Search results for: resuscitation order

Authors: Gubhinder Kundhi, Paul Rilstone

Abstract:

Refined procedures for higher-order asymptotic theory for non-linear models are developed. These include a new method for deriving stochastic expansions of arbitrary order, new methods for evaluating the moments of polynomials of sample averages, a new method for deriving the approximate moments of the stochastic expansions; an application of these techniques to gather improved inferences with the weak instruments problem is considered. It is well established that Instrumental Variable (IV) estimators in the presence of weak instruments can be poorly behaved, in particular, be quite biased in finite samples. In our application, finite sample approximations to the distributions of these estimators are obtained using Edgeworth and Saddlepoint expansions. Departures from normality of the distributions of these estimators are analyzed using higher order analytical corrections in these expansions. In a Monte-Carlo experiment, the performance of these expansions is compared to the first order approximation and other methods commonly used in finite samples such as the bootstrap.

Keywords: edgeworth expansions, higher order asymptotics, saddlepoint expansions, weak instruments

Procedia PDF Downloads 262

Authors: Ying Yi Wu

Abstract:

The study of finite groups is a central topic in algebraic structures, and one of the most fundamental questions in this field is the classification of finite groups up to isomorphism. In this paper, we investigate the cyclic property of groups of prime order, which is a crucial result in the classification of finite abelian groups. We prove the following statement: If p is a prime, then every group G of order p is cyclic. Our proof utilizes the properties of group actions and the class equation, which provide a powerful tool for studying the structure of finite groups. In particular, we first show that any non-identity element of G generates a cyclic subgroup of G. Then, we establish the existence of an element of order p, which implies that G is generated by a single element. Finally, we demonstrate that any two generators of G are conjugate, which shows that G is a cyclic group. Our result has significant implications in the classification of finite groups, as it implies that any group of prime order is isomorphic to the cyclic group of the same order. Moreover, it provides a useful tool for understanding the structure of more complicated finite groups, as any finite abelian group can be decomposed into a direct product of cyclic groups. Our proof technique can also be extended to other areas of group theory, such as the classification of finite p-groups, where p is a prime. Therefore, our work has implications beyond the specific result we prove and can contribute to further research in algebraic structures.

Keywords: group theory, finite groups, cyclic groups, prime order, classification.

Procedia PDF Downloads 65

Authors: Aneta Binkowska, Artur Kamecki

Abstract:

The ability to provide first aid should be one of the basic skills of each of us. First aid by the Law on National Medical Emergency dated 8 September 2006 as amended, is a set of actions undertaken to save a person at the scene of an accident. In Poland, on the basis of Article 162 of the Criminal Code, we are obliged to provide first aid to the victim. In addition, according to a large part of society, unselfishness towards others in need of help is our moral obligation. The aim of the study was to learn the opinion of the members of Medical Rescue Teams (MRT) of the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service (PA and STS ‘Meditrans’) in Warsaw on how people react in real situations threatening life or health of the injured person. The study was conducted in the third quarter of 2015 on 335 members of medical rescue teams, including 77 W and 258 M, who provided medical services in the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service MRT in Warsaw. The research tool was an anonymous questionnaire survey of own design, which consisted of 12 questions: closed, half open and one open question. Respondents were divided into 3 age groups and by individual medical professions (doctor, paramedic, nurse). The straight majority of respondents encountered granting the first aid the event on the spot. However, the frequency of appearing in such proceedings isn’t too high. The first aid has most often been given in the street and in houses. The final audited fairly important element is the reason not to provide first aid by bystanders in the opinion of members of the medical teams. Respondents to this question, which was an open question were asked to name the reason for not taking any action while waiting for an ambulance. Over 50% of respondents could not answer. The most common answers were: fear, lack of knowledge and skills, reluctance, indifference, lack of training, lack of experience and fear that harm. Conclusion: The majority of respondents have encountered instances of first aid provision, but respondents assessed the frequency of such situations as low. Placing the victim in the recovery position is the simplest and most common form of first aid. Therefore, training should be introduced not only on CPR but also in the scope of helping persons in sudden health emergency, who do not have a sudden cardiac arrest. A statement can be formulated, as a main conclusion of the analysis, that only continuous education and in particular practical training will help people to overcome the barrier of their limitations in order to help others. Among the largest group of witnesses providing first aid are the elderly and youth, who are subjected to various forms of education related to first aid provision.

