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Introduction: The incidence of out-of-hospital cardiac arrest (OHCA) in school is approximately 2.1 for 100,000 per year. Although rare, it is a devastating event for the local community. Schools with public access to automated external defibrillators (AED) and an emergency response plan have demonstrated increased survival rates of up to 70% for students who suffer cardiac arrest. Previous studies identified numerous barriers to successful cardiac resuscitation in public school systems. The main objectives of this study were to identify those barriers in the Quebec region elementary school system and to assess the impacts of an AED focused training session. Methods: A previously validated survey focused on the potential barriers to successful defibrillation in OHCA and on demographic variables was sent to 139 elementary schools. Later, 92 employees within three elementary schools who responded to the survey were evaluated before and after receiving training on the use of AED in a mock cardiac arrest scenario. The primary outcome was the time to first shock and the secondary outcomes included correct AED pad placement and safety of the procedure. Results: Survey response rate was 53%, which is comparable to previous studies assaying barriers to cardiac resuscitation in public school systems. 95% of school respondents reported the presence of an AED on the school premises but 46% stated that no formal AED training course was provided to employees. Out of the four schools who reported a previous OHCA, only one had access to an AED at the time of the event. Following focused AED training, 92% of school workers successfully completed a defibrillation sequence in a mock scenario, from 53% before (p < 0.001, McNemar test). The time to first shock went from 66 seconds (95% CI 63-70) to 47 seconds (95% CI 45-49; -29%, p < 0.001). Proper pad placement was the most problematic step for participants and personnel who reported previous training had better performance (OR 3.15, 95% CI 1.33-7.42, p = 0.009). Conclusion: Most elementary schools in the Quebec region have access to AEDs. However, inadequate AED training represents a significant barrier to successful defibrillation in the event of an OHCA. Our results showed that a simple focused AED training could improve the performance of school workers and optimize the chain of survival.
Despite of the evidence of high psychopathological disorders in patients with ATSCI, few data are available on their psychiatric morbidity prior to the injury.
Identify psychiatric morbidity pre-post ATSCI in a sample of patients admitted in the Spinal Injuries Unit of the Vall d’ Hebron University Hospital in Barcelona (Spain).
Material and methods
54 patients with ATSCI patients were admitted between 1st. October 2009 and 1st. October 2010. SPSS (version 16.1) was used to analyze the data.
Seventy-six percent of the inpatients with ATSCI (41 cases) were evaluated by the psychiatrist and constitute the study sample. Twenty-seven (66%) were male and 14 (33%) female. The average age of the sample was 41 years with younger males (p < 0.05).
Reasons for ATSCI in males were traffic accident (26%), accidental falls and sports accidents (both 18.5%). In women were suicidal attempt by precipitation, fall accident (28.6% both) and traffic accident (21.4%).
41% of men versus 14% of women had a history of substance misuse (p < 0.01) while 64% of women versus the 14.8% of males had a prior psychiatric disorder (p < 0.01). 72.5% of men with ATSCI caused by traffic accident had used substances prior to the accident, those association was not found for women.
91% of patients underwent psychopharmacological intervention.
ATSCI patients exhibit high psychiatric morbidity and require specialized assessment. The high incidence of substance use associated with road traffic injuries suggests the need to identify risk groups in order to establish effective preventive measures.
Over the last decade, the frequency of emergency room (ER) visits for pediatric psychiatric disorders has increased in the most western countries. Although data available in France is scarce, a similar trend was observed concerning violent or runaway youth. There is no medical consensus on the status and care management of disruptive behavior (DB) in children and adolescents in ER. Seclusion and physical restraint are often requested to treat violence. With a blur lawful framework for minors, such coercive measures raise ethical issues while contradicting the idea of the patients’ autonomy and well-being. Moreover, consulting in the ER for such situations could lead to an inappropriate use of the healthcare system, a poor assessment of associated psychiatric disorders or comorbidities and an underestimation of suicide risk. Thus, the ER visit for a disruptive child or adolescent is characterized by its uncertainty. It represents a situation of heterogeneity in care management as well as a stake of social exclusion and of dangerous behavior.
