An experimental study on timely activation of smoke alarms and their effective notification in typical residential buildings

The volume of smoke alarm sound in rooms (other than room of sound origin) in real houses and smoke alarm activation time in rooms in full-scale model houses using ionization, photoelectric and dual detector smoke alarms were determined in this study. The alarm sound level measurements indicated that the sound level in many locations is likely to be too low to provide reliable notification, particularly for sleeping people, if smoke alarms are not installed in every room. In addition, changing to a lower frequency (520 Hz square wave) alarm would further aid effective notification of building occupants. The smoke alarm activation measurements showed that the time to detection (given a particular smoke source) was influenced by door position (open versus closed), the room in which the fire occurs, the location (room or hallway) of the detector, the type of detector and the smoke alarm manufacturer. Furthermore time to detection is also influenced by the type and form of the material that is burning. It was observed that photoelectric smoke alarms had the highest incidence of non-activation and when they did activate they, on average, took longer to activate than ionization and dual (ionization and photoelectric) smoke alarms over all smoke sources considered in this study. It is concluded that to achieve early detection and provide adequate notification, smoke alarms are necessary in every room and should be interconnected

Narcolepsy, cataplexy, hypocretin and co-existing other health complaints: A review

The presence of cataplexy in people with narcolepsy has a well-documented tight association with very low or non-detectable levels of the central nervous system neuropeptide, hypocretin (also termed orexin) while levels of hypocretin are normal in people with narcolepsy without cataplexy. There is evidence to suggest that hypocretin may have an association with pain, migraines and headaches in people with narcolepsy. However, these studies have not compared findings across narcolepsy with and without cataplexy. Currently, there are no studies published to determine whether pain, migraines and headaches are just common symptoms experienced by all people with narcolepsy or whether the presence of the cataplexy symptom (and thus assumed low levels of hypocretin) exacerbates these symptoms. Also, it is unclear whether general health and wellbeing (including psychological wellbeing) is similarly affected by hypocretin levels, or may be confounded by different levels of other health symptoms, such as pain. This review poses a number of research questions that need to be explored about whether the presence or absence of cataplexy is differentially associated with different types, severity and location of chronic pain; frequency, location and types of migraines and headaches; and general health and wellbeing among people with narcolepsy. A greater understanding of the role of hypocretin in these health complaints could aid in the development of more appropriate treatments for pain, migraines and headaches amongst people with and without narcolepsy

The predictive validity of the family risk survey and child risk survey for identifying persistent firesetting risk

Young firesetter behavior poses significant risks to individuals and communities. Intervention is important to mitigate youth firesetting, and treatment needs vary depending on underlying motives. Effective screening of persistent firesetter risk to inform intervention approach is critical to ensure appropriate matching of risk and needs. This study aimed to evaluate the utility of the child risk survey (CRS) and family risk survey (FRS) for predicting persistent firesetting risk, and subsequent triaging of cases toward the appropriate treatment. A total of 61 families engaged with the Firelighting Consequences Awareness Program, Melbourne, Australia, completed the CRS and FRS preintervention, and reported their firesetting behavior 1-year postintervention. The CRS was not effective for correctly predicting persistent and nonpersistent firesetters. The FRS was successful at predicting persistent firesetters 85% of the time, but had a high rate of false positives, overclassifying nonpersistent firesetters as high risk. Finally, the actual rate of firesetters that would be deemed suitable for each of the three recommended interventions based on the CRS and FRS scoring protocols was substantially different to the expected rates described in the accompanying manual. Implications for service provision are discussed

