43 CFR 417.4 - Changed conditions, emergency, or hardship modifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Changed conditions, emergency, or hardship modifications. 417.4 Section 417.4 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR PROCEDURAL METHODS FOR IMPLEMENTING COLORADO RIVER WATER CONSERVATION...

43 CFR 417.4 - Changed conditions, emergency, or hardship modifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Changed conditions, emergency, or hardship modifications. 417.4 Section 417.4 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR PROCEDURAL METHODS FOR IMPLEMENTING COLORADO RIVER WATER CONSERVATION...

Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

PubMed Central

Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

2014-01-01

We analyzed 2010 U.S. National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million NTDC-related ED visits in 2010. Less than 1.0% (children) and 2.1% (adults) of all ED visits were for NTDC. There was no significant difference in NTDC-related ED visits or costs for children by ASD status. Adults with ASD had significantly lower odds of NTDC-related ED visits (OR=0.39; 95% CI: 0.29, 0.52; P<0.001) but incurred significantly greater mean costs for NTDC-related ED visits (P<0.006) than did adults without ASD. PMID:25374135

Self-reported financial barriers to care among patients with cardiovascular-related chronic conditions.

PubMed

Campbell, David J T; King-Shier, Kathryn; Hemmelgarn, Brenda R; Sanmartin, Claudia; Ronksley, Paul E; Weaver, Robert G; Tonelli, Marcello; Hennessy, Deirdre; Manns, Braden J

2014-05-01

People with chronic conditions who do not achieve therapeutic targets have a higher risk of adverse health outcomes. Failure to meet these targets may be due to a variety of barriers. This article examines self-reported financial barriers to health care among people with cardiovascular-related chronic conditions. A population-based survey was administered to western Canadians with cardiovascular-related chronic conditions (n = 1,849). Associations between self-reported financial barriers and statin use, the likelihood of stopping use of prescribed medications, and emergency department visits or hospitalizations were assessed. More than 10% respondents reported general financial barriers (12%) and lack of drug insurance (14%); 4% reported financial barriers to accessing medications. Emergency department visits or hospitalizations were 70% more likely among those reporting a general financial barrier. Those reporting a financial barrier to medications were 50% less likely to take statins and three times more likely to stop using prescribed medications. Individuals without drug insurance were nearly 30% less likely to take statins. In this population, self-reported financial barriers were associated with lower medication use and increased likelihood of emergency department visits or hospitalization.

Epidemiology of Eye-Related Emergency Department Visits.

PubMed

Channa, Roomasa; Zafar, Syed Nabeel; Canner, Joseph K; Haring, R Sterling; Schneider, Eric B; Friedman, David S

2016-03-01

Determining the epidemiology of eye-related emergency department (ED) visits on a national level can assist policymakers in appropriate allocation of resources. To study ED visits related to ocular conditions for all age groups across the United States. Nationally representative data from the US Nationwide Emergency Department Sample (NEDS) were used to analyze ED visits from January 1, 2006, to December 31, 2011 (6 years). All patients with eye problems presenting to EDs across the United States were eligible for inclusion. A weighted count of 11 929 955 ED visits were categorized as possibly emergent (emergent), unlikely to be emergent (nonemergent), or could not be determined. Data were analyzed from March 1 to May 30, 2015. Population-based incidence rates of eye-related ED visits, incidence rates of eye injuries, relative proportions of emergent vs nonemergent eye-related ED visits among different age groups, and independent factors associated with emergent vs nonemergent visits. From 2006 to 2011, 11 929 955 ED visits (male patients, 54.2%; mean [SD] age, 31 [22] years) for ocular problems across the United States were categorized as emergent (41.2%), nonemergent (44.3%), or could not determine (14.5%). Corneal abrasions (13.7%) and foreign body in the external eye (7.5%) were the leading diagnoses in the emergent category. More than 4 million visits were for conjunctivitis (28.0%), subconjunctival hemorrhages (3.0%), and styes (3.8%). Emergent visits were significantly more likely to occur among males (odds ratio [OR], 2.00; 95% CI, 2.00-2.01), patients in the highest income quartile (OR, 1.47; 95% CI, 1.46-1.49), older patients (OR, 2.38; 95% CI, 2.38-2.44), and patients with private insurance (OR, 1.29; 95% CI, 1.28-1.30). Mean annual inflation-adjusted charges for all eye-related ED visits totaled $2.0 billion. Across the United States, nonemergent conditions accounted for almost half of all eye-related ED visits. Interventions to facilitate management of these cases outside the ED could make ED resources more available for truly emergent ophthalmic and medical issues.

Preparations for Severe Winter Conditions by Emergency Health Personnel in Turkey.

PubMed

Calışkan, Cüneyt; Algan, Aysun; Koçak, Hüseyin; Biçer, Burcu Küçük; Sengelen, Meltem; Cakir, Banu

2014-04-23

Emergency and core ambulance personnel work under all environmental conditions, including severe weather condtions. We evaluated emergency medical personnel in Çanakkale, Turkey, for their degree of preparedness. A descriptive study was conducted in Çanakkale, Turkey, within 112 emergency service units and their 17 district stations. Surveys were developed to measure the level of preparedness for serious winter conditions that individual workers made for themselves, their homes, and their cars. Of the 167 survey participants, the mean age was 29.8 ± 7.9 years; 52.7% were women; more than half (54.75%) were emergency medical technicians; and 53.3% were married. Only 10.4% of those who heated their homes with natural gas had carbon monoxide detectors. Scores relating to household and individual preparation for severe winter conditions increased by participants' age (P < .003), being married (P < .000) and working in the city center (P < .021); and for men whose cars were equipped with tow ropes, extra clothing, and snow tires (P < .05). Absenteeism was higher for central-city personnel than district workers because they were less prepared for harsh winter conditions (P = .016). Many of the surveyed emergency health personel demonstrated insufficient preparations for serious winter conditions. To increase the safety and efficiency of emergency medical personnel, educational training programs should be rountinely conducted. (Disaster Med Public Health Preparedness. 2014;0:1-4).

Air pollution and children's asthma-related emergency hospital visits in southeastern France.

PubMed

Mazenq, Julie; Dubus, Jean-Christophe; Gaudart, Jean; Charpin, Denis; Nougairede, Antoine; Viudes, Gilles; Noel, Guilhem

2017-06-01

Children's asthma is multifactorial. Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3- to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM 10 and PM 2.5 , meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM 10 measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor. PM 10 and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3- to 18-year-old children in Bouches-du-Rhône. What is Known: • A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New: • This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital. • The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.

Asynchronous emergence by loggerhead turtle (Caretta caretta) hatchlings

NASA Astrophysics Data System (ADS)

Houghton, J. D. R.; Hays, G. C.

2001-03-01

For many decades it has been accepted that marine turtle hatchlings from the same nest generally emerge from the sand together. However, for loggerhead turtles (Caretta caretta) nesting on the Greek Island of Kefalonia, a more asynchronous pattern of emergence has been documented. By placing temperature loggers at the top and bottom of nests laid on Kefalonia during 1998, we examined whether this asynchronous emergence was related to the thermal conditions within nests. Pronounced thermal variation existed not only between, but also within, individual nests. These within-nest temperature differences were related to the patterns of hatchling emergence, with hatchlings from nests displaying large thermal ranges emerging over a longer time-scale than those characterised by more uniform temperatures.

22 CFR 231.01 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... Egypt (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Public...

22 CFR 231.01 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... Egypt (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Public...

22 CFR 231.01 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... Egypt (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Public...

22 CFR 231.01 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... Egypt (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Public...

22 CFR 231.01 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... Egypt (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Public...

Statin Exposure Is Associated with Decreased Asthma-related Emergency Department Visits and Oral Corticosteroid Use

PubMed Central

Li, Lingling; Butler, Melissa G.; Fung, Vicki; Kharbanda, Elyse O.; Larkin, Emma K.; Vollmer, William M.; Miroshnik, Irina; Rusinak, Donna; Weiss, Scott T.; Lieu, Tracy; Wu, Ann Chen

2013-01-01

Rationale: Statins, or HMG-CoA reductase inhibitors, may aid in the treatment of asthma through their pleiotropic antiinflammatory effects. Objectives: To examine the effect of statin therapy on asthma-related exacerbations using a large population-based cohort. Methods: Statin users aged 31 years or greater with asthma were identified from the Population-Based Effectiveness in Asthma and Lung population, which includes data from five health plans. Statin exposure and asthma exacerbations were assessed over a 24-month observation period. Statin users with a statin medication possession ratio greater than or equal to 80% were matched to non–statin users by age, baseline asthma therapy, site of enrollment, season at baseline, and propensity score, which was calculated based on patient demographics and Deyo-Charlson conditions. Asthma exacerbations were defined as two or more oral corticosteroid dispensings, asthma-related emergency department visits, or asthma-related hospitalizations. The association between statin exposure and each of the three outcome measures was assessed using conditional logistic regression. Measurements and Main Results: Of the 14,566 statin users, 8,349 statin users were matched to a nonuser. After adjusting for Deyo-Charlson conditions that remained unbalanced after matching, among statin users, statin exposure was associated with decreased odds of having asthma-related emergency department visits (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.53–0.77; P < 0.0001) and two or more oral corticosteroid dispensings (OR, 0.90; 95% CI, 0.81–0.99; P = 0.04). There were no differences in asthma-related hospitalizations (OR, 0.91; 95% CI, 0.66–1.24; P = 0.52). Conclusions: Among statin users with asthma, statin exposure was associated with decreased odds of asthma-related emergency department visits and oral corticosteroid dispensings. PMID:24093599

Are mental health problems associated with use of Accident and Emergency and health-related harm?

PubMed

Keene, J; Rodriguez, J

2007-08-01

Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole. Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of health-related harm, an accurate profile of mentally ill Emergency patients was generated enabling identification of factors that increased vulnerability to harm. Of the total population of 625 964 individuals, 10.7% contacted Accident and Emergency (A&E) over three years, this proportion rose to 28.6% among the total secondary care mental health population. Young men and older women were more likely to contact A&E, both overall and within mental health populations and were also more likely to be frequent attendees at A&E. Four distinct groups (typologies) of mental health patients attending A&E emerged: young, male frequent attendees with self-inflicted and other traumatic injuries; young females also presenting with self-harm; older patients with multiple medical conditions; and very old patients with cardiac conditions and fractures. The study indicates increased A+E service use and unmet health-related need within a total mental health population. It identifies specific 'care populations' particularly vulnerable to accidents and self-harm and highlights the need for targeted services for mentally ill groups who may not access traditional health and social care services effectively.

Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study

PubMed Central

Harrison, Mark J; Dusheiko, Mark; Sutton, Matt; Gravelle, Hugh; Doran, Tim

2014-01-01

Objective To estimate the impact of a national primary care pay for performance scheme, the Quality and Outcomes Framework in England, on emergency hospital admissions for ambulatory care sensitive conditions (ACSCs). Design Controlled longitudinal study. Setting English National Health Service between 1998/99 and 2010/11. Participants Populations registered with each of 6975 family practices in England. Main outcome measures Year specific differences between trend adjusted emergency hospital admission rates for incentivised ACSCs before and after the introduction of the Quality and Outcomes Framework scheme and two comparators: non-incentivised ACSCs and non-ACSCs. Results Incentivised ACSC admissions showed a relative reduction of 2.7% (95% confidence interval 1.6% to 3.8%) in the first year of the Quality and Outcomes Framework compared with ACSCs that were not incentivised. This increased to a relative reduction of 8.0% (6.9% to 9.1%) in 2010/11. Compared with conditions that are not regarded as being influenced by the quality of ambulatory care (non-ACSCs), incentivised ACSCs also showed a relative reduction in rates of emergency admissions of 2.8% (2.0% to 3.6%) in the first year increasing to 10.9% (10.1% to 11.7%) by 2010/11. Conclusions The introduction of a major national pay for performance scheme for primary care in England was associated with a decrease in emergency admissions for incentivised conditions compared with conditions that were not incentivised. Contemporaneous health service changes seem unlikely to have caused the sharp change in the trajectory of incentivised ACSC admissions immediately after the introduction of the Quality and Outcomes Framework. The decrease seems larger than would be expected from the changes in the process measures that were incentivised, suggesting that the pay for performance scheme may have had impacts on quality of care beyond the directly incentivised activities. PMID:25389120

22 CFR 230.02 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.02 Definitions... 230 and the Emergency Wartime Supplemental Appropriations Act of 2003, Public Law 108-11, as amended...

Autoimmune encephalitis and its relation to infection.

PubMed

Venkatesan, Arun; Benavides, David R

2015-03-01

Encephalitis, an inflammatory condition of the brain that results in substantial morbidity and mortality, has numerous causes. Over the past decade, it has become increasingly recognized that autoimmune conditions contribute significantly to the spectrum of encephalitis causes. Clinical suspicion and early diagnosis of autoimmune etiologies are of particular importance due to the need for early institution of immune suppressive therapies to improve outcome. Emerging clinical observations suggest that the most commonly recognized cause of antibody-mediated autoimmune encephalitis, anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, may in some cases be triggered by herpes virus infection. Other conditions such as Rasmussen's encephalitis (RE) and febrile infection-related epilepsy syndrome (FIRES) have also been posited to be autoimmune conditions triggered by infectious agents. This review focuses on emerging concepts in central nervous system autoimmunity and addresses clinical and mechanistic findings linking autoimmune encephalitis and infections. Particular consideration will be given to anti-NMDA receptor encephalitis and its relation to herpes simplex encephalitis.

22 CFR 230.01 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.01 Purpose. The... (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Public Law 108-11...

22 CFR 230.01 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.01 Purpose. The... (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Pub. L. 108-11. The...

22 CFR 230.01 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.01 Purpose. The... (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Pub. L. 108-11. The...

22 CFR 230.01 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.01 Purpose. The... (“Borrower”), pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003, Pub. L. 108-11. The...

Emergency braking is affected by the use of cruise control.

PubMed

Jammes, Yves; Behr, Michel; Llari, Maxime; Bonicel, Sarah; Weber, Jean Paul; Berdah, Stephane

2017-08-18

We compared the differences in the braking response to vehicle collision between an active human emergency braking (control condition) and cruise control (CC) or adaptive cruise control (ACC). In 11 male subjects, age 22 to 67 years, we measured the active emergency braking response during manual driving using the accelerator pedal (control condition) or in condition mimicking CC or ACC. In both conditions, we measured the brake reaction time (BRT), delay to produce the peak braking force (PBD), total emergency braking response (BRT + PBD), and peak braking force (PBF). Electromyograms of leg and thigh muscles were recorded during braking. The tonic vibratory response (TVR), Hoffman reflex (HR), and M-waves were recorded in leg muscles to explore the change in sensorimotor control. No difference in PBF, TVR amplitude, HR latency, and H max /M max ratio were found between the control and CC/ACC conditions. On the other hand, BRT and PBD were significantly lengthened in the CC/ACC condition (240 ± 13 ms and 704 ± 70 ms, respectively) compared to control (183 ± 7 ms and 568 ± 36 ms, respectively). BRT increased with the age of participants and the driving experience shortened PBD and increased PBF. In male subjects, driving in a CC/ACC condition significantly delays the active emergency braking response to vehicle collision. This could result from higher amplitude of leg motion in the CC/ACC condition and/or by the age-related changes in motor control. Car and truck drivers must take account of the significant increase in the braking distance in a CC/ACC condition.

Emergence of the benefits and costs of grouping for visual search.

PubMed

Wu, Rachel; McGee, Brianna; Rubenstein, Madelyn; Pruitt, Zoe; Cheung, Olivia S; Aslin, Richard N

2018-04-16

The present study investigated how grouping related items leads to the emergence of benefits (facilitation when related items are search targets) and costs (interference when related items are distractors) in visual search. Participants integrated different views (related items) of a novel Lego object via (a) assembling the object, (b) disassembling the object, or (c) sitting quietly without explicit instructions. An omnibus ANOVA revealed that neural responses (N2pc ERP) for attentional selection increased between pretest to posttest regardless of the training condition when a specific target view appeared (benefit) and when a nontarget view from the same object as the target view appeared (cost). Bonferroni-corrected planned comparisons revealed that assembling the object (but not disassembling the object or no training) had a significant impact from pretest to posttest, although the ANOVA did not reveal any interaction effects, suggesting that the effects might not differ across training conditions. This study is one of the first to demonstrate the emergence of the costs and benefits of grouping novel targets on visual search efficiency. © 2018 Society for Psychophysiological Research.

18 CFR 284.263 - Exemption from section 7 of Natural Gas Act and certain regulatory conditions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 7 of Natural Gas Act and certain regulatory conditions. 284.263 Section 284.263 Conservation of... UNDER THE NATURAL GAS POLICY ACT OF 1978 AND RELATED AUTHORITIES CERTAIN SALES AND TRANSPORTATION OF NATURAL GAS UNDER THE NATURAL GAS POLICY ACT OF 1978 AND RELATED AUTHORITIES Emergency Natural Gas Sale...

Go/No-Go Procedure with Compound Stimuli with Children with Autism

ERIC Educational Resources Information Center

Silva, Rafael Augusto; Debert, Paula

2017-01-01

The go/no-go with compound stimuli is an alternative to matching-to-sample to produce conditional and emergent relations in adults. The aim of this study was to evaluate the effectiveness of this procedure with two children diagnosed with autism. We trained and tested participants to respond to conditional relations among arbitrary stimuli using…

18 CFR 284.263 - Exemption from section 7 of Natural Gas Act and certain regulatory conditions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 7 of Natural Gas Act and certain regulatory conditions. 284.263 Section 284.263 Conservation of... UNDER THE NATURAL GAS POLICY ACT OF 1978 AND RELATED AUTHORITIES CERTAIN SALES AND TRANSPORTATION OF NATURAL GAS UNDER THE NATURAL GAS POLICY ACT OF 1978 AND RELATED AUTHORITIES Emergency Natural Gas Sale...

The Emerging Role of Metabotropic Glutamate Receptors in the Pathophysiology of Chronic Stress-Related Disorders

PubMed Central

Peterlik, Daniel; Flor, Peter J.; Uschold-Schmidt, Nicole

2016-01-01

Chronic stress-related psychiatric conditions such as anxiety, depression, and alcohol abuse are an enormous public health concern. The etiology of these pathologies is complex, with psychosocial stressors being among the most frequently discussed risk factors. The brain glutamatergic neurotransmitter system has often been found involved in behaviors and pathophysiologies resulting from acute stress and fear. Despite this, relatively little is known about the role of glutamatergic system components in chronic psychosocial stress, neither in rodents nor in humans. Recently, drug discovery efforts at the metabotropic receptor subtypes of the glutamatergic system (mGlu1-8 receptors) led to the identification of pharmacological tools with emerging potential in psychiatric conditions. But again, the contribution of individual mGlu subtypes to the manifestation of physiological, molecular, and behavioral consequences of chronic psychosocial stress remains still largely unaddressed. The current review will describe animal models typically used to analyze acute and particularly chronic stress conditions, including models of psychosocial stress, and there we will discuss the emerging roles for mGlu receptor subtypes. Indeed, accumulating evidence indicates relevance and potential therapeutic usefulness of mGlu2/3 ligands and mGlu5 receptor antagonists in chronic stress-related disorders. In addition, a role for further mechanisms, e.g. mGlu7-selective compounds, is beginning to emerge. These mechanisms are important to be analyzed in chronic psychosocial stress paradigms, e.g. in the chronic subordinate colony housing (CSC) model. We summarize the early results and discuss necessary future investigations, especially for mGlu5 and mGlu7 receptor blockers, which might serve to suggest improved therapeutic strategies to treat stress-related disorders. PMID:27296643

The relative persuasiveness of narrative versus non-narrative health messages in public health emergency communication: Evidence from a field experiment.

PubMed

Bekalu, Mesfin A; Bigman, Cabral A; McCloud, Rachel F; Lin, Leesa K; Viswanath, K

2018-06-01

Previous studies indicated that narrative health messages are more effective than non-narrative messages in influencing health outcomes. However, this body of evidence does not account for differences in health domain, and little is known about the effectiveness of this message execution strategy during public health emergencies. In this study, we examined the relative effectiveness of the two formats in influencing knowledge and perceived response efficacy related to prevention of pandemic influenza, and determined whether effects of message format vary across population sub-groups. Data for the study come from an experiment fielded in 2013 that involved a nationally representative sample of 627 American adults. Participants were randomly assigned to view either a narrative (n=322) or a non-narrative (n=305) video clip containing closely matched information about knowledge and preventive actions related to pandemic influenza, and completed pre- and post-viewing questions assessing knowledge and perceived response efficacy related to the prevention of pandemic influenza. Results indicated that participants in the non-narrative condition reported greater knowledge and rated pandemic influenza prevention measures as more effective compared with those in the narrative condition. Message format effects did not vary across population sub-groups; post-viewing scores of knowledge and perceptions related to pandemic influenza were consistently higher in the non-narrative condition compared with the narrative condition across five socio-demographic groups: age, gender, education, race/ethnicity and income. We concluded that didactic, non-narrative messages may be more effective than narrative messages to influence knowledge and perceptions during public health emergencies. Copyright © 2017 Elsevier Inc. All rights reserved.

Emergency room visits for respiratory conditions in children increased after Guagua Pichincha volcanic eruptions in April 2000 in Quito, Ecuador observational study: time series analysis.

PubMed

Naumova, Elena N; Yepes, Hugo; Griffiths, Jeffrey K; Sempértegui, Fernando; Khurana, Gauri; Jagai, Jyotsna S; Játiva, Edgar; Estrella, Bertha

2007-07-24

This study documented elevated rates of emergency room (ER) visits for acute upper and lower respiratory infections and asthma-related conditions in the children of Quito, Ecuador associated with the eruption of Guagua Pichincha in April of 2000. We abstracted 5169 (43% females) ER records with primary respiratory conditions treated from January 1-December 27, 2000 and examined the change in pediatric ER visits for respiratory conditions before, during, and after exposure events of April, 2000. We applied a Poisson regression model adapted to time series of cases for three non-overlapping disease categories: acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), and asthma-related conditions in boys and girls for three age groups: 0-4, 5-9, and 10-15 years. At the main pediatric medical facility, the Baca Ortiz Pediatric Hospital, the rate of emergency room (ER) visits due to respiratory conditions substantially increased in the three weeks after eruption (RR = 2.22, 95%CI = [1.95, 2.52] and RR = 1.72 95%CI = [1.49, 1.97] for lower and upper respiratory tract infections respectively. The largest impact of eruptions on respiratory distress was observed in children younger than 5 years (RR = 2.21, 95%CI = [1.79, 2.73] and RR = 2.16 95%CI = [1.67, 2.76] in boys and girls respectively). The rate of asthma and asthma-related diagnosis doubled during the period of volcano fumarolic activity (RR = 1.97, 95%CI = [1.19, 3.24]). Overall, 28 days of volcanic activity and ash releases resulted in 345 (95%CI = [241, 460]) additional ER visits due to respiratory conditions. The study has demonstrated strong relationship between ash exposure and respiratory effects in children.

Injury-related visits and comorbid conditions among homeless persons presenting to emergency departments.

PubMed

Hammig, Bart; Jozkowski, Kristen; Jones, Ches

2014-04-01

The authors examined the clinical characteristics of homeless patients presenting to emergency departments (EDs) in the United States, with a focus on unintentional and intentional injury events and related comorbid conditions. The study included a nationally representative sample of patients presenting to EDs with data obtained from the 2007 through 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS). Descriptive and analytical epidemiologic analyses were employed to examine injuries among homeless patients. Homeless persons made 603,000 visits annually to EDs, 55% of which were for injuries, with the majority related to unintentional (52%) and self-inflicted (23%) injuries. Multivariate logistic regression analyses revealed that homeless patients had a higher odds of presenting with injuries related to unintentional (odds ratio [OR]=1.4. 95% confidence interval [CI]=1.1 to 1.9), self-inflicted (OR=6.0, 95% CI=3.7 to 9.5), and assault (OR=3.0, 95% CI=1.5 to 5.9) injuries. A better understanding of the injuries affecting homeless populations may provide medical and public health professionals insight into more effective ways to intervene and limit further morbidity and mortality related to specific injury outcomes. © 2014 by the Society for Academic Emergency Medicine.

Neuromuscular blocking agent administration for emergent tracheal intubation is associated with decreased prevalence of procedure-related complications.

PubMed

Wilcox, Susan R; Bittner, Edward A; Elmer, Jonathan; Seigel, Todd A; Nguyen, Nicole Thuy P; Dhillon, Anahat; Eikermann, Matthias; Schmidt, Ulrich

2012-06-01

Emergent intubation is associated with a high rate of complications. Neuromuscular blocking agents are routinely used in the operating room and emergency department to facilitate intubation. However, use of neuromuscular blocking agents during emergent airway management outside of the operating room and emergency department is controversial. We hypothesized that the use of neuromuscular blocking agents is associated with a decreased prevalence of hypoxemia and reduced rate of procedure-related complications. Five hundred sixty-six patients undergoing emergent intubations in two tertiary care centers, Massachusetts General Hospital, Boston, MA, and the University of California Los Angeles, Ronald Reagan Medical Center, Los Angeles, CA, were enrolled in a prospective, observational study. The 112 patients intubated during cardiopulmonary resuscitation were excluded, leaving 454 patients for analysis. All intubations were supervised by attendings trained in Critical Care Medicine. We measured intubating conditions, oxygen saturation during and 5 mins following intubation. We assessed the prevalence of procedure-related complications defined as esophageal intubation, traumatic intubation, aspiration, dental injury, and endobronchial intubation. The use of neuromuscular blocking agents was associated with a lower prevalence of hypoxemia (10.1% vs. 17.4%, p = .022) and a lower prevalence of procedure-related complications (3.1% vs. 8.3%, p = .012). This association persisted in a multivariate analysis, which controlled for airway grade, sedation, and institution. Use of neuromuscular blocking agents was associated with significantly improved intubating conditions (laryngeal view, p = .014; number of intubation attempts, p = .049). After controlling for the number of intubation attempts and laryngoscopic view, muscle relaxant use is an independent predictor of complications associated with emergency intubation (p = .037), and there is a trend towards improvement of oxygenation (p = .07). The use of neuromuscular blocking agents, when used by intensivists with a high level of training and experience, is associated with a decrease in procedure-related complications.

Lidocaine and Pain Management in the Emergency Department: A Review Article

PubMed Central

Golzari, Samad EJ; Soleimanpour, Hassan; Mahmoodpoor, Ata; Safari, Saeid; Ala, Alireza

2014-01-01

Context: In the present review, the analgesic effects of lidocaine in acute or chronic painful conditions in the emergency department are discussed. Lidocaine, as a medium-acting local anesthetic with short onset time, is well-recognized, not only as a valuable medication for numerous neuropathic pain conditions, but also for the management of both acute and chronic pain. Evidence Acquisition: Research studies related to the different applications of lidocaine in the emergency department were collected from different databases including Cochrane library, Medline (Ovid) and PubMed. The pooled data were categorized, summarized and finally compared. Results: Our study revealed that lidocaine is broadly used in various therapeutic approaches for different types of pain, such as visceral/central pain, renal colic etc., in the emergency department. Conclusions: The antinociceptive properties of lidocaine are derived from multifaceted mechanisms, turning it into a medication that is safe to administer via different routes which makes it available for use in a variety of medical conditions. PMID:24660158

[Elderly, poor, solitary and marginal patients: geriatric vulnerability in emergency services].

PubMed

Marín Gámez, N; Kessel Sardiñas, H; López Martínez, G; Barnosi Marín, A; Montoya Vergel, J; Navarro Corral, A; Delgado Rodríguez, M

1998-07-01

Status is a powerful determinant of health, and it may influence on the demand of Hospital emergency services. The aim of our investigation is to assess whether elderly patients usually wandering emergency services gather more negative socioeconomic conditions. A cross-sectional study on 800 randomised patients cared in emergency services was carried out. A questionnaire about economic, educational and professional levels, domestic violence, loneliness and life style was applied. A crude analysis was used to assess the age-factor (>/= 65 y.o.) by BMDP (PC 90). The trial was approved by the local Bioethics board. Low incomes, low educational level and loneliness were clinic and statistically related with age (65 and more). Data is offered as n (%), X2 and p < 0.0001 (Fisher exact Test two sided p value). Elderly patients frequently demanding hospital emergency services gather more vulnerability conditions, not merely medical. Low incomes, low educational level and loneliness are probably working as key factors on the geriatric demand of emergency services.

75 FR 81 - Special Conditions: Boeing Model 787-8 Airplane; Overhead Flightcrew Rest Compartment Occupiable...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

..., explain the reason for any recommended change, and include supporting data. We ask that you send us two... changes to the approved OFCR compartment configuration that affect crewmember emergency egress or any other procedures affecting safety of the occupying crewmembers or related emergency training will...

Stock markets as Minority Games: cognitive heterogeneity and equilibrium emergence

NASA Astrophysics Data System (ADS)

Brandouy, O.

2005-04-01

Standard finance theory generally assumes homogeneous agents relatively to their preferences, heuristics and investment strategies. We propose to study, in an agent-based simulation, the emergence of equilibrium under various heterogeneous conditions. Market interaction is stylized with the Minority Game representation. It is shown that inductive rational equilibrium emerges even though agents do not share the same representations of the value. This may lead to consider again the roots of EMH and REH.

Configurations of power relations in the Brazilian emergency care system: analyzing a context of visible practices.

PubMed

Velloso, Isabela; Ceci, Christine; Alves, Marilia

2013-09-01

In this paper, we make explicit the changing configurations of power relations that currently characterize the Brazilian Emergency Care System (SAMU) team in Belo Horizonte, Brazil. The SAMU is a recent innovation in Brazilian healthcare service delivery. A qualitative case study methodology was used to explore SAMU's current organizational arrangements, specifically the power relations that have developed and that demonstrate internal team struggles over space and defense of particular occupational interests. The argument advanced in this paper is that these professionals are developing their work in conditions of exposure, that is, they are always being observed by someone, and that such observational exposure provides the conditions whereby everyday emergency care practices are enacted such that practice is shaped by, as well as shapes, particular, yet recognizable power relationships. Data were collected through the observation of the SAMU's work processes and through semi-structured interviews. Research materials were analyzed using discourse analysis. In the emergency care process of work, visibility is actually embedded in the disciplinary context and can thus be analyzed as a technique applied to produce disciplined individuals through the simple mechanisms elaborated by Foucault such as hierarchical surveillance, normalizing judgment, and the examination. © 2012 John Wiley & Sons Ltd.

Ambulatory care sensitive conditions at out-of-hospital emergence services in Croatia: a longitudinal study based on routinely collected data.

PubMed

Kostanjšek, Diana; Benčić, Miro; Keglević, Mladenka Vrcić

2014-12-01

Conditions for which a hospital and emergency utilization can be considered avoidable are often referred as ambulatory care sensitive conditions (ACSCs). Until now, there has been no published research related to ACSCs in Croatia. This study was undertaken with the aim of determining the trends relating to ACSCs in out-of-hospital ES from 1995-2012. The study is based on data from the Croatian Health Service Yearbooks. Five chronic and three acute conditions were chosen: diabetes, hypertension, congestive heart failure, angina pectoris, asthma and COPD, bacterial pneumonia, urinary tract infections and skin infections. The results indicate that the ES in Croatia is overused, and consequently ACSCs are over-represented; 23.3% Croatian citizens visited the ES and around 15% of all diagnoses belonged to the ACSCs, with decreased trend. The leading diagnosis is hypertension, followed by asthma and COPD. For a better understanding of the importance of ACSC within the Croatian context, further research is needed.

A simulator-based nuclear reactor emergency response training exercise.

