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A mass gathering medicine training program was established for a 7,200-seat arena. The objectives of this study were to describe the program schema and determine its impact in preparing novice emergency medical technicians (EMTs) to manage the difficulties of large-venue emergency medical services (EMS).
Optional, anonymous surveys were administered to EMTs. Novice EMTs were assessed pre-/post-program implementation, and both novice and experienced EMTs completed self-reported Likert scales. Data were analyzed with nonparametric methods.
A total of 43/56 responses (response rate = 76.8%) were received. Only 37.2% of providers felt prepared to work mass gatherings before the training, and 60.5% stated that their previous education did not prepare them for large-venue challenges. After the training program, novice EMTs were significantly associated with increased knowledge of large-venue EMS procedures (P = 0.0170), higher proficiency using extrication equipment (P = 0.0248), increased patient care skills (P = 0.0438), and both increased confidence working events (P = 0.0002) and better teamwork during patient encounters (P = 0.0001). The majority of EMTs reported the program as beneficial.
Upon hire, EMS providers felt unprepared to work large-venue EMS. The analyses demonstrated that this training program improved select large-venue emergency skills for prehospital providers and may fill a gap in the education system regarding mass gathering medicine.
This chapter synthesises insights from the Deep Decarbonisation Pathways Project (DDPP), which provided detailed analysis of how 16 countries representing three-quarters of global emissions can transition to very low-carbon economies. The four ‘pillars’ of decarbonisation are identified as: achieving low or zero-carbon electricity supply; electrification and fuel switching in transport, industry and housing; ambitious energy efficiency improvements; and reducing non-energy emissions. The chapter focuses on decarbonisation scenarios for Australia. It shows that electricity supply can be readily decarbonised and greatly expanded to cater for electrification of transport, industry and buildings. There would be remaining emissions principally from industry and agriculture, these could be fully compensated through land-based carbon sequestration. The analysis shows that such decarbonisation would be consistent with continued growth in GDP and trade, and would require very little change in economic structure of Australia’s economy. Australia is rich in renewable energy potential, which could re-enable new industries such as energy-intensive manufacturing for export
Research in developmental psychology suggests that children are poor tool innovators. However, such research often overlooks the ways in which children's social and physical environments may lead to cross-cultural variation in their opportunities and proclivity to innovate. In this paper, we examine contemporary hunter–gatherer child and adolescent contributions to tool innovation. We posit that the cultural and subsistence context of many hunter–gatherer societies fosters behavioural flexibility, including innovative capabilities. Using the ethnographic and developmental literature, we suggest that socialisation practices emphasised in hunter–gatherer societies, including learning through autonomous exploration, adult and peer teaching, play and innovation seeking may bolster children's ability to innovate. We also discuss whether similar socialisation practices can be interpreted from the archaeological record. We end by pointing to areas of future study for understanding the role of children and adolescents in the development of tool innovations across cultures in the past and present.
Efforts to reduce Clostridioides difficile infection (CDI) have targeted transmission from patients with symptomatic C. difficile. However, many patients with the C. difficile organism are carriers without symptoms who may serve as reservoirs for spread of infection and may be at risk for progression to symptomatic C. difficile. To estimate the prevalence of C. difficile carriage and determine the risk and speed of progression to symptomatic C. difficile among carriers, we established a pilot screening program in a large urban hospital.
Prospective cohort study.
An 800-bed, tertiary-care, academic medical center in the Bronx, New York.
A sample of admitted adults without diarrhea, with oversampling of nursing facility patients.
Perirectal swabs were tested by polymerase chain reaction for C. difficile within 24 hours of admission, and patients were followed for progression to symptomatic C. difficile. Development of symptomatic C. difficile was compared among C. difficile carriers and noncarriers using a Cox proportional hazards model.
Of the 220 subjects, 21 (9.6%) were C. difficile carriers, including 10.2% of the nursing facility residents and 7.7% of the community residents (P = .60). Among the 21 C. difficile carriers, 8 (38.1%) progressed to symptomatic C. difficile, but only 4 (2.0%) of the 199 noncarriers progressed to symptomatic C. difficile (hazard ratio, 23.9; 95% CI, 7.2–79.6; P < .0001).
Asymptomatic carriage of C. difficile is prevalent among admitted patients and confers a significant risk of progression to symptomatic CDI. Screening for asymptomatic carriers may represent an opportunity to reduce CDI.
Uncontrolled bleeding is a leading cause of preventable death in trauma. The “Stop the Bleed” campaign has trained over 130,000 lay people in the US to act to control bleeding. Current hemorrhage control courses, the most well-known being the American College of Surgeon’s Basic Bleeding Control (ACS B-con) course, require in-person training. Scaling this course nationwide is time and resource intensive. Furthermore, groups have advocated that young people, who are disproportionately affected by physical trauma, be universally trained in hemorrhage control.
