Collaborative research on V/STOL control system/cockpit display tradeoffs under the NASA/MOD joint aeronautical program

Summarized here are activities that have taken place from 1979 to the present in a collaborative program between NASA Ames Research Center and the Royal Aerospace Establishment (now Defence Research Agency), Bedford on flight control system and cockpit display tradeoffs for low-speed and hover operations of future V/STOL aircraft. This program was created as Task 8A of the Joint Aeronautical Program between NASA in the United States and the Ministry of Defence (Procurement Executive) in the United Kingdom. The program was initiated based on a recognition by both parties of the strengths of the efforts of their counterparts and a desire to participate jointly in future simulation and flight experiments. In the ensuing years, teams of NASA and RAE engineers and pilots have participated in each other's simulation experiments to evaluate control and display concepts and define design requirements for research aircraft. Both organizations possess Harrier airframes that have undergone extensive modification to provide in-flight research capabilities in the subject areas. Both NASA and RAE have profited by exchanges of control/display concepts, design criteria, fabrication techniques, software development and validation, installation details, and ground and flight clearance techniques for their respective aircraft. This collaboration has permitted the two organizations to achieve jointly substantially more during the period than if they had worked independently. The two organizations are now entering the phase of flight research for the collaborative program as currently defined

A Retrospective Analysis of Paramedic Student Performance Under Simulated Stress

The paramedic profession is an inherently difficult, dangerous and stressful profession. The paramedic is constantly barraged with acute stressors during the performance of his duties. These stressors have predictable, documented, negative effects on performance. The acute and chronic exposure to stress can negatively impact the safety and the well being of the paramedic. These stressors, if not successfully managed, can also result in negative effects to patients. Despite the overwhelming presence of stress in the paramedic environment, most paramedics receive little or no training to successfully perform under stress. One exception was a program called Trauma Lanes that was held at the National EMS Academy in Lafayette, Louisiana from 2009-2012, as part of the Accelerated Paramedic Education Program. This program, based on a similar model developed by the United States Air Force Pararescue Paramedic Program, trains paramedics to overcome the negative effects of stress using a combination of desensitization and overtraining techniques. A retrospective analysis of student performance scores during Trauma Lanes was performed in order to determine the effectiveness of the program. In addition, a survey was distributed to 71 graduates of the Trauma Lanes program who are now practicing paramedics in Louisiana, Texas and Mississippi in order to obtain additional data on the effectiveness of the program. The results indicated that stress could be effectively replicated in a simulated environment and that student performance is negatively impacted by the simulated stress. Students show significant improvements in performance after 12 simulations and continued improvement through the end of 19 simulations. The research also indicated that more simulations were needed to achieve optimal performance levels. The alumni survey responses indicated that the training received in the Trauma Lanes Program was crucial to prepare them for the effects of stress and successfully perform as a paramedic while under stress in real life situations

Domestic Violence and Abuse in the Healthcare Setting

Introduction and Background: Domestic violence and abuse (DVA) is a growing global concern that affects patients encountered by nurses. DVA is defined as anything that is used to establish and maintain control over another person. The occurrence of DVA has ongoing negative consequences for patients related to their safety, especially if nurses are not properly trained to detect and control the situation. Purpose Statement: For all registered nurses, does ongoing training opportunities and implemented universal screening processes on DVA, as compared to inadequate training and generalized screening processes, lead to effectively detecting DVA and providing better emotional, physical, and safety interventions for patients? Literature Review: The process of our literature review included the use of searching the ETSU library scholarly database and comparing our findings from twenty different peer-reviewed research articles. In the search methods used, we chose to look at multiple studies that researched DVA globally. Findings: The major findings of our research as a team included: communication barriers that exist for patients who are victims of DVA, establishing rapport to build better trust with patients, the necessity of standardized screening tools to assess for DVA, the incorporation of the entire healthcare team to create a more supportive network that includes on-call domestic violence advisors, and continuing education for nurses. Conclusions: Key takeaways that were found in our research included eliminating communication barriers with patients, using developed tools to strategically screen for domestic violence and abuse, and the importance of ongoing DVA training for nurses

