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Other Barriers (other + barrier)
Selected AbstractsSurvey of gastroenterologists' awareness and implementation of AGA guidelines on osteoporosis in inflammatory bowel disease patients: Are the guidelines being used and what are the barriers to their use?,INFLAMMATORY BOWEL DISEASES, Issue 7 2009Julianne H. Wagnon MSN Abstract Background: The American Gastroenterology Association (AGA) published guidelines to assist clinicians in the evaluation and management of osteoporosis in inflammatory bowel disease (IBD) patients. Two studies suggest that when clinicians utilized the guidelines, the majority of their IBD patients were appropriately screened and treated for metabolic bone disease. The aim was to study whether physicians who say they use the AGA Guidelines are, in fact, following the recommendations, and to assess the barriers preventing the use of the guidelines in the management of osteoporosis in their IBD patients. Methods: In all, 1000 physicians were selected from the AGA membership list and mailed a survey inquiring into awareness and implementation of the guidelines on osteoporosis in IBD patients. The barriers to implementation of the guidelines were also assessed. The sum of 21 self-reported clinical practices (absence = 0, presence = 1) was used to evaluate adherence to the guidelines. A value of 0 implied no adherence while a score of 21 meant complete adherence. Results: Of 304 responders, 27 fellows, 8 retirees, and 11 incomplete responses were not included in the analysis; thus, 258 respondents were the subject of this analysis. Slightly less than half of the responders used the guidelines in decision-making (126, 49%) or in the management (110, 42%) of their IBD patients. Using the scoring system described above, clinicians self-reporting use of the guidelines had a significantly higher clinical practice score than those who did not use the guidelines (Wilcoxon rank sum test; P < 0.0001). Only 18% (12 of 68) of clinicians whose practice was comprised of ,25% IBD patients used the guidelines compared to 60% (113/187) physicians who cared for more IBD patients (chi-square test; P < 0.0001). Physicians who saw more IBD patients (>25%) were also more likely (97/187 = 52%) to assess and treat osteoporosis in their IBD patients. Conversely, only 16% (11/68) of physicians who saw ,25% IBD patients treated osteoporosis (chi-square test; P < 0.0001). The main reason physicians (n = 115) gave for not utilizing the guidelines was because they felt that IBD should be the focus of the visit (48, 42%); 34 (30%) reported that osteoporosis should be managed by another physician. Other barriers cited were lack of time (13, 11%), cost (10, 9%), and lack of knowledge (10, 9%). Conclusions: Most of the responding physicians do not utilize the AGA Guidelines on metabolic bone disease in IBD patients. The physicians who self-reported utilizing the guidelines were actually adhering to the recommendations. Further education regarding the impact of metabolic bone disease in IBD patients and the importance of the guidelines is needed, particularly as it addresses the barriers set forth above. (Inflamm Bowel Dis 2009) [source] Barriers to Metered-dose Inhaler/spacer Use in Canadian Pediatric Emergency Departments: A National SurveyACADEMIC EMERGENCY MEDICINE, Issue 11 2007Martin H. Osmond MDCM Background Metered-dose inhalers and spacers (MDI+S) are at least as effective as nebulizers for treating children with mild to moderate asthma exacerbations. Despite advantages in terms of efficacy, side effects, and ease of use, MDI+S are not used in many North American pediatric emergency departments (PEDs). Objectives To survey emergency physicians, emergency nurses, and respirologists in Canadian pediatric teaching hospitals regarding their practices, beliefs, and barriers to change with respect to bronchodilator delivery. Methods This was a cross-sectional, mailed survey of all emergency physicians, all respirologists, and a random sample of emergency nurses at ten Canadian PEDs. Results A total of 291 of 349 health care professionals (83%) responded. Twenty-one percent of emergency physicians use MDI+S in the PED (largely concentrated at two "user sites"). A majority at nonuser sites, and virtually all professionals at user sites, responded that MDI+S are at least as effective as nebulizers, switching to MDI+S is justified by existing research, patient outcomes would be equal or better, and they have the required knowledge and skills to use MDI+S in the emergency department. The largest perceived barriers to MDI+S implementation include concerns regarding safety and costs, related to feasibility of providing and sterilizing spacers, and parental expectations for nebulizers. Other