Highly specific spectroscopic photoacoustic molecular imaging of dynamic optical absorption shifts of an antibody-ICG contrast agent (Conference Presentation)

NASA Astrophysics Data System (ADS)

Wilson, Katheryne E.; Bachawal, Sunitha; Abou-Elkacem, Lotfi; Jensen, Kristen C.; Machtaler, Steven; Tian, Lu; Willmann, Juergen K.

2017-03-01

Improved techniques for breast cancer screening are critically needed as current methods lack diagnostic accuracy. Using spectroscopic photoacoustic (sPA) molecular imaging with a priori knowledge of optical absorption spectra allows suppression of endogenous background signal, increasing the overall sensitivity and specificity of the modality to exogenous contrast agents. Here, sPA imaging was used to monitor antibody-indocyanine green (ICG) conjugates as they undergo optical absorption spectrum shifts after cellular endocytosis and degradation to allow differentiation between normal murine mammary glands from breast cancer by enhancing molecular imaging signal from target (B7-H3)-bound antibody-ICG. First, B7-H3 was shown to have highly specific (AUC of 0.93) expression on both vascular endothelium and tumor stroma in malignant lesions through quantitative immunohistochemical staining of B7-H3 on 279 human samples (normal (n=53), benign lesions (11 subtypes, n=182), breast cancers (4 subtypes, n=97)), making B7-H3 a promising target for sPA imaging. Second, absorption spectra of intracellular and degraded B7-H3-ICG and Isotype control (Iso-ICG) were characterized through in vitro and in vivo experiments. Finally, a transgenic murine breast cancer model (FVB/N-Tg(MMTVPyMT)634Mul) was imaged, and sPA imaging in found a 3.01 (IQR 2.63, 3.38, P<0.001) fold increase in molecular B7-H3-ICG signal in tumors (n=80) compared to control conditions (B7-H3-ICG in tumor negative animals (n=60), Iso-ICG (n=30), blocking B7-H3+B7-H3-ICG (n=20), and free ICG (n=20)) despite significant tumor accumulation of Iso-ICG, confirmed through ex vivo histology. Overall, leveraging anti-B7-H3 antibody-ICG contrast agents, which have dynamic optical absorption spectra representative of molecular interactions, allows for highly specific sPA imaging of murine breast cancer.

The second window ICG technique demonstrates a broad plateau period for near infrared fluorescence tumor contrast in glioblastoma

PubMed Central

Sheikh, Saad; Xia, Leilei; Pierce, John; Newton, Andrew; Predina, Jarrod; Cho, Steve; Nasrallah, MacLean; Singhal, Sunil; Dorsey, Jay; Lee, John Y. K.

2017-01-01

Introduction Fluorescence-guided surgery has emerged as a powerful tool to detect, localize and resect tumors in the operative setting. Our laboratory has pioneered a novel way to administer an FDA-approved near-infrared (NIR) contrast agent to help surgeons with this task. This technique, coined Second Window ICG, exploits the natural permeability of tumor vasculature and its poor clearance to deliver high doses of indocyanine green (ICG) to tumors. This technique differs substantially from established ICG video angiography techniques that visualize ICG within minutes of injection. We hypothesized that Second Window ICG can provide NIR optical contrast with good signal characteristics in intracranial brain tumors over a longer period of time than previously appreciated with ICG video angiography alone. We tested this hypothesis in an intracranial mouse glioblastoma model, and corroborated this in a human clinical trial. Methods Intracranial tumors were established in 20 mice using the U251-Luc-GFP cell line. Successful grafts were confirmed with bioluminescence. Intravenous tail vein injections of 5.0 mg/kg (high dose) or 2.5 mg/kg (low dose) ICG were performed. The Perkin Elmer IVIS Spectrum (closed field) was used to visualize NIR fluorescence signal at seven delayed time points following ICG injection. NIR signals were quantified using LivingImage software. Based on the success of our results, human subjects were recruited to a clinical trial and intravenously injected with high dose 5.0 mg/kg. Imaging was performed with the VisionSense Iridium (open field) during surgery one day after ICG injection. Results In the murine model, the NIR signal-to-background ratio (SBR) in gliomas peaks at one hour after infusion, then plateaus and remains strong and stable for at least 48 hours. Higher dose 5.0 mg/kg improves NIR signal as compared to lower dose at 2.5 mg/kg (SBR = 3.5 vs. 2.8; P = 0.0624). Although early (≤ 6 hrs) visualization of the Second Window ICG

Effects of ICG concentration on the optical properties of erythrocyte-derived nano-vectors

NASA Astrophysics Data System (ADS)

Tang, Jack; Bahmani, Baharak; Burns, Joshua; Nuñez, Vicente; Mac, Jenny; Bacon, Danielle; Vullev, Valentine; Sun, Victor; Jia, Wangcun; Nelson, J. S.; Anvari, Bahman

2015-03-01

Erythrocyte-based nanoparticle platforms can offer long circulation times not offered by traditional drug delivery methods. We have developed a novel erythrocyte-based nanoparticle doped with indocyanine green (ICG), the only FDA-approved near-infrared chromophore. Here, we report on the absorption and fluorescence emission characteristics of these nanoparticles fabricated using ICG concentrations in the range of 161-323 μM. These nanoparticles may serve as biocompatible optical materials for various clinical imaging and phototherapeutic applications.

Carnosine-graphene oxide conjugates decorated with hydroxyapatite as promising nanocarrier for ICG loading with enhanced antibacterial effects in photodynamic therapy against Streptococcus mutans.

PubMed

Gholibegloo, Elham; Karbasi, Ashkan; Pourhajibagher, Maryam; Chiniforush, Nasim; Ramazani, Ali; Akbari, Tayebeh; Bahador, Abbas; Khoobi, Mehdi

2018-04-01

Antimicrobial photodynamic therapy (aPDT) has been emerged as a noninvasive strategy to remove bacterial contaminants such as S. mutans from the tooth surface. Photosensitizer (PS), like indocyanine green (ICG), plays a key role in this technique which mainly suffers from the poor stability and concentration-dependent aggregation. An appropriate nanocarrier (NC) with enhanced antibacterial effects could overcome these limitations and improve the efficiency of ICG as a PS. In this study, various ICG-loaded NCs including graphene oxide (GO), GO-carnosine (Car) and GO-Car/Hydroxyapatite (HAp) were synthesized and characterized by Fourier Transform Infrared Spectroscopy (FT-IR), X-ray Diffraction (XRD), Filed Emission Scanning Electron Microscopy (FE-SEM), Energy Dispersive Spectroscopy (EDS), Zeta Potential and Ultraviolet-Visible spectrometry (UV-Vis). The colony forming unit and crystal violet assays were performed to evaluate the antimicrobial and anti-biofilm properties of PSs against S. mutans. The quantitative real-time PCR approach was also applied to determine the expression ratio of the gtfB gene in S. mutans. The zeta potential analysis and UV-Vis spectrometry indicated successful loading of ICG onto/into NCs. GO-Car/HAp showed highest amount of ICG loading (57.52%) and also highest aqueous stability after one week (94%). UV-Vis spectrometry analyses disclosed a red shift from 780 to 800 nm for the characteristic peak of ICG-loaded NCs. In the lack of aPDT, GO-Car@ICG showed the highest decrease in bacterial survival (86.4%) which indicated that Car could significantly promote the antibacterial effect of GO. GO@ICG, GO-Car@ICG and GO-Car/HAp@ICG mediated aPDT, dramatically declined the count of S. mutans strains to 91.2%, 95.5% and 93.2%, respectively (P < 0.05). The GO@ICG, GO-Car@ICG, GO-Car/HAp@ICG significantly suppressed the S. mutans biofilm formation by 51.4%, 63.8%, and 56.8%, respectively (P < 0.05). The expression of gtfB gene was

ICG: a wiki-driven knowledgebase of internal control genes for RT-qPCR normalization.

PubMed

Sang, Jian; Wang, Zhennan; Li, Man; Cao, Jiabao; Niu, Guangyi; Xia, Lin; Zou, Dong; Wang, Fan; Xu, Xingjian; Han, Xiaojiao; Fan, Jinqi; Yang, Ye; Zuo, Wanzhu; Zhang, Yang; Zhao, Wenming; Bao, Yiming; Xiao, Jingfa; Hu, Songnian; Hao, Lili; Zhang, Zhang

2018-01-04

Real-time quantitative PCR (RT-qPCR) has become a widely used method for accurate expression profiling of targeted mRNA and ncRNA. Selection of appropriate internal control genes for RT-qPCR normalization is an elementary prerequisite for reliable expression measurement. Here, we present ICG (http://icg.big.ac.cn), a wiki-driven knowledgebase for community curation of experimentally validated internal control genes as well as their associated experimental conditions. Unlike extant related databases that focus on qPCR primers in model organisms (mainly human and mouse), ICG features harnessing collective intelligence in community integration of internal control genes for a variety of species. Specifically, it integrates a comprehensive collection of more than 750 internal control genes for 73 animals, 115 plants, 12 fungi and 9 bacteria, and incorporates detailed information on recommended application scenarios corresponding to specific experimental conditions, which, collectively, are of great help for researchers to adopt appropriate internal control genes for their own experiments. Taken together, ICG serves as a publicly editable and open-content encyclopaedia of internal control genes and accordingly bears broad utility for reliable RT-qPCR normalization and gene expression characterization in both model and non-model organisms. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

A novel photoacoustic nanoprobe of ICG@PEG-Ag2S for atherosclerosis targeting and imaging in vivo

NASA Astrophysics Data System (ADS)

Wu, Chenxin; Zhang, Yejun; Li, Zhen; Li, Chunyan; Wang, Qiangbin

2016-06-01

Atherosclerosis is a major cause of cardiovascular and cerebrovascular diseases that have high mortality and disability rates. Because of its unclear pathogenic mechanism and heterogeneous distribution feature, it is still a big challenge to achieve precise diagnosis and therapy of atherosclerosis at its early stage in vivo. Herein, we fabricated a new ICG@PEG-Ag2S nanoprobe by a simple self-assembly of DT-Ag2S QDs, amphipathic C18/PEG polymer molecules and ICG. The ICG@PEG-Ag2S nanoprobe showed relatively long blood retention and was selectively accumulated in the region of atherosclerotic plaque due to the lipophilicity of the C18 chain to the atherosclerosis microenvironment, and thus the atherosclerosis was real-time monitored by high contrast-enhanced photoacoustic (PA) imaging of ICG. Combining the high signal-to-noise ratio (SNR) and high spatial resolution fluorescence imaging of Ag2S QDs in the second near-infrared window (NIR-II) and related histological assessment in vitro, the feasibility of this new nanoprobe for atherosclerosis targeting in an Apoe-/- mouse model was verified. Additionally, hemolysis and coagulation assays of the ICG@PEG-Ag2S revealed its decent hemocompatibility and no histological changes were observed in the main organs of the mouse. Such a simple, multifunctional nanoprobe for targeting and PA imaging of atherosclerosis will have a great potential for future clinical applications.Atherosclerosis is a major cause of cardiovascular and cerebrovascular diseases that have high mortality and disability rates. Because of its unclear pathogenic mechanism and heterogeneous distribution feature, it is still a big challenge to achieve precise diagnosis and therapy of atherosclerosis at its early stage in vivo. Herein, we fabricated a new ICG@PEG-Ag2S nanoprobe by a simple self-assembly of DT-Ag2S QDs, amphipathic C18/PEG polymer molecules and ICG. The ICG@PEG-Ag2S nanoprobe showed relatively long blood retention and was selectively

Assessment of plaque vulnerability in atherosclerosis via intravascular photoacoustic imaging of targeted liposomal ICG J-aggregates (Conference Presentation)

NASA Astrophysics Data System (ADS)

Harris, Justin T.; Dumani, Diego S.; Cook, Jason R.; Sokolov, Konstantin V.; Emelianov, Stanislav Y.; Homan, Kimberly A.

2017-03-01

While molecular and cellular imaging can be used to visualize the conventional morphology characteristics of vulnerable plaques, there is a need to monitor other physiological factors correlated with high rupture rates; a high M1 activated macrophage concentration is one such indicator of high plaque vulnerability. Here, we present a molecularly targeted contrast agent for intravascular photoacoustic (IVPA) imaging consisting of liposomes loaded with indocyanine green (ICG) J-aggregates with high absorption at 890 nm, allowing for imaging in the presence of blood. This "Lipo-ICG" was targeted to a biomarker of M1 activated macrophages in vulnerable plaques: folate receptor beta (FRβ). The targeted liposomes accumulate in plaques through areas of endothelial dysfunction, while the liposome encapsulation prevents nonspecific interaction with lipids and endothelium. Lipo-ICG specifically interacts with M1 activated macrophages, causing a spectral shift and change in the 890/780 nm photoacoustic intensity ratio upon breakdown of J-aggregates. This sensing mechanism enables assessment of the M1 activated macrophage concentration, providing a measure of plaque vulnerability. In a pilot in vivo study utilizing ApoE deficient mouse models of atherosclerosis, diseased mice showed increased uptake of FRβ targeted Lipo-ICG in the heart and arteries vs. normal mice. Likewise, targeted Lipo-ICG showed increased uptake vs. two non-targeted controls. Thus, we successfully synthesized a contrast agent to detect M1 activated macrophages in high risk atherosclerotic plaques and exhibited targeting both in vitro and in vivo. This biocompatible agent could enable M1 macrophage detection, allowing better clinical decision making in treatment of atherosclerosis.

Indocyanine green (ICG) as a new adjuvant for the antimicrobial photo-dynamic therapy (aPDT) in dentistry

NASA Astrophysics Data System (ADS)

Meister, Joerg; Hopp, Michael; Schäfers, Johannes; Verbeek, Jonas; Kraus, Dominik; Frentzen, Matthias

2014-02-01

Clinical surveys show a continuous increase of antimicrobial resistance related to the frequency of the administrated medication. The antimicrobial photodynamic therapy (aPDT) is an effective adjuvant to reduce the need of antibiotics in dentistry, especially in periodontics. The antimicrobial effect of lightactivated photosensitizers in periodontics is demonstrated in clinical studies and case reports. Indocyanine green (ICG) as a new adjuvant shows the high potential of antiphlogistic and antimicrobial effects in combination with laser-light activation. In trying to answer the question of just how far the influence of temperature is acting on bacteria, this study was carried out. The influences of ICG at different concentrations (0.01 up to 1 mg/ml) in combination with a culture medium (brain-heart-infusion) and a bacteria culture (Streptococcus salivarius) at different optical densities (OD600 0.5 and 0.1) were investigated under laser-light activation. Laser activation was carried out with diode laser at 810 nm and two different power settings (100 mW/300 mW). The pulse repetition rate was 2 kHz. Taking account of the fiber diameter, distance and spot size on the sample surface, the applicated intensities were 6.2 and 18.7 W/cm2. Total irradiation time was 20 s for all meaurements. Transmitted laser power and temperature increase in the culture medium as well as in the bacteria culture were determined. Additionally the influence of ICG regarding bacterial growth and bactericidal effect was investigated in the bacteria culture without laser irradiation. Without laser, no bactericidal effect of ICG was observed. Only a bacteriostatic effect could be proved. In dependence of the ICG concentration and the applied intensities a temperature increase of ΔT up to 80°C was measured.

In vivo laser assisted end-to-end anastomosis with ICG-infused chitosan patches

NASA Astrophysics Data System (ADS)

Rossi, Francesca; Matteini, Paolo; Esposito, Giuseppe; Scerrati, Alba; Albanese, Alessio; Puca, Alfredo; Maira, Giulio; Rossi, Giacomo; Pini, Roberto

2011-07-01

Laser assisted vascular repair is a new optimized technique based on the use of ICG-infused chitosan patch to close a vessel wound, with or even without few supporting single stitches. We present an in vivo experimental study on an innovative end-to-end laser assisted vascular anastomotic (LAVA) technique, performed with the application of ICGinfused chitosan patches. The photostability and the mechanical properties of ICG-infused chitosan films were preliminary measured. The in vivo study was performed in 10 New Zealand rabbits. After anesthesia, a 3-cm segment of the right common carotid artery was exposed, thus clamped proximally and distally. The artery was then interrupted by means of a full thickness cut. Three single microsutures were used to approximate the two vessel edges. The ICG-infused chitosan patch was rolled all over the anastomotic site and welded by the use of a diode laser emitting at 810 nm and equipped with a 300 μm diameter optical fiber. Welding was obtained by delivering single laser spots to induce local patch/tissue adhesion. The result was an immediate closure of the anastomosis, with no bleeding at clamps release. Thus animals underwent different follow-up periods, in order to evaluate the welded vessels over time. At follow-up examinations, all the anastomoses were patent and no bleeding signs were documented. Samples of welded vessels underwent histological examinations. Results showed that this technique offer several advantages over conventional suturing methods: simplification of the surgical procedure, shortening of the operative time, better re-endothelization and optimal vascular healing process.

Retrospective validation of the laparoscopic ICG SLN mapping in patients with grade 3 endometrial cancer.

PubMed

Papadia, Andrea; Gasparri, Maria Luisa; Radan, Anda P; Stämpfli, Chantal A L; Rau, Tilman T; Mueller, Michael D

2018-04-24

To evaluate the sensitivity, negative predictive value (NPV) and false-negative (FN) rate of the near infrared (NIR) indocyanine green (ICG) sentinel lymph node (SLN) mapping in patients with poorly differentiated endometrial cancer who have undergone a full pelvic and para-aortic lymphadenectomy after SLN mapping. We performed a retrospective analysis of patients with endometrial cancer undergoing a laparoscopic NIR-ICG SLN mapping followed by a systematic pelvic and para-aortic lymphadenectomy. Inclusion criteria were a grade 3 endometrial cancer or a high-risk histology (papillary serous, clear cell carcinoma, carcinosarcoma, and neuroendocrine carcinoma) and a completion pelvic and para-aortic lymphadenectomy to the renal vessels after SLN mapping. Overall and bilateral detection rates, sensitivity, NPV, and FN rates were calculated. From December 2012 until January 2017, 42 patients fulfilled inclusion criteria. Overall and bilateral detection rates were 100 and 90.5%, respectively. Overall, 23.8% of the patients had lymph node metastases. In one patient, despite negative bilateral pelvic SLNs, a metastatic non-SLN-isolated para-aortic metastasis was detected. This NSLN was clinically suspicious and sent to frozen section analysis during the surgery. FN rate, sensitivity, and NPV were 10, 90, and 97.1%, respectively. For the SLN mapping algorithm, FN rate, sensitivity, and NPV were 0, 100, and 100%, respectively. Laparoscopic NIR-ICG SLN mapping in high-risk endometrial cancer patients has acceptable sensitivity, FN rate, and NPV.

ICG-fluorescence imaging for detection of peritoneal metastases and residual tumoral scars in locally advanced ovarian cancer: A pilot study.

PubMed

Veys, Isabelle; Pop, Florin-Catalin; Vankerckhove, Sophie; Barbieux, Romain; Chintinne, Marie; Moreau, Michel; Nogaret, Jean-Marie; Larsimont, Denis; Donckier, Vincent; Bourgeois, Pierre; Liberale, Gabriel

2018-02-01

No intraoperative imaging techniques exist for detecting tumor nodules or tumor scar tissues in patients treated with upfront or interval cytoreductive surgery (CS) after neoadjuvant chemotherapy (NAC). The aims of this study were to evaluate the role of indocyanine green (ICG) fluorescence imaging (FI) for the detection of peritoneal metastases (PM) and evaluate whether it can be used to detect remnant tumor cells in scar tissue. Patients with PM from ovarian cancer admitted for CS were included. ICG, at 0.25 mg per kg of patient weight, was injected intraoperatively after explorative laparotomy before CS. A total of 108 peritoneal lesions, including 25 scars, were imaged in 20 patients. Seventy-three were malignant (67.6%) and 35 benign (32.4%). The mean Tumor to Background Ratio (ex vivo) was 1.8 (SD 1.3) in malignant and 1.0 (SD 0.79) in benign nodules (P = 0.007). Of 25 post-NAC scars, the mean Tumor to Background Ratio (TBR) (in vivo) was 2.06 (SD 1.15) in malignant and 1.21 (SD 0.50) in benign nodules (P = 0.26). The positive predictive value of ICG-FI to detect tumor cells in scars was 57.1%. ICG-FI is accurate to demonstrate PM in ovarian cancer but unable to discriminate between benign and malignant post-NAC. © 2017 Wiley Periodicals, Inc.

Simulation of 'pathologic' changes in ICG waveforms resulting from superposition of the 'preejection' and ejection waves induced by left ventricular contraction

NASA Astrophysics Data System (ADS)

Ermishkin, V. V.; Kolesnikov, V. A.; Lukoshkova, E. V.; Sonina, R. S.

2013-04-01

The impedance cardiography (ICG) is widely used for beat-to-beat noninvasive evaluation of the left ventricular stroke volume and contractility. It implies the correct determination of the ejection start and end points and the amplitudes of certain peaks in the differentiated impedance cardiogram. An accurate identification of ejection onset by ICG is often problematic, especially in the cardiologic patients, due to peculiar waveforms. Using a simple theoretical model, we tested the hypothesis that two major processes are responsible for the formation of impedance systolic wave: (1) the changes in the heart geometry and surrounding vessels produced by ventricular contraction, which occur during the isovolumic phase and precede ejection, and (2) expansion of aorta and adjacent arteries during the ejection phase. The former process initiates the preejection wave WpE and the latter triggers the ejection wave WEj. The model predicts a potential mechanism of generating the abnormal shapes of dZ/dt due to the presence of preejection waves and explains the related errors in ICG time and amplitude parameters. An appropriate decomposition method is a promising way to avoid the masking effects of these waves and a further step to correct determination of the onset of ejection and the corresponding peak amplitudes from 'pathologically shaped' ICG signals.

Hepatic blood flow measurement III. Total hepatic blood flow measured by ICG clearance and electromagnetic flowmeters in a canine septic shock model.

PubMed Central

Nxumalo, J L; Teranaka, M; Schenk, W G

1978-01-01

The validity of the ICG clearance method for the measurement of THBF in abnormal circulatory states remains questionable. In this study THBF measured by this method is compared with the electromagnetic flow technique in a canine spetic model. Good correlation is demonstrated between the two in normal control animals. However, in the septic animals the ICG underestimated the electromagnetic flow result by 20%. This is true in both the high and the low cardiac output septic shock pictures that emerge. In the septic animals, the total hepatic blood flow as measured by the ICG was almost equal to the portal vein flow alone measured by the electromagnetic flowmeters suggesting that this was the quantity it was measuring in this abnormal state. Pathophysiologic mechanisms that may explain the discrepancy are given. PMID:637587

Group crisis intervention for children during ongoing war conflict.

PubMed

Thabet, Abdel Aziz; Vostanis, Panos; Karim, Khalid

2005-08-01

The aim of this study was to evaluate the short-term impact of a group crisis intervention for children aged 9-15 years from five refugee camps in the Gaza Strip during ongoing war conflict. Children were selected if they reported moderate to severe posttraumatic stress reactions, and were allocated to group intervention (N=47) encouraging expression of experiences and emotions through storytelling, drawing, free play and role-play; education about symptoms (N=22); or no intervention (N=42). Children completed the CPTSD-RI and the CDI pre- and post-intervention. No significant impact of the group intervention was established on children's posttraumatic or depressive symptoms. Possible explanations of the findings are discussed, including the continuing exposure to trauma and the non-active nature of the intervention.

Inhibition of canonical WNT signaling pathway by β-catenin/CBP inhibitor ICG-001 ameliorates liver fibrosis in vivo through suppression of stromal CXCL12.

PubMed

Akcora, Büsra Öztürk; Storm, Gert; Bansal, Ruchi

2018-03-01

Quiescent hepatic stellate cells (HSCs), in response to liver injury, undergo characteristic morphological transformation into proliferative, contractile and ECM-producing myofibroblasts. In this study, we investigated the implication of canonical Wnt signaling pathway in HSCs and liver fibrogenesis. Canonical Wnt signaling pathway activation and inhibition using β-catenin/CBP inhibitor ICG001 was examined in-vitro in TGFβ-activated 3T3, LX2, primary human HSCs, and in-vivo in CCl 4 -induced acute liver injury mouse model. Fibroblasts-conditioned medium studies were performed to assess the Wnt-regulated paracrine factors involved in crosstalk between HSCs-macrophages and HSCs-endothelial cells. Canonical Wnt signaling pathway components were significantly up-regulated in-vitro and in-vivo. In-vitro, ICG-001 significantly inhibited fibrotic parameters, 3D-collagen contractility and wound healing. Conditioned medium induced fibroblasts-mediated macrophage and endothelial cells activation was significantly inhibited by ICG-001. In-vivo, ICG-001 significantly attenuated collagen accumulation and HSC activation. Interestingly, ICG-001 drastically inhibited macrophage infiltration, intrahepatic inflammation and angiogenesis. We further analyzed the paracrine factors involved in Wnt-mediated effects and found CXCL12 was significantly suppressed both in-vitro and in-vivo following Wnt inhibition. Wnt-regulated CXCL12 secretion from activated HSCs potentiated macrophage infiltration and activation, and angiogenesis. Pharmacological inhibition of canonical Wnt signaling pathway via suppression of stromal CXCL12 suggests a potential therapeutic approach targeting activated HSCs in liver fibrosis. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Mortality decrease according to socioeconomic groups during the economic crisis in Spain: a cohort study of 36 million people.

PubMed

Regidor, Enrique; Vallejo, Fernando; Granados, José A Tapia; Viciana-Fernández, Francisco J; de la Fuente, Luis; Barrio, Gregorio

2016-11-26

Studies of the effect of macroeconomic fluctuations on mortality in different socioeconomic groups are scarce and have yielded mixed findings. We analyse mortality trends in Spain before and during the Great Recession in different socioeconomic groups, quantifying the change within each group. We did a nationwide prospective study, in which we took data from the 2001 Census. All people living in Spain on Nov 1, 2001, were followed up until Dec 31, 2011. We included 35 951 354 people alive in 2001 who were aged between 10 and 74 years in each one of the four calendar years before the economic crisis (from 2004 to 2007) and in each one of the first four calendar years of the crisis (from 2008 to 2011), and analysed all-cause and cause-specific mortality in those people. We classified individuals by socioeconomic status (low, medium, or high) using two indicators of household wealth: household floor space (<72 m 2 , 72-104 m 2 , and >104 m 2 ) and number of cars owned by the residents of the household (none, one, and two or more). We used Poisson regression to calculate the annual percentage reduction (APR) in mortality rates during 2004-07 (pre-crisis) and 2008-11 (crisis) in each socioeconomic group, as well as the effect size, measured by the APR difference between the pre-crisis and crisis period. The annual decline in all-cause mortality in the three socioeconomic groups was 1·7% (95% CI 1·2 to 2·1) for the low group, 1·7% (1·3 to 2·1) for the medium group, and 2·0% (1·4 to 2·5) for the high group in 2004-07, and 3·0% (2·5 to 3·5) for the low group, 2·8% (2·5 to 3·2) for the medium group, and 2·1% (1·6 to 2·7) for the high group in 2008-11 when individuals were classified by household floor space. The annual decline in all-cause mortality when people were classified by number of cars owned by the household was 0·3% (-0·1 to 0·8) for the low group, 1·6% (1·2 to 2·0) for the medium group, and 2·2% (1·6 to 2·8) for the high group in

A pilot study to assess near infrared laparoscopy with indocyanine green (ICG) for intraoperative sentinel lymph node mapping in early colon cancer.

PubMed

Currie, A C; Brigic, A; Thomas-Gibson, S; Suzuki, N; Moorghen, M; Jenkins, J T; Faiz, O D; Kennedy, R H

2017-11-01

Previous attempts at sentinel lymph node (SLN) mapping in colon cancer have been compromised by ineffective tracers and the inclusion of advanced disease. This study evaluated the feasibility of fluorescence detection of SLNs with indocyanine green (ICG) for lymphatic mapping in T1/T2 clinically staged colonic malignancy. Consecutive patients with clinical T1/T2 stage colon cancer underwent endoscopic peritumoral submucosal injection of indocyanine green (ICG) for fluorescence detection of SLN using a near-infrared (NIR) camera. All patients underwent laparoscopic complete mesocolic excision surgery. Detection rate and sensitivity of the NIR-ICG technique were the study endpoints. Thirty patients mean age = 68 years [range = 38-80], mean BMI = 26.2 (IQR = 24.7-28.6) were studied. Mesocolic sentinel nodes (median = 3/patient) were detected by fluorescence within the standard resection field in 27/30 patients. Overall, ten patients had lymph node metastases, with one of these patients having a failed SLN procedure. Of the 27 patients with completed SLN mapping, nine patients had histologically positive lymph nodes containing malignancy. 3/9 had positive SLNs with 6 false negatives. In five of these false negative patients, tumours were larger than 35 mm with four also being T3/T4. ICG mapping with NIR fluorescence allowed mesenteric detection of SLNs in clinical T1/T2 stage colonic cancer. CLINICALTRIALS.GOV: ID: NCT01662752. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Which group of smokers is more vulnerable to the economic crisis?

PubMed

Gallus, S; Asciutto, R; Muttarak, R; Pacifici, R; La Vecchia, C; Lugo, A

2016-05-01

Studies investigating whether smoking increases or decreases during economic downturn provided contrasting results. For the first time, we used direct questions to analyse changes in smoking behaviour due to the 2008 financial crisis, comparing socio-economic characteristics of smokers who changed with those who kept their smoking intensity. Cross-sectional survey. We used data from three annual surveys conducted in Italy in 2012-2014 on representative samples of the Italian general population aged ≥15 years. A total of 1919 current smokers were asked specific questions on the influence of the economic crisis that started in 2008 on their smoking behaviour. Overall, 77.4% of 1919 current smokers reported not to have changed their smoking behaviour, 19.1% to have reduced, and 3.5% to have increased their smoking intensity as a consequence of the economic crisis. The reduction in cigarette smoking increased with age: compared to the respondents aged <25 years, the multivariate odds ratio (OR) for those aged 25-44, 45-64 and ≥65 years were 0.65, 0.46 and 0.33, respectively (P for trend<0.001). Reduction was significantly lower among intermediate (OR = 0.68 compared to low) and high education levels (OR = 0.28; P for trend<0.001). A significant inverse trend for increasing consumption was observed with age (P = 0.022), education (P = 0.003) and family income (P < 0.001). The large majority of current smokers did not change their smoking habit following the economic crisis. However, there are specific vulnerable subgroups of smokers, constituted by the young and subjects with low socio-economic status, that were reactive to the global economic crisis. These groups are more prone to change their smoking behaviours, either for better or -, in a smaller proportion -, for worse. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Laser-initiated decomposition products of indocyanine green (ICG) and carbon black sensitized biological tissues

NASA Astrophysics Data System (ADS)

Kokosa, John M.; Przyjazny, Andrzej; Bartels, Kenneth E.; Motamedi, Massoud; Hayes, Donald J.; Wallace, David B.; Frederickson, Christopher J.

1997-05-01

Organic dyes have found increasing use a s sensitizers in laser surgical procedures, due to their high optical absorbances. Little is known, however, about the nature of the degradation products formed when these dyes are irradiated with a laser. Previous work in our laboratories has shown that irradiation of polymeric and biological tissues with CO2 and Nd:YAG lasers produces a host of volatile and semivolatile by-products, some of which are known to be potential carcinogens. This work focuses on the identification of the chemical by-products formed by diode laser and Nd:YAG laser irradiation of indocyanine green (ICG) and carbon black based ink sensitized tissues, including bone, tendon and sheep's teeth. Samples were mounted in a 0.5-L Pyrex sample chamber equipped with quartz optical windows, charcoal filtered air inlet and an outlet attached to an appropriate sample trap and a constant flow pump. By-products were analyzed by GC/MS and HPLC. Volatiles identified included benzene and formaldehyde. Semi-volatiles included traces of polycyclic aromatics, arising from the biological matrix and inks, as well as fragments of ICG and the carbon ink components. The significance of these results will be discussed, including the necessity of using appropriate evacuation devices when utilizing lasers for surgical procedures.

Multispectral photoacoustic characterization of ICG and porcine blood using an LED-based photoacoustic imaging system

NASA Astrophysics Data System (ADS)

Shigeta, Yusuke; Sato, Naoto; Kuniyil Ajith Singh, Mithun; Agano, Toshitaka

2018-02-01

Photoacoustic imaging is a hybrid biomedical imaging modality that has emerged over the last decade. In photoacoustic imaging, pulsed-light absorbed by the target emits ultrasound that can be detected using a conventional ultrasound array. This ultrasound data can be used to reconstruct the location and spatial details of the intrinsic/extrinsic light absorbers in the tissue. Recently we reported on the development of a multi-wavelength high frame-rate LED-based photoacoustic/ultrasound imaging system (AcousticX). In this work, we photoacoustically characterize the absorption spectrum of ICG and porcine blood using LED arrays with multiple wavelengths (405, 420, 470, 520, 620, 660, 690, 750, 810, 850, 925, 980 nm). Measurements were performed in a simple reflection mode configuration in which LED arrays where fixed on both sides of the linear array ultrasound probe. Phantom used consisted of micro-test tubes filled with ICG and porcine blood, which were placed in a tank filled with water. The photoacoustic spectrum obtained from our measurements matches well with the reference absorption spectrum. These results demonstrate the potential capability of our system in performing clinical/pre-clinical multispectral photoacoustic imaging.

Three-dimensional dynamics of temperature fields in phantoms and biotissue under IR laser photothermal therapy using gold nanoparticles and ICG dye

NASA Astrophysics Data System (ADS)

Akchurin, Georgy G.; Garif, Akchurin G.; Maksimova, Irina L.; Skaptsov, Alexander A.; Terentyuk, Georgy S.; Khlebtsov, Boris N.; Khlebtsov, Nikolai G.; Tuchin, Valery V.

2010-02-01

We describe applications of silica (core)/gold (shell) nanoparticles and ICG dye to photothermal treatment of phantoms, biotissue and spontaneous tumor of cats and dogs. The laser irradiation parameters were optimized by preliminary experiments with laboratory rats. Three dimensional dynamics of temperature fields in tissue and solution samples was measured with a thermal imaging system. It is shown that the temperature in the volume region of nanoparticles localization can substantially exceed the surface temperature recorded by the thermal imaging system. We have demonstrated effective optical destruction of cancer cells by local injection of plasmon-resonant gold nanoshells and ICG dye followed by continuous wave (CW) diode laser irradiation at wavelength 808 nm.

Risk, interest groups and the definition of crisis: the case of volcanic ash.

PubMed

Hutter, Bridget M; Lloyd-Bostock, Sally

2013-09-01

This paper considers a key aspect of the 'risk society' thesis: the belief that we should be able to manage risks and control the world around us. In particular it focuses on the interface between risk and risk events as socially constructed and the insights that 'critical situations' give us into 'the routine and mundane', the otherwise taken for granted assumptions underlying risk regulation. It does this with reference to the events precipitated by the April 2010 volcanic eruption in the Eyjafjallajökull area of Iceland. The resulting cloud of volcanic ash spread across Europe and much of Europe's airspace was closed to civil aviation for six days, with far reaching consequences including huge financial losses for airlines. The social processes of defining and reacting to risk and crisis both reveal and generate dilemmas and challenges in regulation. This paper examines the role of different interest groups in defining risk expectations and thereby redefining the ash crisis as a regulatory crisis. © London School of Economics and Political Science 2013.

[A Case of Gastric Cancer with Splenic Artery Aneurysm, Intraoperative ICG Fluorography Is Useful in Evaluating the Blood Flow of Stomach and Spleen].

PubMed

Usui, Kenji; Sakamoto, Kaoru; Akabane, Kentaro; Hayasaka, Kazuki; Mizuki, Toru; Yagi, Yutaka; Shirahata, Yasuhiro; Ichikawa, Hiroshi; Hanyu, Takaaki; Ishikawa, Takashi; Kameyama, Hitoshi; Suzuki, Satoshi; Saito, Kiyohiro; Wakai, Toshifumi

2017-11-01

An 81-year-oldwoman with advancedgastric cancer was referredto our hospital. Preoperative contrast-enhancedCT revealeda roundcalcification of the splenic hilum with 15mm in diameter as a splenic artery aneurysm. She underwent transcatheter arterial embolization(TAE)for the splenic artery aneurysm. Celiac artery angiography showedcollateral arterial network of the spleen from left gastric artery. Surgery for the gastric cancer was performed1 4 days after TAE. We cut the right gastric andbilateral epigastric arteries. After the left gastric artery clamping, we performedintraoperative indocyanine green(ICG)fluorography. ICG fluorography confirmedthat the bloodflow of the upper thirdof the stomach andspleen were maintained. We safely performed distal gastrectomy, and the postoperative course was uneventful.

Report of the Tort Policy Working Group on the Causes, Extent and Policy Implications of the Current Crisis in Insurance Availability and Affordability.

ERIC Educational Resources Information Center

Department of Justice, Washington, DC.

Causes and implications of the crisis in liability insurance availability and affordability are discussed in this report. The working group concluded that tort law is a major issue in the insurance crisis and that the federal government can address that issue. The group also concluded that the federal government can do little to remedy other…

In vivo experimental study on laser welded ICG-loaded chitosan patches for vessel repair

NASA Astrophysics Data System (ADS)

Rossi, Francesca; Matteini, Paolo; Esposito, Giuseppe; Albanese, Alessio; Puca, Alfredo; Maira, Giulio; Rossi, Giacomo; Pini, Roberto

2011-03-01

Laser welding of microvessels provides several advantages over conventional suturing techniques: surgical times reduction, vascular healing process improvement, tissue damage reduction. We present the first application of biopolymeric patches in an in vivo laser assisted procedure for vessel repair. The study was performed in 20 New Zealand rabbits. After anesthesia, a 3-cm segment of the right common carotid artery was exposed and clamped proximally and distally. A linear lesion 3 mm in length was carried out. We used a diode laser emitting at 810 nm and equipped with a 300 μm diameter optical fiber. To close the cut, ICG-loaded chitosan films were prepared: chitosan is characterized by biodegradability, biocompatibility, antimicrobial, haemostatic and wound healing-promoting activity. ICG is an organic chromophore commonly used in the laser welding procedures to mediate the photothermal conversion at the basis of the welding effect. The membranes were used to wrap the whole length of the cut, and then they were welded in the correct position by delivering single laser spots to induce local patch/tissue adhesion. The result is an immediate closure of the wound, with no bleeding at clamps release. The animals were observed during follow-up and sacrificed after 2, 7, 30 and 90 days. All the repaired vessels were patent, no bleeding signs were documented. The carotid samples underwent histological examinations. The advantages of the proposed technique are: simplification of the surgical procedure and shortening of the operative time; good strength of the vessel repair; decreased foreign-body reaction, reduced inflammatory response and improved vascular healing process.

[Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands].

PubMed

Buggink, J W; de Goeij, M C M; Otten, F W J; Kunst, A

2016-01-01

International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health, and alcohol and tobacco use changed after the recession started. Cross-sectional study using routinely collected data from surveys of the Dutch population. We used data from the Dutch Health Interview Surveys: 2006-2008 (pre-crisis period) and 2009-2013 (crisis period). Respondents aged 25-64 were divided into socioeconomic groups based on labour status, income level and income change. Inequalities in health and stimulant use among these socioeconomic groups were described by period and changes between the pre-crisis and crisis period were investigated using logistic regression models. Most inequalities did not change, with some exceptions. For perceived general health, inequalities between employed persons and persons not in the labour force were larger in the crisis-period (unfavourable trends for those not in the labour force). For smoking, inequalities between unemployed and employed persons were larger in the crisis period (decreasing smoking rates only for those employed), as did inequalities between persons with low and high income levels (decreasing smoking rates for those with higher income levels). Excessive drinking decreased among employed persons and persons with a decrease in income, while it remained stable among persons not in the labour force and among persons with an increase in income. The widening of some socioeconomic inequalities in health and stimulant use might suggest an enhanced vulnerability of lower socioeconomic groups to the post-2008 crisis.

Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands.

PubMed

Bruggink, Jan-Willem; de Goeij, Moniek C M; Otten, Ferdy; Kunst, Anton E

2016-10-01

International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health, and alcohol and tobacco use changed after the recession started. We used data from the Dutch Health Interview Surveys: 2006-2008 (pre-crisis period) and 2009-2013 (crisis period). Respondents aged 25-64 were divided into socioeconomic groups based on labour status, income level and income change. Inequalities in health and stimulant use among these socioeconomic groups were described by period and changes between the pre-crisis and crisis period were investigated using logistic regression models. Most inequalities did not change, with some exceptions. For perceived general health, inequalities between employed persons and persons not in the labour force were larger in the crisis period (unfavourable trends for those not in the labour force). For smoking, inequalities between unemployed and employed persons were larger in the crisis period (decreasing smoking rates only for those employed), as did inequalities between persons with low and high income levels (decreasing smoking rates for those with higher income levels). Excessive drinking decreased among employed persons and persons with a decrease in income, while it remained stable among persons not in the labour force and among persons with an increase in income. The widening of some socioeconomic inequalities in health and stimulant use might suggest an enhanced vulnerability of lower socioeconomic groups to the post-2008 crisis. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Rethinking the Role of Nitroglycerin Ointment in Ischemic Vascular Filler Complications: An Animal Model With ICG Imaging.

PubMed

Hwang, Catherine J; Morgan, Payam V; Pimentel, Aline; Sayre, James W; Goldberg, Robert A; Duckwiler, Gary

2016-01-01

Soft tissue dermal fillers, both temporary and permanent, are used frequently in facial rejuvenation. As the use of fillers increases, ischemic complications including skin necrosis are becoming more prevalent. In the literature, topical nitroglycerin paste has been recommended in the early treatment of patients presenting with ischemia. The purpose of this study was to evaluate the vascular perfusion effects of topical nitroglycerin paste in an animal model using indocyanine green (ICG) imaging. After Animal Research Committee approval, a rabbit ear model was used to create filler-associated skin ischemia. Ischemia was confirmed to occur after intra-arterial occlusion. Four commonly used soft tissue fillers were injected intra-arterially: Radiesse (Merz USA, Greensboro NC), Restylane (Galderma, Ft. Worth, TX), Juvederm Ultra (Allergan, Irvine CA), Belotero (Merz USA, Greensboro NC) (0.1 ml). A total of 15 ears were used, 1 control and 4 experimental per product. Thirty minutes after occlusion, nitroglycerin ointment USP, 2%(Nitro-Bid) was applied topically to the experimental ears. Vascular perfusion was evaluated with the SPY System (Novadaq Inc.) using ICG imaging. Perfusion images were obtained at baseline, immediately after, and 30 minutes after intra-arterial filler injection, and at 30, 60, 90, and 120 minutes after application of topical nitroglycerin ointment. In this rabbit ear model, no statistically significant improvement in perfusion was noted after topical application of nitroglycerin paste with ICG imaging. In addition, the skin of the rabbit ear post-nitroglycerin ointment appeared to have more of a congested appearance than the controls. Ischemic filler complications are becoming increasingly prevalent. Practitioners often treat these complications with topical nitroglycerin paste based on the knowledge that topical nitroglycerin causes vasodilation. In filler-induced tissue ischemia, however, filler product is present within arterioles

Superselective intra-arterial hepatic injection of indocyanine green (ICG) for fluorescence image-guided segmental positive staining: experimental proof of the concept.

PubMed

Diana, Michele; Liu, Yu-Yin; Pop, Raoul; Kong, Seong-Ho; Legnèr, Andras; Beaujeux, Remy; Pessaux, Patrick; Soler, Luc; Mutter, Didier; Dallemagne, Bernard; Marescaux, Jacques

2017-03-01

Intraoperative liver segmentation can be obtained by means of percutaneous intra-portal injection of a fluorophore and illumination with a near-infrared light source. However, the percutaneous approach is challenging in the minimally invasive setting. We aimed to evaluate the feasibility of fluorescence liver segmentation by superselective intra-hepatic arterial injection of indocyanine green (ICG). Eight pigs (mean weight: 26.01 ± 5.21 kg) were involved. Procedures were performed in a hybrid experimental operative suite equipped with the Artis Zeego ® , multiaxis robotic angiography system. A pneumoperitoneum was established and four laparoscopic ports were introduced. The celiac trunk was catheterized, and a microcatheter was advanced into different segmental hepatic artery branches. A near-infrared laparoscope (D-Light P, Karl Storz) was used to detect the fluorescent signal. To assess the correspondence between arterial-based fluorescence demarcation and liver volume, metallic markers were placed along the fluorescent border, followed by a 3D CT-scanning, after injecting intra-arterial radiological contrast (n = 3). To assess the correspondence between arterial and portal supplies, percutaneous intra-portal angiography and intra-arterial angiography were performed simultaneously (n = 1). Bright fluorescence signal enhancing the demarcation of target segments was obtained from 0.1 mg/mL, in matter of seconds. Correspondence between the volume of hepatic segments and arterial territories was confirmed by CT angiography. Higher background fluorescence noise was found after positive staining by intra-portal ICG injection, due to parenchymal accumulation and porto-systemic shunting. Intra-hepatic arterial ICG injection, rapidly highlights hepatic target segment borders, with a better signal-to-background ratio as compared to portal vein injection, in the experimental setting.

Crisis Management Research Summaries

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.

2009-01-01

In this column, Crisis Management in the Schools Interest Group members summarize recent crisis management publications. The first article summarized was a meta-analysis of the risk factors associated with Posttraumatic Stress Disorder (PTSD) among adults. The second study looked at the presence of life stressors among students who were expelled…

Biofeedback Training in Crisis Managers: A Randomized Controlled Trial.

PubMed

Janka, A; Adler, C; Brunner, B; Oppenrieder, S; Duschek, S

2017-06-01

Working in crisis environments represents a major challenge, especially for executive personnel engaged in directing disaster operations, i.e. crisis managers. Crisis management involves operating under conditions of extreme stress resulting, for instance, from high-level decision-making, principal responsibility for personnel, multitasking or working under conditions of risk and time pressure. The present study aimed to investigate the efficacy of a newly developed biofeedback training procedure based on electrodermal activity, especially designed for the target group of crisis managers. The training comprised exercises promoting acquisition of control over sympathetic arousal under resting conditions and during exposure to visual, acoustic and cognitive stressors resembling situations related to crisis management. In a randomized controlled design, 36 crisis managers were assigned to either a biofeedback training group or waiting list control group. Subjective stress was assessed using the Perceived Stress Scale. In the training group, stress level markedly decreased; the decrease remained stable at follow-up 2 months after the training. The results indicate that biofeedback training in crisis management is an effective method for stress management that may help to reduce vulnerability to stress-related performance decline and stress-related disease.

Hearing impairment: a family crisis.

PubMed

Goldberg, H K

1979-01-01

This paper reviews the initial crisis for hearing impaired children and their families from the perspective of the clinician who must assess their adjustment at the point of entry into a school for the deaf. The use of crisis theory as it relates to the special needs of this client group is discussed.

Crisis in Feminism: The United States and France.

ERIC Educational Resources Information Center

Hogsett, Charlotte

Feminism is experiencing a similar dual crisis in the United States and France. One aspect of this crisis, the movement's alignment with other groups, is destructive, inevitably leading to the subordination of women's issues to "human" issues. The other dimension of the crisis, internal differences, is potentially creative, offering the…

Lunar phases and crisis center telephone calls.

PubMed

Wilson, J E; Tobacyk, J J

1990-02-01

The lunar hypothesis, that is, the notion that lunar phases can directly affect human behavior, was tested by time-series analysis of 4,575 crisis center telephone calls (all calls recorded for a 6-month interval). As expected, the lunar hypothesis was not supported. The 28-day lunar cycle accounted for less than 1% of the variance of the frequency of crisis center calls. Also, as hypothesized from an attribution theory framework, crisis center workers reported significantly greater belief in lunar effects than a non-crisis-center-worker comparison group.

Activatable thermo-sensitive ICG encapsulated pluronic nanocapsules for temperature sensitive fluorescence tomography

NASA Astrophysics Data System (ADS)

Kwong, Tiffany C.; Nouizi, Farouk; Sampathkumaran, Uma; Zhu, Yue; Alam, Maksudul M.; Gulsen, Gultekin

2015-03-01

Fluorescent tomography has been hindered by poor tissue penetration and weak signal which results in poor spatial resolution and quantification accuracy. Recently, it has been reported that activatable temperature responsive fluorescent probes which respond to focused ultrasound heating can improve the resolution and quantification of fluorescent tomography in deep tissue. This has lead to a new imaging modality, "Temperature-modulated fluorescent tomography." This technique relies on activatable thermo-sensitive fluorescent nanocapsules for whose fluorescence quantum efficiency is temperature dependent. Within a 4-5° C temperature range, the fluorescent signal increase more than 10-fold. In this molecular probe, Indocyanine Green (ICG) is encapsulated inside the core of a thermo-reversible pluronic micelle. Here we show the fluorescence response and temperature range of the nanocapsules which have been optimized for a higher temperature range to be used for in vivo animal imaging. We report on the feasibility of these temperature-sensitive reversible nanocapsules for in vivo applications by studying the pharmacokinetics in a subcutaneous mouse tumor model in vivo.

Navigation surgery for intraoperative sentinel lymph node detection using Indocyanine green (ICG) fluorescence real-time imaging in breast cancer.

