Use Of Technical Equipment Research Articles

Inter-hospital transport of critically ill patients; expect surprises

IntroductionInter-hospital transport of critically ill patients is increasing. When performed by specialized retrieval teams there are less adverse events compared to transport by ambulance. These transports are performed with technical equipment also used in an Intensive Care Unit (ICU). As a consequence technical problems may arise and have to be dealt with on the road. In this study, all technical problems encountered while transporting patients with our mobile intensive care unit service (MICU) were evaluated.MethodsFrom March 2009 until August 2011 all transports were reviewed for technical problems. The cause, solution and, where relevant, its influence on protocol were stated.ResultsIn this period of 30 months, 353 patients were transported. In total 55 technical problems were encountered. We provide examples of how they influenced transport and how they may be resolved.ConclusionThe use of technical equipment is part of intensive care medicine. Wherever this kind of equipment is used, technical problems will occur. During inter-hospital transports, without extra personnel or technical assistance, the transport team is dependent on its own ability to resolve these problems. Therefore, we emphasize the importance of having some technical understanding of the equipment used and the importance of training to anticipate, prevent and resolve technical problems. Being an outstanding intensivist on the ICU does not necessarily mean being qualified for transporting the critically ill as well. Although these are lessons derived from inter-hospital transport, they may also apply to intra-hospital transport.

The art of surgery in the 21st century: based on natural sciences and new ethical dimensions

In the future, new surgical techniques will only be introduced in clinical practice if evidence-based results--frequently the results of controlled clinical trials--are presented. Unlike any other medical discipline, surgeons provide their diagnostic and operative skills through the surgeons' hand and the use of technical equipment, which ranges from instruments and devices employed during operation to the use of surgical robots. Analysing the fundaments of surgery on the turn of the century, there is only a little doubt about the increasing impact of data deriving from natural sciences on knowledge in medicine and management of diseases. The natural scientific method of detecting, measuring, and verifying facts is the methodological basis of surgery as well. The autonomy of the surgeon's clinical decision making is significantly restricted by the definition of guidelines. They shift the decision from a single patient to a collective panel. Patient safety and the efficiency of new treatment modalities compared with previous standards are the criteria for the judgement of innovative surgery today. The communication and interaction between surgeon-scientist and patients is guaranteed legally by written consensus. But beside of the high probability of benefit from therapy and written consensus, the surgeon-patient relation is determined by these factors: limitation of time for care of an individual patient, increase of time for administration and documentation, increase of bureaucratic barriers for medical research, and health cost constraints. The medical mandate to cure a sick patient is an individual mandate to take action. Measures, numbers, and images are only preconditions for a surgeon's action in daily clinical work; they can never replace it. The call for an ethical imperative in scientific surgery that is dependent on technology is justified when the state of science and uncritical use of surgical skills and financial constraints have major impact on providing medical care.

Benefits of teaching voice amplification as related to subjective laryngeal symptoms in teachers, and to the listening conditions for pupils

Teachers unfavorable working conditions—large classrooms with poor acoustics, background noise and the great distance between teacher and pupils often are the main reasons for teachers voice problems. For pupils, the same circumstances simultaneously create unfavorable listening conditions. One way to diminish the vocal load of teaching is by making use of technical equipment. This Icelandic study explores whether voice amplification usage: (1) diminishes the teachers subjective symptoms of vocal fatigue; (2) makes it easier for pupils to listen and follow lessons; and (3) reveals other benefits and/or disadvantages of the usage of amplification in classrooms. Thirty-three teachers with their students (total 791), from grade school to university level, volunteered as subjects. The teachers used amplification in class for at least a week. At the end of the research period, the participants answered questionnaires, except the pupils between 6–9 years of age who were asked two questions. The results showed: (1) the majority of teachers found it easier to talk and experienced less fatigue using vocal amplification; (2) the students found it easier to hear the teacher through class chatter and to follow the lessons; (3) the disadvantages mentioned were mainly technical problems.

