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PubMed2005

[First responder defibrillation in the LAGO-die Therme--results and experiences].

The use of automated external defibrillator (AED) by persons other than paramedics and emergency medical technicians is advocated by several US- and European organizations. However, at the present time it is still unclear to identify public places with a high incidence of out-of-hospital cardiac arrest. There are few data on the potential impact of public access defibrillators on survival after out-of-hospital cardiac arrest in sporting arenas or water parks. Therefore, we studied prospectively incidence of out-of-hospital cardiac arrest in the LAGO-die Therme in Herne. This is one of the most important swimming parks in Europe and member of the European Waterpark Association EWA. Eight AEDs were placed in the waterpark LAGO-die Therme. The locations where the defibrillators were stored were chosen to make possible a target interval of 60 seconds from collapse to first defibrillation. Twenty waterpark officers were instructed in cardiopulmonary resuscitation and in the use of the AED. During November 16, 2001 and December 31, 2004, 2.05 Mio. visitors were counted in the LAGO. Out-of-hospital cardiac arrest occurred in none of them. AED were used in two visitors with non arrhythmogenic syncope, no shock was delivered. Questionaires were done in 588 visitors (336 males, 252 females, mean age 38+21 years) in 2002 and in 579 visitors (322 males, 257 females, mean age 37+/-25 years) in 2004. In 2002, 77% of the visitors noticed the AED and, therefore, 49% performed more sporting activities. In addition, in 2004, AED was noticed by 480 visitors (83%) and 277 visitors (48%) did more sporting activities. There were no significant differences between 2002 and 2004 (p=ns). Despite no out-of-hospital cardiac arrest in the waterpark during the 3 year follow- up, it seems reasonable to install AED in sporting places with thousands of visitors per year.

Adult↗
PubMed2004

Water-based exercise for cardiovascular fitness in people with chronic stroke: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of an 8-week, water-based exercise program (experimental group) with that of an upper-extremity function program (control group) to increase cardiovascular fitness within a community setting for people with stroke. DESIGN: Single-blind randomized controlled trial. SETTING: Public community center. PARTICIPANTS: A volunteer sample of 12 community-dwelling people with stroke with mild to moderate residual motor deficits. INTERVENTION: Study subjects participated in group exercise programs for 1 hour, 3 times a week for 8 weeks. The experimental group exercised in chest-deep water at targeted heart rates. The control group performed arm and hand exercises while sitting. Main outcome measures The primary outcome measure was cardiovascular fitness (V(O2)max). Secondary measures were maximal workload, muscle strength, gait speed, and the Berg Balance Scale score. RESULTS: The experimental group attained significant improvements over the control group in cardiovascular fitness, maximal workload, gait speed, and paretic lower-extremity muscle strength. The relatively short program (8 wk) of water-based exercise resulted in a 22% improvement in cardiovascular fitness in a small group of people with stroke who had relatively high function. CONCLUSIONS: A water-based exercise program undertaken as a group program may be an effective way to promote fitness in people with stroke.

Aged↗
PubMed2006

Designing sensor systems capable of differentiating children from adults.

INTRODUCTION: Injury prevention systems intended to prevent children from entering hazardous locations (or at least alert caregivers if that occurs) often respond to every instance of a person's presence, regardless of whether the intruder is a child. This performance results in a high nuisance alarm rate that sometimes causes adults to disable or circumvent the safety system. If a child safety system can accurately identify intruders as adults or children, nuisance alarm rates can be decreased. METHOD: This analysis selects three human factors (height, foot length, and cognition) amenable to adult/child differentiation and describes likely sensor strategies, advantages, and disadvantages. RESULTS: Preliminary testing of prototypes systems shows that simple sensor systems are capable of acquiring adequate data for adult/child differentiation. The discussion addresses requirements for discriminator systems and the effects of various sensor combinations on overall performance.

Accident Prevention↗
PubMed2006

A laboratory hot tub model for disinfectant efficacy evaluation.

This paper describes a novel laboratory hot tub (LHT) apparatus and associated standard operating procedure (SOP) designed to reproduce the key biological, chemical, and engineering parameters associated with recreational and therapeutic hot tubs. Efficacy, as measured quantitatively by log reduction values, was determined against both biofilm and planktonic bacteria. When the LHT was run according to the SOP, with no antimicrobial treatment, a consistent level of bacterial contamination occurred. The means of log10 viable cell densities (+/- the repeatability standard deviation of log densities) were 7.2 (+/-0.31) for the bulk water (density in units of cfu ml-1), 5.3 (+/-0.56) for the coupons (density in units of cfu cm-2), and 6.6 (+/-0.50) for the filters (density in units of cfu cm-2). When control and chlorine treated LHTs were run in parallel, the log reduction increased significantly with chlorine concentration for samples of planktonic bacteria in the bulk water (p=0.016), biofilm bacteria on the coupons (p=0.09) and biofilm bacteria on the filter (p=0.005), indicating that the method was sensitive to chlorine concentration. The method also displayed sensitivity by differentiating between chlorine and bromine treatments; in every case, chlorine produced a greater log reduction than did the same concentration of bromine. The model and SOP were shown to be rugged with respect to slight changes in fluid mixing intensity, water chemistry (saturation index), inoculum size, and organic loading. The LHT and associated SOP provide a reliable second tier in a three-tiered testing process, in which the first tier is a suspension test and the final tier is a field test.