PubMed

Waller, Edward; Bereznai, George; Shaw, John; Chaput, Joseph; Lafortune, Jean-Francois

Training offsite emergency response personnel basic awareness of onsite control room operations during nuclear power plant emergency conditions was the primary objective of a week-long workshop conducted on a CANDU® virtual nuclear reactor simulator available at the University of Ontario Institute of Technology, Oshawa, Canada. The workshop was designed to examine both normal and abnormal reactor operating conditions, and to observe the conditions in the control room that may have impact on the subsequent offsite emergency response. The workshop was attended by participants from a number of countries encompassing diverse job functions related to nuclear emergency response. Objectives of the workshop were to provide opportunities for participants to act in the roles of control room personnel under different reactor operating scenarios, providing a unique experience for participants to interact with the simulator in real-time, and providing increased awareness of control room operations during accident conditions. The ability to "pause" the simulator during exercises allowed the instructors to evaluate and critique the performance of participants, and to provide context with respect to potential offsite emergency actions. Feedback from the participants highlighted (i) advantages of observing and participating "hands-on" with operational exercises, (ii) their general unfamiliarity with control room operational procedures and arrangements prior to the workshop, (iii) awareness of the vast quantity of detailed control room procedures for both normal and transient conditions, and (iv) appreciation of the increased workload for the operators in the control room during a transient from normal operations. Based upon participant feedback, it was determined that the objectives of the training had been met, and that future workshops should be conducted.

Talk-Aloud Protocols during Conditional Discrimination Training and Equivalence Class Formation

ERIC Educational Resources Information Center

Vie, Aleksander; Arntzen, Erik

2017-01-01

The primary focus of the present experiment was to study participants' self-talk during conditional discrimination training and test for the emergence of conditional relations consistent with equivalence. Eighteen adult participants were exposed to either a Many-to-One (MTO) or a One-to-Many (OTM) training structure arranged as a 6-s delayed…

42 CFR 447.90 - FFP: Conditions related to pending investigations of credible allegations of fraud against the...

Code of Federal Regulations, 2011 CFR

2011-10-01

... service is furnished as an emergency item or service, but not including items or services furnished in an emergency room of a hospital; or (2) The State determines and documents that good cause as specified at... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing...

42 CFR 447.90 - FFP: Conditions related to pending investigations of credible allegations of fraud against the...

Code of Federal Regulations, 2013 CFR

2013-10-01

... service is furnished as an emergency item or service, but not including items or services furnished in an emergency room of a hospital; or (2) The State determines and documents that good cause as specified at... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing...

42 CFR 447.90 - FFP: Conditions related to pending investigations of credible allegations of fraud against the...

Code of Federal Regulations, 2012 CFR

2012-10-01

... service is furnished as an emergency item or service, but not including items or services furnished in an emergency room of a hospital; or (2) The State determines and documents that good cause as specified at... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing...

Asynchronous emergence by loggerhead turtle (Caretta caretta) hatchlings.

PubMed

Houghton, J D; Hays, G C

2001-03-01

For many decades it has been accepted that marine turtle hatchlings from the same nest generally emerge from the sand together. However, for loggerhead turtles (Caretta caretta) nesting on the Greek Island of Kefalonia, a more asynchronous pattern of emergence has been documented. By placing temperature loggers at the top and bottom of nests laid on Kefalonia during 1998, we examined whether this asynchronous emergence was related to the thermal conditions within nests. Pronounced thermal variation existed not only between, but also within, individual nests. These within-nest temperature differences were related to the patterns of hatchling emergence, with hatchlings from nests displaying large thermal ranges emerging over a longer time-scale than those characterised by more uniform temperatures. In many egg-laying animals, parental care of the offspring may continue while the eggs are incubating and also after they have hatched. Consequently, the importance of the nest site for determining incubation conditions may be reduced since the parents themselves may alter the local environment. By contrast, in marine turtles, parental care ceases once the eggs have been laid and the nest site covered. The positioning of the nest site, in both space and time, may therefore have profound effects for marine turtles by affecting, for example, the survival of the eggs and hatchlings as well as their sex (Janzen and Paukstis 1991). During incubation, sea turtle embryos grow from a few cells at oviposition to a self-sufficient organism at hatching some 50-80 days later (Ackerman 1997). After hatching, the young turtles dig up through the sand and emerge typically en masse at the surface 1-7 nights later, with a number of stragglers following over the next few nights (Christens 1990). This contrasts with the frequently observed pattern of hatching asynchrony in birds. It has been suggested that the cause of mass emergence in turtles is that eggs within a clutch are fertilised within a short period of time and then, when thermal conditions within the nest are uniform, develop at very similar rates and hence hatch and emerge together (Porter 1972). As a corollary of this idea, it would be predicted that when there are pronounced within-nest thermal gradients, development rates of siblings will be different and hence asynchronous hatching and emergence might occur. While it may be energetically beneficial for hatchlings to emerge in a group (Carr and Hirth 1961), if the extent of hatching asynchrony is marked then there may be severe costs for individuals if they wait for all their siblings to hatch before attempting to dig out of the sand (Hays and Speakman 1992). Under such conditions, the protracted emergence of small groups of hatchlings over several nights may be favoured. Examination of the literature suggests that emergence asynchrony may be more widespread than generally considered. For example, Witherington et al. (1990) described loggerhead turtle hatchlings (Caretta caretta) emerging over 4 days in Florida; for green turtles (Chelonia mydas), Hendrickson (1958) documented that nests in Malaysia and Sarawak produced hatchlings for up to 8 days; whilst Diamond (1976) found that hawksbill (Eretmochelys imbricata) nests on Cousin Island, Seychelles, were active for up to 4 days. Similarly, on the Greek Island of Kefalonia, we have shown that emergence from individual loggerhead turtle nests may occur on up to 11 nights (Hays and Speakman 1992). It is logical to suppose that asynchronous emergence relates to thermal gradients within nests, since the incubation duration of sea turtle eggs is related to temperature, with eggs hatching quicker when the temperature is higher. Here we test this hypothesis by measuring thermal variations within loggerhead turtle nests and comparing these variations to the patterns of hatchling emergence.

MEDICAL SPORTS INJURIES IN THE YOUTH ATHLETE: EMERGENCY MANAGEMENT

PubMed Central

Molony Jr, Joseph T.

2012-01-01

As the number of youth sports participants continues to rise over the past decade, so too have sports related injuries and emergency department visits. With low levels of oversight and regulation observed in youth sports, the responsibility for safety education of coaches, parents, law makers, organizations and institutions falls largely on the sports medicine practitioner. The highly publicized catastrophic events of concussion, sudden cardiac death, and heat related illness have moved these topics to the forefront of sports medicine discussions. Updated guidelines for concussion in youth athletes call for a more conservative approach to management in both the acute and return to sport phases. Athletes younger than eighteen suspected of having a concussion are no longer allowed to return to play on the same day. Reducing the risk of sudden cardiac death in the young athlete is a multi‐factorial process encompassing pre‐participation screenings, proper use of safety equipment, proper rules and regulations, and immediate access to Automated External Defibrillators (AED) as corner stones. Susceptibility to heat related illness for youth athletes is no longer viewed as rooted in physiologic variations from adults, but instead, as the result of various situations and conditions in which participation takes place. Hydration before, during and after strenuous exercise in a high heat stress environment is of significant importance. Knowledge of identification, management and risk reduction in emergency medical conditions of the young athlete positions the sports physical therapist as an effective provider, advocate and resource for safety in youth sports participation. This manuscript provides the basis for management of 3 major youth emergency sports medicine conditions. PMID:22530197

[Dermatology consultations in an emergency department prior to establishment of emergency dermatology cover].

PubMed

Martínez-Martínez, M L; Escario-Travesedo, E; Rodríguez-Vázquez, M; Azaña-Defez, J M; Martín de Hijas-Santos, M C; Juan-Pérez-García, L

2011-01-01

an increasing number of patients seek emergency treatment for dermatologic complaints. The aim of this study was to assess the characteristics of skin complaints seen in an emergency department prior to establishment of specialist dermatology cover. a retrospective, descriptive study was undertaken using data on urgent dermatology cases seen by nonspecialist physicians in the emergency department of Hospital General Universitario de Albacete, Spain, in 2008. a total of 3662 patients with skin diseases were seen (2.59% of all emergency cases; approximately 10 patients per day). The mean age was 27.73 years and there was a slight predominance of female patients. Children and adolescents accounted for 5.85% of cases. A total of 96 different conditions were diagnosed and 84% of cases corresponded to one of 21 different diagnostic entities, urticaria being the most frequent (19.27%). The 96 diagnoses were grouped into 16 categories to facilitate analysis. According to this classification, most patients had infectious diseases (47.49%), followed by urticaria and angioedema (20.13%), "nonspecific diagnosis" (11.93%), and "descriptive diagnosis" (6.49%). In 4.8% of cases, the patient was admitted, most frequently for cellulitis. in nonspecialist emergency services, the number of different diagnoses is small in relation to the number of patients seen and the proportion of nonspecific and descriptive diagnoses is relatively large. In our opinion, an on-call dermatologist should be made available within emergency departments in order to offer a higher quality of care to patients with skin conditions. Copyright © 2010 Elsevier España, S.L. y AEDV. All rights reserved.

Emergency general surgery in the geriatric patient.

PubMed

Desserud, K F; Veen, T; Søreide, K

2016-01-01

Emergency general surgery in the elderly is a particular challenge to the surgeon in charge of their care. The aim was to review contemporary aspects of managing elderly patients needing emergency general surgery and possible alterations to their pathways of care. This was a narrative review based on a PubMed/MEDLINE literature search up until 15 September 2015 for publications relevant to emergency general surgery in the geriatric patient. The number of patients presenting as an emergency with a general surgical condition increases with age. Up to one-quarter of all emergency admissions to hospital may be for general surgical conditions. Elderly patients are a particular challenge owing to added co-morbidity, use of drugs and risk of poor outcome. Frailty is an important potential risk factor, but difficult to monitor or manage in the emergency setting. Risk scores are not available universally. Outcomes are usually severalfold worse than after elective surgery, in terms of both higher morbidity and increased mortality. A care bundle including early diagnosis, resuscitation and organ system monitoring may benefit the elderly in particular. Communication with the patient and relatives throughout the care pathway is essential, as indications for surgery, level of care and likely outcomes may evolve. Ethical issues should also be addressed at every step on the pathway of care. Emergency general surgery in the geriatric patient needs a tailored approach to improve outcomes and avoid futile care. Although some high-quality studies exist in related fields, the overall evidence base informing perioperative acute care for the elderly remains limited. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Clinical decision making in seizures and status epilepticus.

PubMed

Teran, Felipe; Harper-Kirksey, Katrina; Jagoda, Andy

2015-01-01

Seizures and status epilepticus are frequent neurologic emergencies in the emergency department, accounting for 1% of all emergency department visits. The management of this time-sensitive and potentially life-threatening condition is challenging for both prehospital providers and emergency clinicians. The approach to seizing patients begins with differentiating seizure activity from mimics and follows with identifying potential secondary etiologies, such as alcohol-related seizures. The approach to the patient in status epilepticus and the patient with nonconvulsive status epilepticus constitutes a special clinical challenge. This review summarizes the best available evidence and recommendations regarding diagnosis and resuscitation of the seizing patient in the emergency setting.

Health related vulnerability due to chronic diseases: Impact on clinical services across emergency shelters in mass disasters

NASA Astrophysics Data System (ADS)

Koleva, Yordanka Nikolova

Chronic diseases are increasingly recognized as major contributors to the global burden of disease. Individuals with chronic disease are particularly vulnerable during mass emergencies as they may suffer an interruption in their therapeutic programs, leading to life-threatening conditions and complications. Based on the individual and community risk factors framework, three categories are defined as the most vulnerable to extreme natural events: physically, psychologically, and socially vulnerable. Complex emergencies that occurred in the recent decade have provided evidence that these groups suffer more pronounced effects than others. Individuals seeking community support during emergencies have been predominantly medically dependent, elderly, children, people with chronic health conditions, and lower socioeconomic status. The purpose of this study was to investigate the effect of health-related vulnerability on shelter operations, and to estimate the burden of chronic disease on community resources following catastrophic events. A comprehensive survey data collection conducted by the United States Public Health Service in 2005 was used to evaluate clinical services for populations with health conditions accommodated by Louisiana temporary disaster shelters. Correlation and multiple regression analyses determined the relationship between shelter characteristics and the factors predicting shelters' needs for short-term assistance. Significant predictors were identified in all three explored domains: structural shelter characteristics (sponsor, interpreter needed); clinical characteristics (access to health providers, clinic on site, staff had no days off); population characteristics (census, compromised mental health alone, or in combination with chronic conditions and diseases with epidemic potential). Shelters sponsored by faith-based organizations were less likely to be in risk of rapid resource depletion. Shelters with large census demonstrated association with the need of short-term assistance to maintain operations, as larger census was positively correlated with large numbers of individuals with vulnerabilities. Combined health-related vulnerability factor (chronic conditions, psycho-social disorders, and epidemic diseases) influenced significantly the risk of resource depletion. This study provides cross-sectional evidence that large concentration of populations with health-related vulnerabilities during disaster recovery phase is associated with increased demand for medical services. Chronic diseases with high prevalence and incidence like psycho-social disorders, diabetes, and cardiovascular conditions diagnosed during screenings could predict the overall burden on the health network.

Calibration of the soil conditioning index (SCI) to soil organic carbon in the southeastern USA

USDA-ARS?s Scientific Manuscript database

Prediction of soil organic C sequestration with adoption of various conservation agricultural management approaches is needed to meet the emerging market for environmental services provided by agricultural land stewardship. The soil conditioning index (SCI) is a relatively simple model used by the ...

Quality of whey powders stored under adverse conditions

USDA-ARS?s Scientific Manuscript database

Whey protein concentrate powder (WPC) is exported by the U.S. and is included in emergency aid foods, but the bags sent overseas are usually stored without refrigeration and under elevated temperature and relative humidity (RH). The shelf life of WPC under adverse conditions must be known to preven...

Maximizing value and minimizing barriers: Patient-centered community consultation for research in emergency settings.

PubMed

Fordyce, Christopher B; Roe, Matthew T; Dickert, Neal W

2017-02-01

Patients with cardiac arrest and other life-threatening emergencies are unable to provide prospective consent for clinical trials. In the United States and other countries, regulations permit an exception from the requirement for informed consent in emergency settings. However, many potential barriers exist, as evidenced by the scarcity of US trials conducted under exception from the requirement for informed consent. One persistent challenge is the requirement that investigators consult communities prior to study approval. To improve the community consultation process for emergency studies under exception from the requirement for informed consent, we propose that prioritizing engagement of individuals who have experienced the condition under study, or are at high risk for the condition, fulfills regulatory goals and represents the interests of potential enrollees and the community without impeding research. Prioritizing patients engages individuals who are more likely to understand the concerns and experiences of study subjects, to appreciate risks and benefits of the study, and to understand the impact of the disease and intervention on patients' lives than are members of the general public. Similarly, those explicitly at high risk are more likely to identify as potential participants and may impart some level of accountability on the investigator. Finally, the most logical community of relevance is defined by a combination of condition-related experience and living in the area where a study will be conducted; geographic and condition-related communities should not be treated as distinct. In this sense, patients, their family members, and individuals at high risk within the catchment area represent the appropriate "community." Exception from the requirement for informed consent regulations have advanced the goal of improving care for emergency conditions, but common interpretations of the community consultation requirement threaten research in the United States. Focusing on the goals of learning from and demonstrating respect for those most directly affected by a study through engaging people most connected to the condition of interest will make community consultation more valuable, better inform institutional review boards, and increase efficiency.

Neurosurgical Emergencies in Sports Neurology.

PubMed

Ban, Vin Shen; Botros, James A; Madden, Christopher J; Batjer, H Hunt

2016-09-01

Athletic neurosurgical emergencies are injuries that can lead to mortality or significant morbidity and require immediate recognition and treatment. This review article discusses the epidemiology of sports-related traumatic brain injury (TBI) with an attempt to quantify the incidence of neurosurgical emergencies in sports. Emergencies such as intracranial hemorrhage, second impact syndrome, vascular injuries, and seizures are discussed. The incidence of sports-related TBI presenting to level I or II trauma centers in the USA is about 10 in 100,000 population per year. About 14 % of the adult sports-related TBIs and 13 % of the pediatric sports-related TBIs were moderate or severe in nature. Patients presenting with headache and neck pain should prompt further investigation for cervical spine and vascular injuries. CT angiography is becoming the modality of choice to screen for blunt cerebrovascular injuries. The treatment of these injuries remains controversial. High-quality evidence in sports-related TBI is lacking. Further research is required to help guide management of this increasingly prevalent condition. The role of prevention and education should also not be underestimated.

Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice.

PubMed

Bjurling-Sjöberg, Petronella; Wadensten, Barbro; Pöder, Ulrika; Jansson, Inger; Nordgren, Lena

2017-03-01

This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was "balancing intertwined responsibilities." In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon's contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.

Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse.

PubMed

Singhal, Astha; Tien, Yu-Yu; Hsia, Renee Y

2016-01-01

Prescription drug abuse is a growing problem nationally. In an effort to curb this problem, emergency physicians might rely on subjective cues such as race-ethnicity, often unknowingly, when prescribing opioids for pain-related complaints, especially for conditions that are often associated with drug-seeking behavior. Previous studies that examined racial-ethnic disparities in opioid dispensing at emergency departments (EDs) did not differentiate between prescriptions at discharge and drug administration in the ED. We examined racial-ethnic disparities in opioid prescription at ED visits for pain-related complaints often associated with drug-seeking behavior and contrasted them with conditions objectively associated with pain. We hypothesized a priori that racial-ethnic disparities will be present among opioid prescriptions for conditions associated with non-medical use, but not for objective pain-related conditions. Using data from the National Hospital Ambulatory Medical Care Survey for 5 years (2007-2011), the odds of opioid prescription during ED visits made by non-elderly adults aged 18-65 for 'non-definitive' conditions (toothache, back pain and abdominal pain) or 'definitive' conditions (long-bone fracture and kidney stones) were modeled. Opioid prescription at discharge and opioid administration at the ED were the primary outcomes. We found significant racial-ethnic disparities, with non-Hispanic Blacks being less likely (adjusted odds ratio ranging from 0.56-0.67, p-value < 0.05) to receive opioid prescription at discharge during ED visits for back pain and abdominal pain, but not for toothache, fractures and kidney stones, compared to non-Hispanic whites after adjusting for other covariates. Differential prescription of opioids by race-ethnicity could lead to widening of existing disparities in health, and may have implications for disproportionate burden of opioid abuse among whites. The findings have important implications for medical provider education to include sensitization exercises towards their inherent biases, to enable them to consciously avoid these biases from defining their practice behavior.

Emergency room visits for respiratory conditions in children increased after Guagua Pichincha volcanic eruptions in April 2000 in Quito, Ecuador Observational Study: Time Series Analysis

PubMed Central

Naumova, Elena N; Yepes, Hugo; Griffiths, Jeffrey K; Sempértegui, Fernando; Khurana, Gauri; Jagai, Jyotsna S; Játiva, Edgar; Estrella, Bertha

2007-01-01

Background This study documented elevated rates of emergency room (ER) visits for acute upper and lower respiratory infections and asthma-related conditions in the children of Quito, Ecuador associated with the eruption of Guagua Pichincha in April of 2000. Methods We abstracted 5169 (43% females) ER records with primary respiratory conditions treated from January 1 – December 27, 2000 and examined the change in pediatric ER visits for respiratory conditions before, during, and after exposure events of April, 2000. We applied a Poisson regression model adapted to time series of cases for three non-overlapping disease categories: acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), and asthma-related conditions in boys and girls for three age groups: 0–4, 5–9, and 10–15 years. Results At the main pediatric medical facility, the Baca Ortiz Pediatric Hospital, the rate of emergency room (ER) visits due to respiratory conditions substantially increased in the three weeks after eruption (RR = 2.22, 95%CI = [1.95, 2.52] and RR = 1.72 95%CI = [1.49, 1.97] for lower and upper respiratory tract infections respectively. The largest impact of eruptions on respiratory distress was observed in children younger than 5 years (RR = 2.21, 95%CI = [1.79, 2.73] and RR = 2.16 95%CI = [1.67, 2.76] in boys and girls respectively). The rate of asthma and asthma-related diagnosis doubled during the period of volcano fumarolic activity (RR = 1.97, 95%CI = [1.19, 3.24]). Overall, 28 days of volcanic activity and ash releases resulted in 345 (95%CI = [241, 460]) additional ER visits due to respiratory conditions. Conclusion The study has demonstrated strong relationship between ash exposure and respiratory effects in children. PMID:17650330

42 CFR 447.90 - FFP: Conditions related to pending investigations of credible allegations of fraud against the...

Code of Federal Regulations, 2014 CFR

2014-10-01

... required by § 455.23 of this chapter unless— (1) The item or service is furnished as an emergency item or service, but not including items or services furnished in an emergency room of a hospital; or (2) The... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Medicaid Premiums and Cost Sharing...

22 CFR 231.14 - Arbitration.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Arbitration. 231.14 Section 231.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.14 - Arbitration.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Arbitration. 231.14 Section 231.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.14 - Arbitration.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Arbitration. 231.14 Section 231.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.14 - Arbitration.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Arbitration. 231.14 Section 231.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.14 - Arbitration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Arbitration. 231.14 Section 231.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

The emergence of complexity in prosody and syntax

PubMed Central

Meir, Irit; Dachkovsky, Svetlana; Padden, Carol; Aronoff, Mark

2011-01-01

The relation between prosody and syntax is investigated here by tracing the emergence of each in a new language, Al-Sayyid Bedouin Sign Language. We analyze the structure of narratives of four signers of this language: two older second generation signers, and two about 15 years younger. We find that younger signers produce prosodic cues to dependency between semantically related constituents, e.g., the two clauses of conditionals, revealing a type and degree of complexity in their language that is not frequent in that of the older pair. In these younger signers, several rhythmic and (facial) intonational cues are aligned at constituent boundaries, indicating the emergence of a grammatical system. There are no overt syntactic markers (such as complementizers) to relate clauses; prosody is the only clue. But this prosodic complexity is matched by syntactic complexity inside propositions in the younger signers, who are more likely to use pronouns as abstract grammatical markers of arguments, and to combine predicates with their arguments within in a constituent. As the prosodic means emerge for identifying constituent types and signaling dependency relations between them, the constituents themselves become increasingly complex. Finally, our study shows that the emergence of grammatical complexity is gradual. PMID:23087486

A review of in-flight emergencies in the ASRS data base

NASA Technical Reports Server (NTRS)

Porter, R. F.

1981-01-01

A series of 154 in-flight emergencies as reported to the Aviation Safety Reporting System are described. The various types of emergencies are examined and an attempt is made to determine the human errors and other factors associated with each incident, as well as the measures taken to resolve the emergency. It is concluded that nearly one half of those emergencies reported were related to failure or malfunction of aircraft subsystems. Of all the emergencies, nearly one quarter were associated with power plant failure. Other frequently encountered emergency types are associated with operation in instrument meteorological conditions without appropriate clearance or qualification, and with low fuel state situations. Human error is prominently featured in many of the incidents, appearing in the actions of pilots and air traffic controllers.

Cardiovascular emergency preparedness in recreation facilities at major US universities: college fitness center emergency readiness.

PubMed

Herbert, William G; Herbert, David L; McInnis, Kyle J; Ribisl, Paul M; Franklin, Barry A; Callahan, Mandy; Hood, Aaron W

2007-01-01

Recent American Heart Association/American College of Sports Medicine (AHA/ACSM) guidelines advocate preparticipation screening, planning, and rehearsal for emergencies and automated external defibrillators in all health/fitness facilities. The authors evaluated adherence to these recommendations at 158 recreational service departments in major US universities (51% response rate for 313 institutions queried). Many made their facilities available to unaffiliated residents, with 39% offering programs for those with special medical conditions. Only 18% performed universal preparticipation screening. Twenty-seven percent reported having 1 or more exercise-related instances of cardiac arrest or sudden cardiac death within the past 5 years. Seventy-three percent had an automated external defibrillator, but only 6% reported using it in an emergency. Almost all had written emergency plans, but only 50% posted their plans, and only 27% performed the recommended quarterly emergency drills. The authors' findings suggest low awareness of and adherence to the AHA/ACSM recommendations for identifying individuals at risk for exercise-related cardiovascular complications and for handling such emergencies in university-based fitness facilities. (

Germination and emergence of annual species and burial depth: Implications for restoration ecology

NASA Astrophysics Data System (ADS)

Limón, Ángeles; Peco, Begoña

2016-02-01

Due to the high content of viable seeds, topsoil is usually spread on ground left bare during railway and motorway construction to facilitate the regeneration of vegetation cover. However, during handling of the topsoil, seeds are often buried deeply and they cannot germinate or the seedlings cannot emerge from depth. This study experimentally explores the predictive value of seed mass for seed germination, mortality and seedling emergence at different burial depths for 13 common annual species in semiarid Mediterranean environments. We separate the effect of burial depth on germination and emergence by means of two experiments. In the germination experiment, five replicates of 20 seeds for each species were buried at depths ranging from 0 to 4 cm under greenhouse conditions. Germinated and empty or rotten seeds were counted after 8 weeks. In the emergence experiment, five replicates of four newly-germinated seeds per species were buried at the same depths under controlled conditions and emergence was recorded after 3 weeks. The effect of burial depth on percentage of germination and seedling emergence was dependent on seed size. Although all species showed a decrease in germination with burial depth, this decrease was greater for small-than large-seeded species. Percentage of emergence was positively related to seed mass but negatively related to burial depth. Seed mortality was higher for small-than large-seeded species, but there was no general effect of burial depth on this variable. Thus, the current practice of spreading 30 cm deep layers of topsoil in post-construction restoration projects is unadvisable. In this restoration scenario, thinner layers of topsoil should be used to achieve the maximum potential of the topsoil for germination and seedling establishment.

Conditions of Living: Queer Youth Suicide, Homonormative Tolerance, and Relative Misery

ERIC Educational Resources Information Center

Cover, Rob

2013-01-01

Despite the increasing social tolerance accorded nonheterosexual persons in many Western countries, queer youth suicide rates remain high. This opens the need to question not only how broad social conditions continue to make lives unlivable for many queer youth but whether queer community formations and representations that emerge within a…

21 CFR 50.24 - Exception from informed consent requirements for emergency research.

Code of Federal Regulations, 2011 CFR

2011-04-01

... their informed consent as a result of their medical condition; (ii) The intervention under investigation... investigation are reasonable in relation to what is known about the medical condition of the potential class of... the exception provided under paragraph (a) of this section or because of other relevant ethical...

The role of energy conditions in f(R) cosmology

NASA Astrophysics Data System (ADS)

Capozziello, S.; Nojiri, S.; Odintsov, S. D.

2018-06-01

Energy conditions can play an important role in defining the cosmological evolution. Specifically acceleration/deceleration of cosmic fluid, as well as the emergence of Big Rip singularities, can be related to the constraints imposed by the energy conditions. Here we discuss this issue for f (R) gravity considering also conformal transformations. Cosmological solutions and equations of state can be classified according to energy conditions. The qualitative change of some energy conditions when transformation from the Jordan frame to the Einstein frame done is also observed.

22 CFR 231.03 - The Guarantee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false The Guarantee. 231.03 Section 231.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.16 - Governing law.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Governing law. 231.16 Section 231.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.16 - Governing law.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Governing law. 231.16 Section 231.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.03 - The Guarantee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false The Guarantee. 231.03 Section 231.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.14 - Arbitration.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Arbitration. 230.14 Section 230.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.14 Arbitration. Any...

22 CFR 231.16 - Governing law.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Governing law. 231.16 Section 231.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.14 - Arbitration.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Arbitration. 230.14 Section 230.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.14 Arbitration. Any...

22 CFR 231.03 - The Guarantee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false The Guarantee. 231.03 Section 231.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.14 - Arbitration.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Arbitration. 230.14 Section 230.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.14 Arbitration. Any...

22 CFR 231.03 - The Guarantee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false The Guarantee. 231.03 Section 231.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.14 - Arbitration.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Arbitration. 230.14 Section 230.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.14 Arbitration. Any...

22 CFR 231.03 - The Guarantee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false The Guarantee. 231.03 Section 231.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 231.16 - Governing law.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Governing law. 231.16 Section 231.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS...

18 CFR 284.264 - Terms and conditions.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF ENERGY OTHER REGULATIONS UNDER THE NATURAL GAS POLICY ACT OF 1978 AND RELATED AUTHORITIES CERTAIN SALES AND TRANSPORTATION OF NATURAL GAS UNDER THE NATURAL GAS POLICY ACT OF 1978 AND RELATED AUTHORITIES Emergency Natural Gas Sale, Transportation, and Exchange Transactions § 284.264 Terms and...

22 CFR 230.14 - Arbitration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Arbitration. 230.14 Section 230.14 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.14 Arbitration. Any...

22 CFR 230.04 - Guarantee eligibility.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Guarantee eligibility. 230.04 Section 230.04 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.04...

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

PubMed Central

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

2016-01-01

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

Comparison of data sources for the surveillance of work injury

PubMed Central

Chambers, Andrea; McLeod, Christopher; Bielecky, Amber; Smith, Peter M

2012-01-01

Objective The objective of this study was to compare the incidence of work-related injury and illness presenting to Ontario emergency departments to the incidence of worker's compensation claims reported to the Ontario Workplace Safety & Insurance Board over the period 2004–2008. Methods Records of work-related injury were obtained from two administrative data sources in Ontario for the period 2004–2008: workers' compensation lost-time claims (N=435 336) and records of non-scheduled emergency department visits where the main problem was attributed to a work-related exposure (N=707 963). Denominator information required to compute the risk of work injury per 2 000 000 work hours, stratified by age and gender was estimated from labour force surveys conducted by Statistics Canada. Results The frequency of emergency department visits for all work-related conditions was approximately 60% greater than the incidence of accepted lost-time compensation claims. When restricted to injuries resulting in fracture or concussion, gender-specific age differences in injury incidence were similar in the two data sources. Between 2004 and 2008, there was a 14.5% reduction in emergency department visits attributed to work-related causes and a 17.8% reduction in lost-time compensation claims. There was evidence that younger workers were more likely than older workers to seek treatment in an emergency department for work-related injury. Conclusions In this setting, emergency department records available for the complete population of Ontario residents are a valid source of surveillance information on the incidence of work-related disorders. Occupational health and safety authorities should give priority to incorporating emergency department records in the routine surveillance of the health of workers. PMID:22267447

Conditional Relations with Compound Abstract Stimuli Using a Go/No-Go Procedure

ERIC Educational Resources Information Center

Debert, Paula; Matos, Maria Amelia; McIlvane, William

2007-01-01

The aim of this study was to evaluate whether emergent conditional relations could be established with a go/no-go procedure using compound abstract stimuli. The procedure was conducted with 6 adult humans. During training, responses emitted in the presence of certain stimulus compounds (A1B1, A2B2, A3B3, B1C1, B2C2, and B3C3) were followed by…

Invasibility of a nutrient-poor pasture through resident and non-resident herbs is controlled by litter, gap size and propagule pressure.

PubMed

Eckstein, R Lutz; Ruch, Diana; Otte, Annette; Donath, Tobias W

2012-01-01

Since inference concerning the relative effects of propagule pressure, biotic interactions, site conditions and species traits on the invasibility of plant communities is limited, we carried out a field experiment to study the role of these factors for absolute and relative seedling emergence in three resident and three non-resident confamilial herb species on a nutrient-poor temperate pasture. We set up a factorial field experiment with two levels each of the factors litter cover (0 and 400 g m(-2)), gap size (0.01 and 0.1 m(2)) and propagule pressure (5 and 50 seeds) and documented soil temperature, soil water content and relative light availability. Recruitment was recorded in spring and autumn 2010 and in spring 2011 to cover initial seedling emergence, establishment after summer drought and final establishment after the first winter. Litter alleviated temperature and moisture conditions and had positive effects on proportional and absolute seedling emergence during all phases of recruitment. Large gaps presented competition-free space with high light availability but showed higher temperature amplitudes and lower soil moisture. Proportional and absolute seedling recruitment was significantly higher in large than in small gaps. In contrast, propagule pressure facilitated absolute seedling emergence but had no effects on proportional emergence or the chance for successful colonisation. Despite significantly higher initial seedling emergence of resident than non-resident species, seed mass and other species-specific traits may be better predictors for idiosyncratic variation in seedling establishment than status. Our data support the fluctuating resource hypothesis and demonstrate that the reserve effect of seeds may facilitate seedling emergence. The direct comparison of propagule pressure with other environmental factors showed that propagule pressure affects absolute seedling abundance, which may be crucial for species that depend on other individuals for sexual reproduction. However, propagule batch size did not significantly affect the chance for successful colonisation of disturbed plots.

