Arrest in hospital: a study of in hospital cardiac arrest outcomes.

The effect of advances in cardiac arrest management over the last five decades on in-hospital cardiac arrest survival rates is not clear. Data on 212 arrests between January 2010 and May 2013 were retrospectively analyzed by means of an audit form based upon the Utstein template for in-hospital cardiac arrest, with a view to identifying significant associations between arrest characteristics and return of spontaneous circulation or survival to discharge. Significant associations were identified between return of spontaneous circulation and location (ward, 36 patients (38%) vs. ICU, 33 Patients (56%); P = 0.032), whether an arrest was witnessed or not (82 patients (52%) vs. 9 patients (30%); P = 0.029), whether the initial rhythm was shockable or non-shockable (28 patients (85%) vs. 38 patients (31%); P \u3c 0.001), whether the first dose of adrenaline was administered within 2 minutes of arrest onset or later (13 patients (54%) vs. 12 patients (28%); P = 0.04)

Sharing a different voice: Attending to stories in collaborative writing

Through three stories, we hope to reveal how sometimes contradictory or unrecognizable aspects of our lives, selves, and stories can create tensions in the collaborative writing endeavor. We begin with a story that illuminates some of the narrative tensions that surface during a decade of writing collaboratively. In an effort to navigate these tensions, we explore two further stories in dialogue as a way to reveal how dominant narratives shape our lives and the stories we might tell. One aim of sharing these stories is to reveal how problematic ways of being are often inseparable from one’s cultural legacy. Making previously obscured narratives visible paves the way for imaginary leaps that are necessary for change. We hope these insights are useful for other writers and collaborators and those who seek caring, responsive, and nurturing writing relationships yet realize this journey can be problematic

Pseudoconvex domains spread over complex homogeneous manifolds

Using the concept of inner integral curves defined by Hirschowitz we generalize a recent result by Kim, Levenberg and Yamaguchi concerning the obstruction of a pseudoconvex domain spread over a complex homogeneous manifold to be Stein. This is then applied to study the holomorphic reduction of pseudoconvex complex homogeneous manifolds X=G/H. Under the assumption that G is solvable or reductive we prove that X is the total space of a G-equivariant holomorphic fiber bundle over a Stein manifold such that all holomorphic functions on the fiber are constant.Comment: 21 page

Benefit of "Push-pull" Locomotion for Planetary Rover Mobility

As NASAs exploration missions on planetary terrains become more aggressive, a focus on alternative modes of locomotion for rovers is necessary. In addition to climbing steep slopes, the terrain in these extreme environments is often unknown and can be extremely hard to traverse, increasing the likelihood of a vehicle or robot becoming damaged or immobilized. The conventional driving mode in which all wheels are either driven or free-rolling is very efficient on flat hard ground, but does not always provide enough traction to propel the vehicle through soft or steep terrain. This paper presents an alternative mode of travel and investigates the fundamental differences between these locomotion modes. The methods of push-pull locomotion discussed can be used with articulated wheeled vehicles and are identified as walking or inchinginch-worming. In both cases, the braked non-rolling wheels provide increased thrust. An in-depth study of how soil reacts under a rolling wheel vs. a braked wheel was performed by visually observing the motion of particles beneath the surface. This novel technique consists of driving or dragging a wheel in a soil bin against a transparent wall while high resolution, high-rate photographs are taken. Optical flow software was then used to determine shearing patterns in the soil. Different failure modes were observed for the rolling and braked wheel cases. A quantitative comparison of inching vs. conventional driving was also performed on a full-scale vehicle through a series of drawbar pull tests in the Lunar terrain strength simulant, GRC-1. The effect of tire stiffness was also compared; typically compliant tires provide better traction when driving in soft soil, however its been observed that rigid wheels may provide better thrust when non-rolling. Initial tests indicate up to a possible 40 increase in pull force capability at high slip when inching vs. rolling

Economically optimal timing for crop disease control under uncertainty: an options approach

Severe large-scale disease and pest infestations in agricultural regions can cause significant economic damage. Understanding if and when disease control measures should be taken in the presence of risk and uncertainty is a key issue. We develop a framework to examine the economically optimal timing of treatment. The decision to treat should only be undertaken when the benefits exceed the costs by a certain amount and not if they are merely equal to or greater than the costs as standard net-present-value (NPV) analysis suggests. This criterion leads to a reduction in fungicide use. We investigate the effect of the model for disease progress on the value required for immediate treatment by comparing two standard models for disease increase (exponential and logistic growth). Analyses show that the threshold value of benefits required for immediate release of treatment varies significantly with the relative duration of the agricultural season, the intrinsic rate of increase of the disease and the level of uncertainty in disease progression. In comparing the performance of the delay strategy introduced here with the conventional NPV approach, we show how the degree of uncertainty affects the benefits of delaying control

A Cellular Automata Model for Citrus Variagated Chlorosis

A cellular automata model is proposed to analyze the progress of Citrus Variegated Chlorosis epidemics in S\~ao Paulo oranges plantation. In this model epidemiological and environmental features, such as motility of sharpshooter vectors which perform L\'evy flights, hydric and nutritional level of plant stress and seasonal climatic effects, are included. The observed epidemics data were quantitatively reproduced by the proposed model varying the parameters controlling vectors motility, plant stress and initial population of diseased plants.Comment: 10 pages, 10 figures, Scheduled tentatively for the issue of: 01Nov0

Mature Care and Nursing in Psychiatry: Notions Regarding Reciprocity in Asymmetric Professional Relationships

The idea behind this article is to discuss the importance and to develop the concept of reciprocity in asymmetric professional relationships. As an empirical starting point for an examination of the possible forms of reciprocity between patients and nurses in psychiatry, we chose two qualitative in-depth interviews with two different patients. The manners in which these two patients relate to medical personnel—one is dependent, the other is independent—show that this presents challenges to nurses. The theoretical context is provided by the notion of mature care as it has been developed by feminist-oriented ethics of care, in contrast to the notion of altruistic care. In relation to the concept of mature care, we discuss how nursing can be perceived in demanding relationships with patients in psychiatry. Reciprocity implies that, in principle, the interests of the nurses also matter in a nurse-patient relationship. We show that reciprocity—in practice—is complicated and challenging in a number of different ways. Mature care—with its systematic inclusion of relationships and reciprocity—provides an alternative understanding of what takes place between patients and nurses compared with an altruistic notion of care. As such, mature care can be regarded as an useful paradigm for nurse-patient relationships in psychiatry

Spatial Thinking in Practice: A Snapshot of teacher’s Spatial Activity Use in the Early Years’ Classroom

Spatial thinking predicts Science, Technology, Engineering, and Mathematics achievement, yet is often absent from educational policy. We provide benchmarks of teachers' usage and perceptions of spatial activities in practice in the reception classroom (first year of primary school). In this questionnaire study of educational professionals working in the reception classroom in England (N = 104), we found that spatial and numeracy activities were perceived as significantly less important, and were reportedly completed significantly less often, than literacy or life skills. Despite the lower perceived importance of spatial skills in curriculum guidance in England, rates of reported spatial activity use were encouragingly high and were broadly comparable to those of numeracy. Teachers had moderate anxiety levels for both spatial and mathematics domains. The findings highlight a need to elevate teachers' understanding of the importance of developing children's early spatial and numeracy skills, which may begin with efforts to reduce spatial and mathematics anxiety