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Introduction: Most ambulance communication officers receive minimal education on agonal breathing, often leading to unrecognized out-of-hospital cardiac arrest (OHCA). We sought to evaluate the impact of an educational program on cardiac arrest recognition, and on bystander CPR and survival rates. Methods: Ambulance communication officers in Ottawa, Canada received additional training on agonal breathing, while the control site (Windsor, Canada) did not. Sites were compared to their pre-study performance (before-after design), and to each other (concurrent control). Trained investigators used a piloted-standardized data collection tool when reviewing the recordings for all potential OHCA cases submitted. OHCA was confirmed using our local OHCA registry, and we requested 9-1-1 recordings for OHCA cases not initially suspected. Two independent investigators reviewed medical records for non-OHCA cases receiving telephone-assisted CPR in Ottawa. We present descriptive and chi-square statistics. Results: There were 988 confirmed and suspected OHCA in the “before” (540 Ottawa; 448 Windsor), and 1,076 in the “after” group (689 Ottawa; 387 Windsor). Characteristics of “after” group OHCA patients were: mean age (68.1 Ottawa, 68.2 Windsor); Male (68.5% Ottawa, 64.8% Windsor); witnessed (45.0% Ottawa, 41.9% Windsor); and initial rhythm VF/VT (Ottawa 28.9, Windsor 22.5%). Before-after comparisons were: for cardiac arrest recognition (from 65.4% to 71.9% in Ottawa p=0.03; from 70.9% to 74.1% in Windsor p=0.37); for bystander CPR rates (from 23.0% to 35.9% in Ottawa p=0.0001; from 28.2% to 39.4% in Windsor p=0.001); and for survival to hospital discharge (from 4.1% to 12.5% in Ottawa p=0.001; from 3.9% to 6.9% in Windsor p=0.03). “After” group comparisons between Ottawa and Windsor (control) were not statistically different, except survival (p=0.02). Agonal breathing was common (25.6% Ottawa, 22.4% Windsor) and present in 18.5% of missed cases (15.8% Ottawa, 22.2% Windsor p=0.27). In Ottawa, 31 patients not in OHCA received chest compressions resulting from telephone-assisted CPR instructions. None suffered injury or adverse effects. Conclusion: While all OHCA outcomes improved over time, the educational intervention significantly improved OHCA recognition in Ottawa, and appeared to mitigate the impact of agonal breathing.
The role of affective and cognitive factors in learning have long been recognised as imperative determinants of the learning process. Maladaptive styles with which we perceive and explain accomplishments and failures in achievement outcomes have an important motivational impact upon approach and avoidance behaviours towards academic tasks. Interventions to change these maladaptive styles are well established, although they stand to gain via addition of cognitive behavioural therapy components. A pilot study attribution retraining intervention was implemented with eight secondary school students, and their results on academic performance, self-concept, and attributional styles were compared to a control group. With significant gains in some specific academic domains, the attributional retraining program is being substantiated for effective use within secondary schools. Implications suggest that this could be an effective tool to retrain students’ attributions, with some gains, as the reattribution technique is revisited and reinvigorated.
In general population samples, better childhood cognitive functioning is associated with decreased risk of depression in adulthood. However, this link has not been examined in extremely low birth weight survivors (ELBW, <1000 g), a group known to have poorer cognition and greater depression risk. This study assessed associations between cognition at age 8 and lifetime risk of major depressive disorder in 84 ELBW survivors and 90 normal birth weight (NBW, ⩾2500 g) individuals up to 29–36 years of age. The Wechsler Intelligence Scale for Children, Revised (WISC-R), Raven’s Coloured Progressive Matrices and the Token Test assessed general, fluid, and verbal intelligence, respectively, at 8 years of age. Lifetime major depressive disorder was assessed using the Mini International Neuropsychiatric Interview at age 29–36 years. Associations were examined using logistic regression adjusted for childhood socioeconomic status, educational attainment, age, sex, and marital status. Neither overall intelligence quotient (IQ) [WISC-R Full-Scale IQ, odds ratios (OR)=0.87, 95% confidence interval (CI)=0.43–1.77], fluid intelligence (WISC-R Performance IQ, OR=0.98, 95% CI=0.48–2.00), nor verbal intelligence (WISC-R Verbal IQ, OR=0.81, 95% CI=0.40–1.63) predicted lifetime major depression in ELBW survivors. However, every standard deviation increase in WISC-R Full-Scale IQ (OR=0.43, 95% CI=0.20–0.92) and Performance IQ (OR=0.46, 95% CI=0.21–0.97), and each one point increase on the Token Test (OR=0.80, 95% CI=0.67–0.94) at age 8 was associated with a reduced risk of lifetime depression in NBW participants. Higher childhood IQ, better fluid intelligence, and greater verbal comprehension in childhood predicted reduced depression risk in NBW adults. Our findings suggest that ELBW survivors may be less protected by superior cognition than NBW individuals.
