The Interactive Effects of Facial Expressions of Emotion and Verbal Messages on Perceptions of Affective Meaning.

ERIC Educational Resources Information Center

Friedman, Howard S.

1979-01-01

Students' perceptions of sincerity, dominance, and positivity were measured by pairing happy, angry, surprised and sad faces of teachers with teachers' comments characterized as positive or negative and dominant or submissive. Clear effects of facial-verbal combinations emerged; there were no sex differences other than in perceptions of sincerity.…

The Philosophy and Politics of Multicultural Education and Anti-Racist Education: An Analysis of Current Literature.

ERIC Educational Resources Information Center

Vincent, Nelson C.

Multicultural education emerged as a curriculum and pedagogical movement in the late 1960s but it has yet to be clearly understood. Several distinct approaches to multicultural education constitute a range of curricular, pedagogical, and social justice perspectives each with significantly different political, social, and economic goals. A healthy…

Hypercapnic hyperventilation shortens emergence time from isoflurane anesthesia.

PubMed

Sakata, Derek J; Gopalakrishnan, Nishant A; Orr, Joseph A; White, Julia L; Westenskow, Dwayne R

2007-03-01

To shorten emergence time after a procedure using volatile anesthesia, 78% of anesthesiologists recently surveyed used hyperventilation to rapidly clear the anesthetic from the lungs. Hyperventilation has not been universally adapted into clinical practice because it also decreases the Paco2, which decreases cerebral bloodflow and depresses respiratory drive. Adding deadspace to the patient's airway may be a simple and safe method of maintaining a normal or slightly increased Paco2 during hyperventilation. We evaluated the differences in emergence time in 20 surgical patients undergoing 1 MAC of isoflurane under mild hypocapnia (ETco2 approximately 28 mmHg) and mild hypercapnia (ETco2 approximately 55 mmHg). The minute ventilation in half the patients was doubled during emergence, and hypercapnia was maintained by insertion of additional airway deadspace to keep the ETco2 close to 55 mmHg during hyperventilation. A charcoal canister adsorbed the volatile anesthetic from the deadspace. Fresh gas flows were increased to 10 L/min during emergence in all patients. The time between turning off the vaporizer and the time when the patients opened their eyes and mouths, the time of tracheal extubation, and the time for normalized bispectral index to increase to 0.95 were faster whenever hypercapnic hyperventilation was maintained using rebreathing and anesthetic adsorption (P < 0.001). The time to tracheal extubation was shortened by an average of 59%. The emergence time after isoflurane anesthesia can be shortened significantly by using hyperventilation to rapidly clear the anesthetic from the lungs and CO2 rebreathing to induce hypercapnia during hyperventilation. The device should be considered when it is important to provide a rapid emergence, especially after surgical procedures where a high concentration of the volatile anesthetic was maintained right up to the end of the procedure, or where surgery ends abruptly and without warning.

"Having sex" as a graded and hierarchical construct: a comparison of sexual definitions among heterosexual and lesbian emerging adults in the U.K.

PubMed

Horowitz, Ava D; Spicer, Louise

2013-01-01

Research into definitions of "having sex" has tended to employ a dichotomous response design (following Sanders & Reinisch, 1999). However, conceptions of sexual activity may be far less clear-cut (c.f. Faulkner, 2003 ; Peterson & Muehlenhard, 2007). More refinement is also needed regarding the impact of sexual orientation on the construction of what counts as sex. This research employed a continuous response design, asking 124 emerging adults (40 male heterosexuals, 42 female heterosexuals, & 42 lesbians) to judge 13 sexual acts using a graded, six-point scale. Overall, there was substantial agreement that intercourse (vaginal and anal) was "definitely," and kissing "definitely not," sex. However, across the various acts, participants also consistently made use of options between these extremes, such that a clear hierarchy of sexual behaviors emerged. The lesbian group considered a range of forms of genital stimulation to be significantly more constitutive of sex than either heterosexual group, while judgments by male and female heterosexuals did not significantly differ for any listed act. The implications of graded definitions of sex, a hierarchy of sexual behaviors, and the role of sexual behaviors in hetero- and homosexual identity management are explored.

76 FR 65763 - Self-Regulatory Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change To Add...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-24

... Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change To Add Rules Related to the Clearing of Emerging Markets Sovereigns October 18, 2011. I. Introduction On August 30, 2011, ICE Clear Credit... Contracts by ICE Trust), 26D- 315 (Terms of the Cleared SES Contract), 26D-316 (Relevant Physical Settlement...

Translating reference doses into allergen management practice: challenges for stakeholders.

PubMed

Crevel, René W R; Baumert, Joseph L; Luccioli, Stefano; Baka, Athanasia; Hattersley, Sue; Hourihane, Jonathan O'B; Ronsmans, Stefan; Timmermans, Frans; Ward, Rachel; Chung, Yong-joo

2014-05-01

Risk assessment describes the impact of a particular hazard as a function of dose and exposure. It forms the foundation of risk management and contributes to the overall decision-making process, but is not its endpoint. This paper outlines a risk analysis framework to underpin decision-making in the area of allergen cross-contact. Specifically, it identifies challenges relevant to each component of the risk analysis: risk assessment (data gaps and output interpretation); risk management (clear and realistic objectives); and risk communication (clear articulation of risk and benefit). Translation of the outputs from risk assessment models into risk management measures must be informed by a clear understanding of the model outputs and their limitations. This will lead to feasible and achievable risk management objectives, grounded in a level of risk accepted by the different stakeholders, thereby avoiding potential unintended detrimental consequences. Clear, consistent and trustworthy communications actively involving all stakeholders underpin these objectives. The conclusions, integrating the perspectives of different stakeholders, offer a vision where clear, science-based benchmarks form the basis of allergen management and labelling, cutting through the current confusion and uncertainty. Finally, the paper recognises that the proposed framework must be adaptable to new and emerging evidence. Copyright © 2014 ILSI Europe. Published by Elsevier Ltd.. All rights reserved.

The Latent Symptom Structure of the Beck Depression Inventory-II in Outpatients with Major Depression

ERIC Educational Resources Information Center

Quilty, Lena C.; Zhang, K. Anne; Bagby, R. Michael

2010-01-01

The Beck Depression Inventory-II (BDI-II) is a self-report instrument frequently used in clinical and research settings to assess depression severity. Although investigators have examined the factor structure of the BDI-II, a clear consensus on the best fitting model has not yet emerged, resulting in different recommendations regarding how to best…

Treatment of Chronic PTSD by Cognitive Therapy and Exposure: 5-Year Follow-up

ERIC Educational Resources Information Center

Tarrier, Nicholas; Sommerfield, Claire

2004-01-01

Patients who had taken part in a randomized clinical trial of the treatment of chronic PTSD by either cognitive therapy or imaginal exposure were reassessed after 5 years. At 5-year follow-up a clear superiority of cognitive therapy over imaginal exposure emerged, although there had been no difference between the two treatment groups up to 12…

Electronic Information Systems and User Contexts; Emerging Social Science Issues,

DTIC Science & Technology

1981-09-01

long-term national significance. Clearly alternative choices in the management of that process can have substantially different economic and social...systems, reflecting primarily an intersection of eco- nomic needs and technological opportunities. Among the economic factors behind the drive to automate...productivity improvements have lagged far behind industrial and manufacturing growth ( Keating , 1980; Bennis, 1980). These problems are exacerbated by

Visuo-spatial performance in autism: a meta-analysis.

PubMed

Muth, Anne; Hönekopp, Johannes; Falter, Christine M

2014-12-01

Visuo-spatial skills are believed to be enhanced in autism spectrum disorders (ASDs). This meta-analysis tests the current state of evidence for Figure Disembedding, Block Design, Mental Rotation and Navon tasks in ASD and neurotypicals. Block Design (d = 0.32) and Figure Disembedding (d = 0.26) showed superior performance for ASD with large heterogeneity that is unaccounted for. No clear differences were found for Mental Rotation. ASD samples showed a stronger local processing preference for Navon tasks (d = 0.35); less clear evidence for performance differences of a similar magnitude emerged. We discuss the meta-analysis results together with other findings relating to visuo-spatial processing and three cognitive theories of ASD: Weak Central Coherence, Enhanced Perceptual Functioning and Extreme Male Brain theory.

Micro and macro-habitat associations in saproxylic beetles: implications for biodiversity management.

PubMed

Hjältén, Joakim; Stenbacka, Fredrik; Pettersson, Roger B; Gibb, Heloise; Johansson, Therese; Danell, Kjell; Ball, John P; Hilszczański, Jacek

2012-01-01

Restoration of habitats is critically important in preventing full realization of the extinction debt owed as a result of anthropogenic habitat destruction. Although much emphasis has been placed on macrohabitats, suitable microhabitats are also vital for the survival of most species. The aim of this large-scale field experiment was to evaluate the relative importance of manipulated microhabitats, i.e., dead wood substrates of spruce (snags, and logs that were burned, inoculated with wood fungi or shaded) and macrohabitats, i.e., stand types (clear-cuts, mature managed forests, and forest reserves) for species richness, abundance and assemblage composition of all saproxylic and red-listed saproxylic beetles. Beetles were collected in emergence traps in 30 forest stands in 2001, 2003, 2004 and 2006. More individuals emerged from snags and untreated logs than from burned and shaded logs, but species richness did not differ among substrates. Assemblage composition differed among substrates for both all saproxylics and red-listed saproxylic species, mainly attributed to different assemblage composition on snags. This suggests that the practise of leaving snags for conservation purposes should be complemented with log supplementation. Clear-cuts supported fewer species and different assemblages from mature managed forests and reserves. Neither abundance, nor species richness or assemblage composition differed between reserves and mature managed forests. This suggests that managed stands subjected to selective cutting, not clear-felling, maintain sufficient old growth characteristics and continuity to maintain more or less intact assemblages of saproxylic beetles. Thus, alternative management methods, e.g., continuity forestry should be considered for some of these stands to maintain continuity and conservation values. Furthermore, the significantly higher estimated abundance per ha of red-listed beetles in reserves underlines the importance of reserves for maintaining viable populations of rare red-listed species and as source areas for saproxylic species in boreal forest landscapes.

[Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

PubMed

Dick, W

1994-01-01

Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.

Causal cognition in human and nonhuman animals: a comparative, critical review.

PubMed

Penn, Derek C; Povinelli, Daniel J

2007-01-01

In this article, we review some of the most provocative experimental results to have emerged from comparative labs in the past few years, starting with research focusing on contingency learning and finishing with experiments exploring nonhuman animals' understanding of causal-logical relations. Although the theoretical explanation for these results is often inchoate, a clear pattern nevertheless emerges. The comparative evidence does not fit comfortably into either the traditional associationist or inferential alternatives that have dominated comparative debate for many decades now. Indeed, the similarities and differences between human and nonhuman causal cognition seem to be much more multifarious than these dichotomous alternatives allow.

Hyperopia and emergent literacy of young children: pilot study.

PubMed

Shankar, Sunita; Evans, Mary Ann; Bobier, William R

2007-11-01

To compare emergent literacy skills in uncorrected hyperopic and emmetropic children. "Hyperopes" (>or=2.00 D sphere along the most hyperopic meridian; n=13; aged 67+/-13 mo) and "emmetropes" (

77 FR 33013 - Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-04

... Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Add Rules Related to the Clearing of Emerging Markets Sovereign Index Credit Default Swaps May 29, 2012. On April 3, 2012, ICE Clear Credit (``ICC'') filed with the Securities and Exchange...

46 CFR 185.606 - Escape hatches and emergency exits.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Escape hatches and emergency exits. 185.606 Section 185... 100 GROSS TONS) OPERATIONS Markings Required § 185.606 Escape hatches and emergency exits. All escape hatches and other emergency exits used as means of escape must be marked on both sides in clearly legible...

46 CFR 185.606 - Escape hatches and emergency exits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Escape hatches and emergency exits. 185.606 Section 185... 100 GROSS TONS) OPERATIONS Markings Required § 185.606 Escape hatches and emergency exits. All escape hatches and other emergency exits used as means of escape must be marked on both sides in clearly legible...

46 CFR 185.606 - Escape hatches and emergency exits.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Escape hatches and emergency exits. 185.606 Section 185... 100 GROSS TONS) OPERATIONS Markings Required § 185.606 Escape hatches and emergency exits. All escape hatches and other emergency exits used as means of escape must be marked on both sides in clearly legible...

46 CFR 185.606 - Escape hatches and emergency exits.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Escape hatches and emergency exits. 185.606 Section 185... 100 GROSS TONS) OPERATIONS Markings Required § 185.606 Escape hatches and emergency exits. All escape hatches and other emergency exits used as means of escape must be marked on both sides in clearly legible...

46 CFR 185.606 - Escape hatches and emergency exits.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Escape hatches and emergency exits. 185.606 Section 185... 100 GROSS TONS) OPERATIONS Markings Required § 185.606 Escape hatches and emergency exits. All escape hatches and other emergency exits used as means of escape must be marked on both sides in clearly legible...

Connections to Economic Prosperity: Money Aspirations from Adolescence to Emerging Adulthood

ERIC Educational Resources Information Center

Beutler, Ivan F.

2012-01-01

This study examines the "living well" aspirations of an emerging adult sample and compares them with earlier results of middle and high school samples. The tenor of emerging adult responses was more stridently extrinsic and more convincingly intrinsic than adolescent responses, revealing less middle ground as emerging adults more clearly take a…

46 CFR 133.80 - Emergency instructions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Emergency instructions. 133.80 Section 133.80 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.80 Emergency instructions. (a) General. Copies of clear instructions must be...

46 CFR 133.80 - Emergency instructions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Emergency instructions. 133.80 Section 133.80 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.80 Emergency instructions. (a) General. Copies of clear instructions must be...

Magnetic field reconnection. [energy conversion in space plasma

NASA Technical Reports Server (NTRS)

Sonnerup, U. O.

1979-01-01

A reasonably detailed description is obtained of the current status of our understanding of magnetic field reconnection. The picture that emerges is of a process, simple in concept but extremely complicated and multifaceted in detail. Nonlinear MHD processes in the external flow region, governed by distant boundary conditions, are coupled to nonlinear microscopic plasma processes in the diffusion region, in a manner not clearly understood. It appears that reconnection may operate in entirely different ways for different plasma parameters and different external boundary conditions. Steady reconnection may be allowed in some cases, forbidden in others, with intermediate situations involving impulsive or pulsative events.

[Reorganization of the interdisciplinary emergency unit at the university clinic of Göttingen].

PubMed

Blaschke, Sabine; Müller, Gerhard A; Bergmann, Günther

2008-04-01

Configuration of the interdisciplinary emergency unit within the university clinic of Göttingen was successfully reorganized during the past two years. All emergencies except traumatologic, gynecologic and pediatric emergencies are treated within this functional unit which is guided by the center of internal medicine. It is organized in a three shift operation manner over a period of 24 hours. Due to a close interdisciplinary collaboration between different departments patients receive optimal diagnostic and therapeutic treatment within a short period of time. To improve processes within the emergency department a series of measures were taken including the -establishment of an intermediate care unit for unstable patients, setting up of special diagnostic and therapeutic units for the acute coronary syndrome as well as stroke, implementation of standardized clinical pathways, establishment of an electronic data processing network in close communication with all diagnostic entities, introduction of a quality assurance system and reduction of medical costs. Reorganization measures lead to a substantial optimization and acceleration of emergency proceedings and thus, provides optimal patient care around the clock. In addition, medical costs could clearly be reduced at the interface between preclinical and clinical emergency medicine.

[Immigrants' access to health care in Spain: a review].

PubMed

Llop-Gironés, Alba; Vargas Lorenzo, Ingrid; Garcia-Subirats, Irene; Aller, Marta-Beatriz; Vázquez Navarrete, María Luisa

2014-01-01

An important proportion of the population in Spain is immigrant and the international literature indicates their inadequate access to health services. The objective is to contribute to improving the knowledge on access to health care of the immigrant population in Spain. Review of original papers published (1998-2012) on access to health services of the immigrant population in Spain published in Medline and MEDES. Out of 319 studies, 20 were selected, applying predefined criteria. The results were analyzed using the Aday and Andersen framework. Among the publications, 13 quantitative studies analysed differences in health care use between the immigrant and the native population, and 7 studied determinants of access of immigrants. Studies showed less use of specialized care by immigrants, higher use of emergency care and no differences in the use of primary care between groups. Five quantitative articles on determinants of access focused on factors related to the immigrant population (sex, age, educational level and holding private health insurance), but without observing clear patterns. The two qualitative studies analyzed factors related to health services, describing access to healthcare barriers such as the limited provision of information or the requirements for personal health card. Access to health care in immigrants has been scarcely studied, using different approaches and the barely analysed factors related to the services. No clear patterns were observed, as differences depend on the classification of migrants according to country of origin and the level of care. However, studies showed less use of specialized care by immigrants, higher use of emergency care and the existence of determinants of access different to their needs.

Mothers’ Parenting and Child Sex Differences in Behavior Problems among African American Preschoolers

PubMed Central

Barnett, Melissa A.; Scaramella, Laura V.

2014-01-01

Sex differences in rates of behavior problems, including internalizing and externalizing problems, begin to emerge during early childhood. These sex differences may occur because mothers parent their sons and daughters differently, or because the impact of parenting on behavior problems is different for boys and girls. This study examines whether associations between observations of mothers’ positive and negative parenting and children’s externalizing and internalizing behaviors vary as a function of child sex. The sample consists of 137 African American, low-income families with one sibling approximately two-years-old and the closest aged older sibling who is approximately four-years-old. Results from fixed-effects within-family models indicate clear sex differences regardless of child age. Mothers were observed to use less positive parenting with sons than with daughters. Higher levels of observed negative parenting were linked to more externalizing behaviors for boys, while lower levels of positive parenting were linked to more externalizing behaviors for girls. No child sex differences emerged regarding associations between observed positive and negative parenting and internalizing behaviors. PMID:23937420

10 CFR 50.47 - Emergency plans.

Code of Federal Regulations, 2011 CFR

2011-01-01

... clear instruction to the populace within the plume exposure pathway Emergency Planning Zone have been... protective actions has been developed for the plume exposure pathway EPZ for emergency workers and the public... and in place, and protective actions for the ingestion exposure pathway EPZ appropriate to the locale...

Universality of emergent states in diverse physical systems

NASA Astrophysics Data System (ADS)

Guidry, Mike

2017-12-01

Our physics textbooks are dominated by examples of simple weakly-interacting microscopic states, but most of the real world around us is most effectively described in terms of emergent states that have no clear connection to simple textbook states. Emergent states are strongly-correlated and dominated by properties that emerge as a consequence of interactions and are not part of the description of the corresponding weakly-interacting system. This paper proposes a connection of weakly-interacting textbook states and realistic emergent states through fermion dynamical symmetries having fully-microscopic generators of the emergent states. These imply unique truncation of the Hilbert space for the weakly-interacting system to a collective subspace where the emergent states live. Universality arises because the possible symmetries under commutation of generators, which transcend the microscopic structure of the generators, are highly restricted in character and determine the basic structure of the emergent state, with the microscopic structure of the generators influencing emergent state only parametrically. In support of this idea we show explicit evidence that high-temperature superconductors, collective states in heavy atomic nuclei, and graphene quantum Hall states in strong magnetic fields exhibit a near-universal emergent behavior in their microscopically-computed total energy surfaces, even though these systems share essentially nothing in common at the microscopic level and their emergent states are characterized by fundamentally different order parameters.

Sex differences in physiological reactivity to acute psychosocial stress in adolescence.

PubMed

Ordaz, Sarah; Luna, Beatriz

2012-08-01

Females begin to demonstrate greater negative affective responses to stress than males in adolescence. This may reflect the concurrent emergence of underlying differences in physiological response systems, including corticolimbic circuitries, the hypothalamic-pituitary-adrenal axis (HPAA), and the autonomic nervous system (ANS). This review examines when sex differences in physiological reactivity to acute psychosocial stress emerge and the directionality of these differences over development. Indeed, the literature indicates that sex differences emerge during adolescence and persist into adulthood for all three physiological response systems. However, the directionality of the differences varies by system. The emerging corticolimbic reactivity literature suggests greater female reactivity, particularly in limbic regions densely innervated by gonadal hormone receptors. In contrast, males generally show higher levels of HPAA and ANS reactivity. We argue that the contrasting directionality of corticolimbic and peripheral physiological responses may reflect specific effects of gonadal hormones on distinct systems and also sex differences in evolved behavioral responses that demand different levels of peripheral physiological activation. Studies that examine both subjective reports of negative affect and physiological responses indicate that beginning in adolescence, females respond to acute stressors with more intense negative affect than males despite their comparatively lower peripheral physiological responses. This dissociation is not clearly explained by sex differences in the strength of the relationship between physiological and subjective responses. We suggest that females' greater subjective responsivity may instead arise from a greater activity in brain regions that translate stress responses to subjective awareness in adolescence. Future research directions include investigations of the role of pubertal hormones in physiological reactivity across all systems, examining the relationship of corticolimbic reactivity and negative affect, and sex differences in emotion regulation processes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Sex differences in physiological reactivity to acute psychosocial stress in adolescence

PubMed Central

Ordaz, Sarah; Luna, Beatriz

2012-01-01

Summary Females begin to demonstrate greater negative affective responses to stress than males in adolescence. This may reflect the concurrent emergence of underlying differences in physiological response systems, including corticolimbic circuitries, the hypothalamic—pituitary— adrenal axis (HPAA), and the autonomic nervous system (ANS). This review examines when sex differences in physiological reactivity to acute psychosocial stress emerge and the directionality of these differences over development. Indeed, the literature indicates that sex differences emerge during adolescence and persist into adulthood for all three physiological response systems. However, the directionality of the differences varies by system. The emerging corti-colimbic reactivity literature suggests greater female reactivity, particularly in limbic regions densely innervated by gonadal hormone receptors. In contrast, males generally show higher levels of HPAA and ANS reactivity. We argue that the contrasting directionality of corticolimbic and peripheral physiological responses may reflect specific effects of gonadal hormones on distinct systems and also sex differences in evolved behavioral responses that demand different levels of peripheral physiological activation. Studies that examine both subjective reports of negative affect and physiological responses indicate that beginning in adolescence, females respond to acute stressors with more intense negative affect than males despite their comparatively lower peripheral physiological responses. This dissociation is not clearly explained by sex differences in the strength of the relationship between physiological and subjective responses. We suggest that females' greater subjective responsivity may instead arise from a greater activity in brain regions that translate stress responses to subjective awareness in adolescence. Future research directions include investigations of the role of pubertal hormones in physiological reactivity across all systems, examining the relationship of corticolimbic reactivity and negative affect, and sex differences in emotion regulation processes. PMID:22281210

Social determinants of health: a veil that hides socioeconomic position and its relation with health.

PubMed

Regidor, Enrique

2006-10-01

The emergence of theoretical models of social determinants of health has added conceptual ambiguity to the understanding of social inequalities in health, as it is often not possible to clearly distinguish between socioeconomic position and these determinants. Whether the existence of social inequalities in health is based on differences in health or on differences in social determinants of health that are systematically associated with socioeconomic position, policymakers should be clearly informed of the importance of socioeconomic position for health. Thus, the following three basic requirements are proposed: to reach a consensus about the dimensions that reflect socioeconomic position; to agree about what are to be considered the social determinants of health and whether or not these determinants are a construct that can be distinguished from socioeconomic position; and finally, to establish which dimensions and measures of socioeconomic position are most appropriate for the evaluation of interventions that aim to reduce these inequalities.

44 CFR 73.3 - Denial of flood insurance coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Denial of flood insurance coverage. 73.3 Section 73.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... sufficient to confirm its identity and location; (2) A clear and unequivocal declaration that the property is...

14 CFR 27.1557 - Miscellaneous markings and placards.

Code of Federal Regulations, 2011 CFR

2011-01-01

...; (iii) For turbine engine powered rotorcraft, the permissible fuel designations; and (iv) For pressure...) Emergency exit placards. Each placard and operating control for each emergency exit must be red. A placard must be near each emergency exit control and must clearly indicate the location of that exit and its...

14 CFR 27.1557 - Miscellaneous markings and placards.

Code of Federal Regulations, 2013 CFR

2013-01-01

...; (iii) For turbine engine powered rotorcraft, the permissible fuel designations; and (iv) For pressure...) Emergency exit placards. Each placard and operating control for each emergency exit must be red. A placard must be near each emergency exit control and must clearly indicate the location of that exit and its...

14 CFR 27.1557 - Miscellaneous markings and placards.

Code of Federal Regulations, 2012 CFR

2012-01-01

...; (iii) For turbine engine powered rotorcraft, the permissible fuel designations; and (iv) For pressure...) Emergency exit placards. Each placard and operating control for each emergency exit must be red. A placard must be near each emergency exit control and must clearly indicate the location of that exit and its...

14 CFR 27.1557 - Miscellaneous markings and placards.

Code of Federal Regulations, 2014 CFR

2014-01-01

...; (iii) For turbine engine powered rotorcraft, the permissible fuel designations; and (iv) For pressure...) Emergency exit placards. Each placard and operating control for each emergency exit must be red. A placard must be near each emergency exit control and must clearly indicate the location of that exit and its...

Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form

PubMed Central

2012-01-01

Residents in training, medical students and other staff in surgical sector, emergency room (ER) and intensive care unit (ICU) or Burn Unit face a multitude of questions regarding burn care. Treatment of burns is not always straightforward. Furthermore, National and International guidelines differ from one region to another. On one hand, it is important to understand pathophysiology, classification of burns, surgical treatment, and the latest updates in burn science. On the other hand, the clinical situation for treating these cases needs clear guidelines to cover every single aspect during the treatment procedure. Thus, 10 questions have been organised and discussed in a step-by-step form in order to achieve the excellence of education and the optimal treatment of burn injuries in the first 24 hours. These 10 questions will clearly discuss referral criteria to the burn unit, primary and secondary survey, estimation of the total burned surface area (%TBSA) and the degree of burns as well as resuscitation process, routine interventions, laboratory tests, indications of Bronchoscopy and special considerations for Inhalation trauma, immediate consultations and referrals, emergency surgery and admission orders. Understanding and answering the 10 questions will not only cover the management process of Burns during the first 24 hours but also seems to be an interactive clear guide for education purpose. PMID:22583548

Associations between relational sexual behaviour, pornography use, and pornography acceptance among US college students.

PubMed

Willoughby, Brian J; Carroll, Jason S; Nelson, Larry J; Padilla-Walker, Laura M

2014-01-01

Pornography use among emerging adults in the USA has increased in recent decades, as has the acceptance of such consumption. While previous research has linked pornography use to both positive and negative outcomes in emerging adult populations, few studies have investigated how attitudes toward pornography may alter these associations, or how examining pornography use together with other sexual behaviours may offer unique insights into the outcomes associated with pornography use. Using a sample of 792 emerging adults, the present study explored how the combined examination of pornography use, acceptance, and sexual behaviour within a relationship might offer insight into emerging adults' development. Results suggested clear gender differences in both pornography use and acceptance patterns. High male pornography use tended to be associated with high engagement in sex within a relationship and was associated with elevated risk-taking behaviours. High female pornography use was not associated with engagement in sexual behaviours within a relationship and was general associated with negative mental health outcomes.

Consultation for Simple Laceration Repair When On-Call in the Emergency Department: Potential Quagmire.

PubMed

Zbar, Ross I S; Monico, Edward; Calise, Arthur

2017-07-01

What are the forces obligating a plastic surgeon who is on-call for the emergency department to respond to a consultation request for repair of a simple laceration? Although the duties are clear in cases of obvious surgical emergency, ambiguity and subsequent conflict may arise when the true nature of the emergency is less clear. Does the consultant's clinical discretion dictate the obligation in the case of a simple laceration; or is it subservient to either the discretion of the requesting health-care provider or even the patient? Do federal statutes such as the Emergency Medical Treatment and Labor Act, or perhaps more local rules apply, such as the by-laws of the hospital? It would behoove all medical practitioners to familiarize themselves with both the legal and moral implications of these issues. Having legitimate policies in place which actively address those situations where the consultative obligation is unclear is critical to resolve potential conflict.

Diploid Male Production Results in Queen Death in the Stingless Bee Scaptotrigona depilis.

PubMed

Vollet-Neto, Ayrton; Oliveira, Ricardo C; Schillewaert, Sharon; Alves, Denise A; Wenseleers, Tom; Nascimento, Fabio S; Imperatriz-Fonseca, Vera L; Ratnieks, Francis L W

2017-04-01

As in most Hymenoptera, the eusocial stingless bees (Meliponini) have a complementary sex determination (CSD) system. When a queen makes a "matched mating" with a male that shares a CSD allele with her, half of their diploid offspring are diploid males rather than females. Matched mating imposes a cost, since diploid male production reduces the colony workforce. Hence, adaptations preventing the occurrence or attenuating its effects are likely to arise. Here we provide clear evidence that in the stingless bee Scaptotrigona depilis, the emergence of diploid males induces queen death, and this usually occurs within 10-20 days of the emergence of diploid male offspring from their pupae. Queens that have not made a matched mating die when introduced into a colony in which diploid males are emerging. This shows that the adult diploid males, and not the queen that has made a matched mating herself, are the proximate cause of queen death. Analysis of the cuticular hydrocarbon profiles of adult haploid and diploid males shows six compounds with significant differences. Moreover, the diploid and haploid males only acquire distinct cuticular hydrocarbon profiles 10 days after emergence. Our data shows that the timing of queen death occurs when the cuticular hydrocarbons of haploid and diploid males differ significantly, suggesting that these chemical differences could be used as cues or signals to trigger queen death.

Pruning the Pearlsides: Reconciling morphology and molecules in mesopelagic fishes (Maurolicus: Sternoptychidae)

NASA Astrophysics Data System (ADS)

Rees, D. J.; Byrkjedal, I.; Sutton, T. T.

2017-03-01

The genus Maurolicus comprises extremely abundant vertically-migrating fishes that have considerable biomass in a number of regions worldwide. The genus was generally considered monotypic, with a single species, M. muelleri (Gmelin, 1789), inhabiting all world oceans. Based on differences in combinations of a limited number of morphometric characters, 15 separate species have been proposed, mostly associated with different ocean basins and seamounts. However, due to similarities in external morphology and overlap in ranges of morphometric characteristics, there remains a need for further validation of these species. Here, we present results of a multi-gene analysis, together with morphological data, for five putative Maurolicus species from multiple locations in the northern and southern hemispheres. Sampling encompasses described species from the North and South Atlantic, Mediterranean Sea, south-east Indian Ocean and the western South Pacific. Mitochondrial (16S and COI) and nuclear (ITS-2) gene sequences for 120 specimens were used in Maximum Parsimony and Bayesian Inference analyses as well as creation of haplotype networks. Morphological character analyses were based on data from 279 adult individuals. Several clear groupings emerge, conflicting with previously recognised species: (1) a 'northern' clade comprising Maurolicus muelleri and M. amethystinopunctatus, (2) a 'southern' clade comprising M. australis, M. walvisensis (also M. japonicus) and (3) eastern Equatorial and western North Atlantic M. weitzmani. The southern clade taxa are genetically indistinguishable and not well defined morphologically and present a clear case for synonymisation as M. australis. Synonymisation is also proposed for M. muelleri and M. amethystinopunctatus, with limited morphological variation likely to reflect physical and biological differences experienced north / south of the sub-polar front. Maurolicus weitzmani is clearly differentiated from all other Maurolicus species on both a molecular and morphological basis. Studies of genetic and morphological diversity in Maurolicus will further contribute to the question of 'what constitutes a species in the open ocean?', where a complex picture is emerging of both unexpected variation, as well as the unexpectantly absent genetic variation, in cosmopolitan taxa.

Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Working Group: Multi-Agency Coordination After Action Report

DTIC Science & Technology

2012-02-23

Kaski Charles Denver Office of Emergency Management Kellar Scott Arapahoe County/NCR Coordinator Krebs Kathleen Clear Creek County Krugman Jim USDA...Mower John Cubic Applications, Inc. Mueller Matt Denver Office of Emergency Management Ridley Teri WARRP Rubenstein Mike Jefferson County...Office of Emergency Management: Scott Field Denver Office of Emergency Management: Pat Williams Douglas County: Fran Santagata Douglas County: Steve

Utilising a construct of teacher capacity to examine national curriculum reform in mathematics

NASA Astrophysics Data System (ADS)

Zhang, Qinqiong; Stephens, Max

2013-12-01

This study involving 120 Australian and Chinese teachers introduces a construct of teacher capacity to analyse how teachers help students connect arithmetic learning and emerging algebraic thinking. Four criteria formed the basis of our construct of teacher capacity: knowledge of mathematics, interpretation of the intentions of official curriculum documents, understanding of students' thinking, and design of teaching. While these key elements connect to what other researchers refer to as mathematical knowledge for teaching, several differences are made clear. Qualitative and quantitative analyses show that our construct was robust and effective in distinguishing between different levels of teacher capacity.

Short delay in timing of emergence determines establishment success in Pinus sylvestris across microhabitats.

PubMed

Castro, Jorge

2006-12-01

The date of emergence may have far-reaching implications for seedling performance. Seedlings emerging early in the growing season often have a greater rate of survival or grow better if early emergence provides advantages with respect to an environmental cue. As a result, the benefits of early emergence may be lost if the environmental stress creating the differences among cohorts disappears. The experimental manipulation under field conditions of the factors that constitute the main sources of stress for seedling establishment is thus a straightforward method to evaluate the impact of date of emergence on seedling establishment under realistic conditions. Two field experiments were performed to analyse the effect of emergence date on survival and first-year growth of Scots pine seedlings in natural mountain forests in south-east Spain. Two main environmental factors that determine seedling success in these mountains were considered: (1) microhabitat type (monitoring the effect of date of emergence in the three most common microhabitats where seedlings recruit); (2) summer drought (monitored by an irrigation treatment with control and watered sampling points). Overall, early emergence resulted in a higher probability of survival and better growth in the two experiments and across microhabitats. However, the reduction in summer drought did not diminish the differences observed among cohorts: all cohorts increased their survival and growth, but early cohorts still had a clear advantage. Date of emergence determines establishment success of Pinus sylvestris seedlings, even if cohorts are separated by only a few days, irrespective of the intensity of summer drought. The experimental design, covering a gradient of light intensity and soil moisture that simulates conditions of the regeneration niche of Scots pine across its geographical range, allows the results to be extrapolated to other areas of the species. Date of emergence is thus likely to have a large impact on the demography of Scots pine across its geographical range.

Frequency of in-office emergencies in primary care

PubMed Central

Liddy, Clare; Dreise, Heather; Gaboury, Isabelle

2009-01-01

ABSTRACT OBJECTIVE To quantify the frequency and types of in-office emergencies seen by FPs. DESIGN A retrospective descriptive analysis of the frequency and types of in-office emergencies seen by FPs was done using the City of Ottawa Emergency Medical Services database. SETTING Community medical offices in the Ottawa, Ont, region during a 3-year period (2004 to 2006). PARTICIPANTS All patients for whom an ambulance was called to a medical office or clinic during the study period. MAIN OUTCOME MEASURES Number of emergency calls from FPs’ offices, primary complaints, seasonal variation, distance to the nearest emergency facility, and patients’ demographic characteristics. RESULTS A total of 3033 code 04 (life-threatening) emergency calls were received from FPs’ offices during the study period. Demographic analysis of the calls showed that 91.3% of calls were regarding adult patients with an average age of 51.5 years. There was an overall statistically significant difference in the sex of the patients presenting (P < .001), but it was attributable to calls about genitourinary emergencies, which were almost all for women. The most common type of emergency reported was cardiovascular complaints. Of the 992 cardiovascular emergencies, 74.3% were complaints of ischemic chest pain. CONCLUSION There is a great burden on the health care system from emergency calls, with continued unpreparedness from FPs. Clearly, FPs must take seriously the risk of being unprepared for in-office emergencies. Dissemination strategies must be developed so that the guidelines that have been developed can be effectively implemented in FP offices across the country. PMID:19826161

Emergency medicine clerkship curriculum in a high-income developing country: methods for development and application.

PubMed

Cevik, Arif Alper; Cakal, Elif Dilek; Abu-Zidan, Fikri M

2018-06-07

The published recommendations for international emergency medicine curricula cover the content, but exclude teaching and learning methods, assessment, and evaluation. We aim to provide an overview on available emergency medicine clerkship curricula and report the development and application experience of our own curriculum. Our curriculum is an outcome-based education, enriched by e-learning and various up-to-date pedagogic principles. Teaching and learning methods, assessment, and evaluation are described. The theory behind our practice in the light of recent literature is discussed aiming to help other colleagues from developing countries to have a clear map for developing and tailoring their own curricula depending on their needs. The details of our emergency medicine clerkship will serve as an example for developing and developed countries having immature undergraduate emergency medicine clerkship curricula. However, these recommendations will differ in various settings depending on available resources. The main concept of curriculum development is to create a curriculum having learning outcomes and content relevant to the local context, and then align the teaching and learning activities, assessments, and evaluations to be in harmony. This may assure favorable educational outcome even in resource limited settings.

From hypothetical scenario to tragic reality: A salutary lesson in risk communication and the Victorian 2009 bushfires.

PubMed

Burns, Robin; Robinson, Priscilla; Smith, Penelope

2010-02-01

To investigate the ways that the risk of a bushfire emergency and communication strategies are perceived by different community segments. A brief questionnaire preceded focus group discussion of a bushfire scenario with four communications from different sources. Groups were recruited to represent different community segments within a bushfire-prone peri-urban Shire in Victoria. Four groups (28 participants) were recruited. Bushfire experience was highest in the over 40-year-olds, who would use a variety of information sources, preferred to receive information from trusted local sources, such as emergency services and the council, and were more likely to be a member of a local organisation than the under 40s. Younger people used television, local papers, and friends, family and neighbours as information sources. Young parents felt disempowered through lack of local knowledge, and trusted government departments less than older residents. All wanted clear, current, specific local information about ground conditions and actions to be taken during a fire outbreak. Knowledge of and preparedness for bushfire is unequally spread throughout a bushfire community. There is a need in public health risk and emergency situations to focus on community development, information and consultation. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Age correction in cognitive, linguistic, and motor domains for infants born preterm: an analysis of the Bayley Scales of Infant and Toddler Development, Third Edition developmental patterns.

PubMed

Morsan, Valentina; Fantoni, Carlo; Tallandini, Maria Anna

2018-03-15

To verify whether it is appropriate to use age correction for infants born preterm in all the developmental domains (cognitive, linguistic, and motor) considered by the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Seventy-three infants born preterm (26-35wks) without major neurological sequelae and 67 infants born at term were assessed at 12 months (corrected age for infants born preterm). The performance of the infants born preterm was assessed with two different evaluations: scores based on uncorrected age and scores based on corrected age. The developmental trends of infants born at term and infants born preterm differ across domains. Statistical analysis shows that age correction produces an overrated estimate of motor performance (12.5 points [95% confidence interval 9.05-16.01]) but not of cognitive performance. Given the broad use of the Bayley-III by psychologists and paediatricians, these results are important in the early diagnosis of developmental difficulties for children born preterm. Correction for gestational age should be applied for the cognitive domain only; whereas for the motor domain, chronological age should be used. No clear data emerged for language. Age correction with Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) for infants born preterm should be applied differently in cognitive, language, and motor domains. Using corrected age with Bayley-III, the motor skills are overrated. Correction for preterm births adequately measures cognitive skills. No clear indication emerged about language skills. © 2018 Mac Keith Press.

GENDER AND THE MBA: Differences in Career Trajectories, Institutional Support, and Outcomes

PubMed Central

Damaske, Sarah; Sheroff, Christen

2018-01-01

This study asks how men’s and women’s careers diverge following MBA graduation from an elite university, using qualitative interview data from 74 respondents. We discover men and women follow three career pathways post-graduation: lockstep (stable employment), transitory (3 or more employers), and exit (left workforce). While similar proportions of men and women followed the lockstep pathways and launched accelerated careers, sizable gender differences emerged on the transitory pathway; men’s careers soared as women’s faltered on this path—the modal category for both. On the transitory path, men fared much better than women when moving to new organizations, suggesting that gender may become more salient when people have a shorter work history with a company. Our findings suggest that clear building blocks to promotions reduce gender bias and ambiguity in the promotion process, but multiple external moves hamper women, putting them at a clear disadvantage to men whose forward progress is less likely to be stalled by such moves. PMID:29706689

Machine-Learned Data Structures of Lipid Marker Serum Concentrations in Multiple Sclerosis Patients Differ from Those in Healthy Subjects.

PubMed

Lötsch, Jörn; Thrun, Michael; Lerch, Florian; Brunkhorst, Robert; Schiffmann, Susanne; Thomas, Dominique; Tegder, Irmgard; Geisslinger, Gerd; Ultsch, Alfred

2017-06-07

Lipid metabolism has been suggested to be a major pathophysiological mechanism of multiple sclerosis (MS). With the increasing knowledge about lipid signaling, acquired data become increasingly complex making bioinformatics necessary in lipid research. We used unsupervised machine-learning to analyze lipid marker serum concentrations, pursuing the hypothesis that for the most relevant markers the emerging data structures will coincide with the diagnosis of MS. Machine learning was implemented as emergent self-organizing feature maps (ESOM) combined with the U*-matrix visualization technique. The data space consisted of serum concentrations of three main classes of lipid markers comprising eicosanoids ( d = 11 markers), ceramides ( d = 10), and lyosophosphatidic acids ( d = 6). They were analyzed in cohorts of MS patients ( n = 102) and healthy subjects ( n = 301). Clear data structures in the high-dimensional data space were observed in eicosanoid and ceramides serum concentrations whereas no clear structure could be found in lysophosphatidic acid concentrations. With ceramide concentrations, the structures that had emerged from unsupervised machine-learning almost completely overlapped with the known grouping of MS patients versus healthy subjects. This was only partly provided by eicosanoid serum concentrations. Thus, unsupervised machine-learning identified distinct data structures of bioactive lipid serum concentrations. These structures could be superimposed with the known grouping of MS patients versus healthy subjects, which was almost completely possible with ceramides. Therefore, based on the present analysis, ceramides are first-line candidates for further exploration as drug-gable targets or biomarkers in MS.

Beyond clinical priority: what matters when making operational decisions about emergency surgical queues?

PubMed

Fitzgerald, Anneke; Wu, Yong

2017-08-01

Objective This paper describes the perceptions of operating theatre staff in Australia and The Netherlands regarding the influence of logistical or operational reasons that may affect the scheduling of unplanned surgical cases. It is proposed that logistical or operational issues can influence the priority determination of queue position of surgical cases on the emergency waiting list. Methods A questionnaire was developed and conducted in 15 hospitals across The Netherlands and Australia, targeting anaesthetists, managers, nurses and surgeons. Statistical analyses revolved around these four professional groups. Six hypotheses were then developed and tested based on the responses collected from the participants. Results There were significant differences in perceptions of logistics delay factors across different professional groups when patients were waiting for unplanned surgery. There were also significant differences among different groups when setting logistical priority factors for planning and scheduling unplanned cases. The hypotheses tests confirm these differences, and the findings concur with the paradigmatic differences mentioned in the literature. These paradigmatic differences among the four professional groups may explain some of the tensions encountered when making decisions about scheduling emergency surgical queues, and therefore should be taken into consideration for management of operating theatres. Conclusions Queue positions of patients waiting for unplanned surgery, or emergency surgery, are determined by medical clinicians according to clinicians' indication of clinical priority. However, operating theatre managers are important in facilitating smooth operations when planning for emergency surgeries. It is necessary for surgeons to understand the logistical challenges faced by managers when requesting logistical priorities for their operations. What is known about the topic? Tensions exist about the efficient use of operating theatres and negotiating individual surgeon's demands, especially between surgeons and managers, because in many countries surgeons only work in the hospital and not for the hospital. What does this paper add? The present study examined the logistical effects on functionality and purports the notion that, while recognising the importance of clinical precedence, logistical factors influence queue order to ensure efficient use of operating theatre resources. What are the implications for practitioners? The results indicate that there are differences in the perceptions of healthcare professionals regarding the sequencing of emergency patients. These differences may lead to conflicts in the decision making process about triaging emergency or unplanned surgical cases. A clear understanding of the different perceptions of different functional groups may help address the conflicts that often arise in practice.

A Simple Experimental Setup to Clearly Show that Light Does Not Recombine After Passing Through Two Prisms

NASA Astrophysics Data System (ADS)

Garcia-Molina, Rafael; del Mazo, Alejandro; Velasco, Santiago

2018-01-01

We present a simple and cheap experimental setup that clearly shows how the colors of the white light spectrum after passing a prism do not recombine when emerging from an identical second prism, as it is still found in many references.

A Simple Experimental Setup to Clearly Show That Light Does Not Recombine after Passing through Two Prisms

ERIC Educational Resources Information Center

Garcia-Molina, Rafael; del Mazo, Alejandro; Velasco, Santiago

2018-01-01

We present a simple and cheap experimental setup that clearly shows how the colors of the white light spectrum after passing a prism do not recombine when emerging from an identical second prism, as it is still found in many references.

Cockpit emergency safety system

NASA Astrophysics Data System (ADS)

Keller, Leo

2000-06-01

A comprehensive safety concept is proposed for aircraft's experiencing an incident to the development of fire and smoke in the cockpit. Fire or excessive heat development caused by malfunctioning electrical appliance may produce toxic smoke, may reduce the clear vision to the instrument panel and may cause health-critical respiration conditions. Immediate reaction of the crew, safe respiration conditions and a clear undisturbed view to critical flight information data can be assumed to be the prerequisites for a safe emergency landing. The personal safety equipment of the aircraft has to be effective in supporting the crew to divert the aircraft to an alternate airport in the shortest possible amount of time. Many other elements in the cause-and-effect context of the emergence of fire, such as fire prevention, fire detection, the fire extinguishing concept, systematic redundancy, the wiring concept, the design of the power supplying system and concise emergency checklist procedures are briefly reviewed, because only a comprehensive and complete approach will avoid fatal accidents of complex aircraft in the future.

The within-host population dynamics of Mycobacterium tuberculosis vary with treatment efficacy.

PubMed

Trauner, Andrej; Liu, Qingyun; Via, Laura E; Liu, Xin; Ruan, Xianglin; Liang, Lili; Shi, Huimin; Chen, Ying; Wang, Ziling; Liang, Ruixia; Zhang, Wei; Wei, Wang; Gao, Jingcai; Sun, Gang; Brites, Daniela; England, Kathleen; Zhang, Guolong; Gagneux, Sebastien; Barry, Clifton E; Gao, Qian

2017-04-19

Combination therapy is one of the most effective tools for limiting the emergence of drug resistance in pathogens. Despite the widespread adoption of combination therapy across diseases, drug resistance rates continue to rise, leading to failing treatment regimens. The mechanisms underlying treatment failure are well studied, but the processes governing successful combination therapy are poorly understood. We address this question by studying the population dynamics of Mycobacterium tuberculosis within tuberculosis patients undergoing treatment with different combinations of antibiotics. By combining very deep whole genome sequencing (~1000-fold genome-wide coverage) with sequential sputum sampling, we were able to detect transient genetic diversity driven by the apparently continuous turnover of minor alleles, which could serve as the source of drug-resistant bacteria. However, we report that treatment efficacy has a clear impact on the population dynamics: sufficient drug pressure bears a clear signature of purifying selection leading to apparent genetic stability. In contrast, M. tuberculosis populations subject to less drug pressure show markedly different dynamics, including cases of acquisition of additional drug resistance. Our findings show that for a pathogen like M. tuberculosis, which is well adapted to the human host, purifying selection constrains the evolutionary trajectory to resistance in effectively treated individuals. Nonetheless, we also report a continuous turnover of minor variants, which could give rise to the emergence of drug resistance in cases of drug pressure weakening. Monitoring bacterial population dynamics could therefore provide an informative metric for assessing the efficacy of novel drug combinations.

[Drug management of agitation in emergency departments: theoretical recommendations and studies of practices].

PubMed

Horn, Mathilde; Vaiva, Guillaume; Dumais, Alexandre

2015-01-01

Management of agitation is a frequent problematic of emergency departments that often leads to feelings of insecurity among clinicians. There are various practices regarding the drugs to be used in the management of agitations. Guidelines have been proposed by different groups of experts concerning the antipsychotic drugs that should be used for agitations in psychiatric conditions. Nevertheless, there is no clear-cut procedure referring to the utilization of intramuscular drugs in this situation. Moreover, there is no comparison available between the commonly used medications and other drugs, both in terms of superiority of efficacy and tolerance. In order to accurately assess these practices, evaluation protocols must minimize the interference with the service organization and the routine care. Further studies are required in order to develop guidelines about medications that have to be used to handle agitations, which must be based on robust evidence and applicable to emergency services. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Parenting practices and the transmission of ethnic identity.

PubMed

Davey, Maureen; Fish, Linda Stone; Askew, Julie; Robila, Mihaela

2003-04-01

Three years after being interviewed, a nonrandom, purposeful subsample of 14 Jewish families from a larger sample of 48 families living in Central New York was reinterviewed. The primary aim of this follow-up study was to develop a descriptive understanding of parenting practices and the transmission of ethnic identity. Semistructured family interviews were conducted and coded using grounded-theory techniques, in particular the constant comparative method of analysis. Four main qualitative categories emerged from this study: Individual differences in teenagers, stages of ethnic identity development, parenting practices, and parental role models. Findings suggest that clear expectations, a type of authoritative parenting, could be associated with the positive transmission of Jewish ethnic identity. This type of parenting style was direct as parents expressed clear expectations for participation in Jewish activities both at home and in the community.

On opportunity for emergency cesarean hysterectomy and pregnancy outcomes of patients with placenta accreta.

PubMed

Kong, Xiang; Kong, Yan; Yan, Jin; Hu, Jin-Ju; Wang, Fang-Fang; Zhang, Lei

2017-09-01

Effective diagnosis and clinical management of placenta accreta (PA) in China are not clear. The purpose of the study was to analyze the risk factors and diagnosis of PA, maternal and neonatal outcomes in patients with PA. It was a retrospective study of cases with PA, confirmed by histologically and/or clinically suspected during 3 years in 2 tertiary referral hospitals. The incidence rate of patients with PA, who had history of artificial abortion, cesarean section (CS), and placenta previa (PP) was 94%, 70%, and 72%, respectively. In 29 patients of scheduled CS group, 12 cases were performed with cesarean hysterectomy. Mean estimated blood loss (EBL) was 1.5 L, and 17 babies were admitted to neonatal intensive care unit (NICU). In the 18 cases of emergency CS group, 6 cases were performed cesarean hysterectomy. Mean EBL was 2.4 L, and 16 babies were admitted to NICU. The difference of mean EBL, cases of fetal admitted to intensive care unit in 2 groups was significant difference (P < .05).Women with history of uterine curettage, CS or PP are more likely to have PA. PA should be diagnosed early and accurately via ultrasound and magnetic resonance imaging. Maternal and neonatal outcomes in the scheduled CS are better than in emergency CS. Emergency peripartum hysterectomy is a feasible method under the circumstances of heave, fast bleeding, and the failure of conservative surgery.

Universality in Bacterial Colonies

NASA Astrophysics Data System (ADS)

Bonachela, Juan A.; Nadell, Carey D.; Xavier, João B.; Levin, Simon A.

2011-07-01

The emergent spatial patterns generated by growing bacterial colonies have been the focus of intense study in physics during the last twenty years. Both experimental and theoretical investigations have made possible a clear qualitative picture of the different structures that such colonies can exhibit, depending on the medium on which they are growing. However, there are relatively few quantitative descriptions of these patterns. In this paper, we use a mechanistically detailed simulation framework to measure the scaling exponents associated with the advancing fronts of bacterial colonies on hard agar substrata, aiming to discern the universality class to which the system belongs. We show that the universal behavior exhibited by the colonies can be much richer than previously reported, and we propose the possibility of up to four different sub-phases within the medium-to-high nutrient concentration regime. We hypothesize that the quenched disorder that characterizes one of these sub-phases is an emergent property of the growth and division of bacteria competing for limited space and nutrients.

46 CFR 308.551 - War risk insurance clearing agency agreement for cargo, Form MA-321.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false War risk insurance clearing agency agreement for cargo, Form MA-321. 308.551 Section 308.551 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance General § 308.551 War risk insurance...

The Emergence of Star Clusters

NASA Astrophysics Data System (ADS)

Calzetti, Daniela

2017-08-01

We propose to measure the timescale for the clearing of natal dust by young star clusters. We will augment existing archival UV-to-I imaging data with new WFC3/IR images at J, H, and Paschen-beta for a sample of six nearby star forming galaxies. Under the standard scenario that the clearing is performed by supernovae (> 3 Myr), simulations show that not enough ionizing photons can escape galaxies and reionize the Universe at z>6. However, the actual clearing timescale is poorly established. We will obtain accurate ages and extinctions for the embedded and emergent young clusters in our target galaxies, in order to: (1) determine whether dust clearing occurs before or after 3 Myr, (2) investigate environmental dependencies for the timescale, and (3) establish the principal mechanisms for enabling the escape of ionizing photons from galaxies. Our project provides the physical footing for future JWST observations aimed at determining the sources of reionization of the Universe. The combination of archival and new images will also equip the community with a lasting legacy of homogeneous UV-to-IR coverage for a sample of nearby galaxies.

TPACK: An Emerging Research and Development Tool for Teacher Educators

ERIC Educational Resources Information Center

Baran, Evrim; Chuang, Hsueh-Hua; Thompson, Ann

2011-01-01

TPACK (technological pedagogical content knowledge) has emerged as a clear and useful construct for researchers working to understand technology integration in learning and teaching. Whereas first generation TPACK work focused upon explaining and interpreting the construct, TPACK has now entered a second generation where the focus is upon using…

Analysis of good practice of public health Emergency Operations Centers.

PubMed

Xu, Min; Li, Shi-Xue

2015-08-01

To study the public health Emergency Operations Centers (EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Literature review was conducted to explore the EOCs of selected countries. The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

Personality subtypes in female pre-bariatric obese patients: do they differ in eating disorder symptoms, psychological complaints and coping behaviour?

PubMed

Claes, Laurence; Vandereycken, Walter; Vandeputte, An; Braet, Caroline

2013-01-01

In the pre-bariatric psychological assessment of 102 morbidly obese women, two personality subtypes emerged: a resilient/high functioning subtype with a 'normal' personality profile and an emotional dysregulated/ undercontrolled subtype, characterized by high neuroticism and low extraversion/conscientiousness. Emotional dysregulated/ undercontrolled patients showed more concerns about eating/weight/shape, more binge eating driven by emotions and external triggers, more psychological complaints (such as depression and anxiety) and more avoidance and depressive coping reactions than resilient/high functioning patients. Further research should clarify whether these clearly different psychological profiles are related to different outcomes (weight loss or well-being) of bariatric surgery. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

"Biocompatible" Neutral pH Low-GDP Peritoneal Dialysis Solutions: Much Ado About Nothing?

PubMed

Misra, Paraish S; Nessim, Sharon J; Perl, Jeffrey

2017-03-01

Adverse outcomes in peritoneal dialysis (PD), including PD related infections, the loss of residual kidney function (RKF), and longitudinal, deleterious changes in peritoneal membrane function continue to limit the long-term success of PD therapy. The observation that these deleterious changes occur upon exposure to conventional glucose-based PD solutions fuels the search for a more biocompatible PD solution. The development of a novel PD solution with a neutral pH, and lower in glucose degradation products (GDPs) compared to its conventional predecessors has been labeled a "biocompatible" solution. While considerable evidence in support of these novel solutions' biocompatibility has emerged from cell culture and animal studies, the clinical benefits as compared to conventional PD solutions are less clear. Neutral pH low GDP (NpHLGDP) PD solutions appear to be effective in reducing infusion pain, but their effects on other clinical endpoints including peritoneal membrane function, preservation of RKF, PD-related infections, and technique and patient survival are less clear. The literature is limited by studies characterized by relatively few patients, short follow-up time, heterogeneity with regards to the novel PD solution type under study, and the different patient populations under study. Nonetheless, the search for a more biocompatible PD solution continues with emerging data on promising non glucose-based solutions. © 2017 Wiley Periodicals, Inc.

New insights into flood warning reception and emergency response by affected parties

NASA Astrophysics Data System (ADS)

Kreibich, Heidi; Müller, Meike; Schröter, Kai; Thieken, Annegret H.

2017-11-01

Flood damage can be mitigated if the parties at risk are reached by flood warnings and if they know how to react appropriately. To gain more knowledge about warning reception and emergency response of private households and companies, surveys were undertaken after the August 2002 and the June 2013 floods in Germany. Despite pronounced regional differences, the results show a clear overall picture: in 2002, early warnings did not work well; e.g. many households (27 %) and companies (45 %) stated that they had not received any flood warnings. Additionally, the preparedness of private households and companies was low in 2002, mainly due to a lack of flood experience. After the 2002 flood, many initiatives were launched and investments undertaken to improve flood risk management, including early warnings and an emergency response in Germany. In 2013, only a small share of the affected households (5 %) and companies (3 %) were not reached by any warnings. Additionally, private households and companies were better prepared. For instance, the share of companies which have an emergency plan in place has increased from 10 % in 2002 to 34 % in 2013. However, there is still room for improvement, which needs to be triggered mainly by effective risk and emergency communication. The challenge is to continuously maintain and advance an integrated early warning and emergency response system even without the occurrence of extreme floods.

Chaos synchronization in networks of semiconductor superlattices

NASA Astrophysics Data System (ADS)

Li, Wen; Aviad, Yaara; Reidler, Igor; Song, Helun; Huang, Yuyang; Biermann, Klaus; Rosenbluh, Michael; Zhang, Yaohui; Grahn, Holger T.; Kanter, Ido

2015-11-01

Chaos synchronization has been demonstrated as a useful building block for various tasks in secure communications, including a source of all-electronic ultrafast physical random number generators based on room temperature spontaneous chaotic oscillations in a DC-biased weakly coupled GaAs/Al0.45Ga0.55As semiconductor superlattice (SSL). Here, we experimentally demonstrate the emergence of several types of chaos synchronization, e.g. leader-laggard, face-to-face and zero-lag synchronization in network motifs of coupled SSLs consisting of unidirectional and mutual coupling as well as self-feedback coupling. Each type of synchronization clearly reflects the symmetry of the topology of its network motif. The emergence of a chaotic SSL without external feedback and synchronization among different structured SSLs open up the possibility for advanced secure multi-user communication methods based on large networks of coupled SSLs.

