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An “event” tree technique was used alongside conventional methods for structuring and reporting an audit of ambulance services in Lancashire, UK, for patients with…
An “event” tree technique was used alongside conventional methods for structuring and reporting an audit of ambulance services in Lancashire, UK, for patients with suspected acute myocardial infarction (AMI) and cases of cardiac arrest. The audit covered 4,100 patients attended by ambulance crews. Cross tabulations showed that audit targets were not achieved for recording heart rhythms in non‐arrest cases, administering aspirin and intravenous cannulation. The event tree, linked electronically with the audit database, demonstrated explicitly that only one‐third of non‐arrest patients received all three procedures. With cardiac arrests, the event tree showed that survival rates to hospital were similar for patients in ventricular fibrillation who were defibrillated regardless of whether or not they received anti‐arrhythmic drugs. Interpretation of their performance levels is facilitated by the event‐tree technique that allows relationships between clinical procedures and outcomes of ambulance journeys to be displayed.
The paper discusses how a decision analytic framework has been used by an English health authority in relation to the commissioning of ambulance cardiac services…
The paper discusses how a decision analytic framework has been used by an English health authority in relation to the commissioning of ambulance cardiac services. Strategies for the management by ambulance personnel of victims of cardiac arrest and persons with acute chest pain of cardiac origin were modelled in a decision‐event tree, and a bibliographic database established. The international research literature prior to 1997 was searched in order to derive probability values for the tree. However, after checking whether the sub‐groupings of results in the papers were in accordance with the variables in the tree, the number of useful papers on acute chest pain was found to be only two. In the almost complete absence of information ‐ even from small observational studies ‐ on the management of the great majority of patients with cardiac symptoms transported by ambulance, the local ambulance service and the main providers of hospital services in the district are now collaborating in field studies of cardiac care in order to improve the inputs into the model.
IN this issue we conclude our symposium on Modern Library Planning, and although it is not as complete as we could wish, it has certainly proved to be one of the most interesting subjects we have been able to deal with in recent years. We regret that lack of space has prevented us from including some interesting details about new libraries, and that we have laid ourselves open to the criticism of over‐crowding. We hope, however, that we shall be able, from time to time, to add further material as the occasion warrants. We had hoped to obtain a description of the Central Library Extension of the Hull Public Libraries, but this has, unfortunately, proved impossible. Lancashire County Library, too, is constructing four new branch libraries, an account of which we should have liked to include. Plymouth may be mentioned as still another library of which the material was not ready in time for our symposium. Also, we are sorry to have had to omit some of the illustrations which librarians have been kind enough to offer us for reproduction. In spite of these omissions, however, we have been able to gather together much that is new and interesting in modern planning, and one of the points that is well worth notice is the willingness of librarians to experiment in new ideas, even if conservatively.
HARROGATE will be notable as the venue of the Conference in one or two ways that distinctive. The Association Year is now to begin on January 1st and not in September as heretofore; and, in consequence, there will be no election of president or of new council until the end of the year. The Association's annual election is to take place in November, and the advantages of this arrangement must be apparent to everyone who considers the matter. Until now the nominations have been sent out at a time when members have been scattered to all parts of the country on holiday, and committees of the Council have been elected often without the full consideration that could be given in the more suitable winter time. In the circumstances, at Harrogate the Chair will still be occupied by Sir Henry Miers, who has won from all librarians and those interested in libraries a fuller measure of admiration, if that were possible, than he possessed before he undertook the presidency. There will be no presidential address in the ordinary sense, although Sir Henry Miers will make a speech in the nature of an address from the Chair at one of the meetings. What is usually understood by the presidential address will be an inaugural address which it is hoped will be given by Lord Irwin. The new arrangement must bring about a new state of affairs in regard to the inaugural addresses. We take it that in future there will be what will be called a presidential address at the Annual Meeting nine months after the President takes office. He will certainly then be in the position to review the facts of his year with some knowledge of events; he may chronicle as well as prophesy.
OUR New Year number continues the article on Library Planning so well begun by Mr. J. P. Lamb in our last issue. The excellent views and plans included will do something to show a really individual mind at work on our common problem, and the articles to follow will show that librarians are feeling about carefully, and in some cases experimenting boldly, in the direction of libraries which are to combine the qualities of what may be called the standard public library with those of the community centre. There is much in this that must interest all librarians. The old club ventures, fostered by churches, political groups and similar agencies, are disappearing to an extent, but the community needs a substitute: an intellectual centre and meeting place. This the modern library is attempting to supply.
Debates on the ethics of disaster and humanitarian studies concern unequal relations in research (among research institutes/researchers/stakeholders); the physical and…
Debates on the ethics of disaster and humanitarian studies concern unequal relations in research (among research institutes/researchers/stakeholders); the physical and psychological well-being of research participants and researchers; and the imposition of western methods, frameworks and epistemologies to the study of disasters. This paper focuses on everyday ethics: how they need to be translated throughout the everyday practices of research and how researchers can deal with the ethical dilemmas that inevitably occur.
This paper analyses the process of addressing ethics-related dilemmas from the first author's experiences researching disaster governance in high-intensity conflict settings, in particular drawing from 4 to 6 months of fieldwork in South Sudan and Afghanistan. In addition, ethical issues around remote research are discussed, drawing on the example of research conducted in Yemen. It is based on the personal notes taken by the first author and on the experience of both authors translating guidelines for research in remote and hazardous areas into research practices.
The paper concerns translating ethics into the everyday practices of research planning, implementation and communication. It argues for the importance of adaptive research processes with space for continuous reflection in order to advance disaster studies based on (1) equitable collaboration; (2) participatory methodologies wherever possible; (3) safety and security for all involved; (4) ethical approaches of remote research and (5) responsible and inclusive research communication and research-uptake. Openness about gaps and limitations of ethical standards, discussions with peers about dilemmas and reporting on these in research outcomes should be embedded in everyday ethics.
The paper contributes to discussions on everyday ethics, where ethics are integral to the epistemologies and everyday practices of research.