Benefits of teaching voice amplification as related to subjective laryngeal symptoms and perceived voice quality in teachers

Loud speaking due to noisy working conditions is a common cause for teachers’ voice disorders. One way to diminish the vocal load of teaching is to make use of technical equipment. This Icelandic study explores: (1) if the use of amplification in classrooms would diminish the teachers’ experienced symptoms of vocal fatigue; and (2) whether there is a possible change in perceptual voice quality during a teachers’ working day. Thirty-three teachers, from grade school to university level, voluntarily served as subjects. They used amplifiers while teaching for one week at least. After that, they filled out a questionnaire concerning their symptoms and experiences. The results showed that the majority of teachers found amplification beneficial. They found it easier to talk and experienced less fatigue. The few disadvantages were technical. For a perceptual analysis, three females and two males (mean age 51 years) with long teaching experience and three or more dysphonic symptoms during the term, had their speech recorded while teaching, with and without amplification. In the clinical examination, no pathological changes were found in the vocal folds. In both studies, the quality of the voices was esteemed better when amplification was used.

Screening for stereopsis without the use of technical equipment: scale development and cross-validation.

Although adequate stereopsis is important for many common sensory-motor activities, large-scale normative samples of the relationship between stereopsis and other individual difference variables are relatively scarce, and stereopsis is often not routinely tested even in settings where it might play an important role. This is, in part, due to the fact that data collection requires individual testing, the use of costly technical equipment and trained personnel. Beginning with a pool of 161 items and an initial sample of 542 individuals, we developed a self-report inventory-suitable for group testing, survey administration or rapid individual screening--possessing a high correlation with laboratory measures of stereopsis. The inventory was then cross-validated against laboratory measures of stereo-acuity in a separate sample of 573 subjects. For the combined samples, the resulting 10-item Stereopsis Screening Inventory (SSI) correlated with laboratory measures of per cent stereopsis (r = 0.80). The inventory's reliability was assessed with a resulting internal consistency coefficient (alpha) of 0.88. The SSI provides a fast, valid and inexpensive measure of uncorrected stereopsis which can be used for rapid screening or epidemiological surveys. The correct classification rate for the SSI was 84% for a low fence requiring 65% stereopsis or better, and 81% for a high fence of residual stereopsis of 25% or less. A conversion equation, with inventory and scoring procedure is given in the Appendix.

Une assistance multimédia interactive pour les séances de travaux pratiques ? Evaluation

Since 1987 we have seen a change in the methods of technology and design education. Pratical work is part of all courses. At first it is difficult for the teacher because he can't explain to every group of students at the same time. This research compares the effectiveness of three different teaching protocols : demonstrations, handbooks and multimedia aids. It analyses the success of each method in explaining the use of technical equipment. The results of this research is as follows. Firstly we established a means of depicting the time scales needed by the students for each stage of the pratical work. The outcome was that the means of teachers interventions was the best (19 measurements were carried out by the students), next multimedia aids (15...). The least effective was the handbook with 8.5 measurements. The differences between the statistical results are significant (p <.01). Finally, we defined the multimedia aid specifications and two prototypes were developped and are currently used by the students.

Diploma-prepared nurses' use of technological equipment in clinical practice.

Increasingly, nurses throughout the western world are receiving their educational preparation for initial registration in a tertiary environment at either the diploma or bachelor degree level. The length of time spent in the clinical setting has been reduced considerably, with the elimination of the apprenticeship system and the role of the student nurse as paid staff member. Concurrently, the amount of technological equipment used in the health care sector is both increasing rapidly and now found in general wards, not just the traditional 'high tech' environments. It is important to evaluate how well the tertiary experience prepares students in terms of their ability to handle common technological equipment such as infusion control devices or suction pumps. In the study reported here 245 diploma-prepared registered nurses completed a questionnaire designed to assess how nurses from tertiary institutions perceived their ability to handle technical equipment in the workplace. The majority of the respondents had been working for 7 to 12 months. No significant relationship was found between the frequency of use of specific items of clinical equipment and whether that item caused the nurse concern in practice. There was also no significant relationship between the frequency of use of an item and whether participants believed that competence should be acquired in relation to that item prior to tertiary graduation. Although moderate levels of comfort in the use of technical equipment were reported upon entry to the workplace, subjects rapidly acquired high levels of comfort in relation to equipment handling. The implications for hospital administrators and tertiary teaching programmes are discussed.

Perceived sources of stress among student nurses.