22 CFR 230.12 - Prosecution of claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Prosecution of claims. 230.12 Section 230.12 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.12...

22 CFR 230.16 - Governing law.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Governing law. 230.16 Section 230.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.16 Governing law...

22 CFR 230.11 - Subrogation of USAID.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Subrogation of USAID. 230.11 Section 230.11 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.11...

22 CFR 230.03 - The Guarantee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false The Guarantee. 230.03 Section 230.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.03 The Guarantee...

22 CFR 230.13 - Change in agreements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Change in agreements. 230.13 Section 230.13 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.13...

22 CFR 230.16 - Governing law.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Governing law. 230.16 Section 230.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.16 Governing law...

22 CFR 230.12 - Prosecution of claims.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Prosecution of claims. 230.12 Section 230.12 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.12...

22 CFR 230.07 - Fiscal Agent obligations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Fiscal Agent obligations. 230.07 Section 230.07 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.07...

22 CFR 230.13 - Change in agreements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Change in agreements. 230.13 Section 230.13 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.13...

22 CFR 230.11 - Subrogation of USAID.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Subrogation of USAID. 230.11 Section 230.11 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.11...

22 CFR 230.13 - Change in agreements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Change in agreements. 230.13 Section 230.13 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.13...

22 CFR 230.11 - Subrogation of USAID.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Subrogation of USAID. 230.11 Section 230.11 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.11...

22 CFR 230.16 - Governing law.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Governing law. 230.16 Section 230.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.16 Governing law...

22 CFR 230.12 - Prosecution of claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Prosecution of claims. 230.12 Section 230.12 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.12...

22 CFR 230.05 - Non-impairment of the Guarantee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Non-impairment of the Guarantee. 230.05 Section 230.05 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.05 - Non-impairment of the Guarantee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Non-impairment of the Guarantee. 230.05 Section 230.05 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.05 - Non-impairment of the Guarantee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Non-impairment of the Guarantee. 230.05 Section 230.05 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.16 - Governing law.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Governing law. 230.16 Section 230.16 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.16 Governing law...

22 CFR 230.07 - Fiscal Agent obligations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Fiscal Agent obligations. 230.07 Section 230.07 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.07...

22 CFR 230.12 - Prosecution of claims.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Prosecution of claims. 230.12 Section 230.12 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.12...

22 CFR 230.07 - Fiscal Agent obligations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Fiscal Agent obligations. 230.07 Section 230.07 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.07...

22 CFR 230.11 - Subrogation of USAID.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Subrogation of USAID. 230.11 Section 230.11 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.11...

22 CFR 230.03 - The Guarantee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false The Guarantee. 230.03 Section 230.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.03 The Guarantee...

22 CFR 230.05 - Non-impairment of the Guarantee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Non-impairment of the Guarantee. 230.05 Section 230.05 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.03 - The Guarantee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false The Guarantee. 230.03 Section 230.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.03 The Guarantee...

22 CFR 230.03 - The Guarantee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false The Guarantee. 230.03 Section 230.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.03 The Guarantee...

22 CFR 230.07 - Fiscal Agent obligations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Fiscal Agent obligations. 230.07 Section 230.07 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.07...

22 CFR 230.13 - Change in agreements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Change in agreements. 230.13 Section 230.13 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.13...

Using FEMA FIS, HAZUS and WMOST to Evaluate Effectiveness of GI in Moderating Flood-Related Risks

EPA Science Inventory

The ability to accurately assess flood-related risks and costs as well as the effectiveness of green infrastructure on moderating those risks is critical for both emergency management and long-term planning. Potential flooding depths, land use and building conditions are needed ...

22 CFR 230.12 - Prosecution of claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Prosecution of claims. 230.12 Section 230.12 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.12...

22 CFR 230.05 - Non-impairment of the Guarantee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Non-impairment of the Guarantee. 230.05 Section 230.05 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS...

22 CFR 230.07 - Fiscal Agent obligations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fiscal Agent obligations. 230.07 Section 230.07 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.07...

22 CFR 230.11 - Subrogation of USAID.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Subrogation of USAID. 230.11 Section 230.11 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.11...

22 CFR 230.13 - Change in agreements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Change in agreements. 230.13 Section 230.13 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.13...

22 CFR 230.03 - The Guarantee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false The Guarantee. 230.03 Section 230.03 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.03 The Guarantee...

Oncological emergencies: clinical importance and principles of management.

PubMed

Samphao, S; Eremin, J M; Eremin, O

2010-11-01

Oncological emergencies are common conditions associated with significant morbidity and mortality. Delay in diagnosis and treatment can result in unfavourable outcomes. Cancer itself, cancer-related hormones or cytokines, or treatment effects can cause emergency problems. Febrile neutropaenia, frequently associated with chemotherapy, can lead to life-threatening conditions. Treatment requires systematic evaluation and early empirical antibiotics. Hypercalcaemia of malignancy is the most common metabolic emergency in cancer patients. Non-specific clinical features may cause delay in diagnosis and increase morbidity and mortality. Treatment includes active fluid resuscitation, diuretics and intravenous bisphosphonates. Superior vena cava syndrome is usually caused by external compression. Computerised tomography is useful to confirm diagnosis, evaluate the extent of disease and guide invasive tissue diagnosis. Treatment and prognosis depend on the underlying malignancies. Spinal cord compression is a true emergency due to risk of permanent neurological impairment. Localised back pain is the most common presenting symptom while late presentation of neurological deficit is associated with irreversible outcomes. Magnetic resonance imaging is the investigation of choice. Treatment includes corticosteroids, radiotherapy and/or decompressive surgery. © 2009 The Authors. European Journal of Cancer Care © 2009 Blackwell Publishing Ltd.

Travel distance and sociodemographic correlates of potentially avoidable emergency department visits in California, 2006-2010: an observational study.

PubMed

Chen, Brian K; Hibbert, James; Cheng, Xi; Bennett, Kevin

2015-03-21

Use of the hospital emergency department (ED) for medical conditions not likely to require immediate treatment is a controversial topic. It has been faulted for ED overcrowding, increased expenditures, and decreased quality of care. On the other hand, such avoidable ED utilization may be a manifestation of barriers to primary care access. A random 10% subsample of all ED visits with unmasked variables, or approximately 7.2% of all ED visits in California between 2006 and 2010 are used in the analysis. Using panel data methods, we employ linear probability and fractional probit models with hospital fixed effects to analyze the associations between avoidable ED utilization in California and observable patient characteristics. We also test whether shorter estimated road distances to the hospital ED are correlated with non-urgent ED utilization, as defined by the New York University ED Algorithm. We then investigate whether proximity of a Federally Qualified Health Center (FQHC) is correlated with reductions in non-urgent ED utilization among Medicaid patients. We find that relative to the reference group of adults aged 35-64, younger patients generally have higher scores for non-urgent conditions and lower scores for urgent conditions. However, elderly patients (≥65) use the ED for conditions more likely to be urgent. Relative to male and white patients, respectively, female patients and all identified racial and ethnic minorities use the ED for conditions more likely to be non-urgent. Patients with non-commercial insurance coverage also use the ED for conditions more likely to be non-urgent. Medicare and Medicaid patients who live closer to the hospital ED have higher probability scores for non-emergent visits. However, among Medicaid enrollees, those who live in zip codes with an FQHC within 0.5 mile of the zip code population centroid visit the ED for medical conditions less likely to be non-emergent. These patterns of ED utilization point to potential barriers to care among historically vulnerable groups, observable even when using rough estimates of travel distances and avoidable ED utilization.

14 CFR 23.562 - Emergency landing dynamic conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Emergency Landing Conditions § 23.562 Emergency landing dynamic conditions. (a) Each seat/restraint system... dynamic tests conducted in accordance with paragraph (b) of this section: (1) The seat/restraint system... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Emergency landing dynamic conditions. 23...

Cognate status and cross-script translation priming.

PubMed

Voga, Madeleine; Grainger, Jonathan

2007-07-01

Greek-French bilinguals were tested in three masked priming experiments with Greek primes and French targets. Related primes were the translation equivalents of target words, morphologically related to targets, or phonologically related to targets. In Experiment 1, cognate translation equivalents (phonologically similar translations) showed facilitatory priming, relative to matched phonologically related primes, in conditions in which morphologically related primes showed no effect (50-msec prime exposure). Cross-language morphological priming emerged at longer prime exposure durations (66 msec), but cognate primes continued to generate more priming than did those in the morphological condition. In Experiments 2 and 3, the level of phonological overlap across translation equivalents was varied, and priming effects were measured against those for matched phonologically related primes and those in an unrelated prime condition. When measured against the unrelated baseline, cognate primes showed the typical advantage over noncognate primes. However, this cognate advantage disappeared when priming was measured against the phonologically related prime condition. The results are discussed in terms of how translation equivalents are represented in bilingual memory.

Emergency Medicine and the Underage Athlete

PubMed Central

Martin, David E.

1994-01-01

Most high school and some collegiate athletes are legal minors. In civil matters, the law treats minors (usually individuals under the age of 18 years) uniquely. Limitations exist on a minor's ability to enter into contracts, make determinations regarding medical care, and bear responsibility for personal actions. Medical professionals are often unclear on matters relating to the provision of medical care to minors. The purpose of this discourse is to present selected legal issues in the context of two fictional case studies. Case 1 presents issues regarding the definition of emergency medical conditions and the related emergency medical doctrine. Case 2 provides an example of an acute medical concern which fails to fall under emergency medical classification but rather provides a context for discussing the mature minor doctrine. Both cases are analyzed in light of these doctrines in addition to other pertinent legal considerations. PMID:16558280

Electric Power Load Analysis (EPLA) for Surface Ships

DTIC Science & Technology

2012-09-17

112 - Shipping: Emergency Lighting And Power Systems (Copies of this document are available from the Superintendent of Documents, U.S. Government...number of (dry bulb ) temperature/relative humidity ambient conditions and an associated percentage of time the ship is spent operating in the particular...propulsion cannot be otherwise restored in less than 2 minutes. c. Machinery space class W and circle W ventilation. d. Emergency lighting . DDS 310-1

Patterns of cooperation during collective emergencies in the help-or-escape social dilemma

PubMed Central

Moussaïd, Mehdi; Trauernicht, Mareike

2016-01-01

Although cooperation is central to the organisation of many social systems, relatively little is known about cooperation in situations of collective emergency. When groups of people flee from a danger such as a burning building or a terrorist attack, the collective benefit of cooperation is important, but the cost of helping is high and the temptation to defect is strong. To explore the degree of cooperation in emergencies, we develop a new social game, the help-or-escape social dilemma. Under time and monetary pressure, players decide how much risk they are willing to take in order to help others. Results indicated that players took as much risk to help others during emergencies as they did under normal conditions. In both conditions, most players applied an egalitarian heuristic and helped others until their chance of success equalled that of the group. This strategy is less efficient during emergencies, however, because the increased time pressure results in fewer people helped. Furthermore, emergencies tend to amplify participants’ initial tendency to cooperate, with prosocials becoming even more cooperative and individualists becoming even more selfish. Our framework offers new opportunities to study human cooperation and could help authorities to better manage crowd behaviours during mass emergencies. PMID:27629920

Studies of planning behavior of aircraft pilots in normal, abnormal, and emergency situations

NASA Technical Reports Server (NTRS)

Johannsen, G.; Rouse, W. B.; Hillmann, K.

1981-01-01

A methodology for the study of human planning behavior in complex dynamic systems is presented and applied to the study of aircraft pilot behavior in normal, abnormal and emergency situations. The method measures the depth of planning, that is the level of detail employed with respect to a specific task, according to responses to a verbal questionnaire, and compares planning depth with variables relating to time, task criticality and the probability of increased task difficulty. In two series of experiments, depth of planning was measured on a five- or ten-point scale during various phases of flight in a HFB-320 simulator under normal flight conditions, abnormal scenarios involving temporary runway closure due to snow removal or temporary CAT-III conditions due to a dense fog, and emergency scenarios involving engine shut-down or hydraulic pressure loss. Results reveal a dichotomy between event-driven and time-driven planning, different effects of automation in abnormal and emergency scenarios and a low correlation between depth of planning and workload or flight performance.

Contextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies.

PubMed

McRobert, Allistair Paul; Causer, Joe; Vassiliadis, John; Watterson, Leonie; Kwan, James; Williams, Mark A

2013-06-01

It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. Skilled (n=9) and less skilled (n=9) emergency medicine physicians responded to high-fidelity simulated scenarios under high- and low-context information conditions. Skilled physicians demonstrated higher diagnostic accuracy irrespective of condition, and were less affected by the removal of context-specific information compared with less skilled physicians. The skilled physicians generated more options, and selected better quality options during diagnostic reasoning compared with less skilled counterparts. These cognitive processes were active irrespective of the level of context-specific information presented, although high-context information enhanced understanding of the patients' symptoms resulting in higher diagnostic accuracy. Our findings have implications for scenario design and the manipulation of contextual information during simulation training.

Emergency Management of Tension Pneumothorax for Health Professionals on Remote Cat Island Bahamas

PubMed Central

Parsons, Michael; Francis, Leathe; Senoro, Cristian; Chriswell, Caroline; Saunders, Rose; Hollander, Charles

2017-01-01

Patients living in remote areas have higher rates of injury-related death than those living in cities. Rural and remote health professionals working in sparsely populated places, such as Cat Island Bahamas, may have scant resources for treating emergency conditions. Local health professionals must be prepared to rely solely upon clinical judgment to perform emergency “high-stakes low-frequency” procedures while also accurately and effectively communicating with distantly located receiving specialists. However, these health providers may not recently have performed or had the opportunity to practice such emergency procedures. Telesimulation may be a useful way to teach remote practitioners both emergency procedures and communication skills. This technical report describes a simulation exercise for teaching these skills. PMID:28775930

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

PubMed

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

2016-11-01

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

Weather conditions may worsen symptoms in rheumatoid arthritis patients: the possible effect of temperature.

PubMed

Abasolo, Lydia; Tobías, Aurelio; Leon, Leticia; Carmona, Loreto; Fernandez-Rueda, Jose Luis; Rodriguez, Ana Belen; Fernandez-Gutierrez, Benjamin; Jover, Juan Angel

2013-01-01

Patients with rheumatoid arthritis (RA) complain that weather conditions aggravate their symptoms. We investigated the short-term effects of weather conditions on worsening of RA and determined possible seasonal fluctuations. We conducted a case-crossover study in Madrid, Spain. Daily cases of RA flares were collected from the emergency room of a tertiary level hospital between 2004 and 2007. 245 RA patients who visited the emergency room 306 times due to RA related complaints as the main diagnostic reason were included in the study. Patients from 50 to 65 years old were 16% more likely to present a flare with lower mean temperatures. Our results support the belief that weather influences rheumatic pain in middle aged patients. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Emergency department utilization among Medicaid beneficiaries with schizophrenia and diabetes: The consequences of increasing medical complexity

PubMed Central

Shim, Ruth S.; Druss, Benjamin G.; Zhang, Shun; Kim, Giyeon; Oderinde, Adesoji; Shoyinka, Sosunmolu; Rust, George

2014-01-01

Objective Individuals with both physical and mental health problems may have elevated levels of emergency department (ED) service utilization either for index conditions or for associated comorbidities. This study examines the use of ED services by Medicaid beneficiaries with comorbid diabetes and schizophrenia, a dyad with particularly high levels of clinical complexity. Methods Retrospective cohort analysis of claims data for Medicaid beneficiaries with both schizophrenia and diabetes from fourteen Southern states was compared with patients with diabetes only, schizophrenia only, and patients with any diagnosis other than schizophrenia and diabetes. Key outcome variables for individuals with comorbid schizophrenia and diabetes were ED visits for diabetes, mental health-related conditions, and other causes. Results Medicaid patients with comorbid diabetes and schizophrenia had an average number of 7.5 ED visits per year, compared to the sample Medicaid population with neither diabetes nor schizophrenia (1.9 ED visits per year), diabetes only (4.7 ED visits per year), and schizophrenia only (5.3 ED visits per year). Greater numbers of comorbidities (over and above diabetes and schizophrenia) were associated with substantial increases in diabetes-related, mental health-related and all-cause ED visits. Most ED visits in all patients, but especially in patients with more comorbidities, were for causes other than diabetes or mental health-related conditions. Conclusion Most ED utilization by individuals with diabetes and schizophrenia is for increasing numbers of comorbidities rather than the index conditions. Improving care in this population will require management of both index conditions as well as comorbid ones. PMID:24380780

Stress and reward processing in bipolar disorder: an fMRI study

PubMed Central

Berghorst, Lisa H; Kumar, Poornima; Greve, Doug N; Deckersbach, Thilo; Ongur, Dost; Dutra, Sunny; Pizzagalli, Diego A

2016-01-01

Objectives A link between negative life stress and the onset of mood episodes in bipolar disorder (BD) has been established, but processes underlying such a link remain unclear. Growing evidence suggests that stress can negatively affect reward processing and related neurobiological substrates, indicating that a dysregulated reward system may provide a partial explanation. The aim of this study was to test the impact of stress on reward-related neural functioning in BD. Methods Thirteen euthymic or mildly depressed individuals with BD and 15 controls performed a Monetary Incentive Delay task while undergoing functional magnetic resonance imaging during no-stress and stress (negative psychosocial stressor involving poor performance feedback and threat of monetary deductions) conditions. Results In hypothesis-driven region-of- interest-based analyses, a significant group by condition interaction emerged in the amygdala during reward anticipation. Relative to controls, while anticipating a potential reward, subjects with BD were characterized by amygdalar hyperactivation in the no-stress condition but hypoactivation during stress. Moreover, relative to controls, subjects with BD had significantly larger amygdala volumes. After controlling for structural differences, the effects of stress on amygdalar function remained, whereas groups no longer differed during the no-stress condition. During reward consumption, a group by condition interaction emerged in the putamen due to increased putamen activation to rewards in participants with BD during stress, but an opposite pattern in controls. Conclusions Overall, findings highlight possible impairments in using reward-predicting cues to adaptively engage in goal-directed actions in BD, combined with stress-induced hypersensitivity to reward consumption. Potential clinical implications are discussed. PMID:27870507

Event-related potential correlates of emergent inference in human arbitrary relational learning.

PubMed

Wang, Ting; Dymond, Simon

2013-01-01

Two experiments investigated the functional-anatomical correlates of cognition supporting untrained, emergent relational inference in a stimulus equivalence task. In Experiment 1, after learning a series of conditional relations involving words and pseudowords, participants performed a relatedness task during which EEG was recorded. Behavioural performance was faster and more accurate on untrained, indirectly related symmetry (i.e., learn AB and infer BA) and equivalence trials (i.e., learn AB and AC and infer CB) than on unrelated trials, regardless of whether or not a formal test for stimulus equivalence relations had been conducted. Consistent with previous results, event related potentials (ERPs) evoked by trained and emergent trials at parietal and occipital sites differed only for those participants who had not received a prior equivalence test. Experiment 2 further replicated and extended these behavioural and ERP findings using arbitrary symbols as stimuli and demonstrated time and frequency differences for trained and untrained relatedness trials. Overall, the findings demonstrate convincingly the ERP correlates of intra-experimentally established stimulus equivalence relations consisting entirely of arbitrary symbols and offer support for a contemporary cognitive-behavioural model of symbolic categorisation and relational inference. Copyright © 2012 Elsevier B.V. All rights reserved.

Emergency Procedures for the Strength and Conditioning Coach.

ERIC Educational Resources Information Center

Binkley, Helen M.; Williams, Lauren C.

2003-01-01

Presents suggested actions for strength and conditioning coaches to take when an emergency arises, focusing on: athlete collapse; thermoregulatory conditions (heat illness and cold illness and their prevention); asthma/bronchospasm and prevention of asthma/bronchospasm emergencies; diabetes and prevention of diabetic emergencies; and…

Impact of meteorological parameters and air pollution on emergency department visits for cardiovascular diseases in the city of Zagreb, Croatia.

PubMed

Pintarić, Sanja; Zeljković, Ivan; Pehnec, Gordana; Nesek, Višnja; Vrsalović, Mislav; Pintarić, Hrvoje

2016-09-01

The aim of this study was to investigate whether nitrogen dioxide (NO2), ozone (O3), and certain meteorological conditions had an impact on cardiovascular disease (CVD)-related emergency department (ED) visits in the metropolitan area of Zagreb. This retrospective, ecological study included 20,228 patients with a cardiovascular disease as their primary diagnosis who were examined in the EDs of two Croatian University Hospitals, Sisters of Charity and Holy Spirit, in the study period July 2008-June 2010. The median of daily CVD-related ED visits during the study period was 28 and was the highest during winter. A significant negative correlation was found between CVD-related emergency visits and air temperature measured no more than three days prior to the visit, and the highest negative correlation coefficient was measured two days earlier (R=0.266, p≤0.001). The number of CVD-related emergency visits significantly correlated with the average NO2 concentration on the same day (R=0.191, p<0.001). The results of multiple stepwise regression analysis showed that the number of CVD-related emergency visits depended on air temperature, and NO2 and O3 concentrations. The higher the air temperatures, the lower the number of daily CVD-related emergency visits (p<0.001). An increase in NO2 concentrations (p=0.005) and a decrease in O3 concentrations of two days earlier (p=0.006) led to an increase in CVD-related ED visits. In conclusion, the decrease in O3 concentrations and the increase in NO2, even if below the legally binding thresholds, could be associated with an increase in CVD-related emergency visits and a similar effect was observed with lower temperature measured no more than three days prior to the visit.

Summer indoor heat exposure and respiratory and cardiovascular distress calls in New York City, NY, U.S

PubMed Central

Uejio, C. K.; Tamerius, J. D.; Vredenburg, J.; Asaeda, G.; Isaacs, D. A.; Braun, J.; Quinn, A.; Freese, J. P.

2016-01-01

Most extreme heat studies relate outdoor weather conditions to human morbidity and mortality. In developed nations, individuals spend ~90% of their time indoors. This pilot study investigated the indoor environments of people receiving emergency medical care in New York City, NY, U.S., from July to August 2013. The first objective was to determine the relative influence of outdoor conditions as well as patient characteristics and neighborhood sociodemographics on indoor temperature and specific humidity (N = 764). The second objective was to determine whether cardiovascular or respiratory cases experience hotter and more humid indoor conditions as compared to controls. Paramedics carried portable sensors into buildings where patients received care to passively monitor indoor temperature and humidity. The case–control study compared 338 respiratory cases, 291 cardiovascular cases, and 471 controls. Intuitively, warmer and sunnier outdoor conditions increased indoor temperatures. Older patients who received emergency care tended to occupy warmer buildings. Indoor-specific humidity levels quickly adjusted to outdoor conditions. Indoor heat and humidity exposure above a 26 °C threshold increased (OR: 1.63, 95% CI: 0.98–2.68, P = 0.056), but not significantly, the proportion of respiratory cases. Indoor heat exposures were similar between cardiovascular cases and controls. PMID:26086869

Emergencies in motoneuron disease.

PubMed

Finsterer, Josef; Stöllberger, Claudia

2017-08-01

Genetic and acquired motor-neuron-disorders (MNDs) may undergo acute deterioration resulting in various emergency situations. This literature review aims at summarising and discussing current knowledge about emergencies in MNDs. Emergencies that have been reported in MND patients include: respiratory, bulbar, cardiac, septic, epileptic, psychiatric, pain-related, and traumatic emergencies. Emergencies due to respiratory insufficiency have the strongest impact on morbidity and mortality in MNDs. To optimise the management of emergencies in MNDs, it is recommended to discuss these topics with the patient prior to their occurrence. After informed consent, patients may indicate their decision by signing an advance directive as to how such emergencies should be managed in case they arise. Generally, treatment of emergencies in MNDs is not at variance from treatment of similar emergencies due to other causes, but some peculiarities need to be pointed out. It is concluded that patients with MNDs may experience various emergencies during the disease course. Management of these conditions should be discussed with the patient prior to their appearance. Management of these emergencies follows general guidelines, which widely vary between countries, and depend on the availability of a patient's advance directive.

Negative blood oxygen level dependent signals during speech comprehension.

PubMed

Rodriguez Moreno, Diana; Schiff, Nicholas D; Hirsch, Joy

2015-05-01

Speech comprehension studies have generally focused on the isolation and function of regions with positive blood oxygen level dependent (BOLD) signals with respect to a resting baseline. Although regions with negative BOLD signals in comparison to a resting baseline have been reported in language-related tasks, their relationship to regions of positive signals is not fully appreciated. Based on the emerging notion that the negative signals may represent an active function in language tasks, the authors test the hypothesis that negative BOLD signals during receptive language are more associated with comprehension than content-free versions of the same stimuli. Regions associated with comprehension of speech were isolated by comparing responses to passive listening to natural speech to two incomprehensible versions of the same speech: one that was digitally time reversed and one that was muffled by removal of high frequencies. The signal polarity was determined by comparing the BOLD signal during each speech condition to the BOLD signal during a resting baseline. As expected, stimulation-induced positive signals relative to resting baseline were observed in the canonical language areas with varying signal amplitudes for each condition. Negative BOLD responses relative to resting baseline were observed primarily in frontoparietal regions and were specific to the natural speech condition. However, the BOLD signal remained indistinguishable from baseline for the unintelligible speech conditions. Variations in connectivity between brain regions with positive and negative signals were also specifically related to the comprehension of natural speech. These observations of anticorrelated signals related to speech comprehension are consistent with emerging models of cooperative roles represented by BOLD signals of opposite polarity.

Negative Blood Oxygen Level Dependent Signals During Speech Comprehension

PubMed Central

Rodriguez Moreno, Diana; Schiff, Nicholas D.

2015-01-01

Abstract Speech comprehension studies have generally focused on the isolation and function of regions with positive blood oxygen level dependent (BOLD) signals with respect to a resting baseline. Although regions with negative BOLD signals in comparison to a resting baseline have been reported in language-related tasks, their relationship to regions of positive signals is not fully appreciated. Based on the emerging notion that the negative signals may represent an active function in language tasks, the authors test the hypothesis that negative BOLD signals during receptive language are more associated with comprehension than content-free versions of the same stimuli. Regions associated with comprehension of speech were isolated by comparing responses to passive listening to natural speech to two incomprehensible versions of the same speech: one that was digitally time reversed and one that was muffled by removal of high frequencies. The signal polarity was determined by comparing the BOLD signal during each speech condition to the BOLD signal during a resting baseline. As expected, stimulation-induced positive signals relative to resting baseline were observed in the canonical language areas with varying signal amplitudes for each condition. Negative BOLD responses relative to resting baseline were observed primarily in frontoparietal regions and were specific to the natural speech condition. However, the BOLD signal remained indistinguishable from baseline for the unintelligible speech conditions. Variations in connectivity between brain regions with positive and negative signals were also specifically related to the comprehension of natural speech. These observations of anticorrelated signals related to speech comprehension are consistent with emerging models of cooperative roles represented by BOLD signals of opposite polarity. PMID:25412406

eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients' and Health Care Providers' Use of Health-Related Internet Information.

PubMed

Townsend, Anne; Leese, Jenny; Adam, Paul; McDonald, Michael; Li, Linda C; Kerr, Sheila; Backman, Catherine L

2015-06-22

The rapid explosion in online digital health resources is seen as transformational, accelerating the shift from traditionally passive patients to patients as partners and altering the patient-health care professional (HCP) relationship. Patients with chronic conditions are increasingly engaged, enabled, and empowered to be partners in their care and encouraged to take responsibility for managing their conditions with HCP support. In this paper, we focus on patients' and HCPs' use of health-related Internet information and how it influences the patient-HCP relationship. In particular, we examine the challenges emerging in medical encounters as roles and relationships shift and apply a conceptual framework of relational ethics to examine explicit and nuanced ethical dimensions emerging in patient-HCP interactions as both parties make increased use of health-related Internet information. We purposively sampled patients and HCPs in British Columbia, Canada, to participate in focus groups. To be eligible, patients self-reported a diagnosis of arthritis and at least one other chronic health condition; HCPs reported a caseload with >25% of patients with arthritis and multimorbidity. We used a semistructured, but flexible, discussion guide. All discussions were audiotaped and transcribed verbatim. Elements of grounded theory guided our constant comparison thematic analytic approach. Analysis was iterative. A relational ethics conceptual lens was applied to the data. We recruited 32 participants (18 patients, 14 HCPs). They attended seven focus groups: four with patients and three with rehabilitation professionals and physicians. Predominant themes to emerge were how use of health-related Internet information fostered (1) changing roles, (2) patient-HCP partnerships, and (3) tensions and burdens for patients and HCPs. Relational aspects such as mutual trust, uncertainty, and vulnerability are illuminated in patient-HCP interactions around health-related Internet information and the negotiated space of clinical encounters. New roles and associated responsibilities have key ethical dimensions that make clear the changes are fundamental and important to understand in ethical care. When faced with tensions and burdens around incorporating health-related Internet information as a resource in clinical encounters, participants described a particular ambivalence illustrating the fundamental changes being negotiated by both patients and HCPs.

Real Time Flood Alert System (RTFAS) for Puerto Rico

USGS Publications Warehouse

Lopez-Trujillo, Dianne

2010-01-01

The Real Time Flood Alert System is a web-based computer program, developed as a data integration tool, and designed to increase the ability of emergency managers to rapidly and accurately predict flooding conditions of streams in Puerto Rico. The system includes software and a relational database to determine the spatial and temporal distribution of rainfall, water levels in streams and reservoirs, and associated storms to determine hazardous and potential flood conditions. The computer program was developed as part of a cooperative agreement between the U.S. Geological Survey Caribbean Water Science Center and the Puerto Rico Emergency Management Agency, and integrates information collected and processed by these two agencies and the National Weather Service.

Spectrum of migraine variants and beyond: The individual syndromes in children.

PubMed

Gupta, Surya N; Gupta, Vikash S; Borad, Nirali

2016-01-01

"Migraine-related conditions" are probably the second most common condition after seizure encountered in pediatric neurology requiring frequent Emergency Department visits. Among migraines, migraine-related condition presents with an acute onset sign or symptom other than headache or visual aura of unknown etiology. A delay in diagnosis is a common occurrence. Previously, the authors proposed a common clinical profile and suggested that the future review should seek the applicability of the common profile in aid to clinical diagnosis of migraine-related individual syndromes. Authors describe the clinical characteristics and differential diagnosis of the spectrum of migraine variants and beyond in children. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Emergency material allocation and scheduling for the application to chemical contingency spills under multiple scenarios.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Wang, Peng

2017-01-01

In the emergency management relevant to chemical contingency spills, efficiency emergency rescue can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, an emergency material scheduling model (EMSM) with time-effective and cost-effective objectives is developed to coordinate both allocation and scheduling of the emergency materials. Meanwhile, an improved genetic algorithm (IGA) which includes a revision operation for EMSM is proposed to identify the emergency material scheduling schemes. Then, scenario analysis is used to evaluate optimal emergency rescue scheme under different emergency pollution conditions associated with different threat degrees based on analytic hierarchy process (AHP) method. The whole framework is then applied to a computational experiment based on south-to-north water transfer project in China. The results demonstrate that the developed method not only could guarantee the implementation of the emergency rescue to satisfy the requirements of chemical contingency spills but also help decision makers identify appropriate emergency material scheduling schemes in a balance between time-effective and cost-effective objectives.

Developmental emergence of fear/threat learning: neurobiology, associations and timing

PubMed Central

Tallot, L.; Doyère, V.; Sullivan, R. M.