Chikungunya virus: is this the next emerging disease threat to the americas?

PubMed

Girimont, Trina M

2014-12-01

Chikungunya fever is a mosquito-borne infection for which no cure or vaccine is available. It made its first appearance in the Americas in December 2013. Seven months later, two locally acquired cases of the disease emerged in the United States. The emergence of chikungunya fever cases in the Americas emphasizes the need for sustained vector control, clear public health information, and disease awareness and surveillance. Copyright 2014, SLACK Incorporated.

Machine-Learned Data Structures of Lipid Marker Serum Concentrations in Multiple Sclerosis Patients Differ from Those in Healthy Subjects

PubMed Central

Lötsch, Jörn; Thrun, Michael; Lerch, Florian; Brunkhorst, Robert; Schiffmann, Susanne; Thomas, Dominique; Tegder, Irmgard; Geisslinger, Gerd; Ultsch, Alfred

2017-01-01

Lipid signaling has been suggested to be a major pathophysiological mechanism of multiple sclerosis (MS). With the increasing knowledge about lipid signaling, acquired data become increasingly complex making bioinformatics necessary in lipid research. We used unsupervised machine-learning to analyze lipid marker serum concentrations, pursuing the hypothesis that for the most relevant markers the emerging data structures will coincide with the diagnosis of MS. Machine learning was implemented as emergent self-organizing feature maps (ESOM) combined with the U*-matrix visualization technique. The data space consisted of serum concentrations of three main classes of lipid markers comprising eicosanoids (d = 11 markers), ceramides (d = 10), and lyosophosphatidic acids (d = 6). They were analyzed in cohorts of MS patients (n = 102) and healthy subjects (n = 301). Clear data structures in the high-dimensional data space were observed in eicosanoid and ceramides serum concentrations whereas no clear structure could be found in lysophosphatidic acid concentrations. With ceramide concentrations, the structures that had emerged from unsupervised machine-learning almost completely overlapped with the known grouping of MS patients versus healthy subjects. This was only partly provided by eicosanoid serum concentrations. Thus, unsupervised machine-learning identified distinct data structures of bioactive lipid serum concentrations. These structures could be superimposed with the known grouping of MS patients versus healthy subjects, which was almost completely possible with ceramides. Therefore, based on the present analysis, ceramides are first-line candidates for further exploration as drug-gable targets or biomarkers in MS. PMID:28590455

46 CFR 308.551 - War risk insurance clearing agency agreement for cargo, Form MA-321.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 8 2012-10-01 2012-10-01 false War risk insurance clearing agency agreement for cargo, Form MA-321. 308.551 Section 308.551 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Iv-General § 308.551 War risk insurance...

46 CFR 308.551 - War risk insurance clearing agency agreement for cargo, Form MA-321.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false War risk insurance clearing agency agreement for cargo, Form MA-321. 308.551 Section 308.551 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Iv-General § 308.551 War risk insurance...

46 CFR 308.551 - War risk insurance clearing agency agreement for cargo, Form MA-321.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false War risk insurance clearing agency agreement for cargo, Form MA-321. 308.551 Section 308.551 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Iv-General § 308.551 War risk insurance...

46 CFR 308.551 - War risk insurance clearing agency agreement for cargo, Form MA-321.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false War risk insurance clearing agency agreement for cargo, Form MA-321. 308.551 Section 308.551 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Iv-General § 308.551 War risk insurance...

18 CFR 157.17 - Applications for temporary certificates in cases of emergency.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Applications for temporary certificates in cases of emergency. 157.17 Section 157.17 Conservation of Power and Water... responsible officer of applicant having knowledge of the facts, and must state clearly and specifically the...

17 CFR Appendix B to Part 36 - Guidance on, and Acceptable Practices in, Compliance With Core Principles

Code of Federal Regulations, 2010 CFR

2010-04-01

... decision-making process and the reasons for using its emergency action authority. Information on steps... have clear procedures and guidelines for decision-making regarding emergency intervention in the market, including procedures and guidelines to avoid conflicts of interest while carrying out such decision-making...

78 FR 23557 - Fipronil; Receipt of Application for Emergency Exemptions, Solicitation of Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... your concerns and suggest alternatives. vii. Explain your views as clearly as possible, avoiding the... population who, as a result of their location, cultural practices, or other factors, may have atypical or... that an emergency situation exists based upon three factors: A severe increase in cabbage maggot...

A video-based system and method for improving aircraft security

NASA Astrophysics Data System (ADS)

Ebenstein, Samuel E.; Smith, Gregory H.; Zorka, Nicholas G.; Rodin, Yelena M.; Meitzler, Thomas J.

2004-08-01

Commercial airplanes are now a weapon of mass destruction to be used in asymmetric warfare against the United States. There is a clear need for enhanced situational awareness within the passenger cabin of airplanes. If the crew suspected that the security of an aircraft had been compromised it would be critical for a crew member to be able to clearly and rapidly see what is occurring inside the passenger cabin without having to open the door to the cockpit. In case of emergency it would also be extremely valuable for ground personnel and aircraft responding to the emergency to be able to visually monitor what is happening inside the aircraft cabin.

Influence of Thunderstorms on the Structure of the Ionosphere using Composite Analysis

NASA Astrophysics Data System (ADS)

Nava, O.; Sutherland, E.

2017-12-01

It is well known in the amateur (ham) radio community that thunderstorms have a significant influence on local and long-distance high-frequency (HF) communications. This study aims to characterize the structure of the ionosphere in response to strong convective activity and cloud electrification. Superposed Epoch Analysis is applied to surface weather observations and ionosonde data at Eglin Air Force Base, Florida from August 2014 to July 2017. Preliminary results indicate that thunderstorms significantly modify the structure of the ionosphere, generating statistically different measurements of several key parameters (e.g., foEs, hmF2, ITEC) compared to clear-sky observations. Seasonal and diurnal influences between the thunderstorm and clear sky cases are also explored. Accurate characterization of the ionosphere in response to thunderstorms has important implications for the effective use of HF communications in civilian and military operations, to include emergency services, aviation, amateur radio, and over-the-horizon radar.

[Nanotechnology: a big revolution from the small world].

PubMed

Bassi, Matteo; Santinello, Irene; Bevilacqua, Andrea; Bassi, Pierfrancesco

2013-01-01

Nanotechnology is a multidisciplinary field originating from the interaction of several different disciplines, such as engineering, physics, biology and chemistry. New materials and devices effectively interact with the body at molecular level, yielding a brand new range of highly selective and targeted applications designed to maximize the therapeutic efficiency while reducing the side effects. Liposomes, quantum dots, carbon nanotubes and superparamagnetic nanoparticles are among the most assessed nanotechnologies. Meanwhile, other futuristic platforms are paving the way toward a new scientific paradigm, able to deeply change the research path in the medical science. The growth of nanotechnology, driven by the dramatic advances in science and technology, clearly creates new opportunities for the development of the medical science and disease treatment in human health care. Despite the concerns and the on-going studies about their safety, nanotechnology clearly emerges as holding the promise of delivering one of the greatest breakthroughs in the history of medical science.

Responsibility after the apparent end: 'following-up' in clinical ethics consultation.

PubMed

Finder, Stuart G; Bliton, Mark J

2011-09-01

Clinical ethics literature typically presents ethics consultations as having clear beginnings and clear ends. Experience in actual clinical ethics practice, however, reflects a different characterization, particularly when the moral experiences of ethics consultants are included in the discussion. In response, this article emphasizes listening and learning about moral experience as core activities associated with clinical ethics consultation. This focus reveals that responsibility in actual clinical ethics practice is generated within the moral scope of an ethics consultant's activities as she or he encounters the unique and specific features that emerge from interactions with a specific patient, or family, or practitioner within a given situation and over time. A long-form narrative about an ethics consultant's interactions is interwoven with a more didactic discussion to highlight the theme of responsibility and to probe questions that arise regarding follow-up within the practice of clinical ethics consultation. © 2011 Blackwell Publishing Ltd.

A new golden age: testing general relativity with cosmology.

PubMed

Bean, Rachel; Ferreira, Pedro G; Taylor, Andy

2011-12-28

Gravity drives the evolution of the Universe and is at the heart of its complexity. Einstein's field equations can be used to work out the detailed dynamics of space and time and to calculate the emergence of large-scale structure in the distribution of galaxies and radiation. Over the past few years, it has become clear that cosmological observations can be used not only to constrain different world models within the context of Einstein gravity but also to constrain the theory of gravity itself. In this article, we look at different aspects of this new field in which cosmology is used to test theories of gravity with a wide range of observations.

Psychophysical evidence for the number sense.

PubMed

Burr, David C; Anobile, Giovanni; Arrighi, Roberto

2017-02-19

It is now clear that most animals, including humans, possess an ability to rapidly estimate number. Some have questioned whether this ability arises from dedicated numerosity mechanisms, or is derived indirectly from judgements of density or other attributes. We describe a series of psychophysical experiments, largely using adaptation techniques, which demonstrate clearly the existence of a number sense in humans. The number sense is truly general, extending over space, time and sensory modality, and is closely linked with action. We further show that when multiple cues are present, numerosity emerges as the natural dimension for discrimination. However, when element density increases past a certain level, the elements become too crowded to parse, and the scene is perceived as a texture rather than array of elements. The two different regimes are psychophysically discriminable in that they follow distinct psychophysical laws, and show different dependencies on eccentricity, luminance levels and effects of perceptual grouping. The distinction is important, as the ability to discriminate numerosity, but not texture, correlates with formal maths skills.This article is part of the discussion meeting issue 'The origins of numerical abilities'. © 2017 The Authors.

The relationship of parental style to depression and self-esteem in adulthood.

PubMed

Lloyd, C; Miller, P M

1997-11-01

Previous studies have implicated low parental care and parental overprotection as risk factors for depression in adulthood. The present study further examined the association between perceived parental style and depression in two samples of medical students. In general, both low maternal and paternal care were associated with depression. Furthermore, maternal overprotection in the U.S. sample and paternal overprotection in the Scottish sample were also associated with depression. However, when results were analyzed separately for men and women, clear gender differences emerged, indicating that the observed relationships were occurring chiefly in the men, although there were some indications that low paternal care was associated with depression in women. Because such gender differences have not been previously reported, women medical students may be a unique group with respect to these relationships. Also intriguing was that although parental style characteristics demonstrated significant associations with self-esteem, this was clearly true only for men and not for women. Finally, the study provided the first partial support for the hypothesis that self-esteem mediates the relationship between parental style and depression.

Psychophysical evidence for the number sense

PubMed Central

2018-01-01

It is now clear that most animals, including humans, possess an ability to rapidly estimate number. Some have questioned whether this ability arises from dedicated numerosity mechanisms, or is derived indirectly from judgements of density or other attributes. We describe a series of psychophysical experiments, largely using adaptation techniques, which demonstrate clearly the existence of a number sense in humans. The number sense is truly general, extending over space, time and sensory modality, and is closely linked with action. We further show that when multiple cues are present, numerosity emerges as the natural dimension for discrimination. However, when element density increases past a certain level, the elements become too crowded to parse, and the scene is perceived as a texture rather than array of elements. The two different regimes are psychophysically discriminable in that they follow distinct psychophysical laws, and show different dependencies on eccentricity, luminance levels and effects of perceptual grouping. The distinction is important, as the ability to discriminate numerosity, but not texture, correlates with formal maths skills. This article is part of the discussion meeting issue ‘The origins of numerical abilities’. PMID:29292350

Examining pediatric emergency home ventilation practices in home health nurses: Opportunities for improved care.

PubMed

Kun, Sheila S; Beas, Virginia N; Keens, Thomas G; Ward, Sally S L; Gold, Jeffrey I

2015-07-01

To assess the pediatric home health nurses' knowledge in tracheostomy and ventilator emergency care on home mechanical ventilation (HMV). Emergencies are frightening experiences for solo home health nurses and require advanced skills in emergency response and care, especially in pediatric patients who pose unique challenges. Nurses with greater years of nursing experience would perform better on emergency HMV case-based scenarios than nurses with less years of experience. An exploratory online survey was used to evaluate emergency case-based pediatric scenarios. Demographic and professional experiences were profiled. Seventy-nine nurses had an average of 6.73 (SD = 1.41) years in pediatric nursing. Over 70% received their HMV training in their agency, 41% had less than 4 years of experience, and 30.4% had encountered at least one emergency situation at home. The online survey was distributed by managers of 22 home health agencies to nurses providing pediatric HMV care. Nurses scored an average of 4.87 out of 10 possible points. There were no significant differences between nurses with <4 years of experience versus those with more experience on ventilator alarms knowledge or total knowledge. Ninety-seven percent of the nurses favored more training in HMV from a variety of settings (e.g., agency, on-line training). Nurses did not perform well in case-based ventilator alarm scenarios. Length of nursing experience did not differentiate greater knowledge. It is clear that nurses require and want more training in emergency-based HMV. Recommendations for an enhanced curriculum are suggested. © 2014 Wiley Periodicals, Inc.

Sex differences in claimed and behavioral self-handicapping and ADHD symptomatology in emerging adults.

PubMed

Jaconis, Maryanne; Boyd, Stephen J; Hartung, Cynthia M; McCrea, Sean M; Lefler, Elizabeth K; Canu, Will H

2016-12-01

Although the research is clear that boys with ADHD have higher symptomatology and impairment than girls with ADHD, for adults the research is mixed. Some studies suggest no sex differences, whereas others suggest that women might have higher symptomatology and impairment. The present study examined sex differences in ADHD symptomatology and impairment, and the possible role of claimed and behavioral self-handicapping as an explanation for any differences. Claimed self-handicapping (CSH) involves reports of performance-inhibiting conditions, whereas behavioral self-handicapping (BSH) involves reporting more objective, intentional acts that could undermine performance. College students (N = 699) completed an online study. Sex differences were found for hyperactivity such that women reported higher levels, but not for inattention or impairment. The test of the indirect effect of sex through CSH was significant, suggesting that higher levels of CSH in women were associated with elevated ADHD symptoms and impairment. The test of the indirect effect of sex through BSH was also significant, suggesting that higher levels of BSH in men are associated with elevated symptoms of ADHD and impairment. These data extend the literature by suggesting that self-handicapping might at least partially explain differential self-reporting of ADHD symptoms and impairment in emerging adults across the sexes.

Developing protocols for obstetric emergencies.

PubMed

Roth, Cheryl K; Parfitt, Sheryl E; Hering, Sandra L; Dent, Sarah A

2014-01-01

There is potential for important steps to be missed in emergency situations, even in the presence of many health care team members. Developing a clear plan of response for common emergencies can ensure that no tasks are redundant or omitted, and can create a more controlled environment that promotes positive health outcomes. A multidisciplinary team was assembled in a large community hospital to create protocols that would help ensure optimum care and continuity of practice in cases of postpartum hemorrhage, shoulder dystocia, emergency cesarean surgical birth, eclamptic seizure and maternal code. Assignment of team roles and responsibilities led to the evolution of standardized protocols for each emergency situation. © 2014 AWHONN.

Feeding the Future: The Global Emergence of School Lunch Programs

ERIC Educational Resources Information Center

Rutledge, Jennifer Geist

2009-01-01

My dissertation is motivated by a puzzle of international social policy and norm emergence and diffusion. Today, children in one hundred and forty-one countries receive free or subsidized school lunches. Yet less than a century ago, no state had a national child nutrition policy. Feeding children was clearly not considered a state responsibility a…

Leadership. Heaven can wait.

PubMed

Alimo-Metcalfe, B; Alban-Metcalfe, R

2000-10-12

A major survey of some 2,000 NHS managers revealed a clear profile of the leadership qualities seen as important. The most important characteristic emerged as concern for others, followed by the ability to communicate and inspire. The picture which emerges is of the leader as servant, rather than hero. Developing leaders along these lines will require support from the centre.

Should we consider off-pump coronary artery bypass grafting in patients with acute coronary syndrome?

PubMed

Moscarelli, Marco; Harling, Leanne; Ashrafian, Hutan; Athanasiou, Thanos

2013-03-01

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether off-pump coronary artery bypass (OPCAB) grafting should be considered as an alternative to the conventional on-pump surgery (ONCAB) in patients presenting with acute coronary syndrome (ACS) requiring emergency revascularization. Eighty-two papers were identified by a systematic search, of which nine were judged to best answer the clinical question. Of these, one was a randomized controlled trial and the remaining eight were retrospective observational studies. The author, journal, date, patient group, country of publication, relevant outcomes, results and study weaknesses were tabulated. In total, these nine studies included 3001 patients (n = 817 OPCAB, 2184 ONCAB) undergoing emergency revascularization in the setting of ACS. The timing between the onset of ACS and operative intervention ranged from 6 to 72 h. All cases were categorized as urgent/emergent according to the National confidential enquiry into patient outcome and death classification of intervention. Six studies included patients with preoperative cardiogenic shock; however the majority of patients were haemodynamically stable at the time of surgery. Three out of nine studies showed an improvement in 30-day mortality with OPCAB although the remaining six reveal no significant mortality benefit. No difference in long-term mortality was observed between the two techniques. OPCAB was associated with significantly fewer grafts per patient (six studies) and less complete revascularization (two studies). We conclude that whilst OPCAB may have a beneficial effect on 30-day mortality in haemodynamically stable patients undergoing emergency revascularization, there is a lack of high-quality data with clearly defined patient demographics. Future studies must ensure adequate preoperative matching between OPCAB and ONCAB groups and clearly categorize haemodynamic status, disease pattern and time to surgery in order to determine the patients in whom OPCAB may confer the greatest benefit.

Adaptation responses to climate change differ between global megacities

NASA Astrophysics Data System (ADS)

Georgeson, Lucien; Maslin, Mark; Poessinouw, Martyn; Howard, Steve

2016-06-01

Urban areas are increasingly at risk from climate change, with negative impacts predicted for human health, the economy and ecosystems. These risks require responses from cities to improve their resilience. Policymakers need to understand current adaptation spend to plan comprehensively and effectively. Through the measurement of spend in the newly defined `adaptation economy', we analyse current climate change adaptation efforts in ten megacities. In all cases, the adaptation economy remains a small part of the overall economy, representing a maximum of 0.33% of a city's gross domestic product (here referred to as GDPc). Differences in total spend are significant between cities in developed, emerging and developing countries, ranging from #15 million to #1,600 million. Comparing key subsectors, we demonstrate the differences in adaptation profiles. Developing cities have higher proportional spend on health and agriculture, whereas developed cities have higher spend on energy and water. Spend per capita and percentage of GDPc comparisons more clearly show disparities between cities. Developing country cities spend half the proportion of GDPc and significantly less per capita, suggesting that adaptation spend is driven by wealth rather than the number of vulnerable people. This indicates that current adaptation activities are insufficient in major population centres in developing and emerging economies.

Hemodynamic and neurohormonal responses to extreme orthostatic stress in physically fit young adults

NASA Astrophysics Data System (ADS)

Grasser, E. K.; Goswami, N.; Rössler, A.; Vrecko, K.; Hinghofer-Szalkay, H.

2009-04-01

Blood pressure stability may be jeopardized in astronauts experiencing orthostatic stress. There is disagreement about cardiovascular and endocrine stress responses that emerge when a critical (presyncopal) state is reached. We studied hemodynamic and neurohormonal changes as induced by an orthostatic stress paradigm (head-up tilt combined with lower body negative pressure) that leads to a syncopal endpoint. From supine control to presyncope, heart rate increased by 78% and thoracic impedance by 12%. There was a 49% fall in stroke volume index, 19% in mean arterial blood pressure, 14% in total peripheral resistance index and 11% in plasma volume. Plasma norepinephrine rose by 107, epinephrine by 491, plasma renin activity by 167, and cortisol by 25%. Hemodynamic and hormonal changes of clearly different magnitude emerge in presyncope as compared to supine rest. Additional studies are warranted to reveal the exact time course of orthostatic changes up to syncopal levels.

Predictors of H1N1 influenza in the emergency department: proposition for a modified H1N1 case definition.

PubMed

Flick, H; Drescher, M; Prattes, J; Tovilo, K; Kessler, H H; Vander, K; Seeber, K; Palfner, M; Raggam, R B; Avian, A; Krause, R; Hoenigl, M

2014-02-01

Reliable and rapid diagnosis of influenza A H1N1 is essential to initiate appropriate antiviral therapy and preventive measures. We analysed the differences in clinical presentation and laboratory parameters between emergency department patients with PCR-confirmed H1N1 influenza infection (n = 199) and those with PCR-negative influenza-like illness (ILI; n = 252). Cough, wheezing, leucopenia, eosinopenia and a lower C-reactive protein remained significant predictors of H1N1 influenza. Proposed combinations of clinical symptoms with simple laboratory parameters (e.g. reported or measured fever and either cough or leucocytes <8.5 × 10(9) /L) were clearly superior to currently used official ILI case definitions that use clinical criteria alone. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Caffeine accelerates recovery from general anesthesia via multiple pathways.

PubMed

Fong, Robert; Khokhar, Suhail; Chowdhury, Atif N; Xie, Kelvin G; Wong, Josiah Hiu-Yuen; Fox, Aaron P; Xie, Zheng

2017-09-01

Various studies have explored different ways to speed emergence from anesthesia. Previously, we have shown that three drugs that elevate intracellular cAMP (forskolin, theophylline, and caffeine) accelerate emergence from anesthesia in rats. However, our earlier studies left two main questions unanswered. First, were cAMP-elevating drugs effective at all anesthetic concentrations? Second, given that caffeine was the most effective of the drugs tested, why was caffeine more effective than forskolin since both drugs elevate cAMP? In our current study, emergence time from anesthesia was measured in adult rats exposed to 3% isoflurane for 60 min. Caffeine dramatically accelerated emergence from anesthesia, even at the high level of anesthetic employed. Caffeine has multiple actions including blockade of adenosine receptors. We show that the selective A 2a adenosine receptor antagonist preladenant or the intracellular cAMP ([cAMP] i )-elevating drug forskolin, accelerated recovery from anesthesia. When preladenant and forskolin were tested together, the effect on anesthesia recovery time was additive indicating that these drugs operate via different pathways. Furthermore, the combination of preladenant and forskolin was about as effective as caffeine suggesting that both A 2A receptor blockade and [cAMP] i elevation play a role in caffeine's ability to accelerate emergence from anesthesia. Because anesthesia in rodents is thought to be similar to that in humans, these results suggest that caffeine might allow for rapid and uniform emergence from general anesthesia in humans at all anesthetic concentrations and that both the elevation of [cAMP] i and adenosine receptor blockade play a role in this response. NEW & NOTEWORTHY Currently, there is no method to accelerate emergence from anesthesia. Patients "wake" when they clear the anesthetic from their systems. Previously, we have shown that caffeine can accelerate emergence from anesthesia. In this study, we show that caffeine is effective even at high levels of anesthetic. We also show that caffeine operates by both elevating intracellular cAMP levels and by blocking adenosine receptors. This complicated pharmacology makes caffeine especially effective in accelerating emergence from anesthesia. Copyright © 2017 the American Physiological Society.

The expanding spectrum of human infections caused by Kocuria species: a case report and literature review

PubMed Central

Purty, Shashikala; Saranathan, Rajagopalan; Prashanth, K; Narayanan, K; Asir, Johny; Sheela Devi, Chandrakesan; Kumar Amarnath, Satish

2013-01-01

Although not previously known to cause human infections, Kocuria species have now emerged as human pathogens, mostly in compromised hosts with severe underlying disease. Recently, there has been an increasing incidence of different types of Kocuria infections reported, most likely due to the adoption of better identification methods. Here, we report a case of peritonitis caused by Kocuria rosea in a diabetic nephropathy patient who was on continuous ambulatory peritoneal dialysis. Sepsis and peritonitis caused by K. rosea in our case yielded two identical Kocuria isolates from the peritoneal dialysate fluid within a period of three days. The infection was subsequently resolved by antibiotic treatment and catheter removal. In addition to reporting this case, we herein review the literature concerning the emergence of Kocuria as a significant human pathogen. The majority of cases were device-related, acquired in the hospital or endogenous, and different Kocuria species appear to share a common etiology of peritonitis. The overall disease burden associated with Kocuria appears to be high, and the treatment guidelines for diseases associated with Kocuria have not yet been clearly defined. PMID:26038440

The limits of public communication coordination in a nuclear emergency: lessons from media reporting on the Fukushima case.

PubMed

Prezelj, Iztok; Perko, Tanja; Cantone, Marie C; Gallego, Eduardo; Tomkiv, Yevgeniya; Oughton, Deborah H

2016-06-01

Coordination of public communication has become a key issue in management of complex emergencies, and is a matter of debate between nuclear emergency management professionals. A particular problem is when inconsistent information is sent to the media and public by official sources from different levels, which has led to calls for a more coordinated approach. The IAEA created guidelines recommending a one-voice communication approach that provides clear, consistent and coordinated information by relevant stakeholders. The reviewed theory on the emergency communication coordination and the empirical results in this paper demonstrate some challenges regarding the feasibility of the above stated goal. This paper explores the communication process in the two-month period of the Fukushima nuclear emergency by using a quantitative comparative content and discourse analysis of 1340 printed media articles on the Fukushima nuclear disaster from two major newspapers in Spain ('El País' and 'El Mundo'), Italy ('Corriere della Sera' and 'La Repubblica'), Norway ('Aftenposten' and 'Dagsavisen'), Slovenia ('Delo' and 'Večer'), Belgium ('Le Soir' and 'De Standaard') and Russia ('Komsomolskaya Pravda' and 'Izvestiya'). The results show that it will be difficult to achieve a truly coordinated approach and one-voice communication in severe nuclear and radiological emergency due to the communication difficulties created by the dispersion of information sources, a broad and dispersed focus of the reported information, partially subjective and conflicting media reporting. The paper suggests ways to improve public communication coordination in nuclear and radiological disasters.

Health care disparities in emergency medicine.

PubMed

Cone, David C; Richardson, Lynne D; Todd, Knox H; Betancourt, Joseph R; Lowe, Robert A

2003-11-01

The Institute of Medicine's landmark report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," documents the pervasiveness of racial and ethnic disparities in the U.S. health care delivery system, and provides several recommendations to address them. It is clear from research data, such as those demonstrating racial and ethnic disparities in emergency department (ED) pain management, that emergency medicine (EM) is not immune to this problem. The IOM authors describe two strategies that can reduce disparities in EM. First, workforce diversity is likely to result in a community of emergency physicians who are better prepared to understand, learn from, and collaborate with persons from other racial, ethnic, and cultural backgrounds, whether these be patients, fellow clinicians, or the larger medical and scientific community. Given the ethical and practical advantages of a more diverse EM workforce, continued and expanded initiatives to increase diversity within EM should be undertaken. Second, the specialty's educational programs should produce emergency physicians with the skills and knowledge needed to serve an increasingly diverse population. This cultural competence should include an awareness of existing racial and ethnic health disparities, recognition of the risks of stereotyping and biased treatment, and knowledge of the incidence and prevalence of health conditions among diverse populations. Culturally competent emergency care providers also possess the skills to identify and manage racial and ethnic differences in health values, beliefs, and behaviors with the ultimate goal of delivering quality health services to all patients cared for in EDs.

Investigation of Slow-wave Activity Saturation during Surgical Anesthesia Reveals a Signature of Neural Inertia in Humans.

PubMed

Warnaby, Catherine E; Sleigh, Jamie W; Hight, Darren; Jbabdi, Saad; Tracey, Irene

2017-10-01

Previously, we showed experimentally that saturation of slow-wave activity provides a potentially individualized neurophysiologic endpoint for perception loss during anesthesia. Furthermore, it is clear that induction and emergence from anesthesia are not symmetrically reversible processes. The observed hysteresis is potentially underpinned by a neural inertia mechanism as proposed in animal studies. In an advanced secondary analysis of 393 individual electroencephalographic data sets, we used slow-wave activity dose-response relationships to parameterize slow-wave activity saturation during induction and emergence from surgical anesthesia. We determined whether neural inertia exists in humans by comparing slow-wave activity dose responses on induction and emergence. Slow-wave activity saturation occurs for different anesthetics and when opioids and muscle relaxants are used during surgery. There was wide interpatient variability in the hypnotic concentrations required to achieve slow-wave activity saturation. Age negatively correlated with power at slow-wave activity saturation. On emergence, we observed abrupt decreases in slow-wave activity dose responses coincident with recovery of behavioral responsiveness in ~33% individuals. These patients are more likely to have lower power at slow-wave activity saturation, be older, and suffer from short-term confusion on emergence. Slow-wave activity saturation during surgical anesthesia implies that large variability in dosing is required to achieve a targeted potential loss of perception in individual patients. A signature for neural inertia in humans is the maintenance of slow-wave activity even in the presence of very-low hypnotic concentrations during emergence from anesthesia.

Development and current applications of assisted fertilization.

PubMed

Palermo, Gianpiero D; Neri, Queenie V; Monahan, Devin; Kocent, Justin; Rosenwaks, Zev

2012-02-01

Since the very early establishment of in vitro insemination, it became clear that one of the limiting steps is the achievement of fertilization. Among the different assisted fertilization methods, intracytoplasmic sperm injection emerged as the ultimate technique to allow fertilization with ejaculated, epididymal, and testicular spermatozoa. This work describes the early steps that brought forth the development of intracytoplasmic sperm injection and its role in assisted reproductive techniques. The current methods to select the preferential male gamete will be elucidated and the concerns related to the offspring of severe male factor couples will be discussed. Copyright © 2012. Published by Elsevier Inc.

Employee contributions: a primer on their use, historical trends and overall fit within benefits strategy.

PubMed

Peters, Hudson A

2007-01-01

This article focuses on the use of employee contributions as a strategic tool within employee health plans. While most employers require some form of employee contributions for health care, there is no clear "one-size-fits-all" solution. A myriad of strategies are in place, some active and some passive. This article reviews both common and emerging strategies and how they differ based on industry, employer size and region; discusses how employee contribution strategy fits within overall benefits strategy; and provides a strategic framework for approaching employee contributions in the future.

Biopharmaceutical industry-sponsored global clinical trials in emerging countries.

PubMed

Alvarenga, Lenio Souza; Martins, Elisabeth Nogueira

2010-01-01

To evaluate biopharmaceutical industry-sponsored clinical trials placed in countries previously described as emerging regions for clinical research, and potential differences for those placed in Brazil. Data regarding recruitment of subjects for clinical trials were retrieved from www.clinicaltrials.gov on February 2nd 2009. Proportions of sites in each country were compared among emerging countries. Multiple logistic regressions were performed to evaluate whether trial placement in Brazil could be predicted by trial location in other countries and/or by trial features. A total of 8,501 trials were then active and 1,170 (13.8%) included sites in emerging countries (i.e., Argentina, Brazil, China, Czech Republic, Hungary, India, Mexico, Poland, Russia, South Korea, and South Africa). South Korea and China presented a significantly higher proportion of sites when compared to other countries (p<0.05). Multiple logistic regressions detected no negative correlation between placement in other countries when compared to Brazil. Trials involving subjects with less than 15 years of age, those with targeted recruitment of at least 1,000 subjects, and seven sponsors were identified as significant predictors of trial placement in Brazil. No clear direct competition between Brazil and other emerging countries was detected. South Korea showed the higher proportion of sites and ranked third in total number of trials, appearing as a major player in attractiveness for biopharmaceutical industry-sponsored clinical trials.

Social media in disaster risk reduction and crisis management.

PubMed

Alexander, David E

2014-09-01

This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.

Emergencies planning and response: Coupling an exposure model with different atmospheric dispersion models

NASA Astrophysics Data System (ADS)

Sanchez, E. Y.; Colman Lerner, J. E.; Porta, A.; Jacovkis, P. M.

2013-11-01

Information on spatial and time dependent concentration patterns of hazardous substances, as well as on the potential effects on population, is necessary to assist in chemical emergency planning and response. To that end, some models predict transport and dispersion of hazardous substances, and others estimate potential effects upon exposed population. Taken together, both groups constitute a powerful tool to estimate vulnerable regions and to evaluate environmental impact upon affected populations. The development of methodologies and models with direct application to the context in which we live allows us to draft a more clear representation of the risk scenario and, hence, to obtain the adequate tools for an optimal response. By means of the recently developed DDC (Damage Differential Coupling) exposure model, it was possible to optimize, from both the qualitative and the quantitative points of view, the estimation of the population affected by a toxic cloud, because the DDC model has a very good capacity to couple with different atmospheric dispersion models able to provide data over time. In this way, DDC analyzes the different concentration profiles (output from the transport model) associating them with some reference concentration to identify risk zones. In this work we present a disaster scenario in Chicago (USA), by coupling DDC with two transport models of different complexity, showing the close relationship between a representative result and the run time of the models. In the same way, it becomes evident that knowing the time evolution of the toxic cloud and of the affected regions significantly improves the probability of taking the correct decisions on planning and response facing the emergency.

Differential host growth regulation by the solitary endoparasitoid, Meteorus pulchricornis in two hosts of greatly differing mass.

PubMed

Harvey, Jeffrey A; Sano, Takeshi; Tanaka, Toshiharu

2010-09-01

Solitary koinobiont endoparasitoids generally reduce the growth of their hosts by a significant amount compared with healthy larvae. Here, we compared the development and host usage strategies of the solitary koinobiont endoparasitoid, Meteorus pulchricornis, when developing in larvae of a large host species (Mythimna separata) and a much smaller host species (Plutella xylostella). Caterpillars of M. separata were parasitized as L2 and P. xylostella as L3, when they weighed approximately 2mg. The growth of parasitized M. separata larvae was reduced by almost 95% compared with controls, whereas parasitized P. xylostella larvae grew some 30% larger than controls. Still, adult wasps emerging from M. separata larvae were almost twice as large as wasps emerging from P. xylostella larvae, had larger egg loads after 5 days and produced more progeny. Survival to eclosion was also higher on M. separata than on P. xylostella, although parasitoids developed significantly faster when developing on P. xylostella. Our results provide evidence that koinobionts are able to differentially regulate the growth of different host species. However, there are clearly also limitations in the ability of parasitoids to regulate phenotypic host traits when size differences between different host species are as extreme as demonstrated here.

Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000-2015.

PubMed

Hinsliff-Smith, Kathryn; McGarry, Julie

2017-12-01

To identify, review and critically evaluate published empirical studies concerned with the prevalence, management and support for survivors of domestic violence and abuse who present at emergency department. Domestic violence and abuse is a global phenomenon with a wealth of studies that explore the different aspects of the issue including the economic, social and health effects on survivors and on society as a whole. Emergency department is widely recognised as one healthcare facility where domestic violence and abuse survivors will often disclose domestic violence and abuse. In the UK, National Institute of Clinical Excellence produced guidelines in 2014 requiring all sectors of health care and those they work alongside to recognise support and manage survivors of domestic violence and abuse. Whilst there is an increasing body of research on domestic violence and abuse, limited synthesised work has been conducted in the context of domestic violence and abuse within emergency department. This review encompasses empirical studies conducted in emergency department for screening interventions, management and support for domestic violence and abuse patients including prevalence. This review included studies that included emergency department staff, emergency department service users and domestic violence and abuse survivors. A systematic approach across five electronic bibliographic databases found 35 studies meeting the inclusion criteria published between 2000-2015. From the 35 studies, four descriptive overarching themes were identified (i) prevalence of domestic violence and abuse in emergency department, (ii) use of domestic violence and abuse screening tools and emergency department interventions, (iii) current obstacles for staff working in emergency department and (iv) emergency department users and survivor perspectives. Having knowledgeable and supportive emergency department staff can have a positive benefit for the longer-term health of the domestic violence and abuse survivor who seeks help. The physical characteristics of domestic violence and abuse are often easier to identify and manage, but emotional and psychological aspects of domestic violence and abuse are often more complex and difficult for staff to identify. This therefore raises questions as to what approaches can be used, within these busy settings, when often survivors do not want to disclose. Domestic violence and abuse has been shown to have a direct impact on the health and well-being of survivors who will often access emergency department services with direct injuries and associated medical conditions. This article is relevant to those working in the emergency department in raising awareness in a number of areas of practice for example the prevalence of male intimate partner violence survivors. Furthermore, patients do not always disclose domestic violence and abuse even in cases where there is clear sustained injury thus requiring staff to be vigilant to repeat attendees and patient history. This requires a well-maintained and effective reporting system for instances of suspected and disclosed domestic violence and abuse in order that staff can provide the appropriate care and support. Emergency department staff often deal with complex cases, this includes different aspects of domestic violence and abuse including physical, emotional and psychological abuse. Continual support and guidance, including educational interventions, would assist emergency department clinical staff to manage and discuss instances of domestic violence and abuse in their workplace and their interactions with domestic violence and abuse patients. Whilst training for emergency department staff is welcomed, there also needs to be a greater awareness of the potential complexity of domestic violence and abuse presentations beyond physical injury in order for staff to remain observant throughout consultations. It is also suggested that clear domestic violence and abuse assessment and referral mechanisms should be embedded into clinical practice, including emergency department, as described in the UK National Institute of Clinical Excellence guidelines (2014). Overall improvements in reporting mechanisms in emergency department for the identification, management and support for domestic violence and abuse survivors would add to the collective and growing body of evidence surrounding domestic violence and abuse and their presentations within healthcare settings. Such measures would enable those working in emergency department to support disclosure of domestic violence and abuse more effectively. © 2017 John Wiley & Sons Ltd.

Meanings, Mechanisms, and Measures of Holistic Processing

PubMed Central

Richler, Jennifer J.; Palmeri, Thomas J.; Gauthier, Isabel

2012-01-01

Few concepts are more central to the study of face recognition than holistic processing. Progress toward understanding holistic processing is challenging because the term “holistic” has many meanings, with different researchers addressing different mechanisms and favoring different measures. While in principle the use of different measures should provide converging evidence for a common theoretical construct, convergence has been slow to emerge. We explore why this is the case. One challenge is that “holistic processing” is often used to describe both a theoretical construct and a measured effect, which may not have a one-to-one mapping. Progress requires more than greater precision in terminology regarding different measures of holistic processing or different hypothesized mechanisms of holistic processing. Researchers also need to be explicit about what meaning of holistic processing they are investigating so that it is clear whether different researchers are describing the same phenomenon or not. Face recognition differs from object recognition, and not all meanings of holistic processing are equally suited to help us understand that important difference. PMID:23248611

Meanings, mechanisms, and measures of holistic processing.

PubMed

Richler, Jennifer J; Palmeri, Thomas J; Gauthier, Isabel

2012-01-01

Few concepts are more central to the study of face recognition than holistic processing. Progress toward understanding holistic processing is challenging because the term "holistic" has many meanings, with different researchers addressing different mechanisms and favoring different measures. While in principle the use of different measures should provide converging evidence for a common theoretical construct, convergence has been slow to emerge. We explore why this is the case. One challenge is that "holistic processing" is often used to describe both a theoretical construct and a measured effect, which may not have a one-to-one mapping. Progress requires more than greater precision in terminology regarding different measures of holistic processing or different hypothesized mechanisms of holistic processing. Researchers also need to be explicit about what meaning of holistic processing they are investigating so that it is clear whether different researchers are describing the same phenomenon or not. Face recognition differs from object recognition, and not all meanings of holistic processing are equally suited to help us understand that important difference.

Comparison of Microclimate Simulated weather data to ASHRAE Clear Sky Model and Measured Data

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

Bhandari, Mahabir S.

In anticipation of emerging global urbanization and its impact on microclimate, a need exists to better understand and quantify microclimate effects on building energy use. Satisfaction of this need will require coordinated research of microclimate impacts on and from “human systems.” The Urban Microclimate and Energy Tool (Urban-MET) project seeks to address this need by quantifying and analyzing the relationships among climatic conditions, urban morphology, land cover, and energy use; and using these relationships to inform energy-efficient urban development and planning. Initial research will focus on analysis of measured and modeled energy efficiency of various building types in selected urbanmore » areas and temporal variations in energy use for different urban morphologies under different microclimatic conditions. In this report, we analyze the differences between microclimate weather data sets for the Oak Ridge National Laboratory campus produced by ENVI-met and Weather Research Forecast (WRF) models, the ASHRAE clear sky which defines the maximum amounts of solar radiation that can be expected, and measured data from a weather station on campus. Errors with climate variables and their impact on building energy consumption will be shown for the microclimate simulations to help prioritize future improvement for use in microclimate simulation impacts to energy use of buildings.« less

Clear-Sky Narrowband Albedo Variations Derived from VIRS and MODIS Data

NASA Technical Reports Server (NTRS)

Sun-Mack, Sunny; Chen, Yan; Arduini, Robert F.; Minnis, Patrick

2004-01-01

A critical parameter for detecting clouds and aerosols and for retrieving their microphysical properties is the clear-sky radiance. The Clouds and the Earth's Radiant Energy System (CERES) Project uses the visible (VIS; 0.63 m) and near-infrared (NIR; 1.6 or 2.13 m) channels available on same satellites as the CERES scanners. Another channel often used for cloud and aerosol, and vegetation cover retrievals is the vegetation (VEG; 0.86- m) channel that has been available on the Advanced Very High Resolution Radiometer (AVHRR) for many years. Generally, clear-sky albedo for a given surface type is determined for conditions when the vegetation is either thriving or dormant and free of snow. Snow albedo is typically estimated without considering the underlying surface type. The albedo for a surface blanketed by snow, however, should vary with surface type because the vegetation often emerges from the snow to varying degrees depending on the vertical dimensions of the vegetation. For example, a snowcovered prairie will probably be brighter than a snowcovered forest because the snow typically falls off the trees exposing the darker surfaces while the snow on a grassland at the same temperatures will likely be continuous and, therefore, more reflective. Accounting for the vegetation-induced differences should improve the capabilities for distinguishing snow and clouds over different surface types and facilitate improvements in the accuracy of radiative transfer calculations between the snow-covered surface and the atmosphere, eventually leading to improvements in models of the energy budgets over land. This paper presents a more complete analysis of the CERES spectral clear-sky reflectances to determine the variations in clear-sky top-of-atmosphere (TOA) albedos for both snow-free and snow-covered surfaces for four spectral channels using data from Terra and Aqua.. The results should be valuable for improved cloud retrievals and for modeling radiation fields.

A case of timely satellite image acquisitions in support of coastal emergency environmental response management

USGS Publications Warehouse

Ramsey, Elijah W.; Werle, Dirk; Lu, Zhong; Rangoonwala, Amina; Suzuoki, Yukihiro

2009-01-01

The synergistic application of optical and radar satellite imagery improves emergency response and advance coastal monitoring from the realm of “opportunistic” to that of “strategic.” As illustrated by the Hurricane Ike example, synthetic aperture radar imaging capabilities are clearly applicable for emergency response operations, but they are also relevant to emergency environmental management. Integrated with optical monitoring, the nearly real-time availability of synthetic aperture radar provides superior consistency in status and trends monitoring and enhanced information concerning causal forces of change that are critical to coastal resource sustainability, including flooding extent, depth, and frequency.

Eye emergencies

MedlinePlus

... tissue covering the front of the eye. Dust, sand, and other debris can easily enter the eye. ... clear itself of tiny objects, like eyelashes and sand, through blinking and tearing. If not, don't ...

Emergency Communication: A Unique Work in Progress for Those with Disabilities

ERIC Educational Resources Information Center

Murphy, Patti

2009-01-01

Clear communication in the best of human circumstances is often a work in progress, a goal yet to be attained. Efforts to make it happen in an emergency may be thwarted by the shock and distress of people involved or the need to get to a safe place fast. Unique complications may arise for people with limited, if any, natural speech and who are…

Diagnostic utility of hepatocyte nuclear factor 1-beta immunoreactivity in endometrial carcinomas: lack of specificity for endometrial clear cell carcinoma.

PubMed

Fadare, Oluwole; Liang, Sharon X

2012-12-01

Hepatocyte nuclear factor 1-beta (HNF1β) has recently emerged as a relatively sensitive and specific marker for ovarian clear cell carcinoma. The purpose of this study is to assess the diagnostic utility of this marker for endometrial clear cell carcinoma. Immunohistochemical analysis was performed on 75 endometrial tissues using a goat polyclonal antibody raised against a peptide mapping at the C-terminus of human HNF1β protein. The 75 cases included 15 clear cell carcinomas, 20 endometrioid carcinomas, 15 endometrial serous carcinomas/uterine papillary serous carcinomas, 20 cases of normal endometrium, 2 cases of clear cell metaplasia, and 3 cases of Arias Stella reaction. Staining interpretations were based on a semiquantitative scoring system, a 0 to 12+ continuous numerical scale that was derived by multiplying the extent of staining (0 to 4+ scale) by the intensity of staining (0 to 3+ scale) for each case. HNF1β expression was found to be present in a wide spectrum of tissues. Twenty-seven (54%) of the 50 carcinomas displayed at least focal nuclear HNF1β expression, including 11 (73%) of 15, 9 (60%) of 15, and 7 (35%) of 20 clear cell, serous, and endometrioid carcinomas, respectively. The average nuclear staining scores for clear cell carcinomas, endometrioid carcinomas, and serous carcinomas were 5.2, 1.4, and 4.1, respectively. Clear cell carcinomas and endometrioid carcinomas displayed statistically significant differences regarding their nuclear staining scores (P = 0.0027), but clear cell carcinomas and endometrial serous carcinomas did not (P = 0.45). The calculated sensitivity of any nuclear HNF1β expression in classifying a carcinoma as being of the clear cell histotype was 73%, whereas the specificity was 54%. Nineteen of 20 normal endometrium samples displayed at least focal nuclear expression of HNF1β, and this expression was often diffuse. The 5 cases of benign histologic mimics of clear cell carcinomas (Arias Stella reaction and clear cell metaplasia) displayed some degree of HNF1β immunoreactivity, with an average nuclear staining score of 7.3. We conclude that although HNF1β is frequently expressed in clear cell carcinomas, it should be used with caution as a diagnostic marker because of its lack of specificity. It neither distinguishes endometrial serous carcinomas from clear cell carcinomas nor clear cell carcinomas from its benign mimics. The greatest diagnostic utility of HNF1β expression may be in a supportive evidentiary role favoring clear cell carcinoma when the principal differential diagnostic consideration is endometrioid carcinoma.

[Deontology in generalists-specialists relations in domestic emergencies].

PubMed

Leemans, P

2000-09-01

The deontological rules defining the relations between the general practitioners and specialists about domestic emergencies are clearly exposed in the code edited by the National Medical Council of Belgium. Ethical particularities exist. During an emergency situation, the patient could lose his freedom as well as his autonomy and might become a technical subject rather than an ethical person. The ethical values are in opposition with a medical practice trying to be more and more efficient with as a corollary, the necessity to have a full and permanent access to personal medical data.

Bacterial fitness shapes the population dynamics of antibiotic-resistant and -susceptible bacteria in a model of combined antibiotic and anti-virulence treatment

PubMed Central

Ternent, Lucy; Dyson, Rosemary J.; Krachler, Anne-Marie; Jabbari, Sara

2015-01-01

Bacterial resistance to antibiotic treatment is a huge concern: introduction of any new antibiotic is shortly followed by the emergence of resistant bacterial isolates in the clinic. This issue is compounded by a severe lack of new antibiotics reaching the market. The significant rise in clinical resistance to antibiotics is especially problematic in nosocomial infections, where already vulnerable patients may fail to respond to treatment, causing even greater health concern. A recent focus has been on the development of anti-virulence drugs as a second line of defence in the treatment of antibiotic-resistant infections. This treatment, which weakens bacteria by reducing their virulence rather than killing them, should allow infections to be cleared through the body׳s natural defence mechanisms. In this way there should be little to no selective pressure exerted on the organism and, as such, a predominantly resistant population should be less likely to emerge. However, before the likelihood of resistance to these novel drugs emerging can be predicted, we must first establish whether such drugs can actually be effective. Many believe that anti-virulence drugs would not be powerful enough to clear existing infections, restricting their potential application to prophylaxis. We have developed a mathematical model that provides a theoretical framework to reveal the circumstances under which anti-virulence drugs may or may not be successful. We demonstrate that by harnessing and combining the advantages of antibiotics with those provided by anti-virulence drugs, given infection-specific parameters, it is possible to identify treatment strategies that would efficiently clear bacterial infections, while preventing the emergence of antibiotic-resistant subpopulations. Our findings strongly support the continuation of research into anti-virulence drugs and demonstrate that their applicability may reach beyond infection prevention. PMID:25701634

Informed consumer or unlucky visitor? A profile of German patients who received dental services abroad.

PubMed

Panteli, Dimitra; Augustin, Uta; Röttger, Julia; Struckmann, Verena; Verheyen, Frank; Wagner, Caroline; Busse, Reinhard

2015-10-01

A common characteristic of sending countries in cross-border dental care is that of high costs and/or high copayments for dental services. This study aims to provide an insight into the characteristics of German patients receiving planned and emergency (unplanned) dental care abroad and their satisfaction with received services. The Europabefragung is a postal survey carried out by Techniker Krankenkasse for patients who are treated in EU/EEA countries. This study uses data from the Europabefragung 2012. The survey was sent to 45 189 individuals; descriptive statistics for the subset of respondents who received emergency (unplanned) or planned dental treatment are presented. There were 18 339 responses to the questionnaire, out of which 17 543 were deemed valid; 1416 respondents had received emergency (unplanned) (78%) or planned (22%) dental care and were included in the analysis. There were clear differences between unplanned and planned treatments regarding country and type of treatment as well as satisfaction with different aspects of treatment and the need for follow-up care. Overall, satisfaction with treatment was high for both groups; individuals who had received planned treatment were more satisfied on all aspects of care and reported a need for follow-up care less frequently. While German patients who received both emergency (unplanned) and planned services abroad are mostly satisfied with their experience, some concerns arise with regard to continuity of care. Types of information provided to patients seeking care abroad and dissemination modalities should be carefully planned. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of root length on epicotyl dormancy release in seeds of Paeonia ludlowii, Tibetan peony.

PubMed

Hao, Hai-ping; He, Zhi; Li, Hui; Shi, Lei; Tang, Yu-Dan

2014-02-01

Epicotyl dormancy break in seeds that have deep simple epicotyl morphophysiological dormancy (MPD) requires radicle emergence and even a certain root length in some species. However, the mechanisms by which root length affects epicotyl dormancy break are not clear at present. This study aims to explore the relationship between root length and epicotyl dormancy release in radicle-emerged seeds of Tibetan peony, Paeonia ludlowii, with discussion of the possible mechanisms. Radicle-emerged seeds (radicle length 1.5, 3.0, 4.5 and 6.0 cm) were incubated at 5, 10 and 15 °C. During the stratification, some seeds were transferred to 15 °C and monitored for epicotyl-plumule growth. Hormone content was determined by ELISA, and the role of hormones in epicotyl dormancy release was tested by exogenous hormone and embryo culture. Cold stratification did not break the epicotyl dormancy until the root length was ≥6 cm. The indole-3-actic acid (IAA) and GA3 contents of seeds having 6 cm roots were significantly higher than those of seeds with other root lengths, but the abscisic acid (ABA) content was lowest among radicle-emerged seeds. GA3 (400 mg L(-1)) could break epicotyl dormancy of all radicle-emerged seeds, while IAA (200 mg L(-1)) had little or no effect. When grown on MS medium, radicles of naked embryos grew and cotyledons turned green, but epicotyls did not elongate. Naked embryos developed into seedlings on a mixed medium of MS + 100 mg L(-1) GA3. A root length of ≥6.0 cm is necessary for epicotyl dormancy release by cold stratification. The underlying reason for root length affecting epicotyl dormancy release is a difference in the GA3/ABA ratio in the epicotyl within radicle-emerged seeds, which is mainly as a result of a difference in ABA accumulation before cold stratification.

Effect of root length on epicotyl dormancy release in seeds of Paeonia ludlowii, Tibetan peony

PubMed Central

Hao, Hai-ping; He, Zhi; Li, Hui; Shi, Lei; Tang, Yu-Dan

2014-01-01

Background and Aims Epicotyl dormancy break in seeds that have deep simple epicotyl morphophysiological dormancy (MPD) requires radicle emergence and even a certain root length in some species. However, the mechanisms by which root length affects epicotyl dormancy break are not clear at present. This study aims to explore the relationship between root length and epicotyl dormancy release in radicle-emerged seeds of Tibetan peony, Paeonia ludlowii, with discussion of the possible mechanisms. Methods Radicle-emerged seeds (radicle length 1·5, 3·0, 4·5 and 6·0 cm) were incubated at 5, 10 and 15 °C. During the stratification, some seeds were transferred to 15 °C and monitored for epicotyl–plumule growth. Hormone content was determined by ELISA, and the role of hormones in epicotyl dormancy release was tested by exogenous hormone and embryo culture. Key Results Cold stratification did not break the epicotyl dormancy until the root length was ≥6 cm. The indole-3-actic acid (IAA) and GA3 contents of seeds having 6 cm roots were significantly higher than those of seeds with other root lengths, but the abscisic acid (ABA) content was lowest among radicle-emerged seeds. GA3 (400 mg L−1) could break epicotyl dormancy of all radicle-emerged seeds, while IAA (200 mg L−1) had little or no effect. When grown on MS medium, radicles of naked embryos grew and cotyledons turned green, but epicotyls did not elongate. Naked embryos developed into seedlings on a mixed medium of MS + 100 mg L−1 GA3. Conclusions A root length of ≥6·0 cm is necessary for epicotyl dormancy release by cold stratification. The underlying reason for root length affecting epicotyl dormancy release is a difference in the GA3/ABA ratio in the epicotyl within radicle-emerged seeds, which is mainly as a result of a difference in ABA accumulation before cold stratification. PMID:24284815

Effects of vegetation management on plant diversity in traditional irrigation systems.

PubMed

Sánchez Martín, R; Jiménez, M N; Navarro, F B

2018-06-22

Acequias are historical community-operated water channels used for irrigating of traditional farming areas (vegas). They have been traditionally managed by local inhabitants, either by clearing weeds or by burning them in winter, in order to keep the channels clean of vegetation, thus avoiding their clogging. The impact of these cultural practices on vegetation has not still been studied. The aim of this paper is to show how traditional management influences floristic biodiversity in a traditional acequia in the vega of Granada (SE Spain). The acequia was treated following the traditional methodology used by farmers, being divided into areas that were burned, cleared, or left unchanged as control (January 2016). Afterwards, we collected soil samples and analyzed them in the lab to determine the treatment effects on soil properties. Vegetation was monitored in late spring 2016 in order to detect differences between treatments. Traditional management increased plant diversity, this effect being much more patent for the burning than for clearing treatment. Soil analyses revealed only slight differences in pH and CaCO 3 content, higher for the burning treatment. The increase in plant diversity found in areas treated by traditional management was due mainly to the reduction of competition, which promoted the emergence or increase of populations of non-dominant species. The results indicated that traditional management not only offers advantages to the farmers but also promotes plant diversity and ecosystem services. Copyright © 2018 Elsevier Ltd. All rights reserved.

Genetic and environmental influences on adult human height across birth cohorts from 1886 to 1994.

PubMed

Jelenkovic, Aline; Hur, Yoon-Mi; Sund, Reijo; Yokoyama, Yoshie; Siribaddana, Sisira H; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Tan, Qihua; Zhang, Dongfeng; Pang, Zengchang; Aaltonen, Sari; Heikkilä, Kauko; Öncel, Sevgi Y; Aliev, Fazil; Rebato, Esther; Tarnoki, Adam D; Tarnoki, David L; Christensen, Kaare; Skytthe, Axel; Kyvik, Kirsten O; Silberg, Judy L; Eaves, Lindon J; Maes, Hermine H; Cutler, Tessa L; Hopper, John L; Ordoñana, Juan R; Sánchez-Romera, Juan F; Colodro-Conde, Lucia; Cozen, Wendy; Hwang, Amie E; Mack, Thomas M; Sung, Joohon; Song, Yun-Mi; Yang, Sarah; Lee, Kayoung; Franz, Carol E; Kremen, William S; Lyons, Michael J; Busjahn, Andreas; Nelson, Tracy L; Whitfield, Keith E; Kandler, Christian; Jang, Kerry L; Gatz, Margaret; Butler, David A; Stazi, Maria A; Fagnani, Corrado; D'Ippolito, Cristina; Duncan, Glen E; Buchwald, Dedra; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth Jf; Martin, Nicholas G; Medland, Sarah E; Montgomery, Grant W; Jeong, Hoe-Uk; Swan, Gary E; Krasnow, Ruth; Magnusson, Patrik Ke; Pedersen, Nancy L; Dahl-Aslan, Anna K; McAdams, Tom A; Eley, Thalia C; Gregory, Alice M; Tynelius, Per; Baker, Laura A; Tuvblad, Catherine; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Lichtenstein, Paul; Spector, Timothy D; Mangino, Massimo; Lachance, Genevieve; Bartels, Meike; van Beijsterveldt, Toos Cem; Willemsen, Gonneke; Burt, S Alexandra; Klump, Kelly L; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas Sevenius; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Corley, Robin P; Hjelmborg, Jacob V B; Goldberg, Jack H; Iwatani, Yoshinori; Watanabe, Mikio; Honda, Chika; Inui, Fujio; Rasmussen, Finn; Huibregtse, Brooke M; Boomsma, Dorret I; Sørensen, Thorkild I A; Kaprio, Jaakko; Silventoinen, Karri

2016-12-14

Human height variation is determined by genetic and environmental factors, but it remains unclear whether their influences differ across birth-year cohorts. We conducted an individual-based pooled analysis of 40 twin cohorts including 143,390 complete twin pairs born 1886-1994. Although genetic variance showed a generally increasing trend across the birth-year cohorts, heritability estimates (0.69-0.84 in men and 0.53-0.78 in women) did not present any clear pattern of secular changes. Comparing geographic-cultural regions (Europe, North America and Australia, and East Asia), total height variance was greatest in North America and Australia and lowest in East Asia, but no clear pattern in the heritability estimates across the birth-year cohorts emerged. Our findings do not support the hypothesis that heritability of height is lower in populations with low living standards than in affluent populations, nor that heritability of height will increase within a population as living standards improve.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low- and Middle-Income Countries: A Comparative Health Systems and Service Analysis.

PubMed

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H

2017-06-01

This systematic review synthesizes 11 studies of health-sector responses to intimate partner violence (IPV) in low- and middle-income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on-site and off-site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or "linkages" between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems-level response, with all elements implemented in a coordinated manner. © 2017 The Population Council, Inc.

[The innovation of warm disease theory in the Ming Dynasty before Wen yi lun On Pestilence].

