bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Energy Dissipation Rate to Obtain Active Whitecap Fraction
Authors: Anguelova Magdalena D. , Hwang Paul A.
Published: November 2015

Active and total whitecap fractions quantify the spatial extent of oceanic whitecaps in different lifetime stages. Total whitecap fraction W includes both the dynamic foam patches of the initial breaking and the static foam patches during whitecap decay. Dynamic air–sea processes in the upper ocean are best parameterized in terms of active whitecap fraction WA associated with actively breaking crests. The conventional intensity threshold approach used to extract WA from photographs is subjective, which contributes to the wide spread of WA data. A novel approach of obtaining WA from energy dissipation rate ε is proposed. An expression for WA is derived in terms of energy dissipation rate WA(ε) on the basis of the Phillips concept of breaking crest length distribution. This approach allows more objective determination of WA using the breaker kinematic and dynamic properties yet avoids the use of measuring breaking crest distribution from photographs. The feasibility of using WA(ε) is demonstrated with one possible implementation using buoy data and a parametric model for the energy dissipation rate. Results from WA(ε) are compared to WA from photographic data. Sensitivity analysis quantifies variations in WA estimates caused by different parameter choices in the WA(ε) expression. The breaking strength parameter b has the greatest influence on the WA(ε) estimates, followed by the breaker minimal speed and bubble persistence time. The merits and caveats of the novel approach, possible improvements, and implications for using the WA(ε) expression to extract WA from satellite-based radiometric measurements of W are discussed.
A Consistent Treatment of Microwave Emissivity and Radar Backscatter for Retrieval of Precipitation over Water Surfaces
Authors: Munchak S. Joseph , Meneghini Robert , Grecu Mircea , Olson William S.
Published: November 2015

The Global Precipitation Measurement (GPM) Microwave Imager (GMI) and dual-frequency precipitation radar (DPR) are designed to provide the most accurate instantaneous precipitation estimates currently available from space. The GPM Combined Radar–Radiometer Algorithm (CORRA) plays a key role in this process by retrieving precipitation profiles that are consistent with GMI and DPR measurements; therefore, it is desirable that the forward models in CORRA use the same geophysical input parameters. This study explores the feasibility of using internally consistent emissivity and surface backscatter cross-sectional () models for water surfaces in CORRA. An empirical model for DPR Ku- and Ka-band as a function of 10-m wind speed and incidence angle is derived from GMI-only wind retrievals under clear-sky conditions. This allows for the measurements, which are also influenced by path-integrated attenuation (PIA) from precipitation, to be used as input to CORRA and for wind speed to be retrieved as output. Comparisons to buoy data give a wind rmse of 3.7 m s−1 for Ku+GMI retrievals and 3.2 m s−1 for Ku+Ka+GMI retrievals under precipitation (compared to 1.3 m s−1 for clear-sky GMI-only retrievals), and there is a reduction in bias from the global analysis (GANAL) background data (−10%) to the Ku+GMI (−3%) and Ku+Ka+GMI (−5%) retrievals. Ku+GMI retrievals of precipitation increase slightly in light (<1 mm h–1) and decrease in moderate to heavy precipitation (>1 mm h−1). The Ku+Ka+GMI retrievals, being additionally constrained by the Ka reflectivity, increase only slightly in moderate and heavy precipitation at low wind speeds (<5 m s−1) relative to retrievals using the surface reference estimate of PIA as input.
The Editor’s Note
Authors: Richardson Joan
Published: November 2015

Americans are uncomfortable with immigrants in the same way they are uncomfortable with people who may be citizens but are still different from them — a difference of religion or color, for example. Only by first acknowledging the discomfort these differences calls up in each of is will we make the first step toward change and accepting and resolving our differences.
Stages of immigrant parent involvement — survivors to leaders
Authors: Han Young-chan , Love Jennifer
Published: November 2015

Immigrant parents are not all alike. They vary in language skills as well as their understanding of U.S. culture. All of this affects their ability, if not inclination, to become engaged in their children’s education. Educators can assist families by understanding the stages of immigrant parent involvement, which identifies parents’ needs, skills, and interests as they move through the stages of Cultural Survivor, Cultural Learner, Cultural Connector, or Cultural Leader. Understanding these stages better equips educators to identify where families are as well as their unique challenges, and helps determine how to best support them.
Shadowing a student shows how to make learning more relevant
Authors: Ginsberg Margery B.
Published: November 2015

The author reframes the concept of motivation through the observation of a student who is a recent immigrant and seems unmotivated because he is not doing well in his classes. Instead of a lack of motivation by the student, the author finds the system failing to engage the student by enacting four conditions of a motivational framework: establishing inclusion, developing a positive attitude, enhancing meaning, and engendering competence. The author suggests that when and where that is done, student engagement and motivation will improve and so likely will student achievement improve.
Connecting the immigrant experience through literature
Authors: Allen Eliza G.
Published: November 2015

A 3rd-grade teacher used literature to help her immigrant students grapple with some of the larger issues related to immigration. Through the story of one Latino student, the teacher shares the literature that she used and how one student responded.
Summer melts immigrant students’ college plans
Authors: Naranjo Melissa M. , Pang Valerie Ooka , Alvarado Jose Luis
Published: November 2015

