Abstract 197: What Limits the Use of AEDs by Bystanders?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Hiroshi Kaneko ◽  
Tetsuo Hatanaka ◽  
Aki Nagase ◽  
Seishiro Marukawa ◽  
Tetsuya Sakamoto
Keyword(s):  
Cardiac Arrest ◽  
Urban Areas ◽  
Limiting Factors ◽  
Survey Period ◽  
Automated External Defibrillators ◽  
Public Areas ◽  
Patient Side ◽  
Almost All ◽  
Key Steps ◽  
The City

Introduction: In Japan, the number of automated external defibrillators (AEDs) placed in public areas has climbed up to the estimated 530,000. We reported previously that a half of out-of-hospital cardiac arrests occurred within 100 m from a public AED in urban areas. However, shocks for defibrillation were given to less than 15% of those patients. The objectives of this study was to identify the limiting factors against the use of AEDs by bystanders. Methods: A prospective survey on out-of-hospital cardiac arrest was conducted in the city of Osaka (Dec 2016 through Mar 2017) and the city of Nagoya (Dec 2016 through Nov 2017) searching for patient demographics and AED settings including; absence/presence of a public AED on the scene, attachment of AED pads, delivery of shocks before the time of EMS arrival. Results: Of 558 cases of cardiac arrest registered during the survey period, an AED had already been delivered at the patient side by the time of EMS arrival in 92 case (16.5%). Of those, pads had been attached in 89 cased (96.7%). Shocks had been advised in 35 cases (39.3%) and to all but one of those cases at least 1 shock had been given by the bystanders. There were no statistically significant differences between the groups of cases with and without AEDs at the patient side regarding the patient age (65 years [IQR: 48-74] vs 63 years [IQR49-75], p=0.84), gender (p=0.68) and the time from call to EMS arrival (7 min [IQR: 6-9] vs 7 min [IQR: 6-9], p=0.74). Cases occurring indoors had more chances of AEDs being delivered on the patient side than cases occurring outdoors (24.0% vs 7.8%, p<0.001). Conclusions: Our study indicates that once an AED is delivered at the patient side, pads are successfully attached and shocks are given if indicated in almost all cases. This suggests that finding and delivering an AED onto the patient side are the limiting factors against the use of AEDs by bystanders. In order to popularize the use of AEDs by bystanders, informing people with AED placement and clear direction to the AED location seem to be the key steps.

scholarly journals Perancangan Kawasan Perkotaan Di Pulau Bali Sebagai Konektivitas Industri Pariwisata Yang Terintegrasi Pada Sistem ‘’Smart City Development’’

2020 ◽  
Vol 2 (1) ◽  
pp. 93-97
Author(s):  
I Made Agus Mahendra
Keyword(s):  
Smart City ◽  
Urban Areas ◽  
Spatial Vision ◽  
Development Planning ◽  
Tourism Industry ◽  
City Development ◽  
City Region ◽  
Environmental Goals ◽  
Almost All ◽  
The City

City Development Planning can be described as a decision-making process to realize economic, social, cultural and environmental goals through the development of a spatial vision, strategies and plans, and the application of a set of policy principles, tools, institutional participatory mechanisms, and regulatory procedures. Connectivity between cities is needed for a Bali island which is the best tourism destination in Indonesia. Good connectivity between cities can contribute greatly to tourism destinations in each city / region. In the future it will be a great work if the development of urban areas on the island of Bali is the integrated tourism industry path connectivity in the Smart City Development system. Smart city is a dream of almost all countries in the world both in the provincial and urban spheres. With Smart City, various kinds of data and information located in every corner of the city can be collected through sensors installed in every corner of the city, analyzed with smart applications, then presented according to user needs through applications that can be accessed by various types of gadgets. Through the gadget, users can also interactively become data sources, they send information to data centers for consumption by other users.

scholarly journals Description of the targeted water supply and hygiene response strategy implemented during the cholera outbreak of 2017-2018 in Kinshasa, DRC

