Multimodal Active Shooter Training for Emergency Department Personnel: An Initiative for Knowledge, Comfort, and Retention

2021 ◽  
pp. 1-8
Author(s):  
Elizabeth M. Regan ◽  
Thomas Cranmer ◽  
Timothy Hanaway
Keyword(s):  
Emergency Department ◽  
Descriptive Analysis ◽  
T Test ◽  
Second Phase ◽  
Active Shooter ◽  
Effective Response ◽  
Comfort Levels ◽  
Significant Difference ◽  
Paired T Test ◽  
Response Behaviors

Abstract Background: While hospital-related shootings are not common, recent years have demonstrated an increasing trend, especially involving the emergency department (ED). Despite this increase, there remains a lack of effective training for providers for active shooter events. Existing trainings commonly lack active participation, departmental-specific plans, or feasibility. Methods: Sixty-six emergency medicine physicians, nurses, and technicians participated in a two-phased multimodal active shooter training aimed to increase response knowledge and comfort. The initial training phase included a lecture on “Run-Hide-Fight” principles with departmental adaptations, followed by scenario-based discussion, and then safety walkthrough. Months later in the second phase, participants completed an active shooter simulation. An identical knowledge survey was collected before and after each phase along with descriptive analysis. Surveys were compared using paired t-test. Comfort levels were reported on a Likert scale and compared by paired t-test. Results: Paired t-tests confirmed a statistically significant difference in both active shooter knowledge and comfort levels. Participants showed retention of response knowledge and comfort with implementing response behaviors. Further descriptive analysis demonstrated effective fleeing and barricading, suggesting a real-life gain of knowledge and comfort. Conclusion: A two-phased, multimodal training design for active shooter response was successful in increasing ED provider active shooter knowledge, comfort, retention, and effective response behaviors.

The effect of positive thinking training on the quality of life of parents of adolescent with thalassemia

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Adeleh Sadeghloo ◽  
Parna Shamsaee ◽  
Elham Hesari ◽  
Golbanhar Akhondzadeh ◽  
Hamid Hojjati
Keyword(s):  
Quality Of Life ◽  
Emotional Health ◽  
Intervention Group ◽  
T Test ◽  
World Health ◽  
Positive Thinking ◽  
Significant Difference ◽  
And Control ◽  
Paired T Test

Abstract Introduction Thalassemia, as the most common chronic hereditary blood disorder in humans, can impose many adverse effects on parents and their affected children. On the other hand, positive thinking is the method or the result of a positive focus on a constructive issue, so by teaching positive thinking, we can improve physical and social function, and promote emotional health and overall quality of life. The aim of this study was to determine the effect of positive thinking training on the quality of life of parents of adolescents with thalassemia. Methods This quasi-experimental study was performed on 52 parents of adolescents with thalassemia who attended Taleghani Hospital in Golestan province, Iran in 2017. Samples were randomly assigned into two groups of intervention and control. The positive thinking training (based on the theory of Martin Seligman) was carried out in the intervention group in 10 (45–60 min) sessions over a 5-week period. Data collection tools in this study were the World Health Organization (WHO) quality of life questionnaire (WHOQOL-BREF) and a demographic information questionnaire. Data were analyzed by SPSS-16 software using independent t-test, the paired t-test and a covariance test. Results The results of paired t-test showed a significant difference in the score of quality of life in intervention group before and after the intervention (p < 0.001). However, this test did not show any significant difference in the control group (p = 0.11). The covariance test, after removing the pre-test score, showed a significant difference between the intervention and control groups in terms of the score of quality of life, so that 13% of the changes after the intervention were due to the intervention (p = 0.009, η = 0.13). Conclusion The positive thinking training increased the quality of life of parents of adolescents with thalassemia. Therefore, using this program can be an effective way of improving the quality of life of parents. Thus, positive thinking training is suggested to be used as an effective strategy for increasing the quality of life of parents with ill children.

