When firefighting, the combination of exposition to high temperatures, high physical demands and wearing (heavy and insulated) personal protective equipment lead to increased risk of heat stress and exhaustion in firefighters. Heat stress can easily evolve into a life-threatening heat stroke. Once heat stress occurred, the chance of getting another heat stroke during deployment gets higher. Moreover, intermittent exposure to heat stress over several years, is a risk factor for heart diseases. Similarly, exhausted during a deployment, a firefighter needs more time to rehabilitate before he can safely be deployed again. Heat stress and exhaustion can lead to line-of-duty cardiovascular events. Therefore preventing heat stress and exhaustion during deployment is beneficial for health, functioning and employability of firefighters. Since currently available measurement of the core temperature, such as thermometer pill or neck patch thermometer, are not reliable or practical for firefighters, an alternative approach may be used, namely, estimation of the core temperature based on non-invasive observation of the heart rate. Exhaustion is estimated using the training impulse model based on the heart rate reserve. Our achievement is a MoSeS health monitor system (as a smartphone application) that can real time analyze the health status of a firefighter and predict exhaustion and heat stress during deployment. The system is cheap (only a heart rate sensor and a smartphone application is needed), easy to use (intuitive “traffic light” signal), and objective (the health status is determined based on measurements of the heart rate). The only restriction is that the developed model is strongly dependent on personal maximum and minimum heart rate which need to be established behforehand. Moses Health Monitoring system for Firefighters CC BY-NC-ND Conference Proceedings 17th international e-SOCIETY 2019 IADIS
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Background: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining deeper knowledge of clinicians’ views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Interview studies with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of ‘OptiBIRTH’, an ongoing research project. The study reported here is based on interviews in high VBAC countries. The aim of the study was to investigate the views of clinicians working in countries with high VBAC rates on factors of importance for improving VBAC rates. Methods: Individual (face-to-face or telephone) interviews and focus group interviews with clinicians (in different maternity care settings) in three countries with high VBAC rates were conducted during 2012–2013. In total, 44 clinicians participated: 26 midwives and 18 obstetricians. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country. Results: The findings are presented in four main categories with subcategories. First, a common approach is needed, including: feeling confident with VBAC, considering VBAC as the first alternative, communicating well, working in a team, working in accordance with a model and making agreements with the woman. Second, obstetricians need to make the final decision on the mode of delivery while involving women in counselling towards VBAC. Third, a woman who has a previous CS has a similar need for support as other labouring women, but with some extra precautions and additional recommendations for her care. Finally, clinicians should help strengthen women’s trust in VBAC, including building their trust in giving birth vaginally, recognising that giving birth naturally is an empowering experience for women, alleviating fear and offering extra visits to discuss the previous CS, and joining with the woman in a dialogue while leaving the decision about the mode of birth open. Conclusions: This study shows that, according to midwives and obstetricians from countries with high VBAC rates, the important factors for improving the VBAC rate are related to the structure of the maternity care system in the country, to the cooperation between midwives and obstetricians, and to the care offered during pregnancy and birth. More research on clinicians’ perspectives is needed from countries with low, as well as high, VBAC rates.
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BACKGROUND: Physical activity (PA) levels might be a simple overall physical function indicator of recovery in acutely hospitalized older adults; however it is unknown which amount and level of PA is associated with recovery. Our objective was to evaluate the amount and level of post discharge PA and its optimum cut-off values associated with recovery among acutely hospitalized older adults and stratified for frailty.METHODS: We performed a prospective observational cohort study including acutely hospitalized older adults (≥ 70 years). Frailty was assessed using Fried's criteria. PA was assessed using Fitbit up to one week post discharge and quantified in steps and minutes light, moderate or higher intensity. The primary outcome was recovery at 3-months post discharge. ROC-curve analyses were used to determine cut-off values and area under the curve (AUC), and logistic regression analyses to calculate odds ratios (ORs).RESULTS: The analytic sample included 174 participants with a mean (standard deviation) age of 79.2 (6.7) years of whom 84/174 (48%) were frail. At 3-months, 109/174 participants (63%) had recovered of whom 48 were frail. In all participants, determined cut-off values were 1369 steps/day (OR: 2.7, 95% confidence interval [CI]: 1.3-5.9, AUC 0.7) and 76 min/day of light intensity PA (OR: 3.9, 95% CI: 1.8-8.5, AUC 0.73). In frail participants, cut-off values were 1043 steps/day (OR: 5.0, 95% CI: 1.7-14.8, AUC 0.72) and 72 min/day of light intensity PA (OR: 7.2, 95% CI: 2.2-23.1, AUC 0,74). Determined cut-off values were not significantly associated with recovery in non-frail participants.CONCLUSIONS: Post-discharge PA cut-offs indicate the odds of recovery in older adults, especially in frail individuals, however are not equipped for use as a diagnostic test in daily practice. This is a first step in providing a direction for setting rehabilitation goals in older adults after hospitalization.
Electrohydrodynamic Atomization (EHDA), also known as Electrospray (ES), is a technology which uses strong electric fields to manipulate liquid atomization. Among many other areas, electrospray is used as an important tool for biomedical application (droplet encapsulation), water technology (thermal desalination and metal recovery) and material sciences (nanofibers and nano spheres fabrication, metal recovery, selective membranes and batteries). A complete review about the particularities of this tool and its application was recently published (2018), as an especial edition of the Journal of Aerosol Sciences. One of the main known bottlenecks of this technique, it is the fact that the necessary strong electric fields create a risk for electric discharges. Such discharges destabilize the process but can also be an explosion risk depending on the application. The goal of this project is to develop a reliable tool to prevent discharges in electrospray applications.