barriers included staff beliefs regarding the effectiveness of MDI+S, changes in nursing workload, and lack of a physician champion for change. Conclusions MDI+S are infrequently used to treat patients with acute asthma in Canadian PEDs, despite the fact that most emergency staff believe they are effective. Important barriers to using MDI+S have been identified in this study and should be used to guide future implementation strategies. [source] National Study on Emergency Department Visits for Transient Ischemic Attack, 1992,2001ACADEMIC EMERGENCY MEDICINE, Issue 6 2006Jonathan A. Edlow MD Abstract Objectives: To describe the epidemiology of U.S. emergency department (ED) visits for transient ischemic attack (TIA) and to measure rates of antiplatelet medication use, neuroimaging, and hospitalization during a ten-year time period. Methods: The authors obtained data from the 1992,2001 National Hospital Ambulatory Medical Care Survey. TIA cases were identified by having ICD-9 code 435. Results: From 1992 to 2001, there were 769 cases, representing 2,969,000 ED visits for TIA. The population rate of 1.1 ED visits per 1,000 U.S. population (95% CI = 0.92 to 1.30) was stable over time. TIA was diagnosed in 0.3% of all ED visits. Physicians administered aspirin and other antiplatelet agents to a small percentage of patients, and 42% of TIA patients (95% CI = 29% to 55%) received no medications at all in the ED. Too few data points existed to measure a statistically valid trend over time. Physicians performed computed tomography scanning in 56% (95% CI = 45% to 66%) of cases and performed magnetic resonance imaging (MRI) in < 5% of cases, and there was a trend toward increased imaging over time. Admission rates did not increase during the ten-year period, with 54% (95% CI = 42% to 67%) admitted. Regional differences were noted, however, with the highest admission rate found in the Northeast (68%). Conclusions: Between 1992 and 2001, the population rate of ED visits for TIA was stable, as were admission rates (54%). Antiplatelet medications appear to be underutilized and to be discordant with published guidelines. Neuroimaging increased significantly. These findings may reflect the limited evidence base for the guidelines, educational deficits, or other barriers to guideline implementation. [source] Hazardous alcohol consumption and other barriers to antiviral treatment among hepatitis C positive people receiving opioid maintenance treatmentDRUG AND ALCOHOL REVIEW, Issue 3 2007BIANCA WATSON Abstract Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study. [source] Requiring suspended drunk drivers to install alcohol interlocks to reinstate their licenses: effective?ADDICTION, Issue 8 2010Robert B. Voas ABSTRACT Aims To evaluate a new method being used by some states for motivating interlock installation by requiring it as a prerequisite to reinstatement of the driver's license. Design The driving records of Florida DWI offenders convicted between July 2002 and June 2008 were analyzed to determine the proportion of offenders subject to the interlock requirement who installed interlocks. Setting Most driving-while-impaired (DWI) offenders succeed in avoiding state laws requiring the installation of a vehicle alcohol interlock. Participants A total of 82 318 Florida DWI offenders. Findings Due to long periods of complete suspension when no driving was permitted and the failure to complete all the requirements imposed by the court, only 21 377 of the 82 318 offenders studied qualified for reinstatement, but 93% of those who qualified did install interlocks to be reinstated. Conclusions Because of the lengthy license suspensions and other barriers that the offenders face in qualifying for reinstatement, it is not clear that requiring a period on the interlock as a prerequisite to reinstating will greatly increase the current installment rate. [source] Highways block gene flow and cause a rapid decline in genetic diversity of desert bighorn sheepECOLOGY LETTERS, Issue 10 2005Clinton W. Epps Abstract The rapid expansion of road networks has reduced connectivity among populations of flora and fauna. The resulting isolation is assumed to increase population extinction rates, in part because of the loss of genetic diversity. However, there are few cases where loss of genetic diversity has been linked directly to roads or other barriers. We analysed the effects of such barriers on connectivity and genetic diversity of 27 populations of Ovis canadensis nelsoni (desert bighorn sheep). We used partial Mantel tests, multiple linear regression and coalescent simulations to infer changes in gene flow and diversity of nuclear and mitochondrial DNA markers. Our findings link a rapid reduction in genetic diversity (up to 15%) to