PubMed

Toh, U; Iwakuma, N; Mishima, M; Okabe, M; Nakagawa, S; Akagi, Y

2015-09-01

A new sensitive fluorescence imaging system was developed for the real-time identification of sentinel lymph nodes (SLNs) in patients with early breast cancer. The purpose of this study was to evaluate the utility of a color charge-coupled device camera system for the intraoperative detection of SLNs and to determine its clinical efficacy and sensitivity in patients with operable breast cancer. We assessed a total of 168 patients diagnosed with or suspected of having early-stage breast cancer without metastasis in SLNs. The intraoperative detection of SLNs was performed using the conventional Indigo Carmine dye (indigotindisulfonate sodium) technique combined with a new Indocyanine green (ICG) imaging system (HyperEye Medical System: HEMS, MIZUHO IKAKOGYO, Japan) to map SLNs, in which the lymphatic vessels and SLNs were visualized transcutaneously with illuminating ICG fluorescence. Between January 2012 and May 2013, SLNs were successfully identified in all 168 patients (detection rate: 100%). By histopathology, the sensitivity was 93.8% for the detection of the metastatic involvement of SLNs (15 of 16 nodal-positive patients). After a median follow-up of 30.5 months, none of the patients presented with axillary recurrence. These results suggest that the HEMS imaging system is a feasible and effective method for the detection of SLNs in breast cancer. Furthermore, the HEMS device permitted the transcutaneous visualization of lymphatic vessels under light conditions, thus facilitating the identification and detection of SLNs without affecting the surgical procedure, together with a high sensitivity and specificity.

Does teaching crisis resource management skills improve resuscitation performance in pediatric residents?*.

PubMed

Blackwood, Jaime; Duff, Jonathan P; Nettel-Aguirre, Alberto; Djogovic, Dennis; Joynt, Chloe

2014-05-01

The effect of teaching crisis resource management skills on the resuscitation performance of pediatric residents is unknown. The primary objective of this pilot study was to determine if teaching crisis resource management to residents leads to improved clinical and crisis resource management performance in simulated pediatric resuscitation scenarios. A prospective, randomized control pilot study. Simulation facility at tertiary pediatric hospital. Junior pediatric residents. Junior pediatric residents were randomized to 1 hour of crisis resource management instruction or no additional training. Time to predetermined resuscitation tasks was noted in simulated resuscitation scenarios immediately after intervention and again 3 months post intervention. Crisis resource management skills were evaluated using the Ottawa Global Rating Scale. Fifteen junior residents participated in the study, of which seven in the intervention group. The intervention crisis resource management group placed monitor leads 24.6 seconds earlier (p = 0.02), placed an IV 47.1 seconds sooner (p = 0.04), called for help 50.4 seconds faster (p = 0.03), and checked for a pulse after noticing a rhythm change 84.9 seconds quicker (p = 0.01). There was no statistically significant difference in time to initiation of cardiopulmonary resuscitation (p = 0.264). The intervention group had overall crisis resource management performance scores 1.15 points higher (Ottawa Global Rating Scale [out of 7]) (p = 0.02). Three months later, these differences between the groups persisted. A 1-hour crisis resource management teaching session improved time to critical initial steps of pediatric resuscitation and crisis resource management performance as measured by the Ottawa Global Rating Scale. The control group did not develop these crisis resource management skills over 3 months of standard training indicating that obtaining these skills requires specific education. Larger studies of crisis resource education are

Crisis, What Crisis?

ERIC Educational Resources Information Center

Jones, Ken

2010-01-01

Responding to the recent work of Andrew Gamble, the article discusses the extent to which the British situation can be described in terms of crisis. It suggests that an essential element of crisis is that of political and social contestation, and explores the terms on which contestation is taking shape in and around British education.

Learning Crisis Unit through Post-Crisis: Characteristics and Mechanisms

ERIC Educational Resources Information Center

Chebbi, Hela; Pündrich, Aline Pereira

2015-01-01

Purpose: This paper aims to identify the characteristics that a crisis unit should have to achieve effective learning after crisis. Literature has identified many relations between learning organizations and crisis; yet, there is a dearth of research on specific studies about crisis units and their post-crisis learning features. Thus, this paper…

A Study of Crisis Management Based on Stakeholders Analysis Model

NASA Astrophysics Data System (ADS)

Qingchun, Yue

2017-11-01

From the view of stakeholder theory, not only the enterprises should provide services to shareholders, but also take care of the demands of stakeholders. Stakeholders for the enterprise crisis are the organizations and individuals, which cause crisis, respond to the crisis and affected by the enterprise crisis. In this paper, first of all, to comb the development of stakeholder theory systematically; secondly, with the help of the enterprise crisis stakeholder analysis model, analyze the concept of stakeholders for the enterprise crisis and membership, and with the example of Shuanghui Group for further analysis; finally, we put forward relevant proposals for the enterprise crisis from the view of stakeholders.

Knowledge communication: a key to successful crisis management.

PubMed

Johansson, Anders; Härenstam, Malin

2013-09-01

A winning concept of crisis management can be summarized in 2 words: knowledge communication. If decision makers, communicators, experts, and the public understand what the crisis is about and share their knowledge, the process of handling it will be optimized. Effective crisis communication implies the necessity of an unhindered but purposeful exchange of information within and between authorities, organizations, media, involved individuals, and groups before, during, and after a crisis. This article focuses on the importance of the before, or prevention, part of a crisis since it holds a rich possibility to enhance the chances for successful crisis management of a bioterrorism incident. An extended perspective on crisis communication efficiently links to a more thorough understanding of risk perception with various stakeholders and the public, which also will be helpful for situational awareness. Furthermore, the grounded baseline for the dialogue type of crisis communication suitable in modern society and to modern social media is achieved by linking to those risk communication efforts that are made. The link between risk and crisis should be afforded more attention since, especially in biosecurity, there would be no crisis without risk negligence and poor or malfunctioning preventive efforts.

Factors associated with suicidal ideation and attempts in Spain for different age groups. Prevalence before and after the onset of the economic crisis.

PubMed

Miret, Marta; Caballero, Francisco Félix; Huerta-Ramírez, Raúl; Moneta, María Victoria; Olaya, Beatriz; Chatterji, Somnath; Haro, Josep Maria; Ayuso-Mateos, José Luis

2014-07-01

Little is known about whether the prevalence of suicidal ideation and attempts has changed in the wake of the economic crisis. The aim of this study was to estimate current prevalence of suicidal ideation and attempts in the general population in Spain, to compare it with the prevalence found before the economic crisis, and to analyse the factors associated with suicidality in different age groups. A total of 4583 non-institutionalised adults were interviewed in a cross-sectional household survey of a nationally representative sample in Spain. Several modules of an adapted version of the Composite International Diagnostic Interview were administered to the participants, and logistic regression models were employed in each age group. Lifetime prevalence of suicidal ideation and attempts in Spain were respectively, 3.67% and 1.46%. Mental disorders presented the highest significant effects on lifetime suicidal ideation. Marital status, heavy alcohol consumption, and occupational status were associated with lifetime suicidal ideation in people aged 18-49, whereas loneliness was associated with the 50-64 group, and financial problems with the 65+ group. A younger age, poor health status and the presence of depression were all associated with lifetime suicide attempts. The cross-sectional design of the study represents a methodological limitation. The current prevalence of suicidal ideation and attempts in Spain is similar to the one found ten years ago, before the recent economic crisis. The factors associated with suicidality vary among age groups. Suicide prevention programmes should focus on early detection and prevention for depression and anxiety disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

Focus group discussions on the coverage of the southern separatist movement crisis in Yemeni newspapers.

PubMed

Al-Majdhoub, Fatima Mohamed; Hamzah, Azizah Binti; Ariffin, Moh Yahya

2015-01-01

A qualitative method using focus group discussions (FGDs) was applied in this study to identify people's perceptions on newspaper reporting pertaining to the Southern Separatist Movement (SSM) by different Yemeni newspapers. This paper also looked into the attitudes towards the movement and the popularity of the issue of Yemeni unification. Five FGD groups with a total of 30 participants discussed the subject and some other aspects related to it. The findings of the focu19 groups showed that the southern crisis and SSM had shaken the people's trust on the current form of the unity. The discussion with the groups revealed that media in general and the selected four papers from various political persuasions have no credibility and objectivity, but these papers are trying to instill democratic values which is consistent with their ideology, which have a serious impact on the value of liberal democracy. The participants assured that reporting on the southern cause and the SSM indicated the absence of professional journalism in the media and the political discourse in general.

Spanning trees and the Eurozone crisis

NASA Astrophysics Data System (ADS)

Dias, João

2013-12-01

The sovereign debt crisis in the euro area has not yet been solved and recent developments in Spain and Italy have further deteriorated the situation. In this paper we develop a new approach to analyze the ongoing Eurozone crisis. Firstly, we use Maximum Spanning Trees to analyze the topological properties of government bond rates’ dynamics. Secondly, we combine the information given by both Maximum and Minimum Spanning Trees to obtain a measure of market dissimilarity or disintegration. Thirdly, we extend this measure to include a convenient distance not limited to the interval [0, 2]. Our empirical results show that Maximum Spanning Tree gives an adequate description of the separation of the euro area into two distinct groups: those countries strongly affected by the crisis and those that have remained resilient during this period. The measures of market dissimilarity also reveal a persistent separation of these two groups and, according to our second measure, this separation strongly increased during the period July 2009-March 2012.

Crisis Communication and Management: Surviving a Public Relations Crisis

ERIC Educational Resources Information Center

Eramo, Eric M.

2009-01-01

Crisis management, or crisis communication, is never a good thing for a business to experience. It is, however, a public relations' professional moment to shine and put their honed skills to good use. A good crisis management plan is not only action during the crisis but preparation and reflection. Hiring a PR firm that deals with crisis…

[Impact of the economic crisis on the activity of a clinical research ethics committee].

PubMed

Redondo Capafons, S; Arcenillas, Paula; Giménez, Nuria; March López, Pablo; Soriano, Laura; Pla, Ramon; Quintana, Salvador

2014-11-03

Analyze the impact of economic and social crisis in volume and funding of clinical trials (CT) and observational studies (ES) from the activity of an Research Ethics Committee (REC). REC memories 2003-2012 were reviewed. Financing of evaluated projects, CT and OS were analyzed classifying them into four groups: 1) promoted by pharmaceutical industry, 2) by scientific societies with industry support, 3) by scientific societies with government support and 4) unfunding.Two periods were compared: pre-crisis (2003-2007) and crisis (2008-2012). During 10 studied years, 744 protocols were evaluated: a 71% of group 1, a 9% of group 2, a 3% of group 3 and a 17% was no funding. Regarding OS, 40%, 5,4%, 8,6% and 46% were the groups 1, 2, 3 and 4 respectively. Analyzing crisis versus pre-crisis period, statistically significant differences were observed in the decreasing of number of CT phase 2 and 3 and in the rising EO. Comparing crisis related to the pre-crisis period, the Group 4 increased statistically significantly. Evolution of total number of studies evaluated by REC tends to be maintained and even increased over time. REC maintains its activity and even increased at the expense of financing and unfunded OS. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Determination of plasma volume by indocyanine green--validation of the method and use in patients after cardiopulmonary bypass.

PubMed

Menth-Meier, S E; Imoberdorf, R; Regli, B; Kipfer, B; Turgay, M; Ballmer, P E

2001-05-01

Validation of plasma volume (PV) determination by indocyanine green (ICG) in comparison to the gold-standard method with radioiodinated albumin, and investigation of the effect of commonly used plasma expanders (albumin, hydroxyethyl starch, and polygelatine) on PV in the early postoperative phase in patients undergoing cardiac surgery. Prospective clinical study. Department of medicine and intensive care unit at a university hospital. Ten healthy volunteers and 21 patients after elective open-heart surgery. PV of subjects was measured by i.v. injecting 5 microCi [125I]albumin (I-ALB). One hour later, PV was determined by a peripheral i. v. injection of 0.25 mg/kg body weight ICG (ICG1). In five subjects PV was measured repeatedly by ICG (ICG2) 1 h after ICG1. Mean PV of I-ALB and ICG1 or ICG2 showed consistent results. Further, we investigated central vs peripheral intravenous injection of ICG in six patients after open-heart surgery compared to [125I]albumin. There was no difference between mean PV measured by [125I]albumin and peripheral ICG (P = 0.40). PV determined by central injection of ICG was significantly higher than by the other methods. In 15 patients PV was determined by [125I]albumin. Thereafter, patients were randomly divided into three groups. Group ALB was infused with 1.75 ml/kg body weight human albumin 20%, group HAES with 5.25 ml/kg body weight hydroxyethyl starch 6%, and group HAEM with 7.0 ml/kg body weight polygelatine 3.5%. PV was measured 1 h and 4 h after infusion by ICG. There were no significant changes in PV between the groups. PV determination by peripheral i. v. injection of ICG produced reliable and consistent results when a reactive hyperaemia was produced by a tourniquet prior to injection. Therefore, central venous injection of ICG may not be prerequisite for precise measurements of PV. The expected acute increase in PV after infusion of commonly used plasma expanders after cardiac surgery was not found.

First-attack pediatric hypertensive crisis presenting to the pediatric emergency department.

PubMed

Yang, Wen-Chieh; Zhao, Lu-Lu; Chen, Chun-Yu; Wu, Yung-Kang; Chang, Yu-Jun; Wu, Han-Ping

2012-12-31

Hypertensive crisis in children is a relatively rare condition presenting with elevated blood pressure (BP) and related symptoms, and it is potentially life-threatening. The aim of this study was to survey children with first attacks of hypertensive crisis arriving at the emergency department (ED), and to determine the related parameters that predicted the severity of hypertensive crisis in children by age group. This was a retrospective study conducted from 2000 to 2007 in pediatric patients aged 18 years and younger with a diagnosis of hypertensive crisis at the ED. All patients were divided into four age groups (infants, preschool age, elementary school age, and adolescents), and two severity groups (hypertensive urgency and hypertensive emergency). BP levels, etiology, severity, and clinical manifestations were analyzed by age group and compared between the hypertensive emergency and hypertensive urgency groups. The mean systolic/diastolic BP in the hypertensive crisis patients was 161/102 mmHg. The major causes of hypertensive crisis were essential hypertension, renal disorders and endocrine/metabolic disorders. Half of all patients had a single underlying cause, and 8 had a combination of underlying causes. Headache was the most common symptom (54.5%), followed by dizziness (45.5%), nausea/vomiting (36.4%) and chest pain (29.1%). A family history of hypertension was a significant predictive factor for the older patients with hypertensive crisis. Clinical manifestations and severity showed a positive correlation with age. In contrast to diastolic BP, systolic BP showed a significant trend in the older children. Primary clinicians should pay attention to the pediatric patients who present with elevated blood pressure and related clinical hypertensive symptoms, especially headache, nausea/vomiting, and altered consciousness which may indicate that appropriate and immediate antihypertensive medications are necessary to prevent further damage.

First-attack pediatric hypertensive crisis presenting to the pediatric emergency department

PubMed Central

2012-01-01

Background Hypertensive crisis in children is a relatively rare condition presenting with elevated blood pressure (BP) and related symptoms, and it is potentially life-threatening. The aim of this study was to survey children with first attacks of hypertensive crisis arriving at the emergency department (ED), and to determine the related parameters that predicted the severity of hypertensive crisis in children by age group. Methods This was a retrospective study conducted from 2000 to 2007 in pediatric patients aged 18 years and younger with a diagnosis of hypertensive crisis at the ED. All patients were divided into four age groups (infants, preschool age, elementary school age, and adolescents), and two severity groups (hypertensive urgency and hypertensive emergency). BP levels, etiology, severity, and clinical manifestations were analyzed by age group and compared between the hypertensive emergency and hypertensive urgency groups. Results The mean systolic/diastolic BP in the hypertensive crisis patients was 161/102 mmHg. The major causes of hypertensive crisis were essential hypertension, renal disorders and endocrine/metabolic disorders. Half of all patients had a single underlying cause, and 8 had a combination of underlying causes. Headache was the most common symptom (54.5%), followed by dizziness (45.5%), nausea/vomiting (36.4%) and chest pain (29.1%). A family history of hypertension was a significant predictive factor for the older patients with hypertensive crisis. Clinical manifestations and severity showed a positive correlation with age. In contrast to diastolic BP, systolic BP showed a significant trend in the older children. Conclusions Primary clinicians should pay attention to the pediatric patients who present with elevated blood pressure and related clinical hypertensive symptoms, especially headache, nausea/vomiting, and altered consciousness which may indicate that appropriate and immediate antihypertensive medications are necessary to

Serum ferritin concentration in sickle cell crisis.

PubMed Central

Brownell, A; Lowson, S; Brozović, M

1986-01-01

Serum ferritin, aspartate aminotransferase (AST), alkaline phosphatase and hydroxybutyrate dehydrogenase (HBD) were studied during 21 vaso-occlusive crises in 12 adults with sickle cell disease (11 SS, 1 S beta degrees). The patients comprised three groups: those who had been untransfused (4), those who had received occasional exchange transfusion in crisis (3), and those who had been multiply transfused (5). Serum ferritin concentrations in crisis were compared with those of the steady state value. Rises in serum ferritin concentrations occurred in all crises in all groups. Although AST, alkaline phosphatase, and HBD rose, there was no correlation between these and log ferritin concentrations. The clinical impression was that the degree of rise in ferritin related to the severity of the particular crisis, and the above results showed that haemolysis and liver damage were not causally related to this rise. An estimate of serum ferritin cannot be used to assess the state of iron balance in sickle cell disease unless the patient is in the steady state. The considerable rise in serum ferritin concentration found in crisis, however, may be a useful marker of the extent of vaso-occlusion and tissue damage. PMID:3958215

Using impedance cardiography to detect subclinical cardiovascular disease in women with multiple risk factors: a pilot study.

PubMed

Demarzo, Arthur P

2009-01-01

Early detection of cardiovascular disease (CVD) could initiate appropriate treatment and prevent progression. This study used impedance cardiography (ICG) waveform analysis with postural change to detect functional CVD in women older than 40 years with no history of CVD and >or=2 of the following risk factors: cigarette smoking, poor diet, physical inactivity, central adiposity, family history of premature CVD, hypertension, and dyslipidemia. A study group of 32 women underwent ICG in standing and supine positions. An age-matched control group had 20 women with an active lifestyle, no risk factors, and no history of CVD. All women in the control group had normal ICG data. All women in the study group had some abnormal ICG data, with 28 (87.5%) having multiple ICG abnormalities. ICG data indicated that 13 (40.6%) had ventricular dysfunction, 14 (43.8%) had high vascular resistive load, and 30 (93.8%) had elevated vascular pulsatile load. The data suggest that subclinical CVD, detectable by ICG, is prevalent in women older than 40 years with multiple risk factors. Abnormal ICG results could expedite the initiation of customized treatment as part of a preventive approach to CVD. (c) 2009 Wiley Periodicals, Inc.

Preparing for a Crisis.

ERIC Educational Resources Information Center

Perea, Rosalie D.; Morrison, Shirley

1997-01-01

To handle unforeseen crises, Albuquerque Public Schools established a critical-incident response team with a simple, understandable chain of command. The group aims to ensure maximum safety and people' well-being, develop a districtwide crisis-response-management plan, coordinate necessary training, and collaborate with community agencies…

Surgical Crisis Management Skills Training and Assessment

PubMed Central

Moorthy, Krishna; Munz, Yaron; Forrest, Damien; Pandey, Vikas; Undre, Shabnam; Vincent, Charles; Darzi, Ara

2006-01-01

Background: Intraoperative surgical crisis management is learned in an unstructured manner. In aviation, simulation training allows aircrews to coordinate and standardize recovery strategies. Our aim was to develop a surgical crisis simulation and evaluate its feasibility, realism, and validity of the measures used to assess performance. Methods: Surgical trainees were exposed to a bleeding crisis in a simulated operating theater. Assessment of performance consisted of a trainee’s technical ability to control the bleeding and of their team/human factors skills. This assessment was performed in a blinded manner by 2 surgeons and one human factors expert. Other measures consisted of time measures such as time to diagnose the bleeding (TD), inform team members (TT), achieve control (TC), and close the laceration (TL). Blood loss was used as a surrogate outcome measures. Results: There were considerable variations within both senior (n = 10) and junior (n = 10) trainees for technical and team skills. However, while the senior trainees scored higher than the juniors for technical skills (P = 0.001), there were no differences in human factors skills. There were also significant differences between the 2 groups for TD (P = 0.01), TC (P = 0.001), and TL (0.001). The blood loss was higher in the junior group. Conclusions: We have described the development of a novel simulated setting for the training of crisis management skills and the variability in performance both in between and within the 2 groups. PMID:16794399

Changes of vasoactive polypeptides during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage.

PubMed

Wang, Zhi; Wang, Xue-feng; Wang, Chao; Luan, Wen-zhong

2007-12-05

Hypertensive crisis could be found after operation in patients with hypertensive intracerebral hemorrhage (HICH). The aim of this study was to explore the changes and the roles of some vasoactive polypeptides during postoperative hypertensive crisis in patients with HICH. A total of 31 patients, who were admitted for craniotomy, were enrolled into this study. After the operation, the patients were divided into three groups. Group I consisted of 9 patients with postoperative hypertensive crisis, and group II was composed of 13 patients without postoperative hypertensive crisis. Nine patients, who denied history of hypertension or HICH, were set as group III. The levels of some vasoactivators in the three groups were measured before and after the operation. The differences in the results among the groups were analyzed using the ANOVA. The data collected before and after the operation in the group I was compared by Wilcoxon test. The concentration of endothelin in group I was significantly higher than that in group III (P < 0.05). The level of thromboxane A2 and the ratio of thromboxane B2 to 6-keto-PGF1a in group I were significantly higher than those in the other two groups (P < 0.05). In group I, the levels of plasma renin activity, angiotensin II, aldosterone, catecholamine, and endothelin before the operation were significantly higher than those determined after the operation (P > 0.05). Postoperative hypertensive crisis may be due to the increased thromboxane A2 and relatively inadequate prostacyclin, especially 6-keto-PGF1a. The increased level of endothelin and intraoperative stimulation also play a certain role in the development of postoperative hypertensive crisis.

The financial crisis in Europe: Impact on satisfaction with life.

PubMed

Clench-Aas, Jocelyne; Holte, Arne

2017-08-01

The 2008 financial crisis in Europe came abruptly and surprisingly. Many countries also suffered a second recession during the period 2010-2012. We examined the impact of the crisis on life satisfaction (LS) by country and individual socioeconomic level. We used a representative sample from the European Social Survey (2002-2014) with data from 26 countries ( N = 294,407). LS was measured with a single question with 11 response alternatives. Time from start of crisis (either 2008 or 2010-2012) was determined separately for each interview. Data were analyzed by multilevel analysis Results: There was a sharp decrease in LS in the beginning of the crisis in 2008, and another, but not so severe, decline in 2011, each of them of short duration. However, there was also a slight and progressive yearly decrease in LS that continued one to at least 3 years after either financial crisis that was independent of the effect of being unemployed. Associations varied considerably between countries. A negative decline after the financial crisis was especially evident among those in the most educated groups, and in those in the higher occupational levels. The 2008 financial crisis had a double effect on LS: (1) a sharp short-term decrease consistent with the Easterlin paradox; (2) a slighter long-term progressive decrease that was over and above the strong negative relationship with unemployment that lasted several years. The long-term decline in LS after the start of the financial crisis tended to occur especially in the higher socioeconomic groups.

School Crisis Management: A Model of Dynamic Responsiveness to Crisis Life Cycle

ERIC Educational Resources Information Center

Liou, Yi-Hwa

2015-01-01

Purpose: This study aims to analyze a school's crisis management and explore emerging aspects of its response to a school crisis. Traditional linear modes of analysis often fail to address complex crisis situations. The present study applied a dynamic crisis life cycle model that draws on chaos and complexity theory to a crisis management case,…

Visualized Evaluation of Blood Flow to the Gastric Conduit and Complications in Esophageal Reconstruction.

PubMed

Noma, Kazuhiro; Shirakawa, Yasuhiro; Kanaya, Nobuhiko; Okada, Tsuyoshi; Maeda, Naoaki; Ninomiya, Takayuki; Tanabe, Shunsuke; Sakurama, Kazufumi; Fujiwara, Toshiyoshi

2018-03-01

Evaluation of the blood supply to gastric conduits is critically important to avoid complications after esophagectomy. We began visual evaluation of blood flow using indocyanine green (ICG) fluorescent imaging in July 2015, to reduce reconstructive complications. In this study, we aimed to statistically verify the efficacy of blood flow evaluation using our simplified ICG method. A total of 285 consecutive patients who underwent esophagectomy and gastric conduit reconstruction were reviewed and divided into 2 groups: before and after introduction of ICG evaluation. The entire cohort and 68 patient pairs after propensity score matching (PS-M) were evaluated for clinical outcomes and the effect of visualized evaluation on reducing the risk of complication. The leakage rate in the ICG group was significantly lower than in the non-ICG group for each severity grade, both in the entire cohort (285 subjects) and after PS-M; the rates of other major complications, including recurrent laryngeal nerve palsy and pneumonia, were not different. The duration of postoperative ICU stay was approximately 1 day shorter in the ICG group than in the non-ICG group in the entire cohort, and approximately 2 days shorter after PS-M. Visualized evaluation of blood flow with ICG methods significantly reduced the rate of anastomotic complications of all Clavien-Dindo (CD) grades. Odds ratios for ICG evaluation decreased with CD grade (0.3419 for CD ≥ 1; 0.241 for CD ≥ 2; and 0.2153 for CD ≥ 3). Objective evaluation of blood supply to the reconstructed conduit using ICG fluorescent imaging reduces the risk and degree of anastomotic complication. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

The International Commission on Geoheritage (ICG) and the Heritage Sites and Collections Subcommission (HSCS): A new global framework for advancing the science and practice of geodiversity conservation

NASA Astrophysics Data System (ADS)

Page, Kevin; de Wever, Patrick

2017-04-01

The ICG is a new Scientific Commission within IUGS, established at the 35th IGC, Cape Town, South Africa, in August 2016. The ICG was incorporates two pre-existing Task Groups, on Geoheritage (TGG) and the Heritage Stones (HSTG), now transformed into, respectively, the Heritage Sites and Collections Subcommission (HSCS) (http://geoheritage-iugs.mnhn.fr) and the Heritage Stones Subcommission (HSS) (http://globalheritagestone.com/). Although the latter focuses on culturally significant geological heritage resources, its recognition and selection of Global Heritage Stone Resources (GHSR) demonstrates the close symbiosis that exists between the two Subcommissions. The HSTG, however, will focus on those aspects of Geodiversity and Geoheritage associated with natural geological materials and processes, both in-situ (e.g. within 'geosites') and ex-situ in institutional collections - and hence, primarily facets of a natural rather than a cultural heritage. Although the foundations of an appreciation of this aspect of natural heritage conservation go back to at least the late 19th century, it was not until the 1980s that international collaborations began to develop, for instance in Europe, leading to the formation of ProGEO in Europe in 1993, with other groups, often focussed on specific tasks, developing in Africa, Australasia and within IUGS, UNESCO and IUCN. Nevertheless, until the GTG was formed in 2008, there had been no explicitly global focus for all aspects of geological heritage and its sustainable management. The GTG began the process of building a global resource for Geoheritage sites and collections through the establishment of a comprehensive website, including a review of national conservation legislation, links to national geosite inventories (with interactive maps) and the beginnings of an inventory of 'Global Geosites' (a process first begun, abortively, in the 1990s in IUGS). The work of the GTG has confirmed within IUGS the significance of Geoheritage as

Hyperglycemic crisis.

PubMed

Van Ness-Otunnu, Ronald; Hack, Jason B

2013-11-01

Hyperglycemic crisis is a metabolic emergency associated with uncontrolled diabetes mellitus that may result in significant morbidity or death. Acute interventions are required to manage hypovolemia, acidemia, hyperglycemia, electrolyte abnormalities, and precipitating causes. Despite advances in the prevention and management of diabetes, its prevalence and associated health care costs continue to increase worldwide. Hyperglycemic crisis typically requires critical care management and hospitalization and contributes to global health expenditures. Diagnostic and resolution criteria and management strategies for diabetic ketoacidosis and hyperosmolar hyperglycemic crisis are provided. A discussion of prevalence, mortality, pathophysiology, risk factors, clinical presentation, differential diagnosis, evaluation, and management considerations for hyperglycemic crisis are included. Emergency physicians confront the most severe sequelae of uncontrolled diabetes and provide crucial, life-saving management. With ongoing efforts from diabetes societies to incorporate the latest clinical research to refine treatment guidelines, management and outcomes of hyperglycemic crisis in the emergency department continue to improve. We provide an overview of the evaluation and treatment of hyperglycemic crisis and offer a concise, targeted management algorithm to aid the practicing emergency physician. Copyright © 2013 Elsevier Inc. All rights reserved.

Predicting psychological ripple effects: the role of cultural identity, in-group/out-group identification, and attributions of blame in crisis communication.

PubMed

Anagondahalli, Deepa; Turner, Monique Mitchell

2012-04-01

Incidents of intentional food contamination can produce ripple effects in consumers such as reduced trust and increased anxiety. In their postcrisis communication, food companies often direct the blame at the perpetrator in an effort to mitigate potential losses and regain consumer trust. The attempt to placate consumers may, in itself, potentially create psychological ripple effects in message readers. This study examined the interacting influence of two message characteristics: identity of the perpetrator of the crime (in-group/out-group membership), and the attribution of blame (reason why the perpetrator committed the crime), with message receiver characteristic (cultural identity) on psychological ripple effects such as blame, trust, anxiety, and future purchase intention. Results indicated that although group membership of the perpetrator was not significant in predicting outcomes for the organization, the attribution communicated in the message was. American message receivers blamed the organization more and trusted it less when personal dispositional attributions were made about the perpetrator. Asian message receivers blamed the organization more and trusted it less when situational attributions were made about the perpetrator. Lowered trust in the company and increased anxiety correlated with lower purchase intent for both American and Asian message receivers. Implications for crisis message design are discussed. © 2011 Society for Risk Analysis.

Entrococcus faecalis Elimination in Root Canals Using Silver Nanoparticles, Photodynamic Therapy, Diode Laser, or Laser-activated Nanoparticles: An In Vitro Study.

PubMed

Afkhami, Farzaneh; Akbari, Saba; Chiniforush, Nasim

2017-02-01

The aim of this study was to compare the efficacy of silver nanoparticles (AgNPs), an 810-nm diode laser (DL), conventional photodynamic therapy (PDT) with the use of indocyanine green (ICG) photosensitizer, and modified PDT with the use of AgNPs for the disinfection of root canals inoculated with Enterococcus faecalis. The root canals of 65 extracted human single-rooted teeth were prepared, and E. faecalis was incubated in the root canals for 4 weeks. The teeth were then randomly divided into the following 4 experimental groups: the DL group: 810-nm DL irradiation (1 W, 4 times for 10 seconds), the AN group: 5 minutes of irrigation with 5 mL AgNPs (100 ppm), the ICG/DL group: conventional PDT with ICG (1 mg/mL)/810-nm DL (200 mW, 30 seconds), and the AN/ICG/DL group: modified PDT with AgNPs/ICG/810-nm DL (200 mW, 30 seconds). There was also a control group, which consisted of 5 minutes of irrigation with 5 mL 2.5% sodium hypochlorite (n = 9). Samples were obtained from dentin chips before and after the interventions. A reduction in colony count was assessed by counting the colony-forming units. Significant reductions were noted in E. faecalis colony counts in all groups (P < .05). The greatest reduction in colony count (99.12%) was noted in the AN/ICG/DL group (AgNPs/ICG/810-nm diode laser); however, the differences in this respect between the AN/ICG/DL group and the DL (97.41%), AN (94.42%), and control groups (94.61%) were not significant (P > .05). PDT with ICG, an 810-nm diode laser, and AgNPs has the potential to be used as an adjunct for disinfection of the root canal system. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The implementation of psychiatric advance directives: experiences from a Dutch crisis card initiative.

PubMed

van der Ham, Alida J; Voskes, Yolande; van Kempen, Nel; Broerse, Jacqueline E W; Widdershoven, Guy A M

2013-06-01

The crisis card is a specific form of psychiatric advance directive, documenting mental clients' treatment preferences in advance of a potential psychiatric crisis. In this paper, we aim to provide insight into implementation issues surrounding the crisis card. A Dutch crisis-card project formed the scope of this study. Data were collected through interviews with 15 participants from six stakeholder groups. Identified implementation issues are: (a) The role of the crisis-card counselor, (b) lack of distribution and familiarity, (c) care professionals' routines, and (d) client readiness. The crisis-card counselor appears to play a key role in fostering benefits of the crisis card by supporting clients' perspectives. More structural integration of the crisis card in care processes may enhance its impact, but should be carefully explored. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Changes of TXA2 and PGI2 during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage.

PubMed

Wang, Zhi; Wang, Chao; Zhang, Weiguang; Wang, Laizang; Lei, Ting

2008-02-01

In order to explore the changes and the roles of TXA2 and PGI2 during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage, 31 cases subject to craniotomy were divided into three groups: group A, 9 patients with postoperative hypertensive crisis; group B, 13 patients without postoperative hypertensive crisis; and group C, 9 patients without history of hypertension and hypertensive intracerebral hemorrhage. TXA2, TXB2, 6-keto-PGF1 alpha and PGI2 were measured after operation in the three groups respectively. The postoperative blood pressure in group A, including SBP and DBP, was elevated more obviously than that in the other two groups. TXA2 and PGI2 in group A were significantly higher than those in other two groups (P<0.01). Moreover, the ratio of TXB2 to 6-keto-PGF1 alpha in group A was significantly higher than that in other two groups (P<0.05). The increase of TXA2 and the relative inadequacy of prostacyclin, especially 6-keto-PGF1 alpha, may play roles in the postoperative hypertensive crisis. And the increased value of TXB2 to 6-keto-PGF1 alpha could provide the basis for diagnosis of postoperative hypertensive crisis.

Admission to women's crisis houses or to psychiatric wards: women's pathways to admission.

PubMed

Howard, Louise M; Rigon, Elena; Cole, Laura; Lawlor, Caroline; Johnson, Sonia

2008-12-01

This study compared the sociodemographic and clinical characteristics and pathways to admission for women admitted to women's crisis houses and to psychiatric hospitals. A women's crisis house is a residential mental health crisis facility for women who would otherwise be considered for voluntary hospital admission. A survey of all 388 female admissions to women's crisis houses and psychiatric hospitals in four boroughs of London during a 12-week period in 2006 was conducted with questionnaires administered to key workers involved in the admissions. Pathways to admission were significantly less complex for women admitted to the crisis houses (fewer preadmission contacts with police, emergency departments, and other services). Women admitted to psychiatric wards were more likely to require supervision or observation. A multivariate analysis of data for the 245 voluntary admissions indicated that women admitted to women's crisis houses were significantly less likely to have a care coordinator (odds ratio [OR]=.528) or to have gone to an accident and emergency department (OR=.214) before admission. No other differences were found between the two groups. Pathways to admission were somewhat different for women admitted to women's crisis houses, but few clinical or sociodemographic differences were found between the two groups. Women's crisis houses may be a viable alternative to traditional wards for voluntary patients not needing intensive supervision and observation. Research should examine whether women's crisis houses are as effective as traditional inpatient services in treating women with acute psychiatric problems.

An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers.

PubMed

Kalafat, John; Gould, Madelyn S; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie

2007-06-01

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted.

Crisis communication: an inequalities perspective on the 2010 Boston water crisis.

PubMed

Galarce, Ezequiel M; Viswanath, K

2012-12-01

Although the field of crisis risk communication has generated substantial research, the interaction between social determinants, communication processes, and behavioral compliance has been less well studied. With the goal of better understanding these interactions, this report examines how social determinants influenced communications and behavioral compliance during the 2010 Boston, Massachusetts, water crisis. An online survey was conducted to assess Boston residents' knowledge, beliefs, attitudes, mass and interpersonal communication, and preventive behaviors on emergency preparedness topics dealing with the water crisis. Of a total sample of 726 respondents, approximately one-third (n = 267) reported having been affected by the water crisis. Only data from affected participants were analyzed. Following an order to boil water, 87.5% of respondents refrained from drinking unboiled tap water. These behaviors and other cognitive and attitudinal factors, however, were not uniform across population subgroups. All communication and behavioral compliance variables varied across sociodemographic factors. Crisis communication, in conjunction with other public health preparedness fields, is central to reducing the negative impact of sudden hazards. Emergency scenarios such as the Boston water crisis serve as unique opportunities to understand how effectively crisis messages are conveyed to and received by different segments of the population.

Crisis intervention for people with severe mental illnesses.

PubMed

Murphy, Suzanne M; Irving, Claire B; Adams, Clive E; Waqar, Muhammad

2015-12-03

A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis-intervention models of care were developed as a possible solution. To review the effects of crisis-intervention models for anyone with serious mental illness experiencing an acute episode compared to the standard care they would normally receive. If possible, to compare the effects of mobile crisis teams visiting patients' homes with crisis units based in home-like residential houses. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. There is no language, time, document type, or publication status limitations for inclusion of records in the register. This search was undertaken in 1998 and then updated 2003, 2006, 2010 and September 29, 2014. We included all randomised controlled trials of crisis-intervention models versus standard care for people with severe mental illnesses that met our inclusion criteria. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assessed risk of bias for included studies and used GRADE to create a 'Summary of findings' table. The update search September 2014 found no further new studies for inclusion, the number of studies included in this review remains eight with a total of 1144 participants. Our main outcomes of interest are hospital use, global state, mental state, quality of life, participant satisfaction and family burden. With the exception of mental state, it was not possible to pool data for these outcomes.Crisis intervention may reduce repeat admissions to hospital (excluding index admissions) at six months (1 RCT, n = 369, RR 0.75 CI 0.50 to 1.13, high quality evidence), but does appear to reduce family burden (at six months: 1 RCT, n = 120, RR 0.34 CI 0.20 to 0.59, low quality evidence), improve

[Hypertensive crisis in infancy and childhood].

PubMed

Wirbelauer, J; Strotmann, J; Kirchhoff, A; Darge, K; Thomas, W

2008-01-01

The extended physical examination of a patient includes measurement of blood pressure. In infancy and childhood the blood pressure measurement may be difficult due to an uncooperative and restless patient. In a 16-month-old girl apparently unmeasurable blood pressure was a hypertensive crisis with systolic blood pressure of more than 200 mmHg. The cause of the hypertension was found to be a nephroblastoma. In the case of rapidly progressive arterial hypertension in another 16-month-old girl with left ventricular dilatation and reduced function was a consequence of kidney dysplasia. Headache attacks lead to diagnosis of a subtotal coarctation of the aortic isthmus in a 17-year-old boy. Hypertensive crisis in infancy, childhood and adolescence is discussed based on these case reports. Special features of blood pressure measurement in the pediatric age group, pathogenesis of hypertensive crisis and the potential therapies are discussed incorporating a brief review of the literature.

Crisis management strategies.

PubMed

Koster, Maria C; Politis-Norton, Helen

2004-01-01

This paper discusses the different facets of crisis as experienced within the pharmaceutical industry but which are also prevalent throughout other industries. It highlights the importance of early identification and management of crises and issues, which in return are strongly intertwined with a fundamental positive internal corporate climate. A corporate philosophy should always embrace crisis management with the attitude of 'when' and not 'if'; therefore, a company should act today and not tomorrow once a crisis is on its doorstep. Preparation is of utmost importance and there are several items that can be addressed even before a crisis has arisen. Further, this paper also provides guidance on how to deal with the media, what to do and what not to do, and how to appoint the appropriate spokesperson. In this era of fast exchange of information, crisis, which previously may have stayed behind corporate doors, may not do so any longer. Image is very important and should therefore not be risked. Crisis and issue management should therefore be integrated in every company's philosophy and standard operating procedures.

Health outcomes during the 2008 financial crisis in Europe: systematic literature review.

PubMed

Parmar, Divya; Stavropoulou, Charitini; Ioannidis, John P A

2016-09-06

 To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes.  Systematic literature review.  Structural searches of key databases, healthcare journals, and organisation based websites.  Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis.  41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed.  Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

Combined use of fluorescence with a magnetic tracer and dilution effect upon sentinel node localization in a murine model.

PubMed

Kuwahata, Akihiro; Ahmed, Muneer; Saeki, Kohei; Chikaki, Shinichi; Kaneko, Miki; Qiu, Wenqi; Xin, Zonghao; Yamaguchi, Shinji; Kaneko, Akiko; Douek, Michael; Kusakabe, Moriaki; Sekino, Masaki

2018-01-01

Sentinel node biopsy using radioisotope and blue dye remains a gold standard for axillary staging in breast cancer patients with low axillary burden. However, limitations in the use of radioisotopes have resulted in emergence of novel techniques. This is the first in vivo study to assess the feasibility of combining the two most common novel techniques of using a magnetic tracer and indocyanine green (ICG) fluorescence. A total of 48 mice were divided into eight groups. Groups 1 and 2, the co-localization groups, received an injection of magnetic tracers (Resovist ® and Sienna+ ® , respectively) and ICG fluorescence; distilled water was used as the solvent of ICG. Groups 3 and 4, the diluted injection groups, received an injection of magnetic tracers (Resovist and Sienna+, respectively) and saline for dilution. Groups 5, 6, and 7, the control groups, received magnetic tracer (Resovist, Sienna+) and ICG alone, respectively. Fluorescent intensity assessment and iron quantification of excised popliteal lymph nodes were performed. Group 1', a co-localization group, received an injection of magnetic tracers (Resovist) and ICG' fluorescence: saline was used as the solvent for ICG. Lymphatic uptake of all tracers was confined to the popliteal nodes only, with co-localization confirmed in all cases and no significant difference in fluorescent intensity or iron content of ex vivo nodes between the groups (except for Group 1'). There was no impact of dilution on the iron content in the diluted Sienna+ group, but it significantly enhanced Resovist uptake ( P =0.005). In addition, there was a significant difference in iron content ( P =0.003) in Group 1'. The combination of a magnetic tracer (Resovist or Sienna+) and ICG fluorescence is feasible for sentinel node biopsy and will potentially allow for precise transcutaneous node identification, in addition to accurate intraoperative assessment. This radioisotope-free "combined technique" warrants further assessment within a

An Evaluation of Crisis Hotline Outcomes. Part 1: Nonsuicidal Crisis Callers

ERIC Educational Resources Information Center

Kalafat, John; Gould, Madelyn S.; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie

2007-01-01

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed…

Hemolytic crisis

MedlinePlus

Hemolytic crisis occurs when large numbers of red blood cells are destroyed over a short time. The loss of ... During a hemolytic crisis, the body cannot make enough red blood cells to replace those that are destroyed. This causes acute and often ...

[Inconformity between soft tissue defect and bony defect in incomplete cleft palate].

PubMed

Zhou, Xia; Ma, Lian

2014-12-01

To evaluate the inconformity between soft tissue defect and bony defect by observing the cleft extent of palate with complete secondary palate bony cleft in incomplete cleft palate patient. The patients with incomplete cleft palate treated in Hospital of Stomatology Peking University from July 2012 to June 2013 were reviewed, of which 75 cases with complete secondary palate bony cleft were selected in this study. The CT scan and intraoral photograph were taken before operation. The patients were classified as four types according to the extent of soft tissue defect. Type 1: soft tissue defect reached incisive foremen region, Type 2 was hard and soft cleft palate, Type 3 soft cleft palate and Type 4 submucous cleft palate. Type 1 was defined as conformity group (CG). The other three types were defined as inconformity group (ICG) and divided into three subgroups (ICG-I), (ICG-II) and (ICG-III). Fifty-seven patients were in ICG group, and the rate of inconformity was 76% (57/75). The percentage of ICG-I, ICG-II and ICG-III was 47% (27/57), 23% (13/57) and 30% (17/57), respevtively. There are different types of soft tissue deformity with complete secondary palate bony cleft. The inconformity between soft tissue and hard tissue defect exits in 3/4 of isolated cleft palate patients.

Memories of Crisis: Bohr, Kuhn, and the Quantum Mechanical ``Revolution''

NASA Astrophysics Data System (ADS)

Seth, Suman

2013-04-01

``The history of science, to my knowledge,'' wrote Thomas Kuhn, describing the years just prior to the development of matrix and wave mechanics, ``offers no equally clear, detailed, and cogent example of the creative functions of normal science and crisis.'' By 1924, most quantum theorists shared a sense that there was much wrong with all extant atomic models. Yet not all shared equally in the sense that the failure was either terribly surprising or particularly demoralizing. Not all agreed, that is, that a crisis for Bohr-like models was a crisis for quantum theory. This paper attempts to answer four questions: two about history, two about memory. First, which sub-groups of the quantum theoretical community saw themselves and their field in a state of crisis in the early 1920s? Second, why did they do so, and how was a sense of crisis related to their theoretical practices in physics? Third, do we regard the years before 1925 as a crisis because they were followed by the quantum mechanical revolution? And fourth, to reverse the last question, were we to call into the question the existence of a crisis (for some at least) does that make a subsequent revolution less revolutionary?

Phaeochromocytoma [corrected] crisis.

PubMed

Whitelaw, B C; Prague, J K; Mustafa, O G; Schulte, K-M; Hopkins, P A; Gilbert, J A; McGregor, A M; Aylwin, S J B

2014-01-01

Phaeochromocytoma [corrected] crisis is an endocrine emergency associated with significant mortality. There is little published guidance on the management of phaeochromocytoma [corrected] crisis. This clinical practice update summarizes the relevant published literature, including a detailed review of cases published in the past 5 years, and a proposed classification system. We review the recommended management of phaeochromocytoma [corrected] crisis including the use of alpha-blockade, which is strongly associated with survival of a crisis. Mechanical circulatory supportive therapy (including intra-aortic balloon pump or extra-corporeal membrane oxygenation) is strongly recommended for patients with sustained hypotension. Surgical intervention should be deferred until medical stabilization is achieved. © 2013 John Wiley & Sons Ltd.

The usefulness of information and communication technologies in crisis response.

PubMed

Paul, Sharoda A; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher; Deflitch, Christopher J

2008-11-06

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams.

The Usefulness of Information and Communication Technologies in Crisis Response

PubMed Central

Paul, Sharoda A.; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher

2008-01-01

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams. PMID:18998898

Portable widefield imaging device for ICG-detection of the sentinel lymph node

NASA Astrophysics Data System (ADS)

Govone, Angelo Biasi; Gómez-García, Pablo Aurelio; Carvalho, André Lopes; Capuzzo, Renato de Castro; Magalhães, Daniel Varela; Kurachi, Cristina

2015-06-01

Metastasis is one of the major cancer complications, since the malignant cells detach from the primary tumor and reaches other organs or tissues. The sentinel lymph node (SLN) is the first lymphatic structure to be affected by the malignant cells, but its location is still a great challenge for the medical team. This occurs due to the fact that the lymph nodes are located between the muscle fibers, making it visualization difficult. Seeking to aid the surgeon in the detection of the SLN, the present study aims to develop a widefield fluorescence imaging device using the indocyanine green as fluorescence marker. The system is basically composed of a 780nm illumination unit, optical components for 810nm fluorescence detection, two CCD cameras, a laptop, and dedicated software. The illumination unit has 16 diode lasers. A dichroic mirror and bandpass filters select and deliver the excitation light to the interrogated tissue, and select and deliver the fluorescence light to the camera. One camera is responsible for the acquisition of visible light and the other one for the acquisition of the ICG fluorescence. The software developed at the LabVIEW® platform generates a real time merged image where it is possible to observe the fluorescence spots, related to the lymph nodes, superimposed at the image under white light. The system was tested in a mice model, and a first patient with tongue cancer was imaged. Both results showed the potential use of the presented fluorescence imaging system assembled for sentinel lymph node detection.

Before Crisis Hits: Building a Strategic Crisis Plan.

ERIC Educational Resources Information Center

Smith, Larry L.; Millar, Dan P.

This guide offers suggestions to college administrators for dealing with a variety of emergency or crisis situations that could affect a community college's effectiveness. The authors used the Institute for Crisis Management's (ICM) four types of crises in higher education as the framework for the guide. The four types of crises are: (1) sudden;…

EUROPE IN CRISIS

DTIC Science & Technology

2017-04-06

the only international organization that can manage the Syrian refugee security crisis causing problems for the EU from root to branch because NATO is...AIR WAR COLLEGE AIR UNIVERSITY EUROPE IN CRISIS By Peter Halseth, Civilian, Defense Logistics Agency A Research Report Submitted...Syrian refugee crisis and providing intelligence assistance to member countries in the European Union (EU) of foreign fighters returning from the

Sickle Cell Crisis (For Teens)

MedlinePlus

... Safe Videos for Educators Search English Español Sickle Cell Crisis (Pain Crisis) KidsHealth / For Teens / Sickle Cell ... drepanocíticas (Crisis de dolor) What Is a Sickle Cell Crisis? Sickle cell disease changes the shape of ...

Modeling of Economy Considering Crisis

NASA Astrophysics Data System (ADS)

Petrov, Lev F.

2009-09-01

We discuss main modeling's problems of economy dynamic processes and the reason forecast's absence of economic crisis. We present a structure of complexity level of system and models and discuss expected results concerning crisis phenomena. We formulate the basic perspective directions of the mathematical modeling of economy, including possibility of the analysis of the pre crisis, crisis and post crisis phenomena in economic systems.

Near-Infrared Fluorescence Imaging of Liver Metastases in Rats using Indocyanine Green

PubMed Central

van der Vorst, Joost R.; Hutteman, Merlijn; Mieog, Sven D.; de Rooij, Karien E.; Kaijzel, Eric L.; Löwik, Clemens W.G.M.; Putter, Hein; Kuppen, Peter J.K.; Frangioni, John V.; van de Velde, Cornelis J.H.; Vahrmeijer, Alexander L.

