The Positive Impact of Automated External Defibrillator Application Prior to EMS Arrival

In a 2016 County Profile, completed by the North Carolina State Department of Commerce, Caswell County had a population in 2014 of 23,614 and has a projected population for 2019 of 23,484. The population isn’t projected to increase, but the current population is aging. The quality of life for the residents in terms of healthcare is poor. According to this 2016 study, in 2013, Caswell County only had six physicians, the physicians per 10,000 populations was 2.5. Today, the County has three primary care physician offices, two in Yanceyville (the town seat) and one in Prospect Hill as well as the Health Department. The County also has ten volunteer fire departments that respond to medical calls to assist the County Emergency Medical Services (EMS) system, but the majority of them do not hold a North Carolina Office of Emergency Medical Services (i.e. Medical Responder, Emergency Medical Technician (EMT), Advanced EMT or Paramedic) certification. In North Carolina, fire and rescue department personnel are only required to have certifications if their respective departments require it. Caswell County currently has zero fire departments that are, at a minimum, providing EMT level care. Each department provides first responder assistance (these fire personnel have completed a 40 hour Emergency Medical Course) but do not possess a certification. The fire departments have not been approved by the current medical director to become EMT level departments, primarily because of the lack of providers, but also because of the internal training that must be done between the EMS system and the fire departments. There is an abundant need for additional training in the county to increase the level of care being delivered by the fire departments because as a rural county, with only three trucks operating twenty-four hours a day, seven days a week, there are times when the average response time for an ambulance can be over sixteen minutes. This delay in EMS response due to location of the ambulances compared to the location of the 911 calls impacts patient’s chances of survival greatly. This research project involves an analysis of data from January 1, 2014 through December 31, 2016 from Caswell County EMS, Caswell County Enhanced 911 Center, 10 the North Carolina Office of EMS Performance Improvement Center and the patient care reporting system that Caswell County EMS utilizes, known as ESO Solutions, Inc., on patients that received an AED prior to EMS arrival compared to patients that did not receive an AED prior to EMS arrival. Research Question and Hypothesis: The data consists of all patients that received cardiopulmonary resuscitation (CPR) from January 1, 2014 through December 31, 2016 in Caswell County. I will look at first responders and/or bystanders applying AEDs to patients in cardiac arrest and if an AED was not applied prior to EMS arrival with patients in cardiac arrest and their survival rate as well as patients that only had an AED applied by EMS and their survival rate. The research question that I’m posing is that survival rates would be higher if public access defibrillation programs were more accessible in non-Yanceyville areas. My hypothesis is those patients suffering from cardiac arrest that live in Yanceyville, NC have a better chance of survival than patients that live in other parts of Caswell County, referred to as non-Yanceyville due to the availability of AEDs

When the Balance Isn't Easy: A Case Study Exploring the Complications with Work-Life Balance Initiatives in the Australian Construction Industry

Studies of work and life balance often concentrate on the ways in which employees may require and use flexible work practices to cope with the demands of their other ‘non-work’ activities and responsibilities. This paper adds to our knowledge in this arena through presenting a case study of work-life balance. This case study focuses on managerial and employee issues in implementing organisational work life balance initiatives within the construction industry in Australia. For this case study, the workplace was an ‘alliance’ project, of four collaborating companies undertaking a large infrastructure project. The project management group determined that work-life balance was an important issue within the industry and consequently implemented a five-day instead of the industry standard six-day working week as a balance initiative for the workforce. A range of factors contributed to this five-day week initiative reverting to the original work schedule of a six-day working week. This paper explores these issues and analyses the competing priorities and demands of management in endeavouring to develop alternate strategies to maintain a positive work and life balance for employees. The analysis of this case suggests that management and employees were dedicated to improving work-life balance; however, a range of externalities resulted in not all initiatives being successful. Nevertheless, within the constrained choices, the management group instigated alternate initiatives