Keywords: BLS, first aid, medical rescue, resuscitation

Procedia PDF Downloads 130

Authors: Moh'd Alodat

Abstract:

In this paper, we discuss the power function distribution and derive the maximum likelihood estimator of its parameter as well as the reliability parameter. We derive the large sample properties of the estimators based on the selective order statistic scheme. We conduct simulation studies to investigate the significance of the selective order statistic scheme in our setup and to compare the efficiency of the new proposed estimators.

Keywords: fisher information, maximum likelihood estimator, power function distribution, ranked set sampling, selective order statistics sampling

Procedia PDF Downloads 438

Authors: A. A. James, A. O. Adesanya, M. R. Odekunle, D. G. Yakubu

Abstract:

This paper examines the development of one step, five hybrid point method for the solution of first order initial value problems. We adopted the method of collocation and interpolation of power series approximate solution to generate a continuous linear multistep method. The continuous linear multistep method was evaluated at selected grid points to give the discrete linear multistep method. The method was implemented using a constant order predictor of order seven over an overlapping interval. The basic properties of the derived corrector was investigated and found to be zero stable, consistent and convergent. The region of absolute stability was also investigated. The method was tested on some numerical experiments and found to compete favorably with the existing methods.

Keywords: interpolation, approximate solution, collocation, differential system, half step, converges, block method, efficiency

Procedia PDF Downloads 313

Authors: Salisu Ibrahim

Abstract:

The paper studies the commutativity associated with fractional order linear time-varying systems (LTVSs), which is an important area of study in control systems engineering. In this paper, we explore the properties of these systems and their ability to commute. We proposed the necessary and sufficient condition for commutativity for fractional order LTVSs. Through a simulation and mathematical analysis, we demonstrate that these systems exhibit commutativity under certain conditions. Our findings have implications for the design and control of fractional order systems in practical applications, science, and engineering. An example is given to show the effectiveness of the proposed method which is been computed by Mathematica and validated by the use of MATLAB (Simulink).

Keywords: fractional differential equation, physical systems, equivalent circuit, analog control

Procedia PDF Downloads 91

Authors: Salisu Ibrahim

Abstract:

The paper studies the commutativity associated with fractional order linear time-varying systems (LTVSs), which is an important area of study in control systems engineering. In this paper, we explore the properties of these systems and their ability to commute. We proposed the necessary and sufficient condition for commutativity for fractional order LTVSs. Through a simulation and mathematical analysis, we demonstrate that these systems exhibit commutativity under certain conditions. Our findings have implications for the design and control of fractional order systems in practical applications, science, and engineering. An example is given to show the effectiveness of the proposed method which is been computed by Mathematica and validated by the use of Matlab (Simulink).

Keywords: fractional differential equation, physical systems, equivalent circuit, and analog control

Procedia PDF Downloads 54

Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

Procedia PDF Downloads 377

Authors: Huei Chu Weng

Abstract:

This paper presents a study on the effect of second-order slip on forced convection through a long isoflux heated or cooled planar microchannel. The fully developed solutions of flow and thermal fields are analytically obtained on the basis of the second-order Maxwell-Burnett slip and local heat flux boundary conditions. Results reveal that when the average flow velocity increases or the wall heat flux amount decreases, the role of thermal creep becomes more insignificant, while the effect of second-order slip becomes larger. The second-order term in the Deissler slip boundary condition is found to contribute a positive velocity slip and then to lead to a lower pressure drop as well as a lower temperature rise for the heated-wall case or to a higher temperature rise for the cooled-wall case. These findings are contrary to predictions made by the Karniadakis slip model.

Keywords: microfluidics, forced convection, thermal creep, second-order boundary conditions

Procedia PDF Downloads 296

Authors: Saeed Otarod

Abstract:

In a different simple and straight forward analysis a closed-form integral solution is found for nonhomogeneous second order linear ordinary differential equations, in terms of a particular solution of their corresponding homogeneous part. To find the particular solution of the homogeneous part, the equation is transformed into a simple Riccati equation from which the general solution of non-homogeneouecond order differential equation, in the form of a closed integral equation is inferred. The method works well in manyimportant cases, such as Schrödinger equation for hydrogen-like atoms. A non-homogenous second order linear differential equation has been solved as an extra example

Keywords: explicit, linear, differential, closed form

Procedia PDF Downloads 23

Authors: M. Elder, L. Beech, A. Mackie

Abstract:

Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.

Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy

Procedia PDF Downloads 117

Authors: Guy Joseph Eyebe, Gambo Betchewe, Alidou Mohamadou, Timoleon Crepin Kofane

Abstract:

In the present study, the dynamics of nanobeam resting on fractional order softening nonlinear viscoelastic pasternack foundations is studied. The Hamilton principle is used to derive the nonlinear equation of the motion. Approximate analytical solution is obtained by applying the standard averaging method. The Melnikov method is used to investigate the chaotic behaviors of device, the critical curve separating the chaotic and non-chaotic regions are found. It is shown that appearance of chaos in the system depends strongly on the fractional order parameter.

Keywords: chaos, fractional-order, Melnikov method, nanobeam

Procedia PDF Downloads 136

Authors: Brando Vagenende, Marie-Anne Guerry

Abstract:

For stochastic matrices of any order, the geometric description of the convex set of eigenvalues is completely known. The purpose of this study is to investigate the subset of the monotone matrices. This type of matrix appears in contexts such as intergenerational occupational mobility, equal-input modeling, and credit ratings-based systems. Monotone matrices are stochastic matrices in which each row stochastically dominates the previous row. The monotonicity property of a stochastic matrix can be expressed by a nonnegative lower-order matrix with the same eigenvalues as the original monotone matrix (except for the eigenvalue 1). Specifically, the aim of this research is to focus on the properties of eigenvalues of monotone matrices. For those matrices up to order 3, there already exists a complete description of the convex set of eigenvalues. For monotone matrices of order at least 4, this study gives, through simulations, more insight into the geometric description of their eigenvalues. Furthermore, this research treats in a geometric and algebraic way the properties of eigenvalues of monotone matrices of order at least 4.

Keywords: eigenvalues of matrices, finite Markov chains, monotone matrices, nonnegative matrices, stochastic matrices

Procedia PDF Downloads 53

Authors: Fouzi Aboura

Abstract:

The fractional order proportional-integral-derivative (FOPID) controller or fractional order (PIλDµ) is a proportional-integral-derivative (PID) controller where integral order (λ) and derivative order (µ) are fractional, one of the important application of classical PID is the Automatic Voltage Regulator (AVR).The FOPID controller needs five parameters optimization while the design of conventional PID controller needs only three parameters to be optimized. In our paper we have proposed a comparison between algorithms Differential Evolution (DE) and Hybrid Genetic Algorithm Particle Swarm Optimization (HGAPSO) ,we have studied theirs characteristics and performance analysis to find an optimum parameters of the FOPID controller, a new objective function is also proposed to take into account the relation between the performance criteria’s.

Keywords: FOPID controller, fractional order, AVR system, objective function, optimization, GA, PSO, HGAPSO

Procedia PDF Downloads 73

Authors: Rafat Alshorman, Fadi Awawdeh

Abstract:

By employing a simplified bilinear method, a class of generalized fifth-order KdV (gfKdV) equations which arise in nonlinear lattice, plasma physics and ocean dynamics are investigated. With the aid of symbolic computation, both solitary wave solutions and multiple-soliton solutions are obtained. These new exact solutions will extend previous results and help us explain the properties of nonlinear solitary waves in many physical models in shallow water. Parametric analysis is carried out in order to illustrate that the soliton amplitude, width and velocity are affected by the coefficient parameters in the equation.

Keywords: multiple soliton solutions, fifth-order evolution equations, Cole-Hopf transformation, Hirota bilinear method

Procedia PDF Downloads 300

Authors: S. A. M. Yatim, Z. B. Ibrahim, K. I. Othman, M. Suleiman

Abstract:

The method of solving second order stiff ordinary differential equation (ODEs) that is based on backward differentiation formula (BDF) is considered in this paper. We derived the method by increasing the order of the existing method using an improved strategy in choosing the step size. Numerical results are presented to compare the efficiency of the proposed method to the MATLAB’s suite of ODEs solvers namely ode15s and ode23s. The method was found to be efficient to solve second order ordinary differential equation.

Keywords: backward differentiation formulae, block backward differentiation formulae, stiff ordinary differential equation, variable step size

Procedia PDF Downloads 474

Authors: Matthew C. Best

Abstract:

Linear Multi-Input Multi-Output (MIMO) dynamic models can be identified, with no a priori knowledge of model structure or order, using a new Generalised Identifying Filter (GIF). Based on an Extended Kalman Filter, the new filter identifies the model iteratively, in a continuous modal canonical form, using only input and output time histories. The filter’s self-propagating state error covariance matrix allows easy determination of convergence and conditioning, and by progressively increasing model order, the best fitting reduced-order model can be identified. The method is shown to be resistant to noise and can easily be extended to identification of smoothly nonlinear systems.