2011-01-01

Background Near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) is a promising technique to obtain real-time assessment of the extent and number of colorectal liver metastases during surgery. The current study aims to optimize dosage and timing of ICG administration. Materials and methods Liver tumors were induced in 18 male WAG/Rij rats by subcapsular inoculation of CC531 rat colorectal cancer cells into three distinct liver lobes. Rats were divided in 2 groups: imaging after 24 and 48 hours or 72 and 96 hours after intravenous ICG administration. In each time group, rats were allocated to three dose groups: 0.04, 0.08, or 0.16 mg ICG. Intraoperative imaging and ex vivo measurements were performed using Mini-FLARE™ and confirmed by fluorescence microscopy. Fluorescence intensity was quantified using the Mini-FLARE software and the difference between tumor signal and liver signal (tumor-to-liver ratio; TLR) was calculated. Results In all 18 rats, all colorectal liver metastases (N = 34), some as small as 1.2 mm, were identified using ICG and the Mini-FLARE™ imaging system. Average tumor-to-liver ratio (TLR) over all groups was 3.0 ± 1.2. TLR was significantly higher in the 72 h time group compared to other time points. ICG dose did not significantly influence TLR, but a trend was found favoring the 0.08 mg dose group. Fluorescence microscopy demonstrated a clear fluorescent rim around the tumor. Conclusions This study demonstrates that colorectal cancer liver metastases can be clearly identified during surgery using ICG and the Mini-FLARE™ imaging system, with optimal timing of 72 h post-injection and an optimal dose of 0.08 mg (0.25 mg/kg) ICG. NIR fluorescence imaging has the potential to improve intraoperative detection of micrometastases and thus the completeness of resection. PMID:21396660

Waiting for a Crisis: Case Studies of Crisis Leaders in Higher Education

ERIC Educational Resources Information Center

Muffet-Willett, Stacy L.

2010-01-01

This study examines the system of crisis leadership in higher education. Using case study methods, five crisis leadership participants were interviewed to develop a deep understanding of how they perceive their university crisis leadership system. Two participants were from a private institution, and three were from a public institution. Higher…

Effects of the economic crisis on smoking prevalence and number of smokers in the USA.

PubMed

Gallus, Silvano; Ghislandi, Simone; Muttarak, Raya

2015-01-01

Scanty and controversial information is available on the impact of macroeconomic fluctuations on smoking behaviour. No study has quantified the effects of fiscal crises on smoking prevalence. This study aimed to investigate the effects of the 2007-2008 economic crisis on smoking prevalence and number of smokers in the USA. Using data from the repeated Behavioural Risk Factor Surveillance System (BRFSS) surveys in pre-crisis (2005-2007) and post-crisis (2009-2010) periods on a total of 1,981,607 US adults, we separated the expected (after allowance for the demographic growth of the US population, secular smoking prevalence trends and changes in sociodemographic characteristics) from the unexpected (assumed attributable to the economic crisis) changes in the number of smokers across different employment statuses. Joinpoint regression analysis revealed no significant changes in smoking prevalence trends over the period 2005-2010. The crisis resulted in an increase in the number of smokers in the US by 0.6 million. This is largely due to an unexpected decrease of 1.7 million smokers among employed and an increase of 2.4 million smokers among unemployed individuals, whose smoking prevalence also remains extremely high in the post-crisis period (32.6%). The 2008 financial crisis had a weak effect on smoking prevalence. The pro-cyclical relationship (ie, the crisis results in a lower number of smokers) found among the employed is offset by the counter-cyclical relationship (ie, the crisis results in a higher number of smokers) found among unemployed individuals. Public health interventions should specifically target those in unemployment, particularly in hard times. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Principles to enable leaders to navigate the harsh realities of crisis and risk communication.

PubMed

Reynolds, Barbara J

2010-07-01

Leadership during a crisis that involves the physical safety and emotional or financial wellbeing of those being led offers an intense environment that may not allow for on-the-job training. One of the challenges faced by crisis leaders is to communicate effectively the courses of action needed to allow for a reduction of harm to individuals and the ultimate restoration of the group, organisation or community. The six principles of crisis and emergency risk communication (CERC) give leaders tools to navigate the harsh realities of speaking to employees, media, partners and stakeholders during an intense crisis. CERC also helps leaders to avoid the five most common communication mistakes during crises. Much of the harmful individual and group behaviour predicted in a profound crisis can be mitigated with effective crisis and emergency risk communication. A leader must anticipate what mental stresses followers will be experiencing and apply appropriate communication strategies to attempt to manage these stresses among staff or the public and preserve or repair the organisation's reputation. In an emergency, the right message at the right time is a 'resource multiplier' - it helps leaders to get their job done.

Using impedance cardiography to detect asymptomatic cardiovascular disease in prehypertensive adults with risk factors.

PubMed

DeMarzo, Arthur P

2013-06-01

Early detection of cardiovascular disease (CVD) in prehypertension could initiate appropriate treatment and prevent progression. Impedance cardiography (ICG) is a noninvasive technology that can be used to assess cardiovascular function. This study used ICG waveform analysis with postural change to detect CVD in asymptomatic prehypertensive adults over 40 years of age with no history of CVD and at least 2 cardiovascular risk factors: cigarette smoking, poor diet, physical inactivity, central obesity, family history of premature CVD, elevated blood glucose, and dyslipidemia. A study group of 25 apparently healthy adults was tested by ICG in standing and supine positions. Criteria for an age-matched control group of 16 healthy subjects included an active lifestyle, no risk factor, and no history of CVD. In addition to hemodynamic measurements of systemic vascular resistance (SVR) and cardiac index (CI), ICG used SVR to assess vascular resistive load, an index of arterial compliance and a widening of the systolic waveform to assess vascular pulsatile load, and waveform analysis and measured wave amplitude to detect ventricular dysfunction. All subjects in the study group had some abnormal ICG data, with an average of 2.9 ± 1.5 abnormalities per person. ICG indicated that 24 (96%) had elevated vascular load, 13 (52%) had some type of ventricular dysfunction, and 12 (48%) had abnormal hemodynamics. For the control group, ICG showed none (0%) with elevated vascular load, none (0%) with ventricular dysfunction, and 7 (44%) with high CI. Prehypertensives over 40 years of age with multiple risk factors have different cardiovascular abnormalities. This ICG test could be used as part of a prevention program for early detection of CVD. An abnormal ICG test could expedite the initiation of customized treatment that targets the subclinical CVD.

Psychological Health Before, During, and After an Economic Crisis: Results from Indonesia, 1993 - 2000.

PubMed

Friedman, Jed; Thomas, Duncan

The 1997 Indonesian financial crisis resulted in severe economic dislocation and political upheaval, and the detrimental consequences for economic welfare, physical health, and child education have been established in several studies. The crisis also adversely impacted the psychological well-being of the Indonesian population. Comparing responses of the same individuals interviewed before and after the crisis, we document substantial increases in several different dimensions of psychological distress among male and female adults across the entire age distribution. In addition, the imprint of the crisis can be seen in the differential impacts of the crisis on low education groups, the rural landless, and residents in those provinces that were most affected by the crisis. Elevated levels of psychological distress persist even after indicators of economic well-being such as household consumption had returned to pre-crisis levels, suggesting the deleterious effects of the crisis on the psychological well-being of the Indonesian population may be longer lasting than the impacts on economic well-being.

[Crisis in the valuation, emotional labor and occupational burnout among teachers of religion].

PubMed

Lachowska, Bogusława; Starczewski, Karol

2015-01-01

This article presents an analysis of the relationship between the crisis of values and in the valuation, the strategy of emotional labor, and occupational burnout in the group of lay teachers of religion. In addition, the role of emotional labor as a mediator of the relationship between the crisis of values and burnout was analyzed. Three strategies of emotional labor were considered in the study: surface acting, deep acting, and expression of naturally felt emotions. The study was conducted in a group of 169 lay teachers of religion (males - 24%, females - 76%), using the Questionnaire for Investigating Crisis in Valuation developed by Oleś, the Maslach Burnout Inventory, and the Emotional Labour Scale developed by Diefendorff, Croyle and Gosserand. The crisis of values and in the valuation is an important factor responsible for occupational burnout in the group of lay teachers of religion. Surface acting and expression of naturally felt emotions mediate the relationship between crisis in the valuation and emotional exhaustion, depersonalization and lack of personal accomplishment. Surface acting increases, while the expression of naturally felt emotions decreases occupational burnout. Deep acting is not related with occupational burnout. It is justified to seek factors favoring the expression of naturally felt emotions, and also those reducing surface acting. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Crisis Management: Research Summaries

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.; Dorman, Sally; Anderson, Luke; McNair, Daniel

2013-01-01

This article presents summaries of three studies relevant to school crisis response. The first report, "A Framework for International Crisis Intervention" (Sally Dorman), is a review of how existing crisis intervention models (including the NASP PREPaRE model) have been adapted for international use. The second article, "Responding…

Consumer experience of formal crisis-response services and preferred methods of crisis intervention.

PubMed

Boscarato, Kara; Lee, Stuart; Kroschel, Jon; Hollander, Yitzchak; Brennan, Alice; Warren, Narelle

2014-08-01

The manner in which people with mental illness are supported in a crisis is crucial to their recovery. The current study explored mental health consumers' experiences with formal crisis services (i.e. police and crisis assessment and treatment (CAT) teams), preferred crisis supports, and opinions of four collaborative interagency response models. Eleven consumers completed one-on-one, semistructured interviews. The results revealed that the perceived quality of previous formal crisis interventions varied greatly. Most participants preferred family members or friends to intervene. However, where a formal response was required, general practitioners and mental health case managers were preferred; no participant wanted a police response, and only one indicated a preference for CAT team assistance. Most participants welcomed collaborative crisis interventions. Of four collaborative interagency response models currently being trialled internationally, participants most strongly supported the Ride-Along Model, which enables a police officer and a mental health clinician to jointly respond to distressed consumers in the community. The findings highlight the potential for an interagency response model to deliver a crisis response aligned with consumers' preferences. © 2014 Australian College of Mental Health Nurses Inc.

Husserl's Crisis as a crisis of psychology.

PubMed

Feest, Uljana

2012-06-01

This paper places Husserl's mature work, The Crisis of the European Sciences, in the context of his engagement with--and critique of--experimental psychology at the time. I begin by showing (a) that Husserl accorded psychology a crucial role in his philosophy, i.e., that of providing a scientific analysis of subjectivity, and (b) that he viewed contemporary psychology--due to its naturalism--as having failed to pursue this goal in the appropriate manner. I then provide an analysis of Husserl's views about naturalism and scientific philosophy. Some central themes of the Crisis are traced back to Husserl's earlier work and to his relationship with his teacher, Franz Brentano, with whom he disagreed about the status of "inner perception" as the proper scientific method for a phenomenological analysis. The paper then shows that Husserl was well aware of at least one publication about the crisis of psychology (Bühler's 1927 book), and it teases out some aspects of the complicated relationship between Husserl and members of the Würzburg School of thought psychology: The latter had drawn on Husserl's writings, but Husserl felt that they had misunderstood his central thesis. I conclude by placing Husserl's work in the wider context of scientific, cultural, and political crisis-discourses at the time. Copyright © 2011 Elsevier Ltd. All rights reserved.

Crisis Communication Plans: Poor Predictors of Excellent Crisis Public Relations.

ERIC Educational Resources Information Center

Marra, Francis J.

1998-01-01

Argues that newly developed theory in crisis public relations suggests a shift is necessary in the way practitioners view crises. Notes that the new paradigm defines excellent crisis public relations very differently from the literature of the past 20 years. (RS)

Is near infrared fluorescence imaging using indocyanine green dye useful in robotic partial nephrectomy: a prospective comparative study of 94 patients.

PubMed

Krane, L Spencer; Manny, Theodore B; Hemal, Ashok K

2012-07-01

To compare a consecutive prospective cohort of patients who underwent robotic partial nephrectomy (RPN) with near infrared fluorescence (NIRF) imaging with indocyanine green dye (ICG) with a previous consecutive patient cohort. A total of 47 consecutive patients with renal masses suspicious for malignancy undergoing RPN were given 5-7.5 mg of ICG before hilar clamping or tumor excision. This cohort of patients was compared with 47 immediate previous consecutive patients who had undergone RPN without NIRF real-time imaging using ICG. The intraoperative, perioperative, and postoperative parameters were collected in an institutional review board-approved prospective database. The preoperative demographics and tumor complexity according to the nephrometry or preoperative aspects and dimensions used for an anatomic (PADUA) scores were similar. The mean warm ischemia time was significantly decreased in the ICG group (15 vs 17 minutes, P = .01). The median hospital stay was 2 days in both groups. No significant difference was seen in the positive margin rate (ICG, 6% vs control, 8.5%; P = .69) or observed Clavien grade III-IV complications in these 2 cohorts (ICG, 4% vs control, 15%; P = .07). No adverse events were associated with ICG dye administration. Differential ICG uptake was observed with selective clamping or in patients with cystic tumors, hypofluorescent tumors with exophytic components, and angiomyelolipomas, but these benefits could not be quantified. NIRF-ICG was transiently helpful to identify the vascular anatomy and not helpful at all for endophytic tumors. RPN using NIRF-ICG can be performed safely and effectively. A decreased warm ischemia time in the ICG cohort was observed without specific measured advantages. Differential ICG uptake by different tumors did not lead to significant differences in the positive margin rate. Copyright © 2012 Elsevier Inc. All rights reserved.

Unemployment and sovereign debt crisis in the Eurozone: A k-means- r analysis

NASA Astrophysics Data System (ADS)

Dias, João

2017-09-01

Some southern countries in Europe, together with Ireland, were particularly affected by the sovereign debt crises in the Eurozone and were obliged to implement tough corrective measures which proved to be very recessive in nature. As a result, not only GDP declined but unemployment jumped to very high levels as well. This paper uses a modified version of k-means (restricted k-means) to analyze the clustering of the Eurozone countries during the recent sovereign debt crisis, combining monthly data on unemployment and government bond yield rates. Our method shows that the separation of southern Europe from the other Eurozone is not necessarily a good characterization of this area before the crisis but the group of externally assisted countries plus Italy gains consistence as the crisis evolved, although there is no perfect homogeneity in this group, since the problems they faced, the type of response requested, the speed of reaction to the crisis and the lasting effects were not the same for all these countries.

School Response to Violence: A Case Study in Developing Crisis Response Teams

ERIC Educational Resources Information Center

Walsh, Ronald J.

2010-01-01

The purpose of this case study was to evaluate the perceptions of participants regarding their effectiveness in responding to defiant student violence as a crisis response team, following crisis response team training. The participants were a group of 10 volunteer PK-6 public school educators from western Wisconsin. The study took place during the…

The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan.

PubMed

Ueda, P; Kondo, N; Fujiwara, T

2015-09-01

We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn. Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight. Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02-1.24); girls=1.35 (1.23-1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09-1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group. Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence.

The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan

PubMed Central

Ueda, P; Kondo, N; Fujiwara, T

2015-01-01

Background: We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn. Methods: Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight. Results: Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02–1.24); girls=1.35 (1.23–1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09–1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group. Conclusions: Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence. PMID:25982791

From success to persistence: Identifying an evolutionary regime shift in the diverse Paleozoic aquatic arthropod group Eurypterida, driven by the Devonian biotic crisis.

PubMed

Lamsdell, James C; Selden, Paul A

2017-01-01

Mass extinctions have altered the trajectory of evolution a number of times over the Phanerozoic. During these periods of biotic upheaval a different selective regime appears to operate, although it is still unclear whether consistent survivorship rules apply across different extinction events. We compare variations in diversity and disparity across the evolutionary history of a major Paleozoic arthropod group, the Eurypterida. Using these data, we explore the group's transition from a successful, dynamic clade to a stagnant persistent lineage, pinpointing the Devonian as the period during which this evolutionary regime shift occurred. The late Devonian biotic crisis is potentially unique among the "Big Five" mass extinctions in exhibiting a drop in speciation rates rather than an increase in extinction. Our study reveals eurypterids show depressed speciation rates throughout the Devonian but no abnormal peaks in extinction. Loss of morphospace occupation is random across all Paleozoic extinction events; however, differential origination during the Devonian results in a migration and subsequent stagnation of occupied morphospace. This shift appears linked to an ecological transition from euryhaline taxa to freshwater species with low morphological diversity alongside a decrease in endemism. These results demonstrate the importance of the Devonian biotic crisis in reshaping Paleozoic ecosystems. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

Admission to Women’s Crisis Houses or to Psychiatric Wards: Women’s Pathways to Admission

PubMed Central

Howard, Louise M.; Rigon, Elena; Cole, Laura; Lawlor, Caroline; Johnson, Sonia

2009-01-01

Objective This study compared the sociodemographic and clinical characteristics and pathways to admission for women admitted to women’s crisis houses and to psychiatric hospitals. A women’s crisis house is a residential mental health crisis facility for women who would otherwise be considered for voluntary hospital admission. Methods A survey of all 388 female admissions to women’s crisis houses and psychiatric hospitals in four boroughs of London during a 12-week period in 2006 was conducted with questionnaires administered to key workers involved in the admissions. Results Pathways to admission were significantly less complex for women admitted to the crisis houses (fewer preadmission contacts with police, emergency departments, and other services). Women admitted to psychiatric wards were more likely to require supervision or observation. A multivariate analysis of data for the 245 voluntary admissions indicated that women admitted to women’s crisis houses were significantly less likely to have a care coordinator (odds ratio [OR]=.528) or to have gone to an accident and emergency department (OR=.214) before admission. No other differences were found between the two groups. Conclusions Pathways to admission were somewhat different for women admitted to women’s crisis houses, but few clinical or sociodemographic differences were found between the two groups. Women’s crisis houses may be a viable alternative to traditional wards for voluntary patients not needing intensive supervision and observation. Research should examine whether women’s crisis houses are as effective as traditional inpatient services in treating women with acute psychiatric problems. PMID:19033172

Hypertensive crisis in children: an experience in a single tertiary care center in Korea.

PubMed

Lee, Geum Hwa; Lee, I Re; Park, Se Jin; Kim, Ji Hong; Oh, Ji Young; Shin, Jae Il

2015-01-01

Hypertensive crisis is a medical emergency that can cause acute damage to multiple end-organs. However, relatively little is known on the etiology, treatment, and outcomes of hypertensive crisis in Korean children. The aim of this study was to determine the etiologies and efficacy of drugs for hypertensive crisis in children during the past 5 years at a single center in Korea. We analyzed data from 51 children with hypertensive crisis during the period between January 1, 2010 and April 1, 2014. The patients were divided into two groups: those diagnosed with a hypertensive emergency (hypertension with organ injury, n = 31) and those diagnosed with a hypertensive urgency (hypertension without organ injury, n = 20). Baseline etiologies and risk factors were compared between the two groups. In addition, systolic and diastolic blood pressures were evaluated at 1, 2, 4, and 5 hours after the administration of intravenous antihypertensive drugs. Kidney injury and cancer were the common causes in patients with hypertensive crisis. Cardiovascular complications (cardiac hypertrophy) (p = 0.002), central nervous system complications (p = 0.004), and retinopathy (p = 0.034) were more frequently observed in children with hypertensive emergency than those with hypertensive urgency. However, the proportion of renal complications was similar in both groups. Hydralazine was most commonly used in both groups to control acute increasing blood pressure at first. However, it was often ineffective for controlling abrupt elevated blood pressure. Therefore, intravenous antihypertensive drugs were changed from hydralazine to nicardipine, labetalol, or nitroprusside to control the high blood pressure in 45.1 % of the patients. Particularly, in patients with hypertensive crisis, there was no significant difference in reduction of systolic and diastolic blood pressure and in improvement of clinical outcomes between nicardipine and labetalol administration. Close blood

Crisis GIS: Preparing for the Next Volcanic Crisis in the United States

NASA Astrophysics Data System (ADS)

Ramsey, D. W.; Robinson, J. E.; Schilling, S. P.; Schaefer, J. R.; Kimberly, P.; Trusdell, F. A.; Guffanti, M. C.; Mayberry, G. C.; Cameron, C. E.; Smith, J. G.; McIntire, J. A.; Snedigar, S.; Ewert, J. W.

2004-12-01

Geographic Information Systems (GIS) specialists from the Volcano Hazards Program (VHP) of the U.S. Geological Survey (USGS), including personnel at Menlo Park, California, the Cascades Volcano Observatory in Vancouver, Washington, the Alaska Volcano Observatory in Anchorage and Fairbanks, Alaska, the Hawaiian Volcano Observatory in Hawaii National Park, Hawaii, and the Smithsonian Institution Global Volcanism Program in Washington, DC, are developing a GIS response plan in the event of a volcano crisis. This plan, referred to as "Crisis GIS", outlines how VHP can ensure rapid, reliable delivery of spatial and ancillary information for data analysis and visualization at any required location during a volcanic crisis or event within the United States. An effective Crisis GIS needs the capacity to store multiple, large datasets, including: base layer data, elevation data, geologic maps, hazard assessment maps, satellite data, and aerial photography for volcanoes around the U.S. It must be readily accessible by VHP GIS specialists stationed around the Nation. Such a GIS should also support installations of monitoring instruments and telemetry equipment that relay monitoring signals, and provision of updates to public officials, the media, and the public during a crisis. GIS technology has proven to be an invaluable tool for crisis response. Recently, GIS was applied as part of the response efforts to two large-scale crises: the terrorist attacks of September 11, 2001, and the Southern California wildfires of Fall 2003. In each case, GIS was used to organize large quantities of spatial data and to produce electronic and paper maps that illustrated hazards, supported decision making, and communicated developing situations to responsible emergency-management authorities and to the populace affected (Kant, 2002, and Pratt, 2003). VHP GIS specialists are currently testing the software and hardware employed in recent major crisis response efforts and are learning to adapt

Dutch guideline for the management of hypertensive crisis -- 2010 revision.

PubMed

van den Born, B J H; Beutler, J J; Gaillard, C A J M; de Gooijer, A; van den Meiracker, A H; Kroon, A A

2011-05-01

Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated complications remain relatively common. In the Netherlands the number of patients starting renal replacement therapy because of 'malignant hypertension' has increased in the past two decades. In 2003, the first Dutch guideline on hypertensive crisis was released to allow a standardised evidence-based approach for patients presenting with a hypertensive crisis. In this paper we give an overview of the current management of hypertensive crisis and discuss several important changes incorporated in the 2010 revision. These changes include a modification in terminology replacing 'malignant hypertension' with 'hypertensive crisis with retinopathy and reclassification of hypertensive crisis with retinopathy under hypertensive emergencies instead of urgencies. With regard to the treatment of hypertensive emergencies, nicardipine instead of nitroprusside or labetalol is favoured for the management of perioperative hypertension, whereas labetalol has become the drug of choice for the treatment of hypertension associated with pre-eclampsia. For the treatment of hypertensive urgencies, oral administration of nifedipine retard instead of captopril is recommended as first-line therapy. In addition, a section on the management of hypertensive emergencies according to the type of target organ involved has been added. Efforts to increase the awareness and treatment of hypertension in the population at large may lower the incidence of hypertensive crisis and its complications.

Modified crisis intervention for personality disorder.

PubMed

Rudnick, A

1998-01-01

This study proposes that the goal of crisis intervention for persons with personality disorders should be to return them to their pre-crisis level of functioning, even though this is maladaptive. This is contrasted with standard crisis intervention, which aims to return normal or neurotic persons to their pre-crisis normal or neurotic functioning, usually by means of few and short-term therapeutic encounters. The modification proposed costs more time and resources in persons with personality disorders in crisis and fits the intervention to the personality type. This is illustrated by the case of Eve, a patient in crisis, whose pre-crisis functioning was maladaptive because of a dependent personality disorder. The goal of (modified) crisis intervention in this case was to return the patient to her dependent lifestyle, by means of pharmacotherapy combined with intensive supportive psychotherapy during 3-4 months of partial (day) hospitalization. The special nature of crisis in personality disorders is discussed.

Psychological Health Before, During, and After an Economic Crisis: Results from Indonesia, 1993 – 2000

PubMed Central

Friedman, Jed; Thomas, Duncan

2015-01-01

The 1997 Indonesian financial crisis resulted in severe economic dislocation and political upheaval, and the detrimental consequences for economic welfare, physical health, and child education have been established in several studies. The crisis also adversely impacted the psychological well-being of the Indonesian population. Comparing responses of the same individuals interviewed before and after the crisis, we document substantial increases in several different dimensions of psychological distress among male and female adults across the entire age distribution. In addition, the imprint of the crisis can be seen in the differential impacts of the crisis on low education groups, the rural landless, and residents in those provinces that were most affected by the crisis. Elevated levels of psychological distress persist even after indicators of economic well-being such as household consumption had returned to pre-crisis levels, suggesting the deleterious effects of the crisis on the psychological well-being of the Indonesian population may be longer lasting than the impacts on economic well-being. PMID:25892838

Mobile crisis management teams as part of an effective crisis management system for rural communities.

PubMed

Trantham, Doug; Sherry, Anne

2012-01-01

Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.

The future of the welfare state: crisis myths and crisis realities.

PubMed

Castles, Francis G

2002-01-01

Accounts of the future of the welfare state are often presented in crisis terms. Some commentators identify globalization as a force that has already led to a major retreat by the state and is likely to lead to further downsizing of the public sector. Others see the future burden of an aging population as creating huge public expenditure pressures that can be countered only by increased parsimony in most areas of spending. Although both crisis scenarios contain elements of truth, analysis of recent public expenditure trends shows that both are substantially exaggerated as general representations of likely developments over the next two or three decades. However, unnoticed by most commentators, a real, longer-term crisis is beginning to make itself felt. This crisis arises, in part, from the demographic impact of a cultural transformation in the labor market, in progress for several decades. Extreme scenarios of possible consequences over the next 50 to 100 years include population implosion, mass migration, increasingly dangerous eruptions of right-wing populism, and, possibly, territorial conflict between developed and underdeveloped nations. This is not a crisis of the welfare state but rather a crisis for which the welfare state may be an essential part of the answer. The only way Western societies can lessen the future impact of the ongoing cultural transformation of the labor market is through the redesign of welfare state institutions to confront these new challenges.

The synergy of the refugee crisis and the financial crisis in Greece: Impact on mental health.

PubMed

Anagnostopoulos, Dimitris C; Giannakopoulos, George; Christodoulou, Nikos G

2017-06-01

The current global financial crisis that started in 2008 resulted in a significant decline in global trade, slowing/reversing economic growth worldwide, and a dramatic increase in public sector debt. At the same time, the global migrant/refugee crisis has reached extreme rates, with millions of people being forced to abandon their homes and communities because of war, political violence or related threats. There is a broad consensus about the deleterious consequences of these crises on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse and suicidal behavior. Although the separate consequences of economic recession and immigration are extensively discussed in previous research, we know very little about the processes through which the intersection of economic crisis and migrant crisis contributes to the vulnerabilities of natives and migrants during these crises. Of particular concern is the status of children, adolescents and their families, who constitute one of the most vulnerable groups in society. To discuss the contexts that economic and migrant crises shape and suggest possible effects of this intersection on mental health risks, especially among children, adolescents and their families, through reflecting on the recent experience in Greece. Review of the literature and critical analysis of the effects of the confluent crises. The interactive effects of these two crises need further exploration. Novel and diverse models of psychological understanding need to be developed in order to manage the effects of the confluent crises. The role of mental health professionals is crucial in this respect, offering culturally flexible, accommodating and empathetic approaches, allowing healing and acceptance in the face of adversity.

Hypertensive crisis in children.

PubMed

Chandar, Jayanthi; Zilleruelo, Gastón

2012-05-01

Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.

Managing stress in a crisis.

PubMed

Wright-Reid, Alison

2018-01-01

Crisis situations are inherently uncertain and threatening. Although the primal stress reactions they provoke deliver some advantages, they so severely restrict intellect and behaviour that consultants observe crisis teams making the same mistakes over and again. Stress risks can be managed before, during and after a crisis. Crisis planning can select the right people, control the crisis team environment, and mitigate fatigue risks and memory demands. Because stress reactions are primitive, stress can be manipulated at a remarkably primitive level and teams can increase their resilience through such basics as sleep and breathing skills. Teams can learn to manipulate perceptions of danger, to tolerate uncertainty and to become comfortable making decisions which were reasonable at the time. Crisis leaders can frame the crisis as a challenge and options as gains, and can ensure the team avoids groupthink and challenges the paradigm. Where individuals are trained to apply critical thinking processes, intuitive decision-making is not only fast, but also accurate, and helps to challenge assumptions, predictions and groupthink. Crises are more easily recognised and managed where training has covered critical decision methods.

K-12 School Leaders and School Crisis: An Exploration of Principals' School Crisis Competencies and Preparedness

ERIC Educational Resources Information Center

McCarty, Sean P.

2012-01-01

On any given day, principals could find themselves faced with a situation that could define their roles as crisis leaders. This dissertation research offers an exploratory study in the field of crisis response and educational leadership. From experts in the field of crisis response, the author compiled a list of crisis management competencies…

Comparison of informal caregiver and named nurse assessment of symptoms in elderly patients dying in hospital using the palliative outcome scale.

PubMed

Dawber, Rebecca; Armour, Kathy; Ferry, Peter; Mukherjee, Bhaskar; Carter, Christopher; Meystre, Chantal

2016-01-12

A prospective study of symptom assessments made by a healthcare professional (HCP; named nurse) and an informal caregiver (ICG) compared with that of the patient with a terminal diagnosis. To look at the validity of HCP and ICG as proxies, which symptoms they can reliably assess, and to determine who is the better proxy between HCP and ICG. A total of 50 triads of patient (>65 years) in the terminal phase, ICG and named nurse on medical wards of an acute general hospital. Assessments were made using the patient and caregiver versions of the palliative outcome scale (POS), all taken within a 24 h period. Agreement between patient-rated, ICG-rated and HCP-rated POS and POS for symptoms (POS-S) was measured using weighted-κ statistics. Demographic and clinical data on each group of participants were collected. ICG assessments have higher agreement with those of the patient than HCP. Better agreement in both groups was found for physical symptoms, and best agreement was for pain. The worst agreements were for psychological symptoms, such as anxiety and depression, and for satisfaction with information given. Psychological symptoms are overestimated by both ICG and HCP. ICGs are more reliable proxies than HCPs. A trend for overestimation of symptoms was found in both groups which may lead to undervaluation of the quality of life by proxy and overtreatment of symptoms. This highlights the need to always use the patient report when possible, and to be aware of the potential flaws in proxy assessment. Reasons for overestimation by proxies deserve further research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

When Crisis Strikes.

ERIC Educational Resources Information Center

Caudle, Melissa

1994-01-01

School crises may be categorized as emergency situations, human-made crises, natural events, medical emergencies, and mechanical crises. Central to any successful crisis-management plan are onsite and district-level crisis response teams. Plans should specify staff responsibilities; provide for communication codes, devices, and procedures;…

Chaos and Crisis: Propositions for a General Theory of Crisis Communication.

ERIC Educational Resources Information Center

Seeger, Matthew W.

2002-01-01

Presents key concepts of chaos theory (CT) as a general framework for describing organizational crisis and crisis communication. Discusses principles of predictability, sensitive dependence on initial conditions, bifurcation as system breakdown, emergent self-organization, and fractals and strange attractors as principles of organization. Explores…

Thyrotoxic crisis presenting with jaundice.

PubMed

Wickramasinghe, R D S S; Luke, W A N V; Sebastiampillai, B S; Gunathilake, M P M L; Premaratna, R

2016-06-23

Thyrotoxic crisis is a medical emergency requiring early diagnosis and urgent management, which can be challenging due to its diverse clinical presentations. While common presentations include fever, sweating, palpitations, tremors and confusion, presence of jaundice is rare. We report a 35-year-old male who presented with jaundice due to cholestasis along with other features of thyrotoxic crisis due to Graves' disease. He had a good clinical recovery with resolution of cholestasis following treatment for thyrotoxic crisis. Jaundice can be a rare manifestation of thyrotoxic crisis, and should be considered in the differential diagnosis when other clinical features of thyrotoxic crisis are present. However secondary causes of jaundice should be looked into and excluded.

Geometrical-Based Navigation System Performance Assessment in the Space Service Volume Using a Multiglobal Navigation Satellite System Methodology

NASA Technical Reports Server (NTRS)

Welch, Bryan W.

2016-01-01

NASA is participating in the International Committee on Global Navigation Satellite Systems (GNSS) (ICG)'s efforts towards demonstrating the benefits to the space user in the Space Service Volume (SSV) when a multi-GNSS solution space approach is utilized. The ICG Working Group: Enhancement of GNSS Performance, New Services and Capabilities has started a three phase analysis initiative as an outcome of recommendations at the ICG-10 meeting, in preparation for the ICG-11 meeting. The first phase of that increasing complexity and fidelity analysis initiative is based on a pure geometrically-derived access technique. The first phase of analysis has been completed, and the results are documented in this paper.

Geography's Image Crisis.

ERIC Educational Resources Information Center

Hudson, John C.

1984-01-01

If geography faces a crisis today, it is an inner crisis that has come from listening to those who advocate aggrandizement rather than accomplishment. Geographers should devote no more time than necessary to the business of selling themselves and, instead, produce the kind of scholarship that commands attention. (RM)

The health crisis in Argentina.

PubMed

Escudero, José Carlos

2003-01-01

The health crisis in Argentina is part of the larger crisis that has resulted from a collapse in the country's economic and political systems. After a brief review of the country's history over the last century, from international success story to economic failure, the author explains the health crisis in particular and the social crisis in general in terms of failed neoliberal policies imposed on Argentina by the United States and International Monetary Fund through the mediation of the country's political class.

Treadmill exercise after social isolation increases the levels of NGF, BDNF, and synapsin I to induce survival of neurons in the hippocampus, and improves depression-like behavior

PubMed Central

Hong, Young-Pyo; Lee, Hyo-Chul; Kim, Hyun-Tae

2015-01-01

[Purpose] We investigated the effects of 8 weeks of treadmill exercise on nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and synapsin I protein expression and on the number of 5-bromo-2'-deoxyuridine-5'-mono-phosphate (BrdU)-positive cells in the dentate gyrus of the hippocampus in socially isolated rats. Additionally, we examined the effects of exercise on the number of serotonin (5-HT)- and tryptophan hydroxylase (TPH)-positive cells in the raphe nuclei and on depression behaviors induced by social isolation. [Methods] Forty male Sprague-Dawley rats were divided into four groups: (1) group housing and control group (GCG, n = 10); (2) group housing and exercise group (GEG, n = 10); (3) isolated housing and control group (ICG, n = 10); and (4) isolated housing and exercise group (IEG, n = 10). After 1 week of housing under the normal condition of 3 animals per cage, rats were socially isolated via transfer to individual cages for 8 weeks. Rats were then subjected to treadmill exercise for 5 days per week for 8 weeks during which time the speed of the treadmill was gradually increased. [Results] Compared to the GCG, levels of NGF, BDNF, and synapsin I were significantly decreased in the ICG and significantly increased in the IEG (p < 0.001 respectively). Significantly more BrdU-positive cells in the GEG were present as compared to the GCG and ICG, and more BrdU-positive cells were found in the IEG as compared to the ICG (p < 0.001). 5-HT-positive cells in the GEG were significantly increased compared to the GCG and ICG, and more of these cells were found in the IEG as compared to the ICG (p < 0.01). TPH-positive cells in the GEG were significantly increased compared to those in the GCG and ICG (p < 0.05). In the forced swim test, immobility time was significantly increased in the ICG and significantly decreased in the IEG as compared to the ICG (p < 0.01). [Conclusion] These results showed that regular treadmill exercise following social

[Attempted suicide during the financial crisis in Athens].

PubMed

Stavrianakos, K; Kontaxakis, V; Moussas, G; Paplos, K; Papaslanis, T; Havaki-Kontaxaki, B; Papadimitriou, Gn

2014-01-01

) and 95 in 2011, during the financial crisis (mean age 41.0 years, women 65%). There is an increase of suicide attempts by 35.71%. There were no statistically significant differences between the two periods regarding the gender and age of attempters. There was a statistically significant increase of unemployed (p=0.004), as well as of married/widowed/divorced (p=0.02) suicide attempters during the crisis. There was not statistically significant difference in the severity of suicide attempts before and during the economic crisis or the severity of psychopathology of the attempters. The financial crisis is probably associated with upward trend in attempted suicide of the Athens population. Most affected are those who are unemployed, married, widowed, divorced. Suicide prevention programs are essential for the accurate and timely identification and the immediate and effective management of this special high risk group of attempters during the financial crisis.

[A comparison of the effect of oral captopril and nicardipine in hypertensive crisis].

PubMed

Addad, Faouzi; Ferjani, Hayet; Chaabani, Abdelghani; Jelliti, Mounir; Gamra, Habib; Makni, Hatem; Khaldoun, Ben Hamda; Dridi, Zohra; Ben Farhat, Mohamed

2008-02-01

Hypertensive crisis is defined as a severe elevation in blood pressure (BP) without target organ injury. There are few data about the efficacy and safety of comparative oral antihypertensive drugs. To compare the efficacy and safety of oral captopril (25 mg) and nicardipine (20 mg) in hypertensive crisis. This prospective, randomized study included 50 patients attended at the emergency department with a hypertensive crisis (arterial blood pressure of at least 180/110 mmHg without target organ damage confirmed after 15 min of rest. Systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were assessed at several intervals during 4 h after the drug administration. Therapeutic success was defined by a SBP< or =160 and DBP< or =90 mmHg two hours after drug administration. The initial clinical characteristics as age, sex, initial systolic and diastolic BP and HR were no different in the two groups. BP levels started to significantly decrease within 15 minutes. At 2 hours, SBP and DBP dropped were similar in captopril group and nicardipine group,respectively to 162/94 vs 161/89 mmHg; p=ns. The therapeutic success at the second hour has been obtained in 68% of cases in the two groups. Age >70 years was a predictor's factor of therapeutic failure in the captopril group. Heart rate significantly dropped after 30 min in the captopril group (82.3 +/- 11.8 vs 77.6 +/- 12.7 c/min; p=0.037). This effect was maintained over four hours. There were no side effects in this study. Oral captopril or nicardipine are efficacy and safe in the treatment of hypertensive crisis.

Impact of the Syrian Crisis on the Hospitalization of Syrians in a Psychiatric Setting.

PubMed

Lama, Souaiby; François, Kazour; Marwan, Zoghbi; Sami, Richa

2016-01-01

Determine the impact of the Syrian crisis on the hospitalization of Syrians in a psychiatric setting. All Syrians admitted to a psychiatric hospital in Lebanon between the 1st of January 2009 and the 31st of December 2013 were included. Number of admissions, psychiatric disorders and demographic and clinical data relative to patients were compared between those admitted before and after the crisis. 44 patients were admitted before the crisis and 106 after it. The distribution of diagnosis varied significantly after the crisis (p = 0.056) with the majority of patients being admitted for schizophrenia (37.7 %). The prevalence of suicidal ideation was higher after the crisis (p = 0.03) but suicidal attempts, need for electroconvulsive therapy and length of hospitalization did not differ significantly between both groups. Clinicians should be aware of the possible burden of mental illness in Syrians after the beginning of the Syrian crisis.

Crisis leadership in an acute clinical setting: christchurch hospital, new zealand ICU experience following the february 2011 earthquake.

PubMed

Zhuravsky, Lev

2015-04-01

On Tuesday, February 22, 2011, a 6.3 magnitude earthquake struck Christchurch, New Zealand. This qualitative study explored the intensive care units (ICUs) staff experiences and adopted leadership approaches to manage a large-scale crisis resulting from the city-wide disaster. To date, there have been a very small number of research publications to provide a comprehensive overview of crisis leadership from the perspective of multi-level interactions among staff members in the acute clinical environment during the process of the crisis management. The research was qualitative in nature. Participants were recruited into the study through purposive sampling. A semi-structured, audio-taped, personal interview method was chosen as a single data collection method for this study. This study employed thematic analysis. Formal team leadership refers to the actions undertaken by a team leader to ensure the needs and goals of the team are met. Three core, formal, crisis-leadership themes were identified: decision making, ability to remain calm, and effective communication. Informal leaders are those individuals who exert significant influence over other members in the group to which they belong, although no formal authority has been assigned to them. Four core, informal, crisis-leadership themes were identified: motivation to lead, autonomy, emotional leadership, and crisis as opportunity. Shared leadership is a dynamic process among individuals in groups for which the objective is to lead one another to the achievement of group or organizational goals. Two core, shared-leadership themes were identified: shared leadership within formal medical and nursing leadership groups, and shared leadership between formal and informal leaders in the ICU. The capabilities of formal leaders all contributed to the overall management of a crisis. Informal leaders are a very cohesive group of motivated people who can make a substantial contribution and improve overall team performance in a

Pure laparoscopic hepatectomy with augmented reality-assisted indocyanine green fluorescence versus open hepatectomy for hepatocellular carcinoma with liver cirrhosis: A propensity analysis at a single center.

PubMed

Cheung, Tan To; Ma, Ka Wing; She, Wong Hoi; Dai, Wing Chiu; Tsang, Simon Hing Yin; Chan, Albert Chi Yan; Chok, Kenneth Siu Ho; Lo, Chung Mau

2018-05-10

Laparoscopic hepatectomy is considered an acceptable treatment of choice in selected patients with primary hepatocellular carcinoma (HCC). Whether indocyanine green (ICG) immunofluorescence, a new technology, may improve surgery outcomes has yet to be tested. The aim of the present study was to investigate and compare the effect of ICG fluorescence imaging on the outcomes of pure laparoscopic hepatectomy and open hepatectomy for primary HCC with background cirrhosis. From January 2015 to June 2016, 20 patients with HCC and liver cirrhosis underwent laparoscopic hepatectomy with ICG immunofluorescence. The outcomes of pure laparoscopic hepatectomy with ICG immunofluorescence were compared with those of open hepatectomy. To avoid selection bias, patients were propensity score matched in a ratio of 1 : 6, with 20 patients in the laparoscopic group and 120 in the open group. The laparoscopic group had 20 patients, and the open group had 120 patients. The laparoscopic group had less blood loss (125 vs 450 mL, P < 0.001), a shorter operation time (200 vs 250 min, P = 0.003), and a shorter hospital stay (5 vs 6 days, P < 0.001). The complication rate was 0% in the laparoscopic group compared to 15.0% in the open group (P = 0.135). All patients in the laparoscopic group had negative margin involvement. Four patients (3.3%) in the open resection group had positive margin involvement. Two patients in the ICG immunofluorescence group had additional lesions identified and resected during operation. Pure laparoscopic hepatectomy with ICG immunofluorescence for primary HCC can be carried out safely with favorable short-term outcomes even in cirrhotic patients. Better identification of the bile duct structure and better assessment of the tumor resection margin and perfusion are advantages of this new technique. © 2018 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

US health care crisis.

PubMed

Cirić, Ivan

2013-01-01

The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

Keeping Cool in a Crisis

ERIC Educational Resources Information Center

Padgett, Raven

2006-01-01

Many schools are able to avoid disasters by creating a strong, deliberate crisis plan and knowing how to implement it effectively. Good crisis preparedness requires leadership from the top, a critical mass of trained staff members, careful planning, and excellent communication. This article discusses how to prepare for a crisis.

The Achievement Crisis Is Real: A Review of "The Manufactured Crisis."

ERIC Educational Resources Information Center

Stedman, Lawrence C.

1996-01-01

In "The Manufactured Crisis," D. Berliner and B. Biddle argue that there has been no decline in achievement test scores, that today's students outperform their parents and do well in international examinations, and that the supposed crisis in American education does not exist. This review refutes all these claims. (SLD)

Hypertensive crisis.

PubMed

Rodriguez, Maria Alexandra; Kumar, Siva K; De Caro, Matthew

2010-01-01

Hypertension is a common chronic medical condition affecting over 65 million Americans. Uncontrolled hypertension can progress to a hypertensive crisis defined as a systolic blood pressure >180 mm Hg or a diastolic blood pressure >120 mm Hg. Hypertensive crisis can be further classified as a hypertensive urgency or hypertensive emergency depending on end-organ involvement including cardiac, renal, and neurologic injury. The prompt recognition of a hypertensive emergency with the appropriate diagnostic tests and triage will lead to the adequate reduction of blood pressure, ameliorating the incidence of fatal outcomes. Severely hypertensive patients with acute end-organ damage (hypertensive emergencies) warrant admission to an intensive care unit for immediate reduction of blood pressure with a short-acting titratable intravenous antihypertensive medication. Hypertensive urgencies (severe hypertension with no or minimal end-organ damage) may in general be treated with oral antihypertensives as an outpatient. Rapid and short-lived intravenous medications commonly used are labetalol, esmolol, fenoldopam, nicardipine, sodium nitroprusside, and clevidipine. Medications such as hydralazine, immediate release nifedipine, and nitroglycerin should be avoided. Sodium nitroprusside should be used with caution because of its toxicity. The risk factors and prognosticators of a hypertensive crisis are still under recognized. Physicians should perform complete evaluations in patients who present with a hypertensive crisis to effectively reverse, intervene, and correct the underlying trigger, as well as improve long-term outcomes after the episode.

Creativity in Crisis.

ERIC Educational Resources Information Center

Roff, Glenn

This paper suggests that educational resources and opportunities currently in operation in rural Australia are brought forward during times of crisis. The paper discusses five aspects of education in rural Australia that are a response to the perceived sense of crisis and that have improved the general and comparative quality of rural education,…

Mental health crisis and respite services: service user and carer aspirations.

PubMed

Lyons, C; Hopley, P; Burton, C R; Horrocks, J

2009-06-01

There is emerging evidence that crisis resolution services can provide alternatives to hospital admission, reducing demand on inpatient beds. Following a public consultation exercise in Lancashire (England), a team of nurses undertook a study, using interactive research methodology, to gain an understanding of how users and carers define a crisis and what range of crisis services, resources and interventions service users and carers thought would help avoid unnecessary hospital admission. Data collection comprised postal questionnaires and 24 group meetings with service users and carers, which were held during 2006. Data were analysed, and seven themes were identified: (1) definitions of a crisis; (2) access to services; (3) interventions; (4) range of services required (before, during and after crisis); (5) place of treatment; (6) recovery and rehabilitation; and (7) community support. We conclude that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used. Home-based pre-emptive services that reduce the need for unnecessary hospital treatment may avoid progression to social exclusion of service users.

When Crisis Strikes on Campus.

ERIC Educational Resources Information Center

Larson, Wendy Ann, Ed.

This handbook aids in planning for effective crisis communication at institutions of higher education. The book opens with a behind-the-scenes look at a particular crisis--the 1990 murders of five students at the University of Florida. This first section offers tested advice from a campus communicator, an account of the crisis and the…

Crisis in the Curriculum? New Counselors' Crisis Preparation, Experiences, and Self-Efficacy

ERIC Educational Resources Information Center

Morris, Carrie A. Wachter; Minton, Casey A. Barrio

2012-01-01

Professional counselors are responsible for providing crisis assessment, referral, and intervention (Council for Accreditation of Counseling and Related Educational Programs, 2009); however, little is known about their preparation and experiences in these areas. This study examined new professional counselors' (N= 193) crisis intervention…

Top Management Team Crisis Communication after Claims of Sexual Harassment

ERIC Educational Resources Information Center

Bull Schaefer, Rebecca A.; Crosswhite, Alicia M.

2018-01-01

Both sexual harassment and managerial crisis communication are important topics in undergraduate, graduate, and executive programs. This article describes a group role-play exercise that engages students in the process of responding to a public claim of workplace sexual harassment and requires small groups to share their reactions within a press…

["Crisis"--oscillating between keyword and buzzword. On the discourse about a "crisis of medicine" in the Weimar Republic].

PubMed

Geiger, Karin

2010-01-01

The buzzword "crisis" has not only become omnipresent since the recent financial crisis. The term that originated in Ancient Greece underwent several different usages--quantitatively as well as qualitatively; especially in the Weimar Republic, the time period that has long been considered as the crisis era par excellence. Using the discourse about the "crisis of medicine" in the 1920s and the early 1930s as an example, the article attempts to provide a critical reflection on the concept of "crisis". The focus of this article is on the idea's construction, the different semantic usages of "crisis" and the motives of the different authors for their respective rhetorical applications of this term. The analysis of the examined publications on the "crisis of medicine", how they influenced other periods and the reconstruction of their origin show that the semantics of the word "crisis" went far beyond a simply negative connotation, and with regard to its rhetorical usage have oscillated between keyword and a meaningless but catchy buzzword.

Massachusetts Dental Schools Respond to the Prescription Opioid Crisis: A Statewide Collaboration.

PubMed

Keith, David A; Kulich, Ronald J; Bharel, Monica; Boose, Robert E; Brownstein, Jennifer; Da Silva, John D; D'Innocenzo, Richard; Donoff, R Bruce; Factor, Ellen; Hutter, Jeffrey W; Shaefer, Jeffry R; Karimbux, Nadeem Y; Jack, Helen; Thomas, Huw F

2017-12-01

The prescription opioid crisis has involved all sectors of U.S. society, affecting every community, socioeconomic group, and age group. While federal and state agencies are actively working to deal with the epidemic, medical and dental providers have been tasked to increase their awareness of the issues and consider ways to safely prescribe opioids and, at the same time, effectively treat their patients' pain. The Commonwealth of Massachusetts, under the leadership of Governor Charles D. Baker and his administration, challenged the state's four medical schools and three dental schools to improve their curricula to prepare the next generation of clinicians to deal with this crisis in an evidence-based, effective, and sympathetic way. This Perspectives article outlines the national prescription opioid crisis, details its effects in Massachusetts, and describes the interdisciplinary collaboration among the Commonwealth, the three dental schools, the Massachusetts Dental Society, and a concerned student group. The article also describes the efforts each dental school is undertaking as well as an assessment of the challenges and limitations in implementing the initiative. The authors hope that the Massachusetts model will be a useful resource for dental schools in other states.

The Roman Empire - The Third Century Crisis and Crisis Management

DTIC Science & Technology

2012-04-04

December 2010. Hekster, Olivier, Gerda De Kleijn, and Danielle Slootjes. "Introduction." Impact of Empire. 7, (2006, June 1): 3-10. Koselleck...Crisis of the Third Century. Edited by Olivier Hekster, Gerda De Kleijn, and Danielle Slootjes. Vol. 7, Impact of EMpire. Boston: Brill Academic, 2012...1. Protagoras and John Nicols, Mapping the Crisis of the Third Century, ed. Olivier Hekster, Gerda De Kleijn, and Danielle Slootjes

A crisis recovery model for adolescents with severe mental health problems.

