TY - JOUR A1 - Kurrek, Matt M. A1 - Morgan, Pamela A1 - Howard, Steven A1 - Kranke, Peter A1 - Calhoun, Aaron A1 - Hui, Joshua A1 - Kiss, Alex T1 - Simulation as a New Tool to Establish Benchmark Outcome Measures in Obstetrics JF - PLoS ONE N2 - Background There are not enough clinical data from rare critical events to calculate statistics to decide if the management of actual events might be below what could reasonably be expected (i.e. was an outlier). Objectives In this project we used simulation to describe the distribution of management times as an approach to decide if the management of a simulated obstetrical crisis scenario could be considered an outlier. Design Twelve obstetrical teams managed 4 scenarios that were previously developed. Relevant outcome variables were defined by expert consensus. The distribution of the response times from the teams who performed the respective intervention was graphically displayed and median and quartiles calculated using rank order statistics. Results Only 7 of the 12 teams performed chest compressions during the arrest following the 'cannot intubate/cannot ventilate' scenario. All other outcome measures were performed by at least 11 of the 12 teams. Calculation of medians and quartiles with 95% CI was possible for all outcomes. Confidence intervals, given the small sample size, were large. Conclusion We demonstrated the use of simulation to calculate quantiles for management times of critical event. This approach could assist in deciding if a given performance could be considered normal and also point to aspects of care that seem to pose particular challenges as evidenced by a large number of teams not performing the expected maneuver. However sufficiently large sample sizes (i.e. from a national data base) will be required to calculate acceptable confidence intervals and to establish actual tolerance limits. KW - performance KW - anesthesiologists Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-151646 VL - 10 IS - 6 ER - TY - JOUR A1 - Asare-Kyei, Daniel A1 - Forkuor, Gerald A1 - Venus, Valentijn T1 - Modeling Flood Hazard Zones at the Sub-District Level with the Rational Model Integrated with GIS and Remote Sensing Approaches JF - Water N2 - Robust risk assessment requires accurate flood intensity area mapping to allow for the identification of populations and elements at risk. However, available flood maps in West Africa lack spatial variability while global datasets have resolutions too coarse to be relevant for local scale risk assessment. Consequently, local disaster managers are forced to use traditional methods such as watermarks on buildings and media reports to identify flood hazard areas. In this study, remote sensing and Geographic Information System (GIS) techniques were combined with hydrological and statistical models to delineate the spatial limits of flood hazard zones in selected communities in Ghana, Burkina Faso and Benin. The approach involves estimating peak runoff concentrations at different elevations and then applying statistical methods to develop a Flood Hazard Index (FHI). Results show that about half of the study areas fall into high intensity flood zones. Empirical validation using statistical confusion matrix and the principles of Participatory GIS show that flood hazard areas could be mapped at an accuracy ranging from 77% to 81%. This was supported with local expert knowledge which accurately classified 79% of communities deemed to be highly susceptible to flood hazard. The results will assist disaster managers to reduce the risk to flood disasters at the community level where risk outcomes are first materialized. KW - climate change KW - rational model KW - community KW - flood hazard index KW - West Africa KW - GIS KW - vulnerability KW - performance KW - impact KW - risk KW - mapping KW - runoff Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-151581 VL - 7 SP - 3531 EP - 3564 ER - TY - JOUR A1 - Zinner, Christoph A1 - Sperlich, Billy A1 - Wahl, Patrick A1 - Mester, Joachim T1 - Classification of selected cardiopulmonary variables of elite athletes of different age, gender, and disciplines during incremental exercise testing JF - SpringerPlus N2 - Incremental exercise testing is frequently used as a tool for evaluating determinants of endurance performance. The available reference values for the peak oxygen uptake \((VO_{2peak})\), % of \(VO_{2peak}\) , running speed at the lactate threshold \((v_{LT})\), running economy (RE), and maximal running speed \((v_{peak})\) for different age, gender, and disciplines are not sufficient for the elite athletic population. The key variables of 491 young athletes (age range 12–21 years; 250 males, 241 females) assessed during a running step test protocol \((2.4 m s^{−1} ; increase 0.4 m s^{−1} 5 min^{−1})\) were analysed in five subgroups, which were related to combat-, team-, endurance-, sprint- and power-, and racquet-related disciplines. Compared with female athletes, male athletes achieved a higher \(v_{peak}\) (P = 0.004). The body mass, lean body mass, height, abs. \(VO_{2peak} (ml min^{−1})\), rel. \(VO_{2peak} (ml kg^{−1} min^{−1})\), rel. \(VO_{2peak} (ml min^{−1} kg^{−0.75})\), and RE were higher in the male participants compared with the females (P < 0.01). The % of \(VO_2\) at \(v_{LT}\) was lower in the males compared with the females (P < 0.01). No differences between gender were detected for the \(v_{LT}\) (P = 0.17) and % of \(VO_2\) at \(v_{LT}\) (P = 0.42). This study is one of the first to provide a broad spectrum of data to classify nearly 500 elite athletes aged 12–21 years of both gender and different disciplines. KW - performance KW - data KW - competition KW - reference values Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-126275 VL - 4 IS - 544 ER -