2016-01-01

Pavlovian fear or threat conditioning, where a neutral stimulus takes on aversive properties through pairing with an aversive stimulus, has been an important tool for exploring the neurobiology of learning. In the past decades, this neurobehavioral approach has been expanded to include the developing infant. Indeed, protracted postnatal brain development permits the exploration of how incorporating the amygdala, prefrontal cortex and hippocampus into this learning system impacts the acquisition and expression of aversive conditioning. Here, we review the developmental trajectory of these key brain areas involved in aversive conditioning and relate it to pups’ transition to independence through weaning. Overall, the data suggests that adult-like features of threat learning emerge as the relevant brain areas become incorporated into this learning. Specifically, the developmental emergence of the amygdala permits cue learning and the emergence of the hippocampus permits context learning. We also describe unique features of learning in early life that block threat learning and enhance interaction with the mother or exploration of the environment. Finally, we describe the development of a sense of time within this learning and its involvement in creating associations. Together these data suggest that the development of threat learning is a useful tool for dissecting adult-like functioning of brain circuits, as well as providing unique insights into ecologically relevant developmental changes. PMID:26534899

Comparative chronic toxicity of imidacloprid, clothianidin, and thiamethoxam to Chironomus dilutus and estimation of toxic equivalency factors.

PubMed

Cavallaro, Michael C; Morrissey, Christy A; Headley, John V; Peru, Kerry M; Liber, Karsten

2017-02-01

Nontarget aquatic insects are susceptible to chronic neonicotinoid insecticide exposure during the early stages of development from repeated runoff events and prolonged persistence of these chemicals. Investigations on the chronic toxicity of neonicotinoids to aquatic invertebrates have been limited to a few species and under different laboratory conditions that often preclude direct comparisons of the relative toxicity of different compounds. In the present study, full life-cycle toxicity tests using Chironomus dilutus were performed to compare the toxicity of 3 commonly used neonicotinoids: imidacloprid, clothianidin, and thiamethoxam. Test conditions followed a static-renewal exposure protocol in which lethal and sublethal endpoints were assessed on days 14 and 40. Reduced emergence success, advanced emergence timing, and male-biased sex ratios were sensitive responses to low-level neonicotinoid exposure. The 14-d median lethal concentrations for imidacloprid, clothianidin, and thiamethoxam were 1.52 μg/L, 2.41 μg/L, and 23.60 μg/L, respectively. The 40-d median effect concentrations (emergence) for imidacloprid, clothianidin, and thiamethoxam were 0.39 μg/L, 0.28 μg/L, and 4.13 μg/L, respectively. Toxic equivalence relative to imidacloprid was estimated through a 3-point response average of equivalencies calculated at 20%, 50%, and 90% lethal and effect concentrations. Relative to imidacloprid (toxic equivalency factor [TEF] = 1.0), chronic (lethality) 14-d TEFs for clothianidin and thiamethoxam were 1.05 and 0.14, respectively, and chronic (emergence inhibition) 40-d TEFs were 1.62 and 0.11, respectively. These population-relevant endpoints and TEFs suggest that imidacloprid and clothianidin exert comparable chronic toxicity to C. dilutus, whereas thiamethoxam induced comparable effects only at concentrations an order of magnitude higher. However, the authors caution that under field conditions, thiamethoxam readily degrades to clothianidin, thereby likely enhancing toxicity. Environ Toxicol Chem 2017;36:372-382. © 2016 SETAC. © 2016 SETAC.

Copayment and recommended strategies to mitigate its impacts on access to emergency medical services under universal health coverage: a case study from Thailand.

PubMed

Suriyawongpaisal, Paibul; Aekplakorn, Wichai; Srithamrongsawat, Samrit; Srithongchai, Chaisit; Prasitsiriphon, Orawan; Tansirisithikul, Rassamee

2016-10-21

Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk of delayed treatment leading to avoidable disability or death. Using mixed-methods approach to draw evidence from multiple sources (over 40,000 records of administrative dataset of Thai emergency medical services, in-depth interviews, telephone survey of users and documentary review), we are were able to shed light on the existence of copayment and its related factors in the Thai healthcare system despite the presence of universal health coverage since 2001. The copayment poses a barrier of access to emergency care delivered by private hospitals despite the policy proclaiming free access and payment. The copayment differentially affects beneficiaries of the major 3 public-health insurance schemes hence inducing inequity of access. We have identified 6 drivers of the copayment i.e., 1) perceived under payment, 2) unclear operational definitions of emergency conditions or 3) lack of criteria to justify inter-hospital transfer after the first 72 h of admission, 4) limited understanding by the service users of the policy-directed benefits, 5) weak regulatory mechanism as indicated by lack of information systems to trace private provider's practices, and 6) ineffective arrangements for inter-hospital transfer. With demand-side perspectives, we addressed the reasons for bypassing gatekeepers or assigned local hospitals. These are the perception of inferior quality of care and age-related tendency to use emergency department, which indicate a deficit in the current healthcare systems under universal health coverage. Finally, we have discussed strategies to address these potential drivers of copayment and needs for further studies.

Emergent cosmology revisited

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

Bag, Satadru; Sahni, Varun; Shtanov, Yuri

We explore the possibility of emergent cosmology using the effective potential formalism. We discover new models of emergent cosmology which satisfy the constraints posed by the cosmic microwave background (CMB). We demonstrate that, within the framework of modified gravity, the emergent scenario can arise in a universe which is spatially open/closed. By contrast, in general relativity (GR) emergent cosmology arises from a spatially closed past-eternal Einstein Static Universe (ESU). In GR the ESU is unstable, which creates fine tuning problems for emergent cosmology. However, modified gravity models including Braneworld models, Loop Quantum Cosmology (LQC) and Asymptotically Free Gravity result inmore » a stable ESU. Consequently, in these models emergent cosmology arises from a larger class of initial conditions including those in which the universe eternally oscillates about the ESU fixed point. We demonstrate that such an oscillating universe is necessarily accompanied by graviton production. For a large region in parameter space graviton production is enhanced through a parametric resonance, casting serious doubts as to whether this emergent scenario can be past-eternal.« less

Maximizing oyster-reef growth supports green infrastructure with accelerating sea-level rise.

PubMed

Ridge, Justin T; Rodriguez, Antonio B; Joel Fodrie, F; Lindquist, Niels L; Brodeur, Michelle C; Coleman, Sara E; Grabowski, Jonathan H; Theuerkauf, Ethan J

2015-10-07

Within intertidal communities, aerial exposure (emergence during the tidal cycle) generates strong vertical zonation patterns with distinct growth boundaries regulated by physiological and external stressors. Forecasted accelerations in sea-level rise (SLR) will shift the position of these critical boundaries in ways we cannot yet fully predict, but landward migration will be impaired by coastal development, amplifying the importance of foundation species' ability to maintain their position relative to rising sea levels via vertical growth. Here we show the effects of emergence on vertical oyster-reef growth by determining the conditions at which intertidal reefs thrive and the sharp boundaries where reefs fail, which shift with changes in sea level. We found that oyster reef growth is unimodal relative to emergence, with greatest growth rates occurring between 20-40% exposure, and zero-growth boundaries at 10% and 55% exposures. Notably, along the lower growth boundary (10%), increased rates of SLR would outpace reef accretion, thereby reducing the depth range of substrate suitable for reef maintenance and formation, and exacerbating habitat loss along developed shorelines. Our results identify where, within intertidal areas, constructed or natural oyster reefs will persist and function best as green infrastructure to enhance coastal resiliency under conditions of accelerating SLR.

Causes and consequences of occupational stress in emergency nurses, a longitudinal study.

PubMed

Adriaenssens, Jef; De Gucht, Veronique; Maes, Stan

2015-04-01

This longitudinal study examines the influence of changes over time in work and organisational characteristics on job satisfaction, work engagement, emotional exhaustion, turnover intention and psychosomatic distress in emergency room nurses. Organisational and job characteristics of nurses are important predictors of stress-health outcomes. Emergency room nurses are particularly exposed to stressful work-related events and unpredictable work conditions. The study was carried out in 15 emergency departments of Belgian general hospitals in 2008 (T1) and 18 months later (T2) (n = 170). Turnover rates between T1 and T2 were high. Important changes over time were found in predictors and outcomes. Changes in job demand, control and social support predicted job satisfaction, work engagement and emotional exhaustion. In addition, changes in reward, social harassment and work agreements predicted work engagement, emotional exhaustion and intention to leave, respectively. Work-related interventions are important to improve occupational health in emergency room nurses and should focus on lowering job demands, increasing job control, improving social support and a well-balanced reward system. Nursing managers should be aware of the causes and consequences of occupational stress in emergency room nurses in order to enable preventive interventions. © 2013 John Wiley & Sons Ltd.

Pseudomorphic InGaAs Materials

DTIC Science & Technology

1990-07-31

tive mass Schrodinger equation can be cast using a finite element technique (Galerkin residual method) into a symmetric tridiagonal matrix formulation...lnr’Gal-.’As composition. All of the structures were fabricated by molecular beam epitaxy (MBE). The effects of different growth conditions were evaluated... different growth conditions were evaluated with a combination of characterization techniques. Key results to emerge from this work relate to the

Consensus-based Recommendations for Research Priorities Related to Interventions to Safeguard Patient Safety in the Crowded Emergency Department

PubMed Central

Fee, Christopher; Hall, Kendall; Morrison, J. Bradley; Stephens, Robert; Cosby, Karen; Fairbanks, Rollin (Terry) J.; Youngberg, Barbara; Lenehan, Gail; Abualenain, Jameel; O’Connor, Kevin; Wears, Robert

2012-01-01

This article describes the results of the Interventions to Safeguard Safety breakout session of the 2011 Academic Emergency Medicine (AEM) consensus conference entitled “Interventions to Assure Quality in the Crowded Emergency Department.” Using a multistep nominal group technique, experts in emergency department (ED) crowding, patient safety, and systems engineering defined knowledge gaps and priority research questions related to the maintenance of safety in the crowded ED. Consensus was reached for seven research priorities related to interventions to maintain safety in the setting of a crowded ED. Included among these are: 1) How do routine corrective processes and compensating mechanism change during crowding? 2) What metrics should be used to determine ED safety? 3) How can checklists ensure safer care and what factors contribute to their success or failure? 4) What constitutes safe staffing levels / ratios? 5) How can we align emergency medicine (EM)-specific patient safety issues with national patient safety issues? 6) How can we develop metrics and skills to recognize when an ED is getting close to catastrophic overload conditions? and 7) What can EM learn from experts and modeling from fields outside of medicine to develop innovative solutions? These priorities have the potential to inform future clinical and human factors research and extramural funding decisions related to this important topic. PMID:22168192

22 CFR 231.02 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... means the United States Agency for International Development or its successor. (b) Eligible Note(s...

22 CFR 231.02 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... means the United States Agency for International Development or its successor. (b) Eligible Note(s...

22 CFR 231.02 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... means the United States Agency for International Development or its successor. (b) Eligible Note(s...

22 CFR 231.02 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... means the United States Agency for International Development or its successor. (b) Eligible Note(s...

22 CFR 231.02 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ARAB REPUBLIC OF EGYPT LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS... means the United States Agency for International Development or its successor. (b) Eligible Note(s...

Strategies of leaf expansion in Ficus carica under semiarid conditions.

PubMed

González-Rodríguez, A M; Peters, J

2010-05-01

Leaf area expansion, thickness and inclination, gas exchange parameters and relative chlorophyll content were analysed in field-grown fig (Ficus carica L.) leaves over time, from emergence until after full leaf expansion (FLE). Ficus carica leaves showed a subtle change in shape during the early stages of development, and FLE was reached within ca. 30 days after emergence. Changes in leaf thickness and inclination after FLE demonstrated good adaptation to environmental conditions during summer in areas with a Mediterranean climate. Changes in gas exchange parameters and relative chlorophyll content showed that F. carica is a delayed-greening species, reaching maximum values 20 days after FLE. Correlation analysis of datasets collected during leaf expansion, confirmed dependence among structural and functional traits in F. carica. Pn was directly correlated with stomatal conductance (Gs), transpiration (E), leaf area (LA) and relative chlorophyll content up to FLE. The effect of pruning on leaf expansion, a cultural technique commonly applied in this fruit tree, was also evaluated. Although leaf development in pruned branches gave a significantly higher relative leaf area growth rate (RGR(l)) and higher LA than non-pruned branches, no significant differences were found in other morphological and physiological traits, indicating no pruning effect on leaf development. All studied morphological and physiological characteristics indicate that F. carica is well adapted to semiarid conditions. The delayed greening strategy of this species is discussed.

14 CFR 27.562 - Emergency landing dynamic conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Emergency landing dynamic conditions. 27... Conditions § 27.562 Emergency landing dynamic conditions. (a) The rotorcraft, although it may be damaged in... must successfully complete dynamic tests or be demonstrated by rational analysis based on dynamic tests...

14 CFR 29.562 - Emergency landing dynamic conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Emergency landing dynamic conditions. 29... Conditions § 29.562 Emergency landing dynamic conditions. (a) The rotorcraft, although it may be damaged in a... landing must successfully complete dynamic tests or be demonstrated by rational analysis based on dynamic...

Fitness of Crop-Wild Hybrid Sunflower under Competitive Conditions: Implications for Crop-to-Wild Introgression

PubMed Central

Mercer, Kristin L.; Emry, D. Jason; Snow, Allison A.; Kost, Matthew A.; Pace, Brian A.; Alexander, Helen M.

2014-01-01

Understanding the likelihood and extent of introgression of novel alleles in hybrid zones requires comparison of lifetime fitness of parents and hybrid progeny. However, fitness differences among cross types can vary depending on biotic conditions, thereby influencing introgression patterns. Based on past work, we predicted that increased competition would enhance introgression between cultivated and wild sunflower (Helianthus annuus) by reducing fitness advantages of wild plants. To test this prediction, we established a factorial field experiment in Kansas, USA where we monitored the fitness of four cross types (Wild, F1, F2, and BCw hybrids) under different levels of interspecific and intraspecific competition. Intraspecific manipulations consisted both of density of competitors and of frequency of crop-wild hybrids. We recorded emergence of overwintered seeds, survival to reproduction, and numbers of seeds produced per reproductive plant. We also calculated two compound fitness measures: seeds produced per emerged seedling and seeds produced per planted seed. Cross type and intraspecific competition affected emergence and survival to reproduction, respectively. Further, cross type interacted with competitive treatments to influence all other fitness traits. More intense competition treatments, especially related to density of intraspecific competitors, repeatedly reduced the fitness advantage of wild plants when considering seeds produced per reproductive plant and per emerged seedling, and F2 plants often became indistinguishable from the wilds. Wild fitness remained superior when seedling emergence was also considered as part of fitness, but the fitness of F2 hybrids relative to wild plants more than quadrupled with the addition of interspecific competitors and high densities of intraspecific competitors. Meanwhile, contrary to prediction, lower hybrid frequency reduced wild fitness advantage. These results emphasize the importance of taking a full life cycle perspective. Additionally, due to effects of exogenous selection, a given hybrid generation may be especially well-suited to hastening introgression under particular environmental conditions. PMID:25295859

Fitness of crop-wild hybrid sunflower under competitive conditions: implications for crop-to-wild introgression.

PubMed

Mercer, Kristin L; Emry, D Jason; Snow, Allison A; Kost, Matthew A; Pace, Brian A; Alexander, Helen M

2014-01-01

Understanding the likelihood and extent of introgression of novel alleles in hybrid zones requires comparison of lifetime fitness of parents and hybrid progeny. However, fitness differences among cross types can vary depending on biotic conditions, thereby influencing introgression patterns. Based on past work, we predicted that increased competition would enhance introgression between cultivated and wild sunflower (Helianthus annuus) by reducing fitness advantages of wild plants. To test this prediction, we established a factorial field experiment in Kansas, USA where we monitored the fitness of four cross types (Wild, F1, F2, and BCw hybrids) under different levels of interspecific and intraspecific competition. Intraspecific manipulations consisted both of density of competitors and of frequency of crop-wild hybrids. We recorded emergence of overwintered seeds, survival to reproduction, and numbers of seeds produced per reproductive plant. We also calculated two compound fitness measures: seeds produced per emerged seedling and seeds produced per planted seed. Cross type and intraspecific competition affected emergence and survival to reproduction, respectively. Further, cross type interacted with competitive treatments to influence all other fitness traits. More intense competition treatments, especially related to density of intraspecific competitors, repeatedly reduced the fitness advantage of wild plants when considering seeds produced per reproductive plant and per emerged seedling, and F2 plants often became indistinguishable from the wilds. Wild fitness remained superior when seedling emergence was also considered as part of fitness, but the fitness of F2 hybrids relative to wild plants more than quadrupled with the addition of interspecific competitors and high densities of intraspecific competitors. Meanwhile, contrary to prediction, lower hybrid frequency reduced wild fitness advantage. These results emphasize the importance of taking a full life cycle perspective. Additionally, due to effects of exogenous selection, a given hybrid generation may be especially well-suited to hastening introgression under particular environmental conditions.

Characterization, conservation and loss of dignity at the end-of- life in the emergency department. A qualitative protocol.

PubMed

Fernández-Sola, Cayetano; Granero-Molina, José; Díaz-Cortés, María Del Mar; Jiménez-López, Francisca Rosa; Roman-López, Pablo; Saez-Molina, Encarnación; Aranda-Torres, Cayetano José; Muñoz-Terrón, José María; García-Caro, María Paz; Hernández-Padilla, José Manuel

2018-06-01

To explore and understand the experiences of terminally ill patients and their relatives regarding dignity during end-of-life care in the emergency department. The respect given to the concept of dignity is significantly modifying the clinical relationship and the care framework involving the end-of-life patient in palliative care units, critical care units, hospices and their own homes. This situation is applicable to in-hospital emergency departments, where there is a lack of research which takes the experiences of end-of-life patients and their relatives into account. A phenomenological qualitative study. The protocol was approved in December 2016 and will be carried out from December 2016-December 2020. The Gadamer's philosophical underpinnings will be used in the design and development of the study. The data collection will include participant observation techniques in the emergency department, in-depth interviews with terminally ill patients and focus groups with their relatives. For the data analysis, the field notes and verbatim transcriptions will be read and codified using ATLAS.ti software to search for emerging themes. Emerging themes that contribute to comprehending the phenomenon of dignity in end-of-life care in the emergency department are expected to be found. This study's results could have important implications in the implementation of new interventions in emergency departments. These interventions would be focused on improving: the social acceptance of death, environmental conditions, promotion of autonomy and accompaniment and assumption (takeover) of dignified actions and attitudes (respect for human rights). © 2018 John Wiley & Sons Ltd.

Stress and reward processing in bipolar disorder: a functional magnetic resonance imaging study.

PubMed

Berghorst, Lisa H; Kumar, Poornima; Greve, Doug N; Deckersbach, Thilo; Ongur, Dost; Dutra, Sunny J; Pizzagalli, Diego A

2016-11-01

A link between negative life stress and the onset of mood episodes in bipolar disorder (BD) has been established, but processes underlying such a link remain unclear. Growing evidence suggests that stress can negatively affect reward processing and related neurobiological substrates, indicating that a dysregulated reward system may provide a partial explanation. The aim of this study was to test the impact of stress on reward-related neural functioning in BD. Thirteen euthymic or mildly depressed individuals with BD and 15 controls performed a Monetary Incentive Delay (MID) task while undergoing functional magnetic resonance imaging during no-stress and stress (negative psychosocial stressor involving poor performance feedback and threat of monetary deductions) conditions. In hypothesis-driven region-of-interest analyses, a significant group-by-condition interaction emerged in the amygdala during reward anticipation. Relative to controls, while anticipating a potential reward, subjects with BD were characterized by amygdalar hyperactivation in the no-stress condition but hypoactivation during stress. Moreover, relative to controls, subjects with BD had significantly larger amygdala volumes. After controlling for structural differences, the effects of stress on amygdalar function remained, whereas groups no longer differed during the no-stress condition. During reward consumption, a group-by-condition interaction emerged in the putamen due to increased putamen activation in response to rewards in participants with BD during stress, but an opposite pattern in controls. Overall, findings highlight possible impairments in using reward-predicting cues to adaptively engage in goal-directed actions in BD, combined with stress-induced hypersensitivity to reward consumption. Potential clinical implications are discussed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Challenging Circumstances Moderate the Links Between Mothers’ Personality Traits and Their Parenting in Low-Income Families With Young Children

PubMed Central

Kochanska, Grazyna; Kim, Sanghag; Nordling, Jamie Koenig

2013-01-01

The need for research on potential moderators of personality–parenting links has been repeatedly emphasized, yet few studies have examined how varying stressful or challenging circumstances may influence such links. We studied 186 diverse, low-income mother–toddler dyads. Mothers described themselves in terms of Big Five traits, were observed in lengthy interactions with their children, and provided parenting reports. Ecological adversity, assessed as a cumulative index of known risk factors, and the child’s difficulty observed as negative affect and defiance in interactions with mothers were posited as sources of parenting challenge. Mothers high in Neuroticism reported more power assertion. Some personality–parenting relations emerged only under challenging conditions. For mothers raising difficult children, higher Extraversion was linked to increased observed power assertion, but higher Conscientiousness was linked to decreased reported power assertion. There were no such relations for mothers of easy children. By contrast, some relations emerged only in the absence of challenge. Agreeableness was associated with more positive parenting for mothers who lived under conditions of low ecological adversity, and with less reported power for those who had easy children, and Openness was linked to more positive parenting for mothers of easy children. Those traits were unrelated to parenting under challenging conditions. PMID:23066882

Mobile emergency, an emergency support system for hospitals in mobile devices: pilot study.

PubMed

Bellini, Pierfrancesco; Boncinelli, Sergio; Grossi, Francesco; Mangini, Marco; Nesi, Paolo; Sequi, Leonardo

2013-05-23

Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings.

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.

The relation of PTSD symptoms to migraine and headache-related disability among substance dependent inpatients.

PubMed

McDermott, Michael J; Fulwiler, Joshua C; Smitherman, Todd A; Gratz, Kim L; Connolly, Kevin M; Tull, Matthew T

2016-04-01

Despite emerging evidence for the comorbidity of posttraumatic stress disorder (PTSD) and migraine, few studies have examined the relation of PTSD and migraine, particularly among clinical populations at-risk for both conditions (e.g., substance-dependent patients). This study examined the role of PTSD symptoms in migraine and headache-related disability within a sample of 153 substance-dependent inpatients (37.25% female, Mean age 36.46). PTSD symptoms predicted both migraine and headache-related disability above and beyond gender, depression and anxiety symptoms, the experience of a Criterion A traumatic event, and current alcohol use disorder. Findings highlight the strong association between migraine and PTSD symptoms in a unique population at risk for both conditions.

Correspondence and challenges as neurologists to Kumamoto Earthquakes in 2016.

PubMed

Nakajima, Makoto; Nakane, Nozomi; Takamatsu, Kotaro; Yamashita, Satoshi; Nakane, Shunya; Yamashita, Taro; Ando, Yukio

2016-12-28

Kumamoto Earthquakes in 2016 severely affected medical circumstances and condition of each patient with neuro-muscular diseases, in addition to having destroyed life circumstances of local residence. Number of neuro-muscular disease patients admitted to the Department of Neurology, Kumamoto University, the only university hospital in the prefecture, increased approximately twice compared to usual years. Most of the related facilities were able to admit emergency patients with neuro-muscular diseases although the hospital buildings were damaged in various degrees. A number of issues remained unsolved as to emergency contact system, securement of emergency beds for severe neuro-muscular diseases, and information system for these patients.

Policy statement--emergency information forms and emergency preparedness for children with special health care needs.

PubMed

2010-04-01

Children with chronic medical conditions rely on complex management plans for problems that cause them to be at increased risk for suboptimal outcomes in emergency situations. The emergency information form (EIF) is a medical summary that describes medical condition(s), medications, and special health care needs to inform health care providers of a child's special health conditions and needs so that optimal emergency medical care can be provided. This statement describes updates to EIFs, including computerization of the EIF, expanding the potential benefits of the EIF, quality-improvement programs using the EIF, the EIF as a central repository, and facilitating emergency preparedness in disaster management and drills by using the EIF.

A New Face of Cardiac Emergencies: Human Immunodeficiency Virus-Related Cardiac Disease.

PubMed

Tsabedze, Nqoba; Vachiat, Ahmed; Zachariah, Don; Manga, Pravin

2018-02-01

The human immunodeficiency virus epidemic is a major health challenge of the twenty-first century as the transition from infectious complications to noncommunicable disease becomes more evident. These patients may present to the emergency department with a variety of cardiovascular diseases, such as acute coronary syndromes, heart failure, pericardial disease, infective endocarditis, venothromboembolism, and other conditions. Increased awareness is needed among health care professionals to enhance adequate identification and promote prompt management of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Teaching Manual Signs to Adults with Mental Retardation Using Matching-to-Sample Procedures and Stimulus Equivalence

ERIC Educational Resources Information Center

Elias, N. C.; Goyos, C.; Saunders, M.; Saunders, R.

2008-01-01

The objective of this study was to teach manual signs through an automated matching-to-sample procedure and to test for the emergence of new conditional relations and imitative behaviors. Seven adults with mild to severe mental retardation participated. Four were also hearing impaired. Relations between manual signs (set A) and pictures (set B)…

Rational-emotive behavior therapy and the formation of stimulus equivalence classes.

PubMed

Plaud, J J; Gaither, G A; Weller, L A; Bigwood, S J; Barth, J; von Duvillard, S P

1998-08-01

Stimulus equivalence is a behavioral approach to analyzing the "meaning" of stimulus sets and has an implication for clinical psychology. The formation of three-member (A --> B --> C) stimulus equivalence classes was used to investigate the effects of three different sets of sample and comparison stimuli on emergent behavior. The three stimulus sets were composed of Rational-Emotive Behavior Therapy (REBT)-related words, non-REBT emotionally charged words, and a third category of neutral words composed of flower labels. Sixty-two women and men participated in a modified matching-to-sample experiment. Using a mixed cross-over design, and controlling for serial order effects, participants received conditional training and emergent relationship training in the three stimulus set conditions. Results revealed a significant interaction between the formation of stimulus equivalence classes and stimulus meaning, indicating consistently biased responding in favor of reaching criterion responding more slowly for REBT-related and non-REBT emotionally charged words. Results were examined in the context of an analysis of the importance of stimulus meaning on behavior and the relation of stimulus meaning to behavioral and cognitive theories, with special appraisal given to the influence of fear-related discriminative stimuli on behavior.

22 CFR 230.02 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.02 Definitions... International Development or its successor. (b) Eligible Note(s) means [a] Note[s] meeting the eligibility...

22 CFR 230.02 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.02 Definitions... International Development or its successor. (b) Eligible Note(s) means [a] Note[s] meeting the eligibility...

22 CFR 230.02 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.02 Definitions... International Development or its successor. (b) Eligible Note(s) means [a] Note[s] meeting the eligibility...

75 FR 65423 - Crop Assistance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... provide emergency assistance to reestablish the purchasing power of eligible producers of rice, cotton... related conditions in 2009, the Secretary of Agriculture determined that producers of rice, upland cotton... of rice, upland cotton, soybeans, and sweet potatoes. CAP is a limited one-time program to...

Effects of weather and heliophysical conditions on emergency ambulance calls for elevated arterial blood pressure.

PubMed

Vencloviene, Jone; Babarskiene, Ruta M; Dobozinskas, Paulius; Sakalyte, Gintare; Lopatiene, Kristina; Mikelionis, Nerijus

2015-02-27

We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009-2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs), in which the conditions for the emergency calls were made coded I.10-I.15. The Kaunas Weather Station provided daily records of air temperature (T), wind speed (WS), relative humidity, and barometric pressure (BP). We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS>600 km/s) increased the daily number of elevated arterial blood pressure (EABP) by 12% (RR=1.12; 95% confidence interval (CI) 1.04-1.21); and WS≥3.5 knots during days of T<1.5 °C and T≥12.5 °C by 8% (RR=1.08; CI 1.04-1.12). An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T≥17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population's sensitivity to different weather conditions.

Dualities and emergent gravity: Gauge/gravity duality

NASA Astrophysics Data System (ADS)

de Haro, Sebastian

2017-08-01

In this paper I develop a framework for relating dualities and emergence: two notions that are close to each other but also exclude one another. I adopt the conception of duality as 'isomorphism', from the physics literature, cashing it out in terms of three conditions. These three conditions prompt two conceptually different ways in which a duality can be modified to make room for emergence; and I argue that this exhausts the possibilities for combining dualities and emergence (via coarse-graining). I apply this framework to gauge/gravity dualities, considering in detail three examples: AdS/CFT, Verlinde's scheme, and black holes. My main point about gauge/gravity dualities is that the theories involved, qua theories of gravity, must be background-independent. I distinguish two senses of background-independence: (i) minimalistic and (ii) extended. I argue that the former is sufficiently strong to allow for a consistent theory of quantum gravity; and that AdS/CFT is background-independent on this account; while Verlinde's scheme best fits the extended sense of background-independence. I argue that this extended sense should be applied with some caution: on pain of throwing the baby (general relativity) out with the bath-water (extended background-independence). Nevertheless, it is an interesting and potentially fruitful heuristic principle for quantum gravity theory construction. It suggests some directions for possible generalisations of gauge/gravity dualities. The interpretation of dualities is discussed; and the so-called 'internal' vs. 'external' viewpoints are articulated in terms of: (i) epistemic and metaphysical commitments; (ii) parts vs. wholes. I then analyse the emergence of gravity in gauge/gravity dualities in terms of the two available conceptualisations of emergence; and I show how emergence in AdS/CFT and in Verlinde's scenario differ from each other. Finally, I give a novel derivation of the Bekenstein-Hawking black hole entropy formula based on Verlinde's scheme; the derivation sheds light on several aspects of Verlinde's scheme and how it compares to Bekenstein's original calculation.

Relationship between ambient temperature and frequency and severity of cardiovascular emergencies: A prospective observational study based on out-of-hospital care data.

PubMed

Hensel, Mario; Stuhr, Markus; Geppert, Daniel; Kersten, Jan F; Lorenz, Jürgen; Kerner, Thoralf

2017-02-01

To test the hypothesis that more cardiovascular emergencies occur at low rather than at high temperatures under moderate climatic conditions. This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and from the local weather station were evaluated over a 5-year period. Temperature data were matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the temperature and the frequency of individual cardiovascular emergencies. In addition, three threshold-temperatures (0°C, 10°C, 20°C) were defined in order to determine the frequency of cardiovascular emergencies above and below each cut-off value. The severity of emergencies was assessed using the National Advisory Committee for Aeronautics (NACA) scoring system. A total of 35,390 cardiovascular emergencies were treated by Emergency Physicians. Transient Loss of Consciousness increased at high temperatures (above 20°C): +43% (95%-CI: [27%; 59%]). In contrast, Coronary Artery Disease +26% (95%-CI: [17%; 34%]), Cardiac Pulmonary Edema +21% (95%-CI: [14%; 27%]), Hypertensive Urgency +18% (95%-CI: [10%; 25%]) and Cerebrovascular Accident +17% (95%-CI: [8%; 24%]) increased at low temperatures, particularly below 10°C (significance level for all: p<0.001). No temperature-related effect was seen in Cardiac Arrhythmia and Pulmonary Embolism and no significant correlation was found between the severity of emergencies and temperature. Our findings suggest that some cardiovascular emergencies such as Coronary Artery Disease, Cardiac Pulmonary Edema, Hypertensive Urgency and Cerebrovascular Accident are more frequent in low temperatures even under mild climatic conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

18 CFR 376.209 - Procedures during periods of emergency requiring activation of the Continuity of Operations Plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... periods of emergency requiring activation of the Continuity of Operations Plan. 376.209 Section 376.209... GENERAL RULES ORGANIZATION, MISSION, AND FUNCTIONS; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.209 Procedures during periods of emergency requiring activation...

