Sample records for national level emergency

  1. National Emergency Communications Plan

    DTIC Science & Technology

    2008-07-01

    Los Angeles Police Department ( LAPD ), Metropolitan Police of the District of Columbia (MPDC), New York Police Department (NYPD) National...priorities at the national level and establishes departmental responsibilities and processes related to national preparedness and emergency...and emergency management community, both public and private, at the Federal, State, tribal, Territorial, regional, and local levels .

  2. 47 CFR 11.54 - EAS operation during a National Level emergency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... licensees and DBS providers may choose their two EAS sources, one of which must be a PEP station. (2... header codes for a national emergency. (3) After completing the above transmission procedures, key EAS...

  3. 47 CFR 11.54 - EAS operation during a National Level emergency.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... licensees and DBS providers may choose their two EAS sources, one of which must be a PEP station. (2... header codes for a national emergency. (3) After completing the above transmission procedures, key EAS...

  4. 47 CFR 11.43 - National level participation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false National level participation. 11.43 Section 11.43 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS... national level EAS may submit a written request to the Chief, Public Safety and Homeland Security Bureau...

  5. Nonemergent emergency department visits under the National Health Insurance in Taiwan.

    PubMed

    Tsai, Jeffrey Che-Hung; Chen, Wen-Yi; Liang, Yia-Wun

    2011-05-01

    To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Emergency medical dispatch : national standard curriculum ready

    DOT National Transportation Integrated Search

    1996-05-01

    This Traffic Tech describes the recently updated "Emergency Medical Dispatch: National Standard Curriculum," which was developed in 1972. Emergency service providers use these uniform standards to develop or select an emergency medical dispatch progr...

  7. Saving tourists: the status of emergency medical services in California's National Parks.

    PubMed

    Heggie, Travis W; Heggie, Tracey M

    2009-01-01

    Providing emergency medical services (EMS) in popular tourist destinations such as National Parks requires an understanding of the availability and demand for EMS. This study examines the EMS workload, EMS transportation methods, EMS funding, and EMS provider status in California's National Park Service units. A retrospective review of data from the 2005 Annual Emergency Medical Services Report for National Park Service (NPS) units in California. Sixteen NPS units in California reported EMS activity. EMS program funding and training costs totaled USD $1,071,022. During 2005 there were 84 reported fatalities, 910 trauma incidents, 663 non-cardiac medicals, 129 cardiac incidents, and 447 first aid incidents. Sequoia and Kings Canyon National Parks, Yosemite National Park, Golden Gate National Recreation Area, and Death Valley National Park accounted for 83% of the total EMS case workload. Ground transports accounted for 85% of all EMS transports and Emergency Medical Technicians with EMT-basic (EMT-B) training made up 76% of the total 373 EMS providers. Providing EMS for tourists can be a challenging task. As tourist endeavors increase globally and move into more remote environments, the level of EMS operations in California's NPS units can serve as a model for developing EMS operations serving tourist populations.

  8. 3 CFR - Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Colombia, and the extreme level of violence, corruption, and harm such actions cause in the United States... level of violence, corruption, and harm in the United States and abroad, the national emergency declared...

  9. State-level emergency preparedness and response capabilities.

    PubMed

    Watkins, Sharon M; Perrotta, Dennis M; Stanbury, Martha; Heumann, Michael; Anderson, Henry; Simms, Erin; Huang, Monica

    2011-03-01

    Prior assessments of public health readiness had identified gaps in radiation preparedness. In recent years, preparedness planning has involved an "all-hazards" approach. Current assessment of the national status related to radiation public health emergency preparedness capabilities at the state and local health department levels was needed. A survey of state health departments related to radiation readiness was undertaken in 2010 by the Council of State and Territorial Epidemiologists (CSTE). States with nuclear power plants were instructed to consider their responses exclusive of capabilities and resources related to the plants given that the emergency response plans for nuclear power plants are specific and unique. Thirty-eight (76%) state health departments responded to the survey, including 26 of the 31 states with nuclear power plants. Specific strengths noted at the state level included that the majority of states had a written radiation response plan and most plans include a detailed section for communications issues during a radiation emergency. In addition, more than half of the states indicated that their relationship with federal partners is sufficient to provide resources for radiation emergencies, indicating the importance states placed on federal resources and expertise. Specific weaknesses are discussed and include that most states had completed little to no planning for public health surveillance to assess potential human health impacts of a radiation event; less than half had written plans to address exposure assessment, environmental sampling, human specimen collection and analysis, and human health assessment. Few reported having sufficient resources to do public health surveillance, radiation exposure assessment, laboratory functions and other capabilities. Levels of planning, resources and partnerships varied among states, those with nuclear power plants were better prepared. Gaps were evident in all states; however and additional training and

  10. 15 CFR 700.4 - Priorities and allocations in a national emergency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., including domestic emergency preparedness requirements, of approved programs. (b) The special rules... national emergency. 700.4 Section 700.4 Commerce and Foreign Trade Regulations Relating to Commerce and... allocations in a national emergency. (a) In the event of a national emergency, special rules may be...

  11. 76 FR 41273 - National Emergency Communications Plan (NECP) Tribal Report

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0025] National Emergency Communications Plan... Communications (CS&C), Office of Emergency Communications (OEC), will submit the following information collection... concerning New Information Collection Request, National Emergency Communications Plan Tribal Report. DHS...

  12. 76 FR 2700 - National Protection and Programs Directorate; National Emergency Communications Plan (NECP) Goal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ... Programs Directorate (NPPD)/Office of Cybersecurity and Communications (CS&C)/Office of Emergency Communications (OEC) will submit the following Information Collection Request to the Office of Management and... Directorate; National Emergency Communications Plan (NECP) Goal 2 Performance Report AGENCY: National...

  13. 3 CFR - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation... aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation 7757, the national...

  14. 3 CFR - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation... aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation 7757, the national...

  15. 3 CFR - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation... aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation 7757, the national...

  16. 78 FR 13207 - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-26

    ...--Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the... Respect to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... north of Cuba. On February 26, 2004, by Proclamation 7757, the national emergency was extended and its...

  17. 76 FR 11071 - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ...--Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the... Respect to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... north of Cuba. On February 26, 2004, by Proclamation 7757, the national emergency was extended and its...

  18. National Labs and Nuclear Emergency Response

    NASA Astrophysics Data System (ADS)

    Budil, Kimberly

    2015-04-01

    The DOE national laboratories, and in particular the three NNSA national security laboratories, have long supported a broad suite of national nuclear security missions for the U.S. government. The capabilities, infrastructure and base of expertise developed to support the U.S. nuclear weapons stockpile have been applied to such challenges as stemming nuclear proliferation, understanding the nuclear capabilities of adversaries, and assessing and countering nuclear threats including essential support to nuclear emergency response. This talk will discuss the programs that are underway at the laboratories and the essential role that science and technology plays therein. Nuclear scientists provide expertise, fundamental understanding of nuclear materials, processes and signatures, and tools and technologies to aid in the identification and mitigation of nuclear threats as well as consequence management. This talk will also discuss the importance of direct engagement with the response community, which helps to shape research priorities and to enable development of useful tools and techniques for responders working in the field. National Labs and Nuclear Emergency Response.

  19. 3 CFR - Continuation of the National Emergency With Respect to Somalia

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to Somalia Presidential Documents Other Presidential Documents Notice of April 10, 2012 Continuation of the National Emergency With Respect to Somalia On April 12, 2010, by Executive Order 13536, I declared a national emergency pursuant to the...

  20. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Iran Presidential Documents Other Presidential Documents Notice of March 12, 2013 Continuation of the National Emergency With Respect to Iran On March 15, 1995, the President issued Executive Order 12957, which declared a national emergency with...

  1. 3 CFR - Continuation of the National Emergency With Respect to Libya

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to Libya Presidential Documents Other Presidential Documents Notice of February 23, 2012 Continuation of the National Emergency With Respect to Libya On February 25, 2011, by Executive Order 13566, I declared a national emergency pursuant to the...

  2. 3 CFR - Continuation of the National Emergency With Respect to Lebanon

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Lebanon Presidential Documents Other Presidential Documents Notice of July 29, 2013 Continuation of the National Emergency With Respect to Lebanon On August 1, 2007, by Executive Order 13441, the President declared a national emergency with...

  3. 3 CFR - Continuation of the National Emergency With Respect to Zimbabwe

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Zimbabwe Presidential Documents Other Presidential Documents Notice of March 2, 2011 Continuation of the National Emergency With Respect to Zimbabwe On March 6, 2003, by Executive Order 13288, the President declared a national emergency and...

  4. 3 CFR - Continuation of the National Emergency With Respect to Libya

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Libya Presidential Documents Other Presidential Documents Notice of February 13, 2013 Continuation of the National Emergency With Respect to Libya On February 25, 2011, by Executive Order 13566, I declared a national emergency pursuant to the...

  5. 3 CFR - Continuation of the National Emergency With Respect to Zimbabwe

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to Zimbabwe Presidential Documents Other Presidential Documents Notice of February 26, 2010 Continuation of the National Emergency With Respect to Zimbabwe On March 6, 2003, by Executive Order 13288, the President declared a national emergency and...

  6. 3 CFR - Continuation of the National Emergency With Respect to Zimbabwe

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to Zimbabwe Presidential Documents Other Presidential Documents Notice of March 3, 2009 Continuation of the National Emergency With Respect to Zimbabwe On March 6, 2003, by Executive Order 13288, the President declared a national emergency and...

  7. 3 CFR - Continuation of the National Emergency With Respect to Somalia

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Somalia Presidential Documents Other Presidential Documents Notice of April 7, 2011 Continuation of the National Emergency With Respect to Somalia On April 12, 2010, by Executive Order 13536, I declared a national emergency pursuant to the...

  8. 3 CFR - Continuation of the National Emergency With Respect to Somalia

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Somalia Presidential Documents Other Presidential Documents Notice of April 4, 2013 Continuation of the National Emergency With Respect to Somalia On April 12, 2010, by Executive Order 13536, I declared a national emergency pursuant to the...

  9. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to Iran Presidential Documents Other Presidential Documents Notice of March 11, 2009 Continuation of the National Emergency With Respect to Iran On March 15, 1995, by Executive Order 12957, the President declared a national emergency with respect to...

  10. 3 CFR - Continuation of the National Emergency With Respect to Yemen

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Yemen Presidential Documents Other Presidential Documents Notice of May 13, 2013 Continuation of the National Emergency With Respect to Yemen On May 16, 2012, by Executive Order 13611, I declared a national emergency pursuant to the International...

  11. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Iran Presidential Documents Other Presidential Documents Notice of March 8, 2011 Continuation of the National Emergency With Respect to Iran On March 15, 1995, by Executive Order 12957, the President declared a national emergency with respect to...

  12. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to Iran Presidential Documents Other Presidential Documents Notice of March 10, 2010 Continuation of the National Emergency With Respect to Iran On March 15, 1995, by Executive Order 12957, the President declared a national emergency with respect to...

  13. 10 CFR 50.103 - Suspension and operation in war or national emergency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Suspension and operation in war or national emergency. 50..., Emergency Operations by the Commission § 50.103 Suspension and operation in war or national emergency. (a) Whenever Congress declares that a state of war or national emergency exists, the Commission, if it finds it...

  14. 3 CFR - Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Colombia and the extreme level of violence, corruption, and harm such actions cause in the United States... of violence, corruption, and harm in the United States and abroad, the national emergency declared on...

  15. 77 FR 11377 - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... Vol. 77 Friday, No. 37 February 24, 2012 Part VI The President Notice of February 23, 2012--Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of Vessels Notice of February 23, 2012--Continuation of the National Emergency With Respect to Libya #0; #0; #0;...

  16. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... to Iran Presidential Documents Other Presidential Documents Notice of November 12, 2013 Continuation of the National Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran and, pursuant to the International Emergency...

  17. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... to Iran Presidential Documents Other Presidential Documents Notice of November 7, 2011 Continuation of the National Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran, pursuant to the International Emergency...

  18. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... to Iran Presidential Documents Other Presidential Documents Notice of November 9, 2012 Continuation of the National Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran and, pursuant to the International Emergency...

  19. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... to Iran Presidential Documents Other Presidential Documents Notice of November 10, 2010 Continuation of the National Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran, pursuant to the International Emergency...

  20. Pediatric pre-hospital emergencies in Belgium: a 2-year national descriptive study.

    PubMed

    Demaret, Pierre; Lebrun, Frédéric; Devos, Philippe; Champagne, Caroline; Lemaire, Roland; Loeckx, Isabelle; Messens, Marie; Mulder, André

    2016-07-01

    This study aims to describe the pediatric physician-staffed EMS missions at a national level and to compare the pediatric and the adult EMS missions. Using a national database, we analyzed 254,812 interventions including 15,294 (6 %) pediatric emergencies. Less children than adults received an intravenous infusion (52.7 versus 77.1 %, p < 0.001), but the intra-osseous access was used more frequently in children (1.3 versus 0.8 %, p < 0.001). More children than adults benefited from a therapeutic immobilization (16.3 versus 13.2 %, p < 0.001). Endotracheal intubation was rare in children (2.1 %) as well as cardiopulmonary resuscitation (1.2 %). Children were more likely than adults to suffer from a neurological problem (32.4 versus 21.3 %, p < 0.001) or from a trauma (27.1 versus 16.8 %, p < 0.001). The prevalence of the pediatric diagnoses showed an age dependency: the respiratory problems were more prevalent in infants (40.3 % of the 0-12-months old), 52.1 % of the 1-4-year-old children suffered from a neurological problem, and the prevalence of trauma raised from 14.8 % of the infants to 47.1 % of the 11-15 year olds. Pre-hospital pediatric EMS missions are not frequent and differ from the adult interventions. The pediatric characteristics highlighted in this study should help EMS teams to be better prepared to deal with sick children in the pre-hospital setting. • Pediatric and adult emergencies differ. • Pediatric life-threatening emergencies are not frequent. What is New: • This study is the first to describe a European national cohort of pediatric physician-staffed EMS missions and to compare the pediatric and the adult missions at a national level. • This large cohort study confirms scarce regional data indicating that pediatric pre-hospital emergencies are not frequent and mostly non-life-threatening.

  1. Handbook of emergency management for state-level transportation agencies.

    DOT National Transportation Integrated Search

    2010-03-01

    The Department of Homeland Security has mandated specific systems and techniques for the management of emergencies in the United States, including the Incident Command System, the National Incident Management System, Emergency Operations Plans, Emerg...

  2. 10 CFR 70.82 - Suspension and operation in war or national emergency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Suspension and operation in war or national emergency. 70... NUCLEAR MATERIAL Modification and Revocation of Licenses § 70.82 Suspension and operation in war or national emergency. Whenever Congress declares that a state of war or national emergency exists, the...

  3. 3 CFR - Continuation of the National Emergency With Respect to North Korea

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to North Korea Presidential Documents Other Presidential Documents Notice of June 21, 2013 Continuation of the National Emergency With Respect to North Korea On June 26, 2008, by Executive Order 13466, the President declared a national emergency...

  4. 3 CFR - Continuation of the National Emergency With Respect to North Korea

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to North Korea Presidential Documents Other Presidential Documents Notice of June 24, 2009 Continuation of the National Emergency With Respect to North Korea On June 26, 2008, by Executive Order 13466, the President declared a national emergency...

  5. 3 CFR - Continuation of the National Emergency With Respect to North Korea

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to North Korea Presidential Documents Other Presidential Documents Notice of June 23, 2011 Continuation of the National Emergency With Respect to North Korea On June 26, 2008, by Executive Order 13466, the President declared a national emergency...

  6. 77 FR 64221 - Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... extreme level of violence, corruption, and harm such actions cause in the United States and abroad..., corruption, and harm in the United States and abroad, the national emergency declared on October 21, 1995...

  7. 76 FR 65353 - Continuation of the National Emergency With Respect To Significant Narcotics Traffickers Centered...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... extreme level of violence, corruption, and harm such actions cause in the United States and abroad..., corruption, and harm in the United States and abroad, the national emergency declared on October 21, 1995...

  8. 77 FR 67739 - Continuation of the National Emergency With Respect to Iran

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ...--Continuation of the National Emergency With Respect to Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0... Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran and, pursuant to the International Emergency Economic Powers Act...

  9. 78 FR 68321 - Continuation of the National Emergency With Respect to Iran

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ...--Continuation of the National Emergency With Respect to Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0... Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran and, pursuant to the International Emergency Economic Powers Act...

  10. 76 FR 70033 - Continuation of the National Emergency With Respect to Iran

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ...--Continuation of the National Emergency With Respect to Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0... Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran, pursuant to the International Emergency Economic Powers Act (50 U...

  11. 14 CFR 155.9 - Release from war or national emergency restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Release from war or national emergency....9 Release from war or national emergency restrictions. (a) The primary purpose of each transfer of... property transferred, and of the entire airport, for use by the United States during a war or national...

  12. 3 CFR - Continuation of the National Emergency Relating to Cuba and of the Emergency Authority Relating...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of Vessels... Emergency Relating to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and... north of Cuba. On February 26, 2004, by Proclamation 7757, the national emergency was extended and its...

  13. 76 FR 13283 - Continuation of the National Emergency With Respect to Iran

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-10

    ... National Emergency With Respect to Iran On March 15, 1995, by Executive Order 12957, the President declared a national emergency with respect to Iran pursuant to the International Emergency Economic Powers... of Iran. On May 6, 1995, the President issued Executive Order 12959, imposing more comprehensive...

  14. 20 CFR 671.130 - When should applications for national emergency grants be submitted to the Department?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.130... dislocated worker funds are inadequate to provide the level of services needed by the workers being laid off...

  15. 20 CFR 671.130 - When should applications for national emergency grants be submitted to the Department?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.130... dislocated worker funds are inadequate to provide the level of services needed by the workers being laid off...

  16. 3 CFR - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to Certain Terrorist Attacks Presidential Documents Other Presidential Documents Notice of September 10, 2010 Continuation of the National Emergency With Respect to Certain TerroristAttacks Consistent with section 202(d) of the National Emergencies...

  17. 3 CFR - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Certain Terrorist Attacks Presidential Documents Other Presidential Documents Notice of September 10, 2013 Continuation of the National Emergency With Respect to Certain Terrorist Attacks Consistent with section 202(d) of the National Emergencies...

  18. 77 FR 11381 - Continuation of the National Emergency With Respect to Libya

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... took extreme measures against the people of Libya, including by using weapons of war, mercenaries, and... the National Emergency With Respect to Libya On February 25, 2011, by Executive Order 13566, I declared a national emergency pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701...

  19. 78 FR 16395 - Continuation of the National Emergency With Respect to Iran

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-14

    ...--Continuation of the National Emergency With Respect to Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0... With Respect to Iran On March 15, 1995, the President issued Executive Order 12957, which declared a national emergency with respect to Iran and, pursuant to the International Emergency Economic Powers Act...

  20. Discrepancy among acute guideline levels for emergency response.

    PubMed

    Oberg, Mattias; Palmen, Nicole; Johanson, Gunnar

    2010-12-15

    Acute guidance values are tools for public health risk assessment and management during planning, preparedness and response related to sudden airborne release of hazardous chemicals. The two most frequently used values, i.e. Acute Exposure Guidance Levels (AEGL) and Emergency Response Planning Guideline (ERPG), were compared in qualitative and quantitative terms. There was no significant difference between the general level of AEGL and ERPG values, suggesting the two systems are equally precautious. However, the guidance values diverged by a factor of 3 or more for almost 40% of the substances, including many of high production volume. These deviations could be explained by differences in selection of critical effect or critical study and in a few cases differences in interpretation of the same critical study. Diverging guidance values may hamper proper risk communication and risk management. Key factors for broad international acceptance of harmonized values include transparency of the decision process, agreement on definition of toxicological tiers, and a target population including sensitive groups of the general population. In addition, development of purely health based values is encouraged. Risk management issues, such as land use and emergency response planning should be treated separately, as these rely on national legislation and considerations. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. 78 FR 46487 - Continuation of the National Emergency With Respect to Lebanon

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ...--Continuation of the National Emergency With Respect to Lebanon #0; #0; #0; Presidential Documents #0; #0; #0;#0... With Respect to Lebanon On August 1, 2007, by Executive Order 13441, the President declared a national emergency with respect to Lebanon pursuant to the International Emergency Economic Powers Act (50 U.S.C...

  2. 77 FR 46802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ...-0100] National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council. SUMMARY: The... NEMSAC is to provide a nationally recognized council of emergency medical services representatives and...

  3. 5 CFR 230.402 - Agency authority to make emergency-indefinite appointments in a national emergency.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Agency authority to make emergency-indefinite appointments in a national emergency. 230.402 Section 230.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ORGANIZATION OF THE GOVERNMENT FOR PERSONNEL MANAGEMENT...

  4. 5 CFR 230.402 - Agency authority to make emergency-indefinite appointments in a national emergency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Agency authority to make emergency-indefinite appointments in a national emergency. 230.402 Section 230.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ORGANIZATION OF THE GOVERNMENT FOR PERSONNEL MANAGEMENT...

  5. 3 CFR - Continuation of the National Emergency With Respect To Burma

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect To Burma Presidential Documents Other Presidential Documents Notice of May 17, 2012 Continuation of the National Emergency With Respect To Burma On May 20, 1997, the President issued Executive Order...

  6. 78 FR 44415 - Continuation of the National Emergency With Respect to Transnational Criminal Organizations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    ...--Continuation of the National Emergency With Respect to Transnational Criminal Organizations #0; #0; #0... Continuation of the National Emergency With Respect to Transnational Criminal Organizations On July 24, 2011, by Executive Order 13581, I declared a national emergency with respect to transnational criminal...

  7. The global and domestic politics of health policy in emerging nations.

    PubMed

    Gómez, Eduardo J; Ruger, Jennifer Prah

    2015-02-01

    In recent years, several emerging nations with burgeoning economies and in transition to democracy have pursued health policy innovations. As these nations have integrated into the world economy through bilateral trade and diplomacy, they have also become increasingly exposed to international pressures and norms and focused on more effective, equitable health care systems. There are several lessons learned from the case studies of Brazil, Ghana, India, China, Vietnam, and Thailand in this special issue on the global and domestic politics of health policy in emerging nations. For the countries examined, although sensitive to international preferences, domestic governments preferred to implement policy on their own and at their own pace. During the policy-making and implementation process, international and domestic actors played different roles in health policy making vis-à-vis other reform actors -- at times the state played an intermediary role. In several countries, civil society also played a central role in designing and implementing policy at all levels of government. International institutions also have a number of mechanisms and strategies in their tool box to influence a country's domestic health governance, and they use them, particularly in the context of an uncertain state or internal discordance within the state. Copyright © 2015 by Duke University Press.

  8. National survey of emergency departments in Denmark.

    PubMed

    Wen, Leana S; Anderson, Philip D; Stagelund, Søren; Sullivan, Ashley F; Camargo, Carlos A

    2013-06-01

    Emergency departments (EDs) are the basic unit of emergency medicine, but often differ in fundamental features. We sought to describe and characterize EDs in Denmark. All EDs open 24/7 to the general public were surveyed using the National ED Inventories survey instrument (http://www.emnet-nedi.org). ED staff were asked about ED characteristics with reference to the calendar year 2008. Twenty-eight EDs participated (82% response). All were located in hospitals. Less than half [43%, 95% confidence interval (CI) 24-63%] were independent departments. Thirty-nine percent (95% CI 22-59%) had a contiguous layout, with medical and surgical care provided in one area. The vast majority of EDs saw both adults and children; only 10% saw adults only and none saw children only. The median number of annual visits was 32 000 (interquartile range, 14 700-47 000). The majority (68%, 95% CI 47-89%) believed that their ED was at good balance or capacity, with 22% responding that they were under capacity and 9% reporting overcapacity. Technological resources were generally available, with the exception of dedicated computed tomography scanners and negative-pressure rooms. Almost all common emergencies were identified as being treatable 24/7 in the EDs. Although there is some variation in their layout and characteristics, most Danish EDs have a high degree of resource availability and are able to treat common emergencies. As Denmark seeks to reform emergency care through ED consolidation, this national survey helps to establish a benchmark for future comparisons.

  9. 3 CFR - Continuation of the National Emergency With Respect to Sudan

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect... of the National Emergency With Respect to Sudan On November 3, 1997, by Executive Order 13067, the... on November 3, 1997, as expanded on April 26, 2006, and with respect to which additional steps were...

  10. 3 CFR - Continuation of the National Emergency With Respect to Sudan

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect... of the National Emergency With Respect to Sudan On November 3, 1997, by Executive Order 13067, the... on November 3, 1997, as expanded on April 26, 2006, and with respect to which additional steps were...

  11. 3 CFR - Continuation of the National Emergency With Respect to Sudan

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect... of the National Emergency With Respect to Sudan On November 3, 1997, by Executive Order 13067, the... November 3, 1997, as expanded on April 26, 2006, and with respect to which additional steps were taken on...

  12. 3 CFR - Continuation of the National Emergency With Respect to Sudan

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect... of the National Emergency With Respect to Sudan On November 3, 1997, by Executive Order 13067, the... November 3, 1997, as expanded on April 26, 2006, and with respect to which additional steps were taken on...

  13. The National Clinical Assessment Tool for Medical Students in the Emergency Department (NCAT-EM)

    PubMed Central

    Jung, Julianna; Franzen, Douglas; Lawson, Luan; Manthey, David; Tews, Matthew; Dubosh, Nicole; Fisher, Jonathan; Haughey, Marianne; House, Joseph B.; Trainor, Arleigh; Wald, David A.; Hiller, Katherine

    2018-01-01

    Introduction Clinical assessment of medical students in emergency medicine (EM) clerkships is a highly variable process that presents unique challenges and opportunities. Currently, clerkship directors use institution-specific tools with unproven validity and reliability that may or may not address competencies valued most highly in the EM setting. Standardization of assessment practices and development of a common, valid, specialty-specific tool would benefit EM educators and students. Methods A two-day national consensus conference was held in March 2016 in the Clerkship Directors in Emergency Medicine (CDEM) track at the Council of Residency Directors in Emergency Medicine (CORD) Academic Assembly in Nashville, TN. The goal of this conference was to standardize assessment practices and to create a national clinical assessment tool for use in EM clerkships across the country. Conference leaders synthesized the literature, articulated major themes and questions pertinent to clinical assessment of students in EM, clarified the issues, and outlined the consensus-building process prior to consensus-building activities. Results The first day of the conference was dedicated to developing consensus on these key themes in clinical assessment. The second day of the conference was dedicated to discussing and voting on proposed domains to be included in the national clinical assessment tool. A modified Delphi process was initiated after the conference to reconcile questions and items that did not reach an a priori level of consensus. Conclusion The final tool, the National Clinical Assessment Tool for Medical Students in Emergency Medicine (NCAT-EM) is presented here. PMID:29383058

  14. The Role of a National Biocontainment Laboratory in Emergencies.

    PubMed

    Le Duc, James W; Ksiazek, Thomas G

    2015-01-01

    Over a decade ago, the National Institutes of Health awarded partial support for the construction and operation of 2 National Biocontainment Laboratories, with the condition that they would be available to assist in the event of public health emergencies-although how a biocontainment facility located on an academic campus might contribute was not defined. Here we offer examples of how one of these laboratories has contributed to a coordinated response to 2 recent international public health emergencies. Essential assets for success include highly trained and experienced staff, access to reference pathogens and reagents, cutting-edge knowledge of the field, appropriate biocontainment facilities, robust biosafety and biosecurity programs, and availability of modern instrumentation. The ability to marry the strengths of academia in basic and applied research with access to appropriate biocontainment facilities while drawing on a highly skilled cadre of experienced experts has proven extremely valuable in the response to recent national emergencies and will continue to do so in the future. Areas where additional planning and preparation are needed have also been identified through these experiences.

  15. 3 CFR - Continuation of the National Emergency With Respect To Burma

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect To Burma Presidential Documents Other Presidential Documents Notice of May 2, 2013 Continuation of the National Emergency With Respect To Burma On May 20, 1997, the President issued Executive Order 13047, certifying to the Congress under section 570...

  16. 3 CFR - Continuation of the National Emergency With Respect to Burma

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to Burma Presidential Documents Other Presidential Documents Notice of May 13, 2010 Continuation of the National Emergency With Respect to Burma On May 20, 1997, the President issued Executive Order 13047, certifying to the Congress under section 57...

  17. 3 CFR - Continuation of the National Emergency With Respect to Burma

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Burma Presidential Documents Other Presidential Documents Notice of May 16, 2011 Continuation of the National Emergency With Respect to Burma On May 20, 1997, the President issued Executive Order 13047, certifying to the Congress under section 57...

  18. 3 CFR - Continuation of the National Emergency With Respect to Burma

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to Burma Presidential Documents Other Presidential Documents Notice of May 14, 2009 Continuation of the National Emergency With Respect to Burma On May 20, 1997, the President issued Executive Order 13047, certifying to the Congress under section 57...

  19. 75 FR 8791 - Continuation of the National Emergency Relating to Cuba and of the Emergency Authority Relating...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... February 23, 2010 Continuation of the National Emergency Relating to Cuba and of the Emergency Authority....-registered civilian aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation...

  20. [Factors related to the use of pediatric emergency services: results from the Spanish National Health Survey].

    PubMed

    Expósito-Ruiz, Manuela; Sánchez-López, Juan; Ruiz-Bailén, Manuel; Rodríguez-Del Águila, María Del Mar

    2017-01-01

    To determine the frequency of use of Spanish pediatric emergency services, and to describe user profiles and geographic variations. Descriptive study based on data from the Spanish National Health Survey. We calculated descriptive statistics and analyzed crude and adjusted odds ratios (ORs). Thirty-five percent of the 5495 respondents had come to an emergency department in the past year, and 88.1% of them had used the services of a Spanish national health service hospital. Factors associated with higher use of emergency services were male sex of the patient, (OR, 1.202; 95% CI, 1.047-1.381), a higher educational level of parents (OR, 1.255; 95% CI, 0.983-1.603), and younger age of the child (OR, 0.909; 95% CI, 0.894-0.924). Emergency department use varied widely from one Spanish community to another. There was a positive correlation between use and the presence of a foreign-born population (ρ=0.495, P=.031). The rate of emergency department use is high in Spain. Variability between geographic areas is considerable, and some variation is explained by population characteristics.

  1. Emergency medical technician-basic : national standard curriculum (instructor's course guide)

    DOT National Transportation Integrated Search

    1994-01-01

    The curriculum, Emergency Medical Technician-Basic: National Standard Curriculum, : is the cornerstone of EMS prehospital training. Presented here is the : instructor's guide. This new curriculum parallels the recommendations of the : National EMS Ed...

  2. 20 CFR 671.105 - What funds are available for national emergency grants?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What funds are available for national emergency grants? 671.105 Section 671.105 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.105 What funds are available for...

  3. 20 CFR 671.105 - What funds are available for national emergency grants?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What funds are available for national emergency grants? 671.105 Section 671.105 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.105 What funds are available for...

  4. 76 FR 22114 - National Emergency Communications Plan (NECP) Tribal Report

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0025] National Emergency Communications Plan... Communications (CS&C), Office of Emergency Communications (OEC), will submit the following Information Collection... interoperable communications capabilities. The NECP Tribal Report is designed to meet these statutory...

  5. 78 FR 49332 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ...-0091] National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council. SUMMARY: The... emergency medical services representatives and consumers, is to advise and consult with DOT and the Federal...

  6. 77 FR 15227 - Continuation of the National Emergency With Respect to Iran Executive Order 12957

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ...--Continuation of the National Emergency With Respect to Iran Executive Order 12957 #0; #0; #0; Presidential... the National Emergency With Respect to Iran Executive Order 12957 On March 15, 1995, by Executive Order 12957, the President declared a national emergency with respect to Iran, pursuant to the...

  7. A review of emergency medical services events in US national parks from 2007 to 2011.

    PubMed

    Declerck, Matthieu P; Atterton, Laurie M; Seibert, Thomas; Cushing, Tracy A

    2013-09-01

    Outdoor recreation is growing in the United States, with more than 279 million annual visitors to areas controlled by the National Park Service (NPS). Emergency medical needs in these parks are overseen by the National Park's rangers within the NPS Emergency Medical Services (EMS) system. This study examines medical and traumatic emergencies throughout the NPS over a 5-year period to better understand the types of events and fatalities rangers encounter, both regionally and on a national scale. This is a retrospective review of the annual EMS reports published by the 7 NPS regions from 2007 to 2011. The following were compared and examined at a regional and national level: medical versus traumatic versus first aid events, cardiac events and outcomes, use of automated external defibrillators, and medical versus traumatic fatalities. The national incidence of EMS events was 45.9 events per 1 million visitors. Medical, traumatic, and first aid events composed 29%, 28%, and 43% of reports, respectively. Of medical episodes, 1.8% were cardiac arrests, of which 64.2% received automated external defibrillator treatment; 29.1% of cardiac arrests survived to hospital discharge. Of fatalities, 61.4% were traumatic in nature and the remaining 38.5% were nontraumatic (medical). Regional differences were found for all variables. On a national level, the NPS experiences an equal number of medical and traumatic EMS events. This differs from past observed trends that reported a higher incidence of traumatic events than medical events in wilderness settings. Cardiac events and automated external defibrillator usage are relatively infrequent. Traumatic fatalities are more common than medical fatalities in the NPS. Regional variations in events likely reflect differences in terrain, common activities, proximity to urban areas, and access to definitive care between regions. These data can assist the NPS in targeting the regions with the greatest number of incidents and fatalities for

  8. 77 FR 43481 - Taking Additional Steps to Address the National Emergency With Respect to Somalia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... Additional Steps to Address the National Emergency With Respect to Somalia #0; #0; #0; Presidential Documents... Additional Steps to Address the National Emergency With Respect to Somalia By the authority vested in me as... order to take additional steps to deal with the national emergency with respect to the situation in...

  9. 47 CFR 0.387 - Other national security and emergency preparedness delegations; cross reference.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Other national security and emergency preparedness delegations; cross reference. 0.387 Section 0.387 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Delegations of Authority National Security and Emergency...

  10. 77 FR 42617 - Continuation of the National Emergency With Respect To Significant Transnational Criminal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ...--Continuation of the National Emergency With Respect to Significant Transnational Criminal Organizations #0; #0..., 2012 Continuation of the National Emergency With Respect To Significant Transnational Criminal... threat to the national security, foreign policy, and economy of the United States constituted by the...

  11. The National Falls and Bone Health Audit: implications for UK emergency care.

    PubMed

    Banerjee, Jay; Benger, Jonathan; Treml, Jonathan; Martin, Finbarr C; Grant, Rob; Lowe, Derek; Potter, Jonathan; Husk, Janet

    2012-10-01

    The National Clinical Audit of Falls and Bone Health, coordinated by the Royal College of Physicians, assesses progress in implementing integrated falls services across the UK against national standards and enables benchmarking between service providers. Nationally, falls are a leading contributor towards mortality and morbidity in older people and account for 700,000 visits to emergency departments and 4 million annual bed days in England alone. Two rounds of national organisational audit in 2005 and 2008 and one national clinical audit in 2006 were carried out based on indicators developed by a multidisciplinary group. These showed that management of falls and bone health in older people remains suboptimal in emergency departments and minor injury units and opportunities are being missed in carrying out evidence-based risk assessment and management. Older people attending emergency departments in the UK following a fall are receiving a poor deal. There is an urgent need to ensure more effective assessment and management to prevent further falls and fractures.

  12. 47 CFR 0.387 - Other national security and emergency preparedness delegations; cross reference.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Preparedness Delegations § 0.387 Other national security and emergency preparedness delegations; cross... 47 Telecommunication 1 2010-10-01 2010-10-01 false Other national security and emergency preparedness delegations; cross reference. 0.387 Section 0.387 Telecommunication FEDERAL COMMUNICATIONS...

  13. Emergency Medical Dispatch. National Standard Curriculum. Instructor Guide. Trainee Guide.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This guide contains all instructor materials and requirements for the National Highway Traffic Safety Administration (NHTSA), Emergency Medical Dispatch (EMD) National Standard Curriculum. It includes lesson plans, instructional aids, and tools and supporting information designed to elevate trained and experienced public safety telecommunicators…

  14. Idaho National Laboratory Emergency Readiness Assurance Plan - Fiscal Year 2015

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

    Farmer, Carl J.

    Department of Energy Order 151.1C, Comprehensive Emergency Management System requires that each Department of Energy field element documents readiness assurance activities, addressing emergency response planning and preparedness. Battelle Energy Alliance, LLC, as prime contractor at the Idaho National Laboratory (INL), has compiled this Emergency Readiness Assurance Plan to provide this assurance to the Department of Energy Idaho Operations Office. Stated emergency capabilities at the INL are sufficient to implement emergency plans. Summary tables augment descriptive paragraphs to provide easy access to data. Additionally, the plan furnishes budgeting, personnel, and planning forecasts for the next 5 years.

  15. 3 CFR - Continuation of the National Emergency With Respect To Significant Transnational Criminal...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect To Significant Transnational Criminal Organizations Presidential Documents Other Presidential Documents Notice of July 18, 2012 Continuation of the National Emergency With Respect To Significant...

  16. 3 CFR - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to Certain Terrorist Attacks Presidential Documents Other Presidential Documents Notice of September 11, 2012 Continuation of the National Emergency With Respect to Certain Terrorist Attacks Consistent...

  17. 3 CFR - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Certain Terrorist Attacks Presidential Documents Other Presidential Documents Notice of September 9, 2011 Continuation of the National Emergency With Respect to Certain Terrorist Attacks Consistent...

  18. Night emergency cover for ENT in England: a national survey.

    PubMed

    Biswas, D; Rafferty, A; Jassar, P

    2009-08-01

    To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the 'Modernising Medical Careers' initiative, in England. We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England. One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents' hospitals (51 per cent), these courses were of varying duration. Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.

  19. 3 CFR - Continuation of the National Emergency With Respect to Export Control Regulations

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to Export Control Regulations Presidential Documents Other Presidential Documents Notice of August 15, 2012 Continuation of the National Emergency With Respect to Export Control Regulations On August 17...

  20. 3 CFR - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... national emergency declared on September 14, 2001, in Proclamation 7463, with respect to the terrorist attacks of September 11, 2001, and the continuing and immediate threat of further attacks on the United States. Because the terrorist threat continues, the national emergency declared on September 14, 2001...

  1. The challenge of measuring emergency preparedness: integrating component metrics to build system-level measures for strategic national stockpile operations.

    PubMed

    Jackson, Brian A; Faith, Kay Sullivan

    2013-02-01

    Although significant progress has been made in measuring public health emergency preparedness, system-level performance measures are lacking. This report examines a potential approach to such measures for Strategic National Stockpile (SNS) operations. We adapted an engineering analytic technique used to assess the reliability of technological systems-failure mode and effects analysis-to assess preparedness. That technique, which includes systematic mapping of the response system and identification of possible breakdowns that affect performance, provides a path to use data from existing SNS assessment tools to estimate likely future performance of the system overall. Systems models of SNS operations were constructed and failure mode analyses were performed for each component. Linking data from existing assessments, including the technical assistance review and functional drills, to reliability assessment was demonstrated using publicly available information. The use of failure mode and effects estimates to assess overall response system reliability was demonstrated with a simple simulation example. Reliability analysis appears an attractive way to integrate information from the substantial investment in detailed assessments for stockpile delivery and dispensing to provide a view of likely future response performance.

  2. 20 CFR 671.120 - Who is eligible to apply for national emergency grants?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Who is eligible to apply for national emergency grants? 671.120 Section 671.120 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.120 Who is eligible to apply for...

  3. 20 CFR 671.120 - Who is eligible to apply for national emergency grants?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Who is eligible to apply for national emergency grants? 671.120 Section 671.120 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.120 Who is eligible to apply for...

  4. 3 CFR - Continuation of the National Emergency With Respect to the Western Balkans

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to the Western Balkans Presidential Documents Other Presidential Documents Notice of June 22, 2012 Continuation of the National Emergency With Respect to the Western Balkans On June 26, 2001, by Executive Order...

  5. 3 CFR - Continuation of the National Emergency With Respect to Transnational Criminal Organizations

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Transnational Criminal Organizations Presidential Documents Other Presidential Documents Notice of July 19, 2013 Continuation of the National Emergency With Respect to Transnational Criminal Organizations On July 24, 2011, by Executive Order 1358...

  6. Trends in National Emergency Medicine Conference Didactic Lectures Over a 6-Year Period.

    PubMed

    Gottlieb, Michael; Riddell, Jeff; Njie, Abdoulie

    2017-01-01

    National conference didactic lectures have traditionally featured hour-long lecture-based presentations. However, there is evidence that longer lectures can lead to both decreased attention and retention of information. The authors sought to identify trends in lecture duration, lecture types, and number of speakers at four national emergency medicine (EM) conferences over a 6-year period. The authors performed a retrospective analysis of the length, number of speakers, and format of didactic lectures at four different national EM conferences over 6 years. The authors abstracted data from the national academic assemblies for the four largest not-for-profit EM organizations in the United States: American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine. There was a significant yearly decrease in the mean lecture lengths for three of the four conferences. There was an increase in the percentage of rapid fire sessions over the preceding 2 years with a corresponding decrease in the percentage of general educational sessions. There was no significant difference in the mean number of speakers per lecture. An analysis of 4210 didactic lecture sessions from the annual meetings of four national EM organizations over a 6-year period showed significant decreases in mean lecture length. These findings can help to guide EM continuing medical education conference planning and research.

  7. Employee Perceptions of Their Organization's Level of Emergency Preparedness Following a Brief Workplace Emergency Planning Educational Presentation.

    PubMed

    Renschler, Lauren A; Terrigino, Elizabeth A; Azim, Sabiya; Snider, Elsa; Rhodes, Darson L; Cox, Carol C

    2016-06-01

    A brief emergency planning educational presentation was taught during work hours to a convenience sample of employees of various workplaces in Northern Missouri, USA. Participants were familiarized with details about how an emergency plan is prepared by management and implemented by management-employee crisis management teams - focusing on both employee and management roles. They then applied the presentation information to assess their own organization's emergency preparedness level. Participants possessed significantly (p < 0.05) higher perceptions of their organization's level of emergency preparedness than non-participants. It is recommended that an assessment of organizational preparedness level supplement emergency planning educational presentations in order to immediately apply the material covered and encourage employees to become more involved in their organization's emergency planning and response. Educational strategies that involve management-employee collaboration in activities tailored to each workplace's operations and risk level for emergencies should be implemented.

  8. 3 CFR - Continuation of the National Emergency With Respect to Export Control Regulations

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Export Control Regulations Presidential Documents Other Presidential Documents Notice of August 8, 2013 Continuation of the National Emergency With Respect to Export Control Regulations On August 17, 2001, consistent with the authority provided t...

  9. 3 CFR - Continuation of the National Emergency With Respect to the Western Balkans

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Western Balkans Presidential Documents Other Presidential Documents Notice of June 22, 2009 Continuation of the National Emergency With Respect to the Western Balkans On June 26, 2001, by Executive Order 13219, the President declared a...

  10. 3 CFR - Continuation of the National Emergency With Respect to the Western Balkans

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Western Balkans Presidential Documents Other Presidential Documents Notice of June 17, 2013 Continuation of the National Emergency With Respect to the Western Balkans On June 26, 2001, by Executive Order 13219, the President declared a...

  11. 3 CFR - Continuation of the National Emergency With Respect to the Western Balkans

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to the Western Balkans Presidential Documents Other Presidential Documents Notice of June 23, 2011 Continuation of the National Emergency With Respect to the Western Balkans On June 26, 2001, by Executive Order 13219, the President declared a...

  12. Relationships among moral distress, level of practice independence, and intent to leave of nurse practitioners in emergency departments: results from a national survey.