CRA Resolutions Against Agency Guidance

After years of dormancy, the Congressional Review Act (“CRA”) suddenly plays a prominent role in agency policymaking. Under the CRA, Congress has overturned multiple major regulations adopted by the Obama Administration, and the campaign continues. The next stage in this rollback appears to be a program of invalidating agency guidance documents, policy statements, and interpretations. That possibility has frightened many observers because it appears to expose an enormous additional amount of policymaking to CRA attack. We argue that, to the contrary, using the CRA in an attempt to overrule agency policy statements and interpretations will be fruitless, and the effort will, in the long run, reveal important limits on the CRA

Laboratory studies of stratified convection with multiple states

Author Posting. © The Authors, 2005. This is the author's version of the work. It is posted here by permission of Elsevier Ltd for personal use, not for redistribution. The definitive version was published in Ocean Modelling 11 (2006): 333-346, doi:10.1016/j.ocemod.2005.01.002.A simplified box model of the cooling of a salt-stratified ocean has been constructed in the laboratory to test a theory that predicts multiple equilibria if certain conditions exist. An isothermal basin of water had a thin layer of fresh water over salt water. Beside this was a smaller basin connected to the large basin by horizontal tubes at the top, middle and bottom. The small basin was cooled from above. If the top tube has more flow resistance than the bottom tubes, theory indicates that as cooling temperature T* is made colder, there is a sudden transition between two flow states. The velocities in the tubes jump to greater values, while salinity and temperature in the small basin jump to another value. These multiple states are found in the laboratory experiments along with some states that oscillate. Laboratory measurements and layered model calculations for hysteresis and the jump of temperature and salinity agree qualitatively, but there is only rough quantitative agreement.The National Science Foundation, Physical Oceanography Section under Grant OCE-0081179 supported the experimental laboratory studies

GIS and 3D Analysis Applied to Sea Turtle Mortalities and Navigation Channel Dredging

Between 2000 and 2003 there were an increased number of documented sea turtle mortalities related to hopper dredging in the channels of the Chesapeake Bay. A pilot study was undertaken to create a bathymetric surface and three-dimensional model of the Cape Henry Channel using Geographic Information Systems (GIS) as a visualization tool to examine sea turtle mortalities in relation to the dredging. In Fall 2003, the US Army Corps of Engineers dredged the Thimble Shoals Federal Navigation Channel, and a more refined model was developed using this data. This project examines the growing concerns over sea turtle mortality rates and dredging operations, as well as a description of the usage of GIS analysis, interpolation, and visualization methods as tools for examining turtle habitat and mortality issues. Future directions for incorporating GIS into attempts to reduce sea turtle mortality in dredging operations are then outlined

Thermoresponsive and Mechanical Properties of Poly(

Gelation of the left helical N-substituted homopolypeptide poly(l-proline) (PLP) in water was explored, employing rheological and small-angle scattering studies at different temperatures and concentrations in order to investigate the network structure and its mechanical properties. Stiff gels were obtained at 10 wt % or higher at 5 °C, the first time gelation has been observed for homopolypeptides. The secondary structure and helical rigidity of PLP has large structural similarities to gelatin but as gels the two materials show contrasting trends with temperature. With increasing temperature in D₂O, the network stiffens, with broad scattering features of similar correlation length for all concentrations and molar masses of PLP. A thermoresponsive transition was also achieved between 5 and 35 °C, with moduli at 35 °C higher than gelatin at 5 °C. The brittle gels could tolerate strains of 1% before yielding with a frequency-independent modulus over the observed range, similar to natural proline-rich proteins, suggesting the potential for thermoresponsive or biomaterial-based applications.United States. Army Research Office (W911NF-13-D-0001)United States. National Institutes of Health (NIH/NIGMS 5T32GM008334

A Framework for Material Selection in Multi-Generational Components: Sustainable Value Creation for a Circular Economy

AbstractEarly stages of a product's design are critical for decisions impacting the entire life-cycle cost. Product designers have mastered the first generation, but they have no ability to know the impact of their decisions on multi-generational products. There is a need for tools that aim at closing the gap between total life-cycle information and the traditional design process. This paper presents a framework for a decision support tool that uses a combination of a life-cycle costing methodology and an evolutionary algorithm to assess design decisions specifically related to material selection. A case study is included to validate the new methodology