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Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury.
A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems’ jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet.
The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each).
Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service.
Mould-MillmanNK, DixonJM, SefaN, YanceyA, HollongBG, HagahmedM, GindeAA, WallisLA. The State of Emergency Medical Services (EMS) Systems in Africa. Prehosp Disaster Med. 2017;32(3):273–283.
Bystander cardiopulmonary resuscitation (CPR) improves survival after prehospital cardiac arrest. While community CPR training programs have been implemented across the US, little is known about their acceptability in non-US Latino populations.
The purpose of this study was to identify barriers to enrolling in CPR training classes and performing CPR in San José, Costa Rica.
After consulting 10 San José residents, a survey was created, pilot-tested, and distributed to a convenience sample of community members in public gathering places in San José. Questions included demographics, CPR knowledge and beliefs, prior CPR training, having a family member with heart disease, and prior witnessing of a cardiac arrest. Questions also addressed barriers to enrolling in CPR classes (cost/competing priorities). The analysis focused on two main outcomes: likelihood of registering for a CPR class and willingness to perform CPR on an adult stranger. Odds ratios and 95% CIs were calculated to test for associations between patient characteristics and these outcomes.
Among 371 participants, most were male (60%) and <40 years old (77%); 31% had a college degree. Many had family members with heart disease (36%), had witnessed a cardiac arrest (18%), were trained in CPR (36%), and knew the correct CPR steps (70%). Overall, 55% (95% CI, 50-60%) indicated they would “likely” enroll in a CPR class; 74% (95% CI, 70-78%) would perform CPR on an adult stranger. Cardiopulmonary resuscitation class enrollment was associated with prior CPR training (OR: 2.6; 95% CI, 1.6-4.3) and a prior witnessed cardiac arrest (OR: 2.0; 95% CI, 1.1-3.5). Willingness to perform CPR on a stranger was associated with a prior witnessed cardiac arrest (OR: 2.5; 95% CI, 1.2-5.4) and higher education (OR: 1.9; 95% CI, 1.1-3.2). Believing that CPR does not work was associated with a higher likelihood of not attending a CPR class (OR: 2.4; 95% CI, 1.7-7.9). Fear of performing mouth-mouth, believing CPR is against God’s will, and fear of legal risk were associated with a likelihood of not attending a CPR class and not performing CPR on a stranger (range of ORs: 2.4-3.9).
Most San José residents are willing to take CPR classes and perform CPR on a stranger. To implement a community CPR program, barriers must be considered, including misgivings about CPR efficacy and legal risk. Hands-only CPR programs may alleviate hesitancy to perform mouth-to-mouth.
SchmidKM, Mould-MillmanNK, HammesA, KroehlM, Quiros GarcíaR, Umaña McDermottM, LowensteinSR. Barriers and Facilitators to Community CPR Education in San José, Costa Rica. Prehosp Disaster Med. 2016;31(5):509–515.
Since the last General Assembly in Patras, Greece, we have held three meetings of the Working Group. The 10th Meeting was held in Mzkheta, the ancient capital of Georgia, USSR, hosted by their Academy of Sciences on April 3-7, 1984. All members except one, who was represented by a member of his Task Group, were present at the very productive meeting.
The explosive increase in the number of published papers on planetary and satellite research in recent years has made it impossible to provide an adequate summary of progress in the field over a given three year period in the space allotted for this purpose. The problem is particularly acute for the current epoch - 1 January 1976 to 31 December 1978 - because it encompasses major missions to Mars and Venus by the United States and the Soviet Union, as well as a large number of exciting discoveries made from the ground.
The Commission formed a Sub-Commission on Zodiacal Light, presided over by Prof. Issei Yamamoto. The constitution of a sub-commission on the light of the night sky and kindred phenomena was proposed, but left in abeyance, pending the Stockholm Meeting. Dr Jean Dufay kindly consented to write, at the president’s request, a paper on the present state of the problem of the light of the night sky, which is printed with this Report.
Since the General Assembly at New Delhi in November 1985, the Working Group held two meetings within six weeks of each other; most members of the Working Group and several members of Task Groups were able to attend at least one of these meetings. The thirteenth meeting of the Working Group was held at Toulouse, France on June 30 to July 2,1986; the fourteenth meeting was held at Moscow, USSR, on August 10,1986; the fifteenth meeting took place from August 13 to 15 in Soviet Armenia.
The limited space made available for this report by recent regulations of the Executive Committee of our Union does not allow the traditional list of all published papers. Also, it omits the data on detection of cosmic dust, which are now published each year in surveys by the COSPAR Dust Panel. This report is mainly based on completely fresh information contained in numerous letters sent to me.
The accompanying report of our Meteorite Committee is done in the old style, but only a limited number of references are given. Evidence for a terrestrial origin of tektites is becoming stronger every year, and this subject is omitted in order to shorten the report.
Before starting the report, I mention with great regret the death of Prof. Dr Cuno Hoffmeister. His name remains connected forever with the famous period of naked-eye observations of meteors. Another great loss for meteor observers was the death of Mr Koiro Komaki, the President of the Nippon Meteor Society.
It is with great sadness that we have to report the death on 24 August 1990 of the WG’s President, Harold Masursky, at the age of 66. Dr. Masursky is known for his many contributions in planetary science and for his many years of dedicated work in planetary nomenclature. During the interim until the next IAU General Assembly the IAU Executive Committee has appointed K. Aksnes as Acting President of the WG.