    PubMed

    Trautmann, Jennifer; Epstein, Elizabeth; Rovnyak, Virginia; Snyder, Audrey

    2015-01-01

    The aims of this research study were to investigate moral distress among emergency department (ED) nurse practitioners (NPs) and examine relationships between moral distress and level of practice independence as well as intent to leave a position. Moral distress has been studied regarding registered nurses and physicians (MDs) but less so in NPs. It is important to explore moral distress in NPs because they tread a unique path between nursing and physician roles. Moral distress may play a significant role in staff nurses' intention to leave practice, and level of practice independence is found to have a relationship with NPs' intention to leave. A convenience sample of ED NPs was obtained from a mailing list of a national nursing specialty organization, the Emergency Nurses Association. Using a correlational design, survey methods assessed moral distress with the Moral Distress Scale-Revised (MDS-R), level of practice independence with the Dempster Practice Behavior Scale, and intent to leave with self-report. Correlational and regression analyses of data were conducted to characterize moral distress among ED NPs and associations between moral distress, level of practice independence, and intent to leave. Results found ED NPs do experience moral distress with poor patient care results from inadequate staff communication and working with incompetent coworkers in their practice. The MDS-R was a significant predictor of intention to leave among respondents. This study is the first of its kind to explore moral distress in ED NPs. Results suggest moral distress influences ED NPs' intent to leave their position. Further studies are needed to explore the findings from this research and to formulate interventions to alleviate moral distress in ED NPs and improve retention in the clinical setting.

  13. Emergency Medical Technician-Ambulance: National Standard Curriculum. Student Study Guide (Third Edition).

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This student study guide is one of three documents prepared for the Emergency Medical Technician (EMT), National Standard Curriculum. The course is designed to develop skills in symptom recognition and in all emergency care procedures and techniques currently considered to be within the responsibilities of an EMT providing emergency medical care…

  14. National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.

    PubMed

    Kinsman, Jeremiah M; Robinson, Kathy

    2018-02-27

    Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR). State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment. As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist. 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited

  15. 3 CFR - Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered in Colombia Presidential Documents Other Presidential Documents Notice of October 16, 2013 Continuation of the National Emergency With Respect to Significant...

  16. 3 CFR - Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered in Colombia Presidential Documents Other Presidential Documents Notice of October 17, 2012 Continuation of the National Emergency With Respect to Significant...

  17. 3 CFR - Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered in Colombia Presidential Documents Other Presidential Documents Notice of October 19, 2011 Continuation of the National Emergency With Respect to Significant...

  18. 47 CFR 11.54 - EAS operation during a National Level emergency.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... emergency, EAS Participants may transmit in lieu of the EAS audio feed an audio feed of the President's voice message from an alternative source, such as a broadcast network audio feed. [77 FR 16705, Mar. 22...

  19. 47 CFR 11.54 - EAS operation during a National Level emergency.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... emergency, EAS Participants may transmit in lieu of the EAS audio feed an audio feed of the President's voice message from an alternative source, such as a broadcast network audio feed. [77 FR 16705, Mar. 22...

  20. 47 CFR 11.54 - EAS operation during a National Level emergency.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... emergency, EAS Participants may transmit in lieu of the EAS audio feed an audio feed of the President's voice message from an alternative source, such as a broadcast network audio feed. [77 FR 16705, Mar. 22...

  1. Emergency Medical Services Instructor Training Program of the National Standard Curriculum Revised

    DOT National Transportation Integrated Search

    1996-05-01

    In 1986, the National Highway Traffic Safety Administration (NHTSA) developed the first edition of the "Emergency Medical Services Instructor Training Program" to teach instructor skills to Emergency Medical Services (EMS) experts. In 1990, NHTSA rev...

  2. Implementing a national early awareness and alert system for new and emerging health technologies in Italy: the COTE Project.

    PubMed

    Migliore, Antonio; Perrini, Maria Rosaria; Jefferson, Tom; Cerbo, Marina

    2012-07-01

    The aim of this study was to establish a national Early Awareness and Alert (EAA) system for the identification and assessment of new and emerging health technologies in Italy. In 2008, Agenas, a public body supporting Regions and the Ministry of Health (MoH) in health services research, started a project named COTE (Observatory of New and Emerging Health Technologies) with the ultimate aim of implementing a national EAA system. The COTE project involved all stakeholders (MoH, Regions, Industry, Universities, technical government bodies, and Scientific Societies), in defining the key characteristics and methods of the EAA system. Agreement with stakeholders was reached using three separate workshops. During the workshops, participants shared and agreed methods for identification of new and emerging health technologies, prioritization, and assessment. The structure of the Horizon Scanning (HS) reports was discussed and defined. The main channels for dissemination of outputs were identified as the EuroScan database, and the stakeholders' Web portals. During the final workshop, Agenas presented the first three HS reports produced at national level and proposed the establishment of a permanent national EAA system. The COTE Project created the basis for a permanent national EAA system in Italy. An infrastructure to enable the stakeholders network to grow was created, methods to submit new and emerging health technologies for possible evaluation were established, methods for assessment of the technologies selected were defined, and the stakeholders involvement was delineated (in the identification, assessment, and dissemination stages).

  3. 3 CFR - Continuation of the National Emergency With Respect to the Stabilization of Iraq

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to the Stabilization of Iraq Presidential Documents Other Presidential Documents Notice of May 18, 2012 Continuation of the National Emergency With Respect to the Stabilization of Iraq On May 22, 2003...

  4. 75 FR 55659 - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    ...), I am continuing for 1 year the national emergency previously declared on September 14, 2001, in Proclamation 7463, with respect to the terrorist attacks of September 11, 2001, and the continuing and... national emergency declared on September 14, 2001, and the powers and authorities adopted to deal with that...

  5. 3 CFR - Continuation of the National Emergency With Respect to Iran

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... national security, foreign policy, and economy of the United States constituted by the situation in Iran... to Iran Presidential Documents Other Presidential Documents Notice of November 12, 2009 Continuation of the National Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the...

  6. 15 CFR 700.30 - Priorities and allocations in a national emergency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Priorities and allocations in a national emergency. 700.30 Section 700.30 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY...

  7. Benchmarking against the National Emergency Laparotomy Audit recommendations.

    PubMed

    Ho, Yiu Ming; Cappello, Julie; Kousary, Ramin; McGowan, Brian; Wysocki, Arkadiusz P

    2018-05-01

    The Royal College of Anaesthetists published the National Emergency Laparotomy Audit (NELA) to describe and compare inpatient care and outcomes of major emergency abdominal surgery in England and Wales in 2015 and 2016. The purpose of this article is to compare emergency abdominal surgical care and mortality in a regional hospital (Logan Hospital, Queensland, Australia) with NELA results. Data were extracted from two databases. All deaths from May 2010 to April 2015 were reviewed and patients who had an emergency abdominal operation within 30 days of death were identified. The health records of all patients who underwent abdominal surgery were extracted and those who had an emergency laparotomy were identified for analysis. Three hundred and fifty patients underwent emergency laparotomy and were included in the analysis. The total 30-day mortality during this 5-year period was 9.7%. Factors affecting mortality included age, Portsmouth-Physiological and Operative Severity Score (P-POSSUM) and admission source. Timing of antibiotic administration, use of perioperative medical service and frequency of intensive care admission were the same in patients who died and survived. Mortality in patients following emergency laparotomy at Logan Hospital compares favourably with 11.1% reported by NELA. This may be partly attributable to case mix distribution as for each P-POSSUM risk Logan Hospital mortality was at the upper end of that reported by NELA. Further Australia data are required. Improved compliance with NELA recommendations may improve outcomes. © 2017 Royal Australasian College of Surgeons.

  8. Low oxygen saturation is associated with pre-hospital mortality among non-traumatic patients using emergency medical services: A national database of Thailand.

    PubMed

    Sittichanbuncha, Yuwares; Savatmongkorngul, Sorrawit; Jawroongrit, Puchong; Sawanyawisuth, Kittisak

    2015-09-01

    Pre-hospital emergency medical services are an important network for Emergency Medicine. It has been shown to reduce morbidity and mortality of patients by medical procedures. The Thai government established pre-hospital emergency medical services in 2008 to improve emergency medical care. Since then, there are limited data at the national level on mortality rates with pre-hospital care and the risk factors associated with mortality in non-traumatic patients. To study the pre-hospital mortality rate and factors associated with mortality in non-traumatic patients using the emergency medical service in Thailand. This study retrieved medical data from the National Institute for Emergency Medicine, NIEMS. The inclusion criteria were adult patients above the age of 15 who received medical services by the emergency medical services in Thailand (except Bangkok) from April 1st, 2011 to March 31st, 2012. Patients were excluded if there was no treatment during pre-hospital period, if they were trauma patients, or if their medical data was incomplete. Patients were categorized as either in the survival or non-survival group. Factors associated with mortality were examined by multivariate logistic regression analysis. During the study period, there were 127,602 non-traumatic patients who used pre-hospital emergency medical services in Thailand. Of those, 98,587 patients met the study criteria. For the statistical analyses, there were 66,760 patients who had complete clinical investigations. The mortality rate in this group was 1.89%. Only oxygen saturation was associated with mortality by multivariate logistic regression analysis. The adjusted OR was 0.922 (95% CI 0.8550.994). Low oxygen saturation is significantly associated with pre-hospital mortality in a national database of non-traumatic patients using emergency medical services in Thailand. During pre-hospital care, oxygen level should be monitored and promptly treated. Pulse oximetry devices should be available in all

  9. Cubesats: Cost-effective science and technology platforms for emerging and developing nations

    NASA Astrophysics Data System (ADS)

    Woellert, Kirk; Ehrenfreund, Pascale; Ricco, Antonio J.; Hertzfeld, Henry

    2011-02-01

    The development, operation, and analysis of data from cubesats can promote science education and spur technology utilization in emerging and developing nations. This platform offers uniquely low construction and launch costs together with a comparative ubiquity of launch providers; factors that have led more than 80 universities and several emerging nations to develop programs in this field. Their small size and weight enables cubesats to “piggyback” on rocket launches and accompany orbiters travelling to Moon and Mars. It is envisaged that constellations of cubesats will be used for larger science missions. We present a brief history, technology overview, and summary of applications in science and industry for these small satellites. Cubesat technical success stories are offered along with a summary of pitfalls and challenges encountered in both developed and emerging nations. A discussion of economic and public policy issues aims to facilitate the decision-making process for those considering utilization of this unique technology.

  10. 47 CFR 11.43 - National level participation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false National level participation. 11.43 Section 11...) Organization § 11.43 National level participation. Entities that wish to voluntarily participate in the national level EAS may submit a written request to the Chief, Public Safety and Homeland Security Bureau...

  11. Idaho National Laboratory Emergency Readiness Assurance Plan — Fiscal Year 2016

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

    None, None

    Battelle Energy Alliance, LLC, the prime contractor for Idaho National Laboratory (INL), provides this Emergency Readiness Assurance Plan (ERAP) for Fiscal Year 2016 in accordance with DOE O 151.1C, “Comprehensive Emergency Management System.” The ERAP documents the readiness of the INL Emergency Management Program using emergency response planning and preparedness activities as the basis. It describes emergency response planning and preparedness activities, and where applicable, summarizes and/or provides supporting information in tabular form for easy access to data. The ERAP also provides budget, personnel, and planning forecasts for Fiscal Year 2017. Specifically, the ERAP assures the Department of Energy Idahomore » Operations Office that stated emergency capabilities at INL are sufficient to implement PLN 114, “INL Emergency Plan/RCRA Contingency Plan.”« less

  12. Idaho National Laboratory Emergency Readiness Assurance Plan — Fiscal Year 2014

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

    Bush, Shane

    Battelle Energy Alliance, LLC, the prime contractor for Idaho National Laboratory (INL), provides this Emergency Readiness Assurance Plan (ERAP) for Fiscal Year 2014 in accordance with DOE O 151.1C, “Comprehensive Emergency Management System.” The ERAP documents the readiness of the INL Emergency Management Program using emergency response planning and preparedness activities as the basis. It describes emergency response planning and preparedness activities, and where applicable, summarizes and/or provides supporting information in tabular form for easy access to data. The ERAP also provides budget, personnel, and planning forecasts for Fiscal Year 2015. Specifically, the ERAP assures the Department of Energy Idahomore » Operations Office that stated emergency capabilities at INL are sufficient to implement PLN-114, “INL Emergency Plan/RCRA Contingency Plan.”« less

  13. 3 CFR - Continuation of the National Emergency With Respect to the Situation in Zimbabwe

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Situation in Zimbabwe Presidential Documents Other Presidential Documents Notice of March 1, 2013 Continuation of the National Emergency With Respect to the Situation in Zimbabwe On March 6, 2003, by Executive Order 13288, the President...

  14. 3 CFR - Continuation of the National Emergency With Respect to the Situation in Zimbabwe

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to the Situation in Zimbabwe Presidential Documents Other Presidential Documents Notice of March 2, 2012 Continuation of the National Emergency With Respect to the Situation in Zimbabwe On March 6, 2003, by Executive Order 13288, the President...

  15. 3 CFR - Continuation of the National Emergency With Respect to Iran Executive Order 12957

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to Iran Executive Order 12957 Presidential Documents Other Presidential Documents Notice of March 13, 2012 Continuation of the National Emergency With Respect to Iran Executive Order 12957 On March 15, 1995, by Executive Order 12957, the President...

  16. 48 CFR 52.211-14 - Notice of Priority Rating for National Defense, Emergency Preparedness, and Energy Program Use.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for National Defense, Emergency Preparedness, and Energy Program Use. 52.211-14 Section 52.211-14... for National Defense, Emergency Preparedness, and Energy Program Use. As prescribed in 11.604(a), insert the following provision: Notice of Priority Rating for National Defense, Emergency Preparedness...

  17. National Apprenticeship and Training Standards for Emergency Medical Technicians.

    ERIC Educational Resources Information Center

    Employment and Training Administration (DOL), Washington, DC.

    Developed jointly by several professional organizations and government agencies, these national standards depict the essential skills, knowledge, and ability required of certified emergency medical technicians (EMT) to provide optimal prehospital care and transportation to the sick and injured. Topics covered include definitions of terms EMT's…

  18. 3 CFR - Continuation of the National Emergency With Respect to the Stabilization of Iraq

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to the Stabilization of Iraq Presidential Documents Other Presidential Documents Notice of May 17, 2011 Continuation of the National Emergency With Respect to the Stabilization of Iraq On May 22, 2003, by Executive Order 13303, the President declare...

  19. 3 CFR - Continuation of the National Emergency With Respect to the Stabilization of Iraq

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to the Stabilization of Iraq Presidential Documents Other Presidential Documents Notice of May 12, 2010 Continuation of the National Emergency With Respect to the Stabilization of Iraq On May 22, 2003, by Executive Order 13303, the President declare...

  20. 3 CFR - Continuation of the National Emergency With Respect to the Stabilization of Iraq

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Stabilization of Iraq Presidential Documents Other Presidential Documents Notice of May 17, 2013 Continuation of the National Emergency With Respect to the Stabilization of Iraq On May 22, 2003, by Executive Order 13303, the President declare...

  1. 3 CFR - Continuation of the National Emergency With Respect to the Stabilization of Iraq

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Stabilization of Iraq Presidential Documents Other Presidential Documents Notice of May 19, 2009 Continuation of the National Emergency With Respect to the Stabilization of Iraq On May 22, 2003, by Executive Order 13303, the President declare...

  2. Adoption of One Health in Thailand's National strategic plan for emerging infectious diseases.

    PubMed

    Sommanustweechai, Angkana; Iamsirithaworn, Sopon; Patcharanarumol, Walaiporn; Kalpravidh, Wantanee; Tangcharoensathien, Viroj

    2017-02-01

    This study illustrates how Thailand adopted the One Health concept. Massive socio-economic and health consequences of emerging infectious diseases, especially Avian Influenza in 2004, led to recognition of the importance of and need for One Health. Based on collaboration and consultative meetings between the national actors and international development partners, Thailand adopted One Health to drive more effective containment of Emerging Infectious Diseases. This concept gained support from the non-governmental and civil society organizations through processes of the National Health Assembly. In 2012, a Cabinet resolution endorsed a National Strategic Plan for Emerging Infectious Diseases (2013-2016), in which One Health appeared as a core principle. Collaboration among multi-disciplinary groups of professionals, particularly epidemiologists trained in Field Epidemiology Training Programs (FETP), including FETP, FETP-veterinarian, and FETP-wildlife veterinarians, promoted implementation of One Health.

  3. Biosafety Practices and Emergency Response at the Idaho National Laboratory and Los Alamos National Laboratory

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

    Frank F. Roberto; Dina M. Matz

    2008-03-01

    Strict federal regulations govern the possession, use, and transfer of pathogens and toxins with potential to cause harm to the public, either through accidental or deliberate means. Laboratories registered through either the Centers for Disease Control and Prevention (CDC), the U.S. Dept. of Agriculture (USDA), or both, must prepare biosafety, security, and incident response plans, conduct drills or exercises on an annual basis, and update plans accordingly. At the Idaho National Laboratory (INL), biosafety, laboratory, and emergency management staff have been working together for 2 years to satisfy federal and DOE/NNSA requirements. This has been done through the establishment ofmore » plans, training, tabletop and walk-through exercises and drills, and coordination with local and regional emergency response personnel. Responding to the release of infectious agents or toxins is challenging, but through familiarization with the nature of the hazardous biological substances or organisms, and integration with laboratory-wide emergency response procedures, credible scenarios are being used to evaluate our ability to protect workers, the public, and the environment from agents we must work with to provide for national biodefense.« less

  4. Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study.

    PubMed

    Dawson, Samantha L; Baker, Tim; Salzman, Scott

    2015-04-01

    There is little evidence that useful electronic data could be collected at Australian small rural emergency services. If in future their funding model changed to the Activity-Based Funding model, then they would need to collect and submit more data. We determine whether it is possible to collect episode-level data at six small rural emergency services and quantify the accuracy of eight fields. A prospective cross-sectional study. South-West Victoria, Australia. Six small rural emergency services. We collected and audited episode-level emergency data from participating services between 1 February 2011 and 31 January 2012. A random sample of these data were audited monthly. Research assistants located at each service supported data entry and audited data accuracy for four hours per week. Rates for data completeness, accuracy and total accuracy were calculated using audit data. Episode-level data were collected for 20 224 presentations across six facilities. The audit dataset consisted of 8.5% (1504/17 627) of presentations from five facilities. For all fields audited, the accuracy of entered data was high (>93%).Triage category was deemed appropriate for 95.9% (95% confidence interval (CI): 94.9-96.9%) of the patient records reviewed. Some procedures were missing (28.7%, 95%CI: 27.2-30.3%). No significant improvement in data accuracy over 12 months was observed. All six services collected useful episode-level data for 12-months with four hours per week of assistance. Data entry accuracy was high for all fields audited, and data entry completeness was low for procedures. © 2015 National Rural Health Alliance Inc.

  5. 76 FR 70317 - Continuation of the National Emergency With Respect to Weapons of Mass Destruction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... proliferation of nuclear, biological, and chemical weapons (weapons of mass destruction) and the means of...--Continuation of the National Emergency With Respect to Weapons of Mass Destruction #0; #0; #0; Presidential... the National Emergency With Respect to Weapons of Mass Destruction On November 14, 1994, by Executive...

  6. Personality and happiness: a national-level analysis.

    PubMed

    Steel, Piers; Ones, Deniz S

    2002-09-01

    The possibility that national personality traits could explain national subjective well-being (SWB) is controversial, with many researchers arguing that traits are irrelevant to any national-level analysis. The weaknesses of this standpoint are reviewed, followed by a series of empirical investigations. Using Eysenck's 3-factor model (H. J. Eysenck & S. B. G. Eysenck, 1975) and P. T. Costa and R. M. McCrae's (1992b) 5-factor model, the authors found that Neuroticism and Extraversion correlated significantly with national SWB. Lie scale scores were also related strongly to national SWB. Neuroticism and Extraversion incrementally predicted SWB above gross national product per capita. The strength of these results indicates that personality can have stronger relationships at national levels of analysis than at the individual level. National personality traits appear to be unwisely neglected, having considerable but largely unconsidered explanatory power.

  7. 20 CFR 671.125 - What are the requirements for submitting applications for national emergency grants?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What are the requirements for submitting applications for national emergency grants? 671.125 Section 671.125 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.125 What are the...

  8. 20 CFR 671.150 - How do statutory and workflex waivers apply to national emergency grants?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How do statutory and workflex waivers apply to national emergency grants? 671.150 Section 671.150 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.150 How do statutory...

  9. 20 CFR 671.125 - What are the requirements for submitting applications for national emergency grants?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the requirements for submitting applications for national emergency grants? 671.125 Section 671.125 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.125 What are the...

  10. 20 CFR 671.150 - How do statutory and workflex waivers apply to national emergency grants?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false How do statutory and workflex waivers apply to national emergency grants? 671.150 Section 671.150 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.150 How do statutory...

  11. Child Abuse and Neglect: Critical First Steps in Response to a National Emergency.

    ERIC Educational Resources Information Center

    United States Advisory Board on Child Abuse and Neglect, Washington, DC.

    The need for a national strategy on child abuse and neglect has reached crisis proportions. This report declares child abuse and neglect a national emergency and presents the key elements of a national response to this crisis. Following an executive summary, the report is divided into three parts. Part 1, "The Need for a National Strategy on…

  12. Emergency Medical Technician-Ambulance: National Standard Curriculum. Instructor's Lesson Plans (Third Edition).

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This set of instructor's lesson plans is one of three documents prepared for the Emergency Medical Technician (EMT) National Standard Curriculum. It contains detailed outlines of course content and guidance for teaching each course lesson. The training course contains 33 lessons covering all emergency medical techniques currently considered to be…

  13. Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study.

    PubMed

    Ramacciati, Nicola; Ceccagnoli, Andrea; Addey, Beniamino; Rasero, Laura

    2018-05-01

    Physical and verbal aggression against health professionals, particularly nurses, is globally serious and widespread, with the most vulnerable being nurses working in the Accident and Emergency Department. Most international research into this issue focused on quantifying aggression, describing its nature, identifying perpetrators, stratifying risk and implementing preventive or mitigating interventions. Few studies investigated the nurses' subjective perceptions. As part of the 2016 Italian National Survey on Violence against Accident and Emergency Nurses, our research team collected qualitative data to explore their perceptions of Workplace Violence. From 19th July 2016 to 19th March 2017 we distributed online a 39-item validated questionnaire to 15,618 Emergency Nurses working in 668 Italian National Health Service Accident and Emergency Departments in all 20 Italian Regions. Answers were analysed using van Kaan's method. 1100 Emergency Nurses responded to the survey and 265 replied to our focus question. There were 144 Females, 119 Males, 2 not stated, average age 42 ± 9 years, average work experience 18 ± 9 years, average Accident and Emergency Department experience 11 ± 8 years. Four major themes emerged: the nurses' perception of physical and verbal aggression, precipitating factors, consequences, and solutions. These themes confirmed previous findings and showed that Italian nursing staff's perceptions of physical and verbal aggression is the same as emergency nurses working worldwide. How Italian Accident and Emergency nurses perceive Workplace Violence adds to our knowledge of the issue and contributes to finding shared solutions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Emerging & re-emerging infections in India: An overview

    PubMed Central

    Dikid, T.; Jain, S.K.; Sharma, A.; Kumar, A.; Narain, J.P.

    2013-01-01

    The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed. PMID:24056553

  15. Emerging & re-emerging infections in India: an overview.

    PubMed

    Dikid, T; Jain, S K; Sharma, A; Kumar, A; Narain, J P

    2013-01-01

    The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed.

  16. Emergency Medical Services Program Guide.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

  17. From Charity to Security: The Emergence of the National School Lunch Program

    ERIC Educational Resources Information Center

    Rutledge, Jennifer Geist

    2015-01-01

    This paper explores the historical formation of the National School Lunch Program (NSLP) in the United States and argues that programme emergence depended on the ability of policy entrepreneurs to link the economic concerns of agricultural production with the ideational concern of national security. Using a historical institutionalist framework…

  18. Recommended minimal emergency equipment and resources for schools: national consensus group report.

    PubMed

    Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

    2003-06-01

    Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.

  19. 3 CFR - Continuation of the National Emergency With Respect to Sudan

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... in Sudan's Darfur region posed an unusual and extraordinary threat to the national security and... emergency and to implement the Darfur Peace and Accountability Act of 2006 (Public Law 109-344). Because the...

  20. Approaches to emergency management teaching at the master's level.

    PubMed

    Alexander, David

    2013-01-01

    Training and education enable emergency managers to deal with complex situations, create durable networks of people with appropriate expertise, and ensure that knowledge is utilized to improve resilience in the face of disaster risk. Although there is a discrete literature on emergency management training, few attempts have been made to create an overview that discusses the key issues and proposes a standardized approach. This article examines the nature of training and education in emergency and disaster management. It analyzes the composition and requirements of courses at the master's degree level, which is considered to be the most appropriate tier for in-depth instruction in this field. This article defines "training" and "education" in the context of emergency management courses. It reviews the developing profile of the emergency manager in the light of training requirements. This article examines the question of whether emergency management is a branch of management science or whether it is something distinct and separate. Attention is given to the composition of a core curriculum and to the most appropriate pedagogical forms of delivering it. The article reviews the arguments for and against standardization of the curriculum and describes some of the pedagogical methods for delivering courses. Briefly, it considers the impact on training and education of new pedagogic methods based on information technology. It is concluded that the master's level is particularly suited to emergency and crisis management education, as it enables students to complement the in-depth knowledge they acquired in their disciplinary first degrees with a broader synthetic approach at the postgraduate level. Some measures of standardization of course offerings are desirable, in favor of creating a core curriculum that will ensure that essential core knowledge is imparted. Education and training in this field should include problem-solving approaches that enable students to learn

  1. A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs.

    PubMed

    Martin, Shelly D; Bush, Anneke C; Lynch, Julia A

    2006-09-01

    Domestic terrorism is a real threat focusing on a need to engage in effective emergency preparedness planning and training. Front-line physicians are an important component of any emergency preparedness plan. Potential victims of an attack include children who have unique physiologic and psychological vulnerabilities in disasters. Front-line providers need to have adequate training to effectively participate in local planning initiatives and to recognize and treat casualties including children. The goal of the survey was to assess the current state of terrorism preparedness training, including child victims, by emergency medicine, family practice, and pediatric residency programs in the United States and to assess methods of training and barriers to establishing effective training. A survey was e-mailed to a comprehensive list of all US pediatric, family practice, and emergency medicine residency programs 3 times between September 2003 and January 2004. The survey measured the perceived risk of terrorist attack, level of training by type of attack, level of training regarding children, method of training, and barriers to training. Overall, 21% of programs responded (46 of 182 pediatric, 75 of 400 family practice, and 29 of 125 emergency medicine programs). Across all of the event types, emergency medicine programs were more likely to report adequate/comprehensive training. However, < 50% of emergency medicine programs report adequate training for children. Didactic classroom-based lectures were the most commonly used method of training. Emergency medicine programs were more likely to use scenario-based exercises. Among programs that use scenario exercises, 93% report that they never (40%) or only sometimes (53%) incorporate child victims into the scenarios. Time, funding, access to subject matter experts, and availability of training material are the most important barriers to effective training. Children are a precious national resource and a vulnerable population

  2. 3 CFR - Continuation of the National Emergency With Respect to Actions of Certain Persons to Undermine...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Actions of Certain Persons to Undermine the Sovereignty of Lebanon or Its Democratic Processes and Institutions Presidential Documents Other Presidential Documents Notice of July 28, 2011 Continuation of the National Emergency With Respect to...

  3. Assessment and Evaluation of National Human Resource Development System Competitiveness in Emerging Countries

    ERIC Educational Resources Information Center

    Oh, HunSeok; Seo, DongIn; Kim, JuSeuk; Yoo, SangOk; Seong, HeeChang

    2015-01-01

    This study assessed and evaluated the competitiveness of national human resource development (NHRD) systems in emerging countries with potential for growth. The literature on emerging countries and NHRD systems was reviewed. The study developed a model mechanism with forty-one indices and nine sub-components for the NHRD system assessment in…

  4. Policy mapping for establishing a national emergency health policy for Nigeria

    PubMed Central

    Aliyu, Zakari Y

    2002-01-01

    Background The number of potential life years lost due to accidents and injuries though poorly studied has resulted in tremendous economic and social loss to Nigeria. Numerous socio-cultural, economic and political factors including the current epidemic of ethnic and religious conflicts act in concert in predisposing to and enabling the ongoing catastrophe of accident and injuries in Nigeria. Methods Using the "policymaker", Microsoft-Windows® based software, the information generated on accidents and injuries and emergency health care in Nigeria from literature review, content analysis of relevant documents, expert interviewing and consensus opinion, a model National Emergency Health Policy was designed and analyzed. A major point of analysis for the policy is the current political feasibility of the policy including its opportunities and obstacles in the country. Results A model National Emergency Health Policy with policy goals, objectives, programs and evaluation benchmarks was generated. Critical analyses of potential policy problems, associated multiple players, diverging interests and implementation guidelines were developed. Conclusions "Political health modeling" a term proposed here would be invaluable to policy makers and scholars in developing countries in assessing the political feasibility of policy managing. Political modeling applied to the development of a NEHP in Nigeria would empower policy makers and the policy making process and would ensure a sustainable emergency health policy in Nigeria. PMID:12181080

  5. Management of information within emergencies departments in developing countries: analysis at the National Emergency Department in Benin.

    PubMed

    Ahanhanzo, Yolaine Glèlè; Kpozehouen, Alphonse; Sopoh, Ghislain; Sossa-Jérôme, Charles; Ouedraogo, Laurent; Wilmet-Dramaix, Michèle

    2016-01-01

    The management of health information is a key pillar in both emergencies reception and handling facilities, given the strategic position and the potential of these facilities within hospitals, and in the monitoring of public health and epidemiology. With the technological revolution, computerization made the information systems evolve in emergency departments, especially in developed countries, with improved performance in terms of care quality, productivity and patient satisfaction. This study analyses the situation of Benin in this field, through the case of the Academic Clinic of Emergency Department of the National University Teaching Hospital of Cotonou, the national reference hospital. The study is cross-sectional and evaluative. Collection techniques are literature review and structured interviews. The components rated are resources, indicators, data sources, data management and the use-dissemination of the information through a model adapted from Health Metrics Network framework. We used quantitative and qualitative analysis. The absence of a regulatory framework restricts the operation of the system in all components and accounts for the lack and inadequacy of the dedicated resources. Dedication of more resources for this system for crucial needs such as computerization requires sensitization and greater awareness of the administrative authorities about the fact that an effective health information management system is of prime importance in this type of facility.

  6. 76 FR 24791 - Continuation of the National Emergency With Respect to the Actions of the Government of Syria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-03

    ... National Emergency With Respect to the Actions of the Government of Syria On May 11, 2004, pursuant to his authority under the International Emergency Economic Powers Act, 50 U.S.C. 1701-1706, and the Syria... Government of Syria. To deal with this national emergency, Executive Order 13338 authorized the blocking of...

  7. 3 CFR - Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle East Peace Process Presidential Documents Other Presidential Documents Notice of January 20, 2010 Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle...

  8. 3 CFR - Continuation of the National Emergency with Respect to Terrorists Who Threaten to Disrupt the...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency with Respect to Terrorists Who Threaten to Disrupt the Middle East Peace Process Presidential Documents Other Presidential Documents Notice of January 15, 2009 Continuation of the National Emergency with Respect to Terrorists Who Threaten to Disrupt the Middle...

  9. 3 CFR - Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle East Peace Process Presidential Documents Other Presidential Documents Notice of January 19, 2012 Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle...

  10. 3 CFR - Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle East Peace Process Presidential Documents Other Presidential Documents Notice of January 13, 2011 Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle...

  11. 3 CFR - Continuation of the National Emergency With Respect to the Disposition of Russian Highly Enriched...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Disposition of Russian Highly Enriched Uranium Presidential Documents Other Presidential Documents Notice of June 20, 2013 Continuation of the National Emergency With Respect to the Disposition of Russian Highly Enriched Uranium On June 25,...

  12. 3 CFR - Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle East Peace Process Presidential Documents Other Presidential Documents Notice of January 17, 2013 Continuation of the National Emergency With Respect to Terrorists Who Threaten To Disrupt the Middle...

  13. Maternal Evaluations of Children's Emergent Literacy Level, Maternal Mediation in Book Reading, and Children's Emergent Literacy Level: A Comparison Between SES Groups

    ERIC Educational Resources Information Center

    Korat, Ofra; Haglili, Sharon

    2007-01-01

    This study examined whether maternal evaluations of children's emergent literacy (EL) levels, maternal mediation during a book-reading activity with children, and the children's EL levels differ as a function of socioeconomic status (SES; low vs. high), and whether the relationships between these variables differ as a function of SES levels. Study…

  14. Translating national level forest service goals to local level land management: carbon sequestration

    Treesearch

    Steven McNulty; Emrys Treasure; Lisa Jennings; David Meriwether; David Harris; Paul Arndt

    2017-01-01

    The USDA Forest Service has many national level policies related to multiple use management. However, translating national policy to stand level forest management can be difficult. As an example of how a national policy can be put into action, we examined three case studies in which a desired future condition is evaluated at the national, region, and local scale. We...

  15. National survey of emergency physicians for transient ischemic attack (TIA) risk stratification consensus and appropriate treatment for a given level of risk.

    PubMed

    Perry, Jeffrey J; Losier, Justin H; Stiell, Ian G; Sharma, Mukul; Abdulaziz, Kasim

    2016-01-01

    Five percent of transient ischemic attack (TIA) patients have a subsequent stroke within 7 days. The Canadian TIA Score uses clinical findings to calculate the subsequent stroke risk within 7 days. Our objectives were to assess 1) anticipated use; 2) component face validity; 3) risk strata for stroke within 7 days; and 4) actions required, for a given risk for subsequent stroke. After a rigorous development process, a survey questionnaire was administered to a random sample of 300 emergency physicians selected from those registered in a national medical directory. The surveys were distributed using a modified Dillman technique. From a total of 271 eligible surveys, we received 131 (48.3%) completed surveys; 96.2% of emergency physicians would use a validated Canadian TIA Score; 8 of 13 components comprising the Canadian TIA Score were rated as Very Important or Important by survey respondents. Risk categories for subsequent stroke were defined as minimal-risk: 10% risk of subsequent stroke within 7 days. A validated Canadian TIA Score will likely be used by emergency physicians. Most components of the TIA Score have high face validity. Risk strata are definable, which may allow physicians to determine immediate actions, based on subsequent stroke risk, in the emergency department.

  16. Addressing challenges for future strategic-level emergency management: reframing, networking, and capacity-building.

    PubMed

    Bosomworth, Karyn; Owen, Christine; Curnin, Steven

    2017-04-01

    The mounting frequency and intensity of natural hazards, alongside growing interdependencies between social-technical and ecological systems, are placing increased pressure on emergency management. This is particularly true at the strategic level of emergency management, which involves planning for and managing non-routine, high-consequence events. Drawing on the literature, a survey, and interviews and workshops with Australia's senior emergency managers, this paper presents an analysis of five core challenges that these pressures are creating for strategic-level emergency management. It argues that emphasising 'emergency management' as a primary adaptation strategy is a retrograde step that ignores the importance of addressing socio-political drivers of vulnerabilities. Three key suggestions are presented that could assist the country's strategic-level emergency management in tackling these challenges: (i) reframe emergency management as a component of disaster risk reduction rather than them being one and the same; (ii) adopt a network governance approach; and (iii) further develop the capacities of strategic-level emergency managers. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  17. Wage and Salary Stabilization in a National Security Emergency

    DTIC Science & Technology

    1984-10-01

    Arkansas Houston, Texas Eldorado, AR Bryan, TX Fayetteville, AR Lufkin, TX 2-8 Wage and Salary 2 - 9 . Region VI cont. Fort Smith, AR Waco, TX Jonesboro , AR ...applied to: financial and monetary systems: wages, salaries, and benefits; prices; rents; and rationing of essential goods. These measures are ...in terms of a number of conditions. They are : CONDITION I: Peacetime CONDITION II: National emergency (Threat of war) CONDITION ILIA: Mobilization

  18. Translating National Level Forest Service Goals to Local Level Land Management: Carbon Sequestration

    NASA Astrophysics Data System (ADS)

    McNulty, S.; Treasure, E.

    2017-12-01

    The USDA Forest Service has many national level policies related to multiple use management. However, translating national policy to stand level forest management can be difficult. As an example of how a national policy can be put into action, we examined three case studies in which a desired future condition is evaluated at the national, region and local scale. We chose to use carbon sequestration as the desired future condition because climate change has become a major area of concern during the last decade. Several studies have determined that the 193 million acres of US national forest land currently sequester 11% to 15% of the total carbon emitted as a nation. This paper provides a framework by which national scale strategies for maintaining or enhancing forest carbon sequestration is translated through regional considerations and local constraints in adaptive management practices. Although this framework used the carbon sequestration as a case study, this framework could be used with other national level priorities such as the National Environmental Protection Act (NEPA) or the Endangered Species Act (ESA).

  19. Assistance for emergency health.

    PubMed

    Rivera, Antonio

    2002-03-01

    The public health agencies of Pacific island nations have the responsibility of maintaining health during national emergencies. Assistance for completion of this task is available to the Pacific islands in the form of technical, informational, educational and humanitarian aid. Assistance for Pacific island preparedness and response may originate from local, jurisdictional, regional and international levels. The Internet also now offers many useful resources for disaster education, collaboration and aid. This article discusses mechanisms and resources that Pacific island health officials may utilize to promote emergency health within their own jurisdictions.

  20. National and Rural Housing Policy. Historical Development and Emerging Issues.

    ERIC Educational Resources Information Center

    Reeder, William J.; And Others

    This report traces the historical development of federal housing policy that has promoted a 40% decline in substandard housing and a 20% increase in homeownership over the past 50 years. It presents emerging national and rural housing policy concerns: the proper role of federal, state, and local governments in the mortgage credit and insurance…

  1. 76 FR 37235 - Continuation of the National Emergency With Respect to North Korea

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... of the National Emergency With Respect to North Korea Notice of June 23, 2011--Continuation of the... Respect to North Korea On June 26, 2008, by Executive Order 13466, the President declared a national... North Korea that would otherwise have been lifted pursuant to Proclamation 8271 of June 26, 2008, which...

  2. Emerging Infectious Diseases in Free-Ranging Wildlife–Australian Zoo Based Wildlife Hospitals Contribute to National Surveillance

    PubMed Central

    Cox-Witton, Keren; Reiss, Andrea; Woods, Rupert; Grillo, Victoria; Baker, Rupert T.; Blyde, David J.; Boardman, Wayne; Cutter, Stephen; Lacasse, Claude; McCracken, Helen; Pyne, Michael; Smith, Ian; Vitali, Simone; Vogelnest, Larry; Wedd, Dion; Phillips, Martin; Bunn, Chris; Post, Lyndel

    2014-01-01

    Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases. PMID:24787430

  3. [Capability of national reference laboratories in Latin America to detect emerging resistance mechanisms].

    PubMed

    Corso, Alejandra; Guerriero, Leonor; Pasterán, Fernando; Ceriana, Paola; Callejo, Raquel; Prieto, Mónica; Tuduri, Ezequiel; Lopardo, Horacio; Vay, Carlos; Smayevsky, Jorgelina; Tokumoto, Marta; Alvarez, Jorge Matheu; Pardo, Pilar Ramón; Galas, Marcelo

    2011-12-01

    To evaluate the capability of 17 national reference laboratories participating in the Latin American Quality Control Program in Bacteriology and Antibiotic Resistance (LA-EQAS) to detect emerging resistance mechanisms- namely: resistance of enterobacteria to carbapenems due to the presence of Klebsiella pneumoniae carbapenemase (KPC) and metallo-beta-lactamase (MBL) type IMP, and intermediate resistance of Staphylococcus aureus isolates to vancomycin (vancomycin-intermediate resistant S. aureus-VISA). The following three isolates were sent to the 17 participating LA-EQAS laboratories: KPC -producing Klebsiella pneumoniae PAHO-161, IMP-producing Enterobacter cloacae PAHO-166, and S. aureus PAHO-165 with intermediate resistance to vancomycin. Performance of each of the following operations was evaluated: interpretation of sensitivity tests, detection of the resistance mechanism, and assessment of either inhibition halo size (disk diffusion method) or minimum inhibitory concentration (MIC). Concordance in the detection of resistance mechanisms was 76.4%, 73.3%, and 66.7% for the K. pneumoniae PAHO-161, E. cloacae PAHO-166, and S. aureus PAHO-165 strains, respectively. Concordance between the inhibition areas observed by the participating laboratories and the ranges established by the coordinating laboratory was acceptable for all three isolates, at 90.8%, 92.8%, and 88.9%, respectively. Overall concordance in on the detection of KPC, MBL, and VISA resistance mechanisms was 72.1%. We consider the national reference laboratories in Latin America capable of recognizing these emerging resistance mechanisms and expect that maximum levels of concordance will be reached in the future.

  4. 75 FR 67585 - Continuation of the National Emergency With Respect to Sudan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-02

    ... President determined that the conflict in Sudan's Darfur region posed an unusual and extraordinary threat to... respect to the national emergency and to implement the Darfur Peace and Accountability Act of 2006 (Public...

  5. 77 FR 66357 - Continuation of the National Emergency With Respect to Sudan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-02

    ... in Sudan's Darfur region posed an unusual and extraordinary threat to the national security and... emergency and to implement the Darfur Peace and Accountability Act of 2006 (Public Law 109-344). Because the...

  6. 78 FR 65865 - Continuation of the National Emergency With Respect to Sudan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... in Sudan's Darfur region posed an unusual and extraordinary threat to the national security and... emergency and to implement the Darfur Peace and Accountability Act of 2006 (Public Law 109-344). Because the...

  7. Emergency recompression: clinical audit of service delivery at a national level.

    PubMed

    Ross, John As; Sayer, Martin Dj

    2009-03-01

    Clinical audit is an essential element to the maintenance or improvement of delivery of any medical service. During the development phase of a National Recompression Registration Service for Scotland, clinical audit was initiated to provide a standardised tool to monitor the quality of outcome with respect to the severity of presentation. A functional audit process was an essential consideration for planned future measurement of treatment efficacy at local (single hyperbaric unit) and national (multiple hyperbaric units) scales. The audit process was designed to be undemanding, robust and informative, irrespective of the experience of treatment centre and of the clinician in charge of treatment. The clinical records from 104 cases of divers with decompression illness were used to derive and evaluate measures of severity and clinical outcome that could be used for audit and quality assurance. The various measures of disease severity were examined against clinical outcome and days spent in care after admission to a hyperbaric unit. An initial version of the clinical audit format that was developed from this process is presented.

  8. GPs’ use of defibrillators and the national radio network in emergency primary healthcare in Norway

    PubMed Central

    Zakariassen, Erik; Hunskaar, Steinar

    2008-01-01

    Objective To study the geographic size of out-of-hours districts, the availability of defibrillators and use of the national radio network in Norway. Design Survey. Setting The emergency primary healthcare system in Norway. Subjects A total of 282 host municipalities responsible for 260 out-of-hours districts. Main outcome measures Size of out-of-hours districts, use of national radio network and access to a defibrillator in emergency situations. Results The out-of-hours districts have a wide range of areas, which gives a large variation in driving time for doctors on call. The median longest transport time for doctors in Norway is 45 minutes. In 46% of out-of-hours districts doctors bring their own defibrillator on emergency callouts. Doctors always use the national radio network in 52% of out-of-hours districts. Use of the radio network and access to a defibrillator are significantly greater in out-of-hours districts with a host municipality of fewer then 5000 inhabitants compared with host municipalities of more than 20 000 inhabitants. Conclusion In half of out-of-hours districts doctors on call always use the national radio network. Doctors in out-of-hours districts with a host municipality of fewer than 5000 inhabitants are in a better state of readiness to attend an emergency, compared with doctors working in larger host municipalities. PMID:18570012

  9. 77 FR 5983 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ...--Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc]te d'Ivoire... February 3, 2012 Continuation of the National Emergency With Respect to the Situation in or in Relation to... emergency, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with...

