An Experimental Evaluation of Using Automotive HUDs to Reduce Driver Distraction While Answering Cell Phones

To examine strategies for reducing driver distraction while answering the phone, 24 participants answered calls while driving a simulator. Calls were answered using a center-console-mounted phone or one of several phone designs which utilized a HUD to display the caller ID and steering-wheel-mounted buttons to activate the phone. Driving workload was manipulated by varying the curve radius and by varying the timing of the call, either 1 second before or 5 seconds after the start of a curve.

The HUD-based phones resulted in response times that were 39 percent faster than the conventional center-console phone, and they resulted in up to 62 percent fewer line crossings. Additionally, when using the center-console phone, road curvature had a large influence on response times and driving performance; however, the HUD-based phone were less sensitive to increased road curvature or driving workload.

MP14: UTILIZATION OF THE INVASIVE CARDIAC LABORATORY FOR IMMEDIATE CARDIAC CATHETERIZATION: A QUALITY IMPROVEMENT PROJECT

Purpose of Study

Immediate cardiac catheterization is indicated for patients presenting with ST elevation (STE) myocardial infarction, and door-to-balloon time should be <90 min. Patients with non-ST elevation myocardial infarction (NSTEMI) can often be stabilized with medication, and only require urgent invasive evaluation if there is persistent chest pain(despite medical therapy) or hemodynamic or electrical instability. Immediate cardiac catheterization for patients presenting to the ER with chest pain is available in many hospitals, but it involves a large investment of resources which need to be properly utilized. This study evaluated patients sent for urgent invasive evaluation to determine how the facility is utilized.

Abstract MP14 Table 1

STE+STE−≥90%2910≤90% 4 7

Methods Used

In a retrospective chart review, charts from all STEMI code patients presenting between the dates 1/1/15–9/1/15 were studied. The presenting EKG was evaluated to determine whether STE criteria (as per ACC guidelines) were met. The charts were reviewed for angiographic data to determine whether there was ≥90% stenosis of a coronary artery (≥90%) or not (≤90%). Clinical parameters were studied to determine if there were any differences between the groups.

Summary of Results

The study group included 50 patients who went to the cardiology catheterization lab emergently secondary to an indication of STE; 33/50 (66%) patients met guideline criteria for ST elevation (STE+) while 17/50 (34%) did not (STE−). In the STE+ group, 29/33 (88%) had ≥90% occlusion of a coronary artery, while 10/17 (59%) in the STE-group had this degree of stenosis. The sensitivity and specificity of STE for ≥90% coronary artery occlusion on angiography was 74% and 64% respectively. The PPV of STE for >90% stenosis was 88%, while the NPV was 41%.

Conclusions

Significant STE in the proper clinical situation is a Class 1 indication for immediate coronary catheterization. However, 34% referred for immediate catheterization in this study did not meet ACC criteria for STEMI. Although a significant % in the NSTEMI group had ≥90% stenosis, urgent catheterization is only indicated in this group when there is a clinical parameter which dictates the necessity of immediate evaluation.

Survey of infection control and antimicrobial stewardship practices in Australian residential aged-care facilities

This study assessed infection prevention and antimicrobial stewardship (AMS) practices in Australian residential aged-care facilities (RACF). Two hundred and sixty-five surveys (15.6%) were completed with all states represented and the majority (177 (67.3%)) privately run. Only 30.6% RACF had infection control trained staff on site. Few facilities had AMS policies, only 14% had antimicrobial prescribing restrictions. Most facilities offered vaccination to residents (influenza vaccination rates >75% in 73% of facilities), but pneumococcal vaccination was poor.

Social network investigation of a syphilis outbreak in Ottawa, Ontario

BACKGROUND

The incidence of syphilis in Ottawa, Ontario, has risen substantially since 2000 to six cases per 100,000 in 2003, again to nine cases per 100,000 in 2007, and recently rose to 11 cases per 100,000 in 2010. The number of cases reported in the first quarter of 2010 was more than double that in the first quarter of 2009.

OBJECTIVE

In May 2010, the Ontario Ministry of Health and Long Term Care requested the assistance of the Field Epidemiology Program to describe the increase in infectious syphilis rates and to identify social network sources and prevention messages.

METHODS

Syphilis surveillance data were routinely collected from January 1, 2009 to July 15, 2010, and social networks were constructed from an enhanced social network questionnaire. Univariate comparisons between the enhanced surveillance group and the remaining cases from 2009 on non-normally distributed data were conducted using Kruskal-Wallis tests and χ(2) tests.

RESULTS

The outbreak cases were comprised of 89% men. Seventeen of the 19 most recent cases consented to answer the questionnaire, which revealed infrequent use of condoms, multiple sex partners and sex with a same-sex partner. Information regarding social venues where sex partners were met was plotted together with sexual partnerships, linking 18 cases and 40 contacts, representing 37% of the outbreak population and connecting many of the single individuals and dyads.

CONCLUSION

Uncovering the places sex partners met was an effective proxy measure of high-risk activities shared with infected individuals and demonstrates the potential for focusing on interventions at one named bar and one Internet site to reach a high proportion of the population at risk.

Creating musculoskeletal programs for culturally diverse, underserved communities: a community-based participatory research survey

BACKGROUND

Arthritis and other musculoskeletal diseases are the most prevalent health conditions in the USA, causing enormous financial and social burdens, especially in underserved communities. Targeted care and prevention programs are urgently needed.

QUESTIONS/PURPOSES

Within an overall goal of revealing health disparities, the questionnaire explored (1) the use of and access to healthcare, (2) the factors affecting quality of life, and (3) the levels of provider-patient communication.

METHODS

A New York City musculoskeletal hospital conducted a community health needs survey among its diverse ethnic/racial communities. A 39-item questionnaire was administered online, by mail, and in person (in English, Spanish, and Chinese). Answers were analyzed in terms of sociodemographics, to define health disparities within a total sample and two subsamples.

RESULTS

In the total sample, respondents were 60% White, 16% Black, 14% Hispanic/Latino, and 11% Asian, mostly female, and aged 50 to 79. More than 17% of the total sample indicated they could not access a healthcare provider when needed. Poor nutrition and lack of physical activity were large areas of concern, as were falls and poor self-reported health status. Nearly all respondents said they took steps to communicate with their healthcare providers. Dramatic health disparities were found between Whites and non-Whites (e.g., non-Whites were most likely to rate their health poorly, consider their diet fair or poor, lack health insurance, and be unable to access a healthcare provider).

CONCLUSION

The findings are being used to further refine, develop, and expand the hospital's community programs, especially for culturally diverse and underserved communities.

Intravenous nutritional support in pregnancy. Experience following biliopancreatic diversion

11 pregnant women with protein malnutrition following biliopancreatic diversion for obesity were supported by parenteral nutrition (PN). In 2 cases high concentration glucose, lipid emulsions and standard aminoacid mixtures were infused via a central venous catheter; in the other subjects, because oral intake was normal or increased, only aminoacids with or without lipids were administered through a peripheral vein. PN promoted foetal growth and was very well tolerated and totally safe both for mother and infant.