Clinical Experience and Practical Skills: Results from Mexico City's Paramedic Registry

2008 ◽  
Vol 23 (3) ◽  
pp. 227-233
Author(s):  
Luis M. Pinet Peralta ◽  
Juan M. Fraga ◽  
Enrique Asensio
Keyword(s):  
Mexico City ◽  
Field Experience ◽  
Emergency Services ◽  
Prehospital Care ◽  
Total Mortality ◽  
Mean Value ◽  
Future Health ◽  
Non Profit ◽  
Passing Rates ◽  
Using Data

AbstractIntroduction: Trauma is a leading cause of death and disability in Mexico. Unintentional injuries, along with diabetes and heart disease, contribute to >35% of the country's total mortality. Effective and efficient prehospital care of the conditions may improve outcomes.Objective: The objective of this paper was to determine if prehospital field experience (PFE) correlated with higher passing rates among candidates for the paramedic registry in Mexico City.Methods: This was a retrospective, cohort study using data from the Voluntary Registry of Prehospital Care Professionals (VRPHP) in Mexico City.Results: The mean value for candidate age was 30.6 years and mean value for the years of PFE was 6.8 years (CI = 9–13 years). Most of the applicants were male and almost 90% were basic emergency medical services providers. Sixty-five percent of the candidates were from private, non-profit organizations, 73% were volunteers, and 19% had obtained a university degree. More than 57% had ≥5 years of PFE, but the experience level did not correlate significantly with higher passing rates for the registry evaluation (χ2 = 1.66, p = 0.43).The results differed between the two years that the examination was offered (χ2 = 32.98, df = 1, p <0.001, γ = 0.54), regardless of gender, education, and years of experience.Conclusions: Previous field experience showed no correlation with passing rates, although the correlations improved between examination periods. The results may be used to support appropriate implementation of future health policies for prehospital emergency services.

scholarly journals Optimizing Emergency Medical Service Structures Using a Rule-Based Discrete Event Simulation—A Practitioner’s Point of View

2021 ◽  
Vol 18 (5) ◽  
pp. 2649
Author(s):  
Christoph Strauss ◽  
Günter Bildstein ◽  
Jana Efe ◽  
Theo Flacher ◽  
Karen Hofmann ◽  
...  
Keyword(s):  
Discrete Event Simulation ◽  
Emergency Services ◽  
Prehospital Care ◽  
Discrete Event ◽  
Point Of View ◽  
Public Healthcare ◽  
Healthcare Organizations ◽  
Rule Based ◽  
Event Simulation ◽  
Emergency Medical

Many studies in research deal with optimizing emergency medical services (EMS) on both the operational and the strategic level. It is the purpose of this method-oriented article to explain the major features of “rule-based discrete event simulation” (rule-based DES), which we developed independently in Germany and Switzerland. Our rule-based DES addresses questions concerning the location and relocation of ambulances, dispatching and routing policies, and EMS interplay with other players in prehospital care. We highlight three typical use cases from a practitioner’s perspective and go into different countries’ peculiarities. We show how research results are applied to EMS and healthcare organizations to simulate and optimize specific regions in Germany and Switzerland with their strong federal structures. The rule-based DES serves as basis for decision support to improve regional emergency services’ efficiency without increasing cost. Finally, all simulation-based methods suggest normative solutions and optimize EMS’ performance within given healthcare system structures. We argue that interactions between EMS, emergency departments, and public healthcare agencies are crucial to further improving effectiveness, efficiency, and quality.

scholarly journals The mass balance of a cirque glacier in the Italian Alps (Ghiacciaio Della Sforzellina, Ortles–Cevedale Group)

1993 ◽  
Vol 39 (131) ◽  
pp. 87-90
Author(s):  
G. Catasta ◽  
C. Smiraglia
Keyword(s):  
Mass Balance ◽  
Mean Value ◽  
Climatic Conditions ◽  
Mass Balances ◽  
Italian Alps ◽  
Variation Data ◽  
Using Data

AbstractThe net mass balance (1986/87–1989/90) was calculated for a small cirque glacier in the Italian Alps (Ghiacciaio della Sforzellina, 0.42 k m2, Ortles–Cevedale Group). Four annual mass balances are presented here. All four balances were negative (mean value: –0.90 m year−1), with a maximum deficit of –1.16 m year−1 in 1989–90. The climatic conditions (which are analyzed using data from the S. Caterina Valfurva Station) consisted of a succession of cold, dry winters with little snowfall. Frontal-variation data available since 1925 show a constant retreat until 1966, followed by a brief advance period which has already terminated.

scholarly journals Team rivalry and lending on crowdfunding platforms: an empirical analysis

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Ling Ge ◽  
Xuechen Luo
Keyword(s):  
Empirical Analysis ◽  
Non Profit ◽  
Member Participation ◽  
Lending Decisions ◽  
Using Data

