Integrating and maintaining automated external defibrillators and emergency planning in community sport settings: a qualitative case study

Introduction A voluntary State Government-led programme in Victoria, Australia ‘Defibrillators for Sporting Clubs and Facilities Program’ ran from 2015 to 2019, broadly aimed at increasing access to automated external defibrillators (AEDs), together with a greater number of community members trained for management of medical emergencies. This study aimed to understand whether participating sport clubs/facilities had successfully integrated an AED and medical planning with other club/facility safety practices, 12 months after delivery of the programme. Methods This was a qualitative case study of 14 sport clubs/facilities in Victoria, Australia in 2017, underpinned by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. We conducted observational audits of facilities (to locate AED placement, signage and other relevant location-specific factors) and semi-structured, face-to-face interviews with representatives of the clubs/facilities. Interview questions were designed to determine if and how the related, mandated emergency management programme was adapted for the long term (embedding), whether this aligned to ongoing organisational mission (active engagement), and whether or not it was still ongoing 6 months postinitial implementation (sustainability). Data were evaluated using qualitative descriptive methodology. For reporting, descriptive summaries of the audit were combined with interview data to contextualise and visualise the sport club/facility setting and key results. Results Key issues identified were accessibility and visibility of the AED, with inadequate signage and challenges identifying an efficient location for access and storage. Most interviewees reported the AED and training were received with no further actions taken towards safety planning or integration with club/facility practice. Several challenges regarding remaining up to date with training and ensuring required routine checks of the AED take place were also raised. Conclusions This study identified several challenges for community sport clubs/facilities in the implementation of an AED and medical planning programme, including where to store the AED, how to make its presence known to the community and how to integrate changes alongside other club/facility practices

Реорганизация системы внутрихолдинговых расчетов: методический инструментарий, оценка эффективности

In the context of growth trends in the scale and diversification of business, the internal costs of companies with a complex holding structure are also increasing. Solutions that improve the efficiency of settlement systems are particularly relevant and significant. Therefore, the paper is devoted to the problems of building settlement systems that minimize the negative impact of certain factors reducing the economic efficiency of calculations. The purpose of the study is to develop methodological foundations for rationalization the holding’s settlement system based on clearing obligations. The tasks of this paper are set as follows: to propose methodological tools for the reorganization of the system of intra-holding settlements; to test the proposed recommendations for the rationalization of the settlement system in holding structures. According to the results of the study, the authors systematized a set of factors that determine the effectiveness of the system of intra-group settlements. It is proposed to attribute the number of payment transactions and the volume of payment turnover to the quantitative factors of the settlement system efficiency. Qualitative factors of the settlement system efficiency are associated with the consolidation of financial information, the degree of automation of settlement processes, and the flexibility of the settlement system. The authors used the Ward method to build a cluster structure of the holding based on the analysis of payment turnover of pairs of companies, statistical methods of quantitative and qualitative assessment of the effectiveness of the holding’s settlement system. The scientific novelty is expressed by the fact that the paper offers methodological tools for reorganization the system of intra-holding settlements. A methodology for rationalization the holding’s settlement system based on clearing obligations, universal in use by holding-type companies, has been developed and its approbation has been carried out. The conclusions based on the results of the study form recommendations for changing some aspects of the holding’s activities in accordance with the results of the modernization of the holding’s settlement system. The method of rationalization of the system of intra-holding settlements proposed by the authors has versatility in application and can be used in solving management tasks within any holding.В условиях тенденций роста масштабов и диверсификации бизнеса возрастают и внутренние издержки компаний, имеющих сложную холдинговую структуру. Решения, обеспечивающие повышение эффективности расчетных систем, являются особенно актуальными и значимыми. Поэтому работа посвящена проблемам построения расчетных систем, минимизирующих негативное влияние отдельных факторов снижения экономической эффективности расчетов. Цель исследования — развитие методических основ рационализации расчетной системы холдинга на основе клиринга обязательств. Задачи: предложить методический инструментарий реорганизации системы внутрихолдинговых расчетов; осуществить апробацию предложенных рекомендаций по рационализации системы расчетов в холдинговых структурах. По результатам исследования авторами систематизирован комплекс факторов, определяющих эффективность функционирования системы внутригрупповых расчетов. К количественным факторам эффективности расчетной системы предложено отнести количество платежных операций и объем платежного оборота. Качественные факторы эффективности расчетной системы сопряжены с консолидацией финансовой информации, степенью автоматизации процессов расчетов, гибкостью расчетной системы. Авторами использован метод Варда для построения кластерной структуры холдинга на основе анализа платежных оборотов пар компаний, статистические методы количественной и качественной оценки эффективности системы расчетов холдинга. Научная новизна выражена тем, что в статье предложен методический инструментарий реорганизации системы внутрихолдинговых расчетов. Разработана методика рационализации расчетной системы холдинга на основе клиринга обязательств, универсальная в применении компаниями холдингового типа, и осуществлена ее апробация. В выводах по результатам исследования сформированы рекомендации по изменению некоторых аспектов деятельности холдинга в соответствии с результатами модернизации расчетной системы холдинга. Предложенная авторами методика рационализации системы внутрихолдинговых расчетов обладает универсальностью в применении и может быть использована при решении управленческих задач в рамках любого холдинга