  10. National Assessment of Quality Programs in Emergency Medical Services.

    PubMed

    Redlener, Michael; Olivieri, Patrick; Loo, George T; Munjal, Kevin; Hilton, Michael T; Potkin, Katya Trudeau; Levy, Michael; Rabrich, Jeffrey; Gunderson, Michael R; Braithwaite, Sabina A

    2018-01-01

    This study aims to understand the adoption of clinical quality measurement throughout the United States on an EMS agency level, the features of agencies that do participate in quality measurement, and the level of physician involvement. It also aims to barriers to implementing quality improvement initiatives in EMS. A 46-question survey was developed to gather agency level data on current quality improvement practices and measurement. The survey was distributed nationally via State EMS Offices to EMS agencies nation-wide using Surveymonkey©. A convenience sample of respondents was enrolled between August and November, 2015. Univariate, bivariate and multiple logistic regression analyses were conducted to describe demographics and relationships between outcomes of interest and their covariates using SAS 9.3©. A total of 1,733 surveys were initiated and 1,060 surveys had complete or near-complete responses. This includes agencies from 45 states representing over 6.23 million 9-1-1 responses annually. Totals of 70.5% (747) agencies reported dedicated QI personnel, 62.5% (663) follow clinical metrics and 33.3% (353) participate in outside quality or research program. Medical director hours varied, notably, 61.5% (649) of EMS agencies had <5 hours of medical director time per month. Presence of medical director time was correlated with tracking of QI measures. Air medical [OR 9.64 (1.13, 82.16)] and hospital-based EMS agencies [OR 2.49 (1.36, 4.59)] were more likely to track quality measures compared to fire-based agencies. Agencies in rural only environments were less likely to follow clinical quality metrics. (OR 0.47 CI 0.31 -0.72 p < 0.0004). For those that track QI measures, the most common are; Response Time (Emergency) (68.3%), On-Scene Time (66.4%), prehospital stroke screen (64.6%), aspirin administration (64.5%), and 12 lead ECG in chest pain patients (63.0%). EMS agencies in the United States have significant practice variability with regard to quality

  11. 75 FR 5346 - Comment Request for Information Collection for Workforce Investment Act National Emergency Grant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-02

    ... Emergency Grants (NEGs) which are discretionary grants intended to temporarily expand the service capacity... DEPARTMENT OF LABOR Comment Request for Information Collection for Workforce Investment Act National Emergency Grant Program: Application and Reporting Procedures (OMB Control No. 1205-0439...

  12. The North American Forest Database: going beyond national-level forest resource assessment statistics.

    PubMed

    Smith, W Brad; Cuenca Lara, Rubí Angélica; Delgado Caballero, Carina Edith; Godínez Valdivia, Carlos Isaías; Kapron, Joseph S; Leyva Reyes, Juan Carlos; Meneses Tovar, Carmen Lourdes; Miles, Patrick D; Oswalt, Sonja N; Ramírez Salgado, Mayra; Song, Xilong Alex; Stinson, Graham; Villela Gaytán, Sergio Armando

    2018-05-21

    Forests cannot be managed sustainably without reliable data to inform decisions. National Forest Inventories (NFI) tend to report national statistics, with sub-national stratification based on domestic ecological classification systems. It is becoming increasingly important to be able to report statistics on ecosystems that span international borders, as global change and globalization expand stakeholders' spheres of concern. The state of a transnational ecosystem can only be properly assessed by examining the entire ecosystem. In global forest resource assessments, it may be useful to break national statistics down by ecosystem, especially for large countries. The Inventory and Monitoring Working Group (IMWG) of the North American Forest Commission (NAFC) has begun developing a harmonized North American Forest Database (NAFD) for managing forest inventory data, enabling consistent, continental-scale forest assessment supporting ecosystem-level reporting and relational queries. The first iteration of the database contains data describing 1.9 billion ha, including 677.5 million ha of forest. Data harmonization is made challenging by the existence of definitions and methodologies tailored to suit national circumstances, emerging from each country's professional forestry development. This paper reports the methods used to synchronize three national forest inventories, starting with a small suite of variables and attributes.

  13. 3 CFR - Continuation of the National Emergency With Respect to the Actions of the Government of Syria

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Actions of the Government of Syria Presidential Documents Other Presidential Documents Notice of May 7, 2009 Continuation of the National Emergency With Respect to the Actions of the Government of Syria On May 11, 2004, pursuant to his...

  14. 3 CFR - Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor Presidential Documents Other Presidential Documents Notice of July 20, 2011 Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor On July 22, 2004, by...

  15. 3 CFR - Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor Presidential Documents Other Presidential Documents Notice of July 16, 2009 Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor On July 22, 2004, by...

  16. 3 CFR - Continuation of the National Emergency With Respect to the Actions of the Government of Syria

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Actions of the Government of Syria Presidential Documents Other Presidential Documents Notice of May 7, 2013 Continuation of the National Emergency With Respect to the Actions of the Government of Syria On May 11, 2004, pursuant to his...

  17. 3 CFR - Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor Presidential Documents Other Presidential Documents Notice of July 17, 2013 Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor On July 22, 2004, by...

  18. Preparing for a National Emergency: The Committee on Conservation of Cultural Resources, 1939-1944

    ERIC Educational Resources Information Center

    Aikin, Jane

    2007-01-01

    In March 1940 the U.S. National Resources Planning Board established the Committee on Conservation of Cultural Resources to plan for the protection of federal cultural institutions during national emergencies. The committee provided a mechanism to bring officials together to consider protective measures for and evacuation of valuable books,…

  19. 3 CFR - Continuation of the National Emergency With Respect to the Western Balkans

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... year the national emergency with respect to the Western Balkans. This notice shall be published in the Federal Register and transmitted to the Congress.BARACK OBAMATHE WHITE HOUSE, June 8, 2010. ...

  20. 42 CFR 21.52 - Waiver of entrance qualifications for original appointment in time of war or national emergency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Waiver of entrance qualifications for original appointment in time of war or national emergency. 21.52 Section 21.52 Public Health PUBLIC HEALTH SERVICE... entrance qualifications for original appointment in time of war or national emergency. If, in time of war...

  1. An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

    PubMed

    Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

    2017-01-01

    Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

  2. Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

    PubMed

    Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

    2014-01-01

    The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

  3. Emerging national space launch programs: Economics and safeguards

    NASA Astrophysics Data System (ADS)

    Chow, Brian G.

    Most ballistic missile nonproliferation studies have focused on trends in the numbers and performance of missiles and the resulting security threats. This report concentrates on the economic viability of emerging national space launch programs and the prospects for imposing effective safeguards against the use of space launch technology for military missiles. For the convenience of discussion in this report, a reference to ballistic missiles hereafter means surface-to-surface guided ballistic missiles only. Space launch vehicles (SLV's) are surface-to-space ballistic missiles, and they will be referred to explicitly as 'space launch vehicles' or 'space launchers'. Surface-to-surface unguided ballistic missiles will be referred to as 'rockets.'

  4. 3 CFR 13620 - Executive Order 13620 of July 20, 2012. Taking Additional Steps to Address the National Emergency...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Constitution and the laws of the United States of America, including the International Emergency Economic Powers Act (50 U.S.C. 1701 et seq.) (IEEPA), the National Emergencies Act (50 U.S.C. 1601 et seq.) (NEA), section 5 of the United Nations Participation Act (22 U.S.C. 287c) (UNPA), and section 301 of title 3...

  5. 3 CFR - Continuation of the National Emergency With Respect to North Korea

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... to North Korea Presidential Documents Other Presidential Documents Notice of June 14, 2010 Continuation of the National Emergency With Respect to North Korea On June 26, 2008, by Executive Order 13466... necessary to maintain certain restrictions with respect to North Korea that would otherwise have been lifted...

  6. 3 CFR - Continuation of the National Emergency With Respect to North Korea

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... to North Korea Presidential Documents Other Presidential Documents Notice of June 18, 2012 Continuation of the National Emergency With Respect to North Korea On June 26, 2008, by Executive Order 13466... maintain certain restrictions with respect to North Korea that would otherwise have been lifted pursuant to...

  7. The cultural evolution of emergent group-level traits.

    PubMed

    Smaldino, Paul E

    2014-06-01

    Many of the most important properties of human groups - including properties that may give one group an evolutionary advantage over another - are properly defined only at the level of group organization. Yet at present, most work on the evolution of culture has focused solely on the transmission of individual-level traits. I propose a conceptual extension of the theory of cultural evolution, particularly related to the evolutionary competition between cultural groups. The key concept in this extension is the emergent group-level trait. This type of trait is characterized by the structured organization of differentiated individuals and constitutes a unit of selection that is qualitatively different from selection on groups as defined by traditional multilevel selection (MLS) theory. As a corollary, I argue that the traditional focus on cooperation as the defining feature of human societies has missed an essential feature of cooperative groups. Traditional models of cooperation assume that interacting with one cooperator is equivalent to interacting with any other. However, human groups involve differential roles, meaning that receiving aid from one individual is often preferred to receiving aid from another. In this target article, I discuss the emergence and evolution of group-level traits and the implications for the theory of cultural evolution, including ramifications for the evolution of human cooperation, technology, and cultural institutions, and for the equivalency of multilevel selection and inclusive fitness approaches.

  8. Quantitative analysis of the level of readability of online emergency radiology-based patient education resources.

    PubMed

    Hansberry, David R; D'Angelo, Michael; White, Michael D; Prabhu, Arpan V; Cox, Mougnyan; Agarwal, Nitin; Deshmukh, Sandeep

    2018-04-01

    The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology. Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales. The search terms included the following: abdominal ultrasound, abdominal aortic aneurysm, aortic dissection, appendicitis, cord compression, CT abdomen, cholecystitis, CT chest, diverticulitis, ectopic pregnancy, epidural hematoma, dural venous thrombosis, head CT, MRI brain, MR angiography, MRI spine, ovarian torsion, pancreatitis, pelvic ultrasound, pneumoperitoneum, pulmonary embolism, subarachnoid hemorrhage, and subdural hematoma. Any content that was not written for patients was excluded. The 230 articles that were assessed were written, on average, at a 12.1 grade level. Only 2 of the 230 articles (1%) were written at the third to seventh grade recommended reading level set forth by the National Institutes of Health (NIH) and American Medical Association (AMA). Fifty-two percent of the 230 articles were written so as to require a minimum of a high school education (at least a 12th grade level). Additionally, 17 of the 230 articles (7.3%) were written at a level that exceeded an undergraduate education (at least a 16th grade level). The majority of websites with emergency radiology-related patient education materials are not adhering to the NIH and AMA's recommended reading levels, and it is likely that the average reader is not benefiting fully from these information outlets. With the link between health literacy and poor health outcomes, it is important to address the online content in this area of radiology, allowing for patient to more fully benefit

  9. 20 CFR 671.130 - When should applications for national emergency grants be submitted to the Department?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the year. (c) Applications for national emergency grants to respond to a declared emergency or natural disaster as described in § 671.110(e), cannot be considered until FEMA has declared that the affected area is eligible for disaster-related public assistance. ...

  10. 20 CFR 671.130 - When should applications for national emergency grants be submitted to the Department?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the year. (c) Applications for national emergency grants to respond to a declared emergency or natural disaster as described in § 671.110(e), cannot be considered until FEMA has declared that the affected area is eligible for disaster-related public assistance. ...

  11. Stress levels during emergency care: A comparison between reality and simulated scenarios.

    PubMed

    Daglius Dias, Roger; Scalabrini Neto, Augusto

    2016-06-01

    Medical simulation is fast becoming a standard of health care training throughout undergraduate, postgraduate and continuing medical education. Our aim was to evaluate if simulated scenarios have a high psychological fidelity and induce stress levels similarly to real emergency medical situations. Medical residents had their stress levels measured during emergency care (real-life and simulation) in baseline (T1) and immediately post-emergencies (T2). Parameters measuring acute stress were: heart rate, systolic and diastolic blood pressure, salivary α-amylase, salivary interleukin-1β, and State-Trait Anxiety Inventory score. Twenty-eight internal medicine residents participated in 32 emergency situations (16 real-life and 16 simulated emergencies). In the real-life group, all parameters increased significantly (P < .05) between T1 and T2. In the simulation group, only heart rate and interleukin-1β increased significantly after emergencies. The comparison between groups demonstrates that acute stress response (T2 - T1) and State-Trait Anxiety Inventory score (in T2) did not differ between groups. Acute stress response did not differ between both groups. Our results indicate that emergency medicine simulation may create a high psychological fidelity environment similarly to what is observed in a real emergency room. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Climatic Warmth and National Wealth: Some Culture-Level Determinants of National Character Stereotypes.

    PubMed

    McCrae, Robert R; Terracciano, Antonio; Realo, Anu; Allik, Jüri

    2007-12-01

    National character stereotypes are widely shared, but do not reflect assessed levels of personality traits. In this article we present data illustrating the divergence of stereotypes and assessed personality traits in north and south Italy, test hypotheses about the associations of temperature and national wealth with national character stereotypes in 49 cultures, and explore possible links to national values and beliefs. Results suggest that warmth and wealth are common determinants of national stereotypes, but that there are also idiosyncratic influences on the perceptions of individual nations.

  13. Pilot statewide study of pediatric emergency department alignment with national guidelines.

    PubMed

    Costich, Julia F; Fallat, Mary E; Scaggs, C Morgan; Bartlett, Richard

    2013-07-01

    The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nursing Association have developed consensus guidelines for pediatric emergency department policies, procedures, supplies, and equipment. Kentucky received funding from the Health Resources and Services Administration through the Emergency Medical Services for Children program to pilot test the guidelines with the state's hospitals. In addition to providing baseline data regarding institutional alignment with the guidelines, the survey supported development of grant funding to procure missing items. Survey administration was undertaken by staff and members of the Kentucky Board of Emergency Medical Services Emergency Medical Services for Children work group and faculty and staff of the University of Kentucky College of Public Health and the University of Louisville School of Medicine. Responses were solicited primarily online with repeated reminders and offers of assistance. Seventy respondents completed the survey section on supplies and equipment either online or by fax. Results identified items unavailable at 20% or more of responding facilities, primarily the smallest sizes of equipment. The survey section addressing policy and procedure received only 16 responses. Kentucky facilities were reasonably well equipped by national standards, but rural facilities and small hospitals did not stock the smallest equipment sizes because of low reported volume of pediatric emergency department cases. Thus, a centralized procurement process that gives them access to an adequate range of pediatric supplies and equipment would support capacity building for the care of children across the entire state. Grant proposals were received from 28 facilities in the first 3 months of funding availability.

  14. Use of National Burden to Define Operative Emergency General Surgery.

    PubMed

    Scott, John W; Olufajo, Olubode A; Brat, Gabriel A; Rose, John A; Zogg, Cheryl K; Haider, Adil H; Salim, Ali; Havens, Joaquim M

    2016-06-15

    Emergency general surgery (EGS) represents 11% of surgical admissions and 50% of surgical mortality in the United States. However, there is currently no established definition of the EGS procedures. To define a set of procedures accounting for at least 80% of the national burden of operative EGS. A retrospective review was conducted using data from the 2008-2011 National Inpatient Sample. Adults (age, ≥18 years) with primary EGS diagnoses consistent with the American Association for the Surgery of Trauma definition, admitted urgently or emergently, who underwent an operative procedure within 2 days of admission were included in the analyses. Procedures were ranked to account for national mortality and complication burden. Among ranked procedures, contributions to total EGS frequency, mortality, and hospital costs were assessed. The data query and analysis were performed between November 15, 2015, and February 16, 2016. Overall procedure frequency, in-hospital mortality, major complications, and inpatient costs calculated per 3-digit International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. The study identified 421 476 patient encounters associated with operative EGS, weighted to represent 2.1 million nationally over the 4-year study period. The overall mortality rate was 1.23% (95% CI, 1.18%-1.28%), the complication rate was 15.0% (95% CI, 14.6%-15.3%), and mean cost per admission was $13 241 (95% CI, $12 957-$13 525). After ranking the 35 procedure groups by contribution to EGS mortality and morbidity burden, a final set of 7 operative EGS procedures were identified, which collectively accounted for 80.0% of procedures, 80.3% of deaths, 78.9% of complications, and 80.2% of inpatient costs nationwide. These 7 procedures included partial colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy. Only 7 procedures account

  15. 75 FR 69567 - Continuation of the National Emergency With Respect To Iran

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-12

    ... Part III The President Notice of November 10, 2010--Continuation of the National Emergency With Respect To Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 75, No. 218 / Friday, November 12, 2010 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President [[Page 69569...

  16. A national survey on health department capacity for community engagement in emergency preparedness.

    PubMed

    Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

    2015-01-01

    Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and

  17. Climatic Warmth and National Wealth: Some Culture-Level Determinants of National Character Stereotypes

    PubMed Central

    McCrae, Robert R.; Terracciano, Antonio; Realo, Anu; Allik, Jüri

    2009-01-01

    National character stereotypes are widely shared, but do not reflect assessed levels of personality traits. In this article we present data illustrating the divergence of stereotypes and assessed personality traits in north and south Italy, test hypotheses about the associations of temperature and national wealth with national character stereotypes in 49 cultures, and explore possible links to national values and beliefs. Results suggest that warmth and wealth are common determinants of national stereotypes, but that there are also idiosyncratic influences on the perceptions of individual nations. PMID:20046546

  18. Higher levels of state depression in masculine than in feminine nations.

    PubMed

    Arrindell, W A; Steptoe, A; Wardle, J

    2003-07-01

    Studies using identical measures have identified different levels of depression in different countries or cultures. Until now, however, explanations for such differences, other than methodological ones, have not been empirically addressed. It was hypothesized and found that soft or feminine nations in which both women and men are offered equal opportunities for the fulfillment of multiple social roles that are associated with good self-rated health would score significantly lower on national depression levels than tough or masculine societies in which such opportunities exist to a clearly lesser extent. Analyses of data collected in 14 nations in Europe (total N>5000) demonstrated that higher scores on Hofstede's national masculinity index and lower ones on national wealth were independent predictors of higher national depression levels. National trait neuroticism did not mediate the relationship between national masculinity and national depression levels.

  19. Emergency health planning.

    PubMed

    HARDMAN, A C

    1962-12-01

    This paper outlines the development of emergency health planning as a function of government. Ten provinces have the basic responsibility for the organization, preparation and operation of medical, nursing, hospital and public health services in an emergency. The Department of National Health and Welfare is responsible for the provision of advice and assistance to the provincial and municipal governments in such matters. Eight provinces have now hired full-time planning staffs to co-ordinate the health planning of the Provincial Departments of Health and Provincial Emergency Measures Organization.Four major programs have been established. The first program provides for the continuity of leadership and guidance by health authorities at the federal, provincial and municipal level. Essential records have been developed and emergency legislation prepared. This program, however, will be of little use unless health services are organized at the municipal level. In this organizational program, advice and assistance have been provided to existing hospitals and departments of health in the conduct of disaster planning. The efforts of these agencies are co-ordinated by municipal health authorities into a community disaster plan. The third program deals with information and education of the general public and the health workers. This program is designed to make the family unit self-sufficient for up to seven days and the health worker prepared to undertake his emergency role. The first three programs are directed to the organization and training of manpower; the fourth program provides the necessary supplies. From the national medical stockpile of $18,000,000, some $12,000,000 has been received, packaged for long-term storage and distributed to regional depots across the country. To ensure their ready availability in time of emergency an agreement has been reached with seven provinces for the release of hospital disaster kits.

  20. Emergency Procedure Training for Reactor Operators at the High Flux Beam Reactor for Brookhaven National Laboratory.

    ERIC Educational Resources Information Center

    Reyer, Ronald

    A project was conducted to analyze, design, develop, implement, and evaluate an instructional unit intended to improve the diagnostic skills of operating personnel in responding to abnormal and emergency conditions at the High Flux Beam Reactor at Brookhaven National Laboratory. Research was conducted on the occurrence of emergencies at similar…

  1. The impact of an emergency fee increase on the composition of patients visiting emergency departments.

    PubMed

    Jung, Hyemin; Do, Young Kyung; Kim, Yoon; Ro, Junsoo

    2014-11-01

    This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

  2. 78 FR 38193 - Continuation of the National Emergency With Respect to North Korea

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ..., including the procurement of luxury goods; and its illicit and deceptive activities in international markets... goods and currency, bulk cash smuggling, and narcotics trafficking, which destabilize the Korean... measures taken to deal with that national emergency, must continue in effect beyond June 26, 2013...

  3. 77 FR 37263 - Continuation of the National Emergency With Respect to North Korea

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-21

    ..., including the procurement of luxury goods; and its illicit and deceptive activities in international markets... goods and currency, bulk cash smuggling, and narcotics trafficking, which destabilize the Korean... measures taken to deal with that national emergency, must continue in effect beyond June 26, 2012...

  4. Patient experience of general practice and use of emergency hospital services in England: regression analysis of national cross-sectional time series data.

    PubMed

    Cowling, Thomas E; Majeed, Azeem; Harris, Matthew J

    2018-01-22

    The UK Government has introduced several national policies to improve access to primary care. We examined associations between patient experience of general practice and rates of visits to accident and emergency (A&E) departments and emergency hospital admissions in England. The study included 8124 general practices between 2011-2012 and 2013-2014. Outcome measures were annual rates of A&E visits and emergency admissions by general practice population, according to administrative hospital records. Explanatory variables included three patient experience measures from the General Practice Patient Survey: practice-level means of experience of making an appointment, satisfaction with opening hours and overall experience (on 0-100 scales). The main analysis used random-effects Poisson regression for cross-sectional time series. Five sensitivity analyses examined changes in model specification. Mean practice-level rates of A&E visits and emergency admissions increased from 2011-2012 to 2013-2014 (310.3-324.4 and 98.8-102.9 per 1000 patients). Each patient experience measure decreased; for example, mean satisfaction with opening hours was 79.4 in 2011-2012 and 76.6 in 2013-2014. In the adjusted regression analysis, an SD increase in experience of making appointments (equal to 9 points) predicted decreases of 1.8% (95% CI -2.4% to -1.2%) in A&E visit rates and 1.4% (95% CI -1.9% to -0.9%) in admission rates. This equalled 301 174 fewer A&E visits and 74 610 fewer admissions nationally per year. Satisfaction with opening hours and overall experience were not consistently associated with either outcome measure across the main and sensitivity analyses. Associations between patient experience of general practice and use of emergency hospital services were small or inconsistent. In England, realistic short-term improvements in patient experience of general practice may only have modest effects on A&E visits and emergency admissions. © Article author(s) (or their employer

  5. The National Emergency Access Target (NEAT) and the 4-hour rule: time to review the target.

    PubMed

    Sullivan, Clair; Staib, Andrew; Khanna, Sankalp; Good, Norm M; Boyle, Justin; Cattell, Rohan; Heiniger, Liam; Griffin, Bronwyn R; Bell, Anthony Jr; Lind, James; Scott, Ian A

    2016-05-16

    We explored the relationship between the National Emergency Access Target (NEAT) compliance rate, defined as the proportion of patients admitted or discharged from emergency departments (EDs) within 4 hours of presentation, and the risk-adjusted in-hospital mortality of patients admitted to hospital acutely from EDs. Retrospective observational study of all de-identified episodes of care involving patients who presented acutely to the EDs of 59 Australian hospitals between 1 July 2010 and 30 June 2014. The relationship between the risk-adjusted mortality of inpatients admitted acutely from EDs (the emergency hospital standardised mortality ratio [eHSMR]: the ratio of the numbers of observed to expected deaths) and NEAT compliance rates for all presenting patients (total NEAT) and admitted patients (admitted NEAT). ED and inpatient data were aggregated for 12.5 million ED episodes of care and 11.6 million inpatient episodes of care. A highly significant (P < 0.001) linear, inverse relationship between eHSMR and each of total and admitted NEAT compliance rates was found; eHSMR declined to a nadir of 73 as total and admitted NEAT compliance rates rose to about 83% and 65% respectively. Sensitivity analyses found no confounding by the inclusion of palliative care and/or short-stay patients. As NEAT compliance rates increased, in-hospital mortality of emergency admissions declined, although this direct inverse relationship is lost once total and admitted NEAT compliance rates exceed certain levels. This inverse association between NEAT compliance rates and in-hospital mortality should be considered when formulating targets for access to emergency care.

  6. 77 FR 29849 - Continuation of the National Emergency With Respect To Burma

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... Vol. 77 Friday, No. 97 May 18, 2012 Part IV The President Notice of May 17, 2012--Continuation of the National Emergency With Respect To Burma #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 77, No. 97 / Friday, May 18, 2012 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President [[Page 29851

  7. Nascent life cycles and the emergence of higher-level individuality.

    PubMed

    Ratcliff, William C; Herron, Matthew; Conlin, Peter L; Libby, Eric

    2017-12-05

    Evolutionary transitions in individuality (ETIs) occur when formerly autonomous organisms evolve to become parts of a new, 'higher-level' organism. One of the first major hurdles that must be overcome during an ETI is the emergence of Darwinian evolvability in the higher-level entity (e.g. a multicellular group), and the loss of Darwinian autonomy in the lower-level units (e.g. individual cells). Here, we examine how simple higher-level life cycles are a key innovation during an ETI, allowing this transfer of fitness to occur 'for free'. Specifically, we show how novel life cycles can arise and lead to the origin of higher-level individuals by (i) mitigating conflicts between levels of selection, (ii) engendering the expression of heritable higher-level traits and (iii) allowing selection to efficiently act on these emergent higher-level traits. Further, we compute how canonical early life cycles vary in their ability to fix beneficial mutations via mathematical modelling. Life cycles that lack a persistent lower-level stage and develop clonally are far more likely to fix 'ratcheting' mutations that limit evolutionary reversion to the pre-ETI state. By stabilizing the fragile first steps of an evolutionary transition in individuality, nascent higher-level life cycles may play a crucial role in the origin of complex life.This article is part of the themed issue 'Process and pattern in innovations from cells to societies'. © 2017 The Author(s).

  8. 77 FR 56519 - Continuation of the National Emergency With Persons Who Commit, Threaten To Commit, or Support...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-12

    ... of the National Emergency With Persons Who Commit, Threaten To Commit, or Support Terrorism On... persons who commit, threaten to commit, or support terrorism, pursuant to the International Emergency... the grave acts of terrorism and threats of terrorism committed by foreign terrorists, including the...

  9. National Differences in Regional Emergency Department Boarding Times: Are US Emergency Departments Prepared for a Public Health Emergency?

    PubMed

    Love, Jennifer S; Karp, David; Delgado, M Kit; Margolis, Gregg; Wiebe, Douglas J; Carr, Brendan G

    2016-08-01

    Boarding admitted patients decreases emergency department (ED) capacity to accommodate daily patient surge. Boarding in regional hospitals may decrease the ability to meet community needs during a public health emergency. This study examined differences in regional patient boarding times across the United States and in regions at risk for public health emergencies. A retrospective cross-sectional analysis was performed by using 2012 ED visit data from the American Hospital Association (AHA) database and 2012 hospital ED boarding data from the Centers for Medicare and Medicaid Services Hospital Compare database. Hospitals were grouped into hospital referral regions (HRRs). The primary outcome was mean ED boarding time per HRR. Spatial hot spot analysis examined boarding time spatial clustering. A total of 3317 of 4671 (71%) hospitals were included in the study cohort. A total of 45 high-boarding-time HRRs clustered along the East/West coasts and 67 low-boarding-time HRRs clustered in the Midwest/Northern Plains regions. A total of 86% of HRRs at risk for a terrorist event had high boarding times and 36% of HRRs with frequent natural disasters had high boarding times. Urban, coastal areas have the longest boarding times and are clustered with other high-boarding-time HRRs. Longer boarding times suggest a heightened level of vulnerability and a need to enhance surge capacity because these regions have difficulty meeting daily emergency care demands and are at increased risk for disasters. (Disaster Med Public Health Preparedness. 2016;10:576-582).

  10. The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

    PubMed

    Leggio, William Joseph

    2014-10-01

    This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

  11. Hospital-Level Factors Associated with Pediatric Emergency Department Return Visits.

    PubMed

    Pittsenbarger, Zachary; Thurm, Cary; Neuman, Mark; Spencer, Sandra; Simon, Harold; Gosdin, Craig; Shah, Samir; McClead, Richard; Stack, Anne; Alpern, Elizabeth

    2017-07-01

    Return visits (RVs) and RVs with admission (RVAs) are commonly used emergency department quality measures. Visit- and patient-level factors, including several social determinants of health, have been associated with RV rates, but hospital-specific factors have not been studied. To identify what hospital-level factors correspond with high RV and RVA rates. Multicenter mixed-methods study of hospital characteristics associated with RV and RVA rates. Pediatric Health Information System with survey of emergency department directors. Adjusted return rates were calculated with generalized linear mixed-effects models. Hospitals were categorized by adjusted RV and RVA rates for analysis. Twenty-four hospitals accounted for 1,456,377 patient visits with an overall adjusted RV rate of 3.7% and RVA rate of 0.7%. Hospitals with the highest RV rates served populations that were more likely to have government insurance and lower median household incomes and less likely to carry commercial insurance. Hospitals in the highest RV rate outlier group had lower pediatric emergency medicine specialist staffing, calculated as full-time equivalents per 10,000 patient visits: median (interquartile range) of 1.9 (1.5-2.1) versus 2.9 (2.2-3.6). There were no differences in hospital population characteristics or staffing by RVA groups. RV rates were associated with population social determinants of health and inversely related to staffing. Hospital-level variation may indicate population-level economic factors outside the control of the hospital and unrelated to quality of care. © 2017 Society of Hospital Medicine

  12. First aid: level of knowledge of relatives and bystanders in emergency situations.

    PubMed

    Tomruk, Onder; Soysal, Suna; Gunay, Turkan; Cimrin, Arif H

    2007-01-01

    Bystanders who are able to provide immediate first aid to patients who require emergency care can make a big difference in the outcome. Thus, first-aid training should be made available to as many people as possible. The aims of this study were to assess the level of first-aid knowledge among bystanders in emergency situations and to identify factors that affected this level of knowledge. At Dokuz Eylul University Emergency Service between February 1 and February 15, 2002, 318 bystanders were given a questionnaire. The first part of the questionnaire was concerned with demographic characteristics and factors that would affect first-aid knowledge level. The second part consisted of 16 multiple choice questions about first aid. Bystanders answered an average of 7.16+/-3.14 questions correctly. Bystanders who had graduated from a university, were health care personnel, had taken a first-aid course, had a first-aid certificate, or had a driver's license were considered to be more successful.

  13. 20 CFR 671.110 - What are major economic dislocations or other events which may qualify for a national emergency...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS... emergency grant? These include: (a) Plant closures; (b) Mass layoffs affecting 50 or more workers at a...

  14. Anxiety levels and related symptoms in emergency nursing personnel in Greece.

    PubMed

    Stathopoulou, Hariklia; Karanikola, Maria N K; Panagiotopoulou, Fotini; Papathanassoglou, Elizabeth D E

    2011-07-01

    Several studies provide evidence for the association between work stress and mild psychiatric morbidity among emergency nurses. These symptoms have not been explored in Greek nursing personnel employed in emergency departments. The aim of this descriptive correlational study was to investigate the presence of anxiety and stress symptoms among emergency nursing personnel in Greece. The sample was composed of nursing personnel employed in emergency departments of 8 adult General hospitals in Greece (N = 213). The Hamilton Anxiety Scale was applied for the quantitative assessment of anxiety symptoms, along with demographic, vocational, and educational data. Descriptive statistics were explored, and nonparametric comparisons, as well as correlational tests, were performed. Anxiety levels were found to be mild (1.102 ± 0.53), with women (P = .021, Mann-Whitney U test) and nursing personnel employed in public sector hospitals (P = .029, Mann-Whitney U test) having higher anxiety level scores. In addition, a statistically significant mild correlation was observed between work experience in the emergency department and anxiety states (τ = 0.178, P = .011). The most commonly reported manifestations of mild psychiatric symptomatology were sleep disturbances (2.32 ± 1.2), anxious mood (1.57 ± 1.1), and depressed mood (2.38 ± 1.2), with 24.8% of the participants reporting very severe sleep disturbance, 23.9% reporting very severe depressive mood, and 10.7% reporting very severe anxious mood. Hospital administrators need to be aware of the extent of workplace stress and subsequent anxiety symptoms that exist in emergency nurses. Staff counseling, continuing professional education, and empowerment strategies may need to be implemented to prevent psychiatric morbidity, as well as job dissatisfaction and resignations. Copyright © 2011 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  15. National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

    PubMed

    Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2018-01-01

    Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

  16. Capacity building in emerging space nations: Experiences, challenges and benefits

    NASA Astrophysics Data System (ADS)

    Jason, Susan; da Silva Curiel, Alex; Liddle, Doug; Chizea, Francis; Leloglu, Ugur Murat; Helvaci, Mustafa; Bekhti, Mohammed; Benachir, Djouad; Boland, Lee; Gomes, Luis; Sweeting, Martin

    2010-09-01

    This paper focuses on ways in which space is being used to build capacity in science and technology in order to: Offer increasing support for national and global solutions to current and emerging problems including: how to improve food security; resource management; understanding the impacts of climate change and how to deal with them; improving disaster mitigation, management and response. Support sustainable economic development. We present some of the experiences, lessons learned and benefits gained in capacity building projects undertaken by Surrey Satellite Technology Ltd. and our partners from developing and mature space nations. We focus on the Turkish, Algerian and Nigerian know-how and technology transfer programmes which form part of the first Disaster Monitoring Constellation (DMC) in orbit. From the lessons learned on Surrey's know-how and technology transfer partnership programmes, it is clear that space technology needs to be implemented responsibly as part of a long-term capacity building plan to be a sustainable one. It needs to be supported with appropriate policy and legal frameworks, institutional development, including community participation, human resources development and strengthening of managerial systems. In taking this on board, DMC has resulted in a strong international partnership combining national objectives, humanitarian aid and commerce. The benefits include: Ownership of space-based and supporting ground assets with low capital expenditure that is in line with national budgets of developing nations. Ownership of data and control over data acquisition. More for the money via collaborative consortium. Space related capacity building in organisations and nations with the goal of sustainable development. Opportunities for international collaboration, including disaster management and relief.

  17. 3 CFR - Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created by the Accumulation of Weapons-Useable Fissile Material in the Territory of the Russian Federation Presidential Documents Other Presidential Documents Notice of June 18, 2009 Continuation of the National...

  18. 3 CFR - Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created by the Accumulation of Weapons-Usable Fissile Material in the Territory of the Russian Federation Presidential Documents Other Presidential Documents Notice of June 17, 2011 Continuation of the National...

  19. 75 FR 34317 - Continuation of the National Emergency With Respect to North Korea

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... National Emergency With Respect to North Korea On June 26, 2008, by Executive Order 13466, the President... certain restrictions with respect to North Korea that would otherwise have been lifted pursuant to... Enemy Act (50 U.S.C. App. 1-44) with respect to North Korea. Because the existence and the risk of...

  20. 3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of January 26, 2011 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

  1. 3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 4, 2013 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

  2. 3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 2, 2010 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

  3. 3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 3, 2012 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

  4. 3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 4, 2009 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

  5. 78 FR 56579 - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ...--Continuation of the National Emergency With Respect to Certain Terrorist Attacks #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 78 , No. 177 / Thursday, September 12, 2013 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President [[Page 56581

  6. 3 CFR - Continuation of the National Emergency With Respect to Weapons of Mass Destruction

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... to Weapons of Mass Destruction Presidential Documents Other Presidential Documents Notice of November 9, 2011 Continuation of the National Emergency With Respect to Weapons of Mass Destruction On... United States posed by the proliferation of nuclear, biological, and chemical weapons (weapons of mass...

  7. 3 CFR - Continuation of the National Emergency With Respect to Weapons of Mass Destruction

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... to Weapons of Mass Destruction Presidential Documents Other Presidential Documents Notice of November 1, 2012 Continuation of the National Emergency With Respect to Weapons of Mass Destruction On... United States posed by the proliferation of nuclear, biological, and chemical weapons (weapons of mass...

  8. Individual-Level and Socio-Structural Characteristics of Violence: An Emergency Department Study

    ERIC Educational Resources Information Center

    Boyle, Douglas J.; Hassett-Walker, Constance

    2008-01-01

    In this article, the authors present a data collection system to provide information about assault-related injuries within Newark, New Jersey. In 2001, Emergency Department (ED) staff at the six hospitals providing emergency medical care within the city collected data on all assault-related ED visits. Individual-level (n = 1,204) and…

  9. Occupational burnout levels in emergency medicine--a nationwide study and analysis.

    PubMed

    Popa, Florian; Raed, Arafat; Purcarea, Victor Lorin; Lală, Adrian; Bobirnac, George

    2010-01-01

    The specificity of the emergency medical act strongly manifests itself on account of a wide series of psycho-traumatizing factors augmented both by the vulnerable situation of the patient and the paroxysmal state of the act. Also, it has been recognized that the physical solicitation and distress levels are the highest among all medical specialties, this being a valuable marker for establishing the quality of the medical act. We have surveyed a total of 4725 emergency medical workers with the MBI-HSS instrument, receiving 4693 valid surveys (99.32% response rate). Professional categories included Emergency Department doctors (M-EMD), ambulance doctors (M-AMB), ED doctors with field work in emergency and resuscitation (including mobile intensive care units and airborne intensive care units) (D-SMU), medical nurses in Emergency Departments (N-EMD), medical nurses in the ambulance service (N-AMB), ED medical nurses with field activity in emergency and resuscitation (N-SMU), ambulance drivers (DRV) and paramedic (EMT). The n values for every category of subjects and percentage of system coverage (table 3) shows that we have covered an estimated total of 29.94% of the Romanian emergency medical field workers. MBI-HSS results show a moderate to high level of occupational stress for the surveyed subjects. The average values for the three parameters, corresponding to the entire Romanian emergency medical field were 1.41 for EE, 0.99 for DP and 4.47 for PA (95% CI). Average results stratified by professional category show higher EE average values (v) for the M-SMU (v=2.01, 95%CI) and M-EMD (v=2.21, 95% CI) groups corresponding to higher DP values for the same groups (vM-EMD=1.41 and vM-SMU=1.22, 95% CI). PA values for these groups are below average, corresponding to an increased risk factor for high degrees of burnout. Calculated PA values are 4.30 for the M-EMD group and 4.20 for the M-SMU group. Of all surveyed groups, our study shows a high risk of burnout consisting of

  10. National perspective on in-hospital emergency units in Iraq

    PubMed Central

    Lafta, Riyadh K.; Al-Nuaimi, Maha A.

    2013-01-01

    Background: Hospitals play a crucial role in providing communities with essential medical care during times of disasters. The emergency department is the most vital component of hospitals' inpatient business. In Iraq, at present, there are many casualties that cause a burden of work and the need for structural assessment, equipment updating and evaluation of process. Objective: To examine the current pragmatic functioning of the existing set-up of services of in-hospital emergency departments within some general hospitals in Baghdad and Mosul in order to establish a mechanism for future evaluation for the health services in our community. Methods: A cross-sectional study was employed to evaluate the structure, process and function of six major hospitals with emergency units: four major hospitals in Baghdad and two in Mosul. Results: The six surveyed emergency units are distinct units within general hospitals that serve (collectively) one quarter of the total population. More than one third of these units feature observation unit beds, laboratory services, imaging facilities, pharmacies with safe storage, and ambulatory entrance. Operation room was found only in one hospital's reception and waiting area. Consultation/track area, cubicles for infection control, and discrete tutorial rooms were not available. Patient assessment was performed (although without adequate privacy). The emergency specialist, family medicine specialist and interested general practitioner exist in one-third of the surveyed units. Psychiatrist, physiotherapists, occupational therapists, and social work links are not available. The shortage in medication, urgent vaccines and vital facilities is an obvious problem. Conclusions: Our emergency unit's level and standards of care are underdeveloped. The inconsistent process and inappropriate environments need to be reconstructed. The lack of drugs, commodities, communication infrastructure, audit and training all require effective build up. PMID

  11. Unravelling relationships: Hospital occupancy levels, discharge timing and emergency department access block.

    PubMed

    Khanna, Sankalp; Boyle, Justin; Good, Norm; Lind, James

    2012-10-01

    To investigate the effect of hospital occupancy levels on inpatient and ED patient flow parameters, and to simulate the impact of shifting discharge timing on occupancy levels. Retrospective analysis of hospital inpatient data and ED data from 23 reporting public hospitals in Queensland, Australia, across 30 months. Relationships between outcome measures were explored through the aggregation of the historic data into 21 912 hourly intervals. Main outcome measures included admission and discharge rates, occupancy levels, length of stay for admitted and emergency patients, and the occurrence of access block. The impact of shifting discharge timing on occupancy levels was quantified using observed and simulated data. The study identified three stages of system performance decline, or choke points, as hospital occupancy increased. These choke points were found to be dependent on hospital size, and reflect a system change from 'business-as-usual' to 'crisis'. Effecting early discharge of patients was also found to significantly (P < 0.001) impact overcrowding levels and improve patient flow. Modern hospital systems have the ability to operate efficiently above an often-prescribed 85% occupancy level, with optimal levels varying across hospitals of different size. Operating over these optimal levels leads to performance deterioration defined around occupancy choke points. Understanding these choke points and designing strategies around alleviating these flow bottlenecks would improve capacity management, reduce access block and improve patient outcomes. Effecting early discharge also helps alleviate overcrowding and related stress on the system. © 2012 CSIRO. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. [Emergency response management near the tracks of the public railway network: special aspects of missions connected with the German national railway system].

    PubMed

    Krämer, P; Aul, A; Vock, B; Frank, C

    2010-11-01

    Emergency response management and rescue operations concerning the railway network in Germany need special attention and implementation in several ways. The emergency response concerning the German national railway network managed by Deutsche Bahn AG is subject to various rules and regulations which have to be followed precisely. Only by following these rules and procedures is the safety of all emergency staff at the scene ensured. The German national railway network (Deutsche Bahn AG) provides its own emergency response control center, which specializes in managing its response to emergencies and dispatches an emergency response manager to the scene. This person serves as the primary Deutsche Bahn AG representative at the scene and is the only person who is allowed to earth the railway electrical power lines. This article will discuss different emergency situations concerning railway accidents and the emergency medical response to them based on a near collision with a high speed train during a rescue mission close to the railway track. Injury to personnel could only be avoided by chance and luck. The dangers and risks for rescue staff are specified. Furthermore, the article details practical guidelines for rescue operations around the German national railway track system.

  13. Emergency Medical Service (EMS): Rotorcraft Technology Workshop

    NASA Technical Reports Server (NTRS)

    Bauchspies, J. S.; Adams, R. J.

    1981-01-01

    A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

  14. The Electronic Intrusion Threat to National Security and Emergency Preparedness (NS/EP) Telecommunications. An Awareness Document

    DTIC Science & Technology

    1999-03-01

    Responsibilities, a national security emergency is “any occurrence, including natural disaster, military attack, technological emergency, or other...in information systems increase in Russia, “the growing role of information- technology warfare is rapidly lowering the barrier between war and peace...waging war. As one Russian military theorist stated, “it is necessary to place paramount importance on technological indicators of new weapons, which are

  15. Emergency Department Intubation Success With Succinylcholine Versus Rocuronium: A National Emergency Airway Registry Study.

