The effect of training and experience on mass casualty incident triage performance: Evidence from emergency personnel in a high complexity university hospital

Mass casualty incident (MCI) can occur at any time and place and health care institutions must be prepared to deal with these incidents. Emergency department staff rarely learn how to triage MCI patients during their medical or nurse degrees, or through on-the-job training. This study aims to evaluate the effect of training and experience on the MCI triage performance of emergency personnel. METHODOLOGY: This was a cross-sectional prospective study that analyzed the performance of 94 emergency department staff on the triage classifications of 50 trauma patients, before and after a short training in MCI triage, while taking into account their academic background and work experience. RESULTS: The participants were assigned initially to one of two groups: low experience if they had less than 5 years of practice, and high experience if they had more than 5 years of practice. In the low experience group, the initial accuracy was 45.76 percent, over triage 45.84 percent, and subtriage 8.38 percent. In the high experience group, the initial accuracy was 53.80 percent, over triage 37.66 percent, and sub triage 8.57 percent. POSTINTERVENTION RESULTS: In the low experience group, the post intervention accuracy was 63.57 percent, over triage 21.15 percent, and subtriage 15.30 percentage. In the high experience group, the postintervention accuracy was 67.66 percentage, over triage 15.19 percentage, and subtriage 17.14 percentage. CONCLUSION: Upon completion of this study, it can be concluded that MCI triage training significantly improved the performance of all those involved in the workshop and that experience plays an important role in MCI triage performance

Photoacoustic Measurement Of The Thermal Properties Of Two-layer Systems

Using two different photoacoustic techniques for a two-layer system of variable thickness, we show that the thermal diffusivity and the thermal conductivity are completely determined, based upon the effective-sample model widely used in heat-transfer problems. A procedure to establish a standard photothermal technique for measuring both the thermal diffusivity and the thermal conductivity is also discussed. © 1990 The American Physical Society.4274477448

Thermal Diffusivity Of Palladium-hydrogen Systems At Room Temperature Using Photothermal Detection

We report results of measurements on the thermal diffusivity, specific heat and electrical resistivity of hydrogenated-palladium samples. It is shown that repetition of the hydrogenation process with the same sample induces aging effects, which lead to erroneous results. The results for the thermal-property measurements on single-cycled palladium samples reflected a phase transition between -PdH and -PdH as the hydrogen concentration is increased. © 1992 The American Physical Society.4595031503

Effect of copper slag addition on mechanical behaviour of asphalt mixes containing reclaimed asphalt pavement

Annually, copper production and refining processes of generate large volumes of copper slag, and the disposal of this waste remains a major economic and environmental problem. This annual production causes an increase in the number and volume of landfills, as well as the quantity of slag that backs up landfills, it also produces leachates which contain metals such as Cu, Pb, Hg and SO2. In this research, friction and cohesive qualities of copper slag are exploited, in order to incorporate this slag as aggregate in asphalt mixes containing Reclaimed Asphalt Pavement (RAP). Results demonstrate that the use of copper slag in an addition percentage of 35% is favorable, because flow values increase and stability values decrease. The Marshall Quotient is reduced up to 27%, improving the performance of mixes with RAP and obtaining behavior similar to a traditional mixture. This improvement is also reflected in an 8% increase in the indirect tensile strength, which stands the use of copper slag as a solution in RAP applications with more demanding tensile and fatigue requirements.The presented results are part of the FONDECYT Initiation into Research project No. 11140889, funded by CONICYT-Chile, and the DID S-2014-27 project, funded by the Universidad Austral de Chile. The authors also would like to thank Bitumix S.A. and its CDI, CONAV S.A. and the Regional Laboratory of Transportation of Puerto Montt for the material donations and facilitation of their dependencie

Solid catalysts obtained from wastes for FAME production using mixtures of refined palm oil and waste cooking oils

More than 95% of biodiesel production feedstocks come from edible oils, however it may cause some problems such as the competition of land use between food production and biodiesel production. The waste cooking oils (WCO) are an alternative feedstock for biodiesel production; its usage reduces significantly the cost of biodiesel production and has environmental benefits, e.g., a waste recovery instead of its elimination. This work aims to produce a low-cost efficient solid catalyst for fatty acid methyl esters (FAME) production using mixtures of refined palm oil (RPO) and WCO. Four low cost catalysts were prepared (biomass fly ashes, natural dolomite rock, chicken eggshells and polyethylene terephthalate - PET), characterized (by SEM, EDX, XRD, BET, FT-IR and Hammett indicators) and tested regarding their performance in FAME production. The maximum yield of FAME achieved was around 96%wt. for biomass fly ashes catalyst at 60 °C, 9:1 (mol/mol) of methanol to oil mixture, 10%wt. catalyst to oil mixture, over 180 min in batch reactor. The results point out for promising bifunctional catalysts able to achieve also conversion of free fatty acids up to 100% using mixtures of RPO and WCO.publishe