PubMed

Kaplan, Tony; Racussen, Lisa

2013-04-01

A model of intervention at the interface and for the in-patient phase for adolescents with severe mental health crises was developed to reduce length of stay while maintaining quality of service consonant with the 'recovery model'. The model is described, and discussed in the context of the limited literature on both crisis intervention with adolescents and families, and 'recovery' in this age-group. The model may be suitable also for use by community teams dealing with adolescents in crisis.

Active cocaine use does not increase the likelihood of hyperglycemic crisis.

PubMed

Modzelewski, Katherine L; Rybin, Denis V; Weinberg, Janice M; Alexanian, Sara M; McDonnell, Marie E; Steenkamp, Devin W

2017-09-01

Hyperglycemic crisis encompasses a group of diabetes emergencies characterized by insulin deficiency with high morbidity and mortality. Cocaine use is increasingly prevalent in the United States and may be associated with increased risk of diabetic ketoacidosis. The objective was to determine if active cocaine use at hospital admission could be considered a risk factor for development of hyperglycemic crisis. A retrospective case-control analysis was performed on 950 inpatients with hyperglycemia at an urban academic hospital. Patients admitted with non-emergent hyperglycemia were compared to patients who met criteria for diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and hyperosmolar ketoacidosis (HK), based on the absence or presence of cocaine metabolites on urine toxicology screen. Outcomes included frequency of cocaine use in patients with DKA, HHS, HK, and non-emergent hyperglycemia; phenotypic characteristics of cocaine users vs. non-users with hyperglycemia; phenotypic characteristics of patients with hyperglycemic crisis vs. non-emergent hyperglycemia. 950 patients were admitted with hyperglycemia, 133 of which met criteria for hyperglycemic crisis. There was no significant difference in the frequency of cocaine use in individuals with non-emergent hyperglycemia compared to individuals with hyperglycemic crisis (16.9% vs. 17.2%, p = 0.90). 16.9% of patients with DKA, 16.4% of patients with HHS, and 6.4% of patients with HK were cocaine users. We found no association between active cocaine use at the time of hospital admission and development of hyperglycemic crisis, when compared to non-emergent hyperglycemia. The role of routine screening for cocaine use in patients with hyperglycemic crisis is unclear.

Financial crisis and criminality in Greece: 2008 vs 2011.

PubMed

Tsouvelas, G; Kontaxakis, V; Giotakos, O; Konstantakopoulos, G; Kontaxaki, M-I; Papaslanis, Th

2016-01-01

Α number of previous articles have dealt with the negative impact of the Greek Economic crisis on public health, including significant increases in major depression prevalence and suicide and homicide rates. The mentally ill seem to represent a vulnerable social group, with particular difficulties in this context. The number of compulsory assessments and involuntary admissions was recorded by reviewing patient records in the Department of Psychiatry of the University Hospital of Patras, through years 2006-2013. Compulsory assessments increased from 176 in 2006 to 262 in 2009 and 354 in 2013, representing a 48.86% and 101.13% increase in the first and the fifth year of economic crisis, respectively. The assessments resulted in 160 involuntary admissions in 2006, which escalated to 262 admissions (63.75% rise) in 2013. Even though a rise in involuntary placements could be attributed to other factors as well, it may also partly represent a not so evident side of the Greek economic crisis.

From Crisis to Transition: The State of Russian Science Based on Focus Groups with Nuclear Physicists

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gerber, T P; Ball, D Y

and fuel renewed economic progress in Russia. Russian scientists could also be an important source of support for democratic norms: sociologists of science have long argued that scientists tend to support democracy because it provides them with the freedom in which their research can flourish. At the same time, a more recent study suggests that funding shortages may override the researcher's need for freedom and drive scientists to align themselves with the economic policies espoused by Nationalists and Communists in order to survive. Therefore, much turns on the question: ''What is the state of science in Russia today?'' The good news is that focus group interviews with Russian nuclear physicists conducted in October 2001 suggest that the ''science in crisis'' image is one-sided and misleading. Though scientists still complained about low salaries, lack of respect in society, and other similar issues, the participants in the focus groups also expressed positive sentiments about recent changes in the field of science. To be sure, the financing of science remains at a considerably lower level than during the heyday of Soviet times. Yet, it is now possible to earn a decent living as a scientist because of the greater availability of foreign and domestic grants and contracts. In addition, state funding has stabilized over the past few years. Thus, it is more accurate to say that Russian science is in a state of transition rather than in a state of crisis.« less

[Indocyanine green infrared fluorescence angiography and vascular cast--preparation in experimental choroidal circulatory disturbance].

PubMed

Matsunaga, H; Andoh, A; Matsubara, T; Fukushima, I; Takahashi, K; Ohkuma, H; Uyama, M

1996-03-01

We performed experiments in 20 monkey eyes in order to clarify basic problems about interpretation of indocyanine green fluorescence angiography (ICG angiography). We severed the temporal group of posterior ciliary arteries to produce choroidal circulatory disturbance. ICG angiography was performed immediately, and 2 days, 4 days, and 2 weeks later. Following each ICG angiography, the eye was studied by plastic vascular cast technique with scanning electron microscopy. Immediately after occlusion, ICG angiography showed filling defect in the temporal choroidal hemisphere during the early phase. In the later phase, this area was gradually filled by the dye from choroidal arteries in the nasal hemisphere and the anterior ciliary arteries. Vascular cast preparations showed filling defect in the temporal choroidal hemisphere, corresponding with the early ICG angiogaphic findings. Both filling delay in ICG angiography and filling defect in vascular casts improved daily after occlusion. Two weeks after occlusion, The area of choroidal infarct temporal to the macula turned into chorioretinal atrophy. This area showed hypofluorescence in the early-phase ICG angiography and filling defect of the choriocapillaris in plastic casts. The early-phase ICG angiographic findings thus corresponded well with observations of vascular casts. We conclude that ICG angiography correctly reflects the actual circulatory disturbances in the choroid.

Liver reserve function assessment by acoustic radiation force impulse imaging

PubMed Central

Sun, Xiao-Lan; Liang, Li-Wei; Cao, Hui; Men, Qiong; Hou, Ke-Zhu; Chen, Zhen; Zhao, Ya-E

2015-01-01

AIM: To evaluate the utility of liver reserve function by acoustic radiation force impulse (ARFI) imaging in patients with liver tumors. METHODS: Seventy-six patients with liver tumors were enrolled in this study. Serum biochemical indexes, such as aminotransferase (ALT), aspartate aminotransferase (AST), serum albumin (ALB), total bilirubin (T-Bil), and other indicators were observed. Liver stiffness (LS) was measured by ARFI imaging, measurements were repeated 10 times, and the average value of the results was taken as the final LS value. Indocyanine green (ICG) retention was performed, and ICG-K and ICG-R15 were recorded. Child-Pugh (CP) scores were carried out based on patient’s preoperative biochemical tests and physical condition. Correlations among CP scores, ICG-R15, ICG-K and LS values were observed and analyzed using either the Pearson correlation coefficient or the Spearman rank correlation coefficient. Kruskal-Wallis test was used to compare LS values of CP scores, and the receiver-operator characteristic (ROC) curve was used to analyze liver reserve function assessment accuracy. RESULTS: LS in the ICG-R15 10%-20% group was significantly higher than in the ICG-R15 < 10% group; and the difference was statistically significant (2.19 ± 0.27 vs 1.59 ± 0.32, P < 0.01). LS in the ICG-R15 > 20% group was significantly higher than in the ICG-R15 < 10% group; and the difference was statistically significant (2.92 ± 0.29 vs 1.59 ± 0.32, P < 0.01). The LS value in patients with CP class A was lower than in patients with CP class B (1.57 ± 0.34 vs 1.86 ± 0.27, P < 0.05), while the LS value in patients with CP class B was lower than in patients with CP class C (1.86 ± 0.27 vs 2.47 ± 0.33, P < 0.01). LS was positively correlated with ICG-R15 (r = 0.617, P < 0.01) and CP score (r = 0.772, P < 0.01). Meanwhile, LS was negatively correlated with ICG-K (r = -0.673, P < 0.01). AST, ALT and T-Bil were positively correlated with LS, while ALB was negatively

Interventions for treating painful sickle cell crisis during pregnancy.

PubMed

Martí-Carvajal, Arturo J; Peña-Martí, Guiomar E; Comunián-Carrasco, Gabriella; Martí-Peña, Arturo J

2009-01-21

Sickle cell disease is a group of genetic haemoglobin disorders. All over the world, about 300,000 children with these disorders are born each year. Acute sickle cell pain episodes are the most common cause of hospitalisation. Pregnancy in women with sickle cell disease is associated with an increased incidence of maternal and fetal morbidity and mortality. The painful crisis is a severe complication of this illness, and it requires several interventions: packed red cell transfusion, fluid replacement therapy, analgesic drugs, oxygen therapy and steroids; but the approach is not standardised. To assess the effectiveness and safety of different regimens of packed red cell transfusion, oxygen therapy, fluid replacement therapy, analgesic drugs, and steroids for the treatment of painful sickle cell crisis during pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2007), the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register (October 2007), LILACS database (1982 to December 2007) and the following web sites: ClinicalTrials.gov (http://www.clinicaltrials.gov) (December 5, 2007); Current Controlled Trials (http://controlled-trials.com/) (December 5, 2007), and Sistema de Información Esencial en Terapéutica y Salud (http://www.icf.uab.es/informacion/Papyrus/sietes.asp) (December 1, 2007). We also handsearched the European Haematology Association conference (June 2007), the American Society of Hematology conference (December 2007) and reference lists of all retrieved articles. We intended to include randomised clinical trials. We intended to summarise data by standard Cochrane Collaboration methodologies. We could not find any randomised clinical trials on interventions (packed red cell transfusion, oxygen therapy, fluid replacement therapy, analgesic drugs, and steroids) for the treatment of painful sickle cell crisis during pregnancy. This review found no randomised clinical trials on the safety and

Hypertensive crisis. Clinical presentation, comorbidities, and target organ involvement.

PubMed

Al-Bannay, Rashed; Husain, Aysha A

2010-08-01

To evaluate the clinical presentation and comorbidities of hypertensive crisis in our own population. In this cohort based study, we investigate the clinical presentation and comorbidities of hypertensive crisis by evaluating the data collected between January and April 2009. We included 154 patients admitted with systolic and diastolic blood pressure of >179 mm Hg and >119 mm Hg (based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria) in the Department of Internal Medicine, Salmaniya Medical Complex, Kingdom of Bahrain. In the study population, 64.3% had hypertensive urgency (blood pressure elevation without end organ damage) and 35.7% had hypertensive emergency (blood pressure elevation with end organ damage). The mean age group was 45-65 years (56% of the study population) and more men were affected than women (100:54). Shortness of breath and neurological deficits had a strong statistical association with hypertensive emergency, and headache and blurring of vision had the same tendency toward hypertensive urgency. Diabetes mellitus was an independent risk factor for hypertensive crisis. Most of the studied patients were known hypertensive. Diabetes mellitus is powerful predictor for hypertensive crisis. Dyspnea and neurological deficits have significant statistical correlation with hypertensive emergencies.

Indocyanine green kinetics with near-infrared spectroscopy predicts cerebral hyperperfusion syndrome after carotid artery stenting

PubMed Central

Park, Hun Soo; Yokoyama, Shohei; Yamada, Shuichi; Motoyama, Yasushi; Park, Young Su; Wada, Takeshi; Kichikawa, Kimihiko; Nakase, Hiroyuki

2017-01-01

Background Cerebral hyperperfusion syndrome (HPS) is a potentially life-threatening complication following carotid artery stenting (CAS) and carotid endoarterectomy (CEA). Early prediction and treatment of patients at risk for HPS are required in patients undergoing CAS because HPS occurs significantly earlier after CAS than CEA. Near-infrared spectroscopy (NIRS) is often used for monitoring, and indocyanine green (ICG) kinetics by NIRS (ICG-NIRS) can detect reductions in cerebral perfusion in patients with acute stroke. However, whether ICG-NIRS can predict postoperative hyperperfusion phenomenon (HP) after carotid revascularization is unclear. Objective Here, we evaluated whether the blood flow index (BFI) ratio calculated from a time-intensity curve from ICG-NIRS monitoring can predict HPS after CAS. Methods The BFI ratio was prospectively monitored using ICG-NIRS in 135 patients undergoing CAS. Preoperative cerebrovascular reactivity (CVR) and the postoperative asymmetry index (AI) were also assessed with single-photon emission computed tomography before and after CAS, and the correlation was evaluated. In addition, patients were divided into two groups, a non-HP group (n = 113) and an HP group (n = 22), and we evaluated the correlation with hemodynamic impairment in the ipsilateral hemisphere and clinical results. Results Twenty-two cases (16%) showed HP, and four (3%) showed HPS after CAS. The BFI ratio calculated from ICG-NIRS showed a significant linear correlation with preoperative CVR and postoperative AI (r = −0.568, 0.538, P < 0.001, <0.001, respectively). The degree of stenosis, the rate of no cross flow, preoperative CVR, and the incidence of HPS were significantly different between the groups. Conclusions Measurement of ICG kinetics by NIRS is useful for detection of HPS in patients who underwent CAS. PMID:28704454

Treating Chronic Crisis Bearers and Their Families

ERIC Educational Resources Information Center

Doyle, Averil Marie; Dorlac, Charles

1978-01-01

This article presents a method for family crisis intervention. The goal is extended from restoring the crisis bearing unit to its pre-crisis level of coping to a basic restructuring of maladaptive pre-crisis behaviors. It is aimed at general behavior change as well as resolution of the immediate situation. (Author)

Improving drug accumulation and photothermal efficacy in tumor depending on size of ICG loaded lipid-polymer nanoparticles.

PubMed

Zhao, Pengfei; Zheng, Mingbin; Yue, Caixia; Luo, Zhenyu; Gong, Ping; Gao, Guanhui; Sheng, Zonghai; Zheng, Cuifang; Cai, Lintao

2014-07-01

A key challenge to strengthen anti-tumor efficacy is to improve drug accumulation in tumors through size control. To explore the biodistribution and tumor accumulation of nanoparticles, we developed indocyanine green (ICG) loaded poly (lactic-co-glycolic acid) (PLGA) -lecithin-polyethylene glycol (PEG) core-shell nanoparticles (INPs) with 39 nm, 68 nm and 116 nm via single-step nanoprecipitation. These INPs exhibited good monodispersity, excellent fluorescence and size stability, and enhanced temperature response after laser irradiation. Through cell uptake and photothermal efficiency in vitro, we demonstrated that 39 nm INPs were more easily be absorbed by pancreatic carcinoma tumor cells (BxPC-3) and showed better photothermal damage than that of 68 nm and 116 nm size of INPs. Simultaneously, the fluorescence of INPs offered a real-time imaging monitor for subcellular locating and in vivo metabolic distribution. Near-infrared imaging in vivo and photothermal therapy illustrated that 68 nm INPs showed the strongest efficiency to suppress tumor growth due to abundant accumulation in BxPC-3 xenograft tumor model. The findings revealed that a nontoxic, size-dependent, theranostic INPs model was built for in vivo cancer imaging and photothermal therapy without adverse effect. Copyright © 2014 Elsevier Ltd. All rights reserved.

Crisis response to schools.

PubMed

Johnson, K

2000-01-01

While community based crisis response teams offer needed resources to schools impacted by crisis, they are often not asked to help. Reports from crisis team leaders at the school shooting incidents at James W. Parker Middle School, Edinboro, Pennsylvania and Columbine High School, Littleton, Colorado are contrasted regarding utilization of community resources. Factors limiting the usefulness of community based teams include unfamiliarity with school organization, culture, and procedures. Key differences in school vs. community team precepts, decision-making, and strategic paradigms render team coordination difficult. Successful cross training presents opportunities for school-community partnership and utilization of community teams for school duty.

Campus Crisis Response at Viberg College

ERIC Educational Resources Information Center

Eaker, Rachel; Viars, Jamie

2014-01-01

This fictional case study examines crisis response in higher education settings. Information about current crisis response procedures, plans, and trends was gathered from informational interviews, current crisis management literature, and multiple college and university websites. The information was synthesized into a fictional case study using…

Signal Strength-Based Global Navigation Satellite System Performance Assessment in the Space Service Volume

NASA Technical Reports Server (NTRS)

Welch, Bryan W.

2016-01-01

NASA is participating in the International Committee on Global Navigation Satellite Systems (GNSS) (ICG)'s efforts towards demonstrating the benefits to the space user in the Space Service Volume (SSV) when a multi-GNSS solution space approach is utilized. The ICG Working Group: Enhancement of GNSS Performance, New Services and Capabilities has started a three phase analysis initiative as an outcome of recommendations at the ICG-10 meeting, in preparation for the ICG-11 meeting. The second phase of that increasing complexity and fidelity analysis initiative is based on augmenting the Phase 1 pure geometrical approach with signal strength-based limitations to determine if access is valid. The second phase of analysis has been completed, and the results are documented in this paper.

[Health indicators in the time of crisis in Italy].

PubMed

Costa, Giuseppe; Marra, Michele; Salmaso, Stefania

2012-01-01

to estimate for the first time in Italy the consequences of the national current economic crisis on health and on social determinants of health, assessing its impact on a set of distal determinants (development and economic wellbeing, labour and environment) and of prossimal ones (material, psychosocial, professional, environmental and behavioural risk factors) on health care performance and on health outcomes normally related to economic trends, as self-perceived health, depression, number of suicides attempts, road traffic incidents and work injuries. The analysis is therefore aimed at identifying the most promising entry points in order to plan and implement either health care and other policies to tackle the negative effects of crisis on health. using the main international and national references on the measure of wellbeing and on the role of social determinants, this paper draws a conceptual framework of all the connections between recession and health. For each mechanism identified, it examines the value of the main available indicators before and during the crisis in order to measure its impact, adjusting if possible for the trend observed in the previous years. Indicators have been selected according to their availability in the main Italian national informative sources and, when not possible, circumscribing the analysis to the regional or local level. regarding the short term impact, results have shown an association between the recession and the raise of mental health related problems (measured in terms of number of suicides, depression and substance misuse), especially on the most disadvantaged groups because of their higher job and financial insecurity. A first ex-ante impact assessment on long term effects allows to attribute almost two hundred deaths a year due to the increase of unemployment rate. Regarding the budget cuts on public expenditure of the health care sector, significant reductions have been shown in specialist care and in drug

The Crisis "Hotline" as Mediated Therapeutic Communication.

ERIC Educational Resources Information Center

Fish, Sandra L.

Hotlines, or telephone crisis-lines, begun in the 1960s and currently numbering in the hundreds provide assistance to callers in crisis, frequently around the clock. Crisis-line communication can be seen as a form of mediated therapeutic communication premised on the existence of a crisis and the medium of the telephone which shapes the…

Blood flow speed of the gastric conduit assessed by indocyanine green fluorescence

PubMed Central

Koyanagi, Kazuo; Ozawa, Soji; Oguma, Junya; Kazuno, Akihito; Yamazaki, Yasushi; Ninomiya, Yamato; Ochiai, Hiroki; Tachimori, Yuji

2016-01-01

Abstract Anastomotic leakage is considered as an independent risk factor for postoperative mortality after esophagectomy, and an insufficient blood flow in the reconstructed conduit may be a risk factor of anastomotic leakage. We investigated the clinical significance of blood flow visualization by indocyanine green (ICG) fluorescence in the gastric conduit as a means of predicting the leakage of esophagogastric anastomosis after esophagectomy. Forty patients who underwent an esophagectomy with gastric conduit reconstruction were prospectively investigated. ICG fluorescence imaging of the gastric conduit was detected by a near-infrared camera system during esophagectomy and correlated with clinical parameters or surgical outcomes. In 25 patients, the flow speed of ICG fluorescence in the gastric conduit wall was simultaneous with that of the greater curvature vessels (simultaneous group), whereas in 15 patients this was slower than that of the greater curvature vessels (delayed group). The reduced speed of ICG fluorescence stream in the gastric conduit wall was associated with intraoperative blood loss (P = 0.008). Although anastomotic leakage was not found in the simultaneous group, it occurred in 7 patients of the delayed group (P < 0.001). A flow speed of ICG fluorescence in the gastric conduit wall of 1.76 cm/s or less was determined by a receiver operating characteristic (ROC) curve, identified as a significant independent predictor of anastomotic leakage after esophagectomy (P = 0.004). This preliminary study demonstrates that intraoperative evaluation of blood flow speed by ICG fluorescence in the gastric conduit wall is a useful means to predict the risk of anastomotic leakage after esophagectomy. PMID:27472732

Sovereign debt crisis in the European Union: A minimum spanning tree approach

NASA Astrophysics Data System (ADS)

Dias, João

2012-03-01

In the wake of the financial crisis, sovereign debt crisis has emerged and is severely affecting some countries in the European Union, threatening the viability of the euro and even the EU itself. This paper applies recent developments in econophysics, in particular the minimum spanning tree approach and the associate hierarchical tree, to analyze the asynchronization between the four most affected countries and other resilient countries in the euro area. For this purpose, daily government bond yield rates are used, covering the period from April 2007 to October 2010, thus including yield rates before, during and after the financial crises. The results show an increasing separation of the two groups of euro countries with the deepening of the government bond crisis.

Telephone Crisis Support Workers' Intentions to Use Recommended Skills While Experiencing Functional Impairment.

PubMed

Kitchingman, Taneile A; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-05-01

Empathic engagement with distressed others can lead to elevated symptoms of psychological distress and functional impairment, which preclude helping professionals' delivery of optimal patient care. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. This study examined the relationship between functional impairment and intentions to use recommended support skills in a representative national sample of 210 telephone crisis support workers. Participants completed an online survey including measures of functional impairment and intentions to use recommended telephone crisis support skills with callers reporting suicidal ideation, symptoms of depression, and anxiety. As a group, participants who experienced greater functional impairment during the past month reported significantly lower intentions to use recommended support skills with callers than those who reported lower functional impairment. Future research is needed to clarify the extent to which results generalize to telephone crisis support workers from other organizations. Results warrant further research to (a) identify determinants of telephone crisis support workers' functional impairment, and (b) for the deliberate management of telephone crisis support workers' functional impairment through developing and/or modifying existing service strategies to optimize workers' psychological well-being and delivery of support to callers.

When a Crisis Strikes.

ERIC Educational Resources Information Center

Keebler, Barbara A.

1989-01-01

Urges Catholic educators to develop a crisis communication plan to ensure that all communication with the press and public is handled promptly and thoroughly by a designated spokesperson. Describes workshops which simulate real-life challenges as a means of testing crisis management plans. Offers guidelines for the development of a crisis…

Long-term effects of youth unemployment on mental health: does an economic crisis make a difference?

PubMed

Thern, Emelie; de Munter, Jeroen; Hemmingsson, Tomas; Rasmussen, Finn

2017-04-01

Ill health is a risk factor and a consequence of unemployment, which might vary depending on the national rate of unemployment. We investigated the long-term effect of youth unemployment on mental health and explored the possible interaction during periods of high (economic crisis) and low (non-crisis) unemployment rates. A register-linked population-based cohort study was conducted including individuals aged 17-24 years. The crisis cohort (n=6410) took part in the Labour Force Survey during the economic crisis (1991-1994) in Sweden and the non-crisis cohort (n=8162) took part in the same survey before the crisis (1983-1986). Follow-up was 19 years. Adjusted HRs and 95% CIs for an inpatient care discharge mental diagnosis with employed people as the reference group were calculated by Cox regressions models. In fully adjusted models, <3 months (HR: 1.69; 95% CI 1.14 to 2.49), 3-6 months (2.19; 1.43 to 3.37) and >6 months (2.70; 1.71 to 4.28) of unemployment were associated with increased risks of getting a mental diagnosis in the crisis cohort. In the non-crisis cohort the risks were: 1.92; 1.40 to 2.63, 2.60; 1.72 to 3.94 and 3.33; 2.00 to 5.57, respectively. No interactions between labour force status and level of unemployment were found. Youth unemployment is related to mental health problems, independent of the overall national rate of unemployment, which is important as the youth unemployment rates are currently at stable high level. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Hypercalcemic crisis: a clinical review.

PubMed

Ahmad, Shazia; Kuraganti, Gayatri; Steenkamp, Devin

2015-03-01

Hypercalcemia is a common metabolic perturbation. However, hypercalcemic crisis is an unusual endocrine emergency, with little clinical scientific data to support therapeutic strategy. We review the relevant scientific English literature on the topic and review current management strategies after conducting a PubMed, MEDLINE, and Google Scholar search for articles published between 1930 and June 2014 using specific keywords: "hypercalcemic crisis," "hyperparathyroid crisis," "parathyroid storm," "severe primary hyperparathyroidism," "acute hyperparathyroidism," and "severe hypercalcemia" for articles pertaining to the diagnosis, epidemiology, clinical presentation, and treatment strategies. Despite extensive clinical experience, large and well-designed clinical studies to direct appropriate clinical care are lacking. Nonetheless, morbidity and mortality rates have substantially decreased since early series reported almost universal fatality. Improved outcomes can be attributed to modern diagnostic capabilities, leading to earlier diagnosis, along with the recognition that primary hyperparathyroidism is the most common etiology for hypercalcemic crisis. Hypercalcemic crisis is an unusual endocrine emergency that portends excellent outcomes if rapid diagnosis, medical treatment, and definitive surgical treatment are expedited. Copyright © 2015 Elsevier Inc. All rights reserved.

Maintenance Crisis vs Solutions.

ERIC Educational Resources Information Center

Haggard, Susie

Industrial maintenance in Northeast Georgia is facing an acute crisis. Contributing factors are economic development that is depleting the work force, aging of the population, downsizing of the military, and lack of technical school graduates. Solutions to the crisis fall into three categories: short-term, mid-term, and long-term. For short-term…

The Little-Known Crisis

ERIC Educational Resources Information Center

Eckholm, Erik P.

1975-01-01

For one-third of the world's people, the energy crisis means the daily scramble to find the wood they need to cook. The accelerating destruction of forests throughout Africa, Asia and Latin America and the utilization of manure as a firewood substitute may produce the most profound ecological crisis of this century. (BT)

Commercial speech in crisis: Crisis Pregnancy Center regulations and definitions of commercial speech.

PubMed

Gilbert, Kathryn E

2013-02-01

Recent attempts to regulate Crisis Pregnancy Centers, pseudoclinics that surreptitiously aim to dissuade pregnant women from choosing abortion, have confronted the thorny problem of how to define commercial speech. The Supreme Court has offered three potential answers to this definitional quandary. This Note uses the Crisis Pregnancy Center cases to demonstrate that courts should use one of these solutions, the factor-based approach of Bolger v. Youngs Drugs Products Corp., to define commercial speech in the Crisis Pregnancy Center cases and elsewhere. In principle and in application, the Bolger factor-based approach succeeds in structuring commercial speech analysis at the margins of the doctrine.

Timing crisis information release via television.

PubMed

Wei, Jiuchang; Zhao, Dingtao; Yang, Feng; Du, Shaofu; Marinova, Dora

2010-10-01

When and how often to release information on television are important issues in crisis and emergency risk communication. There is a lot of crisis information, including warnings and news, to which people should have access, but most of it is not significantly urgent to interrupt the broadcasting of television programmes. Hence, the right timing for the release of crisis information should be selected based on the importance of the crisis and any associated communication requirements. Using recursive methods, this paper builds an audience coverage model of crisis information release. Based on 2007 Household Using TV (HUT) data for Hefei City, China, the optimal combination of broadcasting sequence (with frequencies between one and eight times) is obtained using the implicit enumeration method. The developed model is applicable to effective transmission of crisis information, with the aim of reducing interference with the normal television transmission process and decreasing the psychological effect on audiences. The same model can be employed for other purposes, such as news coverage and weather and road information. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

The financial crisis and the expected effects on vaccinations in Europe: a literature review.

PubMed

Maltezou, Helena C; Lionis, Christos

2015-07-01

Starting in 2008 several European countries experienced a financial crisis. Historically, diseases whose prevention and treatment depend highly on the continuity of healthcare re-emerge during political and financial crises. Evidence suggests that the current financial crisis has had an impact on the health and welfare of Europeans and that population health status and morbidity as well as mortality patterns may change in the coming years. At the same time decisions about expenditure for health services may impact the ability of public health providers to respond. It is expected that the current crisis will further exacerbate socioeconomic and health inequalities and novel vulnerable groups will emerge in addition to existing ones. We review the available evidence and discuss how the current crisis may have an impact on vaccine-preventable diseases and influence vaccination coverage rates in Europe.

Reviewing the definition of crisis in dementia care

PubMed Central

2013-01-01

Background Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. Methods We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. Results Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. Conclusions This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers. PMID:23374634

Reviewing the definition of crisis in dementia care.

PubMed

MacNeil Vroomen, Janet; Bosmans, Judith E; van Hout, Hein P J; de Rooij, Sophia E

2013-02-01

Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers.

Sickle cell crisis and endothelin antagonists.

PubMed

Angerio, Allan D; Lee, Nicole D

2003-01-01

Sickle cell crisis may be more complex than a vaso-occlusive event in response to hypoxia. Endothelin-1 (ET-1) is a potent vasoconstrictor and mitogen secreted in response to hypoxia. ET-1 contributes to the vaso-occlusion and inflammation in sickle cell crisis. ET-1 antagonists may be useful in the prevention and treatment of crisis.

The looming retirement crisis.

PubMed

Walker, D M

1997-06-01

A retirement crisis looms in the United States due to a number of recent and emerging trends that affect government retirement programs, employer- and union-sponsored retirement benefits and personal savings arrangements. The crisis can be averted, but only with well-thought-out action on a number of issues, particularly Social Security and Medicare reform.

Organizational Crisis Experience and Public Relations Roles.

ERIC Educational Resources Information Center

Guth, David W.

1995-01-01

Suggests a relationship between organizational crisis experience and the placement of the public relations function. Notes a relationship between organization size and crisis experience. Uncovers an alarming absence of crisis planning and training in organizations. (SR)

Crisis behavior: An exploration of theories in concert.

PubMed

McConnell, Jason B; Crudo, Christine

2015-01-01

How might prominent existing communication theory better explain behavior in a crisis context, when considered in concert with one another? This theoretical work highlights the insight to be gained using Situational Crisis Communication Theory and Bandura's notions of self-efficacy to heighten the explanatory power of the Theory of Planned Behavior as applied to communication during times of crisis. Situational Crisis Communication Theory better explains how past experience with crisis influences the attitudes and social norms of crisis behavior, while Bandura's notion of self-efficacy speaks more directly to the availability of resources as contributing factors to perceived behavioral control in a crisis situation. As such, the incorporation of these well-developed notions into the broader framework of the Theory of Planned Behavior affords greater understanding of the relationship between communication and behavior during a crisis. Further exploration of this theoretical relationship is warranted.

Australian baby boomers face retirement during the global financial crisis.

PubMed

Kendig, Hal; Wells, Yvonne; O'Loughlin, Kate; Heese, Karla

2013-01-01

This paper examines the impact in Australia of the global financial crisis on the baby boom cohort approaching later life. Data from national focus groups of people aged 50 to 64 years (N = 73), conducted in late 2008, found widespread but variable concern and uncertainty concerning work and retirement plans and experiences. A national survey (N = 1,009) of those aged 50 to 64 years in mid-2009 reported lower levels of financial satisfaction compared with other life domains; many planned to postpone retirement. Findings are interpreted in the context of policies and markets that differed significantly from those in the United States, notwithstanding the global nature of the financial crisis.

Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents

PubMed Central

2016-01-01

We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2±3.7) and adolescent with complicated grief (3.2±6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ2=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents. PMID:26770046

Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents.

PubMed

Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun

2016-01-01

We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2 ± 3.7) and adolescent with complicated grief (3.2 ± 6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents.

The effect of the subprime crisis on the credit risk in global scale

NASA Astrophysics Data System (ADS)

Lee, Sangwook; Kim, Min Jae; Lee, Sun Young; Kim, Soo Yong; Ban, Joon Hwa

2013-05-01

Credit default swap (CDS) has become one of the most actively traded credit derivatives, and its importance in finance markets has increased after the subprime crisis. In this study, we analyzed the correlation structure of credit risks embedded in CDS and the influence of the subprime crisis on this topological space. We found that the correlation was stronger in the cluster constructed according to the location of the CDS reference companies than in the one constructed according to their industries. The correlation both within a given cluster and between different clusters became significantly stronger after the subprime crisis. The causality test shows that the lead lag effect between the portfolios (into which reference companies are grouped by the continent where each of them is located) is reversed in direction because the portion of non-investable and investable reference companies in each portfolio has changed since then. The effect of a single impulse has increased and the response time relaxation has become prolonged after the crisis as well.

The IGY and the Satellite Race: A Reconsideration of a Cold War Crisis that Never Should Have Been

NASA Astrophysics Data System (ADS)

Launius, R. D.

2006-05-01

In October 1957 the Soviet Union launched the first Earth-circling artificial satellite and the crisis that resulted led to numerous actions in the United States aimed at "remediating" a Cold War crisis. This included the establishment of a separate civilian space agency charged with the conduct of an official program of scientific and technological space exploration, consolidation of Department of Defense space activities, the passage of the National Defense Education Act, the creation of a Presidential Science Advisor, and a host of lesser actions. The politics of these changes is fascinating, and has been interpreted as an appropriate political response to a unique crisis situation. Interest groups, all for differing reasons, prodded national leaders to undertake large-scale efforts, something the president thought unnecessarily expensive and once set in place impossible to dismantle. But was the Sputnik crisis truly a crisis in any real sense? Was it made into one by interest groups who used it for their own ends? This paper will trace briefly some of the major themes associated with the IGY and Sputnik and describe the political construction of the crisis as it emerged in 1957- 1958. It will also discuss something about the transformation of federal science and technology that took place in the aftermath of the "crisis" and how it set in train a series of processes and policies that did not unravel until the end of the Cold War.

Enhancing crisis leadership in public health emergencies.

PubMed

Deitchman, Scott

2013-10-01

Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

Expanding the Crisis Planning Function: Introducing Elements of Risk Communication to Crisis Communication Practice.

ERIC Educational Resources Information Center

Williams, David E.; Olaniran, Bolanle A.

1998-01-01

Suggests use of elements of risk communication by crisis communication practitioners facing increasing industrial reliance on new technologies which might be associated with potential health/environment harm. Studies a small company crisis which reveals that elements of anticipation, public involvement/trust, technological comparison, and media…

Outcome of Extended Thymectomy in Myasthenia Crisis Patient.

PubMed

Aftabuddin, M; Bhandari, S

2016-07-01

Myasthenic crisis is a life-threatening condition. We studied the demographic, frequency, causes and clinical presentation of isolated Myasthenic crisis, steps of treatment and to review our experience of extended thymectomy on patients with at least one episode myasthenic crisis. A prospective and retrospective study was conducted on patients with at least one episode of myasthenic crisis, from March 2010 to September 2014, at the Department of Cardiac Surgery, BSMMU, Dhaka, Bangladesh who were referred for thymectomy. Eighteen patients (13.6% of the total 132 patients with myasthenia gravis were admitted with single to multiple episodes of myasthenic crisis, median crisis was 2.5 episodes. Mean age of the patient was 35.5 (18-72) years with male predominance. All eighteen patients had undergone extended thymectomy after completion of 5 cycle plasmapheresis, of which 2 had experienced postoperative respiratory crisis, required invasive ventilator support for median 14 days. One patient required invasive ventilator support after third post operative day. Six patients had thymoma and 12 had thymic hyperplasia. Three patients needed Intravenous immunoglobin. Nine patients needed post operative anti acetylcholinesterase inhibitor after median 2.5 post days. Post thymectomy remission and decreases the frequency of myasthenic crisis was seen in follow up and post operative medication requirement reduced significantly as compared to the preoperative requirement. This report highlights that the patients who had extended thymectomy after episodes of myasthenia crisis are benefitted even in the histhopathology report does not confirmed thymoma. After thymectomy, there was remission of myasthenic crisis. Patients with myasthenic crisis should have judicious drug adjustments under supervision and should be treated aggressively during impending myasthenic crisis. With modern management of myasthenia gravis, early surgery with myasthenic crisis is safe with good long

Leadership in a (permanent) crisis.

PubMed

Heifetz, Ronald; Grashow, Alexander; Linsky, Marty

2009-01-01

The current economic crisis is not just another rough spell. Today's mix of urgency, high stakes, and uncertainty will continue even after the recession ends. The immediate crisis--which we will get through with policy makers' expert technical adjustments--sets the stage for a sustained, or even permanent, crisis, a relentless series of challenges no one has encountered before. Instead of hunkering down and relying on their familiar expertise to deal with the sustained crisis, people in positions of authority--whether they are CEOs or managers heading up a company initiative--must practice what the authors call adaptive leadership. They must, of course, tackle the underlying causes of the crisis, but they must also simultaneously make the changes that will allow their organizations to thrive in turbulent environments. Adaptive leadership is an improvisational and experimental art, requiring some new practices. Like Julie Gilbert, who overcame internal resistance to reorient Best Buy toward female purchasers, adaptive leaders get things done to meet today's challenges and then modify those things to thrive in tomorrow's world. They also embrace disequilibrium, using turbulence as an opportunity to build crucial new capacities, as Paul Levy did to rescue Beth Israel Deaconess Medical Center from a profound financial crisis. Finally, adaptive leaders, such as Egon Zehnder, the founder of an executive search firm, draw out the leadership skills that reside deep in the organization, recognizing the interdependence of all employees and mobilizing everyone to generate solutions.

Conspiracy theories as part of history: The role of societal crisis situations.

PubMed

van Prooijen, Jan-Willem; Douglas, Karen M

2017-07-01

In the present contribution, we examine the link between societal crisis situations and belief in conspiracy theories. Contrary to common assumptions, belief in conspiracy theories has been prevalent throughout human history. We first illustrate historical incidents suggesting that societal crisis situations-defined as impactful and rapid societal change that calls established power structures, norms of conduct, or even the existence of specific people or groups into question-have stimulated belief in conspiracy theories. We then review the psychological literature to explain why this is the case. Evidence suggests that the aversive feelings that people experience when in crisis-fear, uncertainty, and the feeling of being out of control-stimulate a motivation to make sense of the situation, increasing the likelihood of perceiving conspiracies in social situations. We then explain that after being formed, conspiracy theories can become historical narratives that may spread through cultural transmission. We conclude that conspiracy theories originate particularly in crisis situations and may form the basis for how people subsequently remember and mentally represent a historical event.

Analyzing Crisis in Global Financial Indices

NASA Astrophysics Data System (ADS)

Kumar, Sunil; Deo, Nivedita

We apply the Random Matrix Theory and complex network techniques to 20 global financial indices and study the correlation and network properties before and during the financial crisis of 2008 respectively. We find that the largest eigenvalue deviate significantly from the upper bound which shows a strong correlation between financial indices. By using a sliding window of 25 days we find that largest eigenvalue represent the collective information about the correlation between global financial indices and its trend indicate the market conditions. It is confirmed that eigenvectors corresponding to second largest eigenvalue gives useful information about the sector formation in the global financial indices. We find that these clusters are formed on the basis of the geographical location. The correlation network is constructed using threshold method for different values of threshold θ in the range 0 to 0.9, at θ=0.2 the network is fully connected. At θ=0.6, the Americas, Europe and Asia/Pacific form different clusters before the crisis but during the crisis Americas and Europe are strongly linked. If we further increase the threshold to 0.9 we find that European countries France, Germany and UK consistently constitute the most tightly linked markets before and during the crisis. We find that the structure of Minimum Spanning Tree before the crisis is more star like whereas during the crisis it changes to be more chain like. Using the multifractal analysis, we find that Hurst exponents of financial indices increases during the period of crisis as compared to the period before the crisis. The empirical results verify the validity of measures, and this has led to a better understanding of complex financial markets.

3D modelling of the Carnian Crisis in a new FWF Project (P22109-B17) - Ammonite mass mortality (200 000 000 !!! specimens) as proxy for the Carnian Crisis (Taurus, Turkey)

NASA Astrophysics Data System (ADS)

Mayrhofer, Susanne; Lukeneder, Alexander

2010-05-01

different sciences as the Structural Processes Group at the Departments of Geodynamic and Sedimentology (University of Vienna) and the Geometric Modelling and Industrial Geometry group (3D technology at the Vienna University of Technology). Interdisciplinary collaboration with other scientists is essential in modern times. Statistical analysis of the orientation and relative position (e.g. imbrication) of the ammonoid shells can hint to current or transport directions. 3D modelling of calcite-cement distribution (representing geopedal structures) and post-diagenetic calcite-veins displacing several ammonoids will complete the geometrical reconstruction and shed light on the biostratinomic and additional diagentic processes. The combination in analysing different fossil groups with additional analysis of istotopic, magnetostratigraphic, cyclostratigraphic and geochemical features will help to extract details of the Upper Triassic history around one of the most severe crisis in the Mesozoic time, the Carnian Crisis. Investigations, undertaken at sections (e.g. Asagiyaylabel) possessing this time interval, can work as proxy for the major Upper Triassic Tethyan crisis. Environmental changes as displayed by the sea level and climate can become more obvious and the ‘motor' behind the demise better understood.

Indocyanine Green Clearance Varies as a Function of N-Acetylcysteine Treatment in a Murine Model of Acetaminophen Toxicity

PubMed Central

Milesi-Hallé, Alessandra; Abdel-Rahman, Susan M.; Brown, Aliza; McCullough, Sandra S.; Letzig, Lynda; Hinson, Jack A.; James, Laura P.

2011-01-01

Standard assays to assess acetaminophen (APAP) toxicity in animal models include determination of ALT (alanine aminotransferase) levels and examination of histopathology of liver sections. However, these assays do not reflect the functional capacity of the injured liver. To examine a functional marker of liver injury, the pharmacokinetics of indocyanine green (ICG) were examined in mice treated with APAP, saline, or APAP followed by N-acetylcysteine (NAC) treatment. Male B6C3F1 mice were administered APAP (200 mg/kg IP) or saline. Two additional groups of mice received APAP followed by NAC at 1 or 4 h after APAP. At 24 h, mice were injected with ICG (10 mg/kg IV) and serial blood samples (0, 2, 10, 30, 50 and 75 min) were obtained for determination of serum ICG concentrations and ALT. Mouse livers were removed for measurement of APAP protein adducts and examination of histopathology. Toxicity (ALT values and histology) was significantly increased above saline treated mice in the APAP and APAP/NAC 4 h mice. Mice treated with APAP/NAC 1 h had complete protection from toxicity. APAP protein adducts were increased in all APAP treated groups and were highest in the APAP/NAC 1 h group. Pharmacokinetic analysis of ICG demonstrated that the total body clearance (ClT) of ICG was significantly decreased and the mean residence time (MRT) was significantly increased in the APAP mice compared to the saline mice. Mice treated with NAC at 1 h had ClT and MRT values similar to those of saline treated mice. Conversely, mice that received NAC at 4 h had a similar ICG pharmacokinetic profile to that of the APAP only mice. Prompt treatment with NAC prevented loss of functional activity while late treatment with NAC offered no improvement in ICG clearance at 24 h. ICG clearance in mice with APAP toxicity can be utilized in future studies testing the effects of novel treatments for APAP toxicity. PMID:21145883

Consequences of players' dismissal in professional soccer: a crisis-related analysis of group-size effects.

PubMed

Bar-Eli, Michael; Tenenbaum, Gershon; Geister, Sabine

2006-10-01

This study documents the effect of players' dismissals on team performance in professional soccer. Our aim was to determine whether the punishment meted out for unacceptable player behaviour results in reduced team performance. The official web site of the German Soccer Association was used for coding data from games played in the first Bundesliga between the 1963 - 64 and 2003 - 04 (n = 41) seasons. A sample of 743 games where at least one red card was issued was used to test hypotheses derived from crisis theory (Bar-Eli & Tenenbaum, 1989a). Players' dismissals weaken a sanctioned team in terms of the goals and final score following the punishment. The chances of a sanctioned team scoring or winning were substantially reduced following the sanction. Most cards were issued in the later stages of matches. The statistics pertaining to outcome results as a function of game standing, game location, and time phases - all strongly support the view that teams can be considered conceptually similar to individuals regarding the link between stress and performance. To further develop the concept of team and individual psychological performance crisis in competition, it is recommended that reversal theory (Apter, 1982) and self-monitoring and distraction theories (Baumeister, 1984) be included in the design of future investigations pertaining to choking under pressure.

Could measuring of perceived risk among general practitioners have helped anticipate the French BSE crisis?

PubMed

Setbon, Michel; Fischler, Claude; Lukasiewicz, Esther; Raude, Jocelyn; Flahault, Antoine

2004-01-01

In October of 2000, a second BSE crisis caught French public authorities unprepared and caused a collapse in beef consumption as well as considerable political turmoil. Data collected between May and July, 2000, among a group of general practitioners (GPs), while national consumption of beef was back to pre-BSE levels, paradoxically showed high latent risk perception, suggesting a new crisis was possible or likely.

Helping Crisis Managers Protect Reputational Assets: Initial Tests of the Situational Crisis Communication Theory.

ERIC Educational Resources Information Center

Coombs, W. Timothy; Holladay, Sherry J.

2002-01-01

Explains a comprehensive, prescriptive, situational approach for responding to crises and protecting organizational reputation: the situational crisis communication theory (SCCT). Notes undergraduate students read two crisis case studies from a set of 13 cases and responded to questions following the case. Validates a key assumption in SCCT and…

40 CFR 166.45 - Duration of crisis exemption.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Duration of crisis exemption. 166.45... EXEMPTION OF FEDERAL AND STATE AGENCIES FOR USE OF PESTICIDES UNDER EMERGENCY CONDITIONS Crisis Exemptions § 166.45 Duration of crisis exemption. A crisis exemption may be authorized for: (a) Only as long as is...

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

2017-01-01

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, online survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis,weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Agrofuels, Food Sovereignty, and the Contemporary Food Crisis

ERIC Educational Resources Information Center

Rosset, Peter

2009-01-01

In this article, agrofuels are examined in the context of the world food price crisis and the "food sovereignty" proposal for addressing the crisis. Both short- and long-term causes of the crisis are examined, and while agrofuels are presently not a prime causal factor they are clearly contraindicated by the crisis. Food sovereignty,…

Communicating through Crisis: A Strategy for Organizational Survival.

ERIC Educational Resources Information Center

Sturges, David L.

1994-01-01

Suggests that crisis communication should be a part of the larger issues of communication policy and strategy. Builds a case for the need to consider crisis communication in a larger context. Proposes a model of crisis communication content that may serve as a framework for research into the efficacy of communication during crisis episodes. (RS)

School Crisis Management Manual: Guidelines for Administrators. Second Edition.

ERIC Educational Resources Information Center

Smith, Judie

This three-part manual is intended for principals and other administrators responsible for developing and managing school crisis plans. Part 1, preparation for a school crisis, includes sections on the selection and training of members of the school crisis team, steps in developing a school crisis plan, and four crisis scenarios to train team…

A CLEAR Plan for School Crisis Management.

ERIC Educational Resources Information Center

Moriarty, Anthony; And Others

1993-01-01

Although many school formulas for crisis management are well coordinated internally, many are also shortsighted in recognizing when a school crisis falls simultaneously into law enforcement's domain. An Illinois high school has devised CLEAR, a crisis management plan delineating cognizance of personnel, the linkages they establish, accountability…

Crisis -- A Leadership Opportunity

DTIC Science & Technology

2005-04-01

recognized the great value in understanding crisis theory and the leadership strategies to employ during these situations. Additionally, we discovered...ed.: 50. Mitroff, Ian I. Crisis leadership : Planning for the Unthinkable. Hoboken: Wiley, 2004. Murphy, P. (1996). "Chaos Theory as a Model...Crisis–A Leadership Opportunity COL Victor Braden, ARNG CAPT Justin Cooper II, USN COL Michael Klingele, USA Lt Col John P

The impact of the 2008 economic crisis on the increasing number of young psychiatric inpatients.

PubMed

Medel-Herrero, Alvaro; Gomez-Beneyto, Manuel

2017-11-21

Little is published about the impact of the 2008 economic crisis on mental health services in Spain. An interrupted time series analysis was conducted to investigate a potential short-term association between the 2008 economic crisis and the number of psychiatric hospital admissions. The timing of the intervention (April 2008) was based on observed changes in Gross Domestic Product (GDP). Data on 1,152,880 psychiatric inpatients from the national Hospital Morbidity Survey, 69 months before and after the onset of the economic crisis (April 2008), were analyzed. Age-adjusted psychiatric (ICD9 290-319) hospital discharge rates significantly increased from April 2008, matching the onset of the crisis, especially for inpatients aged 15-24 years old and to a less extend for inpatients aged 25-34 years old. Other age groups were not affected. There was a significant increase in diagnoses for disturbance of conduct and emotions, depression, neurotic and personality disorders and alcohol and drug disorders; however, diagnoses for mental retardation and organic psychosis for 15-34 years old inpatients were unaffected. Psychiatric hospital admissions abruptly increased in April 2008, coinciding with the onset of the economic crisis. We identified age groups and diagnoses affected. Increased hospitalizations were found only at the age-ranges most affected by the rise in unemployment. The diagnoses affected were those most sensitive to environmental changes. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

A Crisis of Legendary Proportions.

ERIC Educational Resources Information Center

Simpson, Christopher

2001-01-01

Describes the activities of Indiana University's crisis communications team during the Bob Knight controversy. Discusses how the school's response was based on four crisis communications principles: create a plan, appoint a single spokesperson, respond with open and continuous communications, and expect the unexpected. (EV)

Evaluation of the 113Online Suicide Prevention Crisis Chat Service: Outcomes, Helper Behaviors and Comparison to Telephone Hotlines.

PubMed

Mokkenstorm, Jan K; Eikelenboom, Merijn; Huisman, Annemiek; Wiebenga, Jasper; Gilissen, Renske; Kerkhof, Ad J F M; Smit, Johannes H

2017-06-01

Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer-operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003-2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention. © 2016 The American Association of Suicidology.