Quantification of deficits in lateral paw positioning after spinal cord injury in dogs

<p>Abstract</p> <p>Background</p> <p>Previous analysis of the behavioural effects of spinal cord injury has focussed on coordination in the sagittal plane of movement between joints, limb girdle pairs or thoracic and pelvic limb pairs. In this study we extend the functional analysis of the consequences of clinical thoracolumbar spinal cord injury in dogs to quantify the well-recognised deficits in lateral stability during locomotion. Dogs have a high centre of mass thereby facilitating recognition of lateral instability.</p> <p>Results</p> <p>We confirm that errors in lateral positioning of the pelvic limb paws can be quantified and that there is a highly significant difference in variability of foot placement between normal and spinal cord injured dogs. In this study there was no detectable difference in lateral paw positioning variability between complete and incomplete injuries, but it appears that intergirdle limb coordination and appropriate lateral paw placement recover independently from one another.</p> <p>Conclusion</p> <p>Analysis of lateral paw position in the dog provides an additional tier of analysis of outcome after spinal cord injury that will be of great value in interpreting the effects of putative therapeutic interventions.</p

Indication documentation and indication-based prescribing within electronic prescribing systems: a systematic review and narrative synthesis

BACKGROUND: Despite recommendations, documentation of indication on prescriptions and inpatient medication orders is not routinely practised. There has been a recent systematic review of indication documentation for antimicrobials, but not for interventions relating to indication documentation for medication more broadly. Our aims were to 1) identify, describe and synthesise the literature relating to effectiveness of interventions aimed at improving indication documentation and/or indication-based prescribing in both primary and secondary healthcare; 2) synthesise participant perspectives to identify barriers and facilitators to these interventions; and 3) make recommendations for both practice and research. METHODS: A systematic literature search was conducted using Medline, Embase and CINAHL using two search concepts: electronic prescribing systems, and indication documentation and/or indication-based prescribing. Qualitative, quantitative and mixed-methods studies were included; outcome measures and results were extracted to produce a narrative synthesis. Quality appraisal by two independent reviewers was undertaken using the Mixed Methods Appraisal Tool. RESULTS: We identified 21 studies evaluating interventions to aid indication documentation. Indication documentation was either via free-text, selection from a list, or by use of pre-defined indication-based order sentences for individual medications. For a number of outcomes, there was a mostly positive impact, including appropriateness of the medication order (6 of 8 studies), rates of prescribing error (2/2) and some less commonly reported clinical (2/4) and workflow-related outcomes (2/3). There was a less favourable impact on accuracy of indication documentation and rates of medication use, highlighting some unintended consequences that may occur when implementing new interventions. Participant insights from prescribers and other healthcare professionals complemented quantitative study results, highlighting both facilitators and barriers to indication documentation and the associated interventions. For example, barriers included long drop-down lists and the need to use workarounds to navigate approval systems due to time or knowledge constraints. Facilitating factors included the perceived benefits of indication documentation on communication among the healthcare team and with the patient. CONCLUSION: Indication documentation has the potential to improve appropriate prescribing and reduce prescribing errors. However, further benefits to the prescriber, multidisciplinary team and patient may only be realised by developing methods of indication documentation that integrate more efficiently with prescriber workflows. PROSPERO REGISTRATION NUMBER: CRD42021278495

Geotechnics and hydrology of landslides in Thompson River Valley, near Ashcroft, British Columbia

