Audit report on Jones County, Iowa for the year ended June 30, 2006

Audit report on Jones County, Iowa for the year ended June 30, 2006

Introducing systematic dispatcher-assisted cardiopulmonary resuscitation (telephone-CPR) in a non-Advanced Medical Priority Dispatch System (AMPDS): implementation process and costs.

OBJECTIVE: In order to improve the quality of our Emergency Medical Services (EMS), to raise bystander cardiopulmonary resuscitation rates and thereby meet what is becoming a universal standard in terms of quality of emergency services, we decided to implement systematic dispatcher-assisted or telephone-CPR (T-CPR) in our medical dispatch center, a non-Advanced Medical Priority Dispatch System. The aim of this article is to describe the implementation process, costs and results following the introduction of this new "quality" procedure. METHODS: This was a prospective study. Over an 8-week period, our EMS dispatchers were given new procedures to provide T-CPR. We then collected data on all non-traumatic cardiac arrests within our state (Vaud, Switzerland) for the following 12months. For each event, the dispatchers had to record in writing the reason they either ruled out cardiac arrest (CA) or did not propose T-CPR in the event they did suspect CA. All emergency call recordings were reviewed by the medical director of the EMS. The analysis of the recordings and the dispatchers' written explanations were then compared. RESULTS: During the 12-month study period, a total of 497 patients (both adults and children) were identified as having a non-traumatic cardiac arrest. Out of this total, 203 cases were excluded and 294 cases were eligible for T-CPR. Out of these eligible cases, dispatchers proposed T-CPR on 202 occasions (or 69% of eligible cases). They also erroneously proposed T-CPR on 17 occasions when a CA was wrongly identified (false positive). This represents 7.8% of all T-CPR. No costs were incurred to implement our study protocol and procedures. CONCLUSIONS: This study demonstrates it is possible, using a brief campaign of sensitization but without any specific training, to implement systematic dispatcher-assisted cardiopulmonary resuscitation in a non-Advanced Medical Priority Dispatch System such as our EMS that had no prior experience with systematic T-CPR. The results in terms of T-CPR delivery rate and false positive are similar to those found in previous studies. We found our results satisfying the given short time frame of this study. Our results demonstrate that it is possible to improve the quality of emergency services at moderate or even no additional costs and this should be of interest to all EMS that do not presently benefit from using T-CPR procedures. EMS that currently do not offer T-CPR should consider implementing this technique as soon as possible, and we expect our experience may provide answers to those planning to incorporate T-CPR in their daily practice.

Audit report on the Jones County Solid Waste Management Commission for the year ended June 30, 2007

Audit report on the Jones County Solid Waste Management Commission for the year ended June 30, 2007

Audit report on Jones County, Iowa for the year ended June 30, 2007

Audit report on Jones County, Iowa for the year ended June 30, 2007

Ocorrência do fungo entomopatogênico Isaria javanica (Frieder. & Bally) Samson & Hywell-Jones (Fungi, Sordariomycetes) em lagartas de Lonomia obliqua Walker (Lepidoptera, Saturniidae, Hemileucinae)

Este fungo foi isolado pela primeira vez de lagartas de L. obliqua de uma agregação em plátano (Platanus acerifolia (Aiton) Wild - Platanaceae), em Bento Gonçalves, RS, Brasil. Após isolamento, purificação e caracterização, realizou-se um teste de patogenicidade com lagartas sadias de L. obliqua para corroborar, sua infectividade pelo postulado de Koch. Constatou-se correspondência morfológica e molecular entre o inóculo e o reisolado, comprovando sua patogenicidade a L. obliqua.

Serum procalcitonin as a marker of post-cardiac arrest syndrome and long-term neurological recovery, but not of early-onset infections, in comatose post-anoxic patients treated with therapeutic hypothermia.

OBJECTIVE: To examine the relationship of early serum procalcitonin (PCT) levels with the severity of post-cardiac arrest syndrome (PCAS), long-term neurological recovery and the risk of early-onset infections in patients with coma after cardiac arrest (CA) treated with therapeutic hypothermia (TH). METHODS: A prospective cohort of adult comatose CA patients treated with TH (33°C, for 24h) admitted to the medical/surgical intensive care unit, Lausanne University Hospital, was studied. Serum PCT was measured early after CA, at two time-points (days 1 and 2). The SOFA score was used to quantify the severity of PCAS. Diagnosis of early-onset infections (within the first 7 days of ICU stay) was made after review of clinical, radiological and microbiological data. Neurological recovery at 3 months was assessed with Cerebral Performance Categories (CPC), and was dichotomized as favorable (CPC 1-2) vs. unfavorable (CPC 3-5). RESULTS: From December 2009 to April 2012, 100 patients (median age 64 [interquartile range 55-73] years, median time from collapse to ROSC 20 [11-30]min) were studied. Peak PCT correlated with SOFA score at day 1 (Spearman's R=0.44, p<0.0001) and was associated with neurological recovery at 3 months (peak PCT 1.08 [0.35-4.45]ng/ml in patients with CPC 1-2 vs. 3.07 [0.89-9.99] ng/ml in those with CPC 3-5, p=0.01). Peak PCT did not differ significantly between patients with early-onset vs. no infections (2.14 [0.49-6.74] vs. 1.53 [0.46-5.38]ng/ml, p=0.49). CONCLUSIONS: Early elevations of serum PCT levels correlate with the severity of PCAS and are associated with worse neurological recovery after CA and TH. In contrast, elevated serum PCT did not correlate with early-onset infections in this setting.

