Test of a smock system on CPR primary emergency measures and medical errors during simulated emergencies

Rates of survival of victims of sudden cardiac arrest (SCA) using cardio pulmonary resuscitation (CPR) have shown little improvement over the past three decades. Since registered nurses (RNs) comprise the largest group of healthcare providers in U.S. hospitals, it is essential that they are competent in performing the four primary measures (compression, ventilation, medication administration, and defibrillation) of CPR in order to improve survival rates of SCA patients. The purpose of this experimental study was to test a color-coded SMOCK system on: 1) time to implement emergency patient care measures 2) technical skills performance 3) number of medical errors, and 4) team performance during simulated CPR exercises. The study sample was 260 RNs (M 40 years, SD=11.6) with work experience as an RN (M 7.25 years, SD=9.42).Nurses were allocated to a control or intervention arm consisting of 20 groups of 5-8 RNs per arm for a total of 130 RNs in each arm. Nurses in each study arm were given clinical scenarios requiring emergency CPR. Nurses in the intervention group wore different color labeled aprons (smocks) indicating their role assignment (medications, ventilation, compression, defibrillation, etc) on the code team during CPR. Findings indicated that the intervention using color-labeled smocks for pre-assigned roles had a significant effect on the time nurses started compressions (t=3.03, p=0.005), ventilations (t=2.86, p=0.004) and defibrillations (t=2.00, p=.05) when compared to the controls using the standard of care. In performing technical skills, nurses in the intervention groups performed compressions and ventilations significantly better than those in the control groups. The control groups made significantly (t=-2.61, p=0.013) more total errors (7.55 SD 1.54) than the intervention group (5.60, SD 1.90). There were no significant differences in team performance measures between the groups. Study findings indicate use of colored labeled smocks during CPR emergencies resulted in: shorter times to start emergency CPR; reduced errors; more technical skills completed successfully; and no differences in team performance.

Quality Control Circles May Answer Industry's Needs

The concept of the quality control circle (QCC) has worked well in Japanese industry in increasing efficiency, production, and profits. The author explores the QCC, its history and advantages, and tells how it could be adapted quite easily and effectively to the hospitality industry

Answer the Fish: BFA Spring Exhibition 1990

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The Effect of Mobile Technology as an Active Student Response System on the Acquisition of U.S. History Content of Secondary Students with Specific Learning Disabilities

Students with specific learning disabilities (SLD) typically learn less history content than their peers without disabilities and show fewer learning gains. Even when they are provided with the same instructional strategies, many students with SLD struggle to grasp complex historical concepts and content area vocabulary. Many strategies involving technology have been used in the past to enhance learning for students with SLD in history classrooms. However, very few studies have explored the effectiveness of emerging mobile technology in K-12 history classrooms. This study investigated the effects of mobile devices (iPads) as an active student response (ASR) system on the acquisition of U.S. history content of middle school students with SLD. An alternating treatments single subject design was used to compare the effects of two interventions. There were two conditions and a series of pretest probesin this study. The conditions were: (a) direct instruction and studying from handwritten notes using the interactive notebook strategy and (b) direct instruction and studying using the Quizlet App on the iPad. There were three dependent variables in this study: (a) percent correct on tests, (b) rate of correct responses per minute, and (c) rate of errors per minute. A comparative analysis suggested that both interventions (studying from interactive notes and studying using Quizlet on the iPad) had varying degrees of effectiveness in increasing the learning gains of students with SLD. In most cases, both interventions were equally effective. During both interventions, all of the participants increased their percentage correct and increased their rate of correct responses. Most of the participants decreased their rate of errors. The results of this study suggest that teachers of students with SLD should consider a post lesson review in the form of mobile devices as an ASR system or studying from handwritten notes paired with existing evidence-based practices to facilitate students’ knowledge in U.S. history. Future research should focus on the use of other interactive applications on various mobile operating platforms, on other social studies subjects, and should explore various testing formats such as oral question-answer and multiple choice.