2019 ◽  
Author(s):  
Didier Bompangue ◽  
Sandra Moore ◽  
Nadège Taty ◽  
Benido Impouma ◽  
Bertrand Sudre ◽  
...  
Keyword(s):  
Water Supply ◽  
Urban Areas ◽  
Response Strategy ◽  
Cholera Outbreak ◽  
Household Water Treatment ◽  
Cholera Case ◽  
Grid Approach ◽  
Public Areas ◽  
Republic Of The Congo ◽  
The City

Abstract Background Rapid control of cholera outbreaks is a significant challenge in overpopulated urban areas. During late-2017, Kinshasa, the capital of the Democratic Republic of the Congo, experienced an increase in cholera cases that showed potential to spread throughout the city. A novel targeted water and hygiene response strategy was implemented to quickly stem the outbreak. Methods We describe the first implementation of the cluster grid response strategy carried out in the community during the cholera outbreak in Kinshasa, in which water and hygiene response activities targeted cholera case clusters. Interventions, which focused on emergency water supply, household water treatment and safe storage, home disinfection and hygiene promotion, were organized using a grid approach. We also performed a preliminary community trial study to assess the temporal pattern of the outbreak, before and after response interventions were implemented. Cholera surveillance databases from the Ministry of Health were analyzed to assess the spatiotemporal dynamics of the outbreak using epidemic curves and cartography. Results From January 2017 to November 2018, a total of 1,712 suspected cholera cases were reported in Kinshasa. During this period, the health zones most affected included Binza Météo, Limeté, Kokolo, Kintambo and Kingabwa. Following implementation of the response strategy, the weekly cholera case numbers in Binza Météo, Kintambo and Limeté decreased by an average of 57% in two weeks and 86% in four weeks. The total weekly case numbers throughout Kinshasa Province dropped by 71% at four weeks after the outbreak peak. Conclusion During the 2017-2018 period, Kinshasa experienced a sharp increase in cholera cases that showed potential to rapidly spread throughout the city. To contain the outbreak, water and hygiene response interventions targeted case households, nearby neighbors and public areas in case clusters using a grid approach. Following implementation of the response, the outbreak in Kinshasa was quickly brought under control. A similar approach may be useful to quickly interrupt cholera transmission in other urban settings.

scholarly journals Strategic Mapping and Optimised Allocation of Automated External Defibrillators in Urban Areas

2020 ◽  
pp. 138-145
Author(s):  
Kanteler Despoina ◽  
Katsaros Evangelos ◽  
Bakouros Yiannis
Keyword(s):  
Cardiac Arrest ◽  
Urban Areas ◽  
Hot Spot ◽  
Public Access ◽  
Capital City ◽  
Public Health Issue ◽  
Time Range ◽  
Public Access Defibrillation ◽  
Full Coverage ◽  
The City

<p><strong>Background</strong>: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death and is regarded as a significant public health issue. Immediate treatment with an automated external defibrillator (AED) increases OHCA patient survival potential. For AEDs to be used and fulfil their lifesaving potential, they need to be in close proximity to the victim and accessible at the time of a cardiac arrest. The current paper sheds light upon an optimized location-allocation method achieving full coverage with immediate accessibility in an urban context given a limited number of available AEDs for deployment using GIS. The case study is the Region of Western Macedonia (RWM) in Greece for a pilot AED placement program for the Governance of RWM. The focus of the current study is the capital city of RWM, Kozani. The initial number of the defibrillators (120) that are needed to be distributed is very small and cannot cover the needs for every major city or rural area in the region. Out of the 120 AEDs, the challenge is to find the minimum required number of AEDs to allocate in the city providing full coverage and accessibility. This paper focuses only on one city, however, the same methodology was applied to allocate AEDs in the other selected cities of the region. The rural dimension and methodology are not in the scope of this paper. <br> <strong>Methods</strong>: Road network data, spatio-temporal analysis of accessibility network, digital elevation model, land uses, population density, seasonal fluctuations and socio-demographic variables were used. GIS algorithms such as spatial analysis, kernel density, hot spot analysis, maximal covering location problem (MCLP) tests, proximity algorithms, buffer zoning, were a few of the tests made in order to find the most efficient positions and maximize coverage keeping in mind that access to an AED until defibrillation time must not exceed the time range of five minutes. <br> <strong>Results</strong>: optimised sites and allocated AEDs in urban areas we managed to achieve full city coverage with 17 AEDs. In every part of the city, people can have access to a nearby AED with its critical radius of less than or equal to 250m achieving defibrillation in the critical period of 5 minutes. The results are promising for the establishment and expansion of optimised AED deployment in cities. <br> <strong>Conclusions</strong>: The progress of the project must be monitored and there are still unresolved problems that need to be tackled to provide a robust allocation of future defibrillators. Further research to enhance our understanding on public access defibrillation and optimize the accessibility and functionality of the medical health care services is needed. A network of engaged and informed citizens ready to act is required for a successful public access defibrillation program.</p>