Keywords: system identification, Kalman filter, linear model, MIMO, model order reduction

Procedia PDF Downloads 571

Authors: A. M. Sagir

Abstract:

Discrete linear multistep block method of uniform order for the solution of first order Initial Value Problems (IVPs) in Ordinary Differential Equations (ODEs) is presented in this paper. The approach of interpolation and collocation approximation are adopted in the derivation of the method which is then applied to first order ordinary differential equations with associated initial conditions. The continuous hybrid formulations enable us to differentiate and evaluate at some grids and off – grid points to obtain four discrete schemes, which were used in block form for parallel or sequential solutions of the problems. Furthermore, a stability analysis and efficiency of the block method are tested on ordinary differential equations, and the results obtained compared favorably with the exact solution.

Keywords: block method, first order ordinary differential equations, hybrid, self-starting

Procedia PDF Downloads 462

Authors: F. Maass, P. Martin, J. Olivares

Abstract:

The aim of this work is the application of the program GeoGebra in teaching the study of nonhomogeneous linear second order differential equations with constant coefficients. Different kind of functions or forces will be considered in the right hand side of the differential equations, in particular, the emphasis will be placed in the case of trigonometrical functions producing the resonance phenomena. In order to obtain this, the frequencies of the trigonometrical functions will be changed. Once the resonances appear, these have to be correlationated with the roots of the second order algebraic equation determined by the coefficients of the differential equation. In this way, the physics and engineering students will understand resonance effects and its consequences in the simplest way. A large variety of examples will be shown, using different kind of functions for the nonhomogeneous part of the differential equations.

Keywords: education, geogebra, ordinary differential equations, resonance

Procedia PDF Downloads 220

Authors: Aurore Cauquis, Philippe Heinrich, Mario Ricchiuto, Audrey Gailler

Abstract:

In this talk, we look for an accurate time scheme to model the propagation of waves. Several numerical schemes have been developed to solve the extended weakly nonlinear weakly dispersive Boussinesq Equations. The temporal schemes used are two Lax-Wendroff schemes, second or third order accurate, two Runge-Kutta schemes of second and third order and a simplified third order accurate Lax-Wendroff scheme. Spatial derivatives are evaluated with fourth order accuracy. The numerical model is applied to two monodimensional benchmarks on a flat bottom. It is also applied to the simulation of the Algerian tsunami generated by a Mw=6 seism on the 18th March 2021. The tsunami propagation was highly dispersive and propagated across the Mediterranean Sea. We study here the effects of the order of temporal discretization on the accuracy of the results and on the time of computation.

Keywords: numerical analysis, tsunami propagation, water wave, boussinesq equations

Procedia PDF Downloads 211

Authors: Soyoon Bak, Sunyoung Bu, Philsu Kim

Abstract:

In this paper, a backward semi-Lagrangian scheme combined with the second-order backward difference formula is designed to calculate the numerical solutions of nonlinear advection-diffusion equations. The primary aims of this paper are to remove any iteration process and to get an efficient algorithm with the convergence order of accuracy 2 in time. In order to achieve these objects, we use the second-order central finite difference and the B-spline approximations of degree 2 and 3 in order to approximate the diffusion term and the spatial discretization, respectively. For the temporal discretization, the second order backward difference formula is applied. To calculate the numerical solution of the starting point of the characteristic curves, we use the error correction methodology developed by the authors recently. The proposed algorithm turns out to be completely iteration-free, which resolves the main weakness of the conventional backward semi-Lagrangian method. Also, the adaptability of the proposed method is indicated by numerical simulations for Burgers’ equations. Throughout these numerical simulations, it is shown that the numerical results are in good agreement with the analytic solution and the present scheme offer better accuracy in comparison with other existing numerical schemes. Semi-Lagrangian method, iteration-free method, nonlinear advection-diffusion equation, second-order backward difference formula

Keywords: Semi-Lagrangian method, iteration free method, nonlinear advection-diffusion equation, second-order backward difference formula

Procedia PDF Downloads 303

Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

Abstract:

Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

Procedia PDF Downloads 129

Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

Abstract:

Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

Procedia PDF Downloads 162

Authors: Olusola Ezekiel Abolarin, Gift E. Noah

Abstract:

This research work considered an innovative procedure to numerically approximate higher-order Initial value problems (IVP) of ordinary differential equations (ODE) using the Legendre polynomial as the basis function. The proposed method is a half-step, self-starting Block integrator employed to approximate fourth and fifth order IVPs without reduction to lower order. The method was developed through a collocation and interpolation approach. The basic properties of the method, such as convergence, consistency and stability, were well investigated. Several test problems were considered, and the results compared favorably with both exact solutions and other existing methods.