Effects of Repeated Readings on Reading Abilities of English Language Learners with Specific Learning Disabilities

This study investigated the effects of repeated readings on the reading abilities of 4, third-, fourth-, and fifth-grade English language learners (ELLs) with specific learning disabilities (SLD). A multiple baseline probe design across subjects was used to explore the effects of repeated readings on four dependent variables: reading fluency (words read correctly per minute; wpm), number of errors per minute (epm), types of errors per minute, and answer to literal comprehension questions. Data were collected and analyzed during baseline, intervention, generalization probes, and maintenance probes. Throughout the baseline and intervention phases, participants read a passage aloud and received error correction feedback. During baseline, this was followed by fluency and literal comprehension question assessments. During intervention, this was followed by two oral repeated readings of the passage. Then the fluency and literal comprehension question assessments were administered. Generalization probes followed approximately 25% of all sessions and consisted of a single reading of a new passage at the same readability level. Maintenance sessions occurred 2-, 4-, and 6-weeks after the intervention ended. The results of this study indicated that repeated readings had a positive effect on the reading abilities of ELLs with SLD. Participants read more wpm, made fewer epm, and answered more literal comprehension questions correctly. Additionally, on average, generalization scores were higher in intervention than in baseline. Maintenance scores were varied when compared to the last day of intervention, however, with the exception of the number of hesitations committed per minute maintenance scores were higher than baseline means. This study demonstrated that repeated readings improved the reading abilities of ELLs with SLD and that gains were generalized to untaught passages. Maintenance probes 2-, 4-, and 6- weeks following intervention indicated that mean reading fluency, errors per minute, and correct answers to literal comprehensive questions remained above baseline levels. Future research should investigate the use of repeated readings in ELLs with SLD at various stages of reading acquisition. Further, future investigations may examine how repeated readings can be integrated into classroom instruction and assessments.

Effective energy conservation and management in the building sector : the answer to the energy predicament

Modern civilization has developed principally through man's harnessing of forces. For centuries man had to rely on wind, water and animal force as principal sources of power. The advent of the industrial revolution, electrification and the development of new technologies led to the application of wood, coal, gas, petroleum, and uranium to fuel new industries, produce goods and means of transportation, and generate the electrical energy which has become such an integral part of our lives. The geometric growth in energy consumption, coupled with the world's unrestricted growth in population, has caused a disproportionate use of these limited natural resources. The resulting energy predicament could have serious consequences within the next half century unless we commit ourselves to the philosophy of effective energy conservation and management. National legislation, along with the initiative of private industry and growing interest in the private sector has played a major role in stimulating the adoption of energy-conserving laws, technologies, measures, and practices. It is a matter of serious concern in the United States, where ninety-five percent of the commercial and industrial facilities which will be standing in the year 2000 - many in need of retrofit - are currently in place. To conserve energy, it is crucial to first understand how a facility consumes energy, how its users' needs are met, and how all internal and external elements interrelate. To this purpose, the major thrust of this report will be to emphasize the need to develop an energy conservation plan that incorporates energy auditing and surveying techniques. Numerous energy-saving measures and practices will be presented ranging from simple no-cost opportunities to capital intensive investments.

A method for enhancing digital information displayed to computer users with visual refractive errors via spatial and spectral processing

This research pursued the conceptualization, implementation, and verification of a system that enhances digital information displayed on an LCD panel to users with visual refractive errors. The target user groups for this system are individuals who have moderate to severe visual aberrations for which conventional means of compensation, such as glasses or contact lenses, does not improve their vision. This research is based on a priori knowledge of the user's visual aberration, as measured by a wavefront analyzer. With this information it is possible to generate images that, when displayed to this user, will counteract his/her visual aberration. The method described in this dissertation advances the development of techniques for providing such compensation by integrating spatial information in the image as a means to eliminate some of the shortcomings inherent in using display devices such as monitors or LCD panels. Additionally, physiological considerations are discussed and integrated into the method for providing said compensation. In order to provide a realistic sense of the performance of the methods described, they were tested by mathematical simulation in software, as well as by using a single-lens high resolution CCD camera that models an aberrated eye, and finally with human subjects having various forms of visual aberrations. Experiments were conducted on these systems and the data collected from these experiments was evaluated using statistical analysis. The experimental results revealed that the pre-compensation method resulted in a statistically significant improvement in vision for all of the systems. Although significant, the improvement was not as large as expected for the human subject tests. Further analysis suggest that even under the controlled conditions employed for testing with human subjects, the characterization of the eye may be changing. This would require real-time monitoring of relevant variables (e.g. pupil diameter) and continuous adjustment in the pre-compensation process to yield maximum viewing enhancement.

