Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation

Background: Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation techniques is poorly understood.Methods: A prospective randomised clinical trial was undertaken in January 2004 in 70 candidates randomly assigned to training in mouth-to-mouth, mouth-to-mask or mouth-to-face shield ventilation. Each candidate was trained for 10 min, after which tidal volume, respiratory rate, minute volume, peak airway pressure and the presence or absence of stomach inflation were measured. 58 subjects were reassessed 1 year later and study parameters were recorded again. Data were analysed with ANOVA, \textgreekq2 and McNemar tests.Results: Tidal volume, minute volume, peak airway pressure, ventilation rate and stomach inflation rate increased significantly at reassessment with all ventilation techniques compared with the initial assessment. However, at reassessment, mean (SD) tidal volume (960 (446) vs 1008 (366) vs 1402 (302) ml; p<0.05), minute volume (12 (5) vs 13 (7) vs 18 (3) l/min; p<0.05), peak airway pressure (14 (8) vs 17 (13) vs 25 (8) cm H2O; p<0.05) and stomach inflation rate (63% vs 58% vs 100%; p<0.05) were significantly lower with mouth-to-mask and mouth-to-face shield ventilation than with mouth-to-mouth ventilation. The ventilation rate at reassessment did not differ significantly between the ventilation techniques.Conclusions: One year after a single episode of ventilation training, lay persons tended to hyperventilate; however, the degree of hyperventilation and resulting stomach inflation were lower when a mouth-to-mask or a face shield device was employed. Regular training is therefore required to retain ventilation skills; retention of skills may be better with ventilation devices

From exercise intolerance to functional improvement: The second wind phenomenon in the identification of McArdle disease

McArdle disease is the most common of the glycogen storage diseases. Onset of symptoms is usually in childhood with muscle pain and restricted exercise capacity. Signs and symptoms are often ignored in children or put down to 'growing pains' and thus diagnosis is often delayed. Misdiagnosis is not uncommon because several other conditions such as muscular dystrophy and muscle channelopathies can manifest with similar symptoms. A simple exercise test performed in the clinic can however help to identify patients by revealing the second wind phenomenon which is pathognomonic of the condition. Here a patient is reported illustrating the value of using a simple 12 minute walk test.RSS is funded by Ciências sem Fronteiras/CAPES Foundation. The authors would like to thank the Association for Glycogen Storage Disease (UK), the EUROMAC Registry funded by the European Union, the Muscular Dystrophy Campaign, the NHS National Specialist Commissioning Group and the Myositis Support Group for funding

Using calibrated surface roughness dating to estimate coastal dune ages at K'gari (Fraser Island) and the Cooloola Sand Mass, Australia

Here we present a novel application of landscape smoothing with time to generate a detailed chronology of a large and complex dune field. K'gari (Fraser Island) and the Cooloola Sand Mass (CSM) dune fields host thousands of emplaced (relict) and active onlapping parabolic dunes that span 800 000 years in age. While the dune fields have a dating framework, their sheer size (~1930 km²) makes high-resolution dating of the entire system infeasible. Leveraging newly acquired (n = 8) and previously published (n = 20) optically stimulated luminescence (OSL) ages from K'gari and the CSM, we estimate the age of Holocene dunes by building a surface roughness (σC)–age relationship model. In this study, we define σC as the standard deviation of topographic curvature for a dune area and we demonstrate an exponential relationship (r² = 0.942, RMSE = 0.892 ka) between σC and timing of dune emplacement on the CSM. This relationship is validated using ages from K'gari. We calculate σC utilizing a 5 m digital elevation model and apply our model to predict the ages of 726 individually delineated Holocene dunes. The timing of dune emplacement events is assessed by plotting cumulative probability density functions derived from both measured and predicted dune ages. We demonstrate that both dune fields had four major phases of dune emplacement, peaking at <0.5, ~1.5, ~4, and ~8.5 ka. We observe that our predicted dune ages did not create or remove major events when compared to the OSL-dated sequence, but instead reinforced these patterns. Our study highlights that σC–age modelling can be an easily applied relative or absolute dating tool for dune fields globally. This systematic approach can fill in chronological gaps using only high-resolution elevation data (3–20 m resolution) and a limited set of dune ages

Exploration of key stakeholders' preferences for pre-hospital physiologic monitoring by emergency rescue services

Peer reviewedPostprintPostprin

Exploring Public Perceptions and Understanding of Dementia: Analysing Narratives from the Mass Observation Project

Over 850,000 people living in the United Kingdom have been diagnosed with dementia, yet knowledge about this condition amongst the general population remains relatively poor. Many studies have evaluated the level of public knowledge and understanding about dementia from a research and professional service perspective, however none have considered this condition from the perspective of the wider public. In this preliminary overview, we analyse and describe high level narratives collected from 143 respondents to a dementia Directive commissioned to the Mass Observation Project. These narratives present a perspective on the public knowledge and understanding about dementia not previously considered, where respondents have written openly about their own experiences, and reflected on their perception of the wider public’s knowledge and understanding about dementia. This unique perspective importantly enhances our knowledge about the public’s understanding and awareness of dementia, and informs the main areas of public concern found in the analysis: care responsibilities, impact on relationships, and fears about developing dementia

Pest and disease management system for supporting winter oilseed rape decisions (PASSWORD) - vaildation phase (HGCA Project Report No. 390)

Pests and particularly diseases cause serious loss of yield and quality in winter oilseed rape estimated to exceed £80 million/annum in some years. These losses have occurred despite an annual expenditure of about £3.5 million for insecticides and £12 million on fungicides. Decision-making is difficult because there is complex spatial and temporal variation in pest and disease problems and improved guidance is required. The main objective of this project was to test new disease models developed in the first phase of this project and deliver a decision support system for both pest and disease control in oilseed rape. The regional light leaf spot forecast is well-established and reliable and indicates an increased risk of this disease in spring 2006. A new regional forecast for stem canker incidence preharvest has been developed and made available on the Internet. It was successful in 2004/05 and offers strategic guidance on risk provided weather factors are within the range used to develop the model. A four-stage crop-specific stem canker risk assessment method was developed that predicts the onset of phoma leaf spotting using post-harvest weather data and thermal time relationships for canker development and canker severity. Yield loss can then be calculated from canker severity and the economic impact of stem canker predicted. There is some flexibility in the timing of fungicide sprays to control stem canker. Delays of 2 to 3 weeks beyond a 10-20% plants affected threshold did not adversely affect yield. Stem canker severity and yield of different cultivars showed large variation between years and sites and smaller, but significant, variation in responses to fungicide. When phoma leaf spot appears in late autumn, it is only when plants are small that stem canker is likely to cause yield loss. In commercial crops, there were consistent trends for higher yields to be associated with higher fungicide inputs. Light leaf spot was very difficult to control with fungicides in the Aberdeen area where use of resistant cultivars is essential. The most effective disease control was obtained using a combination of resistant cultivars and fungicides. In some years, responses to fungicides were not cost-effective and targeting their use to high-risk situations is necessary to give the best margins over input costs. Close contact was maintained with potential users during the project and they influenced priorities and design features. The components of PASSWORD decision support system were tested and provide guidance for the management of invertebrate pests, phoma stem canker and light leaf spot. The system will be available to ArableDS for use in autumn 2006