PubMed

Zhang, Zhi-bin

2008-10-01

Some doctors of the Ming dynasty raised subversive doubts against the traditional viewpoints of "exogenous cold disease is warm-heat" before the emergence of Wen yi lun (On Pestilence), holding that warm-heat disease "is contracted in different seasons instead of being transformed from cold to warm and/or heat". The conception of the separation of warm-heat disease and exogenous cold disease had changed from obscure to clear. As the idea became clear, the recognition on the new affection of warm, heat, summer-heat, pestilent pathogen was formed, and the idea that the pathogens of summer-heat and warm entered the human body through the mouth and nostrils was put forward. The six-channel syndrome differentiation of warm disease and the five sweat-resolving methods in pestilence raised by the doctors of this period are the aspects of the differential diagnosis of syndrome and treatment in warm diseases, and deserve to be paid attention to.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low‐ and Middle‐Income Countries: A Comparative Health Systems and Service Analysis

PubMed Central

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H.

2017-01-01

This systematic review synthesizes 11 studies of health‐sector responses to intimate partner violence (IPV) in low‐ and middle‐income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on‐site and off‐site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or “linkages” between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems‐level response, with all elements implemented in a coordinated manner. PMID:28422291

Global Megacities Differing Adaptation Responses to Climate Change: an Analysis of Annual Spend of Ten Major cities on the adaptation economy

NASA Astrophysics Data System (ADS)

Maslin, M. A.; Georgeson, L.

2015-12-01

Urban areas are increasingly at risk from climate change with negative impacts predicted for human health, the economy and ecosystems. These risks require responses from cities, to improve the resilience of their infrastructure, economy and environment to climate change. Policymakers need to understand what is already being spent on adaptation so that they can make more effective and comprehensive adaptation plans. Through the measurement of spend in the newly defined 'Adaptation Economy' we analysis the current efforts of 10 global megacities in adapting to climate change. These cities were chosen based on their size, geographical location and their developmental status. The cities are London, Paris, New York, Mexico City, Sao Paulo, Beijing, Mumbai, Jakarta, Lagos and Addis Ababa. It is important to study a range of cities in different regions of the world, with different climates and at different states of socio-economic development. While in economic terms, disaster losses from weather, climate and geophysical events are greater in developed countries, fatalities and economic losses as a proportion of GDP are higher in developing countries. In all cities examined the Adaptation Economy is still a small part of the overall economy accounting for a maximum of 0.3% of the Cities total GDP (GDPc). The differences in total spend are significant between cities in developed and rapidly emerging countries, compared to those in developing countries with a spend ranging from £16 million to £1,500 million. Comparing key sub sectors, we demonstrate that there are distinctive adaptation profiles with developing cities having a higher relative spend on health, while developed cities have a higher spend on disaster preparedness, ICT and professional services. Comparing spend per capita and as a percentage of GDPc demonstrates even more clearly disparities between the cities in the study; developing country cities spend half as much as a proportion of GPCc in some cases, and significantly less per capita. This is a clear warning sign as to whether enough is being done to adapt in major population centres in developing and emerging economies.

Preprocedural Ultrasound for Infant Lumbar Puncture: A Randomized Clinical Trial.

PubMed

Kessler, David; Pahalyants, Vartan; Kriger, Joshua; Behr, Gerald; Dayan, Peter

2018-04-12

Our purpose was to determine the potential effect of preprocedural ultrasound (US) to increase lumbar puncture (LP) success compared with standard palpation method. Further, we assessed feasibility of and clinician satisfaction with a standardized US protocol. This prospective, two-arm, parallel-group randomized trial was conducted in a single-center pediatric emergency department. We compared preprocedural US versus palpation method on success with infant LPs. Infants less than 3 months of age requiring LP were enrolled. Sixteen pediatric emergency medicine physicians with varied US experience were trained to conduct the USs to mark interspace locations. Primary outcome was successful LP, defined as obtaining a cerebrospinal fluid (CSF) sample on first attempt with < 1,000 red blood cells per high-powered field (clear CSF). Secondary outcomes included clear CSF on any attempt, any CSF on the first attempt, traumatic LP proportion, and LP attempt frequency. Feasibility was assessed by comparing provider number attempting the LP and procedure duration. Clinician satisfaction and sonographer perceptions of US acceptability and impact were assessed. Eighty-one patients consented and 80 were analyzed (99%): 40 per group. No statistical difference was seen for the primary outcome (p > 0.05) between intervention and control groups (difference 3%; 95% confidence interval = -19% to 24%). There were no statistical differences between intervention and controls groups for secondary outcomes including the rate of traumatic LPs, number of attempts, and the duration of LP procedure. Most sonographers (84%) strongly agreed or agreed that the US protocol was technically easy to perform, well tolerated by the patient (94%), well accepted by the family (100%), and well accepted by the LP procedural clinicians (99%). In the US group, the majority of clinicians who performed the LPs (68.4%) noted that the preprocedural US influenced their behavior, most commonly helping with overall visualization at the selected interspace (28.9%) or prompting a change in interspace (26.3% higher, 5.3% lower). Seventy-seven percent agreed or strongly agreed that they would like to use the technique again for their next LP. The mean US duration was 4.6 minutes. Preprocedural US by did not improve the rates of first-attempt success when compared with palpation method. Our results suggest that US is feasible and well accepted, with a perceptible impact on care. © 2018 by the Society for Academic Emergency Medicine.

Acute dialysis and continuous renal replacement: the emergence of new technology involving the nephrologist in the intensive care setting.

PubMed

Yagi, N; Paganini, E P

1997-07-01

The emergence of dialytic support for patients with reversible renal failure was one of the most significant advances in critical care medicine. Supporting a patient with a failed organ till organ recovery has not had the same success with other organ failures. Despite the indispensable nature of the support, dialysis was intermittent at best, and carried its own morbidity. The emergence of a "continuous" dialysis delivery system, originally through an arteriovenous access and later through veno-venous methodology, began to simulate the continuity of the natural kidney, and lifted much of the fluid and drug restrictions imposed by the intermittent nature of standard dialytic therapies. Components of the system were next reviewed for improvement and biocompatability. Differences in patient outcome were documented with various component comparisons, and disparate patient tolerance of delivery modality was also clearly proven. The hemodynamic stability of continuous treatment created utilization to be focused on the more unstable, the more severely compromised patient group. In this context, comparative studies with intermittent delivery methods showed improved hemodynamic stability among patients treated with continuous renal replacement therapies (CRRT), but no clear difference in patient mortality. Patient characteristics and severity scoring have recently been undertaken to better describe the population, and attempts at dialysis dosing is currently being developed for ARF dialysis recipients. Early results seem to point toward a dialysis dose effect on mortality in certain groups of ICU acute renal failure patients. However, the dialytic process is only depurative and artificial. Plastic membrane bio-incompatibility, human physiological responses to foreign material exposure, either in the circuit material itself or introduced from therapy methodology, pose practical and theoretical problems. Recent advances in the field of bio-artificial technology have allowed the development of functioning hybrid "blood processors," which function as a renal tubule and may be able to not only "clean" blood, but also allow for other cellular functions not currently possible with dead membrane technology. Combining living cells with a continuous delivery method may be the next significant step toward a fully functional renal replacement therapy.

Health systems organization for emergency care.

PubMed

Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel

2013-10-01

The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda. Copyright © 2013 Elsevier Ltd. All rights reserved.

Screening emergency department patients for opioid drug use: A qualitative systematic review.

PubMed

Sahota, Preet Kaur; Shastry, Siri; Mukamel, Dana B; Murphy, Linda; Yang, Narisu; Lotfipour, Shahram; Chakravarthy, Bharath

2018-05-24

The opioid drug epidemic is a major public health concern and an economic burden in the United States. The purpose of this systematic review is to assess the reliability and validity of screening instruments used in emergency medicine settings to detect opioid use in patients and to assess psychometric data for each screening instrument. PubMed/MEDLINE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, Cumulative Index to Nursing and Allied Health Literature and ClinicalTrials.gov were searched for articles published up to May 2018. The extracted articles were independently screened for eligibility by two reviewers. We extracted 1555 articles for initial screening and 95 articles were assessed for full-text eligibility. Six articles were extracted from the full-text assessment. Six instruments were identified from the final article list: Screener and Opioid Assessment for Patients with Pain - Revised; Drug Abuse Screening Test; Opioid Risk Tool; Current Opioid Misuse Measure; an Emergency Medicine Providers Clinician Assessment Questionnaire; and an Emergency Provider Impression Data Collection Form. Screening instrument characteristics, and reliability and validity data were extracted from the six studies. A meta-analysis was not conducted due to heterogeneity between the studies. There is a lack of validity and reliability evidence in all six articles; and sensitivity, specificity and predictive values varied between the different instruments. These instruments cannot be validated for use in emergency medicine settings. There is no clear evidence to state which screening instruments are appropriate for use in detecting opioid use disorders in emergency medicine patients. There is a need for brief, reliable, valid and feasible opioid use screening instruments in the emergency medicine setting. Copyright © 2018 Elsevier Ltd. All rights reserved.

Aids and the Police

DTIC Science & Technology

1990-01-01

emergency medical personnel arrived, he fought their rescue attempts and had to be wrestled to the ground. All the time he was coughing, spitting and...infection. In fact, no emergency worker has been reported to the Centers for Disease Control (CDC) as contracting HIV clearly as a result of job-related...important variable of the AIDS problem, but also stress the necessity of addressing thc, entire issue from a strategic management perspective . This analysis

Topographic Distributions of Emergent Trees in Tropical Forests of the Osa Peninsula, Costa Rica

NASA Astrophysics Data System (ADS)

Balzotti, C.; Asner, G. P.; Taylor, P.; Cole, R. J.; Osborne, B. B.; Cleveland, C. C.; Porder, S.; Townsend, A. R.

2015-12-01

Tropical rainforests are reservoirs of terrestrial carbon and biodiversity. Large and often emergent trees store disproportionately large amounts of aboveground carbon and greatly influence the structure and functioning of tropical rainforests. Despite their importance, controls on the abundance and distribution of emergent trees are largely unknown across tropical landscapes. Conventional field approaches are limited in their ability to characterize patterns in emergent trees across vast landscapes with varying environmental conditions and floristic composition. Here we used a high-resolution light detection and ranging (LiDAR) sensor, aboard the Carnegie Airborne Observatory Airborne Taxonomic Mapping System (CAO-AToMS), to examine the abundance and distribution of tall emergent tree canopies (ETC) relative to surrounding tree canopies (STC), across the Osa Peninsula, a geologically and topographically diverse region of Costa Rica. The abundance of ETC was clearly influenced by fine-scale topographic variation, with distribution patterns that held across a variety of geologic substrates. Specifically, the density of ETC was much greater on lower slopes and in valleys, compared to upper slopes and ridges. Furthermore, using the CAO high-fidelity imaging spectrometer, ETC had a different spectral signature than that of the STC. Most notably, ETC had lower foliar N than STC, which was verified with an independent field survey of canopy leaf chemistry. The underlying mechanisms to explain the topographic-dependence of ETCs and linkages to canopy N are unknown, and remain an important area of research.

Characteristics and trends of emergency patients with drug overdose in Osaka

PubMed Central

Kubota, Yoshie; Hasegawa, Kohei; Taguchi, Hirokazu; Kitamura, Tetsuhisa; Nishiyama, Chika; Iwami, Taku; Nishiuchi, Tatsuya

2015-01-01

Aim Drug overdose is an important issue in emergency medicine. However, studies covering overdose patients transported by ambulance have not been sufficiently carried out. We attempted to clarify problems of suspected drug overdose patients transported by ambulance. Methods This is a prospective population‐based cohort study. Data were collected by emergency medical service crews in Osaka City, Japan, between January 1998 and December 2010. Results Drug overdose cases increased annually from 1,136 in 1998 to 1,822 in 2010 (P < 0.0001 for trend). In these cases, the dominant age range was between 16 and 40 years and the age distribution did not change over time. The age of non‐overdose cases increased (P < 0.0001 for trend), with patients aged ≥66 years becoming most common in recent years, reflecting the aging of society. Males comprised most non‐overdose patients, but the percentage of females increased annually (P < 0.0001 in trend). Females comprised approximately 70% in overdose cases annually throughout the study period. The duration from the emergency call to the arrival at the hospital for overdose patients has increased markedly in recent years. It also takes more time to obtain acceptance from hospitals to care for patients of suspected overdose. Conclusion The characteristics of drug overdose patients are clearly different from those of non‐overdose patients. Recent trends of drug overdose patients indicate the accelerated burden on emergency medical services system. PMID:29123730

Designing smartphone mental health applications for emergency service workers.

PubMed

Deady, M; Peters, D; Lang, H; Calvo, R; Glozier, N; Christensen, H; Harvey, S B

2017-08-01

Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives. To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences. Participants were recruited from four metropolitan Fire and Rescue NSW stations and responded to questionnaire items covering three key domains: current smartphone use, potential future use and preferences for design and content as well as therapeutic techniques. Overall, approximately half the sample (n = 106) claimed they would be interested in trying a tailored emergency-worker MH smartphone application. There were few differences between age groups on preferences. The majority of respondents claimed they would use an app for mental well-being daily and preferred terms such as 'well-being' and 'mental fitness' for referring to MH. Confidentiality, along with a focus on stress, sleep, exercise and resiliency were all considered key features. Behavioural therapeutic techniques were regarded most favourably, compared with other therapies. Emergency workers were interested in utilizing smartphone applications focused on MH, but expressed clear preferences regarding language used in promotion, features required and therapeutic techniques preferred. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

New glossary of terms used in regenerative medicine: standardization continues to emerge as regenerative medicine matures.

PubMed

Sheridan, Ben; Harris, Neil

2009-07-01

Regenerative medicine is an evolving, cross-disciplinary, international field that, as a result, uses terms that are either not widely understood, or may have a number of different meanings. Many stakeholders have identified this lack of clarity as a potential barrier to effective communication within the field. To address this, BSI British Standards, supported by the UK Department for Innovation, Universities and Skills (DIUS), was commissioned to develop guidance on the definitions of terms used within regenerative medicine. The resulting document aims to provide clear consensus terminology to improve communication and facilitate a common understanding for a broad range of potential users.

Emergency surgery for obstructing colonic cancer: a comparison between right-sided and left-sided lesions.

PubMed

Faucheron, J-L; Paquette, B; Trilling, B; Heyd, B; Koch, S; Mantion, G

2018-02-01

Few studies compare management and outcomes of obstructive colonic cancer, depending on the tumor site. We aim to evaluate the differences in patient characteristics, tumor characteristics, and outcomes of emergency surgery for obstructive right-sided versus left-sided colonic cancers. Between 2000 and 2009, 71 consecutive patients had an emergency colectomy following strict and clear definition of obstruction in a single institution. We retrospectively analyzed pre, per, and postoperative data that were prospectively collected. There were 31 and 40 patients in the right and left group, respectively. Patients aged over 80 were more frequent in the right group (p = 0.03). At operation, ileocecal valve was less often competent in the right group (p = 0.03). The one-stage strategy was more frequent in the right group (p = 0.008). Patients in the right group had a higher rate of nodes invasion (p = 0.04). One- and two-year mortality rate in the right group had a tendency to be higher. Patients presenting with a right obstructive colonic cancer are older, have a more advanced locoregional disease, and are more often treated in a one-stage strategy than patients with a left obstructive tumor.

Exact results relating spin-orbit interactions in two-dimensional strongly correlated systems

NASA Astrophysics Data System (ADS)

Kucska, Nóra; Gulácsi, Zsolt

2018-06-01

A 2D square, two-bands, strongly correlated and non-integrable system is analysed exactly in the presence of many-body spin-orbit interactions via the method of Positive Semidefinite Operators. The deduced exact ground states in the high concentration limit are strongly entangled, and given by the spin-orbit coupling are ferromagnetic and present an enhanced carrier mobility, which substantially differs for different spin projections. The described state emerges in a restricted parameter space region, which however is clearly accessible experimentally. The exact solutions are provided via the solution of a matching system of equations containing 74 coupled, non-linear and complex algebraic equations. In our knowledge, other exact results for 2D interacting systems with spin-orbit interactions are not present in the literature.

Physical assistance devices in complex motor skill learning: benefits of a self-controlled practice schedule.

PubMed

Wulf, G; Toole, T

1999-09-01

This study examines the effects of a self-controlled use of physical assistance devices on learning a complex motor skill (i.e., producing slalom-type movements on a ski simulator). Physical assistance was provided by ski poles. One group of learners (self-control) was provided with the poles whenever they requested them, whereas another (yoked) group had no influence on the pole/no-pole schedule. While there were no group differences during the practice phase (Days 1 and 2), clear group differences emerged in the retention test without poles (Day 3). The self-control group produced significantly larger amplitudes than the yoked group. These results extend previous findings by showing learning advantages of the self-controlled use of physical assistance devices in complex motor skill learning.

The Indispensible Weapon: Airpower in Emerging US Grand Strategy

DTIC Science & Technology

2012-06-01

limited force to accomplish more than limited objectives.40 Furthermore, without clear objectives and appropriate physical and diplomatic means to help...Advanced Tactical Aerial Reconnaissance System ( ATARS ) contributed to improved 68 Lambeth

Measuring and improving performance in incident management.

DOT National Transportation Integrated Search

2010-03-01

Traffic incidents account for about 25 percent of traffic congestion and delay. Clearing incidents rapidly is crucial in : minimizing congestion, reducing secondary crashes and improving safety for both emergency responders and : travelers. Especiall...

Priority and emerging pollutants in sewage sludge and fate during sludge treatment.

PubMed

Mailler, R; Gasperi, J; Chebbo, G; Rocher, V

2014-07-01

This paper aims at characterizing the quality of different treated sludges from Paris conurbation in terms of micropollutants and assessing their fate during different sludge treatment processes (STP). To achieve this, a large panel of priority and emerging pollutants (n=117) have been monitored in different STPs from Parisian wastewater treatment plants including anaerobic digestion, thermal drying, centrifugation and a sludge cake production unit. Considering the quality of treated sludges, comparable micropollutant patterns are found for the different sludges investigated (in mg/kg DM - dry matter). 35 compounds were detected in treated sludges. Some compounds (metals, organotins, alkylphenols, DEHP) are found in every kinds of sludge while pesticides or VOCs are never detected. Sludge cake is the most contaminated sludge, resulting from concentration phenomenon during different treatments. As regards treatments, both centrifugation and thermal drying have broadly no important impact on sludge contamination for metals and organic compounds, even if a slight removal seems to be possible with thermal drying for several compounds by abiotic transfers. Three different behaviors can be highlighted in anaerobic digestion: (i) no removal (metals), (ii) removal following dry matter (DM) elimination (organotins and NP) and iii) removal higher than DM (alkylphenols - except NP - BDE 209 and DEHP). Thus, this process allows a clear removal of biodegradable micropollutants which could be potentially significantly improved by increasing DM removal through operational parameters modifications (retention time, temperature, pre-treatment, etc.). Copyright © 2014 Elsevier Ltd. All rights reserved.

Interpretive analysis of 85 systematic reviews suggests that narrative syntheses and meta‐analyses are incommensurate in argumentation

PubMed Central

O'Mara‐Eves, A.; Thomas, J.; Brunton, G.; Caird, J.; Petticrew, M.

2016-01-01

Using Toulmin's argumentation theory, we analysed the texts of systematic reviews in the area of workplace health promotion to explore differences in the modes of reasoning embedded in reports of narrative synthesis as compared with reports of meta‐analysis. We used framework synthesis, grounded theory and cross‐case analysis methods to analyse 85 systematic reviews addressing intervention effectiveness in workplace health promotion. Two core categories, or ‘modes of reasoning’, emerged to frame the contrast between narrative synthesis and meta‐analysis: practical–configurational reasoning in narrative synthesis (‘what is going on here? What picture emerges?’) and inferential–predictive reasoning in meta‐analysis (‘does it work, and how well? Will it work again?’). Modes of reasoning examined quality and consistency of the included evidence differently. Meta‐analyses clearly distinguished between warrant and claim, whereas narrative syntheses often presented joint warrant–claims. Narrative syntheses and meta‐analyses represent different modes of reasoning. Systematic reviewers are likely to be addressing research questions in different ways with each method. It is important to consider narrative synthesis in its own right as a method and to develop specific quality criteria and understandings of how it is carried out, not merely as a complement to, or second‐best option for, meta‐analysis. © 2016 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd. PMID:27860329

Effect of Continuous Cropping Generations on Each Component Biomass of Poplar Seedlings during Different Growth Periods

PubMed Central

Xia, Jiangbao; Zhang, Shuyong; Li, Tian; Liu, Xia; Zhang, Ronghua; Zhang, Guangcan

2014-01-01

In order to investigate the change rules and response characteristics of growth status on each component of poplar seedling followed by continuous cropping generations and growth period, we clear the biomass distribution pattern of poplar seedling, adapt continuous cropping, and provide theoretical foundation and technical reference on cultivation management of poplar seedling, the first generation, second generation, and third generation continuous cropping poplar seedlings were taken as study objects, and the whole poplar seedling was harvested to measure and analyze the change of each component biomass on different growth period poplar leaves, newly emerging branches, trunks and root system, and so forth. The results showed that the whole biomass of poplar seedling decreased significantly with the leaf area and its ratio increased, and the growth was inhibited obviously. The biomass aboveground was more than that underground. The ratios of leaf biomass and newly emerging branches biomass of first continuous cropping poplar seedling were relatively high. With the continuous cropping generations and growth cycle increasing, poplar seedling had a growth strategy to improve the ratio of root-shoot and root-leaf to adapt the limited soil nutrient of continuous cropping. PMID:25401150

A passive mutualistic interaction promotes the evolution of spatial structure within microbial populations.

PubMed

Marchal, Marie; Goldschmidt, Felix; Derksen-Müller, Selina N; Panke, Sven; Ackermann, Martin; Johnson, David R

2017-04-24

While mutualistic interactions between different genotypes are pervasive in nature, their evolutionary origin is not clear. The dilemma is that, for mutualistic interactions to emerge and persist, an investment into the partner genotype must pay off: individuals of a first genotype that invest resources to promote the growth of a second genotype must receive a benefit that is not equally accessible to individuals that do not invest. One way for exclusive benefits to emerge is through spatial structure (i.e., physical barriers to the movement of individuals and resources). Here we propose that organisms can evolve their own spatial structure based on physical attachment between individuals, and we hypothesize that attachment evolves when spatial proximity to members of another species is advantageous. We tested this hypothesis using experimental evolution with combinations of E. coli strains that depend on each other to grow. We found that attachment between cells repeatedly evolved within 8 weeks of evolution and observed that many different types of mutations potentially contributed to increased attachment. We postulate a general principle by which passive beneficial interactions between organisms select for attachment, and attachment then provides spatial structure that could be conducive for the evolution of active mutualistic interactions.

Relationship of young-of-the-year northern pike to aquatic vegetation types in backwaters of the upper Mississippi River

USGS Publications Warehouse

Holland, L.E.; Huston, M.L.

1984-01-01

The association of young-of-the-year northern pike (Esox lucius) with different aquatic plant types (e.g., submerged, emergent, floating) was studied to evaluate the impacts of a potential loss of backwaters on available fish nursery habitats in the upper Mississippi River. Eight biweekly collections were made at each of six representative lentic habitats in Navigation Pool 7. In the spring, average catches of northern pike from areas with submerged vegetation were nearly three times greater than from areas with emergent vegetation, and more than 10 times greater than from an area with no vegetation. This pattern was consistent until late summer, when the young became more common in the more highly oxygenated, less heavily vegetated waters. Food and growth were examined as possible indicators for the selection of areas with submerged vegetation over other habitats. Food varied among fish in the different vegetation types; however, no significant patterns of improved growth or condition were apparent. Young northern pike apparently were successful, opportunistic feeders. Although preference for habitats with submerged vegetation was seemingly not related to food, the overall production of young was clearly best in these habitats.

Breastfeeding and Postpartum Depression: An Overview and Methodological Recommendations for Future Research

PubMed Central

Pope, Carley J.; Mazmanian, Dwight

2016-01-01

Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1) use standardized assessment protocols; (2) confirm diagnosis through established clinical interview when possible; (3) provide a clear operationalized definition for breastfeeding variables; (4) clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5) be prospective or longitudinal in nature; and (6) take into consideration other potential risk factors identified in the empirical literature. PMID:27148457

How students' achievement goals shape their beliefs about effective teaching: a 'build-a-professor' study.

PubMed

Senko, Corwin; Belmonte, Kimberly; Yakhkind, Anastasyia

2012-09-01

Which instructor qualities do students consider most important? The answer likely depends on the student. This study attempted to trace beliefs about the most essential instructor qualities to students' academic achievement goals. The present study tested the hypothesis that students pursuing mastery goals favour instructors who stimulate and challenge them intellectually, whereas those pursuing performance goals favour instructors who present material clearly and provide clear cues about how to succeed. Participants were 157 students at a 4-year public university. Participants designed the ideal professor through a hypothetical combination of nine widely valued instructor qualities, such as enthusiasm, presentation clarity, and an interactive teaching style. The more they acquired of any one instructor quality, the less they could acquire of the others, thus compelling students to distinguish necessary qualities from desirable luxury qualities. Students' achievement goals corresponded to their views about the most essential instructor qualities. Mastery goals predicted greater demand for professors who intellectually challenge students and possess topic expertise, whereas performance goals predicted high demand for professors who present material clearly and provide cues about how to succeed in the course. The findings support emerging theorizing about how mastery and performance goals nudge students to pursue different learning agendas, with distinct consequences to their learning experience. ©2011 The British Psychological Society.

The structural configuration of U.S. hospital medical staffs.

PubMed

Shortell, S M; Evashwick, C

1981-04-01

Using data from the 1973 American Hospital Association national survey of hospital medical staff organization, six factors of medical staff organization structure are examined in relation to each other and to hospital ownership, size, teaching status, geographic region and size of Standard Metropolitan Statistical Area (SMSA). The six factors include 1) Resource Capability; 2) Generalist Physician Contractual Orientation; 3) Communication and Control; 4) Local Staff Orientation; 5) Physician Participation in Decision Making; and 6) Hospital-Based Contractual Orientation. Several relatively distinct patterns emerged related to hospital ownership, size, teaching activity and region of the country, as well as interrelationships among the factors themselves. Differences between smaller and larger hospitals clearly emerged as well as a distinctive pattern for for-profit hospitals. All of the factors are subject to manipulation through administrative and/or public policy interventions and the findings suggest dimensions for future investigation of important policy issues related to the medical staff's role in cost containment, utilization, quality assurance and technology adoption.

Green and Sustainable Separation of Natural Products from Agro-Industrial Waste: Challenges, Potentialities, and Perspectives on Emerging Approaches.

PubMed

Zuin, Vânia G; Ramin, Luize Z

2018-01-17

New generations of biorefinery combine innovative biomass waste resources from different origins, chemical extraction and/or synthesis of biomaterials, biofuels, and bioenergy via green and sustainable processes. From the very beginning, identifying and evaluating all potentially high value-added chemicals that could be removed from available renewable feedstocks requires robust, efficient, selective, reproducible, and benign analytical approaches. With this in mind, green and sustainable separation of natural products from agro-industrial waste is clearly attractive considering both socio-environmental and economic aspects. In this paper, the concepts of green and sustainable separation of natural products will be discussed, highlighting the main studies conducted on this topic over the last 10 years. The principal analytical techniques (such as solvent, microwave, ultrasound, and supercritical treatments), by-products (e.g., citrus, coffee, corn, and sugarcane waste) and target compounds (polyphenols, proteins, essential oils, etc.) will be presented, including the emerging green and sustainable separation approaches towards bioeconomy and circular economy contexts.

[Indications and morbidity associated with double J catheters.

PubMed

Cepeda, M; Mainez, J A; de la Cruz, B; Amón, J H

2016-10-01

The use of double J catheters is usual in urologist's daily practice. The indication can be divided in prophylactic or therapeutic. Prophylactically, they prevent complications derived from endourological procedures, such as ureteral lesion or obstructive uropathy secondary to residual lithiasis or edema. Therapeutically, they treat obstructive uropathy of many different pathologies, either in an emergency setting or scheduled, such as lithiasis, stenosis, extrinsic compression of any nature or urinary tract tumors among others. Although they add clear benefits in both cases, they are not free from side effects. The most frequent symptoms they cause are: voiding urgency and increase in voiding frequency, macroscopic hematuria and suprapubic and lumbar pain. The physiopathological mechanism is explained by a mechanical and inflammatory effect or due to vesicoureteral reflux depending on the symptom. This causes patient's quality of life disturbance that may vary from mild degree to very severe. Thus, several strategies have emerged with the aim of diminishing or palliate the intensity of such symptoms: alpha-blocker drugs, design modifications or reduction of their use.

NGO action on refugees and displaced people.

PubMed

1998-06-01

This article summarizes some issues that emerged from a 1997 seminar on reproductive health among refugees. 90 delegates from 16 countries shared ideas about how to better lend support in emergencies and discussed the prevention and control of AIDS. The role was not clear for nongovernmental organizations (NGOs) that preferred constructing community-based institutions instead of satisfying the basic, urgent needs of displaced persons. The NGO sector recognizes its reliance on UN funding, but desires better UNHCR and UNAIDS guidelines and more positive support. NGOs were very reluctant to integrate HIV testing and counseling in already mistrustful settings, while ignoring the violence against women, which is closely tied to their vulnerability to AIDS. UNHCR solutions appeared to prolong the conflict and offer opportunities to channel energies into negative sexuality. Most refugees are women and children. There is wide inconsistency in beliefs and government responses to basic human rights issues. It was proposed that a deterrent to the spread of AIDS is an emphasis on self-respect and a concept of belonging. Management issues in resettled populations vary with essential needs and different phases of an emergency. Common HIV and refugee concerns include a balance between the needs of host and displaced persons; a balance between long- and short-term HIV emergency needs; and a reduction of violence among militarized refugees. Pressing concerns were advocacy, vulnerability, and research on gender and effects of militarization.

Photo-oxidative stress in emerging and senescing leaves: a mirror image?

PubMed

Juvany, Marta; Müller, Maren; Munné-Bosch, Sergi

2013-08-01

The life cycle of a leaf can be characterized as consisting of different stages: from primordial leaf initiation in the shoot apical meristem (SAM) to leaf senescence. Leaf development, from early leaf growth to senescence, is tightly controlled by plant development and the environment. Here, we primarily focus on summarizing current evidence indicating that photo-oxidative stress occurs at the two extremes of a leaf's lifespan. Some recent studies clearly indicate that--as happens in senescing leaves--emerging new leaves suffer from photo-oxidative stress, which suggests that oxidative stress plays a key role at both ends of the leaf life cycle. We discuss the causes and consequences of suffering from photo-oxidative stress during leaf development, paying attention to the particularities of this process at the two extremes of leaf development. Of particular importance is the current evidence showing mechanisms that maintain an adequate cellular reactive oxygen species/antioxidant (redox) balance that allows growth and prevents oxidative damage in young emerging leaves, while later on photo-oxidative stress induces cell death in senescing leaves. Also of interest is the fact that reductions in the efficiency of photosystem II photochemistry may not necessarily indicate photo-oxidative stress in emerging leaves. In this review, we summarize current knowledge of photoinhibition, photoprotection, and photo-oxidative stress at the two ends of the leaf life cycle: early leaf growth and leaf senescence.

Oil mixing behavior after an oil spill: identification conflicts of different fingerprints.

PubMed

He, Shijie; Yu, Hongjun; Luo, Yongming; Wang, Chuanyuan; Li, Xueshuang; Li, Zhongping

2018-04-01

Clearing up whether spilled oil is mixed or not can strengthen the accuracy of oil spill identification. In the present study, the biomarkers in spilled oil samples were detected. The weathering modes of different types of diagnostic ratio and carbon isotope values of individual n-alkanes were also analyzed. The results showed that the diagnostic ratios of steroids, terpenes and aromatics, and weathering characteristics of carbon isotope composition (δ 13 C) of individual n-alkanes supported the idea that Dalian oil spill emerged from a single oil source. Furthermore, commonly used diagnostic ratios of n-alkanes indicated that the Dalian oil spill had undergone the oil mixing process. The different identifying outcomes indicate that some kinds of n-alkane-rich substance (such as oil dispersants) were mixed in the Dalian spilled oil and interfered with the routine diagnosis ratios of n-alkanes.

Insights into the mechanisms and the emergence of sex-differences in pain.

PubMed

Melchior, Meggane; Poisbeau, Pierrick; Gaumond, Isabelle; Marchand, Serge

2016-12-03

Recent studies describe sex and gender as critical factors conditioning the experience of pain and the strategies to respond to it. It is now clear that men and women have different physiological and behavioral responses to pain. Some pathological pain states are also highly sex-specific. This clinical observation has been often verified with animal studies which helped to decipher the mechanisms underlying the observed female hyper-reactivity and hyper-sensitivity to pain states. The role of gonadal hormones in the modulation of pain responses has been a straightforward hypothesis but, if pertinent in many cases, cannot fully account for this complex sensation, which includes an important cognitive component. Clinical and fundamental data are reviewed here with a special emphasis on possible developmental processes giving rise to sex-differences in pain processing. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

Effects of Colored Noise on Periodic Orbits in a One-Dimensional Map

NASA Astrophysics Data System (ADS)

Li, Feng-Guo; Ai, Bao-Quan

2011-06-01

Noise can induce inverse period-doubling transition and chaos. The effects of the colored noise on periodic orbits, of the different periodic sequences in the logistic map, are investigated. It is found that the dynamical behaviors of the orbits, induced by an exponentially correlated colored noise, are different in the mergence of transition, and the effects of the noise intensity on their dynamical behaviors are different from the effects of the correlation time of noise. Remarkably, the noise can induce new periodic orbits, namely, two new orbits emerge in the period-four sequence at the bifurcation parameter value μ = 3.5, four new orbits in the period-eight sequence at μ = 3.55, and three new orbits in the period-six sequence at μ = 3.846, respectively. Moreover, the dynamical behaviors of the new orbits clearly show the resonancelike response to the colored noise.

Composition, concentration and deprivation: exploring their association with social cohesion among different ethnic groups in the UK.

PubMed

Bécares, Laia; Stafford, Mai; Laurence, James; Nazroo, James

2011-01-01

Although studies in the US have shown an association between the ethnic residential composition of an area and reports of decreased social cohesion among its residents, this association is not clear in the UK, and particularly for ethnic minority groups. The current study analyses a merged dataset from the 2005 and 2007 Citizenship Survey to assess the evidence for an association between social cohesion and ethnic residential concentration, composition and area deprivation across different ethnic groups in the UK. Results of the multilevel regression models show that, after adjusting for area deprivation, increased levels of social cohesion are found in areas of greater ethnic residential heterogeneity. Although different patterns emerge across ethnic groups and the measure of social cohesion used, findings consistently show that it is area deprivation, and not ethnic residential heterogeneity, which erodes social cohesion in the UK.

Observed Personality in Childhood: Psychometric and Behavioral Genetic Evidence of Two Broad Personality Factors

PubMed Central

Wang, Zhe; Chen, Nan; Petrill, Stephen A.; Deater-Deckard, Kirby

2014-01-01

We examined broad dimensions of children’s personalities (total n = 1056; age = 3.5 to 12 years) based on observers’ perceptions following a few hours of structured interaction. Siblings’ behaviors during a two-hour cognitive assessment in the home were rated separately by two different observers. Exploratory and confirmatory factor analyses clearly revealed a two-factor solution in three different samples. There was correspondence between parent-rated temperament and the observer-rated factors. Cross-sectional analyses indicated lower Plasticity among older children and higher Stability among older children. Sex differences were negligible. Plasticity and Stability were correlated in the .2 to .3 range. Most of the sibling similarity in the Plasticity was due to additive genetic influences, whereas most sibling similarity in Stability was attributable to shared environmental influences. The findings implicate a biometric factor structure to childhood personality that fits well with emerging bio-social theories of personality development. PMID:24932065

Running away from unwanted feelings: culture matters.

PubMed

Su, Jenny C; Wei, Meifen; Tsai, Hsiao-Tien

2014-01-01

Findings from past research have suggested a link between experiential avoidance and expressive suppression. However, there is emerging evidence showing that the suppression of emotional expression may have different meanings depending on the specific cultural context. Taking a cultural perspective, the present study aimed to examine whether the link between experiential avoidance and expressive suppression is comparable or divergent between two cultural groups [i.e., European Americans (EAs) and Chinese (CH)] with different cultural norms surrounding emotional expression. We hypothesised that the positive association between experiential avoidance and expressive suppression typically found among EAs would be attenuated among CH. Furthermore, the observed cultural group difference in the experiential avoidance-suppression link was hypothesised to be mediated by beliefs in emotional self-control. Data from 224 EA college students and 190 CH college students provided a clear pattern of support for our hypotheses. Implications for current theories on experiential avoidance are discussed.

Emergency Operations Center at Johnson Space Center

NASA Technical Reports Server (NTRS)

Caylor, Gary C.

1997-01-01

In June 1966, at the start of the Gulf Coast hurricane season, the Johnson Space Center (JSC) celebrated the opening of its new 4,000-square foot, state-of-the-art Emergency Operations Center (EOC). The new EOC has been upgraded and enhanced to support a wide spectrum of emergencies affecting JSC and neighboring communities. One of the main features of the EOC is its premier computerized dispatch center. The new system unites many of JSC's critical emergency functions into one integrated network. It automatically monitors fire alarms, security entrances, and external cameras. It contains the JSC inventory of hazardous materials, by building and room, and can call up Material Safety Data Sheets for most of the generic hazardous materials used on-site. The EOC is available for community use during area emergencies such as hurricanes and is a welcome addition to the Clear Lake/Galveston Bay Area communities' emergency response resources.

Emergency Vehicle Siren Noise Effectiveness

NASA Astrophysics Data System (ADS)

D'Angela, Peter

Navigating safely through traffic, while responding to an emergency, is often a challenge for emergency responders. To help alert other motorists, these responders use emergency lights and/or sirens. However, the former is useful only if within clear visual range of the other drivers. This shortcoming puts a greater emphasis on the importance of the audible emergency siren, which has its own shortcomings. This study considered several emergency siren systems with the goal to determine the most effective siren system(s) based on several criteria. Multiple experimental measurements and subjective analysis using jury testing using an NVH driving simulator were performed. It was found that the traditional mechanical siren was the most effective audible warning device; however, with significantly reduced electrical power requirements, the low frequency Rumbler siren, in conjunction with a more conventional electronic Yelp siren, was the preferred option. Recommendations for future work are also given.

Evaluation of low-cost computer monitors for the detection of cervical spine injuries in the emergency room: an observer confidence-based study.

PubMed

Brem, M H; Böhner, C; Brenning, A; Gelse, K; Radkow, T; Blanke, M; Schlechtweg, P M; Neumann, G; Wu, I Y; Bautz, W; Hennig, F F; Richter, H

2006-11-01

To compare the diagnostic value of low-cost computer monitors and a Picture Archiving and Communication System (PACS) workstation for the evaluation of cervical spine fractures in the emergency room. Two groups of readers blinded to the diagnoses (2 radiologists and 3 orthopaedic surgeons) independently assessed-digital radiographs of the cervical spine (anterior-posterior, oblique and trans-oral-dens views). The radiographs of 57 patients who arrived consecutively to the emergency room in 2004 with clinical suspicion of a cervical spine injury were evaluated. The diagnostic values of these radiographs were scored on a 3-point scale (1 = diagnosis not possible/bad image quality, 2 = diagnosis uncertain, 3 = clear diagnosis of fracture or no fracture) on a PACS workstation and on two different liquid crystal display (LCD) personal computer monitors. The images were randomised to avoid memory effects. We used logistic mixed-effects models to determine the possible effects of monitor type on the evaluation of x ray images. To determine the overall effects of monitor type, this variable was used as a fixed effect, and the image number and reader group (radiologist or orthopaedic surgeon) were used as random effects on display quality. Group-specific effects were examined, with the reader group and additional fixed effects as terms. A significance level of 0.05 was established for assessing the contribution of each fixed effect to the model. Overall, the diagnostic score did not differ significantly between standard personal computer monitors and the PACS workstation (both p values were 0.78). Low-cost LCD personal computer monitors may be useful in establishing a diagnosis of cervical spine fractures in the emergency room.

Magnetic storms and solar flares: can be analysed within similar mathematical framework with other extreme events?

NASA Astrophysics Data System (ADS)

Balasis, Georgios; Potirakis, Stelios M.; Papadimitriou, Constantinos; Zitis, Pavlos I.; Eftaxias, Konstantinos

2015-04-01

The field of study of complex systems considers that the dynamics of complex systems are founded on universal principles that may be used to describe a great variety of scientific and technological approaches of different types of natural, artificial, and social systems. We apply concepts of the nonextensive statistical physics, on time-series data of observable manifestations of the underlying complex processes ending up to different extreme events, in order to support the suggestion that a dynamical analogy characterizes the generation of a single magnetic storm, solar flare, earthquake (in terms of pre-seismic electromagnetic signals) , epileptic seizure, and economic crisis. The analysis reveals that all the above mentioned different extreme events can be analyzed within similar mathematical framework. More precisely, we show that the populations of magnitudes of fluctuations included in all the above mentioned pulse-like-type time series follow the traditional Gutenberg-Richter law as well as a nonextensive model for earthquake dynamics, with similar nonextensive q-parameter values. Moreover, based on a multidisciplinary statistical analysis we show that the extreme events are characterized by crucial common symptoms, namely: (i) high organization, high compressibility, low complexity, high information content; (ii) strong persistency; and (iii) existence of clear preferred direction of emerged activities. These symptoms clearly discriminate the appearance of the extreme events under study from the corresponding background noise.

Occupant Injury Severity and Accident Causes in Helicopter Emergency Medical Services (1983-2014).

PubMed

Boyd, Douglas D; Macchiarella, Nickolas D

2016-01-01

Helicopter emergency medical services (HEMS) transport critically ill patients to/between emergency care facilities and operate in a hazardous environment: the destination site is often encumbered with obstacles, difficult to visualize at night, and lack instrument approaches for degraded visibility. The study objectives were to determine 1) HEMS accident rates and causes; 2) occupant injury severity profiles; and 3) whether accident aircraft were certified to the more stringent crashworthiness standards implemented two decades ago. The National Transportation Safety Board (NTSB) aviation accident database was used to identify HEMS mishaps for the years spanning 1983-2014. Contingency tables (Pearson Chi-square or Fisher's exact test) were used to determine differences in proportions. A generalized linear model (Poisson distribution) was used to determine if accident rates differed over time. While the HEMS accident rate decreased by 71% across the study period, the fraction of fatal accidents (36-50%) and the injury severity profiles were unchanged. None of the accident aircraft fully satisfied the current crashworthiness standards. Failure to clear obstacles and visual-to-instrument flight, the most frequent accident causes (37 and 26%, respectively), showed a downward trend, whereas accidents ascribed to aircraft malfunction showed an upward trend over time. HEMS operators should consider updating their fleet to the current, more stringent crashworthiness standards in an attempt to reduce injury severity. Additionally, toward further mitigating accidents ascribed to inadvertent visual-to-instrument conditions, HEMS aircraft should be avionics-equipped for instrument flight rules flight.

Pediatric Sepsis Secondary to an Occult Dental Abscess: A Case Report.

PubMed

Holmberg, Peter; Hellmich, Thomas; Homme, James

2017-05-01

In general, hematogenous spread of bacteria in children is uncommon. Bacteremia, however, is a known complication of dental procedures and severe caries, but is infrequently associated with primary, asymptomatic, non-procedural-related, dentoalveolar infection. The patient is a 7-year-old previously healthy boy who presented to the Emergency Department (ED) with "fever, mottling, and shaking chills." In the ED, he appeared systemically ill with fever, mottling, delayed capillary refill, and rigors. Physical examination by three different physicians failed to reveal any focus of infection. Laboratory evaluation, including blood cultures, was obtained. The patient later developed unilateral facial swelling and pain, and a dentoalveolar abscess was found. He was started on antibiotics, underwent pulpectomy and eventually, extraction, prior to improvement in symptoms. Blood cultures grew two separate anaerobic bacteria (Veillonella and Lactobacillus). This is, to our knowledge, one of the first reported cases of pediatric sepsis with two different anaerobic organisms secondary to occult dentoalveolar abscess in a pediatric patient. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: It is imperative for emergency physicians to recognize the possibility of pediatric sepsis in the setting of acute maxillary or mandibular pain, as well as in patients for whom no clear focus of infection can be found. This is particularly important for those who appear ill at presentation or meet systemic inflammatory response syndrome criteria and would benefit from further laboratory evaluation, including blood cultures, and possibly antibiotic therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

The business of PET/CT.

PubMed

Halliday, Sue; Thrall, James H

2005-05-01

This chapter discusses how to market to and educate the referral community and third party payers about the benefits of the emerging PET/CT technology. Clearly, the fusion of PET and CT into one piece of equipment will present challenges for years to come. It is important for providers to be involved with all of the administrators, managers, referring and interpreting physicians, and the payer communities in their market to clearly understand individual payer business practices and to identify opportunities to educate and influence changes in payment and coverage policies.

Surface vibrational structure at alkane liquid/vapor interfaces

NASA Astrophysics Data System (ADS)

Esenturk, Okan; Walker, Robert A.

2006-11-01

Broadband vibrational sum frequency spectroscopy (VSFS) has been used to examine the surface structure of alkane liquid/vapor interfaces. The alkanes range in length from n-nonane (C9H20) to n-heptadecane (C17H36), and all liquids except heptadecane are studied at temperatures well above their bulk (and surface) freezing temperatures. Intensities of vibrational bands in the CH stretching region acquired under different polarization conditions show systematic, chain length dependent changes. Data provide clear evidence of methyl group segregation at the liquid/vapor interface, but two different models of alkane chain structure can predict chain length dependent changes in band intensities. Each model leads to a different interpretation of the extent to which different chain segments contribute to the anisotropic interfacial region. One model postulates that changes in vibrational band intensities arise solely from a reduced surface coverage of methyl groups as alkane chain length increases. The additional methylene groups at the surface must be randomly distributed and make no net contribution to the observed VSF spectra. The second model considers a simple statistical distribution of methyl and methylene groups populating a three dimensional, interfacial lattice. This statistical picture implies that the VSF signal arises from a region extending several functional groups into the bulk liquid, and that the growing fraction of methylene groups in longer chain alkanes bears responsibility for the observed spectral changes. The data and resulting interpretations provide clear benchmarks for emerging theories of molecular structure and organization at liquid surfaces, especially for liquids lacking strong polar ordering.

Biosensing and environmental sensing for emergency and protection e-Textiles.

PubMed

Magenes, G; Curone, D; Secco, E L; Bonfiglio, A

2011-01-01

The ProeTEX project introduced for the first time a complete set of smart garments integrating sensors for the physiological and environmental monitoring of emergency operators. These "smart" garments have been deeply tested in emergency-like contexts by professional rescuers, in order to assess real-time acquisition, processing and transmission of data from moving subjects while operating in harsh conditions. Here we report an overview of the main results obtained during field trials performed in 2010 by Italian and French professional firefighters, in specialized training centers, while dressing the ProeTEX prototypes. Results clearly demonstrate the benefit and step forward of such a system in order to monitor and coordinate rescuers even during intervention far away from the emergency headquarter.

Dissuasive exit signage for building fire evacuation.

PubMed

Olander, Joakim; Ronchi, Enrico; Lovreglio, Ruggiero; Nilsson, Daniel

2017-03-01

This work presents the result of a questionnaire study which investigates the design of dissuasive emergency signage, i.e. signage conveying a message of not utilizing a specific exit door. The work analyses and tests a set of key features of dissuasive emergency signage using the Theory of Affordances. The variables having the largest impact on observer preference, interpretation and noticeability of the signage have been identified. Results show that features which clearly negate the exit-message of the original positive exit signage are most effective, for instance a red X-marking placed across the entirety of the exit signage conveys a clear dissuasive message. Other features of note are red flashing lights and alternation of colour. The sense of urgency conveyed by the sign is largely affected by sensory inputs such as red flashing lights or other features which cause the signs to break the tendencies of normalcy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mental and social health during and after acute emergencies: emerging consensus?

PubMed Central

van Ommeren, Mark; Saxena, Shekhar; Saraceno, Benedetto

2005-01-01

Mental health care programmes during and after acute emergencies in resource-poor countries have been considered controversial. There is no agreement on the public health value of the post-traumatic stress disorder concept and no agreement on the appropriateness of vertical (separate) trauma-focused services. A range of social and mental health intervention strategies and principles seem, however, to have the broad support of expert opinion. Despite continuing debate, there is emerging agreement on what entails good public health practice in respect of mental health. In terms of early interventions, this agreement is exemplified by the recent inclusion of a "mental and social aspects of health" standard in the Sphere handbook's revision on minimal standards in disaster response. This affirmation of emerging agreement is important and should give clear messages to health planners. PMID:15682252

Cortisol and alpha-amylase as stress response indicators during pre-hospital emergency medicine training with repetitive high-fidelity simulation and scenarios with standardized patients.

PubMed

Valentin, Bernd; Grottke, Oliver; Skorning, Max; Bergrath, Sebastian; Fischermann, Harold; Rörtgen, Daniel; Mennig, Marie-Therese; Fitzner, Christina; Müller, Michael P; Kirschbaum, Clemens; Rossaint, Rolf; Beckers, Stefan K

2015-04-08

In emergency medicine, the benefits of high-fidelity simulation (SIM) are widely accepted and standardized patients (SP) are known to mimic real patients accurately. However, only limited data are available concerning physicians' stress markers within these training environments. The aim of this pilot study was to investigate repetitive stress among healthcare professionals in simulated pre-hospital emergency scenarios using either SIM or SPs. Teams with one emergency medical services (EMS) physician and two paramedics completed three SIM scenarios and two SP scenarios consecutively. To evaluate stress, salivary cortisol and alpha-amylase were measured in saliva samples taken before, during and after the scenarios. A total of 14 EMS physicians (29% female; mean age: 36.8 ± 5.0 years; mean duration of EMS-experience: 9.1 ± 5.8 years) and 27 paramedics (11% female; age: 30.9 ± 6.9 years; EMS experience: 8.1 ± 6.0 years) completed the study. Alpha-amylase and cortisol levels did not differ significantly between the two professions. Cortisol values showed a gradual and statistically significant reduction over time but little change was observed in response to each scenario. In contrast, alpha-amylase activity increased significantly in response to every SIM and SP scenario, but there was no clear trend towards an overall increase or decrease over time. Increases in salivary alpha-amylase activity suggest that both SIM and SP training produce stress among emergency healthcare professionals. Corresponding increases in salivary cortisol levels were not observed. Among physicians in the emergency setting, it appears that alpha-amylase provides a more sensitive measure of stress levels than cortisol.

What factors might have led to the emergence of Ebola in West Africa?

PubMed

Alexander, Kathleen A; Sanderson, Claire E; Marathe, Madav; Lewis, Bryan L; Rivers, Caitlin M; Shaman, Jeffrey; Drake, John M; Lofgren, Eric; Dato, Virginia M; Eisenberg, Marisa C; Eubank, Stephen

2015-01-01

An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa, and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent. The emergence of this deadly disease in West Africa invites many questions, foremost among these: why now, and why in West Africa? Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need. A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease. Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa. Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily. To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community.

What Factors Might Have Led to the Emergence of Ebola in West Africa?

PubMed Central

Alexander, Kathleen A.; Sanderson, Claire E.; Marathe, Madav; Lewis, Bryan L.; Rivers, Caitlin M.; Shaman, Jeffrey; Drake, John M.; Lofgren, Eric; Dato, Virginia M.; Eisenberg, Marisa C.; Eubank, Stephen

2015-01-01

An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa, and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent. The emergence of this deadly disease in West Africa invites many questions, foremost among these: why now, and why in West Africa? Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need. A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease. Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa. Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily. To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community. PMID:26042592

Are mothers’ and fathers’ parenting characteristics associated with emerging adults’ academic engagement?

PubMed Central

Waterman, Emily A.; Lefkowitz, Eva S.

2017-01-01

Although parenting is clearly linked to academic engagement in adolescence, less is known about links between parenting and academic engagement in emerging adulthood. A diverse sample of college students (N = 633; 53.1% female, 45.7% White/European American, 28.3% Asian American/Hawaiian/Pacific Islander, 26.4% Hispanic/Latino American, 21.6% Black/African American, and 2.8% Native American/American Indian) answered surveys about mothers’ and fathers’ parenting style, parent-offspring relationship quality, academic attitudes, academic behaviors, and academic performance. Emerging adults with more permissive mothers viewed grades as less important than emerging adults with less permissive mothers. Mothers’ authoritarian parenting, mothers’ permissive parenting, and relationship quality with father were differentially related to academic engagement depending on emerging adults’ gender. Both mothers’ and fathers’ parenting characteristics may impact the academic engagement of emerging adults via past parenting behaviors and current quality of the parent-offspring relationship, despite decreased physical proximity of emerging adults and their parents. PMID:28529398

Are mothers' and fathers' parenting characteristics associated with emerging adults' academic engagement?

PubMed

Waterman, Emily A; Lefkowitz, Eva S

2017-06-01

Although parenting is clearly linked to academic engagement in adolescence, less is known about links between parenting and academic engagement in emerging adulthood. A diverse sample of college students ( N = 633; 53.1% female, 45.7% White/European American, 28.3% Asian American/Hawaiian/Pacific Islander, 26.4% Hispanic/Latino American, 21.6% Black/African American, and 2.8% Native American/American Indian) answered surveys about mothers' and fathers' parenting style, parent-offspring relationship quality, academic attitudes, academic behaviors, and academic performance. Emerging adults with more permissive mothers viewed grades as less important than emerging adults with less permissive mothers. Mothers' authoritarian parenting, mothers' permissive parenting, and relationship quality with father were differentially related to academic engagement depending on emerging adults' gender. Both mothers' and fathers' parenting characteristics may impact the academic engagement of emerging adults via past parenting behaviors and current quality of the parent-offspring relationship, despite decreased physical proximity of emerging adults and their parents.

Case reports and case series in prehospital emergency care research.

PubMed

Patterson, P Daniel; Weaver, Matthew; Clark, Sunday; Yealy, Donald M

2010-11-01

Research begins with a clearly stated question, problem or hypothesis. The selection of a study design appropriate to the task is the next key step. This paper provides guidance for the use of case report and case series designs by describing the 'what', 'when' and 'how' of both designs. Also described is the use of case reports and case series study designs in prehospital emergency research and the quality of published literature from 2000 to mid-2008.

Functional vs. Structural Modularity: do they imply each other?

NASA Astrophysics Data System (ADS)

Toroczkai, Zoltan

2009-03-01

While many deterministic and stochastic processes have been proposed to produce heterogeneous graphs mimicking real-world networks, only a handful of studies attempt to connect structure and dynamics with the function(s) performed by the network. In this talk I will present an approach built on the premise that structure, dynamics, and their observed heterogeneity, are implementations of various functions and their compositions. After a brief review of real-world networks where this connection can explicitly be made, I will focus on biological networks. Biological networks are known to possess functionally specialized modules, which perform tasks almost independently of each other. While proposals have been made for the evolutionary emergence of modularity, it is far from clear that adaptation on evolutionary timescales is the sole mechanism leading to functional specialization. We show that non-evolutionary learning can also lead to the formation of functionally specialized modules in a system exposed to multiple environmental constraints. A natural example suggesting that this is possible is the cerebral cortex, where there are clearly delineated functional areas in spite of the largely uniform anatomical construction of the cortical tissue. However, as numerous experiments show, when damaged, regions specialized for a certain function can be retrained to perform functions normally attributed to other regions. We use the paradigm of neural networks to represent a multitasking system, and use several non-evolutionary learning algorithms as mechanisms for phenotypic adaptation. We show that for a network learning to perform multiple tasks, the degree of independence between the tasks dictates the degree of functional specialization emerging in the network. To uncover the functional modules, we introduce a method of node knockouts that explicitly rates the contribution of each node to different tasks (differential robustness). Through a concrete example we also demonstrate the potential inability of purely topology-based clustering methods to detect functional modules. The robustness of these results suggests that similar mechanisms might be responsible for the emergence of functional specialization in other multitasking networks, as well, including social networks.

Identification of emotions in mixed disgusted-happy faces as a function of depressive symptom severity.

PubMed

Sanchez, Alvaro; Romero, Nuria; Maurage, Pierre; De Raedt, Rudi

2017-12-01

Interpersonal difficulties are common in depression, but their underlying mechanisms are not yet fully understood. The role of depression in the identification of mixed emotional signals with a direct interpersonal value remains unclear. The present study aimed to clarify this question. A sample of 39 individuals reporting a broad range of depression levels completed an emotion identification task where they viewed faces expressing three emotional categories (100% disgusted and 100% happy faces, as well as their morphed 50% disgusted - 50% happy exemplars). Participants were asked to identify the corresponding depicted emotion as "clearly disgusted", "mixed", or "clearly happy". Higher depression levels were associated with lower identification of positive emotions in 50% disgusted - 50% happy faces. The study was conducted with an analogue sample reporting individual differences in subclinical depression levels. Further research must replicate these findings in a clinical sample and clarify whether differential emotional identification patterns emerge in depression for different mixed negative-positive emotions (sad-happy vs. disgusted-happy). Depression may account for a lower bias to perceive positive states when ambiguous states from others include subtle signals of social threat (i.e., disgust), leading to an under-perception of positive social signals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Morphological Characterization of Thioflavin-S-Positive Amyloid Plaques in Transgenic Alzheimer Mice and Effect of Passive Aβ Immunotherapy on Their Clearance

PubMed Central

Bussière, Thierry; Bard, Frédérique; Barbour, Robin; Grajeda, Henry; Guido, Terry; Khan, Karen; Schenk, Dale; Games, Dora; Seubert, Peter; Buttini, Manuel

2004-01-01

Transgenic mice mimicking certain features of Alzheimer’s disease (AD)-pathology, namely amyloid plaques and neurofibrillary tangles, have been developed in an effort to better understand the mechanism leading to the formation of these characteristic cerebral lesions. More recently, these animal models have been widely used to investigate emergent therapies aimed at the reduction of the cerebral amyloid load. Several studies have shown that immunotherapy targeting the amyloid peptide (Aβ) is efficacious at clearing the amyloid plaques or preventing their formation, and at reducing the memory/behavior impairment observed in these animals. In AD, different types of plaques likely have different pathogenic significance, and further characterization of plaque pathology in the PDAPP transgenic mice would enhance the evaluation of potential therapeutics. In the present study, a morphological classification of amyloid plaques present in the brains of PDAPP mice was established by using Thioflavin-S staining. Neuritic dystrophy associated with amyloid plaques was also investigated. Finally, the efficacy of passive immunization with anti-Aβ antibodies on the clearance of Thio-S positive amyloid plaques was studied. Our results show that distinct morphological types of plaques are differentially cleared depending upon the isotype of the antibody. PMID:15331422

Semantic and phonetic enhancements for speech-in-noise recognition by native and non-native listeners.

