Analyzing and Optimizing AED Placement Locations in Big Cites—A Geographical Information System Analysis

Out-of-Hospital Cardiac Arrest (OHCA) has been identified as a significant public health issue in China. Numerous studies have demonstrated that using automated external defibrillators (AEDs) can significantly improve the survival rate of OHCA patients, but their low utilization rate is partly due to the accessibility of AED deployment sites. This study collects the location information of AED devices in three representative cities in China: Beijing, Shanghai, and Shenzhen and then combines the kilometer population grid data (2021) with the AED geographic location data for visualization and data analysis through QGIS and Kepler.GL. Our model considers population distribution, subway, and road traffic factors and proposes a new method for AED index measurement. Through empirical analysis, we discovered that the existing AED distribution has an issue with unequal resource allocation. Thus, we have proposed specific suggestions on quantity and specific zones for AED deployment. Furthermore, this study proposes three specific suggestions for the problems currently in developing AEDs in China

Preparing for out of hospital cardiac arrests (OHCA) in Riyadh, Saudi Arabia: A GIS scenario-modeling approach

This study employed location-allocation modeling and a geographic information system (GIS) to study the current placement of automated external defibrillators (AEDs) in relationship to neighborhoods in Riyadh City, Saudi Arabia, and to determine the optimal locations for additional AEDs in the city. Using GIS to mathematically locate additional healthcare facilities for the placement of AEDs is more reliable than to select them using informed guesses. The objective of this research was to elaborate a mathematical and GIS model for placing AED devices so that people who need to use these devices in the City of Riyadh, Saudi Arabia, can access them within a time frame of three minutes or less, which is the international standard for such accessibility. The research employed street blocks as demand points; existing healthcare facilities, mosques, and schools as supply points; and the maximum coverage algorithm to model optimal locations for AED devices. Models were run for both vehicle and pedestrian travel times. Model results of current conditions indicated that 75% of household blocks were covered when vehicles were used to access AED sites, as compared to 9% of people when pedestrian travel to an AED is considered. Introduction of 1,371 mosques and 34 community colleges and universities as additional supply points for AEDs improved coverage to 94% for vehicular access, but only 34% for pedestrian traffic. Although mosques are considered to be focus points for Muslim communities, other facilities including, but not limited to, police stations, malls, primary and secondary schools, and playgrounds should be used to gain wider coverage. In addition, cluster analysis should be employed to avoid selecting AED supply points that are too close to each other and which are unlikely to improve accessibility. The study succeeded in elaborating a framework for conceptualizing the relationship between vehicular and pedestrian access to AEDs. It also demonstrates how GIS-based location-allocation modeling can be used for efficient placement of AEDs. The broad conceptual framework for AED placement used in this study has applicability to other countries in the Middle East

Resuscitation

AimApproximately 424,000 out-of-hospital cardiac arrests (OHCA) occur in the US annually. As automated external defibrillators (AED) are an important part of the community response to OHCA, we investigated how well the spatial demand (likelihood of OHCA) was met by the spatial supply (AEDs) in a dense urban environment.MethodsUsing geographic information system (GIS) software, we applied kernel density and optimized hot spot procedures with two differently-sized radii to model OHCA incidence rates from existing studies, providing an estimate of OHCA likelihood at a given location. We compared these density maps to existing AED coverage in the study area. Descriptive statistics summarized coverage by land use.ResultsWith a 420-ft buffer, we found that 56.0% (79.9%, 840-ft buffer) of the land area in the city center was covered by existing AEDs at, though 70.1 (91.5)% of the OHCA risk was covered using kernel density and 79.8% (98.1) was covered using hot spot analysis.ConclusionsThe difference in coverage by area and risk seems to indicate efficient placement of existing AEDs. Our findings also highlight the possible benefits to expanding the influence of AEDs by lowering search times, and identify opportunities to improve AED coverage in the study area. This article offers one method by which local officials can use spatial data to prioritize attention for AED placement and coverage.R01 HS018362/HS/AHRQ HHS/United StatesR49 CE002474/CE/NCIPC CDC HHS/United StatesT32 HL007034/HL/NHLBI NIH HHS/United States2018-05-24T00:00:00Z27702581PMC596761

Cardiopulmonary resuscitation (CPR) training strategies in the times of COVID-19: A systematic literature review comparing different training methodologies

Background: Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training.Methods: We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts.Results: Of the 978 articles screened, twenty met the final inclusion criteria. All included studies had an experimental design and moderate to strong global quality rating. The trainees in ST group performed better on calling 911, time to initiate chest compressions, hand placement and chest compression depth. Trainees in AT group performed better in assessing scene safety, calling for help, response time including initiating first rescue breathing, adequate ventilation volume, compression rates, shorter hands-off time, confidence, willingness to perform CPR, ability to follow CPR algorithm, and equivalent or better knowledge retention than standard teaching methodology.Conclusion: AT methods of CPR training provide an effective alternative to the standard in-person CPR for large scale public training

Status of the implementation of automated external defibrillators in South Korean health/fitness facilities