as few as 40 years of anthropogenic isolation. Interstate highways, canals and developed areas, where present, have apparently eliminated gene flow. These results suggest that anthropogenic barriers constitute a severe threat to the persistence of naturally fragmented populations. [source] Resistance of Pinus contorta to the European race of Gremmeniella abietinaFOREST PATHOLOGY, Issue 2 2006G. Laflamme Summary Pinus contorta seedlings, together with Pinus resinosa and Pinus banksiana seedlings, were planted adjacent to 25-year-old red pine trees infected by the European (EU) race of Gremmeniella abietina. Resistance to this race was assessed over 5 years. All P. resinosa seedlings were dead after that period while 65% of P. contorta and 86% of P. banksiana seedlings appeared resistant to the disease. The tip blight that occurred on P. contorta was slightly longer than that observed on P. banksiana. In microscopy, one, two, or even more suberized boundaries were seen to be initiated near the surface of the shoot at the base of healthy needles where they extended downward in the direction of the vascular cambium. Suberized boundaries occasionally crossed the xylem and joined together in the pith region to form continuous barriers around necrotic tissues. However, in most cases, these suberized barriers were not continuous across the shoot and compartmentalization was then completed by other barriers mainly constituted of parenchyma cells and xylem tracheids that accumulated phenolic compounds. Meristematic-like cells were observed adjacent to the necrophylactic periderm. Tissue regeneration, restoration of cambial activities and formation of traumatic resin canals also seemed to be associated with the defence system of P. contorta against the EU race of G. abietina. Résumé Des semis de Pinus contorta, de P. resinosa et de P. banksiana ont été plantés près de pins rouges âgés de 25 ans et infectés par la race européenne (EU) de Gremmeniella abietina. La résistance à cette race a étéévaluée sur une période de 5 ans. Tous les semis de P. resinosa sont morts après cette période alors que 65% des semis de P. contorta et 86% des semis de P. banksiana semblaient résister à la maladie. La brûlure à l'extrémité des pousses sur le P. contortaétait un peu plus longue que celle observée sur le P. banksiana. En microscopie, une, deux et même plusieurs couches de cellules subérisées se sont différenciées près de la surface des pousses à la base d'aiguilles saines et continuaient à progresser basipétalement en direction du cambium. Ces couches subérisées traversaient occasionnellement le xylème avant de fusionner près de la moelle pour former des barrières continues autour des tissus nécrosés. Toutefois, dans la plupart des cas, les barrières subérisées présentes dans les pousses étaient discontinues et le compartimentage était alors complété par d'autres barrières constituées de cellules de parenchyme et de trachéides ayant accumulé des composés phénoliques. Des cellules semblables à celles présentes dans les zones méristématiques furent observées près du périderme nécrophylactique. La présence de nouveaux tissus, le rétablissement de l'activité cambiale et la formation de canaux résinifères traumatiques semblaient aussi contribuer au système de défense de P. contorta contre la souche EU de G. abietina. Zusammenfassung In der Nachbarschaft von 25jährigen Pinus resinosa, die mit der europäischen Rasse von Gremmeniella abietina infiziert waren, wurden Sämlinge von Pinus contorta zusammen mit Sämlingen von Pinus resinosa und Pinus banksiana ausgepflanzt. Während fünf Jahren wurde die Resistenz gegenüber dieser Erregerrasse beobachtet. Am Ende des Beobachtungszeitraums waren alle P. resinosa -Sämlinge tot, während 65% der P. contorta und 86% der P. banksiana -Sämlinge überlebten. Die Nekrosen an der Triebspitze waren auf P. contorta etwas länger als bei P. banksiana. Mikroskopisch waren ein, zwei oder sogar mehr suberinisierte Abwehrzonen erkennbar, deren Bildung nahe der Trieboberfläche an der Basis gesunder Nadeln begann und die sich nach unten in Richtung auf das Kambium ausdehnten. Gelegentlich entstanden diese suberinisierten Zonen auch im Xylem und vereinigten sich im Mark miteinander, so dass eine geschlossene Barriere gegen die nekrotischen Gewebe entstand. In den meisten Fällen dehnten sich die suberinisierten Zonen aber nicht durch den ganzen Trieb aus und die Kompartimentierung wurde durch andere Barrieren ergänzt, die vorwiegend aus parenchymatischen Zellen und Tracheiden bestanden, in denen phenolische Stoffe akkumuliert wurden. Neben dem nekrophylaktischen Periderm wurden Zellen mit meristematischer Aktivität beobachtet. Daneben waren die Neubildung von Geweben, die Wiederherstellung der Kambiumaktivität und die Bildung