The training initiative studied significantly reduced the reported likelihood of all barriers studied to prevent respondents from performing bystander CPR and also increased the reported confidence in doing CPR and likelihood of doing CPR on both strangers and family. However, it did not alleviate the pre-training discrepancy between likelihood of performing CPR on strangers versus family. Previous CPR training or certification had no impact on likelihood of or confidence in performing CPR.

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Mercury is a ubiquitous environmental pollutant that can negatively impact physiology and behavior of vertebrates, causing sub-lethal changes in condition and reducing fitness. Here we examine its effect on offspring sex ratio. Previous studies demonstrate the ability of environmental contaminants to skew sex ratios in wild populations toward the production of females, and research in humans has demonstrated a decrease in male births following mercury exposure. We therefore hypothesized that female birds inhabiting the floodplain of a mercury-contaminated river would produce broods more biased towards the production of females relative to birds from uncontaminated areas. We examined complete broods of three species: the aquatic-feeding belted kingfisher Megaceryle alcyon, the terrestrial-feeding eastern bluebird Sialia sialis, and the tree swallow Tachycineta bicolor, which feeds from both aquatic and terrestrial sources. Nestling sex ratios were shifted toward the production of females in all three species on mercury-contaminated sites when compared to uncontaminated reference sites. These results may be explained by endocrine disruption or the Trivers-Willard theory of sex allocation. Our study is the first to examine the impact of mercury on offspring sex ratios in birds, and therefore contributes to our understanding of the potential for this persistent biomagnifying contaminant to alter fitness and effective population size in wildlife.

Cost-effectiveness analysis demonstrates that a community CPR outreach program is a cost-effective means for saving lives when compared to other healthcare-related interventions. Bystander CPR showed a clear trend toward improving the neurologic outcome of survivors. The findings of this study indicate a need for additional research into the economic effects of bystander CPR.

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IntroductionA lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time.MethodsThe MDO was implemented on November 11, 2013. A senior EMS paramedic was assigned to the position and was placed in the fire communication bureau from 9 a.m. to 9 p.m., seven days a week. We defined the pre-intervention period as August 2013 – October 2013 and the post-intervention period as December 2013 – February 2014. We also compared the post-intervention period to the “seasonal match control” one year earlier to adjust for seasonal variation in EMS volume. The MDO was tasked with the prospective management of city EMS resources through intensive monitoring of unit availability and hospital ED traffic. The MDO could suggest alternative transport destinations in the event of ED crowding. We collected and analyzed data from BCFD computer-aided dispatch (CAD) system for the following: ambulance response times, ambulance at-hospital interval, hospital diversion and alert status, and “suppression wait time” (defined as the total time suppression units remained on scene until ambulance arrival). The data analysis used a pre/post intervention design to examine the MDO impact on the BCFD EMS system.ResultsThere were a total of 15,567 EMS calls during the pre-intervention period, 13,921 in the post-intervention period and 14,699 in the seasonal match control period one year earlier. The average at-hospital time decreased by 1.35 minutes from pre- to post-intervention periods and 4.53 minutes from the pre- to seasonal match control, representing a statistically significant decrease in this interval. There was also a statistically significant decrease in hospital alert time (approximately 1,700 hour decrease pre- to post-intervention periods) and suppression wait time (less than one minute decrease from pre- to post- and pre- to seasonal match control periods). The decrease in ambulance response time was not statistically significant.ConclusionProactive deployment of a designated MDO was associated with a small, contemporaneous reduction in at-hospital time within an urban EMS jurisdiction. This project emphasized the importance of better communication between EMS systems and area hospitals as well as uniform reporting of variables for future iterations of this and similar projects.

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the vaccinated compared to 0.96 per 100,000 among the unvaccinated.These data represent a 25-fold risk reduction among the vaccinated. 7 In summary, this study adds to the existing data from randomized controlled trials that demonstrate that the vaccines are safe. 5,