Optimization of FAME production from blends of waste cooking oil and refined palm oil using biomass fly ash as a catalyst

One of the problems associated with biomass combustion is the amount of fly ashes generated and its subsequent management. The search for ways of valorizing these ashes has been a challenge for the academic and industrial community. On the other hand, used cooking oils are wastes which management is quite difficult, by they have a very important energetic potential. The goal of this work was to optimize the Fatty Acid Methyl Esters (FAME) process, recovering two residual materials (waste cooking oils (WCO), and biomass fly flash (BFA)). The optimization of the process was achieved using the response surface methodology and a Box-Benhken experimental design applied to mixtures of WCO and refined palm oil (RPO), using BFA as catalyst. The influence on FAME yield of four variables (catalyst loading, methanol/oil molar ratio, RPO/WCO ratio and reaction temperature) was studied. The higher FAME yield achieved was 73.8% for the following operating conditions: 13.57 wt% of catalyst loading, 6.7 of methanol/oil molar ratio, 28.04 wt% of RPO in the oil mixture with WCO and 55 °C for the reaction temperature. The reusability of the BFA catalyst in the process was also studied through three successive usage cycles finding no loss of catalytic activity.publishe

Ingestive behaviour and performance of feedlot lambs fed saccharine sorghum and corn silages

This study evaluated the ingestive behaviour and performance of feedlot lambs fed saccharine sorghum and corn silages. Ten animals were randomly selected from a group of 32 uncastrated male Suffolk lambs. The four treatments consisted of diets with 50% of silage made from forage sorghum (BD 1615), two varieties of saccharine sorghum (BRS 506 and BRS 511), and corn (BRS 2223). Ingestive behaviour was observed by a scan sampling method using seven strategically positioned video cameras so as not to interfere with the usual animal behaviour. The animals were observed for three 48-hour periods at 15-day intervals, with a total of 144 hours of observation. Video recordings were then examined to identify the time spent in ruminating, eating, drinking water and idling. Times spent feeding or drinking water were not significantly affected by the treatments. Animals fed forage sorghum silage had higher neutral detergent fibre (NDF) intake (0.41 kg of NDF), thus spent more time ruminating (342 min/day). Rumination time was similar for the BD 1615 and BRS 506 silages and was 85 min/day greater than for the BRS 511 and BRS 2223 silages, which were similar. Average daily gain was greater for BRS 2223 (275 g/day) than for BRS 506 and BRS 511 silages, which were similar (196 g/day). Ingestive behaviour for BRS 511 was similar to that observed for BRS 2223. Ingestive behaviour for BRS 506 was similar to that observed for BD 1615. Average daily gain was related to intake and ruminating efficiency. Keywords: eating, idling, roughage, rumination, sheep (Ovis aires

Effectiveness of silver nitrate compared to talc slurry as pleural sclerosing agent in rabbits. Influence of concomitant intrapleural lidocaine