A search for Type Ia supernovae at cosmological distances is being undertaken in an attempt to exploit their standard candle property to constrain the mass density of the universe. We describe the rationale for such a program, the observational approach and strategy taken, and the progress made to date. The science that is being generated by the project in additional to supernova detection is also discussed briefly.
Immunoglobulin A (IgA) is a predominant immunoglobulin present in human breast milk and is known to play an important role in infant gut immunity maturation. Breast milk composition varies between populations, but the environmental and maternal factors responsible for these variations are still unclear. We examined the relationship between different exposures and levels of IgA in colostrum. The objective of this study was to examine whether exposures analysed influence levels of IgA in colostrum. The present study used 294 colostrum samples from the MecMilk International cohort, collected from women residing in London, Moscow and Verona. Samples were analysed in automated Abbott Architect Analyser. We found an inverse correlation between time postpartum and colostrum total IgA level (r=−0.49, P<0.001). Adjusting for maternal parity, smoking, fresh fruit and fish consumption and allergen sensitization, multiple regression model showed that IgA levels were influenced by colostrum collection time (P<0.0001) and country of collection (P<0.01). Mode of delivery influence did not appear to be significant in univariate comparisons, once adjusted for the above maternal characteristics it showed a significant influence on total IgA (P=0.01). We conclude that the concentration of IgA in colostrum drops rapidly after birth and future studies should always consider this factor in analysis. IgA concentration varied significantly between countries, with the highest level detected in Moscow and lowest in Verona. Mode of delivery effect should be confirmed on larger cohorts. Further work is needed to determine ways to correct for IgA decline over time in colostrum, and to find the cause of variations in IgA levels between the countries.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
Merben R. Cebrian, USDOI Bureau of Land Management,
Rodel M. Boyles, Department of Environment and Natural Resources, regional office IVB (MIMAROPA), Philippines,
Josefina L. de Leon, Department of Environment and Natural Resources, Philippines,
James Burton, Senior Research Manager (Oman) at Earthwatch Institute
Names in other languages: French: Tamarau, Tamarao; German: Mindoro-Büffel; Spanish: Tamarao, Búfalo de Mindoro; Italian: Tamaraw
Other common names: Mindoro dwarf buffalo.
Bubalus mindorensis Heude (1888), type specimen Mindoro Island, Philippines. Despite early debates on its proper taxonomic classification (Everett 1878; Meyer 1878; Bartlett 1878), the tamaraw is classified as a distinct species within the genus Bubalus based on morphological characteristics (Groves 1969; Custodio et al. 1996; Braun et al. 2002; Wilson & Reeder 2005) and genetic analyses (Namikawa et al. 1995; Tanaka et al. 1996, 2000). Steere (1888a) also independently described the tamaraw, placing it in the genus Anoa, but was superseded by Heude (1888). Heude’s type specimen was lost and then rediscovered (Braun et al. 2002) in Xujiahui, China, in the Shanghai Natural History Museum, which acquired the museum Heude founded (Zikawei Museum of Natural History).
Subspecies and distribution
The tamaraw is endemic to the island of Mindoro, Philippines (Plate 9; Heaney et al. 1987; Custodio et al. 1996). Thought to be previously widely distributed in Mindoro (Everett 1878; Steere 1888b, 1891), by 1949 there appears to have been fewer than 1000 animals left on the island, with an estimated 244 in Occidental Mindoro (Manuel 1957) in at least three areas (Harrisson 1969a). By 2007 the three areas where tamaraw are now thought to remain are in Mounts Iglit-Baco National Park (MIBNP), the Mount Calavite Wildlife Sanctuary and the Aruyan-Malati area (R. M. Boyles, unpublished; J. de Leon, unpublished).
The Critically Endangered tamaraw Bubalus mindorensis is endemic to Mindoro Island, Philippines, and little is known of its ecology. During 2006–2011 we used community-based monitoring to examine the population status and ecology of tamaraw in the species’ core habitat of Mount Iglit–Baco National Park. Each year, for 5 consecutive days at the end of the dry season, trained local volunteers and rangers or project staff were allocated to 18 vantage points in the study area (c. 160 km2). Tamaraw were categorized as adult (> 5 years), juvenile (2–5 years) or calf (< 2 years), and sexed when possible. During the study period the population was 239–314 (mean 271), with no significant fluctuations in age structure (percentage of adults, juveniles and calves: 57.8, 21.0 and 21.3%) or estimated adult female reproductive rates (29.1%). In adults, but not in juveniles, the sex ratio was biased towards females (1 : 1.86, P < 0.01). Bulls were often solitary (32.2% of sightings), whereas the majority of cows (94.7%) formed small groups of 2–12 individuals of different ages, with or without bulls (53.4 and 46.6%, respectively). These results demonstrate that the population remained relatively stable, maintaining a constant age structure and reproductive rate, and that long-term community-based monitoring was effective for quantitative characterization of the tamaraw's social behaviour, which is critical for conservation and management of the species.