Compare the effectiveness of teaching the ACS B-con course to high school (HS) students utilizing three different delivery mechanisms: in-person live, video-recorded, and virtual-live training.
432 students (aged 15-18) will be recruited from two HS settings: 300 from a local HS and 132 from a national online HS platform. Local HS students will be randomized into two arms: a control arm (in-person live training) and virtual training through a pre-recorded lecture. Online HS students will undergo virtual-live training. The primary outcome is correct tourniquet application following training. Secondary outcomes are the acquisition of personal resilience-associated traits using a validated instrument, motivation for further training, and perception of the importance of live training. Tourniquet application data will be assessed using a non-inferiority design using two pairwise comparisons of the intervention arms to the control (in-person). Pre- to post-training survey data will be assessed using paired univariates tests. Sub-analysis of the impact of demographic variables on these relationships will be assessed.
In addition to integration of cardiopulmonary resuscitation courses into HS curricula, there is momentum to develop effective programs to educate HS students to provide care for the injured and control bleeding before first responders arrive. This trial will help determine the most effective delivery mechanism to teach a hemorrhage control course to HS students at scale.
This chapter explores the interface between co-produced research and community development, drawing on work undertaken in North East England as part of the Imagine project. Discussion of the process and outcomes of Imagine North East provides fruitful material for contributing to perennial debates about whether certain forms of co-produced research (especially participatory action research) are, in fact, indistinguishable from community development. In this chapter we offer a brief overview of the work of Imagine North East before outlining the debates about the relationship between co-production and community development. We then examine three elements of Imagine North East: (1) an academic-led study of community development from the 1970s to the present; (2) a series of community development projects undertaken by local community-based organisations; and (3) a joint process of reflection and co-inquiry. We consider the role of co-produced research in challenging stigma, celebrating place and developing skills and community networks, and also the challenges of a co-inquiry approach.
Exploring community development from the outside and inside: The work of Imagine North East
Imagine North East was a partnership between 12 community-based organisations in Tyneside (including a local museum) and Durham University, officially running during 2014 and 2015, with dissemination and reflection work continuing in 2016. Community development featured in several ways. Not only did community-based sub-projects use processes of community development (mobilising people to work together) and generate community development outcomes (for example, strengthened communities, improved facilities) in their work for Imagine North East, but our study also had community development as its main focus. We adopted three approaches to the study of community development, as outlined below:
1. Studying community development from the outside: The starting point of the research was the community development projects of the 1970s in Benwell (Newcastle-upon-Tyne) and North Shields. These were part of Britain's first anti-poverty programme, combining community development work and research with a view to diagnosing and alleviating poverty locally (Loney, 1983; Banks and Carpenter, 2017). We also looked at community development processes over time (from the 1970s to the present) as these areas were subject to numerous regeneration schemes in which local people were more or less engaged. This research was largely done by academic researchers and then shared in the wider group.
Visual data are transforming the documentation of activities across many legal domains. Visual data can incriminate or exonerate; they can shape and reshape public opinion. Visual evidence can legitimize certain accounts of events while calling others into question. The proliferation of visual data creates challenges for the law at multiple points of entry: recording, distribution or disclosure, redaction or deletion, or use as evidence. This symposium outlines and analyzes legal challenges posed by recent developments in visual data technologies and practices. This introductory essay and the articles that follow highlight legal issues that arise when state actors collect visual data and when visual data are used in legal disputes. Technological development is outpacing empirical research on, and legal regulation of, visual data within society and inside the courtroom. This symposium provides a much-needed opportunity to highlight new legal and empirical research at the intersection of visual data and law.
Sarah Warshauer Freedman, Professor of Education and Research Fellow of the Human Rights Center, The University of California, Berkeley, USA,
Dinka Corkalo, Assistant Professor in the Department of Psychology, Faculty of Philosophy, The University of Zagreb, Croatia,
Naomi Levy, Graduate student in the Department of Political Science, University of California, Berkeley, USA,
Dino Abazovic, Member of the Faculty of Political Sciences and Director of the Center for Human Rights, University of Sarajevo, Bosnia and Herzegovina,
Bronwyn Leebaw, Assistant Professor in the Department of Political Science, University of California, Riverside, USA,
Dean Ajdukovic, Professor of Psychology and Director of the Postgraduate Psychology Program, University of Zagreb, Croatia,
Dino Djipa, Research Director of Prism Research, Sarajevo, Bosnia and Herzegovina,
Harvey M. Weinstein, Associate Director of the Human Rights Center and Clinical Professor of Public Health, University of California, Berkeley, USA
Throughout history, governments of all political stripes have used history and literature curricula to reinforce national ideologies and identities. The promulgation of official memory through the school system can be an effective form of propaganda. The educational setting can become a conduit for the government or leaders' views, presenting political ideas and beliefs as either “correct” or “incorrect.” Textbooks and curricula can be used to justify or deny past state crimes, create revisionist history, present on-going injustices as natural, or perpetuate attitudes that replicate the conditions under which injustices are committed. Where school systems remain segregated and unequal, education can be manipulated to perpetuate inequalities that are a legacy of past conflicts, dispossession, or repression.
