Background: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks.The novice or infrequent laryngoscopist has...Background: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks.The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices(VAIDs) was best suited for in-flight use by U.S. Air Force Critical Care Air Transport Teams by comparing time to successful intubation between novice and expert laryngoscopists under three conditions, Normal Airway Lights on(NAL), Difficult Airway Lights on(DAL) and Difficult Airway Blackout(DAB), using manikins on a standard military transport stanchion and the floor with a minimal amount of setup time and extraneous light emission.Methods: A convenience sample size of 40 participants(24 novices and 16 experts) attempted intubation with each of the 5 different video laryngoscopic devices on high-fidelity airway manikins. Time to tracheal intubation and number of optimization maneuvers used were recorded. Kruskal-Wallis testing determined significant differences between the VAIDs in time to intubation for each particular scenario. Devices with significant differences underwent pair-wise comparison testing using rank-sum analysis to further clarify the difference. Device assembly times, startup times and the amount of light emitted were recorded. Perceived ease of use was surveyed. Results: Novices were fastest with the Pentax AWS in all difficult airway scenarios. Experts recorded the shortest median times consistently using 3 of the 5 devices. The AWS was superior overall in 4 of the 6 scenarios tested. Experts and novices subjectively judged the Glide Scope Ranger as easiest to use. The light emitted by all the devices was less than the USAF-issued headlamp.Conclusion: Novices intubated fastest with the Pentax AWS in all difficult airway scenarios. The Glide Scope required the shortest setup time, and participants judged this device as the easiest to use. The Glide Scope and AWS exhibited the two fastest total setup times. Both devices are suitable for in-flight use by infrequent and seasoned laryngoscopists. Trial registration: not applicable.展开更多
Teachers' lesson planning and preparation, which are the most important part of the job of teaching, are the beginning of teaching process. A class cannot be good or well performed without planning or preparation....Teachers' lesson planning and preparation, which are the most important part of the job of teaching, are the beginning of teaching process. A class cannot be good or well performed without planning or preparation. Referring to the five stages model of Dreyfus(1986) and considering the teaching context of middle schools, the researcher uses qualitative and quantitative methods to get and analyze the data from 96 English teachers in three Chinese middle school. The findings show that in teaching content planning, novice and some proficient teachers cares more about the knowledge and the teaching itself, but the expert teachers pay more attention to the students' abilities and development as well as the knowledge; moreover, the novice teachers are more likely to focus on the teaching aims and choosing of teaching aid. This study also has significance in contributing to the teachers' expertise in planning.展开更多
The paper provides mathematical analysis of sensitivity of different combination rules in the DS/AHP method when an alternative is added to the set of decision alternatives while solving foresight problems. Different ...The paper provides mathematical analysis of sensitivity of different combination rules in the DS/AHP method when an alternative is added to the set of decision alternatives while solving foresight problems. Different cases of rank reversals are defined and two sets of conditions for these cases using the method DS/AHP are considered. Rank reversals are illustrated when the DS/AHP method is used to solve practical problem of critical technologies of energy conservation and power efficiency evaluation in Ukraine. It is shown that the DS/AHP method is not sensitive to exclusion (or addition) of an irrelevant decision alternative from (or to) the set of decision alternatives.展开更多
Research in spreadsheet management proved that the overuse of slow thinking, rather than fast thinking, is the primary source of erroneous end-user computing. However, we found that the reality is not that simple. To ...Research in spreadsheet management proved that the overuse of slow thinking, rather than fast thinking, is the primary source of erroneous end-user computing. However, we found that the reality is not that simple. To view end-user computing in its full complexity, we launched a project to investigate end-user education, training, support, activities, and computer problem solving. In this project we also set up the base and mathability-extended typology of computer problem solving approaches, where quantitative values are assigned to the different problem solving methods and activities. In this paper we present the results of our analyses of teaching materials collected in different languages from all over the world and our findings considering the different problem solving approaches, set in the frame of different thinking modes, the characteristics of expert teachers, and the meaning system model of teaching approaches. Based on our research, we argue that the proportions of fast and slow thinking and most importantly their manifestation are responsible for erroneous end-user activities. Applying the five-point mathability scale of computer problem solving, we recognized slow thinking activities on both tails and one fast thinking approach between them. The low mathability slow thinking activities, where surface navigation and language details are focused on, are widely accepted in end-user computing. The high mathability slow thinking problem solving activities, where the utilization of concept based approaches and schema construction take place, is hardly detectable in end-user activities. Instead of building up knowledge which requires slow thinking and then using the tools with fast thinking, end-users use up their slow thinking in aimless wandering in huge programs, making wrong decisions based on their untrained, clueless intuition, and distributing erroneous end-user documents. We also found that the dominance of low mathability slow thinking activities has its roots in the education system and through this we point out that we are in great need of expert teachers and institutions and their widely accepted approaches and methods.展开更多