traumatischer Harzkanäle offensichtlich bei der Abwehr von P. contorta gegen die EU-Rasse von G. abietina wirksam. [source] Fire in the American South: Vegetation Impacts, History, and Climatic RelationsGEOGRAPHY COMPASS (ELECTRONIC), Issue 8 2010Charles W. Lafon Fire plays a key role in many ecosystems of the southeastern U.S. Longleaf pine (Pinus palustris) and Table Mountain pine-pitch pine (P. pungens,P. rigida) forests along with other ecosystems , including oak (Quercus) forests, grasslands, and spruce-fir (Picea-Abies) forests , illustrate the range of fire effects and plant persistence strategies in the American South. Fire history research reveals that fires and fire-associated vegetation were common before the fire exclusion of the past century. Both lightning and anthropogenic ignitions (caused by American Indians or European settlers) contributed to burning, but their relative importance is debated. The humid climate constrains burning, especially by lightning-ignited fires, which often occur during moist conditions. Studies of fire climatology indicate the importance of dry conditions (e.g. drought years and relatively dry areas) for widespread burning in this humid region. Landscape fragmentation also influences burning. In the past some fires also likely grew much larger than today because they were unimpeded by roads, farms, and other barriers. [source] Towards a more general species,area relationship: diversity on all islands, great and smallJOURNAL OF BIOGEOGRAPHY, Issue 4 2001Lomolino Aim To demonstrate a new and more general model of the species,area relationship that builds on traditional models, but includes the provision that richness may vary independently of island area on relatively small islands (the small island effect). Location We analysed species,area patterns for a broad diversity of insular biotas from aquatic and terrestrial archipelagoes. Methods We used breakpoint or piecewise regression methods by adding an additional term (the breakpoint transformation) to traditional species,area models. The resultant, more general, species,area model has three readily interpretable, biologically relevant parameters: (1) the upper limit of the small island effect (SIE), (2) an estimate of richness for relatively small islands and (3) the slope of the species,area relationship (in semi-log or log,log space) for relatively large islands. Results The SIE, albeit of varying magnitude depending on the biotas in question, appeared to be a relatively common feature of the data sets we studied. The upper limit of the SIE tended to be highest for species groups with relatively high resource requirements and low dispersal abilities, and for biotas of more isolated archipelagoes. Main conclusions The breakpoint species,area model can be used to test for the significance, and to explore patterns of variation in small island effects, and to estimate slopes of the species,area (semi-log or log,log) relationship after adjusting for SIE. Moreover, the breakpoint species,area model can be expanded to investigate three fundamentally different realms of the species,area relationship: (1) small islands where species richness varies independent of area, but with idiosyncratic differences among islands and with catastrophic events such as hurricanes, (2) islands beyond the upper limit of SIE where richness varies in a more deterministic and predictable manner with island area and associated, ecological factors and (3) islands large enough to provide the internal geographical isolation (large rivers, mountains and other barriers within islands) necessary for in situ speciation. [source] Electronic health records: Use, barriers and satisfaction among physicians who care for black and Hispanic patientsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2009Ashish K. Jha MD MPH Abstract Objectives, Electronic health records (EHRs) are a promising tool to improve the quality of health care, although it remains unclear who will benefit from this new technology. Given that a small group of providers care for most racial/ethnic minorities, we sought to determine whether minority-serving providers adopt EHR systems at comparable rates to other providers. Methods, We used survey data from stratified random sample of all medical practices in Massachusetts in 2005. We determined rates of EHR adoption, perceived barriers to adoption, and satisfaction with EHR systems. Results, Physicians who reported patient panels of more than 40% black or Hispanic had comparable levels of EHR adoption than other physicians (27.9% and 21.8%, respectively, P = 0.46). Physicians from minority-serving practices identified financial and other barriers to implementing EHR systems at similar rates, although these physicians were less likely