Many college-intending students find themselves dealing with the undermatch and summer melt phenomena. Undermatch refers to the situation where academically-successful high-school graduates choose not to go to any college or to go to a local community college not commensurate with their academic achievements. Summer melt describes how students may “melt” away from registering for college. Practical recommendations are provided so that educators in high schools and colleges can implement strategies to ensure that after high-school graduation immigrant students register for their selected universities.
R&D
Authors: Lee Stacey J. , Walsh Daniel
Published: November 2015

The Internationals Network for Public Schools has a reputation for engaging in culturally and linguistically responsive pedagogy with immigrant youth. The 19 schools in the internationals school network serve the unique academic and emotional needs of recently arrived immigrant youth who are English language learners. INPS schools are in New York, California, and the Washington, D.C., area. Students in the network come from over 100 countries, speak over 90 languages, have diverse educational backgrounds and about 90% are eligible for free or reduced-price meals. From the Internationals, we can learn what constitutes a high-quality education for immigrant students and what teachers can do to provide a high-quality education for immigrant youth.
Refueling the STEM and special education teacher pipelines
Authors: Goldhaber Dan , Krieg John , Theobald Roddy , Brown Nate
Published: November 2015

Improving the quality of the teacher workforce is high on the nation’s education policy agenda, but school systems continue to face difficulties in staffing STEM and special education classrooms with qualified teachers. This article documents the mismatch between the supply and demand of STEM and special education teachers in Washington State, where almost 4,000 more STEM and special education teachers have left the profession than have been produced by in-state teacher training institutions over the past 25 years. There are a number of potential solutions to this problem, including differential pay systems, reduced barriers to entry, and incentives for teacher training institutions.
Examining the challenges of learner-centered education
Authors: Aslan Sinem , Reigeluth Charles M.
Published: November 2015

Learner-centered education has been touted as an improvement over teacher-centered educational systems. However, educators and researchers need to be cautious about its problems, in addition to considering its benefits. The authors set out to identify challenges to learner-centered education through the eyes of educators in a truly learner-centered school with a self-directed, project-based learning approach. During their interviews, three administrators and all nine teachers described challenges that they faced in learner-centered instruction and learner-centered assessment. The hope is that the study makes learner-centered education easier for educators and more effective for students.
Putative invasive pulmonary aspergillosis in critically ill patients with chronic obstructive pulmonary disease: a matched cohort study
Authors: Delsuc Claire , Cottereau Aurélie , Frealle Emilie , Bienvenu Anne-Lise , Dessein Rodrigue , Jarraud Sophie , Dumitrescu Oana , Le Maréchal Marion , Wallet Florent , Friggeri Arnaud , Argaud Laurent , Rimmelé Thomas , Nseir Saad , Ader Florence
Published: November 2015

Introduction

Patients with advanced chronic obstructive pulmonary disease (COPD) are at risk for developing invasive pulmonary aspergillosis. A clinical algorithm has been validated to discriminate colonization from putative invasive pulmonary aspergillosis (PIPA) in Aspergillus-positive respiratory tract cultures of critically ill patients. We focused on critically ill patients with COPD who met the criteria for PIPA.

Methods

This matched cohort study included critically ill patients with COPD from two university hospital intensive care units (ICUs). We studied the risk factors for PIPA as well as the impact of PIPA on short- and long-term outcomes. Whether PIPA was associated with a pattern of bacterial colonization and/or infection 6 months before and/or during ICU stay was assessed. In addition, antifungal strategies were reviewed.

Results

Fifty cases of PIPA in critically ill patients with COPD in the ICU were matched with one hundred control patients with COPD. The ICU short- and the long-term (at 1 year) mortality were significantly increased in the PIPA group (p < 0.001 for all variables). PIPA was a strong independent risk factor for mortality in the ICU (odds ratio 7.44, 95 % confidence interval 2.93–18.93, p < 0.001) before vasopressor therapy, renal replacement therapy, and duration of mechanical ventilation. Before ICU admission, the use of corticosteroids and antibiotics significantly increased the risk of PIPA (p = 0.004 and p < 0.001, respectively). No significant difference in bacterial etiologic agents responsible for colonization and/or infection was found between the groups. Antifungal treatment was started in 64 % of PIPA cases, with a poor impact on the overall outcome.

Conclusions

PIPA was a strong death predictor in critically ill patients with COPD. The use of corticosteroids and antibiotics before ICU admission was a risk factor for PIPA. PIPA was not associated with a specific bacterial pattern of colonization or infection. Prompting antifungal treatment in critically ill patients with COPD who have PIPA may not be the only factor involved in prognosis reversal.
Surgical management of vascular anomalies in children at a tertiary care hospital in a resource-limited setting: a Tanzanian experience with 134 patients
Authors: Chalya Phillipo L. , Kayange Neema M. , Rambau Peter F. , Manyama Mange , Gilyoma Japhet M.
Published: November 2015

Background

Vascular anomalies pose major diagnostic and therapeutic challenges among pediatricians and pediatric surgeons practicing in resource limited countries. There is paucity of published data regarding this subject in Tanzania and Bugando Medical Centre in particular. This study describes our experiences on the challenges and outcome of surgical management of childhood vascular anomalies in our environment.