Landslides in Pleistocene sediments along the Thompson River, south of Ashcroft, British Columbia have been known since before the Canadian Pacific (CP) railway was built through the valley in the 1880s. The Canadian National (CN) mainline railway, built in the early twentieth century, also follows the valley. Since the CP mainline was open to traffic in 1886, landslides have occurred along both sides of the Thompson valley and have resulted in derailments and traffic disruption along this strategic railway corridor. Past work identified a critical interbedded glaciolacustrine silt and clay unit at the base of the valley fill in which the sliding planes of the landslides were located. In our geotechnical characterization of this unit we identify the clay as the main contributing factor towards the instability of slopes in the Thompson River Valley due to its low residual strength parameters. Ring shear testing of this unit indicate residual friction angles between 10o and 15o. The use of residual shear strength parameters is necessitated by the presence of pre-sheared surfaces in the valley fill material caused by historical landsliding and glacial overriding. An additional contributing factor to slope instability in Thompson River Valley is the presence of artesian pore water pressures located below the failure surfaces of landslides in the valley. Previously suggested explanations for development of the elevated pore pressures include dynamic change in the Thompson River stage, and over irrigation of upslope farm lands. Groundwater models of Thompson River Valley were constructed using the advanced modeling tool HydroGeoSphere in order to determine the origin of these elevated pressures, and to explore additional influences on the regional groundwater flow system, including irrigation and river stage. Analysis of groundwater simulations showed that due to its low permeability, the glaciolacustrine silt and clay unit is important in controlling groundwater flow patterns, and explains the development of artesian pressures in the valley bottom. Further, it was shown that fluctuation in river stage and additional infiltration due to irrigation of upslope farm lands had minimal impact on pore water pressures, and cannot explain the development of landslides in the study area. Groundwater simulations were coupled with slope stability analyses in order to assess the slope Factor of Safety associated with certain groundwater conditions. This was achieved by using SLOPE/W and SEEP/W. Slopes were found to be unstable under natural conditions with a Factor of Safety close to unity. Significant changes to the Factor of Safety were noted for scenarios where precipitation was doubled and halved, but irrigation was again shown to have a minimal effect on the stability of Thompson Valley slopes

The Passive Journalist: How sources dominate the local news

This study explores which sources are “making” local news and whether these sources are simply indicating the type of news that appears, or are shaping newspaper coverage. It provides an empirical record of the extent to which sources are able to dominate news coverage from which future trends in local journalism can be measured. The type and number of sources used in 2979 sampled news stories in four West Yorkshire papers, representing the three main proprietors of local newspapers in the United Kingdom, were recorded for one month and revealed the relatively narrow range of routine sources; 76 per cent of articles cited only a single source. The analysis indicates that journalists are relying less on their readers for news, and that stories of little consequence are being elevated to significant positions, or are filling news pages at the expense of more important stories. Additionally, the reliance on a single source means that alternative views and perspectives relevant to the readership are being overlooked. Journalists are becoming more passive, mere processors of one-sided information or bland copy dictated by sources. These trends indicate poor journalistic standards and may be exacerbating declining local newspaper sales

Keloid : multicentre study on the outcome of multimodality management

Introduction: Keloids are benign hyperproliferative growths of dermal fibroblasts characterized by the excessive deposition of extracellular matrix components, especially collagen, fibronectin, elastin, proteoglycans, and growth factors such as TGF-β. They remain difficult to improve despite a plethora of advocated treatment strategies frequently observed in daily clinical routine. Hence, multimodality treatment is often recommended for optimum control of the disease. This study aims to assess the outcome of intralesional triamcinolone acetonide (TAC) injections with concurrent scar massage in management of keloid scarring in our setting, in order to optimise its management in the local population. Methods:This is a prospective observational study conducted in the Reconstructive Sciences Unit, Hospital UniversitiSains Malaysia (Hospital USM) and the Department of Plastic & Reconstructive Surgery, Hospital Kuala Lumpur (HKL). This study involves the collection of POSAS scores from patients with keloid scars while they undergo treatment with intralesional TAC injections with concurrent scar massage.The POSAS scores is used to analyse the treatment outcome of keloid scars in the Malaysian population

The Role of a General Safety Requirement in Canada's Health Protection Regime

This research was supported in part by a financial contribution from the Health Policy Research Program, Health Canada