18 CFR 375.310 - Delegations during emergency conditions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Delegations during... REGULATORY COMMISSION, DEPARTMENT OF ENERGY REVISED GENERAL RULES THE COMMISSION Delegations § 375.310 Delegations during emergency conditions. For delegations of Commission authority during emergency conditions...

The influence of weather on health-related help-seeking behavior of senior citizens in Hong Kong.

PubMed

Wong, Ho Ting; Chiu, Marcus Yu Lung; Wu, Cynthia Sau Ting; Lee, Tsz Cheung

2015-03-01

It is believed that extreme hot and cold weather has a negative impact on general health conditions. Much research focuses on mortality, but there is relatively little community health research. This study is aimed at identifying high-risk groups who are sensitive to extreme weather conditions, in particular, very hot and cold days, through an analysis of the health-related help-seeking patterns of over 60,000 Personal Emergency Link (PE-link) users in Hong Kong relative to weather conditions. In the study, 1,659,716 PE-link calls to the help center were analyzed. Results showed that females, older elderly, people who did not live alone, non-subsidized (relatively high-income) users, and those without medical histories of heart disease, hypertension, stroke, and diabetes were more sensitive to extreme weather condition. The results suggest that using official government weather forecast reports to predict health-related help-seeking behavior is feasible. An evidence-based strategic plan could be formulated by using a method similar to that used in this study to identify high-risk groups. Preventive measures could be established for protecting the target groups when extreme weather conditions are forecasted.

The influence of weather on health-related help-seeking behavior of senior citizens in Hong Kong

NASA Astrophysics Data System (ADS)

Wong, Ho Ting; Chiu, Marcus Yu Lung; Wu, Cynthia Sau Ting; Lee, Tsz Cheung

2015-03-01

It is believed that extreme hot and cold weather has a negative impact on general health conditions. Much research focuses on mortality, but there is relatively little community health research. This study is aimed at identifying high-risk groups who are sensitive to extreme weather conditions, in particular, very hot and cold days, through an analysis of the health-related help-seeking patterns of over 60,000 Personal Emergency Link (PE-link) users in Hong Kong relative to weather conditions. In the study, 1,659,716 PE-link calls to the help center were analyzed. Results showed that females, older elderly, people who did not live alone, non-subsidized (relatively high-income) users, and those without medical histories of heart disease, hypertension, stroke, and diabetes were more sensitive to extreme weather condition. The results suggest that using official government weather forecast reports to predict health-related help-seeking behavior is feasible. An evidence-based strategic plan could be formulated by using a method similar to that used in this study to identify high-risk groups. Preventive measures could be established for protecting the target groups when extreme weather conditions are forecasted.

Canine and feline emergency room visits and the lunar cycle: 11,940 cases (1992-2002).

PubMed

Wells, Raegan J; Gionfriddo, Juliet R; Hackett, Timothy B; Radecki, Steven V

2007-07-15

To determine the frequency of canine and feline emergency visits with respect to the lunar cycle. Retrospective case series. 11,940 dogs and cats evaluated on an emergency basis during an 11-year period. Date of emergency visit, signalment, and chief complaint were retrieved from a medical records database. Emergency type was categorized as animal bite, cardiac arrest, epilepsy, ophthalmic, gastric dilatation-volvulus, trauma, multiple diseases, neoplasia, or toxicosis. The corresponding lunar phase was calculated and recorded as new moon, waxing crescent, first quarter, waxing gibbous, full moon, waning gibbous, last quarter, or waning crescent. The effect of lunar phase on the frequency of emergency visits was evaluated by calculating relative risk. Of 11,940 cases, 9,407 were canine and 2,533 were feline. Relative risk calculations identified a significant increase in emergencies for dogs and cats on fuller moon days (waxing gibbous to waning gibbous), compared with all other days. Results suggested that more emergency room visits occurred on fuller moon days for dogs and cats. It is unlikely that an attending clinician would notice the fractional increase in visits (0.59 and 0.13 more canine and feline visits, respectively) observed in this study at a facility with a low caseload. If the study is repeated at a facility with a robust emergency caseload, these results may lead to reorganization of staffing on fuller moon dates. A prospective study evaluating these findings under conditions of high caseload is necessary to determine the clinical relevance.

Association between Air Pollution and Emergency Room Visits for Atrial Fibrillation.

PubMed

Solimini, Angelo G; Renzi, Matteo

2017-06-20

Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years' time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM 10 and PM 2.5 , and nitrogen dioxide, NO₂) and the daily count of emergency accesses for AF (ICD-9 code: 427.31). We applied an over-dispersed conditional Poisson model to analyze the associations at different lags after controlling for time, influenza epidemics, holiday periods, temperature, and relative humidity. Additionally, we evaluated bi-pollutant models by including the other pollutant and the influence of several effect modifiers such as personal characteristics and pre-existing medical conditions. In the period of study, 79,892 individuals were admitted to the emergency departments of Rome hospitals because of AF (on average, 15.6 patients per day: min = 1, max = 36). Air pollution levels were associated with increased AF emergency visits within 24 h of exposure. Effect estimates ranged between 1.4% (0.7-2.3) for a 10 µg/m³ increase of PM 10 to 3% (1.4-4.7) for a 10 µg/m³ increase of PM 2.5 at lag 0-1 day. Those effects were higher in patients ≥75 years for all pollutants, male patients for PM 10 , and female patients for NO₂. The presence of previous cardiovascular conditions, but not other effect modifiers, increase the pollution effects by 5-8% depending on the lag. This study found evidence that air pollution is associated with AF emergency visits in the short term.

Grandmothering and cognitive resources are required for the emergence of menopause and extensive post-reproductive lifespan.

PubMed

Aimé, Carla; André, Jean-Baptiste; Raymond, Michel

2017-07-01

Menopause, the permanent cessation of ovulation, occurs in humans well before the end of the expected lifespan, leading to an extensive post-reproductive period which remains a puzzle for evolutionary biologists. All human populations display this particularity; thus, it is difficult to empirically evaluate the conditions for its emergence. In this study, we used artificial neural networks to model the emergence and evolution of allocation decisions related to reproduction in simulated populations. When allocation decisions were allowed to freely evolve, both menopause and extensive post-reproductive life-span emerged under some ecological conditions. This result allowed us to test various hypotheses about the required conditions for the emergence of menopause and extensive post-reproductive life-span. Our findings did not support the Maternal Hypothesis (menopause has evolved to avoid the risk of dying in childbirth, which is higher in older women). In contrast, results supported a shared prediction from the Grandmother Hypothesis and the Embodied Capital Model. Indeed, we found that extensive post-reproductive lifespan allows resource reallocation to increase fertility of the children and survival of the grandchildren. Furthermore, neural capital development and the skill intensiveness of the foraging niche, rather than strength, played a major role in shaping the age profile of somatic and cognitive senescence in our simulated populations. This result supports the Embodied Capital Model rather than the Grand-Mother Hypothesis. Finally, in simulated populations where menopause had already evolved, we found that reduced post-reproductive lifespan lead to reduced children's fertility and grandchildren's survival. The results are discussed in the context of the evolutionary emergence of menopause and extensive post-reproductive life-span.

Association between Air Pollution and Emergency Room Visits for Atrial Fibrillation

PubMed Central

Solimini, Angelo G.; Renzi, Matteo

2017-01-01

Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years’ time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO2) and the daily count of emergency accesses for AF (ICD-9 code: 427.31). We applied an over-dispersed conditional Poisson model to analyze the associations at different lags after controlling for time, influenza epidemics, holiday periods, temperature, and relative humidity. Additionally, we evaluated bi-pollutant models by including the other pollutant and the influence of several effect modifiers such as personal characteristics and pre-existing medical conditions. In the period of study, 79,892 individuals were admitted to the emergency departments of Rome hospitals because of AF (on average, 15.6 patients per day: min = 1, max = 36). Air pollution levels were associated with increased AF emergency visits within 24 h of exposure. Effect estimates ranged between 1.4% (0.7–2.3) for a 10 µg/m3 increase of PM10 to 3% (1.4–4.7) for a 10 µg/m3 increase of PM2.5 at lag 0–1 day. Those effects were higher in patients ≥75 years for all pollutants, male patients for PM10, and female patients for NO2. The presence of previous cardiovascular conditions, but not other effect modifiers, increase the pollution effects by 5–8% depending on the lag. This study found evidence that air pollution is associated with AF emergency visits in the short term. PMID:28632149

Critical incident reporting in emergency medicine: results of the prehospital reports.

PubMed

Hohenstein, Christian; Hempel, Dorothea; Schultheis, Kerstin; Lotter, Oliver; Fleischmann, Thomas

2014-05-01

Medical errors frequently contribute to morbidity and mortality. Prehospital emergency medicine is prone to incidents that can lead to immediate deadly consequences. Critical incident reporting can identify typical problems and be the basis for structured risk management in order to reduce and mitigate these incidents. We set up a free access internet website for German-speaking countries, with an anonymous reporting system for emergency medical services personnel. After a 7-year study period, an expert team analysed and classified the incidents into staff related, equipment related, organisation and tactics, or other. 845 reports were entered in the study period. Physicians reported 44% of incidents, paramedics 42%. Most patients were in a life-threatening or potentially life-threatening situation (82%), and only 53% of all incidents had no influence on the outcome of the patient. Staff-related problems were responsible for 56% of the incidents, when it came to harm, 78% of these incidents were staff related. Incident reporting in prehospital emergency medicine can identify system weaknesses. Most of the incidents were reported during care of patients in life-threatening conditions with a high impact on patient outcome. Staff-related problems contributed to the most frequent and most severe incidents. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

22 CFR 230.04 - Guarantee eligibility.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.04..., Director and Deputy Director, Office of Development Credit, and such other individual(s) designated in a...

22 CFR 230.04 - Guarantee eligibility.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.04..., Director and Deputy Director, Office of Development Credit, and such other individual(s) designated in a...

22 CFR 230.04 - Guarantee eligibility.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.04..., Director and Deputy Director, Office of Development Credit, and such other individual(s) designated in a...

22 CFR 230.04 - Guarantee eligibility.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS § 230.04..., Director and Deputy Director, Office of Development Credit, and such other individual(s) designated in a...

Developmental emergence of fear/threat learning: neurobiology, associations and timing.

PubMed

Tallot, L; Doyère, V; Sullivan, R M

2016-01-01

Pavlovian fear or threat conditioning, where a neutral stimulus takes on aversive properties through pairing with an aversive stimulus, has been an important tool for exploring the neurobiology of learning. In the past decades, this neurobehavioral approach has been expanded to include the developing infant. Indeed, protracted postnatal brain development permits the exploration of how incorporating the amygdala, prefrontal cortex and hippocampus into this learning system impacts the acquisition and expression of aversive conditioning. Here, we review the developmental trajectory of these key brain areas involved in aversive conditioning and relate it to pups' transition to independence through weaning. Overall, the data suggests that adult-like features of threat learning emerge as the relevant brain areas become incorporated into this learning. Specifically, the developmental emergence of the amygdala permits cue learning and the emergence of the hippocampus permits context learning. We also describe unique features of learning in early life that block threat learning and enhance interaction with the mother or exploration of the environment. Finally, we describe the development of a sense of time within this learning and its involvement in creating associations. Together these data suggest that the development of threat learning is a useful tool for dissecting adult-like functioning of brain circuits, as well as providing unique insights into ecologically relevant developmental changes. © 2015 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

Adaptive modeling of viral diseases in bats with a focus on rabies.

PubMed

Dimitrov, Dobromir T; Hallam, Thomas G; Rupprecht, Charles E; McCracken, Gary F

2008-11-07

Many emerging and reemerging viruses, such as rabies, SARS, Marburg, and Ebola have bat populations as disease reservoirs. Understanding the spillover from bats to humans and other animals, and the associated health risks requires an analysis of the disease dynamics in bat populations. Traditional compartmental epizootic models, which are relatively easy to implement and analyze, usually impose unrealistic aggregation assumptions about disease-related structure and depend on parameters that frequently are not measurable in field conditions. We propose a novel combination of computational and adaptive modeling approaches that address the maintenance of emerging diseases in bat colonies through individual (intra-host) models of the response of the host to a viral challenge. The dynamics of the individual models are used to define survival, susceptibility and transmission conditions relevant to epizootics as well as to develop and parametrize models of the disease evolution into uniform and diverse populations. Applications of the proposed approach to modeling the effects of immunological heterogeneity on the dynamics of bat rabies are presented.

Improving access to emergent spinal care through knowledge translation: an ethnographic study.

PubMed

Webster, Fiona; Fehlings, Michael G; Rice, Kathleen; Malempati, Harsha; Fawaz, Khaled; Nicholls, Fred; Baldeo, Navindra; Reeves, Scott; Singh, Anoushka; Ahn, Henry; Ginsberg, Howard; Yee, Albert J

2014-04-14

For patients and family members, access to timely specialty medical care for emergent spinal conditions is a significant stressor to an already serious condition. Timing to surgical care for emergent spinal conditions such as spinal trauma is an important predictor of outcome. However, few studies have explored ethnographically the views of surgeons and other key stakeholders on issues related to patient access and care for emergent spine conditions. The primary study objective was to determine the challenges to the provision of timely care as well as to identify areas of opportunities to enhance care delivery. An ethnographic study of key administrative and clinical care providers involved in the triage and care of patients referred through CritiCall Ontario was undertaken utilizing standard methods of qualitative inquiry. This comprised 21 interviews with people involved in varying capacities with the provision of emergent spinal care, as well as qualitative observations on an orthopaedic/neurosurgical ward, in operating theatres, and at CritiCall Ontario's call centre. Several themes were identified and organized into categories that range from inter-professional collaboration through to issues of hospital-level resources and the role of relationships between hospitals and external organizations at the provincial level. Underlying many of these issues is the nature of the medically complex emergent spine patient and the scientific evidentiary base upon which best practice care is delivered. Through the implementation of knowledge translation strategies facilitated from this research, a reduction of patient transfers out of province was observed in the one-year period following program implementation. Our findings suggest that competing priorities at both the hospital and provincial level create challenges in the delivery of spinal care. Key stakeholders recognized spinal care as aligning with multiple priorities such as emergent/critical care, medical through surgical, acute through rehabilitative, disease-based (i.e. trauma, cancer), and wait times initiatives. However, despite newly implemented strategies, there continues to be increasing trends over time in the number of spinal CritiCall Ontario referrals. This reinforces the need for ongoing inter-professional efforts in care delivery that take into account the institutional contexts that may constrain individual or team efforts.

The Role of Multiple-Exemplar Training and Naming in Establishing Derived Equivalence in an Infant

PubMed Central

Luciano, Carmen; Becerra, Inmaculada Gómez; Valverde, Miguel Rodríguez

2007-01-01

The conditions under which symmetry and equivalence relations develop are still controversial. This paper reports three experiments that attempt to analyze the impact of multiple-exemplar training (MET) in receptive symmetry on the emergence of visual–visual equivalence relations with a very young child, Gloria. At the age of 15 months 24 days (15m24d), Gloria was tested for receptive symmetry and naming and showed no evidence of either repertoire. In the first experiment, MET in immediate and delayed receptive symmetrical responding or listener behavior (from object–sound to immediate and delayed sound–object selection) proceeded for one month with 10 different objects. This was followed, at 16m25d, by a second test conducted with six new objects. Gloria showed generalized receptive symmetry with a 3-hr delay; however no evidence of naming with new objects was found. Experiment 2 began at 17m with the aim of establishing derived visual–visual equivalence relations using a matching-to-sample format with two comparisons. Visual–visual equivalence responding emerged at 19m, although Gloria still had not shown evidence of naming. Experiment 3 (22m to 23m25d) used a three-comparison matching-to-sample procedure to establish visual–visual equivalence. Equivalence responding emerged as in Experiment 2, and naming emerged by the end of Experiment 3. Results are discussed in terms of the history of training in bidirectional relations responsible for the emergence of visual–visual equivalence relations and of their implications for current theories of stimulus equivalence. PMID:17575901

THE ROLE OF THE SPORTS PHYSICAL THERAPIST-MARATHON EVENTS

PubMed Central

Schuemann, Teresa; Hoogenboom, Barbara J.

2013-01-01

The role of the Sports physical therapist (PT) as a part of the sports medical team at marathon-type events varies widely. The PT can assume the role of an emergency medical responder (EMR) whose primary role is the management of the athlete in emergency type situations. The role of the EMR extends beyond the care of the athlete to the care and safety of the spectators. In this role, the PT must be prepared to handle any type of emergency situation, which may occur from medical conditions to acute orthopedic/sports injuries, to medical conditions which may be found in the participants of the race or the spectators. Additional roles of the PT can be in pre-race education, pre-participation screening/physicals, and other concerns by the participant related to injury prevention. Regardless of the role assumed by the PT, prior planning is essential for the safety, security, and maximal performance of the participant and to make the race enjoyable and safe for everyone. Level of Evidence: 5 PMID:24175136

Target foil rupture scenario and provision for handling different models of medical cyclotrons used in India

PubMed Central

Shaiju, V. S.; Sharma, S. D.; Kumar, Rajesh; Sarin, B.

2009-01-01

Medical cyclotron is a particle accelerator used in producing short lived radiotracers such as 18F, 11C, 15O, 13N etc. These radiotracers are labeled with suitable pharmaceuticals for use to gather information related to metabolic activity of the cell using Positron Emission Tomography (PET) scan. Target foil rupture is considered one of the major emergency situations during medical cyclotron operations because there is a potential of over exposure to the working personnel. Radiation protection survey of a self-shielded medical cyclotron installation was carried out during normal and emergency conditions. It is found that the induced activity in the target foil increases with its successive usages. As a case study, we have evaluated the emergency handling procedures of GE PETtrace-6 medical cyclotron. Recommendations have also been made to reduce personal exposure while handling the target foil rupture condition such as the use of L-Bench near the target area and participation of experienced personnel. PMID:20098564

Conservatism and "copy-if-better" in chimpanzees (Pan troglodytes).

PubMed

van Leeuwen, Edwin J C; Call, Josep

2017-05-01

Social learning is predicted to evolve in socially living animals provided the learning process is not random but biased by certain socio-ecological factors. One bias of particular interest for the emergence of (cumulative) culture is the tendency to forgo personal behaviour in favour of relatively better variants observed in others, also known as the "copy-if-better" strategy. We investigated whether chimpanzees employ copy-if-better in a simple token-exchange paradigm controlling for individual and random social learning. After being trained on one token-type, subjects were confronted with a conspecific demonstrator who either received the same food reward as the subject (control condition) or a higher value food reward than the subject (test condition) for exchanging another token-type. In general, the chimpanzees persisted in exchanging the token-type they were trained on individually, indicating a form of conservatism consistent with previous studies. However, the chimpanzees were more inclined to copy the demonstrator in the test compared to the control condition, indicating a tendency to employ a copy-if-better strategy. We discuss the validity of our results by considering alternative explanations and relate our findings to the emergence of cumulative culture.

[Medical emergencies related to HIV/AIDS in tropical zones: a prospective study in Cote d'Ivoire (1999-2000)].

PubMed

Tanon, A; Eholié, S; Binan, Y; Ehui, E; Zana, E; Maurice, C; Bissagnené, E; Aoussi, E; Kakou, A; Kadio, A

2006-04-01

At the beginning of the HIV epidemic, the incidence of the complications considered as emergencies was high in developed countries but with the advent of new therapeutic strategies the frequency of such complications and the associated need for emergency treatment decreased drastically. In developing countries where management resources remain limited, HIV/AIDS patients are still exposed to the risk of serious complications. However few studies have documented exact implication of HIV/AIDS in medical emergencies hospitals in developing countries. The purpose of this prospective study was to describe medical emergencies related to HIV infection in adult patients admitted at Treichvilie University Hospital Center. Evaluation of prevalence was carried out in the infections disease and internal medicine emergency units between May 1999 and January 2000. All patients over the age of 15 years were included after informed consent to undergo pre-testing and HIV serology. A total of 400 patients were recruited including 312 that were HIV positive (78%). Mean patient age of patients was 35 years. The male-to-female sex ratio was 1. The most frequent motives for emergency consultation were deterioration of general condition (62%), diarrhea (39.1%) and cough (20.5%). Illness was chronic in 54% of cases. Physical signs were severe weight lost (84%), fever (50%), pale conjunctivas (29%), respiratory signs (19.2%) and dehydration (19%). The most frequent organic involvement causing admission was digestive (39.7%), neurological (24.4%) and pulmonary (20.5%). No deaths were observed. Most medical emergencies related to the HIV infection in the adult involved opportunistic diseases. They pose a challenge for therapeutic management.

Managing work-related stress in the district nursing workplace.

PubMed

Burke, Michelle

2013-11-01

This article aims to highlight the issue of work-related stress within the district nursing workplace. It will acknowledge how the management of work-related stress has previously been discussed within nursing literature and will consider the emerging relationship between staff working conditions, staff wellbeing and quality of patient care. It will reintroduce the Health and Safety Executive's (HSE's) Management Standards approach to tackling work-related stress, which provides management support to reduce environmental work stressors and encourage enabling work environments and a positive workplace culture.

Developmental cascade models of a parenting-focused program for divorced families on mental health problems and substance use in emerging adulthood.

PubMed

Wolchik, Sharlene A; Tein, Jenn-Yun; Sandler, Irwin N; Kim, Han-Joe

2016-08-01

A developmental cascade model from functioning in adolescence to emerging adulthood was tested using data from a 15-year longitudinal follow-up of 240 emerging adults whose families participated in a randomized, experimental trial of a preventive program for divorced families. Families participated in the program or literature control condition when the offspring were ages 9-12. Short-term follow-ups were conducted 3 months and 6 months following completion of the program when the offspring were in late childhood/early adolescence. Long-term follow-ups were conducted 6 years and 15 years after program completion when the offspring were in middle to late adolescence and emerging adulthood, respectively. It was hypothesized that the impact of the program on mental health and substance use outcomes in emerging adulthood would be explained by developmental cascade effects of program effects in adolescence. The results provided support for a cascade effects model. Specifically, academic competence in adolescence had cross-domain effects on internalizing problems and externalizing problems in emerging adulthood. In addition, adaptive coping in adolescence was significantly, negatively related to binge drinking. It was unexpected that internalizing symptoms in adolescence were significantly negatively related to marijuana use and alcohol use. Gender differences occurred in the links between mental health problems and substance use in adolescence and mental health problems and substance use in emerging adulthood.

Developmental Cascade Models of a Parenting-focused Program for Divorced Families on Mental Health Problems and Substance Use in Emerging Adulthood

PubMed Central

Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.; Kim, Han-Joe

2017-01-01

A developmental cascade model from functioning in adolescence to emerging adulthood was tested using data from a 15-year longitudinal follow-up of 240 emerging adults whose families participated in a randomized, experimental trial of a preventive program for divorced families. Families participated in the program or literature control condition when the offspring were ages 9 – 12. Short-term follow-ups were conducted 3 months and 6 months following completion of the program when the offspring were in middle to late adolescence. Long-term follow-ups were conducted 6 years and 15 years after program completion when the offspring were in emerging adulthood. It was hypothesized that the impact of the program on mental health and substance use outcomes in emerging adulthood would be explained by developmental cascade effects of program effects in adolescence. The results provided support for a cascade effects model. Specifically, academic competence in adolescence had spillover effects on internalizing problems and externalizing problems in emerging adulthood. Also, adaptive coping in adolescence was significantly, negatively related to binge drinking. Unexpectedly, internalizing symptoms in adolescence were significantly negatively related to marijuana use and alcohol use. Gender differences occurred in the links between mental health and substance use outcomes in adolescence and mental health and substance use outcomes in emerging adulthood. PMID:27427811

Maximizing oyster-reef growth supports green infrastructure with accelerating sea-level rise

PubMed Central

Ridge, Justin T.; Rodriguez, Antonio B.; Joel Fodrie, F.; Lindquist, Niels L.; Brodeur, Michelle C.; Coleman, Sara E.; Grabowski, Jonathan H.; Theuerkauf, Ethan J.

2015-01-01

Within intertidal communities, aerial exposure (emergence during the tidal cycle) generates strong vertical zonation patterns with distinct growth boundaries regulated by physiological and external stressors. Forecasted accelerations in sea-level rise (SLR) will shift the position of these critical boundaries in ways we cannot yet fully predict, but landward migration will be impaired by coastal development, amplifying the importance of foundation species’ ability to maintain their position relative to rising sea levels via vertical growth. Here we show the effects of emergence on vertical oyster-reef growth by determining the conditions at which intertidal reefs thrive and the sharp boundaries where reefs fail, which shift with changes in sea level. We found that oyster reef growth is unimodal relative to emergence, with greatest growth rates occurring between 20–40% exposure, and zero-growth boundaries at 10% and 55% exposures. Notably, along the lower growth boundary (10%), increased rates of SLR would outpace reef accretion, thereby reducing the depth range of substrate suitable for reef maintenance and formation, and exacerbating habitat loss along developed shorelines. Our results identify where, within intertidal areas, constructed or natural oyster reefs will persist and function best as green infrastructure to enhance coastal resiliency under conditions of accelerating SLR. PMID:26442712

Contextual and Auditory Fear Conditioning Continue to Emerge during the Periweaning Period in Rats

PubMed Central

Burman, Michael A.; Erickson, Kristen J.; Deal, Alex L.; Jacobson, Rose E.

2014-01-01

Anxiety disorders often emerge during childhood. Rodent models using classical fear conditioning have shown that different types of fear depend upon different neural structures and may emerge at different stages of development. For example, some work has suggested that contextual fear conditioning generally emerges later in development (postnatal day 23–24) than explicitly cued fear conditioning (postnatal day 15–17) in rats. This has been attributed to an inability of younger subjects to form a representation of the context due to an immature hippocampus. However, evidence that contextual fear can be observed in postnatal day 17 subjects and that cued fear conditioning continues to emerge past this age raises questions about the nature of this deficit. The current studies examine this question using both the context pre-exposure facilitation effect for immediate single-shock contextual fear conditioning and traditional cued fear conditioning using Sprague-Dawley rats. The data suggest that both cued and contextual fear conditioning are continuing to develop between PD 17 and 24, consistent with development occurring the in essential fear conditioning circuit. PMID:24977415

14 CFR 25.562 - Emergency landing dynamic conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

....562 Emergency landing dynamic conditions. (a) The seat and restraint system in the airplane must be... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Emergency landing dynamic conditions. 25... successfully complete dynamic tests or be demonstrated by rational analysis based on dynamic tests of a similar...

Mobile Emergency, an Emergency Support System for Hospitals in Mobile Devices: Pilot Study

PubMed Central

2013-01-01

Background Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. Objective The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. Methods The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. Results The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. Conclusions By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings. PMID:23702566

eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients’ and Health Care Providers’ Use of Health-Related Internet Information

PubMed Central

Leese, Jenny; Adam, Paul; McDonald, Michael; Li, Linda C; Kerr, Sheila; Backman, Catherine L

2015-01-01

Background The rapid explosion in online digital health resources is seen as transformational, accelerating the shift from traditionally passive patients to patients as partners and altering the patient–health care professional (HCP) relationship. Patients with chronic conditions are increasingly engaged, enabled, and empowered to be partners in their care and encouraged to take responsibility for managing their conditions with HCP support. Objective In this paper, we focus on patients’ and HCPs’ use of health-related Internet information and how it influences the patient-HCP relationship. In particular, we examine the challenges emerging in medical encounters as roles and relationships shift and apply a conceptual framework of relational ethics to examine explicit and nuanced ethical dimensions emerging in patient-HCP interactions as both parties make increased use of health-related Internet information. Methods We purposively sampled patients and HCPs in British Columbia, Canada, to participate in focus groups. To be eligible, patients self-reported a diagnosis of arthritis and at least one other chronic health condition; HCPs reported a caseload with >25% of patients with arthritis and multimorbidity. We used a semistructured, but flexible, discussion guide. All discussions were audiotaped and transcribed verbatim. Elements of grounded theory guided our constant comparison thematic analytic approach. Analysis was iterative. A relational ethics conceptual lens was applied to the data. Results We recruited 32 participants (18 patients, 14 HCPs). They attended seven focus groups: four with patients and three with rehabilitation professionals and physicians. Predominant themes to emerge were how use of health-related Internet information fostered (1) changing roles, (2) patient-HCP partnerships, and (3) tensions and burdens for patients and HCPs. Conclusions Relational aspects such as mutual trust, uncertainty, and vulnerability are illuminated in patient-HCP interactions around health-related Internet information and the negotiated space of clinical encounters. New roles and associated responsibilities have key ethical dimensions that make clear the changes are fundamental and important to understand in ethical care. When faced with tensions and burdens around incorporating health-related Internet information as a resource in clinical encounters, participants described a particular ambivalence illustrating the fundamental changes being negotiated by both patients and HCPs. PMID:26099267

British Association of Urological Surgeons (BAUS) consensus document for the management of male genital emergencies - penile fracture.

PubMed

Rees, Rowland W; Brown, Gareth; Dorkin, Trevor; Lucky, Marc; Pearcy, Richard; Shabbir, Majid; Shukla, Chitranjan J; Summerton, Duncan J; Muneer, Asif

2018-02-13

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on-site expertise in genitourethral surgery. The aim of these consensus statements is to provide best practice guidance for urological surgeons based in the UK which are developed by an expert consensus. Penile fracture is a rare emergency and in most cases requires prompt exploration and repair to prevent erectile dysfunction and penile curvature. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

5 CFR 630.902 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

...; (c) Parents; (d) Brothers and sisters, and spouses thereof; and (e) Any individual related by blood.... Leave donor means an employee whose voluntary written request for transfer of annual leave to the annual... from the annual leave accounts of one or more leave donors. Medical emergency means a medical condition...

22 CFR Appendix A to Part 230 - Application for Compensation

Code of Federal Regulations, 2014 CFR

2014-04-01

... Part 230 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS Pt... Development Washington, DC 20523 Ref: Guarantee dated as of ____, 20 __: Gentlemen: You are hereby advised...

Impaired conditioned pain modulation in youth with functional abdominal pain

PubMed Central

Morris, Matthew C.; Walker, Lynn S.; Bruehl, Stephen; Stone, Amanda L.; Mielock, Alyssa S.; Rao, Uma

2016-01-01

Functional abdominal pain (FAP) is associated with enhanced pain responsiveness. Although impaired conditioned pain modulation (CPM) characterizes adults with a variety of chronic pain conditions, relatively little is known about CPM in youth with FAP. The present study assessed CPM to evoked thermal pain in 140 youth (ages 10 to 17), 63 of whom had FAP and 77 of whom were healthy controls. Multilevel models demonstrated weaker CPM effects in FAP than healthy youth, as evident in slower within-person decreases in pain ratings during the conditioning phase. Weaker CPM effects were associated with greater somatic symptom severity and functional disability. Pain responses in FAP youth were heterogeneous, with 43% of youth showing an unexpected increase in pain ratings during the conditioning phase, suggesting sensitization rather than CPM-related pain inhibition. These findings highlight directions for future research on the emergence and maintenance of FAP in youth. PMID:27389918

Impaired conditioned pain modulation in youth with functional abdominal pain.

PubMed

Morris, Matthew C; Walker, Lynn S; Bruehl, Stephen; Stone, Amanda L; Mielock, Alyssa S; Rao, Uma

2016-10-01

Functional abdominal pain (FAP) is associated with enhanced pain responsiveness. Although impaired conditioned pain modulation (CPM) characterizes adults with a variety of chronic pain conditions, relatively little is known about CPM in youth with FAP. This study assessed CPM to evoked thermal pain in 140 youth (ages 10-17), 63 of whom had FAP and 77 of whom were healthy controls. Multilevel models demonstrated weaker CPM effects in youth with FAP than in healthy youth, as evident in slower within-person decreases in pain ratings during the conditioning phase. Weaker CPM effects were associated with greater somatic symptom severity and functional disability. Pain responses in youth with FAP were heterogeneous, with 43% of youth showing an unexpected increase in pain ratings during the conditioning phase, suggesting sensitization rather than CPM-related pain inhibition. These findings highlight directions for future research on the emergence and maintenance of FAP in youth.