Methods

Between January 2009 and December 2013, a prospective study on the surgical management of vascular anomalies was undertaken at Bugando Medical Centre.

Results

A total of 134 patients (M; F = 1:2.5) were studied. The median age at presentation was 6 years. Of the 134 patients, 101 (75.4 %) were diagnosed as having vascular tumors and 33 (24.6 %) had vascular malformations. The head and the neck were the most frequent anatomical site recorded as having a tumor (56.7 % of patients). Out of 134 patients, 129 (96.3 %) underwent surgical treatment. Failure to respond to non-operative treatment (86.8 %), huge disfiguring/obstructing mass (4.7 %), infection (3.1 %), ulceration (3.1 %) and hemorrhage (2.3 %) were indications for surgical intervention. Tumor excision and primary wound closure was the most common type of surgical procedure performed in 80.6 % of patients. Surgical site infection was the most frequent complications accounting for 33.8 % of cases. Mortality rate was 1.5 %. Tumor excision and primary wound closure gave better outcome compared with other surgical options (p < 0.001). Outcome of injection sclerotherapy in 3 (3.7 %) children, serial ligation of feeder vessels employed in 2 (1.6 %), and conservative treatment in 5 (3.7 %), were poor and required conversion to surgical excision. Despite low mortality rate recorded in this study, but ugly scar, 14 (20.6 %) and limb deformity, 6 (8.8 %) were problems. The overall result of surgical treatment at the end of follow up period was excellent in 108 (87.1 %) patients.

Conclusion

Surgical excision and primary wound closure gave good outcome which could be employed in complicated and vascular anomalies which failed to respond to other treatment in regions with limited resources.
Presence, Absence, and Victoria's Hair
Authors: Cifor Marika
Published: November 2015

An affective archival encounter with a hair likely belonging to Victoria Schneider, a trans woman, sex worker, and activist, prompts the author's exploration of affect and embodiment in trans archives. This artifact animates how archives can value trans bodies in their centrality, affect, and power by embracing bodily traces, making visible what is absent, and giving due consideration to capturing bodily experience.
Trans/Feminist Oral History
Authors: Brown Elspeth H.
Published: November 2015

This piece discusses current trans oral history projects that bring together feminist methodologies, transgender studies, and queer archives. I offer a map of some of these oral history projects, and their archive partners, while offering some reflections concerning how prior work in transgender ethnography and poststructuralist history are helping to shape contemporary approaches to trans oral history. Projects discussed include the LGBTQ Oral History Digital Collaboratory, the Transgender Archives (University of Victoria), the Digital Transgender Archive, the New York City Trans Oral History Project, the Trans Oral History Project, and the Transgender Oral History Project, Tretter Collection, University of Minnesota Libraries.
Radical Living Archives and Trans* Embodiment
Authors: Kotlarczyk Abbra
Published: November 2015

Multimedia artist Shu Lea Cheang's Brandon was supported by the Guggenheim Museum New York in 1995 as a multiauthor/multi-institutional collaboration. Created in response to the news of the Nebraska murder of transgender youth Brandon Teena in 1993, the project exists as a feminist hypertext and as such can be regarded as a living archive of transgender embodiment. Due to the work's current offline status, questions arise as to how it might be factored beyond its material presence, as a temporal placeholder for radical and affective archiving. Major sociocultural factors such as the introduction of the information super highway at the time of the project's creation allow for a topographical look at how digital codes and online interfacing factor as potential forms of emancipation regarding transgender embodiment and performativity.
Necrotizing enterocolitis: controversies and challenges
Authors: Zani Augusto , Pierro Agostino
Published: November 2015

Necrotizing enterocolitis is a devastating intestinal disease that affects ~5% of preterm neonates. Despite advancements in neonatal care, mortality remains high (30–50%) and controversy still persists with regards to the most appropriate management of neonates with necrotizing enterocolitis. Herein, we review some controversial aspects regarding the epidemiology, imaging, medical and surgical management of necrotizing enterocolitis and we describe new emerging strategies for prevention and treatment.
INTEGRATION OF MONETARY POLICY TOOLS AND FINANCIAL MARKETS DEVELOPMENT IN THE FIELD OF STRATEGIC PLANNING
Authors: Абрамкин  , Abramkin Stanislav , Ханнанов  , Khannanov Marat , Хаялеева  , Khayaleeva Chulpan
Published: November 2015

The article deals with problems of economy management, determining the current difficulties in coordination of monetary policy, the development of financial markets and long-term planning. The proposals for the development of goal-setting ideas in the Bank of Russia was offered.
GOVERNMENT REGULATION OF THE GRAIN MARKET IN THE TERMS OF IMPORT SUBSTITUTION
Authors: Захарова  , Zakharova Galina , Амирова  , Amirova Elmira
Published: November 2015

The article describes the theoretical bases of state regulation of the grain market; trends and challenges of the grain market in the current economic conditions.
SPECIALIZED AGRO-INDUSTRIAL FORMATIONS AS A PART OF INSTITUTIONAL SUBSYSTEM FOR ENSURING THE EFFECTIVE FUNCTIONING OF AGRO-INDUSTRIAL CLUSTERS OF REGIONAL AGRICULTURE
Authors: Сайфутдинов  , Sayfutdinov Almaz
Published: November 2015

