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Prof. Dr. Doris Østergaard, immediate past president of SESAM, and Prof. Dr. Wolfgang Heinrichs, AQAI simulation centre Mayence (Photograph: MR)

SESAM Medical Simulation Conference in Germany

Increased awareness around patient safety, a shortage in resources, and pressure for continuing education are key drivers which put simulation on the agenda of caregivers. Today, the call for this approach reaches well beyond the education of specialists at university level. – Last June, a conference brought together experts, users, and the industry.

The Society in Europe for Simulation Applied to Medicine (SESAM) – founded 15 years ago by a small group of anaesthetists – held its 15th annual meeting in Mayence, Germany. “Physicians are trained to work as individuals, not as team members”, explained immediate past president of the society, Prof. Dr. Doris Østergaard. Issues in organizing workflows and in communication between healthcare workers involved in a patient case contribute significantly to problems. “Things do go wrong inside and outside hospitals, and education and training are required to achieve improvements. Simulation helps in optimizing the distribution of tasks, in communicating, and interacting within teams”, Prof. Østergaard went on to say. Procedures in cardiac arrest are a case in point: first, staff from various medical disciplines and nursing needs to acquire know-how; second, training has to take place – e.g. on a skill simulator; third, these skills have to brought together in a simulation scenario, where team skills are trained.

“Focus Is On Processes”

Prof. Østergaard is the Director of the Danish Institute for Medical Simulation and Associate Professor at Copenhagen University. In addition to the university, her institute today serves caregivers in the capital region in Denmark, with simulation campaigns such as this: “A 55-year old goes jogging at five in the morning, falls, and the ambulance is calle. and takes the patient to the hospital. The team arrives in the emergency unit and proceeds to handle the case. Actions are video recorded, and in a post mortem, are discussed in detail to identify necessary improvements.” The manikin used for resuscitation training, and the ancillary IT which evaluates the effect staff action would have on a real human being, are only part of the “big picture” – the focus is on processes and interaction. The teacher, or facilitator, in these scenarios is challenged in several ways: interdisciplinary know-how is required from him/her, and there is a difficult borderline between letting project members act “as if in real life” and stepping in to curb serious errors. Participants value these scenarios because they receive immediate feedback.

Prof. Dr. Wolfgang Heinrichs is the co-founder of the AQAI simulation centre in Mayence which is one of a few organizations serving healthcare providers in Germany: “We help hospitals of all sizes in improving medical/nursing and social skills for their staff. The private group Helios, for example, uses our organization to train incident management in anaesthetics”.

Optimizing Safety and Cost

Patient safety statistics show clearly that there is significant room for improvement in care. Cost reductions are another benefit to be reaped from optimized education and training. How, according to the expert from Denmark, should specialist and team training be organized? “I think you have to have regional centres plus local simulation activities; and you should collaborate to produce overall comprehensive learning.” The benefit of the use of manikins from Meti, Laerdal, Gaumard, and further vendors is obvious: they allow for a lifelike training of novices which is more suitable than the use of animals. Healthcare workers receive a higher level of qualification before they start working on humans, which helps avoid harm being afflicted to patients.

“In the field of medicine, simulation-based cross-disciplinary training will be required which orients itself to clinical pathways”, predicted Prof. Heinrichs at the conference; “simulation needs to be a requirement in curricula, and an integral part of existing training programmes”, stated Prof. Østergaard; “in future, patients will demand this type of training from their caregivers.”

Genetics and biomarkers are at the top of the agenda; simulation may appear to be a less attractive topic, but it is key to necessary improvements in care. “Many European countries see the need to establish a national society to be linked to SESAM; this is the right path”, “underlined the Danish expert, towards advancing the simulation approach in Europe”.