基金Award number FA8650-11-2-6B03 was issued on October 27,2010 by the United States Air Force's Air Force Materiel Command at USAF/AFMC,Det 1 AF Research Laboratory,2310 Eight St.,Building 167,Wright-Patterson AFB,OH,USA for the allocated sum of $124,000.00 with an award amount of $132,373.00 by Grant Officer Timothy Hannah.The Principal Investigator on the award was Dr.Todd E.Carter
文摘Background: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks.The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices(VAIDs) was best suited for in-flight use by U.S. Air Force Critical Care Air Transport Teams by comparing time to successful intubation between novice and expert laryngoscopists under three conditions, Normal Airway Lights on(NAL), Difficult Airway Lights on(DAL) and Difficult Airway Blackout(DAB), using manikins on a standard military transport stanchion and the floor with a minimal amount of setup time and extraneous light emission.Methods: A convenience sample size of 40 participants(24 novices and 16 experts) attempted intubation with each of the 5 different video laryngoscopic devices on high-fidelity airway manikins. Time to tracheal intubation and number of optimization maneuvers used were recorded. Kruskal-Wallis testing determined significant differences between the VAIDs in time to intubation for each particular scenario. Devices with significant differences underwent pair-wise comparison testing using rank-sum analysis to further clarify the difference. Device assembly times, startup times and the amount of light emitted were recorded. Perceived ease of use was surveyed. Results: Novices were fastest with the Pentax AWS in all difficult airway scenarios. Experts recorded the shortest median times consistently using 3 of the 5 devices. The AWS was superior overall in 4 of the 6 scenarios tested. Experts and novices subjectively judged the Glide Scope Ranger as easiest to use. The light emitted by all the devices was less than the USAF-issued headlamp.Conclusion: Novices intubated fastest with the Pentax AWS in all difficult airway scenarios. The Glide Scope required the shortest setup time, and participants judged this device as the easiest to use. The Glide Scope and AWS exhibited the two fastest total setup times. Both devices are suitable for in-flight use by infrequent and seasoned laryngoscopists. Trial registration: not applicable.
文摘Teachers' lesson planning and preparation, which are the most important part of the job of teaching, are the beginning of teaching process. A class cannot be good or well performed without planning or preparation. Referring to the five stages model of Dreyfus(1986) and considering the teaching context of middle schools, the researcher uses qualitative and quantitative methods to get and analyze the data from 96 English teachers in three Chinese middle school. The findings show that in teaching content planning, novice and some proficient teachers cares more about the knowledge and the teaching itself, but the expert teachers pay more attention to the students' abilities and development as well as the knowledge; moreover, the novice teachers are more likely to focus on the teaching aims and choosing of teaching aid. This study also has significance in contributing to the teachers' expertise in planning.
文摘The paper provides mathematical analysis of sensitivity of different combination rules in the DS/AHP method when an alternative is added to the set of decision alternatives while solving foresight problems. Different cases of rank reversals are defined and two sets of conditions for these cases using the method DS/AHP are considered. Rank reversals are illustrated when the DS/AHP method is used to solve practical problem of critical technologies of energy conservation and power efficiency evaluation in Ukraine. It is shown that the DS/AHP method is not sensitive to exclusion (or addition) of an irrelevant decision alternative from (or to) the set of decision alternatives.
文摘Research in spreadsheet management proved that the overuse of slow thinking, rather than fast thinking, is the primary source of erroneous end-user computing. However, we found that the reality is not that simple. To view end-user computing in its full complexity, we launched a project to investigate end-user education, training, support, activities, and computer problem solving. In this project we also set up the base and mathability-extended typology of computer problem solving approaches, where quantitative values are assigned to the different problem solving methods and activities. In this paper we present the results of our analyses of teaching materials collected in different languages from all over the world and our findings considering the different problem solving approaches, set in the frame of different thinking modes, the characteristics of expert teachers, and the meaning system model of teaching approaches. Based on our research, we argue that the proportions of fast and slow thinking and most importantly their manifestation are responsible for erroneous end-user activities. Applying the five-point mathability scale of computer problem solving, we recognized slow thinking activities on both tails and one fast thinking approach between them. The low mathability slow thinking activities, where surface navigation and language details are focused on, are widely accepted in end-user computing. The high mathability slow thinking problem solving activities, where the utilization of concept based approaches and schema construction take place, is hardly detectable in end-user activities. Instead of building up knowledge which requires slow thinking and then using the tools with fast thinking, end-users use up their slow thinking in aimless wandering in huge programs, making wrong decisions based on their untrained, clueless intuition, and distributing erroneous end-user documents. We also found that the dominance of low mathability slow thinking activities has its roots in the education system and through this we point out that we are in great need of expert teachers and institutions and their widely accepted approaches and methods.