The study aims to:.
– analyze these uncertainties by presenting a multidisciplinary and integrative research methodology through combining clinical evidence and social sciences comprehension;
– to implement a cohort to describe children and adolescents admitted to the ER for DB (aggressiveness, violence, fugue or theft), their care management and their social and clinical outcome;
– to pool these clinical data with an ethnographic fieldwork focused on DB as a “trouble” experienced by various professionals in the ER.
We will focus our presentation on these methodological considerations.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Objectives: To evaluate prospective and retrospective memory abilities in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans with and without a self-reported history of blast-related mild traumatic brain injury (mTBI). Methods: Sixty-one OEF/OIF/OND Veterans, including Veterans with a self-reported history of blast-related mTBI (mTBI group; n=42) and Veterans without a self-reported history of TBI (control group; n=19) completed the Memory for Intentions Test, a measure of prospective memory (PM), and two measures of retrospective memory (RM), the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised. Results: Veterans in the mTBI group exhibited significantly lower PM performance than the control group, but the groups did not differ in their performance on RM measures. Further analysis revealed that Veterans in the mTBI group with current PTSD (mTBI/PTSD+) demonstrated significantly lower performance on the PM measure than Veterans in the control group. PM performance by Veterans in the mTBI group without current PTSD (mTBI/PTSD-) was intermediate between the mTBI/PTSD+ and control groups, and results for the mTBI/PTSD- group were not significantly different from either of the other two groups. Conclusions: Results suggest that PM performance may be a sensitive marker of cognitive dysfunction among OEF/OIF/OND Veterans with a history of self-reported blast-related mTBI and comorbid PTSD. Reduced PM may account, in part, for complaints of cognitive difficulties in this Veteran cohort, even years post-injury. (JINS, 2018, 24, 324–334)
S stars are s-process and C-enriched (0.5<C/O<1) red giants. Their abundances can be determined thanks to a new grid of MARCS model atmospheres covering their whole parameter range. Detailed abundance determinations in intrinsic S stars (TP-AGB) and extrinsic S stars (binary masqueraders) can provide strong constraints on the s-process nucleosynthesis: in particular, the s-process temperature can be determined using zirconium and niobium abundances, independently of stellar evolution models. Synthetic spectra of dwarf S stars have been computed and will be sought for in spectroscopic survey data, constraining their luminosity thanks to Gaia parallaxes.
The Rosenberg Self-Esteem Scale is the most widely used instrument to assess self-esteem. In light of the absence of adaptations in Colombia, this study seeks to validate and adapt this scale in the Colombian population, and perform factorial equivalence with the Spanish version. A total of 1,139 seniors (633 Colombians and 506 Spaniards) were evaluated; the individuals answered the Rosenberg Self-Esteem Scale and sexual self-esteem scale. The average score of the items was similar to the questionnaire’s theoretical average, and standard deviations were close to one. The psychometric properties of the items are generally adequate with alphas of .83 and .86 and significant (CI = .95) and correlations with the sexual self-esteem scale ranging from .31 and .41. Factorial equivalence was confirmed by means of a structural equation model (CFI = .912 and RMSEA = .079), thus showing a strong level of invariance.
Breed risk status assessment methods are key components of country-based early warning and response systems. In this study, a multi-indicator method was developed to assess the risk status of livestock populations. Six indicators were used: (i) the current number of breeding females; (ii) the change in the number of breeding females over the last 5 years or generations (depending on the species); (iii) percentage of cross-breeding; (iv) effective population size; (v) breeders organization and technical support; and (vi) socio-economic context. To make these indicators comparable, observed values were converted into scores on a six-point scale (from 0 = no threat to 5 = maximum threat); a specific conversion method was used for each indicator. For each breed, the different scores were analysed graphically and an overall score was calculated by averaging the six separate indicator scores. This approach was applied to 178 French local breeds, belonging to ten different species: horse, donkey, goat, pig, chicken, turkey, goose and Pekin duck. A large percentage of local breeds were found to be at risk to be lost for farming, although the results were species dependent. All local equine and pig breeds, as well as almost all local poultry breeds appeared to be endangered. About 80 percent of local goat and cattle breeds, and half local sheep breeds were also found to be at risk. The usefulness of this method with regards to conservation strategies and public policy is discussed.