Pioneering Example – Investment in Simulation

According to a statement from Dr. Ian Curran, Associate Dean and Lead for the Simulation and Technology-enhanced Learning Initiative at London Deanery last April, “The London Deanery’s pioneering advances in simulation and medical education are providing our doctors and clinical teams with unique opportunities to develop their individual and team-based skills in a patient safe way. Over the last 18 months, with the support of NHS London, we have invested over £11 mn. equipping every one of the 32 acute trusts in London with state of the art educational equipment. Therefore, we are confident that as simulation training is adopted more widely, it will support the provision of higher quality and safer patient care for London both today and in the future.”

SESAM’s Mission

… is to “…encourage and support the use of simulation in medicine for the purpose of education and research.” Members are physicians, nurses and other health care professionals, also technicians, engineers, psychologists, physicists, and biologists: www.sesam-web.org.

di Irene Giorgi – www.wired.it

Il mondo è nelle nostre mani, o quasi. Non si tratta di delirio di onnipotenza ma di una nuova mappa terrestre, la ‘Global Digital Elevation Map’, che per la prima volta mostra tutti i particolari, dettagliati e accurati, della superficie terrestre. La super mappa, nata da una collaborazione tra la NASA con il giapponese METI, utilizza circa 1,3 milioni di immagini, catturate dal radiometro giapponese Aster, ‘ospite’ speciale del satellite Terra della NASA, ed è anche democratica, basta infatti un click perché possa essere scaricata da tutti via web, gratuitamente…e farci sentire un po’ padroni del mondo.

Sono passati poco più di quarant’anni dalla prima foto ‘umana’ della Terra scattata dallo spazio. Su Wired, Robert Poole traccia un ricordo poetico di quel primo click e ci parla della sorpresa e dell’emozione provata dagli astronauti a bordo dell’Apollo 8. L’immagine di quell’alba terrestre ha poi fatto storia dando il via ad una consapevolezza diversa di una Terra che ora appariva più ‘viva’: nel 1969 venne persino trasformata nella bandiera della Terra dal promotore dei diritti umani John McConnell, anche noto per aver istituito un anno dopo l’Earth Day e poi, via via ha poi ispirato studi, pensieri e movimenti.

Negli anni si è cercato di catturare immagini sempre più precise per una super mappa globale, non è ancora passato mezzo secolo da foto dell’Apollo 8, che già è arrivato altro carburante per soddisfare i sogni degli scienziati o dei semplici terrestri curiosi. La nuova mappa digitale copre la superficie terrestre tra gli 83 gradi di longitudine Nord e gli 83 gradi di latitudine Sud, ed è formata da 23.000 parti, che fanno vedere con precisione le altitudini della superficie terrestre.

La fascinazione avviene a prima vista, ancora una volta come nel ‘68, la terra appare infatti multicolore con le varie zone colorate in modi diversi per identificare a colpo d’occhio le differenze sostanziali delle altitudini: dalle altezze più basse in viola, alle medie in verde e giallo, alle più alte in arancione, rosso e bianco.

La Global Digital Elevation Map, secondo gli obbiettivi degli sviluppatori dovrebbe dare a utenti e studiosi una mappa completa con informazioni dettagliatissime sulle altitudini e la conformazione della superficie terrestre. La super mappa è scaricabile da poco ma è già ricercatissima, i due siti dove è reperibile, l‘archivio EOS della NASA e il Ground Data System del Giappone, sono intasati dalle richieste, tanto che i gestori dei siti, nel tentativo di  gestire la mole di richieste, hanno dovuto raccomandare agli utenti di scaricare il minimo indispensabile.

A quanto rivela la BBC, la Nasa ora sta lavorando a una nuova mappa, ancora più completa, che combinerà i risultati della GDEM con le nuove immagini prese da Aster, che ogni giorno cattura 600 immagini ad alta risoluzione, per un’area di 60  per 60 km, e fornisce agli scienziati persino informazioni sulle temeperature della superficie terrestre.

Not to be outdone by Cirque Du Soleil founder and space tourist Guy Laliberté, who is due to send Earth a poem from the International Space Station (ISS) in September (see way below), I propose we re-open the interstellar message race with the creation of a High Intensity Poetry Beam or HIP Beam, whose sole purpose is to transmit verse to the universe.