The purpose of this study was to investigate the status of automated external defibrillator (AED) implementation in South Korean health/fitness facilities; for facilities with AEDs, to investigate risk management practices associated with AED implementation; and for facilities without AEDs, to investigate constraints to AED implementation. A questionnaire measuring the status of AED implementation, risk management practices for facilities with an AED(s), and constraints to AED implementation was developed and administered to 436 health/fitness facility managers in South Korea. The participants were selected by using random sampling with stratified populations. Results showed that the status of AED implementation in South Korean health/fitness facilities was only 8.7% (38 of 436). The distribution of AEDs by location and ownership was uneven. The level of managers knowledge of AED laws was also low. With regard to risk management practices, about 65% of the managers responded that there was one or more staff members trained to use an AED(s). However, less than 5% (17 of 436) health/fitness facilities were ready to provide defibrillation with an AED by an on-duty trained staff member in an emergency situation. Results of the factor analysis generated a five factor model for perceived constraints to AED implementation including Cost, No Need, Lack of Support, Lack of Information, and Management Concerns. The study elicited the following five managerial constraints to AED implementation: (1) Lack of information associated with required AED certification and training; (2) Lack of an AED instructor; (3) Lack of information regarding supervisory responsibility; (4) Lack of information associated with protection from liability; and (5) Additional staff certification and training. The findings of this study contribute to the body of knowledge on AED implementation in South Korean sport venues in general, and health/fitness facilities specifically. An overall result from this study showed that health/fitness facility managers tend to diminish the probability of a sudden cardiac arrest (SCA) and the need for AED implementation in their facilities. The study may contribute to an increase in overall AED implementation in South Korean health/fitness facilities via facility managers\u27 increased attention to the use of AEDs and the potential for SCA. In the future, the enactment of additional AED regulatory laws in sport venues will also contribute to an increase in AED implementation in South Korean sport facilities.\u2

A Multiple-Case Study: The Deployment of Allied Educators (Learning and Behavioural Support) in Singapore Mainstream Primary Schools

Despite the growth of international research on paraeducator deployment, the understanding of its working in Singapore remains nascent. This study seeks to address the limited knowledge of paraeducator deployment in Singapore by examining how Allied Educator (Learning and Behavioural Support) [AED(LBS)] spend their time in school, how they work with the school community of teachers and school leaders, and the factors that affect the process of working together using Wenger’s (1998) community of practice framework. This study adopted a multiple case-study design with two phases. Phase One employed a survey questionnaire to determine how AEDs(LBS) spend their time in school. Its findings provided an objective understanding of the AED(LBS) role which is currently lacking in the literature. Its findings also assisted in the shortlisting of cases for Phase Two of the multiple-case study i.e. the interviews. Phase Two consisted of a multiple-case study involving in-depth interviews with AEDs(LBS), teachers and school leaders to understand how AEDs(LBS) worked with the school community. Both phases were piloted to refine the tools used in the main study. Data collected was analysed using the thematic analysis approach. Findings revealed that AEDs(LBS) had an intangible impact on their school community in the form of voice and visibility. Voice enabled AEDs(LBS) to express their participation, proficiency, initiative or confidence while visibility enabled colleagues to see their role-related participation, through their physical presence and the products of their participation. AEDs(LBS) who demonstrated voice and visibility, gained the trust of the school community and were better able to influence the school community to take ownership of students with SEN. Leadership and AED(LBS) factors were found to influence voice and visibility. Crucially, the study found that AEDs’(LBS) voice and visibility can be influenced to improve partnership outcomes in school. The findings encourage a reimagination of the paraeducator role as an agent of change who can influence the school community to assume a shared responsibility in SEN

Linkages with practice for higher-education curriculum innovation

This article is inspired by the debate on curriculum innovation for graduate training, emerging out of linkages between universities and agribusiness development actors, targeting entrepreneurial action and employability of graduates. Experiences from implementation of a three-year joint project are enriched by a desk review, stakeholder feedback and interpretative analysis of process documents during the development of the regional graduate curriculum on Agri-Enterprise Development for Egerton and Gulu Universities in Kenya and Uganda, respectively. The graduate curriculum at the two universities in East Africa integrated the approaches of roundtable engagement and research as well as value chain cluster mapping and development through interactive sharing with agribusiness development facilitators. Simultaneously, the two implementing universities showcased the feasibility of integrating community engagement and entrepreneurial skills into a new curriculum. They achieved this by adopting two training approaches from their previous, more limited curriculum, which lacked student entrepreneurial experiential learning. The outcome from the first cohort of students in the innovative programs demonstrates significant institutional change in teaching and learning approaches. These changes prioritize a blend of action research and theoretical exposure. At the university-wide level, a student-centered teaching and learning approach has been established, facilitated by models like Student Farm Attachment, Student Enterprise Scheme, and Student Community Engagement. Additionally, university-based research teams have honed their skills in community action research, leading to the identification of relevant challenges and plausible solutions. Furthermore, students’ skills sets have increasingly enhanced employability. Strengthening linkages between universities and community development actors can enhance curriculum orientation toward problem-solving and entrepreneurial capacity building for young graduates. Purposeful engagement with communities by university faculty and students serves as a complementary extension approach and advisory service. Implementing an innovative curriculum has the potential to boost research uptake and foster innovation. This article demonstrates how university- industrial actors’ collaboration can be exploited for curriculum (re)design, review and up-dating for (a) enhanced relevance of universities to community needs and employability of graduates; and (b) improvements in the research uptake pathways that facilitate research-into-use for desired impacts at community level