Vie de saint François de Sales : évêque et prince de Genève, 1567-1622 / par F. Valentin

Collection : Les petits livres de M. le curé

Audit report on Jones County, Iowa for the year ended June 30, 2008

Audit report on Jones County, Iowa for the year ended June 30, 2008

Audit report on the Jones County Solid Waste Management Commission for the year ended June 30, 2008

Audit report on the Jones County Solid Waste Management Commission for the year ended June 30, 2008

Tolerância de genótipos de cafeeiro ao alumínio em solução nutritiva. II. Teores de P, Ca e Al e eficiência ao P e Ca

Foi instalado um experimento, em janeiro de 1994, em casa de vegetação do Departamento de Fitotecnia da Universidade Federal de Viçosa, Estado de Minas Gerais. Com o objetivo de avaliar o efeito do alumínio nos teores de P, Ca e Al e na eficiência ao fósforo e cálcio de nove genótipos de café, as plantas foram crescidas em solução nutritiva com 0 e 0,296 mmol L-1 de alumínio, com pH 4,0, por um período de 115 dias. Após esse período, as plantas foram divididas em folhas superiores, folhas inferiores, primeiro par de folhas totalmente expandido, caule e raízes, para a determinação da matéria seca e de concentrações de fósforo, cálcio e alumínio. A tolerância ao alumínio foi associada ao menor acúmulo de fósforo nas raízes, à menor redução na translocação desse nutriente para a parte aérea, à menor redução na absorção de cálcio e à maior eficiência no uso do fósforo e do cálcio. Foi observado grande acúmulo de alumínio nas raízes, bem como um transporte restrito do elemento para a parte aérea, para todos os genótipos de café.

Chemical labelling of oyster shells used for time-calibrated high-resolution Mg/Ca ratios: A tool for estimation of past seasonal temperature variations

The geochemical compositions of biogenic carbonates are increasingly used for palaeoenvironmental reconstructions. The skeletal delta O-18 temperature relationship is dependent on water salinity, so many recent studies have focused on the Mg/Ca and Sr/Ca ratios because those ratios in water do not change significantly on short time scales. Thus, those elemental ratios are considered to be good palaeotemperature proxies in many biominerals, although their use remains ambiguous in bivalve shells. Here, we present the high-resolution Mg/Ca ratios of two modern species of juvenile and adult oyster shells, Crassostrea gigas and Ostrea edulis. These specimens were grown in controlled conditions for over one year in two different locations. In situ monthly Mn-marking of the shells has been used for day calibration. The daily Mg/Ca.ratios in the shell have been measured with an electron microprobe. The high frequency Mg/Ca variation of all specimens displays good synchronism with lunar cycles, suggesting that tides strongly influence the incorporation of Mg/Ca into the shells. Highly significant correlation coefficients (0.70<R<0.83, p<0.0001) between the Mg/Ca ratios and the seawater temperature are obtained only for juvenile C. gigas samples, while metabolic control of Mg/Ca incorporation and lower shell growth rates preclude the use of the Mg/Ca ratio in adult shells as a palaeothermometer. Data from three juvenile C. gigas shells from the two study sites are selected to establish a relationship: T = 3.77Mg/Ca + 1.88, where T is in degrees C and Mg/Ca in mmol/mol. (c) 2012 Elsevier B.V. All rights reserved.

Kauppias, kaupunki, kruunu : Turun porvariyhteisö ja talouden organisaatio varhaiskeskiajalta 1570-luvulle

Summary: The merchant, the town and the crown : the burgher community of Turku and economic organization from the early Middle Ages to the 1570's

Contribuição dos mecanismos de fluxo de massa e de difusão para o suprimento de K, Ca e Mg a plantas de arroz

O transporte de nutriente até à superfície das raízes pode ocorrer por fluxo de massa ou por fluxo de massa e difusão, dependendo da atividade do nutriente na solução do solo e da exigência nutricional da planta. Objetivou-se verificar a contribuição dos mecanismos de fluxo de massa e de difusão para o suprimento de potássio, de cálcio e de magnésio a plantas de arroz, em experimento realizado em casa de vegetação. Aplicaram-se em amostra de Latossolo Variação Una, os seguintes tratamentos: Na2CO3, K2CO3, CaCO3 e MgCO3. Aos 75 dias da semeadura, as plantas de arroz foram colhidas e determinadas as quantidades de potássio, de cálcio e de magnésio nelas acumuladas, bem como a concentração desses nutrientes na solução do solo. Essas concentrações, multiplicadas pelo volume de água transpirado, foram usadas para calcular o suprimento por fluxo de massa. A difusão foi estimada por diferença entre a quantidade do nutriente acumulado no vegetal e a transportada por fluxo de massa. Verificou-se que o potássio foi transportado predominantemente por difusão, exceto no tratamento com K2CO3, que gerou altos teores de K na solução de solo, tornando o fluxo de massa suficiente para atender à demanda das plantas. O cálcio e o magnésio foram transportados por fluxo de massa. Segundo os resultados, a difusão foi o principal mecanismo de transporte de potássio nas condições do experimento; todavia, o fluxo de massa pode satisfazer isoladamente a demanda nutricional da planta, quando a concentração de potássio na solução do solo for muito elevada.