Survey research methods

book review

Does first aid have a place in the medical curriculum? A survey of medical students

Introduction: When a medical emergency occurs in the prehospital environment, there is an expectation from the general public for medical students to offer assistance with a similar level of competence as qualified doctors. However, the question is raised; do medical students have sufficient training in first aid skills to fulfil the role expected of them?

Prior to the publication of the latest version of Tomorrow’s Doctors by the UK General Medical Council, a student selected component (SSC) in first aid was delivered at the medical school in Queen’s University Belfast (QUB), Northern Ireland. The overwhelming popularity of this SSC prompted a desire to investigate and understand students’ experiences of first aid.

Aim: To identify first and second year medical students’ knowledge of, and attitudes towards, first aid and their expectations of the medical curriculum.

Methods: A questionnaire was delivered using TurningPoint Audience Response System® during the second semester of the 2008 - 2009 academic year to all first and second year medical students at QUB.

Results: Less than half of the students felt that they had a good level of first aid knowledge, a third would feel confident helping in an emergency and only 10% would be confident leading an emergency situation. The vast majority of students believed first aid is beneficial, that the general public expect medical students to have the knowledge to handle an emergency situation, and that a full first aid course should be included in the core medical curriculum at an early stage. They did not believe it should be a pre-requisite for medical school.

Conclusion: Only a small proportion believed their first aid knowledge adequate. An overwhelming proportion believed that first aid training is beneficial and that the public expect competency in managing emergencies. This study clearly demonstrates students’ need and desire for first aid training in the core medical curriculum at an early stage and to the highest training level possible.

Decisional responsibility for mechanical ventilation and weaning: an international survey

Introduction: Optimal management of mechanical ventilation and weaning requires dynamic and collaborative decision making to minimize complications and avoid delays in the transition to extubation. In the absence of collaboration, ventilation decision making may be fragmented, inconsistent, and delayed. Our objective was to describe the professional group with responsibility for key ventilation and weaning decisions and to examine organizational characteristics associated with nurse involvement.

Methods: A multi-center, cross-sectional, self-administered survey was sent to nurse managers of adult intensive care units (ICUs) in Denmark, Germany, Greece, Italy, Norway, Switzerland, Netherlands and United Kingdom (UK). We summarized data as proportions (95% confidence intervals (CIs)) and calculated odds ratios (OR) to examine ICU organizational variables associated with collaborative decision making.

Results: Response rates ranged from 39% (UK) to 92% (Switzerland), providing surveys from 586 ICUs. Interprofessional collaboration (nurses and physicians) was the most common approach to initial selection of ventilator settings (63% (95% CI 59 to 66)), determination of extubation readiness (71% (67 to 75)), weaning method (73% (69 to 76)), recognition of weaning failure (84% (81 to 87)) and weaning readiness (85% (82 to 87)), and titration of ventilator settings (88% (86 to 91)). A nurse-to-patient ratio other than 1:1 was associated with decreased interprofessional collaboration during titration of ventilator settings (OR 0.2, 95% CI 0.1 to 0.6), weaning method (0.4 (0.2 to 0.9)), determination of extubation readiness (0.5 (0.2 to 0.9)) and weaning failure (0.4 (0.1 to 1.0)). Use of a weaning protocol was associated with increased collaborative decision making for determining weaning (1.8 (1.0 to 3.3)) and extubation readiness (1.9 (1.2 to 3.0)), and weaning method (1.8 (1.1 to 3.0)). Country of ICU location influenced the profile of responsibility for all decisions. Automated weaning modes were used in 55% of ICUs.

Conclusions: Collaborative decision making for ventilation and weaning was employed in most ICUs in all countries although this was influenced by nurse-to-patient ratio, presence of a protocol, and varied across countries. Potential clinical implications of a lack of collaboration include delayed adaptation of ventilation to changing physiological parameters, and delayed recognition of weaning and extubation readiness resulting in unnecessary prolongation of ventilation.

A 330-360 GHz spectral survey of G34.3+0.15 - III. The outer halo

We have undertaken a 330-360 GHz molecular line survey of the halo gas surrounding the hot core associated with G34.26+0.15. In contrast to our molecular line survey of the hot core itself, where 338 lines from at least 38 species were detected, only 18 lines from 9 species were detected in the halo. The lines are mainly single transitions of simple di atomic and triatomic molecules. Lower limits to their column densities have been evaluated by an LTE method. In the case of methanol, where four transitions were detected, the rotation temperature and column density have been evaluated by the rotation diagram technique. We have modified the previous depth-dependent chemical model developed in Paper II to calculate the column densities observed along a general line of sight drawn through the model cloud. The model is also extended to produce beam-averaged column densities for better comparison with those observed. We compare the model column densities with those observed and make recommendations for future depth-dependent chemical modelling of hot cores.