Não está ainda definido, qual o agente ideal para a produção de uma pleurodese efetiva. O talco é o agente mais freqüentemente utilizado apesar de suas manifestações colaterais. Outra possibilidade é o nitrato de prata, largamente usado no passado. OBJETIVOS: Determinar a influência da injeção intrapleural de lidocaina na produção de pleurodese com nitrato de prata, definir o efeito da lidocaina na maturação das fibras colágenas e confirmar que a pleurodese produzida pelo nitrato de prata é mais potente que a conseqüente à injeção intrapleural de talco. MÉTODOS: Foram estudados três grupos de 8 coelhos. Dois receberam nitrato de prata a 0,5%; em um deles, foi injetado previamente 0,5 ml de lidocaina a 2%. O terceiro grupo recebeu 2 ml de talco (400 mg/kg). Os animais foram sacrificados após 28 dias da injeção intrapleural e as cavidades pleurais examinadas macroscopicamente, analisando-se a presença de fusão entre os folhetos pleurais e microscopicamente avaliando-se a inflamação e a fibrose. Quantificou-se o total de colágeno na pleura e a distribuição de fibras finas e grossas, utilizando-se a coloração de pricrosirius. RESULTADOS: Nos dois grupos em que se injetou nitrato de prata (s/ lidocaina: 3.5 + 0.3 e com lidocaina: 3.2 + 0.3), a pleurodese macroscópica (scala 0 - 4) foi significantemente (p = 0.001) melhor do que a pleurodese resultante do talco (1.6 + 0.2). A média da fibrose pleural induzida pelo nitrato de prata (3.5 + 0.2) foi significantemente (p = 0.004) mais acentuada do que a produzida por talco (1.9 + 0.1). A instilação prévia de lidocaina determinou tendência a diminuir a quantidade de fibrose (3.1 + 0.4). A média (10³mm²) do colágeno pleural foi significantemente (p = 0.009) maior nos coelhos que receberam nitrato de prata (116.9 + 22.7) do que naqueles que receberam talco (10.7 + 3.4). A injeção de lidocaina reduziu discretamente o colágeno (80.1 + 30.3). A distribuição das fibras colágenas não foi diferente entre os grupos estudados. CONCLUSÃO: Este modelo animal confirma que, o nitrato de prata injetado no espaço pleural mais efetivo do que o talco na produção de pleurodese. A injeção intrapleural de lidocaina determina uma tendência a reduzir a quantidade de colágeno, mas não muda a efetividade da sínfise pleural ou modifica a maturação do colágeno.The ideal agent for producing pleurodesis has not been identified. Talc, the most commonly used, poses several problems. Another possibility is silver nitrate, which was widely used in the past. PURPOSE: To determine the influence of the intrapleural instillation of lidocaine in producing a pleurodesis with silver nitrate, to define the effect of lidocaine in the maturation of the collagen fibers, and to confirm that the pleurodesis after silver nitrate is stronger than after talc. METHODS: We studied three groups of 8 rabbits. Two groups received 0.5% silver nitrate; in one we had previously injected 0.5 ml of 2% lidocaine. The third group received 400 mg/kg talc (2 ml). The animals were sacrificed 28 days after the injection, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation and fibrosis. The total amount of pleural collagen and the distribution of thick and thin collagen fibers were quantified. Collagen was identified using picrosirius red stain. RESULTS: In the two groups that received silver nitrate (without lidocaine: 3.5 + 03 and with lidocaine: 3.2 + 0.3), the macroscopic pleurodesis (scale 0 -- 4) was significantly (p = 0.001) better than that resulting from talc (1.6 + 0.2). The mean degree of pleural fibrosis induced by silver nitrate (3.5 + 0.2) was significantly (p = 0.004) higher than that induced by talc (1.9 + 0.1). The previous instillation of lidocaine resulted in a tendency for decreased amounts of fibrosis (3.1 + 0.4). The mean amount (10³mm²) of pleural collagen was significantly (p = 0.009) greater in the rabbits that received silver nitrate (116.9 + 22.7) than in those that received talc (10.7 + 3.4). The injection of lidocaine slightly reduced the collagen (80.1 + 30.3). The distribution of collagen fibers did not differ among the groups. CONCLUSION: This rabbit model clearly confirms that intrapleural silver nitrate is more effective than talc for producing pleurodesis. The previous intrapleural instillation of lidocaine results in a decreasing trend in the amount of collagen, but does not change the effectiveness of the pleural fusion or modify the process of collagen maturation

Photoacoustic Spectroscopy For Depth-profile Analysis And Herbicide Monitoring In Leaves

Depth profiles of double-layer biological samples obtained by photoacoustic spectroscopy were studied using the two-signal phase-resolved method. The application of the method was demonstrated by singling out the spectra of the cuticle and the pigment layers of a leaf, and the pericarps and the endosperm layers of a corn kernel. The use of the method for monitoring temporal changes occurring in a leaf under the action of a herbicide was also investigated.112111487149

Preventing and addressing the stress reactions of health care workers caring for patients with COVID-19: Development of a digital platform (Be + against COVID)

Background: COVID-19 became a major public health concern in March 2020. Due to the high rate of hospitalizations for COVID-19 in a short time, health care workers and other involved staff are subjected to a large workload and high emotional distress. Objective: The objective of this study is to develop a digital tool to provide support resources that might prevent and consider acute stress reactions in health care workers and other support staff due to the COVID-19 pandemic. Methods: The contents of the digital platform were created through an evidence-based review and consensus conference. The website was built using the Google Blogger tool. The Android version of the app was developed in the Java and XML languages using Android Studio version 3.6, and the iOS version was developed in the Swift language using Xcode version 11.5. The app was evaluated externally by the Andalusian Agency for Healthcare Quality. Results: We detected the needs and pressing situations of frontline health care workers, and then, we proposed a serial of recommendations and support resources to address them. These resources were redesigned using the feedback received. A website in three different languages (Spanish, English, and Portuguese) and a mobile app were developed with these contents, and the AppSaludable Quality Seal was granted to the app. A specific self-report scale to measure acute stress and additional tools were included to support the health care workforce. This instrument has been used in several Latin American countries and has been adapted considering cultural differences. The resources section of the website was the most visited with 18, 516 out of 68, 913 (26.9%) visits, and the “Self-Report Acute Stress Scale” was the most visited resource with 6468 out of 18, 516 (34.9%) visits. Conclusions: The Be + against COVID platform (website and app) was developed and launched to offer a pool of recommendations and support resources, which were specifically designed to protect the psychological well-being and the work morale of health care workers. This is an original initiative different from the usual psychological assistance hotlines