PubMed

Bradlow, Ann R; Alexander, Jennifer A

2007-04-01

Previous research has shown that speech recognition differences between native and proficient non-native listeners emerge under suboptimal conditions. Current evidence has suggested that the key deficit that underlies this disproportionate effect of unfavorable listening conditions for non-native listeners is their less effective use of compensatory information at higher levels of processing to recover from information loss at the phoneme identification level. The present study investigated whether this non-native disadvantage could be overcome if enhancements at various levels of processing were presented in combination. Native and non-native listeners were presented with English sentences in which the final word varied in predictability and which were produced in either plain or clear speech. Results showed that, relative to the low-predictability-plain-speech baseline condition, non-native listener final word recognition improved only when both semantic and acoustic enhancements were available (high-predictability-clear-speech). In contrast, the native listeners benefited from each source of enhancement separately and in combination. These results suggests that native and non-native listeners apply similar strategies for speech-in-noise perception: The crucial difference is in the signal clarity required for contextual information to be effective, rather than in an inability of non-native listeners to take advantage of this contextual information per se.

Limb Dominance and Its Effects on the Benefits of Intralimb Transfer of Learning: A Visuomotor Aiming Task.

PubMed

Aiken, Christopher A; Pan, Zhujun; Van Gemmert, Arend W A

2015-01-01

Research has attempted to address what characteristics benefit from transfer of learning; however, it is still unclear which characteristics are effector dependent or independent. Furthermore, it is not clear if intralimb transfer shows, similarly to interlimb transfer, an asymmetry of benefits between the upper limbs. The purpose of the current study is to examine if effector independence effects emerge, as observed in interlimb transfer studies, when transfer to new effector group within the same limb occurs, and whether the pattern of intralimb transfer benefits differ between the limbs. Our results suggest that a visuomotor task transfers within both limbs, even though the transfer benefits within the limbs seem to differ. This was supported by more transfer occurring in the dominant limb than the nondominant limb. Potential control mechanisms used for intralimb transfer are discussed.

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

Curchod, Basile F. E.; Agostini, Federica, E-mail: agostini@mpi-halle.mpg.de; Gross, E. K. U.

Nonadiabatic quantum interferences emerge whenever nuclear wavefunctions in different electronic states meet and interact in a nonadiabatic region. In this work, we analyze how nonadiabatic quantum interferences translate in the context of the exact factorization of the molecular wavefunction. In particular, we focus our attention on the shape of the time-dependent potential energy surface—the exact surface on which the nuclear dynamics takes place. We use a one-dimensional exactly solvable model to reproduce different conditions for quantum interferences, whose characteristic features already appear in one-dimension. The time-dependent potential energy surface develops complex features when strong interferences are present, in clear contrastmore » to the observed behavior in simple nonadiabatic crossing cases. Nevertheless, independent classical trajectories propagated on the exact time-dependent potential energy surface reasonably conserve a distribution in configuration space that mimics one of the exact nuclear probability densities.« less

Peripheral Facial Palsy in Emergency Department

PubMed Central

Ferreira-Penêda, José; Robles, Raquel; Gomes-Pinto, Isabel; Valente, Pedro; Barros-Lima, Nuno; Condé, Artur

2018-01-01

Introduction: Peripheral facial palsy (PFP) is commonly diagnosed in every emergency department. Despite being a benign condition in most cases, PFP causes loss in quality of life mostly due to facial dysmorphia. The etiology of PFP remains unknown in most cases, while medical opinion on epidemiology, risk factors and optimal treatment is not consensual. The aim of this study was to review the demographic characteristics of our patients and the medical care administered in our emergency department. Materials and Methods: Emergency episodes occurring in a 4-year period and codified as facial nerve pathology were analyzed. IBM SPSS software was used for statistical analysis. Results: In total, 582 emergency episodes were obtained. Due to inexpressive representation of other causes of PFP in our study, we focused our analyses on the 495 patients who were considered to have idiopathic PFP. There was equal distribution among genders, and all age ranges were affected. There were no clear epidemic phenomena. Hypertension was not a statistically significant risk factor for Bell's palsy. Most patients sought medical care in the early stages of the disease and complained of isolated facial weakness. Most patients had mild-to-moderate symptoms. Previous upper way infections (PUAI) were more frequent among children. There was a statistically significant difference regarding computed tomography (CT) scan requests among specialties. Conclusion: Epidemiologic findings were consistent with most literature on Bell's palsy. Drug therapy is widely used and follows current guidelines. The role of PUAI in the pediatric population must be investigated. Despite evidence of good medical practice, there was an excess of CT scans requested by physicians other than otorhinolaryngologists. PMID:29876329

Zombie Apocalypse: Can the Undead Teach the Living How to Survive an Emergency?

PubMed

Kruvand, Marjorie; Bryant, Fred B

2015-01-01

We examined whether or not CDC's zombie apocalypse campaign had the ability to achieve the agency's goals of educating young people about emergency preparedness and prompting them to get ready by developing an emergency kit and plan. While the campaign was extremely popular, we examined the question of whether the campaign had the capability to translate into knowledge and action. We conducted an online experiment with 340 undergraduate students divided randomly into two groups. One group was exposed to CDC's zombie blog post; the other to the same preparedness information presented in CDC's traditional, straightforward way. Participants then completed a survey designed to gauge their affective feelings, perceptions, retention of preparedness preparation, and intent to develop an emergency kit and plan. While participants who viewed the humorous zombie material clearly enjoyed it, their positive affect did not lead to greater retention of preparedness information or greater expressed intent to prepare, compared with participants exposed to the factual treatment. The zombie approach had no influence on retention or resulted in less retention relative to the factual approach. Also, there was no significant between-group difference in reported likelihood of developing an emergency kit or plan. While the campaign drew unprecedented traffic to CDC's website, our findings suggest that it lacked the capability to fully achieve the agency's goals of educating people about preparedness and prompting them to get ready. This finding supports previous studies concluding that it is challenging to design public health messages that evoke positive affect as well as intended changes in intentions or behaviors.

Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

PubMed Central

Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

2014-01-01

Background As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility. Conclusions The primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities. PMID:25511879

Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam.

PubMed

Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

2014-01-01

As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility. The primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities.

The vacuum splint: an aid in emergency splinting of fractures

PubMed Central

Letts, R. M.; Hobson, D. A.

1973-01-01

The vacuum splint has been shown to be a simple, safe and effective method of emergency splinting of fractured extremities. The splint is simply constructed from clear vinyl sheeting and contains 2-mm. expanded polystyrene balls. Evacuation of air causes the splint to become rigid, thereby providing stability and immobilization of the limb. The splint is radiolucent, containing no obstructive metal components that would interfere with the radiographic appearance of the injured limb. The ease of application of this splint makes it especially effective for the emergency splinting of fractures in children. ImagesFIG. 1FIG. 2AFIG. 2BFIG. 3FIG. 4 PMID:4742489

Cytokines and MicroRNAs as Candidate Biomarkers for Systemic Lupus Erythematosus

PubMed Central

Stypińska, Barbara; Paradowska-Gorycka, Agnieszka

2015-01-01

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, with varied course and symptoms. Its etiology is very complex and not clearly understood. There is growing evidence of the important role of cytokines in SLE pathogenesis, as well as their utility as biomarkers and targets in new therapies. Other potential new SLE biomarkers are microRNAs. Recently, over one hundred different microRNAs have been demonstrated to have a significant impact on the immune system. Various alterations in these microRNAs, associated with disease pathogenesis, have been described. They influence the signaling pathways and functions of immune response cells. Here, we aim to review the emerging new data on SLE etiology and pathogenesis. PMID:26473848

A Semantic Grid Oriented to E-Tourism

NASA Astrophysics Data System (ADS)

Zhang, Xiao Ming

With increasing complexity of tourism business models and tasks, there is a clear need of the next generation e-Tourism infrastructure to support flexible automation, integration, computation, storage, and collaboration. Currently several enabling technologies such as semantic Web, Web service, agent and grid computing have been applied in the different e-Tourism applications, however there is no a unified framework to be able to integrate all of them. So this paper presents a promising e-Tourism framework based on emerging semantic grid, in which a number of key design issues are discussed including architecture, ontologies structure, semantic reconciliation, service and resource discovery, role based authorization and intelligent agent. The paper finally provides the implementation of the framework.

Cost and unit cost calculations using step-down accounting.

PubMed

Conteh, Lesong; Walker, Damian

2004-03-01

There is paucity of unit cost data from low- and middle-income countries, although recent initiatives have emerged to help rectify this. The limited budgets assigned to health care facilities mean that health planners and managers must be able to account for the resources used in health facilities as well as use them efficiently. Step-down cost accounting (SDCA) offers a relatively simple method for generating cost and unit cost data at the facility level. However, to the best of our knowledge, there is a lack of clear and concise guidance on how to undertake SDCA. Therefore, this paper, using a worked example, illustrates the different steps involved to generate cost and unit costs for a small hospital.

Androgen Receptor Signaling in Bladder Cancer

PubMed Central

Li, Peng; Chen, Jinbo; Miyamoto, Hiroshi

2017-01-01

Emerging preclinical findings have indicated that steroid hormone receptor signaling plays an important role in bladder cancer outgrowth. In particular, androgen-mediated androgen receptor signals have been shown to correlate with the promotion of tumor development and progression, which may clearly explain some sex-specific differences in bladder cancer. This review summarizes and discusses the available data, suggesting the involvement of androgens and/or the androgen receptor pathways in urothelial carcinogenesis as well as tumor growth. While the precise mechanisms of the functions of the androgen receptor in urothelial cells remain far from being fully understood, current evidence may offer chemopreventive or therapeutic options, using androgen deprivation therapy, in patients with bladder cancer. PMID:28241422

Are you good enough for your patients? The European certification model in laparoscopic surgery

PubMed Central

Campo, R.; Molinas, C.R.; De Wilde, R.L.; Brolmann, H.; Brucker, S.; Mencaglia, L.; Odonovan, P.; Wallwiener, D.; Wattiez, A.

2012-01-01

Quality control, training and education in gynaecological surgery are challenged and urgent measures are emerging. The implementation of a structured and validated program for training and quality control seems the most urgent measurement to be taken. The European Academy of Gynaecological Surgery has made a first attempt to do so. Through a practical and theoretical tests system, the skills of an individual surgeon is measured and the conditions to enter the different level of expertise are clearly defined. This certification system based on the best possible level of scientific evidence provides a first practical tool, universally implementable for a decent quality control and structured training program in Gynaecological laparoscopic surgery. PMID:24753896

Social Media in Emergency Management: Capability Assessment

DTIC Science & Technology

2014-05-01

blank. iv DRDC-RDDC-2014-R16 Table of contents Abstract...iii Table of contents ...innovation. 2. The decision makers being generally unaware of the value of SMEM – the value proposition of SMEM needs to be clearly communicated including

Relationships between maternal engorgement weight and the number, size, and fat content of larval Ixodes scapularis (Acari: Ixodidae)

USGS Publications Warehouse

Ginsberg, Howard; Lee, Chong; Volson, Barry; Dyer, Megan C.; LeBrun, Roger A.

2017-01-01

The relationship between engorgement weight of female Ixodes scapularis Say and characteristics of offspring was studied using field-collected females fed on rabbits in the laboratory. The number of eggs laid was positively related to maternal engorgement weight in one trial, and larval size (estimated by scutal area) was positively related to maternal engorgement weight in the other. These results suggest a trade-off in number of eggs produced versus average size of offspring, possibly determined during late engorgement. The adults for the two trials were collected from different sites in southern Rhode Island and in different seasons (the fall adults were newly emerged, while the spring adults had presumably lived through the winter), so it is not clear whether these results reflect genetic differences or subtle environmental differences between trials. Percent egg hatch and average fat content of larvae were not related to female engorgement weight. We present a modified method to measure lipid content of pooled larval ticks.

Seedling establishment in a masting desert shrub parallels the pattern for forest trees

NASA Astrophysics Data System (ADS)

Meyer, Susan E.; Pendleton, Burton K.

2015-05-01

The masting phenomenon along with its accompanying suite of seedling adaptive traits has been well studied in forest trees but has rarely been examined in desert shrubs. Blackbrush (Coleogyne ramosissima) is a regionally dominant North American desert shrub whose seeds are produced in mast events and scatter-hoarded by rodents. We followed the fate of seedlings in intact stands vs. small-scale disturbances at four contrasting sites for nine growing seasons following emergence after a mast year. The primary cause of first-year mortality was post-emergence cache excavation and seedling predation, with contrasting impacts at sites with different heteromyid rodent seed predators. Long-term establishment patterns were strongly affected by rodent activity in the weeks following emergence. Survivorship curves generally showed decreased mortality risk with age but differed among sites even after the first year. There were no detectable effects of inter-annual precipitation variability or site climatic differences on survival. Intraspecific competition from conspecific adults had strong impacts on survival and growth, both of which were higher on small-scale disturbances, but similar in openings and under shrub crowns in intact stands. This suggests that adult plants preempted soil resources in the interspaces. Aside from effects on seedling predation, there was little evidence for facilitation or interference beneath adult plant crowns. Plants in intact stands were still small and clearly juvenile after nine years, showing that blackbrush forms cohorts of suppressed plants similar to the seedling banks of closed forests. Seedling banks function in the absence of a persistent seed bank in replacement after adult plant death (gap formation), which is temporally uncoupled from masting and associated recruitment events. This study demonstrates that the seedling establishment syndrome associated with masting has evolved in desert shrublands as well as in forests.

Clinical significance of blood pressure ratios in hypertensive crisis in children.

PubMed

Wu, Han-Ping; Yang, Wen-Chieh; Wu, Yung-Kang; Zhao, Lu-Lu; Chen, Chun-Yu; Fu, Yun-Ching

2012-03-01

Hypertensive crisis is categorised into hypertensive urgency and hypertensive emergency. The present work aimed to determine the effect of different gradings of blood pressure (BP) ratios in predicting the severity of paediatric hypertensive crisis. This was a retrospective case series, based in the paediatric emergency departments of the Changhua Christian Hospital and the Tzu-Chi General Hospital, Taiwan. From 1995 to 2010, the correlation between the severity of hypertension (HTN) and the difference in elevated systolic BP and 99th percentile plus 5 mm Hg (dSBP), the difference in elevated diastolic BP and 99th percentile plus 5 mm Hg (dDBP), dSBP ratio (dSBP/99th percentile plus 5 mm Hg) and dDBP ratio were analysed. A total of 110 children with a first attack of hypertensive crisis were recruited. Patients with hypertensive crisis caused by essential HTN had lower dDBP ratios than the other causes (p=0.033), while those with an oncological aetiology had the highest dSBP and dDBP ratios among all the aetiologies. For clinical presentations, patients with nausea/vomiting and visual impairment presented with higher dSBP ratios than those without the symptoms (both p<0.05), but patients with altered consciousness had higher dSBP and dDBP ratios than those who had clear consciousness (p<0.05). Children with hypertensive urgency had lower dSBP and dDBP ratios than those with hypertensive emergency (both p<0.05). dDBP and dSBP ratios may serve as BP parameters in predicting the severity of paediatric hypertensive crisis. A dSBP ratio greater than 20% may indicate a critical point for severe hypertensive crisis in children.

Improving menstrual hygiene management in emergency contexts: literature review of current perspectives.

PubMed

VanLeeuwen, Crystal; Torondel, Belen

2018-01-01

Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations' menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body's biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in humanitarian emergencies and which sectors should be responsible for the coordination and implementation of such. Increased monitoring and evaluation studies of interventions should be completed and publicly shared, in order to feed evidence-based guidelines in the humanitarian sector.

Improving menstrual hygiene management in emergency contexts: literature review of current perspectives

PubMed Central

VanLeeuwen, Crystal; Torondel, Belen

2018-01-01

Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body’s biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in humanitarian emergencies and which sectors should be responsible for the coordination and implementation of such. Increased monitoring and evaluation studies of interventions should be completed and publicly shared, in order to feed evidence-based guidelines in the humanitarian sector. PMID:29692636

An ancient look at UCP1.

PubMed

Klingenspor, Martin; Fromme, Tobias; Hughes, David A; Manzke, Lars; Polymeropoulos, Elias; Riemann, Tobias; Trzcionka, Magdalene; Hirschberg, Verena; Jastroch, Martin

2008-01-01

Brown adipose tissue serves as a thermogenic organ in placental mammals to defend body temperature in the cold by nonshivering thermogenesis. The thermogenic function of brown adipose tissue is enabled by several specialised features on the organ as well as on the cellular level, including dense sympathetic innervation and vascularisation, high lipolytic capacity and mitochondrial density and the unique expression of uncoupling protein 1 (UCP1). This mitochondrial carrier protein is inserted into the inner mitochondrial membrane and stimulates maximum mitochondrial respiration by dissipating proton-motive force as heat. Studies in knockout mice have clearly demonstrated that UCP1 is essential for nonshivering thermogenesis in brown adipose tissue. For a long time it had been presumed that brown adipose tissue and UCP1 emerged in placental mammals providing them with a unique advantage to survive in the cold. Our subsequent discoveries of UCP1 orthologues in ectotherm vertebrates and marsupials clearly refute this presumption. We can now initiate comparative studies on the structure-function relationships in UCP1 orthologues from different vertebrates to elucidate when during vertebrate evolution UCP1 gained the biochemical properties required for nonshivering thermogenesis.

Prey-capture Strategies of Fish-hunting Cone Snails: Behavior, Neurobiology and Evolution

PubMed Central

Olivera, Baldomero M.; Seger, Jon; Horvath, Martin P.; Fedosov, Alexander

2015-01-01

The venomous fish-hunting cone snails (Conus) comprise eight distinct lineages evolved from ancestors that preyed on worms. In this article we attempt to reconstruct events resulting in this shift in food resource by closely examining patterns of behavior, biochemical agents (toxins) that facilitate prey capture, and the combinations of toxins present in extant species. The first sections introduce three different hunting behaviors associated with piscivory: “taser and tether”, “net engulfment”, and “strike and stalk”. The first two fish-hunting behaviors are clearly associated with distinct groups of venom components, called cabals, which act in concert to modify the behavior of prey in a specific manner. Derived fish-hunting behavior clearly also correlates with physical features of the radular tooth, the device that injects these biochemical components. Mapping behavior, biochemical components, and radular tooth features onto phylogenetic trees shows that fish-hunting behavior emerged at lease twice during evolution. The system presented here may be one of the best examples where diversity in structure, physiology and molecular features was initially driven by particular pathways selected through behavior. PMID:26397110

Genetic and environmental influences on adult human height across birth cohorts from 1886 to 1994

PubMed Central

Jelenkovic, Aline; Hur, Yoon-Mi; Sund, Reijo; Yokoyama, Yoshie; Siribaddana, Sisira H; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Tan, Qihua; Zhang, Dongfeng; Pang, Zengchang; Aaltonen, Sari; Heikkilä, Kauko; Öncel, Sevgi Y; Aliev, Fazil; Rebato, Esther; Tarnoki, Adam D; Tarnoki, David L; Christensen, Kaare; Skytthe, Axel; Kyvik, Kirsten O; Silberg, Judy L; Eaves, Lindon J; Maes, Hermine H; Cutler, Tessa L; Hopper, John L; Ordoñana, Juan R; Sánchez-Romera, Juan F; Colodro-Conde, Lucia; Cozen, Wendy; Hwang, Amie E; Mack, Thomas M; Sung, Joohon; Song, Yun-Mi; Yang, Sarah; Lee, Kayoung; Franz, Carol E; Kremen, William S; Lyons, Michael J; Busjahn, Andreas; Nelson, Tracy L; Whitfield, Keith E; Kandler, Christian; Jang, Kerry L; Gatz, Margaret; Butler, David A; Stazi, Maria A; Fagnani, Corrado; D'Ippolito, Cristina; Duncan, Glen E; Buchwald, Dedra; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth JF; Martin, Nicholas G; Medland, Sarah E; Montgomery, Grant W; Jeong, Hoe-Uk; Swan, Gary E; Krasnow, Ruth; Magnusson, Patrik KE; Pedersen, Nancy L; Dahl-Aslan, Anna K; McAdams, Tom A; Eley, Thalia C; Gregory, Alice M; Tynelius, Per; Baker, Laura A; Tuvblad, Catherine; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Lichtenstein, Paul; Spector, Timothy D; Mangino, Massimo; Lachance, Genevieve; Bartels, Meike; van Beijsterveldt, Toos CEM; Willemsen, Gonneke; Burt, S Alexandra; Klump, Kelly L; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas Sevenius; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Corley, Robin P; Hjelmborg, Jacob v B; Goldberg, Jack H; Iwatani, Yoshinori; Watanabe, Mikio; Honda, Chika; Inui, Fujio; Rasmussen, Finn; Huibregtse, Brooke M; Boomsma, Dorret I; Sørensen, Thorkild I A; Kaprio, Jaakko; Silventoinen, Karri

2016-01-01

Human height variation is determined by genetic and environmental factors, but it remains unclear whether their influences differ across birth-year cohorts. We conducted an individual-based pooled analysis of 40 twin cohorts including 143,390 complete twin pairs born 1886–1994. Although genetic variance showed a generally increasing trend across the birth-year cohorts, heritability estimates (0.69-0.84 in men and 0.53-0.78 in women) did not present any clear pattern of secular changes. Comparing geographic-cultural regions (Europe, North America and Australia, and East Asia), total height variance was greatest in North America and Australia and lowest in East Asia, but no clear pattern in the heritability estimates across the birth-year cohorts emerged. Our findings do not support the hypothesis that heritability of height is lower in populations with low living standards than in affluent populations, nor that heritability of height will increase within a population as living standards improve. DOI: http://dx.doi.org/10.7554/eLife.20320.001 PMID:27964777

Quantitative imaging test approval and biomarker qualification: interrelated but distinct activities.

PubMed

Buckler, Andrew J; Bresolin, Linda; Dunnick, N Reed; Sullivan, Daniel C; Aerts, Hugo J W L; Bendriem, Bernard; Bendtsen, Claus; Boellaard, Ronald; Boone, John M; Cole, Patricia E; Conklin, James J; Dorfman, Gary S; Douglas, Pamela S; Eidsaunet, Willy; Elsinger, Cathy; Frank, Richard A; Gatsonis, Constantine; Giger, Maryellen L; Gupta, Sandeep N; Gustafson, David; Hoekstra, Otto S; Jackson, Edward F; Karam, Lisa; Kelloff, Gary J; Kinahan, Paul E; McLennan, Geoffrey; Miller, Colin G; Mozley, P David; Muller, Keith E; Patt, Rick; Raunig, David; Rosen, Mark; Rupani, Haren; Schwartz, Lawrence H; Siegel, Barry A; Sorensen, A Gregory; Wahl, Richard L; Waterton, John C; Wolf, Walter; Zahlmann, Gudrun; Zimmerman, Brian

2011-06-01

Quantitative imaging biomarkers could speed the development of new treatments for unmet medical needs and improve routine clinical care. However, it is not clear how the various regulatory and nonregulatory (eg, reimbursement) processes (often referred to as pathways) relate, nor is it clear which data need to be collected to support these different pathways most efficiently, given the time- and cost-intensive nature of doing so. The purpose of this article is to describe current thinking regarding these pathways emerging from diverse stakeholders interested and active in the definition, validation, and qualification of quantitative imaging biomarkers and to propose processes to facilitate the development and use of quantitative imaging biomarkers. A flexible framework is described that may be adapted for each imaging application, providing mechanisms that can be used to develop, assess, and evaluate relevant biomarkers. From this framework, processes can be mapped that would be applicable to both imaging product development and to quantitative imaging biomarker development aimed at increasing the effectiveness and availability of quantitative imaging. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10100800/-/DC1. RSNA, 2011

The fear of others: a qualitative analysis of interpersonal threat in social phobia and paranoia.

PubMed

Stopa, Luisa; Denton, Ruth; Wingfield, Megan; Taylor, Katherine Newman

2013-03-01

The cognitive models indicate that people with social phobia and paranoia share a common fear of others. While we recognize clinical differences, it is likely that some of the same psychological processes contribute to the maintenance of both presentations, yet the nature and extent of these similarities and differences are not yet clearly understood. This study explored threat experiences in people with social phobia and persecutory delusions in order to elucidate these aspects of the respective cognitive models. Accounts of interpersonal threat experiences were examined in nine people with social phobia and nine people with persecutory delusions. Verbatim transcripts were analyzed using thematic analysis. Three major themes emerged from the data: participants' experience of threat, reactions while under threat, and subsequent reflections. Narrative coherence emerged as a superordinate theme. Typical fear responses were found in both groups, particularly in their reactions to threat. The key differences were in participants' perceptual experiences, ability to stand back from the threat following the event, and narrative coherence. The findings are discussed in relation to current cognitive models of social phobia and paranoia. Theoretical and clinical implications are drawn out, and highlight the need to examine attentional and metacognitive processes more closely if we are to understand the maintenance of perceived threat in these groups, and means of alleviating associated distress.

Understanding Is Key: An Analysis of Factors Pertaining to Trust in a Real-World Automation System.

PubMed

Balfe, Nora; Sharples, Sarah; Wilson, John R

2018-06-01

This paper aims to explore the role of factors pertaining to trust in real-world automation systems through the application of observational methods in a case study from the railway sector. Trust in automation is widely acknowledged as an important mediator of automation use, but the majority of the research on automation trust is based on laboratory work. In contrast, this work explored trust in a real-world setting. Experienced rail operators in four signaling centers were observed for 90 min, and their activities were coded into five mutually exclusive categories. Their observed activities were analyzed in relation to their reported trust levels, collected via a questionnaire. The results showed clear differences in activity, even when circumstances on the workstations were very similar, and significant differences in some trust dimensions were found between groups exhibiting different levels of intervention and time not involved with signaling. Although the empirical, lab-based studies in the literature have consistently found that reliability and competence of the automation are the most important aspects of trust development, understanding of the automation emerged as the strongest dimension in this study. The implications are that development and maintenance of trust in real-world, safety-critical automation systems may be distinct from artificial laboratory automation. The findings have important implications for emerging automation concepts in diverse industries including highly automated vehicles and Internet of things.

Trends in size of tropical deforestation events signal increasing dominance of industrial-scale drivers

NASA Astrophysics Data System (ADS)

Austin, Kemen G.; González-Roglich, Mariano; Schaffer-Smith, Danica; Schwantes, Amanda M.; Swenson, Jennifer J.

2017-05-01

Deforestation continues across the tropics at alarming rates, with repercussions for ecosystem processes, carbon storage and long term sustainability. Taking advantage of recent fine-scale measurement of deforestation, this analysis aims to improve our understanding of the scale of deforestation drivers in the tropics. We examined trends in forest clearings of different sizes from 2000-2012 by country, region and development level. As tropical deforestation increased from approximately 6900 kha yr-1 in the first half of the study period, to >7900 kha yr-1 in the second half of the study period, >50% of this increase was attributable to the proliferation of medium and large clearings (>10 ha). This trend was most pronounced in Southeast Asia and in South America. Outside of Brazil >60% of the observed increase in deforestation in South America was due to an upsurge in medium- and large-scale clearings; Brazil had a divergent trend of decreasing deforestation, >90% of which was attributable to a reduction in medium and large clearings. The emerging prominence of large-scale drivers of forest loss in many regions and countries suggests the growing need for policy interventions which target industrial-scale agricultural commodity producers. The experience in Brazil suggests that there are promising policy solutions to mitigate large-scale deforestation, but that these policy initiatives do not adequately address small-scale drivers. By providing up-to-date and spatially explicit information on the scale of deforestation, and the trends in these patterns over time, this study contributes valuable information for monitoring, and designing effective interventions to address deforestation.

Implementation and evaluation of health passport communication tools in emergency departments.

PubMed

Heifetz, Marina; Lunsky, Yona

2018-01-01

People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario. Health passport communication tools were locally tailored and implemented in each of the three regions. A total of 28 questionnaires and 18 interviews with stakeholders (e.g., hospital staff, community agency representatives, families) were completed across the regions to obtain feedback on the implementation of health passports with people with IDD. Participants felt that the health passport tools provided helpful information, improved communication between patients with IDD and hospital staff, and were user friendly. Continued efforts are needed to work with communities on maintenance of this tool, ensuring all hospital staff are utilizing the information. These findings emphasize the merits of health passport tools being implemented in the health system to support communication between patients with IDD and health care practitioners and the importance of tailoring tools to local settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends In Susceptibility To Single-Event Upset

NASA Technical Reports Server (NTRS)

Nichols, Donald K.; Price, William E.; Kolasinski, Wojciech A.; Koga, Rukotaro; Waskiewicz, Alvin E.; Pickel, James C.; Blandford, James T.

1989-01-01

Report provides nearly comprehensive body of data on single-event upsets due to irradiation by heavy ions. Combines new test data and previously published data from governmental and industrial laboratories. Clear trends emerge from data useful in predicting future performances of devices.

Evaluation of service reliability impacts of traffic signal priority strategies for bus transit

DOT National Transportation Integrated Search

2003-03-31

Recent progress in technology has facilitated the design, testing, and deployment of traffic signal priority strategies for transit buses. However, a clear consensus has not emerged regarding the evaluation of these strategies. Each agency implementi...

Interpretive analysis of 85 systematic reviews suggests that narrative syntheses and meta-analyses are incommensurate in argumentation.

PubMed

Melendez-Torres, G J; O'Mara-Eves, A; Thomas, J; Brunton, G; Caird, J; Petticrew, M

2017-03-01

Using Toulmin's argumentation theory, we analysed the texts of systematic reviews in the area of workplace health promotion to explore differences in the modes of reasoning embedded in reports of narrative synthesis as compared with reports of meta-analysis. We used framework synthesis, grounded theory and cross-case analysis methods to analyse 85 systematic reviews addressing intervention effectiveness in workplace health promotion. Two core categories, or 'modes of reasoning', emerged to frame the contrast between narrative synthesis and meta-analysis: practical-configurational reasoning in narrative synthesis ('what is going on here? What picture emerges?') and inferential-predictive reasoning in meta-analysis ('does it work, and how well? Will it work again?'). Modes of reasoning examined quality and consistency of the included evidence differently. Meta-analyses clearly distinguished between warrant and claim, whereas narrative syntheses often presented joint warrant-claims. Narrative syntheses and meta-analyses represent different modes of reasoning. Systematic reviewers are likely to be addressing research questions in different ways with each method. It is important to consider narrative synthesis in its own right as a method and to develop specific quality criteria and understandings of how it is carried out, not merely as a complement to, or second-best option for, meta-analysis. © 2016 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd. © 2016 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.

Biomarkers of exposure to new and emerging tobacco delivery products.

PubMed

Schick, Suzaynn F; Blount, Benjamin C; Jacob, Peyton; Saliba, Najat A; Bernert, John T; El Hellani, Ahmad; Jatlow, Peter; Pappas, R Steven; Wang, Lanqing; Foulds, Jonathan; Ghosh, Arunava; Hecht, Stephen S; Gomez, John C; Martin, Jessica R; Mesaros, Clementina; Srivastava, Sanjay; St Helen, Gideon; Tarran, Robert; Lorkiewicz, Pawel K; Blair, Ian A; Kimmel, Heather L; Doerschuk, Claire M; Benowitz, Neal L; Bhatnagar, Aruni

2017-09-01

Accurate and reliable measurements of exposure to tobacco products are essential for identifying and confirming patterns of tobacco product use and for assessing their potential biological effects in both human populations and experimental systems. Due to the introduction of new tobacco-derived products and the development of novel ways to modify and use conventional tobacco products, precise and specific assessments of exposure to tobacco are now more important than ever. Biomarkers that were developed and validated to measure exposure to cigarettes are being evaluated to assess their use for measuring exposure to these new products. Here, we review current methods for measuring exposure to new and emerging tobacco products, such as electronic cigarettes, little cigars, water pipes, and cigarillos. Rigorously validated biomarkers specific to these new products have not yet been identified. Here, we discuss the strengths and limitations of current approaches, including whether they provide reliable exposure estimates for new and emerging products. We provide specific guidance for choosing practical and economical biomarkers for different study designs and experimental conditions. Our goal is to help both new and experienced investigators measure exposure to tobacco products accurately and avoid common experimental errors. With the identification of the capacity gaps in biomarker research on new and emerging tobacco products, we hope to provide researchers, policymakers, and funding agencies with a clear action plan for conducting and promoting research on the patterns of use and health effects of these products.

Code Blue Emergencies: A Team Task Analysis and Educational Initiative.

PubMed

Price, James W; Applegarth, Oliver; Vu, Mark; Price, John R

2012-01-01

The objective of this study was to identify factors that have a positive or negative influence on resuscitation team performance during emergencies in the operating room (OR) and post-operative recovery unit (PAR) at a major Canadian teaching hospital. This information was then used to implement a team training program for code blue emergencies. In 2009/10, all OR and PAR nurses and 19 anesthesiologists at Vancouver General Hospital (VGH) were invited to complete an anonymous, 10 minute written questionnaire regarding their code blue experience. Survey questions were devised by 10 recovery room and operation room nurses as well as 5 anesthesiologists representing 4 different hospitals in British Columbia. Three iterations of the survey were reviewed by a pilot group of nurses and anesthesiologists and their feedback was integrated into the final version of the survey. Both nursing staff (n = 49) and anesthesiologists (n = 19) supported code blue training and believed that team training would improve patient outcome. Nurses noted that it was often difficult to identify the leader of the resuscitation team. Both nursing staff and anesthesiologists strongly agreed that too many people attending the code blue with no assigned role hindered team performance. Identifiable leadership and clear communication of roles were identified as keys to resuscitation team functioning. Decreasing the number of people attending code blue emergencies with no specific role, increased access to mock code blue training, and debriefing after crises were all identified as areas requiring improvement. Initial team training exercises have been well received by staff.

Correlation analysis of motor current and chatter vibration in grinding using complex continuous wavelet coherence

NASA Astrophysics Data System (ADS)

Liu, Yao; Wang, Xiufeng; Lin, Jing; Zhao, Wei

2016-11-01

Motor current is an emerging and popular signal which can be used to detect machining chatter with its multiple advantages. To achieve accurate and reliable chatter detection using motor current, it is important to make clear the quantitative relationship between motor current and chatter vibration, which has not yet been studied clearly. In this study, complex continuous wavelet coherence, including cross wavelet transform and wavelet coherence, is applied to the correlation analysis of motor current and chatter vibration in grinding. Experimental results show that complex continuous wavelet coherence performs very well in demonstrating and quantifying the intense correlation between these two signals in frequency, amplitude and phase. When chatter occurs, clear correlations in frequency and amplitude in the chatter frequency band appear and the phase difference of current signal to vibration signal turns from random to stable. The phase lead of the most correlated chatter frequency is the largest. With the further development of chatter, the correlation grows up in intensity and expands to higher order chatter frequency band. The analyzing results confirm that there is a consistent correlation between motor current and vibration signals in the grinding chatter process. However, to achieve accurate and reliable chatter detection using motor current, the frequency response bandwidth of current loop of the feed drive system must be wide enough to response chatter effectively.

Development of solar wind shock models with tensor plasma pressure for data analysis

NASA Technical Reports Server (NTRS)

Abraham-Shrauner, B.

1975-01-01

The development of solar wind shock models with tensor plasma pressure and the comparison of some of the shock models with the satellite data from Pioneer 6 through Pioneer 9 are reported. Theoretically, difficulties were found in non-turbulent fluid shock models for tensor pressure plasmas. For microscopic shock theories nonlinear growth caused by plasma instabilities was frequently not clearly demonstrated to lead to the formation of a shock. As a result no clear choice for a shock model for the bow shock or interplanetary tensor pressure shocks emerged.

Contemporary Leadership and Doctrine: The Utility of Analyzing the Outcome of Thucydides’ The Peloponnesian War Via Clausewitz’s Concepts as Articulated in On War

DTIC Science & Technology

2001-04-03

Corps doctrine. This made clear to me iii the danger of concentrating on emerging technology during doctrine development, while simultaneously de ...is, but introduces his work as an "inquiry" ( historia ). Herodotus clearly believes in the intervention of the gods in his description of historical...He begins the war as a general in the Athenian armed forces. During the eighth year of the war, the Spartan commander, Brasidas, gains access to the

A New Fast Algorithm to Completely Account for Non-Lambertian Surface Reflection of The Earth

NASA Technical Reports Server (NTRS)

Qin, Wen-Han; Herman, Jay R.; Ahmad, Ziauddin; Einaudi, Franco (Technical Monitor)

2000-01-01

Surface bidirectional reflectance distribution function (BRDF) influences not only radiance just about the surface, but that emerging from the top of the atmosphere (TOA). In this study we propose a new, fast and accurate, algorithm CASBIR (correction for anisotropic surface bidirectional reflection) to account for such influences on radiance measured above TOA. This new algorithm is based on a 4-stream theory that separates the radiation field into direct and diffuse components in both upwelling and downwelling directions. This is important because the direct component accounts for a substantial portion of incident radiation under a clear sky, and the BRDF effect is strongest in the reflection of the direct radiation reaching the surface. The model is validated by comparison with a full-scale, vector radiation transfer model for the atmosphere-surface system. The result demonstrates that CASBIR performs very well (with overall relative difference of less than one percent) for all solar and viewing zenith and azimuth angles considered in wavelengths from ultraviolet to near-infrared over three typical, but very different surface types. Application of this algorithm includes both accounting for non-Lambertian surface scattering on the emergent radiation above TOA and a potential approach for surface BRDF retrieval from satellite measured radiance.

Mechanisms of Silver Nanoparticle Release, Transformation and Toxicity: A Critical Review of Current Knowledge and Recommendations for Future Studies and Applications

PubMed Central

Reidy, Bogumiła; Haase, Andrea; Luch, Andreas; Dawson, Kenneth A.; Lynch, Iseult

2013-01-01

Nanosilver, due to its small particle size and enormous specific surface area, facilitates more rapid dissolution of ions than the equivalent bulk material; potentially leading to increased toxicity of nanosilver. This, coupled with their capacity to adsorb biomolecules and interact with biological receptors can mean that nanoparticles can reach sub-cellular locations leading to potentially higher localized concentrations of ions once those particles start to dissolve or degrade in situ. Further complicating the story is the capacity for nanoparticles to generate reactive oxygen species, and to interact with, and potentially disturb the functioning of biomolecules such as proteins, enzymes and DNA. The fact that the nanoparticle size, shape, surface coating and a host of other factors contribute to these interactions, and that the particles themselves are evolving or ageing leads to further complications in terms of elucidating mechanisms of interaction and modes of action for silver nanoparticles, in contrast to dissolved silver species. This review aims to provide a critical assessment of the current understanding of silver nanoparticle toxicity, as well as to provide a set of pointers and guidelines for experimental design of future studies to assess the environmental and biological impacts of silver nanoparticles. In particular; in future we require a detailed description of the nanoparticles; their synthesis route and stabilisation mechanisms; their coating; and evolution and ageing under the exposure conditions of the assay. This would allow for comparison of data from different particles; different environmental or biological systems; and structure-activity or structure-property relationships to emerge as the basis for predictive toxicology. On the basis of currently available data; such comparisons or predictions are difficult; as the characterisation and time-resolved data is not available; and a full understanding of silver nanoparticle dissolution and ageing under different conditions is observed. Clear concerns are emerging regarding the overuse of nanosilver and the potential for bacterial resistance to develop. A significant conclusion includes the need for a risk—benefit analysis for all applications and eventually restrictions of the uses where a clear benefit cannot be demonstrated. PMID:28809275

How do we capture the emergency nurse practitioners' contribution to value in health service delivery?

PubMed

Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael

2017-03-01

The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

Preimplantation genetic testing for aneuploidy: what technology should you use and what are the differences?

PubMed

Brezina, Paul R; Anchan, Raymond; Kearns, William G

2016-07-01

The purpose of the review was to define the various diagnostic platforms currently available to perform preimplantation genetic testing for aneuploidy and describe in a clear and balanced manner the various strengths and weaknesses of these technologies. A systematic literature review was conducted. We used the terms "preimplantation genetic testing," "preimplantation genetic diagnosis," "preimplantation genetic screening," "preimplantation genetic diagnosis for aneuploidy," "PGD," "PGS," and "PGD-A" to search through PubMed, ScienceDirect, and Google Scholar from the year 2000 to April 2016. Bibliographies of articles were also searched for relevant studies. When possible, larger randomized controlled trials were used. However, for some emerging data, only data from meeting abstracts were available. PGS is emerging as one of the most valuable tools to enhance pregnancy success with assisted reproductive technologies. While all of the current diagnostic platforms currently available have various advantages and disadvantages, some platforms, such as next-generation sequencing (NGS), are capable of evaluating far more data points than has been previously possible. The emerging complexity of different technologies, especially with the utilization of more sophisticated tools such as NGS, requires an understanding by clinicians in order to request the best test for their patients.. Ultimately, the choice of which diagnostic platform is utilized should be individualized to the needs of both the clinic and the patient. Such a decision must incorporate the risk tolerance of both the patient and provider, fiscal considerations, and other factors such as the ability to counsel patients on their testing results and how these may or may not impact clinical outcomes.

Enhance your team-based qualitative research.

PubMed

Fernald, Douglas H; Duclos, Christine W

2005-01-01

Qualitative research projects often involve the collaborative efforts of a research team. Challenges inherent in teamwork include changes in membership and differences in analytical style, philosophy, training, experience, and skill. This article discusses teamwork issues and tools and techniques used to improve team-based qualitative research. We drew on our experiences in working on numerous projects of varying, size, duration, and purpose. Through trials of different tools and techniques, expert consultation, and review of the literature, we learned to improve how we build teams, manage information, and disseminate results. Attention given to team members and team processes is as important as choosing appropriate analytical tools and techniques. Attentive team leadership, commitment to early and regular team meetings, and discussion of roles, responsibilities, and expectations all help build more effective teams and establish clear norms. As data are collected and analyzed, it is important to anticipate potential problems from differing skills and styles, and how information and files are managed. Discuss analytical preferences and biases and set clear guidelines and practices for how data will be analyzed and handled. As emerging ideas and findings disperse across team members, common tools (such as summary forms and data grids), coding conventions, intermediate goals or products, and regular documentation help capture essential ideas and insights. In a team setting, little should be left to chance. This article identifies ways to improve team-based qualitative research with more a considered and systematic approach. Qualitative researchers will benefit from further examination and discussion of effective, field-tested, team-based strategies.

Experimental investigation of edge hardening and edge cracking sensitivity of burr-free parts

NASA Astrophysics Data System (ADS)

Senn, Sergei; Liewald, Mathias

2018-05-01

This experimental study is focused on characterisation of edge hardening of sheet metal and remaining formability of differently prepared cutted edges. Edge cracking sensitivity of counter cutted, shear cutted, recutted and water-jet cutted components are compared and evaluated. Subsequently, edge hardening and hole expansion ratio were correlated for material HC420 LA with sheet thickness of t = 2 mm. As other studies show, the cutting edge surface quality influences the hole expansion ratio: a high clear cut surface increases formability of cutting edges, whereas micro cracks and rough surfaces result into a large fracture surface, which impact remaining formability noticeably. Thus, cutting edges with lower edge hardening behaviour in conjunction with a higher clear cut surface exhibit higher hole expansion ratios. Counter cutting and the recutting do show a similar effect on edge hardening. Using the hole expansion test, it was possible to prove that counter cutted components show a significantly lower edge cracking sensitivity in comparison to conventionally shear cutted components. The hole expansion ratio of counter cutted specimens looks balanced and is comparable to the hole expansion ratio measured from specimens with recutted or water jet cutted edges. The significant difference of the investigated cutting processes is characterized by size of clear cutting area. This area of recutted edges emerges larger than the area of counter cutted specimens, which evidently leads to an increased hole expansion ratio of recutted specimens compared to conventionally shear cutted ones. However, it is important to note that the hole expansion ratio of counter cutted and recutted specimens appear fairly balanced, but counter cutted samples indeed can be produced burr-free. Using counter cutting technology, it is possible to produce burr free surfaces with high edge formability.

[The identity of medical psychology: a historical quest].

PubMed

Steinberg, Holger

2014-11-01

The starting point of this study is the current uncertainty in German-speaking medical psychology about its actual and very own natural area of expertise. The current study ventures to advance the hypothesis that part of this uncertainty is due to the fact that during the scientific area in its history (approx. 1850-1960) medical psychology abandoned its historical core competence as it emerged and developed during the age of enlightenment (end of 17(th)-18(th) centuries). To make this change clear, different examples of the 2 opposing conceptualisations of medical psychology are discussed, of course in a selected and maybe even provocative way. The change in concept also led to the fact that the interrelationships with and differentiation from its neighbouring disciplines are not clear and sharp either, since at times 2 or more disciplines declare themselves competent for one and the same thing. This is exemplified on the manifold overlappings with clinical psychology. Given the lack of resources now and in the future, this lack of a clear definition of competence might lead to continued uncertainty as well as to conflicts over distribution. On the other hand though, the look into the history of the subject reveals that at all times it has been a matter of individual approach or attitude as to what was regarded as core area of interest and competence of medical psychology and how far it overlapped with neighbouring disciplines. From the point of view of the history of psychiatry and on the basis of carefully selected historic material, this paper presents the core of 2 different concepts of medical psychology to elaborate this hypothesis. © Georg Thieme Verlag KG Stuttgart · New York.

Study of the effectiveness of first-line treatment in renal cell carcinoma

PubMed Central

SASTRE-HERES, ALEJANDRO J.; CALERO, MIGUEL ALAGUERO; RUIZ-SÁNCHEZ, DANIEL; GARCÍA, MARÍA TERESA IGLESIAS; HERNANDEZ, MIGUEL ANGEL CALLEJA; MARTÍNEZ, FERNANDO MARTÍNEZ; PEÑA-DÍAZ, JAIME

2014-01-01

The emergence of novel drugs corresponds with the determination of the effectiveness of the current treatments used in clinical practice. A retrospective observational study was conducted to evaluate the effectiveness of first-line treatments and to test the influence of the prognostic factors established using the Memorial Sloan-Kettering Cancer Center (MSKCC) and the analysis of Mekhail’s study for two or more metastatic sites. The primary endpoints were median progression-free survival (mPFS) and median overall survival (mOS) times. A total of 65 patients were enrolled and the mPFS and mOS of the patients treated with sunitinib (n=51) were 9.0 and 20.1 months, respectively, and for the patients treated with temsirolimus (n=14) these were 3.0 and 6.2 months, respectively. In the poor-prognosis (PP) group, a difference of 1.2 months (P=0.049) was found in mPFS depending on the first-line treatment. A difference of 4.1 months (P=0.023) was also found in mPFS when classified by histology (clear verses non-clear cell) in the sunitinib-treatment group. When stratified by the prognostic group, differences of >7 months (P<0.001) were found between the groups. Therefore, it was concluded that the effectiveness of the treatments was reduced compared to previous studies and differences were found in the PP group when classified by first-line drug and histology. Additionally, the influence of prognostic factors on OS and the value of stratifying patients using these factors have been confirmed. PMID:25279217

Biophotonics sensor acclimatization to stem cells environment

NASA Astrophysics Data System (ADS)

Mohamad Shahimin, Mukhzeer

2017-11-01

The ability to discriminate, characterise and purify biological cells from heterogeneous population of cells is fundamental to numerous prognosis and diagnosis applications; often forming the basis for current and emerging clinical protocols in stem cell therapy. Current sorting approaches exploit differences in cell density, specific immunologic targets, or receptor-ligand interactions to isolate particular cells. Identification of novel properties by which different cell types may be discerned and of new ways for their selective manipulation are clearly fundamental components for improving sorting methodologies. Biophotonics sensor developed by our team are potentially capable of discriminating cells according to their refractive index (which is highly dependable on the organelles inside the cell), size (indicator to cell stage) and shape (in certain cases as an indicator to cell type). The sensor, which already discriminate particles efficiently, is modified to acclimatize into biological environment, especially for stem cell applications.

A synopsis on aging—Theories, mechanisms and future prospects

PubMed Central

da Costa, João Pinto; Vitorino, Rui; Silva, Gustavo M.; Vogel, Christine; Duarte, Armando C.; Rocha-Santos, Teresa

2018-01-01

Answering the question as to why we age is tantamount to answering the question of what is life itself. There are countless theories as to why and how we age, but, until recently, the very definition of aging – senescence – was still uncertain. Here, we summarize the main views of the different models of senescence, with a special emphasis on the biochemical processes that accompany aging. Though inherently complex, aging is characterized by numerous changes that take place at different levels of the biological hierarchy. We therefore explore some of the most relevant changes that take place during aging and, finally, we overview the current status of emergent aging therapies and what the future holds for this field of research. From this multi-dimensional approach, it becomes clear that an integrative approach that couples aging research with systems biology, capable of providing novel insights into how and why we age, is necessary. PMID:27353257

The hallmarks of premalignant conditions: a molecular basis for cancer prevention.

PubMed

Ryan, Bríd M; Faupel-Badger, Jessica M

2016-02-01

The hallmarks of premalignant lesions were first described in the 1970s, a time when relatively little was known about the molecular underpinnings of cancer. Yet it was clear there must be opportunities to intervene early in carcinogenesis. A vast array of molecular information has since been uncovered, with much of this stemming from studies of existing cancer or cancer models. Here, examples of how an understanding of cancer biology has informed cancer prevention studies are highlighted and emerging areas that may have implications for the field of cancer prevention research are described. A note of caution accompanies these examples, in that while there are similarities, there are also fundamental differences between the biology of premalignant lesions or premalignant conditions and invasive cancer. These differences must be kept in mind, and indeed leveraged, when exploring potential cancer prevention measures. Published by Elsevier Inc.

Serotonin and female psychopathology.

PubMed

Hall, Elise; Steiner, Meir

2013-01-01

There are sex differences in the prevalence and presentation of many psychiatric disorders. Various trends in symptomatology have emerged that are thought to be linked to periods of hormonal fluctuations such as with menses, pregnancy or menopause. With data from animal and human studies, it has become clear that there is an important interplay between the serotonergic system and gonadal hormones. The majority of the research to date has focused on the influence that estrogen has within the CNS and, in particular, how it leads to an overall increase in serotonin synthesis and availability. In reviewing this female-specific topic we hope to raise awareness to sex/gender differences in psychopathology, help identify at-risk populations and consider development of new treatment options. Future research will also need to consider the influence that progesterone and oxytocin may have on sex-specific psychopathology as well as incorporate neuroimaging and consider the influence of hormones on the serotonergic system at a genetic level.

The hallmarks of premalignant conditions: a molecular basis for cancer prevention

PubMed Central

Ryan, Bríd M.; Faupel-Badger, Jessica M.

2016-01-01

The hallmarks of premalignant lesions were first described in the 1970s, a time when relatively little was known about the molecular underpinnings of cancer. Yet it was clear there must be opportunities to intervene early in carcinogenesis. A vast array of molecular information has since been uncovered, with much of this stemming from studies of existing cancer or cancer models. Here, examples of how an understanding of cancer biology has informed cancer prevention studies are highlighted and emerging areas that may have implications for the field of cancer prevention research are described. A note of caution accompanies these examples, in that while there are similarities, there are also fundamental differences between the biology of premalignant lesions or premalignant conditions and invasive cancer. These differences must be kept in mind, and indeed leveraged, when exploring potential cancer prevention measures. PMID:26970122

Tripolar electric field Structure in guide field magnetic reconnection

NASA Astrophysics Data System (ADS)

Fu, Song; Huang, Shiyong; Zhou, Meng; Ni, Binbin; Deng, Xiaohua

2018-03-01

It has been shown that the guide field substantially modifies the structure of the reconnection layer. For instance, the Hall magnetic and electric fields are distorted in guide field reconnection compared to reconnection without guide fields (i.e., anti-parallel reconnection). In this paper, we performed 2.5-D electromagnetic full particle simulation to study the electric field structures in magnetic reconnection under different initial guide fields (Bg). Once the amplitude of a guide field exceeds 0.3 times the asymptotic magnetic field B0, the traditional bipolar Hall electric field is clearly replaced by a tripolar electric field, which consists of a newly emerged electric field and the bipolar Hall electric field. The newly emerged electric field is a convective electric field about one ion inertial length away from the neutral sheet. It arises from the disappearance of the Hall electric field due to the substantial modification of the magnetic field and electric current by the imposed guide field. The peak magnitude of this new electric field increases linearly with the increment of guide field strength. Possible applications of these results to space observations are also discussed.

A hybrid inventory management system respondingto regular demand and surge demand

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

Mohammad S. Roni; Mingzhou Jin; Sandra D. Eksioglu

2014-06-01

This paper proposes a hybrid policy for a stochastic inventory system facing regular demand and surge demand. The combination of two different demand patterns can be observed in many areas, such as healthcare inventory and humanitarian supply chain management. The surge demand has a lower arrival rate but higher demand volume per arrival. The solution approach proposed in this paper incorporates the level crossing method and mixed integer programming technique to optimize the hybrid inventory policy with both regular orders and emergency orders. The level crossing method is applied to obtain the equilibrium distributions of inventory levels under a givenmore » policy. The model is further transformed into a mixed integer program to identify an optimal hybrid policy. A sensitivity analysis is conducted to investigate the impact of parameters on the optimal inventory policy and minimum cost. Numerical results clearly show the benefit of using the proposed hybrid inventory model. The model and solution approach could help healthcare providers or humanitarian logistics providers in managing their emergency supplies in responding to surge demands.« less

The rule of declining adaptability in microbial evolution experiments

PubMed Central

Couce, Alejandro; Tenaillon, Olivier A.

2015-01-01

One of the most recurrent observations after two decades of microbial evolution experiments regards the dynamics of fitness change. In a given environment, low-fitness genotypes are recurrently observed to adapt faster than their more fit counterparts. Since adaptation is the main macroscopic outcome of Darwinian evolution, studying its patterns of change could potentially provide insight into key issues of evolutionary theory, from fixation dynamics to the genetic architecture of organisms. Here, we re-analyze several published datasets from experimental evolution with microbes and show that, despite large differences in the origin of the data, a pattern of inverse dependence of adaptability with fitness clearly emerges. In quantitative terms, it is remarkable to observe little if any degree of idiosyncrasy across systems as diverse as virus, bacteria and yeast. The universality of this phenomenon suggests that its emergence might be understood from general principles, giving rise to the exciting prospect that evolution might be statistically predictable at the macroscopic level. We discuss these possibilities in the light of the various theories of adaptation that have been proposed and delineate future directions of research. PMID:25815007

Does terrestrial epidemiology apply to marine systems?

USGS Publications Warehouse

McCallum, Hamish I.; Kuris, Armand M.; Harvell, C. Drew; Lafferty, Kevin D.; Smith, Garriet W.; Porter, James

2004-01-01

Most of epidemiological theory has been developed for terrestrial systems, but the significance of disease in the ocean is now being recognized. However, the extent to which terrestrial epidemiology can be directly transferred to marine systems is uncertain. Many broad types of disease-causing organism occur both on land and in the sea, and it is clear that some emergent disease problems in marine environments are caused by pathogens moving from terrestrial to marine systems. However, marine systems are qualitatively different from terrestrial environments, and these differences affect the application of modelling and management approaches that have been developed for terrestrial systems. Phyla and body plans are more diverse in marine environments and marine organisms have different life histories and probably different disease transmission modes than many of their terrestrial counterparts. Marine populations are typically more open than terrestrial ones, with the potential for long-distance dispersal of larvae. Potentially, this might enable unusually rapid propagation of epidemics in marine systems, and there are several examples of this. Taken together, these differences will require the development of new approaches to modelling and control of infectious disease in the ocean.

Can primary care and community-based models of emergency care substitute for the hospital accident and emergency (A & E) department?

PubMed

Roberts, E; Mays, N

1998-06-01

This systematic review assesses the extent to which primary-secondary substitution is possible in the field of emergency care where the range of options for the delivery of care is increasing in the UK and elsewhere. Thirty-four studies were located which met the review inclusion criteria, covering a range of interventions. This evidence suggested that broadening access to primary care and introducing user charges or other barriers to the hospital accident and emergency (A & E) department can reduce demand for expensive secondary care, although the relative cost-effectiveness of these interventions remains unclear. On a smaller scale, employing primary care professionals in the hospital A & E department to treat patients attending with minor illness or injury seems to be a cost-effective method of substituting primary for secondary care resources. Interventions that addressed both sides of the primary-secondary interface and recognised the importance of patient preferences in the largely demand-driven emergency service were more likely to succeed in complementing rather than duplicating existing services. The evidence on other interventions such as telephone triage, minor injuries units and general practitioner out of hours co-operatives was sparse despite the fact that these interventions are growing rapidly in the UK. Quantifying the scope for substitution in any one health system is difficult since the evidence comes from international research studies undertaken in a variety of very different health settings. Simply transferring interventions which succeed in one setting without understanding the underlying process of change is likely to result in unexpected consequences locally. Nevertheless, the review findings clearly demonstrate that shifting the balance of care is possible. It also highlights a persistent gap in professional and lay perceptions of appropriate sources of care for minor illness and injury.

76 FR 3642 - National Human Genome Research Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research....nih.gov . Name of Committee: National Human Genome Research Institute Special Emphasis Panel eMERGE...

Talking Politics, Practicing Citizenship

ERIC Educational Resources Information Center

MacKinnon, Mary Pat

2008-01-01

The message emerging from a recent research series on youth civic and political participation is clear: today's youth are not disengaged from associational and small "p" political life, but they are increasingly disenchanted with formal political institutions and practices. Generation Y (those born after 1979) has less formal political…

First Aid: Dehydration

MedlinePlus

... rapid or weakened pulse What to Do Mild dehydration often can be treated at home. If your child has diarrhea but no vomiting, continue feeding a ... 20 minutes. Seek Emergency Medical Care If Your Child: shows any sign of severe dehydration is unable to keep clear fluids down Think ...

Risk communication in the case of the Fukushima accident: Impact of communication and lessons to be learned.