A survey of molecular line emission towards ultracompact HII regions

We have used the JCMT to survey molecular line emission towards 14 ultracompact HII regions (G5.89, G9.62, G10.30, G10.47, G12.21, G13.87, G29.96, G31.41, G34.26, G43.89, G45.12, G45.45, G45.47, and G75.78). For each source, we observed up to ten 1 GHz bands between 200 and 350 GHz, covering lines of more than 30 species including multiple transitions of CO isotopes, CH3OH, CH3CCH, CH3CN and HCOOCH3, and sulphuretted molecules. The number of transitions detected varied by a factor of 20 between sources; which were chosen following observations of high-excitation ammonia (Cesaroni et al. 1994a) and methyl cyanide (Olmi et al. 1993). In half our sample (the line-poor sources), only (CO)-O-17: (CO)-O-18, SO, (CS)-S-34 and CH3OH were detected. In the line-rich sources, we detected over 150 lines, including high excitation lines of CH3CN, HCOOCH3; C2H5CN, CH3OH, and CH3CCH. We have calculated the physical conditions of the molecular gas. To reproduce the emission from the line-rich sources requires both a hot, dense compact core and an ambient cloud consisting of less dense, cooler gas. The hot cores, which are less than 0.1 pc in size; reach densities of at least 10(8) cm(-3) and temperatures of more than 80 K. The line-poor sources can be modelled without a hot core by a 20-30 K, 10(5) cm(-3) cloud. We find no correlation between the size of the HII region and the current physical conditions in the molecular environment. A comparison with chemical models (Millar et al. 1997) confirms that grain surface chemistry is important in hot cores.

A three-position spectral line survey of Sagittarius B2 between 218 and 263 GHz. I. The observational data

We have surveyed the frequency band 218.30-263.55 GHz toward the core positions N and M and the quiescent cloud position NW in the Sgr B2 molecular cloud using the Swedish-ESO Submillimetre Telescope. In total 1730, 660, and 110 lines were detected in N, M, and NW, respectively, and 42 different molecular species were identified. The number of unidentified lines are 337, 51, and eight. Toward the N source, spectral line emission constitutes 22% of the total detected flux in the observed band, and complex organic molecules are the main contributors. Toward M, 14% of the broadband flux is caused by lines, and SO2 is here the dominant source of emission. NW is relatively poor in spectral lines and continuum. In this paper we present the spectra together with tables of suggested line identifications.

A 330-360 GHz spectral survey of G34.3+0.15 .2. Chemical modelling

We describe a detailed depth-and time-dependent model of the molecular cloud associated with the ultracompact H II region G 34.3+0.15. Previous work on observations of NH3 and CS indicates that the molecular cloud has three distinct physical components:- an ultracompact hot core, a compact hot core and an extended halo. We have used the physical parameters derived from these observations as input to our detailed chemical kinetic modelling. The results of the model calculations are discussed with reference to the different chemistries occuring in each component and are compared with abundances derived from our recent spectral line survey of G 34.3+0.15 (Paper I).

A 330-360 GHz spectral survey of G 34.3+0.15 .1. Data and physical analysis

A 330--360 GHz spectral survey of the hot molecular core associated with the 'cometary' ultracompact HII region G 34.3+/-0.15 observed with the James Clerk Maxwell Telescope has detected 338 spectral lines from at least 35 distinct chemical species plus 19 isotopomers. 70 lines remain unidentified. Chemical abundance and rotation temperature have been determined by rotation diagram analysis for 12 species, and lower limits to abundance found for 38 others.

