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The COVID-19 pandemic has had a major impact on clinical practice. Safe standards of practice are essential to protect health care workers while still allowing them to provide good care. The Canadian Society of Clinical Neurophysiologists, the Canadian Association of Electroneurophysiology Technologists, the Association of Electromyography Technologists of Canada, the Board of Registration of Electromyography Technologists of Canada, and the Canadian Board of Registration of Electroencephalograph Technologists have combined to review current published literature about safe practices for neurophysiology laboratories. Herein, we present the results of our review and provide our expert opinion regarding the safe practice of neurophysiology during the COVID-19 pandemic in Canada.
Personal protective equipment (PPE) is worn by prehospital providers (PHPs) for protection from hazardous exposures. Evidence regarding the ability of PHPs to perform resuscitation procedures has been described in adult but not pediatric models. This study examined the effects of PPE on the ability of PHPs to perform resuscitation procedures on pediatric patients.
Methods:
This prospective study was conducted at a US simulation center. Paramedics wore normal attire at the baseline session and donned full Level B PPE for the second session. During each session, they performed timed sets of psychomotor tasks simulating clinical care of a critically ill pediatric patient. The difference in time to completion between baseline and PPE sessions per task was examined using Wilcoxon signed-rank tests.
Results:
A total of 50 paramedics completed both sessions. Median times for task completion at the PPE sessions increased significantly from baseline for several procedures: tracheal intubation (+4.5 s; P = 0.01), automated external defibrillator (AED) placement (+9.5 s; P = 0.01), intraosseous line insertion (+7 s; P < 0.0001), tourniquet (+8.5 s; P < 0.0001), intramuscular injection (+21-23 s, P < 0.0001), and pulse oximetry (+4 s; P < 0.0001). There was no significant increase in completion time for bag-mask ventilation or autoinjector use.
Conclusions:
PPE did not have a significant impact on PHPs performing critical tasks while caring for a pediatric patient with a highly infectious or chemical exposure. This information may guide PHPs faced with the situation of resuscitating children while wearing Level B PPE.
Trainees were encouraged to tell a mythological story to the class, lasting about ten minutes. They could use props and other visual aids if they wished, but the emphasis was for them to practise speaking before the class, using prompt cards if necessary, and employing all the techniques of a professional oral ‘poet’ – such as gesture, eye contact, tone of voice and so on. There is obviously considerable general interest among younger students about mythology. Locally, interest is captured by the Cambridge School Classics project which puts on an annual Ovid Mythology competition and the website War with Troy is used by several of the schools where trainees are placed. Its use as a stimulus for learning has been well-documented by its author and past PGCE subject lecturer Bob Lister (2005, 2007) and by Walker (2018), a former teacher trainee from the faculty. Some of the Latin textbooks such as Minimus (Bell, 1999) and Suburani (Hands-Up Education, 2020) contain myth episodes and are familiar to the teacher trainees. The GCSE and A Level qualifications often contain mythological subject matter. Khan-Evans (2018) has shown how older students of Classics have retained deep-rooted affection for mythological stories in their earlier schooldays. Research into the power of mythological storytelling as a stimulus for learning, creative arts and even therapy is current, as the Our Mythical Childhood project (2020) has demonstrated. A book of the project's work is eagerly anticipated next year. The recent Troy exhibition at the British Museum has also awoken considerable interest.
Experiments were performed within Sandia National Labs’ Multiphase Shock Tube to measure and quantify the shock-induced dispersal of a shock/dense particle curtain interaction. Following interaction with a planar travelling shock wave, schlieren imaging at 75 kHz was used to track the upstream and downstream edges of the curtain. Data were obtained for two particle diameter ranges (
$d_{p}=106{-}125$
,
$300{-}355~\unicode[STIX]{x03BC}\text{m}$
) across Mach numbers ranging from 1.24 to 2.02. Using these data, along with data compiled from the literature, the dispersion of a dense curtain was studied for multiple Mach numbers (1.2–2.6), particle sizes (
$100{-}1000~\unicode[STIX]{x03BC}\text{m}$
) and volume fractions (9–32 %). Data were non-dimensionalized according to two different scaling methods found within the literature, with time scales defined based on either particle propagation time or pressure ratio across a reflected shock. The data show that spreading of the particle curtain is a function of the volume fraction, with the effectiveness of each time scale based on the proximity of a given curtain’s volume fraction to the dilute mixture regime. It is seen that volume fraction corrections applied to a traditional particle propagation time scale result in the best collapse of the data between the two time scales tested here. In addition, a constant-thickness regime has been identified, which has not been noted within previous literature.
The development of the unsteady pressure field on the floor of a rectangular cavity was studied at Mach 0.9 using high-frequency pressure-sensitive paint. Power spectral amplitudes at each cavity resonance exhibit a spatial distribution with a streamwise-oscillatory pattern; additional maxima and minima appear as the mode number is increased. This spatial distribution also appears in the propagation velocity of modal pressure disturbances. This behaviour was tied to the superposition of a downstream-propagating shear-layer disturbance and an upstream-propagating acoustic wave of different amplitudes and convection velocities, consistent with the classical Rossiter model. The summation of these waves generates a net downstream-travelling wave whose amplitude and phase velocity are modulated by a fixed envelope within the cavity. This travelling-wave interpretation of the Rossiter model correctly predicts the instantaneous modal pressure behaviour in the cavity. Subtle spanwise variations in the modal pressure behaviour were also observed, which could be attributed to a shift in the resonance pattern as a result of spillage effects at the edges of the finite-width cavity.
The Lothagam harpoon site in north-west Kenya's Lake Turkana Basin provides a stratified Holocene sequence capturing changes in African fisher-hunter-gatherer strategies through a series of subtle and dramatic climate shifts (Figure 1). The site rose to archaeological prominence following Robbins's 1965–1966 excavations, which yielded sizeable lithic and ceramic assemblages and one of the largest collections of Early Holocene human remains from Eastern Africa (Robbins 1974; Angel et al. 1980).
South Africa is ready for a new vocabulary than can form the basis for a national consciousness which recognises racialised identities while affirming that, as human beings, we are much more than our racial, sexual, class, religious or national identities.The Colour of Our Future makes a bold and ambitious contribution to the discourse on race. It addresses the tension between the promise of a post-racial society and the persistence of racialised identities in South Africa, which has historically played itself out in debates between the ‘I don’t see race’ of non-racialism and the ‘I’m proud to be black’ of black consciousness. The chapters in this volume highlight the need for a race-transcendent vision that moves beyond ‘the festival of negatives’ embodied in concepts such as non-racialism, non-sexism, anti-colonialism and anti-apartheid. Steve Biko’s notion of a ‘joint culture’ is the scaffold on which this vision rests; it recognises that a race-transcendent society can only be built by acknowledging the constituent elements of South Africa’s EuroAfricanAsian heritage.The distinguished authors in this volume have, over the past two decades, used the democratic space to insert into the public domain new conversations around the intersections of race and the economy, race and the state, race and the environment, race and ethnic difference, and race and higher education. Presented here is some of their most trenchant and yet still evolving thinking.