Electronic interstellar messages have been sent before. In 1979, the Arecibo Message, containing information on the Solar System, Human physiology, atomic numbers and DNA, was aimed at M13: a star cluster 25,000 light years away. In 1999, Cosmic Call 1 was sent to stars in Cygnus and Sagitta; In 2001, Teen Age Message was sent to various constellations; In 2003, Cosmic Call 2 was made; In 2008, ‘Across The Universe’ by The Beatles was fired at Polaris; and again in 2008, A Message From Earth (AMFE) was sent by ‘ad funding’ & Bebo towards Gliese 581 c, a terrestrial extrasolar planet orbiting a red dwarf.

The HIP beam would contain an anthology of verse from around the globe, rather than the explicit invasion instructions we keep sending. It would be the first interstellar message to be sent containing poetry. In conjunction with SETI or Messaging to Extra-Terrestrial Intelligence (METI), a transmission could be sent in 2010, destination to be determined, the issue of there being no poetry in outer space resolved.

All submissions, proposals, applications and feasibility studies most welcome.

PRobinson

From the “maybe visiting extraterrestrial beings aren’t so friendly department”

 Is it possible to transport millions of biological beings over interstellar distances?

That is indeed easier than you may think at the moment. Already during the 1970s a NASA study group showed that this would be possible even with the technology of those times.

Many millions of individuals would be able to exist absolutely self-sufficiently for an unlimited period of time.
They worked out that each of the space arks would consist of a huge rotating cylinder with a length of 32 km and a diameter of 6.4 km, inside it would offer living space for 10 million individuals with 1g including larger lakes, forests, agriculture, etc. With this diame-ter the atmosphere would already create a blue sky with layers of clouds at an altitude of 1-2 km, so they would have earth-like weather and ozone as a protection against cosmic radia-tion.

Space arks with these dimensions are on the limit of what makes sense today from an ecological point of view, but they are still physically feasible.

It would be possible to use the materials available today to build space arks with a diameter of up to 19 kilometres and living space for up to 100 million people. Of course these arks would not accelerate to almost light speed. Under these circumstances with a high quality of life it would be suffi-cientto travel through space »at a leisurely pace« of »only« 60% light speed or even less, and reach the Earth after 350 or more years.

So, that would be the kind of extraterrestrial UFOs we might expects on the sky, far away from what has been sighted as UFOs. Instead of small and nimble saucers ETI UFOs are huge objects with an extension of umpteen kilometres, which because of their mass will only be able to move at a leisurely pace in space and especially near the Earth. In this respect Roland Emerich’s description of extraterrestrial spacecraft in the science fiction film “Inde-pendence Day” was quite correct.

But certainly not his suggestion that they would be hove-ring over the Earth at low altitudes. The required propulsions with their many millions of tons of thrust would leave a corridor of destruction of several square kilometres on the Earth’s surface . The space arks would rather circle the Earth on a safe orbit of some hundred kilometres, and use smaller payload vehicles to descend to the Earth.

Well, the original question whether these ETIs would come with peaceful intentions, is under these circumstances no longer relevant. The crucial issue for them would be to survive, to look for a new home planet. And humans would just be a nuisance on such an attractive planet as the Earth.

 Interstellar space arks as a concept has been around over 100 years, before the Wright Brothers got off the ground with powered flight even!

Despite the heavy anthropomorphic assumptions in the essay, I found it refreshing that at least someone in the mainstream scientific community has given the subject some thought.

Welcome On Planet Earth…?

Hat tip to Adam Crowl of Crowlspace
_______________________________

Recently, some scientists and SF writers have expressed their concern that sending messages to the stars in our galaxy, which may have a habitable life, jeopardizes existence of our own civilization because our signals helps ETs to pin down location of the Solar System in the Milky Way.

If the Aliens reached the level of a super-civilization, it might send a space fleet to the Earth to either destroy it or to convert us to slaves.

The goal of this letter is to estimate the probability of detection of the terrestrial radio signals by a presumable hostile super-civilization existing somewhere in our galaxy.

