669 research outputs found
The US and ASEM: why the hegemon didn't bark
Relationships with the United States and American policy preferences have been important to the Asian and European members of ASEM in its establishment and activities. Yet US policy, business, and media elites have paid little public attention to ASEM. The puzzle is why not. Explanations of inattentiveness or foresight about Asia’s economic difficulties are unpersuasive. Instead, American ‘silence’ fits with a reasoned understanding among internationally oriented policy and business leaders that ASEM has and will pose little in the way of difficulties for their preferences about Asia and the EU for security, civil society, and economic matters. Indeed, the maneuverings in and around ASEM about those three policy areas have been and are likely to continue to be of some modest help to American internationalists. Their domestic persuasiveness benefits from ASEM developments which bolster actions they desire, and reduce pressure for policy positions they wish to avoid or believe are unlikely to gain approval in the American political economy
Transient Signals and Inattentional Blindness in a Multi-Object Tracking Task
Inattentional blindness is a failure to notice an unexpected event when attention is directed elsewhere. The current study examined participants\u27 awareness of an unexpected object that maintained luminance contrast, switched the luminance once, or repetitively flashed. One hundred twenty participants performed a dynamic tracking task on a computer monitor for which they were instructed to count the number of movement deflections of an attended set of objects while ignoring other objects. On the critical trial, an unexpected cross that did not change its luminance (control condition), switched its luminance once (switch condition), or repetitively flashed (flash condition) traveled across the stimulus display. Participants noticed the unexpected cross more frequently when the luminance feature matched their attention set than when it did not match. Unexpectedly, however, a proportion of the participants who noticed the cross in the switch and flash conditions were statistically comparable. The results suggest that an unexpected object with even a single luminance change can break inattentional blindness in a multi-object tracking task
Gasping in Response to Basic Resuscitation Efforts: Observation in a Swine Model of Cardiac Arrest
Objective. To analyze the effect of basic resuscitation efforts on gasping and of gasping on survival. Methods. This is secondary analysis of a previously reported study comparing continuous chest compressions (CCC CPR) versus chest compressions plus ventilation (30:2 CPR) on survival. 64 swine were randomized to 1 of these 2 basic CPR approaches after either short (3 or 4 minutes) or long (5 or 6 minutes) durations of untreated VF. At 12 minutes of VF, all received the same Guidelines 2005 Advanced Cardiac Life Support. Neurologically status was evaluated at 24 hours. A score of 1 is normal, 2 is abnormal, such as not eating or drinking normally, unsteady gait, or slight resistance to restraint, 3 severely abnormal, where the animal is recumbent and unable to stand, 4 is comatose, and 5 is dead. For this analysis a neurological outcome score of 1 or 2 was classified as “good”, and a score of 3, 4, or 5 was classified as “poor.” Results. Gasping was more likely to continue or if absent, to resume in the animals with short durations of untreated VF before basic resuscitation efforts. With long durations of untreated VF, the frequency of gasping and survival was better in swine receiving CCC CPR. In the absence of frequent gasping, intact survival was rare in the long duration of untreated VF group. Conclusions. Gasping is an important phenomenon during basic resuscitation efforts for VF arrest and in this model was more frequent with CCC-CPR
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Use of Long Spinal Board Post-Application of Protocol for Spinal Motion Restriction for Spinal Cord Injury
Introduction: Historically, prehospital care of trauma patients has included nearly universal use of a cervical collar (C-collar) and long spine board (LSB). Due to recent evidence demonstrating harm in using LSBs, implementation of new spinal motion restriction (SMR) protocols in the prehospital setting should reduce LSB use, even among patients with spinal cord injury. Our goal in this study was to evaluate the rates of and reasons for LSB use in high-risk patients—those with hospital-diagnosed spinal cord injury (SCI)—after statewide implementation of SMR protocols.
Methods: Applying data from a state emergency medical services (EMS) registry to a state hospital discharge database, we identified cases in which a participating EMS agency provided care for a patient later diagnosed in the hospital with a SCI. Cases were then retrospectively reviewed to determine the prevalence of both LSB and C-collar use before and after agency adoption of a SMR protocol. We reviewed cases with LSB use after SMR protocol implementation to determine the motivations driving continued LSB use. We used simple descriptive statistics, odds ratios (OR) with 95% confidence intervals (CI) to describe the results.
Results: We identified 52 EMS agencies in the state of Arizona with 417,979 encounters. There were 225 patients with SCI, of whom 74 were excluded. The LSBs were used in 52 pre-SMR (81%) and 49 post-SMR (56%) cases. The odds of LSB use after SMR protocol implementation was 70% lower than it had been before implementation (OR 0.297, 95% CI 0.139–0.643; P = 0.002). Use of a C-collar after SMR implementation was not significantly changed (OR 0.51, 95% CI 0.23–1.143; P = 0.10). In the 49 cases of LSB use after agency SMR implementation, the most common reasons for LSB placement were ease of lifting (63%), placement by non-transporting agency (18%), and extrication (16.3%). High suspicion of SCI was determined as the primary or secondary reason for not removing LSB after assessment in 63% of those with LSB placement, followed by multiple transfers required (20%), and critical illness (10%).
Conclusion: Implementation of selective spinal motion restriction protocols was associated with a statistically significant decrease in the utilization of long spine boards among prehospital patients with acute traumatic spinal cord injury
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