scholarly journals Is Distance to the Nearest Registered Public Automated Defibrillator Associated with the Probability of Bystander Shock for Victims of Out-of-Hospital Cardiac Arrest?

2018 ◽  
Vol 33 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Joel Neves Briard ◽  
Luc de Montigny ◽  
Dave Ross ◽  
François de Champlain ◽  
Eli Segal
Keyword(s):  
Cardiac Arrest ◽  
Urban Areas ◽  
Prehospital Care ◽  
Time Of Day ◽  
Publication Type ◽  
Cross Sectional ◽  
Automated External Defibrillators ◽  
Life Saving ◽  
Sectional Analysis ◽  
Hospital Cardiac Arrest

AbstractIntroductionRapid access to defibrillation is a key element in the management of out-of-hospital cardiac arrests (OHCAs). Public automated external defibrillators (PAEDs) are becoming increasingly available, but little information exists regarding the relation between the proximity to the arrest and their usage in urban areas.MethodsThis study is a retrospective, observational, cross-sectional analysis of non-traumatic OHCA during a 24-month period in the greater Montreal area (Quebec, Canada). Using logistic regression, bystander shock odds are described with regards to distance from the OHCA scene to the nearest PAED, adjusted for prehospital care arrival delay and time of day, and stratifying for type of location.ResultsOut of a total of 2,443 OHCA victims identified, 77 (3%) received bystander PAED shock, 622 (26%) occurred out-of-home, and 743 (30%) occurred during business hours. When controlling for time (business hours versus other hours) and minimum response delay for prehospital care arrival, a marginal negative association was found between bystander shock and distance to the nearest PAED in logged meters (aOR=0.80; CI, 0.64-0.99) for out-of-home cardiac arrests. No significant association was found between distance and bystander shock for at-home arrests. Out-of-home victims had significantly higher odds of receiving bystander shock up to 175 meters of distance to a PAED inclusively (aOR=2.52; CI, 1.07-5.89).ConclusionFor out-of-home cardiac arrests, proximity to a PAED was associated with bystander shock in the greater Montreal area. Strategies aiming to increase accessibility and use of these life-saving devices could further expand this advantage by assisting bystanders in rapidly locating nearby PAEDs.Neves BriardJ, de MontignyL, RossD, de ChamplainF, SegalE. Is distance to the nearest registered public automated defibrillator associated with the probability of bystander shock for victims of out-of-hospital cardiac arrest?Prehosp Disaster Med. 2018;33(2):153–159.

scholarly journals The multifunctionality of urban horticulture and its integration with the city ecosystem: a brief review of concepts and the case of São Luís

2019 ◽  
Vol 37 (3) ◽  
pp. 252-259
Author(s):  
João Flávio B Gomes ◽  
Renata SB Gomes ◽  
Alex O Souza
Keyword(s):  
Urban Agriculture ◽  
Rural Areas ◽  
Urban Areas ◽  
Technical Assistance ◽  
Public Support ◽  
Urban Ecosystem ◽  
The World ◽  
Belo Horizonte ◽  
Almost All ◽  
The City