If public education can function to inflame hatreds, mobilize for war, and teach acceptance of injustice, it can be used also as a powerful tool for the cultivation of peace, democratic change, and respect for others. This premise has been a prominent focus of the United Nations (UN) Office of the High Representative (OHR) in Bosnia and Herzegovina (BiH), as well as numerous non-governmental organizations (NGOs) throughout the Balkans and in conflict zones around the world. If children living in divided societies can come together in the schools, this contact can be used to help them question the prejudices and stereotypes in their surrounding environment.
It has been suggested that twinning may influence handedness through the effects of birth order, intra-uterine crowding and mirror imaging. The influence of these effects on handedness (for writing and throwing) was examined in 3657 Monozygotic (MZ) and 3762 Dizygotic (DZ) twin pairs (born 1893–1992). Maximum likelihood analyses revealed no effects of birth order on the incidence of left-handedness. Twins were no more likely to be left-handed than their singleton siblings (n = 1757), and there were no differences between the DZ co-twin and siblingtwin covariances, suggesting that neither intra-uterine crowding nor the experience of being a twin affects handedness. There was no evidence of mirror imaging; the co-twin correlations of monochorionic and dichorionic MZ twins did not differ. Univariate genetic analyses revealed common environmental factors to be the most parsimonious explanation of familial aggregation for the writing-hand measure, while additive genetic influences provided a better interpretation of the throwing hand data.
Recent publications have suggested that practising cognitive therapy (CT) techniques on oneself may be
valuable in the development of cognitive therapists' clinical skills. The present study asks: Is this useful? If so, in
what ways? We report a qualitative study of the experience of trainees undertaking a CT training course, which
included an explicit self-practice (SP) and self-reflection (SR) component. Key features of the learning process were:
(i) experiencing cognitive techniques from the client's perspective, and (ii) reflecting on this experience that led to
(iii) a “deeper sense of knowing” of CT practices. The primary learning outcome was an enhancement of therapeutic
understandings, which trainees reported to be both professionally and personally useful. Professionally, they reported
deeper understanding of the therapist's role, the cognitive model and change processes. Personally, SP/SR led to
greater understanding of themselves, and to the perception of CT as a useful tool for personal change. The data also
suggested two other positive learning outcomes: an enhancement of therapist skills and therapist self-concept. We
conclude that SP/SR may be a valuable component in CT training. Guidelines and recommendations for inclusion of
SP/SR in training courses are discussed.
In Experiment 1, 42 multilinguals were able to maintain native language writing quality and
fluency in the presence of unattended irrelevant speech while maintaining a concurrent 6-digit
memory load. In Experiment 2, 80 bilinguals reduced fluency during writing with the 6-digit load
only. In previous research, over 100 monolinguals of comparable verbal and nonverbal skills in
three experiments reduced quality and fluency under both secondary tasks (Ransdell, Levy, &
Kellogg, 1996). The results are interpreted in terms of a bilingual skill advantage in suppressing
irrelevant information. Possessing fluency in another language may confer long-term working
memory benefits during dual-task language conditions for bilinguals and even more so for
Nanometer sized gold patterns were produced with controlled spacings using the combination of a top-down (e-beam lithography) and a bottom-up (macromolecular chemistry) technique. Sub-10 nm nanoparticle arrays on silicon consisting of gold nano particles separated by micro meter spacings were fabricated with this approach. Using electron beam lithography, templates comprising of 150 nm to 1 μm sized trenches, holes and aperiodic patterns were made in an electron-beam resist. Block copolymer micelles were then patterned into this template by spincoating. The micelles acted as positioners for a nanometer sized gold precursor that is sequestered within its core. Subsequent removal of the resist layer left an array of Au loaded organic micelles ordered according to the pattern of the template. Exposure of this substrate to a hydrogen plasma removed the organic block copolymer and resulted in an array of sub-10 nm gold nanoparticles/nanoclusters with micron separations. The gold was then used as an anchor point for the tethering of functional molecules in order to localize fluorescent molecules.
This paper concerns certain questions which arose during the analysis of a trial showing positive effects of tacrine in Alzheimer's disease. Cognitive improvement occurred during the first two weeks, reached a maximum at one month and was maintained during the rest of the three-month treatment period. Rebound effects were not detected in any of the key outcome variables, but were suggested by one of the supporting cognitive tests and other measures. Practice effects occurred on tests which were repeated at short intervals or too frequently. The paper discusses the significance of these findings for the interpretation of other trials and for practical management.
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