Feasibility of residential air quality monitoring to address asthma outcomes

Improving asthma outcomes for underserved populations can be addressed through interventions to improve indoor air quality (IAQ). New protocol for measuring IAQ and health outcomes are imperative given advances in IAQ monitoring technology and challenges in conducting intervention research in homes. In this pilot study HEPA air purifiers and HEPA vacuum cleaners were provided to five homes with children with asthma. For 6 weeks, eight common components of air quality were measured using a low-cost multi-channel air quality monitoring device, with data conveyed directly from participant homes via Wi-Fi connection. In conjunction with periodic surveys on asthma control, impact of asthma on quality of life and intervention compliance, outcomes compared IAQ, home characteristics, and asthma-related measures. This pilot study demonstrates the feasibility of a protocol to evaluate a dual component intervention to improve IAQ in homes, as measured with a low-cost air quality monitoring device.

Simulation analysis of high-throughput oyster cryopreservation at three scales of production

Cryopreservation and germplasm repositories offer a variety of potential benefits to aquaculture industries. Despite this, no comprehensive repository systems exist for any prominent aquaculture species. A species that could greatly benefit from the use of cryopreserved sperm and repository storage is the eastern oyster, Crassostrea virginica. High-throughput cryopreservation protocols already exist for this species, and the easy transport of frozen sperm could facilitate selective breeding programs that address pressing challenges currently faced in the industry, such as mortality due to low-salinity conditions. This study addressed the gap between cryopreservation protocols and repository development in the oyster industry by creating simulation models to evaluate cryopreservation needs at three different scales of production. The effects of high-throughput device options and three key parameters (straws per oyster, batch size, and number of operators) on production capacity, time, and cost were evaluated. Recommendations for decisions concerning cryopreservation pathways and repository creation were given at each scale of production. Relative values of broodstock, juvenile oysters, and oyster sperm sold at hatcheries were also discussed. In general, repositories operating at higher production levels benefited from the economy of scale, could use automated high-throughput equipment options, and could hire more labor without drastically increasing production costs.

Community Paramedics' Perception of Frequent ED Users and the Community Paramedicine Program: A Mixed-Methods Study

Community paramedicine (CP) model of care integrates existing emergency medical service (EMS) resources with primary care, public health, social services and community engagement. However, published studies about CP programs in the U.S. are sparse. To understand how paramedics perceive CP programs and patients in the program, we surveyed and interviewed 16 community paramedics (10 men and 6 women) who are currently delivering health care within a CP program. Our analyses highlighted that community paramedics: (1) defined CP patients in sympathetic terms; (2) reported patient and systemic factors contributing to ED overuse; and (3) expressed their frustrations and commendations for CP programs. Several suggestions were identified to improve CP program (all modifiable elements). Further, the frustrations expressed by paramedics highlight the barriers to health care access for underserved communities. We discuss the implications of this research for practice and recommend future qualitative studies on longer operating CP programs.

Resource evaluation framework for total knee arthroplasty

PURPOSE

This article describes a framework for evaluating efficiency of OR procedures incorporating time measurement, personnel activity, and resource utilization using traditional industrial engineering tools of time study and work sampling.

METHODS

The framework measures time using time studies of OR procedures and work sampling of personnel activities, ultimately classified as value-added or non-value-added. Statistical methods ensure that the collected samples meet adequate levels of confidence and accuracy. Resource utilization is captured through documentation of instrument trays used, defects in instruments, and trash weight and classification at the conclusion of surgeries.

FINDINGS

A case study comprising 12 observations of total knee arthroplasty surgeries illustrates the use of the framework. The framework allows researchers to compare time, personnel, and resource utilization simultaneously within the OR setting.

PRACTICAL IMPLICATIONS

The framework provides a holistic evaluation of methods, instrumentation and resources, and staffing levels and allows researchers to identify areas for efficiency improvement.

ORIGINALITY/VALUE

The methods presented in this article are rooted in traditional industrial engineering work measurement methods but are applied to a healthcare setting in order to efficiently identify areas for improvement including time, personnel, and processes in operating rooms.

What to expect from immersive virtual environment exposure: influences of gender, body mass index, and past experience

For those interested in using head-coupled PC-based immersive virtual environment (VE) technology to train, entertain, or inform, it is essential to understand the effects this technology has on its users. This study investigated potential adverse effects, including the sickness associated with exposure and extreme responses (emesis, flashbacks). Participants were exposed to a VE for 15 to 60 min, with either complete or streamlined navigational control and simple or complex scenes, after which time measures of sickness were obtained. More than 80% of participants experienced nausea, oculomotor disturbances, and/or disorientation, with disorientation potentially lasting > 24 hr. Of the participants, 12.9% prematurely ended their exposure because of adverse effects; of these, 9.2% experienced an emetic response, whereas only 1.2% of all participants experienced emesis. The results indicate that designers may be able to reduce these rates by limiting exposure duration and reducing the degrees of freedom of the user's navigational control. Results from gender, body mass, and past experience comparisons indicated it may be possible to identify those who will experience adverse effects attributable to exposure and warn such individuals. Applications for this research include military, entertainment, and any other interactive systems for which designers seek to avoid adverse effects associated with exposure.