The article emphasizes the role and importance of the specialized agroindustrial formations in ensuring the effective functioning of agribusiness cluster of regional agriculture.
SCIENTIFICALLY BASED INSTITUTIONAL REFORMS AS A FACTOR TO ACCELERATE SOCIAL AND ECONOMIC DEVELOPMENT OF THE COUNTRY
Authors: Хисматуллин  , Khismatullin Marsel , Хафизов  , Khafizov Dafik
Published: November 2015

The article deals with the topical issues of the institutional reforms in the agricultural sector, taking into account Russia’s accession to the World Trade Organization. The The paper substantiates the necessity of rapid modernization of agricultural production in order to increase the competitiveness of Russian agricultural products in domestic and foreign markets due to the country’s accession to the WTO, a significant increase the size of the state support of agriculture in the early years of the state program. The tendencies were revealed, the forecast of the development of various forms of economic activity in Russia and the Republic of Tatarstan for the period until 2017 was given.
METHOD OF CROP ENERGY CALCULATION, LOST BECAUSE OF THE NEGATIVE IMPACT OF TRACTOR’S PROPELLER ON THE SOIL
Authors: Хафизов  , Khafizov Ramil
Published: November 2015

The article highlighted the necessity to determine the dependence of maximum pressure of wheel propellers on the parameters of tractor, wheel and the soil characteristics, for calculation the crop energy, which was lost due to the negative impact of the tractor wheels on the soil. Using the theory of similarity, the criteria of similarity was defined and several options of dependence of maximum pressure of tractor wheels on the soil were identified, taking into account various factors. The use of the similarity theory helped to reduce the number of factors for the design of experiments while maintaining the informative value of the title of the regression equation.
INDICES OF IMMUNE RESPONSES OF BULLS IN THE NECROBACILLOSIS VACCINATION OF THE CATTLE
Authors: Михеева  , Mikheeva Ekaterina , Бабинцева  , Babintseva Tatyana , Макаев  , Makaev Kharis
Published: November 2015

Metabolic disorders and dysfunctional state of the digestive organs lead to the development of distal extremities diseases. The greatest danger is neсrobacrillosis. Vaccination is one of the ways to prevent and control this disease. The article reflects the data on the effect of vaccination (“Nekovak” and formol-emulsion neсrobacrillosis vaccine of Federal Centre for toxicology, radiation and biological safety) on immunological and serological parameters of blood and blood serum of cattle in the Udmurt Republic. After immunization with “Nekovak” vaccine and formol-emulsion neсrobacrillosis vaccine, we determined an increase of the number of leukocytes to 7th day, and also an increase of T-lymphocytes to 14th day. The number of B-lymphocytes reaches a maximum on 21st day. The content of gamma globulins, including specific antibodies against the neсrobacrillosis pathogen, exceeded the control and reached a maximum on the 21st day after vaccination.
SELECTION OF TREES AND SHRUBS ASSORTMENT FOR PROTECTIVE AFFORESTATION IN THE REPUBLIC OF TATARSTAN
Authors: Минниханов  , Minnikhanov Azat
Published: November 2015

The article presents the results of research, devoted to the selection of trees and shrubs assortment for protective afforestation in the Republic of Tatarstan. The selection is based on the analysis of soil and climatic conditions of the region.
LANDSCAPE FELLING IN FOREST REPRODUCTION
Authors: Шайхалиев  , Shaykhaliev Ruslan , Газизов  , Gazizov Ruslan , Мусин  , Musin Kharris
Published: November 2015

The analysis of landscape felling in old-growth pine forests was carried out, the measures to promote natural reforestation were justified.
RESISTANT OF TRITICUM AESTIVUM VARIETIES OF DIFFERENT ORIGIN TO BIOTIC STRESSORS ON THE FOREST-STEPPE AND STEPPE ZONES OF ORENBURG URALS
Authors: Тимошенкова  , Timoshenkova Tatyana , Мухитов  , Mukhitov Lenar , Самуилов  , Samuilov Feofan
Published: November 2015

The article summarizes the results of surveys on the development of the spring wheat disease. The composition of the pathogenic complex in the Orenburg region was analyzed. The paper cites an assessment of the stability of varieties of different origin in the forest steppe and steppe zones of Orenburg Urals. The most common and harmful diseases of spring wheat were: brown leaf rust (Puccinia triticina), stem rust (Puccinia graminis), oidium (Erysiphe graminis, Blumeria graminis Speer.), helminthiasis and fusariose root rot (Bipolaris sorokiniana and Fusarium spp.). Among the samples of local breeding Orenburgskaya 13 variety was the strongly susceptible to the disease of wheat. Logachevka and Uchitel variety were mildly susceptible. Varyag variety was characterized by susceptibility to leaf rust, oidium and dust-brand. According to the complex resistance to diseases of the local races of wheat, we can allocate the following varieties: in the forest-steppe zone: Kinelskaya 59, Kinelskaya 60, Saratovskaya 55, Tulaykovskaya 5, steppe Tulaykovskaya, YuV 4 and in the steppe zone - Belyanka, Saratovskaya 70, Tulaykovskaya 10 and steppe Tulaykovskaya. The inclusion of these varieties in the hybridization will provide a more disease-resistant hybrids and new varieties of spring wheat.
ASSESSMENT OF PRODUCTIVITY AND ECOLOGICAL PLASTICITY OF SPRING SOFT WHEAT VARIETIES IN THE REPUBLIC OF TATARSTAN
Authors: Нижегородцева  , Nizhegorodtseva Lyubov , Турнин  , Turnin Sergey , Амиров  , Amirov Ayrat , Сафин  , Safin Radik
Published: November 2015