The Brain’s Heart – Therapeutic Opportunities for Patent Foramen Ovale (PFO) and Neurovascular Disease

PubMed Central

Ning, MingMing; Lo, Eng H.; Ning, Pei-Chen; Xu, Su-Yu; McMullin, David; Demirjian, Zareh; Inglessis, Ignacio; Dec, G William; Palacios, Igor; Buonanno, Ferdinando S.

2013-01-01

Patent foramen ovale (PFO), a common congenital cardiac abnormality, is a connection between the right and left atria in the heart. As a “back door to the brain”, PFO can serve as a conduit for paradoxical embolism, allowing venous thrombi to enter the arterial circulation, avoiding filtration by the lungs, and causing ischemic stroke. PFO-related strokes affect more than 150,000 people per year in the US, and PFO is present in up to 60% of migraine patients with aura, and in one out of four normal individuals. So, in such a highly prevalent condition, what are the best treatment and prevention strategies? Emerging studies show PFO-related neurovascular disease to be a multi-organ condition with varying individual risk factors that may require individualized therapeutic approaches – opening the field for new pharmacologic and therapeutic targets. The anatomy of PFO suggests that, in addition to thrombi, it can also allow harmful circulatory factors to travel directly from the venous to the arterial circulation, a concept important in finding novel therapeutic targets for PFO-related neurovascular injury. Here, we: 1) review emerging data on PFO-related injuries and clinical trials; 2) discuss potential mechanisms of PFO-related neurovascular disease in the context of multi-organ interaction and heart-brain signaling; and 3) discuss novel therapeutic targets and research frontiers. Clinical studies and molecular mapping of the circulatory landscape of this multi-organ disease will both be necessary in order to better individualize clinical treatment for a condition affecting more than a quarter of the world’s population. PMID:23528225

Training medical assistants for surgery.

PubMed Central

Vaz, F.; Bergström, S.; Vaz, M. da l.; Langa, J.; Bugalho, A.

1999-01-01

A successful programme is reported from Mozambique for training middle-level health workers to perform fairly advanced surgical procedures in remote areas where the services of consultants are virtually unobtainable. Manpower and financial constraints obliged Mozambique to train medical assistants to perform surgical work in rural areas, where three broad priorities were identified: pregnancy-related complications, trauma-related complications, and emergency inflammatory conditions. Since 1984, 20 health workers have emerged from three-year courses to become técnicos de cirurgía (assistant medical officers), and it is expected that there will be 46 by 1999. The training comprises two years of lectures and practical sessions in the Maputo Central Hospital, and a practical internship lasting a year at a provincial hospital. Three workshops organized since 1989 suggest that the upgraded personnel are performing well. More detailed evaluation and follow-up are in progress. Throughout 1995 a follow-up was conducted on 14 assistant medical officers. They performed 10,258 surgical operations, some 70% of which were emergency interventions. Low rates of complication occurred and postoperative mortality amounted to 0.4% and 0.1% in emergency and elective interventions respectively. PMID:10516791

Introduction to the WHO Commission on Social Determinants of Health Employment Conditions Network (EMCONET) study, with a glossary on employment relations.

PubMed

Benach, Joan; Muntaner, Carles; Solar, Orielle; Santana, Vilma; Quinlan, Michael

2010-01-01

Although the conditions and power relations of employment are known to be crucial health determinants for workers and their families, the nature of these relations and their effects on health have yet to be fully researched. Several types of employment--precarious employment in developed countries; informal sectors, child labor, slavery, and bonded labor in developing countries--expose workers to risky working conditions. Hazardous work and occupation-related diseases kill approximately 1,500 workers, globally, every day. Growing scientific evidence suggests that particular employment conditions, such as job insecurity and precarious employment, create adverse health effects; yet the limited number of studies and the poor quality of their methods prevent our understanding, globally, the complexity of employer-employee power relations, working conditions, levels of social protections, and the reality of employment-related health inequalities. This article introduces a special section on employment-related health inequalities, derived from the EMCONET approach, which focuses on (1) describing major methods and sources of information; (2) presenting theoretical models at the micro and macro levels; (3) presenting a typology of labor markets and welfare states worldwide; (4) describing the main findings in employment policies, including four key points for implementing strategies; and (5) suggesting new research developments, a policy agenda, and recommendations. This introduction includes a glossary of terms in the emerging area of employment conditions and health inequalities.

Effects of Weather and Heliophysical Conditions on Emergency Ambulance Calls for Elevated Arterial Blood Pressure

PubMed Central

Vencloviene, Jone; Babarskiene, Ruta M.; Dobozinskas, Paulius; Sakalyte, Gintare; Lopatiene, Kristina; Mikelionis, Nerijus

2015-01-01

We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009–2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs), in which the conditions for the emergency calls were made coded I.10–I.15. The Kaunas Weather Station provided daily records of air temperature (T), wind speed (WS), relative humidity, and barometric pressure (BP). We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS > 600 km/s) increased the daily number of elevated arterial blood pressure (EABP) by 12% (RR = 1.12; 95% confidence interval (CI) 1.04–1.21); and WS ≥ 3.5 knots during days of T < 1.5 °C and T ≥ 12.5 °C by 8% (RR = 1.08; CI 1.04–1.12). An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T ≥ 17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population’s sensitivity to different weather conditions. PMID:25734792

38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

Code of Federal Regulations, 2010 CFR

2010-07-01

... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment...

[European migrant crisis and reemergence of infections in Switzerland].

PubMed

Jaton, Laure; Kritikos, Antonios; Bodenmann, Patrick; Greub, Gilbert; Merz, Laurent

2016-04-13

Current conflicts in some regions of the world give rise to massive immigration waves. Consequently, some infections that had nearly disappeared in Europe nowadays re-emerge. They are related to the epidemiology of the refugees' origin, but also to the epidemiology of the country crossed during migration. Hygiene conditions, often precarious during the journey, favor their transmission. Thus, cases of louse borne relapsing fever and diphtheria emerge in Europe and in Switzerland since 2074 whereas cutaneous Panton-Valen tine Staphylococcus aureus infection are more commonly observed nowadays.

38 CFR 17.1002 - Substantive conditions for payment or reimbursement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services for Nonservice.... Payment or reimbursement under 38 U.S.C. 1725 for emergency services may be made only if all of the following conditions are met: (a) The emergency services were provided in a hospital emergency department or...

The Initiation of Solar Eruptions by Flux Emergence

NASA Astrophysics Data System (ADS)

Leake, J. E.; Linton, M.; Antiochos, S. K.

2013-12-01

Understanding the mechanism for the initiation of solar eruptions, or coronal mass ejections (CMEs), is a vital step in the prediction of space weather. There are a number of different theoretical and numerical magnetic models for the initiation of CMEs, and to some extent they all rely on idealized initial conditions or boundary conditions. These idealizations typically involve the presence of pre-formed sheared magnetic fields in the corona, which contain enough free energy to drive an eruption, or the generation of sheared magnetic fields by velocity/electric field boundary flows. The roots of coronal magnetic fields lie in the convection zone, and to understand the CME initiation mechanism, we must understand how these convection zone fields emerge from the high beta convection zone into the low beta corona. Using visco-resistive MHD numerical simulations, we show how simple convection zone magnetic fields that are consistent with our understanding of the solar dynamo can dynamically emerge through the photosphere/chromosphere and into the corona and form sheared magnetic structures which are capable of erupting and creating CMEs. These results extend current CME models by introducing increased realism and removing the idealized initial coronal field conditions and kinematic boundary conditions, which is an important step in relating space weather and the Sun's dynamo generation of magnetic field. This work was funded by NASA's 'Living With a Star' program.

Videomaking as Sociomaterial Assemblage

ERIC Educational Resources Information Center

Toohey, Kelleen; Dagenais, Diane

2015-01-01

In this paper, we present excerpts from ethnographic data collected when a diverse classroom of children, some of whom were multilingual and others monolingual in English, used iPads to make videos. We discuss the practices, social relations, objects and material conditions that emerged as the children engaged in this production, with special…

22 CFR Appendix A to Part 230 - Application for Compensation

Code of Federal Regulations, 2011 CFR

2011-04-01

... Part 230 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS Pt... Development Washington, DC 20523 Ref: Guarantee dated as of , 19__: Gentlemen: You are hereby advised that...

22 CFR Appendix A to Part 230 - Application for Compensation

Code of Federal Regulations, 2013 CFR

2013-04-01

... Part 230 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS Pt... Development Washington, DC 20523 Ref: Guarantee dated as of , 19__: Gentlemen: You are hereby advised that...

22 CFR Appendix A to Part 230 - Application for Compensation

Code of Federal Regulations, 2012 CFR

2012-04-01

... Part 230 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ISRAEL LOAN GUARANTEES ISSUED UNDER THE EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUB. L. 108-11-STANDARD TERMS AND CONDITIONS Pt... Development Washington, DC 20523 Ref: Guarantee dated as of , 19__: Gentlemen: You are hereby advised that...

Oak Tatters

Treesearch

Linda Haugen; Phil Marshall; Jane Cummings Carlson; Mark Vitosh; Ed Hayes

2000-01-01

Oak tatters is a relatively new condition that affects emerging oak leaves, causing them to appear lacy or tattered. It has been observed throughout the Midwestern United States, including Minnesota, Michigan, Wisconsin, Iowa, Illinois, Indiana, Ohio, and Missouri. This disorder was first reported during the 1980's in Iowa, Indiana and Ohio, but has been observed...

Transportability of Equivalence-Based Programmed Instruction: Efficacy and Efficiency in a College Classroom

ERIC Educational Resources Information Center

Fienup, Daniel M.; Critchfield, Thomas S.

2011-01-01

College students in a psychology research-methods course learned concepts related to inferential statistics and hypothesis decision making. One group received equivalence-based instruction on conditional discriminations that were expected to promote the emergence of many untaught, academically useful abilities (i.e., stimulus equivalence group). A…

27 CFR 25.23 - Restrictions on use.

Code of Federal Regulations, 2014 CFR

2014-04-01

... beverages, vitamins, ice, malt, malt syrup, and other by-products of the brewing process, or soft drinks and... because of emergency conditions; (5) Involve experiments or research projects related to equipment... on brewery premises in accordance with § 25.25. (c) Application. Except as provided in § 25.25 for...

27 CFR 25.23 - Restrictions on use.

Code of Federal Regulations, 2012 CFR

2012-04-01

... beverages, vitamins, ice, malt, malt syrup, and other by-products of the brewing process, or soft drinks and... because of emergency conditions; (5) Involve experiments or research projects related to equipment... on brewery premises in accordance with § 25.25. (c) Application. Except as provided in § 25.25 for...

27 CFR 25.23 - Restrictions on use.

Code of Federal Regulations, 2011 CFR

2011-04-01

... beverages, vitamins, ice, malt, malt syrup, and other by-products of the brewing process, or soft drinks and... because of emergency conditions; (5) Involve experiments or research projects related to equipment... on brewery premises in accordance with § 25.25. (c) Application. Except as provided in § 25.25 for...

27 CFR 25.23 - Restrictions on use.

Code of Federal Regulations, 2013 CFR

2013-04-01

... beverages, vitamins, ice, malt, malt syrup, and other by-products of the brewing process, or soft drinks and... because of emergency conditions; (5) Involve experiments or research projects related to equipment... on brewery premises in accordance with § 25.25. (c) Application. Except as provided in § 25.25 for...

22 CFR 231.16 - Governing law.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Governing law. 231.16 Section 231.16 Foreign... EMERGENCY WARTIME SUPPLEMENTAL APPROPRIATIONS ACT OF 2003, PUBLIC LAW 108-11-STANDARD TERMS AND CONDITIONS § 231.16 Governing law. This Guarantee shall be governed by and construed in accordance with the laws of...

7 CFR 623.4 - Eligible land.

Code of Federal Regulations, 2011 CFR

2011-01-01

... restored on the land under a CRP contract, or under a Federal or State wetland restoration program with an... AGRICULTURE WATER RESOURCES EMERGENCY WETLANDS RESERVE PROGRAM § 623.4 Eligible land. (a) Except as otherwise... condition and repairing related floodwater control systems; (3) Is likely to have its wetland value restored...

Social validation and training of emergency fire safety skills for potential injury prevention and life saving.

PubMed Central

Jones, R T; Kazdin, A E; Haney, J I

1981-01-01

A multifaceted behavioral program designed to teach emergency fire escape procedures to children was evaluated in a multiple-baseline design. Five children were trained to respond correctly to nine home emergency fire situations under simulated conditions. The situations and responses focused upon in training were identified by a social validation procedure involving consultation with several safety agencies, including the direct input of firefighters. Training, carried out in simulated bedrooms at school, resulted in significant improvements in both overt behavior and self-report of fire safety skills. The gains were maintained at a post-check assessment 2 weeks after training had been terminated. The results are discussed in relation both to the importance of social validation of targets and outcomes and the implications for further research in assessing and developing emergency response skills. PMID:7298537

Foliar sorption of emerging and priority contaminants under controlled conditions.

PubMed

Calderón-Preciado, Diana; Matamoros, Víctor; Biel, Carmen; Save, Robert; Bayona, Josep M

2013-09-15

Agricultural irrigation water contains a variety of contaminants that can be introduced into the food chain through intake by irrigated crops. This paper describes an experiment under controlled conditions designed to simulate sprinkle irrigation with polluted water at two different relative humidities (40 and 90%). Specifically, shed lettuce-heart leaves were spiked with an aqueous solution containing organic microcontaminants, including pharmaceuticals (ibuprofen, diclofenac, clofibric acid, and carbamazepine), fragrances (tonalide), biocides (triclosan), insecticides (lindane), herbicides (atrazine), phenolic estrogen (bisphenol A), and polycyclic aromatic hydrocarbons (phenanthrene and pyrene). Following an incubation period (48 h), the treated leaves were rinsed with water, and both the solution used to rinse them and the leaves themselves were independently analyzed to investigate the foliar sorption and uptake of the spiked organic contaminants through cuticle. The results showed that the foliar sorption of emerging and priority microcontaminants in leaves wetted by irrigation practices is related to their polarity (logD(ow)) and volatility (logk(H)), regardless of their compound class and the relative humidity. The results thus underscore the need to improve the quality of reclaimed water in crop irrigation, particularly when sprinkle irrigation is used. Copyright © 2013 Elsevier B.V. All rights reserved.

Sensitivity to initial conditions in the Bak-Sneppen model of biological evolution

NASA Astrophysics Data System (ADS)

Tamarit, F. A.; Cannas, S. A.; Tsallis, C.

1998-03-01

We consider biological evolution as described within the Bak and Sneppen 1993 model. We exhibit, at the self-organized critical state, a power-law sensitivity to the initial conditions, calculate the associated exponent, and relate it to the recently introduced nonextensive thermostatistics. The scenario which here emerges without tuning strongly reminds of that of the tuned onset of chaos in say logistic-like one-dimensional maps. We also calculate the dynamical exponent z.

Communicating in the "gray zone": perceptions about emergency physician hospitalist handoffs and patient safety.

PubMed

Apker, Julie; Mallak, Larry A; Gibson, Scott C

2007-10-01

To identify the perceptions of emergency physicians (EPs) and hospitalists regarding interservice handoff communication as patients are transferred from the emergency department to the inpatient setting. Investigators conducted individual interviews with 12 physicians (six EPs and six hospitalists). Data evaluation consisted of using the steps of constant comparative, thematic analysis. Physicians perceived handoff communication as a gray zone characterized by ambiguity about patients' conditions and treatment. Two major themes emerged regarding the handoff gray zone. The first theme, poor communication practices and conflicting communication expectations, presented barriers that exacerbated physicians' information ambiguity. Specifically, handoffs consisting of insufficient information, incomplete data, omissions, and faulty information flow exacerbated gray zone problems and may negatively affect patient outcomes. EPs and hospitalists had different expectations about handoffs, and those expectations influenced their interactions in ways that may result in communication breakdowns. The second theme illustrated how poor handoff communication contributes to boarding-related patient safety threats for boarders and emergency department patients alike. Those interviewed talked about the systemic failures that lead to patient boarding and how poor handoffs exacerbated system flaws. Handoffs between EPs and hospitalists both reflect and contribute to the ambiguity inherent in emergency medicine. Poor handoffs, consisting of faulty communication behaviors and conflicting expectations for information, contribute to patient boarding conditions that can pose safety threats. Pragmatic conclusions are drawn regarding physician-physician communication in patient transfers, and recommendations are offered for medical education.

On the evolutionary origins of the egalitarian syndrome

PubMed Central

Gavrilets, Sergey

2012-01-01

The evolutionary emergence of the egalitarian syndrome is one of the most intriguing unsolved puzzles related to the origins of modern humans. Standard explanations and models for cooperation and altruism—reciprocity, kin and group selection, and punishment—are not directly applicable to the emergence of egalitarian behavior in hierarchically organized groups that characterized the social life of our ancestors. Here I study an evolutionary model of group-living individuals competing for resources and reproductive success. In the model, the differences in fighting abilities lead to the emergence of hierarchies where stronger individuals take away resources from weaker individuals and, as a result, have higher reproductive success. First, I show that the logic of within-group competition implies under rather general conditions that each individual benefits if the transfer of the resource from a weaker group member to a stronger one is prevented. This effect is especially strong in small groups. Then I demonstrate that this effect can result in the evolution of a particular, genetically controlled psychology causing individuals to interfere in a bully–victim conflict on the side of the victim. A necessary condition is a high efficiency of coalitions in conflicts against the bullies. The egalitarian drive leads to a dramatic reduction in within-group inequality. Simultaneously it creates the conditions for the emergence of inequity aversion, empathy, compassion, and egalitarian moral values via the internalization of behavioral rules imposed by natural selection. It also promotes widespread cooperation via coalition formation. PMID:22891349

The Emergence and Unfolding of Telemonitoring Practices in Different Healthcare Organizations

PubMed Central

2018-01-01

Telemonitoring, a sub-category of telemedicine, is promoted as a solution to meet the challenges in Western healthcare systems in terms of an increasing population of people with chronic conditions and fragmentation issues. Recent findings from large-scale telemonitoring programs reveal that these promises are difficult to meet in complex real-life settings which may be explained by concentrating on the practices that emerge when telemonitoring is used to treat patients with chronic conditions. This paper explores the emergence and unfolding of telemonitoring practices in relation to a large-scale, inter-organizational home telemonitoring program which involved 5 local health centers, 10 district nurse units, four hospitals, and 225 general practice clinics in Denmark. Twenty-eight interviews and 28 h of observations of health professionals and administrative staff were conducted over a 12-month period from 2014 to 2015. This study’s findings reveal how telemonitoring practices emerged and unfolded differently among various healthcare organizations. This study suggests that the emergence and unfolding of novel practices is the result of complex interplay between existing work practices, alterations of core tasks, inscriptions in the technology, and the power to either adopt or ignore such novel practices. The study enhances our understanding of how novel technology like telemonitoring impacts various types of healthcare organizations when implemented in a complex inter-organizational context. PMID:29301384

Teaching Manual Signs to Adults With Mental Retardation Using Matching-to-Sample Procedures and Stimulus Equivalence

PubMed Central

Elias, Nassim Chamel; Goyos, Celso; Saunders, Muriel; Saunders, Richard

2008-01-01

The objective of this study was to teach manual signs through an automated matching-to-sample procedure and to test for the emergence of new conditional relations and imitative behaviors. Seven adults with mild to severe mental retardation participated. Four were also hearing impaired. Relations between manual signs (set A) and pictures (set B) were initially taught, followed by the training of corresponding printed words (set C) and pictures (set B). Further presentations of conditional discriminations tested for the emergence of AC, followed by tests for the emergence of imitative signing behavior (D) in the presence of either pictures (B) or printed words (C). Each stimulus set was comprised of 9 elements. The stimuli were still pictures, printed words, and dynamic presentations of manual signs. A pretest was conducted to determine which signs the participants could make pre-experimentally. Teaching was arranged in a multiple baseline design across 3 groups of 3 words each. The purpose of the present study was to determine whether participants would emit manual signs in expressive signs tests as a result of observation (video modeling) during match-to-sample training in the absence of explicit training. Five of the 7 subjects passed tests of emergence and emitted at least 50% of the signs. Two were hearing impaired with signing experience, and 3 were not hearing impaired and had no signing experience. Thus, observation of video recorded manual signs in a matching-to-sample training procedure was effective at establishing some signs by adults with mental retardation. PMID:22477400

Suitability of Coastal Marshes as Whooping Crane Foraging Habitat in Southwest Louisiana, USA

USGS Publications Warehouse

King, Sammy L.; Kang, Sung-Ryong

2014-01-01

Foraging habitat conditions (i.e., water depth, prey biomass, digestible energy density) can be a significant predictor of foraging habitat selection by wading birds. Potential foraging habitats of Whooping Cranes (Grus americana) using marshes include ponds and emergent marsh, but the potential prey and energy availability in these habitat types have rarely been studied. In this study, we estimated daily digestible energy density for Whooping Cranes in different marsh and microhabitat types (i.e., pond, flooded emergent marsh). Also, indicator metrics of foraging habitat suitability for Whooping Cranes were developed based on seasonal water depth, prey biomass, and digestible energy density. Seasonal water depth (cm), prey biomass (g wet weight m-2), and digestible energy density (kcal g-1m-2) ranged from 0.0 to 50.2 ± 2.8, 0.0 to 44.8 ± 22.3, and 0.0 to 31.0 ± 15.3, respectively. With the exception of freshwater emergent marsh in summer, all available habitats were capable of supporting one Whooping Crane per 0.1 ha per day. All habitat types in the marshes had relatively higher suitability in spring and summer than in fall and winter. Our study indicates that based on general energy availability, freshwater marshes in the region can support Whooping Cranes in a relatively small area, particularly in spring and summer. In actuality, the spatial density of ponds, the flood depth of the emergent marsh, and the habitat conditions (e.g., vegetation density) between adjacent suitable habitats will constrain suitable habitat and Whooping Crane numbers.

Care Situation for Female Victims of Sexual Violence in Metropolitan Emergency Departments with Charité/Berlin as an Example

PubMed Central

Hoffmann-Walbeck, H.; Möckel, M.; Etzold, S.; David, M.

2016-01-01

of the perpetrators were friends or relations; 17 % were (ex-)partners. The waiting time in the Charité emergency departments amounted to 58 minutes on average, the medical treatment time 55 minutes. About 80 % of the personnel evaluated the “stuprum kit” as being altogether good or very good. More than ⅓ considered the time and room conditions as being unsuitable or rather unsuitable for the situation. Two thirds expressed the desire for further training and supervision. Conclusion: The structured procedure by means of the “stuprum kit” has proved its value. A need for optimisation was seen especially for the examination facilities in the emergency departments. PMID:27904168

Vegetation-Induced Roughness in Low-Reynold's Number Flows

NASA Astrophysics Data System (ADS)

Piercy, C. D.; Wynn, T. M.

2008-12-01

Wetlands are important ecosystems, providing habitat for wildlife and fish and shellfish production, water storage, erosion control, and water quality improvement and preservation. Models to estimate hydraulic resistance due to vegetation in emergent wetlands are crucial to good wetland design and analysis. The goal of this project is to improve modeling of emergent wetlands by linking properties of the vegetation to flow. Existing resistance equations such as Hoffmann (2004), Kadlec (1990), Moghadam and Kouwen (1997), Nepf (1999), and Stone and Shen (2002) were evaluated. A large outdoor vegetated flume was constructed at the Price's Fork Research Center near Blacksburg, Virginia to measure flow and water surface slope through woolgrass (Scirpus cyperinus), a common native emergent wetland plant. Measurements of clump and stem density, diameter, and volume, blockage factor, and stiffness were made after each set of flume runs. Flow rates through the flume were low (3-4 L/s) resulting in very low stem-Reynold's numbers (15-102). Since experimental flow conditions were in the laminar to transitional range, most of the models considered did not predict velocity or stage accurately except for conditions in which the stem-Reynold's number approached 100. At low stem-Reynold's numbers (<100), the drag coefficient is inversely proportional to the Reynold's number and can vary greatly with flow conditions. Most of the models considered assumed a stem-Reynold's number in the 100-105 range in which the drag coefficient is relatively constant and as a result did not predict velocity or stage accurately except for conditions in which the stem-Reynold's number approached 100. The only model that accurately predicted stem layer velocity was the Kadlec (1990) model since it does not make assumptions about flow regime; instead, the parameters are adjusted according to the site conditions. Future work includes relating the parameters used to fit the Kadlec (1990) model to measured vegetation parameters as described previously and adapting the force balance upon which all the considered models were based for the observed experimental conditions, leading to a model that will conform to assumptions consistent with low stem-Reynold's number flows.

Determinants of General Health, Work-Related Strain, and Burnout in Public Versus Private Emergency Medical Technicians in Istanbul.

PubMed

Tunaligil, Verda; Dokucu, Ali Ihsan; Erdogan, Mehmet Sarper

2016-07-01

This study investigated the impact of working for public versus private ambulance services in Turkey and elaborated on predictors of mental, physical, and emotional well-being in emergency medical technicians (EMT-Bs). In this observational cross-sectional study, an 81-question self-report survey was used to gather data about employee demographics, socioeconomic status, educational background, working conditions, and occupational health and workplace safety (OHS), followed by the 12-item General Health Questionnaire (GHQ-12), the Work-Related Strain Inventory (WRSI), and the Maslach Burnout Inventory (MBI) with three subscales: Emotional Exhaustion (MBI-EE), Depersonalization (MBI-DP), and Diminished Personal Accomplishment (MBI-PA). In 2011, 1,038 EMT-Bs worked for publicly operated and 483 EMT-Bs worked for privately owned ambulance services in Istanbul, Turkey, of which 606 (58.4%) and 236 (48.9%) participated in the study (overall participation rate = 55.4%), respectively. On all scales, differences between total mean scores in both sectors were statistically insignificant (p > .05). In the public sector, work locations, false accusations, occupational injuries and diseases, work-related permanent disabilities, and organizational support were found to significantly influence self-reported perceptions of well-being (p < .05). In the private sector, commute time to and from work (p < .05), false accusations (p < .05), vocational training and education (p < .05), informed career choices (p < .05), and work-related permanent disabilities (p < .05) were found to significantly influence self-reported perceptions of well-being. EMT-Bs were asked about aspects of their working lives that need improvement; priority expectations in the public and private sectors were higher earnings (17.5%; 16.7%) and better social opportunities (17.4%; 16.8%). Working conditions, vocational training, and OHS emerged as topics that merit priority attention. © 2016 The Author(s).

Impacts of extreme heat on emergency medical service calls in King County, Washington, 2007-2012: relative risk and time series analyses of basic and advanced life support.

PubMed

Calkins, Miriam M; Isaksen, Tania Busch; Stubbs, Benjamin A; Yost, Michael G; Fenske, Richard A

2016-01-28

Exposure to excessive heat kills more people than any other weather-related phenomenon, aggravates chronic diseases, and causes direct heat illness. Strong associations between extreme heat and health have been identified through increased mortality and hospitalizations and there is growing evidence demonstrating increased emergency department visits and demand for emergency medical services (EMS). The purpose of this study is to build on an existing regional assessment of mortality and hospitalizations by analyzing EMS demand associated with extreme heat, using calls as a health metric, in King County, Washington (WA), for a 6-year period. Relative-risk and time series analyses were used to characterize the association between heat and EMS calls for May 1 through September 30 of each year for 2007-2012. Two EMS categories, basic life support (BLS) and advanced life support (ALS), were analyzed for the effects of heat on health outcomes and transportation volume, stratified by age. Extreme heat was model-derived as the 95th (29.7 °C) and 99th (36.7 °C) percentile of average county-wide maximum daily humidex for BLS and ALS calls respectively. Relative-risk analyses revealed an 8 % (95 % CI: 6-9 %) increase in BLS calls, and a 14 % (95 % CI: 9-20 %) increase in ALS calls, on a heat day (29.7 and 36.7 °C humidex, respectively) versus a non-heat day for all ages, all causes. Time series analyses found a 6.6 % increase in BLS calls, and a 3.8 % increase in ALS calls, per unit-humidex increase above the optimum threshold, 40.7 and 39.7 °C humidex respectively. Increases in "no" and "any" transportation were found in both relative risk and time series analyses. Analysis by age category identified significant results for all age groups, with the 15-44 and 45-64 year old age groups showing some of the highest and most frequent increases across health conditions. Multiple specific health conditions were associated with increased risk of an EMS call including abdominal/genito-urinary, alcohol/drug, anaphylaxis/allergy, cardiovascular, metabolic/endocrine, diabetes, neurological, heat illness and dehydration, and psychological conditions. Extreme heat increases the risk of EMS calls in King County, WA, with effects demonstrated in relatively younger populations and more health conditions than those identified in previous analyses.

Overview of Common Sleep Disorders and Intersection with Dermatologic Conditions.

PubMed

Walia, Harneet K; Mehra, Reena

2016-04-30

Sleep disorders are very common, often under-recognized and therefore undertreated, are associated with a myriad of medical conditions and could lead to significant impairment of quality of life. This review provides an up-to-date synopsis of common sleep disorders encompassing insufficient sleep syndrome, insomnia, circadian rhythm disorders and obstructive sleep apnea with a brief overview of epidemiology, screening, diagnostic testing and treatment. We also emphasize the emerging area of the intersection of sleep disorders and dermatologic conditions and present compelling data regarding underlying mechanisms including sleep dysfunction in relation to disorders of skin inflammation, aging and skin cancer.

Psychiatric emergencies of minors with and without migration background.

PubMed

Akkaya-Kalayci, Türkan; Popow, Christian; Waldhör, Thomas; Winkler, Dietmar; Özlü-Erkilic, Zeliha

2017-03-01

The conditions of children and adolescents with migration background receiving emergency psychiatric care in Europe are not well known. Migrants usually attend regular psychiatric care less frequently than the autochthonous population. We therefore speculated that, being undertreated, they would be overrepresented among psychiatric emergency care patients. We retrospectively analyzed the records of 1093 minors aged 4‑18 years treated during a period of three years at the psychiatric emergency outpatient clinic of the Department of Child and Adolescent Psychiatry at the Medical University of Vienna. More minors with migration background than natives consulted our emergency clinic. Most frequent reasons for referral were suicide attempts by Turkish patients, acute stress disorder in Serbian/Croatian/Bosnian and in Austrian patients. Psychiatric diagnoses like eating and personality disorders were mostly diagnosed in natives. We found gender specific differences between the groups. The reasons for these differences possibly relate to deficits of adequate mental health-care in Austria, to intercultural and intrafamiliar conflicts related to acculturation distress in the migrant population. Prospective longitudinal studies focusing on the utilization of mental health care by the migrant children and the impact of the migration background on their mental health are needed for improving adequate culture-sensitive mental-health care for this population.

Management of select bacterial and parasitic conditions of raptors.

PubMed

Willette, Michelle; Ponder, Julia; Cruz-Martinez, Luis; Arent, Lori; Bueno Padilla, Irene; de Francisco, Olga Nicolas; Redig, Patrick

2009-09-01

Raptors are susceptible to a broad array of established and emerging bacterial and parasitic diseases, including babesiosis, chlamydiosis, clostridiosis, coccidiosis, cryptosporidiosis, malaria, mycobacteriosis, pasteurellosis, salmonellosis, trichomoniasis, and pododermatitis. Many of these conditions are opportunistic and can be easily managed or averted with proper preventive measures related to captive management, husbandry and diet, and veterinary care. Once infected, treatment must be prompt, appropriate, and judicious. This article examines the significance, diagnosis, management, and prevention of select bacterial and parasitic pathogens of raptors.

Children and the Creative Process.

ERIC Educational Resources Information Center

Whitehurst, Keturah E.

