Trauma unit emergency doctor airway management

Objectives. To audit indications for and practice (in terms of training/qualification) of definitive airway management compared with current UK practices. Design. Consecutive observational study. Setting. Tygerberg Academic Hospital Trauma Service, Western Cape. Subjects. All trauma patients either arriving intubated or requiring intubation at the Trauma unit during the period 1 - 31 August 2006. Outcome measures. A data collection proforma was completed either at the time of intubation or from medical records. Results. Fifty-seven patients required definitive airway management. In the unit 32 patients (56%) were intubated by emergency medicine registrars or medical officers, with rapidsequence intubations (RSIs) in all 32 (100%). Seven patients (12.3%) were intubated by paramedics pre-hospital, and 18 patients (31.6%) were intubated at referring hospitals by nonanaesthetists. Endotracheal intubation was successful in 55 patients (96.4%). Two patients (3.6%) could not be intubated and therefore underwent surgical cricothyroidotomy at the unit. Clinical outcomes included 12 patients (21%) extubated for ward transfer, 7 patients (12.3%) admitted to an intensive care unit (ICU), 21 patients (36.8%) taken for surgery, and 17 patients (29.8%) died. Motor vehicle accident (MVA) was the predominant mechanism of injury, accounting for 30 (52.6%) patients, while 16 patients (28.1%) had penetrating injuries (gunshot and/or stab wounds), 6 patients (10.5%) had blunt trauma, and the remaining 5 patients (8.8%) suffered serious burns. Conclusion. The most common indication for intubation was a Glasgow Coma Score (GCS) of less than 8, typically in the polytrauma patient with suspected head injury due to MVA. Emergency doctors managed 100% of definitive airway inhospital, and RSI was the favoured method. This differs greatly from the UK where non-anaesthetists only perform between 31% and 56% of trauma intubations, with the rest performed by anaesthetists. Outcome was, however, similar to that described in the literature. South African Medical Journal Vol. 97 (9) 2007: pp. 864-86

Continental land cover classification using meteorological satellite data

The use of the National Oceanic and Atmospheric Administration's advanced very high resolution radiometer satellite data for classifying land cover and monitoring of vegetation dynamics over an extremely large area is demonstrated for the continent of Africa. Data from 17 imaging periods of 21 consecutive days each were composited by a technique sensitive to the in situ green-leaf biomass to provide cloud-free imagery for the whole continent. Virtually cloud-free images were obtainable even for equatorial areas. Seasonal variation in the density and extent of green leaf vegetation corresponded to the patterns of rainfall associated with the inter-tropical convergence zone. Regional variations, such as the 1982 drought in east Africa, were also observed. Integration of the weekly satellite data with respect to time produced a remotely sensed assessment of biological activity based upon density and duration of green-leaf biomass. Two of the 21-day composited data sets were used to produce a general land cover classification. The resultant land cover distributions correspond well to those of existing maps

Geological investigation of palaeotsunamis in the Samoan islands: interim report and research directions

The Komandorsky seismic gap has distinctive boundaries and a length of 650 km. Its period of “seismic silence” comes close to the maximum recurrence interval for great earthquakes in the Aleutian Island Arc - the stress concentration here probably having reached the critical value. So,estimation of possible earthquake and tsunami characteristics within this gap becomes a significant problem. The closest analog of a similar gap is the area where the 2004 Sumatra-Andaman catastrophic event occurred. Thus, for the present study we used the same modeling scheme as we used for that event. It was assumed that a source length of 650 km, consisting of 9 blocks, and an earthquake with a moment magnitude MW=8.5. Several block motion scenarios were considered. The tsunami generation and propagation in the Pacific Ocean and the possible wave characteristics on near and far-field coasts were estimated. Modeling of such an event showed that the wave heights on different Pacific coasts will vary from 3 to 9 meters. A tsunami wave with a 9-meter height is capable in causing significant loss of human life and economic damage.© 2013, Tsunami Society International

Development of Methodologies to Reduce the DCAD of Hay for Transition Dairy Cows

Ration formulation for dairy cows prior to parturition must control the diet cation-anion difference (DCAD) if hypocalcemia and milk fever are to be avoided. One key to reducing hypocalcemia is to avoid incorporation of high K forages into the ration. The excessive K content of these forages can cause metabolic alkalosis in the cow and subsequently hypocalcemia and milk fever. Alfalfa and other cool season grasses are often used in dairy rations. Reducing K content of forages can be achieved by restricting K fertilization so that soils do not support luxury K consumption by the crops. Because K is the major cation contributing to high DCAD diets, an obvious solution is to limit K fertilization to avoid luxury consumption of K by the forage crop. However,some forages may have reduced yield and increased winter kill if K concentrations are \u3c 2.0%, particularly alfalfa. Thus, producing alfalfa with less than 2% K may not be profitable, especially in northern regions. In addition to decreasing forage K, the producer can also increase the Cl content of the forages, the resulting DCAD will be more favorable for the late gestation cow

The Real Combination Problem : Panpsychism, Micro-Subjects, and Emergence

Panpsychism harbors an unresolved tension, the seriousness of which has yet to be fully appreciated. I capture this tension as a dilemma, and offer panpsychists advice on how to resolve it. The dilemma, briefly, is as follows. Panpsychists are committed to the perspicuous explanation of macro-mentality in terms of micro-mentality. But panpsychists take the micro-material realm to feature not just mental properties, but also micro-subjects to whom these properties belong. Yet it is impossible to explain the constitution of a macro-subject (like one of us) in terms of the assembly of micro-subjects, for, I show, subjects cannot combine. Therefore the panpsychist explanatory project is derailed by the insistence that the world’s ultimate material constituents (ultimates) are subjects of experience. The panpsychist faces a choice of abandoning her explanatory project, or recanting the claim that the ultimates are subjects. This is the dilemma. I argue that the latter option is to be preferred. This needn’t constitute a wholesale abandonment of panpsychism, however, since panpsychists can maintain that the ultimates possess phenomenal qualities, despite not being subjects of those qualities. This proposal requires us to make sense of phenomenal qualities existing independently of experiencing subjects, a challenge I tackle in the penultimate section. The position eventually reached is a form of neutral monism, so another way to express the overall argument is to say that, keeping true to their philosophical motivations, panpsychists should really be neutral monists.Peer reviewedFinal Accepted Versio

Development of a pilot data management infrastructure for biomedical researchers at University of Manchester – approach, findings, challenges and outlook of the MaDAM Project

Management and curation of digital data has been becoming ever more important in a higher education and research environment characterised by large and complex data, demand for more interdisciplinary and collaborative work, extended funder requirements and use of e-infrastructures to facilitate new research methods and paradigms. This paper presents the approach, technical infrastructure, findings, challenges and outlook (including future development within the successor project, MiSS) of the ‘MaDAM: Pilot data management infrastructure for biomedical researchers at University of Manchester’ project funded under the infrastructure strand of the JISC Managing Research Data (JISCMRD) programme. MaDAM developed a pilot research data management solution at the University of Manchester based on biomedical researchers’ requirements, which includes technical and governance components with the flexibility to meet future needs across multiple research groups and disciplines