The article presents the results of studies on assessment the productivity and the plasticity of spring soft wheat varieties in the conditions of the Republic of Tatarstan. The groups of varieties, differing in yield and biometric indicators, were underlined. The high dependency of productivity of spring wheat varieties to plant height index at Tatarstan was shown.
Implementing peer learning to prepare students for OSCEs
Authors: Pegram Anne , Fordham-Clarke Carol
Published: November 2015

First-year nursing students undertaking a first-year clinical skills module were given an opportunity to take part in a voluntary peer learning scheme, where they would learn from more senior students. It was envisaged this would help the students prepare for the module's summative assessment—an objective structured clinical examination (OSCE), which students can find stressful. The first-year students found peer learning helped them improve clinical skills, reduced anxiety and increased their self-confidence, and they appreciated the non-threatening learning environment and constructive feedback. The more senior students felt it helped prepare them for their mentoring role after registration. Incorporating peer learning more widely into the curriculum would allow it to be evaluated in more depth.
Staffing for neonatal units in jeopardy
Authors: Glasper Alan
Published: November 2015

Emeritus professor Alan Glasper, from the University of Southampton, discusses the crisis in neonatal-unit staffing highlighted in a new report by the charity Bliss
Special care dentistry: two sides of a coin
Authors: Valle-Jones Richard , Chandler Debbie
Published: November 2015

In this article, Richard Valle-Jones and Debbie Chandler discuss the optimal treatment outcomes for both special care patients and special care dentistry teams
Sports dentistry, dental trauma and endodontics
Authors: Meehan Lyndon
Published: November 2015

This article outlines the potential impact of sports participation on the individuals' teeth, starting from the dietary risk factors to the endodontic treatment implications following dental trauma
Changes to the Care Quality Commission regulations
Authors: Harris Richard
Published: November 2015

In this article, Richard Harris describes what the Care Quality Commission regulations mean and what a practice might expect from an inspection under the new system
Research roundup
Authors: Costello John
Published: November 2015

Synopses of a selection of recently published research articles of relevance to palliative care.
High-dose haemodialysis: a review of the evidence
Authors: Spalding Elaine , Henry Maire
Published: November 2015

High-dose haemodialysis (HD) can result in improved solute control, reduced cardiovascular risk and better patient satisfaction. Patient and staff education is essential to enhance uptake of alternative HD regimens and fully realise their potential benefits. Elaine Spalding and Maire Henry summarise the background of and evidence for high-dose HD and discuss ways to address barriers to treatment.
Evaluation of pre-hospital point-of-care testing for lactate in sepsis and trauma patients
Authors: Younger Paul , McClelland Graham
Published: November 2015

Objective: Lactate is a significant marker of critical illness and mortality in sepsis and trauma patients. The purpose of this study is to evaluate point-of-care lactate testing by paramedics in a UK ambulance service.

Methods: Selected enhanced care paramedics were trained to use the lactate meter in patients with suspected sepsis and patients who trigger the major trauma bypass protocol. Feedback was collected on the practicalities of using the meter and the potential impact on the diagnosis of sepsis.

Results: Data were collected on 114 patients, 96% had suspected sepsis (n=109) and 4% (n=5) were patients who had sustained trauma. The participants found that the ability to take lactate readings was useful and increased their confidence in their clinical decision making.

Conclusions: Point-of-care lactate measurement is feasible in pre-hospital care and appears to support paramedics in their decision making.
The use of telemedicine technology to support in pre-hospital patient care
Authors: Sibson Lynda
Published: November 2015

Lack of accurate clinical information and availability to expertise at the incident scene can affect patient safety and outcome. The use of technology to capture, transmit and assess patient data and information can be used to ensure better patient outcome and more efficient use of resources. Telemedicine can also be of benefit for ED doctors to discuss emergency situations with paramedics, providing advice in terms of treatment, triage and referral to alternative medical facilities.
An insight into the demands and stressors experienced by Community First Responders
Authors: Kindness Peter , Fitzpatrick David , Mellish Chris , Masthoff Judith , O'Meara Patrick , McEwan Murray
Published: November 2015

Background:

Community First Responders (CFR) are volunteers who respond to appropriate medical emergencies while an ambulance is en route. The emergencies that CFRs attend are situations where stress is inherent, yet little is known of which stressors and demands are present and which are considered to be the greatest attributer to stress experienced.

Objective:

This survey aims to gain further understanding of the demands and stressors experienced by CFRs.

Design:

An online survey using a modified NASA-TLX scoring system was distributed to CFRs throughout Scotland (n=535). CFRs were asked to gauge the demands and stressors experienced during a ‘typical’ and their ‘most stressful’ callout, what would be the biggest cause of stress if present and the most stressful time-period during callouts.