to be concerned with privacy and security concerns of EHRs (47.1% vs. 64.4%, P = 0.01). Finally, physicians from high-minority practices had similar perceptions about the positive impact of EHRs on quality (73.7% vs. 76.6%, P = 0.43) and costs (46.9% vs. 51.5%, P = 0.17) of care. Conclusions, In a state with a diverse minority population, we found no evidence that minority-serving providers had lower EHR adoption rates, faced different barriers to adoption or were less satisfied with EHRs. Given the importance of ensuring that minority-serving providers have equal access to EHR systems, we failed to find evidence of a new digital divide. [source] Oil demand in North America: 1980-2020OPEC ENERGY REVIEW, Issue 4 2001Salman Saif Ghouri This paper first analyses price and income elasticity of oil demand in the United States, Canada and Mexico for the period 1980-99. Economic activity is the main driving force that influences oil consumption in each country. Changes in oil consumption generally lagged by a few years before the full impact of changes in oil prices was realized. Consumers in the short run are constrained by technological and other barriers and, therefore, less sensitive to changes in oil prices; however, they are more responsive in the long run , though response is still inelastic. The use of advanced technology facilitated these countries to use less oil over time. The paper then looks at demand over the next 20 years. The best-fitting model predicts that, by the end of 2020 (reference case), the USA, Canada and Mexico will respectively consume 24,900, 2,596 and 2,321 thousand barrels daily, compared with 19,519, 1,943 and 1,970 thousand b/d in 1999. The model forecasts economic slowdown during 2000/2002. The USA and Canada are expected to recover quickly, while Mexico will take longer. [source] A Performance Approach to Job AnalysisPERFORMANCE IMPROVEMENT QUARTERLY, Issue 4 2001Al Folsom ABSTRACT When we think of conducting analyses with a performance view, we commonly lean toward tools like front end analysis, needs assessment, performance analysis, and several variations. Usually, this starts because of a performance problem or because of an anticipated new performance. What about existing training? We look to training evaluation in its various levels to determine whether people like it, learn from it, transfer it, and whether the organization is benefiting from it. This paper describes a scenario where existing training was occurring, people suspected it could be more efficient, and yet the individuals' performance was for the most part satisfactory. We wanted to determine where the training could be made more efficient, determine if there were other barriers to performance, and do this with valid and reliable data from a large workforce. The Coast Guard's Performance Technology Center was in its infancy and was given the permission to try out alternative methods of conducting its work. This article describes the lessons learned about the process, about the technologies employed, and even the logistics of carrying out a rather large-scale effort in minimal time. [source] Are There Enough Doctors in My Rural Community?THE JOURNAL OF RURAL HEALTH, Issue 2 2009Perceptions of the Local Physician Supply ABSTRACT:,Purpose: To assess whether people in the rural Southeast perceive that there is an adequate number of physicians in their communities, assess how these perceptions relate to county physician-to-population (PtP) ratios, and identify other factors associated with the perception that there are enough local physicians. Methods: Adults (n = 4,879) from 150 rural counties in eight southeastern states responded through a telephone survey. Agreement or disagreement with the statement "I feel there are enough doctors in my community" constituted the principal outcome. Weighted chi-square analysis and a generalized estimating equation (GEE) assessed the strength of association between perceptions of an adequate physician workforce and county PtP ratios, individual characteristics, attitudes about and experiences with medical care, and other county characteristics. Findings: Forty-nine percent of respondents agreed there were enough doctors in their communities, 46% did not agree, and 5% were undecided. Respondents of counties with higher PtP ratios were only somewhat more likely to agree that there were enough local doctors (Pearson's correlation coefficient = 0.09, P < .001). Multivariate analyses revealed that perceiving that there were enough local physicians was more common among men, those 65 and older, whites, and those with lower regard for physician care. Perceptions that the local physician supply was inadequate were more common for those who had longer travel distances, problems with