Questionnaire data was collected from a sample of 306 student nurses from three institutions (university, college of advanced education and hospital) during the second week of the first year of their course, and from 189 students from two of the institutions (university and CAE) at the conclusion of their first year of education. The main sources of stress on both occasions were essentially the same for women and men, and for students from the different institutions. These concerns focussed on study-related issues, the emotional demands of nursing, the use of technical equipment, interpersonal interaction, and lack of time for family and personal pursuits. It was suggested that these concerns could be reduced through the introduction of education in study skills, the provision of the opportunity to gain hands-on experience with technical equipment, and the development of social skills.

Some Characteristics of a New Concept of Technology

A partial answer or “informing response” is sought to the question, “what are the characteristics of knowledge derived during the production of the built environment?”The dialectical relationship between builders and their environments leads to a special kind of knowledge which comes from their use of technical equipment, processes and theories.Understanding of production ranges from experience of the environment through the equipment, etc., to experience of the equipment, etc., i.e. from transparent to opaque mediation.The concepts of amplification and reduction explain the extensions and losses of experience that result from the particular functional characteristics of equipment, processes and theories.Architects as builders respond to the scientific, ethical and aesthetic agenda of societies; and their production exhibits an appropriateness—to and/or appropriation—of aspects of those agenda.Understanding the characteristics of the new concept of technology leads to new questions and identifies new dangers. Is there an inexorable shift from transparency to opacity? Can it be reversed? Should we return to a pre-technical condition? And among the dangers that mediation presents are: a fragmentation of perception and experience; the abstract seems more real than the mundane; the persistence of the codifications of architectural languages from archaic perceptions; and the separation of the professional from the layman.The new concept of technology will generate new perceptions that might lead to new concepts of architectural space and time which will demand a new language of architecture.

Color vision screening without the use of technical equipment: Scale development and cross-validation

Large-scale normative samples of data dealing with visual function and their relationships to individual difference variables are relatively scarce. This scarcity is, in part, due to the fact that data collection usually requires individual testing and the use of technical equipment and trained personnel rather than simple survey instruments. Using a sample of 175 individuals, we developed a self-report behavioral inventory, suitable for group testing or survey administration, to assess color vision, and validated it against laboratory tests. The inventory was then cross-validated in a separate sample of 596 subjects. The resultant brief 10-item scale was shown to be a valid and reliable predictor of color-vision deficit. Hit- and miss-rate tables were developed, and these are presented to allow investigators to select classification criteria appropriate for their purposes. A copy of the inventory and scoring procedure is appended to this report.

Visual screening without the use of technical equipment: preliminary development of a behaviorally validated questionnaire

The collection of epidemiological data pertaining to visual status usually requires individual testing and the use of technical equipment and trained personnel. To expedite such screening a self-report inventory, which validly predicted laboratory or clinical testing, but in a format suitable for group testing and administration by nontechnically trained staff, would be useful. This paper demonstrates the feasibility of such a screening technique. A preliminary inventory was validated against laboratory tests for acuity, color vision, and binocular function and was shown to be capable of ascertaining visual capacities and predicting visual deficits on these dimensions.

A Few observations on productivity in seaports

In this paper, the author describes and discusses the cargo-handling productivity in European seaports and the various factors which may influence it. He focuses on the effects of the ‘port revolution’ which began in the years of reconstruction following the end of the Second World War. This involved the introduction of new (and usually mechanized) cargo-handling techniques which die so much to change the traditional approach to shipping and port operations. He goes on to assess the importance of these developments for the Port of Antwerp, stressing particularly the organization of dock labour, the physical lay-out of the port, and the type and extent of use of technical equipment. He concludes that big differences exist in port productivity between continental European ports, due to the degree to which they have been affected by, and, more importantly perhaps, responded to, the changes of the past few decades.

Spare Part Logistics Systems in West German Industries: An Empirical Analysis

One of the significant features of modern economies is the extensive use of technical equipment throughout production and consumption. Defects and malfunctioning of technical products result in various extra costs in terms of interrupted production as well as lost utility and additional expenses in private households. These consequences of product failures are amplified by the interdependencies within our economic system. Following an initiative by the Federal Association of Logistics Germany (Bundesvereinigung Logistik e.V.) an investigation of spare part logistics systems (SPLSs) in a number of West German industries was just completed. The research concentrated particularly on car, truck, and farming vehicle manufacturing, household appliances, audio and television equipment, and machinery. Our attention was focused on the structure and the functioning of SPLSs, in particular, whether to make or to buy a SPLS, which efficiency standards are employed and what kind of reorganisation had taken place during recent years.