Смешанное дистанционно-аудиторное обучение как альтернатива традиционному аудиторному обучению базовой сердечно-легочнои реанимации и автоматической наружной дефибрилляции

Introduction. Early bystander cardiopulmonary resuscitation (CPR) is a critical factor in out-of-hospital cardiac arrest survival, and the readiness of bystanders to provide the first aid is known to be positively influenced by effective training. It is recommended to use alternative teaching methods in order to increase the accessibility of CPR training. The study was carried out to assess the effectiveness of the blended approach to resuscitation training, where classroom training hours are partially substituted with remote learning.Material and methods. This prospective randomized study was conducted in November-December 2018. Nursing students and nonmedical university students underwent classroom training (1 hour of lecture, 3 hours of hands-on training) or blended training (1 hour of on-line course, 3 hours of hands-on training) in basic CPR with automated external defibrillation (AED). CPR knowledge and willingness to attempt resuscitation were evaluated before and after the training, and resuscitation skills were assessed as well after training in a simulation scenario. CPR quality measures were registered using the skills checklist when analyzing video recordings, and automatically by means of the Resusci Anne QCPR manikin.Results. The training and the study assessments were completed by 94 participants: 55 - classroom training, 39 - blended training. The mean age was 19 years and 17 years, respectively, 24% and 31% were male. Whereas there were more participants with previous training in CPR in the classroom training group (36% vs. 13%; p<0.05), the baseline levels of knowledge and readiness to perform resuscitation on a stranger were generally comparable between the groups. After the training, there was an increase in willingness to perform resuscitation (from 3.6 to 4.4 points in both groups) and improvement in self-perceived CPR knowledge (from 2.4 to 4.0 points in the classroom training group and from 2.6 to 4.3 in the blended training group). The assessment of the CPR quality in the simulation scenario revealed no significant differences between groups, excepting higher rate of chest compressions in the blended training group (116.0 vs. 109.4, р<0.01).Conclusion. The suggested method of blended training in basic CPR with AED is no less efficient than traditional classroom training, and it can be recommended for increasing access to high-quality training in first aid.Введение. Раннее начало сердечно-легочной реанимации (СЛР) свидетелями остановки кровообращения является ключевым фактором, определяющим исход, а повышение готовности свидетелей к оказанию первой помощи достигается эффективным обучением. Для увеличения доступности обучения СЛР рекомендуется использовать альтернативные формы преподавания. Исследование проведено с целью оценки эффективности смешанной формы обучения реанимации, подразумевающей замещение части аудиторной подготовки дистанционным освоением материала.Материал и методы. Проспективное рандомизированное исследование проведено в период с ноября по декабрь 2018 г. Учащиеся медицинского колледжа и студенты вуза немедицинского профиля прошли очное обучение (лекция 1 час, отработка навыков 3 часа) или смешанное обучение (онлайн курс 1 час, отработка навыков 3 часа) базовой СЛР с использованием автоматического наружного дефибриллятора (АНД). Проводилась исходная и заключительная оценка знаний по реанимации и готовности к проведению СЛР, заключительная оценка практических навыков в симуляционной сессии. Показатели качества реанимации регистрировались при анализе видеозаписей с помощью контрольного листа и автоматически при помощи манекена ResusciAnne OCPR.Результаты. Полностью прошли обучение и получили оценку 94 участника: 55 - очное, 39 - смешанное обучение. Средний возраст составил, соответственно, 19 лет и 17 лет, участников мужского пола - 24% и 31%. В группе очной подготовки оказалось больше участников, обучавшихся СЛР в прошлом (36% против 13%; p<0,05), но исходный уровень знаний и готовности к проведению реанимации незнакомому человеку в целом был сходным. После обучения наблюдалось увеличение готовности к оказанию помощи (с 3,6 до 4,4 балла в обеих группах) и повышение уровня знаний по данным самооценки (с 2,4 до 4,0 балла в группе очного обучения и с 2,6 до 4,3 в группе смешанного обучения). Оценка показателей качества СЛР в симуляционном эксперименте не выявила существенных различий между группами, за исключением большей частоты компрессий грудной клетки в группе смешанного обучения (116,0 против 109,4, р<0,01).Вывод. Предложенный метод смешанного обучения сердечно-легочной реанимации с применением автоматического наружного дефибриллятора по эффективности не уступает традиционной аудиторной подготовке и может быть рекомендован для повышения доступности качественного обучения первой помощи

Pastoralism and Emergent Complex Settlement in the Middle Bronze Age, Azerbaijan: Isotopic analyses of mobility strategies in transformation