scholarly journals EFFECTIVENESS OF GLUTEAL MUSCLE STRENGTHENING ON FLAT FOOT

2017 ◽  
Vol 10 (6) ◽  
pp. 219
Author(s):  
Pooja A Mulchandani ◽  
Trupti Warude ◽  
Amrutkuvar Pawar
Keyword(s):  
T Test ◽  
P Value ◽  
Random Allocation ◽  
Gluteal Muscle ◽  
Flat Foot ◽  
Muscle Strengthening ◽  
Intrinsic Muscle ◽  
Navicular Drop ◽  
Significant Difference ◽  
Paired T Test

Objectives: To compare the effect of gluteal muscle strengthening along with conventional exercises versus conventional exercises alone on flat foot.Method: An experimental study conducted at Physiotherapy Department of Krishna Institute of Medical Sciences, Karad. A total of 52 subjects were equally divided into two groups using convenient sampling with random allocation (Groups A and B). Baseline treatment was given to both groups (intrinsic muscle strengthening). Group A was given intrinsic muscle strengthening alone while Group B was given gluteal muscle strengthening along with intrinsic muscle strengthening.Result: Statistical analysis was performed using paired t-test and unpaired t-test. In pre-intervention there was no statistically significant difference seen with p values for the navicular drop was 0.3563 and for Ink test was 0.7342. While on comparing the post-interventional values, the results between the two groups using paired t-test revealed that there was extremely significant difference seen with p-value for the navicular drop was <0.0001 and for Ink test was <0.0001.Conclusion: From the study, it can be concluded that there was a significant effect of gluteal muscle strengthening on the flat foot.

Agreement analysis comparing iPad LCVA and Sloan testing in multiple sclerosis patients

2017 ◽  
Vol 24 (8) ◽  
pp. 1126-1130 ◽  
Author(s):  
Neda Sattarnezhad ◽  
Samantha Farrow ◽  
Dorlan Kimbrough ◽  
Bonnie Glanz ◽  
Brian Healy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
T Test ◽  
Computerized Testing ◽  
Low Contrast ◽  
Significant Difference ◽  
Increased Sensitivity ◽  
The Right ◽  
Multiple Sclerosis Patients ◽  
Paired T Test

Background: Visual symptoms are common in multiple sclerosis (MS). Low-contrast visual acuity (LCVA) testing using Sloan charts has demonstrated increased sensitivity for visual deficits compared to high-contrast acuity testing. Computerized testing of visual acuity may facilitate use in the clinic setting. Objectives: To evaluate the agreement between an iPad-based and Sloan testing of LCVA in a cohort of MS patients. Methods: A total of 38 patients with relapsing-remitting MS were enrolled after providing informed written consent at Partners MS Center, Brigham and Women’s hospital. Monocular LCVA was measured using retroilluminated Sloan chart and iPad-based LogMAR chart. Number of correct letters and agreement between two measurements were assessed for each eye using Bland–Altman analysis and paired t-test. Results: For both eyes, there was no significant difference in number correct between the two measurements using a paired t-test, and there was high correlation between two measurements (oculus dextrus (OD) r = 0.89, p < 0.001; oculus sinister (OS) r = 0.78, p < 0.001). The limits of agreement were −7.9 to +8.5 letters for the right eye and −10.9 to +11.2 letters for the left eye. Conclusion: An iPad-based LCVA test shows good agreement with Sloan testing in MS patients.

scholarly journals PERFORMANCE COMPARISON OF LASTON AC-WC BASED ON AGGREGATE GRADATION SPECIFICATIONS

2018 ◽  
Vol 2 (02) ◽  
pp. 151
Author(s):  
Devi Yulita Metasari ◽  
Akhmad Hasanuddin ◽  
Dewi Junita Koesoemawati
Keyword(s):  
Flow Rate ◽  
Outer Layer ◽  
Performance Comparison ◽  
High Flow ◽  
T Test ◽  
Aggregate Gradation ◽  
Significant Difference ◽  
Bitumen Content ◽  
Asphalt Content ◽  
Paired T Test