Results:

88 CFRs started the survey with 40 continuing to completion. Frustration that the CFR could not help the patient more was considered to be the biggest stressor for both a typical and most the stressful callout. Emotional demand was the most present demand in a typical callout and mental demand in the most stressful callout. If present, loneliness and isolation was deemed to be the biggest cause of stress for CFRs. Prior to arrival at scene was the most stressful time.

Conclusions:

This insight provides a valuable appraisal for the Scottish Ambulance Service of the CFR scheme and the concerns and demands experienced by its volunteers. The results also act as a cross-sectional study for research investigating stress alleviation through human-computer interaction in the pre-hospital care domain.
Rapid sequence induction and the paramedic
Authors: Williams Meirion , Higginson Ray
Published: November 2015

It is usually the most obtund and critically ill of patients that receive paramedic pre-hospital endotracheal intubation. Without a patent airway, asphyxia will lead to death rapidly if not corrected. Pre-hospital endotracheal intubation is indicated in patients when there is—or a risk of—apnoea, upper airway blockage and a need for safeguarding against aspiration due to a decreased Glasgow Coma Scale. Endotracheal intubation is currently routinely performed on cardiac arrest patients and traumatic injury patients by paramedics. However, rapid sequence intubation induction, as an advanced paramedical procedure, is not currently advocated for UK paramedic practice. Rapid sequence intubation differs from the normal method of endotracheal intubation in that it can be performed on originally conscious and/or semi-conscious patients and that it uses sedation and paralytic pharmacological agents coupled with protective airway manoeuvres to induce a state of sedation suitable to facilitate endotracheal intubation. This paper explores some of the issues surrounding whether it is feasible for paramedics to routinely perform RSI in the future.
Pre-hospital lactate monitoring for adults with sepsis
Authors: Charlton Karl
Published: November 2015

Background: Sepsis is a life-threatening condition that claims 37 000 lives in the UK. The sepsis six care bundle was developed by the surviving sepsis campaign in 2002 to address this high mortality rate. Part of this care bundle involves measuring blood lactate which is prognostic of mortality. Lactate can be measured by paramedics in the pre-hospital setting using hand held monitors similar to blood glucose machines, with accuracy that is comparable to laboratory measured lactate.

Method: A focused electronic literature search was carried out on a number of different databases as well as a hand search of specific relevant journals. Data was also obtained from reference harvesting, although the limitations of this was appreciated. Experts in the field were also contacted with relevant data obtained. An ongoing pre-hospital trial monitoring lactate was also identified and these researchers were contacted with relevant data obtained.

Conclusions: Pre-hospital lactate monitoring would promote better recognition of sepsis in adults and improve the quality of care. It could be used to initiate a specific treatment regime such as intravenous antibiotics. This would reduce the numbers of patients admitted to intensive care, helping to reduce mortality and costs for the NHS.
Australian paramedic graduates transitioning into UK NHS ambulance services: what are the potential challenges?
Authors: Devenish Scott , Clark Michele , Fleming MaryLou , Tippett Vivienne
Published: November 2015

With United Kingdom (UK) Ambulance National Health Service (NHS) Trusts and Foundation Trusts actively recruiting Australian paramedic graduates, this article seeks to stimulate discussion by identifying differences existing between the two ambulance systems, as well as highlighting potential challenges that Australian graduates may face when transitioning to the UK ambulance service. It also identifies similarities between Australian and UK ambulance systems, which may assist new graduates to overcome the transition shock. This article suggests that transition shock is not solely related to Australian graduates moving to the UK, and may well be present for graduates moving to comparable international ambulance services in Canada, the Middle East, Ireland and South Africa.
Ambulance response time in Ireland: the legal implications
Authors: O'Shea Ellen
Published: November 2015

In Ireland, reports indicate that response times by ambulances to 999 or 112 pre-hospital emergency healthcare calls are not meeting key performance indicators. This can have implications for the patient and the ambulance service. Delays in response times or a failure to meet key performance indicators could lead to claims for negligence against the ambulance service, as has happened in the United Kingdom (UK). In such cases, the plaintiff must prove that he or she is owed a duty of care, that there was a breach of the standard of care expected, that he or she suffered an injury or wrong, and that the injury or wrong was a direct result of the ambulance service not attending within a reasonable or set time frame. This paper will examine the legal implications of failing to respond to 999 or 112 telephone calls within a reasonable time or within agreed guidelines.
Can pre-hospital recognition and intervention improve outcome for patients with severe sepsis?
Authors: Hilditch Marina
Published: November 2015

Pre-hospital provision of care for patients with severe sepsis and septic shock varies significantly throughout the UK. Timely recognition of this complex and highly morbid syndrome is known to be challenging, and significant evidence exists to support the clear association between advancing pre-hospital care and improving patient outcomes. The aim of this literature review is to analyse the opportunities for pre-hospital clinicians to transform the increasing burden of sepsis care. There is evidently a lack of research in this area, reflected in the relative scarcity of relevant research papers. Following a comprehensive literature search, 10 quantitative studies were selected for critical appraisal. Results would suggest that pre-hospital clinicians could effectively contribute to improving outcomes for this patient group. The clinical importance of immediate identification of sepsis is highlighted, recognising the need for sepsis screening aids, standardised pre-hospital evidence-based guidelines and diagnostic tools. Improved communication between pre-hospital clinicians and receiving hospitals was advocated. Further research was proposed to evaluate the effect of pre-hospital therapeutic interventions.
Pre-hospital technology research: reflecting on a collaborative project between ambulance service and academia
Authors: Mort Alasdair J , Fitzpatrick David , Schneider Anne , Wilson Philip , Mellish Chris
Published: November 2015

