Observational cadaveric study of emergency bystander cricothyroidotomy with a ballpoint pen by untrained junior doctors and medical students

Emerg Med J. 2013 Apr;30(4):308-11
doi: 10.1136/emermed-2012-201317
Epub 2012 May 5

Andrew Neill [1], Philip Anderson [2]

[1] Anatomy Department, Trinity College Dublin, Ireland
[2] Foundation Year 2 Doctor, Northern Ireland Deanery, UK

Correspondence to Dr A Neill, Level 1, Biomedical Sciences Institute, Trinity College, Pearse St, Dublin 2, Ireland

Contributors
AN conceived the study, performed most of the dissection and drafted the manuscript. PA aided with the dissection and compiled the results.

Objective

Apart from case reports and anecdotes, there are no published studies on the feasibility of using non-medical devices for emergency bystander cricothyroidotomy. This study evaluated the ability of non-trained junior doctors and medical students to place an emergency cricothyroidotomy on an embalmed cadaver using only a blade and a ballpoint pen.

Methods

Participants were junior doctors with no prior experience of surgical airways and second year medical students at the end of their head and neck anatomy course. Nine participants were asked to place an emergency cricothyroidotomy in an undissected embalmed cadaver using only a No 26 scalpel and a dismantled ballpoint pen (Papermate Flexigrip Ultra, external diameter 8.9 mm; internal diameter 7.0 mm). Times were recorded and direct visualisation by dissection was used to assess placement and complications.

Results

Nine participants performed a total of 14 separate cricothyroidtomies on separate cadavers. Landmarks were palpable by researchers in 10 of the 14 cadavers. Eight of 14 (57%) procedures were deemed successful. No major vascular injury occurred. Injuries to the thyroid and cricoid cartilages were common; four of 14 (29%) of these injuries were fractures.

Conclusions

In embalmed cadavers, inexperienced junior doctors and medical students with no prior training were able to place a successful cricothyroidotomy slightly more than half the time. It suggests that surgical cricothyroidotomy with a ballpoint pen and blade is a feasible option in extremis. It is unknown whether junior doctors from other specialties, such as emergency medicine, would perform better.

http://emj.bmj.com/content/30/4/308.abstract

Oral sex as infidelity-detection

Personality and Individual Differences
Volume 54, Issue 6, April 2013, Pages 792–795

Michael N. Pham, Todd K. Shackelford

Department of Psychology, Oakland University, Rochester, MI 48309, USA

Abstract

An evolutionary history of human female infidelity and consequent sperm competition may have caused the evolution of male counter-adaptations. The infidelity-detection hypothesis for oral sex proposes that men perform oral sex to gather information about their partner’s recent sexual history. We tested this hypothesis with data secured from 231 men in committed, sexual, heterosexual relationships. We found support for two derivative predictions: men at a greater recurrent risk of sperm competition expressed greater interest in, and spent more time performing, oral sex on their partner, even after controlling statistically for relationship length, relationship satisfaction, and sexual intercourse duration. The discussion addresses limitations of this research and highlights directions for future research, including distinguishing empirically the infidelity-detection hypothesis from alternative hypotheses for oral sex.

Highlights

► We test the idea that oral sex functions to detect partner’s sexual infidelity.
► Men with more attractive partners have more interest in performing oral sex.
► Men with more attractive partners spend more time performing oral sex.

http://www.sciencedirect.com/science/article/pii/S0191886912005764

Booing

Contemporary Theatre Review
Volume 23, Issue 1, 2013, pages 11-15
Published online: 18 Mar 2013
DOI: 10.1080/10486801.2013.765102

Dan Rebellato

Department of Drama and Theatre
Royal Holloway
University of London

Three cheers for booing! C’mon people, put your hands together for the little bit of theatre you love to hate!
It’s about time booing got a round of applause - usually booing is jeered off the stage. Plato in The Laws
observes a change from silently respectful audiences to the noisily opinionated audience of his own time,
referring to ‘catcalls and uncouth yelling’. These baying crowds, he suggests, by privileging their own pleasure over the purity and refinement of musical form, have established a ‘theatrocracy’, a mob relativism about artistic standards which will lead in turn to the disre-gard of laws and parental authority, a slow decline into moral chaos, and ‘a wretched life of endless misery’.

[...]

Booing isn’t empty, and even if it could be ejected from the theatre, which it can’t, should be cheered, because booing is a moment where the audience represents the theatre to itself by dramatizing and drawing attention to the fault-lines of performance. It is a kind of liminal activity that throws theatre into sharp relief and asks profound questions about performance. Booing troubles the edges of theatre. Is it a response prompted legitimately by performance and therefore contained within it? Or is it a disruption of performance from performance’s outside? Booing is theatre at its most philosophical and its most theatrical.

http://www.tandfonline.com/doi/abs/10.1080/10486801.2013.765102

Significant changes in the skin microbiome mediated by the sport of roller derby

PeerJ 1:e53
2013-03-12
http://dx.doi.org/10.7717/peerj.53

James F. Meadow [​1], Ashley C. Bateman [1], Keith M. Herkert [1,2], Timothy K. O’Connor [1,3], Jessica L. Green [1,4]

[1] Biology and the Built Environment Center, Institute of Ecology and Evolution, University of Oregon, Eugene, OR, USA
[2] Oregon Health & Science University, Portland, OR, USA
[3] Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, USA
[4] Santa Fe Institute, Santa Fe, NM, USA

Abstract

Diverse bacterial communities live on and in human skin. These complex communities vary by skin location on the body, over time, between individuals, and between geographic regions. Culture-based studies have shown that human to human and human to surface contact mediates the dispersal of pathogens, yet little is currently known about the drivers of bacterial community assembly patterns on human skin. We hypothesized that participation in a sport involving skin to skin contact would result in detectable shifts in skin bacterial community composition. We conducted a study during a flat track roller derby tournament, and found that teammates shared distinct skin microbial communities before and after playing against another team, but that opposing teams’ bacterial communities converged during the course of a roller derby bout. Our results are consistent with the hypothesis that the human skin microbiome shifts in composition during activities involving human to human contact, and that contact sports provide an ideal setting in which to evaluate dispersal of microorganisms between people.

https://peerj.com/articles/53/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628844/