    PubMed

    April, Michael D; Arana, Allyson; Pallin, Daniel J; Schauer, Steven G; Fantegrossi, Andrea; Fernandez, Jessie; Maddry, Joseph K; Summers, Shane M; Antonacci, Mark A; Brown, Calvin A

    2018-05-07

    Although both succinylcholine and rocuronium are used to facilitate emergency department (ED) rapid sequence intubation, the difference in intubation success rate between them is unknown. We compare first-pass intubation success between ED rapid sequence intubation facilitated by succinylcholine versus rocuronium. We analyzed prospectively collected data from the National Emergency Airway Registry, a multicenter registry collecting data on all intubations performed in 22 EDs. We included intubations of patients older than 14 years who received succinylcholine or rocuronium during 2016. We compared the first-pass intubation success between patients receiving succinylcholine and those receiving rocuronium. We also compared the incidence of adverse events (cardiac arrest, dental trauma, direct airway injury, dysrhythmias, epistaxis, esophageal intubation, hypotension, hypoxia, iatrogenic bleeding, laryngoscope failure, laryngospasm, lip laceration, main-stem bronchus intubation, malignant hyperthermia, medication error, pharyngeal laceration, pneumothorax, endotracheal tube cuff failure, and vomiting). We conducted subgroup analyses stratified by paralytic weight-based dose. There were 2,275 rapid sequence intubations facilitated by succinylcholine and 1,800 by rocuronium. Patients receiving succinylcholine were younger and more likely to undergo intubation with video laryngoscopy and by more experienced providers. First-pass intubation success rate was 87.0% with succinylcholine versus 87.5% with rocuronium (adjusted odds ratio 0.9; 95% confidence interval 0.6 to 1.3). The incidence of any adverse event was also comparable between these agents: 14.7% for succinylcholine versus 14.8% for rocuronium (adjusted odds ratio 1.1; 95% confidence interval 0.9 to 1.3). We observed similar results when they were stratified by paralytic weight-based dose. In this large observational series, we did not detect an association between paralytic choice and first-pass rapid sequence

  16. 20 CFR 671.160 - What rapid response activities are required before a national emergency grant application is...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS... needs of the affected workers and the resources available to them. (b) In accordance with national... section 132(b)(2)(B) of the Act, have been used to initiate appropriate services to the eligible workers...

  17. 20 CFR 671.160 - What rapid response activities are required before a national emergency grant application is...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS... needs of the affected workers and the resources available to them. (b) In accordance with national... section 132(b)(2)(B) of the Act, have been used to initiate appropriate services to the eligible workers...

  18. Research on the development for emerging industries in Nantong under the national strategy

    NASA Astrophysics Data System (ADS)

    Li, Zhongnian; Qin, Yan; Zhang, Lijuan; Li, Tianying; Wang, Qing

    2017-08-01

    In this paper, according to the relevant national strategic emerging industry planning and policy, conducted in-depth research on the development of emerging industries in Nantong, and believes that current economic social development in Nantong has been entered into a new normal period, in the new period to “innovation” as the core characteristics, strategic emerging industry opportunities and challenges facing the industry. Therefore, Nantong should persist in innovation driven, focus on the cultivation and development of new industries, to provide new impetus to Nantong’s economic vitality and development. According to the development and upgrading of traditional industries, and expand the advantages of industry, cultivate new industries, for each kind of industry to come up with specific development strategies and suggestions: Nantong municipal government will be the seven emerging industries four in the industry (i.e., new material industry, new energy industry, new information technology industry, high-end equipment manufacturing industry) as the development object, further “bigger and stronger”, and strive to enhance the industrial scale and the formation of local characteristics as soon as possible.

  19. Environmental contaminants of emerging concern in seafood – European database on contaminant levels

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

    Vandermeersch, Griet, E-mail: griet.vandermeersch@ilvo.vlaanderen.be; Lourenço, Helena Maria; Alvarez-Muñoz, Diana

    Marine pollution gives rise to concern not only about the environment itself but also about the impact on food safety and consequently on public health. European authorities and consumers have therefore become increasingly worried about the transfer of contaminants from the marine environment to seafood. So-called “contaminants of emerging concern” are chemical substances for which no maximum levels have been laid down in EU legislation, or substances for which maximum levels have been provided but which require revision. Adequate information on their presence in seafood is often lacking and thus potential risks cannot be excluded. Assessment of food safety issuesmore » related to these contaminants has thus become urgent and imperative. A database ( (www.ecsafeseafooddbase.eu)), containing available information on the levels of contaminants of emerging concern in seafood and providing the most recent data to scientists and regulatory authorities, was developed. The present paper reviews a selection of contaminants of emerging concern in seafood including toxic elements, endocrine disruptors, brominated flame retardants, pharmaceuticals and personal care products, polycyclic aromatic hydrocarbons and derivatives, microplastics and marine toxins. Current status on the knowledge of human exposure, toxicity and legislation are briefly presented and the outcome from scientific publications reporting on the levels of these compounds in seafood is presented and discussed. - Highlights: • Development of a European database regarding contaminants of emerging concern. • Current status on knowledge of human exposure, toxicity and legislation. • Review on the occurrence of contaminants of emerging concern in seafood.« less

  20. A national survey of emergency nurses and avian influenza threat.

    PubMed

    Bell, Mary Ann; Dake, Joseph A; Price, James H; Jordan, Timothy R; Rega, Paul

    2014-05-01

    The purpose of this study was to determine the perceived likelihood of emergency nurses reporting to work during an avian influenza outbreak, to consider options if nurses decided not to report work, and to explore Protection Motivation Theory constructs as predictors of reporting to work. A descriptive, nonexperimental, cross-sectional survey of emergency nurses within the United States. A total of 332 nurses (46%) responded. Most emergency nurses (84%) reported they would report to work (1 in 6 would not). The likelihood of reporting to work differed by education level, nurses' avian influenza information sources, and nurses who had family living with them. Of the nurses who decided not to report to work, the majority were willing to provide health information (90%), administer vaccinations (82%), and triage (74%) neighbors/friends from home. One third of nurses had not attended a disaster-preparedness drill within the past year. Only 20% identified formal training while on the job as a source of avian influenza information. A third of emergency nurses would be worried about getting an avian influenza vaccination because of potential adverse effects. Protection Motivation Theory accounted for almost 40% of the variance of likelihood to report to work, with response costs being the largest predictor. Disaster drills, avian influenza job training, and vaccination education are necessary to prepare emergency nurses for an outbreak. The findings support emergency nurses' willingness to work from home if they are unable to report to work. This finding is new and may have implications for disaster planning, staffing, and ED operations. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  1. Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

    PubMed

    Heggestad, Torhild; Børsheim, Knut Yngve

    2002-01-01

    To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.

  2. 76 FR 56631 - Continuation of the National Emergency With Respect to Certain Terrorist Attacks

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... declared on September 14, 2001, in Proclamation 7463, with respect to the terrorist attacks of September 11... terrorist threat continues, the national emergency declared on September 14, 2001, and the powers and... September 14, 2001, with respect to the terrorist threat. This notice shall be published in the Federal...

  3. 76 FR 37826 - Public Land Order No. 7773; Emergency Withdrawal of Public and National Forest System Lands...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ...] Public Land Order No. 7773; Emergency Withdrawal of Public and National Forest System Lands, Coconino and... Forest System lands from location and entry under the 1872 Mining Law for a period of 6 months under the... described above aggregate approximately 1,010,776 acres public and National Forest System lands in Coconino...

  4. Comprehensive national analysis of emergency and essential surgical capacity in Rwanda.

    PubMed

    Petroze, R T; Nzayisenga, A; Rusanganwa, V; Ntakiyiruta, G; Calland, J F

    2012-03-01

    Disparities in the global availability of operating theatres, essential surgical equipment and surgically trained providers are profound. Although efforts are ongoing to increase surgical care and training, little is known about the surgical capacity in developing countries. The aim of this study was to create a baseline for surgical development planning at a national level. A locally adapted World Health Organization survey was conducted in November 2010 to assess emergency and essential surgical capacity and volumes, with on-site interviews at 44 district and referral hospitals in Rwanda. Results were compiled for education and capacity development discussions with the Rwandan Ministry of Health and the Rwanda Surgical Society. Among 10·1 million people, there were 44 hospitals and 124 operating rooms (1·2 operating rooms per 100,000 persons). There was a total of 50 surgeons practising full- or part-time in Rwanda (0·49 total surgeons per 100,000 persons). The majority of consultant surgeons worked in the capital (covering 10 per cent of the population). Anaesthesia was performed primarily by anaesthesia technicians, and six of 44 hospitals had no trained anaesthesia provider. Continuous availability of electricity, running water and generators was lacking in eight hospitals, and 19 reported an absence or shortage in the availability of pulse oximetry. Equipment for life-saving surgical airway procedures, particularly in children, was lacking. A dedicated emergency area was available in only 19 hospitals. In 2009 and 2010 over 80,000 surgical procedures (major and minor) were recorded annually in Rwanda. A comprehensive countrywide assessment of surgical capacity in resource-limited settings found severe shortages in available resources. Immediate local feedback is a useful tool for creating a baseline of surgical capacity to inform country-specific surgical development. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons

  5. Environmental contaminants of emerging concern in seafood--European database on contaminant levels.

    PubMed

    Vandermeersch, Griet; Lourenço, Helena Maria; Alvarez-Muñoz, Diana; Cunha, Sara; Diogène, Jorge; Cano-Sancho, German; Sloth, Jens J; Kwadijk, Christiaan; Barcelo, Damia; Allegaert, Wim; Bekaert, Karen; Fernandes, José Oliveira; Marques, Antonio; Robbens, Johan

    2015-11-01

    Marine pollution gives rise to concern not only about the environment itself but also about the impact on food safety and consequently on public health. European authorities and consumers have therefore become increasingly worried about the transfer of contaminants from the marine environment to seafood. So-called "contaminants of emerging concern" are chemical substances for which no maximum levels have been laid down in EU legislation, or substances for which maximum levels have been provided but which require revision. Adequate information on their presence in seafood is often lacking and thus potential risks cannot be excluded. Assessment of food safety issues related to these contaminants has thus become urgent and imperative. A database (www.ecsafeseafooddbase.eu), containing available information on the levels of contaminants of emerging concern in seafood and providing the most recent data to scientists and regulatory authorities, was developed. The present paper reviews a selection of contaminants of emerging concern in seafood including toxic elements, endocrine disruptors, brominated flame retardants, pharmaceuticals and personal care products, polycyclic aromatic hydrocarbons and derivatives, microplastics and marine toxins. Current status on the knowledge of human exposure, toxicity and legislation are briefly presented and the outcome from scientific publications reporting on the levels of these compounds in seafood is presented and discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. 76 FR 5053 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ... January 26, 2011 Continuation of the National Emergency With Respect to the Situation in or in Relation to... emergency, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with... constituted by the situation in or in relation to C[ocirc]te d'Ivoire and ordered related measures blocking...

  7. 75 FR 5675 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-04

    ... February 2, 2010 Continuation of the National Emergency With Respect to the Situation in or in Relation to... emergency, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with... constituted by the situation in or in relation to C[ocirc]te d'Ivoire and ordered related measures blocking...

  8. Comparison of the International Crowding Measure in Emergency Departments (ICMED) and the National Emergency Department Overcrowding Score (NEDOCS) to measure emergency department crowding: pilot study.

    PubMed

    Boyle, Adrian; Abel, Gary; Raut, Pramin; Austin, Richard; Dhakshinamoorthy, Vijayasankar; Ayyamuthu, Ravi; Murdoch, Iona; Burton, Joel

    2016-05-01

    There is uncertainty about the best way to measure emergency department crowding. We have previously developed a consensus-based measure of crowding, the International Crowding Measure in Emergency Departments (ICMED). We aimed to obtain pilot data to evaluate the ability of a shortened form of the ICMED, the sICMED, to predict senior emergency department clinicians' concerns about crowding and danger compared with a very well-studied measure of emergency department crowding, the National Emergency Department Overcrowding Score (NEDOCS). We collected real-time observations of the sICMED and NEDOCS and compared these with clinicians' perceptions of crowding and danger on a visual analogue scale. Data were collected in four emergency departments in the East of England. Associations were explored using simple regression, random intercept models and models accounting for correlation between adjacent time points. We conducted 82 h of observation in 10 observation sets. Naive modelling suggested strong associations between sICMED and NEDOCS and clinician perceptions of crowding and danger. Further modelling showed that, due to clustering, the association between sICMED and danger persisted, but the association between these two measures and perception of crowding was no longer statistically significant. Both sICMED and NEDOCS can be collected easily in a variety of English hospitals. Further studies are required but initial results suggest both scores may have potential use for assessing crowding variation at long timescales, but are less sensitive to hour-by-hour variation. Correlation in time is an important methodological consideration which, if ignored, may lead to erroneous conclusions. Future studies should account for such correlation in both design and analysis. 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/

  9. National Biocontainment Training Center

    DTIC Science & Technology

    2010-06-01

    published in the peer reviewed journal, Emerging Infectious Diseases : Le Due, J.W., Anderson, K., Bloom, M.E., Carrion Jr., R., Feldmann, H., Fitch, J.P...infectious diseases , bioterrorism preparedness and biocontainment. To meet the growing demand for training opportunities offered through the NBTC, we are...Security Rule on Biological Safety Level-4. Emerging Infectious Diseases 15 (7), July 2009 online only. ISSN: 1080-6059. 16 CONCLUSIONS The National

  10. Effect of Uruguay's National 100% Smokefree Law on Emergency Visits for Bronchospasm.

    PubMed

    Kalkhoran, Sara; Sebrié, Ernesto M; Sandoya, Edgardo; Glantz, Stanton A

    2015-07-01

    Implementation of smokefree laws is followed by drops in hospital admissions for cardiovascular diseases and asthma. The impact of smokefree laws on use of non-hospital medical services has not been assessed. The purpose of this study is to evaluate the impact of Uruguay's national 100% smokefree legislation on non-hospital emergency care visits, hospitalizations for bronchospasm, and bronchodilator use. The monthly number of non-hospital emergency care visits and hospitalizations for bronchospasm, as well as monthly puffs of bronchodilators (total and per person), from 3 years prior to the adoption of the 100% smokefree policy on March 1, 2006, through 5 years after the policy were assessed using interrupted time series negative binomial regression. Data analysis was conducted in 2014. The incidence of non-hospital emergency visits for bronchospasm decreased by 15% (incidence rate ratio [IRR]=0.85, 95% CI=0.76, 0.94) following implementation of the law. Hospitalizations for bronchospasm did not change significantly (IRR=0.89, 95% CI=0.66, 1.21). Total monthly puffs of salbutamol and ipratropium administered in the non-hospital emergency setting decreased by 224 (95% CI=-372, -76) and 179 (95% CI=-340, -18.6), respectively, from means of 1,222 and 1,007 before the law. Uruguay's 100% smokefree law was followed by fewer emergency visits for bronchospasm and less need for treatment, supporting adoption of such policies in low- and middle-income countries to reduce the disease burden and healthcare costs associated with smoking. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Emergency management response to a warning-level Alaska-source tsunami impacting California: Chapter J in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    USGS Publications Warehouse

    Miller, Kevin M.; Long, Kate

    2013-01-01

    This chapter is directed towards two audiences: Firstly, it targets nonemergency management readers, providing them with insight on the process and challenges facing emergency managers in responding to tsunami Warning, particularly given this “short fuse” scenario. It is called “short fuse” because there is only a 5.5-hour window following the earthquake before arrival of the tsunami within which to evaluate the threat, disseminate alert and warning messages, and respond. This action initiates a period when crisis communication is of paramount importance. An additional dynamic that is important to note is that within 15 minutes of the earthquake, the National Oceanic and Atmospheric Administration (NOAA) and the National Weather Service (NWS) will issue alert bulletins for the entire Pacific Coast. This is one-half the time actually presented by recent tsunamis from Japan, Chile, and Samoa. Second, the chapter provides emergency managers at all levels with insights into key considerations they may need to address in order to augment their existing plans and effectively respond to tsunami events. We look at emergency management response to the tsunami threat from three perspectives:“Top Down” (Threat analysis and Alert/Warning information from the Federal agency charged with Alert and Warning) “Bottom Up” (Emergency management’s Incident Command approach to responding to emergencies and disasters based on the needs of impacted local jurisdictions) “Across Time” (From the initiating earthquake event through emergency response) We focus on these questions: What are the government roles, relationships, and products that support Tsunami Alert and Warning dissemination? (Emergency Planning and Preparedness.) What roles, relationships, and products support emergency management response to Tsunami Warning and impact? (Engendering prudent public safety response.) What are the key emergency management activities, considerations, and challenges brought

  12. The Emergence Of The National Research And Education Network (NREN) And Its Implications For American Telecommunications

    NASA Astrophysics Data System (ADS)

    Maloff, Joel H.

    1990-01-01

    "The nation which most completely assimilates high performance computing into its economy will very likely emerge as the dominant intellectual, economic, and technological force in the next century", Senator Albert Gore, Jr., May 18, 1989, while introducing Senate Bill 1067, "The National High Performance Computer Technology Act of 1989". A national network designed to link supercomputers, particle accelerators, researchers, educators, government, and industry is beginning to emerge. The degree to which the United States can mobilize the resources inherent within our academic, industrial and government sectors towards the establishment of such a network infrastructure will have direct bearing on the economic and political stature of this country in the next century. This program will have significant impact on all forms of information transfer, and peripheral benefits to all walks of life similar to those experienced from the moon landing program of the 1960's. The key to our success is the involvement of scientists, librarians, network designers, and bureaucrats in the planning stages. Collectively, the resources resident within the United States are awesome; individually, their impact is somewhat more limited. The engineers, technicians, business people, and educators participating in this conference have a vital role to play in the success of the National Research and Education Network (NREN).

  13. The financial burden of emergency general surgery: National estimates 2010 to 2060.

    PubMed

    Ogola, Gerald O; Gale, Stephen C; Haider, Adil; Shafi, Shahid

    2015-09-01

    Adoption of the acute care surgery model has led to increasing volumes of emergency general surgery (EGS) patients at trauma centers. However, the financial burden of EGS services on trauma centers is unknown. This study estimates the current and future costs associated with EGS hospitalization nationwide. We applied the American Association for the Surgery of Trauma's DRG International Classification of Diseases-9th Rev. criteria for defining EGS to the 2010 National Inpatient Sample (NIS) data and identified adult EGS patients. Cost of hospitalization was obtained by converting reported charges to cost using the 2010 all-payer inpatient cost-to-charge ratio for all hospitals in the NIS database. Cost was modeled via a log-gamma model in a generalized linear mixed model to account for potential correlation in cost within states and hospitals in the NIS database. Patients' characteristics and hospital factors were included in the model as fixed effects, while state and hospital were included as random effects. The national incidence of EGS was calculated from NIS data, and the US Census Bureau population projections were used to estimate incidence for 2010 to 2060. Nationwide costs were obtained by multiplying projected incidences by estimated costs and reported in year 2010 US dollar value. Nationwide, there were 2,640,725 adult EGS hospitalizations in 2010. The national average adjusted cost per EGS hospitalization was $10,744 (95% confidence interval [CI], $10,615-$10,874); applying these cost data to the national EGS hospitalizations gave a total estimated cost of $28.37 billion (95% CI, $28.03-$28.72 billion). Older age groups accounted for greater proportions of the cost ($8.03 billion for age ≥ 75 years, compared with $1.08 billion for age 18-24 years). As the US population continues to both grow and age, EGS costs are projected to increase by 45% to $41.20 billion (95% CI, $40.70-$41.7 billion) by 2060. EGS constitutes a significant portion of US health

  14. A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study.

    PubMed

    April, Michael D; Schauer, Steven G; Brown Rd, Calvin A; Ng, Patrick C; Fernandez, Jessie; Fantegrossi, Andrea E; Maddry, Joseph K; Summers, Shane; Sessions, Daniel J; Barnwell, Robert M; Antonacci, Mark

    2017-01-01

    Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition. We cross-referenced these forms against the numbers of intubation events reported in the ED nursing daily reports to ensure capture of all intubations. Providers completed forms for every intubation within 6 weeks of the procedure. We analyzed data from March 28, 2016, to March 27, 2017. During the study period, providers performed 259 intubations in the BAMC ED. Reasons for intubation were related to trauma for 184 patients (71.0%) and medical conditions for 75 patients (29.0%). Overall, first-attempt success was 83.0%. Emergency medicine residents performed a majority of first attempts (95.0%). Most common devices chosen on first attempt were a video laryngoscope for 143 patients (55.2%) and a direct laryngoscope for 115 patients (44.4%). One patient underwent cricothyrotomy. The 2 most common induction agents were ketamine (59.8%; 95% CI, 55.2%-67.4%) and etomidate (19.3%; 95% CI, 14.7%-24.7%). The most common neuromuscular blocking agents were rocuronium (62.9%; 95% CI, 56.7%-68.8%) and succinylcholine (18.9%; 95% CI, 14.3%-24.2%). In the BAMC ED, emergency intubation most commonly occurred for trauma indications using video laryngoscopy with a high first-pass success.

  15. Basic Training Program for Emergency Medical Technician Ambulance: Course Guide.

    ERIC Educational Resources Information Center

    Fucigna, Joseph T.; And Others

    In an effort to upgrade or further develop the skills levels of all individuals involved in the emergency medical care service, this training program was developed for the National Highway Safety Bureau. This specific course is an attempt to organize, conduct, and standardize a basic training course for emergency medical technicians (EMTs). The…

  16. Self-reported preparedness of New Zealand acute care providers to mass emergencies before the Canterbury Earthquakes: a national survey.

    PubMed

    Al-Shaqsi, Sultan; Gauld, Robin; McBride, David; Al-Kashmiri, Ammar; Al-Harthy, Abdullah

    2015-02-01

    Disasters occur more frequently. Acute care providers are the first to respond to mass emergencies from the healthcare sector. The preparedness of acute care providers in New Zealand to respond to mass emergencies has not been previously studied. To assess the self-reported training and experience of New Zealand acute care providers to respond to mass emergencies and the factors associated with strong preparedness. A cross-sectional national survey of 1500 acute care providers in New Zealand carried out between 2009 and 2010. The survey assessed experience, training and self-reported preparedness. It also determined the factors associated with strong perceived preparedness. The response rate to this survey was 60.7%. Nurses had a higher response rate than doctors or paramedics. Only 29.2% of acute care providers reported responding to a previous mass emergency event. There were 53.5% of acute care providers who reported having formal training in how to deal with mass emergencies, whereas 58.1% of participants reported that they were aware of their role during a healthcare mass emergency response. The factors associated with self-reported strong preparedness to deal with mass emergencies included: being a paramedic, previous training, participation in a drill, willingness to report to work during an infection or man-made emergency, ability to triage and general awareness of the role during a mass emergency. Almost half of New Zealand acute healthcare providers have no training in dealing with mass emergency events. Training and general awareness of the role during a mass emergency response were the main factors associated with strong self-reported preparedness of acute care providers. The apparent efficacy of training allied to lack of availability means that it should be a national priority. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  17. 77 FR 66513 - Continuation of the National Emergency With Respect to Weapons of Mass Destruction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ... proliferation of nuclear, biological, and chemical weapons (weapons of mass destruction) and the means of delivering such weapons. On July 28, 1998, the President issued Executive Order 13094 amending Executive... the National Emergency With Respect to Weapons of Mass Destruction On November 14, 1994, by Executive...

  18. Emergency healthcare of the future.

    PubMed

    FitzGerald, Gerry; Toloo, Ghasem Sam; Romeo, Michele

    2014-06-01

    Emergency healthcare is a high profile component of modern healthcare systems, which over the past three decades has fundamentally transformed in many countries. However, despite this rapid development, and associated investments in service standards, there is a high level of concern with the performance of emergency health services relating principally to system wide congestion. The factors driving this problem are complex but relate largely to the combined impact of growing demand, expanded scope of care and blocked access to inpatient beds. These factors are unlikely to disappear in the medium term despite the National Emergency Access Target. The aim of this article is to stimulate a conversation about the future design and functioning of emergency healthcare systems; examining what we understand about the problem and proposing a rationale that may underpin future strategic approaches. This is also an invitation to join the conversation. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Does Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) Predict Levels of Depressive Symptoms during Emerging Adulthood?

    PubMed Central

    Meinzer, Michael C.; Pettit, Jeremy W.; Waxmonsky, James G.; Gnagy, Elizabeth; Molina, Brooke S.G.; Pelham, William E.

    2015-01-01

    Little is known about the development and course of depressive symptoms through emerging adulthood among individuals with a childhood history of attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to examine if a history of ADHD in childhood significantly predicted depressive symptoms during emerging adulthood (i.e., ages 18–25 years), including the initial level of depressive symptoms, continued levels of depressive symptoms at each age year, and the rate of change in depressive symptoms over time. 394 participants (205 with ADHD and 189 without ADHD; 348 males and 46 females) drawn from the Pittsburgh ADHD Longitudinal Study (PALS) completed annual self-ratings of depressive symptoms between the ages of 18 and 25 years. Childhood history of ADHD significantly predicted a higher initial level of depressive symptoms at age 18, and higher levels of depressive symptoms at every age year during emerging adulthood. ADHD did not significantly predict the rate of change in depressive symptoms from age 18 to age 25. Childhood history of ADHD remained a significant predictor of initial level of depressive symptoms at age 18 after controlling for comorbid psychiatric diagnoses, but not after controlling for concurrent ADHD symptoms and psychosocial impairment. Participants with childhood histories of ADHD experienced significantly higher levels of depressive symptoms than non-ADHD comparison participants by age 18 and continued to experience higher, although not increasing, levels of depressive symptoms through emerging adulthood. Clinical implications and directions for future research are discussed. PMID:26272531

  20. Clinical Skills Performed By Iranian Emergency Nurses: Perceived Competency Levels and Attitudes Toward Expanding Professional Roles.

    PubMed

    Hassankhani, Hadi; Hasanzadeh, Firooz; Powers, Kelly A; Dadash Zadeh, Abbas; Rajaie, Rouzbeh

    2018-03-01

    Emergency nurses play an important role in the care of critically ill and injured patients, and their competency to perform clinical skills is vital to safe and effective patient care. The aim of this study was to evaluate the frequency of clinical skills performed and perceived competency levels among Iranian emergency nurses. In addition, attitudes toward expanding the professional roles of Iranian emergency nurses were also assessed. In this descriptive correlational study, 319 emergency nurses from 30 hospitals in northwest Iran participated. Data were collected using a self-report questionnaire. Descriptive statistics and Pearson's correlation coefficient were used to present the findings. Overall competency of the emergency nurses was 73.31 ± 14.2, indicating a good level of perceived competence. The clinical skills most frequently performed were in the domains of organizational and workload competencies (3.43 ± 0.76), diagnostic function (3.25 ± 0.82), and the helping role (3.17 ± 0.83). A higher level of perceived competence was found for skills within these domains. Less frequently, participants performed skills within the domains of effective management of rapidly changing situations (2.70 ± 0.94) and administering and monitoring therapeutic interventions (2.60 ± 0.97); a lower perceived level of competence was noted for these clinical skills. There was a significant correlation between frequency of performing clinical skills and perceived competency level (r = 0.651, P < .001). Participants had positive attitudes toward expanding their professional roles (2.13 ± 0.92), with 81.5% agreeing it would improve their job satisfaction. Higher perceived competency levels were significantly associated with more frequent performance of clinical skills. This has implications for nurse managers and educators who may consider offering more frequent experiential and educational opportunities to emergency nurses. Expansion of nurses' roles could also result in

  1. [Potential for the survey of quality indicators based on a national emergency department registry : A systematic literature search].

    PubMed

    Hörster, A C; Kulla, M; Brammen, D; Lefering, R

    2018-06-01

    Emergency department processes are often key for successful treatment. Therefore, collection of quality indicators is demanded. A basis for the collection is systematic, electronic documentation. The development of paper-based documentation into an electronic and interoperable national emergency registry is-besides the establishment of quality management for emergency departments-a target of the AKTIN project. The objective of this research is identification of internationally applied quality indicators. For the investigation of the current status of quality management in emergency departments based on quality indicators, a systematic literature search of the database PubMed, the Cochrane Library and the internet was performed. Of the 170 internationally applied quality indicators, 25 with at least two references are identified. A total of 10 quality indicators are ascertainable by the data set. An enlargement of the data set will enable the collection of seven further quality indicators. The implementation of data of care behind the emergency processes will provide eight additional quality indicators. This work was able to show that the potential of a national emergency registry for the establishment of quality indicators corresponds with the international systems taken into consideration and could provide a comparable collection of quality indicators.

  2. Curriculum Guides for Level I and Level II: National Manpower Model.

    ERIC Educational Resources Information Center

    National Inst. on Mental Retardation, Toronto (Ontario).

    Curriculum guides to levels I and II of the Canadian National Manpower Model, which elaborate on content originally presented in 1971, are provided for personnel training programs in the field of mental retardation and related handicapping areas. The guides are said to be based on a philosophy that demands society's acceptance of retarded and…

  3. 3 CFR 8443 - Proclamation 8443 of October 23, 2009. Declaration of a National Emergency With Respect to the...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of a National Emergency With Respect to the 2009 H1N1 Influenza Pandemic 8443 Proclamation 8443... Emergency With Respect to the 2009 H1N1 Influenza PandemicBy the President of the United States of America A... to the 2009 H1N1 influenza virus. The Secretary has renewed that declaration twice, on July 24, 2009...

  4. National Emergency Centers Establishment Act

    THOMAS, 113th Congress

    Rep. Hastings, Alcee L. [D-FL-20

    2013-01-23

    House - 02/21/2013 Referred to the Subcommittee on Intelligence, Emerging Threats & Capabilities. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  5. First Responder: National Standard Curriculum (Instructor's Course Guide)

    DOT National Transportation Integrated Search

    1995-08-01

    This course is one of a series of courses making up a National EMS education : program for out-of hospital care. The First Responder is a designated level of : emergency medical care provider as outlined by the National EMS Education and : Practice B...

  6. ENVIRONMENTAL MONITORING AND MODELING ASSOCIATED WITH NATIONAL EMERGENCIES - EXPERIENCES GAINED FROM THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    A workshop was held in Research Triangle Park, NC on November 18-19, 2002 to discuss scientific issues associated with measuring, modeling, and assessing exposure and risk to air containing contaminants generated as a result of national emergencies and disasters. Participants wer...

  7. Individual and national level associations between economic deprivation and partner violence among college students in 31 national settings.

    PubMed

    Sabina, Chiara

    2013-01-01

    This study expands previous work by examining individual and national level effects of economic deprivation on partner violence among college students. Three main hypotheses were tested: (1) individual level economic deprivation (i.e., ability to meet daily needs and family income) is associated with partner violence, (2) gross national income is associated with the mean rates of partner violence across nations, and (3) the association between individual level economic deprivation and partner violence varies according to the economic national context as measured by gross national income. Data for 14,090 participants from 31 nations came from the International Dating Violence Study that queried university students about violence in their relationships and relevant risk factors. A series of overdispersed Poisson hierarchical linear regression models were specified to test the hypotheses. Ability to meet daily needs, but not family income, was associated with rates of partner violence. Gross national income was also associated with mean rates of partner violence across nations as well as the relationships between ability to meet daily and partner violence and between family income and partner violence. The findings show the importance of context, as indicated by national economic standing, on rates of partner violence. Not only do economically deprived individuals experience more partner violence, but those living in poorer nations experience more partner violence, regardless of individual economic deprivation. Limitations of the study include a non-random sample and substantial variation in the study sites beyond economic standing. Nonetheless, findings indicate efforts to confront partner violence must also call for cross-national economic development. © 2013 Wiley Periodicals, Inc.

  8. Cultural evolution and emergent group-level traits through social heterosis.

    PubMed

    Nonacs, Peter; Kapheim, Karen M

    2014-06-01

    Smaldino proposes emergent properties of human groups, arising when individuals display both differentiation and organization, constitute a novel unit of cultural selection not addressed by current evolutionary theory. We propose existing theoretical frameworks for maintenance of genetic diversity - social heterosis and social genomes - can similarly explain the appearance and maintenance of human cultural diversity (i.e., group-level traits) and collaborative interdependence.

  9. The development of sustainable emergency care in ghana: physician, nursing and prehospital care training initiatives.

    PubMed

    Martel, John; Oteng, Rockefeller; Mould-Millman, Nee-Kofi; Bell, Sue Anne; Zakariah, Ahmed; Oduro, George; Kowalenko, Terry; Donkor, Peter

    2014-10-01

    Ghana's first Emergency Medicine residency and nursing training programs were initiated in 2009 and 2010, respectively, at Komfo Anokye Teaching Hospital in the city of Kumasi in association with Kwame Nkrumah University of Science and Technology and the Universities of Michigan and Utah. In addition, the National Ambulance Service was commissioned initially in 2004 and has developed to include both prehospital transport services in all regions of the country and Emergency Medical Technician training. Over a decade of domestic and international partnership has focused on making improvements in emergency care at a variety of institutional levels, culminating in the establishment of comprehensive emergency care training programs. We describe the history and status of novel postgraduate emergency physician, nurse, and prehospital provider training programs as well as the prospect of creating a board certification process and formal continuing education program for practicing emergency physicians. Significant strides have been made in the development of emergency care and training in Ghana over the last decade, resulting in the first group of Specialist-level emergency physicians as of late 2012, as well as development of accredited emergency nursing curricula and continued expansion of a national Emergency Medical Service. This work represents a significant move toward in-country development of sustainable, interdisciplinary, team-based emergency provider training programs designed to retain skilled health care workers in Ghana and may serve as a model for similar developing nations. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Are Older Adults Prepared to Ensure Food Safety during Extended Power Outages and Other Emergencies?: Findings from a National Survey

    ERIC Educational Resources Information Center

    Kosa, Katherine M.; Cates, Sheryl C.; Karns, Shawn; Godwin, Sandria L.; Coppings, Richard J.

    2012-01-01

    Natural disasters and other emergencies can cause an increased risk of foodborne illness. We conducted a nationally representative survey to understand consumers' knowledge and use of recommended practices during/after extended power outages and other emergencies. Because older adults are at an increased risk for foodborne illness, this paper…

  11. International Exchange of Emergency Phase Information and Assessment: An Aid to Inter/National Decision Makers

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

    Sullivan, T J; Chino, M; Ehrhardt, J

    2003-09-01

    This paper discusses a collaborative project whose purpose is (1) to demonstrate the technical feasibility and mutual benefit of a system seeking early review or preview, in a ''quasi peer review'' mode, of nuclear accident plume and dose assessment predictions by four major international nuclear accident emergency response systems before release of their calculations to their respective national authorities followed by (2) sharing these results with responsible international authorities. The extreme sensitivity of the general public to any nuclear accident information has been a strong motivation to seek peer review prior to public release. Another intended objective of this workmore » is (3) the development of an affordable/accessible system for distribution of prediction results to countries having no prediction capabilities and (4) utilization of the link for exercises and collaboration studies. The project exploits the Internet as a ubiquitous communications medium, browser technology as a simple, user friendly interface, and low-cost PC level hardware. The participants are developing a web based dedicated node with ID and password access control, where the four systems can deposit a minimal set of XML-based data and graphics files, which are then displayed in a common identical map format. Side-by-side viewing and televideo conferencing will permit rapid evaluation, correction or elaboration of data, recalculation (if necessary) and should produce a strong level of consensus to assist international decision makers. Successful completion of this work could lead to easy utilization by national and international organizations, such as the IAEA and WHO, as well as by non-nuclear states at risk of a trans-boundary incursion on their territory.« less

  12. Estimates of emergency operating capacity in U.S. manufacturing industries: 1994--2005

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

    Belzer, D.B.

    1997-02-01

    To develop integrated policies for mobilization preparedness, planners require estimates and projections of available productive capacity during national emergency conditions. This report develops projections of national emergency operating capacity (EOC) for 458 US manufacturing industries at the 4-digit Standard Industrial Classification (SIC) level. These measures are intended for use in planning models that are designed to predict the demands for detailed industry sectors that would occur under conditions such as a military mobilization or a major national disaster. This report is part of an ongoing series of studies prepared by the Pacific Northwest National Laboratory to support mobilization planning studiesmore » of the Federal Emergency Planning Agency/US Department of Defense (FEMA/DOD). Earlier sets of EOC estimates were developed in 1985 and 1991. This study presents estimates of EOC through 2005. As in the 1991 study, projections of capacity were based upon extrapolations of equipment capital stocks. The methodology uses time series regression models based on industry data to obtain a response function of industry capital stock to levels of industrial output. The distributed lag coefficients of these response function are then used with projected outputs to extrapolate the 1994 level of EOC. Projections of industrial outputs were taken from the intermediate-term forecast of the US economy prepared by INFORUM (Interindustry Forecasting Model, University of Maryland) in the spring of 1996.« less

  13. Emergency Preparedness & Recovery News Releases - PHE

    Science.gov Websites

    and reload this page. Skip over global navigation links U.S. Department of Health and Human Services Health Emergency - Leading a Nation Prepared Search Search PHE Home > Emergency Emergency Preparedness necesitan medicamentos HHS Acting Secretary Declares Public Health Emergency to Address National Opioid

  14. 3 CFR - Continuation of the National Emergency With Respect to the Actions of Certain Persons To...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to the Actions of Certain Persons To Undermine the Sovereignty of Lebanon or Its Democratic Processes or Institutions Presidential Documents Other Presidential Documents Notice of July 24, 2012...

  15. 3 CFR - Continuation of the National Emergency With Respect to the Actions of Certain Persons to...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to the Actions of Certain Persons to Undermine the Sovereignty of Lebanon or Its Democratic Processes and Institutions Presidential Documents Other Presidential Documents Notice of July 29, 2010...

  16. 3 CFR - Continuation of the National Emergency With Respect to the Actions and Policies of Certain...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to the Actions and Policies of Certain Members of the Government of Belarus and Other Persons That Undermine Democratic Processes or Institutions in Belarus Presidential Documents Other Presidential...

  17. 20 CFR 671.100 - What is the purpose of national emergency grants under WIA section 173?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... grants under WIA section 173? 671.100 Section 671.100 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.100 What is the... provide supplemental dislocated worker funds to States, Local Boards and other eligible entities in order...

  18. 20 CFR 671.100 - What is the purpose of national emergency grants under WIA section 173?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... grants under WIA section 173? 671.100 Section 671.100 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS § 671.100 What is the... provide supplemental dislocated worker funds to States, Local Boards and other eligible entities in order...

  19. Past Emergencies

    EPA Pesticide Factsheets

    These activities, some of national significance requiring coordination with other agencies, demonstrate the emergency response program and provide valuable experience so that EPA can better prevent, prepare for, and respond to emergencies in the future.

  20. [Consensus statement of the National AIDS Plan Secretariat, Spanish Society of Emergency Medicine and AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology on Emergency and Human Immunodeficiency Virus Infection].

    PubMed

    2013-01-01

    Supporting non-HIV specialist professionals in the treatment of patients with urgent diseases resulting from HIV infection. These recommendations have been agreed by an expert panel from the National AIDS Plan Secretariat, the Spanish Society of Emergency Medicine, and the AIDS Study Group. A review has been made of the safety and efficacy results of clinical trials and cohort studies published in biomedical journals (PubMed and Embase) or presented at conferences. The strength of each recommendation (A, B, C) and the level of supporting evidence (I, II, III) are based on a modification of the criteria of the Infectious Diseases Society of America. The data to be collected from the emergency medical history in order to recognize the patient at risk of HIV infection were specified. It stressed the basic knowledge of ART principles and its importance in terms of decline in morbidity and mortality of HIV+ patients and referring to the HIV specialist for follow-up, where appropriate, including drug interactions. Management of different emergency situations that may occur in patients with HIV infection is also mentioned. The non-HIV specialist professional, will find the necessary tools to approach HIV patients with an emergency disease. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  1. Effect of Uruguay’s National 100% Smokefree Law on Emergency Visits for Bronchospasm

    PubMed Central

    Kalkhoran, Sara; Sebrié, Ernesto M; Sandoya, Edgardo; Glantz, Stanton A.

    2014-01-01

    Introduction Implementation of smokefree laws is followed by drops in hospital admissions for cardiovascular diseases and asthma. The impact of smokefree laws on use of non-hospital medical services has not been assessed. The purpose of this study is to evaluate the impact of Uruguay’s national 100% smokefree legislation on non-hospital emergency care visits and hospitalizations for bronchospasm and bronchodilator use. Methods The monthly number of non-hospital emergency care visits and hospitalizations for bronchospasm, as well as monthly puffs of bronchodilators (total and per person), from 3 years prior to the adoption of the 100% smokefree policy on March 1, 2006 through 5 years after the policy were assessed using interrupted time series negative binomial regression. Data analysis was conducted in 2014. Results The incidence of non-hospital emergency visits for bronchospasm decreased by 15% (incidence rate ratio [IRR]=0.85, 95% CI=0.76, 0.94) following implementation of the law. Hospitalizations for bronchospasm did not change significantly (IRR=0.89, 95% CI=0.66, 1.21). Total monthly puffs of salbutamol and ipratropium administered in the non-hospital emergency setting decreased by 224 (95% CI= −372, −76) and 179 (95% CI= −340, −18.6), respectively, from means of 1,222 and 1,007 before the law. Conclusions Uruguay’s 100% smokefree law was followed by fewer emergency visits for bronchospasm and less need for treatment, supporting adoption of such policies in low- and middle-income countries to reduce the disease burden and healthcare costs associated with smoking. PMID:25997906

  2. Disaster Monitoring and Emergency Response Services in China

    NASA Astrophysics Data System (ADS)

    Wu, J.; Han, X.; Zhou, Y.; Yue, P.; Wang, X.; Lu, J.; Jiang, W.; Li, J.; Tang, H.; Wang, F.; Li, X.; Fan, J.

    2018-04-01

    The Disaster Monitoring and Emergency Response Service(DIMERS) project was kicked off in 2017 in China, with the purpose to improve timely responsive service of the institutions involved in the management of natural disasters and man-made emergency situations with the timely and high-quality products derived from Space-based, Air-based and the in-situ Earth observation. The project team brought together a group of top universities and research institutions in the field of Earth observations as well as the operational institute in typical disaster services at national level. The project will bridge the scientific research and the response services of massive catastrophe in order to improve the emergency response capability of China and provide scientific and technological support for the implementation of the national emergency response strategy. In response to the call for proposal of "Earth Observation and Navigation" of 2017 National Key R&D Program of China, Professor Wu Jianjun, the deputy chairman of Faculty of Geographical Science of Beijing Normal University, submitted the Disaster Monitoring and Emergency Response Service (DIMERS) project, jointly with the experts and scholars from Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, Wuhan University, China Institute of Earthquake Forecasting of China Earthquake Administration and China Institute of Water Resources and Hydropower Science. After two round evaluations, the proposal was funded by Ministry of Science and Technology of China.

  3. Volcano-hazards Education for Emergency Officials Through Study Trip Learning—The 2013 Colombia-USA Bi-national Exchange

    NASA Astrophysics Data System (ADS)

    Driedger, C. L.; Ewert, J. W.

    2015-12-01

    A central tenant of hazard communication is that colleagues with principal responsibilities for emergency planning and response sustain a 'long-term conversation' that builds trust, and increases understanding of hazards and successful protocols. This requires well maintained partnerships among a broad spectrum of officials who are knowledgeable about volcano hazards; credible within their communities; and who have personal and professional stake in their community's safety. It can require that volcano scientists facilitate learning opportunities for partners in emergency management who have little or no familiarity with eruption response. Scientists and officials from Colombia and the Cascades region of the United States recognized that although separated by geographic and cultural distance, their communities faced similar hazards from lahars. For the purpose of sharing best practices, the 2013 Colombia-USA Bi-national Exchange was organized by the US Geological Survey (USGS) and the Washington Emergency Management Division, with support from the US Agency for International Development (USAID). Nine Colombian emergency officials and scientists visited the U.S. to observe emergency response planning and protocols and to view the scale of a potential lahar disaster at Mount Rainier. Ten U.S. delegates visited Colombia to absorb best practices developed after the catastrophic 1985 eruption and lahars at Nevado del Ruiz. They observed the devastation and spoke with survivors, first responders, and emergency managers responsible for post-disaster recovery efforts. Delegates returned to their nations energized and with improved knowledge about volcanic crises and effective mitigation and response. In the U.S., trainings, hazard signage, evacuation routes and assembly points, and community websites have gained momentum. Colombian officials gained a deeper appreciation of and a renewed commitment to response planning, education, and disaster preparedness.