ABSTRACT Urban agriculture is currently carried out all over the world. The activity is characterized by its multifunctionality, contributing to food security, preservation of biodiversity, better use of urban spaces, and proper management of soil and water, in addition to contributing to increasing income and improving the quality of life of farmers who live in the cities. In the 1980s and 1990s, urban agriculture gained momentum on the international scene and, from 2005, in Brazil. Some successful experiences in the world (Detroit, Havana, and St. Petersburg) and in Brazil (Teresina, Sao Paulo, and Belo Horizonte) are briefly reported here. Then, we describe in more detail the case of the city of São Luís. The municipality is situated on an island and its rural spaces have characteristics of peri-urban areas. Agricultural production has low expression in municipal GDP (Gross Development Product). The main products are papaya, cassava, beans, bananas, coconut, and passion fruit and, among the vegetables, roselle, chives, coriander, and West Indian gherkin, traditional regional species of Maranhão cuisine. The activity has two primary groups of actors: producers and intermediaries, with 83 and 41% of them, respectively, living in rural areas. Almost all producers (92%) use their area, 79% use some sustainable fertilization practice, and 69% do not use pesticides. Production areas are small and producers need technical assistance. Transport and poor road conditions are the main challenges to bring products to the markets. The reality that came out from our study indicates the lack of public support to urban farmers in São Luís. On the contrary, successful experiences of urban agriculture have in common the convergence of public policies of urban planning, agriculture and supply, education, and health. Urban agriculture is dynamic and must be integrated into the urban ecosystem to make it possible to unveiling new perspectives on the countryside-city relationship.

scholarly journals PERANCANGAN TAMAN OLAHRAGA DI KELAPA GADING

2020 ◽  
Vol 2 (1) ◽  
pp. 1101
Author(s):  
Devi Septiani ◽  
Tony Winata
Keyword(s):  
Public Space ◽  
Urban Areas ◽  
Open Space ◽  
Healthy Lifestyle ◽  
Third Space ◽  
Third Place ◽  
The Third ◽  
Recreational Facility ◽  
Almost All ◽  
The City

Reduced public open space due to competition in urban areas has resulted in reduced community gathering activities (third place). Many big cities in Indonesia are aggressively building new parks or revitalizing old parks, like in the city of Jakarta. This is because the population density reaches 15,663 people / km2. The population continues to grow from 4.5 million people (1970) to double that, which is 9.6 million in 2010, while now it has reached 10.4 million people and is estimated to be 11-15 million by 2020-2030. As a result, almost all of the surface of the city has been devoured by buildings and changed the function of its designation Kelapa Gading sub-district with an area of 161.21 ha, this district has several shopping centers whose area exceeds the existing green space, namely, an area of 996,215 m2, through the results of observational studies that have been carried out then a proposed project that can meet the needs of the ivory coconut community for a healthy lifestyle with limited land as a means of sports that can accommodate various groups of people. Not only as a sports facility, but as a recreational facility and container that can accommodate interactions in the ivory coconut community. By looking at the parameters that exist in designing the third space, this design is adjusted to the ivory community's need for public space as the third space. AbstrakBerkurangnya ruang terbuka publik akibat persaingan lahan di perkotaan mengakibatkan berkurangnya aktivitas berkumpul bagi masyarakat (third place). Banyak kota – kota besar di Indonesia yang gencar untuk membangun taman baru atau merevitalisasi taman lama, seperti di Kota Jakarta. Hal ini dikarenakan tingkat kepadatan penduduk yang mencapai 15.663 jiwa/km2. Populasi terus bertambah dari 4.5 juta jiwa (1970) hingga menjadi dua kali lipatnya, yaitu 9.6 juta pada tahun 2010, sedangkan sekarang telah mencapai 10.4 juta orang dan diperkirakan untuk menjadi 11 – 15 juta pada tahun 2020 – 2030 mendatang. Akibatnya hampir seluruh permukaan kota telah habis dimakan bangunan dan berubah fungsi peruntukannya Kecamatan Kelapa gading dengan luasan wilayah 161,21 ha, kecamatan ini memiliki beberapa pusat perbelanjaan yang luasnya melebihi RTH yang ada yaitu, seluas 996.215 m2, melalui hasil studi observasi yang telah dilakukan maka diusulkan proyek yang dapat memenuhi kebutuhan masyarakat kelapa gading akan gaya hidup yang sehat dengan lahan yang terbatas sebagai sarana olahraga yang dapat menampung berbagai kalangan maasyarakat. Tidak hanya sebagai sarana olahraga, tetapi sebagai sarana rekreasi dan wadah yang dapat menampung terjadinya interaksi dalam masyarakat kelapa gading. Dengan melihat parameter yang ada dalam mendesain ruang ketiga maka rancangan ini disesuaikan dengan kebutuhan masyarakat kelapa gading akan ruang publik sebagai ruang ketiga.