Expose is a multi-user instrument for astrobiological and astrochemical experiments in space. Installed at the outer surface of the International Space Station, it enables investigators to study the impact of the open space environment on biological and biochemical test samples. Two Expose missions have been completed so far, designated as Expose-E (Rabbow et al. 2012) and Expose-R (Rabbow et al. this issue). One of the space-unique environmental factors offered by Expose is full-spectrum, ultraviolet (UV)-rich electromagnetic radiation from the Sun. This paper describes and analyses how on Expose-R, access of the test samples to Solar radiation degraded during space exposure in an unpredicted way. Several windows in front of the Sun-exposed test samples acquired a brown shade, resulting in a reduced transparency in visible light, UV and vacuum UV (VUV). Post-flight investigations revealed the discolouration to be caused by a homogenous film of cross-linked organic polymers at the inside of the windows. The chemical signature varied per sample carrier. No such films were found on windows from sealed, pressurized compartments, or on windows that had been kept out of the Sun. This suggests that volatile compounds originating from the interior of the Expose facility were cross-linked and photo-fixed by Solar irradiation at the rear side of the windows. The origin of the volatiles was not fully identified; most probably there was a variety of sources involved including the biological test samples, adhesives, plastics and printed circuit boards. The outer surface of the windows (pointing into space) was chemically impacted as well, with a probable effect on the transparency in VUV. The reported analysis of the window contamination on Expose-R is expected to help the interpretation of the scientific results and offers possibilities to mitigate this problem on future missions – in particular Expose-R2, the direct successor of Expose-R.
The study of the evolution of organic matter subjected to space conditions, and more specifically to Solar photons in the vacuum ultraviolet range (120–200 nm) has been undertaken in low-Earth orbit since the 1990s, and implemented on various space platforms. This paper describes a photochemistry experiment called AMINO, conducted during 22 months between 2009 and 2011 on the EXPOSE-R ESA facility, outside the International Space Station. Samples with relevance to astrobiology (connected to comets, carbonaceous meteorites and micrometeorites, the atmosphere of Titan and RNA world hypothesis) have been selected and exposed to space environment. They have been analysed after return to the Earth. This paper is not discussing the results of the experiment, but rather gives a general overview of the project, the details of the hardware used, its configuration and recent developments to enable long-duration exposure of gaseous samples in tight closed cells enabling for the first time to derive quantitative results from gaseous phase samples exposed in space.
Interventional cardiologists (ICs) are repeatedly exposed to scattered ionising radiation
during the cardiac procedures they perform, and radiation protection is an important issue
for these medical professionals. The use of radiation protection tools is particularly
relevant to this population. SISERI (Système d’Information de la Surveillance de
l’Exposition aux Rayonnement Ionisants, that is, an information system for monitoring
exposure to ionising radiation) is a register that stores personal dosimeter readings for
dosimetric monitoring. This paper, based on data for a sample of French ICs from the
O’CLOC epidemiological study, aims to provide an overview of the use of radiation
protection equipment and dosimetric devices reported by ICs in a specific questionnaire as
well as the dosimetric information found in the SISERI database for this population.