  4. Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

    PubMed

    Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

    2018-05-01

    Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with

  5. Report on the International Conference on Emergency Health Care Development.

    PubMed Central

    Dines, G B

    1990-01-01

    Emergency medical services (EMS) provide rescue, field stabilization, transportation to medical facilities, and definitive care for persons experiencing medical emergencies. In order to advance worldwide development and refinement of EMS systems, and their integration with emergency preparedness and response programs, the International Conference on Emergency Health Care Development was held in Crystal City, Arlington, VA, August 15-19, 1989. The conference was supported by the Department of Health and Human Services and its Health Resources and Services Administration; the Department of Transportation and its National Highway Traffic and Safety Administration; and the Pan American Health Organization. Objectives of the conference were to clarify linkages between various levels of emergency response, to present methods for developing or improving EMS systems within societies with different resources, to demonstrate processes by which EMS systems have been developed, and to propose international emergency health care development goals. Topics included development of services in developing nations, case studies of underdeveloped countries' responses to natural disasters, and a method for updating disaster response through use of available medical resources. PMID:1968669

  6. Canadian National Dairy Study: Herd-level milk quality.

    PubMed

    Bauman, C A; Barkema, H W; Dubuc, J; Keefe, G P; Kelton, D F

    2018-03-01

    The objective of this study was to estimate Canadian national milk quality parameters and estimate the bulk tank milk (BTM) prevalence of 4 mastitis pathogens, Staphylococcus aureus, Streptococcus agalactiae, Mycoplasma bovis, and Prototheca spp., on Canadian dairy farms. A questionnaire was sent to all Canadian dairy producers. Of the 1,062 producers who completed the questionnaire, 374 producers from across the country were visited and milking hygiene was assessed. Farm-level milk quality data for all Canadian dairy producers was collected from the provincial marketing boards and combined with the questionnaire and farm visit data. In addition, a BTM sample was collected either during the farm visit or by the marketing board in November of 2015 and was tested for 4 major mastitis pathogens using the PathoProof Mastitis Major 4 PCR Assay (Thermo Fisher Scientific Inc., Waltham, MA). Apparent herd-level prevalence was 46% for S. aureus, 6% for Prototheca spp., 0% for M. bovis, and 0% for Strep. agalactiae. Due to the low prevalence of M. bovis and Strep. agalactiae and a lack of significant factors associated with farms testing positive for Prototheca spp., an association analysis could only be carried out for Staph. aureus-positive farms. Factors associated with Staph. aureus-positive farms were not fore-stripping cows before milking (odds ratio = 1.87), milking with a pipeline system (odds ratio = 2.21), and stall bases made of a rubberized surface (mats and mattresses), whereas protective factors were using blanket dry cow therapy (odds ratio = 0.49) and applying a tag or visible mark on cows known to have chronic mastitis infections (odds ratio = 0.45). The Canadian national production-weighted geometric mean somatic cell count was determined to be 208,000 cells/mL. This is the first national dairy study conducted in Canada. Participating farms had higher milk yield; were more likely to have a loose housing system, parlor, or automated milking system; and had

  7. 78 FR 8955 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... the National Emergency With Respect to the Situation in or in Relation to C[ocirc]te d'Ivoire On... International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with the unusual and extraordinary... or in relation to C[ocirc]te d'Ivoire and ordered related measures blocking the property of certain...

  8. 78 FR 37925 - Continuation of the National Emergency With Respect to the Disposition of Russian Highly Enriched...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-24

    ... National Emergency With Respect to the Disposition of Russian Highly Enriched Uranium On June 25, 2012, by... America and the Government of the Russian Federation Concerning the Disposition of Highly Enriched Uranium... Russian highly enriched uranium declared in Executive Order 13617. [[Page 37926

  9. Emergency and trauma care in Pakistan: a cross-sectional study of healthcare levels

    PubMed Central

    Razzak, Junaid A; Baqir, Syed M; Khan, Uzma Rahim; Heller, David; Bhatti, Junaid; Hyder, Adnan A

    2015-01-01

    Background The importance of emergency medical care for the successful functioning of health systems has been increasingly recognised. This study aimed to evaluate emergency and trauma care facilities in four districts of the province of Sindh, Pakistan. Method We conducted a cross-sectional health facility survey in four districts of the province of Sindh in Pakistan using a modified version of WHO’s Guidelines for essential trauma care. 93 public health facilities (81 primary care facilities, nine secondary care hospitals, three tertiary hospitals) and 12 large private hospitals were surveyed. Interviews of healthcare providers and visual inspections of essential equipment and supplies as per guidelines were performed. A total of 141 physicians providing various levels of care were tested for their knowledge of basic emergency care using a validated instrument. Results Only 4 (44%) public secondary, 3 (25%) private secondary hospitals and all three tertiary care hospitals had designated emergency rooms. The majority of primary care health facilities had less than 60% of all essential equipments overall. Most of the secondary level public hospitals (78%) had less than 60% of essential equipments, and none had 80% or more. A fourth of private secondary care facilities and all tertiary care hospitals (n=3; 100%) had 80% or more essential equipments. The average percentage score on the physician knowledge test was 30%. None of the physicians scored above 60% correct responses. Conclusions The study findings demonstrated a gap in both essential equipment and provider knowledge necessary for effective emergency and trauma care. PMID:24157684

  10. Nutrition and sustainability: an emerging food policy discourse.

    PubMed

    Lang, Tim; Barling, David

    2013-02-01

    It is well known that food has a considerable environmental impact. Less attention has been given to mapping and analysing the emergence of policy responses. This paper contributes to that process. It summarises emerging policy development on nutrition and sustainability, and explores difficulties in their integration. The paper describes some policy thinking at national, European and international levels of governance. It points to the existence of particular policy hotspots such as meat and dairy, sustainable diets and waste. Understanding the environmental impact of food systems challenges nutrition science to draw upon traditions of thinking which have recently been fragmented. These perspectives (life sciences, social and environmental) are all required if policy engagement and clarification is to occur. Sustainability issues offer opportunities for nutrition science and scientists to play a more central role in the policy analysis of future food systems. The task of revising current nutrition policy advice to become sustainable diet advice needs to begin at national and international levels.

  11. Workload differences across command levels and emergency response organizations during a major joint training exercise.

    PubMed

    Prytz, Erik G; Rybing, Jonas; Jonson, Carl-Oscar

    2016-01-01

    This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded. The NASA TLX was used to test for differences in workload between commanders and subordinates and among three different emergency response organizations during a joint emergency exercise. Questionnaire-based evaluation with professional emergency responders. The study was performed in conjunction with a large-scale interorganizational joint emergency exercise in Sweden. A total of 20 participants from the rescue services, 12 from the emergency medical services, and 12 from the police participated in the study (N=44). Ten participants had a command-level role during the exercise and the remaining 34 were subordinates. The main outcome measures were the workload subscales of the NASA TLX: mental demands, physical demands, temporal demands, performance, effort, and frustration. The results showed that the organizations experienced different levels of workload, that the commanders experienced a higher workload than the subordinates, and that two out of three organizations fell below the twenty-fifth percentile of average workload scores compiled from 237 prior studies. The results support the notion that the NASA TLX could be a useful complementary tool to evaluate exercise designs and outcomes. This should be further explored and verified in additional studies.

  12. 77 FR 37261 - Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-21

    ... National Emergency With Respect to the Risk of Nuclear Proliferation Created by the Accumulation of Weapons... Extracted from Nuclear Weapons, dated February 18, 1993, and related contracts and agreements (collectively... derived from nuclear weapons to low enriched uranium for peaceful commercial purposes. The order invoked...

  13. Country- and individual-level socioeconomic determinants of depression: multilevel cross-national comparison.

    PubMed

    Rai, Dheeraj; Zitko, Pedro; Jones, Kelvyn; Lynch, John; Araya, Ricardo

    2013-03-01

    The prevalence and correlates of depression vary across countries. Contextual factors such as country-level income or income inequalities have been hypothesised to contribute to these differences. To investigate associations of depression with socioeconomic factors at the country level (income inequality, gross national income) and individual (education, employment, assets and spending) level, and to investigate their relative contribution in explaining the cross-national variation in the prevalence of depression. Multilevel study using interview data of 187 496 individuals from 53 countries participating in the World Health Organization World Health Surveys. Depression prevalence varied between 0.4 and 15.7% across countries. Individual-level factors were responsible for 86.5% of this variance but there was also reasonable variation at the country level (13.5%), which appeared to increase with decreasing economic development of countries. Gross national income or country-level income inequality had no association with depression. At the individual level, fewer material assets, lower education, female gender, economic inactivity and being divorced or widowed were associated with increased odds of depression. Greater household spending, unlike material assets, was associated with increasing odds of depression (adjusted analysis). The variance of depression prevalence attributable to country-level factors seemed to increase with decreasing economic development of countries. However, country-level income inequality or gross national income explained little of this variation, and individual-level factors appeared more important than contextual factors as determinants of depression. The divergent relationship of assets and spending with depression emphasise that different socioeconomic measures are not interchangeable in their associations with depression.

  14. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module X. Medical Emergencies.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on medical emergencies is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Ten units of study are presented: (1) diabetic emergencies; (2) anaphylactic reactions; (3) exposure to environmental extremes; (4) alcoholism and drug abuse; (5) poisoning and…

  15. Community-Based Academic Level I Trauma Center Prepares for the 2016 Republican National Convention.

    PubMed

    Keefe, Judy; Cern, Kathy; Wiita, Sharon; Raubenolt, Amy; Atkins, Elizabeth

    Disaster preparedness has come to the forefront for hospitals since the 9/11 attacks in 2001. Many improvements have been made in emergency management and planning for catastrophic events. Both urban and community hospitals have the same responsibilities and commitments to their patients and communities. When the announcement was made that the 2016 Republican National Convention was going to be held in Cleveland, OH, Cleveland Clinic Akron General (CCAG) had to be confident in its abilities to handle any situation that might arise not just as a community hospital but also as a Level I trauma center. Organizing and preparing for more than a year, CCAG developed a detailed and well-thought-out preparedness program, with senior leadership implementing a clear chain of command. Developing and maintaining a strong and steady defense through detailed preparation, communication, teamwork, and organization are the keys to success.

  16. The Effect of Emergency Department Overcrowding on Efficiency of Emergency Medicine Residents' Education.

    PubMed

    Sabzghabaei, Anita; Shojaee, Majid; Alimohammadi, Hossein; Derakhshanfar, Hojjat; Kashani, Parvin; Nassiriabrishamchi, Shohreh

    2015-01-01

    Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding (EDO) on the training of emergency medicine residents (EMR) is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR's education. In this cross-sectional study, the effects of overcrowding on EMR's education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs. The crowding level was calculated based on the national emergency department overcrowding scale (NEDOCS). The relationship between the two studied variables was evaluated using independent sample t-test and SPSS 21 statistical software. 130 questionnaires were filled out during 61 shifts. 47 (77.05%) shifts were overcrowded. The attend's ability to teach was not affected by overcrowding in the resuscitation room (p=0.008). The similar results were seen regarding the attend's training ability in the acute care unit. It seems that the emergency department overcrowding has no effect on the quality of education to the EMRs.

  17. 3 CFR - Continuation of the National Emergency With Respect to the Actions and Policies of Certain...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Actions and Policies of Certain Members of the Government of Belarus and Other Persons To Undermine Belarus's Democratic Processes or Institutions Presidential Documents Other Presidential Documents Notice of June 13, 2013 Continuation of the...

  18. 3 CFR - Continuation of the National Emergency With Respect to the Actions and Policies of Certain...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Actions and Policies of Certain Members of the Government of Belarus and Other Persons that Undermine Democratic Processes or Institutions in Belarus Presidential Documents Other Presidential Documents Notice of June 12, 2009 Continuation of...

  19. Burden of emergency conditions and emergency care utilization: New estimates from 40 countries

    PubMed Central

    Chang, Cindy Y.; Abujaber, Samer; Reynolds, Teri A.; Camargo, Carlos A.; Obermeyer, Ziad

    2016-01-01

    Objective To estimate the global and national burden of emergency conditions, and compare them to emergency care utilization rates. Methods We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care utilization rates were obtained from a systematic literature review on emergency care facilities in low- and middle-income countries (LMICs), supplemented by national health system reports. Findings All 15 leading causes of death and DALYs globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency utilization. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47,728 per 100,000 population (IQR 45,253-50,085) in low-income, 25,186 (IQR 21,982-40,480) in middle-income, and 15,691 (IQR 14,649-16,382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency utilization rates were the lowest in low-income countries, with median 8 visits per 1,000 population (IQR 6-10), 78 (IQR 25-197) in middle-income, and 264 (IQR 177-341) in high-income countries. Conclusion Despite higher burden of emergency conditions, emergency utilization rates are substantially lower in LMICs, likely due to limited access to emergency care. PMID:27334758

  20. Management of potentially life-threatening emergencies at 74 primary level hospitals in Mongolia: results of a prospective, observational multicenter study.

    PubMed

    Mendsaikhan, Naranpurev; Gombo, Davaa; Lundeg, Ganbold; Schmittinger, Christian; Dünser, Martin W

    2017-05-08

    While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period. An emergency/resuscitation room was available in 62.2% of hospitals. One third of the study hospitals had an operation theatre (32.4%). No hospital ran an intensive care unit or had trained emergency/critical care physicians or nurses available. Diagnostic resources were inconsistently available (sonography, 59.5%; echocardiography, 0%). Basic emergency procedures (wound care, 97.3%; foreign body removal, 86.5%; oxygen application, 85.2%) were commonly but advanced procedures (advanced cardiac life support, 10.8%; airway management, 13.5%; mechanical ventilation, 0%; renal replacement therapy, 0%) rarely available. During 6 months, 14,545 patients were hospitalized in the 74 study hospitals, of which 8.7% [n = 1267; median age, 34 (IQR 18-53) years; male gender, 54.4%] were included in the study. Trauma (excl. brain trauma) (20.4%), acute abdomen (16.9%) and heart failure (9.6%) were the most common conditions. Five-hundred-thirty patients (41.8%) were transferred to a secondary level hospital. The hospital mortality of patients not transferred was 3.2%. Capacities of Mongolian primary level hospitals to manage life-threatening emergencies are highly limited. Trauma, surgical and medical conditions make up the most common emergencies. In view of the fact that almost half of the patients with a potentially life-threatening emergency were transferred to secondary level hospitals and the mortality of those

  1. 76 FR 35953 - Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... Accumulation of Weapons-Useable Fissile Material in the Territory of the Russian Federation #0; #0; #0... National Emergency With Respect to the Risk of Nuclear Proliferation Created by the Accumulation of Weapons... Extracted from Nuclear Weapons, dated February 18, 1993, and related contracts and agreements (collectively...

  2. Building capacity in VA to provide emergency gynecology services for women.

    PubMed

    Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M

    2015-04-01

    Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.

  3. Los Alamos National Laboratory emergency management plan. Revision 1

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

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents,more » transportation accidents, electrical accidents, and natural disasters.« less

  4. The use of hospital emergency departments for nonurgent health problems: a national perspective.

    PubMed

    Cunningham, P J; Clancy, C M; Cohen, J W; Wilets, M

    1995-11-01

    The use of the hospital emergency department (ED) for nonurgent health problems has been a subject of considerable controversy, in part because there is no widely accepted definition of "nonurgent." Elimination or substantial reduction in nonurgent ED use is frequently offered as a strategy for reducing health expenditures. Previous studies, often limited to individual hospitals or communities, have limited generalizability and do not permit examination of multiple factors likely to influence nonurgent ED utilization or examination of ED use for nonurgent problems in the context of overall outpatient utilization. This analysis of the 1987 National Medical Expenditure Survey (NMES) provides a nationally representative examination of nonurgent ED utilization that describes the frequency of ED use for nonurgent problems, characteristics of individuals that are associated with an increased likelihood of nonurgent ED use, the use of other outpatient physician services, and expenditures associated with nonurgent ED visits.

  5. Job stress and its relationship with the level of secretory IgA in saliva: a comparison between nurses working in emergency wards and hospital clerks.

    PubMed

    Golshiri, Parastoo; Pourabdian, Siyamak; Najimi, Arash; Zadeh, Hamideh Mosa; Hasheminia, Javad

    2012-03-01

    The current study was carried out to evaluate and compare the job stress of female nurses working in emergency wards and female clerks and to analyze the possible relationship between the stress level and level of saliva secretory IgA (SIgA). Eighty four female nurses in emergency wards and female clerks of hospitals were selected (42 in each group). Their stress level was measured using the Persian short version of generic job stress questionnaire of the National Institute for Occupational Safety and Health (NIOSH). Moreover, the SIgA level was determined using the ELISA method. SPSS software (version 17), independent t-test, variance analysis and partial correlation were used for data analysis. The mean score of job stress was 97.30 and 91.85 in nurses and clerks, respectively (p = 0.016). The levels of saliva SIgA in nurses and clerks were 338.04 +/- 380.93 and 706 +/- 354.70, respectively (p < 0.001). The results showed a negative correlation between the levels of saliva SIgA and job stress (p = 0.02, r = -0.203). Nurses have a higher stress level compared to clerks; while the saliva SIgA level of nurses was much lower than that of the clerks. Considering the negative correlation between the saliva SIgA level and job stress, further study to evaluate the potential uses of saliva SIgA as a biomarker can be performed.

  6. Retrospective on the construction and practice of a state-level emergency medical rescue team.

    PubMed

    Lei, Zhang; Haitao, Guo; Xin, Wang; Yundou, Wang

    2014-10-01

    For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

  7. 78 FR 67289 - Continuation of the National Emergency With Respect to the Proliferation of Weapons of Mass...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... economy of the United States posed by the proliferation of nuclear, biological, and chemical weapons (weapons of mass destruction) and the means of delivering such weapons. On July 28, 1998, the President... November 7, 2013 Continuation of the National Emergency With Respect to the Proliferation of Weapons of...

  8. National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

    PubMed Central

    Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

    2016-01-01

    Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

  9. Personal needs versus national needs: public attitudes regarding health care priorities at the personal and national levels.

    PubMed

    Kaplan, Giora; Baron-Epel, Orna

    2015-01-01

    Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level. A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance. Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance. At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.

  10. 32 CFR 263.7 - Emergency vehicles.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 false Emergency vehicles. 263.7 Section 263.7 National... TRAFFIC AND VEHICLE CONTROL ON CERTAIN DEFENSE MAPPING AGENCY SITES § 263.7 Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when operating with siren or...

  11. 32 CFR 263.7 - Emergency vehicles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Emergency vehicles. 263.7 Section 263.7 National... TRAFFIC AND VEHICLE CONTROL ON CERTAIN DEFENSE MAPPING AGENCY SITES § 263.7 Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when operating with siren or...

  12. 32 CFR 263.7 - Emergency vehicles.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Emergency vehicles. 263.7 Section 263.7 National... TRAFFIC AND VEHICLE CONTROL ON CERTAIN DEFENSE MAPPING AGENCY SITES § 263.7 Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when operating with siren or...

  13. 32 CFR 263.7 - Emergency vehicles.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Emergency vehicles. 263.7 Section 263.7 National... TRAFFIC AND VEHICLE CONTROL ON CERTAIN DEFENSE MAPPING AGENCY SITES § 263.7 Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when operating with siren or...

  14. 32 CFR 263.7 - Emergency vehicles.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Emergency vehicles. 263.7 Section 263.7 National... TRAFFIC AND VEHICLE CONTROL ON CERTAIN DEFENSE MAPPING AGENCY SITES § 263.7 Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when operating with siren or...

  15. 31 CFR 9.8 - Emergency action.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Emergency action. 9.8 Section 9.8 Money and Finance: Treasury Office of the Secretary of the Treasury EFFECTS OF IMPORTED ARTICLES ON THE NATIONAL SECURITY § 9.8 Emergency action. In emergency situations or when in his judgment national security...

  16. The preparedness of schools to respond to emergencies in children: a national survey of school nurses.

    PubMed

    Olympia, Robert P; Wan, Eric; Avner, Jeffrey R

    2005-12-01

    Because children spend a significant proportion of their day in school, pediatric emergencies such as the exacerbation of medical conditions, behavioral crises, and accidental/intentional injuries are likely to occur. Recently, both the American Academy of Pediatrics and the American Heart Association have published guidelines stressing the need for school leaders to establish emergency-response plans to deal with life-threatening medical emergencies in children. The goals include developing an efficient and effective campus-wide communication system for each school with local emergency medical services (EMS); establishing and practicing a medical emergency-response plan (MERP) involving school nurses, physicians, athletic trainers, and the EMS system; identifying students at risk for life-threatening emergencies and ensuring the presence of individual emergency care plans; training staff and students in first aid and cardiopulmonary resuscitation (CPR); equipping the school for potential life-threatening emergencies; and implementing lay rescuer automated external defibrillator (AED) programs. The objective of this study was to use published guidelines by the American Academy of Pediatrics and the American Heart Association to examine the preparedness of schools to respond to pediatric emergencies, including those involving children with special care needs, and potential mass disasters. A 2-part questionnaire was mailed to 1000 randomly selected members of the National Association of School Nurses. The first part included 20 questions focusing on: (1) the clinical background of the school nurse (highest level of education, years practicing as a school health provider, CPR training); (2) demographic features of the school (student attendance, grades represented, inner-city or rural/suburban setting, private or public funding, presence of children with special needs); (3) self-reported frequency of medical and psychiatric emergencies (most common reported school

  17. Emergency department visits due to pesticide poisoning in South Korea, 2006-2009.

    PubMed

    Ko, Yousun; Kim, Hyun Joong; Cha, Eun Shil; Kim, Jaeyoung; Lee, Won Jin

    2012-02-01

    The objective of this study is to estimate the numbers and rate of emergency department visits in South Korea that are the result of pesticide poisoning and to describe their epidemiologic characteristics. Data collected from the National Emergency Department Information System were used to estimate the number of emergency department visits due to pesticide poisoning in South Korea for the period spanning 2006 through 2009. Emergency department visits for pesticide poisoning were defined by ICD-10 codes (T60.0-T60.9). National estimates and their 95% confidence intervals were calculated per 100 000 population. Among the 65 877 total poisoning-related emergency department visits in the data, 11 985 (18.2%) were emergency department visits resulting from pesticide poisoning. During the study period, the annual average rate of emergency department visits for pesticide poisoning was 26.8 per 100 000 population. Intentional pesticide poisoning (51.4%) was more frequent than unintentional. The fatality rate from intentional pesticide poisoning was also higher than that from unintentional or cases where the intention was unknown. In terms of age-specific rates of emergency department visits for pesticide poisoning, they increased with age, as did the gap between men and women. This study provide estimates for emergency department visits due to pesticide poisoning at the national level and suggests that pesticide poisonings, both intentional and unintentional, require significant public health interventions in South Korea.

  18. 75 FR 6064 - Draft Emergency Action Level Frequently Asked Questions; Request for Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... provide clarification of endorsed Nuclear Energy Institute (NEI) guidance related to the development of... NUCLEAR REGULATORY COMMISSION [NRC-2010-0034] Draft Emergency Action Level Frequently Asked Questions; Request for Comment AGENCY: Nuclear Regulatory Commission. ACTION: Notice of availability and...

  19. The preparedness level of final year medical students for an adequate medical approach to emergency cases: computer-based medical education in emergency medicine

    PubMed Central

    2014-01-01

    Background We aimed to observe the preparedness level of final year medical students in approaching emergencies by computer-based simulation training and evaluate the efficacy of the program. Methods A computer-based prototype simulation program (Lsim), designed by researchers from the medical education and computer science departments, was used to present virtual cases for medical learning. Fifty-four final year medical students from Ondokuz Mayis University School of Medicine attended an education program on June 20, 2012 and were trained with Lsim. Volunteer attendants completed a pre-test and post-test exam at the beginning and end of the course, respectively, on the same day. Results Twenty-nine of the 54 students who attended the course accepted to take the pre-test and post-test exams; 58.6% (n = 17) were female. In 10 emergency medical cases, an average of 3.9 correct medical approaches were performed in the pre-test and an average of 9.6 correct medical approaches were performed in the post-test (t = 17.18, P = 0.006). Conclusions This study’s results showed that the readiness level of students for an adequate medical approach to emergency cases was very low. Computer-based training could help in the adequate approach of students to various emergency cases. PMID:24386919

  20. 75 FR 47856 - Draft Emergency Action Level Frequently Asked Questions; Request for Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... provide clarification of guidance submitted by the Nuclear Energy Institute (NEI) and endorsed by the NRC... NUCLEAR REGULATORY COMMISSION [NRC-2010-0273] Draft Emergency Action Level Frequently Asked Questions; Request for Comment AGENCY: Nuclear Regulatory Commission. ACTION: Notice of availability and...

  1. Leadership in Middle Level Education. Volume I: A National Survey of Middle Level Leaders and Schools.

    ERIC Educational Resources Information Center

    Valentine, Jerry W.; And Others

    The National Association of Secondary School Principals periodically studies practices and characteristics of secondary schools to help inform educators and shape policy. Such studies of middle-level education were conducted in 1966 and 1981. As middle-level education moved into the 1990s, many new questions about education and leadership needed…

  2. Sense of meaning as a predictor of burnout in emergency physicians in Israel: a national survey

    PubMed Central

    Ben-Itzhak, Shulamit; Dvash, Jonathan; Maor, Maya; Rosenberg, Noa; Halpern, Pinchas

    2015-01-01

    Objective Burnout is common in physicians and particularly acute in emergency physicians. Physician burnout may adversely affect physicians’ lives and the quality of care they provide, but much remains unknown about its main contributing factors. The present study evaluated burnout rates and contributing factors in emergency physicians in Israel, specifically focusing on the role of a sense of meaning, which has received little attention in the literature concerning burnout in emergency physicians. Methods A multicenter study, involving a convenience sample of physicians working full-time in the emergency departments of 16 general hospitals in Israel, was conducted. Questionnaires were used to assess burnout, demographic characteristics, professional stress, emotional distress, satisfaction, and quality of professional life, and open-ended questions were used to evaluate subjective perception of job satisfaction. Results Seventy physicians completed the questionnaires; 71.4% reported significant burnout levels in at least one of the burnout measures, while 82% also reported medium or high levels of competency. Burnout levels were associated with work-life balance, work satisfaction, social support, depressive symptoms, stress, and preoccupying thoughts. Regression analysis yielded two significant factors associated with burnout: worry and a sense of existential meaning derived from work. In addition, 61%, 51%, and 17% of participants exhibited high emotional exhaustion, high depersonalization, and a low sense of personal accomplishment, respectively. Conclusion These results indicate a high burnout rate in emergency physicians in Israel and highlight relevant positive and negative factors including the importance of addressing existential meaning in designing specific intervention programs to counter burnout. PMID:27752601

  3. Sense of meaning as a predictor of burnout in emergency physicians in Israel: a national survey.

    PubMed

    Ben-Itzhak, Shulamit; Dvash, Jonathan; Maor, Maya; Rosenberg, Noa; Halpern, Pinchas

    2015-12-01

    Burnout is common in physicians and particularly acute in emergency physicians. Physician burnout may adversely affect physicians' lives and the quality of care they provide, but much remains unknown about its main contributing factors. The present study evaluated burnout rates and contributing factors in emergency physicians in Israel, specifically focusing on the role of a sense of meaning, which has received little attention in the literature concerning burnout in emergency physicians. A multicenter study, involving a convenience sample of physicians working full-time in the emergency departments of 16 general hospitals in Israel, was conducted. Questionnaires were used to assess burnout, demographic characteristics, professional stress, emotional distress, satisfaction, and quality of professional life, and open-ended questions were used to evaluate subjective perception of job satisfaction. Seventy physicians completed the questionnaires; 71.4% reported significant burnout levels in at least one of the burnout measures, while 82% also reported medium or high levels of competency. Burnout levels were associated with work-life balance, work satisfaction, social support, depressive symptoms, stress, and preoccupying thoughts. Regression analysis yielded two significant factors associated with burnout: worry and a sense of existential meaning derived from work. In addition, 61%, 51%, and 17% of participants exhibited high emotional exhaustion, high depersonalization, and a low sense of personal accomplishment, respectively. These results indicate a high burnout rate in emergency physicians in Israel and highlight relevant positive and negative factors including the importance of addressing existential meaning in designing specific intervention programs to counter burnout.

  4. National mass care strategy: a national integrated approach.

    PubMed

    Mintz, Amy; Gonzalez, Waddy

    2013-01-01

    Mass care refers to a wide range of humanitarian activities that collectively provide life- sustaining services, such as emergency sheltering, feeding, reunification, distribution of emergency supplies and recovery information, before or in the aftermath of an emergency or disaster. Most services are coordinated and provided by non-governmental organisations and/or local government. Based on the lessons learned in the aftermath of Hurricanes Katrina and Rita in 2005, the American Red Cross, the Federal Emergency Management Agency and the National Voluntary Organizations Active in Disasters joined efforts to expand national mass care capabilities in order to support survivors in the wake of catastrophic events, as well as to enhance the integration of volunteers and non-governmental organisations into the broader national effort. These efforts resulted in the creation of the National Mass Care Council in 2010, with representatives of Federal and State agencies, voluntary organisations and the private sector working together to develop a unified approach to mass care and to ensure the provision of consistent and uniform services across the USA, regardless of the magnitude of the event.

  5. Application of National Emergency X-Ray Utilizations Study low-risk c-spine criteria in high-risk geriatric falls.

    PubMed

    Evans, Daniel; Vera, Luis; Jeanmonod, Donald; Pester, Jonathan; Jeanmonod, Rebecca

    2015-09-01

    We sought to validate National Emergency X-Radiography Utilizations Study low-risk cervical spine (C spine) criteria in a geriatric trauma population. We sought to determine whether patients' own baseline mental status (MS) could substitute for Glasgow Coma Scale (GCS) to meet the criteria "normal alertness." We further sought to refine the definition of "distracting injury." This is a retrospective review of geriatric fall patients presenting to a level 1 trauma center and triaged to the trauma bay. We queried our database from 2008 to 2013. Abstractors recorded GCS, deviation from baseline MS, midline neck tenderness, intoxication, focal deficit, signs of trauma, and presence of other injury. Patients were considered at baseline MS if specific documentation was present on the chart, or if their GCS was 15. Six hundred sixty elderly fall patients were trauma alerts during the study period. Seventeen were excluded for incomplete records/death before imaging, leaving 647. The median age was 81 (interquartile range, 74-87). Fifty patients (8.0%) had C spine or cord injury. Two hundred ninety-four (44.5%) had baseline MS (including GCS 13-15), no spine tenderness, no intoxication, and no focal neurologic deficit. Of these, 18 had C-spine injury. Using physical findings of head trauma as the only "distracting injury," no injury would have been missed (sensitivity, 100% [confidence interval, 91.1-100]; specificity, 14.2%). Our study suggests that National Emergency X-Radiography Utilizations Study can be safely applied in elderly fall patients who are at their personal baseline MS. Furthermore, our data support a more narrow definition of distracting injury to include only patients with signs of trauma to the head. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. E-learning for grass-roots emergency public health personnel: Preliminary lessons from a national program in China.

    PubMed

    Xu, Wangquan; Jiang, Qicheng; Qin, Xia; Fang, Guixia; Hu, Zhi

    2016-07-19

    In China, grass-roots emergency public health personnel have relatively limited emergency response capabilities and they are constantly required to update their professional knowledge and skills due to recurring and new public health emergencies. However, professional training, a principal solution to this problem, is inadequate because of limitations in manpower and financial resources at grass-roots public health agencies. In order to provide a cost-effective and easily expandable way for grass-roots personnel to acquire knowledge and skills, the National Health Planning Commission of China developed an emergency response information platform and provided trial access to this platform in Anhui and Heilongjiang provinces in China. E-learning was one of the modules of the platform and this paper has focused on an e-learning pilot program. Results indicated that e-learning had satisfactorily improved the knowledge and ability of grass-roots emergency public health personnel, and the program provided an opportunity to gain experience in e-course design and implementing e-learning. Issues such as the lack of personalized e-courses and the difficulty of evaluating the effectiveness of e-learning are topics for further study.

  7. Have First-Year Emergency Medicine Residents Achieved Level 1 on Care-Based Milestones?

    PubMed Central

    Weizberg, Moshe; Bond, Michael C.; Cassara, Michael; Doty, Christopher; Seamon, Jason

    2015-01-01

    Background Residents in Accreditation Council for Graduate Medical Education accredited emergency medicine (EM) residencies were assessed on 23 educational milestones to capture their progression from medical student level (Level 1) to that of an EM attending physician (Level 5). Level 1 was conceptualized to be at the level of an incoming postgraduate year (PGY)-1 resident; however, this has not been confirmed. Objectives Our primary objective in this study was to assess incoming PGY-1 residents to determine what percentage achieved Level 1 for the 8 emergency department (ED) patient care–based milestones (PC 1–8), as assessed by faculty. Secondary objectives involved assessing what percentage of residents had achieved Level 1 as assessed by themselves, and finally, we calculated the absolute differences between self- and faculty assessments. Methods Incoming PGY-1 residents at 4 EM residencies were assessed by faculty and themselves during their first month of residency. Performance anchors were adapted from ACGME milestones. Results Forty-one residents from 4 programs were included. The percentage of residents who achieved Level 1 for each subcompetency on faculty assessment ranged from 20% to 73%, and on self-assessment from 34% to 92%. The majority did not achieve Level 1 on faculty assessment of milestones PC-2, PC-3, PC-5a, and PC-6, and on self-assessment of PC-3 and PC-5a. Self-assessment was higher than faculty assessment for PC-2, PC-5b, and PC-6. Conclusions Less than 75% of PGY-1 residents achieved Level 1 for ED care-based milestones. The majority did not achieve Level 1 on 4 milestones. Self-assessments were higher than faculty assessments for several milestones. PMID:26692971

  8. Can Nonurgent Emergency Department Care Costs be Reduced? Empirical Evidence from a U.S. Nationally Representative Sample.

    PubMed

    Xin, Haichang; Kilgore, Meredith L; Sen, Bisakha Pia; Blackburn, Justin

    2015-09-01

    A well-functioning primary care system has the capacity to provide effective care for patients to avoid nonurgent emergency department (ED) use and related costs. This study examined how patients' perceived deficiency in ambulatory care is associated with nonurgent ED care costs nationwide. This retrospective cohort study used data from the 2010-2011 Medical Expenditure Panel Survey. This study chose usual source of care, convenience of needed medical care, and patient evaluation of care quality as the main independent variables. The marginal effect following a multivariate logit model was employed to analyze the urgent vs. nonurgent ED care costs in 2011, after controlling for covariates in 2010. The endogeneity was accounted for by the time lag effect and controlling for education levels. Sample weights and variance were adjusted with the survey procedures to make results nationally representative. Patient-perceived poor and intermediate levels of primary care quality had higher odds of nonurgent ED care costs (odds ratio [OR] = 2.22, p = 0.035, and OR = 2.05, p = 0.011, respectively) compared to high-quality care, with a marginal effect (at means) of 13.0% and 11.5% higher predicted probability of nonurgent ED care costs. Costs related to these ambulatory care quality deficiencies amounted to $229 million for private plans (95% confidence interval [CI] $100 million-$358 million), $58.5 million for public plans (95% CI $33.9 million-$83.1 million), and an overall of $379 million (95% CI $229 million-$529 million) nationally. These findings highlight the improvement in ambulatory care quality as the potential target area to effectively reduce nonurgent ED care costs. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

    PubMed

    Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

    2008-08-01

    The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

  10. Ambient Noise in Emergency Rooms and Its Health Hazards

    PubMed Central

    Filus, Walderes; Lacerda, Adriana Bender Moreira de; Albizu, Evelyn

    2014-01-01

    Introduction The occupational risk due to high levels of noise in the hospital environment has been recognized, and the National Agency of Sanitary Surveillance of the Ministry of Health recommends evaluation and control of noise in hospital areas. Objectives To assess the sound environment in the emergency ward of a general trauma reference hospital in the city of Curitiba, Parana State, Brazil. Methods In this descriptive study, noise levels were assessed on mornings, afternoons, and evenings using an integrating Bruel & Kjaer (Denmark) calibrated sound level meter, type 2230. Ten indoor points in the emergency ward were assessed; the helicopter as well as several available pieces of equipment in the ward were assessed individually. Results Noise levels in sound pressure level ambiance [dBA] ranged from 56.6 to 68.8. The afternoon period was the noisiest. The helicopter at 119 dBA and the cast saw at 90 dBA were the noisiest equipment, and the lowest noise level found was the activated oximeter at 61.0 dBA. Conclusion In all assessed points, noise levels were above the comfort levels recommended by the Brazilian Association of Technical Standards (1987), which may harm users' and professionals' health as well as influence professional performance in the emergency ward. Sound pressure levels of the helicopter and cast saw reach high hearing hazard levels, requiring professionals to use individual protection equipment, and point to the need for creation and implementation of effective control measures of noise levels in emergency wards. PMID:26157493

  11. 76 FR 58999 - Continuation of the National Emergency With Respect to Persons Who Commit, Threaten To Commit, Or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... Terrorism #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 76, No. 184 / Thursday... Commit, Or Support Terrorism On September 23, 2001, by Executive Order 13224, the President declared a national emergency with respect to persons who commit, threaten to commit, or support terrorism, pursuant...

  12. 75 FR 57159 - Continuation of the National Emergency With Respect to Persons Who Commit, Threaten to Commit, or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-20

    ... Commit, or Support Terrorism On September 23, 2001, by Executive Order 13224, the President declared a national emergency with respect to persons who commit, threaten to commit, or support terrorism, pursuant... economy of the United States constituted by the grave acts of terrorism and threats of terrorism committed...

  13. Burden of emergency conditions and emergency care usage: new estimates from 40 countries.

    PubMed

    Chang, Cindy Y; Abujaber, Samer; Reynolds, Teri A; Camargo, Carlos A; Obermeyer, Ziad

    2016-11-01

    To estimate the global and national burden of emergency conditions, and compare them to emergency care usage rates. We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care usage rates were obtained from a systematic literature review on emergency care facilities in low-income and middle-income countries (LMICs), supplemented by national health system reports. All 15 leading causes of death and disability-adjusted life years (DALYs) globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency usage. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47 728 per 100 000 population (IQR 45 253-50 085) in low-income, 25 186 (IQR 21 982-40 480) in middle-income and 15 691 (IQR 14 649-16 382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency usage rates were the lowest in low-income countries, with median 8 visits per 1000 population (IQR 6-10), 78 (IQR 25-197) in middle-income and 264 (IQR 177-341) in high-income countries. Despite higher burden of emergency conditions, emergency usage rates are substantially lower in LMICs, likely due to limited access to emergency care. 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/.

  14. The Italian National Health Service expenditure on workplace prevention and safety (2006-2013): a national-level analysis.

    PubMed

    Signorelli, C; Riccò, M; Odone, A

    2016-01-01

    The World Health Organization (WHO) stated that countries' health policies should give high priority to primary prevention of occupational health hazards. Scant data are available on health expenditure on workplace prevention and safety services and on its impact on occupational health outcomes in Italy and in other European countries. objective of the present study was to systematically retrieve, analyse and critically appraise the available national-level data on public health expenditure on workplace prevention and safety services as well as to correlate them with occupational health outcomes. National-level data on total public health expenditure on prevention services, its share spent on workplace prevention and safety services as well as on number of workers receiving appropriate health surveillance were derived from the national public health expenditure monitoring system over a 8-year study period (2006-2013). An analytic approach was adopted to explore the association between health expenditure and occupational health services supply. The Italian National Health Service spends almost € 5 billion per year on preventive care, of which 13.3% are spent on workplace prevention and safety programmes (€ 645 million, € 10.6 per capita). There is wide heterogeneity between Italian regions. Our findings are useful for health systems and policies analysis, national and international comparisons as well as for health policy makers to plan, implement and monitor occupational health prevention programmes.

  15. Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities.

    PubMed

    Timpka, Toomas; Schyllander, Jan; Stark Ekman, Diana; Ekman, Robert; Dahlström, Örjan; Hägglund, Martin; Kristenson, Karolina; Jacobsson, Jenny

    2018-02-01

    Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries. One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  16. Emergency medical systems in low- and middle-income countries: recommendations for action.

    PubMed Central

    Kobusingye, Olive C.; Hyder, Adnan A.; Bishai, David; Hicks, Eduardo Romero; Mock, Charles; Joshipura, Manjul

    2005-01-01

    Emergency medical care is not a luxury for rich countries or rich individuals in poor countries. This paper makes the point that emergency care can make an important contribution to reducing avoidable death and disability in low- and middle-income countries. But emergency care needs to be planned well and supported at all levels--at the national, provincial and community levels--and take into account the entire spectrum of care, from the occurrence of an acute medical event in the community to the provision of appropriate care at the hospital. The mix of personnel, materials, and health-system infrastructure can be tailored to optimize the provision of emergency care in settings with different levels of resource availability. The misconception that emergency care cannot be cost effective in low-income settings is demonstrably inaccurate. Emergencies occur everywhere, and each day they consume resources regardless of whether there are systems capable of achieving good outcomes. With better planning, the ongoing costs of emergency care can result in better outcomes and better cost-effectiveness. Every country and community can and should provide emergency care regardless of their place in the ratings of developmental indices. We make the case for universal access to emergency care and lay out a research agenda to fill the gaps in knowledge in emergency care. PMID:16184282

  17. Current European data collection on emergency department presentations with acute recreational drug toxicity: gaps and national variations.

    PubMed

    Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Yates, Christopher; Dines, Alison M; Sedefov, Roumen; Wood, David M; Dargan, Paul I

    2014-12-01

    The number of new (novel) psychoactive substances (NPS) available in the illegal market is increasing; however, current monitoring of the drug situation in Europe focuses mainly on classical drugs of abuse, with limited emphasis on clinical presentation in the emergency department (ED). The European Drug Emergencies Network (Euro-DEN) is a European Commission-funded project that aims to improve the knowledge of acute drug toxicity of both classical recreational drugs and NPS. As a baseline for this project, we performed a study to establish which data are currently being collected and reported in Europe on ED presentations with acute toxicity related to NPS and classical drugs of abuse. We used a three-pronged approach to identify any systematic collection of data on NPS toxicity in Europe by i) performing a literature search, ii) utilising an online survey of the European Monitoring Centre for Drugs and Drug Addiction Re seau Europe en d'Information sur les Drogues et les Toxicomanies national focal points and iii) exploiting the knowledge and resources of the Euro-DEN network members. The literature search revealed 21 papers appropriate for assessment, but only one described a systematic collection of clinical data on NPS. Twenty-seven of thirty countries responded to the online survey. More than half of all the countries (52%) did not perform any registration at all of such data, 37% collected systematic clinical data on NPS at a national level, while 44% collected data on classical drugs. A few examples for good practice of systematic collection of clinical data on ED presentations due to acute toxicity were identified. The systematic collection of data on ED presentation of toxicity related to NPS and classical drugs in Europe is scarce; the existing collection is limited to single centres, single countries, groups of patients or not focused on novel drugs; the collection of data is highly variable between the different countries. Euro-DEN, a European

  18. Adolescent occupational injuries requiring hospital emergency department treatment: a nationally representative sample.