scholarly journals PERSEPSI ANAK JALANAN TERHADAP BIMBINGAN SOSIAL MELALUI RUMAH SINGGAH DI KOTAMADYA BANDUNG

2005 ◽  
Vol 1 (1) ◽  
Author(s):  
Sr Tjahjorini ◽  
Margono Slamet ◽  
Pang S Asngari ◽  
Djoko Susanto
Keyword(s):  
Urban Areas ◽  
Qualitative Data ◽  
Street Children ◽  
Sampling Technique ◽  
Interview Schedule ◽  
Guidance Program ◽  
The Social ◽  
Public Areas ◽  
The City ◽  
Better Than

The street children has become an important phenomenon in urban areas. Most of the children spent their time on the street or in other public areas. Government throught Social Welfare Departement developed an transit house program which providing social guidance fo ther street children, but the budget can not cover all of the children. Many of the children are still on the street that cause them to be out of control and easily trapped in juvenile delinquency. The study tried to understand perception of the children on the social guidance of the transit house program, since there are not enough information about the issue. The study used quantitative and qualitative data and analized in non parametric statistic. Bandung was selected as location of the study since the city is one of cities in Indonesia that has street children problems. Population of the study are street children of 6-18 years old. Stratifield random sampling technique was used to get 60 respondents. The data was collected through interview schedule, field observation and desk study. The research fond that the perception of the respondents toward social guidance program is negative in terms of physical, mentality, social and skill. But, the respondent that involved in the program less or equal to 6 months is better than whose that involved 7-12 months and more than 13 months, especially in terms of mental and skill guidance. Based on the finding, a reorientation of the program is needed throught in form of guidance and councelling package that short in time (less than 6 months), relevance with interest and talent of the children, emphasize on developing the children skill, but still concern with physical, mental and social development.

scholarly journals PRINCIPLES OF FORMING A GREEN FRAME IN THE CITY STRUCTURE

2020 ◽  
pp. 76-83
Author(s):  
O. A. Kryzhantovska ◽  
◽  
E S. Evstigneeva ◽  
Keyword(s):  
Urban Planning ◽  
Urban Environment ◽  
Urban Areas ◽  
Theory And Practice ◽  
Ecological Planning ◽  
Ecological Compensation ◽  
Green Architecture ◽  
Public Areas ◽  
The City

In the last decade, the issue of forming a green framework system during the development and organization of cities, the structure and principles of its formation has been widely discussed. Meanwhile, the concept of a green framework in urban planning and ecology is different, which requires the synthesis and analysis of these concepts in urban ecology. The article is devoted to determining the role of the natural framework in the structure of the modern urban environment, it also highlights key issues related to urban development features of the formation of the green framework in the structure of the city, at the same level with the problems of its organization. This article reflects various approaches to the development of a green framework in an urban environment and the problems in its formation in modern conditions. The role of the green framework as the basis for ecological planning of the territory and optimization of the quality of the urban environment is considered. In the process of analysis, we conclude that the main aspects of compensation in urban areas are the preservation and development of the gardening system, the determination of their size and connectedness, ecological and urban planning functions that provide ecological compensation for the city, as well as the creation of green architecture. The preservation and growth of green spaces in cities is one of the main environmental tasks. The indifferent attitude of citizens to their environment is a serious urgent problem. The article raises the issue of increasing the civic activity of residents of megacities in the field of preserving the green frame of cities. The successful experience in the conservation of natural resources and the development of green public areas is described on the example of 5 European cities. The obtained results can be used by architects for the theory and practice of the formation of green frames in a modern urban environment.

