Whether you survive a cardiac arrest may depend, at least in part, on which emergency medical services (EMS) agency shows up to treat you, a new study suggests.
Researchers found a wide variation in cardiac arrest survival rates depending on which EMS agency provided initial treatment, according to the study published in JAMA Cardiology. The odds of surviving to hospital discharge(出院)could vary by more than 50 percent for two similar patients treated by two randomly selected EMS agencies. “We found large outcome variations between EMS agencies that come after a cardiac arrest even after adjusting for many factors,” said lead author Masashi Okubo, an instructor of emergency medicine at the University of Pittsburgh.
The study did not reveal why some EMS agencies did better than others, however. “We need to determine in future research what are the underlying factors,” Okubo said.
Cardiac arrest “is the abrupt loss of heart function, and if appropriate steps are not taken immediately it most often is fatal,” explained Gregg Fonarow, a professor of cardiovascular medicine and science at the David Geffen School of Medicine at the University of California at Los Angeles. He also is co-director of the UCLA Preventive Cardiology Program. “Each year in the United States, more than 350,000 cardiac arrests occur outside the hospital setting.”
Altogether, the researchers studied 43,656 patients treated from 2011 to 2015 by 112 EMS agencies. When they looked at how many patients survived long enough to be discharged from the hospital, variations among agencies were quite large: the worst performing agency had 0 survivors out of 36 patients treated, or 0 percent, as compared with 66 survivors out of 228 patients treated, or nearly 30 percent, for the best-performing agency.
The pattern was similar when it came to recovery of function by the time a patient was discharged from the hospital. The worst performing agency in this category had favorable functional recovery in 0 out of 87 patients, or 0 percent, while the best had favorable functional recovery in 11 out of 54 patients, or 20 percent.
“These findings suggest there may be important differences in the quality of resuscitation efforts among different EMS agencies,” Fonarow said in an email.
Also, he said, “More layperson interventions(非正式人员干预)such as timely CPR (cardiopulmonary resuscitation 心肺复苏术) and more EMS personnel responding to cardiac arrest patients were related to better outcomes.
“These findings suggest that dissemination of best practices and use of formal quality improvement programs by community-based EMS agencies may help to improve quality and outcomes in cardiac arrest,” he said.
Can anything be done in the meantime?
Yes, said Fonarow, who was not involved in the new research. “When performed promptly and properly, CPR can markedly improve the chance of survival for someone having an out-of-hospital cardiac arrest,” he said. “The best advice that might save lives of loved ones if a cardiac arrest occurs is to learn CPR. Anyone can and everyone should learn CPR.”
1.What does the new study tell us?
A. EMS agencies have adjusted outcome variations.
B. People with cardiac arrest depend on EMS agencies.
C. Initial treatment has been provided for cardiac arrest patients.
D. Cardiac arrest survival is partly determined by certain EMS agencies.
2.The underlined word “odds” in Paragraph 2 probably means ______.
A. probabilities B. examples C. difficulties D. differences
3.According to Okubo, what are they planning to do in future research?
A. To determine which EMS agencies are good.
B. To reveal the underlying factors of cardiac arrest.
C. To find out the hidden reasons for better EMS agencies.
D. To identify the relationship between different EMS agencies.
4.What does “the pattern” in Paragraph 6 refer to?
A. The worst performing agency. B. The best performing agency.
C. The large variations among agencies. D. The comparison between survivors and patients.
5.According to the findings, what leads to better outcomes in cardiac arrest?
A. more layperson interventions B. better quality in EMS agencies
C. better practices in CPR D. more EMS members
6.What is Fonarow’s attitude towards CPR?
A. Arbitrary. B. Favorable. C. Contradictory. D. Doubtful.
Alice was beginning to get very tired of sitting by her sister on the bank, and of having nothing to do. Once or twice she had peeped into the book her sister was reading, but it had no pictures or conversations in it. “What is the use of a book,” thought Alice, “without pictures or conversation?”
So she was considering in her own mind (as well as she could, for the hot day made her feel very sleepy and stupid), whether the pleasure of making a daisy-chain would be worth the trouble of getting up and picking the daisies, when suddenly a White Rabbit with pink eyes ran close by her.