On Generators of the Hardy and the Bergman Spaces

A function which is analytic and bounded in the Unit disk is called a generator for the Hardy space or the Bergman space if polynomials in that function are dense in the corresponding space. We characterize generators in terms of sub-spaces which are invariant under multiplication by the generator and also invariant under multiplication by z, and study wandering properties of such sub-spaces. Density of bounded analytic functions in the sub-spaces of the Hardy space which are invariant under multiplication by the generator is also investigated.Comment: 9 page

Optical spectroscopy of complex open 4dd-shell ions Sn7+^{7+}-Sn10+^{10+}

We analyze the complex level structure of ions with many-valence-electron open [Kr] 4$d^\textrm{m}$ sub-shells ($\textrm{m}$=7-4) with ab initio calculations based on configuration-interaction many-body perturbation theory (CI+MBPT). Charge-state-resolved optical and extreme ultraviolet (EUV) spectra of Sn$^{7+}$-Sn$^{10+}$ ions were obtained using an electron beam ion trap. Semi-empirical spectral fits carried out with the orthogonal parameters technique and Cowan code calculations lead to 90 identifications of magnetic-dipole transitions and the determination of 79 energy ground-configuration levels, questioning some earlier EUV-line assignments. Our results, the most complete data set available to date for these ground configurations, confirm the ab initio predictive power of CI+MBPT calculations for the these complex electronic systems.Comment: 18 pages, 5 figure

Modelling of gibbsite calcination in a fluidized bed reactor

A steady state, non‐isothermal fluidized bed reactor model for co‐current flow of gas and solids has been developed as a series of Continuous Stirred Tank Reactor (CSTR) compartments. For each CSTR compartment, mass and energy balances were coupled with a particle‐scale gibbsite calcination kinetic model previously developed by the authors. The overall solids residence time distribution is captured by the compartment calcination model. The multi‐scale model was solved numerically through an iterative procedure that alternated between solving particle‐scale and reactor‐scale parts of the model. Gas, water vapour and solids concentrations, as well as particle and gas temperatures and gibbsite conversion profiles, are predicted inside the calcination reactor. The developed model can be used to facilitate improvements in the operation and design of industrial‐scale reactors

Multi-stage shrinking core model for thermal decomposition reactions with a self-inhibiting nature

Among the variety of thermal decomposition reactions, some display self-inhibiting behaviour, where the produced gas negatively influences the reaction progress. Further, a build-up of internal pressure caused by the product gas may alter the reaction pathway over the reaction duration in a way that favours a particular pathway over others. Two well-known cases of this kind of reaction are the thermal decomposition of limestone and gibbsite, in which carbon dioxide and water vapour are the produced gases, respectively. A multi-stage, multi-reaction, shrinking core model is proposed for this type of reaction. The model emphasises the role of the produced gas, not only in the mass transfer rate, but also in the reaction kinetics. It also includes parallel and series reaction pathways, which allows for the presence of an intermediate species. The model has been applied to the conversion of gibbsite to alumina, and it includes the formation of boehmite as an intermediate product. The model results are in good agreement with experimental data for gibbsite calcination reported in the literature. Gibbsite conversion, boehmite formation and subsequent consumption, as well as alumina formation, are successfully simulated. Further, the corresponding kinetic parameters are estimated for all reactions of interest

Dialysis vs conservative management decision aid: a study protocol

When patients' kidney function deteriorates to chronic kidney disease stage 5, services offer patients a choice for the next phase of their care. Renal replacement therapies may not have survival benefits, and conservative management may have less treatment burden for older patients with associated comorbidities or frailty. Anna E Winterbottom et al discuss the development of a patient decision aid

Critical review of leaflets about conservative management used in UK renal services

Background: Written information supplements nurse‐led education about treatment options. It is unclear if this information enhances patients’ reasoning about conservative management (CM) and renal replacement therapy decisions. Aim: This study describes a critical review of resources U.K. renal staff use when providing CM options to people with Established Kidney Disease (EKD) during usual pre‐dialysis education. Design: A survey using mixed methods identified and critically analysed leaflets about CM. Participants & measurements: All 72 renal units in the United Kingdom received an 11‐item questionnaire to elicit how CM education is delivered, satisfaction and/or needs with patient resources and staff training. Copies of leaflets were requested. A coding frame was utilised to produce a quality score for each leaflet. Results: Fifty‐four (75%) units participated. Patients discuss CM with a nephrologist (98%) or nurse (100%). Eighteen leaflets were reviewed, mean scores were 8.44 out of 12 (range 5–12, SD = 2.49) for information presentation; 3.50 out of 6 (range 0–6, SD = 1.58) for inclusion of information known to support shared decision‐making and 2.28 out of 6 (range 1–4, SD = 0.96) for presenting non‐biased information. Conclusions: Nurses preferred communicating via face‐to‐face contact with patients and/or families because of the emotional consequences and complexity of planning treatment for the next stage of a person's worsening kidney disease. Conversations were supplemented with written information; 66% of which were produced locally. Staff perceived a need for using leaflets, and spend time and resources developing them to support their services. However, no leaflets included the components needed to help people reason about conservative care and renal replacement therapy options during EKD education consultations