Clinical outcomes of double staining and additional ILM peeling during ERM surgery.

PubMed

Oh, Ha Na; Lee, Joo Eun; Kim, Hyun Woong; Yun, Il Han

2013-08-01

To assess the clinical outcomes in idiopathic epiretinal membrane (ERM) patients after vitrectomy and ERM removal with or without additional indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling. The medical records of 43 patients with an idiopathic ERM that underwent vitrectomy and ERM removal between July 2007 and April 2010 were reviewed. The patients were divided into two groups: triamcinolone-assisted simple ERM peeling only (group A, n = 23) and triamcinolone-assisted ERM peeling followed by ICG staining and peeling of the remaining internal ILM (group B, n = 20). No difference was found between the two groups in terms of visual acuity, macular thickness, P1 amplitude or implicit time on multifocal-electroretinogram (mfERG) at six and 12 months postoperatively. In group B, ICG staining after ERM peeling demonstrated that the ILM had been removed together with the ERM in 12 eyes (60%), and all 12 eyes showed punctate retinal hemorrhages during ERM peeling. There was no recurrence of an ERM in either group. Additional procedures involving ICG staining and ILM peeling during ERM surgery do not appear to have an additive effect on the clinical outcomes in terms of visual acuity, retinal function based on mfERG, or recurrence rate.

The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial.

PubMed

Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri

2018-01-01

The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group. Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can

Hyperfibrinogenaemia and hyperviscosity in sickle-cell crisis.

PubMed Central

Richardson, S G; Breeze, G R; Stuart, J

1976-01-01

Plasma fibrinogen concentration and whole-blood viscosity, the latter measured at two shear rates (23 and 230 sec-1), were estimated during eight episodes of sickle-cell crisis and compared with values in 26 sickle-cell anaemia patients who were not in crisis. Painful crisis was associated with a significant increase in both plasma fibrinogen and whole-blood viscosity. Increased fibrinogen-erythrocyte interaction in vivo may be a significant contributory factor to raising blood viscosity and precipitating vaso-occlusive crisis in sickle-cell disease. PMID:977763

Affinity of Indocyanine Green in the Detection of Colorectal Peritoneal Carcinomatosis.

PubMed

Filippello, Alexandre; Porcheron, Jack; Klein, Jean Philippe; Cottier, Michèle; Barabino, Gabriele

2017-04-01

Indocyanine green (ICG) is increasingly being used in digestive oncology. In colorectal cancer, ICG can be used to detect lymph node metastasis and hepatic metastasis on the surface of the liver. In peritoneal carcinomatosis, it was previously suspected that the diffusion of ICG in the tumor mass was due to the enhanced permeability and retention effect; however, this phenomenon has not been clearly demonstrated. Using bevacizumab, an antibody directed against vascular endothelial growth factor that consequently inhibits neoangiogenesis, we sought to confirm the mode of ICG diffusion. We compared the fluorescence of peritoneal carcinomatosis nodules from patients who had previously received bevacizumab during their oncologic treatment with those who did not receive this therapy. The sensitivity of the carcinomatosis nodule fluorescence was higher in the patients who did not receive bevacizumab compared with those who received the drug (76.3% and 65.0%, respectively). The rate of false-negative results was higher in the bevacizumab group than in the group that did not receive the drug (53.8% and 42.9%, respectively). Using bevacizumab, we demonstrate that the enhanced permeability and retention effect causes ICG accumulation in peritoneal carcinomatosis resulting from colorectal cancer.

Organizational Learning and Crisis Management

ERIC Educational Resources Information Center

Wang, Jia

2007-01-01

The impact of crises on organizations has been stronger than ever. This article explores the role of organizational learning in crisis management, an area that has received little attention from HRD community. Recognizing the dynamics and interconnectedness of crisis management, organizational learning, and organizational change, the article…

Health outcomes during the 2008 financial crisis in Europe: systematic literature review

PubMed Central

Parmar, Divya; Ioannidis, John P A

2016-01-01

Objective To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes. Design Systematic literature review. Data sources Structural searches of key databases, healthcare journals, and organisation based websites. Review methods Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis. Results 41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed. Conclusions Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis. PMID:27601477

A pre-crisis vs. crisis analysis of peripheral EU stock markets by means of wavelet transform and a nonlinear causality test

NASA Astrophysics Data System (ADS)

Polanco-Martínez, J. M.; Fernández-Macho, J.; Neumann, M. B.; Faria, S. H.

2018-01-01

This paper presents an analysis of EU peripheral (so-called PIIGS) stock market indices and the S&P Europe 350 index (SPEURO), as a European benchmark market, over the pre-crisis (2004-2007) and crisis (2008-2011) periods. We computed a rolling-window wavelet correlation for the market returns and applied a non-linear Granger causality test to the wavelet decomposition coefficients of these stock market returns. Our results show that the correlation is stronger for the crisis than for the pre-crisis period. The stock market indices from Portugal, Italy and Spain were more interconnected among themselves during the crisis than with the SPEURO. The stock market from Portugal is the most sensitive and vulnerable PIIGS member, whereas the stock market from Greece tends to move away from the European benchmark market since the 2008 financial crisis till 2011. The non-linear causality test indicates that in the first three wavelet scales (intraweek, weekly and fortnightly) the number of uni-directional and bi-directional causalities is greater during the crisis than in the pre-crisis period, because of financial contagion. Furthermore, the causality analysis shows that the direction of the Granger cause-effect for the pre-crisis and crisis periods is not invariant in the considered time-scales, and that the causality directions among the studied stock markets do not seem to have a preferential direction. These results are relevant to better understand the behaviour of vulnerable stock markets, especially for investors and policymakers.

Crisis and Employment: The Case of Korea

ERIC Educational Resources Information Center

Cho, Dongchul; Shin, Sukha

2012-01-01

This paper examines Korea's employment dynamics and analyzes how adverse impacts could be mitigated during the recent economic crisis in comparison with the 1997 to 1998 Asian crisis. A clear lesson is that policies to mitigate adverse impacts of financial crisis on the macroeconomic level should be given priority for preserving employment. In…

Crisis of Youth or Youth in Crisis? Education, Employment and Legitimation Crisis

ERIC Educational Resources Information Center

Simmons, Robin; Smyth, John

2016-01-01

This paper uses the Habermasian concept of legitimation crisis to critique the relationship between post-compulsory education and training and the chronic levels of youth unemployment and under-employment which now characterise post-industrial Western economies, such as the UK. It draws on data from an ethnographic study of the lives of young…

Cardiac troponin I in sickle cell crisis.

PubMed

Aslam, Ahmad K; Rodriguez, Carlos; Aslam, Ahmed F; Vasavada, Balendu C; Khan, Ijaz A

2009-03-20

Gross and microscopic findings consistent with acute and healed myocardial injury without coronary artery disease have been described in autopsy studies of patients with sickle cell crisis. The present study was designed to determine whether serum levels of cardiac troponin I are elevated in sickle cell crisis. Cardiac troponin I levels were measured in 32 patients age>18 years with the admission diagnosis of sickle cell crisis. All patients had cardiac troponin I level drawn >24 h after the onset of symptoms. The clinical profile and electrocardiograms were analyzed. Out of 32 patients, 2 patients had serum cardiac troponin I elevated, both had presented with acute chest syndrome. Serum cardiac troponin I may be elevated during sickle cell crisis, possibly by myocardial ischemia resulting from microvascular coronary obstruction during sickle cell crisis.

Effects of Supervision in the Training of Nonprofessional Crisis-Intervention Counselors

ERIC Educational Resources Information Center

Doyle, William W., Jr.; And Others

1977-01-01

This study evaluated three major models currently used by crisis-intervention centers to train and supervise nonprofessional counselors. Training groups included preservice training only (PSO), preservice training and delayed supervision (PSD), and preservice training and immediate supervision (PSI). Findings indicate most learning by…

Communications and the Urban Crisis: Doing Our Own Thing.

ERIC Educational Resources Information Center

Hilliard, Robert L.

The urban crisis has sparked two primary needs: 1) orienting formal education to the aural-visual needs and psychological set of the child, rather than to the outmoded administrative ease of the teacher; and 2) educating the majority society to the needs and problems of minority racial groups. Two efforts to meet the first problem are use of media…

Crisis in Context Theory: An Ecological Model

ERIC Educational Resources Information Center

Myer, Rick A.; Moore, Holly B.

2006-01-01

This article outlines a theory for understanding the impact of a crisis on individuals and organizations. Crisis in context theory (CCT) is grounded in an ecological model and based on literature in the field of crisis intervention and on personal experiences of the authors. A graphic representation denotes key components and premises of CCT,…

Use of Tc-99m-galactosyl-neoglycoalbumin (Tc-NGA) to determine hepatic blood flow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stadalnik, R.C.; Vera, D.R.; Woodle, E.S.

1984-01-01

Tc-NGA is a new liver radiopharmaceutical which binds to a hepatocyte-specific membrane receptor. Three characteristics of Tc-NGA can be exploited in the measurement of hepatic blood flow (HBF): 1) ability to alter the affinity of Tc-NGA for its receptor by changing the galactose: albumin ratio; 2) ability to achieve a high specific activity with Tc-99m labeling; and 3) ability to administer a high molar dose of Tc-NGA without physiologic side effects. In addition, kinetic modeling of Tc-NGA dynamic data can provide estimates of hepatic receptor concentration. In experimental studies in young pigs, HBF was determined using two techniques: 1) kineticmore » modeling of dynamic data using moderate affinity, low specific activity Tc-NGA (Group A, n=12); and 2) clearance (CL) technique using high affinity, high specific activity Tc-NGA (Group B, n=4). In both groups, HBF was determined simultaneously by continuous infusion of indocyanine green (CI-ICG) with hepatic vein sampling. Regression analysis of HBF measurements obtained with the Tc-NGA kinetic modeling technique and the CI-ICG technique (Group A) revealed good correlation between the two techniques (r=0.802, p=0.02). Similarly, HBF determination by the clearance technique (Group B) provided highly accurate measurements when compared to the CI-ICG technique. Hepatic blood flow measurements by the clearance technique (CL-NGA) fell within one standard deviation of the error associated with each CI-ICG HBF measurement (all CI-ICG standard deviations were less than 10%).« less

Crisis management teams in health organisations.

PubMed

Canyon, Deon V

2012-01-01

Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

Myasthenic crisis patients who require intensive care unit management.

PubMed

Sakaguchi, Hideya; Yamashita, Satoshi; Hirano, Teruyuki; Nakajima, Makoto; Kimura, En; Maeda, Yasushi; Uchino, Makoto

2012-09-01

The purpose of this report was to investigate predictive factors that necessitate intensive care in myasthenic crisis (MC). We retrospectively reviewed MC patients at our institution and compared ICU and ward management groups. Higher MG-ADL scale scores, non-ocular initial symptoms, infection-triggered findings, and higher MGFA classification were observed more frequently in the ICU group. In patients with these prognostic factors, better outcomes may be obtained with early institution of intensive care. Copyright © 2012 Wiley Periodicals, Inc.

[The NETWASS prevention model for early identification and assessment of adolescents in psychosocial crisis].

PubMed

Sommer, Friederike; Fiedler, Nora; Leuschner, Vincenz; Scheithauer, Herbert

2016-01-01

The research-based NETWASS prevention model aims to enable school staff to identify students experiencing a psychosocial crisis that could lead to severe targeted school violence and to initiate appropriate support measures. A detailed analysis of the adolescent psychosocial crisis is conducted at an early stage by evaluating possible warning behaviors, crisis symptoms, a student’s individual and social background, and resources. The model was implemented in 98 schools. During the project duration of seven months staff from 59 schools reported 99 cases of a student’s psychosocial crisis. Three experts conducted a content analysis of the reported qualitative data focusing on crisis symptoms of the students as well as the initiated measures. Results show a broad spectrum of risk factors, whereas aggressive behavior of students was reported most frequently. On the basis of theoretical assumptions, the reported cases were divided into three distinct risk groups. A total of eight high-risk cases were observed and reported by the school staff. The school staff mostly reacted to the student crisis by initiating resource-orientated measures, the expertise of child and youth therapists was mostly requested for the high risk cases. By describing the impact of cases and choice of measures undertaken, the study aims to give an overview of incidents schools as well as clinical psychologists and therapists are confronted with.

Ultrastructure of the membrana limitans interna after dye-assisted membrane peeling.

PubMed

Brockmann, Tobias; Steger, Claudia; Westermann, Martin; Nietzsche, Sandor; Koenigsdoerffer, Ekkehart; Strobel, Juergen; Dawczynski, Jens

2011-01-01

The purpose of this study was to investigate the ultrastructure of the membrana limitans interna (internal limiting membrane, ILM) and to evaluate alterations to the retinal cell layers after membrane peeling with vital dyes. Twenty-five patients (25 eyes) who underwent macular hole surgery were included, whereby 12 indocyanine green (ICG)- and 13 brilliant blue G (BBG)-stained ILM were analyzed using light, transmission electron and scanning electron microscopy. Retinal cell fragments on the ILM were identified in both groups using immunohistochemistry. Comparing ICG- and BBG-stained membranes, larger cellular fragments were observed at a higher frequency in the BBG group. Thereby, the findings indicate that ICG permits an enhanced separation of the ILM from the underlying retina with less mechanical destruction. A possible explanation might be seen in the known photosensitivity of ICG, which induces a stiffening and shrinkage of the ILM but also generates retinal toxic metabolites. Copyright © 2011 S. Karger AG, Basel.

Glomerular function in sickle cell disease patients during crisis.

PubMed

Aderibigbe, A; Arije, A; Akinkugbe, O O

1994-06-01

An 8 month prospective study was carried out in 20 adult sickle cell disease (SCD) patients 16 sickle cell anaemia (Hbss) and 4 sickle cell Hbc disease (Hbsc); who had vaso-occlusive crises within the study period to determine the extent of the effect of sickle cell crisis on glomerular function in SCD patients during crisis. The male: female ratio was 1:57 and their mean age was 21.1 +/- 7.9 years. Creatinine clearance (CCr), as an index of glomerular function, was determined at the pre-crisis, crisis, 2 and 4 weeks post-crisis and at the end of the study period. The mean values of their CCr dropped from 113.37 +/- 33.80mls/min at pre-crisis stage to 96.39 +/- 30.13mls/min during crisis (p < 0.001) indicating glomerular dysfunction. It improved significantly to 107.75 +/- 30.20mls/min at 4 weeks post-crisis (p < 0.001). There was no significant differences in the mean values of CCr at the end of the study (116.20 +/- 31.43mls/min) compared to the pre-crisis stage (p > 0.05). It is concluded that glomerular dysfunction in SCD patients during crisis is potentially reversible.

Optimal dye concentration and irradiance for laser-assisted vascular anastomosis.

PubMed

Ren, Zhen; Xie, Hua; Lagerquist, Kathryn A; Burke, Allen; Prahl, Scott; Gregory, Kenton W; Furnary, Anthony P

2004-04-01

This investigation was done in order to find optimal indocyanine green (ICG) concentration and energy irradiance in laser vascular welding. Many studies have shown that laser tissue welding with albumin solder/ICG may be an effective technique in surgical reconstruction. However, there are few reports regarding optimal laser settings and concentrations of ICG within the albumin solder in laser-assisted vascular anastomosis. Porcine carotid artery strips (n = 120) were welded in end-to-end by diode laser with 50% albumin solder of 0.01, 0.1, and 1.0 mM ICG at irradiance of 27.7, 56.7, and 76.9 W/cm(2), respectively. Temperature was measured by inserting thermocouples outside and inside the vessel. Tensile strength and histology were studied. Temperature and strength of the anastomosis significantly decreased (all p < 0.05) with increasing ICG concentration at 56.7 W/cm(2). Histological study showed minimal thermal injury limited to adventitia and no appreciable difference between all groups. ICG concentration within solder is the most important factor affecting both vascular temperature and tensile strength. The optimal balance between strength and minimal thermal injury may be achieved primarily at 56.7 W/cm(2) and 0.01 mM ICG.

Education and Our Ecological Crisis

ERIC Educational Resources Information Center

Klimas, John

1970-01-01

Discusses causes of our ecological crisis and suggests that in order to overcome the crisis we have to sprinkle our teaching with a sense of wonder, impress upon the youth that there is nothing difficult or mysterious about the ecological viewpoint, give youth an awareness of the diversity of things in our environment, stress interrelationships…

Supervision Experiences of Professional Counselors Providing Crisis Counseling

ERIC Educational Resources Information Center

Dupre, Madeleine; Echterling, Lennis G.; Meixner, Cara; Anderson, Robin; Kielty, Michele

2014-01-01

In this phenomenological study, the authors explored supervision experiences of 13 licensed professional counselors in situations requiring crisis counseling. Five themes concerning crisis and supervision were identified from individual interviews. Findings support intensive, immediate crisis supervision and postlicensure clinical supervision.

Crisis intervention for people with severe mental illnesses

PubMed Central

Murphy, Suzanne; Irving, Claire B; Adams, Clive E; Driver, Ron

2014-01-01

Background A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. Objectives To review the effects of crisis intervention models for anyone with serious mental illness experiencing an acute episode, compared with ‘standard care’. Search methods We updated the 1998, 2003 and 2006 searches with a search of the Cochrane Schizophrenia Group’s Register of trials (2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE, and PsycINFO. Selection criteria We included all randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. Data collection and analysis We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early from a trial had no improvement. Main results Three new studies have been found since the last review in 2006 to add to the five studies already included in this review. None of the previously included studies investigated crisis intervention alone; all used a form of home care for acutely ill people, which included elements of crisis intervention. However, one of the new studies focuses purely on crisis intervention as provided by Crisis Resolution Home Teams within the UK; the two other new studies investigated crisis houses i.e. residential alternatives to hospitalisation providing home-like environments. Crisis intervention appears to reduce repeat admissions to hospital after the initial ‘index’ crises investigated in the included studies, this was particularly so for mobile crisis teams supporting patients in their own homes. Crisis intervention reduces the number of people leaving the study early, reduces family burden, is a more

Pheochromocytoma crisis is not a surgical emergency.

PubMed

Scholten, Anouk; Cisco, Robin M; Vriens, Menno R; Cohen, Jenny K; Mitmaker, Elliot J; Liu, Chienying; Tyrrell, J Blake; Shen, Wen T; Duh, Quan-Yang

2013-02-01

Pheochromocytoma crisis is a feared and potentially lethal complication of pheochromocytoma. We sought to determine the best treatment strategy for pheochromocytoma crisis patients and hypothesized that emergency resection is not indicated. Retrospective cohort study (1993-2011); literature review (1944-2011). Tertiary referral center. There were 137 pheochromocytoma patients from our center and 97 pheochromocytoma crisis patients who underwent adrenalectomy from the literature. Medical management of pheochromocytoma crisis; adrenalectomy. Perioperative complications, conversion, and mortality. In our database, 25 patients (18%) presented with crisis. After medical stabilization and α-blockade, 15 patients were discharged and readmitted for elective surgery and 10 patients were operated on urgently during the same hospitalization. None underwent emergency surgery. Postoperatively, patients who underwent elective surgery had shorter hospital stays (1.7 vs 5.7 d, P = 0.001) and fewer postoperative complications (1 of 15 [7%] vs 5 of 10 [50%], P = 0.045) and were less often admitted to the intensive care unit (1 of 15 [7%] vs 5 of 10 [50%], P = 0.045) in comparison with urgently operated patients. There was no mortality. Review of the literature (n = 97) showed that crisis patients who underwent elective or urgent surgery vs emergency surgery had less intraoperative (13 of 31 [42%] vs 20 of 25 [80%], P < 0.001) and postoperative complications (15 of 45 [33%] vs 15 of 21 [71%], P = 0.047) and a lower mortality (0 of 64 vs 6 of 33 [18%], P = 0.002). Management of patients presenting with pheochromocytoma crisis should include initial stabilization of the acute crisis followed by sufficient α-blockade before surgery. Emergency resection of pheochromocytoma is associated with high surgical morbidity and mortality.

[The crisis of medicine or the antimedicine crisis].

PubMed

Foucault, M

1976-01-01

In this lecture, Professor Michel Foucault makes an in-depth study of the problems currently afflicting medical institutions and the medical practice. He deals with the thesis set forth by Ivan Illich in his book Medical Nemesis--The expropriation of Health, as well as the 1942 Beveridge Plan, but goes even further back in history to discover the origin of the medical crisis common throughout the world--back to the XVIII century roots of the social practice of medicine. He also describes the phases through which medical activity has passed from then until now and deals with what he calls the political economy of medicine. Finally, he reaches the conclusion that what matters is not so much the present crisis of medicine, which he considers to be a false concept, but the discipline's historical model dating from the XVIII century and serving to determine to what extent it can be modified.

School Buildings in Today's Crisis

ERIC Educational Resources Information Center

Blyth, Alastair

2009-01-01

To get a picture of the impact of the current economic and financial crisis on educational building programmes so far, the OECD Centre for Effective Learning Environments (CELE) has been conducting a survey of member countries and regions. The survey focuses on three main issues: the impact of the crisis on publicly funded projects, the impact on…

Leaders Urge Colleges to Think Globally Despite Economic Crisis

ERIC Educational Resources Information Center

McMurtrie, Beth; Wheeler, David

2008-01-01

The global economic crisis has accelerated the fear that the United States' international power is fading. It has also made clear the need for American higher education to engage more deeply with the rest of the world, not run from it. That was the consensus among a group of presidents and provosts who met in New York this month as part of…

Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis

PubMed Central

Lawlor, Caroline; Cole, Laura; Howard, Louise M.

2012-01-01

Background: Much recent debate on excess rates of compulsory detention and coercive routes to care has focused on young black men; evidence is less clear regarding ethnic variations among women and factors that may mediate these. Aim: To explore ethnic variations in compulsory detentions of women, and to explore the potential role of immediate pathways to admission and clinician-rated reasons for admission as mediators of these differences. Method: All women admitted to an acute psychiatric inpatient ward or a women’s crisis house in four London boroughs during a 12-week period were included. Data were collected regarding their pathways to care, clinician-rated reasons for admission, hospital stays, and social and clinical characteristics. Results: Two hundred and eighty seven (287) women from white British, white other, black Caribbean, black African and black other groups were included. Adjusting for social and clinical characteristics, all groups of black patients and white other patients were significantly more likely to have been compulsorily admitted than white British patients; white British patients were more likely than other groups to be admitted to a crisis house and more likely than all the black groups to be admitted because of perceived suicide risk. Immediate pathways to care differed: white other, black African and black other groups were less likely to have referred themselves in a crisis and more likely to have been in contact with the police. When adjustment was made for differences in pathways to care, the ethnic differences in compulsory admission were considerably reduced. Discussion: There are marked ethnic inequities not only between white British and black women, but also between white British and white other women in experiences of acute admission. Differences between groups in help-seeking behaviours in a crisis may contribute to explaining differences in rates of compulsory admission. PMID:21059630

Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis.

PubMed

Lawlor, Caroline; Johnson, Sonia; Cole, Laura; Howard, Louise M

2012-01-01

Much recent debate on excess rates of compulsory detention and coercive routes to care has focused on young black men; evidence is less clear regarding ethnic variations among women and factors that may mediate these. To explore ethnic variations in compulsory detentions of women, and to explore the potential role of immediate pathways to admission and clinician-rated reasons for admission as mediators of these differences. All women admitted to an acute psychiatric inpatient ward or a women's crisis house in four London boroughs during a 12-week period were included. Data were collected regarding their pathways to care, clinician-rated reasons for admission, hospital stays, and social and clinical characteristics. Two hundred and eighty seven (287) women from white British, white other, black Caribbean, black African and black other groups were included. Adjusting for social and clinical characteristics, all groups of black patients and white other patients were significantly more likely to have been compulsorily admitted than white British patients; white British patients were more likely than other groups to be admitted to a crisis house and more likely than all the black groups to be admitted because of perceived suicide risk. Immediate pathways to care differed: white other, black African and black other groups were less likely to have referred themselves in a crisis and more likely to have been in contact with the police. When adjustment was made for differences in pathways to care, the ethnic differences in compulsory admission were considerably reduced. There are marked ethnic inequities not only between white British and black women, but also between white British and white other women in experiences of acute admission. Differences between groups in help-seeking behaviours in a crisis may contribute to explaining differences in rates of compulsory admission.

Treatment of Near-Infrared Photodynamic Therapy Using a Liposomally Formulated Indocyanine Green Derivative for Squamous Cell Carcinoma

PubMed Central

Maruyama, Tetsuro; Akutsu, Yasunori; Suganami, Akiko; Tamura, Yutaka; Fujito, Hiromichi; Ouchi, Tomoki; Akanuma, Naoki; Isozaki, Yuka; Takeshita, Nobuyoshi; Hoshino, Isamu; Uesato, Masaya; Toyota, Taro; Hayashi, Hideki; Matsubara, Hisahiro

2015-01-01

Introduction Photodynamic therapy (PDT) is a less invasive option for cancer treatment that has evolved through recent developments in nanotechnology. We have designed and synthesized a novel liposome system that includes an indocyanine green (ICG) derivative, ICG-C18, in its bilayer. In addition to its use as an optical imager to visualize blood, lymphatic, and bile flow, ICG has also been used as an optical sensitizer. In the present report, we evaluate the use of our novel liposome system, LP-ICG-C18, in PDT for squamous cell carcinoma in an autologous murine model. Materials and Methods An excitation pulse beam (300 μJ/pulse) of a single band (800 nm) was used for sensitization. The cytotoxicity of the photodynamic therapy was evaluated in terms of cellular morphology changes, methyl thiazolyl tetrazolium (MTT) assay results, and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) staining. We tested the enhanced permeability and retention effect of LP-ICG-C18 in tumor-bearing C3H/He mice using a near-infrared fluorescence imaging system and fluorescence microscopy. We also examined the antitumor effect of PDT by measuring tumor volume in tumor-bearing mice. Results Cell death and apoptosis were only observed in the PDT group receiving LP-ICG-C18. LP-ICG-C18 itself had no cytotoxic activity and showed good biocompatibility. LP-ICG-C18 accumulated on the tumor 24 hours after injection and was retained for approximately 3 weeks. Tumor cell apoptosis following PDT with LP-ICG-C18 was also observed under optical microscopy, MTT assay, and TUNEL staining. Conclusion These findings suggest that LP-ICG-C18 may be an effective intervening material in PDT for malignant disease. PMID:25850029

Treatment of near-infrared photodynamic therapy using a liposomally formulated indocyanine green derivative for squamous cell carcinoma.

PubMed

Maruyama, Tetsuro; Akutsu, Yasunori; Suganami, Akiko; Tamura, Yutaka; Fujito, Hiromichi; Ouchi, Tomoki; Akanuma, Naoki; Isozaki, Yuka; Takeshita, Nobuyoshi; Hoshino, Isamu; Uesato, Masaya; Toyota, Taro; Hayashi, Hideki; Matsubara, Hisahiro

2015-01-01

Photodynamic therapy (PDT) is a less invasive option for cancer treatment that has evolved through recent developments in nanotechnology. We have designed and synthesized a novel liposome system that includes an indocyanine green (ICG) derivative, ICG-C18, in its bilayer. In addition to its use as an optical imager to visualize blood, lymphatic, and bile flow, ICG has also been used as an optical sensitizer. In the present report, we evaluate the use of our novel liposome system, LP-ICG-C18, in PDT for squamous cell carcinoma in an autologous murine model. An excitation pulse beam (300 μJ/pulse) of a single band (800 nm) was used for sensitization. The cytotoxicity of the photodynamic therapy was evaluated in terms of cellular morphology changes, methyl thiazolyl tetrazolium (MTT) assay results, and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) staining. We tested the enhanced permeability and retention effect of LP-ICG-C18 in tumor-bearing C3H/He mice using a near-infrared fluorescence imaging system and fluorescence microscopy. We also examined the antitumor effect of PDT by measuring tumor volume in tumor-bearing mice. Cell death and apoptosis were only observed in the PDT group receiving LP-ICG-C18. LP-ICG-C18 itself had no cytotoxic activity and showed good biocompatibility. LP-ICG-C18 accumulated on the tumor 24 hours after injection and was retained for approximately 3 weeks. Tumor cell apoptosis following PDT with LP-ICG-C18 was also observed under optical microscopy, MTT assay, and TUNEL staining. These findings suggest that LP-ICG-C18 may be an effective intervening material in PDT for malignant disease.

Adult Sickle Cell Anaemia Patients in Bone Pain Crisis have Elevated Pro-Inflammatory Cytokines

PubMed Central

Alagbe, Adekunle Emmanuel; Aworanti, Oladapo Wale

2018-01-01

Background and Objectives Inflammatory markers that influence bone pain crisis (BPC) and other complications of sickle cell anaemia (SCA) are numerous and play various roles. This study determined the plasma levels of tumour necrosis factor (TNF) - α, interleukin - 8 (IL-8), and endothelin - 1 (ET-1) in adult SCA patients during BPC and in steady state. In addition, the plasma levels of these cytokines were correlated with the severity of BPC of the patients. Methods and Materials Sixty adult SCA patients (30 during BPC and 30 during steady state) and 30 haemoglobin A controls were enrolled for this cross-sectional study. The severity of BPC was assessed clinically, and questionnaires were filled. Plasma levels of TNF- α, IL-8 and ET-1 were quantified by ELISA, and haematological parameters were determined using a 5-part auto-analyzer. Plasma levels were correlated with the severity of bone pain crisis. Results were considered statistically significant if p<0.05. Results Plasma TNF-α, IL-8, and ET-1 were significantly elevated in the BPC group than in the steady state group and the controls. Plasma TNF-α, IL-8 and ET-1 were markedly higher in the severe BPC groups than the steady state and control groups, There was a positive correlation between TNF-α and ET-1 in the bone pain crisis group. Conclusion Elevated levels of plasma TNF-α, IL-8, and ET-1 further establish the chronic inflammatory state in SCA and equally affirm their significant contribution, not only to pathogenesis but also to the severity of pain in SCA. PMID:29531654

Cool Heads: Crisis Management for Administrators.

ERIC Educational Resources Information Center

Smiar, Nicholas P.

1992-01-01

Applies risk management models to child care administration. These models have been used by corporations to plan for crisis management. The formation of a crisis management policy and procedure is described, and features of effective communication during crises are outlined. (GLR)

Thinking About Opponent Behavior in Crisis and Conflict: A Generic Model for Analysis and Group Discussion

DTIC Science & Technology

1991-01-01

games. A leader with limited rationality will make decisions that bear a -vi- reasonable relationship to his objectives and values, but they may be...possible reasoning of opponents before or during crisis and conflict. The methodology is intended for use in analysis and defense planning, especially...overconfidence in prediction, failure to hedge, and failure actively to find ways to determine and affect the opponent’s reasoning before it is too late

Effects of the Global Financial Crisis on Health in High-Income Oecd Countries: A Narrative Review.

PubMed

Karanikolos, Marina; Heino, Pia; McKee, Martin; Stuckler, David; Legido-Quigley, Helena

2016-01-01

A growing body of evidence documents how economic crises impact aspects of health across countries and over time. We performed a systematic narrative review of the health effects of the latest economic crisis based on studies of high-income countries. Papers published between January 2009 and July 2015 were selected based on review of titles and abstracts, followed by a full text review conducted by two independent reviewers. Ultimately, 122 studies were selected and their findings summarized. The review finds that the 2008 financial crisis had negative effects on mental health, including suicide, and to a varying extent on some non-communicable and communicable diseases and access to care. Although unhealthy behaviors such as hazardous drinking and tobacco use appeared to decline during the crisis, there have been increases in some groups, typically those already at greatest risk. The health impact was greatest in countries that suffered the largest economic impact of the crisis or prolonged austerity. The Great Recessions in high-income countries have had mixed impacts on health. They tend to be worse when economic impacts are more severe, prolonged austerity measures are implemented, and there are pre-existing problems of substance use among vulnerable groups. © The Author(s) 2016.

Volumetrically-Derived Global Navigation Satellite System Performance Assessment from the Earths Surface through the Terrestrial Service Volume and the Space Service Volume

NASA Technical Reports Server (NTRS)

Welch, Bryan W.

2016-01-01

NASA is participating in the International Committee on Global Navigation Satellite Systems (GNSS) (ICG)'s efforts towards demonstrating the benefits to the space user from the Earth's surface through the Terrestrial Service Volume (TSV) to the edge of the Space Service Volume (SSV), when a multi-GNSS solution space approach is utilized. The ICG Working Group: Enhancement of GNSS Performance, New Services and Capabilities has started a three phase analysis initiative as an outcome of recommendations at the ICG-10 meeting, in preparation for the ICG-11 meeting. The first phase of that increasing complexity and fidelity analysis initiative was recently expanded to compare nadir-facing and zenith-facing user hemispherical antenna coverage with omnidirectional antenna coverage at different distances of 8,000 km altitude and 36,000 km altitude. This report summarizes the performance using these antenna coverage techniques at distances ranging from 100 km altitude to 36,000 km to be all encompassing, as well as the volumetrically-derived system availability metrics.

Write the Plan before You Have the Crisis.

ERIC Educational Resources Information Center

Wirth, Eileen

2002-01-01

Outlines the development process and essential elements of a crisis communication strategy. Key steps include: (1) selecting a spokesperson; (2) publicizing the spokesperson's identity; (3) preparing a crisis notebook; (4) providing cell phones; (5) choosing a news conference location; (6) rehearsing crisis scenarios; and (7) obtaining interview…

Operation Safe Border: The Ecuador-Peru Crisis

DTIC Science & Technology

1996-01-01

52 JFQ / Spring 1996 In January 1995, the hemisphere was shocked by an outbreak of fighting between Ecuador and Peru over a long-festering border...Weidner, USA, is commander of the U.S. Military Group-Honduras and served as commander of the U.S. Contingent, Military Observer Mission, Ecuador ...Peru. Operation Safe Border: The Ecuador -Peru Crisis By G L E N N R. W E I D N E R Santiago River (fore- ground) and Yaupi River on Ecuador -Peru

The effect of the late 2000s financial crisis on suicides in Spain: an interrupted time-series analysis.

PubMed

Lopez Bernal, James A; Gasparrini, Antonio; Artundo, Carlos M; McKee, Martin

2013-10-01

The current financial crisis is having a major impact on European economies, especially that of Spain. Past evidence suggests that adverse macro-economic conditions exacerbate mental illness, but evidence from the current crisis is limited. This study analyses the association between the financial crisis and suicide rates in Spain. An interrupted time-series analysis of national suicides data between 2005 and 2010 was used to establish whether there has been any deviation in the underlying trend in suicide rates associated with the financial crisis. Segmented regression with a seasonally adjusted quasi-Poisson model was used for the analysis. Stratified analyses were performed to establish whether the effect of the crisis on suicides varied by region, sex and age group. The mean monthly suicide rate in Spain during the study period was 0.61 per 100 000 with an underlying trend of a 0.3% decrease per month. We found an 8.0% increase in the suicide rate above this underlying trend since the financial crisis (95% CI: 1.009-1.156; P = 0.03); this was robust to sensitivity analysis. A control analysis showed no change in deaths from accidental falls associated with the crisis. Stratified analyses suggested that the association between the crisis and suicide rates is greatest in the Mediterranean and Northern areas, in males and amongst those of working age. The financial crisis in Spain has been associated with a relative increase in suicides. Males and those of working age may be at particular risk of suicide associated with the crisis and may benefit from targeted interventions.

The effects of crisis plans for patients with psychotic and bipolar disorders: a randomised controlled trial.

PubMed

Ruchlewska, A; Mulder, C L; Smulders, R; Roosenschoon, B J; Koopmans, G; Wierdsma, A

2009-07-09

Crises and (involuntary) admissions have a strong impact on patients and their caregivers. In some countries, including the Netherlands, the number of crises and (involuntary) admissions have increased in the last years. There is also a lack of effective interventions to prevent their occurrence. Previous research has shown that a form of psychiatric advance statement - joint crisis plan - may prevent involuntary admissions, but another study showed no significant results for another form. The question remains which form of psychiatric advance statement may help to prevent crisis situations. This study examines the effects of two other psychiatric advance statements. The first is created by the patient with help from a patient's advocate (Patient Advocate Crisis Plan: PACP) and the second with the help of a clinician only (Clinician facilitated Crisis Plan: CCP). We investigate whether patients with a PACP or CCP show fewer emergency visits and (involuntary) admissions as compared to patients without a psychiatric advance statement. Furthermore, this study seeks to identify possible mechanisms responsible for the effects of a PACP or a CCP. This study is a randomised controlled trial with two intervention groups and one control condition. Both interventions consist of a crisis plan, facilitated through the patient's advocate or the clinician respectively.Outpatients with psychotic or bipolar disorders, who experienced at least one psychiatric crisis during the previous two years, are randomly allocated to one of the three groups. Primary outcomes are the number of emergency (after hour) visits, (involuntary) admissions and the length of stay in hospital. Secondary outcomes include psychosocial functioning and treatment satisfaction. The possible mediator variables of the effects of the crisis plans are investigated by assessing the patient's involvement in the creation of the crisis plan, working alliance, insight into illness, recovery style, social support, locus

Beyond policy networks: policy framing and the politics of expertise in the 2001 Foot and Mouth Disease crisis.

PubMed

Wilkinson, Katy; Lowe, Philip; Donaldson, Andrew

2010-01-01

For the past decade, the policy community/issue network typology of pressure group interaction has been used to explain policy outcomes and the policy-making process. To re-examine the validity of this typology, the paper focuses on the UK government's response to the 2001 Foot and Mouth Disease (FMD) crisis, and in particular the decision to pursue contiguous culling rather than vaccination to overcome the epidemic. Rather than illustrating the emergence of an issue network in agricultural policy, the decision-making process of the FMD outbreak demonstrates continuity with prior crises. In addition, the politicization of scientific expertise is identified as an emerging trend in crisis management. Policy framing is used to explain the impetus behind the contiguous cull decision, concluding that the legacy of previous policy choices conditioned the crisis response to a far greater degree than contemporaneous pressure group action.

Pastoral crisis intervention with children: recognizing and responding to the spiritual reaction of children.

PubMed

McPherson, Kenneth F

2004-01-01

Many individuals struggle to express their thoughts and feelings following a crisis situation. When these feelings include questions related to spiritual issues such as bad things happening to good people, meaning in life and its tragedies, and the very existence of a caring and loving God, people shut down even more tightly. Imagine how much greater this difficulty becomes for those who lack the ability to verbalize what they are experiencing. Many of our most widely used crisis intervention models rely on verbal techniques to elicit people's thoughts and feelings about stressful incidents they've just experienced. The main focus of this paper is to provide alternative techniques for eliciting the thoughts and feelings of children during traumatic times. The paper reviews basic principles of pastoral crisis intervention (PCI), presents typical spiritual reactions of children to trauma by age groups, presents Crisis Response Play Therapy (CRPT) as one alternative method that bypasses the need for verbalization, and proposes the use of similar experiential techniques for special needs populations, including adults, who have difficulty giving voice to their experiences.

[The economic-financial crisis and health in Spain. Evidence and viewpoints. SESPAS report 2014].

PubMed

Cortès-Franch, Imma; González López-Valcárcel, Beatriz

2014-06-01

The objectives of the SESPAS 2014 Report are as follows: a) to analyze the impact of the economic crisis on health and health-related behaviors, on health inequalities, and on the determinants of health in Spain; b) to describe the changes in the Spanish health system following measures to address the crisis and assess its potential impact on health; c) to review the evidence on the health impact of economic crises in other countries, as well as policy responses; and d) to suggest policy interventions alternative to those carried out to date with a population health perspective and scientific evidence in order to help mitigate the impact of the economic downturn on health and health inequalities. The report is organized in five sections: 1) the economic, financial and health crisis: causes, consequences, and contexts; 2) the impact on structural determinants of health and health inequalities; 3) the impact on health and health-related behaviors, and indicators for monitoring; 4) the impact on health systems; and 5) the impact on specific populations: children, seniors, and immigrants. There is some evidence on the relationship between the crisis and the health of the Spanish population, health inequalities, some changes in lifestyle, and variations in access to health services. The crisis has impacted many structural determinants of health, particularly among the most vulnerable population groups. Generally, policy responses on how to manage the crisis have not taken the evidence into account. The crisis may contribute to making public policy vulnerable to corporate action, thus jeopardizing the implementation of healthy policies. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Effects of the financial crisis on the wealth distribution of Korea's companies

NASA Astrophysics Data System (ADS)

Lim, Kyuseong; Kim, Soo Yong; Swanson, Todd; Kim, Jooyun

2017-02-01

We investigated the distribution functions of Korea's top-rated companies during two financial crises. A power-law scaling for rank distribution, as well as cumulative probability distribution, was found and observed as a general pattern. Similar distributions can be shown in other studies of wealth and income distributions. In our study, the Pareto exponents designating the distribution differed before and after the crisis. The companies covered in this research are divided into two subgroups during a period when the subprime mortgage crisis occurred. Various industrial sectors of Korea's companies were found to respond differently during the two financial crises, especially the construction sector, financial sectors, and insurance groups.

Liver tumor boundaries identified intraoperatively using real-time indocyanine green fluorescence imaging.

PubMed

Zhang, Ya-Min; Shi, Rui; Hou, Jian-Cun; Liu, Zi-Rong; Cui, Zi-Lin; Li, Yang; Wu, Di; Shi, Yuan; Shen, Zhong-Yang

2017-01-01

Clear delineation between tumors and normal tissues is ideal for real-time surgical navigation imaging. We investigated applying indocyanine green (ICG) fluorescence imaging navigation using an intraoperative administration method in liver resection. Fifty patients who underwent liver resection were divided into two groups based on clinical situation and operative purpose. In group I, sizes of superficial liver tumors were determined; tiny tumors were identified. In group II, the liver resection margin was determined; real-time navigation was performed. ICG was injected intravenously at the beginning of the operation; the liver surface was observed with a photodynamic eye (PDE). Liver resection margins were determined using PDE. Fluorescence contrast between normal liver and tumor tissues was obvious in 32 of 35 patients. A boundary for half the liver or specific liver segments was determined in nine patients by examining the portal vein anatomy after ICG injection. Eight small tumors not observed preoperatively were detected; the smallest was 2 mm. ICG fluorescence imaging navigation is a promising, simple, and safe tool for routine real-time intraoperative imaging during hepatic resection and clinical exploration in hepatocellular carcinoma, enabling high sensibility for identifying liver resection margins and detecting tiny superficial tumors.

Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident.

PubMed

Han, Hyesung; Noh, Jin Won; Huh, Hyu Jung; Huh, Seung; Joo, Ji Young; Hong, Jin Hyuk; Chae, Jeong Ho

2017-07-01

Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved family members of the Sewol ferry accident were recruited. Severity of complicated grief, post-traumatic stress disorder (PTSD) and depressive disorder was assessed through self-reporting questionnaire, inventory of complicated grief (ICG), PTSD Check List-5 (PCL-5) and Patient Health Questionnaire-9 (PHQ-9). We also included demographic, socioeconomic, health-related variables, and Functional Social Support Questionnaire (FSSQ), which affect the ICG score. Participants were divided into 4 groups based on the experience of psychotherapy or psychiatry clinic service before the accident and mental health support after the disaster. In univariate analysis, these 4 groups showed a significant difference in the mean ICG score (P = 0.020). Participants who received mental health support only after the Sewol ferry accident (group 2) showed a lower mean ICG score than those who received neither psychotherapy or psychiatry clinic service before the disaster nor mental health support after the accident (group 4). There was no significant correlation between the ICG score and other variables except for subjective health status measured 1 month after the disaster (P = 0.005). There was no significant difference in PCL-5 (P = 0.140) and PHQ-9 scores (P = 0.603) among groups, respectively. In conclusion, mental health support significantly reduced the severity of grief only in those participants who had not received any psychotherapy or psychiatry clinic service before the accident. © 2017 The Korean Academy of Medical Sciences.

Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident

PubMed Central

2017-01-01

Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved family members of the Sewol ferry accident were recruited. Severity of complicated grief, post-traumatic stress disorder (PTSD) and depressive disorder was assessed through self-reporting questionnaire, inventory of complicated grief (ICG), PTSD Check List-5 (PCL-5) and Patient Health Questionnaire-9 (PHQ-9). We also included demographic, socioeconomic, health-related variables, and Functional Social Support Questionnaire (FSSQ), which affect the ICG score. Participants were divided into 4 groups based on the experience of psychotherapy or psychiatry clinic service before the accident and mental health support after the disaster. In univariate analysis, these 4 groups showed a significant difference in the mean ICG score (P = 0.020). Participants who received mental health support only after the Sewol ferry accident (group 2) showed a lower mean ICG score than those who received neither psychotherapy or psychiatry clinic service before the disaster nor mental health support after the accident (group 4). There was no significant correlation between the ICG score and other variables except for subjective health status measured 1 month after the disaster (P = 0.005). There was no significant difference in PCL-5 (P = 0.140) and PHQ-9 scores (P = 0.603) among groups, respectively. In conclusion, mental health support significantly reduced the severity of grief only in those participants who had not received any psychotherapy or psychiatry clinic service before the accident. PMID:28581276

A fuzzy set approach to economic crisis, austerity and public health. Part II: How are configurations of crisis and austerity related to changes in population health across Europe?

PubMed

Saltkjel, Therese; Holm Ingelsrud, Mari; Dahl, Espen; Halvorsen, Knut

2017-08-01

Based on the ideal type classification of European countries done in Part I of this paper, Part II explores whether the real 'danger' to public health is the interplay between austerity and crisis, rather than recession itself. We constructed two fuzzy sets of changes in population health based on a pooled file of European Union Statistics on Income and Living Conditions (EU-SILC) data (2008 and 2013) including 29 European countries. The linear probability analyses of 'limiting long-standing illness' and 'less than good' health were restricted to the age group 20-64 years. We performed fuzzy set qualitative comparative analysis (fsQCA) and studied whether configurations of 'severe crisis' and 'austerity' were linked to changes in population health. Overall, the results of this fsQCA do not support the 'crisis-austerity' thesis. Results on 'less than good' health were highly inconsistent, while results on 'limiting long-standing illness', contrary to the thesis, showed a two-path model. Countries with either no severe crisis or no austerity were subsets of the set of countries that experienced deteriorated health. Results also show that several countries combined both paths. This fuzzy set analysis does not support Stuckler and Basu's 'crisis-austerity' thesis, as those European countries that experienced recession and austerity were not consistently the countries with deteriorating health. There may be multiple reasons for this result, including analytical approach and operationalization of key concepts, but also resilient forces such as family support. We suggest more research on the topic based on more recent data and possibly other, or more, dimensions of austerity.

Health Disparities by Income in Spain Before and After the Economic Crisis.

PubMed

Coveney, Max; García-Gómez, Pilar; Van Doorslaer, Eddy; Van Ourti, Tom

2016-11-01

Little is known about how health disparities by income change during times of economic crisis. We apply a decomposition method to unravel the contributions of income growth, income inequality and differential income mobility across socio-demographic groups to changes in health disparities by income in Spain using longitudinal data from the Survey of Income and Living Conditions for the period 2004-2012. We find a modest rise in health inequality by income in Spain in the 5 years of economic growth prior to the start of the crisis in 2008, but a sharp fall after 2008. The drop mainly derives from the fact that loss of employment and earnings has disproportionately affected the incomes of the younger and healthier groups rather than the (mainly stable pension) incomes of the groups over 65 years. This suggests that unequal distribution of income protection by age may reduce health inequality in the short run after an economic recession. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Targeted Imaging and Chemo-Phototherapy of Brain Cancer by a Multifunctional Drug Delivery System.

PubMed

Hao, Yongwei; Wang, Lei; Zhao, Yalin; Meng, Dehui; Li, Dong; Li, Haixia; Zhang, Bingxiang; Shi, Jinjin; Zhang, Hongling; Zhang, Zhenzhong; Zhang, Yun

2015-11-01

The aim of this study was to develop multifunctional poly lactide-co-glycolide (PLGA) nanoparticles with the ability to simultaneously deliver indocyanine green (ICG) and docetaxel (DTX) to the brain by surface decoration with the brain-targeting peptide angiopep-2 to achieve combined chemo-phototherapy for glioma under near-infrared (NIR) imaging. ICG was selected as a near-infrared imaging and phototherapy agent and DTX was employed as a chemotherapeutic agent. ICG and DTX were simultaneously incorporated into PLGA nanoparticles with higher stability. These nanoparticles were further decorated with angiopep-2 via the outer maleimide group of 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(polyethyleneglycol)-2000]-maleinimide incorporated in the nanoparticles. The NIR image-guided chemo-phototherapy of the angiopep-2 modified PLGA/DTX/ICG nanoparticles (ANG/PLGA/DTX/ICG NPs) not only highly induced U87MG cell death in vitro, but also efficiently prolonged the life span of the brain orthotopic U87MG glioma xenograft-bearing mice in vivo. Thus, this study suggests that ANG/PLGA/DTX/ICG NPs have the potential for combinatorial chemotherapy and phototherapy for glioma. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Attribution Theory and Crisis Intervention Therapy.

ERIC Educational Resources Information Center

Skilbeck, William M.

It was proposed that existing therapeutic procedures may influence attributions about emotional states. Therefore an attributional analysis of crisis intervention, a model of community-based, short-term consultation, was presented. This analysis suggested that crisis intervention provides attributionally-relevant information about both the source…

Air and Space Expeditionary Force Crisis Action Leadership for Commanders

DTIC Science & Technology

2004-04-01

2002), 337. 2 Mark, Friedman, M.D., Everyday Crisis Management (Naperville, IL: First Decision Press, 2002), 5. 3 Stephen R. Covey, The 7 Habits of Highly Effective People (New...Berkley Publishing Group, 2002), 9. 12 Lt Col Bryan Gallagher, USAF, interviewed by author, February 2004. 13 Stephen R. Covey, The 7 Habits of Highly Effective People (New

Economic crisis and nursing in Spain.