Laston AC-WC is the outer layer of the pavement that is directly related to the outside, so a strong mixture is required. One of the major effects is the aggregate gradation.This experiment aims to find out the comparison of Laston AC-WC performance between mixtures used aggregat egradation above and below the restriction zone. Each mixture used 6 variations of asphalt content and there were 3 specimens on each variation of bitumen content. The asphalt contents used were 5,5%; 6%; 6,5%; 7%; 7,5% dan 8%. From the results of the experiments, the mixture with the aggregate above the restriction zone at 7% and 7.5% asphalt content had a density value of 2.13 gr / cc and 2.12 gr / cc respectively; VMA value of 15.49% and 15.91%; VFA values ​​of 80.48% and 79.98%; VIM value of 3.16% and 3.18%; stability value of 3013.58 kg and 2332.57 kg; flow value of 2.47 mm and 2.18 mm; as well as MQ values ​​of 1222.25 kg / mm and 1184.59 kg / mm. While on the mixture with the aggregate under the restriction zone in the asphalt content of 7% and 7.5% obtained density value of 2.11 gr / cc and 2.14 gr / cc; VMA value of 17.21% and 16.3%; VFA value of 71.21% and 78.65%; VIM value of 4.99% and 3.49%; stability value of 2518,75 kg and 3234,72 kg; flow values ​​of 2 mm and 2.07 mm; as well as the MQ value of 1259.37 kg / mm and 1623.54 kg / mm. From the results are analyzed Paired T test and found that the value of flow has a significant difference. The high flow rate was found in the mixture with the aggregate above the restriction zone at 7% asphalt content, so this mixture is more durable due to good flexibility. Laston AC-WC merupakan lapisan terluar perkerasan yang berhubungan langsung dengan keadaan luar, sehingga dibutuhkan campuran yang kuat. Salah satu yang berpengaruh besar adalah gradasi agregat yang digunakan. Penelitian ini bertujuan untuk mengetahui perbandingan kinerja laston AC-WC antara campuran yang menggunakan gradasi di atas dengan di bawah daerah larangan. Penelitian ini dilakukan terhadap campuran laston AC-WC. Masing-masing campuran menggunakan 6 variasi kadar aspal dan terdapat 3 benda uji pada setiap kadar aspal. Kadar aspal yang digunakan adalah 5,5%; 6%; 6,5%; 7%; 7,5% dan 8%. Dari hasil penelitian, campuran dengan agregat di atas daerah larangan pada kadar aspal 7% dan 7,5% memiliki nilai density berturut-turut sebesar 2,13 gr/cc dan 2,12 gr/cc; nilai VMA sebesar 15,49% dan 15,91%; nilai VFA sebesar 80,48% dan 79,98%; nilai VIM sebesar 3,16% dan 3,18%; nilai stabilitas sebesar 3013,58 kg dan 2332,57 kg; nilai flow sebesar 2,47 mm dan 2,18 mm; serta nilai MQ sebesar 1222,25 kg/mm dan 1184,59 kg/mm. Sedangkan pada campuran dengan agregat di bawah daerah larangan pada kadar aspal 7% dan 7,5% didapatkan nilai density sebesar 2,11 gr/cc dan 2,14 gr/cc; nilai VMA sebesar 17,21% dan 16,3%; nilai VFA sebesar 71,21% dan 78,65%; nilai VIM sebesar 4,99% dan 3,49%; nilai stabilitas sebesar 2518,75 kg dan 3234,72 kg; nilai flow sebesar 2 mm dan 2,07 mm; serta nilai MQ sebesar 1259,37 kg/mm dan 1623,54 kg/mm. Dari hasil tersebut dilakukan analisa Uji T Berpasangan dan didapatkan bahwa nilai flow memiliki perbedaan yang signifikan. Nilai flow yang tinggi terdapat pada campuran dengan agregat di atas daerah larangan pada kadar aspal 7%, sehingga campuran ini lebih tahan lama dikarenakan memiliki kelenturan yang baik.

scholarly journals Comparison of Copper Level and Color Vision in Pulmonary Tuberculosis Patients Before and After Ethambutol Treatment in Category I and II

2020 ◽  
Vol 3 (1) ◽  
pp. 19-25
Author(s):  
Febria Restissa ◽  
Ahmad Rasyid ◽  
Devi Azri Wahyuni
Keyword(s):  
Color Vision ◽  
Total Error ◽  
T Test ◽  
Wilcoxon Test ◽  
Copper Level ◽  
Tuberculosis Patients ◽  
Vision Disorder ◽  
Significant Difference ◽  
Before And After ◽  
Paired T Test