The new photometric observations of PG 2303+243 were obtained in 2012 during a campaign carried out with three telescopes. The analysis of these observations is presented in this paper. We identified l = 1 and l = 2 pulsation modes. The pulsation periods were compared with theoretical ones for models of ZZ Ceti stars. This allowed us to estimate the physical parameters of PG 2303+243. The star seems to be cooler and has thicker hydrogen layer than it was thought before. We have derived M*/M⊙ = 0.66, Teff = 11014 K and log(MH/M*)=−4.246 for this star.
On June 13, 2012, a group of key stakeholders, leaders, and national experts on tuberculosis (TB), occupational health, and laboratory science met in Atlanta, Georgia, to focus national discussion on the higher than expected positive results occurring among low-risk, unexposed healthcare workers undergoing serial testing with interferon-γ release assays (IGRAs). The objectives of the meeting were to present the latest clinical and operational research findings on the topic, to discuss evaluation and treatment algorithms that are emerging in the absence of national guidance, and to develop a consensus on the action steps needed to assist programs and physicians in the interpretation of serial testing IGRA results. This report summarizes its proceedings.
The Neotropics house two guilds of large arboreal vertebrate seed predators: parrots and the pitheciin primates. Both have diets dominated by immature fruits. The possibility of members of the Pitheciinae (genera Cacajao, Chiropotes and Pithecia) acting as occasional seed dispersers has been mooted, but not experimentally shown. We combined primate behavioural data and seed germination data from three separate field studies in the Brazilian states of Amazonas and Pará to analyse patterns of post-consumption seed survivorship for seeds discarded by three pitheciin species (Cacajao melanocephalus ouakary, Chiropotes chiropotes and Chiropotes albinasus). We then calculated the frequency of dispersal events for four species eaten by C. m. ouakary. All three primate species dropped intact seeds while feeding, and 30.7% of 674 dropped seeds germinated ex situ. Undamaged seeds from unripe and ripe samples germinated (29.3% and 42.7%, respectively), and all three primate species carried some fruits up to 20 m from the parent tree before consuming them. Potential seed-dispersal events varied from 1 (Macrolobium acaciifolium) per fruiting cycle to more than 6500 (Duroia velutina), suggesting that there are differences in dispersal potential. In summary, although they are highly specialized seed predators, these primates may also act as important dispersers for some plant species, and effective dispersal is not restricted to ripe fruits, as immature fruits removed from a tree may continue to mature and the seeds later germinate, a much-neglected aspect of dispersal ecology. The possibility that similar events occur in parrots should be experimentally investigated.
Decision making is a significant activity within industry and although much attention has been paid to the manner in which goals impact on how decision making is executed, there has been less focus on the impact decision making resources can have. This article describes an experiment that sought to provide greater insight into the impact that resources can have on how decision making is executed. Investigated variables included the experience levels of decision makers and the quality and availability of information resources. The experiment provided insights into the variety of impacts that resources can have upon decision making, manifested through the evolution of the approaches, methods, and processes used within it. The findings illustrated that there could be an impact on the decision-making process but not on the method or approach, the method and process but not the approach, or the approach, method, and process. In addition, resources were observed to have multiple impacts, which can emerge in different timescales. Given these findings, research is suggested into the development of resource-impact models that would describe the relationships existing between the decision-making activity and resources, together with the development of techniques for reasoning using these models. This would enhance the development of systems that could offer improved levels of decision support through managing the impact of resources on decision making.
Adults with intellectual disabilities experience high rates of obesity. Despite this higher risk, there is little evidence on the effectiveness of weight-loss interventions for adults with intellectual disabilities and obesity. The present study examined the effectiveness of the TAKE 5 multi-component weight-loss intervention. Adults with obesity were invited using specialist intellectual disability services to participate in the study. Obesity was defined as a BMI of 30 kg/m2 or greater. TAKE 5 included a daily energy-deficit diet of 2510 kJ (600 kcal), achieved via a personalised dietary prescription. Participants' body weight, BMI, waist circumference and levels of physical activity and sedentary behaviour were measured before and after the intervention. A total of fifty-four individuals consented to participate, of which forty-seven (87 %) completed the intervention in the study period. There was a significant decrease in body weight (mean difference − 4·47 (95 % CI − 5·91, − 3·03) kg; P < 0·0001), BMI ( − 1·82 (95 % CI − 2·36, − 1·29) kg/m2; P < 0·0001), waist circumference ( − 6·29 (95 % CI − 7·85, − 4·73) cm; P < 0·0001) and daily sedentary behaviour of participants ( − 41·40 (95 % CI − 62·45, − 20·35) min; P = 0·00 034). Of the participants who completed the intervention, seventeen (36·2 %) lost 5 % or more of their initial body weight. Findings from the study suggest that TAKE 5 is an effective weight-loss intervention for adults with intellectual disabilities and obesity. The effectiveness of TAKE 5 should be examined further in a controlled study.