Keywords: initial value problem, ordinary differential equation, implicit off-grid block method, collocation, interpolation

Procedia PDF Downloads 55

Authors: Bashara Want

Abstract:

One of the key factors limiting the performance of magnetic memory is that the coercivity has a distribution with finite width, and the reversal starts at the weakest link in the distribution. So one must first know the distribution of coercivities in order to learn how to reduce the width of distribution and increase the coercivity field to obtain a system with narrow width. First Order Reversal Curve (FORC) method characterizes a system with hysteresis via the distribution of local coercivities and, in addition, the local interaction field. The method is more versatile than usual conventional major hysteresis loops that give only the statistical behaviour of the magnetic system. The FORC method will be presented and discussed at the conference.

Keywords: magnetic materials, hysteresis, first-order reversal curve method, nanostructures

Procedia PDF Downloads 61

Authors: A. Gün Güneş

Abstract:

This study aims to explicate the functionality of the responsibility to protect (R2P) in terms of order and justice within the context of the main traditions of the English School theory. The conflicts in Libya and Syria and the response of the international society to these crises are analyzed in the pluralism-solidarism dichotomy of the English School. In this regard, the intervention under R2P in Libya exemplifies the solidaristic side emphasizing justice, while the non-intervention in Syria exemplifies the pluralistic side emphasizing order. This study discusses the cases of Libya and Syria on the basis of Great Powers.

Keywords: English school theory, international society, order, justice, responsibility to protect

Procedia PDF Downloads 405

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

Abstract:

Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

Procedia PDF Downloads 306

Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

Abstract:

Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

Procedia PDF Downloads 148

Authors: Ruxandra Barbulescu, Daniel Ioan, Gabriela Ciuprina

Abstract:

The saltatory conduction is the way the action potential is transmitted along a myelinated axon. The potential diffuses along the myelinated compartments and it is regenerated in the Ranvier nodes due to the ion channels allowing the flow across the membrane. For an efficient simulation of populations of neurons, it is important to use reduced order models both for myelinated compartments and for Ranvier nodes and to have control over their accuracy and inner parameters. The paper presents a reduced order model of this neural system which allows an efficient simulation method for the saltatory conduction in myelinated axons. This model is obtained by concatenating reduced order linear models of 1D myelinated compartments and nonlinear 0D models of Ranvier nodes. The models for the myelinated compartments are selected from a series of spatially distributed models developed and hierarchized according to their modeling errors. The extracted model described by a nonlinear PDE of hyperbolic type is able to reproduce the saltatory conduction with acceptable accuracy and takes into account the finite propagation speed of potential. Finally, this model is again reduced in order to make it suitable for the inclusion in large-scale neural circuits.

Keywords: action potential, myelinated segments, nonlinear models, Ranvier nodes, reduced order models, saltatory conduction

Procedia PDF Downloads 137

Authors: Juliet Udoudom

Abstract:

Complement ordering principles of natural language phrases (XPs) stipulate that Head terms be consistently placed phrase initially or phrase-finally, yielding two basic theoretical orders – Head – Complement order or Complement – Head order. This paper examines the principles which determine complement ordering in English V- and N-bar structures. The aim is to determine the extent to which complement linearisations in the two phrase types are consistent with the two theoretical orders outlined above given the flexible and varied nature of natural language structures. The objective is to see whether there are variation(s) in the complement linearisations of the XPs studied and the implications which such variations hold for the inter-language syntax of English and Ibibio. A corpus-based approach was employed in obtaining the English data. V- and -N – bar structures containing complement structures were isolated for analysis. Data were examined from the perspective of the X-bar and Government – theories of Chomsky’s (1981) Government-Binding format. Findings from the analysis show that in V – bar structures in English, heads are consistently placed phrase – initially yielding a Head – Complement order; however, complement linearisation in the N – bar structures studied exhibited parametric variations. Thus, in some N – bar structures in English the nominal head is ordered to the left whereas in others, the head term occurs to the right. It may therefore be concluded that the principles which determine complement ordering are both Language – Particular and Phrase – specific following insights provided within Phrasal Syntax.

Keywords: complement order, complement–head order, head–complement order, language–particular principles

Procedia PDF Downloads 327