    PubMed Central

    Layne, L A; Castillo, D N; Stout, N; Cutlip, P

    1994-01-01

    Data from a nationally representative sample of emergency departments for the 6-month period July through December 1992 were used to examine nonfatal occupational injuries sustained by adolescents aged 14 through 17 years. There were 679 occupational injuries, corresponding to an estimated 37,405 injuries nationwide. Males constituted 65.8% of the injury victims. The injury rate for males was 7.0 per 100 full-time employees, compared with 4.4 for females. Lacerations to the hand or finger accounted for 25.6% of all injuries. The majority of injuries occurred in retail trades (53.7%), which also had the highest rate (6.3 per 100 full-time employees). Seventy-one percent of the injuries in retail trade occurred in eating and drinking establishments. PMID:8154574

  19. Theme: Emerging Technologies.

    ERIC Educational Resources Information Center

    Malpiedi, Barbara J.; And Others

    1989-01-01

    Consists of six articles discussing the effect of emerging technologies on agriculture. Specific topics include (1) agriscience programs, (2) the National Conference on Agriscience and Emerging Occupations and Technologies, (3) biotechnology, (4) program improvement through technology, (5) the Agriscience Teacher of the Year program, and (6)…

  20. National Survey of Preventive Health Services in US Emergency Departments

    PubMed Central

    Delgado, M. Kit; Acosta, Colleen D.; Ginde, Adit A.; Wang, N. Ewen; Strehlow, Matthew C.; Khandwala, Yash S.; Camargo, Carlos A.

    2012-01-01

    Study objective We describe the availability of preventive health services in US emergency departments (EDs), as well as ED directors’ preferred service and perceptions of barriers to offering preventive services. Methods Using the 2007 National Emergency Department Inventory (NEDI)–USA, we randomly sampled 350 (7%) of 4,874 EDs. We surveyed directors of these EDs to determine the availability of (1) screening and referral programs for alcohol, tobacco, geriatric falls, intimate partner violence, HIV, diabetes, and hypertension; (2) vaccination programs for influenza and pneumococcus; and (3) linkage programs to primary care and health insurance. ED directors were asked to select the service they would most like to implement and to rate 5 potential barriers to offering preventive services. Results Two hundred seventy-seven EDs (80%) responded across 46 states. Availability of services ranged from 66% for intimate partner violence screening to 19% for HIV screening. ED directors wanted to implement primary care linkage most (17%) and HIV screening least (2%). ED directors “agreed/strongly agreed” that the following are barriers to ED preventive care: cost (74%), increased patient length of stay (64%), lack of follow-up (60%), resource shifting leading to worse patient outcomes (53%), and philosophical opposition (27%). Conclusion Most US EDs offer preventive services, but availability and ED director preference for type of service vary greatly. The majority of EDs do not routinely offer Centers for Disease Control and Prevention–recommended HIV screening. Most ED directors are not philosophically opposed to offering preventive services but are concerned with added costs, effects on ED operations, and potential lack of follow-up. PMID:20889237

  1. Developing an operational capabilities index of the emergency services sector.

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

    Collins, M.J.; Eaton, L.K.; Shoemaker, Z.M.

    2012-02-20

    In order to enhance the resilience of the Nation and its ability to protect itself in the face of natural and human-caused hazards, the ability of the critical infrastructure (CI) system to withstand specific threats and return to normal operations after degradation must be determined. To fully analyze the resilience of a region and the CI that resides within it, both the actual resilience of the individual CI and the capability of the Emergency Services Sector (ESS) to protect against and respond to potential hazards need to be considered. Thus, a regional resilience approach requires the comprehensive consideration of allmore » parts of the CI system as well as the characterization of emergency services. This characterization must generate reproducible results that can support decision making with regard to risk management, disaster response, business continuity, and community planning and management. To address these issues, Argonne National Laboratory, in collaboration with the U.S. Department of Homeland Security (DHS) Sector Specific Agency - Executive Management Office, developed a comprehensive methodology to create an Emergency Services Sector Capabilities Index (ESSCI). The ESSCI is a performance metric that ranges from 0 (low level of capabilities) to 100 (high). Because an emergency services program has a high ESSCI, however, does not mean that a specific event would not be able to affect a region or cause severe consequences. And because a program has a low ESSCI does not mean that a disruptive event would automatically lead to serious consequences in a region. Moreover, a score of 100 on the ESSCI is not the level of capability expected of emergency services programs; rather, it represents an optimal program that would rarely be observed. The ESSCI characterizes the state of preparedness of a jurisdiction in terms of emergency and risk management. Perhaps the index's primary benefit is that it can systematically capture, at a given point in time

  2. Nonresident Enrollment Demand in Public Higher Education: An Analysis at National, State, and Institutional Levels

    ERIC Educational Resources Information Center

    Zhang, Liang

    2007-01-01

    This article estimates the standard demand equations for nonresident students using national, state, and institutional level data. The national-level analysis reveals a near-unitary price elasticity, but increases in nonresident tuition and fees do not decrease nonresident enrollment. Finally, results from the institutional level of analysis…

  3. Simulation in Canadian postgraduate emergency medicine training - a national survey.

    PubMed

    Russell, Evan; Hall, Andrew Koch; Hagel, Carly; Petrosoniak, Andrew; Dagnone, Jeffrey Damon; Howes, Daniel

    2018-01-01

    Simulation-based education (SBE) is an important training strategy in emergency medicine (EM) postgraduate programs. This study sought to characterize the use of simulation in FRCPC-EM residency programs across Canada. A national survey was administered to residents and knowledgeable program representatives (PRs) at all Canadian FRCPC-EM programs. Survey question themes included simulation program characteristics, the frequency of resident participation, the location and administration of SBE, institutional barriers, interprofessional involvement, content, assessment strategies, and attitudes about SBE. Resident and PR response rates were 63% (203/321) and 100% (16/16), respectively. Residents reported a median of 20 (range 0-150) hours of annual simulation training, with 52% of residents indicating that the time dedicated to simulation training met their needs. PRs reported the frequency of SBE sessions ranging from weekly to every 6 months, with 15 (94%) programs having an established simulation curriculum. Two (13%) of the programs used simulation for resident assessment, although 15 (94%) of PRs indicated that they would be comfortable with simulation-based assessment. The most common PR-identified barriers to administering simulation were a lack of protected faculty time (75%) and a lack of faculty experience with simulation (56%). Interprofessional involvement in simulation was strongly valued by both residents and PRs. SBE is frequently used by Canadian FRCPC-EM residency programs. However, there exists considerable variability in the structure, frequency, and timing of simulation-based activities. As programs transition to competency-based medical education, national organizations and collaborations should consider the variability in how SBE is administered.

  4. National Geospatial Program

    USGS Publications Warehouse

    Carswell, William J.

    2011-01-01

    increases the efficiency of the Nation's geospatial community by improving communications about geospatial data, products, services, projects, needs, standards, and best practices. The NGP comprises seven major components (described below), that are managed as a unified set. For example, The National Map establishes data standards and identifies geographic areas where specific types of geospatial data need to be incorporated into The National Map. Partnership Network Liaisons work with Federal, State, local, and tribal partners to help acquire the data. Geospatial technical operations ensure the quality control, integration, and availability to the public of the data acquired. The Emergency Operations Office provides the requirements to The National Map and, during emergencies and natural disasters, provides rapid dissemination of information and data targeted to the needs of emergency responders. The National Atlas uses data from The National Map and other sources to make small-scale maps and multimedia articles about the maps.

  5. Coastal vulnerability assessment of Olympic National Park to sea-level rise

    USGS Publications Warehouse

    Pendleton, Elizabeth A.; Hammar-Klose, Erika S.; Thieler, E. Robert; Williams, S. Jeffress

    2004-01-01

    A coastal vulnerability index (CVI) was used to map the relative vulnerability of the coast to future sea-level rise within Olympic National Park (OLYM), Washington. The CVI scores the following in terms of their physical contribution to sea-level rise-related coastal change: geomorphology, regional coastal slope, rate of relative sea-level rise, shoreline change rates, mean tidal range and mean wave height. The rankings for each variable were combined and an index value calculated for 1-minute grid cells covering the park. The CVI highlights those regions where the physical effects of sea-level rise might be the greatest. This approach combines the coastal system's susceptibility to change with its natural ability to adapt to changing environmental conditions, yielding a quantitative, although relative, measure of the park's natural vulnerability to the effects of sea-level rise. The CVI provides an objective technique for evaluation and long-term planning by scientists and park managers. The Olympic National Park coast consists of rocky headlands, pocket beaches, glacial-fluvial features, and sand and gravel beaches. The Olympic coastline that is most vulnerable to sea-level rise are beaches in gently sloping areas.

  6. Selected resources for emergency and disaster preparedness and response from the United States National Library of Medicine.

    PubMed

    Hochstein, Colette; Arnesen, Stacey; Goshorn, Jeanne; Szczur, Marti

    2008-01-01

    The Toxicology and Environmental Health Information Program (TEHIP) of the National Library of Medicine (NLM) works to organize and provide access to a wide range of environmental health and toxicology resources. In recent years, the demand for, and availability of, information on health issues related to natural and man-made emergencies and disasters has increased. Recognizing that access to information is essential in disaster preparedness, a new focus of NLM's 2006-2016 Long Range Plan calls for the establishment of a Disaster Information Management Research Center (DIMRC) that will aid in collecting, disseminating, and sharing information related to health and disasters. This paper introduces several of TEHIP's resources for emergency/disaster preparedness and response, such as the Radiation Event Medical Management Web site (REMM) and the Wireless Information System for Emergency Responders (WISER) . Several of NLM's other disaster preparedness and response resources will also be reviewed.

  7. National surgical mortality audit may be associated with reduced mortality after emergency admission.

    PubMed

    Kiermeier, Andreas; Babidge, Wendy J; McCulloch, Glenn A J; Maddern, Guy J; Watters, David A; Aitken, R James

    2017-10-01

    The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia. The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in surgical mortality. Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P < 0.0001). A similar decrease was seen in all regions. The mortality reduction was overwhelmingly observed in elderly patients admitted as an emergency. The commencement of this nation-wide mortality audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes. © 2017 Royal Australasian College of Surgeons.

  8. Social Immunity: Emergence and Evolution of Colony-Level Disease Protection.

    PubMed

    Cremer, Sylvia; Pull, Christopher D; Fürst, Matthias A

    2018-01-07

    Social insect colonies have evolved many collectively performed adaptations that reduce the impact of infectious disease and that are expected to maximize their fitness. This colony-level protection is termed social immunity, and it enhances the health and survival of the colony. In this review, we address how social immunity emerges from its mechanistic components to produce colony-level disease avoidance, resistance, and tolerance. To understand the evolutionary causes and consequences of social immunity, we highlight the need for studies that evaluate the effects of social immunity on colony fitness. We discuss the roles that host life history and ecology have on predicted eco-evolutionary dynamics, which differ among the social insect lineages. Throughout the review, we highlight current gaps in our knowledge and promising avenues for future research, which we hope will bring us closer to an integrated understanding of socio-eco-evo-immunology.

  9. Employability Competencies for Entry Level Emergency Medical Aides.

    ERIC Educational Resources Information Center

    Werner, Claire

    This document describes competencies needed by persons who complete the Los Angeles Schools' emergency medical aide competency-based program, which is designed to enhance their ability to obtain certification as an Emergency Medical Technician (EMT). The overall competency statement ("goal") of the program heads each page and is defined by one or…

  10. Does the emergency surgery score accurately predict outcomes in emergent laparotomies?

    PubMed

    Peponis, Thomas; Bohnen, Jordan D; Sangji, Naveen F; Nandan, Anirudh R; Han, Kelsey; Lee, Jarone; Yeh, D Dante; de Moya, Marc A; Velmahos, George C; Chang, David C; Kaafarani, Haytham M A

    2017-08-01

    The emergency surgery score is a mortality-risk calculator for emergency general operation patients. We sought to examine whether the emergency surgery score predicts 30-day morbidity and mortality in a high-risk group of patients undergoing emergent laparotomy. Using the 2011-2012 American College of Surgeons National Surgical Quality Improvement Program database, we identified all patients who underwent emergent laparotomy using (1) the American College of Surgeons National Surgical Quality Improvement Program definition of "emergent," and (2) all Current Procedural Terminology codes denoting a laparotomy, excluding aortic aneurysm rupture. Multivariable logistic regression analyses were performed to measure the correlation (c-statistic) between the emergency surgery score and (1) 30-day mortality, and (2) 30-day morbidity after emergent laparotomy. As sensitivity analyses, the correlation between the emergency surgery score and 30-day mortality was also evaluated in prespecified subgroups based on Current Procedural Terminology codes. A total of 26,410 emergent laparotomy patients were included. Thirty-day mortality and morbidity were 10.2% and 43.8%, respectively. The emergency surgery score correlated well with mortality (c-statistic = 0.84); scores of 1, 11, and 22 correlated with mortalities of 0.4%, 39%, and 100%, respectively. Similarly, the emergency surgery score correlated well with morbidity (c-statistic = 0.74); scores of 0, 7, and 11 correlated with complication rates of 13%, 58%, and 79%, respectively. The morbidity rates plateaued for scores higher than 11. Sensitivity analyses demonstrated that the emergency surgery score effectively predicts mortality in patients undergoing emergent (1) splenic, (2) gastroduodenal, (3) intestinal, (4) hepatobiliary, or (5) incarcerated ventral hernia operation. The emergency surgery score accurately predicts outcomes in all types of emergent laparotomy patients and may prove valuable as a bedside decision

  11. Emergency assessment of post-fire debris-flow hazards for the 2013 Rim Fire, Stanislaus National Forest and Yosemite National Park, California

    USGS Publications Warehouse

    Staley, Dennis M.

    2013-01-01

    Wildfire can significantly alter the hydrologic response of a watershed to the extent that even modest rainstorms can produce dangerous flash floods and debris flows. In this report, empirical models are used to predict the probability and magnitude of debris-flow occurrence in response to a 10-year rainstorm for the 2013 Rim fire in Yosemite National Park and the Stanislaus National Forest, California. Overall, the models predict a relatively high probability (60–80 percent) of debris flow for 28 of the 1,238 drainage basins in the burn area in response to a 10-year recurrence interval design storm. Predictions of debris-flow volume suggest that debris flows may entrain a significant volume of material, with 901 of the 1,238 basins identified as having potential debris-flow volumes greater than 10,000 cubic meters. These results of the relative combined hazard analysis suggest there is a moderate likelihood of significant debris-flow hazard within and downstream of the burn area for nearby populations, infrastructure, wildlife, and water resources. Given these findings, we recommend that residents, emergency managers, and public works departments pay close attention to weather forecasts and National-Weather-Service-issued Debris Flow and Flash Flood Outlooks, Watches and Warnings and that residents adhere to any evacuation orders.

  12. Variations in mortality after emergency laparotomy: the first report of the UK Emergency Laparotomy Network.

    PubMed

    Saunders, D I; Murray, D; Pichel, A C; Varley, S; Peden, C J

    2012-09-01

    Emergency laparotomy is a common intra-abdominal procedure. Outcomes are generally recognized to be poor, but there is a paucity of hard UK data, and reports have mainly been confined to single-centre studies. Clinicians were invited to join an 'Emergency Laparotomy Network' and to collect prospective non-risk-adjusted outcome data from a large number of NHS Trusts providing emergency surgical care. Data concerning what were considered to be key aspects of perioperative care, including thirty-day mortality, were collected over a 3 month period. Data from 1853 patients were collected from 35 NHS hospitals. The unadjusted 30 day mortality was 14.9% for all patients and 24.4% in patients aged 80 or over. There was a wide variation between units in terms of the proportion of cases subject to key interventions that may affect outcomes. The presence of a consultant surgeon in theatre varied between 40.6% and 100% of cases, while a consultant anaesthetist was present in theatre for 25-100% of cases. Goal-directed fluid management was used in 0-63% of cases. Between 0% and 68.9% of the patients returned to the ward (level one) after surgery, and between 9.7% and 87.5% were admitted to intensive care (level three). Mortality rates varied from 3.6% to 41.7%. This study confirms that emergency laparotomy in the UK carries a high mortality. The variation in clinical management and outcomes indicates the need for a national quality improvement programme.

  13. 3 CFR - Continuation of the National Emergency Relating to Cuba and of the Emergency Authority Relating...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of Vessels... Emergency Relating to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and... north of Cuba. In July 1996 and on subsequent occasions, the Cuban government stated its intent to...

  14. Health-based Provisional Advisory Levels (PALs) for homeland security.

    PubMed

    Adeshina, Femi; Sonich-Mullin, Cynthia; Ross, Robert H; Wood, Carol S

    2009-12-01

    The Homeland Security Presidential Directive #8 (HSPD-8) for National Emergency Preparedness was issued to " establish policies to strengthen the preparedness of the United States to prevent and respond to threatened or actual domestic terrorist attacks, major disasters, and other emergencies by requiring a national domestic all- hazards preparedness goal. "In response to HSPD-8 and HSPD-22 (classified) on Domestic Chemical Defense, the US Environmental Protection Agency (US EPA) National Homeland Security Research Center (NHSRC) is developing health-based Provisional Advisory Levels (PALs) for priority chemicals (including chemical warfare agents, pesticides, and toxic industrial chemicals) in air and drinking water. PALs are temporary values that will neither be promulgated, nor be formally issued as regulatory guidance. They are intended to be used at the discretion of risk managers in emergency situations. The PAL Program provides advisory exposure levels for chemical agents to assist in emergency planning and response decision-making, and to aid in making informed risk management decisions for evacuation, temporary re-entry into affected areas, and resumed-use of infrastructure, such as water resources. These risk management decisions may be made at the federal, state, and local levels. Three exposure levels (PAL 1, PAL 2, and PAL 3), distinguished by severity of toxic effects, are developed for 24-hour, 30-day, 90-day, and 2-year durations for potential exposure to drinking water and ambient air by the general public. Developed PALs are evaluated both by a US EPA working group, and an external multidisciplinary panel to ensure scientific credibility and wide acceptance. In this Special Issue publication, we present background information on the PAL program, the methodology used in deriving PALs, and the technical support documents for the derivation of PALs for acrylonitrile, hydrogen sulfide, and phosgene.

  15. Meeting national response time targets for priority 1 incidents in an urban emergency medical services system in South Africa: More ambulances won't help.

    PubMed

    Stein, Christopher; Wallis, Lee; Adetunji, Olufemi

    2015-09-19

    Response time is viewed as a key performance indicator in most emergency medical services (EMS) systems. To determine the effect of increased emergency vehicle numbers on response time performance for priority 1 incidents in an urban EMS system in Cape Town, South Africa, using discrete-event computer simulation. A simulation model was created, based on input data from part of the EMS operations. Two different versions of the model were used, one with primary response vehicles and ambulances and one with only ambulances. In both cases the models were run in seven different scenarios. The first scenario used the actual number of emergency vehicles in the real system, and in each subsequent scenario vehicle numbers were increased by adding the baseline number to the cumulative total. The model using only ambulances had shorter response times and a greater number of responses meeting national response time targets than models using primary response vehicles and ambulances. In both cases an improvement in response times and the number of responses meeting national response time targets was observed with the first incremental addition of vehicles. After this the improvements rapidly diminished and eventually became negligible with each successive increase in vehicle numbers. The national response time target for urban areas was never met, even with a seven-fold increase in vehicle numbers. The addition of emergency vehicles to an urban EMS system improves response times in priority 1 incidents, but alone is not capable of the magnitude of response time improvement needed to meet the national response time targets.

  16. 75 FR 24777 - Continuation of the National Emergency With Respect To the Actions of the Government of Syria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... Part II The President Notice of May 3, 2010--Continuation of the National Emergency With Respect to the Actions of the Government of Syria #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 75, No. 86 / Wednesday, May 5, 2010 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President [[Page 24779

  17. National targets, process transformation and local consequences in an NHS emergency department (ED): a qualitative study

    PubMed Central

    2014-01-01

    Background In the attempt to reduce waiting times in emergency departments, various national health services have used benchmarking and the optimisation of patient flows. The aim of this study was to examine staff attitudes and experience of providing emergency care following the introduction of a 4 hour wait target, focusing on clinical, organisational and spatial issues. Methods A qualitative research design was used and semi-structured interviews were conducted with 28 clinical, managerial and administrative staff members working in an inner-city emergency department. A thematic analysis method was employed and NVivo 8 qualitative data analysis software was used to code and manage the emerging themes. Results The wait target came to regulate the individual and collective timescales of healthcare work. It has compartmentalised the previous unitary network of emergency department clinicians and their workspace. It has also speeded up clinical performance and patient throughput. It has disturbed professional hierarchies and facilitated the development of new professional roles. A new clinical information system complemented these reconfigurations by supporting advanced patient tracking, better awareness of time, and continuous, real-time management of emergency department staff. The interviewees had concerns that this target-oriented way of working forces them to have a less personal relationship with their patients. Conclusions The imposition of a wait-target in response to a perceived “crisis” of patients’ dissatisfaction led to the development of a new and sophisticated way of working in the emergency department, but with deep and unintended consequences. We show that there is a dynamic interrelation of the social and the technical in the complex environment of the ED. While the 4 hour wait target raised the profile of the emergency department in the hospital, the added pressure on clinicians has caused some concerns over the future of their

  18. The emerging mental health strategy of the European Union: a multi-level work-in-progress.

    PubMed

    Kelly, Brendan D

    2008-01-01

    Policy-making in the European Union (EU) is a complex process that can appear impenetrable and opaque. This paper examines the ongoing process of mental health policy-making in the EU. In 2005, the Health and Consumer Protectorate Director-General of the European Commission published a Green Paper and launched a consultation process aimed at mental health service-users, advocates, providers, business, social services and governments. While there were varying levels of participation between member states, a range of trans-national, national and infra-national actors made contributions. Based on these consultations, a 'Consultative Platform' was created and made 10 recommendations centered on the principles of partnership; establishing policy competencies; integrating mental health into national policies; involving stakeholders; and protecting human rights. This ongoing process illustrates many features of EU policy-making: (a) the European Commission generates an initiative; (b) policy focuses on EU standardization, with member states remaining central actors in service-delivery; (c) policy focuses on social inclusion; (d) the European Commission coordinates diverse networks of actors; and (e) there is 'multi-level' involvement, with direct interaction between trans-national, national and infra-national actors. An enhanced focus on epidemiological data and 'evidence-based policy' would increase rigor and focus further attention on this relatively neglected policy area.

  19. Emergency Response

    EPA Pesticide Factsheets

    Information for first responders, industry, federal, state and local governments on EPA's role and available resources for response to oil spills, chemical, biological, radiological releases, and large-scale national emergencies.

  20. 32 CFR 2001.52 - Emergency authority.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Safeguarding § 2001... dissemination, transmission, safeguarding, and destruction of classified information during certain emergency...

  1. Compliance of middle school-aged babysitters in central Pennsylvania with national recommendations for emergency preparedness and safety practices.

    PubMed

    Hackman, Nicole M; Cass, Katie; Olympia, Robert P

    2012-06-01

    To determine the compliance of middle school-aged babysitters with national recommendations for emergency preparedness and safety practices. A prospective, self-administered questionnaire-based study was conducted at 3 middle schools in central Pennsylvania. A total of 1364 questionnaires were available for analysis. Responding babysitters (n = 890) reported previous training that included babysitter (21%), first aid (64%), and cardiopulmonary resuscitation (59%) training. Reported unsafe babysitter practices were leaving a child unattended (36%) and opening the door to a stranger (24%). The most common emergency experience encountered by responding babysitters included cut or scrape (83%), burns (28%), and choking (14%). Ten percent of responding babysitters have activated the 911 system. Middle school-aged babysitters will likely encounter common household emergencies and therefore benefit from first aid training; however, very little difference in safety knowledge was found between trained and untrained babysitters, suggesting modifications in babysitter training programs may be required.

  2. 76 FR 22911 - National Advisory Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-25

    ... discussions on professionalism of emergency management, approaches for National Incident Management System... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2007-0008] National Advisory Council AGENCY: Federal Emergency Management Agency, DHS. ACTION: Committee Management...

  3. Accountability of Tertiary Education at the National Level: A Chimera?

    ERIC Educational Resources Information Center

    Lindsay, Alan; O'Byrne, Garry

    1979-01-01

    The concept of accountability and its application to Australian higher education are discussed. It is suggested that due to political, financial, and educational characteristics of tertiary education at the national system level there are fundamental and insoluble problems associated with achieving accountability. (SF)

  4. Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage. A national study using spatial analysis

    PubMed Central

    2012-01-01

    Background A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person’s home postcode, and stratified by socio-economic disadvantage. Results This study covered July – December 2009 with data from 10,064 patients. People from the highest SEIFA group (least disadvantaged) were significantly less likely to be referred to a specialist palliative care service, likely to be referred closer to death and to have more episodes of inpatient care for longer time. Physical proximity of a person’s home to inpatient care showed a gradient with increasing distance by decreasing levels of socio-economic advantage. Conclusion These data suggest that a simple relationship of low socioeconomic status and poor access to a referral-based specialty such as palliative care does not exist. Different patterns of referral and hence different patterns of care emerge. PMID:23176397

  5. L-arginine levels are diminished in adult acute vaso-occlusive sickle cell crisis in the emergency department.

    PubMed

    Lopez, Bernard L; Kreshak, Allyson A; Morris, Claudia R; Davis-Moon, Linda; Ballas, Samir K; Ma, Xin-Liang

    2003-02-01

    Paediatric studies have demonstrated that l-arginine (l-arg), the precursor to nitric oxide, is diminished in vaso-occlusive crisis (VOC). This study aimed to determine whether l-arginine levels are altered in adult VOC in the emergency department. Plasma l-arg and nitric oxide metabolite (NOx) levels were obtained in adult VOC patients presenting to the emergency department. Fifty patients had significantly low plasma l-arg (29.78 micromol/l +/- 11.21, P < 0.05 vs steady-state control = 41.16 micromol/l +/- 5.04) and significantly low plasma NOx (12.33 micromol/l +/- 10.28, P < 0.05 vs steady-state control = 25.2 +/- 2.6 micro mol/l). Neither l-arg nor NOx levels could predict VOC clinical course.

  6. Multitier specification for NSEP (National Security/Emergency Preparedness) enhancement of fiber-optic long-distance telecommunication networks. Volume 1. The multitier specification - an executive summary. Technical Information Bulletin

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

    Peach, D.F.

    1987-12-01

    Fiber optic telecommunication systems are susceptible to both natural and man-made stress. National Security/Emergency Preparedness (NSEP) is a function of how durable these systems are in light of projected levels of stress. Emergency Preparedness in 1987 is not just a matter of--can they deliver food, water, energy and other essentials--but can they deliver the vital information necessary to maintain corporate function of our country. 'Communication stamina' is a function of 'probability of survival' when faced with stress. This report provides an overview of the enhancements to a fiber-optic communication system/installation that will increase durability. These enhancements are grouped, based onmore » their value in protecting the system, such that a Multitier Specification is created that presents multiple levels of hardness. Mitigation of effects due to high-altitude electromagnetic pulse (HEMP) and gamma radiation, and protection from vandalism and weather events are discussed in the report. The report is presented in two volumes. Volume I presents the Multitier Specification in a format that is usable for management review. The attributes of specified physical parameters, and the levels of protection stated in Volume I, are discussed in more detail in Volume II.« less

  7. Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study

    PubMed Central

    Broccoli, Morgan C; Calvello, Emilie J B; Skog, Alexander P; Wachira, Benjamin; Wallis, Lee A

    2015-01-01

    Objectives We undertook this study in Kenya to understand the community's emergency care needs and barriers they face when trying to access care, and to seek community members’ thoughts regarding high impact solutions to expand access to essential emergency services. Design We used a qualitative research methodology to conduct 59 focus groups with 528 total Kenyan community member participants. Data were coded, aggregated and analysed using the content analysis approach. Setting Participants were uniformly selected from all eight of the historical Kenyan provinces (Central, Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley and Western), with equal rural and urban community representation. Results Socioeconomic and cultural factors play a major role both in seeking and reaching emergency care. Community members in Kenya experience a wide range of medical emergencies, and seem to understand their time-critical nature. They rely on one another for assistance in the face of substantial barriers to care—a lack of: system structure, resources, transportation, trained healthcare providers and initial care at the scene. Conclusions Access to emergency care in Kenya can be improved by encouraging recognition and initial treatment of emergent illness in the community, strengthening the pre-hospital care system, improving emergency care delivery at health facilities and creating new policies at a national level. These community-generated solutions likely have a wider applicability in the region. PMID:26586324

  8. Urbanization and health in China, thinking at the national, local and individual levels.

    PubMed

    Li, Xinhu; Song, Jinchao; Lin, Tao; Dixon, Jane; Zhang, Guoqin; Ye, Hong

    2016-03-08

    China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need. In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels. Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health. At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take

  9. National profile on commercially generated low-level radioactive mixed waste

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

    Klein, J.A.; Mrochek, J.E.; Jolley, R.L.

    1992-12-01

    This report details the findings and conclusions drawn from a survey undertaken as part of a joint US Nuclear Regulatory Commission and US Environmental Protection Agency-sponsored project entitled ``National Profile on Commercially Generated Low-Level Radioactive Mixed Waste.`` The overall objective of the work was to compile a national profile on the volumes, characteristics, and treatability of commercially generated low-level mixed waste for 1990 by five major facility categories-academic, industrial, medical, and NRC-/Agreement State-licensed goverment facilities and nuclear utilities. Included in this report are descriptions of the methodology used to collect and collate the data, the procedures used to estimate themore » mixed waste generation rate for commercial facilities in the United States in 1990, and the identification of available treatment technologies to meet applicable EPA treatment standards (40 CFR Part 268) and, if possible, to render the hazardous component of specific mixed waste streams nonhazardous. The report also contains information on existing and potential commercial waste treatment facilities that may provide treatment for specific waste streams identified in the national survey. The report does not include any aspect of the Department of Energy`s (DOES) management of mixed waste and generally does not address wastes from remedial action activities.« less

  10. How The Australian National University's emergency management and continuity plans responded to a large-scale fire.

    PubMed

    Meehan, Bart

    2008-01-01

    On 18th January, 2003, one of the worst bushfires in the history of Australia hit the capital city, Canberra. By the time it was under control, four people were dead and more than 500 homes were destroyed. The fire also destroyed the Mount Stromlo campus of the Australian National University, the location of the Research School of Astronomy and Astrophysics. In response to the fires, the University initiated its emergency management strategy and business continuity plans. These allowed the School to recommence limited operations within two weeks of the disaster. This paper details a case study of the impact of the fire (in part using personal recollections of staff and students), and the emergency response implemented by the University. It describes the development of the University's emergency management strategy, with its emphasis on the key elements of clear chain of command and flexibility in developing an incident-specific response. The paper also provides an assessment of how the plan worked during an actual incident and some of the lessons learned, including the importance of the early response, managing the impact on people, media management, insurance and communications.

  11. 77 FR 42413 - The Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... Vol. 77 Wednesday, No. 138 July 18, 2012 Part III The President Notice of July 17, 2012--The Continuation of the National Emergency With Respect to the Former Liberian Regime of Charles Taylor #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 77, No. 138 / Wednesday, July 18, 2012 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President [...

  12. 78 FR 58149 - Continuation of the National Emergency With Respect to Persons Who Commit, Threaten To Commit, or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... Vol. 78 Friday, No. 183 September 20, 2013 Part VI The President Notice of September 18, 2013--Continuation of the National Emergency With Respect to Persons Who Commit, Threaten To Commit, or Support Terrorism #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 78 , No. 183 / Friday, September 20, 2013 / Presidential Documents#0;#0; #0; #0;Title...

  13. Rural Emergency Department Staffing and Participation in Emergency Certification and Training Programs

    ERIC Educational Resources Information Center

    Casey, Michelle M.; Wholey, Douglas; Moscovice, Ira S.

    2008-01-01

    Context: The practice of emergency medicine presents many challenges in rural areas. Purpose: We describe how rural hospitals nationally are staffing their Emergency Departments (EDs) and explore the participation of rural ED physicians and other health care professionals in selected certification and training programs that teach skills needed to…

  14. 75 FR 65933 - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... Respect to the Situation in or in Relation to the Democratic Republic of the Congo #0; #0; #0... Republic of the Congo On October 27, 2006, by Executive Order 13413, the President declared a national emergency with respect to the situation in or in relation to the Democratic Republic of the Congo and...

  15. Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

    PubMed Central

    2013-01-01

    Background A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks. Methods This was a register-based follow-up study of all 1-1-2 calls in a 6-month period that were triaged according to the Danish Index – the new criteria-based dispatch protocol. Danish Index data were linked with hospital and vital status data from national registries. Confidence intervals (95%) for proportions with binomial data were computed using exact methods. To test for trend the Wald test was used. Results Information on level of emergency according to the Danish Index rating was available for 67,135 patients who received ambulance service. Emergency level A (urgent cases) accounted for 51.4% (n = 34,489) of patients, emergency level B for 46.3% (n = 31,116), emergency level C for 2.1% (n = 1,391) and emergency level D for 0.2% (n = 139). For emergency level A, the median time from call receipt to ambulance dispatch was 2 min 1 s, and the median time to arrival was 6 min 11 s. Data concerning admission and case fatality was available for 55,270 patients. The hospital admission risk for emergency level A patients was 64.4% (95% CI = 63.8-64.9). There was a significant trend (p < 0.001) towards lower admission risks for patients with lower levels of emergency. The case fatality risk for emergency level A patients on the same day as the 1-1-2 call was 4.4% (95% CI = 4.1-4.6). The relative case-fatality risk among emergency level A patients compared to emergency level B–D patients was 14.3 (95% CI: 11.5-18.0). Conclusion The majority of patients were assessed as Danish Index emergency level A or B. Case fatality and hospital admission risks were substantially higher for emergency level A patients than for emergency level B–D patients. Thus

  16. Epidemiology of Eye-Related Emergency Department Visits.

    PubMed

    Channa, Roomasa; Zafar, Syed Nabeel; Canner, Joseph K; Haring, R Sterling; Schneider, Eric B; Friedman, David S

    2016-03-01

    Determining the epidemiology of eye-related emergency department (ED) visits on a national level can assist policymakers in appropriate allocation of resources. To study ED visits related to ocular conditions for all age groups across the United States. Nationally representative data from the US Nationwide Emergency Department Sample (NEDS) were used to analyze ED visits from January 1, 2006, to December 31, 2011 (6 years). All patients with eye problems presenting to EDs across the United States were eligible for inclusion. A weighted count of 11 929 955 ED visits were categorized as possibly emergent (emergent), unlikely to be emergent (nonemergent), or could not be determined. Data were analyzed from March 1 to May 30, 2015. Population-based incidence rates of eye-related ED visits, incidence rates of eye injuries, relative proportions of emergent vs nonemergent eye-related ED visits among different age groups, and independent factors associated with emergent vs nonemergent visits. From 2006 to 2011, 11 929 955 ED visits (male patients, 54.2%; mean [SD] age, 31 [22] years) for ocular problems across the United States were categorized as emergent (41.2%), nonemergent (44.3%), or could not determine (14.5%). Corneal abrasions (13.7%) and foreign body in the external eye (7.5%) were the leading diagnoses in the emergent category. More than 4 million visits were for conjunctivitis (28.0%), subconjunctival hemorrhages (3.0%), and styes (3.8%). Emergent visits were significantly more likely to occur among males (odds ratio [OR], 2.00; 95% CI, 2.00-2.01), patients in the highest income quartile (OR, 1.47; 95% CI, 1.46-1.49), older patients (OR, 2.38; 95% CI, 2.38-2.44), and patients with private insurance (OR, 1.29; 95% CI, 1.28-1.30). Mean annual inflation-adjusted charges for all eye-related ED visits totaled $2.0 billion. Across the United States, nonemergent conditions accounted for almost half of all eye-related ED visits. Interventions to facilitate management of

  17. Trends in the Incidence of Hypertensive Emergencies in US Emergency Departments From 2006 to 2013.

    PubMed

    Janke, Alexander T; McNaughton, Candace D; Brody, Aaron M; Welch, Robert D; Levy, Phillip D

    2016-12-05

    The incidence of hypertensive emergency in US emergency departments (ED) is not well established. This study is a descriptive epidemiological analysis of nationally representative ED visit-level data from the Nationwide Emergency Department Sample for 2006-2013. Nationwide Emergency Department Sample is a publicly available database maintained by the Healthcare Cost and Utilization Project. An ED visit was considered to be a hypertensive emergency if it met all the following criteria: diagnosis of acute hypertension, at least 1 diagnosis indicating acute target organ damage, and qualifying disposition (admission to the hospital, death, or transfer to another facility). The incidence of adult ED visits for acute hypertension increased monotonically in the period from 2006 through 2013, from 170 340 (1820 per million adult ED visits overall) to 496 894 (4610 per million). Hypertensive emergency was rare overall, accounting for 63 406 visits (677 per million adult ED visits overall) in 2006 to 176 769 visits (1670 per million) in 2013. Among adult ED visits that had any diagnosis of hypertension, hypertensive emergency accounted for 3309 per million in 2006 and 6178 per million in 2013. The estimated number of visits for hypertensive emergency and the rate per million adult ED visits has more than doubled from 2006 to 2013. However, hypertensive emergencies are rare overall, occurring in about 2 in 1000 adult ED visits overall, and 6 in 1000 adult ED visits carrying any diagnosis of hypertension in 2013. This figure is far lower than what has been sometimes cited in previous literature. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module XI. Obstetric/Gynecologic Emergencies.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on obstetric/gynecologic emergencies is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Six units of study are presented: (1) anatomy and physiology of the female reproductive system; (2) patient assessment; (3) pathophysiology and management of gynecologic…

  19. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

    ERIC Educational Resources Information Center

    Naradko, Anthony M.

    2017-01-01

    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  20. Travel Services, Levels 2-4. Travel Services (Field Operations), Levels 2-4. National Vocational Qualifications.

    ERIC Educational Resources Information Center

    Business and Technology Education Council, London (England).

    Britain's National Vocational Qualifications (NVQs) are work qualifications that measure what an employee or potential employee can do as well as how much he or she knows and understands about a particular job. Used as written proof of usable workplace skills that can be put to profitable use by an employer, NVQs range from basic Level 1, for…

  1. National low-level waste management program radionuclide report series, Volume 15: Uranium-238

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

    Adams, J.P.

    1995-09-01

    This report, Volume 15 of the National Low-Level Waste Management Program Radionuclide Report Series, discusses the radiological and chemical characteristics of uranium-238 ({sup 238}U). The purpose of the National Low-Level Waste Management Program Radionuclide Report Series is to provide information to state representatives and developers of low-level radioactive waste disposal facilities about the radiological, chemical, and physical characteristics of selected radionuclides and their behavior in the waste disposal facility environment. This report also includes discussions about waste types and forms in which {sup 238}U can be found, and {sup 238}U behavior in the environment and in the human body.

  2. One size fits all? An assessment tool for solid waste management at local and national levels

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

    Broitman, Dani, E-mail: danib@techunix.technion.ac.il; Ayalon, Ofira; Kan, Iddo

    2012-10-15

    Highlights: Black-Right-Pointing-Pointer Waste management schemes are generally implemented at national or regional level. Black-Right-Pointing-Pointer Local conditions characteristics and constraints are often neglected. Black-Right-Pointing-Pointer We developed an economic model able to compare multi-level waste management options. Black-Right-Pointing-Pointer A detailed test case with real economic data and a best-fit scenario is described. Black-Right-Pointing-Pointer Most efficient schemes combine clear National directives with local level flexibility. - Abstract: As environmental awareness rises, integrated solid waste management (WM) schemes are increasingly being implemented all over the world. The different WM schemes usually address issues such as landfilling restrictions (mainly due to methane emissions and competingmore » land use), packaging directives and compulsory recycling goals. These schemes are, in general, designed at a national or regional level, whereas local conditions and constraints are sometimes neglected. When national WM top-down policies, in addition to setting goals, also dictate the methods by which they are to be achieved, local authorities lose their freedom to optimize their operational WM schemes according to their specific characteristics. There are a myriad of implementation options at the local level, and by carrying out a bottom-up approach the overall national WM system will be optimal on economic and environmental scales. This paper presents a model for optimizing waste strategies at a local level and evaluates this effect at a national level. This is achieved by using a waste assessment model which enables us to compare both the economic viability of several WM options at the local (single municipal authority) level, and aggregated results for regional or national levels. A test case based on various WM approaches in Israel (several implementations of mixed and separated waste) shows that local characteristics

  3. Helpful Hints for School Emergency Management: The National Incident Management System (NIMS) and Schools. Frequently Asked Questions and FY 2006 NIMS Compliance Activities for Schools

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The National Incident Management System (NIMS) is a comprehensive system that improves tribal and local emergency response operations through the use of the Incident Command System (ICS) and the application of standardized…

  4. [Proposal for magnetic/electromagnetic fields protection norms on national level].

    PubMed

    Dordević, Drago; Raković, Dejan

    2008-01-01

    The modern life is not possible without application of magnetic/electromagnetic fields, which can be both helpful and harmful for human body. The non-ionizing radiation, especially magnetic/electromagnetic fields of all frequencies (0-300 GHz), can have many harmful effects on the human health that is confirmed by numerous epidemiological studies, studies with volunteers, animal studies, and in vitro studies. Proposal for magnetic/electromagnetic fields protection norms on national level based on the WHO Program for Environment, International Commission on Non-Ionizing Radiation Protection (ICNIRP)], and WHO International EMF Project. Protection from harmful effects of the magnetic/electromagnetic fields is still a great problem in many countries of modern society--huge costs, impaired quality of life, and more important, damage to the human health. Numerous data and publications of harmful effects of the magnetic/electromagnetic fields represents one's country basic necessary documentation for making decisions and law documents for protection norms on national level concerning the health maintenance according to the ICNIRP normatives.

  5. National estimates of outdoor recreational injuries treated in emergency departments, United States, 2004-2005.

    PubMed

    Flores, Adrian H; Haileyesus, Tadesse; Greenspan, Arlene I

    2008-01-01

    To provide national estimates of nonfatal outdoor recreational injuries treated in US emergency departments (EDs). Outdoor recreational injuries from January 2004 through December 2005 were identified using the National Electronic Injury Surveillance System-All Injury Program, a nationally representative sample of ED visits. National estimates of outdoor recreational injuries were calculated, and activities leading to injury, demographic characteristics, principal diagnoses, and primary body parts affected were described. From January 2004 through December 2005, an estimated 212 708 (95% CI = 113 808- 311 608) persons were treated each year in US EDs for outdoor recreational injuries. The annual rate of injuries was 72.1 per 100 000 population (95% CI = 38.6-105.6). Males accounted for 68.2% of the injuries. The lower limb (27%), upper limb (25%), and head and neck region (23.3%) were the most commonly injured body regions. Fractures (27.4%) and sprains or strains (23.9%) were the most common diagnoses. Traumatic brain injuries were diagnosed in 6.5% of injuries, and 5% of injuries resulted in hospitalization or transfer to another hospital. The results of this study provide a starting point for further research into the epidemiology of outdoor and wilderness injury. The results reinforce many common perceptions about the nature of these injuries while highlighting the potential severity and long-term consequences of the injuries. The general recommendations of proper planning, preparation, and problem anticipation for outdoor and wilderness injury prevention should be followed to reduce both the number and severity of injuries.