Fire fatality and alcohol intake: analysis of key risk factors

ABSTRACT. Objective: After a brief review of the literature on the role of alcohol in residential fi re deaths, a comparison of different risk factors for residential fi re fatality was undertaken by closely analyzing the circumstances of fi re victims as a function of alcohol intake. Method: Analyses were based on Australian coroners' fi re fatality records for the state of Victoria (1998Victoria ( -2006 and considered demographic, behavioral, and environmental factors for the 95 adult fi re victims who were tested for alcohol (64 male, 31 female). Results: Most (58%) had a positive blood alcohol concentration (BAC) test, with 31% of the total sample having a BAC of more than 0.20 gm per 100 ml. Odds ratio analyses showed that four variables were signifi cantly more associated with victims who had consumed alcohol compared with sober victims. In descending odds ratio order, these variables were as follows: (a) being aged 18-60 years, (b) involving smoking materials (e.g. cigarettes, pipes), (c) having no conditions preventing escape, and (d) being male. An important new fi nding is that fi re fatalities with positive BAC levels were more than three times less likely to have their clothing alight or exits blocked than sober fi re victims. Conclusions: The risk of dying in a fi re for alcohol-affected people who are capable of being alerted and escaping may be reduced if they can be alerted more quickly and effectively. Suitable measures for improving smoke alarms via interlinking and the use of an alarm signal demonstrated to be more effective at waking sleepers, including those who are alcohol affected, are discussed

New Scientific-teaching Staff

Additional file 1: Table S1. Demographic and clinical data summary of d-lactic acidosis episodes (n = 59) included in the qualitative synthesis. All episodes simultaneously reported at least one high d-lactate level (from blood or urine analysis) and documented neurological symptoms. Episodes were screened for information about patient demographics, neurological symptoms, non-neurological symptoms, d-lactate levels, l-lactate levels, anion gap, pH levels, microbial composition, proposed triggers, medical history/comorbid conditions and treatment. Numbers in brackets (1) and (2) indicate separate episodes for the same patient. The letters a and b identify different patient cases reported in the same reference. Episodes from non-SBS patients are marked with an asterisk

The Impact of Narcolepsy on Psychological Health and Role Behaviours: Negative Effects and Comparisons With Other Illness Groups

Adjustment to an illness can be conceptualised in terms of people's ability to adequately function in their life roles (eg worker, spouse, parent and friend). The PAIS-SR questionnaire assesses psychosocial adjustment across seven domains and was investigated in a sample of people with narcolepsy in relation to age, gender, the disruptive effects of symptoms and medication status. Participants (n=129) were recruited via the Australian narcolepsy support group and questionnaires were distributed and received by post. Males were found to be more vulnerable than females in terms of adjustment, and younger narcoleptics may have particular problems in the vocational environment. Those patients taking no medication for narcolepsy were least inclined to participate in social and leisure activities. The level of disruption reported due to symptoms was strongly associated with both psychological distress and overall psychosocial adjustment and was most notable in those taking both stimulants and tricyclic antidepressants. Narcoleptics reported more adjustment problems in comparison to three other illness groups (cardiac, mixed cancer and diabetes), with particular differences in health care orientation and psychological distress. A table of normative PAIS-SR values for narcolepsy was developed from this sample. The high levels of psychological distress found in this study are of particular concern, suggesting there is an urgent need for health professionals to provide support for adjustment problems experienced in narcolepsy across a variety of life roles. The need for action in several areas is discussed

A Comparison of sleep deprivation and Narcolepsy in terms of complex cognitive performance and subjective sleepiness

Objectives: (i) To expose 'normal sleepers' to a thirty two hour sleep deprivation protocol and evaluate the impact of this deprivation on a complex performance task i.e. The Paced Auditory Serial Addition Test (PASAT), (ii) To compare these sleep deprivation performance findings with historical data on the impact of sleepiness secondary to narcolepsy on PASAT performance measures, (iii) To investigate the recuperative effects of a brief nap period on both sleepiness and PASAT performance for the sleep deprived subjects, (iv) To compare these post nap effects with historical data relating to the impact of napping on both sleepiness and PASAT performance for subjects with narcolepsy. Background: Previous research has demonstrated that sleepiness induced by sleep deprivation in normal sleepers may lead to cognitive impairment across a range of performance tasks. Sleepiness secondary to narcolepsy has also been noted to impair cognitive function especially for complex processing tasks. Direct comparison of the effects of sleepiness on performance between non pathological and pathological sleepiness states is confounded however by methodological differences in research design especially in relation to levels of induced sleepiness and performance task selection. The purpose of the current study was to undertake a sleep deprivation study that achieved a methodological match with published data evaluating the impact of sleepiness on cognitive performance for subjects with narcolepsy. This methodological matching allowed for a more precise comparison of the impact of sleepiness on performance between non-pathological and pathological sleepiness groups. Results: Normal sleepers required a thirty-two hour deprivation protocol to develop a subjective level of sleepiness that equated with that identified by subjects with narcolepsy. This induced sleepiness in normal sleepers did not result in any significant decrement in complex performance a finding that was in contrast to the performance decrement previously found in subjects with narcolepsy with equivalent subjective sleepiness ratings. A twenty-minute nap produced more improvement in both arousal and cognitive processing performance for the subjects with narcolepsy than for the current sleep-deprivation cohort. Conclusion: This study identified significant differences in the impact of sleepiness on complex performance between non-pathological sleep deprived subjects and subjects with narcolepsy. The paper explores these differences in relation to the potential for both quantitative and qualitative differences to exist in the nature of sleepiness between non-pathological and pathological sleepiness states