PubMed

Zabalegui, Adelaida; Cabrera, Esther

2010-07-01

The purpose of the present study is to describe the economic context in Spain and its impact on the health care sector and in nursing schools. The global economic crisis is affecting nursing in Spain. This study analyses and compares indicators related to health care and nursing schools among European countries. Some new strategies to cope with the challenges arising from the health care crisis are suggested. Health care costs are increasing as a result of the ageing of the Spanish population, immigration, chronicity of health problems and new medical technology. Nursing education has changed in 2010 from a 3-year diploma programme to a 4-year University degree in Nursing. This change requires new resources involving staff, facilities and equipment, all of which are lacking because of the economic crisis in Spain. The worldwide economic crisis has affected Spain more than it has other European Union (EU) countries. This global crisis has an impact on the health care sector as well on nursing schools. It is essential for nursing management to develop creative approaches to maintain cost effective patient care. New programmes and technology must be carefully evaluated in terms of cost effectiveness before being implemented. All health care professionals should be well informed and have a solid understanding of this situation.

Intervention among Suicidal Men: Future Directions for Telephone Crisis Support Research.

PubMed

Hunt, Tara; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-01-01

Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff's identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed.

Governing during an Institutional Crisis: 10 Fundamental Principles

ERIC Educational Resources Information Center

White, Lawrence

2012-01-01

In today's world, managing a campus crisis poses special challenges for an institution's governing board, which may operate some distance removed from the immediate events giving rise to the crisis. In its most challenging form, a campus crisis--a shooting, a natural disaster, a fraternity hazing death, the arrest of a prominent campus…

How do frequent users of crisis helplines differ from other users regarding their reasons for calling? Results from a survey with callers to Lifeline, Australia's national crisis helpline service.

PubMed

Middleton, Aves; Woodward, Alan; Gunn, Jane; Bassilios, Bridget; Pirkis, Jane

2017-05-01

Crisis helplines are designed to provide short-term support to people in an immediate crisis. However, there is a group of users who call crisis helplines frequently over an extended period of time. The reasons for their ongoing use remain unclear. The aim of this study was to investigate the differences in the reasons for calling between frequent and other users of crisis helplines. This was achieved by examining the findings from a brief survey completed by callers to Lifeline Australia at the end of their call between February and July 2015. In the survey, callers reported on their socio-demographics, reasons for their current call and number of calls made in the past month. Survey respondents were categorised as frequent, episodic and one-off users, and analyses were conducted using ordered logistic regression. Three hundred and fifteen callers completed the survey, which represented 57% of eligible callers. Twenty-two per cent reported calling 20 times or more in the past month (frequent users), 51% reported calling between 2 and 19 times (episodic users) and 25% reported calling once (one-off users). Two per cent were unable to recall the number of calls they made in the past month. Frequent users reported similar reasons for calling as other users but they were more likely to call regularly to talk about their feelings [OR = 6.0; 95% CI: 3.7-9.8]. This pattern of service use is at odds with the current model of care offered by crisis helplines which is designed to provide one-off support. There is a need to investigate further the factors that drive frequent users to call crisis helplines regularly. © 2016 John Wiley & Sons Ltd.

Exploring Crisis Management in U.S. Small Businesses

NASA Astrophysics Data System (ADS)

Williams, Jon

As a critical infrastructure, the US electricity grid supplies electricity to 340 million people within eight separate regions. The power infrastructure is vulnerable to many types of disasters capable of severing supplies of electricity. The impact on the employees and communities when small- and medium-size enterprises are shut down due to disasters can be severe. The purpose of the quantitative comparative study was to explore small- and medium-size enterprises crisis management strategies in the case of power infrastructure vulnerabilities. Perceptions of small business leaders were probed about crisis management planning relevant to three secondary factors: prior experience of crises, threat perceptions, and planning self-efficacy. Participants completed an adapted questionnaire instrument based on a five-point Likert scale for six sub-factors including resilience through planning, financial impact, operational crisis management, the perfect storm, the aftermath of survival, and atrophy. The instrument also measured three additional factors to include, prior experience of crises, threat perceptions, and planning self-efficacy, across seven types of crises. The results of this study indicated that of the 276 respondents, 104 had no crisis plans, but 172 did have crisis plans. Of those who had implemented crisis plans, 19% had specific provisions to address power outages or attacks on the electrical grid. Of the respondents who had not planned for power outages nor experienced significant losses of power, a statistically significant number acknowledged an external threat to their business. The majority of respondents indicated that long-term planning was related to resilience; however, the migration of crisis understanding into the planning process or implementation was not implemented. This heightened awareness of potential crises without the corresponding development and implementation of mitigation crisis plans requires additional research to understand

Midlife crisis perceptions, experiences, help-seeking, and needs among multi-ethnic malaysian women.

PubMed

Wong, Li Ping; Awang, Halimah; Jani, Rohana

2012-01-01

In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting.

Intervention among Suicidal Men: Future Directions for Telephone Crisis Support Research

PubMed Central

Hunt, Tara; Wilson, Coralie J.; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-01-01

Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff’s identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed. PMID:29404319

Sickle Cell Crisis and the Acute Abdomen

PubMed Central

Nazem, Ahmad; Walker, Mark

1986-01-01

Abdominal pain is one of the most common symptoms in sickle cell crisis, and its cause remains controversial. Simple vaso-occlusive crisis may be an explanation. The abdominal pain may also reflect an acute surgical abdomen. A patient presented with sickle cell crisis and abdominal pain; he had a periappendiceal abscess at the site of an appendiceal stump five months after appendectomy. The role of sickle cell anemia in the pathogenesis of this abscess is uncertain. PMID:3531534

Changes in mortality after the recent economic crisis in South Korea.

PubMed

Kim, Hanjoong; Song, Young Jong; Yi, Jee Jeon; Chung, Woo Jin; Nam, Chung Mo

2004-07-01

To examine the changes in all cause mortality and cause-specific mortality after the economic crisis in South Korea. Monthly mortality data for an entire country was used and intervention analysis applied to compare mortality after the crisis with mortality which would have occurred if the trends before the crisis had continued. All cause mortality began to increase about 1 year after the crisis, while cardiovascular increased immediately. Transport accidents decreased significantly during the year following the crisis and then regressed towards the pre-economic crisis level. Suicides increased rapidly and maintained an upward trend but subsequently reduced towards the pre-economic crisis level. This study has shown an evidence of a relationship between economic crisis and mortality.

Surgical Strategy Based on Indocyanine Green Test for Chemotherapy-Associated Liver Injury and Long-Term Outcome in Colorectal Liver Metastases.

PubMed

Takamoto, Takeshi; Hashimoto, Takuya; Ichida, Akihiko; Shimada, Kei; Maruyama, Yoshikazu; Makuuchi, Masatoshi

2018-06-01

It remains unclear whether the presence of chemotherapy-induced liver injury (CALI) or impaired liver functional reserve affects the long-term outcome. This study assessed the applicability and long-term effects of using criteria based on the indocyanine green (ICG) test results in selecting the operative procedure among patients with colorectal liver metastases (CRLM) who had a risk of CALI. CRLM patients who received preoperative chemotherapy including oxaliplatin and/or irinotecan prior to a curative hepatectomy between 2007 and 2017 were included. For each case, the minimum required future remnant liver volume and operative procedure were decided based on the ICG retention rate at 15 min (ICG R15). Patients with an ICG R15 > 10% and who had undergone a major hepatectomy were categorized in a marginal liver functional reserve (MHML) group. Overall, 161 patients were included; 77 of them had an ICG R15 > 10%, and 57 had pathological liver injury (PLI). After the median follow-up time of 30.9 months, the 5-year overall survival rate was 36.1%. The presence of an impaired ICG test result or CALI did not negatively impact the overall and recurrence-free survival outcomes. A multivariate analysis revealed that the presence of four or more nodules of liver metastases was the only independent predictor of a poor overall survival. A significantly larger proportion of patients in the MHML group (n = 37) had a 25% or larger increase in splenic volume (30 vs. 13%; P = 0.024). The presence of an impaired ICG test result or PLI did not affect the long-term outcome after individually selected operative procedure. However, patients undergoing MHML had a higher possibility of developing a > 25% splenic volume increase after hepatectomy.

Utilization of medical care following the Three Mile Island crisis.

PubMed

Houts, P S; Hu, T W; Henderson, R A; Cleary, P D; Tokuhata, G

1984-02-01

Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small.

Utilization of medical care following the Three Mile Island crisis.

PubMed Central

Houts, P S; Hu, T W; Henderson, R A; Cleary, P D; Tokuhata, G

1984-01-01

Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small. PMID:6691524

School Crisis Response: Expecting the Unexpected.

ERIC Educational Resources Information Center

Lichtenstein, Robert; And Others

1994-01-01

The typical administrator certification program does not devote specific attention to shootings, suicide, terminal illness, and natural disasters. A crisis of major proportion calls for enlightened leadership: a take-charge manner, combined with effective teamwork and delegation of vital operations. Crisis teams should exist at regional, district,…

Being PREPaREd for Crisis in Northern Colorado

ERIC Educational Resources Information Center

Hancock, Kathy; Malvey, Michelle; Rastatter, Dennis

2010-01-01

The Thompson School District recognized after the Columbine incident in the spring of 1999 that it was lacking an adequate plan for crisis response. Colorado legislation led to a mandate for having a crisis response plan so the district purchased a "canned" crisis response plan that served the needs of response in a very immediate but…

Long-term effects of youth unemployment on mental health: does an economic crisis make a difference?

PubMed Central

Thern, Emelie; de Munter, Jeroen; Hemmingsson, Tomas; Rasmussen, Finn

2017-01-01

Background Ill health is a risk factor and a consequence of unemployment, which might vary depending on the national rate of unemployment. We investigated the long-term effect of youth unemployment on mental health and explored the possible interaction during periods of high (economic crisis) and low (non-crisis) unemployment rates. Methods A register-linked population-based cohort study was conducted including individuals aged 17–24 years. The crisis cohort (n=6410) took part in the Labour Force Survey during the economic crisis (1991–1994) in Sweden and the non-crisis cohort (n=8162) took part in the same survey before the crisis (1983–1986). Follow-up was 19 years. Adjusted HRs and 95% CIs for an inpatient care discharge mental diagnosis with employed people as the reference group were calculated by Cox regressions models. Results In fully adjusted models, <3 months (HR: 1.69; 95% CI 1.14 to 2.49), 3–6 months (2.19; 1.43 to 3.37) and >6 months (2.70; 1.71 to 4.28) of unemployment were associated with increased risks of getting a mental diagnosis in the crisis cohort. In the non-crisis cohort the risks were: 1.92; 1.40 to 2.63, 2.60; 1.72 to 3.94 and 3.33; 2.00 to 5.57, respectively. No interactions between labour force status and level of unemployment were found. Conclusions Youth unemployment is related to mental health problems, independent of the overall national rate of unemployment, which is important as the youth unemployment rates are currently at stable high level. PMID:28087812

Electronic gaming and the obesity crisis.

PubMed

Calvert, Sandra L; Staiano, Amanda E; Bond, Bradley J

2013-01-01

Children and adolescents in the United States and in many countries are projected to have shorter life spans than their parents, partly because of the obesity crisis engulfing the developed world. Exposure to electronic media is often implicated in this crisis because media use, including electronic game play, may promote sedentary behavior and increase consumption of high-calorie foods and beverages that are low in nutritional value. Electronic games, however, may increase children's physical activity and expose them to healthier foods. We examine the role of electronic games in the pediatric obesity crisis and their contribution to more favorable health outcomes. Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.

Electronic Gaming and the Obesity Crisis

PubMed Central

Calvert, Sandra L.; Staiano, Amanda E.; Bond, Bradley J.

2014-01-01

Children and adolescents in the United States and in many countries are projected to have shorter life spans than their parents, partly because of the obesity crisis engulfing the developed world. Exposure to electronic media is often implicated in this crisis because media use, including electronic game play, may promote sedentary behavior and increase consumption of high-calorie foods and beverages that are low in nutritional value. Electronic games, however, may increase children’s physical activity and expose them to healthier foods. We examine the role of electronic games in the pediatric obesity crisis and their contribution to more favorable health outcomes. PMID:23483693

[Impact of the economic crisis on the right to a healthy diet. SESPAS report 2014].

PubMed

Antentas, Josep Maria; Vivas, Esther

2014-06-01

The present article analyzes the impact of the economic crisis on food consumption in Spain, the most affected social profiles, and the consequences of changing patterns of food consumption on health. This article is based on official reports and previous empirical studies. The crisis has affected diet and food consumption. Families are attempting to spend less money on food. Food insecurity is rising and the most affected groups are those spending a higher proportion of their income on food. Cuts in food spending run parallel with unhealthy eating habits that encourage obesity. Consequently, the crisis contributes to undermining the right to a healthy diet, recognized by the International Covenant on Economic, Social and Cultural Rights of the United Nations. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

LENR/"Cold Fusion" and Modern Physics: A Crisis Within a Crisis

NASA Astrophysics Data System (ADS)

Mallove, Eugene F. E.

2004-03-01

The primary theorists in the field of Cold Fusion/LENR have generally assumed that the excess heat phenomena is commensurate with nuclear ash (such as helium), whether already identified or presumed to be present but not yet found, and moreover that it can be explained by hydrided metal lattice structures acting coherently. Though this was an excellent initial hypothesis, the commensurate nuclear ash hypothesis has not been proved, and appears to be approximately correct in only a few experiments. At the same time, compelling evidence has also emerged for other microphysical sources of energy that were unexpected by accepted physics. The exemplars have been the work Dr. Randell Mills and his colleagues at BlackLight Power Corporation and Dr. Paulo and Alexandra Correa in Canada.This has led to a crisis within a crisis: Neither "cold fusion" nor "Modern Physics" will be able to explain the full range of experimental data now available---not even the data within "mainstream" cold fusion/LENR per se--- by insisting that the fundamental paradigms of Modern Physics are without significant flaw. The present crisis is of magnitude comparable to the Copernican Revolution. Neither Modern Physics nor Cold Fusion/LENR will survive in their present forms when this long delayed revolution has run its course.

Neo-Liberalism in Crisis? Educational Dimensions

ERIC Educational Resources Information Center

Small, David

2011-01-01

Until the global financial crisis, neo-liberalism had appeared invincible. This article examines the global rise of neo-liberalism and its impact on education, particularly its treatment of the social democratic ideal of equality. Drawing on examples from education and other socio-political factors, it considers whether the financial crisis is…

Crisis and Loss: Information for Families.

ERIC Educational Resources Information Center

Canter, Andrea, Ed.

1999-01-01

During a crisis, parents can do a great deal to help their child deal with grief and anxiety. This special issue provides information and promising practices that might be helpful in dealing with various crisis situations. Provides the following articles: (1) "Children Killing Children" (Kevin Dwyer); (2) "Disaster: Helping Children…

The financial crisis in Italy: implications for the healthcare sector.

PubMed

de Belvis, Antonio Giulio; Ferrè, Francesca; Specchia, Maria Lucia; Valerio, Luca; Fattore, Giovanni; Ricciardi, Walter

2012-06-01

The global economic and financial crisis is having and impact on the Italian healthcare system which is undergoing a devolution process from the central government to regions and where about one third of the regional governments (mainly in the central and southern part of the country) are facing large financial deficits. The paper briefly describes the current macro scenario and the main responses taken to face the crisis and highlights the downside risks of introducing "linear" cuts in the allocation of resources. While justified by the risk of a national debt default, present fiscal policies might increase inequalities in access to care, deteriorate overall health indicators and population wellbeing, and sharpen existing difference in the quality of care between regions. Preliminary evidence shows that the crisis is affecting the quality of nutrition and the incidence of psychiatric disorders. During this difficult financial situation Italy is also facing the risk of a major reduction in investments for preventive medicine, Evidence Based Medicine infrastructures, health information systems and physical capital renewal. This cost-cutting strategy may have negative long term consequences Also, important achievement in terms of limiting waiting lists, improving continuity of care and patients' centeredness, and promoting integration between social and health care may be negatively affected by unprecedented resources' cuts. It is essential that in such a period of public funding constraints health authorities monitor incidence of diseases and access to care of the most vulnerable groups and specifically target interventions to those who may be disproportionally hit by the crisis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Solving the Antibiotic Crisis.

PubMed

Wright, Gerard D

2015-02-13

Antibiotics are essential for both treating and preventing infectious diseases. Paradoxically, despite their importance as pillars of modern medicine, we are in danger of losing antibiotics because of the evolution and dissemination of resistance mechanisms throughout all pathogenic microbes. This fact, coupled with an inability to bring new drugs to market at a pace that matches resistance, has resulted in a crisis of global proportion. Solving this crisis requires the actions of many stakeholders, but chemists, chemical biologists, and microbiologists must drive the scientific innovation that is required to maintain our antibiotic arsenal. This innovation requires (1) a deep understanding of the evolution and reservoirs of resistance; (2) full knowledge of the molecular mechanisms of antibiotic action and resistance; (3) the discovery of chemical and genetic probes of antibiotic action and resistance; (4) the integration of systems biology into antibiotic discovery; and (5) the discovery of new antimicrobial chemical matter. Addressing these pressing scientific gaps will ensure that we can meet the antibiotic crisis with creativity and purpose.

Health disparities by income in Spain before and after the economic crisis

PubMed Central

Coveney, Max; García-Gómez, Pilar; Van Doorslaer, Eddy

2016-01-01

Little is known about what the economic crisis has done to health disparities by income. We apply a decomposition method to unravel the contributions of income growth, income inequality and differential income mobility across socio-demographic groups to changes in health disparities by income in Spain using longitudinal data from the Survey of Income and Living Conditions (SILC) for the period 2004–2012. We find a modest rise in health inequality by income in Spain in the five years of economic growth prior to the start of the crisis in 2008, but a sharp fall after 2008. The drop mainly derives from the fact that loss of employment and earnings has disproportionately affected the incomes of the younger and healthier groups rather than the (mainly stable pension) incomes of the over 65s. This suggests that unequal distribution of income protection by age may reduce health inequality in the short run after an economic recession. PMID:27870306

Crisis Management

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.

2011-01-01

This paper presents summaries of four articles relevant to school crisis response. The first article, "Peritraumatic Dissociation Predicts Posttraumatic Stress in Youth Following Accidents" summarized by Jim Matthews, suggests that peritraumatic dissociation is a powerful predictor of PTSD symptoms among youth who have been in a car…

Vygotsky's Crisis: Argument, context, relevance.

PubMed

Hyman, Ludmila

2012-06-01

Vygotsky's The Historical Significance of the Crisis in Psychology (1926-1927) is an important text in the history and philosophy of psychology that has only become available to scholars in 1982 in Russian, and in 1997 in English. The goal of this paper is to introduce Vygotsky's conception of psychology to a wider audience. I argue that Vygotsky's argument about the "crisis" in psychology and its resolution can be fully understood only in the context of his social and political thinking. Vygotsky shared the enthusiasm, widespread among Russian leftist intelligentsia in the 1920s, that Soviet society had launched an unprecedented social experiment: The socialist revolution opened the way for establishing social conditions that would let the individual flourish. For Vygotsky, this meant that "a new man" of the future would become "the first and only species in biology that would create itself." He envisioned psychology as a science that would serve this humanist teleology. I propose that The Crisis is relevant today insofar as it helps us define a fundamental problem: How can we systematically account for the development of knowledge in psychology? I evaluate how Vygotsky addresses this problem as a historian of the crisis. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using Crisis Simulations in Public Relations Education

ERIC Educational Resources Information Center

Veil, Shari R.

2010-01-01

Objectives: Students will demonstrate research, decision making, team building, and public speaking skills, while applying issues management and crisis communication concepts in a realistic setting. Courses: Introduction to Public Relations, Public Relations Cases, Crisis Communication.

Electronic Gaming and the Obesity Crisis

ERIC Educational Resources Information Center

Calvert, Sandra L.; Staiano, Amanda E.; Bond, Bradley J.

2013-01-01

Children and adolescents in the United States and in many countries are projected to have shorter life spans than their parents, partly because of the obesity crisis engulfing the developed world. Exposure to electronic media is often implicated in this crisis because media use, including electronic game play, may promote sedentary behavior and…

Pakistan's Education Crisis: The Real Story

ERIC Educational Resources Information Center

Naviwala, Nadia

2016-01-01

Pakistan suffers from an extensive education crisis. Millions of Pakistani children do not attend school, and those that do must deal with absent teachers and poor learning environments, among other challenges. While this crisis is frequently discussed in Pakistan and beyond, it is often misunderstood. This new Wilson Center report, based on…

Crisis Communications in a Digital World

ERIC Educational Resources Information Center

Trump, Kenneth S.

2015-01-01

Kenneth Trump, a school safety expert who consults with districts on how to respond to school safety crises, explains how the new prevalence of threats of violence being delivered over digital and social media creates for administrators a "communication crisis" that unfolds alongside the real or perceived crisis of school safety being…

Crisis and Loss: Information for Educators.

ERIC Educational Resources Information Center

Canter, Andrea, Ed.

1999-01-01

Crisis intervention is a vital component of any comprehensive approach to maintaining psychological well being. An active school-based crisis intervention team can make a powerful contribution to a school's sense of community and commitment to taking care of each other. This special edition presents promising practices that may be helpful to…

Long term effects of an integrated care intervention on hospital utilization in patients with severe COPD: a single centre controlled study.

PubMed

Titova, Elena; Steinshamn, Sigurd; Indredavik, Bent; Henriksen, Anne Hildur

2015-02-03

Chronic obstructive pulmonary disease (COPD) is one of the main causes of morbidity and mortality globally. In Trondheim in 2008 an integrated care model (COPD-Home) consisting of an education program, self-management plan, home visits and a call centre for patient support and communication was developed. The objective was to determine the efficacy of an intervention according to the COPD-Home model in reducing hospital utilization among patients with COPD stage III and IV (GOLD 2007) discharged after hospitalization for acute exacerbations of COPD (AECOPD). A single centre, prospective, open, controlled clinical study comparing COPD-Home integrated care (IC) with usual care (UC). Ninety-one versus 81 patients mean age 73.4 ± 9.3 years (57% women) were included in the IC group (ICG) and the UC group (UCG) respectively, and after 2 years 51 and 49 patients were available for control in the respective groups. During the year prior to study start there were 71 hospital admissions (HA) in the ICG and 84 in the UCG. There was a 12.6% reduction in HA in the ICG during the first year of follow-up and a 46.5% reduction during the second year (p = 0.01) compared to an 8.3% increase during the first year and no change during the second year in the ICG. During the year prior to study start, the number of hospital days (HD) was 468 in the ICG and 479 in the UCG. In the IC group, the number of HD was reduced by 48.3% during the first year (p = 0.01), and remained low during the second year of follow-up (p=0.02). In the UC group, the number of HD remained unchanged during the follow-up period. There was a trend towards a shorter survival time among patients in the ICG compared to the UCG, hazard ratio 1.33 [95% CI 0.77 to 2.33]. Intervention according to the COPD-Home model reduced hospital utilization in patients with COPD III and IV with a persisting effect throughout the 2 years of follow-up. However, there was a trend towards a shorter survival time in the intervention

The consequences of the economic crisis in radiology.

PubMed

2015-12-01

The effects of the economic crisis have led to complex problems in radiology. The crisis has led to a reduction in the turnover of imaging equipment. This reflects on the quantity and quality of output, an aspect which is worsened by the contraction of the radiology market, late payments on supplies, and competitive procurement of medical goods centralized on a regional or national level. Many local and national institutions have operated with significant reductions of reimbursement for procedures, forcing a reorganization of facilities, manpower, and equipment. The reduction in operating margins of the industry has resulted in a reduction of invested capital for projects of industrial R&D and direct or indirect sponsorship. The quality of care will be affected with less comfortable conditions, reduction of local availability of radiologists, and failure to invest in lower dose equipment to control population medical radiation exposure. The crisis resulted in a reduction in the number of graduates in medicine and scholarships for specialization induced by linear cuts will result in a drastic reduction of radiological specialists. This will favour the development of teleradiology services, with the risk of accelerating the demedicalisation of radiology departments, and isolation of the professionals. • The economic crisis has led to reduction in the turnover of imaging equipment. • The economic crisis has led to reductions of reimbursement for procedures. • The economic crisis has led to reductions in operating margins of the industry. • The economic crisis has led to contraction of quantity and quality of output. • The economic crisis resulted in demedicalisation of radiology departments and isolation of professionals.

Technological disasters, crisis management and leadership stress.

PubMed

Weisaeth, Lars; Knudsen, Øistein; Tønnessen, Arnfinn

2002-07-01

This paper discusses how psychological stress disturbs decision making during technological crisis and disaster, and how to prevent this from happening. This is exemplified by scientific studies of a Norwegian large scale accident involving hazardous material, and of handling the far-off effects of the nuclear disaster at Chernobyl. The former constitutes an operative level of crisis management, whereas the latter involves crisis management at the strategic and political level. We conclude that stress had a negative effect on decision making in both cases.

What's in a Name? That Which We Call a Crisis? A Commentary on Michael Young's Article "Overcoming the Crisis in Curriculum Theory"

ERIC Educational Resources Information Center

Lundgren, Ulf P.

2015-01-01

Michael Young's article "Overcoming the crisis in curriculum theory: a knowledge-based approach" ("JCS, 45", 2) is discussed from the starting point that the claimed crisis is constructed from a decisive solution, that is the solution determines what is a crisis. But curriculum research and curriculum theory are in need of…

Crisis management, capabilities and preparedness: the case of public hospitals in Iran.

PubMed

Najafbagy, Reza

2010-01-01

Crises occurred in recent decades show that organizations' preparedness to predict and respond to undesired problems is directly related to the degree of their capabilities and preparedness to manage crises in this context, hospitals compared to other organizations are more viable to suffer damages if a crisis occurs. This study investigates the degree of public hospitals capabilities and preparedness to handled possible crises. Responses from hospital managers and directors show that most of them were not familiar with crisis management, while majority of them mentioned that they had crisis management plan and committee in their hospitals. Moreover, most of the respondents believed that if a crisis occurs in the hospital, patients, personnel and documents will be the first victims of the crisis. The study also indicates that having a crisis plan and crisis committee without being familiar with knowledge of crisis management, do not help managers to cope with crisis. Moreover, correlations show that older managers were more familiar with crisis management experiences abroad, and defined responsibilities contributed to setting up crisis committee, and taking crisis seriously.

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

9C.03: THE BENEFIT FROM HEMODYNAMICALLY GUIDED ANTIHYPERTENSIVE THERAPY DEPENDS ON BASELINE BLOOD PRESSURE.

PubMed

Krzesinski, P; Gielerak, G; Stanczyk, A; Piotrowicz, K; Skrobowski, A

2015-06-01

Impedance cardiography (ICG) revealed to be useful in tailoring antihypertensive therapy to the patient's individual hemodynamic profile but little is known who benefits more from such therapeutic approach. The aim of this study was to estimate the effectiveness of ICG-guided antihypertensive therapy in 12-weeks observation with respect to baseline blood pressure (BP). This analysis involved 272 patients with untreated AH, recruited in two randomized, prospective and controlled trials (www.nauka-polska.pl: ID227062 and ClinicalTrials.gov: NCT01996085). After baseline evaluation including office blood pressure measurement (OBPM: OSBP, ODBP, OMBP) and ambulatory blood pressure monitoring (ABPM: 24-mean_SBP, 24-mean_DBP) the subjects were randomly assigned to groups of: [GE] empiric and [HD] ICG-guided antihypertensive therapy. The effectiveness of ICG-guided therapy was evaluated after 12 weeks in subgroups derived from median of OMBP (110 mmHg) of: higher (n = 120) and lower baseline OMBP (n = 121). The comparative analysis included absolute change of BP (d_OSBP, d_ODBP, d_24-mean_SBP, d_24-mean_DBP) and percentage of patients with change of BP equal or higher than 10 mmHg (d10_OSBP, d10_ODBP, d10_24-mean_SBP, d10_24-mean_DBP). In the whole study group the BP reduction in HD group was higher than in GE group: d_OSBP (18.3 vs. 14.3 mmHg; p = 0.011), d_ODBP (11.9 vs. 8.5 mmHg; p = 0.011), d_24-mean SBP (15.9 vs. 11.6 mmHg; p = 0.011) and d_24-mean SBP (10.4 vs. 8.9 mmHg; p = 0.147). However, the effect of ICG-guided therapy was significantly more pronounced in subjects with higher baseline OMBP - Table.(Figure is included in full-text article.) : The ICG-guided therapy effects with increased BP reduction in patients with AH, especially those with higher baseline BP. The patients with advanced AH can benefit more from individual these therapeutic approach.

Resilient Communication: A New Crisis Communication Strategy for Homeland Security

DTIC Science & Technology

2012-03-01

communication theory. Author, Timothy Coombs , in Ongoing Crisis Communication , discusses the need for a crisis management 10 plan to prepare for potential... COMMUNICATION : A NEW CRISIS COMMUNICATION STRATEGY FOR HOMELAND SECURITY by Sharon L. Watson March 2012 Thesis Advisor: Christopher Bellavita...REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Resilient Communication : A New Crisis Communication

Multifractal analysis of Asian markets during 2007-2008 financial crisis

NASA Astrophysics Data System (ADS)

Hasan, Rashid; Mohammad, Salim M.

2015-02-01

2007-2008 US financial crisis adversely affected the stock markets all over the world. Asian markets also came under pressure and were differently affected. As markets under stress could reveal features that remain hidden under normal conditions, we use MF-DFA technique to investigate the multifractal structure of the US and seven Asian stock markets during the crisis period. The overall period of study, from 01 July 2002 to 31 December 2013, is divided into three sub-periods: pre-crisis period, crisis period and post-crisis period. We find during the crisis period markets of the US, Japan, Hong Kong, S. Korea and Indonesia show very strong non-linearity for positive values of the moment q. We calculate the singularity spectra, f(α) for the three sub-periods for all markets. During the crisis period, we observe that the peaks of the f(α) spectra shift to lower values of α and markets of the US, Japan, Hong Kong, Korea and Indonesia exhibit increased long range correlations of large fluctuations in index returns. We also study the impact of the crisis on the power law exponent in the tail region of the cumulative return distribution and find that by excluding the crisis period from the overall data sets, the tail exponent increases across all markets.

Conspiracy theories as part of history: The role of societal crisis situations

PubMed Central

van Prooijen, Jan-Willem; Douglas, Karen M

2017-01-01

In the present contribution, we examine the link between societal crisis situations and belief in conspiracy theories. Contrary to common assumptions, belief in conspiracy theories has been prevalent throughout human history. We first illustrate historical incidents suggesting that societal crisis situations—defined as impactful and rapid societal change that calls established power structures, norms of conduct, or even the existence of specific people or groups into question—have stimulated belief in conspiracy theories. We then review the psychological literature to explain why this is the case. Evidence suggests that the aversive feelings that people experience when in crisis—fear, uncertainty, and the feeling of being out of control—stimulate a motivation to make sense of the situation, increasing the likelihood of perceiving conspiracies in social situations. We then explain that after being formed, conspiracy theories can become historical narratives that may spread through cultural transmission. We conclude that conspiracy theories originate particularly in crisis situations and may form the basis for how people subsequently remember and mentally represent a historical event. PMID:29081831

Ischemic stroke risk factors during Greek economic crisis.

PubMed

Katsanos, Aristeidis H; Fiolaki, Aidonio; Markou, Sofia; Markoula, Sofia; Kosmidou, Maria; Kyritsis, Athanassios P; Giannopoulos, Sotirios

2016-02-01

The impact of Greece's economic crisis on healthcare is of great concern. The aim of the present study was to assess the impact of economic crisis on the prevention of cerebral ischemic events. Retrospective analysis of patients with ischemic stroke (IS) or transient ischemic attack (TIA) admitted to a tertiary neurological department in northwestern Greece during the period 2008-2014. Using 2011 as the transitional year IS/TIA patients were dichotomized according to their admission date in two subgroups: the "before economic crisis" subgroup and the "after economic crisis" subgroup. Logistic regression analyses were performed to identify predictor variables of statin/antihypertensive pretreatment. Patients admitted after the economic crisis outbreak (mean age: 57.6 ± 13.5 years) were found to have lower waist periphery measurements (p = 0.001), lower incidence of diabetes (p = 0.028), hyperlipidemia (p = 0.002) and metabolic syndrome(p < 0.001), at stroke onset with lower rates of antilipidemic treatment prescription prior to stroke onset compared to those patients with cerebral ischemia that were hospitalized before the financial crisis (mean age: 59.6 ± 11.1 years). However, between the two subgroups were no significant differences in the rates of untreated patients with hyperlipidemia (p = 0.189) and/or hypertension (p = 0.313). Even though statin pretreatment prior to stroke onset was found to be reduced during economic crisis compared to the period before the crisis, (OR = 0.58, 95%CI: 0.34-0.95, p = 0.032), this association did not retain statistical significance in the multivariate logistic regression analysis (OR = 1.69, 95%CI = 0.83-3.42, p = 0.143). Our study supports that at present financial crisis has not significantly affected the prevention of cerebrovascular events in the citizens of a provincial city area. Data from other regions and time-periods are needed for the final verdict. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Trends in cardiovascular risk factors in Greece before and during the financial crisis: the impact of social disparities.

PubMed

Filippidis, Filippos T; Schoretsaniti, Sotiria; Dimitrakaki, Christine; Vardavas, Constantine I; Behrakis, Panagiotis; Connolly, Gregory N; Tountas, Yannis

2014-12-01

Economic crises may have a significant impact on public health. The objective of this study was to assess trends in health-related behaviours and cardiovascular risk factors within Greece before, at the beginning and during the current financial crisis by comparing data from three waves of the Greek cross-sectional household 'Hellas Health' surveys. Data from three waves were analysed. The first wave was conducted in 2006 (n = 1005), the second in 2008 (n = 1490) and the third in 2011 (n = 1008). Samples were representative of the Greek adult population in terms of age and residency. Smoking status, height, weight and fruit and vegetable consumption were self-reported. Physical activity levels were assessed with the International Physical Activity Questionnaire. The prevalence of smoking in Greece decreased from 42.6 to 38.1% during the crisis period 2008-11 (P = 0.026), but not during 2006-8. The prevalence of high levels of physical activity increased among Greek adults (from 21.9 to 31.7%, P < 0.001) in all socio-economic and demographic groups, with the exception of the highest socio-economic status (SES) group. On the contrary, the consumption of at least five portions of fruit and vegetables per day significantly decreased during the crisis among those of lower SES (from 9.0 to 4.1%, P = 0.006). Prevalence of obesity did not show significant trends. During the economic crisis, fruit and vegetable consumption alarmingly decreased, especially among those of lower SES, whereas trends in smoking prevalence and physical activity levels seem favourable. These results indicate that the economic crisis may unequally impact cardiovascular risk factors among different socio-economic groups. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Content Knowledge--The Real Reading Crisis

ERIC Educational Resources Information Center

Kato, Tsuguhiko; Manning, Maryann

2007-01-01

The perceived crisis in reading achievement may be misplaced--the real crisis may be what is ignored in the curriculum. People are alarmed at the lack of emphasis being placed on teaching content knowledge in many of today's classrooms. They laugh when Jay Leno takes to the street, interviewing teenagers and young adults who do not have the…

Defining crisis in families of individuals with autism spectrum disorders

PubMed Central

Wingsiong, Aranda; Lunsky, Yona

2014-01-01

Parents of children diagnosed with autism spectrum disorder often report higher levels of depression, anxiety, and mental health–related issues. The combination of stressors and family adjustment difficulties can cause distress which may develop into a crisis. Understanding crisis in the family is important to mental health practice since it can serve as a guide in delivering service to at-risk families. This study investigated the subjective experience of crisis in 155 mothers of children diagnosed with autism spectrum disorder. Thematic analysis revealed that crisis is characterized by factors influencing four major areas: demands, internal capabilities, external resources, and subjective appraisal. Understanding what crisis means to families of individuals with autism spectrum disorder can help inform effective preventative and crisis services. PMID:24254639

40 CFR 166.49 - Public notice of crisis exemptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Public notice of crisis exemptions... PROGRAMS EXEMPTION OF FEDERAL AND STATE AGENCIES FOR USE OF PESTICIDES UNDER EMERGENCY CONDITIONS Crisis Exemptions § 166.49 Public notice of crisis exemptions. (a) Periodic notices. At least quarterly, the...

Elevated IL-8 levels during sickle cell crisis.

PubMed

Duits, A J; Schnog, J B; Lard, L R; Saleh, A W; Rojer, R A

1998-11-01

The vaso-occlusive process (VOC) in sickle cell disease is of a complex nature. It involves intricate interactions between sickle red blood cells, endothelium and probably also leukocytes. As these interactions are regulated by cytokines, we analyzed the role of the potent neutrophil chemokine IL-8 by measuring serum levels in sickle cell patients during sickle cell crisis. These results were compared to nonsymptomatics and healthy controls. In patients having a vaso-occlusive crisis both HbSS and HbSC patients showed significantly enhanced serum IL-8 levels compared to healthy controls. Several of these patients showed extremely elevated serum IL-8 levels which were independent of the crisis inducing factor. Furthermore, a sickle cell patient with VOC as a complication of rhGM-CSF treatment similarly showed high IL-8 serum levels at crisis onset. Nonsymptomatic sickle cell patients serum IL-8 levels were comparable to healthy controls. These results implicate a role for IL-8 at or during (the initiation of) sickle cell crisis.

40 CFR 166.50 - Reporting and recordkeeping requirements for crisis exemption.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for crisis exemption. 166.50 Section 166.50 Protection of Environment ENVIRONMENTAL PROTECTION... EMERGENCY CONDITIONS Crisis Exemptions § 166.50 Reporting and recordkeeping requirements for crisis... a crisis exemption must be immediately reported to the Agency. (b) Final reports. (1) A report...

Foreign currency exchange network topology across the 2008 credit crisis

NASA Astrophysics Data System (ADS)

Sharif, Shamshuritawati; Ap, Nuraisah Che; Ruslan, Nuraimi

2017-05-01

A stable world currency exchange rate is a very important aspect to be considered for a developed country, i.e Malaysia. A better understanding about the currencies itself is needed nowadays. This project is about to understanding the fluctuation and to identify the most influential world currencies in the three different cases; before credit crisis, during credit crisis and after credit crisis. A network topology approach is use to examine the interrelationship between currencies based on correlation analysis. With this point of view, those relationships can be measured by a correlation structure among the currencies. The network can be analyse by filtering the important information using minimum spanning tree (MST) and interpret it using degree centrality as the centrality measure. This topology will give a useful guide to understand the behaviour and determine the most influential currency in the network as a part of a complex system. All currencies are compared among the three different cases; before credit crisis, during credit crisis and after credit crisis period. The result of this project shows that Unites State Dollar (USD), Brazilian Real (BRL), United Kingdom Pound (EUR) and Danish Krone (DKK) are the most influential currencies before the credit crisis period. With respect to during the credit crisis, New Zealand Dollar (NZD) dominates the network and it is followed by Singapore Dollar (SGD) for after the credit crisis period.

When a Crisis Hits, Will Your School Be Ready?

ERIC Educational Resources Information Center

Decker, Robert H.

This guidebook describes the components involved in proactively developing a comprehensive crisis-management plan. Chapter 1 explains the philosophical underpinnings of a crisis-management plan and discusses the importance of vision and staff development. Chapter 2 answers the questions: Why do we need a crisis-management plan? Who needs to be…

An Information-Processing Model of Crisis Management.

ERIC Educational Resources Information Center

Egelhoff, William G.; Sen, Falguni

1992-01-01

Develops a contingency model for managing a variety of corporate crises. Views crisis management as an information-processing situation and organizations that must cope with crisis as information-processing systems. Attempts to fit appropriate information-processing mechanisms to different categories of crises. (PRA)

Wundt contested: The first crisis declaration in psychology.

PubMed

Mülberger, Annette

2012-06-01

When reflecting on the history and the present situation of their field, psychologists have often seen their discipline as being in a critical state. The first author to warn of a crisis was, in 1897, the now scarcely known philosopher Rudolf Willy. He saw a crisis in psychology resulting, firstly, from a profuse branching out of psychology. Adopting a radical empiriocriticist point of view, he, secondly, made the metaphysical stance of scholars like Wilhelm Wundt responsible for the crisis. Meanwhile, the priest Constantin Gutberlet responded to the claim of crisis arguing, on the contrary, that the crisis resulted from research that was empirical only. Throughout the discipline psychologists felt troubled by a widespread sense of fragmentation in the field. I will argue that this is due to psychology's early social success and popularization in modern society. Moreover the paper shows that the first declaration of crisis emerged at a time when a discussion of fundamentals was already underway between Wundt and the empiriocriticist Richard Avenarius. The present historical research reveals the depth of the confrontation between Wundt and Willy, entailing a clash of two worldviews that embrace psychological, epistemological, and political aspects. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ideological Responses to the EU Refugee Crisis

PubMed Central

van Prooijen, Jan-Willem; Krouwel, André P. M.; Emmer, Julia

2017-01-01

The 2016 European Union (EU) refugee crisis exposed a fundamental distinction in political attitudes between the political left and right. Previous findings suggest, however, that besides political orientation, ideological strength (i.e., political extremism) is also relevant to understand such distinctive attitudes. Our study reveals that the political right is more anxious, and the political left experiences more self-efficacy, about the refugee crisis. At the same time, the political extremes—at both sides of the spectrum—are more likely than moderates to believe that the solution to this societal problem is simple. Furthermore, both extremes experience more judgmental certainty about their domain-specific knowledge of the refugee crisis, independent of their actual knowledge. Finally, belief in simple solutions mediated the relationship between ideology and judgmental certainty, but only among political extremists. We conclude that both ideological orientation and strength matter to understand citizens’ reactions to the refugee crisis. PMID:29593852

Responding to the Unthinkable: School Crisis Response and Recovery

ERIC Educational Resources Information Center

Cowan, Katherine C.; Rossen, Eric

2014-01-01

The mental health implications of crisis exposure have emerged as a critical and challenging facet of school safety and crisis response, expanding our focus to encompass both psychological and physical safety, as well as prevention and recovery. Best practice reflects this evolution in our understanding and encompasses the continuum of crisis and…

Wilderness Crisis Management. Explore Magazine Technical Series No. 11.

ERIC Educational Resources Information Center

Raffan, James

This paper deals with managing a crisis in a wilderness situation. The terms "crisis" and "turning point" are used to describe what is more traditionally called an accident. Using these terms introduces the idea that crisis events occur as logical consequences of preceding decisions, errors, or omissions, not as the result of…

The Global Economic Crisis: Setbacks to the Educational Agenda for the Minority in Sub-Saharan Africa

ERIC Educational Resources Information Center

Ingubu, Moses Shiasha

2010-01-01

This paper captures the impact of the Global Economic Crisis on educational programs serving minority groups in developing countries. It has been established that the most vulnerable groupings include nomadic and pastoralist communities, slum dwellers, children in war zones, and women. Various educational interventions such as mobile schooling,…

On the Epistemological Crisis in Genomics

PubMed Central

Dougherty, Edward R

2008-01-01

There is an epistemological crisis in genomics. At issue is what constitutes scientific knowledge in genomic science, or systems biology in general. Does this crisis require a new perspective on knowledge heretofore absent from science or is it merely a matter of interpreting new scientific developments in an existing epistemological framework? This paper discusses the manner in which the experimental method, as developed and understood over recent centuries, leads naturally to a scientific epistemology grounded in an experimental-mathematical duality. It places genomics into this epistemological framework and examines the current situation in genomics. Meaning and the constitution of scientific knowledge are key concerns for genomics, and the nature of the epistemological crisis in genomics depends on how these are understood. PMID:19440447

Declining death rates from hyperglycemic crisis among adults with diabetes, U.S., 1985-2002.

PubMed

Wang, Jing; Williams, Desmond E; Narayan, K M Venkat; Geiss, Linda S

2006-09-01

To examine trends in death rates for hyperglycemic crisis (diabetic ketoacidosis or hyperglycemic hyperosmolar state) among adults with diabetes in the U.S. from 1985 to 2002. Deaths with hyperglycemic crisis as the underlying cause were identified from national mortality data. Death rates were calculated using estimates of adults with diabetes from the National Health Interview Survey as the denominator and age adjusted to the 2000 U.S. population. The trends from 1985 to 2002 were tested using joinpoint regression analysis. Deaths due to hyperglycemic crisis dropped from 2,989 in 1985 to 2,459 in 2002. During the time period, age-adjusted death rates decreased from 42.4 to 23.8 per 100,000 adults with diabetes (4.4% decrease per year, P for trend <0.01). Death rates declined in all age-groups, with the greatest decrease occurring among individuals aged > or =65 years. Age-adjusted death rates fell for all race-sex subgroups, with black men experiencing the smallest decline. About one-fifth of deaths occurred at home or on arrival at the hospital, and the death rates for hyperglycemic crisis occurring at these places declined only modestly over time (2.1% decrease per year, P for trend = 0.049). Overall death rates due to hyperglycemic crisis among adults with diabetes have declined in the U.S. However, scope for further improvement remains, especially to further reduce death rates among black men and to prevent deaths occurring at home.

The Cuban Missile Crisis: Evolving Historical Perspectives.

ERIC Educational Resources Information Center

Medland, William J.

1990-01-01

Presents a synthesis of the views of participants and counterviews of scholars concerning the Cuban missile crisis of 1962. Reviews historical and analytical accounts of the crisis. Describes critical areas of conflicting interpretations by historians and participants. Includes an annotated bibliography of teaching resources. (NL)

The Crisis Treatment of Suicide

PubMed Central

Tabachnick, Norman

1970-01-01

Almost all suicidal persons who consult physicians wish to live. Generally they fall into one of two groups. Interpersonal suiciders manifest frequent threats and attempts, are emotionally labile, have ill-defined suicide plans, and clear ideas as to how their crises might be resolved. Intrapersonal suiciders are less open in manifestations of suicidal drive, withdrawn rather than emotional, often have clearly-formulated suicide plans and do not have ideas (other than suicide) as to how their crises might end. The suicidal situation results from two factors: (1) the loss of some valuable person or commodity, and (2) the loss of self-esteem. What ensues is temporary character disorganization—crisis. Treatment is based on restoration or replacement of lost objects and building up of self-esteem. PMID:5429131

Adverse effect of the financial crisis in Greece on perinatal factors.

PubMed

Zografaki, Irini; Papamichail, Dimitris; Panagiotopoulos, Takis

2018-05-16

Starting in 2008 recession affected many European countries and especially Greece. Previous studies have reported increases in low birth weight, preterm birth and stillbirth rates in Greece during early crisis. In our study we used data on births from 1980 to 2014 that allowed us to distinguish recent changes, which could possibly be attributed to the financial crisis, from long term trends, and controlled for maternal age and country of origin as potential confounders. Our study covered a longer period (up to 2014) than what has been studied before and looked separately at the effect of early and established crisis. We used national vital statistics data from 1980 to 2014. We performed age standardization and calculated age standardized rates and standardized rate ratios (SRRs) for perinatal factors for three time periods (pre-crisis, early crisis and established crisis) for Greek and non-Greek women. We found an increase in low birth weight deliveries independent of maternal age and origin and an increased stillbirth rate in Greek women younger than 25 in early (RR = 1.42 95%CI: 1.12-1.80) and established crisis periods (RR = 1.36 95%CI: 1.07-1.72) compared with pre-crisis. Non-Greek women have also been affected, with their advantage regarding birth outcomes becoming less profound in the established crisis period (low birth weight: established crisis SRR = 0.84 95%CI: 0.82-0.87, pre-crisis SRR = 0.79 95% CI: 0.76- 0.81). The financial crisis has possibly adversely affected perinatal factors in Greece. Our results highlight the need of appropriate public health interventions and family support policies, especially for younger people, unemployed and immigrants.

[Hypertensive crisis in children and adolescents].

PubMed

Skrzypczyk, Piotr; Roszkowska-Blaim, Maria; Daniel, Maria

2013-12-01

Hypertensive crisis is a sudden rise in blood pressure above 99 c. for sex, age and height +5 mm Hg. Depending on patient's symptoms, hypertensive crisis can be divided into hypertensive emergency severe arterial hypertension with target organ insufficiency and/r damage (central nervous system, heart, kidney, eye), and hypertensive urgency - severe arterial hypertension without target organ insufficiency and damage with non-specific symptoms like: headaches, vertigo, nasal bleeding, nausea, and vomiting. The most common causes of hypertensive crisis in neonates and infants are renal artery thrombosis, broncho-pulmonary dysplasia, and coarctation of aorta; in older children - kidney diseases and renal artery stenosis. In neonates and infants symptoms of cardiac failure predominate, whereas in older children symptoms from central nervous system (headaches, nausea, vomiting, changes in level of consciousness, seizures, focal deficits). Hypertensive crisis is treated with fast- and short-acting medications; 25% reduction of blood pressure within first 8 hours is recommended, with complete normalization within 24-48 hours. Hypertensive emergency should be treated with intravenous agents (labetalol, hydralazine, nicardipine, and sodium nitroprusside), hypertensive urgency with intravenous or oral agents like nifedipine, isradipine, clonidine and minoxidil. Nicardipine is a first-choice medication in neonates.

[Assessing aggression in patients of the mental health crisis service].

PubMed

Penterman, E J M; Nijman, H L I

2009-01-01

Care workers of the outreach psychiatric crisis team are frequently confronted with aggressive patients. To prevent dangerous situations from developing it could be advantageous to have in place a method of risk assessment that is based on information about patients before they are actually contacted by the crisis team. To test the predictive validity of an instrument specifically designed to assess the risks of aggression from severely disturbed psychiatric patients before they are seen by the crisis team. Over a period of two years and prior to any outreach contact with patients in crisis situations a Checklist of Risks to the Crisis team (CRC) was completed. Then, following outreach contact with the patient any perceived aggression was recorded by means of the Staff Observation Aggression Scale-Revised (SOAS-R). Aggressive behaviour by patients was observed during 51 of 499 crisis contacts with members of the outreach crisis team. On the basis of three factors in the CRC, namely the clinical assessment on a visual-analogue scale, an estimate of the number of aggressive persons in the vicinity of the crisis patient concerned and the reporting of crises by the patient himself, it was possible to predict outwardly directed aggression with a sensitivity of 74% and a specificity of 84%. Although the findings still need to be reproduced, an instrument such as the crc could be very useful to members of the crisis service.