DENSE GAS IN NEARBY GALAXIES .9. A SURVEY FOR HNC

Ten detections and five tentative detections of hydrogen isocyanide (HNC) J=1-0 emission are reported from a survey including sixteen galaxies. Full maps are presented for the nuclear regions of NGC 253 and IC 342, partial maps for Maffei 2, M 82, and M 83. Toward IC 342, the HNC and HCO+ distributions differ from those observed in 12CO, 13CO, HCN, CS, and NH3. This is likely a consequence of the density structure. Relative HNC abundances are with 10(-10)-10(-9) much smaller than those measured in nearby dark clouds and appear to be slightly smaller than those in regions of massive star formation of the Galactic disk. This is consistent with the presence of dense warm gas or a frequent occurrence of shocks in the nuclear regions of the galaxies observed. As in prominent Galactic star forming regions, 3 mm HNC line emission tends to be weaker than the corresponding emission from HCN and HCO+. Toward Arp 220, however, the 3 mm HNC/HCN line intensity ratio is > 1. HNC/HCO+, HNC/CO, and HNC to 20 cm radio continuum luminosity ratios are also particularly large. A possible interpretation is the presence of cool quiescent gas outside the central region which contains the starburst. In the other ultraluminous galaxy observed, NGC 6240, X(HNC) 10 smaller than in Arp 220, demonstrating that the molecular composition in ultraluminous galaxies is far from being uniform.

Do psychosocial factors moderate the association of fixed-term employment with work interference with family and sleeping problems in registered nurses: A cross-sectional questionnaire survey

Background: The use affixed-term employment has increased lately, particularly in Europe and in the health care sector. Previous studies have shown that especially among the health care sector employee's organizational justice perceptions and job control are important factors that are directly related to the welfare and attitudes of employees and may also help to buffer the negative impacts of many detrimental factors.

Eclipsing Binary Science via the Merging of Transit and Doppler Exoplanet Survey Data—A Case Study with the MARVELS Pilot Project and SuperWASP

Exoplanet transit and Doppler surveys discover many binary stars during their operation that can be used to conduct a variety of ancillary science. Specifically, eclipsing binary stars can be used to study the stellar mass-radius relationship and to test predictions of theoretical stellar evolution models. By cross-referencing 24 binary stars found in the MARVELS Pilot Project with SuperWASP photometry, we find two new eclipsing binaries, TYC 0272-00458-1 and TYC 1422-01328-1, which we use as case studies to develop a general approach to eclipsing binaries in survey data. TYC 0272-00458-1 is a single-lined spectroscopic binary for which we calculate a mass of the secondary and radii for both components using reasonable constraints on the primary mass through several different techniques. For a primary mass of M 1 = 0.92 ± 0.1 M sun, we find M 2 = 0.610 ± 0.036 M sun, R 1 = 0.932 ± 0.076 R sun, and R 2 = 0.559 ± 0.102 R sun, and find that both stars have masses and radii consistent with model predictions. TYC 1422-01328-1 is a triple-component system for which we can directly measure the masses and radii of the eclipsing pair. We find that the eclipsing pair consists of an evolved primary star (M 1 = 1.163 ± 0.034 M sun, R 1 = 2.063 ± 0.058 R sun) and a G-type dwarf secondary (M 2 = 0.905 ± 0.067 M sun, R 2 = 0.887 ± 0.037 R sun). We provide the framework necessary to apply this analysis to much larger data sets.

Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees

Background: In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model - effort, rewards and ERI - are associated with the co-occurrence of lifestyle risk factors.

Geophysical and geochemical survey of a large marine pockmark on the Malin Shelf, Ireland

Marine pockmarks are a specific type of seabed geological setting resembling craters or pits and are considered seabed surface expressions of fluid flow in the subsurface. A large composite pockmark on the Malin Shelf, off the northern coast of Ireland was surveyed and ground truthed to assess its activity and investigate fluid related processes in the subsurface. Geophysical (including acoustic and electromagnetic) data confirmed the subsurface presence of signatures typical of fluids within the sediment. Shallow seismic profiling revealed a large shallow gas pocket and typical gas related indicators such as acoustic blanking and enhanced reflectors present underneath and around the large pockmark. Sulphate profiles indicate that gas from the shallow reservoir has been migrating upwards, at least recently. However, there are no chimney structures observed in the sub-bottom data and the migration pathways are not apparent. Electromagnetic data show slightly elevated electrical conductivity on the edges of the pockmarks and a drop below regional levels within the confines of the pockmark, suggesting changes in physical properties of the sediment. Nuclear Magnetic Resonance (NMR) experiments were employed to characterize the organic component of sediments from selected depths. Very strong microbial signatures were evident in all NMR spectra but microbes outside the pockmark appear to be much more active than inside. These observations coincide with spikes in conductivity and the lateral gas bearing body suggesting that there is an increase in microbial activity and biomass when gas is present.