scholarly journals Impacts of River Engineering on River Channel Behaviour: Implications for Managing Downstream Flood Risk

Water ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1355
Author(s):  
George Heritage ◽  
Neil Entwistle
Keyword(s):  
Sediment Transport ◽  
Urban Areas ◽  
Transport Processes ◽  
Channel Switching ◽  
Survey Period ◽  
Sediment Delivery ◽  
Erosion And Deposition ◽  
Overbank Sedimentation ◽  
The Uk ◽  
The City

Although knowledge of sediment transport has improved over the last 25 years, our understanding of bedload transfer and sediment delivery is still based on a limited set of observations or on models that make assumptions on hydraulic and sediment transport processes. This study utilises repeat lidar survey data of the River Caldew above the City of Carlisle in the UK to investigate the balance of erosion and deposition associated with channel switching from an engineered and managed single thread channel to a naturalising incipient wandering system. Over the 11-year survey period (four bankfull flood events) around 271,000 m3 of sediment were delivered to the river and floodplain and 197,000 m3 eroded suggesting that storage rates of around 7000 m3/annum occurred. The balance of erosion and deposition is influenced by channelisation with very restricted overbank sedimentation and only limited local and transient in-channel bar deposition along the engineered reach (8000 m3 eroded). This contrasts with the activity of the naturalising reach downstream where a developing wandering channel system is acting to store coarse sediment in-stream as large bar complexes and the associated upstream aggrading plane bed reaches and overbank as splay deposits (87,000 m3 stored). Such behavior suggests that naturalisation of channelised systems upstream of flood vulnerable urban areas can have a significant impact on sediment induced flooding downstream. This conclusion must, however, be moderated in the light of the relatively small volumes of material needed to instigate local aggradation in over-capacity urban channels.

scholarly journals Investigation Of Tree Stands Of Public Spaces In Szeged

2015 ◽  
Vol 8 (3-4) ◽  
pp. 33-39 ◽  
Author(s):  
Ágnes Takács ◽  
Márton Kiss ◽  
Eszter Tanács ◽  
Levente Varga ◽  
Ágnes Gulyás
Keyword(s):  
Urban Areas ◽  
Green Space ◽  
Complex Analysis ◽  
Urban Climate ◽  
Well Being ◽  
Urban Trees ◽  
City Management ◽  
Space Management ◽  
Public Areas ◽  
The City

Abstract In urban areas vegetation (especially woody vegetation) is of utmost importance, since it affects the ecological conditions of the city. Urban trees play an important role in improving urban climate both at the local (city, district) and the micro-level (e.g. in public squares). Establishing and maintaining advanced and detailed information systems necessary for the management of urban tree stands is an important task of environmental and climate-conscious city management. Despite that, few of the Hungarian municipalities have a regularly updated tree database. The city of Szeged started efficient green space management in autumn 2013, when we started the creation of a detailed and up-to-date tree register for the public areas, which has been continuously expanded ever since. The survey of the present study covers the period of the growing season, from late spring to early autumn of 2013. All the trees are included in the survey and quite a number of data are recorded for each individual (e.g. species, age, size parameters, exact location, health status, etc.). The recorded data are paper-based, however they are included in a GIS-based green space inventory software, Greenformatic, where coordinates are associated to each object, while information on the state of the tree, its location and handling can be found in the attribute table. The trees included are mostly concentrated in the inner city of Szeged, but the surveys will gradually cover ever larger areas of the city. The results highlight the fact that the structural attributes of the different species’ populations are formed by the integrated effect of the species’ urban tolerance and planting policies of the past decades. The current database already allows highly complex analysis, which contributes to the well-being of city residents.

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