This article briefly reviews some of the psychological research literature defining and assessing creativity, and examines such questions as: (1) Does creativity simply emerge as the expression of the genius of a gifted elite? (2) Can it be taught? If so, how? (3) What conditions foster creativity? (4) Is it related to intelligence and academic…

Bologna Network: A New Sociopolitical Area in Higher Education

ERIC Educational Resources Information Center

Croche, Sarah

2009-01-01

The project of the Bologna process to create a "European Higher Education Area" (EHEA) has established the necessary conditions for the emergence of a new sociopolitical space of higher education in Europe. This space has become a cooperation/competition area that changes the European and national balance of power: the relations the…

On the Causes for and Countermeasures against Academic Corruption

ERIC Educational Resources Information Center

Yongning, Yuan; Jian, Zhang; Haibo, Wang

2007-01-01

Combating corruption is an important condition for bringing about the flourishing of academic research. There are many reasons for the emergence and proliferation of academic corruption today. These are closely related to the long-term lack of training among our country's scholars in modern academic standards and the absence of an academic spirit…

75 FR 75 - Special Conditions: Boeing Model 787-8 Airplane; Overhead Crew Rest Compartment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

..., explain the reason for any recommended change, and include supporting data. We ask that you send us two...-site operational evaluation. Any changes to the approved OCR compartment configuration that affect crewmember emergency egress or any other procedures affecting safety of the occupying crewmembers or related...

Late Onset First Episode Psychosis Emerging as Delusional Misidentification of Familiar Sacred Places During a Holy Pilgrimage: A Case Report and Literature Review.

PubMed

Awara, Mahmoud A; Moselhy, Hamdy F; Elnenaei, Manal O

2017-11-07

The delusional misidentification syndromes (DMS) include a myriad of discrete but related syndromes, which have wide spectrum anomalies of familiarity. Several misidentification syndromes have been described in the psychiatric literature, the most common of these delusions are: the Capgras syndrome; the Fregoli syndrome; the syndrome of inter-metamorphosis; reduplicative paramnesia; and environmental reduplication. The reported case highlights the emergence of late onset first episode psychosis in a Middle Eastern 65-year-old female who has no previous psychiatric history. The nature of psychosis was mainly delusions of misidentification and persecution. DMS are relatively rare and occur predominantly in association with schizophrenia and affective psychosis. Between 25 and 40% are associated with organic conditions such as dementia, head injuries, brain tumors, and epilepsy. Only three cases of misidentification of sacred places have been reported previously in the literature. This case report is the first to present a DMS, emerging as a late onset first episode psychosis during the sacred journey of Hajj. The reported case highlights the importance of early recognition and treatment of mental health conditions that may appear de novo during the Hajj sacred journey. Readily available psychiatric resources, psychotropic medications, and psycho-education may be pivotal in ensuring mental well-being of pilgrims, which is fundamental to maintain the mental capacity required for completing these journeys.

Getting women to hospital is not enough: a qualitative study of access to emergency obstetric care in Bangladesh.

PubMed

Pitchforth, E; van Teijlingen, E; Graham, W; Dixon-Woods, M; Chowdhury, M

2006-06-01

To explore what happened to poor women in Bangladesh once they reached a hospital providing comprehensive emergency obstetric care (EmOC) and to identify support mechanisms. Mixed methods qualitative study. Large government medical college hospital in Bangladesh. Providers and users of EmOC. Ethnographic observation in obstetrics unit including interviews with staff and women using the unit and their carers. Women had to mobilise significant financial and social resources to fund out of pocket expenses. Poorer women faced greater challenges in receiving treatment as relatives were less able to raise the necessary cash. The official financial support mechanism was bureaucratic and largely unsuitable in emergency situations. Doctors operated a less formal "poor fund" system to help the poorest women. There was no formal assessment of poverty; rather, doctors made "adjudications" of women's need for support based on severity of condition and presence of friends and relatives. Limited resources led to a "wait and see" policy that meant women's condition could deteriorate before help was provided. Greater consideration must be given to what happens at health facilities to ensure that (1) using EmOC does not further impoverish families; and (2) the ability to pay does not influence treatment. Developing alternative finance mechanisms to reduce the burden of out of pocket expenses is crucial but challenging. Increased investment in EmOC must be accompanied by an increased focus on equity.

Twentieth century surge of excess adult male mortality

PubMed Central

Beltrán-Sánchez, Hiram; Finch, Caleb E.; Crimmins, Eileen M.

2015-01-01

Using historical data from 1,763 birth cohorts from 1800 to 1935 in 13 developed countries, we show that what is now seen as normal—a large excess of female life expectancy in adulthood—is a demographic phenomenon that emerged among people born in the late 1800s. We show that excess adult male mortality is clearly rooted in specific age groups, 50–70, and that the sex asymmetry emerged in cohorts born after 1880 when male:female mortality ratios increased by as much as 50% from a baseline of about 1.1. Heart disease is the main condition associated with increased excess male mortality for those born after 1900. We further show that smoking-attributable deaths account for about 30% of excess male mortality at ages 50–70 for cohorts born in 1900–1935. However, after accounting for smoking, substantial excess male mortality at ages 50–70 remained, particularly from cardiovascular disease. The greater male vulnerability to cardiovascular conditions emerged with the reduction in infectious mortality and changes in health-related behaviors. PMID:26150507

14 CFR 25.1362 - Electrical supplies for emergency conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Equipment Electrical Systems and Equipment § 25.1362 Electrical supplies for emergency conditions. A suitable electrical supply must be... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Electrical supplies for emergency...

Parental spirituality in life-threatening pediatric cancer.

PubMed

Nicholas, David B; Barrera, Maru; Granek, Leeat; D'Agostino, Norma Mammone; Shaheed, Jenny; Beaune, Laura; Bouffet, Eric; Antle, Beverley

2017-01-01

This study addressed parental spirituality in the context of pediatric cancer with a poor prognosis. Drawing upon previous research implementing a longitudinal grounded theory design examining parental hope, 35 parents were interviewed regarding their experiences with an emergent description of the role of spirituality in parents' daily lives. Spirituality included religious beliefs and practices, notions of a higher force or cosmos, relationship with a divine being, as well as elements emerging from meaning-making and relationships. Parental expectations of spirituality remained relatively constant across data collection time points (3-9 months postdiagnosis), although limited variation occurred relative to shifting circumstance (e.g., deterioration of the child's condition). Spirituality appeared to offer: greater acceptance of parents' inability to protect their child from harm related to her/his life-threatening illness, guidance and emotion decompression, and support from one's faith community. Recommendations for integrating spiritual assessment in clinical care practice are offered.

Drivers, dynamics, and control of emerging vector-borne zoonotic diseases

PubMed Central

Kilpatrick, A. Marm; Randolph, Sarah E.

2013-01-01

Emerging vector-borne diseases represent an important issue for global health. Many vector-borne pathogens have appeared in new regions in the past two decades, and many endemic diseases have increased in incidence. Although introductions and local emergence are frequently considered distinct processes, many emerging endemic pathogens are in fact invading at a local scale coincident with habitat change. We highlight key differences in the dynamics and disease burden that result from increased pathogen transmission following habitat change compared with the introduction of pathogens to new regions. Truly in situ emergence is commonly driven by changes in human factors as much as by enhanced enzootic cycles whereas pathogen invasion results from anthropogenic trade and travel and suitable conditions for a pathogen, including hosts, vectors, and climate. Once established, ecological factors related to vector characteristics shape the evolutionary selective pressure on pathogens that may result in increased use of humans as transmission hosts. We describe challenges inherent in the control of vector-borne zoonotic diseases and some emerging non-traditional strategies that may be more effective in the long term. PMID:23200503

Perspectives of emergency department staff on the triage of mental health-related presentations: Implications for education, policy and practice.

PubMed

Gerdtz, Marie F; Weiland, Tracey J; Jelinek, George A; Mackinlay, Claire; Hill, Nicole

2012-10-01

To explore ED staff perceptions of the factors that influence accuracy of triage for people with mental health problems. This qualitative learning needs analysis used a descriptive exploratory design. Participants were Australian emergency nurses and doctors. We used a criterion-based sampling approach. Recruitment was facilitated by the College of Emergency Nursing Australasia and the Australasian College for Emergency Medicine. A semi-structured interview schedule was developed. Telephone interviews were conducted, audio recorded and transcribed verbatim. Thematic analysis was used to identify factors perceived to affect triage outcomes and to explore strategies to optimise the accuracy of triage assessments. Thirty-six staff participated (16 nurses and 20 doctors). Four major factors were perceived to influence accuracy. These were: environmental factors (physical structure, time pressures, activity levels, and interruptions), policy and education (guidelines, training and resources), staff factors (knowledge, experience, attitudes) and patient factors (police presence, patient behaviour, clinical condition). Differences of opinion were expressed by emergency doctors about the validity of the time to treatment objectives included in the Australasian Triage Scale for mental health presentations, and the utility of the scale to differentiate urgency for psychiatric conditions. Clinical guidelines and training have been developed to support the use of the Australasian Triage Scale. Further evaluation of the application of this scale to assess mental health problems is indicated. Additional work is also required to reduce variance in urgency assignment based on staff knowledge and attitudes about the causes, assessment and early management of psychiatric disorders. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Health impact of the 2004 Andaman Nicobar earthquake and tsunami in Indonesia.

PubMed

Guha-Sapir, Debarati; van Panhuis, Willem Gijsbert

2009-01-01

The human impact of the tsunami that occurred on 26 December 2004 was enormous, with Indonesia bearing a huge proportion of the losses. The aftermath brought predictions of communicable disease outbreaks and widespread fear of epidemics. However, evidence from previous disasters due to natural hazards does not support all of these predictions. The objectives of this study were to: (1) describe the relative importance of infectious diseases and injuries as a consequence of a disaster due to natural hazards; and (2) identify key recommendations for the improvement of control and surveillance of these diseases during and after disasters. A team from the Center for Research on the Epidemiology of Disasters visited Jakarta and Banda Aceh from 11-23 January 2005, and collected data from the Central and Provincial Ministries of Health (MOH), the World Health Organization (WHO), and a field hospital from the International Committee of the Red Cross in Banda Aceh. The epidemiological profiles of diseases before and after the tsunami were compared. Cholera, tetanus, wounds and wound infections, acute respiratory infections, malaria, and dengue were included in this analysis. Certain diseases (e.g., cholera, malaria, dengue) are not always an immediate priority post-disaster. Rates of disaster-related health conditions requiring emergency response fell by half, and became negligible around four weeks after the precipitating events. Some conditions, such as aspiration pneumonia and tetanus, which normally are rare, require special preparedness for emergency personnel. In addition, resistant and rare pathogens are associated with disasters due to natural hazards in the tropics and require specialized knowledge for the rapid and successful treatment of related infections. Within the first four weeks of a disaster, international humanitarian agencies in the health sector should start working with the MOH. The WHO surveillance system established immediately after the tsunami offers lessons for developing a prototype for future emergencies. Guidelines for tetanus and aspiration pneumonia should be included in disaster medicine handbooks, and humanitarian aid groups should be prepared to provide emergency obstetrics and post-natal services. Relief funding after naturally occurring disasters should consider funding sustainability. Donors should know when to stop providing emergency relief funds and transition to recovery/development strategies.

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.

On factors influencing air-water gas exchange in emergent wetlands

USGS Publications Warehouse

Ho, David T.; Engel, Victor C.; Ferron, Sara; Hickman, Benjamin; Choi, Jay; Harvey, Judson W.

2018-01-01

Knowledge of gas exchange in wetlands is important in order to determine fluxes of climatically and biogeochemically important trace gases and to conduct mass balances for metabolism studies. Very few studies have been conducted to quantify gas transfer velocities in wetlands, and many wind speed/gas exchange parameterizations used in oceanographic or limnological settings are inappropriate under conditions found in wetlands. Here six measurements of gas transfer velocities are made with SF6 tracer release experiments in three different years in the Everglades, a subtropical peatland with surface water flowing through emergent vegetation. The experiments were conducted under different flow conditions and with different amounts of emergent vegetation to determine the influence of wind, rain, water flow, waterside thermal convection, and vegetation on air-water gas exchange in wetlands. Measured gas transfer velocities under the different conditions ranged from 1.1 cm h−1 during baseline conditions to 3.2 cm h−1 when rain and water flow rates were high. Commonly used wind speed/gas exchange relationships would overestimate the gas transfer velocity by a factor of 1.2 to 6.8. Gas exchange due to thermal convection was relatively constant and accounted for 14 to 51% of the total measured gas exchange. Differences in rain and water flow among the different years were responsible for the variability in gas exchange, with flow accounting for 37 to 77% of the gas exchange, and rain responsible for up to 40%.

Panic anxiety, under the weather?

NASA Astrophysics Data System (ADS)

Bulbena, A.; Pailhez, G.; Aceña, R.; Cunillera, J.; Rius, A.; Garcia-Ribera, C.; Gutiérrez, J.; Rojo, C.

2005-03-01

The relationship between weather conditions and psychiatric disorders has been a continuous subject of speculation due to contradictory findings. This study attempts to further clarify this relationship by focussing on specific conditions such as panic attacks and non-panic anxiety in relation to specific meteorological variables. All psychiatric emergencies attended at a general hospital in Barcelona (Spain) during 2002 with anxiety as main complaint were classified as panic or non-panic anxiety according to strict independent and retrospective criteria. Both groups were assessed and compared with meteorological data (wind speed and direction, daily rainfall, temperature, humidity and solar radiation). Seasons and weekend days were also included as independent variables. Non-parametric statistics were used throughout since most variables do not follow a normal distribution. Logistic regression models were applied to predict days with and without the clinical condition. Episodes of panic were three times more common with the poniente wind (hot wind), twice less often with rainfall, and one and a half times more common in autumn than in other seasons. These three trends (hot wind, rainfall and autumn) were accumulative for panic episodes in a logistic regression formula. Significant reduction of episodes on weekends was found only for non-panic episodes. Panic attacks, unlike other anxiety episodes, in a psychiatric emergency department in Barcelona seem to show significant meteorotropism. Assessing specific disorders instead of overall emergencies or other variables of a more general quality could shed new light on the relationship between weather conditions and behaviour.

Adolescent Brain Development and Underage Drinking in the United States: Identifying Risks of Alcohol Use in College Populations

PubMed Central

Silveri, Marisa M.

2015-01-01

Alcohol use typically is initiated during adolescence, an age period that overlaps with critical structural and functional maturation of the brain. Brain maturation and associated improvements in decision-making continue into the second decade of life, reaching plateaus within the period referred to as “emerging adulthood” (18–24 years). Emerging adulthood is the typical age span of the traditionally aged college student, which includes the age (21 years) when alcohol consumption becomes legal in the United States. This review highlights neurobiological evidence indicating the vulnerabilities of the emerging adult brain to alcohol effects. This review also identifies that reduced sensitivity to alcohol sedation and increased sensitivity to alcohol-related disruptions in memory, positive family history of alcoholism effects on brain structure and function, and emerging co-morbid psychiatric conditions serve as unique vulnerabilities that increase the risks associated with underage alcohol use. These vulnerabilities likely contribute to excessive and unsupervised drinking in college students. Discouraging alcohol consumption until neurobiological adulthood is reached is important for minimizing alcohol-related disruptions in brain development and decision-making capacity, and reducing the negative behavioral consequences associated with underage alcohol use. PMID:22894728

Typologies of Altruistic and Financial Motivations for Research Participation.

PubMed

Chin, Lisa J; Berenson, Jacqueline A; Klitzman, Robert L

2016-10-01

Questions arise concerning participants' motives in risky studies, such as HIV vaccine trials (HVTs). We interviewed in-depth 20 gay/bisexual men. Participants described both altruistic and nonaltruistic motives. Altruistic motivations emerged primarily, with nine typologies: (a) cultural, (b) community related, (c) familial, (d) religious, (e) professional, (f) political (e.g., HIV activism), (g) moral (e.g., making up for past wrongs), (h) existential (e.g., providing sense of meaning), and (i) other psychological (e.g., emotional gratification). Views of compensation varied: not a factor (55%), added incentive (25%), main motivator, but in conjunction with altruism (15%), and primary motivator (5%). HVT participants thus often have both altruistic and financial motives, and related typologies emerged. These findings have critical implications for studies on HIV, other conditions, and research ethics.

Emerging Directions in Emotional Episodic Memory.

PubMed

Dolcos, Florin; Katsumi, Yuta; Weymar, Mathias; Moore, Matthew; Tsukiura, Takashi; Dolcos, Sanda

2017-01-01

Building upon the existing literature on emotional memory, the present review examines emerging evidence from brain imaging investigations regarding four research directions: (1) Social Emotional Memory , (2) The Role of Emotion Regulation in the Impact of Emotion on Memory , (3) The Impact of Emotion on Associative or Relational Memory , and (4) The Role of Individual Differences in Emotional Memory . Across these four domains, available evidence demonstrates that emotion- and memory-related medial temporal lobe brain regions (amygdala and hippocampus, respectively), together with prefrontal cortical regions, play a pivotal role during both encoding and retrieval of emotional episodic memories. This evidence sheds light on the neural mechanisms of emotional memories in healthy functioning, and has important implications for understanding clinical conditions that are associated with negative affective biases in encoding and retrieving emotional memories.

Emerging Directions in Emotional Episodic Memory

PubMed Central

Dolcos, Florin; Katsumi, Yuta; Weymar, Mathias; Moore, Matthew; Tsukiura, Takashi; Dolcos, Sanda

2017-01-01

Building upon the existing literature on emotional memory, the present review examines emerging evidence from brain imaging investigations regarding four research directions: (1) Social Emotional Memory, (2) The Role of Emotion Regulation in the Impact of Emotion on Memory, (3) The Impact of Emotion on Associative or Relational Memory, and (4) The Role of Individual Differences in Emotional Memory. Across these four domains, available evidence demonstrates that emotion- and memory-related medial temporal lobe brain regions (amygdala and hippocampus, respectively), together with prefrontal cortical regions, play a pivotal role during both encoding and retrieval of emotional episodic memories. This evidence sheds light on the neural mechanisms of emotional memories in healthy functioning, and has important implications for understanding clinical conditions that are associated with negative affective biases in encoding and retrieving emotional memories. PMID:29255432

Response inhibition or evaluation of danger? An event-related potential study regarding the origin of the motor interference effect from dangerous objects.

PubMed

Liu, Peng; Cao, Rong; Chen, Xuhai; Wang, Yonghui

2017-06-01

Previous studies have identified an interference effect from dangerous objects on prepared responses. However, its origin remains arguable. This study investigated the neural processes of this motor interference effect. The design adopted a motor priming paradigm mixed with a Go/NoGo task. Pictures of a left or right hand were used as primes, and green (Go signal) or red (NoGo signal) circles superimposed on dangerous or safe objects were used as targets. Participants were instructed to prepare the corresponding key press using the hand that was consistent with the handedness of the prime and not to execute until a Go signal appeared. Behavioral results indicated longer reaction times and a trend that participants made more errors for the dangerous condition than for the safe condition in the Go trials. However, the difference between the error rates for the dangerous and safe conditions did not emerge in the NoGo trials. Event-related potential analysis revealed a similar effect on the P3 component, which may reflect an assignment of cognitive resources to evaluate danger. More positive parietal P3 amplitudes were identified in response to the dangerous condition in the Go trials. However, the difference in the P3 amplitudes between the dangerous and safe conditions was not significant in the NoGo trials. Together, the motor interference effect from dangerous objects may originate from the danger evaluations. Furthermore, differences between the dangerous and safe conditions also emerged in the P1, posterior N1, P2, and posterior N2 components; the possible processes that underlie these components were discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

The emergence densities of annual cicadas (Hemiptera: Cicadidae) increase with sapling density and are greater near edges in a bottomland hardwood forest.

PubMed

Chiavacci, Scott J; Bednarz, James C; McKay, Tanja

2014-08-01

The emergence densities of cicadas tend to be patchy at multiple spatial scales. While studies have identified habitat conditions related to these patchy distributions, their interpretation has been based primarily on periodical cicada species; habitat factors associated with densities of nonperiodical (i.e., annual) cicadas have remained under studied. This is despite their widespread distribution, diversity, and role as an important trophic resource for many other organisms, particularly within riparian areas. We studied habitat factors associated with the emergence densities of Tibicen spp. in a bottomland hardwood forest in east-central Arkansas. We found emergence densities were greatest in areas of high sapling densities and increased toward forest edges, although sapling density was a much stronger predictor of emergence density. Emergence densities also differed among sample areas within our study system. The habitat features predicting nymph densities were likely driven by a combination of factors affecting female selection of oviposition sites and the effects of habitat conditions on nymph survival. The differences in nymph densities between areas of our system were likely a result of the differential effects of flooding in these areas. Interestingly, our findings were similar to observations of periodical species, suggesting that both types of cicadas select similar habitat characteristics for ovipositing or are under comparable selective pressures during development. Our findings also imply that changes in habitat characteristics because of anthropogenically altered disturbance regimes (e.g., flooding) have the potential to negatively impact both periodical and annual species, which could have dramatic consequences for organisms at numerous trophic levels.

Intensive Farming: Evolutionary Implications for Parasites and Pathogens

PubMed Central

Nilsen, Frank; Ebert, Dieter; Skorping, Arne

2010-01-01

An increasing number of scientists have recently raised concerns about the threat posed by human intervention on the evolution of parasites and disease agents. New parasites (including pathogens) keep emerging and parasites which previously were considered to be ‘under control’ are re-emerging, sometimes in highly virulent forms. This re-emergence may be parasite evolution, driven by human activity, including ecological changes related to modern agricultural practices. Intensive farming creates conditions for parasite growth and transmission drastically different from what parasites experience in wild host populations and may therefore alter selection on various traits, such as life-history traits and virulence. Although recent epidemic outbreaks highlight the risks associated with intensive farming practices, most work has focused on reducing the short-term economic losses imposed by parasites, such as application of chemotherapy. Most of the research on parasite evolution has been conducted using laboratory model systems, often unrelated to economically important systems. Here, we review the possible evolutionary consequences of intensive farming by relating current knowledge of the evolution of parasite life-history and virulence with specific conditions experienced by parasites on farms. We show that intensive farming practices are likely to select for fast-growing, early-transmitted, and hence probably more virulent parasites. As an illustration, we consider the case of the fish farming industry, a branch of intensive farming which has dramatically expanded recently and present evidence that supports the idea that intensive farming conditions increase parasite virulence. We suggest that more studies should focus on the impact of intensive farming on parasite evolution in order to build currently lacking, but necessary bridges between academia and decision-makers. PMID:21151485

Emergency eye care in rural Australia: role of internet.

PubMed

Kumar, S; Yogesan, K; Hudson, B; Tay-Kearney, M-L; Constable, I J

2006-12-01

Significant differences exist in the utilization of emergency eye care services in rural and urban Australia. Meanwhile, influence of internet-based technology in emergency eye care service utilization has not been established. This study aims to demonstrate, from a health provider perspective, an internet-based service's impact on emergency eye care in rural Australia. The teleophthalmology service was initiated in the Carnarvon Regional Hospital (CRH) of the Gascoyne region in Western Australia. A digital, slit lamp and fundus camera were used for the service. Economic data was gathered from the Department of Health of Western Australia (DOHWA), the CRH and the Lions Eye Institute. During the study period (January-December, 2003) 118 persons took part in teleophthalmology consultations. Emergency cases constituted 3% of these consultations. Previous year, there were seven eye-related emergency evacuations (inter-hospital air transfers) from the Gascoyne region to City of Perth. Analysis demonstrates implementation of internet-based health services has a marked impact on rural emergency eye care delivery. Internet is well suited to ophthalmology for the diagnosis and management of acute conditions in remote areas. Integration of such services to mainstream health care is recommended.

44 CFR 61.5 - Special terms and conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Special terms and conditions. 61.5 Section 61.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... area management or control law, regulation, or ordinance. (b) In order to reduce the administrative...

Concentration transport calculations by an original C++ program with interediate fidelity physics through user-defined buildings with an emphasis on release scenarios in radiological facilities

NASA Astrophysics Data System (ADS)

Sayre, George Anthony

The purpose of this dissertation was to develop the C ++ program Emergency Dose to calculate transport of radionuclides through indoor spaces using intermediate fidelity physics that provides improved spatial heterogeneity over well-mixed models such as MELCORRTM and much lower computation times than CFD codes such as FLUENTRTM . Modified potential flow theory, which is an original formulation of potential flow theory with additions of turbulent jet and natural convection approximations, calculates spatially heterogeneous velocity fields that well-mixed models cannot predict. Other original contributions of MPFT are: (1) generation of high fidelity boundary conditions relative to well-mixed-CFD coupling methods (conflation), (2) broadening of potential flow applications to arbitrary indoor spaces previously restricted to specific applications such as exhaust hood studies, and (3) great reduction of computation time relative to CFD codes without total loss of heterogeneity. Additionally, the Lagrangian transport module, which is discussed in Sections 1.3 and 2.4, showcases an ensemble-based formulation thought to be original to interior studies. Velocity and concentration transport benchmarks against analogous formulations in COMSOLRTM produced favorable results with discrepancies resulting from the tetrahedral meshing used in COMSOLRTM outperforming the Cartesian method used by Emergency Dose. A performance comparison of the concentration transport modules against MELCORRTM showed that Emergency Dose held advantages over the well-mixed model especially in scenarios with many interior partitions and varied source positions. A performance comparison of velocity module against FLUENTRTM showed that viscous drag provided the largest error between Emergency Dose and CFD velocity calculations, but that Emergency Dose's turbulent jets well approximated the corresponding CFD jets. Overall, Emergency Dose was found to provide a viable intermediate solution method for concentration transport with relatively low computation times.

Gödel metrics with chronology protection in Horndeski gravities

NASA Astrophysics Data System (ADS)

Geng, Wei-Jian; Li, Shou-Long; Lü, H.; Wei, Hao

2018-05-01

Gödel universe, one of the most interesting exact solutions predicted by General Relativity, describes a homogeneous rotating universe containing naked closed time-like curves (CTCs). It was shown that such CTCs are the consequence of the null energy condition in General Relativity. In this paper, we show that the Gödel-type metrics with chronology protection can emerge in Einstein-Horndeski gravity. We construct such exact solutions also in Einstein-Horndeski-Maxwell and Einstein-Horndeski-Proca theories.

Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community.

PubMed

Yap, Matthew; Kok, Mei-Ruu; Nanda, Soniya; Vickery, Alistair; Whyatt, David

2018-03-01

High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04-1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88-0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.

Quality of Care as an Emergent Phenomenon out of a Small-World Network of Relational Actors.

PubMed

Fiorini, Rodolfo; De Giacomo, Piero; Marconi, Pier Luigi; L'Abate, Luciano

2014-01-01

In Healthcare Decision Support System, the development and evaluation of effective "Quality of Care" (QOC) indicators, in simulation-based training, are key feature to develop resilient and antifragile organization scenarios. Is it possible to conceive of QOC not only as a result of a voluntary and rational decision, imposed or even not, but also as an overall system "emergent phenomenon" out of a small-world network of relational synthetic actors, endowed with their own personality profiles to simulate human behaviour (for short, called "subjects")? In order to answer this question and to observe the phenomena of real emergence we should use computational models of high complexity, with heavy computational load and extensive computational time. Nevertheless, De Giacomo's Elementary Pragmatic Model (EPM) intrinsic self-reflexive functional logical closure enables to run simulation examples to classify the outcomes grown out of a small-world network of relational subjects fast and effectively. Therefore, it is possible to take note and to learn of how much strategic systemic interventions can induce context conditions of QOC facilitation, which can improve the effectiveness of specific actions, which otherwise might be paradoxically counterproductive also. Early results are so encouraging to use EPM as basic block to start designing more powerful Evolutive Elementary Pragmatic Model (E2PM) for real emergence computational model, to cope with ontological uncertainty at system level.

Using the Second Life Digital Environment for FL Education: A Postmodern Perspective

ERIC Educational Resources Information Center

Uzun, Levent

2017-01-01

The aim of the present study was to raise awareness related to the postmodern educational philosophies, and to the opportunities provided by the emerging technologies and conditions of our era with regard to foreign language (FL) education. The main discussion was that educators and educational practices are not in complete harmony with the recent…

46 CFR 64.63 - Minimum emergency venting capacity.

Code of Federal Regulations, 2013 CFR

2013-10-01

... tank may have a reduction if— (1) It is shown to the Coast Guard that the insulation reduces the heat... in square feet. L=Latent heat of the product being vaporized at relieving conditions in Btu per pound... based on relation of specific heats, in accordance with appendix J of division 1 of section VIII of the...

46 CFR 64.63 - Minimum emergency venting capacity.

Code of Federal Regulations, 2011 CFR

2011-10-01

... tank may have a reduction if— (1) It is shown to the Coast Guard that the insulation reduces the heat... in square feet. L=Latent heat of the product being vaporized at relieving conditions in Btu per pound... based on relation of specific heats, in accordance with Appendix J of Division 1 of Section VIII of the...

46 CFR 64.63 - Minimum emergency venting capacity.

Code of Federal Regulations, 2010 CFR

2010-10-01

... tank may have a reduction if— (1) It is shown to the Coast Guard that the insulation reduces the heat... in square feet. L=Latent heat of the product being vaporized at relieving conditions in Btu per pound... based on relation of specific heats, in accordance with Appendix J of Division 1 of Section VIII of the...

46 CFR 64.63 - Minimum emergency venting capacity.

Code of Federal Regulations, 2012 CFR

2012-10-01

... tank may have a reduction if— (1) It is shown to the Coast Guard that the insulation reduces the heat... in square feet. L=Latent heat of the product being vaporized at relieving conditions in Btu per pound... based on relation of specific heats, in accordance with Appendix J of Division 1 of Section VIII of the...

46 CFR 64.63 - Minimum emergency venting capacity.

Code of Federal Regulations, 2014 CFR

2014-10-01

... tank may have a reduction if— (1) It is shown to the Coast Guard that the insulation reduces the heat... in square feet. L=Latent heat of the product being vaporized at relieving conditions in Btu per pound... based on relation of specific heats, in accordance with appendix J of division 1 of section VIII of the...

78 FR 29135 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

...: Examination and Treatment for Emergency Medical Conditions and Women in Labor (EMTALA), 42 CFR 482.12, 488.18... individuals with emergency medical conditions and women in labor. The emergency department reporting the... Medicare plan beneficiaries who are hospital inpatients about their hospital rights and discharge rights...

The Emerging Field of Human Social Genomics

PubMed Central

Slavich, George M.; Cole, Steven W.

2013-01-01

Although we generally experience our bodies as being biologically stable across time and situations, an emerging field of research is demonstrating that external social conditions, especially our subjective perceptions of those conditions, can influence our most basic internal biological processes—namely, the expression of our genes. This research on human social genomics has begun to identify the types of genes that are subject to social-environmental regulation, the neural and molecular mechanisms that mediate the effects of social processes on gene expression, and the genetic polymorphisms that moderate individual differences in genomic sensitivity to social context. The molecular models resulting from this research provide new opportunities for understanding how social and genetic factors interact to shape complex behavioral phenotypes and susceptibility to disease. This research also sheds new light on the evolution of the human genome and challenges the fundamental belief that our molecular makeup is relatively stable and impermeable to social-environmental influence. PMID:23853742

Distancing from experienced self: how global-versus-local perception affects estimation of psychological distance.

PubMed

Liberman, Nira; Förster, Jens

2009-08-01

In 4 studies, the authors examined the prediction derived from construal level theory (CLT) that higher level of perceptual construal would enhance estimated egocentric psychological distance. The authors primed participants with global perception, local perception, or both (the control condition). Relative to the control condition, global processing made participants estimate larger psychological distances in time (Study 1), space (Study 2), social distance (Study 3), and hypotheticality (Study 4). Local processing had the opposite effect. Consistent with CLT, all studies show that the effect of global-versus-local processing did emerge when participants estimated egocentric distances, which are distances from the experienced self in the here and now, but did not emerge with temporal distances not from now (Study 1), spatial distances not from here (Study 2), social distances not from the self (Study 3), or hypothetical events that did not involve altering an experienced reality (Study 4).

The emergence of the Activity Reduces Conflict Associated Strain (ARCAS) model: a test of a conditional mediation model of workplace conflict and employee strain.

