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67 results

Page 1 of 4

  • Developing a Lay First Responder Program in Chad: A 12-Month Follow-Up Evaluation of a Rural Prehospital Emergency Care Program

  • Canaan J. Hancock, Peter G. Delaney, Zachary J. Eisner, Eric Kroner, Issa Mahamet-Nuur, John W. Scott, Krishnan Raghavendran
  • Journal:
    Prehospital and Disaster Medicine / Volume 35 / Issue 5 / October 2020
    Published online by Cambridge University Press:
    29 July 2020, pp. 546-553
    Print publication:
    October 2020
  • Introduction:

    The World Health Organization (WHO; Geneva, Switzerland) recommends lay first responder (LFR) programs as a first step toward establishing formal Emergency Medical Services (EMS) in low- and middle-income countries (LMICs) to address injury. There is a scarcity of research investigating LFR program development in predominantly rural settings of LMICs.

    Study Objective:

    A pilot LFR program was launched and assessed over 12 months to investigate the feasibility of leveraging pre-existing transportation providers to scale up prehospital emergency care in rural, low-resource settings of LMICs.

    Methods:

    An LFR program was established in rural Chad to evaluate curriculum efficacy, using a validated 15-question pre-/post-test to measure participant knowledge improvement. Pre-/post-test score distributions were compared using a Wilcoxon Signed-Rank test. For test evaluation, each pre-test question was mapped to its corresponding post-test analog and compared using McNemar’s Chi-Squared Test to examine knowledge acquisition on a by-question basis. Longitudinal prehospital care was evaluated with incident reports, while program cost was tracked using a one-way sensitivity analysis. Qualitative follow-up surveys and semi-interviews were conducted at 12 months, with initial participants and randomly sampled motorcycle taxi drivers, and used a constructivist grounded theory approach to understand the factors motivating continued voluntary participation to inform future program continuity. The consolidated criteria for reporting qualitative research (COREQ) checklist was used to guide design, analysis, and reporting the qualitative results.

    Results:

    A total of 108 motorcycle taxi participants demonstrated significant knowledge improvement (P <.001) across three of four curricular categories: scene safety, airway and breathing, and bleeding control. Lay first responders treated 71 patients over six months, encountering five deaths, and provided patient transport in 82% of encounters. Lay first responders reported an average confidence score of 8.53/10 (n = 38). In qualitative follow-up surveys and semi-structured interviews, the ability to care for the injured, new knowledge/skills, and the resultant gain in social status and customer acquisition motivated continued involvement as LFRs. Ninety-six percent of untrained, randomly sampled motorcycle taxi drivers reported they would be willing to pay to participate in future training courses.

    Conclusion:

    Lay first responder programs appear feasible and cost-effective in rural LMIC settings. Participants demonstrate significant knowledge acquisition, and after 12 months of providing emergency care, report sustained voluntary participation due to social and financial benefits, suggesting sustainability and scalability of LFR programs in low-resource settings.

  • Early survival following in utero myocardial infarction

  • Peter Cosgrove, Shan Modi, Karla Lawson, Camille Hancock-Friesen, Gregory Johnson
  • Journal:
    Cardiology in the Young / Volume 28 / Issue 10 / October 2018
    Published online by Cambridge University Press:
    23 July 2018, pp. 1079-1087

  • Intrauterine myocardial infarction is a rare and frequently fatal diagnosis. It has been presented in the literature only as case reports and short series. We present a case report of a coronary occlusive intrauterine myocardial infarction and survival and present a systematic review of the literature. This is the first summative description of current data on intrauterine and perinatal myocardial infarction. We performed the systematic review based on the guidelines established by the PRISMA statement. Our population of intrauterine and perinatal myocardial infarction included published cases who presented as a live birth within the first 28 postnatal days, and had a diagnosis of myocardial infarction. We conducted descriptive statistics and regression analysis on short-term mortality as the primary outcome. After applying exclusion criteria we described 84 individual cases of myocardial infarction from 63 full-text articles including our own case. Presentation within the first 12 hours was associated with mortality (OR 3.90, p=0.004). Treatment modalities were varied and inconsistently recorded. The aetiologies and comorbidities are varied in our systematic review. We would have a low threshold to perform viral testing, consider anticoagulation early and coronary imaging if feasible. The use of extracorporeal membranous oxygenation may serve as a bridge to cardiac recovery.

  • Indexed containers

  • Part of
  • THORSTEN ALTENKIRCH, NEIL GHANI, PETER HANCOCK, CONOR MCBRIDE, PETER MORRIS
  • Journal:
    Journal of Functional Programming / Volume 25 / 2015
    Published online by Cambridge University Press:
    20 May 2015, e5
    • Article
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  • We show that the syntactically rich notion of strictly positive families can be reduced to a core type theory with a fixed number of type constructors exploiting the novel notion of indexed containers. As a result, we show indexed containers provide normal forms for strictly positive families in much the same way that containers provide normal forms for strictly positive types. Interestingly, this step from containers to indexed containers is achieved without having to extend the core type theory. Most of the construction presented here has been formalized using the Agda system.

The Cambridge Handbook of Applied Perception Research
  • Edited by Robert R. Hoffman, Peter A. Hancock, Mark W. Scerbo, Raja Parasuraman, James L. Szalma
  • Published online:
    05 July 2015
    Print publication:
    26 January 2015
  • The Cambridge Handbook of Applied Perception Research covers core areas of research in perception with an emphasis on its application to real-world environments. Topics include multisensory processing of information, time perception, sustained attention, and signal detection, as well as pedagogical issues surrounding the training of applied perception researchers. In addition to familiar topics, such as perceptual learning, the Handbook focuses on emerging areas of importance, such as human-robot coordination, haptic interfaces, and issues facing societies in the twenty-first century (such as terrorism and threat detection, medical errors, and the broader implications of automation). Organized into sections representing major areas of theoretical and practical importance for the application of perception psychology to human performance and the design and operation of human-technology interdependence, it also addresses the challenges to basic research, including the problem of quantifying information, defining cognitive resources, and theoretical advances in the nature of attention and perceptual processes.

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