The University of Aberdeen MIME project (Managing Information in Medical Emergencies) aimed to develop technology to support volunteer rural community first responders when managing patients. This can be a particularly stressful activity with many challenges to overcome while waiting for ambulance clinicians to arrive. The MIME system employed lightweight medical sensors streaming data (heart and respiratory rate, and blood oxygen saturation) wirelessly to a tablet computer. Novel software was developed to present these data on-screen in a simple way and facilitate the quick digital capture of first responder actions and observations. MIME also applied the technique of Natural Language Generation, which interrogated sensor data, user-inputted actions and observations to automatically generate a handover report in English. This paper describes the MIME system, and then focuses on our collaboration journey between academia and the Scottish Ambulance Service. We illustrate the challenges encountered during our research and development, and describe the academia-ambulance service collaboration model that was developed to deliver success. We also discuss the Knowledge Exchange sub-context to our research activities, which coincided with the early development of research capacity within the ambulance service.
The Blue Light Fight: making a stand for independent ambulance providers
Authors: Bustin Penny
Published: November 2015

The Blue Light Fight is the Independent Ambulance Association's (IAA) campaign to stop legislation rushed into law before the general election that would prevent independent ambulance providers from using certain driving exemptions. Penny Bustin, director of communications at the IAA, explains how the campaign is at the very heart of what motivates members: the need to save lives.
Independent prescribing: a journey to provide the best possible care
Authors: Sharman Andy
Published: November 2015

Many patients benefit, and will continue to benefit, as a result of paramedics being able to administer medicines under standards set by the Medicines and Healthcare products Regulatory Agency and the National Institute for Health and Care Excellence, regarding the use of patient group directions (PGDs), patient specific directions (PSDs) and exemptions. It is not uncommon, however, for these mechanisms to prove ineffective. This can result in delays for patients receiving the care that is best suited to their individual needs.

This article looks at how independent prescribing by paramedics would allow patients to receive the care and medicines they need, resulting in a far greater number of patients benefiting from improved and more timely care and greater convenience.
Paramedic prescribing: a potion for success or a bitter pill to swallow?
Authors: Griffin Dylan
Published: November 2015

In a climate of unprecedented demand on healthcare services, ageing demographics, population growth through immigration, a reduction in junior doctors' working hours, and overriding political agendas, the need to develop innovative new roles and expand the scope of practice for existing practitioners, including paramedics, is paramount if the NHS is to maintain resilience in an evolving healthcare system. Recent legislative changes now permit chiropodists/podiatrists and physiotherapists to independently prescribe, further fuelling other allied health professions (AHPs), such as paramedics' and radiographers' desire to become future independent prescribers. Implementation has the potential to enhance patient/clinician experiences through improved access to medicines, and would significantly reduce the need for multi-disciplinary involvement per care episode, yielding cost-efficiency savings through reduced ambulance journeys, fewer avoidable admissions, further augmenting patient care delivery. Paramedic independent prescribing (PIP) would also elicit improved inter-professional collaboration, enhance employability and promote professional autonomy in evolving advanced practice roles. Such innovation requires legislative changes, but remains paramount if paramedics are to actively contribute towards tackling the increasing burden of unprecedented demand, limited resources, and ongoing commitment to achieve cost-efficiency savings within the modern NHS.
Pain: understanding the biopsychosocial model and the paramedic's role within the multi-disciplinary team
Authors: Parkinson Martin
Published: November 2015

Pain, and its consequent management, is a major factor in today's ambulance service, with up to 50% of patients reporting pain among their symptoms when contacting the emergency service. This article explores the role of the paramedic within the multi-disciplinary team and asks the question: ‘What is the appropriate treatment?’ A study of the biopsychosocial model shows that modern clinicians who focus solely on the biomedical model are under-treating the patient's pain by ignoring the psychological and sociological aspects. All this belies a culture of pain management where recognition and treatments of painful conditions bias heavily on some diseases while ignoring or dismissing others. This can, in the eyes of patients, make the individuals complicit with the neglect of painful and life-altering conditions that may permanently change the patients focus and aspirations for the future, and disconnect the patient from the people that are there to help them.
Musculoskeletal injury risks for ambulance workers
Authors: Hignett Sue
Published: November 2015

The provision of emergency and urgent care has been recognised for many years as exposing ambulance workers to high risks of muskuloskeletal injuries. Sue Hignett explores the common manual handling risks faced by paramedics and considers the role of human factors/ergonomics in occupational health and patient safety.
Impact of Reactive Extrusion Parameters on the Resistant Contents and Pasting Properties of Starch Citrates
Authors: Kim Seung-Hyun , Kim Hyun-Seok
Published: November 2015