PubMed

Perko, Tanja

2016-10-01

Risk communication about the Fukushima Daiichi nuclear power plant accident in 2011 was often not transparent, timely, clear, nor factually correct. However, lessons related to risk communication have been identified and some of them are already addressed in national and international communication programmes and strategies. The Fukushima accident may be seen as a practice scenario for risk communication with important lessons to be learned. As a result of risk communication failures during the accident, the world is now better prepared for communication related to nuclear emergencies than it was 5 years ago The present study discusses the impact of communication, as applied during the Fukushima accident, and the main lessons learned. It then identifies pathways for transparent, timely, clear and factually correct communication to be developed, practiced and applied in nuclear emergency communication before, during, and after nuclear accidents. Integr Environ Assess Manag 2016;12:683-686. © 2016 SETAC. © 2016 SETAC.

Photonic microstructures for energy-generating clear glass and net-zero energy buildings

NASA Astrophysics Data System (ADS)

Vasiliev, Mikhail; Alghamedi, Ramzy; Nur-E-Alam, Mohammad; Alameh, Kamal

2016-08-01

Transparent energy-harvesting windows are emerging as practical building-integrated photovoltaics (BIPV), capable of generating electricity while simultaneously reducing heating and cooling demands. By incorporating spectrally-selective diffraction gratings as light deflecting structures of high visible transparency into lamination interlayers and using improved spectrally-selective thin-film coatings, most of the visible solar radiation can be transmitted through the glass windows with minimum attenuation. At the same time, the ultraviolet (UV) and a part of incident solar infrared (IR) radiation energy are converted and/or deflected geometrically towards the panel edge for collection by CuInSe2 solar cells. Experimental results show power conversion efficiencies in excess of 3.04% in 10 cm × 10 cm vertically-placed clear glass panels facing direct sunlight, and up to 2.08% in 50 cm × 50 cm installation-ready framed window systems. These results confirm the emergence of a new class of solar window system ready for industrial application.

Neoadjuvant imatinib for borderline resectable GIST.

PubMed

Koontz, M Zach; Visser, Brendan M; Kunz, Pamela L

2012-12-01

A 36-year-old woman presented to the emergency department with black stools and syncope. Her hemoglobin was 7.0 and her red blood cells were microcytic. Upper endoscopy did not identify a clear source of bleeding, but a bulge in the third portion of the duodenum was noted. A CT scan showed a large extraintestinal mass, and follow-up esophagogastroduodenoscopy/endoscopic ultrasound with biopsy revealed a spindle cell neoplasm, consistent with gastrointestinal stromal tumor (GIST). Because of the size of the lesion and association with the superior mesenteric vein and common bile duct, she was referred to medical oncology for consideration of neoadjuvant imatinib. Neoadjuvant tyrosine kinase inhibitor therapy for GISTs is emerging as a viable treatment strategy for borderline resectable tumors, although the dose, duration, and optimal imaging modalities have not been clearly established. Recent pathologic and radiographic data have provided insight into the mechanism and kinetics of this approach. This case report presents a patient for whom surgery was facilitated using neoadjuvant imatinib.

Photonic microstructures for energy-generating clear glass and net-zero energy buildings.

PubMed

Vasiliev, Mikhail; Alghamedi, Ramzy; Nur-E-Alam, Mohammad; Alameh, Kamal

2016-08-23

Transparent energy-harvesting windows are emerging as practical building-integrated photovoltaics (BIPV), capable of generating electricity while simultaneously reducing heating and cooling demands. By incorporating spectrally-selective diffraction gratings as light deflecting structures of high visible transparency into lamination interlayers and using improved spectrally-selective thin-film coatings, most of the visible solar radiation can be transmitted through the glass windows with minimum attenuation. At the same time, the ultraviolet (UV) and a part of incident solar infrared (IR) radiation energy are converted and/or deflected geometrically towards the panel edge for collection by CuInSe2 solar cells. Experimental results show power conversion efficiencies in excess of 3.04% in 10 cm × 10 cm vertically-placed clear glass panels facing direct sunlight, and up to 2.08% in 50 cm × 50 cm installation-ready framed window systems. These results confirm the emergence of a new class of solar window system ready for industrial application.

Photonic microstructures for energy-generating clear glass and net-zero energy buildings

PubMed Central

Vasiliev, Mikhail; Alghamedi, Ramzy; Nur-E-Alam, Mohammad; Alameh, Kamal

2016-01-01

Transparent energy-harvesting windows are emerging as practical building-integrated photovoltaics (BIPV), capable of generating electricity while simultaneously reducing heating and cooling demands. By incorporating spectrally-selective diffraction gratings as light deflecting structures of high visible transparency into lamination interlayers and using improved spectrally-selective thin-film coatings, most of the visible solar radiation can be transmitted through the glass windows with minimum attenuation. At the same time, the ultraviolet (UV) and a part of incident solar infrared (IR) radiation energy are converted and/or deflected geometrically towards the panel edge for collection by CuInSe2 solar cells. Experimental results show power conversion efficiencies in excess of 3.04% in 10 cm × 10 cm vertically-placed clear glass panels facing direct sunlight, and up to 2.08% in 50 cm × 50 cm installation-ready framed window systems. These results confirm the emergence of a new class of solar window system ready for industrial application. PMID:27550827

Measured and perceived environmental comfort: field monitoring in an Italian school.

PubMed

De Giuli, Valeria; Zecchin, Roberto; Corain, Livio; Salmaso, Luigi

2014-07-01

Microclimatic conditions were recorded in an Italian school and Fanger's indexes PMV and PPD were calculated under different conditions. Students' sensations were investigated four times by means of two surveys, one related to actual microclimatic conditions and one on overall satisfaction, interaction occupant-building and reactions to discomfort. Pupils' classroom position was considered to look for possible influence on thermal comfort: a difference emerged from PMV and the survey, but the results obtained from the two approaches differ for both the entity of discomfort and its distribution within each classroom. Innovative multivariate nonparametric statistical techniques were applied to compare and rank the classrooms in accordance with students' subjective perceptions; a global ranking has been also calculated, considering thermal and visual comfort and air quality. Comparing pupil-sensation-based ranking with environmental parameters no clear correspondence was found, except for mid-season, where PMV, CO2 concentration and desk illuminance were similar in all the classrooms. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

From Social Integration to Social Isolation: The Relationship Between Social Network Types and Perceived Availability of Social Support in a National Sample of Older Canadians.

PubMed

Harasemiw, Oksana; Newall, Nancy; Shooshtari, Shahin; Mackenzie, Corey; Menec, Verena

2017-01-01

It is well-documented that social isolation is detrimental to health and well-being. What is less clear is what types of social networks allow older adults to get the social support they need to promote health and well-being. In this study, we identified social network types in a national sample of older Canadians and explored whether they are associated with perceived availability of different types of social support (affectionate, emotional, or tangible, and positive social interactions). Data were drawn from the baseline questionnaire of the Canadian Longitudinal Study on Aging for participants aged 65-85 (unweighted n = 8,782). Cluster analyses revealed six social network groups. Social support generally declined as social networks became more restricted; however, different patterns of social support availability emerged for different social network groups. These findings suggest that certain types of social networks place older adults at risk of not having met specific social support needs.

Epigenomics of cancer – emerging new concepts

PubMed Central

Hassler, Melanie R.; Egger, Gerda

2012-01-01

The complexity of the mammalian genome is regulated by heritable epigenetic mechanisms, which provide the basis for differentiation, development and cellular homeostasis. These mechanisms act on the level of chromatin, by modifying DNA, histone proteins and nucleosome density/composition. During the last decade it became clear that cancer is defined by a variety of epigenetic changes, which occur in early stages of disease and parallel genetic mutations. With the advent of new technologies we are just starting to unravel the cancer epigenome and latest mechanistic findings provide the first clue as to how altered epigenetic patterns might occur in different cancers. Here we review latest findings on chromatin related mechanisms and hypothesize how their impairment might contribute to the altered epigenome of cancer cells. PMID:22609632

Multiple Myeloma and Epidural Spinal Cord Compression : Case Presentation and a Spine Surgeon's Perspective

PubMed Central

Ha, Kee-Yong; Kim, Hyun-Woo

2013-01-01

Multiple myeloma, a multicentric hematological malignancy, is the most common primary tumor of the spine. As epidural myeloma causing spinal cord compression is a rare condition, its therapeutic approach and clinical results have been reported to be diverse, and no clear guidelines for therapeutic decision have been established. Three patients presented with progressive paraplegia and sensory disturbance. Image and serological studies revealed multiple myeloma and spinal cord compression caused by epidural myeloma. Emergency radiotherapy and steroid therapy were performed in all three cases. However, their clinical courses and results were distinctly different. Following review of our cases and the related literature, we suggest a systematic therapeutic approach for these patients to achieve better clinical results. PMID:24175035

Mind-Wandering as a Natural Kind: A Family-Resemblances View.

PubMed

Seli, Paul; Kane, Michael J; Smallwood, Jonathan; Schacter, Daniel L; Maillet, David; Schooler, Jonathan W; Smilek, Daniel

2018-06-01

As empirical research on mind-wandering accelerates, we draw attention to an emerging trend in how mind-wandering is conceptualized. Previously articulated definitions of mind-wandering differ from each other in important ways, yet they also maintain overlapping characteristics. This conceptual structure suggests that mind-wandering is best considered from a family-resemblances perspective, which entails treating it as a graded, heterogeneous construct and clearly measuring and describing the specific aspect(s) of mind-wandering that researchers are investigating. We believe that adopting this family-resemblances approach will increase conceptual and methodological connections among related phenomena in the mind-wandering family and encourage a more nuanced and precise understanding of the many varieties of mind-wandering. Copyright © 2018 Elsevier Ltd. All rights reserved.

Variability of DKA Management Among Pediatric Emergency Room and Critical Care Providers: A Call for More Evidence-Based and Cost-Effective Care?

PubMed

Clark, Matthew G; Dalabih, Abdallah

2014-09-01

Management protocols have been shown to be effective in the pediatric emergency medicine (PEM) and pediatric critical care (PCC) settings. Treatment protocols define clear goals which are achieved with consistency in implementation. Over the last decade, many new recommendations have been proposed on managing diabetic ketoacidosis (DKA). Although no perfect set of guidelines exist, many institutions are developing DKA treatment protocols. We sought to determine the variability between institutions in implementation of these protocols.

Stimulating debate: ethics in a multidisciplinary functional neurosurgery committee

PubMed Central

Ford, Paul J; Kubu, Cynthia S

2006-01-01

Multidisciplinary healthcare committees meet regularly to discuss patients' candidacy for emerging functional neurosurgical procedures, such as Deep Brain Stimulation (DBS). Through debate and discussion around the surgical candidacy of particular patients, functional neurosurgery programs begin to mold practice and policy supported both by scientific evidence and clear value choices. These neurosurgical decisions have special considerations not found in non‐neurologic committees. The professional time used to resolve these conflicts provides opportunities for the emergence of careful, ethical practices simultaneous with the expansion of therapy applications PMID:16446416

A clearing house for diagnostic testing: the solution to ensure access to and use of patented genetic inventions?

PubMed Central

van Zimmeren, Esther; Verbeure, Birgit; Matthijs, Gert; Van Overwalle, Geertrui

2006-01-01

In genetic diagnostics, the emergence of a so-called "patent thicket" is imminent. Such an overlapping set of patent rights may have restrictive effects on further research and development of diagnostic tests, and the provision of clinical diagnostic services. Currently, two models that may facilitate access to and use of patented genetic inventions are attracting much debate in various national and international fora: patent pools and clearing houses. In this article, we explore the concept of clearing houses. Several types of clearing houses are identified. First, we describe and discuss two types that would provide access to information on the patented inventions: the information clearing house and the technology exchange clearing house. Second, three types of clearing houses are analysed that not only offer access to information but also provide an instrument to facilitate the use of the patented inventions: the open access clearing house, the standardized licences clearing house and the royalty collection clearing house. A royalty collection clearing house for genetic diagnostic testing would be the most comprehensive as it would serve several functions: identifying patents and patent claims essential to diagnostic testing, matching licensees with licensors, developing and supplying standardized licences, collecting royalties, monitoring whether users respect licensing conditions, and providing dispute resolution services such as mediation and arbitration. In this way, it might function as an effective model for users to facilitate access to and use of the patented inventions. However, it remains to be seen whether patent holders with a strong patent portfolio will be convinced by the advantages of the royalty collection clearing house and be willing to participate. PMID:16710543

Seedling performance covaries with dormancy thresholds: maintaining cryptic seed heteromorphism in a fire-prone system.

PubMed

Liyanage, Ganesha S; Ayre, David J; Ooi, Mark K J

2016-11-01

The production of morphologically different seeds or fruits by the same individual plant is known as seed heteromorphism. Such variation is expected to be selected for in disturbance-prone environments to allow germination into inherently variable regeneration niches. However, there are few demonstrations that heteromorphic seed characteristics should be favored by selection or how they may be maintained. In fire-prone ecosystems, seed heteromorphism is found in the temperatures needed to break physical dormancy, with seeds responding to high or low temperatures, ensuring emergence under variable fire-regime-related soil heating. Because of the relationship between dormancy-breaking temperature thresholds and fire severity, we hypothesize that different post-fire resource conditions have selected for covarying seedling traits, which contribute to maintenance of such heteromorphism. Seeds with low thresholds emerge into competitive conditions, either after low-severity fire or in vegetation gaps, and are therefore likely to experience selection for seedling characteristics that make them good competitors. On the other hand, high-temperature-threshold seeds would emerge into less competitive environments, indicative of stand-clearing high-severity fires, and would not experience the same selective forces. We identified high and low-threshold seed morphs via dormancy-breaking heat treatments and germination trials for two study species and compared seed mass and other morphological characteristics between morphs. We then grew seedlings from the two different morphs, with and without competition, and measured growth and biomass allocation as indicators of seedling performance. Seedlings from low-threshold seeds of both species performed better than their high-threshold counterparts, growing more quickly under competitive conditions, confirming that different performance can result from this seed characteristic. Seed mass or appearance did not differ between morphs, indicating that dormancy-breaking temperature threshold variation is a form of cryptic heteromorphism. The potential shown for the selective influence of different post-fire environmental conditions on seedling performance provides evidence of a mechanism for the maintenance of heteromorphic variation in dormancy-breaking temperature thresholds. © 2016 The Authors. Ecology, published by Wiley Periodicals, Inc., on behalf of the Ecological Society of America.

Turning EGFR mutation-positive non-small-cell lung cancer into a chronic disease: optimal sequential therapy with EGFR tyrosine kinase inhibitors

PubMed Central

Hirsh, Vera

2018-01-01

Four epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), erlotinib, gefitinib, afatinib and osimertinib, are currently available for the management of EGFR mutation-positive non-small-cell lung cancer (NSCLC), with others in development. Although tumors are exquisitely sensitive to these agents, acquired resistance is inevitable. Furthermore, emerging data indicate that first- (erlotinib and gefitinib), second- (afatinib) and third-generation (osimertinib) EGFR TKIs differ in terms of efficacy and tolerability profiles. Therefore, there is a strong imperative to optimize the sequence of TKIs in order to maximize their clinical benefit. Osimertinib has demonstrated striking efficacy as a second-line treatment option in patients with T790M-positive tumors, and also confers efficacy and tolerability advantages over first-generation TKIs in the first-line setting. However, while accrual of T790M is the most predominant mechanism of resistance to erlotinib, gefitinib and afatinib, resistance mechanisms to osimertinib have not been clearly elucidated, meaning that possible therapy options after osimertinib failure are not clear. At present, few data comparing sequential regimens in patients with EGFR mutation-positive NSCLC are available and prospective clinical trials are required. This article reviews the similarities and differences between EGFR TKIs, and discusses key considerations when assessing optimal sequential therapy with these agents for the treatment of EGFR mutation-positive NSCLC. PMID:29383041

The Machine behind the Stage: A Neurobiological Approach toward Theoretical Issues of Sensory Perception

PubMed Central

Moutoussis, Konstantinos

2016-01-01

The purpose of the present article is to try and give a brief, scientific perspective on several issues raised in the Philosophy of Perception literature. This perspective gives a central role to the brain mechanisms that underlie perception: a percept is something that emerges when the brain is activated in a certain way and thus all perceptual experiences (whether veridical, illusory, or hallucinatory) have a common cause behind them, namely a given brain-activation pattern. What distinguishes between different cases of perception is what has caused this activation pattern, i.e., something very separate and very different from the perceptual experience itself. It is argued that separating the perceptual event from its hypothetical content, a direct consequence of the way everyday language is structured, creates unnecessary ontological complications regarding the nature of the hypothetical ‘object’ of perception. A clear distinction between the physical properties of the real world on the one hand (e.g., wavelength reflectance), and the psychological properties of perceptual experiences on the other (e.g., color) is clearly made. Finally, although perception is a way of acquiring knowledge/information about the world, this acquisition should be considered as a cognitive process which is separate to and follows perception. Therefore, the latter should remain neutral with respect to the ‘correctness’ or ‘truth’ of the knowledge acquired. PMID:27679587

The Machine behind the Stage: A Neurobiological Approach toward Theoretical Issues of Sensory Perception.

PubMed

Moutoussis, Konstantinos

2016-01-01

The purpose of the present article is to try and give a brief, scientific perspective on several issues raised in the Philosophy of Perception literature. This perspective gives a central role to the brain mechanisms that underlie perception: a percept is something that emerges when the brain is activated in a certain way and thus all perceptual experiences (whether veridical, illusory, or hallucinatory) have a common cause behind them, namely a given brain-activation pattern. What distinguishes between different cases of perception is what has caused this activation pattern, i.e., something very separate and very different from the perceptual experience itself. It is argued that separating the perceptual event from its hypothetical content, a direct consequence of the way everyday language is structured, creates unnecessary ontological complications regarding the nature of the hypothetical 'object' of perception. A clear distinction between the physical properties of the real world on the one hand (e.g., wavelength reflectance), and the psychological properties of perceptual experiences on the other (e.g., color) is clearly made. Finally, although perception is a way of acquiring knowledge/information about the world, this acquisition should be considered as a cognitive process which is separate to and follows perception. Therefore, the latter should remain neutral with respect to the 'correctness' or 'truth' of the knowledge acquired.

76 FR 14021 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

... Project Clostridium difficile Infection (CDI) Surveillance--New--National Center for Emerging and Zoonotic... Description Steady increases in the rate and severity of Clostridium difficile infection (CDI) indicate a clear need to conduct longitudinal assessments of the impact of CDI in the United States. C. difficile...

Cyberbullying: Predicting Victimisation and Perpetration

ERIC Educational Resources Information Center

Walrave, Michel; Heirman, Wannes

2011-01-01

The double-edged nature of modern technology, continuously balancing between risks and opportunities, manifests itself clearly in an emerging societal problem known as cyberbullying. To analyse the extent and nature of the issue in Belgium, 1318 adolescents were questioned explicitly about their involvement in cyberbullying, as well as implicitly…

1979 and the Re-Emergence of the Islamic Empire

DTIC Science & Technology

2009-05-21

war created even more hostility as Egypt became embroiled in the geopolitics of the Arabian Peninsula, something Saudi Arabia viewed as clearly...Organization structure . At the same time that Arafat and the PLO organization were consolidating their position, a rival group was growing in the Gaza

Education, Conflict and Development

ERIC Educational Resources Information Center

Paulson, Julia, Ed.

2011-01-01

Under various names--education and conflict, education and fragility, education and insecurity, etc.--the understanding of linkages between education and violent conflict has emerged as an important and pressing area of inquiry. Work and research by practitioners and scholars has clearly pointed to the negative potential of education to contribute…

Urns and Chameleons: two metaphors for two different types of measurements

NASA Astrophysics Data System (ADS)

Accardi, Luigi

2013-09-01

The awareness of the physical possibility of models of space, alternative with respect to the Euclidean one, begun to emerge towards the end of the 19-th century. At the end of the 20-th century a similar awareness emerged concerning the physical possibility of models of the laws of chance alternative with respect to the classical probabilistic models (Kolmogorov model). In geometry the mathematical construction of several non-Euclidean models of space preceded of about one century their applications in physics, which came with the theory of relativity. In physics the opposite situation took place. In fact, while the first example of non Kolmogorov probabilistic models emerged in quantum physics approximately one century ago, at the beginning of 1900, the awareness of the fact that this new mathematical formalism reflected a new mathematical model of the laws of chance had to wait until the early 1980's. In this long time interval the classical and the new probabilistic models were both used in the description and the interpretation of quantum phenomena and negatively interfered with each other because of the absence (for many decades) of a mathematical theory that clearly delimited the respective domains of application. The result of this interference was the emergence of the so-called the "paradoxes of quantum theory". For several decades there have been many different attempts to solve these paradoxes giving rise to what K. Popper baptized "the great quantum muddle": a debate which has been at the core of the philosophy of science for more than 50 years. However these attempts have led to contradictions between the two fundamental theories of the contemporary physical: the quantum theory and the theory of the relativity. Quantum probability identifies the reason of the emergence of non Kolmogorov models, and therefore of the so-called the paradoxes of quantum theory, in the difference between the notion of passive measurements like "reading pre-existent properties" (urn metaphor) and measurements consisting in reading "a response to an interaction" (chameleon metaphor). The non-trivial point is that one can prove that, while the urn scheme cannot lead to empirical data outside of classic probability, response based measurements can give rise to non classical statistics. The talk will include entirely classical examples of non classical statistics and potential applications to economic, sociological or biomedical phenomena.

Unclear-onset intracerebral hemorrhage: Clinical characteristics, hematoma features, and outcomes.

PubMed

Inoue, Yasuteru; Miyashita, Fumio; Koga, Masatoshi; Minematsu, Kazuo; Toyoda, Kazunori

2017-12-01

Background and purpose Although unclear-onset ischemic stroke, including wake-up ischemic stroke, is drawing attention as a potential target for reperfusion therapy, acute unclear-onset intracerebral hemorrhage has been understudied. Clinical characteristics, hematoma features, and outcomes of patients who developed intracerebral hemorrhage during sleep or those with intracerebral hemorrhage who were unconscious when witnessed were determined. Methods Consecutive intracerebral hemorrhage patients admitted within 24 hours after onset or last-known normal time were classified into clear-onset intracerebral hemorrhage and unclear-onset intracerebral hemorrhage groups. Outcomes included initial hematoma volume, initial National Institutes of Health Stroke Scale score, hematoma growth on 24-hour follow-up computed tomography, and vital and functional prognoses at 30 days. Results Of 377 studied patients (122 women, 69 ± 11 years old), 147 (39.0%) had unclear-onset intracerebral hemorrhage. Patients with unclear-onset intracerebral hemorrhage had larger hematoma volumes (p = 0.044) and higher National Institutes of Health Stroke Scale scores (p < 0.001) than those with clear-onset intracerebral hemorrhage after multivariable adjustment for risk factors and comorbidities. Hematoma growth was similarly common between the two groups (p = 0.176). There were fewer patients with modified Rankin Scale (mRS) scores of 0-2 (p = 0.033) and more patients with mRS scores of 5-6 (p = 0.009) and with fatal outcomes (p = 0.049) in unclear-onset intracerebral hemorrhage group compared with clear-onset intracerebral hemorrhage as crude values, but not after adjustment. Conclusions Patients with unclear-onset intracerebral hemorrhage presented with larger hematomas and higher National Institutes of Health Stroke Scale scores at emergent visits than those with clear-onset intracerebral hemorrhage, independent of underlying characteristics. Unclear-onset intracerebral hemorrhage patients showed poorer 30-day vital and functional outcomes than clear-onset intracerebral hemorrhage patients; these differences seem to be mainly due to initial hematoma volumes and National Institutes of Health Stroke Scale scores.

Multiple pathways of commodity crop expansion in tropical forest landscapes

NASA Astrophysics Data System (ADS)

Meyfroidt, Patrick; Carlson, Kimberly M.; Fagan, Matthew E.; Gutiérrez-Vélez, Victor H.; Macedo, Marcia N.; Curran, Lisa M.; DeFries, Ruth S.; Dyer, George A.; Gibbs, Holly K.; Lambin, Eric F.; Morton, Douglas C.; Robiglio, Valentina

2014-07-01

Commodity crop expansion, for both global and domestic urban markets, follows multiple land change pathways entailing direct and indirect deforestation, and results in various social and environmental impacts. Here we compare six published case studies of rapid commodity crop expansion within forested tropical regions. Across cases, between 1.7% and 89.5% of new commodity cropland was sourced from forestlands. Four main factors controlled pathways of commodity crop expansion: (i) the availability of suitable forestland, which is determined by forest area, agroecological or accessibility constraints, and land use policies, (ii) economic and technical characteristics of agricultural systems, (iii) differences in constraints and strategies between small-scale and large-scale actors, and (iv) variable costs and benefits of forest clearing. When remaining forests were unsuitable for agriculture and/or policies restricted forest encroachment, a larger share of commodity crop expansion occurred by conversion of existing agricultural lands, and land use displacement was smaller. Expansion strategies of large-scale actors emerge from context-specific balances between the search for suitable lands; transaction costs or conflicts associated with expanding into forests or other state-owned lands versus smallholder lands; net benefits of forest clearing; and greater access to infrastructure in already-cleared lands. We propose five hypotheses to be tested in further studies: (i) land availability mediates expansion pathways and the likelihood that land use is displaced to distant, rather than to local places; (ii) use of already-cleared lands is favored when commodity crops require access to infrastructure; (iii) in proportion to total agricultural expansion, large-scale actors generate more clearing of mature forests than smallholders; (iv) property rights and land tenure security influence the actors participating in commodity crop expansion, the form of land use displacement, and livelihood outcomes; (v) intensive commodity crops may fail to spare land when inducing displacement. We conclude that understanding pathways of commodity crop expansion is essential to improve land use governance.

Sick notes, general practitioners, emergency departments and fracture clinics

PubMed Central

Walker, C A; Gregori, A; O'Connor, P; Jaques, K; Joseph, R

2007-01-01

Background General practitioner waiting times are increasing. The two national surveys regarding general practice showed that the number of patients waiting for ⩾2 days for an appointment rose from 63% to 72% between 1998 and 2002, with 25% waiting for ⩾4 days. The Department of Health recognised that many patients discharged from hospitals and outpatient clinics required to visit their general practitioner for the sole purpose of obtaining a sick note. The report entitled Making a difference: reducing general practitioner paperwork estimated that 518 000 appointments (and 42 000 GP h) could be saved by ensuring that these patients were issued with a sick note directly from hospital rather than being referred to their general practitioner. This practice was to be adopted from July 2001 and included patients discharged from wards as well as those seen in outpatient departments. Method 50 emergency departments and fracture clinics in Scotland and England were contacted to assess whether these guidelines had been adopted. Only hospitals with both accident and emergency and fracture clinics were included; nurse‐led and paediatric departments were excluded. Results Of the 25 Scottish emergency hospitals contacted, 4 (16%) accident and emergency departments and 8 (32%) fracture clinics issued sick notes. This was compared with 5 of 25 (20%) accident and emergency departments and 12 of 25 (48%) fracture clinics in England. Four Scottish and five English accident and emergency departments stated that it was policy to give sick notes, three Scottish and four English departments said that it was policy not to give them and the rest (72% in Scotland and 64% in England) stated that they had no clear policy but “just don't give them”. Conclusion The 2001 guidance from the joint Cabinet Office/Department of Health has not been fully incorporated into standard practice in Scotland and England. If all emergency departments and fracture clinics were to issue sick notes to patients requiring >7 days absence from work, this could reduce general practitioner consultations and improve waiting times. PMID:17183039

Government health insurance and privatization: an examination of the concept and of equity.

PubMed

Anderson, O W

1988-01-01

After almost a century of the evolution of welfare capitalism in the liberal-democratic countries, and the spread of government intervention in the financing and provision of health services, the debate is now whether or not government can, or should, be as all-encompassing as it has clearly become. What is emerging with greater force is a pattern of private insurance and private provision, though its future is not easy to predict. What is clear, however, is that a modified version of a politically acceptable concept of equity will have to be formulated.

Pedestrian crowd dynamics in merging sections: Revisiting the ;faster-is-slower; phenomenon

NASA Astrophysics Data System (ADS)

Shahhoseini, Zahra; Sarvi, Majid; Saberi, Meead

2018-02-01

The study of the discharge of active or self-driven matter in narrow passages has become of the growing interest in a variety of fields. The question has particularly important practical applications for the safety of pedestrian human flows notably in emergency scenarios. It has been suggested predominantly through simulation in some theoretical studies as well as through few experimentations that under certain circumstances, an elevated vigour to escape may exacerbate the outflow and cause further delay although the experimental evidence is rather mixed. The dimensions of this complex phenomenon known as the "faster-is slower" effect are of crucial importance to be understood owing to its potential practical implications for the emergency management. The contextual requirements of observing this phenomenon are yet to be identified. It is not clear whether a "do not speed up" policy is universally beneficial and advisable in an evacuation scenario. Here for the first time we experimentally examine this phenomenon in relation to the pedestrian flows at merging sections as a common geometric feature of crowd egress. Various merging angles and three different speed regimes were examined in high-density laboratory experiments. The measurements of flow interruptions and egress efficiency all indicated that the pedestrians were discharged faster when moving at elevated speed levels. We also observed clear dependencies between the discharge rate and the physical layout of the merging with certain designs clearly outperforming others. But regardless of the design, we observed faster throughput and greater avalanche sizes when we instructed pedestrians to run. Our results give the suggestion that observation of the faster-is-slower effect may necessitate certain critical conditions including passages being overly narrow relative to the size of participles (pedestrians) to create long-lasting blockages. The faster-is-slower assumption may not be universal and there may be circumstances where faster is, in fact, faster for evacuees. In the light of these findings, we suggest that it is important to identify and formulate those conditions so they can be disentangled from one another in the models. Misguided overgeneralisations may have unintended adverse ramifications for the safe evacuation management, and this highlights the need for further exploration of this phenomenon.

Sex differences in cognitive impairment in Alzheimer’s disease

PubMed Central

Laws, Keith R; Irvine, Karen; Gale, Tim M

2016-01-01

Sex differences in neurocognitive abilities have been extensively explored both in the healthy population and in many disorders. Until recently, however, little work has examined such differences in people with Alzheimer’s disease (AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge. PMID:27014598

Propionibacterium acnes and antimicrobial resistance in acne.

PubMed

Dessinioti, Clio; Katsambas, Andreas

The human commensal bacterium Propionibacterium acnes (P. acnes) resides in the pilosebaceous duct of the skin. It has been long implicated in the pathogenesis of acne, although its exact role in the development of inflammatory acne lesions and in the formation of the microcomedo in the early stages of acne remains controversial. The worldwide prevalence of antibiotic-resistant P. acnes is increasing, with rates varying in different parts of the world. The reason for the difference in the antibiotic resistance patterns of P. acnes among different countries is not clear, although it may be attributed to different antibiotic prescribing habits, concomitant use of topical agents (retinoids, benzoyl peroxide, or other antibiotics), varying methods of bacterial sampling, or even different P. acnes populations. Although the relative abundances of P. acnes may be similar among patients with acne and individuals without acne, P. acnes populations and the presence of P. acnes biofilms differ, with different potential virulence properties and antimicrobial resistance patterns. Implications of the use of antibiotics and of antimicrobial resistance in patients with acne include the decreased efficacy of antibiotic treatments for acne, and the possible emergence of other resistant bacterial species via selective pressure by antibiotic use. Copyright © 2017 Elsevier Inc. All rights reserved.

Anaerobic biodegradation of (emerging) organic contaminants in the aquatic environment.

PubMed

Ghattas, Ann-Kathrin; Fischer, Ferdinand; Wick, Arne; Ternes, Thomas A

2017-06-01

Although strictly anaerobic conditions prevail in several environmental compartments, up to now, biodegradation studies with emerging organic contaminants (EOCs), such as pharmaceuticals and personal care products, have mainly focused on aerobic conditions. One of the reasons probably is the assumption that the aerobic degradation is more energetically favorable than degradation under strictly anaerobic conditions. Certain aerobically recalcitrant contaminants, however, are biodegraded under strictly anaerobic conditions and little is known about the organisms and enzymatic processes involved in their degradation. This review provides a comprehensive survey of characteristic anaerobic biotransformation reactions for a variety of well-studied, structurally rather simple contaminants (SMOCs) bearing one or a few different functional groups/structural moieties. Furthermore it summarizes anaerobic degradation studies of more complex contaminants with several functional groups (CMCs), in soil, sediment and wastewater treatment. While strictly anaerobic conditions are able to promote the transformation of several aerobically persistent contaminants, the variety of observed reactions is limited, with reductive dehalogenations and the cleavage of ether bonds being the most prevalent. Thus, it becomes clear that the transferability of degradation mechanisms deduced from culture studies of SMOCs to predict the degradation of CMCs, such as EOCs, in environmental matrices is hampered due the more complex chemical structure bearing different functional groups, different environmental conditions (e.g. matrix, redox, pH), the microbial community (e.g. adaptation, competition) and the low concentrations typical for EOCs. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Treatment Analysis in a Cancer Stem Cell Context Using a Tumor Growth Model Based on Cellular Automata.

PubMed

Monteagudo, Ángel; Santos, José

2015-01-01

Cancer can be viewed as an emergent behavior in terms of complex system theory and artificial life, Cellular Automata (CA) being the tool most used for studying and characterizing the emergent behavior. Different approaches with CA models were used to model cancer growth. The use of the abstract model of acquired cancer hallmarks permits the direct modeling at cellular level, where a cellular automaton defines the mitotic and apoptotic behavior of cells, and allows for an analysis of different dynamics of the cellular system depending on the presence of the different hallmarks. A CA model based on the presence of hallmarks in the cells, which includes a simulation of the behavior of Cancer Stem Cells (CSC) and their implications for the resultant growth behavior of the multicellular system, was employed. This modeling of cancer growth, in the avascular phase, was employed to analyze the effect of cancer treatments in a cancer stem cell context. The model clearly explains why, after treatment against non-stem cancer cells, the regrowth capability of CSCs generates a faster regrowth of tumor behavior, and also shows that a continuous low-intensity treatment does not favor CSC proliferation and differentiation, thereby allowing an unproblematic control of future tumor regrowth. The analysis performed indicates that, contrary to the current attempts at CSC control, trying to make CSC proliferation more difficult is an important point to consider, especially in the immediate period after a standard treatment for controlling non-stem cancer cell proliferation.

Understanding Is Key: An Analysis of Factors Pertaining to Trust in a Real-World Automation System

PubMed Central

Balfe, Nora; Sharples, Sarah; Wilson, John R.

2018-01-01

Objective: This paper aims to explore the role of factors pertaining to trust in real-world automation systems through the application of observational methods in a case study from the railway sector. Background: Trust in automation is widely acknowledged as an important mediator of automation use, but the majority of the research on automation trust is based on laboratory work. In contrast, this work explored trust in a real-world setting. Method: Experienced rail operators in four signaling centers were observed for 90 min, and their activities were coded into five mutually exclusive categories. Their observed activities were analyzed in relation to their reported trust levels, collected via a questionnaire. Results: The results showed clear differences in activity, even when circumstances on the workstations were very similar, and significant differences in some trust dimensions were found between groups exhibiting different levels of intervention and time not involved with signaling. Conclusion: Although the empirical, lab-based studies in the literature have consistently found that reliability and competence of the automation are the most important aspects of trust development, understanding of the automation emerged as the strongest dimension in this study. The implications are that development and maintenance of trust in real-world, safety-critical automation systems may be distinct from artificial laboratory automation. Application: The findings have important implications for emerging automation concepts in diverse industries including highly automated vehicles and Internet of things. PMID:29613815

Multicentre prospective validation of use of the Canadian C-Spine Rule by triage nurses in the emergency department

PubMed Central

Stiell, Ian G.; Clement, Catherine M.; O’Connor, Annette; Davies, Barbara; Leclair, Christine; Sheehan, Pamela; Clavet, Tamara; Beland, Christine; MacKenzie, Taryn; Wells, George A.

2010-01-01

Objectives The Canadian C-Spine Rule for imaging of the cervical spine was developed for use by physicians. We believe that nurses in the emergency department could use this rule to clinically clear the cervical spine. We prospectively evaluated the accuracy, reliability and acceptability of the Canadian C-Spine Rule when used by nurses. Methods We conducted this three-year prospective cohort study in six Canadian emergency departments. The study involved adult trauma patients who were alert and whose condition was stable. We provided two hours of training to 191 triage nurses. The nurses then assessed patients using the Canadian C-Spine Rule, including determination of neck tenderness and range of motion, reapplied immobilization and completed a data form. Results Of the 3633 study patients, 42 (1.2%) had clinically important injuries of the cervical spine. The kappa value for interobserver assessments of 498 patients with the Canadian C-Spine Rule was 0.78. We calculated sensitivity of 100.0% (95% confidence interval [CI] 91.0%–100.0%) and specificity of 43.4% (95% CI 42.0%–45.0%) for the Canadian C-Spine Rule as interpreted by the investigators. The nurses classified patients with a sensitivity of 90.2% (95% CI 76.0%–95.0%) and a specificity of 43.9% (95% CI 42.0%–46.0%). Early in the study, nurses failed to identify four cases of injury, despite the presence of clear high-risk factors. None of these patients suffered sequelae, and after retraining there were no further missed cases. We estimated that for 40.7% of patients, the cervical spine could be cleared clinically by nurses. Nurses reported discomfort in applying the Canadian C-Spine Rule in only 4.8% of cases. Conclusion Use of the Canadian C-Spine Rule by nurses was accurate, reliable and clinically acceptable. Widespread implementation by nurses throughout Canada and elsewhere would diminish patient discomfort and improve patient flow in overcrowded emergency departments. PMID:20457772

Emergency preparedness and public health systems lessons for developing countries.

PubMed

Kruk, Margaret E

2008-06-01

Low- and middle-income countries, where emerging diseases often make their debut, are also likely to bear the harshest consequences of a potential influenza pandemic. Yet public health systems in developing countries are underfunded, understaffed, and in many cases struggling to deal with the existing burden of disease. As a result, developed countries are beginning to expand assistance for emergency preparedness to the developing world. Given developing countries' weak infrastructure and many competing public health priorities, it is not clear how to best direct these resources. Evidence from the U.S. and other developed countries suggests that some investments in bioterror and pandemic emergency preparedness, although initially implemented as vertical programs, have the potential to strengthen the general public health infrastructure. This experience may hold some lessons for how global funds for emergency preparedness could be invested in developing countries to support struggling public health systems in responding to current health priorities as well as potential future public health threats.

Confronting Ethical and Regulatory Challenges of Emergency Care Research With Conscious Patients.

PubMed

Dickert, Neal W; Brown, Jeremy; Cairns, Charles B; Eaves-Leanos, Aaliyah; Goldkind, Sara F; Kim, Scott Y H; Nichol, Graham; O'Conor, Katie J; Scott, Jane D; Sinert, Richard; Wendler, David; Wright, David W; Silbergleit, Robert

2016-04-01

Barriers to informed consent are ubiquitous in the conduct of emergency care research across a wide range of conditions and clinical contexts. They are largely unavoidable; can be related to time constraints, physical symptoms, emotional stress, and cognitive impairment; and affect patients and surrogates. US regulations permit an exception from informed consent for certain clinical trials in emergency settings, but these regulations have generally been used to facilitate trials in which patients are unconscious and no surrogate is available. Most emergency care research, however, involves conscious patients, and surrogates are often available. Unfortunately, there is neither clear regulatory guidance nor established ethical standards in regard to consent in these settings. In this report-the result of a workshop convened by the National Institutes of Health Office of Emergency Care Research and Department of Bioethics to address ethical challenges in emergency care research-we clarify potential gaps in ethical understanding and federal regulations about research in emergency care in which limited involvement of patients or surrogates in enrollment decisions is possible. We propose a spectrum of approaches directed toward realistic ethical goals and a research and policy agenda for addressing these issues to facilitate clinical research necessary to improve emergency care. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Cancer Treatment Side Effects: A Meta-analysis of the Relationship Between Response Expectancies and Experience.

PubMed

Devlin, Elise J; Denson, Linley A; Whitford, Hayley S

2017-08-01

Although previous research has, overall, suggested a moderate relationship between response expectancies (REs) and cancer treatment-related side effects, empirical results have been mixed. We aimed to further explore these relationships, hypothesizing that REs would predict subsequent toxicities with the inclusion of more recent studies, across a broader range of side effects, while incorporating the impact of potential moderators including patients' experience with treatment and measurement methods. We further investigated the impact of REs across individual toxicities. A systematic search and analysis were conducted across four databases (PsychInfo, PubMed, CINAHL, and Embase) and reference lists, from 1985 to February 2016. This provided 27 eligible studies with 4474 participants, through which the main analysis, moderator analyses, and individual side-effect analyses were explored. REs were moderately related to side effects overall (r = 0.26), and effect sizes were significantly influenced by sample diagnostic homogeneity, whereas differences between type and timing of measurement showed trends. Of the 16 toxicities examined, 15 demonstrated significant relationships between REs and side-effect experience, with hair loss (r = 0.48) the strongest. No clear difference emerged between objective and subjective side effects; however, significant differences across individual toxicities were revealed. Findings support a relationship between REs and a wide range of subsequent side effects, yet differences between individual RE-toxicity associations emerged. These findings provide direction for the measurement of side effects and REs and support REs as potential targets for intervention during the informed consent process. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Governing the implementation of Emergency Obstetric Care: experiences of Rural District Health Managers, Tanzania

PubMed Central

2014-01-01

Background Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. Methods The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Results Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development. Conclusion The study revealed that implementing EmOC is a process accompanied by challenges that require an approach with multiple partners to address them and that, for effective partnership, the roles and responsibilities of each partner should be well stipulated in a clear working framework within the district health system. Partnerships strengthen health system governance and therefore ensure effective implementation of health policies at a local level. PMID:25086597

Governing the implementation of emergency obstetric care: experiences of rural district health managers, Tanzania.

PubMed

Mkoka, Dickson Ally; Kiwara, Angwara; Goicolea, Isabel; Hurtig, Anna-Karin

2014-08-03

Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development. The study revealed that implementing EmOC is a process accompanied by challenges that require an approach with multiple partners to address them and that, for effective partnership, the roles and responsibilities of each partner should be well stipulated in a clear working framework within the district health system. Partnerships strengthen health system governance and therefore ensure effective implementation of health policies at a local level.

Infectious diseases in Mexico. A survey from 1995-2000.

PubMed

Flisser, Ana; Velasco-Villa, Andrés; Martínez-Campos, Carmen; González-Domínguez, Fernando; Briseño-García, Baltasar; García-Suárez, Rosario; Caballero-Servín, Angel; Hernández-Monroy, Irma; García-Lozano, Herlinda; Gutiérrez-Cogco, Lucina; Rodríguez-Angeles, Guadalupe; López-Martínez, Irma; Galindo-Virgen, Sonia; Vázquez-Campuzano, Roberto; Balandrano-Campos, Susana; Guzmán-Bracho, Carmen; Olivo-Díaz, Angélica; de la Rosa, Jorge; Magos, Clementina; Escobar-Gutiérrez, Alejandro; Correa, Dolores

2002-01-01

Data obtained at a central laboratory for emerging, re-emerging, and other infectious diseases in Mexico from 1995-2000 are presented. An outstanding increase of DEN-3 circulation was identified. Aedes aegypti, the dengue vector, is widely distributed. Leptospirosis has become the most important differential diagnosis for dengue. Identification of rabies virus variants allowed cataloging of new transmitters of rabies. Rotavirus showed a clear seasonal distribution, while different proportions of pathogenic classes of Escherichia coli under endemic and outbreak conditions were seen. Serotypes of several bacteria are reported as well as the sources of isolation and frequency of Shigella, Salmonella, and Vibrio cholerae. Rise and disappearance of cholera could be followed along the past decade. Influenza strains were identified, as were several pathogens causing sexually transmitted infections. Laboratory support was important for surveillance after Hurricane Mitch. Multidrug-resistant strains of Mycobacterium tuberculosis are emerging and primary resistance is very high. It is now mandatory to search for antibodies to Trypanosoma cruzi in blood banks. Triatoma barberi, a peridomestic bug, is the main vector of Chagas disease. Localized cutaneous leishmaniosis increased in regions having a guerrilla element in Chiapas. Modern immunodiagnostic techniques are used for control studies of cysticercosis and similar techniques were recently standardized for Trichinella spiralis detection. Low iodine values in children's urine were found in several Mexican states; therefore, use of iodized salt should be encouraged.

Atypical serum immunofixation patterns frequently emerge in immunomodulatory therapy and are associated with a high degree of response in multiple myeloma.

PubMed

Mark, Tomer; Jayabalan, David; Coleman, Morton; Pearse, Roger N; Wang, Y Lynn; Lent, Richard; Christos, Paul J; Lee, Joong W; Agrawal, Yash P; Matthew, Susan; Ely, Scott; Mazumdar, Madhu; Cesarman, Ethel; Leonard, John P; Furman, Richard R; Chen-Kiang, Selina; Niesvizky, Ruben

2008-12-01

The M-protein is the major reference measure for response in multiple myeloma (MM) and its correct interpretation is key to clinical management. The emergence of oligoclonal banding is recognized as a benign finding in the postautologous stem cell transplantation setting (ASCT) for MM but its significance during non-myeloablative therapy is unknown. In a study of the immunomodulatory combination BiRD, (lenalidomide and dexamethasone with clarithromycin), we frequently detected the emergence of mono- and oligo-clonal immunoglobulins unrelated to the baseline diagnostic M-protein. The new M-proteins seen on serum immunofixation electrophoresis were clearly different in either heavy or light chain component(s) from the original M-spike protein and were termed atypical serum immunofixation patterns (ASIPs). Overall, 24/72 (33%) patients treated with BiRD developed ASIPs. Patients who developed ASIPs compared with patients treated with BiRD without ASIPs, had a significantly greater overall response (100% vs. 85%) and complete response rates (71% vs. 23%). ASIPs were not associated with new clonal plasma cells or other lymphoproliferative processes, and molecular remissions were documented. This is the first time this phenomenon has been seen with regularity in non-myeloablative therapy for MM. Analogous to the ASCT experience, ASIPs do not signal incipient disease progression, but rather herald robust response.

[Concept analysis of the nursing profession, published from 1994 to 2008].

PubMed

Palese, A; Dante, A; Gherbezza, S; Venturato, E; Maragnolli, O; Ambrosi, E; Saiani, L

2012-01-01

Concept analysis is a research method in which concepts are examined in a logical and systematic fashion to form clear and rigorous conceptual definitions. To describe the concept analyses published between 1994 and 2008 and identify the emerging tendencies in the Nursing discipline, a two-staged study has been developed. In the first stage a systematic review of the literature was conducted: research published in the journals indexed in the MedLine, CINAHL and Cochrane databases were judged eligible, if they reported the theme of 'concept analysis' and 'nursing' in the title or in their key words and were published in English language. In the second stage, the articles that emerged were subjected to a content analysis. Some 158 concept analyses emerged, on average 10/year (range 1-22, median 11, +/- 5.6): these regarded 129 different concepts. Ninety-one (57.6%) concepts were focused on the nursing profession, while 67 (42.4%) were focused on the patients. Although in a few cases the effort made by the researchers moved toward the definition of new concepts, in others it appeared oriented toward including in Nursing some typical concepts from other disciplines, thus tracing an expansion of the domain of the Nursing discipline. Monitoring over time the concepts analysed constitutes an important research area to comprehend, both at a national and international level, the progressive evolution of the Nursing discipline.

Unscripted Responsible Research and Innovation: Adaptive space creation by an emerging RRI practice concerning juvenile justice interventions.

PubMed

de Jong, Irja Marije; Kupper, Frank; Broerse, Jacqueline

2018-01-24

Emerging RRI practices have goals with respect to learning, governance and achieving RRI outcomes (action). However, few practices actually achieve the action phase as actors lack room to manoeuvre, and lack guidance on how to move forward because of the inherent unscriptedness of the emerging RRI practice. In this explorative research an emerging RRI practice is studied to identify factors and barriers to the creation of adaptive space, in which actors can be responsive to the other and adapt, and a narrative can be created in the act of doing. This paper describes how formal and informal ways of organizing emerging RRI practices contribute to adaptive space, and how the metaphorical heuristic of improvisational theatre provides clear action principles to actors involved in emerging RRI practices in action. The RRI practice studied here lies in the domain of juvenile justice, where barriers that restrict room to manoeuvre are abundant. Five factors - 'informality over formality', 'shared action space', 'be flexible', 'keep the action moving' and 'put the relationship central' - were identified to facilitate reflexivity and adaptation in this space.

Land-Use Change and Emerging Infectious Disease on an Island Continent

PubMed Central

McFarlane, Rosemary A.; Sleigh, Adrian C.; McMichael, Anthony J.

2013-01-01

A more rigorous and nuanced understanding of land-use change (LUC) as a driver of emerging infectious disease (EID) is required. Here we examine post hunter-gatherer LUC as a driver of infectious disease in one biogeographical region with a compressed and documented history—continental Australia. We do this by examining land-use and native vegetation change (LUCC) associations with infectious disease emergence identified through a systematic (1973–2010) and historical (1788–1973) review of infectious disease literature of humans and animals. We find that 22% (20) of the systematically reviewed EIDs are associated with LUCC, most frequently where natural landscapes have been removed or replaced with agriculture, plantations, livestock or urban development. Historical clustering of vector-borne, zoonotic and environmental disease emergence also follows major periods of extensive land clearing. These advanced stages of LUCC are accompanied by changes in the distribution and density of hosts and vectors, at varying scales and chronology. This review of infectious disease emergence in one continent provides valuable insight into the association between accelerated global LUC and concurrent accelerated infectious disease emergence. PMID:23812027

Caring for older people in prehospital emergency care: can nurses make a difference?

PubMed

Melby, Vidar; Ryan, Assumpta

2005-10-01

The aim of this paper is to explore older people's experiences in prehospital emergency care, and identify benefits and difficulties associated with developing a nurse-led ambulance service. Data were collected at sites in Sweden and Norway. Focus group interviews were conducted to enable the collection of data from paramedics, ambulance nurses and nursing students, while individual interviews were utilized to gather data from older people. There is little research on the quality of care older people over 65 years old receive in prehospital emergency care. Older people often present with multiple pathology and diverse needs that nurses are well equipped to deal with, but presently there is no clearly defined role for nurses in prehospital emergency care in the United Kingdom, although other countries such as Sweden and Norway are developing an ambulance nurse role. If the multiple needs of older people were addressed in the prehospital field, a reduction in readmissions and increased functional ability might be achieved. Comprehensive training is required for ambulance staff to enable them to meet such needs. While nurses have a great foundation for this care, additional specialist ambulance training is required alongside a need for education on older people's needs and attitudes to older people. The introduction of ambulance nurses will result in role differentiation between paramedics and ambulance nurses, which has the potential for creating role conflict. To ensure a smooth transition appropriate training and education for nurses and paramedics should be provided. The end result is a potentially greatly enhanced ambulance care provision, enabling high quality care to all patients.

The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience

PubMed Central

Cleland, Kelly; Zhu, Haoping; Goldstuck, Norman; Cheng, Linan; Trussell, James

2012-01-01

BACKGROUND Intrauterine devices (IUDs) have been studied for use for emergency contraception for at least 35 years. IUDs are safe and highly effective for emergency contraception and regular contraception, and are extremely cost-effective as an ongoing method. The objective of this study was to evaluate the existing data to estimate the efficacy of IUDs for emergency contraception. METHODS The reference list for this study was generated from hand searching the reference lists of relevant articles and our own article archives, and electronic searches of several databases: Medline, Global Health, Clinicaltrials.gov, Popline, Wanfang Data (Chinese) and Weipu Data (Chinese). We included studies published in English or Chinese, with a defined population of women who presented for emergency contraception and were provided with an IUD, and in which the number of pregnancies was ascertained and loss to follow-up was clearly defined. Data from each article were abstracted independently by two reviewers. RESULTS The 42 studies (of 274 retrieved) that met our inclusion criteria were conducted in six countries between 1979 and 2011 and included eight different types of IUD and 7034 women. The maximum timeframe from intercourse to insertion of the IUD ranged from 2 days to 10 or more days; the majority of insertions (74% of studies) occurred within 5 days of intercourse. The pregnancy rate (excluding one outlier study) was 0.09%. CONCLUSIONS IUDs are a highly effective method of contraception after unprotected intercourse. Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options offered to patients presenting after unprotected intercourse. This review is limited by the fact that the original studies did not provide sufficient data on the delay between intercourse and insertion of the IUD, parity, cycle day of intercourse or IUD type to allow analysis by any of these variables. PMID:22570193

Staff perceptions of best practice for information transfer about multitrauma patients on discharge from the emergency department: a focus group study.

PubMed

Calleja, Pauline; Aitken, Leanne; Cooke, Marie

2016-10-01

To understand: (1) staff perceptions of best practice for information transfer for multitrauma patients on discharge from the emergency department; (2) what information should be conveyed at transfer and (3) how information is transferred. Information transfer for multitrauma patients is an integral factor for continuity of care, safety, quality assurance and patient outcomes; however, this has not been the focus of previous studies. This was a qualitative study using focus group interviews. Data were collected during focus group interviews across five clinical areas. Themes were derived from the data with consensus from three data coders. Purposive sampling was used and included staff caring for trauma patients during patient transition out of the emergency department. Participants were representatives of the emergency department, perioperative care, intensive care unit, high dependency care unit and the trauma service unit. Twenty-six registered nurses and two medical officers participated. Five focus group interviews were held. Themes emerged from the data including 'Variability', 'Continuity' and 'Putting the pieces together'. The first three themes were all influenced by the fourth theme of 'Values/Context'. Considered together these themes influenced staff perception of the quality of information transfer for multitrauma patients on discharge from the emergency department. Staff perceived best practice for information transfer to be clear, concise, relevant documentation that travelled with the patient and interactive communication at handover that adhered to agreed principles and a minimum data set specific to trauma patients. Clinicians involved in handover need to actively listen, avoiding 'doing' at the same time, be aware of essential questions to ask about the patient. An agreed expectation between different clinical areas needs to exist about information transfer to reduce variability. The minimum data required to provide ongoing safe care for multitrauma patients are identified. © 2016 John Wiley & Sons Ltd.

Survival, development, and growth of Snake River fall Chinook salmon Embryos, Alevins, and Fry Exposed to Variable Thermal and Dissolved Oxygen Regimes

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

Geist, David R.; Abernethy, Cary S.; Hand, Kristine D.

2006-11-01

Fall Chinook salmon (Oncorhynchus tshawytscha) initiate spawning in the Hells Canyon reach of the Snake River, Idaho (rkm 240-397), at water temperatures above 16 C. This temperature exceeds the states of Idaho and Oregon water quality standards for salmonid spawning. These standards are consistent with results from studies of embryos exposed to a constant thermal regime, while salmon eggs in the natural environment are rarely exposed to a constant temperature regime. The objective of this study was to assess whether variable temperatures (i.e., declining after spawning) affected embryo survival, development, and growth of Snake River fall Chinook salmon alevins andmore » fry. In 2003, fall Chinook salmon eggs were exposed to initial incubation temperatures ranging from 11-19 C in 2 C increments, and in 2004 eggs were exposed to initial temperatures of 13 C, 15 C, 16 C, 16.5 C, and 17 C. In both years, temperatures were adjusted downward approximately 0.2 C/day to mimic the thermal regime of the Snake River where these fish spawn. At 37-40 days post-fertilization, embryos were moved to a common exposure regime that followed the thermal profile of the Snake River through emergence. Mortality of fall Chinook salmon embryos increased markedly at initial incubation temperatures >17 C in both years. A logistic regression model estimated that a 50% reduction in survival from fertilization to emergence would occur at an initial incubation temperature of {approx}16 C. The laboratory results clearly showed a significant reduction in survival between 15 C and 17 C, which supported the model estimate. Results from 2004 showed a rapid decline in survival occurred between 16.5 C and 17 C, with no significant differences in survival at initial incubation temperatures <16.5 C. There were no significant differences across the range of initial temperature exposures for alevin and fry size at hatch and emergence. Differences in egg mass among females (notably 2003) most likely masked any size differences. Egg mass explained 86-98% of the variation of the size of alevins and fry at hatch and emergence. In 2003, maximum alevin wet weight increased as the initial temperatures increased, whereas the number of days it took to reach maximum wet weight decreased with increasing temperature. The number of days from fertilization to eyed egg, hatch, and emergence was highly related to temperature. Eggs exposed to initial temperatures of 13 C took 30-45 days longer to reach emergence than eggs initially exposed to 16.5 C. Overall, this study indicates that exposure to water temperatures up to 16.5 C will not have deleterious impacts on survival or growth from egg to emergence if temperatures decline at a rate of >0.2 C/day following spawning.« less

The "Australian Curriculum: History"--The Challenges of a Thin Curriculum?

ERIC Educational Resources Information Center

Ditchburn, Geraldine

2015-01-01

The "Australian Curriculum: History" has emerged out of a neoliberal federal education policy landscape. This is a policy landscape where pragmatic and performative, rather than pedagogic concerns are clearly foregrounded, and this has implications for curriculum development and implementation. A useful way to conceptualise the features,…

Anatomy of a Crisis: Report from the Front Line.

ERIC Educational Resources Information Center

Goens, George A.

1996-01-01

Describes events following the murder of a Wisconsin high school principal from the superintendent's viewpoint. A conceptual emergency plan is needed to get through the immediate tidal wave of the crisis. Simple guidelines are most useful. Plans should be clear and flexible and provide for inservice training, psychological assistance, and…

Predictors of Restrictive Reactive Strategy Use in People with Challenging Behaviour

ERIC Educational Resources Information Center

Allen, David; Lowe, Kathy; Brophy, Sam; Moore, Kate

2009-01-01

Background: Intrusive reactive strategies (physical restraint, emergency medication and seclusion) are frequently used procedures in the management of challenging behaviour. The present study identifies predictors for reactive strategy use in an attempt to more clearly delineate at risk service users. Method: Eight hundred and thirty-nine agencies…

77 FR 25716 - Fipronil; Receipt of Applications for Emergency Exemptions, Solicitation of Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-01

... pesticide manufacturer. Potentially affected entities may include, but are not limited to: Crop production (NAICS code 111). Animal production (NAICS code 112). Food manufacturing (NAICS code 311). Pesticide... your concerns and suggest alternatives. vii. Explain your views as clearly as possible, avoiding the...