ABSTRACT Objective : to determine the correlation between duration of ethambutol and copper levels in serum with color vision disorder examined with Farnsworth Munsell 100 Hue (FM100) in patients with tuberculosis. Methods: This study was an explorative observation of 20 samples during November 2017 - January 2018 period. Comparative analysis using independent t-test, paired t-test, Wilcoxon test and Mann-Whitney test, while correlation analysis using Spearman's test and Pearson's test.  Results: There was a significant difference of FM100 value before and after in category I (p=0.000) with increase of total error value 11.80+5.31 or category II (p=0.000) with increase of total error value 15.00+7.41. There was significant difference of Cu2+ level before and after in category I (p=0.005) with decrease of Cu2+ level 15.57+5.04 mg/dL or category II (p=0.005) with decrease of Cu2+ level 31.66+7.35 mg/dL. There was significant correlation between color vision and duration of ethambutol (p=0.000), but there was no significant correlation of Cu2+ with color vision (p>0.05). Conclusion: The duration of Ethambutol was related to changes in color vision examined with FM100.

scholarly journals Analysis The Level Of Cattleman’s Knowledge Using The T-Test And Wilcoxon In Maju Farmer Group

2020 ◽  
Vol 15 (1) ◽  
pp. 1
Author(s):  
Bismi Widi Hastari ◽  
Dyah Gandasari ◽  
Harry Harry
Keyword(s):  
T Test ◽  
Statistical Software ◽  
City Administration ◽  
Group Data ◽  
Significant Difference ◽  
Urine Production ◽  
Before And After ◽  
Post Test ◽  
Level Of Knowledge ◽  
Paired T Test

Tani Maju farmer group is one of the farming groups located in Rorotan Village, Cilincing District, North Jakarta City Administration. This group has a lot of sheep and advanced management. Despite they manage their sheep well, they are not well informed on how to manage the sewage from their castles (faces and urine). So far, they just throw away the sewage or gave them to fellow farmers. This study aimed to analyze the level of farmers' knowledge in making use of sheep's urine to be degraded into bio urine in the Maju Farmer group. Data was collected through the pre-test and post-test. The data were analyzed using paired t-test and Wilcoxon statistical software (IBM SPSS Statistics 25). The results of the study showed that farmers' knowledge in sewage (Urine) management increased; there is a significant difference in farmers' level of knowledge in bio urine production before and after bio urine extension.

scholarly journals PENGARUH MENYIKAT GIGI DENGAN SIWAK (Salvadora persica) TERHADAP pH SALIVA

2016 ◽  
Vol 4 (1) ◽  
pp. 45-54
Author(s):  
Yossy Juliarni ◽  
Gunawan Gunawan2
Keyword(s):  
T Test ◽  
Control Group ◽  
Case Group ◽  
Salvadora Persica ◽  
Control Group Design ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Significant Difference ◽  
Salivary Ph ◽  
Paired T Test

Background: Salivary pH is one of factor which involved in caries development. Decreasing of salivary pH will cause enamel demineralization. Miswak (Salvadora persica) as a toothbrush because it has mechanical and chemical effects such as essential oil and bicarbonate which can stimulate salivary secretion. Thus, it will increase the buffer capacity and salivary pH lead to enamel remineralization. Objective: This study aimed to know the effect of toothbrushing with miswak (Salvadora persica) on salivary pH. Methods: The clinical experiment study with pre-test and post-test control group design. The sample of this study is the students of Faculty of Dentistry, Andalas University, Padang. There are 34 students that divided into two groups randomly that is case and control group. Case group used miswak while control group used conventional toothbrush, respectively brushing horizontally for 2 minutes. Salivary pH was measured using digital pH meter in scale of 0.0 to 14.0 with 0.1 sensitivity from pen type pH meter. The data analyzed by Shapiro-Wilk test continued by paired t-test and Mann-Whitney test. Results: paired t-test produced significant value p=0,001 in case group and p=0,000 in control group. Mann-Whitney test produced significant value p=0.317. There was no significant difference in statistic among these groups. Conclusion: Toothbrushing with miswak has effect on salivary pH. Miswak as effective as toothbrush on salivary pH Keywords:Toothbrushing, miswak (Salvadora persica), Salivar

scholarly journals A comparison between orthodontic model analysis using conventional methods and iModelAnalysis