'HTA for Crisis': sharing experiences during the 7th EBHC Symposium.

PubMed

Wladysiuk, Magdalena; Tabor, Anna; Godman, Brian

2013-02-01

The Central and Eastern European Society of Technology Assessment in Health Care was founded in Krakow, Poland in 2003. On October 8th and 9th, the 7th symposium took place titled 'HTA for Crisis'. This meeting was attended by over 250 decision makers, evidence-based specialists, healthcare managers, commercial company personnel and experts. The symposium was principally divided into four main themes: insurance in times of crisis; importance of pricing of health services in times of crisis; managing welfare benefits in times of crisis and Health Technology Assessment in crisis-laden countries. The symposium finished by debating potential ways forward for healthcare systems in times of crisis.

Cell Death During Crisis Is Mediated by Mitotic Telomere Deprotection

PubMed Central

Hayashi, Makoto T.; Cesare, Anthony J.; Rivera, Teresa; Karlseder, Jan

2015-01-01

Tumour formation is blocked by two barriers, replicative senescence and crisis1. Senescence is triggered by short telomeres and is bypassed by disruption of tumour suppressive pathways. After senescence bypass, cells undergo crisis, during which almost all of the cells in the population die. Cells that escape crisis harbor unstable genomes and other parameters of transformation. The mechanism of cell death during crisis remained elusive. We show that cells in crisis undergo spontaneous mitotic arrest, resulting in death during mitosis or in the following cell cycle. The phenotype was induced by loss of p53 function, and suppressed by telomerase overexpression. Telomere fusions triggered mitotic arrest in p53-compromised non-crisis cells, indicating such fusions as the underlying cause. Exacerbation of mitotic telomere deprotection by partial TRF2 knockdown2 increased the ratio of cells that died during mitotic arrest and sensitized cancer cells to mitotic poisons. We propose a crisis pathway wherein chromosome fusions induce mitotic arrest, resulting in mitotic telomere deprotection and cell death, thereby eliminating precancerous cells from the population. PMID:26108857

Economic Crisis, Austerity Policies, Health and Fairness: Lessons Learned in Spain.

PubMed

Lopez-Valcarcel, Beatriz G; Barber, Patricia

2017-02-01

This paper reviews economic and medical research publications to determine the extent to which the measures applied in Spain to control public health spending following the economic and financial crisis that began in 2008 have affected healthcare utilization, health and fairness within the public healthcare system. The majority of the studies examined focus on the most controversial cutbacks that came into force in mid-2012. The conclusions drawn, in general, are inconclusive. The consequences of this new policy of healthcare austerity are apparent in terms of access to the system, but no systematic effects on the health of the general population are reported. Studies based on indicators of premature mortality, avoidable mortality or self-perceived health have not found clear negative effects of the crisis on public health. The increased demands for co-payment provoked a short-term cutback in the consumption of medicines, but this effect faded after 12-18 months. No deterioration in the health of immigrants after the onset of the crisis was unambiguously detected. The impact of the recession on the general population in terms of diseases associated with mental health is well documented; however, the high levels of unemployment are identified as direct causes. Therefore, social policies rather than measures affecting the healthcare system would be primarily responsible. In addition, some health problems have a clear social dimension, which seems to have become more acute during the crisis, affecting in particular the most vulnerable population groups and the most disadvantaged social classes, thus widening the inequality gap.

Chromothripsis and kataegis induced by telomere crisis

PubMed Central

Maciejowski, John; Li, Yilong; Bosco, Nazario; Campbell, Peter J.; de Lange, Titia

2015-01-01

Telomere crisis occurs during tumorigenesis when depletion of the telomere reserve leads to frequent telomere fusions. The resulting dicentric chromosomes have been proposed to drive genome instability. Here we examine the fate of dicentric human chromosomes in telomere crisis. We observed that dicentric chromosomes invariably persisted through mitosis and developed into 50-200 μm chromatin bridges connecting the daughter cells. Before their resolution at 3-20 h after anaphase, the chromatin bridges induced nuclear envelope rupture in interphase, accumulated the cytoplasmic 3' nuclease TREX1, and developed RPA-coated single stranded (ss) DNA. CRISPR knockouts showed that TREX1 contributed to the generation of the ssDNA and the resolution of the chromatin bridges. Post-crisis clones showed chromothripsis and kataegis, presumably resulting from DNA repair and APOBEC editing of the fragmented chromatin bridge DNA. We propose that chromothripsis in human cancer may arise through TREX1-mediated fragmentation of dicentric chromosomes formed in telomere crisis. PMID:26687355

Urbanization eases water crisis in China

USGS Publications Warehouse

Wu, Yiping; Liu, Shu-Guang; Ji, Chen

2012-01-01

Socioeconomic development in China has resulted in rapid urbanization, which includes a large amount of people making the transition from rural areas to cities. Many have speculated that this mass migration may have worsened the water crisis in many parts of the country. However, this study shows that the water crisis would be more severe if the rural-to-urban migration did not occur.

[Celiac crisis: presentation as bleeding diathesis].

PubMed

Gutiérrez, Sebastián; Toro, Martín; Cassar, Alejandro; Ongay, Rodrigo; Isaguirre, Jorge; López, Candelaria; Benedetti, Laura

2009-03-01

Celiac crisis is a severe and potentially fatal complication of celiac disease. Unusual at present, it has been described mainly in children younger than 2-years-old, but reports in adults do exist. We report a 26-years-old lady with tetany and bleeding diathesis at presentation. In spite of it rareness, it is important to consider celiac crisis among the multiple manifestations of celiac disease.

Telephone Crisis Support Workers' Psychological Distress and Impairment.

PubMed

Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-01

In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to. A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms. Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining. Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data. While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information. There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

Miscarriage: A Special Type of Family Crisis.

ERIC Educational Resources Information Center

Day, Randal D.; Hooks, Daniel

1987-01-01

Surveyed 102 women about their experience with miscarriage. Found that family resource variables were a much stronger predictor of level of crisis and recovery than were personal or community resource variables. Adaptation and cohesion were significant predictors of speed or recovery and level of crisis, respectively. (Author/NB)

Do You Have a Crisis Management Plan?

ERIC Educational Resources Information Center

Pleviak, Walter; Milkevitch, Frank

2001-01-01

Although certain crises cannot be prevented, reactions to many can be planned. A crisis-management team should be organized for each building. Critical crisis-plan elements include telephone trees, forms, reference articles, sample letters, and processes for dealing with local media. Spokespersons should have facts straight before speaking. (MLH)

The impact of the 2008/2009 financial crisis on specialist physician activity in Canada.

PubMed

Lavergne, M Ruth; Hedden, Lindsay; Law, Michael R; McGrail, Kim; Ahuja, Megan; Barer, Morris

2018-06-19

Fee-for-service physicians are responsible for planning for their retirements, and there is no mandated retirement age. Changes in financial markets may influence how long they remain in practice and how much they choose to work. The 2008 crisis provides a natural experiment to analyze elasticity in physician service supply in response to dramatic financial market changes. We examined quarterly fee-for-service data for specialist physicians over the period from 1999/2000 to 2013/2014 in Canada. We used segmented regression to estimate changes in the number of physicians receiving payments, per-physician service counts, and per-physician payments following the 2008 financial crisis and explored whether patterns differed by physician age. The number of specialist physicians increased more rapidly in the period since 2008 than in earlier years, but increases were largest within the youngest age group, and we observed no evidence of delayed retirement among older physicians. Where changes in service volume and payments were observed, they occurred across all ages and not immediately following the 2008 financial crisis. We conclude that any response to the financial crisis was small compared with demographic shifts in the physician population and changes in payments per service over the same time period. Copyright © 2018 John Wiley & Sons, Ltd.

Near-infrared-fluorescence imaging of lymph nodes by using liposomally formulated indocyanine green derivatives.

PubMed

Toyota, Taro; Fujito, Hiromichi; Suganami, Akiko; Ouchi, Tomoki; Ooishi, Aki; Aoki, Akira; Onoue, Kazutaka; Muraki, Yutaka; Madono, Tomoyuki; Fujinami, Masanori; Tamura, Yutaka; Hayashi, Hideki

2014-01-15

Liposomally formulated indocyanine green (LP-ICG) has drawn much attention as a highly sensitive near-infrared (NIR)-fluorescence probe for tumors or lymph nodes in vivo. We synthesized ICG derivatives tagged with alkyl chains (ICG-Cn), and we examined NIR-fluorescence imaging for lymph nodes in the lower extremities of mice by using liposomally formulated ICG-Cn (LP-ICG-Cn) as well as conventional liposomally formulated ICG (LP-ICG) and ICG. Analysis with a noninvasive preclinical NIR-fluorescence imaging system revealed that LP-ICG-Cn accumulates in only the popliteal lymph node 1h after injection into the footpad, whereas LP-ICG and ICG accumulate in the popliteal lymph node and other organs like the liver. This result indicates that LP-ICG-Cn is a useful NIR-fluorescence probe for noninvasive in vivo bioimaging, especially for the sentinel lymph node. Copyright © 2013 Elsevier Ltd. All rights reserved.

Facing the Crisis: Third World Agriculture in the 1980s.

ERIC Educational Resources Information Center

Singh, Ajit; Tabatabai, Hamid

1990-01-01

Examines how developing nations' agrarian economy fared in the 1980s in the wake of the world economic crisis. Discusses how the economic crisis affected agricultural development and whether the performance of the agrarian economy was responsible for the economic crisis. (JOW)

Effectiveness and cost-effectiveness of admissions to women's crisis houses compared with traditional psychiatric wards: pilot patient-preference randomised controlled trial.

PubMed

Howard, L; Flach, C; Leese, M; Byford, S; Killaspy, H; Cole, L; Lawlor, C; Betts, J; Sharac, J; Cutting, P; McNicholas, S; Johnson, S

2010-08-01

Women's crisis houses have been developed in the UK as a less stigmatising and less institutional alternative to traditional psychiatric wards. To examine the effectiveness and cost-effectiveness of women's crisis houses by first examining the feasibility of a pilot patient-preference randomised controlled trial (PP-RCT) design (ISRCTN20804014). We used a PP-RCT study design to investigate women presenting in crisis needing informal admission. The four study arms were the patient preference arms of women's crisis house or hospital admission, and randomised arms of women's crisis house or hospital admission. Forty-one women entered the randomised arms of the trial (crisis house n = 19, wards n = 22) and 61 entered the patient-preference arms (crisis house n = 37, ward n = 24). There was no significant difference in outcomes (symptoms, functioning, perceived coercion, stigma, unmet needs or quality of life) or costs for any of the groups (randomised or preference arms), but women who obtained their preferred intervention were more satisfied with treatment. Although the sample sizes were too small to allow definite conclusions, the results suggest that when services are able to provide interventions preferred by patients, those patients are more likely to be satisfied with treatment. This pilot study provides some evidence that women's crisis houses are as effective as traditional psychiatric wards, and may be more cost-effective.

[Provincial public center for crisis intervention and psycho-social rehabilitation. A path towards communitary suicidology].

PubMed

Martínez, Carlos

2014-01-01

This work on the systematic comprehensive approach towards the Prevention and Postvencion of Suicide started to develop back in mid 2011 in Río Gallegos, capital of Santa Cruz Province. The first step on this development was a Pilot Plan for the Training of Professionals and also field intervention. The Center for Crisis Intervention and Psycho-social Rehabilitation was founded eight months later. The case-client in crisis plus family group- undergoes quantitative and qualitative evaluation by means of a triage system, all of which allows starting intensive face-to-face and also phone follow up according to the Crisis Intervention Model. Such intervention is developed by means of the participation in the "Grupo Sostén", the Adolescents Group if the client fits into that age, and also family relationship interviews as well as Multi-family meetings open to the Community. There is also a Community Team in the Center which performs collective assessment in schools, in conjunction with the "Equidad en Redes" Educational Specialty Team, belonging to the Provincial Education Council. The approach takes place on the field, and works as a screening step for the early detection of risk. Such risk is dealt with by means of short term intervention group programs involving the whole of the educational community. When facing situations of committed suicide there are interventions in communities to the interior of the province, fundamentally through the Hospital Team which works as the cluster convener for the social intersectoral frame-work.

School Crisis Aftermath: Care for the Caregivers

ERIC Educational Resources Information Center

Paine, Cathy Kennedy

2009-01-01

"Professional" crisis caregivers (e.g., emergency responders, mental health providers, medical professionals, victim assistance counselors, and faith leaders) are trained to handle exposure to images of destruction and loss and to help victims or survivors cope with the impact of a crisis. They try to help individuals, schools, and communities…

When a Crisis Occurs: A Trustee's Perspective.

ERIC Educational Resources Information Center

Kenney, Phyllis Gutierrez

1997-01-01

Argues that, although crises are unavoidable, they can be planned for and that there should be a crisis management model for each situation. Discusses components of an effective crisis management plan, including clear lines of governance, trust, and communication between boards and the president and effective communication with the media and…

Assessment of pre-crisis and syn-crisis seismic hazard at Campi Flegrei and Mt. Vesuvius volcanoes, Campania, southern Italy

NASA Astrophysics Data System (ADS)

Convertito, Vincenzo; Zollo, Aldo

2011-08-01

In this study, we address the issue of short-term to medium-term probabilistic seismic hazard analysis for two volcanic areas, Campi Flegrei caldera and Mt. Vesuvius in the Campania region of southern Italy. Two different phases of the volcanic activity are considered. The first, which we term the pre-crisis phase, concerns the present quiescent state of the volcanoes that is characterized by low-to-moderate seismicity. The second phase, syn-crisis, concerns the unrest phase that can potentially lead to eruption. For the Campi Flegrei case study, we analyzed the pattern of seismicity during the 1982-1984 ground uplift episode (bradyseism). For Mt. Vesuvius, two different time-evolutionary models for seismicity were adopted, corresponding to different ways in which the volcano might erupt. We performed a site-specific analysis, linked with the hazard map, to investigate the effects of input parameters, in terms of source geometry, mean activity rate, periods of data collection, and return periods, for the syn-crisis phase. The analysis in the present study of the pre-crisis phase allowed a comparison of the results of probabilistic seismic hazard analysis for the two study areas with those provided in the Italian national hazard map. For the Mt. Vesuvius area in particular, the results show that the hazard can be greater than that reported in the national hazard map when information at a local scale is used. For the syn-crisis phase, the main result is that the data recorded during the early months of the unrest phase are substantially representative of the seismic hazard during the whole duration of the crisis.

Crisis on campus: Eating disorder intervention from a developmental-ecological perspective.

PubMed

Taylor, Julia V; Gibson, Donna M

2016-01-01

The purpose of this article is to review a crisis intervention using the developmental-ecological protocol (Collins and Collins, 2005) with a college student presenting with symptomatology of an active eating disorder. Participants included University Wellness Center employees responding to the crisis. Methods include an informal review of the crisis intervention response and application of the ABCDE developmental-ecological crisis model. Results reported include insight into crisis intervention when university counseling and health center is not available as resources. ABCDE Developmental-ecological model recommendations for university faculty and staff are included.

Towards integrated crisis support of regional emergency networks.

PubMed

Caro, D H

1999-01-01

Emergency and crisis management pose multidimensional information systems challenges for communities across North America. In the quest to reduce mortality and morbidity risks and to increase the level of crisis preparedness, regional emergency management networks have evolved. Integrated Crisis Support Systems (ICSS) are enabling information technologies that assist emergency managers by enhancing the ability to strategically manage and control these regional emergency networks efficiently and effectively. This article underscores the ICCS development, control and leadership issues and their promising implications for regional emergency management networks.

Practicing discernment: pastoral care in crisis situations.

PubMed

Landes, Scott D

2010-01-01

This article correlates a particular experience of providing pastoral care for a person in a crisis situation with a particular understanding of the practice of pastoral care. Through engaging in correlative practical theology, it highlights the need for practicing discernment when providing pastoral care for persons utilizing narratives to work through crisis situations.

Crisis Management's New Role in Educational Settings

ERIC Educational Resources Information Center

Gainey, Barbara S.

2009-01-01

From natural disasters to the financial debacle, it is clear to the educational community that crises know no boundaries. Far from a passing fad, crisis planning must be an integrated part of effective school district leadership. Two studies explore the status of crisis management in selected public school systems and offer recommendations for…

Financial Crisis Management in Higher Education: Responses by 20 Private Colleges and Universities to the 2007-2009 Financial Crisis

ERIC Educational Resources Information Center

Dorantes, Andrew R.; Low, Justin R.

2016-01-01

As a result of the Great Recession, higher education in the United States suffered from the most significant financial crisis since the Great Depression (Breneman 2008; Zumeta 2010). This crisis affected all institutions of higher education since it challenged three major revenue sources: net tuition income, endowment income, and gift income…

Coast Guard Deepwater Acquisition Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2011-03-18

NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Congressional Research Service,Library Of Congress,101...Deepwater Acquisition into asset-based Acquisition Program Baselines, the proposed changes align projects that were formerly grouped under...Integrated Coast Guard Systems (ICGS)—an industry team led by Lockheed Martin and Northrop Grumman Ship Systems ( NGSS ). ICGS was awarded an indefinite

Stress in crisis managers: evidence from self-report and psychophysiological assessments.

PubMed

Janka, A; Adler, C; Fischer, L; Perakakis, P; Guerra, P; Duschek, S

2015-12-01

Directing disaster operations represents a major professional challenge. Despite its importance to health and professional performance, research on stress in crisis management remains scarce. The present study aimed to investigate self-reported stress and psychophysiological stress responses in crisis managers. For this purpose, 30 crisis managers were compared with 30 managers from other disciplines, in terms of self-reported stress, health status and psychophysiological reactivity to crisis-related and non-specific visual and acoustic aversive stimuli and cognitive challenge. Crisis managers reported lower stress levels, a more positive strain-recuperation-balance, greater social resources, reduced physical symptoms, as well as more physical exercise and less alcohol consumption. They exhibited diminished electrodermal and heart rate responses to crisis-related and non-specific stressors. The results indicate reduced stress and physical complaints, diminished psychophysiological stress reactivity, and a healthier life-style in crisis managers. Improved stress resistance may limit vulnerability to stress-related performance decline and facilitate preparedness for major incidents.

Trust, confidence, and the 2008 global financial crisis.

PubMed

Earle, Timothy C

2009-06-01

The 2008 global financial crisis has been compared to a "once-in-a-century credit tsunami," a disaster in which the loss of trust and confidence played key precipitating roles and the recovery from which will require the restoration of these crucial factors. Drawing on the analogy between the financial crisis and environmental and technological hazards, recent research on the role of trust and confidence in the latter is used to provide a perspective on the former. Whereas "trust" and "confidence" are used interchangeably and without explicit definition in most discussions of the financial crisis, this perspective uses the TCC model of cooperation to clearly distinguish between the two and to demonstrate how this distinction can lead to an improved understanding of the crisis. The roles of trust and confidence-both in precipitation and in possible recovery-are discussed for each of the three major sets of actors in the crisis, the regulators, the banks, and the public. The roles of trust and confidence in the larger context of risk management are also examined; trust being associated with political approaches, confidence with technical. Finally, the various stances that government can take with regard to trust-such as supportive or skeptical-are considered. Overall, it is argued that a clear understanding of trust and confidence and a close examination of the specific, concrete circumstances of a crisis-revealing when either trust or confidence is appropriate-can lead to useful insights for both recovery and prevention of future occurrences.

Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters.

PubMed

Chen, Wei-Jen; Ho, Chi-Kung; Shyu, Shi-Sen; Chen, Cheng-Chung; Lin, Guei-Ging; Chou, Li-Shiu; Fang, Yun-Ju; Yeh, Pin-Yang; Chung, Tieh-Chi; Chou, Frank Huang-Chih

2013-07-17

Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources. The aim of the present study was to evaluate the effectiveness of case management using crisis postcards over a 6-month follow-up period. A randomised controlled trial was conducted in Kaohsiung, Taiwan. Prevention of further suicide attempts was compared between two groups with and without the postcard intervention. The intervention group consisted of 373 participants (139 males, 234 females; age: 39.8 ± 14.0 yrs.). The control group consisted of 388 participants (113 males, 275 females; age: 40.0 ± 16.0 yrs.). A survival analysis was used to test the effectiveness of the crisis postcard intervention for the prevention of suicide reattempts. Per-protocol and intention-to-treat analyses were conducted. The intention-to-treat analysis indicated that the crisis postcard had no effect (hazard ratio = 0.84; 95% CI = 0.56 - 1.29), whereas the per-protocol analysis showed a strong benefit for the crisis postcard (hazard ratio = 0.39; 95% CI = 0.21 - 0.72). Although the results of the present study indicated that the postcard intervention did not reduce subsequent suicide behaviour, our study provides an alteration to the postcard intervention. Further studies need to be conducted to clarify whether this type of intervention can reduce subsequent suicidal behaviour, with a particular focus on reducing the rate of loss to follow-up.

Guide of Hypertensive Crisis Pharmacotherapy.

PubMed

Wani-Parekh, Priyanka; Blanco-Garcia, Carlos; Mendez, Melissa; Mukherjee, Debabrata

2017-01-01

Cardiovascular diseases (CVD) are the number one cause of death globally compared to any other cause. CVD accounts for approximately 17.3 million deaths per year and are rising. Hypertension is the leading risk factor for cardiovascular diseases. Approximately, 80 million people suffer from hypertension in the U.S. While, majority of these individuals are on antihypertensive medications only 54% of individuals with hypertension are optimally controlled. Heart failure and stroke are some of the devastating complications of uncontrolled hypertension. Hypertensive crisis can be classified as either an urgency or emergency; difference between the two is the presence of end organ damage, which is noted in hypertensive emergency. Hypertensive crisis is usually treated by parenteral antihypertensive medications. The main drug classes of drugs for treatment are nitrates, calcium channel blockers, dopamine-1 agonists, adrenergic-blocking agents etc. In this review, we discuss approach to management of hypertensive crisis and each drug class with its physiology and complications. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Capsaicin and arterial hypertensive crisis.

PubMed

Patanè, Salvatore; Marte, Filippo; La Rosa, Felice Carmelo; La Rocca, Roberto

2010-10-08

Chili peppers are rich in capsaicin. The potent vasodilator calcitonin gene-related peptide (CGRP) is stored in a population of C-fiber afferents that are sensitive to capsaicin. CGRP and peptides released from cardiac C fibers have a beneficial effect in myocardial ischemia and reperfusion. It has been reported that capsaicin pretreatment can deplete cardiac C-fiber peptide stores. Furthermore, it has also been reported that capsaicin-treated pigs have significantly increased mean arterial blood pressure compared with controls, and that the decrease in CGRP synthesis and release contributes to the elevated blood pressure. A case has also been reported of an arterial hypertensive crisis in a patient with a large ingestion of peppers and chili peppers the day before. We present a case of an arterial hypertensive crisis in a 19-year-old Italian man with an abundant ingestion of peppers and of chili peppers the preceding day. This case describes an unusual pattern of arterial hypertensive crisis due to capsaicin. Copyright © 2008 Elsevier Ireland Ltd. All rights reserved.

Framework See-Think as a Tool for Crowdsourcing Support - Case Study on Crisis Management

NASA Astrophysics Data System (ADS)

Netek, R.; Panek, J.

2016-06-01

See-Think-Do is a framework originally used as an approach focused on a service and product marketing on the Internet. Customers can be classified into three groups according to their involvement from potential users to real customers. The article presents an idea of public involvement in community mapping in three levels: "See"—almost any user; "Think"—potential contributors; and "Do"—interested users. The case study implements the See-Think-Do framework as an awareness-based approach used for The Crisis Map of the Czech Republic. It is an Ushahidi-based crowdsourcing platform for sharing spatial and multimedia information during crisis situations, e.g. disaster floods in 2013. While the current crisis projects use public mapping just at the onset of the disaster, according to See-Think-Do any user can be considered as a potential contributor even during the dormant period. The focus is put on the "See" and "Think" groups of contributors, which are currently ignored. The objective of this paper is to summarize approaches (social networks, mass-media, emailing, gamification, …) and tools (GIT/GIS, ICT, multimedia) for increasing the awareness about the project within the resting phase. That recruits a higher number of both active and passive users during the disaster. It allows the training in ICT, cartographical, spatial and GIS skills in a non-stressful way and the targeting on specific operators. Volunteers from the "Think" group may be used for data processing or rectification, GIS professionals from the "Do" group for data verification. The results refer that contributors with already established skills and required literacy (interface, data uploading) provide data faster and more accurate, the usability of the project increases based on users' comments.

Resource Guide for Crisis Management in Schools.

ERIC Educational Resources Information Center

LaPointe, Richard T.; And Others

A crisis can occur at any time, whether or not a school's staff plans for it. This resource guide is a compilation of user-friendly examples of policies, procedures, guidelines, checklists, and forms to help Virginia schools develop and implement a systematic crisis-management plan. Chapter 1 provides an introductory overview of the essential…

The Financial Crisis in the Community College.

ERIC Educational Resources Information Center

Lombardi, John

The author examines the financial crisis in community colleges on a national scale in this first paper in a projected long-range study of this crucial topic. Economic causes contributing to the crisis include inflation, rising enrollments, and such labor-intensive aspects as spiraling labor and security costs, and increasing demands for funds by…

Abortion misinformation from crisis pregnancy centers in North Carolina.

PubMed

Bryant, Amy G; Levi, Erika E

2012-12-01

This study assessed the accuracy of medical information provided by crisis pregnancy centers in North Carolina. We performed a secondary data analysis of a "secret shopper survey" performed by a nonprofit organization. Reports from phone calls and visits to crisis pregnancy centers were analyzed for quality and content of medical information provided. Web sites of crisis pregnancy centers in the state were also reviewed. Thirty-two crisis pregnancy centers were contacted. Nineteen of these were visited. Fourteen centers (44%) offered that they "provide counseling on abortion and its risks." Inaccurate information provided included a link between abortion and breast cancer (16%), infertility (26%) and mental health problems (26%). Of the 36 Web sites identified, 31 (86%) provided false or misleading information, including 26 sites (72%) linking abortion to "post-abortion stress." Many crisis pregnancy centers give inaccurate medical information regarding the risks of abortion. Overstating risks stigmatizes abortion, seeks to intimidate women and is unethical. Copyright © 2012 Elsevier Inc. All rights reserved.

Impedance cardiography: a comparison of cardiac output vs waveform analysis for assessing left ventricular systolic dysfunction.

PubMed

DeMarzo, Arthur P; Kelly, Russell F; Calvin, James E

2007-01-01

Early detection of asymptomatic left ventricular systolic dysfunction (LVSD) is beneficial in managing heart failure. Recent studies have cast doubt on the usefulness of cardiac output as an indicator of LVSD. In impedance cardiography (ICG), the dZ/dt waveform has a systolic wave called the E wave. This study looked at measurements of the amplitude and area of the E wave compared with ICG-derived cardiac output, stroke volume, cardiac index, and stroke index as methods of assessing LVSD. ICG data were obtained from patients (n=26) admitted to a coronary care unit. Clinical LVSD severity was stratified into 4 groups (none, mild, moderate, and severe) based on echocardiography data and standard clinical assessment by a cardiologist blinded to ICG data. Statistical analysis showed that the E wave amplitude and area were better indicators of the level of LVSD than cardiac output, stroke volume, cardiac index, or stroke index. ICG waveform analysis has potential as a simple point-of-care test for detecting LVSD in asymptomatic patients at high risk for developing heart failure and for monitoring LVSD in patients being treated for heart failure.

Alcohol and the economic crisis in Argentina: recent findings.

PubMed

Munné, Myriam I

2005-12-01

In 2002 Argentina participated in the GENACIS project (Gender, Alcohol, and Culture: An International Study) as one of the countries funded by the World Health Organization. Four questions about the current economic crisis in Argentina were added to the original GENACIS questionnaire in order to find out the opinions of the general population in relation to alcohol and the economic crisis. Gender differences in the answers to these questions were examined. Logistic regression was used to identify demographic, drinking pattern and drinking problems variables related significantly to responses to the economic crisis questions. During the economic crisis people stopped or reduced going to bars and instead drank at home or at friends' homes. A large number of respondents also reported that people had changed to cheaper or lower-quality alcoholic drinks. Women were more likely to agree with statements that the economic crisis had increased 'escape' drinking and required reductions in money spent on alcohol; men were more likely to agree that the crisis had led to less drinking in bars and to the purchase of cheaper or lower-quality alcoholic beverages. Respondents who reported having significant others with drinking-related problems were more likely to endorse all four statements about effects of the economic crisis on drinking behaviour. A qualitative approach was used to discuss themes in the general comments that were recorded by the interviewers while collecting data. A strongly moralistic attitude towards alcohol was present in these comments, especially among women. The findings suggest that the economic crisis in Argentina led to major changes in patterns of drinking that differed according to gender roles and other demographic variables. The long-term effects of these changes remain to be determined as economic circumstances improve.

Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial.

PubMed

Borschmann, Rohan; Barrett, Barbara; Hellier, Jennifer M; Byford, Sarah; Henderson, Claire; Rose, Diana; Slade, Mike; Sutherby, Kim; Szmukler, George; Thornicroft, Graham; Hogg, Joanna; Moran, Paul

2013-05-01

People with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published. To examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan. An RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness. In total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU; n = 46) or TAU alone (n = 42). This represented approximately 75% of our target sample size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI 0.53-6.5, P = 0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI 0.34-1.63, P = 0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs. It is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study.

How Should the Financial Crisis Change How We Teach Economics?

ERIC Educational Resources Information Center

Shiller, Robert J.

2010-01-01

Student dissatisfaction with teaching of economics--particularly with macroeconomics--during the current financial crisis mirrors dissatisfaction that was expressed during the last big crisis, the Great Depression. Then and now, a good number of students have felt that their lectures bear little relation to the economic crisis raging outside the…

A Human Rights Crisis in Indian Country

ERIC Educational Resources Information Center

Vigil, Chris

2015-01-01

There is a human rights crisis in Indian Country. This crisis--one of many--is the result of an almost universal lack of legal representation of Native people when they appear as defendants in tribal courts. The lack of lay advocates and attorneys representing Native defendants creates tremendous problems for tribal members who find themselves in…

The Leading Edge: Enduring a Campus Crisis

ERIC Educational Resources Information Center

Moeser, James

2003-01-01

On June 2003, the University of North Carolina at Chapel Hill (UNC) faced a frightening crisis when an employee was diagnosed with Severe Acute Respiratory Syndrome (SARS). In this article, the author looks back and identifies four factors that enabled the university to navigate this crisis. These factors were: (1) leadership at every level; (2)…

The Philadelphia School District's Ongoing Financial Crisis

ERIC Educational Resources Information Center

Caskey, John; Kuperberg, Mark

2014-01-01

This article describes the budget crisis that the School District of Philadelphia has faced for the past few years. Three specific events triggered the 2012 crisis: an abrupt reduction in federal and state funding, the inability of the district to cut many of its costs, and political pressures on the district to spend available revenues in a given…

Disrupting gatekeeping practices: Journalists’ source selection in times of crisis

PubMed Central

van der Meer, Toni G.L.A.; Verhoeven, Piet; Beentjes, Johannes W.J.; Vliegenthart, Rens

2016-01-01

As gatekeepers, journalists have the power to select the sources that get a voice in crisis coverage. The aim of this study is to find out how journalists select sources during a crisis. In a survey, journalists were asked how they assess the following sources during an organizational crisis: news agencies, an organization undergoing a crisis, and the general public. The sample consisted of 214 Dutch experienced journalists who at least once covered a crisis. Using structural equation modeling, sources’ likelihood of being included in the news was predicted using five source characteristics: credibility, knowledge, willingness, timeliness, and the relationship with the journalist. Findings indicated that during a crisis, news agencies are most likely to be included in the news, followed by the public, and finally the organization. The significance of the five source characteristics is dependent on source type. For example, to be used in the news, news agencies and organizations should be mainly evaluated as knowledgeable, whereas information from the public should be both credible and timely. In addition, organizations should not be seen as too willing or too eager to communicate. The findings imply that, during a crisis, journalists remain critical gatekeepers; however, they rely mainly on familiar sources. PMID:29278263

Disrupting gatekeeping practices: Journalists' source selection in times of crisis.

PubMed

van der Meer, Toni G L A; Verhoeven, Piet; Beentjes, Johannes W J; Vliegenthart, Rens

2017-10-01

As gatekeepers, journalists have the power to select the sources that get a voice in crisis coverage. The aim of this study is to find out how journalists select sources during a crisis. In a survey, journalists were asked how they assess the following sources during an organizational crisis: news agencies, an organization undergoing a crisis, and the general public. The sample consisted of 214 Dutch experienced journalists who at least once covered a crisis. Using structural equation modeling, sources' likelihood of being included in the news was predicted using five source characteristics: credibility, knowledge, willingness, timeliness, and the relationship with the journalist. Findings indicated that during a crisis, news agencies are most likely to be included in the news, followed by the public, and finally the organization. The significance of the five source characteristics is dependent on source type. For example, to be used in the news, news agencies and organizations should be mainly evaluated as knowledgeable, whereas information from the public should be both credible and timely. In addition, organizations should not be seen as too willing or too eager to communicate. The findings imply that, during a crisis, journalists remain critical gatekeepers; however, they rely mainly on familiar sources.

An Analysis of Secondary Schools' Crisis Management Preparedness: National Implications

ERIC Educational Resources Information Center

Adams, Cheantel M.; Kritsonis, William Allan

2006-01-01

The purpose of this study is to analyze crisis management plans of schools that have experienced crisis situations in the past. The plans used by these schools to manage these crisis situations will be evaluated for their effectiveness or ineffectiveness in re-establishing stability to their organization. With such information, other schools may…

Financial crisis, austerity, and health in Europe.

PubMed

Karanikolos, Marina; Mladovsky, Philipa; Cylus, Jonathan; Thomson, Sarah; Basu, Sanjay; Stuckler, David; Mackenbach, Johan P; McKee, Martin

2013-04-13

The financial crisis in Europe has posed major threats and opportunities to health. We trace the origins of the economic crisis in Europe and the responses of governments, examine the effect on health systems, and review the effects of previous economic downturns on health to predict the likely consequences for the present. We then compare our predictions with available evidence for the effects of the crisis on health. Whereas immediate rises in suicides and falls in road traffic deaths were anticipated, other consequences, such as HIV outbreaks, were not, and are better understood as products of state retrenchment. Greece, Spain, and Portugal adopted strict fiscal austerity; their economies continue to recede and strain on their health-care systems is growing. Suicides and outbreaks of infectious diseases are becoming more common in these countries, and budget cuts have restricted access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health. Although there are many potentially confounding differences between countries, our analysis suggests that, although recessions pose risks to health, the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe. Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health, yet public health voices have remained largely silent during the economic crisis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Managing a Crisis

ERIC Educational Resources Information Center

Pierce, Dennis

2016-01-01

Planning ahead, practicing your response for various scenarios, being open and honest, showing empathy and respect for other peoples' perspectives and assuring stakeholders that you have the situation covered are the foundations of communicating successfully during a crisis, experts say. This article provides strategies for Community College…

Intranasal dexmedetomidine for adrenergic crisis in familial dysautonomia.

PubMed

Spalink, Christy L; Barnes, Erin; Palma, Jose-Alberto; Norcliffe-Kaufmann, Lucy; Kaufmann, Horacio

2017-08-01

To report the use of intranasal dexmedetomidine, an α 2 -adrenergic agonist for the acute treatment of refractory adrenergic crisis in patients with familial dysautonomia. Case series. Three patients with genetically confirmed familial dysautonomia (case 1: 20-year-old male; case 2: 43-year-old male; case 3: 26-year-old female) received intranasal dexmedetomidine 2 mcg/kg, half of the dose in each nostril, for the acute treatment of adrenergic crisis. Within 8-17 min of administering the intranasal dose, the adrenergic crisis symptoms abated, and blood pressure and heart rate returned to pre-crises values. Adrenergic crises eventually resumed, and all three patients required hospitalization for investigation of the cause of the crises. Intranasal dexmedetomidine is a feasible and safe acute treatment for adrenergic crisis in patients with familial dysautonomia. Further controlled studies are required to confirm the safety and efficacy in this population.

Summary of the June 2009 Educationtoday Crisis Survey: Initial Reflections on the Impact of the Economic Crisis on Education. OECD Education Working Papers, No. 43

ERIC Educational Resources Information Center

Karkkainen, Kiira

2010-01-01

This paper provides initial reflections on the impact of the economic crisis on education across the Organisation for Economic Cooperation and Development (OECD) area by analysing the OECD educationtoday crisis survey responses of June 2009. It first looks at the impact of the crisis on education demand and participation, after which the focus…

Development of effective prophylaxis against intraoperative carcinoid crisis.

PubMed

Woltering, Eugene A; Wright, Anne E; Stevens, Melissa A; Wang, Yi-Zarn; Boudreaux, John P; Mamikunian, Gregg; Riopelle, James M; Kaye, Alan D

2016-08-01

The prophylactic use of a preoperative, intraoperative, and postoperative high-dose continuous octreotide acetate infusion was evaluated for its ability to minimize the incidence of carcinoid crises during neuroendocrine tumor (NET) cytoreductive surgeries. A retrospective study was approved by the institutional review boards at Ochsner Medical Center-Kenner and Louisiana State University Health Sciences Center. Ochsner Medical Center-Kenner operating room and multispecialty NET clinic. One hundred fifty consecutive patients who underwent a total of 179 cytoreductive surgeries for stage IV, small bowel NETs. All patients received a 500-μg/h infusion of octreotide acetate preoperatively, intraoperatively, and postoperatively. Anesthesia and surgical records were reviewed. Carcinoid crisis was defined as a systolic blood pressure of less than 80mm Hg for greater than 10minutes. Patients who experienced intraoperative hypertension or hypotension, profound tachycardia, or a "crisis" according to the operative note were also reviewed. One hundred sixty-nine (169/179; 94%) patients had normal anesthesia courses. The medical records of 10 patients were further investigated for a potential intraoperative crisis using the aforementioned criteria. Upon review, 6 patients were determined to have had a crisis. The final incidence of intraoperative crisis was 3.4% (6/179). A continuous high-dose infusion of octreotide acetate intraoperatively minimizes the incidence of carcinoid crisis. We believe that the low cost and excellent safety profile of octreotide warrant the use of this therapy during extensive surgical procedures for midgut and foregut NETs. Copyright © 2016 Elsevier Inc. All rights reserved.

HRD Challenges Faced in the Post-Global Financial Crisis Period--Insights from the UK

ERIC Educational Resources Information Center

Keeble-Ramsay, Diane Rose; Armitage, Andrew

2015-01-01

Purpose: The paper aims to report initial empirical research that examines UK employees' perceptions of the changing nature of work since the Global Financial Crisis (GFC) to consider how the financial context may have constrained HRD practice and more sustainable approaches. Design/methodology/approach: Focus group research was facilitated…

Assessing aggression risks in patients of the ambulatory mental health crisis team.

PubMed

Penterman, Berry; Nijman, Henk

2011-08-01

During outreaching crisis visits, crisis team members run the risk of being confronted with aggressive behavior from their patients. To prevent dangerous situations, a method to assess risks in advance, on the basis of information received before the visit to the patient in crisis, could prove useful. During a two-year period, crisis team members completed a checklist before visiting patients in psychiatric crises. After each crisis visit, if there had been any aggression, this was recorded by means of the SOAS-R. In 51 of 499 crisis visits (10%) aggression was documented. The results indicate that the predictive validity of the presented checklist for occurrences of aggression may be fair-to-good. Use of the checklist in everyday crisis team practice seems recommendable as it structures the way risks are assessed before entering a potentially dangerous situation.

[Public health in major socio-economic crisis].

PubMed

Cosmacini, G

2014-01-01

The term "crisis" in different cultures (such as ancient Greece or China) can have a positive meaning, since it indicates a time of growth, change and opportunity. Over the centuries there have been times of severe economic and social crisis that led to the implementation of major reforms and improved population health. Nowadays, despite the new economic crisis which has also affected health care for its rising costs, health economics does not hesitate to affirm the importance of key objectives such as prevention and medical assistance. Prevention is not prediction. Prevention means "going upstream" and fixing a problem at the source; the goal is to reduce diseases' effects, causes and risk factors, thereby reducing the prevalence of costly medical conditions.

Greece Financial Crisis and Quality of Life.

PubMed

Mechili, Aggelos E; Kalokairinou, Athena; Kaitelidou, Dafni; Diomidous, Marianna

2015-01-01

The last six years the global community is facing an economic crisis that first appeared in USA. This crisis has a lot of impacts especially in health sector. Unemployment, job insecurity and the loss of disposable income have a significant impact in health too. The main objective of this research was to investigate the quality of life of the general population in Greece during the financial crisis. To collect the data it has been used the Greek version of Short Form (36) Health Survey (SF-36v2). In general, income, level of education, cohabitation and parenthood had a significant impact in quality of life. As a conclusion, unemployed participants' score was lower in the entire dimensions and in the two summary scales too.

Attenuating a sickle cell crisis with annexin V.

PubMed

Kennedy, James Randall

2015-05-01

A sickle cell crisis is a painful and dangerous condition that defies effective treatment but fortunately it usually terminates spontaneously and patients spend far more time crisis free than in its painful throes. This suggests that an unstable physiologic balance exists between steady state sickle cell disease (SCD) and the crisis state and if this is so a therapeutic nudge during a crisis may help to terminate it. Annexin V may be able to provide this push. The phosphatidylserine (PS) molecules normally appear on the surface of senescent erythrocytes where they are recognized by macrophages and rapidly removed so that normally only about 1% are present in the circulation but in SCD 30-40% are prematurely senescent and their removal is delayed. The PS+ sickle erythrocytes remaining in the circulation adhere to the endothelium and their exposed PS acts as a platform for the initiation of the coagulation cascade that is responsible for clot propagation. Annexin V's great affinity for PS allows it to bond to it forming a shield that blocks both of these actions suggesting that its therapeutic administration during a sickle crisis may be able to hasten its termination. Copyright © 2015 The Author. Published by Elsevier Ltd.. All rights reserved.

Specialized Police-Based Mental Health Crisis Response: The First 10 Years of Colorado's Crisis Intervention Team Implementation.

PubMed

Khalsa, Hari-Mandir K; Denes, Attila C; M Pasini-Hill, Diane; Santelli, Jeffrey C; Baldessarini, Ross J

2018-02-01

This study examined the implementation of crisis intervention teams by law enforcement agencies in Colorado. Rates of Special Weapons and Tactics (SWAT) use, arrests, use of force, and injuries were assessed during 6,353 incidents involving individuals experiencing a mental health crisis. Relationships among original complaint, psychiatric illness, substance abuse, violence risk, and disposition of crisis calls were analyzed. Rates of SWAT use (<1%), injuries (<1%), arrests (<5%), and use of force (<5%) were low. The relative risk of transfer to treatment (versus no transfer) was significantly higher for incidents involving psychiatric illness, suicide threat or attempt, weapons, substance abuse, and violence potential. Use of force or SWAT, arrests, and injuries were infrequent. Suicide risk, psychiatric illness and substance abuse, even in the presence of a weapon or violence threat, increased the odds of transfer to treatment, whereas suicide risk lowered the odds of transfer to jail.

Coping with Crisis.

ERIC Educational Resources Information Center

Akenhead, James; Andreani, Alan

2002-01-01

School officials put a crisis communications plan into action after two Ohio students died and a third became critically ill from meningitis in May 2001. A mass immunization program prevented a major outbreak, and rumor control helped calm the public's fears. Recounts things learned from the experience. (MLF)

The differential impact of the financial crisis on Health in Ireland and Greece: A quasi-experimental approach

PubMed Central

Hessel, P; Vandoros, S; Avendano, M

2015-01-01

Objectives Greece and Ireland suffered an economic recession of similar magnitude, but whether their health has deteriorated as a result has not yet been well established. Study design Based on five waves (2006-2010) of the European Union Statistics of Income and Living Conditions (EU-SILC) survey we implemented a difference-in-differences (DID) approach that compared trends in self-rated health in Greece and Ireland before and after the crisis with trends in a control population (Poland) that did not experience a recession and had health trends comparable to both countries before the crisis. Methods Logistic regression using a difference-in-differences (DID) approach. Results A simple examination of trends suggests that there was no significant change in health in Greece or Ireland following the onset of the financial crisis. However, DID estimates that incorporated a control population suggest an increase in the prevalence of poor-self rated health in Greece (OR=1.216; CI=1.11 - 1.32). Effects were most pronounced for older individuals and those living in high-density areas, but effects in Greece were overwhelmingly consistent in different population sub-groups. In contrast, DID estimates revealed no effect of the financial crisis in Ireland (OR=0.97; CI=0.81-1.16). Conclusions Contradicting results from a simple comparison of single-country trends, DID estimates suggest that the financial crisis has led to deterioration of population health trends in Greece but not in Ireland, where policies may have prevented a worsening of health as a result of the recent economic crisis. PMID:25369355

Managing crisis: the role of primary care for people with serious mental illness.

PubMed

Lester, Helen; Tritter, Jonathan Q; Sorohan, Helen

2004-01-01

More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

A Proposed Solution to the Scholarly Communications Crisis

ERIC Educational Resources Information Center

Schatzle, Chad

2005-01-01

After reviewing the history and parameters of the scholarly communications crisis, particularly in regard to skyrocketing prices for journals in the natural sciences, the author reviews and rejects previously attempted solutions. He then employs the principles of game theory in proposing a new solution to the crisis.

The impact of communication on human behaviour in times of crisis.

PubMed

MacLeod, Andrew

Decision makers have constantly sought to find the most appropriate ways to use communication to influence behaviour during times of crises to assist in their recovery. This paper will investigate why policy makers wish to utilise effective crisis communications and explore the importance of crisis communication on influencing human behaviour in a time of crisis as well as the influence that the medium of communication can have. It will be noted that the medium of the message is important to ensure that the correct audience has been reached. This paper will suggest that, for decision makers to maximise the impact of crisis communications during a crisis, they must utilise rhetoric and cognitive response theory. It will also be suggested that the most importance factor in influencing behaviour in a time of crisis is that communications are provided from a credible source and are empathic in nature.

Management of myasthenic crisis in a child.

PubMed

Rybojad, Beata; Lesiuk, Witold; Fijałkowska, Anna; Rybojad, Paweł; Sawicki, Marek; Lesiuk, Leszek

2013-01-01

Myasthenia gravis is an autoimmune disorder of peripheral nervous system, leading to fluctuating muscle weakness. It is caused by circulating antibodies that block acetylcholine nicotinic postsynaptic receptors at the postsynaptic neuromuscular junction. Myasthenic crisis is a life-threatening complication, which is defined as weakness from acquired myasthenia gravis. In this paper we described a 15-year-old boy who was admitted to the Paediatric Intensive Care Unit due to myasthenic crisis. He had suffered not only from myasthenia gravis but also hypothyroidism, cerebral palsy and epilepsy. The patient required mechanical ventilation and was successfully treated with both plasmapheresis and intravenous immunoglobulins. He recovered from the crisis and then thymectomy was performed. Perioperative period and anaesthesia passed uncomplicated. Discharged home from the hospital after 2.5 month-treatment, for the last 4 years, he has only come on scheduled outpatient medical appointments. This case reveals that myasthenic crisis, albeit rare, may occur in male adolescents. In such cases multidisciplinary care followed by surgery becomes a procedure of choice. Concomitant medical problems, if well controlled, do not affect the results of outcome of the underlying disease.

Public Health Crisis Preparedness and Response in Korea

PubMed Central

Lee, Hye-Young; Oh, Mi-Na; Park, Yong-Shik; Chu, Chaeshin; Son, Tae-Jong

2013-01-01

Since the 2006 Pandemic Influenza Preparedness and Response Plan according to the World Health Organization’s recommendation, the Republic of Korea has prepared and periodically evaluated the plan to respond to various public health crises including pandemic influenza. Korea has stockpiled 13,000,000 doses of antiviral drugs covering 26% of the Korean population and runs 519 isolated beds in 16 medical institutions. The division of public health crisis response in Korea Centers for Disease Control and Prevention are in charge of responding to public health crises caused by emerging infectious diseases including severe acute respiratory syndrome, avian influenza human infection, and pandemic influenza. Its job description includes preparing for emerging infectious diseases, securing medical resources during a crisis, activating the emergency response during the crisis, and fortification of capabilities of public health personnel. It could evolve into a comprehensive national agency to deal with public health crisis based on the experience of previous national emerging infectious diseases. PMID:24298444

[Families of the economic crisis in paediatric Primary Care clinics: descriptive observational study].

PubMed

Martín Martín, R; Sánchez Bayle, M; Gancedo García, C; Teruel de Francisco, M C; Coullaut López, A

2016-04-01

To study the impact of the economic crisis on the families of the children who attend Primary Health Care and its relationship with their socioeconomic status. Observational descriptive study was conducted by analysing the results of 453 questionnaires, given to the parents of children between 1 and 7 years old who attended 4 paediatric clinics in Madrid. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. In the multivariate analysis, the variables related to the non-acquisition of prescribed medication are: lower income level OR=0.118, p<.0001 and lower educational level OR=0.464, p<.001; the variables related to the reduction of food expenditure are: lower income level OR=0.100, p<.0001 and a higher number of family members OR=1.308, p=.045; the variables related to anti-pneumococcal vaccination without public funding are: higher income level OR=2.170, p=.0001, higher educational level OR=1.835, p=.013, and not being an immigrant OR=0.532, p=.037. The presence of health problems from the beginning of the economic crisis is related to unemployment OR=4.079, p=.032, lower educational level R=0.678, p=.042, and income level OR=0.342, p<.0001. In all cases, the models achieved a statistical significance of p<.0001. The economic crisis has greater impact on the group with the lowest income level in all analysed variables. The lower educational level and higher number of family members has an impact on the reduction in food expenditure. The fact of being an immigrant has an impact on not receiving the anti-pneumococcal and rotavirus vaccination. Unemployment leads to an increase in health problems in the family. To sum up, the economic crisis has increased inequalities according to socioeconomic status. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

The Function of Epideictic and Deliberative Strategies in Presidential Crisis Rhetoric.