affordability, and little confidence in their physicians. Perceptions of physician shortages were more common in counties with higher poverty rates. Conclusions: County PtP ratios only partially account for rural perceptions that there are or are not enough local physicians. Perceptions of an adequate local physician workforce are also related to how much people value physicians' care and whether they face other barriers to care. [source] Oral Hygiene Measures and Promotion: Review and ConsiderationsAUSTRALIAN DENTAL JOURNAL, Issue 3 2001Audrey Choo Abstract Current mechanical and chemotherapeutic approaches to oral hygiene aim to modify the oral microflora to promote healthy periodontal and dental tissues. Current oral hygiene measures, appropriately used and in conjunction with regular professional care, are capable of virtually preventing caries and most periodontal disease and maintaining oral health. Toothbrushing and flossing are most commonly used, although interdental brushes and wooden sticks can offer advantages in periodontally involved dentitions. Chewing sugar-free gums as a salivary stimulant is a promising caries-preventive measure. Despite new products and design modifications, mechanical measures require manual dexterity and cognitive ability. Chemotherapeutic supplementation of mechanical measures using dentifrices, mouthrinses, gels and chewing gums as delivery vehicles can improve oral hygiene. The list includes anticalculus, antibacterial and cariostatic agents. For the population at large to make effective use of these oral hygiene measures, oral hygiene promotion needs to be implemented. Considerations include the role of parents, school and the media for children and the workplace, social environments, nursing homes and trained carers for adults and the elderly. Community oral hygiene promotion must attempt to maximise opportunities for oral health for all and reduce inequalities by removing financial and other barriers. Oral health approaches should be tailored to lifestyles and abilities of children, adults and the elderly in order to enable them to make decisions to improve personal oral hygiene and oral health. [source] Overcoming the barriers to voting experienced by people with learning disabilitiesBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 4 2001Dorothy M. Bell Summary The present paper clarifies the legal situation with respect to people with a learning disability who wish to vote. It also considers other barriers to full participation in the voting franchise, which is a right that many of us see as a sign of our full participation in the democratic process and one that ensures that we have proper representation at the highest level. This paper also considers how many of the obstacles may be overcome. [source] The "Vertical Response Time": Barriers to Ambulance Response in an Urban AreaACADEMIC EMERGENCY MEDICINE, Issue 9 2007Robert A. Silverman MD Background: Ambulance response time is typically reported as the time interval from call dispatch to arrival on-scene. However, the often unmeasured "vertical response time" from arrival on-scene to arrival at the patient's side may be substantial, particularly in urban areas with high-rise buildings or other barriers to access. Objectives: To measure the time interval from arrival on-scene to the patient in a large metropolitan area and to identify barriers to emergency medical services arrival. Methods: This was a prospective observational study of response times for high-priority call types in the New York City 9-1-1 emergency medical services system. Research assistants riding with paramedics enrolled a convenience sample of calls between 2001 and 2003. Results: A total of 449 paramedic calls were included, with a median time from call dispatch to arrival on-scene of 5.2 minutes. The median on-scene to patient arrival interval was 2.1 minutes, leading to an actual response interval (dispatch to patient) of 7.6 minutes. The median on-scene to patient interval was 2.8 minutes for residential buildings, 2.7 minutes for office complexes, 1.3 minutes for private homes (less than four stories), and 0.5 minutes for outdoor calls. Overall, for all calls, the on-scene to patient interval accounted for 28% of the actual response interval. When an on-scene escort provided assistance in locating and reaching the patient, the on-scene to patient interval decreased from 2.3 to 1.9 minutes. The total dispatch to patient arrival interval was less than 4 minutes in 8.7%, less than 6 minutes in 28.5%, and less than 8 minutes in 55.7% of calls. Conclusions: The time from arrival on-scene to the patient's side is an important component of overall response time in large urban areas, particularly in multistory buildings. [source] | |||||||||||||||||||