Material and Methods − Annual information on interventional cardiology activity for the
period from 01/01/2005 to 31/12/2009 was collected in an occupational questionnaire. ICs
were asked to report the frequency in which they used individual dosimeter and radiation
protection tools (lead apron, thyroid shield, eyewear or face shield, ceiling-suspended
shield) as follows: never (0% of the time), occasionally (<50%), regularly (>50%), always (100%). We retrieved their
medical radiation exposure information (monitored status and monthly effective doses) from
the SISERI database for the period 2005−2009. Results – Information for 132 ICs (mean age in
2005 = 46 ± 7 years) was
available. All ICs reported routine use of lead aprons, in contrast to their occasional
use of lead eyewear or face shields. During the study period, 49% reported systematic use
of personal dosimeters, and 21% more regular use. On the other hand, 18% never used a
dosimeter during this period. The SISTERI database included 92% of our population, 73% of
whom had complete annual dose monitoring in SISERI (corresponding to at least 11 months
per year of recorded data). Conclusion − ICs must improve their regular use of
radiation protection tools and systematic use of personal dosimeters. The SISERI database
is an appropriate tool for flagging those medical professionals exposed to ionising
radiation. Better awareness of the importance of radiation protection rules in this
population, in particular, systematic dosimeter use, remains an important issue.
Deoxynivalenol (DON) and fumonisins (FB) are mycotoxins produced by Fusarium species, which naturally co-occur in animal diets. The gastrointestinal tract represents the first barrier met by exogenous food/feed compounds. The purpose of the present study was to investigate the effects of DON and FB, alone and in combination, on some intestinal parameters, including morphology, histology, expression of cytokines and junction proteins. A total of twenty-four 5-week-old piglets were randomly assigned to four different groups, receiving separate diets for 5 weeks: a control diet; a diet contaminated with either DON (3 mg/kg) or FB (6 mg/kg); or both toxins. Chronic ingestion of these contaminated diets induced morphological and histological changes, as shown by the atrophy and fusion of villi, the decreased villi height and cell proliferation in the jejunum, and by the reduced number of goblet cells and lymphocytes. At the end of the experiment, the expression levels of several cytokines were measured by RT-PCR and some of them (TNF-α, IL-1β, IFN-γ, IL-6 and IL-10) were significantly up-regulated in the ileum or the jejunum. In addition, the ingestion of contaminated diets reduced the expression of the adherent junction protein E-cadherin and the tight junction protein occludin in the intestine. When animals were fed with a co-contaminated diet (DON+FB), several types of interactions were observed depending on the parameters and segments assessed: synergistic (immune cells); additive (cytokines and junction protein expression); less than additive (histological lesions and cytokine expression); antagonistic (immune cells and cytokine expression). Taken together, the present data provide strong evidence that chronic ingestion of low doses of mycotoxins alters the intestine, and thus may predispose animals to infections by enteric pathogens.
Pseudomonas aeruginosa is one of the leading nosocomial pathogens. The question of the respective contribution of endogenous and exogenous sources remains controversial. In this study, we shed new light on this issue by means of a multilevel logistic regression analysis which allowed a simultaneous investigation of factors associated with prevalence of patients infected with P. aeruginosa at two levels: patient and healthcare facility (HCF) in the eastern regions of France. A total of 25 533 in-patients from 51 HCFs were included in the analysis. The overall prevalence was 0·37% (range 0–1·65%). Multilevel modelling estimated that <14% of total variability of the outcome variable was explained by differences between HCFs and that after adjusting for patient-level variables, which explained 52% of HCF-level variance, the latter became non-significantly different from zero. A compositional effect (patient factors), rather than a contextual effect (ecological factors), explains heterogeneity of the prevalence of patients infected with P. aeruginosa in the eastern HCFs of France.
This work reports on the epitaxial growth of crystalline high-k Gd2O3 on Si (111) by Molecular Beam Epitaxy (MBE) for CMOS gate application. Epitaxial Gd2O3 films of different thicknesses have been deposited on Si (111) between 650°C~750°C. Electrical characterizations reveal that the sample grown at the optimal temperature (700°C) presents an equivalent oxide thickness (EOT) of 0.73nm with a leakage current density of 3.6×10-2 A/cm2 at |Vg-VFB|=1V. Different Post deposition Annealing (PDA) treatments have been performed for the samples grown under optimal condition. The Gd2O3 films exhibit good stability and the PDA process can effectively reduce the defect density in the oxide layer, which results in higher performances of the Gd2O3/Si (111) capacitor.