Biofilms↗
PubMed1997

Risk perception following exposure to a job-related electrocution accident: the mediating role of perceived control.

Perceived control was proposed to be a significant mediator for the relation often observed between mental simulation (simulation heuristic) and perceived personal risk for future lethal events. Baron and Kenny's (1986) procedure for testing a mediational hypothesis was used to evaluate this hypothesis. Employees of a recreational facility where a lifeguard was accidently electrocuted and a matched control group (N = 32) estimated their perceived risk for future electrocution events, how much personal control they believed they had over preventing future events, and the degree of clarity for mentally simulating future events. Although perceived control was not found to be a significant mediator for the relation between mental simulation and perceived risk as hypothesized, both mental simulation and perceived control accounted for a significant proportion of the variance in perceived risk for future electrocution events. The trauma group reported significantly higher ratings for perceived risk and mental simulation of future events. However, the trauma group did not differ from the non-trauma group on perceived control over future events. Possible explanations for the relatively high degree of perceived control over future electrocution events within the trauma group, in spite of their experience with a near-fatal electrocution event, are discussed.

Accidents, Occupational↗
PubMed1983

Rectosigmoid perforation and intestinal evisceration from transanal suction.

Transanal suction injuries were sustained in 1981 by five children when they sat upon uncovered swimming area drain sites. Tears of the rectosigmoid areas occurred in each with associated evisceration and loss of substantial amounts of small intestine because of mesenteric separation. These cases are reviewed.

Child, Preschool↗
PubMed1985

Primary amebic meningoencephalitis.

Primary amebic meningoencephalitis is a disease caused by the free-living amebae of the genera Naegleria or Acanthamoeba. The clinical course may result in death a few days after presentation or it may be insidious, with progressive neurologic deterioration and death after a chronic course. This article describes the organisms involved, the clinical course, pathology, diagnosis, and treatment of the disease.

Adolescent↗
PubMed1998

A characterization of performance by men and women in a virtual Morris water task: a large and reliable sex difference.

In many mammalian species, it is known that males and females differ in place learning ability. The performance by men and women is commonly reported to also differ, despite a large amount of variability and ambiguity in measuring spatial abilities. In the non-human literature, the gold standard for measuring place learning ability in mammals is the Morris water task. This task requires subjects to use the spatial arrangement of cues outside of a circular pool to swim to a hidden goal platform located in a fixed location. We used a computerized version of the Morris water task to assess whether this task will generalize into the human domain and to examine whether sex differences exist in this domain of topographical learning and memory. Across three separate experiments, varying in attempts to maximize spatial performance, we consistently found males navigate to the hidden platform better than females across a variety of measures. The effect sizes of these differences are some of the largest ever reported and are robust and replicable across experiments. These results are the first to demonstrate the effectiveness and utility of the virtual Morris water task for humans and show a robust sex difference in virtual place learning.

Adult↗
PubMed2002

The relative influence of individual, social and physical environment determinants of physical activity.

Environmental determinants of health are receiving growing attention in the literature, although there is little empirical research in this area. The Study on Environmental and Individual Determinants of Physical Activity (known as the SEID project) was a social ecological project that examined the relative influence of individual, social environmental and physical environmental determinants of recreational physical activity. It involved a community survey of 1803 healthy workers and home-makers aged 18-59 years living in a 408 km2 area of metropolitan Perth, Western Australia. Physical environmental determinants were mainly conceptualised as spatial access to popular recreational facilities. Overall, 59% of respondents exercised as recommended. Recreational facilities located near home were used by more respondents than facilities located elsewhere. The most frequently used facilities were informal: the streets (45.6%); public open space (28.8%) and the beach (22.7%). The physical environment's directs the influence on exercising as recommended was found to be secondary to individual and social environmental determinants. Nevertheless, accessible facilities determined whether or not they were used and in this way, support and enhance the achievement of recommended levels of physical activity behaviour by providing opportunities. The results suggest that access to a supportive physical environment is necessary, but may be insufficient to increase recommended levels of physical activity in the community. Complementary strategies are required that aim to influence individual and social environmental factors. Given the popularity of walking in the community, it is recommended that greater emphasis be placed on creating streetscapes that enhance walking for recreation and transport.

Adolescent↗
PubMed1999

The physiology and biomechanics of competitive swimming.

Fast swimming, either in the pool, in open water swimming, or in water polo and synchronized swimming, requires maximizing the efficiencies with which the human body can move through a liquid medium. A multitude of factors can affect the ability to swim fast as well as the final outcome. Physiology and biomechanics are the present tools used by sports scientists to determine which factors are important to fast swimming and, subsequently, to determine how the swimmer may maximize these factors to improve performance.

Biomechanical Phenomena↗