There was nothing so VERY remarkable in that; nor did Alice think it so VERY much out of the way to hear the Rabbit say to itself, “Oh dear! Oh dear! I shall be late!” (when she thought it over afterwards, it occurred to her that she ought to have wondered at this, but at the time it all seemed quite natural); but when the Rabbit actually TOOK A WATCH OUT OF ITS WAISTCOAT-POCKET, and looked at it, and then hurried on, Alice started to her feet, for it flashed across her mind that she had never before seen a rabbit with either a waistcoat-pocket, or a watch to take out of it, and burning with curiosity, she ran across the field after it, and fortunately was just in time to see it pop down a large rabbit-hole under the hedge(树篱).
In another moment down went Alice after it, never once considering how in the world she was to get out again.
The rabbit-hole went straight on like a tunnel for some way, and then dipped suddenly down, so suddenly that Alice had not a moment to think about stopping herself before she found herself falling down a very deep well.
Either the well was very deep, or she fell very slowly, for she had plenty of time as she went down to look about her and to wonder what was going to happen next. First, she tried to look down and make out what she was coming to, but it was too dark to see anything; then she looked at the sides of the well, and noticed that they were filled with cupboards and book-shelves; here and there she saw maps and pictures hung upon pegs. She took down a jar from one of the shelves as she passed; it was labelled “ORANGE MARMALADE”, but to her great disappointment it was empty: she did not like to drop the jar for fear of killing somebody, so managed to put it into one of the cupboards as she fell past it.
“Well!” thought Alice to herself, “after such a fall as this, I shall think nothing of tumbling down stairs! How brave they’ll all think of me at home! Why, I wouldn’t say anything about it, even if I fell off the top of the house!” (Which was very likely true.)
Down, down, down. Would the fall NEVER come to an end!
By LEWIS CARROL
1.What might have caused Alice to run after the rabbit?
A. The pleasure of picking the daisies.
B. The sight of the rabbit with pink eyes.
C. Her thought about the way the rabbit spoke to itself.
D. Her interest in the rabbit with a waistcoat-pocket and a watch.
2.Alice’s adventure mainly happened ______.
A. in a rabbit hole B. around a hedge
C. in her family garden D. on the river bank
3.As Alice fell down the well, she felt rather ______.
A. disappointed B. proud C. afraid D. relaxed
4.From which sentence can we judge this is a fairy tale?
A. The hot day made her feel very sleepy and stupid.
B. “I have nothing to do but make a daisy-chain.” said Alice.
C. “Oh dear! Oh dear! I shall be too late!” the Rabbit said to itself.
D. “THE ORANGE MARMLADE is empty,” said Alice disappointedly.
Every day we experience one of the wonders of the world around us without even realizing it. It is not the amazing complexity of television, nor the impressive technology of transport. The universal wonder we share and experience is our ability to make noise without mouths, and so transmit ideas and thoughts to each other’s minds. ① This ability comes so naturally that we tend to forget what a miracle it is.
② Obviously, the ability to talk is something that marks humans off from animals. Of course, some animals have powers just as amazing. Birds can fly thousands of miles by observing positions of the stars in the sky in relation to the time of day and year. In Nature’s talent show, humans are a species of animals that have developed their own special act. If we reduce it to basic terms, it’s an ability for communicating information to others, by varying sounds we make as we breathe out.
③ Not that we don’t have other powers of communication. Our facial expressions convey our emotions, such as anger, or joy, or disappointment. The way we hold our heads can indicate to others whether we are happy or sad. This is so-called “body language”. Bristling (直立的) fur is an unmistakable warning of attack among many animals. Similarly, the bowed head or drooping tail shows a readiness to take second place in any animal gathering.
Such a means of communication is a basic mechanism that animals, including human beings, instinctively(本能地)acquire and display. ④ If so, how did human beings acquire this amazing skills? Biologists can readily indicate that particular area of our brain where speech mechanisms function, but this doesn’t tell us how that part of our bodies originated in our biological history.
1.According to the passage, the wonder we take for granted is .
A. the amazing power of technology B. our ability to use language
C. the unforgettable miracle of nature D. our ability to make noises with mouth
2.Which is the most suitable place for “Is the ability to speak just another sort of instinct?”
A. ④ B. ③ C. ② D. ①
3.This passage is mainly about .
A. the development of body language
B. the special role humans play in nature
C. the power to convey information to others
D. the difference between humans and animals
Ever wanted to make a difference and train to be a coach?
With the Ollie School, you could be changing lives before you know it.
Despite the very best efforts of our education system, it is struggling to cope with fully supporting the emotional wellbeing of our children within the curriculum.