Narcolepsy and disruption to social functioning

This study sought to create an in depth understanding of the impact of living with narcolepsy (a disorder of excessive daytime sleepiness) through qualitative research. The study used an essentially phenomenological methodology. Twenty- seven participants (18 females, 9 males, Mean age = 54.30, range = 26-90 years) were recruited from medical files in Canada and the narcolepsy support group in Australia. Data were collected via an open-ended narrative inviting the informant to focus on the impact of the disorder and analysed thematically. The issue of social context emerged as a key theme in understanding perceptions of the impact of living with narcolepsy. A secondary theme was that narcolepsy was experienced as an invisible illness. Thus the impact of living with narcolepsy is embedded in the need to maintain acceptable social functioning (within family, friendship and work relationships) and, related to this, cognitive functioning. This is complicated by the often indistinguishable nature of the symptoms from behaviors that people without narcolepsy experience. Health professionals need to understand that narcolepsy differs from other illnesses in that its key impact is a disruption to normal social functioning

The Natural History of Health and Symptoms in Narcolepsy: a 10 year Longitudinal Study

The aim of the study was to compare, over a 10 year period (1991/2001), reported changes in people with narcolepsy in terms of (1) life impact of symptoms (2) sleep propensity (3) body mass index, and (4) concomitant illnesses. Also, to document, using retrospective report, (5) environmental factors influencing narcolepsy severity, and (6) reported time of worst symptom severity following narcolepsy onset.\ud In 1991 127 people with diagnosed narcolepsy and cataplexy completed a wide ranging questionnaire. In 2001 attempts were made to recontact these participants and 67 were traceable. Of these, 47 people, (18 males, 29 females; mean age 61.76 years, age range 31-86 years) returned a revised questionnaire. The reported impact of excessive daytime sleepiness (EDS) on the ability to carry out day to day activities showed minor increases in severity over the 10 year period in this older narcolepsy sample, and this could not be attributed to major changes in medication status. It is argued that the underlying severity of EDS does not increase with time, but rather that the interaction of EDS with the aging process increases its detrimental impact. There was no evidence that any narcolepsy symptom became substantially worse with time for most people with the disorder. The influence of environmental factors on symptoms was inconsistent within the group. In terms of other health issues, the elevated BMI, stable over time, suggested that excess weight may be a trait often associated with narcolepsy, possibly linked to hypocretin deficiency. A high prevalence rate of diabetes was noted in the sample

Growing up with narcolepsy: Consequences for adolescents and young adults

Background Narcolepsy, a disorder of excessive daytime sleepiness, often has its major onset in adolescence. The aim of the present study was to focus on the scope and psychosocial impact of narcolepsy symptoms in adolescence. Materials and methods Semistructured interviews with 9 adolescents and young adults with narcolepsy provided detailed descriptions of the topic as perceived by the participants. Results Narcolepsy symptoms in adolescence varied and often worsened at puberty onset. Sleep may be experienced as unrefreshing. The widespread and often severe psychosocial effects partially arose from a delay in diagnosis. Severe educational failure was a common consequence. Symptoms affected work and life goals. Increased social withdrawal and lower self esteem were often evident. Sleepiness was a problem both for public transportation and driving, substantially affecting independent mobility. Conclusion Increased awareness of the disease and the provision of psychoeducational support, in conjunction with early diagnosis and medical treatment, are strongly warranted to prevent the most common educational and psychosocial problems, including risk of depression