 55 +/- 5% with respect to the basal value. This effect was not only completely reversed by the alpha(2)-adrenoceptor antagonist, RX 821002 (0.2 mg/kg, i.v.), but also prevented by previous application of both idazoxan (0.05 and 0.1 mg/kg, i.v.) and RX 821002 (6.25 microg/kg, i.v). Furthermore, when noradrenaline was depleted from axon terminals by means of the injection of alpha-methyl-DL-tyrosine (250 mg/kg, i.p.) 24 h prior to the experiment, fluoxetine failed to inhibit locus coeruleus activity. In rat brain slices, perfusion with fluoxetine (100 microM for 5 min) did not modify the firing rate of locus coeruleus neurons (n = 7). We conclude that fluoxetine inhibits locus coeruleus neurons in vivo through a mechanism involving noradrenaline interacting with alpha(2)-adrenoceptors. However, the lack of effect on brain slices would seem to indicate that afferents to the nucleus may be involved in the observed inhibitory effect.
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