Tunable Terahertz Metamaterials with Germanium Telluride Components

DTIC Science & Technology

2016-03-24

emerging field with many exciting applications. THz waves can be used to locate explosives and illicit drugs in security applications, or DNA and...17 Fig. 7. Absorbance spectra of various drugs and explosives. The resonant peaks of each material are clearly distinguishable [22...holder designed with help from the school model shop

The Purposeful Use of Technology.

ERIC Educational Resources Information Center

Asfeldt, Morten; Hvenegaard, Glen

2003-01-01

Equipment use in outdoor education is secondary to having clear goals and sound pedagogy. Examples from the authors' 21-day canoe expeditions to the Canadian tundra illustrate how the reflection component of an outdoor program can mitigate the potential negative side effects of emerging technology. Involving the group in decisions concerning…

Designing Academic Leadership Minor Programs: Emerging Models

ERIC Educational Resources Information Center

Diallo, Lamine; Gerhardt, Kris

2017-01-01

With a growing number of leadership programs in universities and colleges in North America, leadership educators and researchers are engaged in a wide ranging dialogue to propose clear processes, content, and designs for providing academic leadership education. This research analyzes the curriculum design of 52 institutions offering a "Minor…

Professional Identity: A Qualitative Inquiry of Experienced Counsellors

ERIC Educational Resources Information Center

Alves, Sara; Gazzola, Nicola

2011-01-01

There are many recent changes to the practice of counselling and psychotherapy in Canada. Newly established statutory regulation of psychotherapy in Ontario and Quebec, and new legislation in the province of Nova Scotia protecting the title "counselling therapist," are examples of an emerging trend in Canada that seeks to clearly define…

Ecosystem Services - An Emerging Direction for the U.S.EPA

EPA Science Inventory

Forty years ago the United States Environmental Protection Agency (U.S.EPA) was formed to “protect human health and the environment”. In those days the environment was being severely, and obviously, degraded by any number of pollution inputs, and it was clear that a healthy envi...

Keeping the Peace

ERIC Educational Resources Information Center

Levinson, Matt

2010-01-01

In a November 7, 2007, "New York Times" article "New Class (room) War: Teacher vs. Technology," author Michael Bugeja noted that "the baby boomers seem to see technology as information and communication. Their offspring and the emerging generation seem to see the same devices as entertainment and socializing." This became abundantly clear to Nueva…

How Students' Expectations Shape Their Quest for Purpose during College

ERIC Educational Resources Information Center

Robinson, Jessica A.; Glanzer, Perry L.

2016-01-01

This article presents the findings of a 75-participant phenomenological study that examined the relationship between students' expectations of their university experience and their perception of purpose development. A clear dichotomy emerged between those who had a "holistic" mindset and understood their university as a place to develop…

Three Views of Systems Theories and Their Implications for Sustainability Education

ERIC Educational Resources Information Center

Porter, Terry; Cordoba, Jose

2009-01-01

Worldwide, there is an emerging interest in sustainability and sustainability education. A popular and promising approach is the use of systems thinking. However, the systems approach to sustainability has neither been clearly defined nor has its practical application followed any systematic rigor, resulting in confounded and underspecified…

Measuring School Readiness: Conceptual and Practical Considerations

ERIC Educational Resources Information Center

Snow, Kyle L.

2006-01-01

Recent interest and investment in early childhood education as a means of promoting children's school readiness has prompted the need for clear definitions of school readiness. Traditionally school readiness has been viewed within a maturationist frame, based on a chronological set-point, which led to the emergence of readiness testing. Following…

Co-Ordinating Education during Emergencies and Reconstruction: Challenges and Responsibilities

ERIC Educational Resources Information Center

Sommers, Marc

2004-01-01

While co-ordination is essentially a method of getting institutions to work together, it is clearly not synonymous with togetherness. Undercurrents of suspicion and distrust between individuals and institutional actors can affect important relationships and give rise to enduring misunderstandings and perplexing challenges. Turf battles involving…

14 CFR 91.513 - Emergency equipment.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Must clearly indicate its method of operation; and (4) When carried in a compartment or container, must have that compartment or container marked as to contents and date of last inspection. (c) Hand fire extinguishers must be provided for use in crew, passenger, and cargo compartments in accordance with the...

14 CFR 91.513 - Emergency equipment.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Must clearly indicate its method of operation; and (4) When carried in a compartment or container, must have that compartment or container marked as to contents and date of last inspection. (c) Hand fire extinguishers must be provided for use in crew, passenger, and cargo compartments in accordance with the...

14 CFR 91.513 - Emergency equipment.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Must clearly indicate its method of operation; and (4) When carried in a compartment or container, must have that compartment or container marked as to contents and date of last inspection. (c) Hand fire extinguishers must be provided for use in crew, passenger, and cargo compartments in accordance with the...

14 CFR 91.513 - Emergency equipment.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Must clearly indicate its method of operation; and (4) When carried in a compartment or container, must have that compartment or container marked as to contents and date of last inspection. (c) Hand fire extinguishers must be provided for use in crew, passenger, and cargo compartments in accordance with the...

Continuing Education of the Professions: Issues, Ethics, and Conflicts

ERIC Educational Resources Information Center

Frandson, Phillip E.

1975-01-01

Relicensure has emerged as one of today's key issues in the continuing education of the professional. The conflict is clear: Who shall be controlling force? A grid involving the six issues focuses on the constituencies who seek to control these issues. The medical profession is used as an example. (BP)

7 CFR 246.12 - Food delivery systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

... operational requirements for food delivery systems. In recognition of emergent electronic benefits transfer... vouchers. Each printed food instrument and cash-value voucher must clearly bear on its face the following... customers at no charge or below face value; (3) Cash gifts in any amount for any reason; (4) Anything made...

7 CFR 246.12 - Food delivery systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... operational requirements for food delivery systems. In recognition of emergent electronic benefits transfer... vouchers. Each printed food instrument and cash-value voucher must clearly bear on its face the following... customers at no charge or below face value; (3) Cash gifts in any amount for any reason; (4) Anything made...

7 CFR 246.12 - Food delivery systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

... operational requirements for food delivery systems. In recognition of emergent electronic benefits transfer... vouchers. Each printed food instrument and cash-value voucher must clearly bear on its face the following... customers at no charge or below face value; (3) Cash gifts in any amount for any reason; (4) Anything made...

On the Dialect Question and Reading. Technical Report No. 121.

ERIC Educational Resources Information Center

Hall, William S.; Guthrie, Larry F.

Representative research studies of the interference of Vernacular Black English (VBE) on beginning reading of VBE speakers at the phonological, grammatical, and lexical and content levels are examined. The following conclusions emerge: (1) phonological interference in learning to read has not been established; (2) VBE does not clearly interfere…

Current and emerging operational uses of remote sensing in Swedish forestry

Treesearch

Hakan Olsson; Mikael Egberth; Jonas Engberg; Johan E.S. Fransson; Tina Granqvist Pahlen; < i> et al< /i>

2007-01-01

Satellite remote sensing is being used operationally by Swedish authorities in applications involving, for example, change detection of clear felled areas, use of k-Nearest Neighbour estimates of forest parameters, and post-stratification (in combination with National Forest Inventory plots). For forest management planning of estates, aerial...

Workload and casemix in Cape Town emergency departments.

PubMed

Wallis, Lee A; Twomey, Michele

2007-12-01

Little is known about the nature of patients presenting to emergency departments (EDs) in South Africa. This study aimed to provide evidence on ED usage in Cape Town by studying patients at four community health centre (CHC) EDs, with details of the severity of their presentation and their disposal. A total of 16,392 patients presented in this 8-week prospective observational study, and 15,681 were included in the descriptive data analysis. One-quarter were children. There were clear and predictable peaks in attendance after 1600 hr and at weekends, with a steady stream of patients presenting overnight. Case severity was evenly distributed between emergency, urgent and routine care. Nearly 10% of patients were referred on to a higher level of care. The data from this study present a model for staffing and resource allocation. It has implications for the provision of emergency care in CHC EDs.

The opportunistic Sarcoptes scabiei: a new episode from giraffe in the drought-suffering Kenya.

PubMed

Alasaad, S; Ndeereh, D; Rossi, L; Bornstein, S; Permunian, R; Soriguer, R C; Gakuya, F

2012-04-30

The ubiquitous Sarcoptes mite is unexplainable emerging and re-emerging parasite, threatening biodiversity and human health. When a new outbreak occurs, it is not clear if it is a genuine emergence resulting from a new incidence or apparent emergence resulting from increased detection. In this paper we report, for the first time to our knowledge, an outbreak of sarcoptic mange in giraffes in the wild. Three decaying carcasses and five free-ranging subadult reticulated giraffes were observed to have mange-like lesions in the drought-suffering Wajir Region in North Eastern Kenya, while apparently all sympatric wild and domestic animals were mange-free. Affected giraffes were captured and successfully treated. The possible relations between this outbreak and annual seasons, animal age-classes and sex, and spatial distribution are discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

Traditional and emerging forms of dental practice. Cost, accessibility, and quality factors.

PubMed Central

Rovin, S; Nash, J

1982-01-01

The traditional and predominant manner of delivering dental care is through a fee-for-service, private practice system. A number of alternative dental care delivery systems have emerged and are being tested, and others are just emerging. These systems include department store practices, hospital dental services, health maintenance organizations, the independent practice of dental hygiene, and denturism. Although it is too soon to draw final conclusions about the efficacy and effectiveness of these systems, we examine them for their potential to compete with and change the way dental care is currently delivered. Using the parameters of cost, accessibility, and quality, we compare these systems to traditional dental practice. Some of these emerging forms clearly have the potential to complete favorably with traditional practice. Other seem less likely to alter the existing system substantially. The system which can best control costs, increase accessibility, and enhance quality will gain the competitive edge. PMID:7091453

[Mechanisms of viral emergence and interspecies transmission: the exemple of simian foamy viruses in Central Africa].

PubMed

Gessain, Antoine

2013-12-01

A large proportion of viral pathogens that have emerged during the last decades in humans are considered to have originated from various animal species. This is well exemplified by several recent epidemics such as those of Nipah, Severe Acute Respiratory Syndrome, Avian flu, Ebola, Monkeypox, and Hantaviruses. After the initial interspecies transmission per se, the viruses can disseminate into the human population through various and distinct mechanisms. Some of them are well characterized and understood, thus allowing a certain level of risk control and prevention. Surprisingly and in contrast, the initial steps that lead to the emergence of several viruses, and of their associated diseases, remain still poorly understood. Epidemiological field studies conducted in certain specific high-risk populations are thus necessary to obtain new insights into the early events of this emergence process. Human infections by simian viruses represent increasing public health concerns. Indeed, by virtue of their genetic andphysiological similarities, non-human primates (NHPs) are considered to be likely the sources of viruses that can infect humans and thus may pose a significant threat to human population. This is well illustrated by retroviruses, which have the ability to cross species, adapt to a new host and sometimes spread within these new species. Sequence comparison and phylogenetic studies have thus clearly showed that the emergence of human immunodeficiency virus type 1 (HIV-1) and HIV-2 in humans have resulted from several independent interspecies transmissions of different SIV types from Chimpanzees and African monkeys (including sooty mangabeys), respectively, probably during the first part of the last century. The situation for Human T cell Lymphotropic virus type 1 (HTLV-1) is, for certain aspects, quite comparable. Indeed, the origin of most HTLV-1 subtypes appears to be linked to interspecies transmission between STLV-1-infected monkeys and humans, followed by variable periods of evolution in the human host. In this review, after an introduction on emerging viruses, we will briefly present the results of a large epidemiological study performed in groups of Bantus and Pygmies living in villages and settlements located in the rain forest of the South region of Cameroon. These populations are living nearby the habitats of several monkeys and apes, often naturally infected by different retroviruses including SIV, STLV and simianfoamy virus. Most of the persons included in this study were hunters of such NHPs, thus at high risk of contact with infected body fluids (blood, saliva,...) during hunting activities. After reviewing the current available data on the discovery, cross-species transmission from monkeys and apes to humans of the simian foamy retroviruses, we will report the results of our study. Such infection is a unique natural model to study the different mechanisms of restriction of retroviral emergence in Humans.

Host Genetics and Environment Drive Divergent Responses of Two Resource Sharing Gall-Formers on Norway Spruce: A Common Garden Analysis.

PubMed

Axelsson, E Petter; Iason, Glenn R; Julkunen-Tiitto, Riitta; Whitham, Thomas G

2015-01-01

A central issue in the field of community genetics is the expectation that trait variation among genotypes play a defining role in structuring associated species and in forming community phenotypes. Quantifying the existence of such community phenotypes in two common garden environments also has important consequences for our understanding of gene-by-environment interactions at the community level. The existence of community phenotypes has not been evaluated in the crowns of boreal forest trees. In this study we address the influence of tree genetics on needle chemistry and genetic x environment interactions on two gall-inducing adelgid aphids (Adelges spp. and Sacchiphantes spp.) that share the same elongating bud/shoot niche. We examine the hypothesis that the canopies of different genotypes of Norway spruce (Picea abies L.) support different community phenotypes. Three patterns emerged. First, the two gallers show clear differences in their response to host genetics and environment. Whereas genetics significantly affected the abundance of Adelges spp. galls, Sacchiphantes spp. was predominately affected by the environment suggesting that the genetic influence is stronger in Adelges spp. Second, the among family variation in genetically controlled resistance was large, i.e. fullsib families differed as much as 10 fold in susceptibility towards Adelges spp. (0.57 to 6.2 galls/branch). Also, the distribution of chemical profiles was continuous, showing both overlap as well as examples of significant differences among fullsib families. Third, despite the predicted effects of host chemistry on galls, principal component analyses using 31 different phenolic substances showed only limited association with galls and a similarity test showed that trees with similar phenolic chemical characteristics, did not host more similar communities of gallers. Nonetheless, the large genetic variation in trait expression and clear differences in how community members respond to host genetics supports our hypothesis that the canopies of Norway spruce differ in their community phenotypes.

Values on Paper, in the Head, and in Action: On Max Weber and Value Freedom Today.

PubMed

Betta, Michela; Swedberg, Richard

2017-11-01

This article starts out with a summary of Weber's views on value freedom, by emphasizing: (1) that value freedom constitutes a special constellation of values; and (2) that value freedom makes it possible for the social scientist to theorize on the basis of new and more extensive knowledge than if she had simply stated her own values and focused the analysis around these. The latter point emerges most clearly in Weber's instructions for how a social scientist should proceed when carrying out an analysis of her own preferred social policy. After the section on Weber's views on value freedom, an attempt is made to update his views. This is done by arguing that the impact of values (and value freedom) differs, depending on where these can be found: on paper, in the head of the social scientist, or in her actions. "Actions," in the context of value freedom, refer to the research process and especially to the element of theorizing. Value freedom helps to guide the research into new and fruitful directions and to steer it clear of propaganda. © 2017 Canadian Sociological Association/La Société canadienne de sociologie.

Climate change and water security with a focus on the Arctic.

PubMed

Evengard, Birgitta; Berner, Jim; Brubaker, Michael; Mulvad, Gert; Revich, Boris

2011-01-01

Water is of fundamental importance for human life; access to water of good quality is of vital concern for mankind. Currently however, the situation is under severe pressure due to several stressors that have a clear impact on access to water. In the Arctic, climate change is having an impact on water availability by melting glaciers, decreasing seasonal rates of precipitation, increasing evapotranspiration, and drying lakes and rivers existing in permafrost grounds. Water quality is also being impacted as manmade pollutants stored in the environment are released, lowland areas are flooded with salty ocean water during storms, turbidity from permafrost-driven thaw and erosion is increased, and the growth or emergence of natural pollutants are increased. By 2030 it is estimated that the world will need to produce 50% more food and energy which means a continuous increase in demand for water. Decisionmakers will have to very clearly include life quality aspects of future generations in the work as impact of ongoing changes will be noticeable, in many cases, in the future. This article will focus on effects of climate-change on water security with an Arctic perspective giving some examples from different countries how arising problems are being addressed.

Imaging of murine embryonic cardiovascular development using optical coherence tomography (Conference Presentation)

NASA Astrophysics Data System (ADS)

Huang, Yongyang; Degenhardt, Karl R.; Astrof, Sophie; Zhou, Chao

2016-03-01

We have demonstrated the capability of spectral domain optical coherence tomography (SDOCT) system to image full development of mouse embryonic cardiovascular system. Monitoring morphological changes of mouse embryonic heart occurred in different embryonic stages helps identify structural or functional cardiac anomalies and understand how these anomalies lead to congenital heart diseases (CHD) present at birth. In this study, mouse embryo hearts ranging from E9.5 to E15.5 were prepared and imaged in vitro. A customized spectral domain OCT system was used for imaging, with a central wavelength of 1310nm, spectral bandwidth of ~100nm and imaging speed of 47kHz A-scans/s. Axial resolution of this system was 8.3µm in air, and transverse resolution was 6.2 µm with 5X objective. Key features of mouse embryonic cardiovascular development such as vasculature remodeling into circulatory system, separation of atria and ventricles and emergence of valves could be clearly seen in three-dimensional OCT images. Optical clearing was applied to overcome the penetration limit of OCT system. With high resolution, fast imaging speed, 3D imaging capability, OCT proves to be a promising biomedical imaging modality for developmental biology studies, rivaling histology and micro-CT.

Status-Dependent Vasotocin Modulation of Dominance and Subordination in the Weakly Electric Fish Gymnotus omarorum.

PubMed

Perrone, Rossana; Silva, Ana C

2018-01-01

Dominant-subordinate status emerges from agonistic encounters. The weakly electric fish, Gymnotus omarorum , displays a clear-cut example of non-breeding territorial aggression. The asymmetry in the behavior of dominants and subordinates is outstanding. Dominants are highly aggressive and subordinates signal submission in a precise sequence of locomotor and electric traits: retreating, decreasing their electric organ discharge rate, and emitting transient electric signals. The hypothalamic neuropeptide arginine-vasotocin (AVT) and its mammalian homolog arginine-vasopressin, are key modulators of social behavior, known to adapt their actions to different contexts. By analyzing the effects of pharmacological manipulations of the AVT system in both dominants and subordinates, we show evidence of distinct status-dependent actions of AVT. We demonstrate an endogenous effect of AVT on dominants' aggression levels: blocking the V1a AVT receptor induced a significant decrease in dominants' attack rate. AVT administered to subordinates enhanced the expression of the electric signals of submission, without affecting subordinates' locomotor displays. This study contributes a clear example of status-dependent AVT modulation of agonistic behavior in teleosts, and reveals distinctive activation patterns of the AVT system between dominants and subordinates.

Climate change and water security with a focus on the Arctic

PubMed Central

Evengard, Birgitta; Berner, Jim; Brubaker, Michael; Mulvad, Gert; Revich, Boris

2011-01-01

Water is of fundamental importance for human life; access to water of good quality is of vital concern for mankind. Currently however, the situation is under severe pressure due to several stressors that have a clear impact on access to water. In the Arctic, climate change is having an impact on water availability by melting glaciers, decreasing seasonal rates of precipitation, increasing evapotranspiration, and drying lakes and rivers existing in permafrost grounds. Water quality is also being impacted as manmade pollutants stored in the environment are released, lowland areas are flooded with salty ocean water during storms, turbidity from permafrost-driven thaw and erosion is increased, and the growth or emergence of natural pollutants are increased. By 2030 it is estimated that the world will need to produce 50% more food and energy which means a continuous increase in demand for water. Decisionmakers will have to very clearly include life quality aspects of future generations in the work as impact of ongoing changes will be noticeable, in many cases, in the future. This article will focus on effects of climate-change on water security with an Arctic perspective giving some examples from different countries how arising problems are being addressed. PMID:22043217

Changes in reflectance anisotropy of wheat crop during different phenophases

NASA Astrophysics Data System (ADS)

Lunagaria, Manoj M.; Patel, Haridas R.

2017-04-01

The canopy structure of wheat changes significantly with growth stages and leads to changes in reflectance anisotropy. Bidirectional reflectance distribution function characterises the reflectance anisotropy of the targets, which can be approximated. Spectrodirectional reflectance measurements on wheat crop were acquired using a field goniometer system. The bidirectional reflectance spectra were acquired at 54 view angles to cover the hemispheric span up to 60° view zenith. The observations were made during early growth stages till maturity of the crop. The anisotropy was not constant for all wavelengths and anisotropic factors clearly revealed spectral dependence, which was more pronounced in near principal plane. In near infrared, wheat canopy expressed less reflectance anisotropy because of higher multiple scattering. The broad hotspot signature was noticeable in reflectance of canopy whenever view and solar angles were close. Distinct changes in bidirectional reflectance distribution function were observed during booting to flowering stages as the canopy achieves more uniformity, height and head emergence. The function clearly reveals bowl shape during heading to early milking growth stages of the crop. Late growth stages show less prominent gap and shadow effects. Anisotropy index revealed that wheat exhibits changes in reflectance anisotropy with phenological development and with spectral bands.

The Development of a Checklist to Enhance Methodological Quality in Intervention Programs.

PubMed

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Sánchez-Martín, Milagrosa

2016-01-01

The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed.

Is there anything "autonomous" in the nervous system?

PubMed

Rasia-Filho, Alberto A

2006-03-01

The terms "autonomous" or "vegetative" are currently used to identify one part of the nervous system composed of sympathetic, parasympathetic, and gastrointestinal divisions. However, the concepts that are under the literal meaning of these words can lead to misconceptions about the actual nervous organization. Some clear-cut examples indicate that no element shows "autonomy" in an integrated body. Nor are they solely "passive" or generated "without mental elaboration." In addition, to be "not consciously controlled" is not a unique attribute of these components. Another term that could be proposed is "homeostatic nervous system" for providing conditions to the execution of behaviors and maintenance of the internal milieu within normal ranges. But, not all homeostatic conditions are under the direct influence of these groups of neurons, and some situations clearly impose different ranges for some variables that are adaptative (or hazardous) in the tentative of successfully coping with challenging situations. Finally, the name "nervous system for visceral control" emerges as another possibility. Unfortunately, it is not only "viscera" that represent end targets for this specific innervation. Therefore, it is commented that no quite adequate term for the sympathetic, parasympathetic, and gastrointestinal divisions has already been coined. The basic condition for a new term is that it should clearly imply the whole integrated and collaborative functions that the components have in an indivisible organism, including the neuroendocrine, immunological, and respiratory systems. Until that, we can call these parts simply by their own names and avoid terms that are more "convenient" than appropriate.

The Development of a Checklist to Enhance Methodological Quality in Intervention Programs

PubMed Central

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Sánchez-Martín, Milagrosa

2016-01-01

The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed. PMID:27917143

Algorithms in the First-Line Treatment of Metastatic Clear Cell Renal Cell Carcinoma--Analysis Using Diagnostic Nodes.

PubMed

Rothermundt, Christian; Bailey, Alexandra; Cerbone, Linda; Eisen, Tim; Escudier, Bernard; Gillessen, Silke; Grünwald, Viktor; Larkin, James; McDermott, David; Oldenburg, Jan; Porta, Camillo; Rini, Brian; Schmidinger, Manuela; Sternberg, Cora; Putora, Paul M

2015-09-01

With the advent of targeted therapies, many treatment options in the first-line setting of metastatic clear cell renal cell carcinoma (mccRCC) have emerged. Guidelines and randomized trial reports usually do not elucidate the decision criteria for the different treatment options. In order to extract the decision criteria for the optimal therapy for patients, we performed an analysis of treatment algorithms from experts in the field. Treatment algorithms for the treatment of mccRCC from experts of 11 institutions were obtained, and decision trees were deduced. Treatment options were identified and a list of unified decision criteria determined. The final decision trees were analyzed with a methodology based on diagnostic nodes, which allows for an automated cross-comparison of decision trees. The most common treatment recommendations were determined, and areas of discordance were identified. The analysis revealed heterogeneity in most clinical scenarios. The recommendations selected for first-line treatment of mccRCC included sunitinib, pazopanib, temsirolimus, interferon-α combined with bevacizumab, high-dose interleukin-2, sorafenib, axitinib, everolimus, and best supportive care. The criteria relevant for treatment decisions were performance status, Memorial Sloan Kettering Cancer Center risk group, only or mainly lung metastases, cardiac insufficiency, hepatic insufficiency, age, and "zugzwang" (composite of multiple, related criteria). In the present study, we used diagnostic nodes to compare treatment algorithms in the first-line treatment of mccRCC. The results illustrate the heterogeneity of the decision criteria and treatment strategies for mccRCC and how available data are interpreted and implemented differently among experts. The data provided in the present report should not be considered to serve as treatment recommendations for the management of treatment-naïve patients with multiple metastases from metastatic clear cell renal cell carcinoma outside a clinical trial; however, the data highlight the different treatment options and the criteria used to select them. The diversity in decision making and how results from phase III trials can be interpreted and implemented differently in daily practice are demonstrated. ©AlphaMed Press.

Optimising the emergency to ward handover process: A mixed methods study.

PubMed

Bakon, Shannon; Millichamp, Tracey

2017-11-01

The effective handover of patient health data from the emergency department to other hospital units is integral for the continuity of patient care. Yet no handover process has been identified as superior to others within this context. This study within a regional Australian hospital employed mixed methods approach including focus groups and key stakeholder consultation to develop a handover form appropriate for patient transfer from the emergency department to a variety of clinical areas. Paper-based surveys and audits were then employed to evaluate the implementation and understand staff perceptions of the form. The implementation of a patient handover form within the emergency setting was well received. Participants indicated that the form is clear, well designed and easy to navigate. It provided prompts to standardise their clinical handover and increased their accountability and responsibility within this process. To deliver an optimal nursing handover from the emergency department to various wards handovers should be structured and provide standardised content. The positive reception and use of this form provides evidence that a structured handover process can ensure standardisation of emergency department to ward nursing handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Impact of vehicular networks on emergency medical services in urban areas.

PubMed

Lee, Chun-Liang; Huang, Chung-Yuan; Hsiao, Tzu-Chien; Wu, Chun-Yen; Chen, Yaw-Chung; Wang, I-Cheng

2014-10-31

The speed with which emergency personnel can provide emergency treatment is crucial to reducing death and disability among acute and critically ill patients. Unfortunately, the rapid development of cities and increased numbers of vehicles are preventing emergency vehicles from easily reaching locations where they are needed. A significant number of researchers are experimenting with vehicular networks to address this issue, but in most studies the focus has been on communication technologies and protocols, with few efforts to assess how network applications actually support emergency medical care. Our motivation was to search the literature for suggested methods for assisting emergency vehicles, and to use simulations to evaluate them. Our results and evidence-based studies were cross-referenced to assess each method in terms of cumulative survival ratio (CSR) gains for acute and critically ill patients. Simulation results indicate that traffic light preemption resulted in significant CSR increases of between 32.4% and 90.2%. Route guidance was found to increase CSRs from 14.1% to 57.8%, while path clearing increased CSRs by 15.5% or less. It is our hope that this data will support the efforts of emergency medical technicians, traffic managers, and policy makers.

Impact of Vehicular Networks on Emergency Medical Services in Urban Areas

PubMed Central

Lee, Chun-Liang; Huang, Chung-Yuan; Hsiao, Tzu-Chien; Wu, Chun-Yen; Chen, Yaw-Chung; Wang, I.-Cheng

2014-01-01

The speed with which emergency personnel can provide emergency treatment is crucial to reducing death and disability among acute and critically ill patients. Unfortunately, the rapid development of cities and increased numbers of vehicles are preventing emergency vehicles from easily reaching locations where they are needed. A significant number of researchers are experimenting with vehicular networks to address this issue, but in most studies the focus has been on communication technologies and protocols, with few efforts to assess how network applications actually support emergency medical care. Our motivation was to search the literature for suggested methods for assisting emergency vehicles, and to use simulations to evaluate them. Our results and evidence-based studies were cross-referenced to assess each method in terms of cumulative survival ratio (CSR) gains for acute and critically ill patients. Simulation results indicate that traffic light preemption resulted in significant CSR increases of between 32.4% and 90.2%. Route guidance was found to increase CSRs from 14.1% to 57.8%, while path clearing increased CSRs by 15.5% or less. It is our hope that this data will support the efforts of emergency medical technicians, traffic managers, and policy makers. PMID:25365059

Postlingual adult performance in noise with HiRes 120 and ClearVoice Low, Medium, and High.

PubMed

Holden, Laura K; Brenner, Christine; Reeder, Ruth M; Firszt, Jill B

2013-11-01

The study's objectives were to evaluate speech recognition in multiple listening conditions using several noise types with HiRes 120 and ClearVoice (Low, Medium, High) and to determine which ClearVoice program was most beneficial for everyday use. Fifteen postlingual adults attended four sessions; speech recognition was assessed at sessions 1 and 3 with HiRes 120 and at sessions 2 and 4 with all ClearVoice programs. Test measures included sentences presented in restaurant noise (R-SPACE), in speech-spectrum noise, in four- and eight-talker babble, and connected discourse presented in 12-talker babble. Participants completed a questionnaire comparing ClearVoice programs. Significant group differences in performance between HiRes 120 and ClearVoice were present only in the R-SPACE; performance was better with ClearVoice High than HiRes 120. Among ClearVoice programs, no significant group differences were present for any measure. Individual results revealed most participants performed better in the R-SPACE with ClearVoice than HiRes 120. For other measures, significant individual differences between HiRes 120 and ClearVoice were not prevalent. Individual results among ClearVoice programs differed and overall preferences varied. Questionnaire data indicated increased understanding with High and Medium in certain environments. R-SPACE and questionnaire results indicated an advantage for ClearVoice High and Medium. Individual test and preference data showed mixed results between ClearVoice programs making global recommendations difficult; however, results suggest providing ClearVoice High and Medium and HiRes 120 as processor options for adults willing to change settings. For adults unwilling or unable to change settings, ClearVoice Medium is a practical choice for daily listening.

Sex Bias in Infectious Disease Epidemiology: Patterns and Processes

PubMed Central

Guerra-Silveira, Felipe; Abad-Franch, Fernando

2013-01-01

Background Infectious disease incidence is often male-biased. Two main hypotheses have been proposed to explain this observation. The physiological hypothesis (PH) emphasizes differences in sex hormones and genetic architecture, while the behavioral hypothesis (BH) stresses gender-related differences in exposure. Surprisingly, the population-level predictions of these hypotheses are yet to be thoroughly tested in humans. Methods and Findings For ten major pathogens, we tested PH and BH predictions about incidence and exposure-prevalence patterns. Compulsory-notification records (Brazil, 2006–2009) were used to estimate age-stratified ♂:♀ incidence rate ratios for the general population and across selected sociological contrasts. Exposure-prevalence odds ratios were derived from 82 published surveys. We estimated summary effect-size measures using random-effects models; our analyses encompass ∼0.5 million cases of disease or exposure. We found that, after puberty, disease incidence is male-biased in cutaneous and visceral leishmaniasis, schistosomiasis, pulmonary tuberculosis, leptospirosis, meningococcal meningitis, and hepatitis A. Severe dengue is female-biased, and no clear pattern is evident for typhoid fever. In leprosy, milder tuberculoid forms are female-biased, whereas more severe lepromatous forms are male-biased. For most diseases, male bias emerges also during infancy, when behavior is unbiased but sex steroid levels transiently rise. Behavioral factors likely modulate male–female differences in some diseases (the leishmaniases, tuberculosis, leptospirosis, or schistosomiasis) and age classes; however, average exposure-prevalence is significantly sex-biased only for Schistosoma and Leptospira. Conclusions Our results closely match some key PH predictions and contradict some crucial BH predictions, suggesting that gender-specific behavior plays an overall secondary role in generating sex bias. Physiological differences, including the crosstalk between sex hormones and immune effectors, thus emerge as the main candidate drivers of gender differences in infectious disease susceptibility. PMID:23638062

The effects of experimental lake acidification on the reproductive success of tree swallows

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

St. Louis, V.L.

1992-01-01

The effects of lake acidification on reproductive success of tree swallows (Tachycineta bicolor) breeding near experimentally acidified and unmanipulated reference lakes at the Experimental Lake Area (ELA) were studied. Tree swallows are aerial insectivores that commonly breed near water and forage on emergent insects. Predictions suggest that avian food abundance and quality may be altered due to acidification. Breeding swallows foraged on chironomids emerging at their nest-site lakes before searching for food elsewhere. Among the calcium-rich items consumed by the swallows, fish bones were most numerous, followed by crayfish exoskeleton, clam shell, and bird eggshell. We found significantly fewer calcium-richmore » items in the stomachs of nestlings from acid lakes than in those from reference lakes. Chironomid species were significantly more abundant in acid lakes, while the Chironominae were less numerous. Biomass of emerging chironomids either increased significantly following acidification, or was not different from that of reference lakes. Concentrations of Al, Ca, Mn, and Zn were on average higher in chironomids from a number of the acid lakes than in chironomids from reference lakes. Calcium concentrations in chironomids from the most acid lake were significantly lower, suggesting that Ca may be difficult to sequester at low pH levels. Hepatic concentrations of metallothioneins in tree swallow nestlings were negatively correlated with pH of the nest-site lake. Additive concentrations of Cu and Zn in the liver were correlated with liver MT concentrations, but Cd was not. Near acidified lakes, eggs were smaller in certain dimensions, hatching success was lower, certain nestling body characters were smaller, nestling wing length was shorter, and growth functions were different than near unmanipulated reference lakes. Clearly even non-aquatic organisms are affected by acidification of freshwater ecosystems.« less

Citation-related reliability analysis for a pilot sample of underground coal mines.

PubMed

Kinilakodi, Harisha; Grayson, R Larry

2011-05-01

The scrutiny of underground coal mine safety was heightened because of the disasters that occurred in 2006-2007, and more recently in 2010. In the aftermath of the 2006 incidents, the U.S. Congress passed the Mine Improvement and New Emergency Response Act of 2006 (MINER Act), which strengthened the existing regulations and mandated new laws to address various issues related to emergency preparedness and response, escape from an emergency situation, and protection of miners. The National Mining Association-sponsored Mine Safety Technology and Training Commission study highlighted the role of risk management in identifying and controlling major hazards, which are elements that could come together and cause a mine disaster. In 2007 MSHA revised its approach to the "Pattern of Violations" (POV) process in order to target unsafe mines and then force them to remediate conditions in their mines. The POV approach has certain limitations that make it difficult for it to be enforced. One very understandable way to focus on removing threats from major-hazard conditions is to use citation-related reliability analysis. The citation reliability approach, which focuses on the probability of not getting a citation on a given inspector day, is considered an analogue to the maintenance reliability approach, which many mine operators understand and use. In this study, the citation reliability approach was applied to a stratified random sample of 31 underground coal mines to examine its potential for broader application. The results clearly show the best-performing and worst-performing mines for compliance with mine safety standards, and they highlight differences among different mine sizes. Copyright © 2010 Elsevier Ltd. All rights reserved.

New targeted treatments for non-small-cell lung cancer - role of nivolumab.

PubMed

Zago, Giulia; Muller, Mirte; van den Heuvel, Michel; Baas, Paul

2016-01-01

Non-small-cell lung cancer (NSCLC) is often diagnosed at an advanced stage of disease, where it is no longer amenable to curative treatment. During the last decades, the survival has only improved significantly for lung cancer patients who have tumors harboring a driver mutation. Therefore, there is a clear unmet need for effective therapies for patients with no mutation. Immunotherapy has emerged as an effective treatment for different cancer types. Nivolumab, a monoclonal inhibitory antibody against PD-1 receptor, can prolong survival of NSCLC patients, with a manageable toxicity profile. In two Phase III trials, nivolumab was compared to docetaxel in patients with, respectively, squamous (CheckMate 017) and non-squamous NSCLC (CheckMate 057). In both trials, nivolumab significantly reduced the risk of death compared to docetaxel (41% and 27% lower risk of death for squamous and non-squamous NSCLC, respectively). Therefore, nivolumab has been approved in the US and in Europe as second-line treatment for advanced NSCLC. Unfortunately, accurate predictive factors for patient selection are lacking, making it difficult to decide who will benefit and who will not. Currently, there are many ongoing trials that evaluate the efficacy of nivolumab in different settings and in combination with other agents. This paper reviews the present literature about the role of nivolumab in the treatment of NSCLC. Particular attention has been given to efficacy studies, toxicity profile, and current and emerging predictive factors.

Defining frequent use of an urban emergency department

PubMed Central

Locker, Thomas E; Baston, Simon; Mason, Suzanne M; Nicholl, Jon

2007-01-01

Objective This study aimed to develop a definition of frequent use of an emergency department (ED) by comparing differences in the observed frequency distribution with that of a theoretical frequency distribution. Methods A retrospective analysis of attendance of ED and minor injury unit attendances in one city over 1 year was conducted. From these data, the expected frequency distribution was determined based upon a Poisson distribution. Results During the period studied, 75 141 people attended on 98 908 occasions. The theoretical frequency distribution showed that there were 2764 (3.7%) “frequent users” presenting repeatedly due to non‐random events. These patients made 12 316 (12.4%) attendances. Frequent users were older than chance users (mean age 49.7 vs 44.5 years). A greater proportion arrived by ambulance (55.3% vs 27.5%), presented with psychiatric problems (5.8% vs 1.1%) or alcohol intoxication (1.3% vs 0.5%), and were admitted to hospital (37.4% vs 19.6%). Conclusion We have identified that there is a group of patients who present repeatedly due to non‐random events, confirming the existence of “frequent users”. Their characteristics are clearly different to other patients in the ED. We propose that “frequent users” be defined as any patient who makes more than four attendances per year. PMID:17513534

Definitions, Foundations and Associations of Physical Literacy: A Systematic Review.

PubMed

Edwards, Lowri C; Bryant, Anna S; Keegan, Richard J; Morgan, Kevin; Jones, Anwen M

2017-01-01

The concept of physical literacy has stimulated increased research attention in recent years-being deployed in physical education, sport participation, and the promotion of physical activity. Independent research groups currently operationalize the construct differently. The purpose of this systematic review was to conduct a systematic review of the physical literacy construct, as reflected in contemporary research literature. Five databases were searched using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for systematic reviews. Inclusion criteria were English language, peer reviewed, published by March 2016, and seeking to conceptualize physical literacy. Articles that met these criteria were analyzed in relation to three core areas: properties/attributes, philosophical foundations and theoretical associations with other constructs. A total of 50 published articles met the inclusion criteria and were analyzed qualitatively using inductive thematic analysis. The thematic analysis addressed the three core areas. Under definitions, core attributes that define physical literacy were identified, as well as areas of conflict between different approaches currently being adopted. One relatively clear philosophical approach was prominent in approximately half of the papers, based on a monist/holistic ontology and phenomenological epistemology. Finally, the analysis identified a number of theoretical associations, including health, physical activity and academic performance. Current literature contains different representations of the physical literacy construct. The costs and benefits of adopting an exclusive approach versus pluralism are considered. Recommendations for both researchers and practitioners focus on identifying and clearly articulating the definitions, philosophical assumptions and expected outcomes prior to evaluating the effectiveness of this emerging concept.

Identifying barriers to emergency care services.

PubMed

Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

2012-01-01

This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

Delayed diagnosis of traumatic ventricular septal defect in penetrating chest injury: small evidence on echocardiography makes big difference.

PubMed

Jeon, Kihyun; Lim, Woo-Hyun; Kang, Si-Hyuck; Cho, Iksung; Kim, Kyung-Hee; Kim, Hyung-Kwan; Kim, Yong-Jin; Sohn, Dae-Won

2010-03-01

Cardiac trauma from penetrating chest injury is a life-threatening condition. It was reported that < 10% of patients arrives at the emergency department alive. Penetrating chest injury can cause serious damage in more than 1 cardiac structure, including myocardial lacerations, ventricular septal defect (VSD), fistula between aorta and right cardiac chamber and valves. The presence of pericardial effusion (even a small amount) on the initial echocardiography might be the only clue to serious cardiac damage in the absence of definite evidence of anatomical defect in heart. We here present a case, in which clear diagnosis of VSD and pseudoaneurysmal formation was delayed a few days after penetrating chest injury due to the lack of anatomical evidence of damage.

Plasticity following early-life brain injury: Insights from quantitative MRI.

PubMed

Fiori, Simona; Guzzetta, Andrea

2015-03-01

Over the last decade, the application of novel advanced neuroimaging techniques to study congenital brain damage has provided invaluable insights into the mechanisms underlying early neuroplasticity. The concept that is clearly emerging, both from human and nun-human studies, is that functional reorganization in the immature brain is substantially different from that of the more mature, developed brain. This applies to the reorganization of language, the sensorimotor system, and the visual system. The rapid implementation and development of higher order imaging methods will offer increased, currently unavailable knowledge about the specific mechanisms of cerebral plasticity in infancy, which is essential to support the development of early therapeutic interventions aimed at supporting and enhancing functional reorganization during a time of greatest potential brain plasticity. Copyright © 2015. Published by Elsevier Inc.

Thermalization and prethermalization in isolated quantum systems: a theoretical overview

NASA Astrophysics Data System (ADS)

Mori, Takashi; Ikeda, Tatsuhiko N.; Kaminishi, Eriko; Ueda, Masahito

2018-06-01

The approach to thermal equilibrium, or thermalization, in isolated quantum systems is among the most fundamental problems in statistical physics. Recent theoretical studies have revealed that thermalization in isolated quantum systems has several remarkable features, which emerge from quantum entanglement and are quite distinct from those in classical systems. Experimentally, well isolated and highly controllable ultracold quantum gases offer an ideal testbed to study the nonequilibrium dynamics in isolated quantum systems, promoting intensive recent theoretical endeavors on this fundamental subject. Besides thermalization, many isolated quantum systems show intriguing behavior in relaxation processes, especially prethermalization. Prethermalization occurs when there is a clear separation of relevant time scales and has several different physical origins depending on individual systems. In this review, we overview theoretical approaches to the problems of thermalization and prethermalization.

Mosaic nature of the mitochondrial proteome: Implications for the origin and evolution of mitochondria.

PubMed

Gray, Michael W

2015-08-18

Comparative studies of the mitochondrial proteome have identified a conserved core of proteins descended from the α-proteobacterial endosymbiont that gave rise to the mitochondrion and was the source of the mitochondrial genome in contemporary eukaryotes. A surprising result of phylogenetic analyses is the relatively small proportion (10-20%) of the mitochondrial proteome displaying a clear α-proteobacterial ancestry. A large fraction of mitochondrial proteins typically has detectable homologs only in other eukaryotes and is presumed to represent proteins that emerged specifically within eukaryotes. A further significant fraction of the mitochondrial proteome consists of proteins with homologs in prokaryotes, but without a robust phylogenetic signal affiliating them with specific prokaryotic lineages. The presumptive evolutionary source of these proteins is quite different in contending models of mitochondrial origin.

The butterfly effect: parasite diversity, environment, and emerging disease in aquatic wildlife.

PubMed

Adlard, Robert D; Miller, Terrence L; Smit, Nico J

2015-04-01

Aquatic wildlife is increasingly subjected to emerging diseases often due to perturbations of the existing dynamic balance between hosts and their parasites. Accelerating changes in environmental factors, together with anthropogenic translocation of hosts and parasites, act synergistically to produce hard-to-predict disease outcomes in freshwater and marine systems. These outcomes are further complicated by the intimate links between diseases in wildlife and diseases in humans and domestic animals. Here, we explore the interactions of parasites in aquatic wildlife in terms of their biodiversity, their response to environmental change, their emerging diseases, and the contribution of humans and domestic animals to parasitic disease outcomes. This work highlights the clear need for interdisciplinary approaches to ameliorate disease impacts in aquatic wildlife systems. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Impact of Racial Socialization on the Academic Performance and Prosocial Involvement of Black Emerging Adults

ERIC Educational Resources Information Center

White-Johnson, Rhonda L.

2015-01-01

Despite evidence linking racial socialization processes to the functioning of Black youth, the effect of these parenting practices among Black college students is less clear. This study examined the relationship among racial socialization messages, academic performance, and prosocial involvement for 295 Black college students. Results revealed…

US Nuclear Policy, 1945-68: Lessons from the Past for Dealing with the Emerging Threat from Iran

DTIC Science & Technology

2010-01-01

clear weapons—or to any development of deterrence strategies for dealing with Iran. Fariborz Mokhtari offers additional insight into Iranian national...University Press, 2007), 265. 20. Fariborz Mokhtari , “No One Will Scratch My Back: Iranian Security Perceptions in Historical Con- text,” Middle East

The Use of Photo-Luminescence as an Emergency Egress Guidance System on ISS

NASA Technical Reports Server (NTRS)

Maida, James C.

2014-01-01

Because ever increasing performance, photoluminescence has moved from “glow in the dark” toys to greatly expanded use in offices, factories, homes and many other places where it can be charged regularly by light and seen clearly and effectively in the dark for extended periods of time.

Limited Evidence That Competitive Food and Beverage Practices Affect Adolescent Consumption Behaviors

ERIC Educational Resources Information Center

Vericker, Tracy C.

2013-01-01

Childhood obesity is emerging as a considerable public health problem with no clear antidote. The school food environment is a potential intervention point for policy makers, with competitive food and beverage regulation as a possible policy lever. This research examines the link between competitive food and beverage availability in school and…

Presidents and Trustees in Partnership. ERIC Digest.

ERIC Educational Resources Information Center

Iwanaga, John

This digest discusses the relationship between community college trustees and the president, focusing on the necessity of establishing a rapport before times of crises. It is vital that the roles of both parties be clearly defined, and that each has a mutual responsibility to inform the other in an emergency. The president should embody the…

Social Justice Training in School Psychology: Applying Principles of Organizational Consultation to Facilitate Change in Graduate Programs

ERIC Educational Resources Information Center

Grapin, Sally L.

2017-01-01

Scholars and professional organizations have called for an increased emphasis on social justice training in applied psychology graduate programs, including school psychology programs (SPPs). During the past decade, emerging research has identified some features of high-quality social justice education, including a clear program mission statement…

Human Supervision of Multiple Autonomous Vehicles

DTIC Science & Technology

2013-03-22

manufacture , use, or sell any patented invention that may relate to them. This report was cleared for public release by the 88th Air Base Wing Public...This mode is referred to as the “ noodle ,” as it presented a flexible line segment resembling a bendable noodle emerging from the nose of an UAS

The Early Emergence of Guilt-Motivated Prosocial Behavior

ERIC Educational Resources Information Center

Vaish, Amrisha; Carpenter, Malinda; Tomasello, Michael

2016-01-01

Guilt serves vital prosocial functions: It motivates transgressors to make amends, thus restoring damaged relationships. Previous developmental research on guilt has not clearly distinguished it from sympathy for a victim or a tendency to repair damage in general. The authors tested 2- and 3-year-old children (N = 62 and 64, respectively) in a…

25 CFR 11.1204 - Obtaining an emergency order of protection.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INDIAN OFFENSES AND LAW AND ORDER CODE Child Protection and Domestic Violence Procedures § 11.1204... petition clearly shows that an act of domestic violence has occurred. The order must meet the content... to have committed a family violence act and seek to hold a hearing as soon as possible. If a hearing...

47 CFR 10.240 - Notification to new subscribers of non-participation in WEA.

Code of Federal Regulations, 2013 CFR

2013-10-01

... part or in whole, shall provide clear and conspicuous notice, which takes into account the needs of... messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third party reseller... emergency alert capable devices, please ask a sales representative, or go to [[CMS provider's URL

47 CFR 10.240 - Notification to new subscribers of non-participation in CMAS.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CMAS Alert Messages, in part or in whole, shall provide clear and conspicuous notice, which takes into... to provide Alert messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third... availability of this service and wireless emergency alert capable devices, please ask a sales representative...

47 CFR 10.240 - Notification to new subscribers of non-participation in WEA.

Code of Federal Regulations, 2014 CFR

2014-10-01

... part or in whole, shall provide clear and conspicuous notice, which takes into account the needs of... messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third party reseller... emergency alert capable devices, please ask a sales representative, or go to [[CMS provider's URL

47 CFR 10.240 - Notification to new subscribers of non-participation in CMAS.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CMAS Alert Messages, in part or in whole, shall provide clear and conspicuous notice, which takes into... to provide Alert messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third... availability of this service and wireless emergency alert capable devices, please ask a sales representative...

17 CFR Appendix B to Part 36 - Guidance on, and Acceptable Practices in, Compliance With Core Principles

Code of Federal Regulations, 2011 CFR

2011-04-01

... have clear procedures and guidelines for decision-making regarding emergency intervention in the market... COMMODITY FUTURES TRADING COMMISSION EXEMPT MARKETS Pt. 36, App. B Appendix B to Part 36—Guidance on, and... trading in significant price discovery contracts to prevent market manipulation, price distortion, and...

Engineering new medicine: an interview with James Collins.

PubMed

Collins, James

2010-01-01

At first glance, the commonality among synthetic gene networks, nerve cell response times and the emergence of antibiotic resistance is obscure. Yet, when speaking with James (Jim) Collins, the relationship becomes clear: all are applications-oriented problems, and all inspire unique approaches from this unusual engineer who is empowered by his freedom to fail.

Eco-Transactional Influences on Sociopolitical Youth Development Work

ERIC Educational Resources Information Center

Murray, Ira E.

2017-01-01

An emerging and growing body of research has clearly established the importance of youth building sociopolitical consciousness in order to be more democratically engaged citizens. An overwhelming amount of sociopolitical youth development work occurs outside of school. Much of the research on this work has focused on youth outcomes, and we know…

Can physicians help curb adolescent violence?

PubMed

Prothrow-Stith, D

1992-06-15

Some of the factors associated with such violence, notably racism and poverty, clearly demand societal solutions. Other factors, however, may respond to public health intervention strategies. Emergency room workers can practice secondary intervention, as they do with victims of child abuse, sexual assault, or attempted suicide. Family physicians can refer adolescents for appropriate help.

A Two-Phase Model of Resource Allocation in Visual Working Memory

ERIC Educational Resources Information Center

Ye, Chaoxiong; Hu, Zhonghua; Li, Hong; Ristaniemi, Tapani; Liu, Qiang; Liu, Taosheng

2017-01-01

Two broad theories of visual working memory (VWM) storage have emerged from current research, a discrete slot-based theory and a continuous resource theory. However, neither the discrete slot-based theory or continuous resource theory clearly stipulates how the mental commodity for VWM (discrete slot or continuous resource) is allocated.…

Stress-Induced Elevation of Oxytocin in Maltreated Children: Evolution, Neurodevelopment, and Social Behavior

ERIC Educational Resources Information Center

Seltzer, Leslie J.; Ziegler, Toni; Connolly, Michael J.; Prososki, Ashley R.; Pollak, Seth D.

2014-01-01

Child maltreatment often has a negative impact on the development of social behavior and health. The biobehavioral mechanisms through which these adverse outcomes emerge, however, are not clear. To better understand the ways in which early life adversity affects subsequent social behavior, changes in the neuropeptide oxytocin (OT) in children…

Minnesota Measures: 2008 Report on Higher Education Performance

ERIC Educational Resources Information Center

Minnesota Office of Higher Education, 2008

2008-01-01

For most of Minnesota's 150 years of statehood, its distinctive economic advantages were largely a function of its natural resources, such as timber, taconite and tourism. Today, while these and other resources remain cornerstones of the state economy, it is clear that the intellectual capacity of Minnesota's people is emerging as a promising…

78 FR 27153 - Duty Periods for Establishing Eligibility for Health Care

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... could be eligible for VA medical benefits based on only certain periods of inactive duty training (i.e... current regulation does not make clear. An individual could also be eligible for VA medical benefits based... the Office of Scientific effective August Research and Development, 27,1999. Office of Emergency...

Teaching Style, ICT Experience and Teachers' Attitudes toward Teaching with Web 2.0

ERIC Educational Resources Information Center

Kale, Ugur; Goh, Debbie

2014-01-01

Emphasis on 21st Century Skills development has increased expectations on teachers to take advantages of emerging technologies to support student learning. Yet it is not clear whether teachers are well equipped with the necessary skills, support, and positive attitudes toward integrating them in their practices. Even though student-centered…

78 FR 30386 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

... 24 side windows and no end windows. Nineteen side windows are 27'' x 61'' and five are 27'' x 25''. Each window has dual- pane-style laminated safety glazing (plated outside and laminated inside). None of the windows opens; however, the two emergency exit windows on each end of ORXX 3247 are clearly...

Literacy Training for Early Childhood Providers: Changes in Knowledge, Beliefs, and Instructional Practices

ERIC Educational Resources Information Center

Armstrong, Kathleen; Cusumano, Dale Lynn; Todd, Melissa; Cohen, Rachel

2008-01-01

While it is clear that reading is critical to children's success throughout schooling and reading instruction research has dramatically increased over the past 2 decades, few early childhood providers have the necessary knowledge, skills and/or confidence to effectively implement evidence-based, emergent literacy strategies in their settings. This…

25 CFR 11.1204 - Obtaining an emergency order of protection.

Code of Federal Regulations, 2011 CFR

2011-04-01

... INDIAN OFFENSES AND LAW AND ORDER CODE Child Protection and Domestic Violence Procedures § 11.1204... petition clearly shows that an act of domestic violence has occurred. The order must meet the content... to have committed a family violence act and seek to hold a hearing as soon as possible. If a hearing...

Complex systems dynamics in aging: new evidence, continuing questions.

PubMed

Cohen, Alan A

2016-02-01

There have long been suggestions that aging is tightly linked to the complex dynamics of the physiological systems that maintain homeostasis, and in particular to dysregulation of regulatory networks of molecules. This review synthesizes recent work that is starting to provide evidence for the importance of such complex systems dynamics in aging. There is now clear evidence that physiological dysregulation--the gradual breakdown in the capacity of complex regulatory networks to maintain homeostasis--is an emergent property of these regulatory networks, and that it plays an important role in aging. It can be measured simply using small numbers of biomarkers. Additionally, there are indications of the importance during aging of emergent physiological processes, functional processes that cannot be easily understood through clear metabolic pathways, but can nonetheless be precisely quantified and studied. The overall role of such complex systems dynamics in aging remains an important open question, and to understand it future studies will need to distinguish and integrate related aspects of aging research, including multi-factorial theories of aging, systems biology, bioinformatics, network approaches, robustness, and loss of complexity.

Airborne exposure limits for chemical and biological warfare agents: is everything set and clear?

PubMed

Sabelnikov, Alex; Zhukov, Vladimir; Kempf, C Ruth

2006-08-01

Emergency response strategies (guidelines) for biological, chemical, nuclear, or radiological terrorist events should be based on scientifically established exposure limits for all the agents or materials involved. In the case of a radiological terrorist event, emergency response guidelines (ERG) have been worked out. In the case of a terrorist event with the use of chemical warfare (CW) agents the situation is not that clear, though the new guidelines and clean-up values are being generated based on re-evaluation of toxicological and risk data. For biological warfare (BW) agents, such guidelines do not yet exist. In this paper the current status of airborne exposure limits (AELs) for chemical and biological warfare (CBW) agents are reviewed. Particular emphasis is put on BW agents that lack such data. An efficient, temporary solution to bridge the gap in experimental infectious data and to set provisional AELs for BW agents is suggested. It is based on mathematically generated risks of infection for BW agents grouped by their alleged ID50 values in three categories: with low, intermediate and high ID50 values.

Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa-a systematic review protocol.

PubMed

Geleto, Ayele; Chojenta, Catherine; Mussa, Abdulbasit; Loxton, Deborah

2018-04-16

Nearly 15% of all pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labor, and complications of abortion. Between 1990 and 2015, an estimated 10.7 million women died due to obstetric complications. Almost all of these deaths (99%) happened in developing countries, and 66% of maternal deaths were attributed to sub-Saharan Africa. The majority of cases of maternal mortalities can be prevented through provision of evidence-based potentially life-saving signal functions of emergency obstetric care. However, different factors can hinder women's ability to access and use emergency obstetric services in sub-Saharan Africa. Therefore, the aim of this review is to synthesize current evidence on barriers to accessing and utilizing emergency obstetric care in sub-Saharan African. Decision-makers and policy formulators will use evidence generated from this review in improving maternal healthcare particularly the emergency obstetric care. Electronic databases including MEDLINE, CINAHL, Embase, and Maternity and Infant Care will be searched for studies using predefined search terms. Articles published in English language between 2010 and 2017 with quantitative and qualitative design will be included. The identified papers will be assessed for meeting eligibility criteria. First, the articles will be screened by examining their titles and abstracts. Then, two reviewers will review the full text of the selected articles independently. Two reviewers using a standard data extraction format will undertake data extraction from the retained studies. The quality of the included papers will be assessed using the mixed methods appraisal tool. Results from the eligible studies will be qualitatively synthesized using the narrative synthesis approach and reported using the three delays model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be employed to present the findings. This systematic review will present a detailed synthesis of the evidence for barriers to access and utilization of emergency obstetric care in sub-Saharan Africa over the last 7 years. This systematic review is expected to provide clear information that can help in designing maternal health policy and interventions particularly in emergency obstetric care in sub-Saharan Africa where maternal mortality remains high. PROSPERO CRD42017074102 .

Legal considerations in infectious diseases and dentistry.

PubMed

Burris, S

1996-04-01

Dentists, similar to other professionals subject to legal regulation, often have an overly simple view of the legal system. Communicable diseases present questions on the cutting edge of the law, and, as the previous discussion makes perhaps painfully clear, there is considerable uncertainty on many important legal points. Legal uncertainty is often a reflection of social or scientific uncertainty. Clear answers emerge less from the words of lawyers and judges than from the actions of professionals themselves, who ultimately set the standard of care. In any area of legal uncertainty, the dentist is best advised to adhere to the best scientific information available and to meet the ethical standards of the profession.

Relating Residual Stress and Substructural Evolution During Tensile Deformation of an Aluminum-Manganese Alloy

NASA Astrophysics Data System (ADS)

Lodh, Arijit; Tak, Tawqeer Nasir; Prakash, Aditya; Guruprasad, P. J.; Hutchinson, Christopher; Samajdar, Indradev

2017-11-01

Interrupted tensile tests were coupled with ex situ measurements of residual stress and microtexture. The residual stress quantification involved measurements of six independent Laue spots and conversion of the interplanar spacings to the residual stress tensor. A clear orientation-dependent residual stress evolution emerged from the experiments and the numerical simulations. For the orientations undergoing negligible changes in ρ GND (density of geometrically necessary dislocation), the residual stress developments appeared to be governed by the elastic stiffness of the grain clusters. For the others, the evolution of the residual stress and ρ GND exhibited a clear orientation-dependent scaling.

Tower Based Measurements of Bio-indicators Over the Growing Season at a Mature Douglas-fir Coniferous Forest

NASA Astrophysics Data System (ADS)

Cheng, Y.; Hilker, T.; Middleton, E. M.; Coops, N. C.; Black, T. A.; Krishnan, P.