The contribution of meteor observations to our knowledge of meteoroids and interplanetary dust is reviewed under four headings – flux, mass distribution, physical structure and chemical composition. For lower limits of particle mass ranging from 1 g to 10−5 g the mean cumulative flux into the earth’s atmosphere varies from 2 × 10−15 to 6 × 10−9 particles m−2 s−1 (2Πster)−1, and the mean size distribution of these particles is given by log N = C – 1.3 log M, where N is the cumulative number of particles counted down to a lower mass limit M, and C is a constant. The physical structure of meteoroids in the above range is essentially fragile, with generally low mean bulk densities that tend to increase with decrease in mass. A minor fraction, about 10 or 15 per cent, with orbits lying inside that of Jupiter, have densities several times the average densities, approaching those of the carbonaceous chondrites. The mean chemical composition of meteoroids seems to be similar to the bronzite chondrites for the elements heavier than number 10, but with the probable addition of extra quantities of the light volatiles H, C and O.
A detailed summary of the progress of meteor spectroscopy over more than a century has been published recently (Millman 1980), and only a few historical facts will be noted here. Serious research in this field was initiated by Alexander Stewart Herschel, a grandson of Sir William Herschel, in 1863 (Herschel 1865). Originally, the observational data were entirely visual records but, in the first decade of the twentieth century, a brief program for the photography of meteor spectra was carried out at the Moscow Observatory by S. Blajko (1907). Interest in this type of observation developed slowly and further programs were not attempted until the thirties. At the outbreak of World War II some 60 meteor spectra had been photographed. In the post-war period a general interest in the upper atmosphere led to the development of more efficient meteor cameras which employed replica gratings, and later electronic image-intensification systems recording on video tape (Hemenway et al. 1971; Clifton et al. 1979). As a result several thousand meteor spectra are now available for study.
Accurate and complete reporting of study methods, results and interpretation are essential components for any scientific process, allowing end-users to evaluate the internal and external validity of a study. When animals are used in research, excellence in reporting is expected as a matter of continued ethical acceptability of animal use in the sciences. Our primary objective was to assess completeness of reporting for a series of studies relevant to mitigation of pain in neonatal piglets undergoing routine management procedures. Our second objective was to illustrate how authors can report the items in the Reporting guidElines For randomized controLled trials for livEstoCk and food safety (REFLECT) statement using examples from the animal welfare science literature. A total of 52 studies from 40 articles were evaluated using a modified REFLECT statement. No single study reported all REFLECT checklist items. Seven studies reported specific objectives with testable hypotheses. Six studies identified primary or secondary outcomes. Randomization and blinding were considered to be partially reported in 21 and 18 studies, respectively. No studies reported the rationale for sample sizes. Several studies failed to report key design features such as units for measurement, means, standard deviations, standard errors for continuous outcomes or comparative characteristics for categorical outcomes expressed as either rates or proportions. In the discipline of animal welfare science, authors, reviewers and editors are encouraged to use available reporting guidelines to ensure that scientific methods and results are adequately described and free of misrepresentations and inaccuracies. Complete and accurate reporting increases the ability to apply the results of studies to the decision-making process and prevent wastage of financial and animal resources.
Early visual observations of meteor spectra were instigated by A.S. Herschel and, in the period 1866-1880, resulted in the recording of several hundred spectra and the correct identification of the lines of neutral sodium and magnesium. Some 60 meteor spectra were photographed from 1897 to 1940, which resulted in the identification of 9 neutral and 4 singly ionized atoms. Improved cameras and techniques after World War II, and in particular the use of closed-circuit television equipment recording on video tape, increased the data-bank of meteor spectra to several thousand and made possible the identification in these spectra of between 15 and 20 neutral atoms, 9 singly ionized atoms and 6 diatomic molecules. Reliable luminous efficiencies of the atoms and molecules radiating in the observed light of meteors are available in only a few cases. Where relative abundances of the elements have been calculated, these agree in general with those found by other techniques for interplanetary dust, and with abundances for the solar system as a whole.
The atomic multiplets and molecular band systems identified in six categories of upper-air sources are studied. These total 510 multiplets of 38 atoms and ions, and 54 band systems of 27 molecules. The average excitation decreases as one progresses from the sources resulting from the influx of the faster and smaller particles to those produced by the slower and larger objects.
From about 1930 on various scattered notes appeared from time to time, pointing out certain radio effects that probably resulted from meteors. However, the real birth of the serious observation of meteors by radio took place on the night of October 9–10, 1946, when the Giacobinid meteor shower returned in considerable strength. This was observed with re-built World-War II radar equipment in both England and the U.S.A., and the results achieved left no doubt concerning the value of the new technique in meteoric astronomy. Figure 1 illustrates two historic examples of meteor echoes recorded in England on this occasion (Appleton and Naismith, 1947; Hey et al., 1947). Since this date the field has expanded rapidly. Useful general summaries may be found in a number of monographs, e.g., Lovell (1954), McKinley (1961).
Several neurological variables have been investigated as premorbid biomarkers of vulnerability for schizophrenia and other related disorders. The current study examined whether childhood dyspraxia predicted later adult nonaffective–psychosis-spectrum disorders. From a standardized neurological examination performed with children (aged 10–13) at genetic high risk of schizophrenia and controls, several measures of dyspraxia were used to create a scale composed of face/head dyspraxia, oral articulation, ideomotor dyspraxia (clumsiness), and dressing dyspraxia (n = 244). Multinomial logistic regression showed higher scores on the dyspraxia scale predict nonaffective–psychosis-spectrum disorders relative to other psychiatric disorders and no mental illness outcomes, even after controlling for genetic risk, χ2 (4, 244) = 18.61, p < .001. Findings that symptoms of dyspraxia in childhood (reflecting abnormalities spanning functionally distinct brain networks) specifically predict adult nonaffective–psychosis-spectrum disorders are consistent with a theory of abnormal connectivity, and they highlight a marked early-stage vulnerability in the pathophysiology of nonaffective–psychosis-spectrum disorders.