This study investigated the effects of reactive extrusion conditions on resistant starch contents and pasting viscosity profiles of starch citrates prepared at 10% and 40% (dry starch weight basis, s.b) citric acid (CA) using a convection oven (CVO) and twin-screw extruder (TWE). A TWE without a die was used as a reactor for reactive extrusion (REX). REX parameters were temperatures (130-190°C), screw speeds (10-50 rpm), and passage numbers (1-7 times). The FT-IR spectra of starch citrates prepared by CVO and TWE revealed the presence of carbonyl groups of ester compounds. In starch citrates by TWE, the resistant starch (RS) contents increased with increasing temperatures, decreasing screw speeds, and increasing passage numbers. Maximum RS contents were 48.4% and 93.3% for starch citrates at 10% (190°C, 10 rpm, five passages) and 40% (170°C, 10 rpm, five passages) CA, respectively. Starch citrates prepared at 10% CA by TWE developed significant levels of pasting viscosities, except for those at 170°C and 190°C. At 40% CA, however, pasting viscosity was significantly developed for only starch citrate (150°C, 50 rpm, five passages) with 58.0% RS. Overall, REX would be a potential way of preparing starch citrate upon considering RS contents, as well as minimal losses of its physical properties.
Effect of Blanching Conditions and Thawing Methods on the Quality Properties of Butterbur Stem
Authors: Lee SangYoon , Choi Soo Young , Han Hye Min , Yoo Seon Mi , Choi Mi-Jung
Published: November 2015

The pre-treatment conditions of butterbur stem such as blanching, freezing, and thawing were studied to optimize it for producing frozen butterbur stem to improve its storage ability. Butterbur stems were hot water blanched at 100°C for 3, 5, or 7 min respectively and then soaked in cold water. After peeling out and cutting into blocks (4.5×1.0×0.5 cm), butterbur stems were air-dried for 5, 10, or 15 min respectively. Dried samples were analyzed for their physicochemical properties. With blanching, the hardness value increased from 2.91 kg to 3.64 kg (p>0.05); however, adhesiveness decreased drastically after 5 min of blanching (p<0.05), which changed to a crisp texture. In addition, considering other physicochemical properties, it was assumed that 5-min blanching was optimal pre-treatment to maintain the original quality of butterbur stem for freezing. Five-minute blanched butterbur stems were airdried 5 min, frozen and thawed with several methods, and analyzed for their properties. Considering the thawing loss, hardness, and color change, the fastest freezing and thawing method had the lowest changes on the quality of frozen butterbur stem. Therefore, to produce frozen butterbur stem, it was assumed that immersion freezing and running water or room temperature thawing (25°C) were the best process.
LIMITAÇÕES E DIFICULDADES NA UTILIZAÇÃO DA ABORDAGEM EXPERIENCIAL NO ENSINO DE GERENCIAMENTO DE PROJETOS EM UM CURSO DE GRADUAÇÃO EM ADMINISTRAÇÃO
Authors: Schmitz Leandro Costa , Alperstedt Graziela Dias , Van Bellen Hans Michael , Schmitz Janaina Lopes
Published: November 2015

O presente artigo aprofunda o estudo da utilização da abordagem experiencial na disciplina de gerenciamento de projetos em um curso de graduação em Administração por meio da apresentação dos resultados de uma pesquisa com duração de dois anos, que analisou as limitações e as dificuldades encontradas, sob o ponto de vista dos alunos. Para isso, inicialmente é evidenciado o problema da adequação do processo de ensino e aprendizagem ao conteúdo, bem como é apresentada a abordagem experiencial e sua aplicação na disciplina de gerenciamento de projetos. A pesquisa foi operacionalizada por meio de questionários com perguntas abertas para os alunos concluintes da disciplina ao longo de quatro semestres letivos, totalizando 157 respondentes. Das informações fornecidas emergiram categorias de análise para a abordagem das limitações, dificuldades e propostas de melhoria. Trechos das respostas foram utilizados para ilustrar as principais conclusões que apontam para a relevância das categorias Conteúdo, Tempo e Professor no que tange às limitações, das categorias Conteúdo, Tempo e Comprometimento quanto às dificuldades e, das categorias Conteúdo, Professor e Integração no que se refere às propostas de melhoria. Os resultados permitirão o aprimoramento na condução da disciplina.
Honor the Past. Then Get Over It.
Authors: Swenson Sue
Published: November 2015

This speech was presented at a conference, the National Goals in Research, Policy, and Practice, held in Washington, DC, on August 6-7, 2015. The conference was a working meeting to summarize the current state of knowledge and identify a platform of national goals in research, practice, and policy in intellectual and developmental disabilities. The meeting was jointly organized by the Research and Training Center on Community Living, Institute on Community Integration, University of Minnesota; Rehabilitation Research and Training Center on Developmental Disabilities and Health, Institute on Disability and Human Development, University of Illinois Chicago; Rehabilitation Research and Training Center on Advancing Employment for Individuals with Intellectual and Developmental Disabilities, Institute for Community Inclusion, University of Massachusetts Boston; The Arc of the United States; Association of University Centers on Disabilities (AUCD); and American Association on Intellectual and Developmental Disabilities (AAIDD), with the support of National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).