The Schrödinger equation describes the motion of a particle in a statistical sense. It consequently possesses the two main properties of the Vlasov equation (dynamic and statistic) and can replace this last equation provided we take sophisticated initial conditions. The scheme must be considered as a new attempt to discretize intelligently the amount of information contained in the phase space distribution and to stop, without destroying it, the flow of information which usually goes to high wavenumbers in velocity space. The method is applied to the breaking of highly nonlinear waves in a cold plasma (usually treated by the Lagrangian method) and to double beam instability. It is shown that such an Eulerian scheme works quite well with a much smaller number of discretized functions than are required in the regular Fourier—Fourier or Fourier-Hermite methods. The central point is the introduction of the phase space Wigner distribution function which is a useful mathematical tool in spite of its poor physical properties.
The complete second-order theory of the multiple water-bag model is developed for one-dimensional collisionless electrostatic waves, in terms of the initial value problem. Nonlinear frequency spectra are obtained in Van Kampen's formulation, and a new pole, already predicted by R. W. B. Best, appears for hot plasmas. This theory is successfully checked by a full numerical experiment of the Vlasov–Poisson system.
In periodic, inhomogeneous plasma, the dispertion relation w(k) can begeneralized to a relation w(k, K), where K is the wave-number of the periodic steady state. Two models are studied: the ‘water-bag’ model and the ‘two-stream’ model. The solution for these models is obtained easily by the introduction of a Lagrangian formulation. Results are presented. It is shown that, in the water-bag case, the appearance of narrow bands of allowed frequencies practically discretizes the lower part of the spectrum. In the two-stream case, while the long wavelengths have a smaller growth rate, an increased instability is found for k/K = ½
To assess the proportion of children being stunted and underweight-for-age at 3, 9 and 15 months in Lambaréné, Gabon, using the WHO child growth standards released in 2006 as compared with the Centers for Disease Control and Prevention (CDC) 2000 and the National Center for Health Statistics (NCHS) 1978 child growth charts/references.
Design and setting
Prospective birth cohort in Lambaréné, Gabon.
Two hundred and eighty-nine children from birth to 15 months of age.
Weight and length were recorded at 3, 9 and 15 months. Corresponding Z scores for stunting and underweight-for-age were calculated for the three different standards/references. Children with a height-for-age or weight-for-age below –2 sd of the corresponding reference median (Z score ≤−2) were classified as stunted or underweight-for-age, respectively.
With the new WHO 2006 standards a higher proportion (4·0 %) of 3-month-old infants were underweight compared with the CDC (1·0 %) or the NCHS (0·7 %) child growth charts/references. In contrast to the NCHS references or the CDC charts, this proportion did not increase from 3 to 9 months or from 9 to 15 months. The proportion of children being stunted was highest (above 20 %) with the WHO 2006 standards at all three ages. Again, in contrast to the old standards, this proportion did not increase from 3 to 9 months or from 9 to 15 months.
The present results show considerably different growth faltering patterns for Gabonese children depending on the growth charts used to assess the prevalence of stunting and underweight. Shifting to the new WHO child growth standards may have important implications for child health programmes.
The preparation of partially filled n-type InxCo4Sb12 skutterudite compounds has been recently reported. The results were particularly promising, the materials exhibiting a ZT value far higher than one at moderated temperature. In this paper, we propose to investigate another way to tune the electrical and thermal properties by substituting Co atoms by Ni atoms in InxCo4Sb12. InxCo4-yNiySb12 polycrystalline samples have been prepared by a conventional metallurgical route. Structural analyses have been carried out by X-ray diffraction. The chemical composition and micro-homogeneity have been checked by electron probe microanalysis. Measurements of the electrical resistivity, thermoelectric power and thermal conductivity have been performed between 300 and 800 K. The influence of the presence of Ni on the thermoelectric properties of InxCo4Sb12 compounds is presented and discussed.