Abstract Background Prosocial crowdfunding helps the underprivileged obtain non-profit seeking loans from multitudinous lenders. Some platforms introduce team competition to motivate member participation and may thus induce team rivalry. Methods We investigate how team rivalry affects lending decisions using data from Kiva.org. We argue that a rivalry relationship may engage teams to compete directly against rivals by lending to the same project or prevent them from doing so because they intend not to cooperate. Result We find that a team is less likely to lend to a project that has received funding from its rival team, suggesting that rival teams tend to avoid cooperation. Conclusions We discuss the implications of our findings for crowdfunding and competition-based motivation mechanisms in general.

scholarly journals Autozygosity influences cardiometabolic disease-associated traits in the AWI-Gen sub-Saharan African study

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Francisco C. Ceballos ◽  
Scott Hazelhurst ◽  
David W. Clark ◽  
Godfred Agongo ◽  
Gershim Asiki ◽  
...  
Keyword(s):  
Inbreeding Depression ◽  
Mean Value ◽  
Cardiometabolic Disease ◽  
Cholesterol Levels ◽  
Environmental Interactions ◽  
Genomic Studies ◽  
Sub Saharan ◽  
Using Data ◽  
Study Sites ◽  
Subcutaneous Adipose

AbstractThe analysis of the effects of autozygosity, measured as the change of the mean value of a trait among offspring of genetic relatives, reveals the existence of directional dominance or overdominance. In this study we detect evidence of the effect of autozygosity in 4 out of 13 cardiometabolic disease-associated traits using data from more than 10,000 sub-Saharan African individuals recruited from Ghana, Burkina Faso, Kenya and South Africa. The effect of autozygosity on these phenotypes is found to be sex-related, with inbreeding having a significant decreasing effect in men but a significant increasing effect in women for several traits (body mass index, subcutaneous adipose tissue, low-density lipoproteins and total cholesterol levels). Overall, the effect of inbreeding depression is more intense in men. Differential effects of inbreeding depression are also observed between study sites with different night-light intensity used as proxy for urban development. These results suggest a directional dominant genetic component mediated by environmental interactions and sex-specific differences in genetic architecture for these traits in the Africa Wits-INDEPTH partnership for Genomic Studies (AWI-Gen) cohort.

scholarly journals Impute.me: An Open-Source, Non-profit Tool for Using Data From Direct-to-Consumer Genetic Testing to Calculate and Interpret Polygenic Risk Scores

2020 ◽  
Vol 11 ◽  
Author(s):  
Lasse Folkersen ◽  
Oliver Pain ◽  
Andrés Ingason ◽  
Thomas Werge ◽  
Cathryn M. Lewis ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Open Source ◽  
Risk Scores ◽  
Non Profit ◽  
Polygenic Risk ◽  
Direct To Consumer ◽  
Using Data

Hurricane Impact on Emergency Services and Use of Telehealth to Support Prehospital Care

2019 ◽  
Vol 14 (1) ◽  
pp. 39-43
Author(s):  
David M. French ◽  
Greg A. Hall ◽  
Todd McGeorge ◽  
Michael Haschker ◽  
Joseph G. Brazeal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Management ◽  
Emergency Services ◽  
Health Care Systems ◽  
Prehospital Care ◽  
Storm Duration ◽  
Care Systems ◽  
Hurricane Impact ◽  
State And Local ◽  
The Impact

ABSTRACTThe impact of hurricanes on emergency services is well-known. Recent history demonstrates the need for prehospital and emergency department coordination to serve communities during evacuation, storm duration, and cleanup. The use of telehealth applications may enhance this coordination while lessening the impact on health-care systems. These applications can address triage, stabilization, and diversion and may be provided in collaboration with state and local emergency management operations through various shelters, as well as during other emergency medical responses.

scholarly journals Tropospheric ozone in CMIP6 Simulations

2020 ◽  
Author(s):  
Paul T. Griffiths ◽  
Lee T. Murray ◽  
Guang Zeng ◽  
Alexander T. Archibald ◽  
Louisa K. Emmons ◽  
...  
Keyword(s):  
Tropospheric Ozone ◽  
Climate Models ◽  
Decadal Variability ◽  
Stratospheric Ozone ◽  
Coupled Model ◽  
Mean Value ◽  
Ozone Production ◽  
Chemical Production ◽  
The Difference ◽  
Using Data