2007-12-01

The use of remotely sensed measurements collected by satellite, aircraft, and ground instruments to improve our understanding of ecological and hydrological processes were successfully demonstrated through the First International Satellite Land Surface Climatology (ISLSCP) Field Experiment [FIFE] and the BOReal Ecosystem- Atmosphere Study [BOREAS]. Following the concept of FIFE and BOREAS, we analyzed hyperspectral reflectance measurements collected at a coastal forest in British Columbia, Canada through the 2006 growing season. Diurnal and seasonal dynamics of the Photochemical Reflectance Index (PRI), a normalized difference spectral band-ratio index based on the xanthophyll signal at 531 nm which expresses protective responses to high light stress, were studied. This index has been shown to correlate with photosynthetic light use efficiency (LUE), an essential variable to model carbon uptake efficiency by plants. The measurements were collected from an automated system mounted on a flux tower under different sun and view geometries and atmospheric conditions through the 2006 growing season. Canopy structure was modeled using Light Detection and Ranging (LiDAR) technology, from which the sunlit and shaded canopy fractions were calculated as a function of incoming photosynthetically active radiation (PAR). These automated directional observations allowed us to: 1) investigate diurnal and seasonal changes of the PRI under different sky conditions; 2) compare the PRI with tower-based micro-meteorological measurements; and 3) separately investigate the PRI dynamics for sunlit and shaded partitions of the canopy which differ in response to their light environments. The data were categorized into six different groups based on two sky conditions (sunny and cloudy) and three illumination conditions (sunlit, shaded and intermediate). PRI showed a clear correlation with the LiDAR-based shadow fraction estimates. In April, the commencement of the growing season, clear diurnal dynamics of the PRI were observed for the sunlit foliage subset which showed lower (more negative) PRI values and a more dramatic change with sun altitude than shaded leaves. This was expected since leaves exposed to direct sunlight in their natural environment are likely under higher light stress. Consequently, diurnal changes of PRI and the differences among foliage groups were less obvious on overcast days because of limited direct irradiance. In August, when water availability was at its lowest of the year, the PRI exhibited relatively constant values throughout the day but with clear distinguishable values among the three leaf groups on sunny days. For other tower based measurements, PAR and GEP both showed clear seasonal patterns. Better estimates of the actual PAR intensity illuminating the sunlit and shaded canopy fractions were retrieved using the shadow fraction to reduce the above-canopy PAR. A clear seasonal pattern emerged for this revised PAR that distinguished among the groups and was also used to estimate LUE for the leaf groups. The correlation between PRI and LUE was confirmed. From these results, better understandings of the dynamics of carbon exchange bio-indicators that can be derived from directional hyperspectral reflectance measurements were demonstrated. Keywords: PRI, photosynthesis, PAR, GEP, LUE

Sexual conflict over parental care promotes the evolution of sex differences in care and the ability to care

PubMed Central

McNamara, John M.; Wolf, Max

2015-01-01

Strong asymmetries in parental care, with one sex providing more care than the other, are widespread across the animal kingdom. At present, two factors are thought to ultimately cause sex differences in care: certainty of parentage and sexual selection. By contrast, we here show that the coevolution of care and the ability to care can result in strong asymmetries in both the ability to care and the level of care, even in the absence of these factors. While the coevolution of care and the ability to care does not predict which sex evolves to care more than the other, once other factors give rise to even the slightest differences in the cost and benefits of care between the sexes (e.g. differences in certainty in parentage), a clear directionality emerges; the sex with the lower cost or higher benefit of care evolves both to be more able to care and to provide much higher levels of care than the other sex. Our findings suggest that the coevolution of levels of care and the ability to care may be a key factor underlying the evolution of sex differences in care. PMID:25694618

Recent Observations on Australian Bat Lyssavirus Tropism and Viral Entry

PubMed Central

Weir, Dawn L.; Annand, Edward J.; Reid, Peter A.; Broder, Christopher C.

2014-01-01

Australian bat lyssavirus (ABLV) is a recently emerged rhabdovirus of the genus lyssavirus considered endemic in Australian bat populations that causes a neurological disease in people indistinguishable from clinical rabies. There are two distinct variants of ABLV, one that circulates in frugivorous bats (genus Pteropus) and the other in insectivorous microbats (genus Saccolaimus). Three fatal human cases of ABLV infection have been reported, the most recent in 2013, and each manifested as acute encephalitis but with variable incubation periods. Importantly, two equine cases also arose recently in 2013, the first occurrence of ABLV in a species other than bats or humans. Similar to other rhabdoviruses, ABLV infects host cells through receptor-mediated endocytosis and subsequent pH-dependent fusion facilitated by its single fusogenic envelope glycoprotein (G). Recent studies have revealed that proposed rabies virus (RABV) receptors are not sufficient to permit ABLV entry into host cells and that the unknown receptor is broadly conserved among mammalian species. However, despite clear tropism differences between ABLV and RABV, the two viruses appear to utilize similar endocytic entry pathways. The recent human and horse infections highlight the importance of continued Australian public health awareness of this emerging pathogen. PMID:24556791

Recent observations on Australian bat lyssavirus tropism and viral entry.

PubMed

Weir, Dawn L; Annand, Edward J; Reid, Peter A; Broder, Christopher C

2014-02-19

Australian bat lyssavirus (ABLV) is a recently emerged rhabdovirus of the genus lyssavirus considered endemic in Australian bat populations that causes a neurological disease in people indistinguishable from clinical rabies. There are two distinct variants of ABLV, one that circulates in frugivorous bats (genus Pteropus) and the other in insectivorous microbats (genus Saccolaimus). Three fatal human cases of ABLV infection have been reported, the most recent in 2013, and each manifested as acute encephalitis but with variable incubation periods. Importantly, two equine cases also arose recently in 2013, the first occurrence of ABLV in a species other than bats or humans. Similar to other rhabdoviruses, ABLV infects host cells through receptor-mediated endocytosis and subsequent pH-dependent fusion facilitated by its single fusogenic envelope glycoprotein (G). Recent studies have revealed that proposed rabies virus (RABV) receptors are not sufficient to permit ABLV entry into host cells and that the unknown receptor is broadly conserved among mammalian species. However, despite clear tropism differences between ABLV and RABV, the two viruses appear to utilize similar endocytic entry pathways. The recent human and horse infections highlight the importance of continued Australian public health awareness of this emerging pathogen.

[Intraosseous infusion. An important technique also for paediatric anaesthesia].

PubMed

Weiss, M; Henze, G; Eich, C; Neuhaus, D

2009-09-01

Timely establishment of venous access in infants and toddlers can prove a particularly challenging task. Since the 1940s the technique of intraosseous infusion has established itself as a valuable alternative means for rapid, efficient and safe delivery of drugs and fluids to critically ill children. Whereas international guidelines for paediatric emergency medical care have assigned intraosseous infusion a high priority, most anaesthetists utilize this well-proven technique with great reluctance. This article describes the technique of intraosseous infusion, introduces two different cannulation systems, and discusses its potential indications in paediatric anaesthesia, based on current emergency medical care guidelines as well as some of our own case studies. In particular, children with acutely life-threatening conditions, such as circulatory arrest, laryngospasm, acute airway haemorrhage, hypovolaemic shock or hypothermia secondary to extensive burns, should receive an intraosseous cannula if intravenous access cannot be rapidly established. Future discussion may reveal whether a transiently inserted intraosseous infusion would also be indicated if the child with difficult or impossible venous access presents without acute life-threatening conditions for anaesthesia. Successful application of the intraosseous infusion technique requires immediate access to the necessary equipment, intensive education, continuous training and clear guidelines for its application in an anaesthesia department.

A construct divided: prosocial behavior as helping, sharing, and comforting subtypes.

PubMed

Dunfield, Kristen A

2014-01-01

The development and maintenance of prosocial, other-oriented behaviors has been of considerable recent interest. Though it is clear that prosocial behaviors emerge early and play a uniquely important role in the social lives of humans, there is less consensus regarding the mechanisms that underlie and maintain these fundamental acts. The goal of this paper is to clarify inconsistencies in our understanding of the early emergence and development of prosocial behavior by proposing a taxonomy of prosocial behavior anchored in the social-cognitive constraints that underlie the ability to act on behalf of others. I will argue that within the general domain of prosocial behavior, other-oriented actions can be categorized into three distinct types (helping, sharing, and comforting) that reflect responses to three distinct negative states (instrumental need, unmet material desire, and emotional distress). In support of this proposal, I will demonstrate that the three varieties of prosocial behavior show unique ages of onset, uncorrelated patterns of production, and distinct patterns of individual differences. Importantly, by differentiating specific varieties of prosocial behavior within the general category, we can begin to explain inconsistencies in the past literature and provide a framework for directing future research into the ontogenetic origins of these essential social behaviors.

A bottom-up institutional approach to cooperative governance of risky commons

NASA Astrophysics Data System (ADS)

Vasconcelos, Vítor V.; Santos, Francisco C.; Pacheco, Jorge M.

2013-09-01

Avoiding the effects of climate change may be framed as a public goods dilemma, in which the risk of future losses is non-negligible, while realizing that the public good may be far in the future. The limited success of existing attempts to reach global cooperation has been also associated with a lack of sanctioning institutions and mechanisms to deal with those who do not contribute to the welfare of the planet or fail to abide by agreements. Here we investigate the emergence and impact of different types of sanctioning to deter non-cooperative behaviour in climate agreements. We show that a bottom-up approach, in which parties create local institutions that punish free-riders, promotes the emergence of widespread cooperation, mostly when risk perception is low, as it is at present. On the contrary, global institutions provide, at best, marginal improvements regarding overall cooperation. Our results clearly suggest that a polycentric approach involving multiple institutions is more effective than that associated with a single, global one, indicating that such a bottom-up, self-organization approach, set up at a local scale, provides a better ground on which to attempt a solution for such a complex and global dilemma.

Advances in the endoscopic management of pancreatic collections.

PubMed

Ruiz-Clavijo, David; de la Higuera, Belen González; Vila, Juan J

2015-04-16

Treatment of pancreatic collections has experienced great progress in recent years with the emergence of alternative minimally invasive techniques comparing to the classic surgical treatment. Such techniques have been shown to improve outcomes of morbidity vs surgical treatment. The recent emergence of endoscopic drainage is noteworthy. The advent of endoscopic ultrasonography has been crucial for treatment of these specific lesions. They can be characterized, their relationships with neighboring structures can be evaluated and the drainage guided by this technique has been clearly improved compared with the conventional endoscopic drainage. Computed tomography is the technique of choice to characterize the recently published new classification of pancreatic collections. For this reason, the radiologist's role establishing and classifying in a rigorously manner the collections according to the new nomenclature is essential to making therapeutic decisions. Ideal scenario for comprehensive treatment of these collections would be those centers with endoscopic ultrasound and interventional radiology expertise together with hepatobiliopancreatic surgery. This review describes the different types of pancreatic collections: acute peripancreatic fluid collection, pancreatic pseudocysts, acute necrotic collection and walled-off necrosis; the indications and the contraindications for endoscopic drainage, the drainage technique and their outcomes. The integrated management of pancreatic collections according to their type and evolution time is discussed.

Important skills for biomedical services: The perspectives of Malaysian employers and employees.

PubMed

Buntat, Yahya; Saud, Muhammad Sukri; Mokhtar, Mahani; Kamin, Yusri; Feh, Lim Set

2016-10-17

Increase in the occurrence of existing diseases, continual emergence of new or exotic diseases and re-emergence of old diseases have placed increasing demands on biomedical services in Malaysia. Biomedical technicians play an important role in operating biomedical instruments. However, there are no clear specifications about characteristics and traits for these semi-professional employees. Employers in a few studies claimed that biomedical graduates are not ready to enter and face challenges in the job market. Therefore, the purpose of this study is to identify technical and generic skills for a biomedical technician from the perspectives of the biomedical technicians and their employers. A quantitative survey design was employed whereby data were obtained through the administration of an instrument developed by the researchers. The sample consisted of 20 hospital managers and 186 biomedical technicians who are currently working in Malaysian government hospitals. The findings show that there are no difference in the perceptions of hospital managers and biomedical technicians regarding technical and non-technical skills. These findings resulted in a checklist which can be used for institutions to produce future biomedical technician graduates in order to meet job demands. However, future research is needed to validate the findings and explore the variables in depth.

Ego consciousness in the Japanese psyche: culture, myth and disaster.

PubMed

Yama, Megumi

2013-02-01

With globalization, modern Western consciousness has spread across the world. This influx has affected the Japanese culture but ego consciousness has emerged through a long history and different course from that of the West. At a personal level, I have been interested in the establishment of a subject in a culture that values homogeneity and to understand this, I reflect on my own history of living in both the East and the West and on my experience practising psychotherapy. To show Japanese collective functioning at its best, I describe the human inter-connectedness and collaboration during the 2011 disaster. I explore the 'Nothing' at the centre of the Japanese psyche, through a reading of Japanese myth, especially the most originary and almost pre-human stories that come before the anthropomorphized 'First Parents'. A retelling of this founding story, reveals the multiple iterations over time that manifest in embodied being; this gradual emergence of consciousness is contrasted with Western myths of origin that are more clear and specific. This study attempts to bring awareness of the value and meaning of Eastern consciousness and its centre in the 'Nothing'. © 2013, The Society of Analytical Psychology.

Coronal manifestations of preflare activity

NASA Technical Reports Server (NTRS)

Schmahl, E. J.; Webb, D. F.; Woodgate, B.; Waggett, P.; Bentley, R.; Hurford, G.; Schadee, A.; Schrijver, J.; Harrison, R.; Martens, P.

1986-01-01

A variety of coronal manifestations of precursors or preheating for flares are discussed. Researchers found that almost everyone with a telescope sees something before flares. Whether an all-encompassing scenario will ever be developed is not at all clear at present. The clearest example of preflare activity appears to be activated filaments and their manifestations, which presumably are signatures of a changing magnetic field. But researchers have seen two similar eruptions, one without any evidence of emerging flux (Kundu et al., 1985) and the other with colliding poles (Simon et al., 1984). While the reconnection of flux is generally agreed to be required to energize a flare, the emergence of flux from below (at least on short timescales and in compact regions) does not appear to be a necessary condition. In some cases the cancelling of magnetic flux (Martin, 1984) by horizontal motions instead may provide the trigger (Priest, 1985) Researchers found similarities and some differences between these and previous observations. The similarities, besides the frequent involvement of filaments, include compact, multiple precursors which can occur both at and near (not at) the flare site, and the association between coronal sources and activity lower in the atmosphere (i.e., transition zone and chromosphere).

Emergence of complex behavior in pili-based motility in early stages of P. aeruginosa surface adaptation

NASA Astrophysics Data System (ADS)

Brill-Karniely, Yifat; Jin, Fan; Wong, Gerard C. L.; Frenkel, Daan; Dobnikar, Jure

2017-04-01

Pseudomonas aeruginosa move across surfaces by using multiple Type IV Pili (TFP), motorized appendages capable of force generation via linear extension/retraction cycles, to generate surface motions collectively known as twitching motility. Pseudomonas cells arrive at a surface with low levels of piliation and TFP activity, which both progressively increase as the cells sense the presence of a surface. At present, it is not clear how twitching motility emerges from these initial minimal conditions. Here, we build a simple model for TFP-driven surface motility without complications from viscous and solid friction on surfaces. We discover the unanticipated structural requirement that TFP motors need to have a minimal amount of effective angular rigidity in order for cells to perform the various classes of experimentally-observed motions. Moreover, a surprisingly small number of TFP are needed to recapitulate movement signatures associated with twitching: Two TFP can already produce movements reminiscent of recently observed slingshot type motion. Interestingly, jerky slingshot motions characteristic of twitching motility comprise the transition region between different types of observed crawling behavior in the dynamical phase diagram, such as self-trapped localized motion, 2-D diffusive exploration, and super-diffusive persistent motion.

Vowels in clear and conversational speech: Talker differences in acoustic characteristics and intelligibility for normal-hearing listeners

NASA Astrophysics Data System (ADS)

Hargus Ferguson, Sarah; Kewley-Port, Diane

2002-05-01

Several studies have shown that when a talker is instructed to speak as though talking to a hearing-impaired person, the resulting ``clear'' speech is significantly more intelligible than typical conversational speech. Recent work in this lab suggests that talkers vary in how much their intelligibility improves when they are instructed to speak clearly. The few studies examining acoustic characteristics of clear and conversational speech suggest that these differing clear speech effects result from different acoustic strategies on the part of individual talkers. However, only two studies to date have directly examined differences among talkers producing clear versus conversational speech, and neither included acoustic analysis. In this project, clear and conversational speech was recorded from 41 male and female talkers aged 18-45 years. A listening experiment demonstrated that for normal-hearing listeners in noise, vowel intelligibility varied widely among the 41 talkers for both speaking styles, as did the magnitude of the speaking style effect. Acoustic analyses using stimuli from a subgroup of talkers shown to have a range of speaking style effects will be used to assess specific acoustic correlates of vowel intelligibility in clear and conversational speech. [Work supported by NIHDCD-02229.

Dynamic competition in pharmaceuticals. Patent expiry, generic penetration, and industry structure.

PubMed

Magazzini, Laura; Pammolli, Fabio; Riccaboni, Massimo

2004-06-01

This paper investigates patterns of industrial dynamics and competition in the pharmaceutical industry, with particular reference to the consequences of patent expiry in different countries. We focus on the competition at the level of single chemical entities, distinguishing between original brands and generic products. Quarterly data, spanning from July 1987 to December 1998, on sales of pharmaceutical products in four countries (USA, UK, Germany, and France) constitute the basis of our analysis. All the products containing major molecules whose patent expiration date lies between 1986 and 1996 are included in our sample. We show how diffusion of generics is linked to the characteristics of the market and investigate how price dynamics of original products are affected by generic competition. Our empirical investigation shows that the dynamics of drug prices and the competition by generic drugs vary significantly across countries. This heterogeneity notwithstanding, a clear distinction seems to emerge. On the one hand, systems that rely on market-based competition in pharmaceuticals promote a clear distinction between firms that act as innovators and firms that act as imitators after patent expiry. Here, original products enjoy premium prices and exclusivity profits under patent protection, and face fierce price competition after patent expiry. On the other hand, in systems that rely on administered prices, penetration by generic drugs tends to be rather limited. Its descriptive and preliminary nature notwithstanding, our analysis seems to have relevant implications at different levels of generality, especially for Europe.

Rationalisation and Validation of an Acrylamide-Free Procedure in Three-Dimensional Histological Imaging

PubMed Central

Lai, Hei Ming; Liu, Alan King Lun; Ng, Wai-Lung; DeFelice, John; Lee, Wing Sang; Li, Heng; Li, Wen; Ng, Ho Man; Chang, Raymond Chuen-Chung; Lin, Bin; Wu, Wutian; Gentleman, Steve M.

2016-01-01

Three-dimensional visualization of intact tissues is now being achieved by turning tissues transparent. CLARITY is a unique tissue clearing technique, which features the use of detergents to remove lipids from fixed tissues to achieve optical transparency. To preserve tissue integrity, an acrylamide-based hydrogel has been proposed to embed the tissue. In this study, we examined the rationale behind the use of acrylamide in CLARITY, and presented evidence to suggest that the omission of acrylamide-hydrogel embedding in CLARITY does not alter the preservation of tissue morphology and molecular information in fixed tissues. We therefore propose a novel and simplified workflow for formaldehyde-fixed tissue clearing, which will facilitate the laboratory implementation of this technique. Furthermore, we have investigated the basic tissue clearing process in detail and have highlighted some areas for targeted improvement of technologies essential for the emerging subject of three-dimensional histology. PMID:27359336

Concerted Creativity: Emergence in the Socio-(Im)Material and Intangible Practice of Making Music.

PubMed

Hvidtfeldt, Dan Lund

2018-06-01

The purpose of this article is to explore how the basic conception of 'emergence' informs the study of creativity as a socio-material practice. Initially, the article explicates how creative processes, products and performances involve not only tangible, but also intangible and social elements. Secondly, the theoretical conception of creativity as socio-material and the general philosophical notion of emergence are introduced. Inspired by the idea that a 'whole' is other than the sum of its 'parts' and by examples primarily from the world of music, the article argues that the relationship between subject and object - the main analytical focus of studies on creativity as a socio-material practice - is fundamentally embedded in an emergent process. The article concludes by highlighting how emergence theory acknowledges the performance or product as an intangible material for creative processes of musicians, and that studies of the socio-materiality of creative practices clearly involving tangible, intangible and social elements must refer to the emergent process through which the creative product or performance evolves meaning. The theoretical framework suggested is relevant for researchers interested in exploring how materials, social settings and physical environments are involved in creative processes.

Challenge of hospital emergency preparedness: analysis and recommendations.

PubMed

Barbera, Joseph A; Yeatts, Dale J; Macintyre, Anthony G

2009-06-01

In the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research.

Evolution of European Union legislation on emergency research.

PubMed

Mentzelopoulos, Spyros D; Mantzanas, Michail; van Belle, Gerald; Nichol, Graham

2015-06-01

Emergency research is necessary to prevent exposure of patients to unvalidated clinical practice (nonmaleficence), and to improve the dismal prognosis of disorders requiring emergent treatment such as cardiac arrest (beneficence). Regulations that govern clinical research should conform to bioethical principles of respect for nonmaleficence, beneficence, autonomy, and justice. Our objectives are to review the evolution of European Union (EU) legislation on emergency research, and to identify potentially remaining problems. EU legislative sources on clinical research and medical literature describing the impact of EU Regulations on emergency research. Article 5 of EU Directive 2001/20/EC required consent before enrolment in a research study to ensure the autonomy of potentially incapacitated research subjects. However, obtaining such consent is often impossible in emergency situations. Directive 2001/20/EC was criticized for potentially preventing emergency research. Several EU Member States addressed this problem by permitting deferred consent. International ethical guidelines supporting deferred consent were also cited by Good Clinical Practice Directive 2005/28/EC. However, Directive 2001/20/EC was not revised to achieve harmonization of EU emergency research, thus resulting in ongoing "ambiguity" as regards to emergency research legitimacy. This will be definitively addressed by applying EU Regulation No. 536/2014 and repealing Directive 2001/20/EC. The new EU Regulation permits using deferred consent under clearly specified conditions, and may foster emergency research that evaluates interventions posing minimal risk relative to standard practice. Legislation related to emergency research in Europe has evolved to increase concordance with bioethical principles so as to increase evidence-based improvements in emergency care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Boredom begs to differ: Differentiation from other negative emotions.

PubMed

van Tilburg, Wijnand A P; Igou, Eric R

2017-03-01

Boredom research is booming. Nonetheless, a comprehensive understanding of boredom in relation to other negative emotions is lacking. This ambiguity impedes accurate interpretation of boredom's causes and consequences. To gain more insights into boredom, we examined in detail how it differs from a range of other negative experiences, namely sadness, anger, frustration, fear, disgust, depression, guilt, shame, regret, and disappointment. Our research indicates that the appraisals associated with boredom distinguish it clearly from other negative emotions; conceptually (Study 1), in terms of state experiences (Study 2), and in terms of individual differences in these experiences (Study 3). Our findings suggest that boredom is mild in negative valence, low in arousal, is associated with low perceived challenge and low perceived meaningfulness, and has low relevance to moral judgment and behavior. Boredom also involves low attention given to situations and tasks, and the lack of perceived meaningfulness and attention associated with boredom emerged as particularly distinctive characteristics. The findings underscore the importance of carefully discriminating boredom from other emotions in experimental induction, psychometric assessment, and conceptual discussion. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Managing troubled data: Coastal data partnerships smooth data integration

USGS Publications Warehouse

Hale, S.S.; Hale, Miglarese A.; Bradley, M.P.; Belton, T.J.; Cooper, L.D.; Frame, M.T.; Friel, C.A.; Harwell, L.M.; King, R.E.; Michener, W.K.; Nicolson, D.T.; Peterjohn, B.G.

2003-01-01

Understanding the ecology, condition, and changes of coastal areas requires data from many sources. Broad-scale and long-term ecological questions, such as global climate change, biodiversity, and cumulative impacts of human activities, must be addressed with databases that integrate data from several different research and monitoring programs. Various barriers, including widely differing data formats, codes, directories, systems, and metadata used by individual programs, make such integration troublesome. Coastal data partnerships, by helping overcome technical, social, and organizational barriers, can lead to a better understanding of environmental issues, and may enable better management decisions. Characteristics of successful data partnerships include a common need for shared data, strong collaborative leadership, committed partners willing to invest in the partnership, and clear agreements on data standards and data policy. Emerging data and metadata standards that become widely accepted are crucial. New information technology is making it easier to exchange and integrate data. Data partnerships allow us to create broader databases than would be possible for any one organization to create by itself.

Environmental transmission of Mycobacterium ulcerans drives dynamics of Buruli ulcer in endemic regions of Cameroon

NASA Astrophysics Data System (ADS)

Garchitorena, Andrés; Ngonghala, Calistus N.; Texier, Gaëtan; Landier, Jordi; Eyangoh, Sara; Bonds, Matthew H.; Guégan, Jean-François; Roche, Benjamin

2015-12-01

Buruli Ulcer is a devastating skin disease caused by the pathogen Mycobacterium ulcerans. Emergence and distribution of Buruli ulcer cases is clearly linked to aquatic ecosystems, but the specific route of transmission of M. ulcerans to humans remains unclear. Relying on the most detailed field data in space and time on M. ulcerans and Buruli ulcer available today, we assess the relative contribution of two potential transmission routes -environmental and water bug transmission- to the dynamics of Buruli ulcer in two endemic regions of Cameroon. The temporal dynamics of Buruli ulcer incidence are explained by estimating rates of different routes of transmission in mathematical models. Independently, we also estimate statistical models of the different transmission pathways on the spatial distribution of Buruli ulcer. The results of these two independent approaches are corroborative and suggest that environmental transmission pathways explain the temporal and spatial patterns of Buruli ulcer in our endemic areas better than the water bug transmission.

Fibre multi-wave mixing combs reveal the broken symmetry of Fermi-Pasta-Ulam recurrence

NASA Astrophysics Data System (ADS)

Mussot, Arnaud; Naveau, Corentin; Conforti, Matteo; Kudlinski, Alexandre; Copie, Francois; Szriftgiser, Pascal; Trillo, Stefano

2018-05-01

In optical fibres, weak modulations can grow at the expense of a strong pump to form a triangular comb of sideband pairs, until the process is reversed. Repeated cycles of such conversion and back-conversion constitute a manifestation of the universal nonlinear phenomenon known as Fermi-Pasta-Ulam recurrence. However, it remains a major challenge to observe the coexistence of different types of recurrences owing to the spontaneous symmetry-breaking nature of such a phenomenon. Here, we implement a novel non-destructive technique that allows the evolution in amplitude and phase of frequency modes to be reconstructed via post-processing of the fibre backscattered light. We clearly observe how control of the input modulation seed results in different recursive behaviours emerging from the phase-space structure dictated by the spontaneously broken symmetry. The proposed technique is an important tool to characterize other mixing processes and new regimes of rogue-wave formation and wave turbulence in fibre optics.

Asymmetry of the Brain: Development and Implications.

PubMed

Duboc, Véronique; Dufourcq, Pascale; Blader, Patrick; Roussigné, Myriam

2015-01-01

Although the left and right hemispheres of our brains develop with a high degree of symmetry at both the anatomical and functional levels, it has become clear that subtle structural differences exist between the two sides and that each is dominant in processing specific cognitive tasks. As the result of evolutionary conservation or convergence, lateralization of the brain is found in both vertebrates and invertebrates, suggesting that it provides significant fitness for animal life. This widespread feature of hemispheric specialization has allowed the emergence of model systems to study its development and, in some cases, to link anatomical asymmetries to brain function and behavior. Here, we present some of what is known about brain asymmetry in humans and model organisms as well as what is known about the impact of environmental and genetic factors on brain asymmetry development. We specifically highlight the progress made in understanding the development of epithalamic asymmetries in zebrafish and how this model provides an exciting opportunity to address brain asymmetry at different levels of complexity.

Autonomic Dysfunction and Risk Factors Associated with Trypanosoma cruzi Infection among Children in Arequipa, Peru

PubMed Central

Bowman, Natalie M.; Kawai, Vivian; Gilman, Robert H.; Bocangel, Cesar; Galdos-Cardenas, Gerson; Cabrera, Lilia; Levy, Michael Z.; Cornejo del Carpio, Juan Geny; Delgado, Freddy; Rosenthal, Lauren; Pinedo-Cancino, Vivian V.; Steurer, Francis; Seitz, Amy E.; Maguire, James H.; Bern, Caryn

2011-01-01

Chagas disease affects an estimated 8 million people in Latin America. Infected individuals have 20–30% lifetime risk of developing cardiomyopathy, but more subtle changes in autonomic responses may be more frequent. We conducted a matched case-control study of children in Arequipa, Peru, where triatomine infestation and Trypanosoma cruzi infection are emerging problems. We collected data on home environment, history, physical examination, electrocardiogram, and autonomic testing. Signs of triatomine infestation and/or animals sleeping in the child's room and household members with Chagas disease were associated with increased infection risk. Electrocardiogram findings did not differ between cases and controls. However, compared with control children, infected children had blunted autonomic responses by three different measures, the Valsalva maneuver, the cold pressor test, and the orthostatic test. T. cruzi-infected children show autonomic dysfunction, although the prognostic value of this finding is not clear. Sustained vector control programs are essential to decreasing future T. cruzi infections. PMID:21212207

The role of regional heterogeneity in age-related differences in functional hemispheric asymmetry: an fMRI study.

PubMed

Heng, Jiamin Gladys; Wu, Chiao-Yi; Archer, Josephine Astrid; Miyakoshi, Makoto; Nakai, Toshiharu; Chen, Shen-Hsing Annabel

2017-10-09

Neuroimaging literature has documented age-related hemispheric asymmetry reduction in frontal regions during task performances. As most studies employed working memory paradigms, it is therefore less clear if this pattern of neural reorganization is constrained by working memory processes or it would also emerge in other cognitive domains which are predominantly lateralized. Using blocked functional magnetic resonance imaging (fMRI), the present study used a homophone judgment task and a line judgment task to investigate age-related differences in functional hemispheric asymmetry in language and visuospatial processing respectively. Young and older adults achieved similar task accuracy although older adults required a significantly longer time. Age-related functional hemispheric asymmetry reduction was found only in dorsal inferior frontal gyrus and was associated with better performance when the homophone condition was contrasted against fixation, and not line condition. Our data thus highlights the importance of considering regional heterogeneity of aging effects together with general age-related cognitive processes.

A synopsis on aging-Theories, mechanisms and future prospects.

PubMed

da Costa, João Pinto; Vitorino, Rui; Silva, Gustavo M; Vogel, Christine; Duarte, Armando C; Rocha-Santos, Teresa

2016-08-01

Answering the question as to why we age is tantamount to answering the question of what is life itself. There are countless theories as to why and how we age, but, until recently, the very definition of aging - senescence - was still uncertain. Here, we summarize the main views of the different models of senescence, with a special emphasis on the biochemical processes that accompany aging. Though inherently complex, aging is characterized by numerous changes that take place at different levels of the biological hierarchy. We therefore explore some of the most relevant changes that take place during aging and, finally, we overview the current status of emergent aging therapies and what the future holds for this field of research. From this multi-dimensional approach, it becomes clear that an integrative approach that couples aging research with systems biology, capable of providing novel insights into how and why we age, is necessary. Copyright © 2016 Elsevier B.V. All rights reserved.

Evolving paradigms in multifocal breast cancer.

PubMed

Salgado, Roberto; Aftimos, Philippe; Sotiriou, Christos; Desmedt, Christine

2015-04-01

The 7th edition of the TNM defines multifocal breast cancer as multiple simultaneous ipsilateral and synchronous breast cancer lesions, provided they are macroscopically distinct and measurable using current traditional pathological and clinical tools. According to the College of American Pathologists (CAP), the characterization of only the largest lesion is considered sufficient, unless the grade and/or histology are different between the lesions. Here, we review three potentially clinically relevant aspects of multifocal breast cancers: first, the importance of a different intrinsic breast cancer subtype of the various lesions; second, the emerging awareness of inter-lesion heterogeneity; and last but not least, the potential introduction of bias in clinical trials due to the unrecognized biological diversity of these cancers. Although the current strategy to assess the lesion with the largest diameter has clearly its advantages in terms of costs and feasibility, this recommendation may not be sustainable in time and might need to be adapted to be compliant with new evolving paradigms in breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

Managing troubled data: coastal data partnerships smooth data integration.

PubMed

Hale, Stephen S; Miglarese, Anne Hale; Bradley, M Patricia; Belton, Thomas J; Cooper, Larry D; Frame, Michael T; Friel, Christopher A; Harwell, Linda M; King, Robert E; Michener, William K; Nicolson, David T; Peterjohn, Bruce G

2003-01-01

Understanding the ecology, condition, and changes of coastal areas requires data from many sources. Broad-scale and long-term ecological questions, such as global climate change, biodiversity, and cumulative impacts of human activities, must be addressed with databases that integrate data from several different research and monitoring programs. Various barriers, including widely differing data formats, codes, directories, systems, and metadata used by individual programs, make such integration troublesome. Coastal data partnerships, by helping overcome technical, social, and organizational barriers, can lead to a better understanding of environmental issues, and may enable better management decisions. Characteristics of successful data partnerships include a common need for shared data, strong collaborative leadership, committed partners willing to invest in the partnership, and clear agreements on data standards and data policy. Emerging data and metadata standards that become widely accepted are crucial. New information technology is making it easier to exchange and integrate data. Data partnerships allow us to create broader databases than would be possible for any one organization to create by itself.

Detection of antibody to Purpureocillium lilacinum by immunofluorescent assay and flow cytometry in serum of infected C57BL/6 mice.

PubMed

de Sequeira, Danielly C M; Peixoto, Mariana L P; De Luca, Paula M; Oliveira-Ferreira, Joseli; Antas, Paulo R Z; Borba, Cintia M

2013-10-31

Purpureocillium lilacinum is an emerging pathogenic fungus that can cause different clinical manifestations ranging from cutaneous and sub-cutaneous infections to severe oculomycosis. In this study, using both conventional indirect immunofluorescence and non-conventional flow cytometry approaches, IgG antibodies were readily detected in both C57BL/6 immunocompetent and immunosuppressed mice after i.v. infection with P. lilacinum. The humoral immune response was specific, since virtually no antibodies were detected in the serum of control mice. Flow cytometry assays also showed both quantitative and qualitative differences in total IgG and its isotypes in sera of immunocompetent and immunosupressed infected mice. Although a good starting point, it is clear that the effectiveness of serological assays for P. lilacinum hyalohyphomycosis identification in clinical studies still requires further standardization. Upon further validation in humans, these techniques have the potential to be suitable to detect P. lilacinum infection in patients, thereby avoiding current laborious and time-consuming culture techniques. © 2013.

Non-tuberculous Mycobacteria isolated from lymph nodes and faecal samples of healthy slaughtered cattle and the abattoir environment.

PubMed

Ghielmetti, G; Friedel, U; Scherrer, S; Sarno, E; Landolt, P; Dietz, O; Hilbe, M; Zweifel, C; Stephan, R

2018-06-01

Infections caused by non-tuberculous mycobacteria (NTM) are reported as emerging disease in many countries worldwide. The occurrence of NTM in different hosts and their implication as obligate or opportunistic pathogen remain largely unclear. Lymph nodes and faecal samples of clinically healthy Swiss cattle at slaughter were analysed for the presence of NTM. Based on the examined lymph nodes, NTM were detected in 20% of 108 cattle originating from different premises. The 22 isolates belonged to five different species of Mycobacteria (M. avium subsp. hominissuis, M. kansasii, M. persicum, "M. lymphaticum" and M. europaeum). M. avium subsp. hominissuis (63%) and M. kansasii (18%) thereby predominated and were found in lymph nodes with and without macroscopic changes. Moreover, M. persicum found in two cattle has recently been described as a human pathogen and is closely related to M. kansasii. Amongst cattle with lymph nodes positive for mycobacteria, viable NTM were occasionally also detected in bovine faeces. However, the isolated NTM species from lymph nodes and respective faecal samples (M. hassiacum, M. phlei and M. vaccae) did not coincide. Moreover, NTM species identified amongst isolates from the slaughterhouse environment clearly differed from those from lymph nodes and faecal samples, excluding cross-contamination of the tissue specimens through the environment or laboratory processing. Assuming that some NTM interfere with the detection of bovine tuberculosis (bTB), the present findings in healthy animals emphasize the need of more specific diagnostic tools for bTB eradication programs. © 2017 The Authors. Transboundary and Emerging Diseases Published by Blackwell Verlag GmbH.

The transition to clinical expert: enhanced decision making for children aged less than 5 years attending the paediatric ED with acute respiratory conditions.

PubMed

Bowen, Leah; Shaw, Alison; Lyttle, Mark D; Purdy, Sarah

2017-02-01

Rates of unplanned paediatric admissions are persistently high. Many admissions are short-stay events, lasting less than 48 hours. This qualitative research explores factors that influence clinical decision making in the paediatric ED (PED) for children under 5 attending with acute respiratory conditions, focusing on how management decisions adapt with increasing experience. Semi-structured interviews were conducted with 15 PED clinicians (doctors, emergency nurse practitioners and registered nurses) with varying levels of experience in paediatric emergency medicine (PEM), emergency medicine or paediatrics. Audio-recorded interviews were transcribed and analysed thematically. There were clear differences in decision-making approaches between experienced clinicians and junior staff. The latter were more risk adverse, relying heavily on guidelines, set admission criteria, clinical theory and second opinions. This was particularly true for doctors. 'Informal' learning was apparent in accounts from less-experienced doctors and nurses, whereby tacit knowledge and risk management played an increasing role in the development of clinical intuition that permitted rapid assessment and treatment of young patients. The emergence of intuition entwined with approaches to risk management and the role of these skills in clinical decision making, carry implications for the development of training programmes for clinicians working in PEM. Enhanced training for such groups to permit development of the supplementary skills described in this study could have the ability to improve care delivery and even reduce paediatric admissions. 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/.

Timely pain management in the emergency department.

PubMed

Patrick, Patricia A; Rosenthal, Barry M; Iezzi, Carina A; Brand, Donald A

2015-03-01

Delivering timely pain relief remains a challenge for most emergency departments. To evaluate the effectiveness of a policy aimed at delivering analgesics within 30 min to patients presenting to an emergency department with severe pain. Subjects were aged ≥19 years, had a principal diagnosis of renal colic, hip fracture, or sickle cell disease, reported a pain score ≥8 on a scale of 0 to 10 at triage, and continued to report a score in this range until receiving analgesia. The study compared proportions of patients receiving analgesics within the 30-min target, median time to analgesic administration, and median time to relief of severe pain (decline in pain level to score <8) during 6 months before vs. 6 months after implementation of the new pain management policy. Paradoxically, the median total waiting time to analgesic administration increased from 64 min (n = 75) to 80 min (n = 70) after policy implementation (p = 0.01), and the proportion of patients receiving analgesics within 30 min declined from 17% (13/75) to 7% (5/70) (p = 0.08). Median time to relief of severe pain did not differ significantly between periods (130.5 vs. 153 min; p = 0.31). After implementation of the new pain management policy, the proportion of patients with severe pain receiving analgesics within 30 min actually declined. Although a 30-min target may be unrealistic, it seems reasonable to conclude that something is wrong when patients with notoriously painful conditions must typically wait 1-2 h to obtain relief. Given the millions of individuals who receive care in emergency departments nationwide each year, the suffering caused by delays occurs on a large scale, so creative approaches are clearly needed to overcome the obstacles. Copyright © 2015 Elsevier Inc. All rights reserved.

Role of early experience in ant enslavement: a comparative analysis of a host and a non-host species

PubMed Central

Blatrix, Rumsaïs; Sermage, Claire

2005-01-01

Background Ants use the odour of the colony to discriminate nestmates. In some species, this odour is learned during the first days following emergence, and thus early experience has a strong influence on nestmate discrimination. Slave-making ants are social parasites that capture brood of other ant species to increase the worker force of their colony. After emerging in the slave-maker nest, slave workers work as if they were in their own colony. We tested the hypothesis that early experience allows the deception of commonly enslaved species, while non-host species use a different mechanism, which does not involve learning. Results Pupae of a host species, Temnothorax unifasciatus, and a non-host species, T. parvulus, were allowed to emerge in the presence of workers of one of two slave-maker species, Chalepoxenus muellerianus or Myrmoxenus ravouxi. When T. unifasciatus was exposed to slave-makers for 10 days following emergence, they were more aggressive towards their own sisters and groomed the slave-maker more. T. parvulus gave a less clear result: while workers behaved more aggressively towards their sisters when exposed early to C. muellerianus workers, this was not the case when exposed early to M. ravouxi workers. Moreover, T. parvulus workers allogroomed conspecific nestmates less than T. unifasciatus. Allogrooming activity might be very important for the slave-makers because they are tended by their slaves. Conclusion Our findings show that early experience influences nestmate discrimination in the ant T. unifasciatus and can account for the successful enslavement of this species. However, the non-host species T. parvulus is less influenced by the early environment. This might help to explain why this species is never used by social parasites. PMID:16076389

The naming impairment of living and nonliving items in Alzheimer's disease.

PubMed

Montanes, P; Goldblum, M C; Boller, F

1995-01-01

Several studies of semantic abilities in Dementia of the Alzheimer Type (DAT) suggest that their semantic disorders may affect specific categories of knowledge. In particular, the existence of a category-specific semantic impairment affecting, selectively, living things has frequently been reported in association with DAT. We report here results from two naming tasks of 25 DAT patients and two subgroups within this population. The first naming task used 48 black and white line drawings from Snodgrass and Vanderwart (1980) which controlled the visual complexity of stimuli from living and nonliving categories. The second task used 44 colored pictures (to assess the influence of word frequency in living vs. nonliving categories). Within the set of black and white pictures, both DAT patients and controls obtained significantly lower scores on high visual complexity stimuli than on stimuli of low visual complexity. A clear effect of semantic category emerged for DAT patients and controls, with a lower performance on the living category. Within the colored set, pictures corresponding to high frequency words gave rise to significantly higher scores than pictures corresponding to low frequency words. No significant difference emerged between living versus nonliving categories, either in DAT patients or in controls. In the two tasks, the two subgroups of DAT patients presented a different profile of performance and error type. As color constitutes the main difference between the two sets of pictures, our results point to the relevance of this cue in the processing of semantic information, with visual complexity and frequency also being very relevant.

Participation process and outcome interactions: Exploring participation in water resource management

NASA Astrophysics Data System (ADS)

Carr, G.; Loucks, D. P.; Blöschl, G.

2012-04-01

Evaluating participation programmes, projects and activities aids understanding of effective mechanisms and enables the identification of improvements to current strategies. Characteristics of participation processes, such whether the process is cost effective, adequately facilitated, accessible, includes a representative section of society or interest groups and allocates power equivalently between participants, are commonly described and evaluated in the literature. A key question concerns whether effective processes lead to desirable outcomes. Two types of outcomes can be identified from participation programmes - tangible and non-tangible. Tangible outcomes include resource management changes or resource quality changes. Non tangible outcomes include developing and strengthening communication and action networks, building trust between individuals and/or organisations, developing innovative solutions, or developing shared knowledge and understandings of issues. To better understand how participation impacts upon resource management it is necessary to identify i) how non-tangible outcomes lead to resource management outcomes and ii) which characteristics of the participation process are connected to achieving non-tangible outcomes. This has been attempted with a literature based meta-analysis. Literature has been analysed to identify outcomes from participations programmes, and the process characteristics present that are associated with promoting or inhibiting their achievement. Preliminary analysis shows that process characteristics such as representation, facilitation and accessibility are important for achieving non-tangible outcomes. The relationship between non-tangible outcomes and resource management outcomes is less clear in the literature. This may be due to the different timescales over which the different types of outcomes emerge (resource management outcomes emerge over longer time periods) and the different contexts or settings in which participation takes place.

Whole-body and Whole-Organ Clearing and Imaging Techniques with Single-Cell Resolution: Toward Organism-Level Systems Biology in Mammals.

PubMed

Susaki, Etsuo A; Ueda, Hiroki R

2016-01-21

Organism-level systems biology aims to identify, analyze, control and design cellular circuits in organisms. Many experimental and computational approaches have been developed over the years to allow us to conduct these studies. Some of the most powerful methods are based on using optical imaging in combination with fluorescent labeling, and for those one of the long-standing stumbling blocks has been tissue opacity. Recently, the solutions to this problem have started to emerge based on whole-body and whole-organ clearing techniques that employ innovative tissue-clearing chemistry. Here, we review these advancements and discuss how combining new clearing techniques with high-performing fluorescent proteins or small molecule tags, rapid volume imaging and efficient image informatics is resulting in comprehensive and quantitative organ-wide, single-cell resolution experimental data. These technologies are starting to yield information on connectivity and dynamics in cellular circuits at unprecedented resolution, and bring us closer to system-level understanding of physiology and diseases of complex mammalian systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Large-Scale Phylogenomic Analysis Reveals the Complex Evolutionary History of Rabies Virus in Multiple Carnivore Hosts

PubMed Central

Troupin, Cécile; Dacheux, Laurent; Tanguy, Marion; Sabeta, Claude; Blanc, Hervé; Bouchier, Christiane; Vignuzzi, Marco; Holmes, Edward C.; Bourhy, Hervé

2016-01-01

The natural evolution of rabies virus (RABV) provides a potent example of multiple host shifts and an important opportunity to determine the mechanisms that underpin viral emergence. Using 321 genome sequences spanning an unprecedented diversity of RABV, we compared evolutionary rates and selection pressures in viruses sampled from multiple primary host shifts that occurred on various continents. Two major phylogenetic groups, bat-related RABV and dog-related RABV, experiencing markedly different evolutionary dynamics were identified. While no correlation between time and genetic divergence was found in bat-related RABV, the evolution of dog-related RABV followed a generally clock-like structure, although with a relatively low evolutionary rate. Subsequent molecular clock dating indicated that dog-related RABV likely underwent a rapid global spread following the intensification of intercontinental trade starting in the 15th century. Strikingly, although dog RABV has jumped to various wildlife species from the order Carnivora, we found no clear evidence that these host-jumping events involved adaptive evolution, with RABV instead characterized by strong purifying selection, suggesting that ecological processes also play an important role in shaping patterns of emergence. However, specific amino acid changes were associated with the parallel emergence of RABV in ferret-badgers in Asia, and some host shifts were associated with increases in evolutionary rate, particularly in the ferret-badger and mongoose, implying that changes in host species can have important impacts on evolutionary dynamics. PMID:27977811

Large-Scale Phylogenomic Analysis Reveals the Complex Evolutionary History of Rabies Virus in Multiple Carnivore Hosts.

PubMed

Troupin, Cécile; Dacheux, Laurent; Tanguy, Marion; Sabeta, Claude; Blanc, Hervé; Bouchier, Christiane; Vignuzzi, Marco; Duchene, Sebastián; Holmes, Edward C; Bourhy, Hervé

2016-12-01

The natural evolution of rabies virus (RABV) provides a potent example of multiple host shifts and an important opportunity to determine the mechanisms that underpin viral emergence. Using 321 genome sequences spanning an unprecedented diversity of RABV, we compared evolutionary rates and selection pressures in viruses sampled from multiple primary host shifts that occurred on various continents. Two major phylogenetic groups, bat-related RABV and dog-related RABV, experiencing markedly different evolutionary dynamics were identified. While no correlation between time and genetic divergence was found in bat-related RABV, the evolution of dog-related RABV followed a generally clock-like structure, although with a relatively low evolutionary rate. Subsequent molecular clock dating indicated that dog-related RABV likely underwent a rapid global spread following the intensification of intercontinental trade starting in the 15th century. Strikingly, although dog RABV has jumped to various wildlife species from the order Carnivora, we found no clear evidence that these host-jumping events involved adaptive evolution, with RABV instead characterized by strong purifying selection, suggesting that ecological processes also play an important role in shaping patterns of emergence. However, specific amino acid changes were associated with the parallel emergence of RABV in ferret-badgers in Asia, and some host shifts were associated with increases in evolutionary rate, particularly in the ferret-badger and mongoose, implying that changes in host species can have important impacts on evolutionary dynamics.

Acoustics of Clear Speech: Effect of Instruction

ERIC Educational Resources Information Center

Lam, Jennifer; Tjaden, Kris; Wilding, Greg

2012-01-01

Purpose: This study investigated how different instructions for eliciting clear speech affected selected acoustic measures of speech. Method: Twelve speakers were audio-recorded reading 18 different sentences from the Assessment of Intelligibility of Dysarthric Speech (Yorkston & Beukelman, 1984). Sentences were produced in habitual, clear,…

Networked Governance in Three Policy Areas with Implications for the Common Core State Standards Initiative

ERIC Educational Resources Information Center

Manna, Paul

2010-01-01

Policy makers and researchers now recognize that designing effective institutions to govern policy networks is a major challenge of the 21st Century. Presently, the Common Core State Standards Initiative resembles an emerging network of organizations united around the goal of developing clear and challenging academic expectations for students in…

What Do We Know about School Mental Health Promotion Programmes for Children and Youth?

ERIC Educational Resources Information Center

O'Mara, Linda; Lind, Candace

2013-01-01

There are numerous studies of school mental health promotion and primary prevention and many reviews of these studies; however, no clear consensus statement has emerged regarding school mental health promotion other than that child mental health is an important area that should be addressed in schools. This integrative review seeks to address this…

Novel approaches for integrating chemistry, transcriptomics and physiology of caged fish to examine the impacts of contaminants of emerging concern.

EPA Science Inventory

Product Description:Many chemicals are being detected in the Great Lakes watershed, but it is not always clear which of these may be of concern and should be prioritized for monitoring or management. The current study investigates the use of novel biologically-based monitoring me...

Theorizing Democratic Education from a Senian Perspective

ERIC Educational Resources Information Center

DeCesare, Tony

2014-01-01

Despite the growing body of literature and general interest in the intersection between the capabilities approach (CA) and education, little work has been done so far to theorize democratic education from a CA perspective. This essay attempts to do so by, first, getting clear about the theory of democracy that has emerged from Amartya Sen's…

The Battle Era and Labor in Uruguay and U.S. Low-Intensity in Conflict Policy in Latin America

DTIC Science & Technology

1990-05-01

administration’s problems in developing a policy toward Nicaragua were deficient due to "an emphasis on covert, rather than overt action; tardiness in...not the extermination of a popular movement with legitimate grievances. This is one clear lesson emerging from Vietnam, El Salvador, and the Philippines

Neoliberal Dynamics within Japan's National University Sector: Faculty Perspectives of the 2004 Reforms

ERIC Educational Resources Information Center

Weldon, Peter Alexander

2011-01-01

Globalization has emerged as one of the key social, political, and economic forces of the twenty-first century, challenging national borders, long-established institutions of governance, and cultural norms and behaviors across the globe. While many believe the process has been underway for centuries, what is clear is that it has both accelerated…

Brief Report: Bone Fractures in Children and Adults with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Neumeyer, Ann M.; O'Rourke, Julia A.; Massa, Alexandra; Lee, Hang; Lawson, Elizabeth A.; McDougle, Christopher J.; Misra, Madhusmita

2015-01-01

Peripubertal boys with autism spectrum disorder (ASD) have lower bone mineral density (BMD) than typically developing controls. However, it is not clear whether lower BMD in ASD results in an increased fracture rate. This study examined the rate of fractures in children and adults with and without ASD using a national database of emergency room…

Infants' Emerging Sensitivity to Emotional Body Expressions: Insights from Asymmetrical Frontal Brain Activity

ERIC Educational Resources Information Center

Missana, Manuela; Grossmann, Tobias

2015-01-01

Sensitive responding to others' emotional body expressions is an essential social skill in humans. Using event-related brain potentials, it has recently been shown that the ability to discriminate between emotional body expressions develops between 4 and 8 months of age. However, it is not clear whether the perception of emotional body expressions…

Is the cervical spine clear? Undetected cervical fractures diagnosed only at autopsy.

PubMed

Sweeney, J F; Rosemurgy, A S; Gill, S; Albrink, M H

1992-10-01

Undetected cervical-spine injuries are a nemesis to both trauma surgeons and emergency physicians. Radiographic protocols have been developed to avoid missing cervical-spine fractures but are not fail-safe. Three case reports of occult cervical fractures documented at autopsy in the face of normal cervical-spine radiographs and computerized tomography scans are presented.

Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

ERIC Educational Resources Information Center

Heilbron, Nicole; Goldston, David; Walrath, Christine; Rodi, Michael; McKeon, Richard

2013-01-01

Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request…

Exploring the Borderlands between Media and Health: Conceptualizing "Critical Media Health Literacy"

ERIC Educational Resources Information Center

Higgins, Joan Wharf; Begoray, Deborah

2012-01-01

In Canada, as elsewhere, there is considerable concern about adolescents' health. Much of the blame is thought to lie in the social context for today's adolescents and their interaction with and dependence on various media. Yet, it is not clear whether and how adolescents learn to engage critically with media messages about health. Emerging from…

The Creative Classroom: The Role of Space and Place toward Facilitating Creativity

ERIC Educational Resources Information Center

Warner, Scott A.; Myers, Kerri L.

2010-01-01

As people become more sophisticated in their understanding of the workings of the human mind, it becomes increasingly clear that the processes of teaching and learning are more complex and subtle than was once thought. Models of education that were appropriate in the past are now obsolete. Cornell (2002) proposed an emerging paradigm of teaching…

A New Role in Education: The Evaluator.

ERIC Educational Resources Information Center

Sorenson, Garth

1968-01-01

With the increase of federal funds for education, a new professional is emerging--the "evaluator"--whose role needs to be more clearly defined. He must not, first of all, take an absolutist position in his relationship to other educational experts or he will fail to get the cooperation of teachers and the support of powerful community groups.…

Having the AP Conversation: Why It's Time to Re-Evaluate Advanced Placement Courses

ERIC Educational Resources Information Center

Weaver, Roger

2010-01-01

Since its widespread emergence in the mid-1960s, the Advanced Placement (AP) curriculum has successfully established and maintained an identity as the gold standard of transcript currency for college preparatory schools. It is something that nearly all independent school parents and students believe they understand and clearly expect, and it is…

Towards to an Explanation for Conceptual Change: A Mechanistic Alternative

ERIC Educational Resources Information Center

Rusanen, Anna-Mari

2014-01-01

Conceptual change is one of the most studied fields in science education and psychology of learning. However, there are still some foundational issues in conceptual change research on which no clear consensus has emerged. Firstly, there is no agreement on what changes in belief and concept systems constitute conceptual change and what changes do…

Rethinking the Machine Metaphor since Descartes: On the Irreducibility of Bodies, Minds, and Meanings

ERIC Educational Resources Information Center

Lowney, Charles

2011-01-01

Michael Polanyi's conceptions of tacit knowing and emergent being are used to correct a reductionism that developed from, or reacted against, the excesses of several Cartesian assumptions: (a) the method of universal doubt; (b) the emphasis on reductive analysis to unshakeable foundations, via connections between clear and distinct ideas; (c) the…

How Talk Becomes Text: Investigating the Concept of Oral Rehearsal in Early Years' Classrooms

ERIC Educational Resources Information Center

Myhill, Debra; Jones, Susan

2009-01-01

The principle that emergent writing is supported by talk, and that an appropriate pedagogy for writing should include planned opportunities for talk is well researched and well understood. However, the process by which talk becomes text is less clear. The term "oral rehearsal" is now commonplace in English classrooms and curriculum policy…

Converging social trends - emerging outdoor recreation issues

Treesearch

Carl H. Reidel

1980-01-01

I can't recall when I have attended a national conference with a more clearly defined objective than this one. We are here to document outdoor recreation trends and explore their meaning for the future. The word "trend" appears no less than 45 times in the conference brochure, and the symposium organizers are determined that the proceedings will be...

Early Career Teachers, Mathematics and Technology: Device Conflict and Emerging Mathematical Knowledge

ERIC Educational Resources Information Center

Attard, Catherine; Orlando, Joanne

2014-01-01

Information and communication technologies (ICT) are positioned in policy/syllabus documents as an essential resource in the teaching of mathematics. Given their youth and lifelong experience with technology, early career teachers (ECTs) are expected to excel in their use of ICT; however, we are not clear on the viability of these expectations and…

Emerging Areas of Inquiry: Special Education Teacher Induction. Induction Insights. Supporting Special Education Teachers - Teacher Educators [TEII-8

ERIC Educational Resources Information Center

National Center to Inform Policy and Practice in Special Education Professional Development, 2010

2010-01-01

General education induction has received substantial attention from policymakers, researchers, and school district practitioners. Yet, the literature base has been described as fragmented, with methodological problems that often make it difficult to draw clear implications. The special education induction literature base is even less developed.…

The Rugged Frontier: A Decade of Charter Schooling in Arizona

ERIC Educational Resources Information Center

Hassel, Bryan C.; Terrell, Michelle Godard

2004-01-01

Arizona's charter experience over the past decade has clearly shown the power of a relatively open chartering system. Schools have sprung up in all corners of the state; parents and teachers have flocked to them in great numbers. Interesting new approaches have emerged. Quite a few of the schools have been strikingly successful. In many places,…

Learning Analytics Methods, Benefits, and Challenges in Higher Education: A Systematic Literature Review

ERIC Educational Resources Information Center

Avella, John T.; Kebritchi, Mansureh; Nunn, Sandra G.; Kanai, Therese

2016-01-01

Higher education for the 21st century continues to promote discoveries in the field through learning analytics (LA). The problem is that the rapid embrace of of LA diverts educators' attention from clearly identifying requirements and implications of using LA in higher education. LA is a promising emerging field, yet higher education stakeholders…

Watching to See until It Becomes Clear to You: Metaphorical Mapping--A Method for Emergence

ERIC Educational Resources Information Center

Atleo, Marlene

2008-01-01

Searching for a methodology that would allow the author to "see" across worldviews and articulate them both was the academic challenge of investigating learning ideology across Canadian and Aboriginal worldviews with Aboriginal Nuu-chah-nulth Elders. A mode of inquiry was required permitting the author to hold a Euro-heritage and an…

Improvements for international medicine donations: a review of the World Health Organization Guidelines for Medicine Donations, 3rd edition.