Ever felt that you would love to help, but were powerless to act? Well, here’s your opportunity to do something positive.
The Ollie School has opened its doors, with plans to build an army of coaches who can make the world a better place, one child at a time. Ollie Coaching is a holistic (整体的) approach that leads all our youngsters to a place where they can thrive in the chaos of modern living.
So many schools are battling to provide an appropriate mental health environment, and busy parents are up against it in our fast-paced lives ruled by social media.
That’s why Alison Knowles, who was challenged throughout her life with undiagnosed dyslexia (读写困难症), decided to set up the Ollie School.
Transformational work
The Ollie methodology is all about empowering children to seek solutions and take control of their emotions, rather than be controlled by them.
The Ollie School trains coaches in a combination of methodologies that brings together NLP, CBT, EFT and play therapy, to make sure they cover all bases. The Ollie methodology is all about personalisation and identifying which technique will work with each individual child – no one-size-fits-all approach here.
The Ollie School graduates are awarded a certified qualification in NLP and a licence to work as an Ollie coach. If helping children and their families to be more emotionally strong appeals to you, contact us for a brochure and let’s talk about getting you with the programme.
Get in touch
To train to become an Ollie coach, find a coach in your area or book an event, visit ollieandhissuperpowers.com, or contact us via email at info@ollieandhissuperpowes.com. We would love to hear from you!
1.What is special with regard to the Ollie School’s education?
A. It demonstrates a fit-for-all approach.
B. It advocates individualized education.
C. It helps those with undiagnosed dyslexia.
D. It focuses on play therapy for physical problems.
2.The Ollie School is probably intended for ______.
A. parents who are up against social media
B. coaches who need a certified qualification
C. children struggling in our education system
D. people aiming to help children be mentally healthy
Gillian was only eight years old, but her future was already at risk.
Her schoolwork was a ______, at least as far as her teachers were concerned. She ______ assignments late, her handwriting was terrible, and she ______ poorly. Not only that, she was a disruption to the entire class, one minute moving ______, the next staring out the window, ______ the teacher to stop the class to pull Gillian’s ______ back, and the next doing something to ______ the other children around her. Gillian wasn’t ______ concerned about any of this, but the school was very concerned. This came to a head when the school ______ to her parents.
The school thought that Gillian had a ______ disorder of some sort and that it might be more ______ for her to be in a school for children with special ______. Gillian’s parents received the letter from the school with great concern and sprang to ______. Gillian’s mother took her to a psychologist for assessment, ______ the worst.
The psychologist sat Gillian on a huge leather sofa. ______ about the impression she would make, she sat on her hands so that she wouldn’t move. Eventually, Gillian’s mother and the psychologist stopped talking.
“Gillian, you’ve been very ______, and I thank you for that. But we’re going out of the room for a few more minutes...” With the radio turned on, the two adults left.
Nearly immediately, Gillian was on her ______, moving around the room to the ______. Anyone would have noticed there was something natural about Gillian’s ______.
The psychologist turned to Gillian’s mother and said, “Gillian isn’t ______. She’s a dancer. Take her to a dance school.”
1.A. disaster B. burden C. reward D. thrill
2.A. brought out B. took in C. turned in D. reached out
3.A. equipped B. tested C. wrote D. behaved
4.A. desperately B. quietly C. hopelessly D. noisily
5.A. encouraging B. reminding C. attracting D. forcing
6.A. leg B. attention C. influence D. image
7.A. disturb B. strike C. seize D. abuse
8.A. particularly B. formally C. willingly D. partly
9.A. spoke B. submitted C. wrote D. appealed
10.A. learning B. moving C. sleeping D. reading
11.A. convenient B. equal C. personal D. appropriate
12.A. hobbies B. talents C. looks D. needs
13.A. prayer B. action C. assistance D. escape
14.A. witnessing B. fearing C. preparing D. underlining
15.A. Embarrassed B. Confused C. Nervous D. Curious
16.A. patient B. dynamic C. honest D. cautious
17.A. own B. seat C. feet D. run
18.A. mirror B. radio C. music D. romance
19.A. movements B. assessment C. ambition D. passion
20.A. clumsy B. delicate C. violent D. sick
— Sue slept overnight in front of the stadium in order to get concert tickets.
— That’s what the proverb “______” means.
A. every cloud has a silver lining B. make hay while the sun shines
C. the early bird catches the worm D. don’t count your chickens before they hatch