  6. Disparities in access to emergency general surgery care in the United States.

    PubMed

    Khubchandani, Jasmine A; Shen, Connie; Ayturk, Didem; Kiefe, Catarina I; Santry, Heena P

    2018-02-01

    As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room." Internet search and direct contact confirmed emergency general surgery services that covered the emergency room 7 days a week, 24 hours a day. Geographic and population-level emergency general surgery access was derived from Geographic Information Systems and US Census. Of the 6,356 hospitals in the 2013 American Hospital Association database, only 2,811 were emergency general surgery hospitals. Counties with greater percentages of black, Hispanic, uninsured, and low-education individuals and rural counties disproportionately lacked access to emergency general surgery care. For example, counties above the 75th percentile of African American population (10.2%) had >80% odds of not having an emergency general surgery hospital compared with counties below the 25th percentile of African American population (0.6%). Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities. Policy initiatives need to increase emergency general surgery capacity nationwide. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Decreased levels of alpha-1-acid glycoprotein are related to the mortality of septic patients in the emergency department.

    PubMed

    Barroso-Sousa, Romualdo; Lobo, Romulo R; Mendonça, Patricia R; Memória, Renan R; Spiller, Fernando; Cunha, Fernando Q; Pazin-Filho, Antonio

    2013-01-01

    To determine the validity of alpha-1-acid glycoprotein as a novel biomarker for mortality in patients with severe sepsis. We prospectively included patients with severe sepsis or septic shock at the emergency department at a single tertiary referral teaching hospital. All of the patients were enrolled within the first 24 hours of emergency department admission, and clinical data and blood samples were obtained. As the primary outcome, we investigated the association of serum levels of alpha-1-acid glycoprotein and 96-hour mortality with logistic regression analysis and generalized estimating equations adjusted for age, sex, shock status and Acute Physiology and Chronic Health Evaluation II score. Patients with septic shock had lower alpha-1-acid glycoprotein levels at the time of emergency department admission compared to patients without shock (respectively, 149.1 ±42.7 vs. 189.8 ±68.6; p = 0.005). Similarly, non-survivors in the first 96 hours were also characterized by lower levels of alpha-1-acid glycoprotein at the time of emergency department admission compared to survivors (respectively, 132.18 ±50.2 vs. 179.8 ±61.4; p = 0.01). In an adjusted analysis, alpha-1-acid glycoprotein levels ≤120 mg/dL were significantly associated with 96-hour mortality (odds ratio = 14.37; 95% confidence interval = 1.58 to 130.21). Septic shock patients exhibited lower circulating alpha-1-acid glycoprotein levels than patients without shock. Alpha-1-acid glycoprotein levels were independently associated with 96-hour mortality in individuals with severe sepsis.

  8. Beyond pilotitis: taking digital health interventions to the national level in China and Uganda.

    PubMed

    Huang, Fei; Blaschke, Sean; Lucas, Henry

    2017-07-31

    Innovation theory has focused on the adoption of new products or services by individuals and their market-driven diffusion to the population at large. However, major health sector innovations typically emerge from negotiations between diverse stakeholders who compete to impose or at least prioritise their preferred version of that innovation. Thus, while many digital health interventions have succeeded in terms of adoption by a substantial number of providers and patients, they have generally failed to gain the level of acceptance required for their integration into national health systems that would promote sustainability and population-wide application. The area of innovation considered here relates to a growing number of success stories that have created considerable enthusiasm among donors, international agencies, and governments for the potential role of ICTs in transforming weak national health information systems in middle and low income countries. This article uses a case study approach to consider the assumptions, institutional as well as technical, underlying this enthusiasm and explores possible ways in which outcomes might be improved. Literature review and case study analysis. The two systems considered have had considerable success in terms of gaining and maintaining government support and addressing the concerns of providers without compromising their core elements. In Uganda, the system has flourished in spite of severe resource constraints, using a participatory approach that has encouraged a high level of community engagement. In China, concern with past failures generated the political will to build a high quality surveillance system, using the latest technology and drawing on a highly skilled human resource base. Both example stress the importance of recognising the political, social and historical context within which information systems have to function. Implementers need to focus as much on the perceptions, attitudes and needs of stakeholders

  9. Agriculture, Levels 1-4. Agriculture & Commercial Horticulture, Levels 1-4. Commercial Horticulture, Levels 1-3. Environmental Conservation, Levels 2-4. National Vocational Qualifications.

    ERIC Educational Resources Information Center

    Business and Technology Education Council, London (England).

    Britain's National Vocational Qualifications (NVQs) are work qualifications that measure what an employee or potential employee can do as well as how much he or she knows and understands about a particular job. Used as written proof of usable workplace skills that can be put to profitable use by an employer, NVQs range from basic Level 1, for…

  10. Correlation of Level of Trauma Activation With Emergency Department Intervention.

    PubMed

    Cooper, Michael C; Srivastava, Geetanjali

    2018-06-01

    In-hospital trauma team activation criteria are formulated to identify severely injured patients requiring specialized multidisciplinary care. Efficacy of trauma activation (TA) criteria is commonly measured by emergency department (ED) disposition, injury severity score, and mortality. Necessity of critical ED interventions is another measure that has been proposed to evaluate the appropriateness of TA criteria. Two-year retrospective cohort study of 1715 patients from our trauma registry at a Level 1 pediatric trauma center. We abstracted data on acute interventions, level and criterion of TA, ED disposition, and mortality. We report odds ratio (OR) with 95% confidence intervals (CIs), positive predictive value, and frequency of acute interventions. Trauma activation was initiated for 947 (55%) of the 1715 patients. There were 426 ED interventions performed on 235 patients (14%); 67.8% were in level 1 activations; 17.6% in level 2, and 14.6% in level 3. Highest-level activations were highly associated with need for ED interventions (OR, 16.1; 95% CI, 11.5-22.4). The ORs for requiring an ED intervention were low for lower level activations (OR, 0.4; 95% CI, 0.3-0.5), trauma service consults (OR, 0.3; 95% CI, 0.2-0.4), and certain mechanism-based criteria. The ORs for ED intervention for isolated motor vehicle collision (0.2; 95% CI, 0.1-0.7), isolated all-terrain vehicle rollover (0.4; 95% CI, 0.1-1.7), and suspected spinal cord injury (0.5; 95% CI, 0.1-3.7) were significantly lower than 1. Highest-level activation criteria correlate with high utilization of ED resources and interventions. Lower level activation criteria and trauma service consult criteria are not highly correlated with need for ED interventions. Downgrading isolated motor vehicle collision and all-terrain vehicle rollovers and suspected spinal cord injury to lower level activations could decrease the overtriage rate, and adding age-specific bradycardia as a physiologic criterion could improve our

  11. Financial Impacts of Foot-and-Mouth Disease at Village and National Levels in Lao PDR.

    PubMed

    Nampanya, S; Khounsy, S; Abila, R; Young, J R; Bush, R D; Windsor, P A

    2016-10-01

    To assist policies on Foot-and-Mouth Disease (FMD) control in Laos and the Mekong region, the financial impact of recent outbreaks at village and national levels was examined. Village-level impacts were derived from recent research on financial losses due to FMD per smallholder household and number of households with FMD-affected livestock in the village. National-level impacts of FMD were determined from examination of 2011-2013 FMD reported to the Lao Department of Livestock and Fisheries (DLF), with the 2011 epidemic reported separately due to the large number and size of outbreaks of FMD in that year. Estimates of the national financial impact of FMD were based on (i) total FMD financial losses at the village level and (ii) the costs of FMD responses and other related costs at the DLF, provincial and district levels where FMD was reported, but excluding the costs of revenue forgone. A Monte Carlo simulation was utilized to account for likelihood of FMD over- and under-reporting. Foot-and-mouth disease was recorded in four provinces of Phonsaly, Bokeo, Xayyabouli and Champasak in three consecutive years from 2011 to 2013. However, the FMD epidemic in 2011 was more widely distributed and involved 414 villages in 14 provinces, with thousands of cases of morbidity in cattle and buffalo and some mortalities. The estimated financial losses due to FMD in 2011 were USD 30 881(±23 176) at the village level and USD 13 512 291 at the national level based on the number of villages with FMD outbreaks reported. However, when the likelihood of FMD under-reporting was accounted for, the estimated financial losses at the national level could potentially increase to USD 102 094 464 (±52 147 261), being almost 12% of the estimated farm gate value of the national large ruminant herd. These findings confirm that FMD causes substantial financial impacts in villages and to the national economy of Laos, providing justification for sustained investments in FMD control

  12. Nanotechnology: Emerging Developments and Early Detection of Cancer. A Two-Day Workshop Sponsored by the National Cancer Institute and the National Institute of Standards and Technology, August 30–31 2001, on the National Institute of Standards and Technology Campus, Gaithersburg, MD, USA

    PubMed Central

    Zullo, Steven J.; Srivastava, Sudhir; Looney, J. Patrick; Barker, Peter E.

    2002-01-01

    A recent meeting jointly sponsored by the National Cancer Institute (NCI) and National Institute of Standards and Technology (NIST) brought together researchers active in nanotechnology and cancer molecular biology to discuss and evaluate the interface between disciplines. Emerging areas where nanotechnologies may impact cancer prevention and early cancer detection were elaborated by key researchers who catalyzed interdisciplinary dialogue aimed at fostering cross-discipline communications and future collaboration. PMID:12590168

  13. Handling Emergency Management in [an] Object Oriented Modeling Environment

    NASA Technical Reports Server (NTRS)

    Tokgoz, Berna Eren; Cakir, Volkan; Gheorghe, Adrian V.

    2010-01-01

    It has been understood that protection of a nation from extreme disasters is a challenging task. Impacts of extreme disasters on a nation's critical infrastructures, economy and society could be devastating. A protection plan itself would not be sufficient when a disaster strikes. Hence, there is a need for a holistic approach to establish more resilient infrastructures to withstand extreme disasters. A resilient infrastructure can be defined as a system or facility that is able to withstand damage, but if affected, can be readily and cost-effectively restored. The key issue to establish resilient infrastructures is to incorporate existing protection plans with comprehensive preparedness actions to respond, recover and restore as quickly as possible, and to minimize extreme disaster impacts. Although national organizations will respond to a disaster, extreme disasters need to be handled mostly by local emergency management departments. Since emergency management departments have to deal with complex systems, they have to have a manageable plan and efficient organizational structures to coordinate all these systems. A strong organizational structure is the key in responding fast before and during disasters, and recovering quickly after disasters. In this study, the entire emergency management is viewed as an enterprise and modelled through enterprise management approach. Managing an enterprise or a large complex system is a very challenging task. It is critical for an enterprise to respond to challenges in a timely manner with quick decision making. This study addresses the problem of handling emergency management at regional level in an object oriented modelling environment developed by use of TopEase software. Emergency Operation Plan of the City of Hampton, Virginia, has been incorporated into TopEase for analysis. The methodology used in this study has been supported by a case study on critical infrastructure resiliency in Hampton Roads.

  14. Analysis for water level data for Everglades National Park, Florida

    USGS Publications Warehouse

    Buchanan, T.J.; Hartwell, J.H.

    1972-01-01

    Stage-duration curves were developed for five gaging stations in Everglades National Park, Florida. Four of the five curves show similar characteristics with an increase in the slope when the water level is below land surface. Monthly stage-duration curves, developed for one of the stations, reflect the seasonal trends of the water level. Recession curves were prepared for the same five stations. These curves represent the average water-level decline during periods of little or no rainfall. They show the decline in level at the end of 10, 20, and 60 days for any given initial stage. A family of curves was also prepared to give the recession from various initial stages for any period up to 60 days.

  15. Compliance of child care centers in Pennsylvania with national health and safety performance standards for emergency and disaster preparedness.

    PubMed

    Olympia, Robert P; Brady, Jodi; Kapoor, Shawn; Mahmood, Qasim; Way, Emily; Avner, Jeffrey R

    2010-04-01

    To determine the preparedness of child care centers in Pennsylvania to respond to emergencies and disasters based on compliance with National Health and Safety Performance Standards for Out-of-Home Child Care Programs. A questionnaire focusing on the presence of a written evacuation plan, the presence of a written plan for urgent medical care, the immediate availability of equipment and supplies, and the training of staff in first aid/cardiopulmonary resuscitation (CPR) as delineated in Caring for Our Children: National Health and Safety Performance Standards for Out-of-Home Child Care Programs, 2nd Edition, was mailed to 1000 randomly selected child care center administrators located in Pennsylvania. Of the 1000 questionnaires sent, 496 questionnaires were available for analysis (54% usable response rate). Approximately 99% (95% confidence interval [CI], 99%-100%) of child care centers surveyed were compliant with recommendations to have a comprehensive written emergency plan (WEP) for urgent medical care and evacuation, and 85% (95% CI, 82%-88%) practice their WEP periodically throughout the year. More than 20% of centers did not have specific written procedures for floods, earthquakes, hurricanes, blizzards, or bomb threats, and approximately half of the centers did not have specific written procedures for urgent medical emergencies such as severe bleeding, unresponsiveness, poisoning, shock/heart or circulation failure, seizures, head injuries, anaphylaxis or allergic reactions, or severe dehydration. A minority of centers reported having medications available to treat an acute asthma attack or anaphylaxis. Also, 77% (95% CI, 73%-80%) of child care centers require first aid training for each one of its staff members, and 33% (95% CI, 29%-37%) require CPR training. Although many of the child care centers we surveyed are in compliance with the recommendations for emergency and disaster preparedness, specific areas for improvement include increasing the frequency

  16. 78 FR 13085 - Proposed Collection, Comments Requested: FBI National Academy Level 1 Evaluation: Student Course...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-26

    ..., Comments Requested: FBI National Academy Level 1 Evaluation: Student Course Questionnaire and FBI National Academy: General Remarks Questionnaire ACTION: 60-day notice. The Department of Justice (DOJ), Federal... Evaluation: Student Course Questionnaire FBI National Academy: General Remarks Questionnaire. 3. Agency Form...

  17. Variations in task constraints shape emergent performance outcomes and complexity levels in balancing.

    PubMed

    Caballero Sánchez, Carla; Barbado Murillo, David; Davids, Keith; Moreno Hernández, Francisco J

    2016-06-01

    This study investigated the extent to which specific interacting constraints of performance might increase or decrease the emergent complexity in a movement system, and whether this could affect the relationship between observed movement variability and the central nervous system's capacity to adapt to perturbations during balancing. Fifty-two healthy volunteers performed eight trials where different performance constraints were manipulated: task difficulty (three levels) and visual biofeedback conditions (with and without the center of pressure (COP) displacement and a target displayed). Balance performance was assessed using COP-based measures: mean velocity magnitude (MVM) and bivariate variable error (BVE). To assess the complexity of COP, fuzzy entropy (FE) and detrended fluctuation analysis (DFA) were computed. ANOVAs showed that MVM and BVE increased when task difficulty increased. During biofeedback conditions, individuals showed higher MVM but lower BVE at the easiest level of task difficulty. Overall, higher FE and lower DFA values were observed when biofeedback was available. On the other hand, FE reduced and DFA increased as difficulty level increased, in the presence of biofeedback. However, when biofeedback was not available, the opposite trend in FE and DFA values was observed. Regardless of changes to task constraints and the variable investigated, balance performance was positively related to complexity in every condition. Data revealed how specificity of task constraints can result in an increase or decrease in complexity emerging in a neurobiological system during balance performance.

  18. Estimation of child vaccination coverage at state and national levels in India

    PubMed Central

    Gupta, Satish; Kumar, Rakesh; Haldar, Pradeep; Sethi, Raman; Bahl, Sunil

    2016-01-01

    Abstract Objective To review the data, for 1999–2013, on state-level child vaccination coverage in India and provide estimates of coverage at state and national levels. Methods We collated data from administrative reports, population-based surveys and other sources and used them to produce annual estimates of vaccination coverage. We investigated bacille Calmette–Guérin vaccine, the first and third doses of vaccine against diphtheria, tetanus and pertussis, the third dose of oral polio vaccine and the first dose of vaccine against measles. We obtained relevant data covering the period 1999–2013 for each of 16 states and territories and the period 2001–2013 for the state of Jharkhand – which was only created in 2000. We aggregated the resultant state-level estimates, using a population-weighted approach, to give national values. Findings For each of the vaccinations we investigated, about half of the 253 estimates of annual coverage at state level that we produced were based on survey results. The rest were based on interpolation between – or extrapolation from – so-called anchor points or, more rarely, on administrative data. Our national estimates indicated that, for each of the vaccines we investigated, coverage gradually increased between 1999 and 2010 but then levelled off. Conclusion The delivery of routine vaccination services to Indian children appears to have improved between 1999 and 2013. There remains considerable scope to improve the recording and reporting of childhood vaccination coverage in India and regular systematic reviews of the coverage data are recommended. PMID:27843162

  19. Emergency medicine point-of-care ultrasonography: a national needs assessment of competencies for general and expert practice.

    PubMed

    Fischer, Lisa M; Woo, Michael Y; Lee, A Curtis; Wiss, Ray; Socransky, Steve; Frank, Jason R

    2015-01-01

    Emergency medicine point-of-care ultrasonography (EM-PoCUS) is a core competency for residents in the Royal College of Physicians and Surgeons of Canada and College of Family Physicians of Canada emergency medicine (EM) training programs. Although EM-PoCUS fellowships are currently offered in Canada, there is little consensus regarding what training should be included in a Canadian EM-PoCUS fellowship curriculum or how this contrasts with the training received in an EM residency.Objectives To conduct a systematic needs assessment of major stakeholders to define the essential elements necessary for a Canadian EM-PoCUS fellowship training curriculum. We carried out a national survey of experts in EM-PoCUS, EM residency program directors, and EM residents. Respondents were asked to identify competencies deemed either nonessential to EM practice, essential for general EM practice, essential for advanced EM practice, or essential for EM-PoCUS fellowship trained (‘‘expert’’) practice. The response rate was 81% (351 of 435). PoCUS was deemed essential to general EM practice for basic cardiac, aortic, trauma, and procedural imaging. PoCUS was deemed essential to advanced EM practice in undifferentiated symptomatology, advanced chest pathologies, and advanced procedural applications. Expert-level PoCUS competencies were identified for administrative, pediatric, and advanced gynecologic applications. Eighty-seven percent of respondents indicated that there was a need for EM-PoCUS fellowships, with an ideal length of 6 months. This is the first needs assessment of major stakeholders in Canada to identify competencies for expert training in EM-PoCUS. The competencies should form the basis for EM-PoCUS fellowship programs in Canada.

  20. Decreased levels of alpha-1-acid glycoprotein are related to the mortality of septic patients in the emergency department

    PubMed Central

    Barroso-Sousa, Romualdo; Lobo, Romulo R.; Mendonça, Patricia R.; Memória, Renan R.; Spiller, Fernando; Cunha, Fernando Q.; Pazin-Filho, Antonio

    2013-01-01

    OBJECTIVE: To determine the validity of alpha-1-acid glycoprotein as a novel biomarker for mortality in patients with severe sepsis. METHODS: We prospectively included patients with severe sepsis or septic shock at the emergency department at a single tertiary referral teaching hospital. All of the patients were enrolled within the first 24 hours of emergency department admission, and clinical data and blood samples were obtained. As the primary outcome, we investigated the association of serum levels of alpha-1-acid glycoprotein and 96-hour mortality with logistic regression analysis and generalized estimating equations adjusted for age, sex, shock status and Acute Physiology and Chronic Health Evaluation II score. RESULTS: Patients with septic shock had lower alpha-1-acid glycoprotein levels at the time of emergency department admission compared to patients without shock (respectively, 149.1±42.7 vs. 189.8±68.6; p = 0.005). Similarly, non-survivors in the first 96 hours were also characterized by lower levels of alpha-1-acid glycoprotein at the time of emergency department admission compared to survivors (respectively, 132.18±50.2 vs. 179.8±61.4; p = 0.01). In an adjusted analysis, alpha-1-acid glycoprotein levels ≤120 mg/dL were significantly associated with 96-hour mortality (odds ratio = 14.37; 95% confidence interval = 1.58 to 130.21). CONCLUSION: Septic shock patients exhibited lower circulating alpha-1-acid glycoprotein levels than patients without shock. Alpha-1-acid glycoprotein levels were independently associated with 96-hour mortality in individuals with severe sepsis. PMID:24037010

  1. Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study

    PubMed Central

    Harrison, Mark J; Dusheiko, Mark; Sutton, Matt; Gravelle, Hugh; Doran, Tim

    2014-01-01

    Objective To estimate the impact of a national primary care pay for performance scheme, the Quality and Outcomes Framework in England, on emergency hospital admissions for ambulatory care sensitive conditions (ACSCs). Design Controlled longitudinal study. Setting English National Health Service between 1998/99 and 2010/11. Participants Populations registered with each of 6975 family practices in England. Main outcome measures Year specific differences between trend adjusted emergency hospital admission rates for incentivised ACSCs before and after the introduction of the Quality and Outcomes Framework scheme and two comparators: non-incentivised ACSCs and non-ACSCs. Results Incentivised ACSC admissions showed a relative reduction of 2.7% (95% confidence interval 1.6% to 3.8%) in the first year of the Quality and Outcomes Framework compared with ACSCs that were not incentivised. This increased to a relative reduction of 8.0% (6.9% to 9.1%) in 2010/11. Compared with conditions that are not regarded as being influenced by the quality of ambulatory care (non-ACSCs), incentivised ACSCs also showed a relative reduction in rates of emergency admissions of 2.8% (2.0% to 3.6%) in the first year increasing to 10.9% (10.1% to 11.7%) by 2010/11. Conclusions The introduction of a major national pay for performance scheme for primary care in England was associated with a decrease in emergency admissions for incentivised conditions compared with conditions that were not incentivised. Contemporaneous health service changes seem unlikely to have caused the sharp change in the trajectory of incentivised ACSC admissions immediately after the introduction of the Quality and Outcomes Framework. The decrease seems larger than would be expected from the changes in the process measures that were incentivised, suggesting that the pay for performance scheme may have had impacts on quality of care beyond the directly incentivised activities. PMID:25389120

  2. Patterns of salivary cortisol levels can manifest work stress in emergency care providers.

    PubMed

    Nakajima, Yasushi; Takahashi, Takayuki; Shetty, Vivek; Yamaguchi, Masaki

    2012-05-01

    To develop objective assessments of work fatigue, we investigated the patterns of changes in salivary cortisol levels in emergency care providers working extended work shifts. Fourteen subjects, comprising seven physicians and seven physician assistants, provided unstimulated saliva samples at regular intervals over the course of a 24-h work shift and over their subsequent free day. There was a significant time effect, with early morning cortisol levels being significantly attenuated following the work shift. Native diurnal variations varied by gender, with the female subjects manifesting greater cortisol levels. Physicians also had higher cortisol profiles even though their wake-rest cycles were similar to those of the physician assistants. Our results suggest that temporal changes, as well as diurnal similarities, in the salivary cortisol patterns can reflect work-related stress and recovery. In particular, early morning cortisol levels may manifest individual reactivity to work stressors as well as sleep deprivation.

  3. Delivering Core Engineering Concepts to Secondary Level Students

    ERIC Educational Resources Information Center

    Merrill, Chris; Custer, Rodney L.; Daugherty, Jenny; Westrick, Martin; Zeng, Yong

    2008-01-01

    Through the efforts of National Center for Engineering and Technology Education (NCETE), three core engineering concepts within the realm of engineering design have emerged as crucial areas of need within secondary level technology education. These concepts are constraints, optimization, and predictive analysis (COPA). COPA appears to be at the…

  4. Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

    PubMed Central

    Shah, Gulzar H.; Newell, Bobbie; Whitworth, Ruth E.

    2016-01-01

    Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness. Methods: We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities. Results: Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency in the 12 months period prior to the survey, but a much larger proportion provided emergency preparedness training to staff (84.3%), and/or participated in tabletop exercises (76.4%). Our multivariable analysis showed that after adjusting for several resource-related LHD characteristics, LHDs with more of the 6 information systems still tend to have slightly more preparedness activities. In addition, having a designated emergency preparedness coordinator, and having one or more emergency preparedness staff were among the most significant factors associated with LHDs performing more emergency preparedness activities. Conclusion: LHDs might want to utilize better health information systems and information technology tools to improve their activity level in emergency preparedness, through improved information dissemination, and evidence collection. PMID:27694648

  5. Designing for adaptation to novelty and change: functional information, emergent feature graphics, and higher-level control.

    PubMed

    Hajdukiewicz, John R; Vicente, Kim J

    2002-01-01

    Ecological interface design (EID) is a theoretical framework that aims to support worker adaptation to change and novelty in complex systems. Previous evaluations of EID have emphasized representativeness to enhance generalizability of results to operational settings. The research presented here is complementary, emphasizing experimental control to enhance theory building. Two experiments were conducted to test the impact of functional information and emergent feature graphics on adaptation to novelty and change in a thermal-hydraulic process control microworld. Presenting functional information in an interface using emergent features encouraged experienced participants to become perceptually coupled to the interface and thereby to exhibit higher-level control and more successful adaptation to unanticipated events. The absence of functional information or of emergent features generally led to lower-level control and less success at adaptation, the exception being a minority of participants who compensated by relying on analytical reasoning. These findings may have practical implications for shaping coordination in complex systems and fundamental implications for the development of a general unified theory of coordination for the technical, human, and social sciences. Actual or potential applications of this research include the design of human-computer interfaces that improve safety in complex sociotechnical systems.

  6. The influence of a major sporting event upon emergency department attendances; A retrospective cross-national European study.

    PubMed

    Hughes, Helen E; Colón-González, Felipe J; Fouillet, Anne; Elliot, Alex J; Caserio-Schonemann, Céline; Hughes, Thomas C; Gallagher, Naomh; Morbey, Roger A; Smith, Gillian E; Thomas, Daniel Rh; Lake, Iain R

    2018-01-01

    Major sporting events may influence attendance levels at hospital emergency departments (ED). Previous research has focussed on the impact of single games, or wins/losses for specific teams/countries, limiting wider generalisations. Here we explore the impact of the Euro 2016 football championships on ED attendances across four participating nations (England, France, Northern Ireland, Wales), using a single methodology. Match days were found to have no significant impact upon daily ED attendances levels. Focussing upon hourly attendances, ED attendances across all countries in the four hour pre-match period were statistically significantly lower than would be expected (OR 0.97, 95% CI 0.94-0.99) and further reduced during matches (OR 0.94, 95% CI 0.91-0.97). In the 4 hour post-match period there was no significant increase in attendances (OR 1.01, 95% CI 0.99-1.04). However, these impacts were highly variable between individual matches: for example in the 4 hour period following the final, involving France, the number of ED attendances in France increased significantly (OR 1.27, 95% CI 1.13-1.42). Overall our results indicate relatively small impacts of major sporting events upon ED attendances. The heterogeneity observed makes it difficult for health providers to predict how major sporting events may affect ED attendances but supports the future development of compatible systems in different countries to support cross-border public health surveillance.

  7. The influence of a major sporting event upon emergency department attendances; A retrospective cross-national European study

    PubMed Central

    Colón-González, Felipe J.; Fouillet, Anne; Elliot, Alex J.; Caserio-Schonemann, Céline; Hughes, Thomas C.; Gallagher, Naomh; Morbey, Roger A.; Smith, Gillian E.; Thomas, Daniel Rh.; Lake, Iain R.

    2018-01-01

    Major sporting events may influence attendance levels at hospital emergency departments (ED). Previous research has focussed on the impact of single games, or wins/losses for specific teams/countries, limiting wider generalisations. Here we explore the impact of the Euro 2016 football championships on ED attendances across four participating nations (England, France, Northern Ireland, Wales), using a single methodology. Match days were found to have no significant impact upon daily ED attendances levels. Focussing upon hourly attendances, ED attendances across all countries in the four hour pre-match period were statistically significantly lower than would be expected (OR 0.97, 95% CI 0.94–0.99) and further reduced during matches (OR 0.94, 95% CI 0.91–0.97). In the 4 hour post-match period there was no significant increase in attendances (OR 1.01, 95% CI 0.99–1.04). However, these impacts were highly variable between individual matches: for example in the 4 hour period following the final, involving France, the number of ED attendances in France increased significantly (OR 1.27, 95% CI 1.13–1.42). Overall our results indicate relatively small impacts of major sporting events upon ED attendances. The heterogeneity observed makes it difficult for health providers to predict how major sporting events may affect ED attendances but supports the future development of compatible systems in different countries to support cross-border public health surveillance. PMID:29898000

  8. Kinematical Comparison of the 200 m Backstroke Turns between National and Regional Level Swimmers

    PubMed Central

    Veiga, Santiago; Cala, Antonio; Frutos, Pablo González; Navarro, Enrique

    2013-01-01

    The aims of this investigation were to determine the evolution of selected turn variables during competitive backstroke races and to compare these kinematic variables between two different levels of swimmers. Sixteen national and regional level male swimmers participant in the 200 m backstroke event at the Spanish Swimming Championships in short course (25 m) were selected to analyze their turn performances. The individual distances method with two-dimensional Direct Linear Transformation (2D-DLT) algorithms was used to perform race analyses. National level swimmers presented a shorter “turn time”, a longer “distance in”, a faster “underwater velocity” and “normalized underwater velocity”, and a faster “stroking velocity” than regional level swimmers, whereas no significant differences were detected between levels for the “underwater distance”. National level swimmers maintained similar “turn times” over the event and increased “underwater velocity” and “normalized underwater velocity” in the last (seventh) turn segment, whereas regional level swimmers increased “turn time” in the last half of the race. For both national and regional level swimmers, turn “underwater distance” during the last three turns of the race was significantly shorter while no significant differences in distance into the wall occurred throughout the race. The skill level of the swimmers has an impact on the competitive backstroke turn segments. In a 200 m event, the underwater velocity should be maximized to maintain turn proficiency, whereas turn distance must be subordinated to the average velocity. Key Points The underwater turn velocity is as a critical variable related to the swimmers’ level of skill in a 200 m backstroke event. Best swimmers perform faster but no longer turn segments during a 200 m backstroke event. Best swimmers maintain their turn performance throughout the 200 m backstroke event by increasing the underwater velocity

  9. Hospital all-risk emergency preparedness in Ghana.

    PubMed

    Norman, I D; Aikins, M; Binka, F N; Nyarko, K M

    2012-03-01

    This paper assessed the emergency preparedness programs of health facilities for all-risks but focused on Road Traffic Accidents, (RTA) resulting in surge demand. It adopted W. H. O checklist covering hospital preparedness, equipment, manpower and surge capacity planning as best practices for the mitigation of public health emergencies. This is a cross-sectional study of purposively selected health facilities. The method used consisted of site visit, questionnaire survey, literature and internet review. The W. H. O. standard for emergency preparedness of health facilities was used to evaluate and assess the nation's hospitals surge capacity programs. The study was conducted between March-June, 2010. A total of 22 district and regional health facilities including teaching hospitals participated in the study. All 10 regions of the country were covered. These were: (1) many of the nation's hospitals were not prepared for large RTA's resulting in surge demands, and did not possess general emergency preparedness programs. (2) The hospitals' respective abilities to handle large scale RTA's were compromised by the lack of competent medical and allied health personnel and adequate supplies. The inadequacies of the hospital system in responding to emergencies raise serious public health concerns. The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. The paper ended with recommendations on how the nation's hospitals and their supervisory agencies could improve emergency preparedness.

  10. A critical assessment of outcomes in emergency versus nonemergency general surgery using the American College of Surgeons National Surgical Quality Improvement Program database.

    PubMed

    Becher, Robert D; Hoth, J Jason; Miller, Preston R; Mowery, Nathan T; Chang, Michael C; Meredith, J Wayne

    2011-07-01

    Emergent operations are thought to carry higher morbidity and mortality than nonemergent cases. However, there is a lack of specific outcomes data for emergent general surgery procedures. The objective of our study was to assess and quantify postoperative morbidity and mortality for emergency versus nonemergency general surgery operations. All general surgery inpatients were identified in the American College of Surgeons National Surgical Quality Improvement Program 2008 database. Preoperative, intraoperative, and postoperative clinical metrics and occurrences were assessed. A total of 25,770 emergent and 98,867 nonemergent cases were identified. Postoperative morbidity was significantly worse in the emergent group, including ventilation more than 48 hours, bleeding requiring transfusion, deep vein thrombosis, renal failure, and need for reoperation. Overall, emergent cases had significantly more postoperative complications (22.8% vs 14.2%) and higher mortality rates (6.5% vs 1.4%). General surgery patients who undergo emergent operations have significantly poorer outcomes when compared with nonemergent patients; our analysis has quantified these differences. Emergent patients seem to manifest unique clinical, pathophysiologic, and inflammatory responses to their surgical disease. This data suggests that there is a need for improvement in both methods and systems of care for the emergent population.

  11. 2015 TRI National Analysis: Toxics Release Inventory Releases at Various Summary Levels

    EPA Pesticide Factsheets

    The TRI National Analysis is EPA's annual interpretation of TRI data at various summary levels. It highlights how toxic chemical wastes were managed, where toxic chemicals were released and how the 2015 TRI data compare to data from previous years. This dataset reports US state, county, large aquatic ecosystem, metro/micropolitan statistical area, and facility level statistics from 2015 TRI releases, including information on: number of 2015 TRI facilities in the geographic area and their releases (total, water, air, land); population information, including populations living within 1 mile of TRI facilities (total, minority, in poverty); and Risk Screening Environmental Indicators (RSEI) model related pounds, toxicity-weighted pounds, and RSEI score. The source of administrative boundary data is the 2013 cartographic boundary shapefiles. Location of facilities is provided by EPA's Facility Registry Service (FRS). Large Aquatic Ecosystems boundaries were dissolved from the hydrologic unit boundaries and codes for the United States, Puerto Rico, and the U.S. Virgin Islands. It was revised for inclusion in the National Atlas of the United States of America (November 2002), and updated to match the streams file created by the USGS National Mapping Division (NMD) for the National Atlas of the United States of America.

  12. Resilient National Security and Emergency Preparedness Communications: Service Metrics

    DTIC Science & Technology

    2015-10-01

    the East Coast of the United States after a tornado . Emergency management services are immediately called into duty to protect, provide, and secure...channel, radios that are vulnerable to congestion during heavy usage. During a tornado emergency prior to the hurricane, in a period of only 10...In terms of Survivability, the probability of a tornado occurring in any given year in this location is P( tornado ) = 0.05. The

  13. 45 CFR 3.21 - Emergency vehicles.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Emergency vehicles. 3.21 Section 3.21 Public... THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Traffic Regulations § 3.21 Emergency vehicles. A person must yield the right of way to an emergency vehicle operating its siren or flashing lights. ...

  14. 45 CFR 3.21 - Emergency vehicles.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Emergency vehicles. 3.21 Section 3.21 Public... THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Traffic Regulations § 3.21 Emergency vehicles. A person must yield the right of way to an emergency vehicle operating its siren or flashing lights. ...

  15. 45 CFR 3.21 - Emergency vehicles.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Emergency vehicles. 3.21 Section 3.21 Public... THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Traffic Regulations § 3.21 Emergency vehicles. A person must yield the right of way to an emergency vehicle operating its siren or flashing lights. ...

  16. 45 CFR 3.21 - Emergency vehicles.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Emergency vehicles. 3.21 Section 3.21 Public... THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Traffic Regulations § 3.21 Emergency vehicles. A person must yield the right of way to an emergency vehicle operating its siren or flashing lights. ...

  17. 15 CFR 705.9 - Emergency action.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Emergency action. 705.9 Section 705.9 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... IMPORTED ARTICLES ON THE NATIONAL SECURITY § 705.9 Emergency action. In emergency situations, or when in...

  18. 15 CFR 705.9 - Emergency action.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Emergency action. 705.9 Section 705.9 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... IMPORTED ARTICLES ON THE NATIONAL SECURITY § 705.9 Emergency action. In emergency situations, or when in...

  19. Administration and leadership competencies: establishment of a national consensus for emergency medicine.

    PubMed

    Thoma, Brent; Poitras, Julien; Penciner, Rick; Sherbino, Jonathan; Holroyd, Brian R; Woods, Robert A

    2015-03-01

    The Royal College of Physicians and Surgeons of Canada requires emergency medicine (EM) residency programs to meet training objectives relating to administration and leadership. The purpose of this study was to establish a national consensus on the competencies for inclusion in an EM administration and leadership curriculum. A modified Delphi process involving two iterative rounds of an electronic survey was used to achieve consensus on competencies for inclusion in an EM administration and leadership curriculum. An initial list of competencies was compiled using peer-reviewed and grey literature. The participants included 14 EM residency program directors and 43 leadership and administration experts from across Canada who were recruited using a snowball technique. The proposed competencies were organized using the CanMEDS Physician Competency Framework and presented in English or French. Consensus was defined a priori as >70% agreement. Nearly all (13 of 14) of the institutions with an FRCPC EM program had at least one participant complete both surveys. Thirty-five of 57 (61%) participants completed round 1, and 30 (53%) participants completed both rounds. Participants suggested an additional 16 competencies in round 1. The results of round 1 informed the decisions in round 2. Fifty-nine of 109 (54.1%) competencies achieved consensus for inclusion. Based on a national modified Delphi process, we describe 59 competencies for inclusion in an EM administration and leadership curriculum that was arranged by CanMEDS Role. EM educators may consider these competencies when designing local curricula.

  20. 10 CFR 51.13 - Emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Emergencies. 51.13 Section 51.13 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy Act-Regulations Implementing Section 102(2) § 51.13 Emergencies...

  1. 10 CFR 51.13 - Emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Emergencies. 51.13 Section 51.13 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy Act-Regulations Implementing Section 102(2) § 51.13 Emergencies...

  2. 2016 Emergent Data on Students in Australian Schools Receiving Adjustments for Disability. Nationally Consistent Collection of Data. School Students with Disability

    ERIC Educational Resources Information Center

    Education Council, 2016

    2016-01-01

    The Nationally Consistent Collection of Data on School Students with Disability (the collection) identified 685,911 students received an educational adjustment due to disability. Through this collection, teachers use their professional judgement based on evidence to capture information. This report looks at the emergent data on students in…

  3. The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

    PubMed

    Burkle, Frederick M

    2016-08-01

    During the May 2016 World Health Assembly of 194 member states, the World Health Organization (WHO) announced the process of developing and launching emergency medical teams as a critical component of the global health workforce concept. Over 64 countries have either launched or are in the development stages of vetting accredited teams, both international and national, to provide surge support to national health systems through WHO Regional Organizations and the delivery of emergency clinical care to sudden-onset disasters and outbreak-affected populations. To date, the United States has not yet committed to adopting the emergency medical team concept in funding and registering an international field hospital level team. This article discusses future options available for health-related nongovernmental organizations and the required educational and training requirements for health care provider accreditation. (Disaster Med Public Health Preparedness. 2016;10:531-535).

  4. USGS Emergency Response Resources

    USGS Publications Warehouse

    Bewley, Robert D.

    2011-01-01

    Every day, emergency responders are confronted with worldwide natural and manmade disasters, including earthquakes, floods, hurricanes, landslides, tsunami, volcanoes, wildfires, terrorist attacks, and accidental oil spills.The U.S. Geological Survey (USGS) is ready to coordinate the provisioning and deployment of USGS staff, equipment, geospatial data, products, and services in support of national emergency response requirements.

  5. Responding to the deaf in disasters: establishing the need for systematic training for state-level emergency management agencies and community organizations.

    PubMed

    Engelman, Alina; Ivey, Susan L; Tseng, Winston; Dahrouge, Donna; Brune, Jim; Neuhauser, Linda

    2013-03-07

    Deaf and hard-of-hearing (Deaf/HH) individuals have been underserved before and during emergencies. This paper will assess Deaf/HH related emergency preparedness training needs for state emergency management agencies and deaf-serving community-based organizations (CBOs). Four approaches were used: 1) a literature review; 2) results from 50 key informant (KI) interviews from state and territorial-level emergency management and public health agencies; 3) results from 14 KI interviews with deaf-serving CBOs in the San Francisco Bay Area; and 4) a pilot program evaluation of an emergency responder training serving the Deaf/HH in one urban community. Results from literature review and state and territorial level KIs indicate that there is a substantive gap in emergency preparedness training on serving Deaf/HH provided by state agencies. In addition, local KI interviews with 14 deaf-serving CBOs found gaps in training within deaf-serving CBOs. These gaps have implications for preparing for and responding to all-hazards emergencies including weather-related or earthquake-related natural disasters, terrorist attacks, and nuclear-chemical disasters. Emergency preparedness trainings specific to responding to or promoting preparedness of the Deaf/HH is rare, even for state agency personnel, and frequently lack standardization, evaluation, or institutionalization in emergency management infrastructure. This has significant policy and research implications. Similarly, CBOs are not adequately trained to serve the needs of their constituents.

  6. 15 CFR 265.13 - Emergency vehicles.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Emergency vehicles. 265.13 Section 265.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE... Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when...

  7. 15 CFR 265.13 - Emergency vehicles.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Emergency vehicles. 265.13 Section 265.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE... Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when...

  8. 15 CFR 265.13 - Emergency vehicles.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Emergency vehicles. 265.13 Section 265.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE... Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when...

  9. 15 CFR 265.13 - Emergency vehicles.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Emergency vehicles. 265.13 Section 265.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE... Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when...

  10. 15 CFR 265.13 - Emergency vehicles.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Emergency vehicles. 265.13 Section 265.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE... Emergency vehicles. No person shall fail or refuse to yield the right-of-way to an emergency vehicle when...

  11. Cancer incidence estimates at the national and district levels in Colombia.

    PubMed

    Piñeros, Marion; Ferlay, Jacques; Murillo, Raúl

    2006-01-01

    To estimate national and district cancer incidence for 18 major cancer sites in Colombia. National and district incidence was estimated by applying a set of age, sex and site-specific incidence/mortality ratios, obtained from a population-based cancer registry, to national and regional mortality. The work was done in Bogotá (Colombia) and Lyon (France) between May 2003 and August 2004. The annual total number of cases expected (all cancers but skin) was 17 819 in men and 18 772 in women. Among males the most frequent cancers were those of the prostate (45.8 per 100 000), stomach (36.0), and lung (20.0). In females the most frequent were those of the cervix uteri (36.8 per 100 000), breast (30.0), and stomach (20.7). Districts with the lowest death certification coverage yielded the highest incidence rates. In the absence of national population-based cancer registry data, estimates of incidence provide valuable information at national and regional levels. As mortality data are an important source for the estimation,the quality of death certification should be considered as a possible cause of bias.

  12. Estimates of emergency operating capacity in US manufacturing and nonmanufacturing industries

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

    Belzer, D.B.; Serot, D.E.; Kellogg, M.A.

    1991-03-01

    Development of integrated mobilization preparedness policies requires planning estimates of available productive capacity during national emergency conditions. Such estimates must be developed in a manner that allows evaluation of current trends in capacity and the consideration of uncertainties in various data inputs and in engineering assumptions. This study, conducted by Pacific Northwest Laboratory (PNL), developed estimates of emergency operating capacity (EOC) for 446 manufacturing industries at the 4-digit Standard Industrial Classification (SIC) level of aggregation and for 24 key non-manufacturing sectors. This volume presents tabular and graphical results of the historical analysis and projections for each SIC industry. (JF)

  13. 47 CFR 11.19 - EAS Non-participating National Authorization Letter.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false EAS Non-participating National Authorization Letter. 11.19 Section 11.19 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT... level EAS. It states that the EAS Participant has agreed to go off the air or discontinue programming on...

  14. 47 CFR 11.19 - EAS Non-participating National Authorization Letter.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false EAS Non-participating National Authorization Letter. 11.19 Section 11.19 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT... level EAS. It states that the EAS Participant has agreed to go off the air or discontinue programming on...

  15. Pharmaceutical products as emerging contaminant in water: relevance for developing nations and identification of critical compounds for Indian environment.