 
Dr. Zaitsev then refers to his chart that shows our incidental signal leakage is more than his METI messages, a 1000 times more!

I’m not too sure about that. His METI radio signals are concentrated and narrow, that’s true. But incidental radar is only pointed at targets here on Earth and in the Solar System and would diffuse greatly at interstellar distances.

Maybe if the aliens were close enough, say maybe out to Alpha Centauri distance (4.3 light-years), they might detect leakage, but even that’s a stretch.

I don’t know. I’m the type of person who wouldn’t wave a bunch of bananas to the 800 pound gorilla in the room unless I had a very, very, very, very good reason to do so.
 
Detection Probability of Terrestrial Radio Signals by a Hostile Super-civilization

____________________________________

La idea de los proyectos SETI es bien conocida: explorar el espectro electromagnético en busca de señales que sugieran la existencia de civilizaciones alienígenas. Se trata de algo muy parecido a la búsqueda de una aguja (que no sabemos siquiera si existe) en un pajar, y de hecho lo infructuoso de todas las iniciativas SETI sugiere que a pesar de lo enorme del pajar hay pocas agujas en él, están muy bien escondidas, o simplemente no sabemos reconocerlas. La paradoja que supone la ubicuidad (supuesta) de la vida en el Universo con la falta de evidencia de vida inteligente es la que conduce a hipótesis como la de la Tierra Rara, de la que precisamente hablábamos hace unos días.

Esta falta de resultados ha inducido a parte de la comunidad científica a proponer estrategias de búsqueda más invasivas, como puede ser el denominado SETI activo: emitir señales que atraigan la atención de hipotéticos alienígenas, con idea de que éstos actúen de manera análoga y podamos detectar su presencia. Sería algo así como llamar a la puerta para ver si la casa está habitada. Un enfoque más extremo es el denominado METI (Messaging to Extra-Terrestrial Intelligence) planteado por el astrónomo ruso Alexander Zaitsev, y en el que la finalidad no es tanto llamar para obtener una respuesta, sino simplemente llamar para decir que existimos (el matiz es del propio Zaitsev, y a fuer de ser sinceros no demasiado relevante en términos prácticos).

Ha habido varios mensajes de este tipo, de los que quizás el más célebre fue el enviado desde Arecibo en 1974, y en cuyo diseño participaron entre otros Frank Drake y Carl Sagan. Este mensaje no llegará a su destino -M13, el Cúmulo de Hércules- hasta dentro de 26.000 años, por lo que se trata de un acto fundamentalmente simbólico. Otros mensajes posteriores como por ejemplo el Cosmic Call 2 sí llegarán en breve a su destino (Casiopea en 2036 en este caso). La cuestión es qué puede pasar si hubiera alguien escuchando. Más aún, ¿qué pasaría si el mensaje lo recibe una civilización hostil con medios técnicos suficientes para plantarse aquí?

Éste es un temor recurrente y bastante razonable (al menos en la misma medida de la propia idea de SETI), por lo que no puede obviarse a priori. No obstante, según los cálculos del propio Alexader Zaitsev, se trata de un riesgo independiente del propio METI. Para llegar a esa conclusión, Zaitsev ha estimado la fracción del firmamento iluminada por señales de astronomía radar y la duración de estas transmisiones, y ha cotejado esta estimación con la correspondiente a las señales METI. La comparativa puede verse en una pequeña comunicación titulada

• Detection Probability of Terrestrial Radio Signals by a Hostile Super-civilization

Para Zaitsev hay una relación de 1/2000 en la fracción de firmamento iluminado y de 1/500 en duración de la transmisión, siempre a favor de la astronomía radar. Por lo tanto -concluye- la probabilidad de que seamos detectados a través de nuestra actividad astronómica es un millón de veces superior a la de serlo debido a METI. Dado que no parece razonable pedir la supresión de la astronomía radar (sumamente útil por ejemplo para el estudio de NEOs), la conclusión sería que no hay que temer a METI. Sin entrar en consideraciones cuantitativas sobre la estimación de Zaitsev, y suponiendo que ésta es correcta, la cuestión que surge en cualquier caso es ¿para qué vamos a perder entonces el tiempo con METI (e incluso con SETI activo), si nuestra propia actividad tecnológica ya nos delata?