Last Interglacial synthesis of high-latitude temperature: temperature anomalies and associated errors for 4 time slices

The Last Interglacial (LIG, 129-116 thousand of years BP, ka) represents a test bed for climate model feedbacks in warmer-than-present high latitude regions. However, mainly because aligning different palaeoclimatic archives and from different parts of the world is not trivial, a spatio-temporal picture of LIG temperature changes is difficult to obtain. Here, we have selected 47 polar ice core and sub-polar marine sediment records and developed a strategy to align them onto the recent AICC2012 ice core chronology. We provide the first compilation of high-latitude temperature changes across the LIG associated with a coherent temporal framework built between ice core and marine sediment records. Our new data synthesis highlights non-synchronous maximum temperature changes between the two hemispheres with the Southern Ocean and Antarctica records showing an early warming compared to North Atlantic records. We also observe warmer than present-day conditions that occur for a longer time period in southern high latitudes than in northern high latitudes. Finally, the amplitude of temperature changes at high northern latitudes is larger compared to high southern latitude temperature changes recorded at the onset and the demise of the LIG. We have also compiled four data-based time slices with temperature anomalies (compared to present-day conditions) at 115 ka, 120 ka, 125 ka and 130 ka and quantitatively estimated temperature uncertainties that include relative dating errors. This provides an improved benchmark for performing more robust model-data comparison. The surface temperature simulated by two General Circulation Models (CCSM3 and HadCM3) for 130 ka and 125 ka is compared to the corresponding time slice data synthesis. This comparison shows that the models predict warmer than present conditions earlier than documented in the North Atlantic, while neither model is able to produce the reconstructed early Southern Ocean and Antarctic warming. Our results highlight the importance of producing a sequence of time slices rather than one single time slice averaging the LIG climate conditions.

Um estudo sobre a variabilidade do vento no nordeste do Brasil através de métodos estatísticos e via modelos dinâmicos de meso e micro escala

The objective of this study was to determine the seasonal and interannual variability and calculate the trends of wind speed in NEB and then validate the mesoscale numerical model for after engage with the microscale numerical model in order to get the wind resource at some locations in the NEB. For this we use two data sets of wind speed (weather stations and anemometric towers) and two dynamic models; one of mesoscale and another of microscale. We use statistical tools to evaluate and validate the data obtained. The simulations of the dynamic mesoscale model were made using data assimilation methods (Newtonian Relaxation and Kalman filter). The main results show: (i) Five homogeneous groups of wind speed in the NEB with higher values in winter and spring and with lower in summer and fall; (ii) The interannual variability of the wind speed in some groups stood out with higher values; (iii) The large-scale circulation modified by the El Niño and La Niña intensified wind speed for the groups with higher values; (iv) The trend analysis showed more significant negative values for G3, G4 and G5 in all seasons and in the annual average; (v) The performance of dynamic mesoscale model showed smaller errors in the locations Paracuru and São João and major errors were observed in Triunfo; (vi) Application of the Kalman filter significantly reduce the systematic errors shown in the simulations of the dynamic mesoscale model; (vii) The wind resource indicate that Paracuru and Triunfo are favorable areas for the generation of energy, and the coupling technique after validation showed better results for Paracuru. We conclude that the objective was achieved, making it possible to identify trends in homogeneous groups of wind behavior, and to evaluate the quality of both simulations with the dynamic model of mesoscale and microscale to answer questions as necessary before planning research projects in Wind-Energy area in the NEB

Far field of binary phase gratings with errors in the height of the strips

Diffraction gratings are not always ideal but, due to the fabrication process, several errors can be produced. In this work we show that when the strips of a binary phase diffraction grating present certain randomness in their height, the intensity of the diffraction orders varies with respect to that obtained with a perfect grating. To show this, we perform an analysis of the mutual coherence function and then, the intensity distribution at the far field is obtained. In addition to the far field diffraction orders, a "halo" that surrounds the diffraction order is found, which is due to the randomness of the strips height.