PubMed

Cañigueral-Vila, Nuria; Chen, Jennifer C; Frenkel-Rorden, Lindsey; Laing, Richard

2015-01-01

Some humanitarian and development organizations respond to major natural disasters and emergencies by donating medicines. Many provide medicines on a routine basis to support health systems, particularly those run by Faith-Based Organizations. Although such donations can provide essential medicines to populations in great need, inappropriate donations also take place, with burdensome consequences. The World Health Organization (WHO) has developed the interagency Guidelines for Medicine Donations for use by donors and recipients in the context of emergency aid and international development assistance. Although comprehensive in nature and transferable to various emergency situations, adjustments to both content and formatting would improve this resource. Recommendations for the next version of these guidelines include: specific wording and consistent formatting; definition of who is a recipient, clear distinction between acute and long-term emergencies, and proper donation procedures pertaining to each; inclusion of visual aides such as flowcharts, checklists, and photos; and improving the citations system.

"Futile Care"-An Emergency Medicine Approach: Ethical and Legal Considerations.

PubMed

Simon, Jeremy R; Kraus, Chadd; Rosenberg, Mark; Wang, David H; Clayborne, Elizabeth P; Derse, Arthur R

2017-11-01

Futility often serves as a proposed reason for withholding or withdrawing medical treatment, even in the face of patient and family requests. Although there is substantial literature describing the meaning and use of futility, little of it is specific to emergency medicine. Furthermore, the literature does not provide a widely accepted definition of futility, and thus is difficult if not impossible to apply. Some argue that even a clear concept of futility would be inappropriate to use. This article will review the origins of and meanings suggested for futility, specific challenges such cases create in the emergency department (ED), and the relevant legal background. It will then propose an approach to cases of perceived futility that is applicable in the ED and does not rely on unilateral decisions to withhold treatment, but rather on avoiding and resolving the conflicts that lead to physicians' believing that patients are asking them to provide "futile" care. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Emergent features and perceptual objects: re-examining fundamental principles in analogical display design.

PubMed

Holt, Jerred; Bennett, Kevin B; Flach, John M

2015-01-01

Two sets of design principles for analogical visual displays, based on the concepts of emergent features and perceptual objects, are described. An interpretation of previous empirical findings for three displays (bar graph, polar graphic, alphanumeric) is provided from both perspectives. A fourth display (configural coordinate) was designed using principles of ecological interface design (i.e. direct perception). An experiment was conducted to evaluate performance (accuracy and latency of state identification) with these four displays. Numerous significant effects were obtained and a clear rank ordering of performance emerged (from best to worst): configural coordinate, bar graph, alphanumeric and polar graphic. These findings are consistent with principles of design based on emergent features; they are inconsistent with principles based on perceptual objects. Some limitations of the configural coordinate display are discussed and a redesign is provided. Practitioner Summary: Principles of ecological interface design, which emphasise the quality of very specific mappings between domain, display and observer constraints, are described; these principles are applicable to the design of all analogical graphical displays.

The development of the specialism of emergency medicine: media and cultural influences.

PubMed

Timmons, Stephen; Nairn, Stuart

2015-01-01

In this article we analyse, via a critical review of the literature, the development of a relatively new medical specialism in the United Kingdom, that of emergency medicine. Despite the high media profile of emergency care, it is a low-status specialism within UK medicine. The creation of a specialist College in 2008 means that, symbolically, recognition as a full specialism has now been achieved. In this article, we will show, using a sociology of professions approach, how emergency medicine defined itself as a specialism, and sought to carve out a distinctive jurisdiction. While, in the context of the UK National Health Service, the state was clearly an important factor in the development of this profession, we wish to develop the analysis further than is usual in the sociology of professions. We will analyse the wider cultural context for the development of this specialism, which has benefited from its high profile in the media, through both fictional and documentary sources. © The Author(s) 2014.

Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department

PubMed Central

Miller, Joseph B.; Arter, Andrew; Wilson, Suprat S.; Janke, Alexander T.; Brody, Aaron; Reed, Brian P.; Levy, Phillip D.

2017-01-01

Introduction While moderate to severely elevated blood pressure (BP) is present in nearly half of all emergency department (ED) patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV) antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. Methods We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18–89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. Results We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4%) were considered inappropriately treated. Overall, labetalol (61%) was the most commonly used medication, followed by enalaprilat (18%), hydralazine (18%), and metoprolol (3%). There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2%) patients in the inappropriate treatment cohort and in two (1%) patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. Conclusion More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant resources could perhaps be saved through education of providers and development of clearly defined BP treatment protocols. PMID:28874950

Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department.

PubMed

Miller, Joseph B; Arter, Andrew; Wilson, Suprat S; Janke, Alexander T; Brody, Aaron; Reed, Brian P; Levy, Phillip D

2017-08-01

While moderate to severely elevated blood pressure (BP) is present in nearly half of all emergency department (ED) patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV) antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18-89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4%) were considered inappropriately treated. Overall, labetalol (61%) was the most commonly used medication, followed by enalaprilat (18%), hydralazine (18%), and metoprolol (3%). There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2%) patients in the inappropriate treatment cohort and in two (1%) patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant resources could perhaps be saved through education of providers and development of clearly defined BP treatment protocols.

Human Trafficking in the Emergency Department

PubMed Central

Patel, Ronak B.; Ahn, Roy; Burke, Thomas F.

2010-01-01

Human trafficking continues to persist, affecting up to 200 million people worldwide. As clinicians in emergency departments commonly encounter victims of intimate partner violence, some of these encounters will be with trafficking victims. These encounters provide a rare opportunity for healthcare providers to intervene and help. This case report of a human trafficking patient from a teaching hospital illustrates the complexity in identifying these victims. Clinicians can better identify potential trafficking cases by increasing their awareness of this phenomenon, using qualified interpreters, isolating potential victims by providing privacy and using simple clear reassuring statements ensuring security. A multidisciplinary approach can then be mobilized to help these patients. PMID:21293753

Translation of Real-Time Infectious Disease Modeling into Routine Public Health Practice

PubMed Central

Chughtai, Abrar A.; Heywood, Anita; Gardner, Lauren M.; Heslop, David J.; MacIntyre, C. Raina

2017-01-01

Infectious disease dynamic modeling can support outbreak emergency responses. We conducted a workshop to canvas the needs of stakeholders in Australia for practical, real-time modeling tools for infectious disease emergencies. The workshop was attended by 29 participants who represented government, defense, general practice, and academia stakeholders. We found that modeling is underused in Australia and its potential is poorly understood by practitioners involved in epidemic responses. The development of better modeling tools is desired. Ideal modeling tools for operational use would be easy to use, clearly indicate underlying parameterization and assumptions, and assist with policy and decision making. PMID:28418309

Developing regulatory strategy for microbicides.

PubMed

Nardi, Ronald; Arterburn, Linda; Carlton, Lisa

2014-01-01

Ever since the discovery that a virus was responsible for AIDS, prevention of HIV infection has been a drug/vaccine development target in therapeutic research. Microbicide products are a viable, globally applicable option; however, to date, no product has been approved anywhere in the world. Development of such a product will need to account for the changing disease landscape and will need to leverage available regulatory pathways to gain approvals in the developed world and emerging markets. In countries where the regulatory pathway is not clear which is the case in several emerging markets, sponsors will need to employ a flexible approach to gather and meet local regulatory requirements and ultimately gain product approvals.

[A case of emergency surgery in a patient with bronchial asthma under continuous spinal anesthesia].

PubMed

Noda, Keiichi; Ryo, Kenshu; Nakamoto, Ai

2003-10-01

A 78-year-old male, observed for bronchial asthma, underwent two emergency operations within eight days. The first operation was performed under general anesthesia with tracheal intubation. Anesthesia was maintained by sevoflurane-oxygen and continuous infusion of propofol in combination with epidural injection of lidocaine. During the operation, respiratory sound was almost clear. But wheezing occurred as he awoke after discontinuation of the anesthetics. He needed ventilatory support for three days for status asthmatics. The second operation was performed under continuous spinal anesthesia using hypobaric tetracaine and hyperbaric bupivacaine. No ventilatory support was necessary after the operation and he was discharged uneventfully.

Serial Escape System For Aircraft Crews

NASA Technical Reports Server (NTRS)

Wood, Kenneth E.

1990-01-01

Emergency escape system for aircraft and aerospace vehicles ejects up to seven crewmembers, one by one, within 120 s. Intended for emergencies in which disabled craft still in stable flight at no more than 220 kn (113 m/s) equivalent airspeed and sinking no faster than 110 ft/s (33.5 m/s) at altitudes up to 50,000 ft (15.2 km). Ejection rockets load themselves from magazine after each crewmember ejected. Jumpmaster queues other crewmembers and helps them position themselves on egress ramp. Rockets pull crewmembers clear of aircraft structure. Provides orderly, controlled exit and avoids ditching at sea or landing in rough terrain.

Automated Announcements of Approaching Emergency Vehicles

NASA Technical Reports Server (NTRS)

Bachelder, Aaron; Foster, Conrad

2006-01-01

Street intersections that are equipped with traffic lights would also be equipped with means for generating audible announcements of approaching emergency vehicles, according to a proposal. The means to generate the announcements would be implemented in the intersection- based subsystems of emergency traffic-light-preemption systems like those described in the two immediately preceding articles and in "Systems Would Preempt Traffic Lights for Emergency Vehicles" (NPO-30573), NASA Tech Briefs, Vol. 28, No. 10 (October 2004), page 36. Preempting traffic lights is not, by itself, sufficient to warn pedestrians at affected intersections that emergency vehicles are approaching. Automated visual displays that warn of approaching emergency vehicles can be helpful as a supplement to preemption of traffic lights, but experience teaches that for a variety of reasons, pedestrians often do not see such displays. Moreover, in noisy and crowded urban settings, the lights and sirens on emergency vehicles are often not noticed until a few seconds before the vehicles arrive. According to the proposal, the traffic-light preemption subsystem at each intersection would generate an audible announcement for example, emergency vehicle approaching, please clear intersection whenever a preemption was triggered. The subsystem would estimate the time of arrival of an approaching emergency vehicle by use of vehicle identity, position, and time data from one or more sources that could include units connected to traffic loops and/or transponders connected to diagnostic and navigation systems in participating emergency vehicles. The intersection-based subsystem would then start the announcement far enough in advance to enable pedestrians to leave the roadway before any emergency vehicles arrive.

Emerging synthetic strategies for core cross-linked star (CCS) polymers and applications as interfacial stabilizers: bridging linear polymers and nanoparticles.

PubMed

Chen, Qijing; Cao, Xueteng; Xu, Yuanyuan; An, Zesheng

2013-10-01

Core cross-linked star (CCS) polymers become increasingly important in polymer science and are evaluated in many value-added applications. However, limitations exist to varied degrees for different synthetic methods. It is clear that improvement in synthetic efficiency is fundamental in driving this field moving even further. Here, the most recent advances are highlighted in synthetic strategies, including cross-linking with cross-linkers of low solubility, polymerization-induced self-assembly in aqueous-based heterogeneous media, and cross-linking via dynamic covalent bonds. The understanding of CCS polymers is also further refined to advocate their role as an intermediate between linear polymers and polymeric nanoparticles, and their use as interfacial stabilizers is rationalized within this context. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Lovesick: How Couples’ Relationships Influence Health

PubMed Central

Kiecolt-Glaser, Janice K.; Wilson, Stephanie J.

2017-01-01

This review highlights recent advances in research addressing intimate partner relationships and health. Consideration of the strong mutual influences that the members of a couple have on each other's mental and physical health trajectories provides a new way to view the health implications of couples’ convergence or interdependence; marital closeness can have a clear downside when one partner has mental or physical health problems. Couples’ interconnectedness can also be leveraged to promote better treatment outcomes. Major themes addressed include the pivotal role of depression, as well as the importance of gender differences in the pathways from the marital relationship to physiological functioning and health. The health risks and benefits of support are weighed. Additionally, two prominent emerging paths from marital distress to poor health are emphasized: sleep problems, and metabolic alterations that promote obesity and its comorbidities. PMID:28301763

A global distributed storage architecture

NASA Technical Reports Server (NTRS)

Lionikis, Nemo M.; Shields, Michael F.

1996-01-01

NSA architects and planners have come to realize that to gain the maximum benefit from, and keep pace with, emerging technologies, we must move to a radically different computing architecture. The compute complex of the future will be a distributed heterogeneous environment, where, to a much greater extent than today, network-based services are invoked to obtain resources. Among the rewards of implementing the services-based view are that it insulates the user from much of the complexity of our multi-platform, networked, computer and storage environment and hides its diverse underlying implementation details. In this paper, we will describe one of the fundamental services being built in our envisioned infrastructure; a global, distributed archive with near-real-time access characteristics. Our approach for adapting mass storage services to this infrastructure will become clear as the service is discussed.

Insight into Amyloid Structure Using Chemical Probes

PubMed Central

Reinke, Ashley A.; Gestwicki, Jason E.

2011-01-01

Alzheimer’s disease (AD) is a common neurodegenerative disorder characterized by the deposition of amyloids in the brain. One prominent form of amyloid is composed of repeating units of the amyloid-β (Aβ) peptide. Over the past decade, it has become clear that these Aβ amyloids are not homogeneous; rather, they are composed of a series of structures varying in their overall size and shape and the number of Aβ peptides they contain. Recent theories suggest that these different amyloid conformations may play distinct roles in disease, although their relative contributions are still being discovered. Here, we review how chemical probes, such as congo red, thioflavin T and their derivatives, have been powerful tools for better understanding amyloid structure and function. Moreover, we discuss how design and deployment of conformationally selective probes might be used to test emerging models of AD. PMID:21457473

Children's motivation in elementary physical education: an expectancy-value model of achievement choice.

PubMed

Xiang, Ping; McBride, Ron; Guan, Jianmin; Solmon, Melinda

2003-03-01

This study examined children's motivation in elementary physical education within an expectancy-value model developed by Eccles and her colleagues. Four hundred fourteen students in second and fourth grades completed questionnaires assessing their expectancy-related beliefs, subjective task values, and intention for future participation in physical education. Results indicated that expectancy-related beliefs and subjective task values were clearly distinguishable from one another across physical education and throwing. The two constructs were related to each other positively. Children's intention for future participation in physical education was positively associated with their subjective task values and/or expectancy-related beliefs. Younger children had higher motivation for learning in physical education than older children. Gender differences emerged and the findings provided empirical evidence supporting the validity of the expectancy-value model in elementary physical education.

Cytokines and the immune-neuroendocrine network: What did we learn from infection and autoimmunity?

PubMed

Correa, Silvia G; Maccioni, Mariana; Rivero, Virginia E; Iribarren, Pablo; Sotomayor, Claudia E; Riera, Clelia M

2007-01-01

The initial view of the neuroendocrine-immune communication as the brake of immune activation is changing. Recent evidence suggests that the optimization of the body's overall response to infection could be actually the role of the immune-endocrine network. In gradually more complex organisms, the multiplicity of host-pathogen interfaces forced the development of efficient and protective responses. Molecules such as cytokines and Toll-like receptors (TLRs) are distributed both in the periphery and in the brain to participate in a coordinated adaptive function. When sustained release of inflammatory mediators occurs, as in autoimmune diseases, undesirable pathological consequences become evident with different manifestations and outcomes. Clearly, organisms are not well adapted to that disregulated condition yet, suggesting that additional partners within neuroendocrine-immune interactions might emerge from the evolutionary road.

An estimation of Canada's public health physician workforce.

PubMed

Russell, Margaret L; McIntyre, Lynn

2009-01-01

Public health emergency planning includes a consideration of public health human resource requirements. We addressed the hypothetical question: How many public health physicians could Canada mobilize in the event of a public health emergency? We used the 2004 National Physician Survey (NPS) to estimate the number of public health physicians in Canada. Using weighting to account for non-response, we estimated the numbers and population estimates of public health physicians who were active versus 'in reserve'. We explored the impact of using diverse definitions of public health physician based upon NPS questions on professional activity, self-reported degrees and certifications, and physician database classifications. Of all Canadian physicians, an estimated 769 (1.3%) are qualified to practice public health by virtue of degrees and certifications relevant to public health, of whom 367 (48%) also report active 'community medicine/public health' practice. Even among Canada's 382 Community Medicine specialists, only 60% report active public health practice. The estimation of the size of Canada's public health physician workforce is currently limited by the lack of a clear definition and appropriate monitoring. It appears that, even with a reserve public health physician workforce that would almost double its numbers, Canada's available workforce is only 40% of projected requirements. Public health emergency preparedness planning exercises should clearly delineate public health physician roles and needs, and action should be taken accordingly to enhance the numbers of Canadian public health physicians and their capacity to meet these requirements.

Qualitative exploration of nurses' decisions to activate rapid response teams.

PubMed

Astroth, Kim S; Woith, Wendy M; Stapleton, Stephen J; Degitz, R Joseph; Jenkins, Sheryl H

2013-10-01

To identify barriers and facilitators to nurses' decisions regarding activation of rapid response teams (RRTs) in hospitals. Hospitalised patients in the United States who experience cardiopulmonary arrest seldom recover. Most of these patients show signs of clinical deterioration prior to cardiopulmonary arrest. RRTs have been shown to decrease the incidence of cardiopulmonary arrest by bringing needed resources to unstable patients. Despite the evidence in support of the activation of RRTs, nurses do not always use this resource. Nurses' decisions to activate or not to activate the RRT are not clearly understood. We used a qualitative design for this study. A purposive sample of 15 medical/surgical nurses was recruited from a small medical centre in the Midwest. Researchers used semistructured, open-ended questions to elicit subject responses regarding facilitators and barriers to activating RRTs. Themes emerged and were categorised as facilitators and barriers to calling the RRT. Facilitators and barriers were then subdivided into distinct subthemes: RRT characteristics and unit culture. The expertise of the RRT members and support and encouragement from nursing unit colleagues and leaders emerged as two potential facilitators. Communication of the RRT members and calling the physician first emerged as two potential barriers. We also identified educational factors that were not clearly facilitators or barriers to calling the RRT. Further study is needed using quantitative designs with larger sample sizes. Nurses can build upon knowledge of facilitators and barriers related to RRT characteristics and nursing unit culture. © 2013 Blackwell Publishing Ltd.

The contribution of different forms of violence exposure to internalizing and externalizing symptoms among young South African adolescents.

PubMed

du Plessis, Bernice; Kaminer, Debra; Hardy, Anneli; Benjamin, Arlene

2015-07-01

While many youth are exposed to multiple forms of co-occurring violence, the comparative impact of different forms of violence on the mental health of children and adolescents has not been clearly established. Studies from low and middle income countries in particular are lacking. The present study examined the contribution of different forms of violence to internalizing and externalizing symptoms among young adolescents in South Africa. A community-based sample of 616 high school learners completed self-report scales assessing exposure to six different forms of violence and the severity of depression, aggression and conduct disorder symptoms. In bivariate analyses, all six forms of violence were significantly associated with internalizing and externalizing difficulties. When the contribution of all forms of violence to mental health outcomes was examined simultaneously, domestic victimization emerged as the strongest predictor of both internalizing and externalizing difficulties. Cumulative exposure to other forms of violence contributed further to the prediction of aggression and conduct disorder, but not depression. Recommendations for future research, and the implications of the findings for prioritizing the development of violence prevention and intervention initiatives in the South African context, are considered. Copyright © 2015 Elsevier Ltd. All rights reserved.

The internal processes and behavioral dynamics of hospital boards: an exploration of differences between high- and low-performing hospitals.

PubMed

Kane, Nancy M; Clark, Jonathan R; Rivenson, Howard L

2009-01-01

Nonprofit hospital boards are under increasing pressure to improve financial, clinical, and charitable and community benefit performance. Most research on board effectiveness focuses on variables measuring board structure and attributes associated with competing ideal models of board roles. However, the results do not provide clear evidence that one role is superior to another and suggest that in practice boards pursue hybrid roles. Board dynamics and processes have received less attention from researchers, but emerging theoretical frameworks highlight them as key to effective corporate governance. We explored differences in board processes and behavioral dynamics between financially high- and low-performing hospitals, with the goal of developing a better understanding of the best board practices in nonprofit hospitals. A comparative case study approach allowed for in-depth, qualitative assessments of how the internal workings of boards differ between low- and high-performing facilities. Boards of hospitals with strong financial performance exhibited behavioral dynamics and internal processes that differed in important ways from those of hospitals with poor financial performance. Boards need to actively attend to key processes and foster positive group dynamics in decision making to be more effective in governing hospitals.

Responses to familiar and unfamiliar objects by belugas (Delphinapterus leucas), bottlenose dolphins (Tursiops truncatus), and Pacific white-sided dolphins (Lagenorhynchus obliquidens).

PubMed

Guarino, Sara; Yeater, Deirdre; Lacy, Steve; Dees, Tricia; Hill, Heather M

2017-09-01

Previous research with bottlenose dolphins (Tursiops truncatus) demonstrated their ability to discriminate between familiar and unfamiliar stimuli. Dolphins gazed longer at unfamiliar stimuli. The current study attempted to extend this original research by examining the responses of three species of cetaceans to objects that differed in familiarity. Eleven belugas from two facilities, five bottlenose dolphins and five Pacific white-sided dolphins housed at one facility were presented different objects in a free-swim scenario. The results indicated that the animals gazed the longest at unfamiliar objects, but these gaze durations did not significantly differ from gaze durations when viewing familiar objects. Rather, the animals gazed longer at unfamiliar objects when compared to the apparatus alone. Species differences emerged with longer gaze durations exhibited by belugas and bottlenose dolphins and significantly shorter gaze durations for Pacific white-sided dolphins. It is likely that the animals categorized objects into familiar and unfamiliar categories, but the free-swim paradigm in naturalistic social groupings did not elicit clear responses. Rather this procedure emphasized the importance of attention and individual preferences when investigating familiar and unfamiliar objects, which has implications for cognitive research and enrichment use.

Emergency contraceptive pills: Exploring the knowledge and attitudes of community health workers in a developing Muslim country.

PubMed

Mir, Azeem Sultan; Malik, Raees

2010-08-01

Unsafe abortion is a major Public health problem in developing countries, where women make several unsafe attempts at termination of the unintended pregnancy before turning to health services. Community health workers can act as a bridge between the community and their health facilities and can use Emergency Contraceptive Pills to significantly reduce the mortality and morbidity related to unsafe abortions. This study explores the knowledge, attitudes and practices of the Lady Health Supervisor of the National Program for Family Planning, district Rawalpindi, regarding emergency contraception pills. The cross sectional survey was conducted during the monthly meeting of Lady Health Supervisors. Self administered, anonymous and voluntary questionnaire consisting of 17 items, regarding demographic profile, awareness, knowledge, attitudes and practices, was used. Insufficient knowledge, high misinformation and strongly negative attitudes were revealed. More than half did not know that emergency contraceptive pills do not cause abortion. About four fifths believed that emergency contraceptive pills will lead to 'evil' practices in society. More than four fifths recognized that the clients of National Program for Family Planning need emergency contraceptive pills. The attitudes were significantly associated with knowledge (P=0.034, Fisher's Exact Test). The awareness of emergency contraceptive pills is high. Serious gaps in knowledge have been identified. There is a clear recognition of the need of emergency contraceptive pills for the clients of National Program for Family Planning. However, any strategy to introduce emergency contraceptive pills must cater for the misplaced beliefs of the work force.

Continuing Medical Education

PubMed Central

Cameron, Douglas G.

1965-01-01

The proper role of departments of continuing medical education in the medical faculties of universities needs to be more clearly defined. Much of the initiative for the development of extramural postgraduate instruction in this country came from organized medicine. The individual practising doctor has traditionally made his needs known most effectively through his professional organizations and should be encouraged to continue to do so. The individual doctor, professional organizations, hospitals and medical schools are all vital elements in any successful program of continuing medical education. A variety of administrative patterns may well emerge, each adapted specially to the region it serves. With a sense of urgency and the co-operation of all concerned, rapid progress in this important field is clearly possible. PMID:14278032

Enhanced functional expression of transient outward current in hypertrophied feline myocytes.

PubMed

Ten Eick, R E; Zhang, K; Harvey, R D; Bassett, A L

1993-08-01

Cardiac hypertrophy can decrease myocardial contractility and alter the electrophysiological activity of the heart. It is well documented that action potentials recorded from hypertrophied feline ventricular cells can exhibit depressed plateau voltages and prolonged durations. Similar findings have been made by others in rabbit, rat, guinea pig, and human heart. Whole-cell patch voltage-clamp studies designed to explain these changes in the action potential suggest that the only component of the membrane current recorded from feline right ventricular (RV) myocytes found to be substantially different from normal is the 4-amino-pyridine-sensitive transient outward current (I(to)). However, it was not clear if the change in I(to) could explain the changes in the action potential of hypertrophied cardiocytes, nor was it clear if these changes reflect an alteration in the electrophysiological character of the channels underlying I(to). A kinetic comparison of I(to) elicited by hypertrophied RV myocytes with that elicited by comparable normal RV myocytes previously revealed no differences, suggesting that the increased magnitude of the peak I(to) recorded from hypertrophied myocytes arises because the current density increases and not because of any alteration in the kinetic parameters governing the current. This finding suggests that in hypertrophy additional normal channels are expressed rather than a kinetically different channel subtype emerging. Investigations designed to determine if enhancement of I(to) could explain the hypertrophy-induced changes in plateau voltage and action potential duration suggest that a change in I(to) density can indeed explain the entire effect of hypertrophy on RV action potentials. If this notion is correct, the likelihood of "sudden death" in patients with myocardial hypertrophy might be decreased by a blocker selective for cardiac I(to).

Distinct chronology of neuronal cell cycle re-entry and tau pathology in the 3xTg-AD mouse model and Alzheimer's disease patients.

PubMed

Hradek, Alex C; Lee, Hyun-Pil; Siedlak, Sandra L; Torres, Sandy L; Jung, Wooyoung; Han, Ashley H; Lee, Hyoung-gon

2015-01-01

Cell cycle re-entry in Alzheimer's disease (AD) has emerged as an important pathological mechanism in the progression of the disease. This appearance of cell cycle related proteins has been linked to tau pathology in AD, but the causal and temporal relationship between the two is not completely clear. In this study, we found that hyperphosphorylated retinoblastoma protein (ppRb), a key regulator for G1/S transition, is correlated with a late marker for hyperphosphorylation of tau but not with other early markers for tau alteration in the 3xTg-AD mouse model. However, in AD brains, ppRb can colocalize with both early and later markers for tau alterations, and can often be found singly in many degenerating neurons, indicating the distinct development of pathology between the 3xTg-AD mouse model and human AD patients. The conclusions of this study are two-fold. First, our findings clearly demonstrate the pathological link between the aberrant cell cycle re-entry and tau pathology. Second, the chronological pattern of cell cycle re-entry with tau pathology in the 3xTg-AD mouse is different compared to AD patients suggesting the distinct pathogenic mechanism between the animal AD model and human AD patients.

Identification and phylogeny of Arabian snakes: Comparison of venom chromatographic profiles versus 16S rRNA gene sequences.

PubMed

Al Asmari, Abdulrahman; Manthiri, Rajamohammed Abbas; Khan, Haseeb Ahmad

2014-11-01

Identification of snake species is important for various reasons including the emergency treatment of snake bite victims. We present a simple method for identification of six snake species using the gel filtration chromatographic profiles of their venoms. The venoms of Echis coloratus, Echis pyramidum, Cerastes gasperettii, Bitis arietans, Naja arabica, and Walterinnesia aegyptia were milked, lyophilized, diluted and centrifuged to separate the mucus from the venom. The clear supernatants were filtered and chromatographed on fast protein liquid chromatography (FPLC). We obtained the 16S rRNA gene sequences of the above species and performed phylogenetic analysis using the neighbor-joining method. The chromatograms of venoms from different snake species showed peculiar patterns based on the number and location of peaks. The dendrograms generated from similarity matrix based on the presence/absence of particular chromatographic peaks clearly differentiated Elapids from Viperids. Molecular cladistics using 16S rRNA gene sequences resulted in jumping clades while separating the members of these two families. These findings suggest that chromatographic profiles of snake venoms may provide a simple and reproducible chemical fingerprinting method for quick identification of snake species. However, the validation of this methodology requires further studies on large number of specimens from within and across species.

Developmental Changes in Locating Voice and Sound in Space

PubMed Central

Kezuka, Emiko; Amano, Sachiko; Reddy, Vasudevi

2017-01-01

We know little about how infants locate voice and sound in a complex multi-modal space. Using a naturalistic laboratory experiment the present study tested 35 infants at 3 ages: 4 months (15 infants), 5 months (12 infants), and 7 months (8 infants). While they were engaged frontally with one experimenter, infants were presented with (a) a second experimenter’s voice and (b) castanet sounds from three different locations (left, right, and behind). There were clear increases with age in the successful localization of sounds from all directions, and a decrease in the number of repetitions required for success. Nonetheless even at 4 months two-thirds of the infants attempted to search for the voice or sound. At all ages localizing sounds from behind was more difficult and was clearly present only at 7 months. Perseverative errors (looking at the last location) were present at all ages and appeared to be task specific (only present in the 7 month-olds for the behind location). Spontaneous attention shifts by the infants between the two experimenters, evident at 7 months, suggest early evidence for infant initiation of triadic attentional engagements. There was no advantage found for voice over castanet sounds in this study. Auditory localization is a complex and contextual process emerging gradually in the first half of the first year. PMID:28979220

Chromosome 3p loss of heterozygosity is associated with a unique metabolic network in clear cell renal carcinoma

PubMed Central

Gatto, Francesco; Nookaew, Intawat; Nielsen, Jens

2014-01-01

Several common oncogenic pathways have been implicated in the emergence of renowned metabolic features in cancer, which in turn are deemed essential for cancer proliferation and survival. However, the extent to which different cancers coordinate their metabolism to meet these requirements is largely unexplored. Here we show that even in the heterogeneity of metabolic regulation a distinct signature encompassed most cancers. On the other hand, clear cell renal cell carcinoma (ccRCC) strongly deviated in terms of metabolic gene expression changes, showing widespread down-regulation. We observed a metabolic shift that associates differential regulation of enzymes in one-carbon metabolism with high tumor stage and poor clinical outcome. A significant yet limited set of metabolic genes that explained the partial divergence of ccRCC metabolism correlated with loss of von Hippel-Lindau tumor suppressor (VHL) and a potential activation of signal transducer and activator of transcription 1. Further network-dependent analyses revealed unique defects in nucleotide, one-carbon, and glycerophospholipid metabolism at the transcript and protein level, which contrasts findings in other tumors. Notably, this behavior is recapitulated by recurrent loss of heterozygosity in multiple metabolic genes adjacent to VHL. This study therefore shows how loss of heterozygosity, hallmarked by VHL deletion in ccRCC, may uniquely shape tumor metabolism. PMID:24550497

Seasonal to Mesoscale Variability of Water Masses in Barrow Canyon,Chukchi Sea

NASA Astrophysics Data System (ADS)

Nobre, C.; Pickart, R. S.; Moore, K.; Ashjian, C. J.; Arrigo, K. R.; Grebmeier, J. M.; Vagle, S.; Itoh, M.; Berchok, C.; Stabeno, P. J.; Kikuchi, T.; Cooper, L. W.; Hartwell, I.; He, J.

2016-02-01

Barrow Canyon is one of the primary conduits by which Pacific-origin water exits the Chukchi Sea into the Canada Basin. As such, it is an ideal location to monitor the different water masses through the year. At the same time, the canyon is an energetic environment where mixing and entrainment can occur, modifying the pacific-origin waters. As part of the Distributed Biological Observatory (DBO) program, a transect across the canyon was occupied 24 times between 2010-2013 by international ships of opportunity passing through the region during summer and early-fall. Here we present results from an analysis of these sections to determine the seasonal evolution of the water masses and to investigate the nature of the mesoscale variability. The mean state shows the clear presence of six water masses present at various times through the summer. The seasonal evolution of these summer water masses is characterized both in depth space and in temperature-salinity (T-S) space. Clear patterns emerge, including the arrival of Alaskan coastal water and its modification in early-fall. The primary mesoscale variability is associated with wind-driven upwelling events which occur predominantly in September. The atmospheric forcing of these events is investigated as is the oceanic response.

Simultaneous wood and metal particle detection on dark-field radiography.

PubMed

Braig, Eva-Maria; Birnbacher, Lorenz; Schaff, Florian; Gromann, Lukas; Fingerle, Alexander; Herzen, Julia; Rummeny, Ernst; Noël, Peter; Pfeiffer, Franz; Muenzel, Daniela

2018-01-01

Currently, the detection of retained wood is a frequent but challenging task in emergency care. The purpose of this study is to demonstrate improved foreign-body detection with the novel approach of preclinical X-ray dark-field radiography. At a preclinical dark-field x-ray radiography, setup resolution and sensitivity for simultaneous detection of wooden and metallic particles have been evaluated in a phantom study. A clinical setting has been simulated with a formalin fixated human hand where different typical foreign-body materials have been inserted. Signal-to-noise ratios (SNR) have been determined for all test objects. On the phantom, the SNR value for wood in the dark-field channel was strongly improved by a factor 6 compared to conventional radiography and even compared to the SNR of an aluminium structure of the same size in conventional radiography. Splinters of wood < 300 μm in diameter were clearly detected on the dark-field radiography. Dark-field radiography of the formalin-fixated human hand showed a clear signal for wooden particles that could not be identified on conventional radiography. x-ray dark-field radiography enables the simultaneous detection of wooden and metallic particles in the extremities. It has the potential to improve and simplify the current state-of-the-art foreign-body detection.

The Difference between Right and Wrong: Accuracy of Older and Younger Adults’ Story Recall

PubMed Central

Davis, Danielle K.; Alea, Nicole; Bluck, Susan

2015-01-01

Sharing stories is an important social activity in everyday life. This study used fine-grained content analysis to investigate the accuracy of recall of two central story elements: the gist and detail of socially-relevant stories. Younger (M age = 28.06) and older (M age = 75.03) American men and women (N = 63) recalled fictional stories that were coded for (i) accuracy of overall gist and specific gist categories and (ii) accuracy of overall detail and specific detail categories. Findings showed no age group differences in accuracy of overall gist or detail, but differences emerged for specific categories. Older adults more accurately recalled the gist of when the event occurred whereas younger adults more accurately recalled the gist of why the event occurred. These differences were related to episodic memory ability and education. For accuracy in recalling details, there were some age differences, but gender differences were more robust. Overall, women remembered details of these social stories more accurately than men, particularly time and perceptual details. Women were also more likely to accurately remember the gist of when the event occurred. The discussion focuses on how accurate recall of socially-relevant stories is not clearly age-dependent but is related to person characteristics such as gender and episodic memory ability/education. PMID:26404344

The Difference between Right and Wrong: Accuracy of Older and Younger Adults' Story Recall.

PubMed

Davis, Danielle K; Alea, Nicole; Bluck, Susan

2015-09-02

Sharing stories is an important social activity in everyday life. This study used fine-grained content analysis to investigate the accuracy of recall of two central story elements: the gist and detail of socially-relevant stories. Younger (M age = 28.06) and older (M age = 75.03) American men and women (N = 63) recalled fictional stories that were coded for (i) accuracy of overall gist and specific gist categories and (ii) accuracy of overall detail and specific detail categories. Findings showed no age group differences in accuracy of overall gist or detail, but differences emerged for specific categories. Older adults more accurately recalled the gist of when the event occurred whereas younger adults more accurately recalled the gist of why the event occurred. These differences were related to episodic memory ability and education. For accuracy in recalling details, there were some age differences, but gender differences were more robust. Overall, women remembered details of these social stories more accurately than men, particularly time and perceptual details. Women were also more likely to accurately remember the gist of when the event occurred. The discussion focuses on how accurate recall of socially-relevant stories is not clearly age-dependent but is related to person characteristics such as gender and episodic memory ability/education.

What a Difference a Parameter Makes: a Psychophysical Comparison of Random Dot Motion Algorithms

PubMed Central

Pilly, Praveen K.; Seitz, Aaron R.

2009-01-01

Random dot motion (RDM) displays have emerged as one of the standard stimulus types employed in psychophysical and physiological studies of motion processing. RDMs are convenient because it is straightforward to manipulate the relative motion energy for a given motion direction in addition to stimulus parameters such as the speed, contrast, duration, density, aperture, etc. However, as widely as RDMs are employed so do they vary in their details of implementation. As a result, it is often difficult to make direct comparisons across studies employing different RDM algorithms and parameters. Here, we systematically measure the ability of human subjects to estimate motion direction for four commonly used RDM algorithms under a range of parameters in order to understand how these different algorithms compare in their perceptibility. We find that parametric and algorithmic differences can produce dramatically different performances. These effects, while surprising, can be understood in relationship to pertinent neurophysiological data regarding spatiotemporal displacement tuning properties of cells in area MT and how the tuning function changes with stimulus contrast and retinal eccentricity. These data help give a baseline by which different RDM algorithms can be compared, demonstrate a need for clearly reporting RDM details in the methods of papers, and also pose new constraints and challenges to models of motion direction processing. PMID:19336240

Bidirectional Reflectance Functions for Application to Earth Radiation Budget Studies

NASA Technical Reports Server (NTRS)

Manalo-Smith, N.; Tiwari, S. N.; Smith, G. L.

1997-01-01

Reflected solar radiative fluxes emerging for the Earth's top of the atmosphere are inferred from satellite broadband radiance measurements by applying bidirectional reflectance functions (BDRFs) to account for the anisotropy of the radiation field. BDRF's are dependent upon the viewing geometry (i.e. solar zenith angle, view zenith angle, and relative azimuth angle), the amount and type of cloud cover, the condition of the intervening atmosphere, and the reflectance characteristics of the underlying surface. A set of operational Earth Radiation Budget Experiment (ERBE) BDRFs is available which was developed from the Nimbus 7 ERB (Earth Radiation Budget) scanner data for a three-angle grid system, An improved set of bidirectional reflectance is required for mission planning and data analysis of future earth radiation budget instruments, such as the Clouds and Earth's Radiant Energy System (CERES), and for the enhancement of existing radiation budget data products. This study presents an analytic expression for BDRFs formulated by applying a fit to the ERBE operational model tabulations. A set of model coefficients applicable to any viewing condition is computed for an overcast and a clear sky scene over four geographical surface types: ocean, land, snow, and desert, and partly cloudy scenes over ocean and land. The models are smooth in terms of the directional angles and adhere to the principle of reciprocity, i.e., they are invariant with respect to the interchange of the incoming and outgoing directional angles. The analytic BDRFs and the radiance standard deviations are compared with the operational ERBE models and validated with ERBE data. The clear ocean model is validated with Dlhopolsky's clear ocean model. Dlhopolsky developed a BDRF of higher angular resolution for clear sky ocean from ERBE radiances. Additionally, the effectiveness of the models accounting for anisotropy for various viewing directions is tested with the ERBE along tract data. An area viewed from nadir and from the side give two different radiance measurements but should yield the same flux when converted by the BDRF. The analytic BDRFs are in very good qualitative agreement with the ERBE models. The overcast scenes exhibit constant retrieved albedo over viewing zenith angles for solar zenith angles less than 60 degrees. The clear ocean model does not produce constant retrieved albedo over viewing zenith angles but gives an improvement over the ERBE operational clear sky ocean BDRF.

Myeloid derived suppressor cells in cancer: therapeutic, predictive, and prognostic implications

PubMed Central

Diaz-Montero, C. Marcela; Finke, Jim; Montero, Alberto J.

2014-01-01

Immune evasion is a hallmark of cancer. While, there are multiple different mechanisms that cancer cells employ, myeloid deriver suppressor cells (MDSCs) are one of the key drivers of tumor mediated immune evasion. MDSCs begin as myeloid cells recruited to the tumor microenvironment where they are transformed into potent immunosuppressive cells. Our understanding of the clinical relevance of MDSCs in cancer patients, however has significantly lagged behind the preclinical literature in part due to the absence of a cognate molecule present in mice, as well as the considerable heterogeneity of MDSCs. However, if one evaluates the clinical literature through the filter of clinically robust endpoints, such as overall survival, three important phenotypes have emerged: promyelocytic, monocytic, and granulocytic. Based on these studies, MDSCs have clear prognostic importance in multiple solid tumors, and emerging data supports the utility of circulating MDSCs as a predictive marker for cancer immunotherapy, and even as an early leading marker for predicting clinical response to systemic chemotherapy in patients with advanced solid tumors. More recent preclinical data in immunosuppressed murine models suggest that MDSCs play an important role in tumor progression and the metastatic process that is independent of their immunosuppressive properties. Consequently, targeting MDSCs either in combination with cancer immunotherapy or independently as part of an approach to inhibit the metastatic process, appears to be a very clinically promising strategy. We review different approaches to target MDSCs that could potentially be tested in future clinical trials in cancer patients. PMID:24787291

Eye movements reveal the time-course of anticipating behaviour based on complex, conflicting desires.

PubMed

Ferguson, Heather J; Breheny, Richard

2011-05-01

The time-course of representing others' perspectives is inconclusive across the currently available models of ToM processing. We report two visual-world studies investigating how knowledge about a character's basic preferences (e.g. Tom's favourite colour is pink) and higher-order desires (his wish to keep this preference secret) compete to influence online expectations about subsequent behaviour. Participants' eye movements around a visual scene were tracked while they listened to auditory narratives. While clear differences in anticipatory visual biases emerged between conditions in Experiment 1, post-hoc analyses testing the strength of the relevant biases suggested a discrepancy in the time-course of predicting appropriate referents within the different contexts. Specifically, predictions to the target emerged very early when there was no conflict between the character's basic preferences and higher-order desires, but appeared to be relatively delayed when comprehenders were provided with conflicting information about that character's desire to keep a secret. However, a second experiment demonstrated that this apparent 'cognitive cost' in inferring behaviour based on higher-order desires was in fact driven by low-level features between the context sentence and visual scene. Taken together, these results suggest that healthy adults are able to make complex higher-order ToM inferences without the need to call on costly cognitive processes. Results are discussed relative to previous accounts of ToM and language processing. Copyright © 2011 Elsevier B.V. All rights reserved.

Distributed Energy Resources and Dynamic Microgrid: An Integrated Assessment

NASA Astrophysics Data System (ADS)

Shang, Duo Rick

The overall goal of this thesis is to improve understanding in terms of the benefit of DERs to both utility and to electricity end-users when integrated in power distribution system. To achieve this goal, a series of two studies was conducted to assess the value of DERs when integrated with new power paradigms. First, the arbitrage value of DERs was examined in markets with time-variant electricity pricing rates (e.g., time of use, real time pricing) under a smart grid distribution paradigm. This study uses a stochastic optimization model to estimate the potential profit from electricity price arbitrage over a five-year period. The optimization process involves two types of PHEVs (PHEV-10, and PHEV-40) under three scenarios with different assumptions on technology performance, electricity market and PHEV owner types. The simulation results indicate that expected arbitrage profit is not a viable option to engage PHEVs in dispatching and in providing ancillary services without more favorable policy and PHEV battery technologies. Subsidy or change in electricity tariff or both are needed. Second, it examined the concept of dynamic microgrid as a measure to improve distribution resilience, and estimates the prices of this emerging service. An economic load dispatch (ELD) model is developed to estimate the market-clearing price in a hypothetical community with single bid auction electricity market. The results show that the electricity market clearing price on the dynamic microgrid is predominantly decided by power output and cost of electricity of each type of DGs. At circumstances where CHP is the only source, the electricity market clearing price in the island is even cheaper than the on-grid electricity price at normal times. Integration of PHEVs in the dynamic microgrid will increase electricity market clearing prices. It demonstrates that dynamic microgrid is an economically viable alternative to enhance grid resilience.

Satellite and Aerial Remote Sensing in Support of Disaster Response Operations Conducted by the Texas Division of Emergency Management

NASA Astrophysics Data System (ADS)

Wells, G. L.; Tapley, B. D.; Bettadpur, S. V.; Howard, T.; Porter, B.; Smith, S.; Teng, L.; Tapley, C.

2014-12-01

The effective use of remote sensing products as guidance to emergency managers and first responders during field operations requires close coordination and communication with state-level decision makers, incident commanders and the leaders of individual strike teams. Information must be tailored to meet the needs of different emergency support functions and must contain current (ideally near real-time) data delivered in standard formats in time to influence decisions made under rapidly changing conditions. Since 2003, a representative of the University of Texas Center for Space Research (CSR) has served as a member of the Governor's Emergency Management Council and has directed the flow of information from remote sensing observations and high performance computing modeling and simulations to the Texas Division of Emergency Management in the State Operations Center. The CSR team has supported response and recovery missions resulting from hurricanes, tornadoes, flash floods, wildfires, oil spills and other natural and man-made disasters in Texas and surrounding states. Through web mapping services, state emergency managers and field teams have received threat model forecasts, real-time vehicle tracking displays and imagery to support search-and-clear operations before hurricane landfall, search-and-rescue missions following floods, tactical wildfire suppression, pollution monitoring and hazardous materials detection. Data servers provide near real-time satellite imagery collected by CSR's direct broadcast receiving system and post data products delivered during activations of the United Nations International Charter on Space and Major Disasters. In the aftermath of large-scale events, CSR is charged with tasking state aviation resources, including the Air National Guard and Texas Civil Air Patrol, to acquire geolocated aerial photography of the affected region for wide area damage assessment. A data archive for each disaster is available online for years following the event to assist forensic studies and local plans for recovery. The use of portable devices, including commodity smartphones and tablets, will soon permit even more responsive data delivery during future disasters through the expansion of wireless Public Safety Broadband (FirstNet) targeted to serve first responders.

Incidence and patterns of surgical glove perforations: experience from Addis Ababa, Ethiopia.

PubMed

Bekele, Abebe; Makonnen, Nardos; Tesfaye, Lidya; Taye, Mulat

2017-03-20

Surgical glove perforation is a common event. The operating staff is not aware of the perforation until the procedure is complete, sometimes in as high as 70% of the incidences. Data from Ethiopia indicates that the surgical workforce suffers from a very surgery related accidents, however there is paucity of data regarding surgical glove perforation. The main objective is to describe the incidence and patterns of surgical glove perforation during surgical procedures and to compare the rates between emergency and elective surgeries at one of the main hospitals in Addis Ababa Ethiopia. This is a prospective study, performed at the Minilik II referral hospital, Addis Ababa. All surgical gloves worn during all major surgical procedures (Emergency and Elective) from June 1-July 20, 2016 were collected and used for the study. Standardised visual and hydro insufflation techniques were used to test the gloves for perforations. Parameters recorded included type of procedure performed, number of perforations, localisation of perforation and the roles of the surgical team. A total of 2634 gloves were tested, 1588 from elective and 1026 from emergency procedures. The total rate of perforation in emergency procedures was 41.4%, while perforation in elective surgeries was 30.0%. A statistically significant difference (P < 0.05) was found in between emergency and elective surgeries. There were a very high rate of perforations of gloves among first surgeons 40.6% and scrub nurses 38.8% during elective procedures and among first surgeons (60.14%), and second assistants (53.0%) during emergency surgeries. Only 0.4% of inner gloves were perforated. The left hand, the left index finger and thumb were the most commonly perforated parts of the glove. Glove perforation rate was low among consultant surgeons than residents. Our reported perforation rate is higher than most publications, and this shows that the surgical workforce in Ethiopia is under a clear and present threat. Measures such as double gloving seems to have effectively prevented cutaneous blood exposure and thus should become a routine for all surgical procedures. Manufacturing related defects and faults in glove quality may also be contributing factors.

Diapause in copepods (Crustacea) from ephemeral habitats with different hydroperiods in Everglades National Park (Florida, U.S.A.)

USGS Publications Warehouse

Bruno, M.C.; Loftus, W.F.; Reid, J.W.; Perry, S.A.

2001-01-01

Water management practices in the Everglades have severely stressed the natural system, particularly by reducing the hydroperiods of much of the region. During the dry season of 1999, we investigated the influence of hydroperiod on the species composition and dormancy patterns of freshwater copepod communities in seasonal wetlands of Everglades National Park, Florida, U.S.A. The habitats were characterized by an annual dry season, from December through June. We sampled at two locations: the Long Pine Key area of the Rocky Glades region (short hydroperiod, ca. 4-5 months), and western Taylor Slough (intermediate hydroperiod, ca. 8-10 months). Both areas have experienced a reduction in natural hydroperiods and an increase in the frequency of dry-down. We collected weekly plankton samples from Rocky Glades solution holes to assess the potential species pool of copepods. To document the taxa capable of surviving dry-down by resting, we performed three immersion trials in which we rehydrated, in laboratory aquaria, sediment patches from solution holes and surface soils from all stations. Only a subset of the planktonic species collected emerged from the dried sediments. The cyclopoids Microcyclops rubellus and Paracyclops poppei were dominant. This is the first record of diapause for P. poppei. Species distributions from the different hydroperiod soil patches indicated that more diapausing species occurred at the sites that dried for shorter periods. Emerging individuals of M. rubellus and P. poppei were mainly ovigerous females, demonstrating a resting strategy seldom before recorded. The cyclopoid Diacyclops nearcticus had not been previously reported to diapause, but they emerged from the dried sediments in our trials. Our collections included six new records for Florida: Diacyclops nearcticus, Megacyclops latipes, Orthocyclops modestus, Elaphoidella marjoryae, Bryocamptus sp. and Bryocamptus cf. newyorkensis. Paracyclops poppei, Macrocyclops fuscus and Arctodiaptomus floridanus are new records for Everglades National Park. Clearly, diapause is an important strategy for the persistence of copepods in short-hydroperiod wetlands. The duration of the dry period appears to be inversely related to the number of species that emerge from diapause.

THE PREVALENCE AND IMPACT OF WOLF–RAYET STARS IN EMERGING MASSIVE STAR CLUSTERS

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

Sokal, Kimberly R.; Johnson, Kelsey E.; Indebetouw, Rémy

We investigate Wolf–Rayet (WR) stars as a source of feedback contributing to the removal of natal material in the early evolution of massive star clusters. Despite previous work suggesting that massive star clusters clear out their natal material before the massive stars evolve into the WR phase, WR stars have been detected in several emerging massive star clusters. These detections suggest that the timescale for clusters to emerge can be at least as long as the time required to produce WR stars (a few million years), and could also indicate that WR stars may be providing the tipping point inmore » the combined feedback processes that drive a massive star cluster to emerge. We explore the potential overlap between the emerging phase and the WR phase with an observational survey to search for WR stars in emerging massive star clusters hosting WR stars. We select candidate emerging massive star clusters from known radio continuum sources with thermal emission and obtain optical spectra with the 4 m Mayall Telescope at Kitt Peak National Observatory and the 6.5 m MMT.{sup 4} We identify 21 sources with significantly detected WR signatures, which we term “emerging WR clusters.” WR features are detected in ∼50% of the radio-selected sample, and thus we find that WR stars are commonly present in currently emerging massive star clusters. The observed extinctions and ages suggest that clusters without WR detections remain embedded for longer periods of time, and may indicate that WR stars can aid, and therefore accelerate, the emergence process.« less

ECG interpretation skills of South African Emergency Medicine residents

PubMed Central

Wallis, Lee; Maritz, David

2010-01-01

Background The use and interpretation of electrocardiograms (ECGs) are widely accepted as an essential core skill in Emergency Medicine. It is imperative that emergency physicians are expert in ECG interpretation when they exit their training programme. Aim It is unknown whether South African Emergency Medicine trainees are getting the necessary skills in ECG interpretation during the training programme. Currently there are no clear criteria to assess emergency physicians’ competency in ECG interpretation in South Africa. Methods A prospective cross-sectional study of Emergency Medicine residents and recently qualified emergency physicians was conducted between August 2008 and February 2009 using a focused questionnaire. Results At the time of the study, there were 55 eligible trainees in South Africa. A total of 55 assessments were distributed; 50 were returned (91%) and 49 were fully completed (89%). In this study, we found the overall average score of ECG interpretation was 46.4% [95% confidence interval (CI) 41.5–51.2%]. The junior group had an overall average of 42.2% (95% CI 36.9–47.5%), whereas the senior group managed 52.5% (95% CI 43.4–61.5%). Conclusion In this prospective cross-sectional study of Emergency Medicine residents and recently qualified emergency physicians, we found that there was improvement in the interpretation of ECGs with increased seniority. There exists, however, a low level of accuracy for many of the critical ECG diagnoses. The average score of 46.4% obtained in this study is lower than the scores obtained by other international studies from countries where Emergency Medicine is a well-established speciality. PMID:21373298

RTSTEP regional transportation simulation tool for emergency planning - final report.

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

Ley, H.; Sokolov, V.; Hope, M.

2012-01-20

Large-scale evacuations from major cities during no-notice events - such as chemical or radiological attacks, hazardous material spills, or earthquakes - have an obvious impact on large regions rather than on just the directly affected area. The scope of impact includes the accommodation of emergency evacuation traffic throughout a very large area; the planning of resources to respond appropriately to the needs of the affected population; the placement of medical supplies and decontamination equipment; and the assessment and determination of primary escape routes, as well as routes for incoming emergency responders. Compared to events with advance notice, such as evacuationsmore » based on hurricanes approaching an affected area, the response to no-notice events relies exclusively on pre-planning and general regional emergency preparedness. Another unique issue is the lack of a full and immediate understanding of the underlying threats to the population, making it even more essential to gain extensive knowledge of the available resources, the chain of command, and established procedures. Given the size of the area affected, an advanced understanding of the regional transportation systems is essential to help with the planning for such events. The objectives of the work described here (carried out by Argonne National Laboratory) is the development of a multi-modal regional transportation model that allows for the analysis of different evacuation scenarios and emergency response strategies to build a wealth of knowledge that can be used to develop appropriate regional emergency response plans. The focus of this work is on the effects of no-notice evacuations on the regional transportation network, as well as the response of the transportation network to the sudden and unusual demand. The effects are dynamic in nature, with scenarios changing potentially from minute to minute. The response to a radiological or chemical hazard will be based on the time-delayed dispersion of such materials over a large area, with responders trying to mitigate the immediate danger to the population in a variety of ways that may change over time (e.g., in-place evacuation, staged evacuations, and declarations of growing evacuation zones over time). In addition, available resources will be marshaled in unusual ways, such as the repurposing of transit vehicles to support mass evacuations. Thus, any simulation strategy will need to be able to address highly dynamic effects and will need to be able to handle any mode of ground transportation. Depending on the urgency and timeline of the event, emergency responders may also direct evacuees to leave largely on foot, keeping roadways as clear as possible for emergency responders, logistics, mass transport, and law enforcement. This RTSTEP project developed a regional emergency evacuation modeling tool for the Chicago Metropolitan Area that emergency responders can use to pre-plan evacuation strategies and compare different response strategies on the basis of a rather realistic model of the underlying complex transportation system. This approach is a significant improvement over existing response strategies that are largely based on experience gained from small-scale events, anecdotal evidence, and extrapolation to the scale of the assumed emergency. The new tool will thus add to the toolbox available to emergency response planners to help them design appropriate generalized procedures and strategies that lead to an improved outcome when used during an actual event.« less

Improved insect emergence trap for stream community population sampling

Treesearch

Eric. H. LaGasa; Stamford D. Smith

1978-01-01

A sealed-edge pyramidal trap to sample total insectemergence from a segment of a small stream has been designed and tested in northeastern Oregon. The trap is approximately 10 by 10 feet at the base, and is constructed of wood, clear plastic, and galvanized screening. It is efficient and readily used, and can yield significant data on seasonal population changes and on...

Phonics Pathways: Clear Steps to Easy Reading and Perfect Spelling. 10th Edition

ERIC Educational Resources Information Center

Hiskes, Dolores G.

2011-01-01

This tenth edition of the best-selling book teaches reading using sounds and spelling patterns. These sounds and patterns are introduced one at a time, and slowly built into words, syllables, phrases, and sentences. Simple step-by-step directions begin every lesson. Although originally designed for K-2 emergent readers, this award-winning book is…

A School-to-Work Transition System for the United States. Workforce Skills Program.

ERIC Educational Resources Information Center

Tucker, Marc

The core features of the preindustrial model of school-to-work transition are needed now. An environment must be recreated in which young people see the vital connections among education, training, and work that were once so clear. The emerging consensus model has these features: combined formal schooling and structured on-the-job training leading…

An Examination of Cultural Influences on Team Cognition and Information Sharing in Emergency Crisis Management Domains: A Mixed Methodological Approach

ERIC Educational Resources Information Center

Endsley, Tristan Caroline

2016-01-01

The consequence for better understanding and facilitating teamwork during crisis and disaster response in the coming years is significant. It becomes clear that environmental and situational complexity requires a reliance on teams to carry out response efforts. Crises, regardless of the type of event, require complex decision-making and planning…

Where to Begin? The Evolving Role of Placement Exams for Students Starting College. Executive Summary

ERIC Educational Resources Information Center

Burdman, Pamela

2012-01-01

For years, colleges have used placement exams to determine whether to deem incoming students "college ready" or assign them to developmental education. Emerging information reveals the tests have little correlation to students' future success, casting doubt on their use even as the high stakes for students of taking remedial courses become clear.…

Exploring Socio-Demographics, Mobility, and Living Arrangement as Risk Factors for Academic Performance among Children Experiencing Homelessness

ERIC Educational Resources Information Center

Howland, Allison; Chen, Li-Ting; Chen, Ming-E; Min, Mina

2017-01-01

Homeless children usually experience high mobility. Yet, it is not clear if the degree of mobility among homeless children is associated with their academic performance. Furthermore, an emerging body of literature is beginning to examine the impact of specific living arrangements (e.g., living with families or friends) on homeless family and child…

Does the inherence heuristic take us to psychological essentialism?

PubMed

Marmodoro, Anna; Murphy, Robin A; Baker, A G

2014-10-01

We argue that the claim that essence-based causal explanations emerge, hydra-like, from an inherence heuristic is incomplete. No plausible mechanism for the transition from concrete properties, or cues, to essences is provided. Moreover, the fundamental shotgun and storytelling mechanisms of the inherence heuristic are not clearly enough specified to distinguish them, developmentally, from associative or causal networks.

Rebuilding Inequity: The Re-Emergence of the School-to-Prison Pipeline in New Orleans

ERIC Educational Resources Information Center

Tuzzolo, Ellen; Hewitt, Damon T.

2007-01-01

After a state take-over of most local schools, the fate of public education in New Orleans has been clouded by uncertainty. However, many problems are already clear. The community has expressed outrage on numerous occasions about the management, conditions, policies, and practices of the RSD schools. One fundamental concern has been about the lack…