Free movement of goods, labor, and capital oxygenate capitalism. In my April 15 post I pointed out Japan’s innovative solution to a potentially implosive problem of labor shortage in its aging society. It’s too early to tell if robotic technology will sustain its homogeneous society, but certainly no technology is revolutionary enough to invigorate its lackluster capital markets including the Nikkei. To do that, Japan need only to embrace foreign investors, but its distrust of foreigners impedes. Their biggest fear: takeovers of homegrown enterprises, and not just the hostile kind.

Typical of the ineffective and obtrusive nature of bureaucracy, Japan’s METI (Ministry of Economy, Trade, and Industry) irrationally justifies the fear of foreign investors. The Wall Street Journal quotes a vice minister of METI in a speech earlier this year, “Are corporations the property of stockholders?” Stockholders are “stupid, greedy, adulterous, irresponsible and threatening…They are the type of people who just sell the stock if they get mad.” Somebody please explain to this misinformed fellow that shareholders do, in fact, own corporations, and consistently successful shareholders who focus on the long-term aren’t stupid, greedy, irresponsible, and threatening, although they might be adulterous.

Closing the investment market to foreigners who want a controlling interest in Japanese firms is backed by a visceral, altruistic response. Protection of jobs, loyalty to benevolent founders, and worry of reduced funding for research and development is touted. What’s missing is the foreign influence to increase productivity and competitiveness through restructuring and more capital. Without foreign investment, Japan’s companies may stagnate for years. Twenty five years from now, per capital G.D.P. in the dynamic South Korea may exceed Japan’s, and this may be the catalyst for change for the proud nation of Japan.

Le projet SETI (Search for ExtraTerrestrial Intelligence) écoute les signaux radio en provenance de l’espace depuis 1960, à la recherche de messages envoyés par des extra terrestres. Pourquoi ne reçoit-on rien ? Voici un petit tour des raisons possibles :

1. La fameuse équation de Drake pourrait contenir de très petits facteurs, ayant pour conséquence qu’il n’y ait qu’une civilisation intelligence dans la Voie Lactée , nous, voire quelques autres mais qu’elles sont trop loin pour les capter.
2. Le dernier facteur de Drake est particulièrement intéressant, celui concernant la durée de vie moyenne d’une civilisation capable de communiquer à travers l’Univers. Certains pessimistes (comme Yves…) imaginent que cette durée puisse être courte en raison d’une tendance à l’autodestruction.
3. Les optimistes auraient plutôt tendance à penser que les progrès rapides de la technologie rendent les ondes radio rapidement obsolètes comme moyen de communication. Nous sommes incapables actuellement de capter des flux de neutrinos modulés ou d’extraire des photons intriqués par exemple, et nous ne soupçonnons pas que l’explosion d’une supernova puisse être l’oeuvre d’une civilisation de type II, encore moins qu’une type III fasse traverser le disque d’accrétion d’un trou noir par un autre juste pour dire bonjour…
4. Peut-être que les civilisations réellement intelligentes n’émettent pas. Et c’est une question très importante : a-t-on intérêt à envoyer des signaux dans l’espace ?
   Pour le professeur Alexander L. Zaitsev, SETI n’a pas de sens sans son projet “Active SETI” ou METI (Messaging to Extra-Terrestrial Intelligence) qui a déjà effectué plusieurs puissantes émissions de signaux vers les étoiles.
   D’autres comme l’auteur de science fiction David Brin estiment que cette activité est dangereuse car elle révèle la position d’une planète habitable à des ennemis potentiels. (Je partage ce point de vue, en le fondant sur mon Principe de Saturation Cubique)
   La question a été suffisamment importante pour que l’ International Academy of Astronautics mette au point en 2005 l’Echelle de San Marin, qui définit une échelle de risque de 1 à 10 en fonction de la puissance d’émission et de la nature du message. L’idée est que des autorités politiques internationales devraient autoriser l’émission de messages risqués, notamment la réponse à un message reçu.