Abstract. The evolution of tropospheric ozone from 1850 to 2100 has been studied using data from Phase 6 of the Coupled Model Intercomparison Project (CMIP6). We evaluate long-term changes using coupled atmosphere-ocean chemistry-climate models, focusing on the CMIP historical and ScenarioMIP ssp370 experiments, for which detailed tropospheric ozone diagnostics were archived. The model ensemble has been evaluated against a suite of surface, sonde, and satellite observations of the past several decades, and found to reproduce well the salient spatial, seasonal and decadal variability and trends. The tropospheric ozone burden increases from 244 ± 30 Tg in 1850 to a mean value of 348 ± 15 Tg for the period 2005–2014, an increase of 40 %. Modelled present day values agree well with previous determinations (ACCENT: 336 ± 27 Tg; ACCMIP: 337 ± 23 Tg and TOAR: 340 ± 34 Tg). In the ssp370 experiments, the ozone burden reaches a maximum of 402 ± 36 Tg in 2090, before declining slightly to 396 ± 32 Tg by 2100. The ozone budget has been examined over the same period using lumped ozone production (PO3) and loss (LO3) diagnostics. There are large differences (30 %) between models in the preindustrial period, with the difference narrowing to 15 % in the present day. Both ozone production and chemical loss terms increase steadily over the period 1850 to 2100, with net chemical production (PO3-LO3) reaching a maximum around the year 2000. The residual term, which contains contributions from stratosphere-troposphere transport reaches a minimum around the same time, while dry deposition increases steadily across the experiment. Differences between the model residual terms are explained in terms of variation in tropopause height and stratospheric ozone burden.

scholarly journals Corporate Hypocrisy: Role of Non-Profit Corporate Foundations in Earnings Management of For-Profit Founder Firms

2018 ◽  
Vol 10 (11) ◽  
pp. 3991 ◽  
Author(s):  
Liping Xu ◽  
Shuxia Zhang ◽  
Ning Liu ◽  
Li Chen
Keyword(s):  
Earnings Management ◽  
Non Profit ◽  
For Profit ◽  
Corporate Foundations ◽  
Chinese Characteristics ◽  
Significant Difference ◽  
Self Interest ◽  
Using Data ◽  
Corporate Social ◽  
Privately Owned

The purpose of this study is to examine whether for-profit firms make opportunistic use of their corporate foundations to pursue self-serving earnings objectives in China. Using data on corporate foundations and a sample of firms listed on the A-share market from 2010 to 2016, we first use the propensity score matching method to explore the effect of corporate foundations on earnings management of their founder firms. We find that the overall discretionary accruals of firms with corporate foundations are significantly higher than for those without corporate foundations. Given the ownership property with Chinese characteristics, we further find that the significant difference is driven by privately-owned firms. Then we develop a model of discretionary donation expenditures to measure the magnitude of earnings management associated with corporate foundations. We observe that firms with small profits and consecutive earnings increase record income-increasing discretionary donation expenditures. While firms that record income-decreasing discretionary donation expenditures create earnings reserves that they can use in subsequent periods to report consecutive earnings increases. The results demonstrate that the visibly ethical behavior of establishing corporate foundations does not necessarily represent the consistent embodiment of corporate social responsibility (CSR), but can be regarded as corporate hypocrisy with self-interest embedded in benevolence.

Probabilistic Models for Corrosion in Structural Reliability Assessment—Part 1: Empirical Models

2003 ◽  
Vol 125 (4) ◽  
pp. 264-271 ◽  
Author(s):  
Robert E. Melchers
Keyword(s):  
Structural Reliability ◽  
Probabilistic Models ◽  
Poor Quality ◽  
Mean Value ◽  
Marine Corrosion ◽  
Existing Structures ◽  
Immersion Corrosion ◽  
Using Data ◽  
Marine Applications ◽  
Many Sources

Reliability theory for the assessment of existing structures for remaining safe life must consider the probabilistic deterioration of structural strength as well as multiple applied loadings. This requires good-quality models of deterioration processes. Models for corrosion, which have been applied in the literature for marine applications, are reviewed. It is shown that these usually are statistical only, using data pooled from many sources. They also use little or no theoretical insight. As a result, they provide poor-quality mean-value information and very high statistical uncertainties. The conclusion is that better modeling is required and that this involves much better understanding of the factors influencing marine corrosion. These factors are reviewed briefly, with particular emphasis on marine immersion corrosion of mild steel.

scholarly journals Emergency Medicine in Malaysia

2005 ◽  
Vol 12 (4) ◽  
pp. 246-251 ◽  
Author(s):  
NHNA Rahman ◽  
CJ Holliman
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Training Program ◽  
Emergency Services ◽  
Postgraduate Training ◽  
Health Care Systems ◽  
Prehospital Care ◽  
Residency Training Program ◽  
Care Systems ◽  
Medical Health Care

The concept of emergency medical health care systems in Malaysia has existed since the 1950s. As in other countries in Asia, their functions and important contributions to the overall healthcare system have been much underestimated compared to other specialties. Historically, the concept of prehospital care management was almost non-existent and the casualty (accident & emergency department) was considered as a dumping place for under-performed medical officers. Postgraduate training in Emergency Medicine in Malaysia is still at its infancy and a lot more effort is required to improve the training program. The establishment of a structured residency training program and certified emergency physicians have revolutionized the emergency services that were neglected for so many years. Many challenges have been encountered since the start of the first program but each of the problems was tackled with great enthusiasm. It is hoped that in time Emergency Medicine and emergency health care in the country would be placed equal or even higher than any other specialty.

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