2018 ◽  
Vol 51 (4) ◽  
pp. 173
Author(s):  
Vita Previa Indirayana ◽  
Gita Gayatri ◽  
N. R. Yuliawati Zenab
Keyword(s):  
Sampling Method ◽  
Model Analysis ◽  
T Test ◽  
Normality Test ◽  
Time Period ◽  
Significant Difference ◽  
The Mean ◽  
Conventional Methods ◽  
Paired T Test ◽  
Dental Casts

Background: Model analysis constitutes an essential aspect of orthodontic diagnostic practice. Pavan has developed an application to simplify the mathematical calculations employed in orthodontic model analysis. Purpose: This study was conducted to obtain the differences in results and time periods of model analysis using conventional means and iModelAnalysis. Methods: The research represented a comparative analytic study. The populations comprised dental casts dating from 2014 in the Orthodontics Laboratory of Padjadjaran University. The samples comprised 31 dental casts which were subjected to a total sampling method consisting of two treatments; a conventional method calculation and one using iModelAnalysis. A normality test was conducted and processed using a paired t-test with α=0.05. Results: The means of arch length discrepancies were 1.64±2.63 mm and 1.37±3.07 mm for the conventional methods and 1.65±2.43mm and 1.42±3.04mm for iModelAnalysis. The results of a Bolton analysis for conventional methods were 78.05±2.69% and 91.93±1.29%, while those for iModelAnalysis were 77.91±2.70% and 91.96±2.13%. A Howes analysis of conventional methods produced a result of 45.56±2.83%, while for an iModelAnalysis one of 45.56±2.85%. Pont analysis for conventional methods was 39.35±0.04 mm and 49.17±2.55 mm, while for iModelAnalysis it was 39.35±0.07 mm and 49.19±2.57mm. The mean of the duration of analysis using conventional methods was 1703.81±56.46 seconds, while for iModelAnalysis it was 990.06±34.87 seconds. A normality test confirmed that the data was normally distributed (p>0.05). The results of a paired sample t-test with p>0.05 showed that there was no significant difference between the results of each analysis, while there was significant difference in the time period of analysis. Conclusion: There was no difference in the analysis results. However, there was difference in the time period of analysis between conventional methods and that of iModelAnalysis.

scholarly journals Comparison of Computerized and Standard Cognitive Test in Thai Memory Clinic

2018 ◽  
Vol 09 (01) ◽  
pp. 140-142
Author(s):  
Pornpatr A. Dharmasaroja ◽  
Disya Ratanakorn ◽  
Samart Nidhinandana ◽  
Thammanard Charernboon
Keyword(s):  
Mental State ◽  
Evaluation Process ◽  
T Test ◽  
Cognitive Test ◽  
Kappa Statistics ◽  
Moderate Dementia ◽  
Significant Difference ◽  
Computer Based ◽  
State Examination ◽  
Paired T Test

ABSTRACT Background: Computer-based Thai Cognitive Test or Computer-based Thai Mental State Examination (cTMSE) was developed aiming to help doctors to easily get the accurate results of TMSE in a routine, busy outpatient clinics. The purpose of this study was to compare the evaluation process in terms of feasibility, duration of the test, participants/administrator preference, and the results of cognitive test between cTMSE and the standard Thai Mental State Examination (sTMSE). Methods: Twenty-two elderly participants (>60 years old) who were not demented and 22 patients with mild-to-moderate dementia were included in the study. All participants would be asked to have TMSE by standard method (sTMSE) and computer-based method (cTMSE), at least 2 weeks and up to 2 months apart. Scores and duration of the test were compared using dependent paired t-test. Agreement of the tests between two methods and Kappa statistics were analyzed. Results: Paired t-test showed no significant difference in scores between the two methods (mean sTMSE vs. cTMSE: 22.84 vs. 22.62, 95% confidence interval [CI]: [−0.465] to 0.987, P = 0.524). Percent of agreement between the two methods was 92.5%, with the Kappa of 0.85 (P < 0.001). Duration of the test by sTMSE was slightly shorter than the cTMSE (7.31 min vs. 7.97 min, 95% CI: [−1.159] to [−0.175], P = 0.09). Overall, participants liked being tested by cTMSE more than sTMSE. Conclusion: Computer-based TMSE was feasible to use and accurate for screening in aging adults and for cognitive evaluation in patients with mild-to-moderate dementia.