    PubMed

    Chinnaiyan, Prakash; Thampi, Santosh G; Kumar, Mathava; Mini, K M

    2018-04-17

    Pharmaceuticals and personal care products (PPCPs) are contaminants of emerging concern and have been detected worldwide in water bodies in trace concentrations. Most of these emerging contaminants are not regulated in water quality standards except a few in the developed countries. In the case of developing countries, research in this direction is at a nascent stage. For the effective management of Pharmaceutical contaminants (PC) in developing countries, the relevance of PCs as an emerging contaminant has to be analyzed followed by regular monitoring of the environment. Considering the resource constraints, this could be accomplished by identifying the priority compounds which is again region specific and dependent on consumption behavior and pattern. In this work, relevance of pharmaceutical compound as emerging contaminant in water for a developing country like India is examined by considering the data pertaining to pharmaceutical consumption data. To identify the critical Pharmaceutical Contaminants to be monitored in the Indian environment, priority compounds from selected prioritization methods were screened with the compounds listed in National List of Essential Medicine (NLEM), India. Further, information on the number of publications on the compound as an emerging contaminant, data on monitoring studies in India and the number of brands marketing the compound in India were also analyzed. It is found that out of 195 compounds from different prioritization techniques, only 77 compounds were found relevant to India based on NLEM sorting.

  16. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data

    PubMed Central

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-01-01

    Background The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. Objective To determine whether primary care access is associated with the route of emergency admission—via a GP versus via an A and E department. Methods Retrospective analysis of national administrative data from English hospitals for 2011–2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access—the percentage of patients able to get a general practice appointment on their last attempt—was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. Results The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Conclusions Among hospital inpatients admitted as an emergency, patients

  17. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data.

    PubMed

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-06-01

    The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. To determine whether primary care access is associated with the route of emergency admission-via a GP versus via an A and E department. Retrospective analysis of national administrative data from English hospitals for 2011-2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access-the percentage of patients able to get a general practice appointment on their last attempt-was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Among hospital inpatients admitted as an emergency, patients registered to more accessible general practices were more

  18. Australia’s first national level quantitative environmental justice assessment of industrial air pollution

    NASA Astrophysics Data System (ADS)

    Chakraborty, Jayajit; Green, Donna

    2014-04-01

    This study presents the first national level quantitative environmental justice assessment of industrial air pollution in Australia. Specifically, our analysis links the spatial distribution of sites and emissions associated with industrial pollution sources derived from the National Pollution Inventory, to Indigenous status and social disadvantage characteristics of communities derived from Australian Bureau of Statistics indicators. Our results reveal a clear national pattern of environmental injustice based on the locations of industrial pollution sources, as well as volume, and toxicity of air pollution released at these locations. Communities with the highest number of polluting sites, emission volume, and toxicity-weighted air emissions indicate significantly greater proportions of Indigenous population and higher levels of socio-economic disadvantage. The quantities and toxicities of industrial air pollution are particularly higher in communities with the lowest levels of educational attainment and occupational status. These findings emphasize the need for more detailed analysis in specific regions and communities where socially disadvantaged groups are disproportionately impacted by industrial air pollution. Our empirical findings also underscore the growing necessity to incorporate environmental justice considerations in environmental planning and policy-making in Australia.

  19. The complex reality of sea-level rise in an atoll nation

    NASA Astrophysics Data System (ADS)

    Donner, S. D.

    2012-12-01

    Sea-level rise famously poses an existential threat to island nations like Kiribati, Tuvalu and the Maldives. Yet as the global mean sea-level rises, the response of any one location at any given time will depend on the natural variability in regional sea-level and other impact of local human activities on coastal processes. As with climate warming, the state of an individual shoreline or the extent of flooding on a given day is not proof of a sea-level trend, nor is a global sea-level trend a good predictor of individual flooding or erosion events. Failure to consider the effect of natural variability and local human activity on coastal processes often leads to misattribution of flooding events and even some long-term shoreline changes to global sea level rise. Moreover, unverified attribution of individual events or changes to specific islets to sea level rise can inflame or invite scepticism of the strong scientific evidence for an accelerating increase in the global sea level due to the impacts of human activity on the climate system. This is particularly important in developing nations like Kiribati, which are depending on international financial support to adapt to rising sea levels. In this presentation, I use gauge data and examples from seven years of field work in Tarawa Atoll, the densely populated capital of Kiribati, to examine the complexity of local sea level and shoreline change in one of the world's most vulnerable countries. First, I discuss how the combination of El Nino-driven variability in sea-level and the astronomical tidal cycle leads to flooding and erosion events which can be mistaken for evidence of sea-level rise. Second, I show that human modification to shorelines has redirected sediment supply, leading, in some cases, to expansion of islets despite rising sea levels. Taken together, the analysis demonstrates the challenge of attributing particular coastal events to global mean sea-level rise and the impact on decision-making. The

  20. A comparison of experiences of training emergency care in military exercises and competences among conscript nurses with different levels of education.

    PubMed

    Johansson, Anders; Odén, Anders; Dahlgren, Lars-Owe; Sjöström, Björn

    2007-10-01

    The military emergency care education of nurses is primarily concerned with the treatment of soldiers with combat-related injuries. Even though great progress has been made in military medicine, there is still the pedagogical question of what emergency care education for military nurses should contain and how it should be taught. The aim of this study was to describe and compare experiences of training emergency care in military exercises among conscript nurses with different levels of education. A descriptive study was performed to describe and compare experiences of training emergency care in military exercises among conscript nurses with different levels of education in nursing. There were statistical differences between nurses with general nursing education and nurses with a general nursing education and supplementary education. A reasonable implication of the differences is that the curriculum must be designed differently depending on the educational background of the students. Hence, there is an interaction between background characteristics, e.g., the level of previous education and differences pertaining to clinical experience of the participants, and the impact of the exercise itself.

  1. Slovak Flood Forecasting Service at the National and International Level

    NASA Astrophysics Data System (ADS)

    Leskova, Danica; Mikuličková, Michaela

    2017-04-01

    National Flood Forecasting Service is based on national legislation /Slovak legislation/ so that it could deal with the flood situation at the local level. Information about international rivers, e.g.: Danube, March (Morava), Uh, and Latorica are received on the basis of bilateral agreements. An important supplementary information is the European Flood Awareness System (EFAS). In this presentation a forecasting system POVAPSYS, which has been in Slovakia in use since 2016, is also shown. The Slovak Hydrometeorological Institute (SHMI) is a partner of EFAS, but simultaneously is a part of consortium of the EFAS Dissemination Centre, and its role is to analyze results of models, to analyze hydrometeorological situation, to disseminate information, and to send flood notifications to the EFAS partners. Both systems will be presented.

  2. Modeling emergent border-crossing behaviors during pandemics

    NASA Astrophysics Data System (ADS)

    Santos, Eunice E.; Santos, Eugene; Korah, John; Thompson, Jeremy E.; Gu, Qi; Kim, Keum Joo; Li, Deqing; Russell, Jacob; Subramanian, Suresh; Zhang, Yuxi; Zhao, Yan

    2013-06-01

    Modeling real-world scenarios is a challenge for traditional social science researchers, as it is often hard to capture the intricacies and dynamisms of real-world situations without making simplistic assumptions. This imposes severe limitations on the capabilities of such models and frameworks. Complex population dynamics during natural disasters such as pandemics is an area where computational social science can provide useful insights and explanations. In this paper, we employ a novel intent-driven modeling paradigm for such real-world scenarios by causally mapping beliefs, goals, and actions of individuals and groups to overall behavior using a probabilistic representation called Bayesian Knowledge Bases (BKBs). To validate our framework we examine emergent behavior occurring near a national border during pandemics, specifically the 2009 H1N1 pandemic in Mexico. The novelty of the work in this paper lies in representing the dynamism at multiple scales by including both coarse-grained (events at the national level) and finegrained (events at two separate border locations) information. This is especially useful for analysts in disaster management and first responder organizations who need to be able to understand both macro-level behavior and changes in the immediate vicinity, to help with planning, prevention, and mitigation. We demonstrate the capabilities of our framework in uncovering previously hidden connections and explanations by comparing independent models of the border locations with their fused model to identify emergent behaviors not found in either independent location models nor in a simple linear combination of those models.

  3. Incorporating Human Readiness Levels at Sandia National Laboratories

    DOE PAGES

    See, Judi E.; Morris, Jason; Craft, Richard; ...

    2018-01-24

    Since 2010, the concept of human readiness levels has been under development as a possible supplement to the existing technology readiness level (TRL) scale. The intent is to provide a mechanism to address safety and performance risks associated with the human component in a system that parallels the TRL structure already familiar to the systems engineering community. Sandia National Laboratories in Albuquerque, New Mexico, initiated a study in 2015 to evaluate options to incorporate human readiness planning for Sandia processes and products. The study team has collected the majority of baseline assessment data and has conducted interviews to understand staffmore » perceptions of four different options for human readiness planning. Preliminary results suggest that all four options may have a vital role, depending on the type of work performed and the phase of product development. Upon completion of data collection, the utility of identified solutions will be assessed in one or more test cases.« less

  4. Incorporating Human Readiness Levels at Sandia National Laboratories

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

    See, Judi E.; Morris, Jason; Craft, Richard

    Since 2010, the concept of human readiness levels has been under development as a possible supplement to the existing technology readiness level (TRL) scale. The intent is to provide a mechanism to address safety and performance risks associated with the human component in a system that parallels the TRL structure already familiar to the systems engineering community. Sandia National Laboratories in Albuquerque, New Mexico, initiated a study in 2015 to evaluate options to incorporate human readiness planning for Sandia processes and products. The study team has collected the majority of baseline assessment data and has conducted interviews to understand staffmore » perceptions of four different options for human readiness planning. Preliminary results suggest that all four options may have a vital role, depending on the type of work performed and the phase of product development. Upon completion of data collection, the utility of identified solutions will be assessed in one or more test cases.« less

  5. Systematic review of emergency medicine clinical practice guidelines: Implications for research and policy.

    PubMed

    Venkatesh, Arjun K; Savage, Dan; Sandefur, Benjamin; Bernard, Kenneth R; Rothenberg, Craig; Schuur, Jeremiah D

    2017-01-01

    Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence. Systematic review of clinical practice guidelines (Clinical Policies) published by the American College of Emergency Physicians from January 1990 to January 2016. Standardized data were abstracted from each Clinical Policy including the number and level of recommendations as well as the reported class of evidence. Primary outcomes were the proportion of Level C equivalent recommendations and Class III equivalent evidence. The primary analysis was limited to current Clinical Policies, while secondary analysis included all Clinical Policies. A total of 54 Clinical Policies including 421 recommendations and 2801 cited references, with an average of 7.8 recommendations and 52 references per guideline were included. Of 19 current Clinical Policies, 13 of 141 (9.2%) recommendations were Level A, 57 (40.4%) Level B, and 71 (50.4%) Level C. Of 845 references in current Clinical Policies, 67 (7.9%) were Class I, 272 (32.3%) Class II, and 506 (59.9%) Class III equivalent. Among all Clinical Policies, 200 (47.5%) recommendations were Level C equivalent, and 1371 (48.9%) of references were Class III equivalent. Emergency medicine clinical practice guidelines are largely based on lower classes of evidence and a majority of recommendations are expert opinion based. Emergency medicine appears to suffer from an evidence gap that should be prioritized in the national research agenda and considered by policymakers prior to developing future quality

  6. Cardiovascular Diseases on the Global Agenda: The United Nations High Level Meeting, Sustainable Development Goals, and the Way Forward.

    PubMed

    Ralston, Johanna; Reddy, K Srinath; Fuster, Valentin; Narula, Jagat

    2016-12-01

    In 2011, the United Nations (UN) organized the first ever meeting for heads of state to discuss the problem of noncommunicable diseases (NCD), including cardiovascular disease (CVD), cancer, chronic respiratory disease, and diabetes mellitus. Recognizing that these had emerged as leading causes of morbidity and mortality in the world, including in many low- and middle-income countries, advocates from government and civil society had called for increased attention and a UN response. Earlier, NCD including CVD were absent from the global health agenda in part because of their omission from the Millennium Development Goals. The UN meeting and the global advocacy response offered a game-changing opportunity to redress this omission. The World Heart Federation (WHF) played an instrumental role in the UN meeting and follow up, including inclusion of CVD in the Sustainable Development Goals. The next phase of the global CVD movement is expected through national action, including CVD roadmaps and partnering with the World Health Organization. The WHF is heavily committed to these goals and the other nongovernmental organizations invested in the mission must help take this historical mandate forward. Instrumental to this will be the engagement of people affected by or at risk of developing CVD, to draw more attention and resources to NCD and to ensure that successes to date in global policy translate into action at the national level. Copyright © 2016 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  7. Education and Nutrition Linkages in Africa: Evidence from National Level Analysis

    ERIC Educational Resources Information Center

    Mukudi, E.

    2003-01-01

    National level data were analyzed to establish the nature of association and the magnitude of contribution of education exposure to variance on measures nutritional well-being across Africa. Height and weight dependent anthropometric measures were used to assess nutritional well-being. Literacy (illiteracy) rates were the measures of educational…

  8. Responding to the deaf in disasters: establishing the need for systematic training for state-level emergency management agencies and community organizations

    PubMed Central

    2013-01-01

    Background Deaf and hard-of-hearing (Deaf/HH) individuals have been underserved before and during emergencies. This paper will assess Deaf/HH related emergency preparedness training needs for state emergency management agencies and deaf-serving community-based organizations (CBOs). Methods Four approaches were used: 1) a literature review; 2) results from 50 key informant (KI) interviews from state and territorial-level emergency management and public health agencies; 3) results from 14 KI interviews with deaf-serving CBOs in the San Francisco Bay Area; and 4) a pilot program evaluation of an emergency responder training serving the Deaf/HH in one urban community. Results Results from literature review and state and territorial level KIs indicate that there is a substantive gap in emergency preparedness training on serving Deaf/HH provided by state agencies. In addition, local KI interviews with 14 deaf-serving CBOs found gaps in training within deaf-serving CBOs. These gaps have implications for preparing for and responding to all-hazards emergencies including weather-related or earthquake-related natural disasters, terrorist attacks, and nuclear-chemical disasters. Conclusion Emergency preparedness trainings specific to responding to or promoting preparedness of the Deaf/HH is rare, even for state agency personnel, and frequently lack standardization, evaluation, or institutionalization in emergency management infrastructure. This has significant policy and research implications. Similarly, CBOs are not adequately trained to serve the needs of their constituents. PMID:23497178

  9. 78 FR 15968 - National Advisory Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2007-0008] National Advisory Council AGENCY: Federal Emergency Management Agency, DHS. ACTION: Committee Management... Management Agency (FEMA) is requesting individuals who are interested in serving on the National Advisory...

  10. 77 FR 9953 - National Advisory Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-21

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2007-0008] National Advisory Council AGENCY: Federal Emergency Management Agency, DHS. ACTION: Committee Management... Management Agency (FEMA) is requesting individuals who are interested in serving on the National Advisory...

  11. Emergency medical personnel training: I. An historical perspective.

    PubMed

    Sytkowski, P A; Jacobs, L M; Meany, M

    1983-01-01

    The status of Emergency Medical Technicians has evolved from an undefined role with few rules, regulations, or standards to an established health care profession and a nationally administered program. The evolution of this profession received major impetus from the 1966 report by the National Academy of Science/National Research Council that provided recommended training standards. Development of a training course curriculum for basic life support (BLS) followed. The need for coordinated training of Emergency Medical Technical Technicians was recognized, and funds became available to aid in the national standardization of education, examination, certification, and recertification procedures for EMTs. Concomitant with the attempt to standardize BLS training, advanced life support (ALS) programs grew in number. By 1977 the National Standard Training Curriculum became available and was soon followed by a national certification exam. As states have the option to accept or reject the federal standards embodied in the national training course, there remains variation among programs offered by each state. Because of the difference in need for specific emergency services among the states at a time of increased professional mobility, arguments still exist regarding the desirability of federally mandated training and certification programs.

  12. 40 CFR 6.210 - Emergency circumstances.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 6.210 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS EPA's NEPA Environmental Review Procedures § 6.210 Emergency circumstances. If emergency circumstances...

  13. Barriers and perceived needs for understanding and using research among emergency nurses.

    PubMed

    Chan, Garrett K; Barnason, Susan; Dakin, Cynthia L; Gillespie, Gordon; Kamienski, Mary C; Stapleton, Stephen; Williams, Jennifer; Juarez, Altair; Li, Suling

    2011-01-01

    Nurses are involved in conducting research and incorporating evidence into their practice. However, barriers exist at the individual, unit, and organizational level related to understanding, conducting, and evaluating the evidence. The Emergency Nurses Association (ENA) conducted a study to understand levels of education in research, the extent of experience, and needs and barriers to research at the individual and organizational levels in emergency nursing. A cross-sectional survey design was used to poll members of the ENA. A 62-item survey instrument was designed to assess five areas: 1) nurses' research values, skills, experience, and awareness; 2) organizational settings' opportunities, barriers, and limitations to research; 3) nurses' understanding and comprehension of research and evidence; 4) presentation and accessibility of research; and 5) continuing educational topics to improve knowledge of the research process. Respondents (n = 948) identified barriers at the individual level that included lack of knowledge about critiquing research studies and familiarity with the research process. Barriers at the unit level included obtaining help from administrators and other staff in starting a project or having the authority to change practice. Barriers at the institution level included lack of support systems such as protected time to conduct research or implement changes in practice. Emergency nurses are highly motivated and interested in learning more about conducting and utilizing research to improve practice. Perceived personal, unit-based, and organizational barriers were identified through this research in an effort to highlight areas for improvement at the local and national levels. Copyright © 2011 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  14. The national financial adjustment policy and the equalisation of health levels among prefectures.

    PubMed

    Takano, T; Nakamura, K

    2001-10-01

    The objectives of this study were to examine (1) trends concerning financial assistance from the national government to local governments, (2) trends regarding death rates and life expectancies among prefectures, and (3) the effect of the national financial adjustment policy in equalising both the revenues of local governments and variations in the health levels among prefectures in terms of death rates and life expectancies. The study analysed prefectural income, the amount of national taxes collected, financial assistance from the national government to local governments, and age adjusted death rates and life expectancies of all of the prefectures in Japan during the period from 1965 through 1995. (1) Under the financial adjustment policy, financial assistance from the national government to the local governments, which consists of the sum of the local allocation tax and treasury disbursements, increased from 1831 billion yen in 1965 to 31 116 billion yen in 1995. (2) During the same period, the age adjusted death rate per 100 000 people decreased from 1168.9 (1965) to 545.3 (1995). The range of variation in the age adjusted death rate among prefectures diminished as the coefficient of variation of the death rate declined from 0.060 in 1965 to 0.043 in 1995. (3) There was a significant statistical correlation between higher prefectural incomes and lower mortality rates during from 1965 until 1975 (p < 0.05), whereas this correlation was indistinct in the 1980s and has not been observed since 1990. (4) The relative health level of Tokyo has declined in terms of its ranking among all the prefectures with regard to life expectancy, from being the best in 1965 to below average in 1995. The national financial adjustment policy to balance the revenues of local governments has increased the health levels of rural prefectures. It is probable that the policy reduced the disparity in death rates and life expectancies among prefectures throughout the country. However, the

  15. Emergency management and homeland security: Exploring the relationship.

    PubMed

    Kahan, Jerome H

    2015-01-01

    In the years after the 9/11 tragedy, the United States continues to face risks from all forms of major disasters, from potentially dangerous terrorist attacks to catastrophic acts of nature. Professionals in the fields of emergency management and homeland security have responsibilities for ensuring that all levels of government, urban areas and communities, nongovernmental organizations, businesses, and individual citizens are prepared to deal with such hazards though actions that reduce risks to lives and property. Regrettably, the overall efficiency and effectiveness of the nation's ability to deal with disasters is unnecessarily challenged by the absence of a common understanding on how these fields are related in the workforce and educational arenas. Complicating matters further is the fact that neither of these fields has developed agreed definitions. In many ways, homeland security and emergency management have come to represent two different worlds and cultures. These conditions can have a deleterious effect on preparedness planning for public and private stakeholders across the nation when coordinated responses among federal, state, and local activities are essential for dealing with consequential hazards. This article demonstrates that the fields of emergency management and homeland security share many responsibilities but are not identical in scope or skills. It argues that emergency management should be considered a critical subset of the far broader and more strategic field of homeland security. From analytically based conclusions, it recommends five steps that be taken to bring these fields closer together to benefit more from their synergist relationship as well as from their individual contributions.

  16. Use of social media during public emergencies by people with disabilities.

    PubMed

    Morris, John T; Mueller, James L; Jones, Michael L

    2014-08-01

    People with disabilities are generally more vulnerable during disasters and public emergencies than the general population. Physical, sensory and cognitive impairments may result in greater difficulty in receiving and understanding emergency alert information, and greater difficulty in taking appropriate action. The use of social media in the United States has grown considerably in recent years. This has generated increasing interest on the part of national, state and local jurisdictions in leveraging these channels to communicate public health and safety information. How and to what extent people with disabilities use social and other communications media during public emergencies can help public safety organizations understand the communication needs of the citizens in their jurisdictions, and plan their social media and other communications strategies accordingly. This article presents data from a survey on the use of social media and other communications media during public emergencies by people with disabilities conducted from November 1, 2012 through March 30, 2013. The data presented here show four key results. First, levels of use of social media in general are high for people with disabilities, as well as for the general population. Second, use of social media during emergencies is still low for both groups. Third, levels of use of social media are not associated with income levels, but are significantly and strongly associated with age: younger people use social media at higher rates than older people in both groups (p<0.001). Fourth, differences in the use of social media during emergencies across disability types are slight, with the exception of deaf and hard-of-hearing respondents, the former more likely to have used social media to receive (p=0.002), verify (p=0.092) and share (p=0.007) emergency information. These last two results suggest that effective emergency communications strategies need to rely on multiple media types and channels to reach

  17. [Key content and formulation of national Chinese materia medica resources survey at county level].

    PubMed

    Lu, Jian-Wei; Zhang, Xiao-Bo; Li, Hai-Tao; Guo, Lan-Ping; Zhao, Run-Huai; Zhang, Ben-Gang; Sun, Li-Ying; Huang, Lu-Qi

    2013-08-01

    According to National Census for Water, National Population Census, National Land and Resources Survey, and work experience of experimental measures for national Chinese materia medica resources(CMMR) survey,the national CMMR survey at the county level is the key point of whole survey, that includes organization and management, field survey, sorting data three key links. Organization and management works of national CMMR survey needs to finish four key contents, there are definite goals and tasks, practicable crew, preparation directory, and security assurance. Field survey works of the national CMMR survey needs to finish five key contents, there are preparation works for field survey, the choice of the key survey area (samples), fill in the questionnaire, video data collection, specimen and other physical collection. Sorting data works of the national CMMR survey needs to finish tree key contents, there are data, specimen and census results.

  18. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Emergency medical assistance. 71.10 Section 71... ESTATES PROTECTION AND WELFARE OF CITIZENS AND THEIR PROPERTY Emergency Medical/Dietary Assistance for U.S. Nationals Incarcerated Abroad § 71.10 Emergency medical assistance. (a) Eligibility criteria. A U.S...

  19. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Emergency medical assistance. 71.10 Section 71... ESTATES PROTECTION AND WELFARE OF CITIZENS AND THEIR PROPERTY Emergency Medical/Dietary Assistance for U.S. Nationals Incarcerated Abroad § 71.10 Emergency medical assistance. (a) Eligibility criteria. A U.S...

  20. On the Threshold of Safety: A Qualitative Exploration of Nurses' Perceptions of Factors Involved in Safe Staffing Levels in Emergency Departments.

    PubMed

    Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Clark, Paul R; Moon, Michael D

    2017-03-01

    The emergency department is a unique practice environment in that the Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates a medical screening examination for all presenting patients, effectively precludes any sort of patient volume control; staffing needs are therefore fluid and unpredictable. The purpose of this study is to explore emergency nurses' perceptions of factors involved in safe staffing levels and to identify factors that negatively and positively influence staffing levels and might lend themselves to more effective interventions and evaluations. We used a qualitative exploratory design with focus group data from a sample of 26 emergency nurses. Themes were identified using a constructivist perspective and an inductive approach to content analysis. Five themes were identified: (1) unsafe environment of care, (2) components of safety, (3) patient outcomes: risky care, (4) nursing outcomes: leaving the profession, and (5) possible solutions. Participants reported that staffing levels are determined by the number of beds in the department (as in inpatient units) but not by patient acuity or the number of patients waiting for treatment. Participants identified both absolute numbers of staff, as well as experience mix, as components of safe staffing. Inability to predict the acuity of patients waiting to be seen was a major component of nurses' perceptions of unsafe staffing. Emergency nurses perceive staffing to be inadequate, and therefore unsafe, because of the potential for poor patient outcomes, including missed or delayed care, missed deterioration (failure to rescue), and additional ED visits resulting from ineffective discharge teaching. Both absolute numbers of staff, as well as skill and experience mix, should be considered to provide staffing levels that promote optimal patient and nurse outcomes. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  1. An integrated and dynamic optimisation model for the multi-level emergency logistics network in anti-bioterrorism system

    NASA Astrophysics Data System (ADS)

    Liu, Ming; Zhao, Lindu

    2012-08-01

    Demand for emergency resources is usually uncertain and varies quickly in anti-bioterrorism system. Besides, emergency resources which had been allocated to the epidemic areas in the early rescue cycle will affect the demand later. In this article, an integrated and dynamic optimisation model with time-varying demand based on the epidemic diffusion rule is constructed. The heuristic algorithm coupled with the MATLAB mathematical programming solver is adopted to solve the optimisation model. In what follows, the application of the optimisation model as well as a short sensitivity analysis of the key parameters in the time-varying demand forecast model is presented. The results show that both the model and the solution algorithm are useful in practice, and both objectives of inventory level and emergency rescue cost can be controlled effectively. Thus, it can provide some guidelines for decision makers when coping with emergency rescue problem with uncertain demand, and offers an excellent reference when issues pertain to bioterrorism.

  2. Equality of care between First Nations and non-First Nations patients in Saskatoon emergency departments.

    PubMed

    Batta, Rachit; Carey, Robert; Sasbrink-Harkema, Martin Ashley; Oyedokun, Taofiq Olusegun; Lim, Hyun J; Stempien, James

    2018-03-28

    CLINICIAN'S CAPSULE What is known about the topic? There are concerns regarding unequal treatment towards First Nations people when engaged with health care services. What did this study ask? Whether quantitative differences in care exist between First Nations and non-First Nations patients in the ED. What did this study find? First Nations presenting with abdominal pain were found to have no difference in the time-related care parameters relative to non-First Nations patients. Why does this study matter to clinicians? Future quantitative and qualitative studies will be necessary to further understand the care inequality that has been expressed among First Nations patients.

  3. Current and Future Employment Opportunities in New and Emerging Occupations within Illinois. Final Project Report.

    ERIC Educational Resources Information Center

    Spetz, Sally H.; And Others

    An Illinois project identified new and emerging occupations within the state and determined the types, levels, and distribution of new vocational education curricula needed to meet employment demands for skilled workers in those occupations. Project staff reviewed similar national research efforts, recently enacted Illinois legislation, and…

  4. Selective versus comprehensive emergency management in Korea.

    PubMed

    Ha, Kyoo-Man; Oh, Hyeon-Mun

    2014-01-01

    In spite of Korean governments' efforts, many emergency management practitioners wonder whether what is actually being practiced is selective or comprehensive management. Using a qualitative content analysis and experiences in practice, the article analyzes the barriers to selective emergency management and the paths to comprehensive emergency management via the same three management elements: stakeholders, phases of the emergency management lifecycle, and hazards and impacts. Four analytical levels are considered: central government level, industry level, community level, and household level. Korea, despite its self-praise, has to transform its selective emergency management into comprehensive emergency management in time.

  5. Establishing an autologous versus allogeneic hematopoietic cell transplant program in nations with emerging economies.

    PubMed

    Chaudhri, Naeem A; Aljurf, Mahmoud; Almohareb, Fahad I; Alzahrani, Hazzaa A; Bashir, Qaiser; Savani, Bipin; Gupta, Vikas; Hashmi, Shahrukh K

    2017-12-01

    More than 70,000 hematopoietic cell transplants are currently performed each year, and these continue to increase every year. However, there is a significant variation in the number of absolute transplants and transplant rates between centers, countries, and global regions. The prospect for emerging countries to develop a hematopoietic cell transplantation (HCT) program, as well as to decide on whether autologous HCT (auto-HCT) or allogeneic HCT (allo-HCT) should be established to start with, relies heavily on factors that can explain differences between these two procedures. Major factors that will influence a decision about establishing the type of HCT program are macroeconomic factors such as organization of the healthcare network, available resources and infrastructure. Prevalence of specific diseases in the region as well genetic background of donors and recipients will also influence the mandate or priority of the HCT in the national healthcare plan to explain some of the country-specific differences. Furthermore, microeconomic factors play a role, such as center-specific experience in treating various disorders requiring hematopoietic stem cell transplantation, along with accreditation status and patient volume. The objective of the transplant procedure was to improve the survival and quality of life of patients. The regional difference that one notices in emerging countries about the higher number of allo-HCT compared with auto-HCT procedures performed is primarily based on suboptimal healthcare network in treating various malignant disorders that are the primary indication for auto-stem cell transplantation. In this context, nonmalignant disorders such as bone marrow failure syndromes, inherited genetic disorders and hemoglobinopathies have become the major indication for stem cell transplantation. Better understanding of these factors will assist in establishing new transplant centers in the emerging countries to achieve their specific objectives and

  6. Cervical cancer risk levels in Turkey and compliance to the national cervical cancer screening standard.

    PubMed

    Açikgöz, Ayla; Ergör, Gül

    2011-01-01

    Cervical cancer screening with Pap smear test is a cost-effective method. The Ministry of Health in Turkey recommends that it be performed once every five years after age 35. The purpose of this study was to determine the cervical cancer risk levels of women between 35 and 69, and the intervals they have the Pap smear test, and to investigate the relation between the two. This study was performed on 227 women aged between 35 and 69 living in Balçova District of İzmir province. Using the cervical cancer risk index program of Harvard School of Public Health, the cervical cancer risk level of 70% of the women was found below average, 22.1% average, and 7.9% above average. Only 52% of the women have had Pap smear test at least once in their lives. The percentage screening regularly in conformity with the national screening standard was 39.2%. Women in the 40-49 age group, were married, conformed significantly more (p<0.05) to the national screening standard. Compliance also increased with the level of education and decreased with the cervical cancer risk level (p<0.05). A logistic regression model was constructed including age, education level, menstruation state of the women and the economic level of the family. Not having the Pap smear test in conformity with the national cervical cancer screening standard in 35-39 age group was 2.52 times more than 40-49 age group, while it was 3.26 times more in 60-69 age group (p< 0.05). Not having Pap smear test in 35-39 age group more than other groups might result from lack of information on the cervical cancer national screening standard and the necessity of having Pap smear test. As for 60-69 age group, the low education level might cause not having Pap smear test. Under these circumstances, the cervical cancer risk levels should be determined and the individuals should be informed. Providing Pap smear test screening service to individuals in the target group of national screening standard, as a public service may resolve

  7. Telemedicine-Assisted Intubation in Rural Emergency Departments: A National Emergency Airway Registry Study.

    PubMed

    Van Oeveren, Lucas; Donner, Julie; Fantegrossi, Andrea; Mohr, Nicholas M; Brown, Calvin A

    2017-04-01

    Intubation in rural emergency departments (EDs) is a high-risk procedure, often with little or no specialty support. Rural EDs are utilizing real-time telemedicine links, connecting providers to an ED physician who may provide clinical guidance. We endeavored to describe telemedicine-assisted intubation in rural EDs that are served by an ED telemedicine network. Prospective data were collected on all patients who had an intubation attempt while on the video telemedicine link from May 1, 2014 to April 30, 2015. We report demographic information, indication, methods, number of attempts, operator characteristics, telemedicine involvement/intervention, adverse events, and clinical outcome by using descriptive statistics. Included were 206 intubations. The most common indication for intubation was respiratory failure. First-pass success rate (postactivation) was 71%, and 96% were eventually intubated. Most attempts (66%) used rapid-sequence intubation. Fifty-four percent of first attempts used video laryngoscopy (VL). Telemedicine providers intervened in 24%, 43%, and 55% of first-third attempts, respectively. First-pass success with VL and direct laryngoscopy was equivalent (70% vs. 71%, p = 0.802). Adverse events were reported in 49 cases (24%), which were most frequently hypoxemia. The impact of telemedicine during emergency intubation is not defined. We showed a 71% first-pass rate post-telemedicine linkage (70% of cases had a previous attempt). Our ultimate success rate was 96%, similar to that in large-center studies. Telemedicine support may contribute to success. Telemedicine-supported endotracheal intubation performed in rural hospitals is feasible, with good success rates. Future research is required to better define the impact of telemedicine providers on emergency airway management.

  8. Emergency Response Alternatives

    EPA Pesticide Factsheets

    Based on the National Contingency Plan, EPA defines the following types: classic emergencies, requiring on-site activities within minutes/hours; time-critical actions, which must occur within 6 months; and non-time-critical actions, which can take longer.

  9. The Emergency Care of Patients With Cancer: Setting the Research Agenda.

    PubMed

    Brown, Jeremy; Grudzen, Corita; Kyriacou, Demetrios N; Obermeyer, Ziad; Quest, Tammie; Rivera, Donna; Stone, Susan; Wright, Jason; Shelburne, Nonniekaye

    2016-12-01

    To identify research priorities and appropriate resources and to establish the infrastructure required to address the emergency care of patients with cancer, the National Institutes of Health's National Cancer Institute and the Office of Emergency Care Research sponsored a one-day workshop, "Cancer and Emergency Medicine: Setting the Research Agenda," in March 2015 in Bethesda, MD. Participants included leading researchers and clinicians in the fields of oncology, emergency medicine, and palliative care, and representatives from the National Institutes of Health. Attendees were charged with identifying research opportunities and priorities to advance the understanding of the emergency care of cancer patients. Recommendations were made in 4 areas: the collection of epidemiologic data, care of the patient with febrile neutropenia, acute events such as dyspnea, and palliative care in the emergency department setting. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  10. When Health Insurance Is Not a Factor: National Comparison of Homeless and Nonhomeless US Veterans Who Use Veterans Affairs Emergency Departments

    PubMed Central

    Doran, Kelly M.; Rosenheck, Robert A.

    2013-01-01

    Objectives. We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. Methods. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64 091) and nonhomeless (n = 866 621) ED users on sociodemographics, medical and psychiatric diagnoses, and other clinical characteristics. Results. Homeless veterans had 4 times the odds of using EDs than nonhomeless veterans. Multivariate analyses found few differences between homeless and nonhomeless ED users on the medical conditions examined, but homeless ED users were more likely to have been diagnosed with a drug use disorder (odds ratio [OR] = 4.12; 95% confidence interval [CI] = 3.97, 4.27), alcohol use disorder (OR = 3.67; 95% CI = 3.55, 3.79), or schizophrenia (OR = 3.44; 95% CI = 3.25, 3.64) in the past year. Conclusions. In a national integrated health care system with no specific requirements for health insurance, the major differences found between homeless and nonhomeless ED users were high rates of psychiatric and substance abuse diagnoses. EDs may be an important location for specialized homeless outreach (or “in” reach) services to address mental health and addictive disorders. PMID:24148061

  11. 78 FR 26396 - Proposed Collection; Comments Requested: FBI National Academy Level 1 Evaluation: Student Course...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... Academy Level 1 Evaluation: Student Course Questionnaire and FBI National Academy: General Remarks Questionnaire ACTION: 30-Day Notice. The Department of Justice (DOJ), Federal Bureau of Investigation (FBI...: Student Course Questionnaire. FBI National Academy: General Remarks Questionnaire. 3. Agency Form Number...

  12. RED Alert – Early warning or detection of global re-emerging infectious disease (RED)

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

    Deshpande, Alina

    This is the PDF of a presentation for a webinar given by Los Alamos National Laboratory (LANL) on the early warning or detection of global re-emerging infectious disease (RED). First, there is an overview of LANL biosurveillance tools. Then, information is given about RED Alert. Next, a demonstration is given of a component prototype. RED Alert is an analysis tool that can provide early warning or detection of the re-emergence of an infectious disease at the global level, but through a local lens.

  13. Emergency contraception.

    PubMed

    2012-12-01

    Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours. Indications for the use of emergency contraception include sexual assault, unprotected intercourse, condom breakage or slippage, and missed or late doses of hormonal contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring (ie, improper placement or loss/expulsion), and injectable contraception. Adolescents younger than 17 years must obtain a prescription from a physician to access emergency contraception in most states. In all states, both males and females 17 years or older can obtain emergency contraception without a prescription. Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need. The aim of this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on safety, efficacy, and use of emergency contraception in teenagers; and (3) encourage routine counseling and advance emergency-contraception prescription as 1 part of a public health strategy to reduce teen pregnancy. This policy focuses on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected coitus for the prevention of unintended pregnancy. Emergency contraceptive medications include products labeled and dedicated for use as emergency contraception by the US Food and Drug Administration (levonorgestrel and ulipristal) and the "off-label" use of combination oral contraceptives.

  14. Coastal vulnerability assessment of Dry Tortugas National Park (DRTO) to sea-level rise

    USGS Publications Warehouse

    Pendleton, Elizabeth A.; Thieler, E. Robert; Williams, S. Jeffress

    2005-01-01

    A coastal vulnerability index (CVI) was used to map the relative vulnerability of the coast to future sea-level rise within Dry Tortugas National Park in Florida. The CVI ranks the following in terms of their physical contribution to sea-level rise-related coastal change: geomorphology, regional coastal slope, rate of relative sea-level rise, historical shoreline change rates, mean tidal range and mean significant wave height. The rankings for each input variable were combined and an index value calculated for 1-minute grid cells covering the park. The CVI highlights those regions where the physical effects of sea-level rise might be the greatest. This approach combines the coastal system's susceptibility to change with its natural ability to adapt to changing environmental conditions, yielding a quantitative, although relative, measure of the park's natural vulnerability to the effects of sea-level rise. The CVI provides an objective technique for evaluation and long-term planning by scientists and park managers. Dry Tortugas National Park (DRTO) consists of relatively stable to washover-dominated portions of carbonate beach and man-made fortification. The areas within Dry Tortugas that are likely to be most vulnerable to sea-level rise are those with the highest rates of shoreline erosion and the highest wave energy.

  15. Coastal vulnerability assessment of Cape Hatteras National Seashore (CAHA) to sea-level rise

    USGS Publications Warehouse

    Pendleton, Elizabeth A.; Theiler, E. Robert; Williams, S. Jeffress

    2005-01-01

    A coastal vulnerability index (CVI) was used to map the relative vulnerability of the coast to future sea-level rise within Cape Hatteras National Seashore (CAHA) in North Carolina. The CVI ranks the following in terms of their physical contribution to sea-level rise-related coastal change: geomorphology, regional coastal slope, rate of relative sea-level rise, historical shoreline change rates, mean tidal range, and mean significant wave height. The rankings for each variable were combined and an index value was calculated for 1-minute grid cells covering the park. The CVI highlights those regions where the physical effects of sea-level rise might be the greatest. This approach combines the coastal system's susceptibility to change with its natural ability to adapt to changing environmental conditions, yielding a quantitative, although relative, measure of the park's natural vulnerability to the effects of sea-level rise. The CVI provides an objective technique for evaluation and long-term planning by scientists and park managers. Cape Hatteras National Seashore consists of stable and washover dominated segments of barrier beach backed by wetland and marsh. The areas within Cape Hatteras that are likely to be most vulnerable to sea-level rise are those with the highest occurrence of overwash and the highest rates of shoreline change.

  16. Coastal Vulnerability Assessment of Padre Island National Seashore (PAIS) to Sea-Level Rise

    USGS Publications Warehouse

    Pendleton, Elizabeth A.; Thieler, E. Robert; Williams, S. Jeffress; Beavers, Rebecca S.

    2004-01-01

    A coastal vulnerability index (CVI) was used to map the relative vulnerability of the coast to future sea-level rise within Padre Island National Seashore in Texas. The CVI ranks the following in terms of their physical contribution to sea-level rise-related coastal change: geomorphology, regional coastal slope, rate of relative sea-level rise, shoreline change rates, mean tidal range and mean significant wave height. The rankings for each variable were combined and an index value calculated for 1-minute grid cells covering the park. The CVI highlights those regions where the physical effects of sea-level rise might be the greatest. This approach combines the coastal system's susceptibility to change with its natural ability to adapt to changing environmental conditions, yielding a quantitative, although relative, measure of the park's natural vulnerability to the effects of sea-level rise. The CVI provides an objective technique for evaluation and long-term planning by scientists and park managers. Padre Island National Seashore consists of stable to washover dominated portions of barrier beach backed by wetland, marsh, tidal flat, or grassland. The areas within Padre that are likely to be most vulnerable to sea-level rise are those with the highest occurrence of overwash and the highest rates of shoreline change.

  17. Setters and Samoyeds: The Emergence of Subordinate Level Categories as a Basis for Inductive Inference in Preschool-Age Children.

    ERIC Educational Resources Information Center

    Waxman, Sandra R.; Lynch, Elizabeth B.; Casey, K. Lyman; Baer, Leslie

    1997-01-01

    Three experiments examine how preschoolers partition their basic level categories to form subordinate level categories and whether these have inductive potential. Results suggest that contrastive information promotes the emergence of subordinate categories as a basis of inductive inference and newly established subordinate categories can retain…

  18. A multi-level model of emerging technology: An empirical study of the evolution of biotechnology from 1976 to 2003

    PubMed Central

    van Witteloostuijn, Arjen

    2018-01-01

    In this paper, we develop an ecological, multi-level model that can be used to study the evolution of emerging technology. More specifically, by defining technology as a system composed of a set of interacting components, we can build upon the argument of multi-level density dependence from organizational ecology to develop a distribution-independent model of technological evolution. This allows us to distinguish between different stages of component development, which provides more insight into the emergence of stable component configurations, or dominant designs. We validate our hypotheses in the biotechnology industry by using patent data from the USPTO from 1976 to 2003. PMID:29795575

  19. Measuring Up on College-Level Learning. National Center Report #05-8

    ERIC Educational Resources Information Center

    Miller, Margaret A.; Ewell, Peter T.

    2005-01-01

    To address the issue of student learning at the state level, an invitational forum of public policy, business, and education leaders was convened by James B. Hunt Jr., governor of North Carolina. The forum recommended that the National Center for Public Policy and Higher Education initiate a "demonstration project" to determine whether or not it…

  20. Five-level emergency triage systems: variation in assessment of validity.

    PubMed

    Kuriyama, Akira; Urushidani, Seigo; Nakayama, Takeo

    2017-11-01

    Triage systems are scales developed to rate the degree of urgency among patients who arrive at EDs. A number of different scales are in use; however, the way in which they have been validated is inconsistent. Also, it is difficult to define a surrogate that accurately predicts urgency. This systematic review described reference standards and measures used in previous validation studies of five-level triage systems. We searched PubMed, EMBASE and CINAHL to identify studies that had assessed the validity of five-level triage systems and described the reference standards and measures applied in these studies. Studies were divided into those using criterion validity (reference standards developed by expert panels or triage systems already in use) and those using construct validity (prognosis, costs and resource use). A total of 57 studies examined criterion and construct validity of 14 five-level triage systems. Criterion validity was examined by evaluating (1) agreement between the assigned degree of urgency with objective standard criteria (12 studies), (2) overtriage and undertriage (9 studies) and (3) sensitivity and specificity of triage systems (7 studies). Construct validity was examined by looking at (4) the associations between the assigned degree of urgency and measures gauged in EDs (48 studies) and (5) the associations between the assigned degree of urgency and measures gauged after hospitalisation (13 studies). Particularly, among 46 validation studies of the most commonly used triages (Canadian Triage and Acuity Scale, Emergency Severity Index and Manchester Triage System), 13 and 39 studies examined criterion and construct validity, respectively. Previous studies applied various reference standards and measures to validate five-level triage systems. They either created their own reference standard or used a combination of severity/resource measures. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All

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