Sources:

• “Call into the Cosmos“, 2008, Centauri Dreams
• David Brin, “Shouting at the Cosmos …Or How SETI has Taken a Worrisome Turn Into Dangerous Territory “, 2006
• Larry Klaes, “Should We Shout into the Darkness?”, 2008, Astrogator’s Logs

METI (Ministry of Economy, Trade and Industry) and the Finance Ministry of Japan will make an official decision by 11th April to ‘advise’ a British investment fund to modify or desist from its investment plans as announced in its application to increase its stock holdings in Japanese electricity-producing giant J-Power as “There is a risk that this [an increase in foreign ownership of J-Power stocks] will prevent the maintenance of order in the public sphere”.

The application to increase stock holdings in J-Power was made by the UK-based ‘The Children’s Investment Fund’ (TCI). The two ministries judged that an increase in the influence of TCI in the management of J-Power would create risks with regard to the stable supply of electricity and the safe management and disposal of nuclear fuel.

The two ministries, under the Foreign Echange and Foreign Trade Law, will call a meeting of the Special Foreign Section of the Customs and Foreign Exchange Deliberation Committee on 11th April. It is the first time that a ‘worrying investment’ has led to such a meeting being called. The committee will review the TCI’s intentions and hear explanations from members and experts before deciding whether or not to issue a warning to the fund’s management.

Under the Foreign Exchange Law, national approval must be obtained before more than 10% of the stock of an electricity producer can be held by a foreign investor. In January TCI applied for an increase in their holdings to 20% of total stock. The deadline for deliberations on the Japanese side is 14th May, but this may be extended by a month by the Special Foreign Section of the Customs and Foreign Exchange Deliberation Committee. In the meantime, an increase in TCI stock holdings in J-Power will not be possible. TCI have taken the stance that ‘The Japanese market is a closed system’ and, if the government issues a warning, a full-on confrontation is expected.

J-Power sells electricity to the ten major electricity producers in Japan. Company infrastructure includes an electricity distribution network and frequency transformer stations, and the company is planning a large nuclear power station in Aomori prefecture.

Robot de Servicio

Kyushu University
Hitachi, Ltd
Hitachi Medical Corp
MIZUHO Co, Ltd
Universidad de Tokio
Universidad de Waseda

(JPG) (622,816 bytes) ( 1,770 x 1,509 )

Credit:

NASA/GSFC/METI/ERSDAC/JAROS,
and U.S./Japan ASTER Science Team

Description:

On December 19, 2006 ASTER captured this image of Karymsky volcano erupting in the Russian Far East. Karymsky is one of numerous active volcanoes on the Kamchatka peninsula in Russian Siberia. The hot spot on the volcano summit is highlighted in the thermal bands in red and yellow, as is an area of the southeast flank, possibly indicating a pyroclastic flow. An obvious ash track is seen as a triangular dark area covering the countryside to the east of the summit. The short white streak emanating ESE from the summit is probably a water vapor cloud. The image covers an area of 26.5 x 22.6 km, and is located near 54.1 degrees north latitude and 159.3 degrees east longitude.

Primo giorno di lavoro e si incominicia a pianificare il tutto. L’obiettivo finale è di integrare il mio lavoro nel manichino…insomma una sorta di tentativo di resuscitare qualcosa che è morto da sempre…una specie di spaventapasseri tipo mago di OZ che cerca il suo cervello disperatamente…un Frankestein dei tempi nostri!

Beh vedremo cosa si potrà fare…per ora mi sono limitato a “giocare” con il manichino (CPR, ECG ecc.)…

P.S.

La macchina è una Dodge Neon datata…cambio automatico, aria condizionata (come tutte le macchine americane…anche le più vecchie!!!), bianca…niente di speciale…però mi porta in giro!