scholarly journals P0755CALCIUM/MAGNESIUM RATIO: NEW PREDICTOR OF INCREASED PULSE PRESSURE IN CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Eduarda Carias ◽  
Filipa Mendes ◽  
André Fragoso ◽  
Pedro Leão Neves ◽  
Ana Silva
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pulse Pressure ◽  
Descriptive Analysis ◽  
Risk Groups ◽  
T Test ◽  
Chaid Analysis ◽  
Stage 4 ◽  
Significant Difference ◽  
Calcium Magnesium

Abstract Background and Aims Cardiovascular disease (CVD) is the main cause of death in chronic kidney patient. Increase pulse pressure (PP) is associated with adverse cardiovascular outcomes and is an independent risk factor of progression of chronic kidney disease. In this study we aim to identify the risk factors associated with increased PP in a population with severely decreased glomerular filtration rate. Method This was a prospective analysis conducted in an outpatient nephropathy clinic between 2005-2018, enrolling 692 patients with stage 4 CKD. Patients were divided into two groups according to their pulse pressure. Group 1 mean PP&lt; 50 mmHg, Group2 mean PP &gt;50 mmHg. Based on the calcium/magnesium ratio (rCaMg), the subjects were also divided into 4 risk groups according to the following criteria: &lt;25th percentile (rCaMg &lt; 3.8mg/dl; n=168) – G1; 25-50th percentile (rCaMg: 3.8-4.7; n=171) – G2; 50-75th percentile (rCaMg: 4.7-8.6; n=188) – G3; and &gt;75th percentile (rCaMg: &gt; 8.6; n=165) - G4. We used descriptive analysis, Student's t test, Univariate logistics regression analysis and CHAID analysis to determine the relationship between variables and PP. Results Total of 682 patients, with mean age 70 (SD 12.5), female 54%. An independent t-test was conducted to compare groups. There was a significant difference in mean hemoglobin level (p=0.005), calcium (p=0.029), phosphorus (p=0.017), magnesium (p&lt;0.001), Ca/Mg ratio (p&lt;0.001) and eGFR (p=0.034). Phosphorus OR 1.906 (CI 1.338-2.715) p&lt;0.001, eGFR OR 1.440 (CI 1.023-2.027) p=0.037 were all associated with increased PP. We also compared PP with the subjects of the 4 groups based on calcium/magnesium ratio. Results: G2= OR 7.003 (CI 4.162-11.783) p&lt;0.001; G3= OR 5.136 (CI 3.205-8.230) p&lt;0.001; G4= OR 6.695 (CI 3.999-11.208) p&lt;0.001. After adjusting for confounding variables only sex OR 0.613 (CI 0.420-0.896) p=0.012 and rCa/Mg groups: G1 OR 7.392 (CI 4.362-12.527) p&lt;0.001, G2 OR 6.436 (CI 3.361-12.323) p&lt;0.001 and G3 OR 8.485 (CI 4.009-17.957) p&lt;0.001, showed significant differences. CHAID analysis identified rCa/Mg G2, G3, G4 (82.4%) as the more likely significant predictor to PP&gt; 50 mmHg (p&lt;0.001) in association with male gener (86.2%) (p=0.037). The model correctly classified 76.2% of patients and the estimate of the risk misclassification of events was 0.238±0.016. Conclusion These results suggest increased calcium/magnesium rate and male gender were associated with increased pulse pressure in a population with stage 4 CKD. Further studies are needed to understand this relationship.

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