Objectives. This article explores the scale and seasonal patterns of mobility at the complex settlement site of Qızqala during the Middle Bronze Age (2400–1,500 BCE). By integrating human bone, teeth, and environmental samples this research tests the hypothesis of the persistent importance of community-wide seasonal pastoral transhumance during the early formation of complex settlement systems of the South Caucasus. Methods. This research applies stable oxygen and radiogenic strontium isotope analyses on incremental samples of human tooth enamel, bulk tooth enamel, and bone to resolve mobility patterns. Sequential and bulk sampling techniques elucidate seasonal and residential mobility behaviors. Extensive environmental isotope samples of plant and water were collected through regional survey and establish local and regional isotopic baselines, which are compared to human isotope analysis results. Results. Qızqala individuals exhibit low isotopic variability compared to regional contemporaries. 87Sr/86Sr ratios from human remains indicate seasonal and residential isotopic variability within the baseline ranges of local landscapes. δ18O values display erratic patterns, but correspond to seasonal variability with fluctuations between highland and lowland altitudinal zone baseline values. Conclusions. Results suggest that isotopic analysis of multiple elements and sequential enamel samples offers finer resolution on the complexities of human mobility strategies and elucidate the daily lives of often overlooked mobile populations. Higher resolution of individual mobility reveals shared routine behaviors that underscore the importance of diverse social collaborations in forming complex polities in the South Caucasus

Blended Distance-classroom Training as an Alternative to the Traditional Classroom Training in Basic Cardiopulmonary Resuscitation and Automated External Defibrillation

Introduction. Early bystander cardiopulmonary resuscitation (CPR) is a critical factor in out-of-hospital cardiac arrest survival, and the readiness of bystanders to provide the first aid is known to be positively influenced by effective training. It is recommended to use alternative teaching methods in order to increase the accessibility of CPR training. The study was carried out to assess the effectiveness of the blended approach to resuscitation training, where classroom training hours are partially substituted with remote learning.Material and methods. This prospective randomized study was conducted in November-December 2018. Nursing students and nonmedical university students underwent classroom training (1 hour of lecture, 3 hours of hands-on training) or blended training (1 hour of on-line course, 3 hours of hands-on training) in basic CPR with automated external defibrillation (AED). CPR knowledge and willingness to attempt resuscitation were evaluated before and after the training, and resuscitation skills were assessed as well after training in a simulation scenario. CPR quality measures were registered using the skills checklist when analyzing video recordings, and automatically by means of the Resusci Anne QCPR manikin.Results. The training and the study assessments were completed by 94 participants: 55 - classroom training, 39 - blended training. The mean age was 19 years and 17 years, respectively, 24% and 31% were male. Whereas there were more participants with previous training in CPR in the classroom training group (36% vs. 13%; p<0.05), the baseline levels of knowledge and readiness to perform resuscitation on a stranger were generally comparable between the groups. After the training, there was an increase in willingness to perform resuscitation (from 3.6 to 4.4 points in both groups) and improvement in self-perceived CPR knowledge (from 2.4 to 4.0 points in the classroom training group and from 2.6 to 4.3 in the blended training group). The assessment of the CPR quality in the simulation scenario revealed no significant differences between groups, excepting higher rate of chest compressions in the blended training group (116.0 vs. 109.4, р<0.01).Conclusion. The suggested method of blended training in basic CPR with AED is no less efficient than traditional classroom training, and it can be recommended for increasing access to high-quality training in first aid

Archaeometallurgical Investigations in Nakhchivan, Azerbaijan: What Does the Evidence from Late Chalcolithic Ovçular Tepesi Tell Us about the Beginning of Extractive Metallurgy?

International audienceThe Late Chalcolithic (4400–3950 b.c.) occupation levels from Ovçular Tepesi have yielded a significant assemblage of copper objects and remains of copper production. Together with ore finds, two fragments of nozzle, crucible remains, and a number of small metal artifacts, this assemblage includes the unexpected discovery of three copper axes in an infant burial jar. These axes are the earliest examples of large copper tools known to date in southwestern Asia, whether it is in the Caucasus, Iran, or the Anatolian highlands. More importantly, the fact that these objects were locally produced suggests that significant metallurgical activities were being carried out at Ovçular as early as the second half of the 5th millennium b.c. After presenting the evidence from Ovçular Tepesi, this paper will proceed to a reassessment of the available archaeological and geochemical data concerning the emergence of extractive metallurgy in the southern Caucasus. © 2017, © Trustees of Boston University 2017