ERIC Educational Resources Information Center

Dow, Bonnie J.

1989-01-01

Argues for a revised perspective on presidential crisis rhetoric informed by an understanding of differing exigencies and functions. Uses speeches by Ronald Reagan to examine two types of crisis rhetoric. Concludes that crisis rhetoric can not be viewed as a homogeneous type of discourse. (MM)

Developing Discourse of Renewal during a Campus Crisis

ERIC Educational Resources Information Center

Boatwright, Brandon; Mazer, Joseph P.

2017-01-01

Course: This assignment is a unit activity designed for use in a skills-focused undergraduate public relations, organizational communication, or crisis communication course. Objective: The goal of this activity is to increase students' understanding of and ability to apply discourse of renewal in a crisis scenario. Students will work…

Crisis Communication in the Area of Risk Management: The CriCoRM Project.

PubMed

Scarcella, Carmelo; Antonelli, Laura; Orizio, Grazia; Rossmann, Costanze; Ziegler, Lena; Meyer, Lisa; Garcia-Jimenez, Leonarda; Losada, Jose Carlos; Correia, Joao; Soares, Joana; Covolo, Loredana; Lirangi, Enrico; Gelatti, Umberto

2013-09-02

During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies. THE PROJECT WILL PERFORM DIFFERENT ACTIVITIES: i) state of the art review; ii) identification of key stakeholders; iii) communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv) improvement of the existing guidelines; v) development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi) organization of exercises and training on this issues. In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations. Significance for public healthThe specific aim of the project is to develop a European strategy approach on how to communicate with the population and with different stakeholders groups involved in the crisis management process, based on an analysis of the communication process during the H1N1 pandemic (content analysis of press releases, press coverage and forum discussions) and on interviews with key

Preliminary evaluation of a "formulation-driven cognitive behavioral guided self-help (fCBT-GSH)" for crisis and transitional case management clients.

PubMed

Naeem, Farooq; Johal, Rupinder K; Mckenna, Claire; Calancie, Olivia; Munshi, Tariq; Hassan, Tariq; Nasar, Amina; Ayub, Muhammad

2017-01-01

Cognitive behavioral therapy (CBT) is found to be effective for common mental disorders and has been delivered in self-help and guided self-help formats. Crisis and transitional case management (TCM) services play a vital role in managing clients in acute mental health crises. It is, therefore, an appropriate setting to try CBT in guided self-help format. This was a preliminary evaluation of a formulation-driven cognitive behavioral guided self-help. Thirty-six (36) consenting participants with a diagnosis of nonpsychotic illness, attending crisis and the TCM services in Kingston, Canada, were recruited in this study. They were randomly assigned to the guided self-help plus treatment as usual (TAU) (treatment group) or to TAU alone (control group). The intervention was delivered over 8-12 weeks. Assessments were completed at baseline and 3 months after baseline. The primary outcome was a reduction in general psychopathology, and this was done using Clinical Outcomes in Routine Evaluation - Outcome Measure. The secondary outcomes included a reduction in depression, measured using the Hospital Anxiety and Depression Scale, and reduction in disability, measured using the World Health Organization Disability Assessment Schedule 2.0. Participants in the treatment group showed statistically significant improvement in overall psychopathology ( P <0.005), anxiety and depression ( P <0.005), and disability ( P <0.005) at the end of the trial compared with TAU group. A formulation-driven cognitive behavioral guided self-help was feasible for the crisis and TCM clients and can be effective in improving mental health, when compared with TAU. This is the first report of a trial of guided self-help for clients attending crisis and TCM services.

[Crisis intervention--the summary of a unique interventional program for medical students].

PubMed

Perry, Zvi; Busiba, Ziva; Uziel, Elia; Meiri, Gal

2009-02-01

found that student involvement in different wards has exposed them to various methods of crisis management. The close chaperoning of students by an attending physician, as well as the wards social worker, has shown the students a good example of staff involvement in the patient's emotional turmoil in the midst of his medical crisis. This learning process, which is mainly experiential in nature, and which is reinforced academically by the frontal lectures, as well as learning in small groups and class discussions, has enabled our students to meet and hopefully identify with a more humane perception of the physician, as one whose professionalism is measured not only by his clinical skills, but also by his communication skills.

Lessons for Physicians from Flint's Water Crisis.

PubMed

Carravallah, Laura A; Reynolds, Lawrence A; Woolford, Susan J

2017-10-01

Physicians form a vital front in recognizing unusual clinical presentations that could herald a health threat. In the Flint water crisis, physicians can be credited with playing critical roles in both uncovering the crisis and providing leadership when government failed to respond effectively. Yet most physicians in Flint were not formally trained in advocacy or leadership and might have recognized the health implications of the crisis more quickly had they received formal environmental health training. Furthermore, connections to other professional disciplines-and to the community-are vital for effective responses to environmental health threats. We explore some lessons learned in Flint that might help expedite resolution of future environmental health crises, particularly those involving aging infrastructure and diminished or dysfunctional regulation or oversight. © 2017 American Medical Association. All Rights Reserved.

Nutritional status of children during and post-global economic crisis in China.

PubMed

Chen, ChunMing; He, Wu; Wang, YuYing; Deng, LiNa; Jia, FengMei

2011-08-01

To describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis. Data from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System. Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites. Anthropometric and hemoglobin measurements for children under 5 were conducted. Nutritional status was determined according to WHO child growth standards. Prevalence of underweight and stunting in children under 5 had a downward trend. Underweight prevalence was close to normal (less than 5%), with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas. Prevalence of stunting in infants under 6 months and 6-12 months old in poorer rural areas increased from 5.7%-9.1% and 6.7%-12.5%, respectively, in 2008-2009. This trend also continued post-crisis in 2010. Prevalence of stunting in children left behind by mothers was 20%-30% higher than in children the same age in general and poorer rural areas. Prevalence of anemia in children did not change in rural areas, but prevalence of anemia in all age groups increased in poorer rural areas, especially in children under 24 months old. Level reached 30%-40% in 2009, and fluctuated in 2010. The nutritional status of children under 5 was comparatively stable during and after the global economic crisis, attributable to the Chinese government's policy response. The nutritional status in poorer rural areas fluctuated in response to the economic crisis and, thus, relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas. A proper national nutritional strategy for children under 2 years old, including nutrition supplementation for pregnant women and in-home fortification for complementary feeding, should be initiated. Copyright © 2011 The Editorial Board of Biomedical and Environmental Sciences. Published by

Costs of treating patients with schizophrenia who have illness-related crisis events.

PubMed

Zhu, Baojin; Ascher-Svanum, Haya; Faries, Douglas E; Peng, Xiaomei; Salkever, David; Slade, Eric P

2008-08-26

Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37,329), persons with prior

Costs of treating patients with schizophrenia who have illness-related crisis events

PubMed Central

Zhu, Baojin; Ascher-Svanum, Haya; Faries, Douglas E; Peng, Xiaomei; Salkever, David; Slade, Eric P

2008-01-01

Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37

Crisis management with applicability on fire fighting plants

NASA Astrophysics Data System (ADS)

Panaitescu, M.; Panaitescu, F. V.; Voicu, I.; Dumitrescu, L. G.

2017-08-01

The paper presents a case study for a crisis management analysis which address to fire fighting plants. The procedures include the steps of FTA (Failure tree analysis). The purpose of the present paper is to describe this crisis management plan with tools of FTA. The crisis management procedures have applicability on anticipated and emergency situations and help to describe and planning a worst-case scenario plan. For this issue must calculate the probabilities in different situations for fire fighting plants. In the conclusions of paper is analised the block diagram with components of fire fighting plant and are presented the solutions for each possible risk situations.

Hypertensive Crisis From the Aquamantys Bipolar Sealing System.

PubMed

Hardy, Brian C; Giordano, Christopher R

2016-12-15

Hypertension is a common occurrence during general anesthesia. Apart from pathological causes of hypertension, it is rarely extreme enough to be classified as a hypertensive crisis (systolic blood pressure >180 mm Hg or diastolic blood pressure >120 mm Hg). There is literature concerning the unintentional electrocauterization of the adrenal gland leading to hypertensive crisis, but to date, no reports have been made of adrenal stimulation from the use of an Aquamantys for hemostasis. Here, we report such a case when a hypertensive crisis (systolic blood pressure >300 mm Hg) occurred while using an Aquamantys during a liver transplant after unintentional stimulation of the adrenal glands.

Thyrotoxic and pheochromocytoma multisystem crisis: a case report.

PubMed

Suzuki, Kodai; Miyake, Takahito; Okada, Hideshi; Yamaji, Fuminori; Kitagawa, Yuichiro; Fukuta, Tetsuya; Yasuda, Ryu; Tanaka, Yoshihito; Okamoto, Haruka; Nachi, Sho; Doi, Tomoaki; Yoshida, Takahiro; Kumada, Keisuke; Yoshida, Shozo; Ushikoshi, Hiroaki; Toyoda, Izumi; Ogura, Shinji

2017-06-23

Thyrotoxic crisis and pheochromocytoma multisystem crisis are rare, life-threatening, emergency endocrine diseases with various clinical manifestations. Here we report a case of a patient who simultaneously developed thyrotoxic crisis and pheochromocytoma multisystem crisis and required intensive cardiovascular management. A 60-year-old Asian man experienced nausea and vomiting, and subsequently developed dyspnea and cold sweats while farming. His serum free thyroxine, free triiodothyronine, and thyrotropin receptor antibody levels were elevated at 2.9 ng/dL, 7.2 pg/dL, and 4.7 IU/L, respectively. Serum thyrotropin levels were suppressed at less than 0.01 μIU/mL. Thyroid echography demonstrated no thyroid swelling (23 × 43 mm). A whole body computed tomography was performed for systemic evaluation. This revealed exophthalmos and a mass of size 57 × 64 mm in the anterior pararenal space. Based on these findings, we made an initial diagnosis of thyrotoxic crisis secondary to exacerbation of Grave's hyperthyroidism. Treatment was begun with an iodine agent at a dose of 36 mg/day, thiamazole at a dose of 30 mg/day, and hydrocortisone at a dose of 300 mg daily for 3 consecutive days. To control tachycardia, continuous intravenously administered propranolol and diltiazem infusions were given. At the same time, small doses of doxazosin and carvedilol were used for both alpha and beta adrenergic blockade. On hospital day 5, his blood pressure and serum catecholamine concentrations (adrenalin 42,365 pg/mL, dopamine 6409 pg/mL, noradrenalin 72,212 pg/mL) were still high despite higher beta blocker and calcium channel blocker doses. These findings contributed to the diagnosis of pheochromocytoma multisystem crisis with simultaneous thyrotoxic crisis. We increased the doses of doxazosin and carvedilol, which stabilized his hemodynamic status. On hospital day 16, metaiodobenzylguanidine scintigraphy showed high accumulation in the right adrenal gland tumor

Democracy in Crisis?

ERIC Educational Resources Information Center

O'Neill, Brenda

2006-01-01

This article discusses the state of Canadian democracy. Although calling Canadian democracy as something to be in a crisis is still debatable, the author expresses worry over the declining turnout levels in recent elections. Canada--along with a number of other liberal democracies--has experienced a significant and consistent decline in election…

Sharp Transition in the Lift Force of a Fluid Flowing Past Nonsymmetrical Obstacles: Evidence for a Lift Crisis in the Drag Crisis Regime.

PubMed

Bot, Patrick; Rabaud, Marc; Thomas, Goulven; Lombardi, Alessandro; Lebret, Charles

2016-12-02

Bluff bodies moving in a fluid experience a drag force which usually increases with velocity. However in a particular velocity range a drag crisis is observed, i.e., a sharp and strong decrease of the drag force. This counterintuitive result is well characterized for a sphere or a cylinder. Here we show that, for an object breaking the up-down symmetry, a lift crisis is observed simultaneously to the drag crisis. The term lift crisis refers to the fact that at constant incidence the time-averaged transverse force, which remains small or even negative at low velocity, transitions abruptly to large positive values above a critical flow velocity. This transition is characterized from direct force measurements as well as from change in the velocity field around the obstacle.

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... health crisis. 550.409 Section 550.409 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

International labor migration and financial crisis in Korea.

PubMed

Hyunho, S

1999-06-01

Although the Korean economy became severely depressed because of the financial crisis in November 1997, most foreign migrant workers in the country opted to stay rather than return to their home countries. This study examined the causes of their relative immobility at both the macro- and microlevel through the use of government statistics and survey data. The first section of this study explored in- and outflows of migrant workers in relation to labor market conditions and government interventions before and after the crisis. The second section looked into the effects of the crisis on the companies employing migrant workers, while the final section investigated the effects of the crisis on migrant workers. The findings of this study indicated that the amnesty measure, which was a major government policy to reduce the number of illegal sojourners, exerted some positive effect in the first months after the crisis. Employment and income opportunities at origin countries are important factors determining mobility. Moreover, manufacturing companies still prefer to hire migrant workers before native workers because of cheaper wages for the former. Overall, most migrant workers, regardless of their sojourn status, desire to stay in Korea because of two main reasons: 1) their total earnings are less than their migration costs; 2) they cannot get a job in their home country.

A scoping review of crisis teams managing dementia in older people.

PubMed

Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

2017-01-01

Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.

Power-law behavior in complex organizational communication networks during crisis

NASA Astrophysics Data System (ADS)

Uddin, Shahadat; Murshed, Shahriar Tanvir Hasan; Hossain, Liaquat

2011-08-01

Communication networks can be described as patterns of contacts which are created due to the flow of messages and information shared among participating actors. Contemporary organizations are now commonly viewed as dynamic systems of adaptation and evolution containing several parts, which interact with one another both in internal and in external environment. Although there is limited consensus among researchers on the precise definition of organizational crisis, there is evidence of shared meaning: crisis produces individual crisis, crisis can be associated with positive or negative conditions, crises can be situations having been precipitated quickly or suddenly or situations that have developed over time and are predictable etc. In this research, we study the power-law behavior of an organizational email communication network during crisis from complexity perspective. Power law simply describes that, the probability that a randomly selected node has k links (i.e. degree k) follows P(k)∼k, where γ is the degree exponent. We used social network analysis tools and techniques to analyze the email communication dataset. We tested two propositions: (1) as organization goes through crisis, a few actors, who are prominent or more active, will become central, and (2) the daily communication network as well as the actors in the communication network exhibit power-law behavior. Our preliminary results support these two propositions. The outcome of this study may provide significant advancement in exploring organizational communication network behavior during crisis.

Crisis of Meaning Predicts Suicidality in Youth Independently of Depression.

PubMed

Schnell, Tatjana; Gerstner, Rebekka; Krampe, Henning

2018-02-23

At times, the question for meaning comes to nothing and a crisis of meaning ensues. This state is very painful, but difficult to account. Both those who suffer from it and care professionals find themselves at a loss for words. This study introduces an operationalization of a crisis of meaning. It aims to distinguish the concept from depression, and to investigate whether a crisis of meaning can explain suicidality beyond the known protective and risk factors self-esteem, family functioning, life-event load, and depression. Final-year school pupils in Ecuador (N = 300) completed questionnaires assessing the above variables. Data were analyzed using chi-square, hierarchic multiple regression, serial mediation, and moderator analyses. Crisis of meaning was distinguished from depression. It explained a significant amount of variance in suicidality beyond the mentioned protective and risk factors. For males, crisis of meaning was the only significant risk factor, and the strongest predictor overall. The acute risk factors depression and crisis of meaning mediated the effects of the baseline factors self-esteem, family functioning, and life-event load on suicidality. The study was cross-sectional; assessed factors predicted variance in suicidal thoughts, plans, and past suicide attempts, while their relevance cannot be generalized to actual future suicide attempts. A crisis of meaning is an important factor to take into account in further research on the prevention and treatment of people at risk of suicide.

Hyperparathyroid crisis presenting with hyperemesis gravidarum.

PubMed

Yilmaz, Banu Aktaş; Altay, Mustafa; Değertekin, Ceyla Konca; Çimen, Ali Riza; Iyidir, Özlem Turhan; Biri, Aydan; Yüksel, Osman; Törüner, Füsun Baloş; Arslan, Metin

2014-10-01

Primary hyperparathyroidism during pregnancy is a rare condition, and the diagnosis may be confounded by pregnancy related conditions. Since the appropriate management reduces the maternal and fetal complications; differential diagnosis becomes quite crucial. Clinical course of a patient with hyperparathyroid crisis will be discussed with the review of the literature. A 22-year- old, (gravida 2, para 1) woman was presented with hyperparathyroid crisis at the 11th weeks' gestation. She was hospitalized twice due to hyperemesis gravidarum. When she was admitted to the hospital for the third time due to increased vomiting and weight-loss, serum biochemistry panel was performed and it revealed severe hypercalcemia that serum Ca was 17.59 mg/dl, and she was referred to our hospital as parathyroid crisis. Maternal hypercalcemia was resolved after urgent parathyroidectomy. She was diagnosed as preeclampsia at the 30 weeks' gestation and delivered a male infant weighing 1,090 g at 33 weeks' gestation with APGAR scores 6 at 1 min, and 7 at min 5, without evidence of neonatal hypocalcemia or tetany. Urgent parathyroidectomy is the definite treatment in symptomatic patients with hyperparathyroidism during pregnancy. Resolving maternal hypercalcemia prevents neonatal tetany and hypocalcemia. Hyperemesis may lead to hypercalcemic crisis in patients with hyperparathyroidism, so serum Ca level should be checked in patients with hyperemesis gravidarum especially who detoriate rapidly. Although they share some common pathogenetic mechanisms, there is not enough evidence for attributing preeclampsia to primary hyperparathyroidism.

Interactions of Indocyanine Green and Lipid in Enhancing Near-Infrared Fluorescence Properties: The Basis for Near-Infrared Imaging in Vivo

PubMed Central

2015-01-01

Indocyanine green (ICG) is a near-infrared (NIR) contrast agent commonly used for in vivo cardiovascular and eye imaging. For medical diagnosis, ICG is limited by its aqueous instability, concentration-dependent aggregation, and rapid degradation. To overcome these limitations, scientists have formulated ICG in various liposomes, which are spherical lipid membrane vesicles with an aqueous core. Some encapsulate ICG, while others mix it with liposomes. There is no clear understanding of lipid–ICG interactions. Therefore, we investigated lipid–ICG interactions by fluorescence and photon correlation spectroscopy. These data were used to design stable and maximally fluorescent liposomal ICG nanoparticles for NIR optical imaging of the lymphatic system. We found that ICG binds to and is incorporated completely and stably into the lipid membrane. At a lipid:ICG molar ratio of 250:1, the maximal fluorescence intensity was detected. ICG incorporated into liposomes enhanced the fluorescence intensity that could be detected across 1.5 cm of muscle tissue, while free ICG only allowed 0.5 cm detection. When administered subcutaneously in mice, lipid-bound ICG in liposomes exhibited a higher intensity, NIR image resolution, and enhanced lymph node and lymphatic vessel visualization. It also reduced the level of fluorescence quenching due to light exposure and degradation in storage. Lipid-bound ICG could provide additional medical diagnostic value with NIR optical imaging for early intervention in cases of lymphatic abnormalities. PMID:24512123

Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

PubMed

Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

2016-01-01

Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

Crisis Intervention and Counseling by Telephone. Second Edition.

ERIC Educational Resources Information Center

Lester, David, Ed.

This extensively revised second edition provides a practical framework for offering immediate problem-solving assistance by telephone to persons in crisis. The text offers specific techniques to deal with out-of-control situations with the highly important initial steps to protect the caller, the crisis worker, and the community. The scope of the…

Toward Successful School Crisis Intervention: 9 Key Issues

ERIC Educational Resources Information Center

Jaksec, Charles M., III

2007-01-01

Despite their best and frequently heroic efforts, school crisis intervention teams often find themselves unprepared for the many types of tragedies they face. This timely text prompts crisis intervention team members to reevaluate their beliefs and practices and consider a new approach to dealing with school crises. The author, a longtime school…

Leading in crisis: lessons for safety leaders.

PubMed

George, William W; Denham, Charles R; Burgess, L Hayley; Angood, Peter B; Keohane, Carol

2010-03-01

The National Quality Forum (NQF) Safe Practices are a group of 34 evidence-based Safe Practices that should be universally used to reduce the risk of harm to patients. Four of these practices specifically address leadership. A recently published book, 7 Lessons for Leading in Crisis, offers practical advice on how to lead in crisis. An analysis of how concepts from the 7 lessons could be applied to the Safe Practices was presented nationally by webinar to assess the audience's reaction to the information. The objective of this article was to present the information and the audience's reaction to it. Recommendations for direct actions that health care leaders can take to accelerate adoption of NQF Safe Practices were presented to health care leaders, followed by an immediate direct survey that used Reichheld's "Net Promoter Score" to assess whether the concepts presented were considered applicable and valuable to the audience. In a separate presentation, the challenges and crises facing nursing leaders were addressed by nursing leaders. Six hundred seventy-four hospitals, with an average of 4.5 participants per hospital, participated in the webinar. A total of 272 safety leaders responded to a survey immediately after the webinar. A Net Promoter Score assessment revealed that 58% of those surveyed rated the value of the information at 10, and 91% scored the value of the webinar to be between 8 and 10, where 10 is considered a strong recommendation that those voting would recommend this program to others. The overwhelmingly high score indicated that the principles presented were important and valuable to this national audience of health care leadership. The 2010 environment of uncertainty and shrinking financial resources poses significant risk to patients and new challenges for leaders at all levels. A values-grounded focus on personal accountability for leading in crisis situations strongly resonates with those interested in or leading patient safety initiatives.

Crisis Management Systems: A Case Study for Aspect-Oriented Modeling

NASA Astrophysics Data System (ADS)

Kienzle, Jörg; Guelfi, Nicolas; Mustafiz, Sadaf

The intent of this document is to define a common case study for the aspect-oriented modeling research community. The domain of the case study is crisis management systems, i.e., systems that help in identifying, assessing, and handling a crisis situation by orchestrating the communication between all parties involved in handling the crisis, by allocating and managing resources, and by providing access to relevant crisis-related information to authorized users. This document contains informal requirements of crisis management systems (CMSs) in general, a feature model for a CMS product line, use case models for a car crash CMS (CCCMS), a domain model for the CCCMS, an informal physical architecture description of the CCCMS, as well as some design models of a possible object-oriented implementation of parts of the CCCMS backend. AOM researchers who want to demonstrate the power of their AOM approach or technique can hence apply the approach at the most appropriate level of abstraction.

Crisis management aspects of bam catastrophic earthquake: review article.

PubMed

Sadeghi-Bazargani, Homayoun; Azami-Aghdash, Saber; Kazemi, Abdolhassan; Ziapour, Behrad

2015-01-01

Bam earthquake was the most catastrophic natural disasters in recent years. The aim of this study was to review different aspects of crisis management during and after the catastrophic earthquake in Bam City, Iran. Data needed for this systematic review were collected through searching PubMed, EMBASE and SID databases, for the period from 2003 to 2011. Keywords included earthquake, Iran and Bam earthquake. The data were summarized and were analyzed using Content Analysis. Out of 422 articles, 25 articles were included in the study. Crisis Management aspects and existing pitfalls were classified into seven categories including planning and organization, human resource management, management of logistics, international humanitarian aids, field performance of the military and security forces, health and medical service provision, and information management. Positive aspects and major pitfalls of crisis management have been introduced in all the mentioned categories. The available evidence indicated poor crisis management during Bam earthquake that resulted in aggravating the losses as well as diminishing the effect of interventions. Thus, concerning the importance of different aspects of the crisis management and the high prevalence of disasters in Iran, the observed vulnerability in disaster management process should be addressed.

Nursing in Crisis

ERIC Educational Resources Information Center

Fulcher, Roxanne

2007-01-01

Both the nation's health-care and nursing education systems are in crisis. While the care provided by registered nurses (RNs) is essential to patients' recovery from acute illness and to the effective management of their chronic conditions, the United States is experiencing a nursing shortage that is anticipated to increase as baby boomers age and…

Effect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study.

PubMed

Arzalier-Daret, Ségolène; Buléon, Clément; Bocca, Marie-Laure; Denise, Pierre; Gérard, Jean-Louis; Hanouz, Jean-Luc

2018-04-01

Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator. Each resident was evaluated in a sleep-deprived state (deprived group, after a night shift duty) and control state (control group, after a night of sleep). Performance was assessed through points obtained during crisis scenario 1 (oesophageal intubation followed by anaphylactic shock) and scenario 2 (anaesthesia-related bronchospasm followed by ventricular tachycardia). Sleep periods were recorded by actigraphy. Two independent observers assessed the performances. The primary endpoint of the study was the score obtained for each scenario. Resident's crisis management performance is associated with sleep deprivation (scenario 1: control=39 [33-42] points vs. deprived=26 [19-40] points, P=0.02; scenario 2: control=21 [17-24] vs. deprived=14 [12-19], P=0.01). The main errors observed were: error in drug administration and dose, delay in identification of hypotension, and missing communication with the surgical team about situation. The present study showed that sleep deprivation is associated with impairment of performance to manage crisis situations by residents in anaesthesia. Copyright © 2017 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Implementation and effect of life space crisis intervention in special schools with residential treatment for students with emotional and behavioral disorders (EBD).

PubMed

DOosterlinck, Franky; Goethals, Ilse; Broekaert, Eric; Boekaert, Eric; Schuyten, Gilberte; De Maeyer, Jessica

2008-03-01

The increase of violence in present-day society calls for adequate crisis interventions for students with behavioral problems. Life Space Crisis Intervention (LSCI) is a systematic and formatted response to a student's crisis, based on cognitive, behavioral, psychodynamic and developmental theory. The following research article evaluates a LSCI Program with students referred to special schools with residential treatment because of severe behavioral problems. The evaluation was conducted using a quasi experimental pre-test-post-test control group design. Thirty-one match paired students were pre-tested before the interventions started and post-tested after a period of 11 months. Five standardized questionnaires were examined to assess the effectiveness of the LSCI Program. General Linear Model (GLM) with repeated measures was used to analyze all data. For the total group of subjects (n = 62) it was found that students' perception about their athletic competence decrease significantly after 11 months in residential care. A positive effect of LSCI was found on direct aggression and social desirability.

Crisis and emergency risk communication as an integrative model.

PubMed

Reynolds, Barbara; W Seeger, Matthew

2005-01-01

This article describes a model of communication known as crisis and emergency risk communication (CERC). The model is outlined as a merger of many traditional notions of health and risk communication with work in crisis and disaster communication. The specific kinds of communication activities that should be called for at various stages of disaster or crisis development are outlined. Although crises are by definition uncertain, equivocal, and often chaotic situations, the CERC model is presented as a tool health communicators can use to help manage these complex events.

Crisis management: an extended reference framework for decision makers.

PubMed

Carone, Alessandro; Iorio, Luigi Di

2013-01-01

The paper discusses a reference framework for capabilities supporting effective crisis management. This framework has been developed by joining experiences in the field and knowledge of organisational models for crisis management, and executives' empowerment, coaching and behavioural analysis. The paper is aimed at offering further insight to executives on critical success factors and means for managing crisis situations by extending the scope of analysis to human behaviour, to emotions and fears and their correlation with decision making. It is further intended to help familiarise them and to facilitate approaching a path towards emotional awareness.

Factors predicting crisis counselor referrals to other crisis counseling, disaster relief, and psychological services: a cross-site analysis of post-Katrina programs.

PubMed

Rosen, Craig S; Matthieu, Monica M; Norris, Fran H

2009-05-01

An important aspect of crisis counseling is linking survivors with services for their unmet needs. We examined determinants of referrals for disaster relief, additional crisis counseling, and psychological services in 703,000 crisis counseling encounters 3-18 months after Hurricane Katrina. Referrals for disaster relief were predicted by clients' losses, age (adults rather than children), and urbanicity. Referrals for additional counseling and psychological services were predicted by urbanicity, losses and trauma exposure, prior trauma, and preexisting mental health problems. Counseling and psychological referrals declined over time despite continuing mental health needs. Results confirm large urban-rural disparities in access to services.

Impact of CNG Crisis on Student's Academic Life

ERIC Educational Resources Information Center

Azeem, Kiran; Nadeem, Wajiha; Zia, Afsa; Shehzad, Shiza; Anwar, Zara

2017-01-01

The goal of this study is to determine the impact of Compressed Natural Gas (CNG) crisis on Student's Academic Life of Karachi Pakistan. This research helps in observing the behavior of students and their educational progress includes depression and anxiety, rate of absenteeism and undesirable results in exams threatens due to CNG crisis and…

School Crisis Teams within an Incident Command System

ERIC Educational Resources Information Center

Nickerson, Amanda B.; Brock, Stephen E.; Reeves, Melissa A.

2006-01-01

Despite the increasing attention given to the need for schools to be prepared to respond in a variety of crisis situations, there is a lack of information about how to coordinate with multiple agencies following a crisis. This article describes the U. S. Department of Homeland Security's (2004) National Incident Management System and its Incident…

Energy shortage: a benign crisis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Armstrong, E.L.

The energy crisis is real and the days of cheap and plentiful energy are gone, perhaps forever. Resources and technology are available to meet the energy austerity. The good evolving from the energy crisis means conservation in many considerations of city planning such as master planning for transportation, water supply, sewers, and utilities; urban construction; and recreation facilities near subdivisions. Urban and suburban areas are evolving from low density residential communities clustering around a well-defined central city to a collection of regional subcenters around the central-city area, each consisting of malls, high- rise office buildings, industrial areas, and apartment complexesmore » linked by belt highways. (MCW)« less

How are the employed and unemployed affected by the economic crisis in Spain? Educational inequalities, life conditions and mental health in a context of high unemployment.

PubMed

Córdoba-Doña, Juan Antonio; Escolar-Pujolar, Antonio; San Sebastián, Miguel; Gustafsson, Per E

2016-03-15

Despite an increasing number of studies on the factors mediating the impact of the economic recession on mental health, research beyond the individual employment status is scarce. Our objectives were to investigate in which ways the mental health of employed and unemployed populations is differently affected by the current economic recession along the educational scale and to examine whether financial strain and social support explain these effects of the crisis. A repeated cross-sectional study, using two waves of the Andalusian Health Survey in 2007 (pre-crisis) and 2011-2012 (crisis). A population aged between 19 and 64 years was selected. The dependent variable was the Mental Component Summary of the SF-12 questionnaire. We performed Poisson regression models stratified by working status, with period, educational level, financial strain and social support as independent variables. We examined interactions between period and educational level. Age, sex, main earner, cohabitation and partner's working status were considered as covariates. The study included 3210 individuals (1185 women) in 2007 and 3633 individuals (1486 women) in 2011-2012. In working individuals the prevalence of poor mental health increased for secondary and complete primary studies groups during crisis compared to the pre-crisis period, while it decreased significantly in the university study group (PR = 0.76, 95% CI: 0.58-0.99). However, in unemployed individuals prevalence ratios for poor mental health increased significantly only in the secondary studies group (PR = 1.73, 95% CI: 1.06-2.83). Financial strain and social support yielded consistent associations with mental health in all subgroups. Only financial strain could partly explain the crisis effect on mental health among the unemployed. Our study supports the finding that current economic recession is associated with poorer mental health differentially according to labour market status and educational level. Those with secondary

The correlation between stress and economic crisis: a systematic review

PubMed Central

Mucci, Nicola; Giorgi, Gabriele; Roncaioli, Mattia; Fiz Perez, Javier; Arcangeli, Giulio

2016-01-01

In 2008 a deep economic crisis started in the US and rapidly spread around the world. The crisis severely affected the labor market and employees’ well-being. Hence, the aim of this work is to implement a systematic review of the principal studies that analyze the impact of the economic crisis on the health of workers. We conducted our search on the PubMed database, and a total of 19 articles were selected for review. All studies showed that the economic crisis was an important stressor that had a negative impact on workers’ mental health. Most of the studies documented that a rise in unemployment, increased workload, staff reduction, and wages reduction were linked to an increased rate of mood disorders, anxiety, depression, dysthymia, and suicide. Some studies showed that problems related to the crisis may have also affected the general health of workers by increasing the risk of such health problems as cardiovascular and respiratory diseases. Finally, some studies looked at the impact of the crisis on health care services. These studies demonstrated that the reduction in public expenditure on health care services, and the reduction of public hospital budgets due to the recession, led to organizational problems (eg, medical supply shortages). PMID:27143898

The correlation between stress and economic crisis: a systematic review.

PubMed

Mucci, Nicola; Giorgi, Gabriele; Roncaioli, Mattia; Fiz Perez, Javier; Arcangeli, Giulio

2016-01-01

In 2008 a deep economic crisis started in the US and rapidly spread around the world. The crisis severely affected the labor market and employees' well-being. Hence, the aim of this work is to implement a systematic review of the principal studies that analyze the impact of the economic crisis on the health of workers. We conducted our search on the PubMed database, and a total of 19 articles were selected for review. All studies showed that the economic crisis was an important stressor that had a negative impact on workers' mental health. Most of the studies documented that a rise in unemployment, increased workload, staff reduction, and wages reduction were linked to an increased rate of mood disorders, anxiety, depression, dysthymia, and suicide. Some studies showed that problems related to the crisis may have also affected the general health of workers by increasing the risk of such health problems as cardiovascular and respiratory diseases. Finally, some studies looked at the impact of the crisis on health care services. These studies demonstrated that the reduction in public expenditure on health care services, and the reduction of public hospital budgets due to the recession, led to organizational problems (eg, medical supply shortages).

The Impact of the 2008 Economic Crisis on Substance Use Patterns in the Countries of the European Union.

PubMed

Dom, Geert; Samochowiec, Jerzy; Evans-Lacko, Sara; Wahlbeck, Kristian; Van Hal, Guido; McDaid, David

2016-01-13

From 2008 on, a severe economic crisis (EC) has characterized the European Union (E.U.). However, changes in substance use behavioral patterns as a result of the economic crisis in Europe, have been poorly reflected upon, and underlying mechanisms remain to be identified; In this review we explore and systematize the available data on the effect of the 2008 economic crisis on patterns of substance use and related disorders, within the E.U. countries; The results show that effects of the recession need to be differentiated. A number of studies point to reductions in population's overall substance use. In contrast, an increase in harmful use and negative effects is found within specific subgroups within the society. Risk factors include job-loss and long-term unemployment, and pre-existing vulnerabilities. Finally, our findings point to differences between types of substances in their response on economic crisis periods; the effects of the 2008 economic crisis on substance use patterns within countries of the European Union are two-sided. Next to a reduction in a population's overall substance use, a number of vulnerable subgroups experience serious negative effects. These groups are in need of specific attention and support, given that there is a real risk that they will continue to suffer negative health effects long after the economic downfall has formally been ended.

The Impact of the 2008 Economic Crisis on Substance Use Patterns in the Countries of the European Union

PubMed Central

Dom, Geert; Samochowiec, Jerzy; Evans-Lacko, Sara; Wahlbeck, Kristian; Van Hal, Guido; McDaid, David

2016-01-01

Background: From 2008 on, a severe economic crisis (EC) has characterized the European Union (E.U.). However, changes in substance use behavioral patterns as a result of the economic crisis in Europe, have been poorly reflected upon, and underlying mechanisms remain to be identified; Methods: In this review we explore and systematize the available data on the effect of the 2008 economic crisis on patterns of substance use and related disorders, within the E.U. countries; Results: The results show that effects of the recession need to be differentiated. A number of studies point to reductions in population’s overall substance use. In contrast, an increase in harmful use and negative effects is found within specific subgroups within the society. Risk factors include job-loss and long-term unemployment, and pre-existing vulnerabilities. Finally, our findings point to differences between types of substances in their response on economic crisis periods; Conclusions: the effects of the 2008 economic crisis on substance use patterns within countries of the European Union are two-sided. Next to a reduction in a population’s overall substance use, a number of vulnerable subgroups experience serious negative effects. These groups are in need of specific attention and support, given that there is a real risk that they will continue to suffer negative health effects long after the economic downfall has formally been ended. PMID:26771628

Randomised controlled trial of joint crisis plans to reduce compulsory treatment for people with psychosis: economic outcomes.

PubMed

Barrett, Barbara; Waheed, Waquas; Farrelly, Simone; Birchwood, Max; Dunn, Graham; Flach, Clare; Henderson, Claire; Leese, Morven; Lester, Helen; Marshall, Max; Rose, Diana; Sutherby, Kim; Szmukler, George; Thornicroft, Graham; Byford, Sarah

2013-01-01

Compulsory admission to psychiatric hospitals may be distressing, disruptive to patients and families, and associated with considerable cost to the health service. Improved patient experience and cost reductions could be realised by providing cost-effective crisis planning services. Economic evaluation within a multi-centre randomised controlled trial comparing Joint Crisis Plans (JCP) plus treatment as usual (TAU) to TAU alone for patients aged over 16, with at least one psychiatric hospital admission in the previous two years and on the Enhanced Care Programme Approach register. JCPs, containing the patient's treatment preferences for any future psychiatric emergency, are a form of crisis intervention that aim to mitigate the negative consequences of relapse, including hospital admission and use of coercion. Data were collected at baseline and 18-months after randomisation. The primary outcome was admission to hospital under the Mental Health Act. The economic evaluation took a service perspective (health, social care and criminal justice services) and a societal perspective (additionally including criminal activity and productivity losses). The addition of JCPs to TAU had no significant effect on compulsory admissions or total societal cost per participant over 18-months follow-up. From the service cost perspective, however, evidence suggests a higher probability (80%) of JCPs being the more cost-effective option. Exploration by ethnic group highlights distinct patterns of costs and effects. Whilst the evidence does not support the cost-effectiveness of JCPs for White or Asian ethnic groups, there is at least a 90% probability of the JCP intervention being the more cost-effective option in the Black ethnic group. The results by ethnic group are sufficiently striking to warrant further investigation into the potential for patient gain from JCPs among black patient groups. Current Controlled Trials ISRCTN11501328.

A scoping review of crisis teams managing dementia in older people

PubMed Central

Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

2017-01-01

Background Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. Methods For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. Results The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Conclusion Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness. PMID:29042760

Indocyanine green-loaded hollow mesoporous silica nanoparticles as an activatable theranostic agent

NASA Astrophysics Data System (ADS)

Hong, Suk ho; Kim, Hyunjin; Choi, Yongdoo

2017-05-01

Here we report indocyanine green (ICG)-loaded hollow mesoporous silica nanoparticles (ICG@HMSNP) as an activatable theranostic platform. Near-infrared fluorescence and singlet oxygen generation of ICG@HMSNP was effectively quenched (i.e. turned off) in its native state because of the fluorescence resonance energy transfer between ICG molecules. Therefore, ICG@HMSNP was nonfluorescent and nonphototoxic in the extracellular region. After the nanoparticles entered the cancer cells via endocytosis, they became highly fluorescent and phototoxic. In addition, intracellular uptake of ICG@HMSNP was 2.75 times higher than that of free ICG, resulting in an enhanced phototherapy of cancer.

World Hunger Crisis Kit. Hope for the Hungry.

ERIC Educational Resources Information Center

Woito, Robert, Ed.

This booklet introduces the problem of world hunger and provides information, facts, and perspectives about the crisis. Section one presents the reader with the basic facts of the hunger crisis through a self-survey, a statistical study of the developed Oil Producing Export Countries (OPEC), and a one-page indication of what one would have to give…

The Crisis Crisis in Higher Education: Is That a Wolf or a Pussycat at the Academy's Door? ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Birnbaum, Robert; Shushok, Frank

This paper reviews the literature using the word "crisis" in relation to current higher education and analyzes claims of three specific crises of the past 25 years. It considers reasons why educational institutions may be particularly vulnerable to claims of crisis and offers some ideas about the nature of higher education crises and the…

Nucleosomes and neutrophil activation in sickle cell disease painful crisis

PubMed Central

Schimmel, Marein; Nur, Erfan; Biemond, Bart J.; van Mierlo, Gerard J.; Solati, Shabnam; Brandjes, Dees P.; Otten, Hans-Martin; Schnog, John-John; Zeerleder, Sacha

2013-01-01

Activated polymorphonuclear neutrophils play an important role in the pathogenesis of vaso-occlusive painful sickle cell crisis. Upon activation, polymorphonuclear neutrophils can form neutrophil extracellular traps. Neutrophil extracellular traps consist of a meshwork of extracellular DNA, nucleosomes, histones and neutrophil proteases. Neutrophil extracellular traps have been demonstrated to be toxic to endothelial and parenchymal cells. This prospective cohort study was conducted to determine neutrophil extracellular trap formation in sickle cell patients during steady state and painful crisis. As a measure of neutrophil extracellular traps, plasma nucleosomes levels were determined and polymorphonuclear neutrophil activation was assessed measuring plasma levels of elastase-α1-antitrypsin complexes in 74 patients in steady state, 70 patients during painful crisis, and 24 race-matched controls using Enzyme Linked Immunosorbent Assay. Nucleosome levels in steady state sickle cell patients were significantly higher than levels in controls. During painful crisis levels of both nucleosomes and elastase-α1-antitrypsin complexes increased significantly. Levels of nucleosomes correlated significantly to elastase-α1-antitrypsin complex levels during painful crisis, (Sr = 0.654, P<0.001). This was seen in both HbSS/HbSβ0-thalassemia (Sr=0.55, P<0.001) and HbSC/HbSβ+-thalassemia patients (Sr=0.90, P<0.001) during painful crisis. Levels of nucleosomes showed a correlation with length of hospital stay and were highest in patients with acute chest syndrome. These data support the concept that neutrophil extracellular trap formation and neutrophil activation may play a role in the pathogenesis of painful sickle cell crisis and acute chest syndrome. PMID:23911704

40 CFR 166.53 - EPA review of crisis exemption and revocation of authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false EPA review of crisis exemption and... CONDITIONS Crisis Exemptions § 166.53 EPA review of crisis exemption and revocation of authority. (a) Review. When a crisis exemption is about to be or has already been declared by a State or Federal agency, EPA...

SARS: Key factors in crisis management.

PubMed

Tseng, Hsin-Chao; Chen, Thai-Form; Chou, Shieu-Ming

2005-03-01

This study was conducted at a single hospital selected in Taipei during the SARS (Severe Acute Respiratory Syndrome) outbreak from March to July, 2003 in Taiwan. During this period of time, 104 SARS patients were admitted to the hospital. There were no negative reports related to the selected hospital despite its being located right in the center of an area struck by the epidemic. The purpose of this study was to identify the key factors enabling the hospital to survive SARS unscathed. Data were collected from in-depth interviews with the nursing directors and nursing managers of the SARS units, along with a review of relevant hospital documents. The five key elements identified as survival factors during this SARS crisis are as follows: 1. good control of timing for crisis management, 2. careful decision-making, 3. thorough implementation, 4. effective communication, and 5. trust between management and employees. The results of this study reconfirmed the selected hospital as a model for good crisis management during the SARS epidemic.

Nitric oxide for inhalation in the acute treatment of sickle cell pain crisis: A randomized clinical trial

PubMed Central

Gladwin, Mark T.; Kato, Gregory J.; Weiner, Debra; Onyekwere, Onyinye C.; Dampier, Carlton; Hsu, Lewis; Hagar, R. Ward; Howard, Thomas; Nuss, Rachelle; Okam, Maureen M.; Tremonti, Carole K.; Berman, Brian; Villella, Anthony; Krishnamurti, Lakshmanan; Lanzkron, Sophie; Castro, Oswaldo; Gordeuk, Victor R.; Coles, Wynona A.; Peters-Lawrence, Marlene; Nichols, James; Hall, Mary K.; Hildesheim, Mariana; Blackwelder, William C.; Baldassarre, James; Casella, James F.

2012-01-01

Context Inhaled nitric oxide (NO) has shown evidence of efficacy in mouse models of sickle cell disease (SCD), case series of patients with acute chest syndrome, and 2 small placebo-controlled trials for treatment of vaso-occlusive pain crisis (VOC). Objective To determine whether inhaled NO gas reduces the duration of painful crisis in patients with SCD who present to the emergency room or hospital for care. Design, Setting and Participants Prospective, multicenter, double-blind, randomized, placebo-controlled clinical trial for up to 72 hours of inhaled NO gas versus inhaled nitrogen placebo in 150 participants presenting with VOC of SCD at 11 centers between October 5, 2004 and December 22, 2008. The primary endpoint was the time to resolution of painful crisis, defined by: 1) freedom from parenteral opioid use for 5 hours; 2) pain relief as assessed by visual analog pain scale scores ≤ 6 cm; 3) ability to walk; and 4) patient and family’s decision, with physician consensus, that the remaining pain could be managed at home. Intervention Inhaled NO gas versus inhaled nitrogen placebo. Results There was no significant change in the primary endpoint between the NO and the placebo groups, with a median time to resolution of crisis of 73.0 hours (95% CI: 46.0–91.0) and 65.5 hours (95% CI: 48.1–84.0), respectively (P=.87). There were no significant differences in secondary outcome measures, including length of hospitalization, VAS scores, cumulative opioid usage and the rate of acute chest syndrome. Inhaled NO was well tolerated with no increase in serious adverse events. Increases in venous methemoglobin concentration confirmed compliance and randomization, but did not exceed 5% in any study participant. Significant increases in plasma nitrate occurred in the treatment group, but there were no observed increases in plasma or whole blood nitrite. Conclusions Among patients with SCD hospitalized with VOC, the use of inhaled NO compared with placebo did not

Indocyanine Green-Encapsulated Hybrid Polymeric Nanomicelles for Photothermal Cancer Therapy.

PubMed

Jian, Wei-Hong; Yu, Ting-Wei; Chen, Chien-Ju; Huang, Wen-Chia; Chiu, Hsin-Cheng; Chiang, Wen-Hsuan

2015-06-09

Indocyanine green (ICG), an FDA approved medical near-infrared (NIR) imaging agent, has been extensively used in cancer theranosis. However, the limited aqueous photostability, rapid body clearance, and poor cellular uptake severely restrict its practical applications. For these problems to be overcome, ICG-encapsulated hybrid polymeric nanomicelles (PNMs) were developed in this work through coassociation of the amphiphilic diblock copolymer poly(lactic-co-glycolic acid)-b-poly(ethylene glycol) (PLGA-b-PEG) and hydrophobic electrostatic complexes composed of ICG molecules and branched poly(ethylenimine) (PEI). The ICG-encapsulated hybrid PNMs featured a hydrophobic PLGA/ICG/PEI core stabilized by hydrophilic PEG shells. The encapsulation of electrostatic ICG/PEI complexes into the compact PLGA-rich core not only facilitated the ICG loading but also promoted its aqueous optical stability. The effects of the chain length of PEI in combination with ICG on the physiochemical properties of PNMs and their drug leakage were also investigated. PEI(10k) (10 kDa) could form highly robust and dense complexes with ICG, and thus prominently reduced ICG outflow from the PNMs. The results of in vitro cellular uptake and cytotoxicity studies revealed that the ICG/PEI(10k)-loaded PNMs significantly promoted cellular uptake of ICG by HeLa cells due to their near-neutral surface, and thereby augmented the NIR-triggered hyperthermia effect in destroying cancer cells. These findings strongly indicate that the ICG/PEI10k-loaded PNMs have significant potential for attaining effective cancer imaging and photothermal therapy.

Letter Writing as a Tool To Increase Client Motivation To Change: Application to an Inpatient Crisis Unit.

ERIC Educational Resources Information Center

Tubman, Jonathan G.; Montgomery, Marilyn J.; Wagner, Eric F.

2001-01-01

Describes the application of a letter writing exercise as a motivational technique for group counseling in contemporary crisis unit settings. Discusses guidelines and implications for clinical practice with clients with multiple, chronic problems. (Contains 37 references and 1 table.) (GCP)

Interprofessional team debriefings with or without an instructor after a simulated crisis scenario: An exploratory case study.

PubMed

Boet, Sylvain; Pigford, Ashlee-Ann; Fitzsimmons, Amber; Reeves, Scott; Triby, Emmanuel; Bould, M Dylan

2016-11-01

The value of debriefing after an interprofessional simulated crisis is widely recognised; however, little is known about the content of debriefings and topics that prompt reflection. This study aimed to describe the content and topics that facilitate reflection among learners in two types of interprofessional team debriefings (with or without an instructor) following simulated practice. Interprofessional operating room (OR) teams (one anaesthesia trainee, one surgical trainee, and one staff circulating OR nurse) managed a simulated crisis scenario and were randomised to one of two debriefing groups. Within-team groups used low-level facilitation (i.e., no instructor but a one-page debriefing form based on the Ottawa Global Rating Scale). The instructor-led group used high-level facilitation (i.e., gold standard instructor-led debriefing). All debriefings were recorded, transcribed, and thematically analysed using the inductive qualitative methodology. Thirty-seven interprofessional team-debriefing sessions were included in the analysis. Regardless of group allocation (within-team or instructor-led), the debriefings centred on targeted crisis resource management (CRM) content (i.e., communication, leadership, situation awareness, roles, and responsibilities). In both types of debriefings, three themes emerged as topics for entry points into reflection: (1) the process of the debriefing itself, (2) experience of the simulation model, including simulation fidelity, and (3) perceived performance, including the assessment of CRM. Either with or without an instructor, interprofessional teams focused their debriefing discussion on targeted CRM content. We report topics that allowed learners to enter reflection. This is important for understanding how to maximise learning opportunities when creating education activities for healthcare providers that work in interprofessional settings.