Error tolerance of topological codes with independent bit-flip and measurement errors

Topological quantum error correction codes are currently among the most promising candidates for efficiently dealing with the decoherence effects inherently present in quantum devices. Numerically, their theoretical error threshold can be calculated by mapping the underlying quantum problem to a related classical statistical-mechanical spin system with quenched disorder. Here, we present results for the general fault-tolerant regime, where we consider both qubit and measurement errors. However, unlike in previous studies, here we vary the strength of the different error sources independently. Our results highlight peculiar differences between toric and color codes. This study complements previous results published in New J. Phys. 13, 083006 (2011).

The Land Reform (Scotland) Act 2016 : another answer to the Scottish land question

Peer reviewed

Optimizing the Correction of Memory Errors

People are always at risk of making errors when they attempt to retrieve information from memory. An important question is how to create the optimal learning conditions so that, over time, the correct information is learned and the number of mistakes declines. Feedback is a powerful tool, both for reinforcing new learning and correcting memory errors. In 5 experiments, I sought to understand the best procedures for administering feedback during learning. First, I evaluated the popular recommendation that feedback is most effective when given immediately, and I showed that this recommendation does not always hold when correcting errors made with educational materials in the classroom. Second, I asked whether immediate feedback is more effective in a particular case—when correcting false memories, or strongly-held errors that may be difficult to notice even when the learner is confronted with the feedback message. Third, I examined whether varying levels of learner motivation might help to explain cross-experimental variability in feedback timing effects: Are unmotivated learners less likely to benefit from corrective feedback, especially when it is administered at a delay? Overall, the results revealed that there is no best “one-size-fits-all” recommendation for administering feedback; the optimal procedure depends on various characteristics of learners and their errors. As a package, the data are consistent with the spacing hypothesis of feedback timing, although this theoretical account does not successfully explain all of the data in the larger literature.

New evidence in trauma resuscitation - is 1:1:1 the answer?

Traumatic injury is a common problem, with over five million worldwide deaths from trauma per year. An estimated 10 to 20% of these deaths are potentially preventable with better control of bleeding. Damage control resuscitation involves early delivery of plasma and platelets as a primary resuscitation approach to minimize trauma-induced coagulopathy. Plasma, red blood cell and platelet ratios of 1:1:1 appear to be the best substitution for fresh whole blood; however, the current literature consists only of survivor bias-prone observational studies.

(Table 1) Age markers and errors for the last 1215 ka in IODP Exp302

Despite its importance in the global climate system, age-calibrated marine geologic records reflecting the evolution of glacial cycles through the Pleistocene are largely absent from the central Arctic Ocean. This is especially true for sediments older than 200 ka. Three sites cored during the Integrated Ocean Drilling Program's Expedition 302, the Arctic Coring Expedition (ACEX), provide a 27 m continuous sedimentary section from the Lomonosov Ridge in the central Arctic Ocean. Two key biostratigraphic datums and constraints from the magnetic inclination data are used to anchor the chronology of these sediments back to the base of the Cobb Mountain subchron (1215 ka). Beyond 1215 ka, two best fitting geomagnetic models are used to investigate the nature of cyclostratigraphic change. Within this chronology we show that bulk and mineral magnetic properties of the sediments vary on predicted Milankovitch frequencies. These cyclic variations record ''glacial'' and ''interglacial'' modes of sediment deposition on the Lomonosov Ridge as evident in studies of ice-rafted debris and stable isotopic and faunal assemblages for the last two glacial cycles and were used to tune the age model. Potential errors, which largely arise from uncertainties in the nature of downhole paleomagnetic variability, and the choice of a tuning target are handled by defining an error envelope that is based on the best fitting cyclostratigraphic and geomagnetic solutions.