PubMed

Dijkstra, Maria T M; Beersma, Bianca; Cornelissen, Roosmarijn A W M

2012-07-01

To test and extend the emerging Activity Reduces Conflict-Associated Strain (ARCAS) model, we predicted that the relationship between task conflict and employee strain would be weakened to the extent that people experience high organization-based self-esteem (OBSE). A survey among Dutch employees demonstrated that, consistent with the model, the conflict-employee strain relationship was weaker the higher employees' OBSE and the more they engaged in active problem-solving conflict management. Our data also revealed that higher levels of OBSE were related to more problem-solving conflict management. Moreover, consistent with the ARCAS model, we could confirm a conditional mediation model in which organization-based self-esteem through its relationship with problem-solving conflict management weakened the relationship between task conflict and employee strain. Potential applications of the results are discussed.

Fire season and intensity affect shrub recruitment in temperate sclerophyllous woodlands.

PubMed

Knox, K J E; Clarke, P J

2006-10-01

The season in which a fire occurs may regulate plant seedling recruitment because of: (1) the interaction of season and intensity of fire and the temperature requirements for seed release, germination and growth; (2) post-fire rainfall and temperature patterns affecting germination; (3) the interaction of post-fire germination conditions and competition from surrounding vegetation; and (4) the interaction of post-fire germination conditions and seed predators and/or seedling herbivores. This study examined the effects of different fire intensities and fire seasons on the emergence and survival of shrubs representing a range of fire response syndromes from a summer rainfall cool climate region. Replicated experimental burns were conducted in two seasons (spring and autumn) in 2 consecutive years and fuel loads were increased to examine the effects of fire intensity (low intensity and moderate intensity). Post-fire watering treatments partitioned the effects of seasonal temperature from soil moisture. Higher intensity fires resulted in enhanced seedling emergence for hard-seeded species but rarely influenced survival. Spring fires enhanced seedling emergence across all functional groups. Reduced autumn recruitment was related to seasonal temperature inhibiting germination rather than a lack of soil moisture or competition. In Mediterranean-type climate regions, seedling emergence has been related to post-fire rainfall and exposure of seeds to seed predators. We think a similar model may operate in temperate summer rainfall regions where cold-induced dormancy over winter exposes seeds to predators for a longer time and subsequently results in recruitment failure. Our results support the theory that the effect of fire season is more predictable where there are strong seasonal patterns in climate. In this study seasonal temperature rather than rainfall appears to be more influential.

Kinetic Monte Carlo simulation of dopant-defect systems under submicrosecond laser thermal processes

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

Fisicaro, G.; Pelaz, Lourdes; Lopez, P.

2012-11-06

An innovative Kinetic Monte Carlo (KMC) code has been developed, which rules the post-implant kinetics of the defects system in the extremely far-from-the equilibrium conditions caused by the laser irradiation close to the liquid-solid interface. It considers defect diffusion, annihilation and clustering. The code properly implements, consistently to the stochastic formalism, the fast varying local event rates related to the thermal field T(r,t) evolution. This feature of our numerical method represents an important advancement with respect to current state of the art KMC codes. The reduction of the implantation damage and its reorganization in defect aggregates are studied as amore » function of the process conditions. Phosphorus activation efficiency, experimentally determined in similar conditions, has been related to the emerging damage scenario.« less

Overwintering temperature and body condition shift emergence dates of spring-emerging solitary bees.

PubMed

Schenk, Mariela; Mitesser, Oliver; Hovestadt, Thomas; Holzschuh, Andrea

2018-01-01

Solitary bees in seasonal environments must align their life-cycles with favorable environmental conditions and resources; the timing of their emergence is highly fitness relevant. In several bee species, overwintering temperature influences both emergence date and body weight at emergence. High variability in emergence dates among specimens overwintering at the same temperatures suggests that the timing of emergence also depends on individual body conditions. However, possible causes for this variability, such as individual differences in body size or weight, have been rarely studied. In a climate chamber experiment using two spring-emerging mason bees ( Osmia cornuta and O. bicornis ), we investigated the relationship between temperature, emergence date, body weight, and body size, the last of which is not affected by overwintering temperature. Our study showed that body weight declined during hibernation more strongly in warm than in cold overwintering temperatures. Although bees emerged earlier in warm than in cold overwintering temperatures, at the time of emergence, bees in warm overwintering temperatures had lower body weights than bees in cold overwintering temperatures (exception of male O. cornuta ). Among specimens that experienced the same overwintering temperatures, small and light bees emerged later than their larger and heavier conspecifics. Using a simple mechanistic model we demonstrated that spring-emerging solitary bees use a strategic approach and emerge at a date that is most promising for their individual fitness expectations. Our results suggest that warmer overwintering temperatures reduce bee fitness by causing a decrease in body weight at emergence. We showed furthermore that in order to adjust their emergence dates, bees use not only temperature but also their individual body condition as triggers. This may explain differing responses to climate warming within and among bee populations and may have consequences for bee-plant interactions as well as for the persistence of bee populations under climate change.

Bradford Hill's criteria, emerging zoonoses, and One Health.

PubMed

Asokan, G V; Asokan, Vanitha

2016-09-01

Zoonoses constitute more than 60% of infectious diseases and 75% of emerging infectious diseases. Inappropriate overemphasis of specialization of disciplines has ignored public health. Identifying the causes of disease and determining how exposures are related to outcomes in "emerging zoonoses" affecting multiple species are considered to be the hallmarks of public health research and practice that compels the adoption of "One Health". The interactions within and among populations of vertebrates in the causation and transmissions of emerging zoonotic diseases are inherently dynamic, interdependent, and systems based. Disease causality theories have moved from one or several agents causing disease in a single species, to one infectious agent causing disease in multiple species-emerging zoonoses. Identification of the causative pathogen components or structures, elucidating the mechanisms of species specificity, and understanding the natural conditions of emergence would facilitate better derivation of the causal mechanism. Good quality evidence on causation in emerging zoonoses affecting multiple species makes a strong recommendation under the One Health approach for disease prevention and control from diagnostic tests, treatment, antimicrobial resistance, preventive vaccines, and evidence informed health policies. In the tenets of One Health, alliances work best when the legitimate interests of the different partners combine to prevent and control emerging zoonoses. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Risk factors for age-related maculopathy.

PubMed

Connell, Paul P; Keane, Pearse A; O'Neill, Evelyn C; Altaie, Rasha W; Loane, Edward; Neelam, Kumari; Nolan, John M; Beatty, Stephen

2009-01-01

Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

Social media use in emergency management.

PubMed

Wukich, Clayton

2015-01-01

To identify and illustrate the range of strategies and tactics available for emergency managers using social media. This study uses content analysis of more than 80 related journal articles, research reports, and government documents as well as more than 120 newspaper articles, identified through LexisNexis search queries. Three strategies, information dissemination, monitoring real-time data, and engaging the public in a conversation and/or crowdsourcing, are available to emergency managers to augment communication practices via face-to-face contact and through traditional media outlets. Academic research has identified several message types disseminated during response operations.(1,2) Message types during other emergency phases have received less attention; however, news reporting and government reports provide best practices and inform this study. This article provides the foundation for a more complete typology of emergency management messages. Relatedly, despite limited attention in the academic research, monitoring social media feeds to accrue situational awareness and interacting with others to generate a conversation and/or to coordinate collective action also take place in various forms and are discussed. Findings integrate the fragmented body of knowledge into a more coherent whole and suggest that practitioners might maximize outcomes through a three-step process of information dissemination, data monitoring, and the direct engagement of diverse sets of actors to spur risk reduction efforts. However, these steps require time, personnel, and resources, which present obstacles for agencies operating under conditions of personnel and resource scarcity.

Variations in task constraints shape emergent performance outcomes and complexity levels in balancing.

PubMed

Caballero Sánchez, Carla; Barbado Murillo, David; Davids, Keith; Moreno Hernández, Francisco J

2016-06-01

This study investigated the extent to which specific interacting constraints of performance might increase or decrease the emergent complexity in a movement system, and whether this could affect the relationship between observed movement variability and the central nervous system's capacity to adapt to perturbations during balancing. Fifty-two healthy volunteers performed eight trials where different performance constraints were manipulated: task difficulty (three levels) and visual biofeedback conditions (with and without the center of pressure (COP) displacement and a target displayed). Balance performance was assessed using COP-based measures: mean velocity magnitude (MVM) and bivariate variable error (BVE). To assess the complexity of COP, fuzzy entropy (FE) and detrended fluctuation analysis (DFA) were computed. ANOVAs showed that MVM and BVE increased when task difficulty increased. During biofeedback conditions, individuals showed higher MVM but lower BVE at the easiest level of task difficulty. Overall, higher FE and lower DFA values were observed when biofeedback was available. On the other hand, FE reduced and DFA increased as difficulty level increased, in the presence of biofeedback. However, when biofeedback was not available, the opposite trend in FE and DFA values was observed. Regardless of changes to task constraints and the variable investigated, balance performance was positively related to complexity in every condition. Data revealed how specificity of task constraints can result in an increase or decrease in complexity emerging in a neurobiological system during balance performance.

Using voluntary reports from physicians to learn from diagnostic errors in emergency medicine.

PubMed

Okafor, Nnaemeka; Payne, Velma L; Chathampally, Yashwant; Miller, Sara; Doshi, Pratik; Singh, Hardeep

2016-04-01

Diagnostic errors are common in the emergency department (ED), but few studies have comprehensively evaluated their types and origins. We analysed incidents reported by ED physicians to determine disease conditions, contributory factors and patient harm associated with ED-related diagnostic errors. Between 1 March 2009 and 31 December 2013, ED physicians reported 509 incidents using a department-specific voluntary incident-reporting system that we implemented at two large academic hospital-affiliated EDs. For this study, we analysed 209 incidents related to diagnosis. A quality assurance team led by an ED physician champion reviewed each incident and interviewed physicians when necessary to confirm the presence/absence of diagnostic error and to determine the contributory factors. We generated descriptive statistics quantifying disease conditions involved, contributory factors and patient harm from errors. Among the 209 incidents, we identified 214 diagnostic errors associated with 65 unique diseases/conditions, including sepsis (9.6%), acute coronary syndrome (9.1%), fractures (8.6%) and vascular injuries (8.6%). Contributory factors included cognitive (n=317), system related (n=192) and non-remedial (n=106). Cognitive factors included faulty information verification (41.3%) and faulty information processing (30.6%) whereas system factors included high workload (34.4%) and inefficient ED processes (40.1%). Non-remediable factors included atypical presentation (31.3%) and the patients' inability to provide a history (31.3%). Most errors (75%) involved multiple factors. Major harm was associated with 34/209 (16.3%) of reported incidents. Most diagnostic errors in ED appeared to relate to common disease conditions. While sustaining diagnostic error reporting programmes might be challenging, our analysis reveals the potential value of such systems in identifying targets for improving patient safety in the ED. 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/

Eyeblink conditioning in the developing rabbit

PubMed Central

Brown, Kevin L.; Woodruff-Pak, Diana S.

2011-01-01

Eyeblink classical conditioning in pre-weanling rabbits was examined in the present study. Using a custom lightweight headpiece and restrainer, New Zealand white littermates were trained once daily in 400 ms delay eyeblink classical conditioning from postnatal days (PD) 17–21 or PD 24–28. These ages were chosen because eyeblink conditioning emerges gradually over PD 17–24 in rats (Stanton, Freeman, & Skelton, 1992), another altricial species with neurodevelopmental features similar to those of rabbits. Consistent with well-established findings in rats, rabbits trained from PD 24–28 showed greater conditioning relative to littermates trained from PD 17–21. Both age groups displayed poor retention of eyeblink conditioning at retraining one month after acquisition. These findings are the first to demonstrate eyeblink conditioning in the developing rabbit. With further characterization of optimal conditioning parameters, this preparation may have applications to neurodevelopmental disease models as well as research exploring the ontogeny of memory. PMID:21953433

44 CFR 13.12 - Special grant or subgrant conditions for “high-risk” grantees.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Special grant or subgrant conditions for âhigh-riskâ grantees. 13.12 Section 13.12 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL UNIFORM ADMINISTRATIVE REQUIREMENTS FOR...

44 CFR 13.12 - Special grant or subgrant conditions for “high-risk” grantees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Special grant or subgrant conditions for âhigh-riskâ grantees. 13.12 Section 13.12 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL UNIFORM ADMINISTRATIVE REQUIREMENTS FOR...

14 CFR 25.561 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... STANDARDS: TRANSPORT CATEGORY AIRPLANES Structure Emergency Landing Conditions § 25.561 General. (a) The airplane, although it may be damaged in emergency landing conditions on land or water, must be designed as prescribed in this section to protect each occupant under those conditions. (b) The structure must be...

Involvement of the intrinsic/default system in movement-related self recognition.

PubMed

Salomon, Roy; Malach, Rafael; Lamy, Dominique

2009-10-21

The question of how people recognize themselves and separate themselves from the environment and others has long intrigued philosophers and scientists. Recent findings have linked regions of the 'default brain' or 'intrinsic system' to self-related processing. We used a paradigm in which subjects had to rely on subtle sensory-motor synchronization differences to determine whether a viewed movement belonged to them or to another person, while stimuli and task demands associated with the "responded self" and "responded other" conditions were precisely matched. Self recognition was associated with enhanced brain activity in several ROIs of the intrinsic system, whereas no differences emerged within the extrinsic system. This self-related effect was found even in cases where the sensory-motor aspects were precisely matched. Control conditions ruled out task difficulty as the source of the differential self-related effects. The findings shed light on the neural systems underlying bodily self recognition.

Age-related differences in decision-making for digital escape route signage under strenuous emergency conditions of tilted passenger ships.

PubMed

Kwee-Meier, Sonja Th; Mertens, Alexander; Schlick, Christopher M

2017-03-01

This age-differentiated study investigated preferences for new digital, situation-adaptive escape route signage with informative and flashing elements under simulated emergency conditions of tilted passenger ships. The decision-making behaviour of 26 young (20-30 years) and 26 elderly (60-77 years) participants was observed in four conditions varying in applied stressors and in level versus uphill walking at 7° and 14°. In line with previous studies, decisions of young participants were significantly influenced by flashing elements on signs. In contrast, elderly participants based their decisions significantly stronger on integrated information about the sign's updatedness and reported irritation by flashing elements. These preferences were also persistent under increased mental, emotional and physical strain, evaluated by ratings and (psycho-)physiological measures. The findings demonstrate the importance to carefully design digital, situation-adaptive signage for passenger ships in a way that it not only attracts attention but also inspires trust especially for the elderly population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of Drought-Stress on Fusarium Crown Rot Development in Barley

PubMed Central

Liu, Xinlun; Liu, Chunji

2016-01-01

Fusarium crown rot (FCR), caused by various Fusarium species, is a chronic disease of cereals in many semi-arid regions worldwide. To clarify what effects drought-stress may have on FCR development, visual assessment, histological analysis and quantitative PCR were used to analyse the infection process of F. pseudograminearum in barley. This study observed for the first time that the severity of FCR symptom reflects the quantity of pathogens in infected tissues of barley under both drought-stressed and well-watered conditions. Drought-stress prolongs the initial infection phase but enhances the proliferation and spread of Fusarium pathogens after the initial infection phase. Under drought-stressed conditions, the invading hyphae were frequently observed to re-emerge from stomata and invade again the surrounding epidermis cells. Under the well-watered conditions, however, very few hyphae re-emerged from stomata and most infection was caused by hyphae intracellularly grown. It was also observed that drought-stress increased the length and density of trichomes dramatically especially in the susceptible genotypes, and that the length and density of trichomes were positively related to fungal biomass of F. pseudograminearum in plants. PMID:27936004

Time and Associative Learning.

PubMed

Balsam, Peter D; Drew, Michael R; Gallistel, C R

2010-01-01

In a basic associative learning paradigm, learning is said to have occurred when the conditioned stimulus evokes an anticipatory response. This learning is widely believed to depend on the contiguous presentation of conditioned and unconditioned stimulus. However, what it means to be contiguous has not been rigorously defined. Here we examine the empirical bases for these beliefs and suggest an alternative view based on the hypothesis that learning about the temporal relationships between events determines the speed of emergence, vigor and form of conditioned behavior. This temporal learning occurs very rapidly and prior to the appearance of the anticipatory response. The temporal relations are learned even when no anticipatory response is evoked. The speed with which an anticipatory response emerges is proportional to the informativeness of the predictive cue (CS) regarding the rate of occurrence of the predicted event (US). This analysis gives an account of what we mean by "temporal pairing" and is in accord with the data on speed of acquisition and basic findings in the cue competition literature. In this account, learning depends on perceiving and encoding temporal regularities rather than stimulus contiguities.

Time and Associative Learning

PubMed Central

Balsam, Peter D; Drew, Michael R.; Gallistel, C.R.

2010-01-01

In a basic associative learning paradigm, learning is said to have occurred when the conditioned stimulus evokes an anticipatory response. This learning is widely believed to depend on the contiguous presentation of conditioned and unconditioned stimulus. However, what it means to be contiguous has not been rigorously defined. Here we examine the empirical bases for these beliefs and suggest an alternative view based on the hypothesis that learning about the temporal relationships between events determines the speed of emergence, vigor and form of conditioned behavior. This temporal learning occurs very rapidly and prior to the appearance of the anticipatory response. The temporal relations are learned even when no anticipatory response is evoked. The speed with which an anticipatory response emerges is proportional to the informativeness of the predictive cue (CS) regarding the rate of occurrence of the predicted event (US). This analysis gives an account of what we mean by “temporal pairing” and is in accord with the data on speed of acquisition and basic findings in the cue competition literature. In this account, learning depends on perceiving and encoding temporal regularities rather than stimulus contiguities. PMID:21359131

A systematic approach to emergencies in uveitis.

PubMed

Al-Dhibi, Hassan A; Al-Mahmood, Ammar M; Arevalo, J Fernando

2014-01-01

Uveitis is a common cause of preventable blindness although it is consider a sight-threatening condition particularly in cases with posterior segment inflammation. To deal with emergency conditions in uveitis, we must aware of the essential signs and symptoms that reflect a true uveitic emergency. Failure to recognize these essential signs and symptoms of a true uveitic emergency may result in a devastating visual outcome. This review provides general ophthalmologists and residents, clinical guidelines for the main uveitic entities that require immediate recognition and urgent intervention in the emergency room to prevent severe permanent visual loss.

Asthma and climatic conditions: experience from Bermuda, an isolated island community.

PubMed Central

Carey, M J; Cordon, I

1986-01-01

A retrospective study of patients attending the emergency department with acute asthma was performed in Bermuda. Climatic data (barometric pressure, rainfall, humidity, and wind strength and direction) were obtained and compared with frequency of exacerbations of asthma. Three factors--namely, relative humidity, average daily temperature, and northeasterly winds--were found to be related to worsening asthma. Owing to Bermuda's lack of pollution and aeroallergens it was thought that these weather parameters had a direct effect on the asthmatic population. PMID:3094682

Exploring the heavy air pollution in Beijing in the fourth quarter of 2015: assessment of environmental benefits for red alerts

NASA Astrophysics Data System (ADS)

Nie, Teng; Nie, Lei; Zhou, Zhen; Wang, Zhanshan; Xue, Yifeng; Gao, Jiajia; Wu, Xiaoqing; Fan, Shoubin; Cheng, Linglong

2018-06-01

In recent years, Beijing has experienced severe air pollution which has caused widespread public concern. Compared to the same period in 2014, the first three quarters of 2015 exhibited significantly improved air quality. However, the air quality sharply declined in the fourth quarter of 2015, especially in November and December. During that time, Beijing issued the first red alert for severe air pollution in history. In total, 2 red alerts, 3 orange alerts, 3 yellow alerts, and 3 blue alerts were issued based on the adoption of relatively temporary emergency control measures to mitigate air pollution. This study explored the reasons for these variations in air quality and assessed the effectiveness of emergency alerts in addressing severe air pollution. A synthetic analysis of emission variations and meteorological conditions was performed to better understand these extreme air pollution episodes in the fourth quarter of 2015. The results showed that compared to those in the same period in 2014, the daily average emissions of air pollutants decreased in the fourth quarter of 2015. However, the emission levels of primary pollutants were still relatively high, which was the main intrinsic cause of haze episodes, and unfavorable meteorological conditions represented important external factors. Emergency control measures for heavy air pollution were implemented during this red alert period, decreasing the emissions of primary air pollutants by approximately 36% and the PM2.5 concentration by 11%‒21%.

Emerging Major Histocompatibility Complex Class I-Related Functions of NLRC5.

PubMed

Chelbi, S T; Dang, A T; Guarda, G

2017-01-01

Recent evidence demonstrates a key role for the nucleotide-binding oligomerization domain-like receptor (NLR) family member NLRC5 (NLR family, CARD domain containing protein 5) in the transcriptional regulation of major histocompatibility complex (MHC) class I and related genes. Detailed information on NLRC5 target genes in various cell types and conditions is emerging. Thanks to its analogy to CIITA (class II major MHC transactivator), a NLR family member known for over 20 years to be the master regulator of MHC class II gene transcription, also the molecular mechanisms underlying NLRC5 function are being rapidly unraveled. MHC class I molecules are crucial in regulating innate and adaptive cytotoxic responses. Whereas CD8 + T cells detect antigens presented on MHC class I molecules by infected or transformed cells, natural killer (NK) lymphocytes eliminate target cells with downregulated MHC class I expression. Data uncovering the relevance of NLRC5 in homeostasis and activity of these two lymphocyte subsets have been recently reported. Given the importance of CD8 + T and NK cells in controlling infection and cancer, it is not surprising that NLRC5 is also starting to emerge as a central player in these diseases. This chapter summarizes and discusses novel insights into the molecular mechanisms underlying NLRC5 activity and its relevance to pathological conditions. A thorough understanding of both aspects is essential to evaluate the clinical significance and therapeutic potential of NLRC5. © 2017 Elsevier Inc. All rights reserved.

Getting women to hospital is not enough: a qualitative study of access to emergency obstetric care in Bangladesh

PubMed Central

Pitchforth, E; van Teijlingen, E; Graham, W; Dixon‐Woods, M; Chowdhury, M

2006-01-01

Objective To explore what happened to poor women in Bangladesh once they reached a hospital providing comprehensive emergency obstetric care (EmOC) and to identify support mechanisms. Design Mixed methods qualitative study. Setting Large government medical college hospital in Bangladesh. Sample Providers and users of EmOC. Methods Ethnographic observation in obstetrics unit including interviews with staff and women using the unit and their carers. Results Women had to mobilise significant financial and social resources to fund out of pocket expenses. Poorer women faced greater challenges in receiving treatment as relatives were less able to raise the necessary cash. The official financial support mechanism was bureaucratic and largely unsuitable in emergency situations. Doctors operated a less formal “poor fund” system to help the poorest women. There was no formal assessment of poverty; rather, doctors made “adjudications” of women's need for support based on severity of condition and presence of friends and relatives. Limited resources led to a “wait and see” policy that meant women's condition could deteriorate before help was provided. Conclusions Greater consideration must be given to what happens at health facilities to ensure that (1) using EmOC does not further impoverish families; and (2) the ability to pay does not influence treatment. Developing alternative finance mechanisms to reduce the burden of out of pocket expenses is crucial but challenging. Increased investment in EmOC must be accompanied by an increased focus on equity. PMID:16751473

[Anaerobic bacteria 150 years after their discovery by Pasteur].

PubMed

García-Sánchez, José Elías; García-Sánchez, Enrique; Martín-Del-Rey, Ángel; García-Merino, Enrique

2015-02-01

In 2011 we celebrated the 150th anniversary of the discovery of anaerobic bacteria by Louis Pasteur. The interest of the biomedical community on such bacteria is still maintained, and is particularly focused on Clostridium difficile. In the past few years important advances in taxonomy have been made due to the genetic, technological and computing developments. Thus, a significant number of new species related to human infections have been characterised, and some already known have been reclassified. At pathogenic level some specimens of anaerobic microflora, that had not been isolated from human infections, have been now isolated in some clinical conditions. There was emergence (or re-emergence) of some species and clinical conditions. Certain anaerobic bacteria have been associated with established infectious syndromes. The virulence of certain strains has increased, and some hypotheses on their participation in certain diseases have been given. In terms of diagnosis, the routine use of MALDI-TOF has led to a shortening of time and a cost reduction in the identification, with an improvement directly related to the improvement of data bases. The application of real-time PCR has been another major progress, and the sequencing of 16srRNA gene and others is currently a reality for several laboratories. Anaerobes have increased their resistance to antimicrobial agents, and the emergence of resistance to carbapenems and metronidazole, and multi-resistance is a current reality. In this situation, linezolid could be an effective alternative for Bacteroides. Fidaxomicin is the only anti-anaerobic agent introduced in the recent years, specifically for the diarrhoea caused by C.difficile. Moreover, some mathematical models have also been proposed in relation with this species. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

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.

Typologies of altruistic and financial motivations for research participation: A qualitative study of MSM in HIV vaccine trials

PubMed Central

Chin, Lisa J; Berenson, Jacqueline A.; Klitzman, Robert L

2016-01-01

Questions arise concerning participants’ motives in risky studies, such as HIV vaccine trials (HVTs). We interviewed in-depth 20 gay/bisexual men. Participants described both altruistic and non-altruistic motives. Altruistic motivations emerged primarily, with nine typologies: 1) cultural; 2) community-related; 3) familial; 4) religious; 5) professional; 6) political (e.g., HIV activism); 7) moral (e.g., making up for past wrongs); 8) existential (e.g., providing sense of meaning); and 9) other psychological (e.g., emotional gratification). Views of compensation varied: not a factor (55%); added incentive (25%); main motivator, but in conjunction with altruism (15%); and primary motivator (5%). HVT participants thus often have both altruistic and financial motives, and related typologies emerged. These findings have critical implications for studies on HIV, other conditions, and research ethics. PMID:28251864

The role of law in addressing mental health-related aspects of disasters and promoting resilience.

PubMed

Rutkow, Lainie

2012-01-01

Law plays a critical role in emergency preparedness and disaster response by establishing an infrastructure for the response and facilitating coordination among the federal, state, and local governments. Once a disaster occurs, certain legal mechanisms are activated to ensure that individuals' needs for mental health care are met, both for pre-existing and emergent conditions. This includes the rapid deployment of mental health care personnel and the implementation of crisis counseling programs in affected regions. By facilitating an influx of resources, including personnel, supplies, and financial assistance, the law can help communities quickly rebound and return to a sense of normal. Drawing on examples from the United States, this article illustrates the diverse ways in which the law simultaneously addresses mental health-related aspects of disasters and promotes resilience within affected communities.

Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

PubMed

Savkin, M N; Sneve, M K; Grachev, M I; Frolov, G P; Shinkarev, S M; Jaworska, A

2008-12-01

Regulatory cooperation between the Norwegian Radiation Protection Authority and the Federal Medical Biological Agency (FMBA) of the Russian Federation has the overall goal of promoting improvements in radiation protection in Northwest Russia. One of the projects in this programme has the objectives to review and improve the existing medical emergency preparedness capabilities at the sites for temporary storage of spent nuclear fuel and radioactive waste. These are operated by SevRAO at Andreeva Bay and in Gremikha village on the Kola Peninsula. The work is also intended to provide a better basis for regulation of emergency response and medical emergency preparedness at similar facilities elsewhere in Russia. The purpose of this paper is to present the main results of that project, implemented by the Burnasyan Federal Medical Biophysical Centre. The first task was an analysis of the regulatory requirements and the current state of preparedness for medical emergency response at the SevRAO facilities. Although Russian regulatory documents are mostly consistent with international recommendations, some distinctions lead to numerical differences in operational intervention criteria under otherwise similar conditions. Radiological threats relating to possible accidents, and related gaps in the regulation of SevRAO facilities, were also identified. As part of the project, a special exercise on emergency medical response on-site at Andreeva Bay was prepared and carried out, and recommendations were proposed after the exercise. Following fruitful dialogue among regulators, designers and operators, special regulatory guidance has been issued by FMBA to account for the specific and unusual features of the SevRAO facilities. Detailed sections relate to the prevention of accidents, and emergency preparedness and response, supplementing the basic Russian regulatory requirements. Overall it is concluded that (a) the provision of medical and sanitary components of emergency response at SevRAO facilities is a priority task within the general system of emergency preparedness; (b) there is an effective and improving interaction between SevRAO and the local medical institutions of FMBA and other territorial medical units; (c) the infrastructure of emergency response at SevRAO facilities has been created and operates within the framework of Russian legal and normative requirements. Further proposals have been made aimed at increasing the effectiveness of the available system of emergency preparedness and response, and to promote interagency cooperation.

The ties to unbind: age-related differences in feature (un)binding in working memory for emotional faces

PubMed Central

Pehlivanoglu, Didem; Jain, Shivangi; Ariel, Robert; Verhaeghen, Paul

2014-01-01

In the present study, we investigated age-related differences in the processing of emotional stimuli. Specifically, we were interested in whether older adults would show deficits in unbinding emotional expression (i.e., either no emotion, happiness, anger, or disgust) from bound stimuli (i.e., photographs of faces expressing these emotions), as a hyper-binding account of age-related differences in working memory would predict. Younger and older adults completed different N-Back tasks (side-by-side 0-Back, 1-Back, 2-Back) under three conditions: match/mismatch judgments based on either the identity of the face (identity condition), the face’s emotional expression (expression condition), or both identity and expression of the face (both condition). The two age groups performed more slowly and with lower accuracy in the expression condition than in the both condition, indicating the presence of an unbinding process. This unbinding effect was more pronounced in older adults than in younger adults, but only in the 2-Back task. Thus, older adults seemed to have a specific deficit in unbinding in working memory. Additionally, no age-related differences were found in accuracy in the 0-Back task, but such differences emerged in the 1-Back task, and were further magnified in the 2-Back task, indicating independent age-related differences in attention/STM and working memory. Pupil dilation data confirmed that the attention/STM version of the task (1-Back) is more effortful for older adults than younger adults. PMID:24795660

The ties to unbind: age-related differences in feature (un)binding in working memory for emotional faces.

PubMed

Pehlivanoglu, Didem; Jain, Shivangi; Ariel, Robert; Verhaeghen, Paul

2014-01-01

In the present study, we investigated age-related differences in the processing of emotional stimuli. Specifically, we were interested in whether older adults would show deficits in unbinding emotional expression (i.e., either no emotion, happiness, anger, or disgust) from bound stimuli (i.e., photographs of faces expressing these emotions), as a hyper-binding account of age-related differences in working memory would predict. Younger and older adults completed different N-Back tasks (side-by-side 0-Back, 1-Back, 2-Back) under three conditions: match/mismatch judgments based on either the identity of the face (identity condition), the face's emotional expression (expression condition), or both identity and expression of the face (both condition). The two age groups performed more slowly and with lower accuracy in the expression condition than in the both condition, indicating the presence of an unbinding process. This unbinding effect was more pronounced in older adults than in younger adults, but only in the 2-Back task. Thus, older adults seemed to have a specific deficit in unbinding in working memory. Additionally, no age-related differences were found in accuracy in the 0-Back task, but such differences emerged in the 1-Back task, and were further magnified in the 2-Back task, indicating independent age-related differences in attention/STM and working memory. Pupil dilation data confirmed that the attention/STM version of the task (1-Back) is more effortful for older adults than younger adults.

Emergence periodicity of Phlebotomus argentipes annandale and brunetti (Diptera: psychodidae): A laboratory study.

PubMed

Dinesh, D S; Singh, A; Kumar, V; Kesari, S; Kumar, A J; Kishore, K; Roy, S P; Bhattacharya, S K; Das, P

2009-12-01

Phlebotomus argentipes Annandale and Brunetti (Diptera: Psychodidae) is the vector for visceral leishmaniasis in India. The aspects of its biology such as feeding and man vector contact are associated with emergence periodicity of the adult. Hence, the present study was made to find out the actual emergence period of P. argentipes. Wild caught P. argentipes were confined in the rearing pots inside laboratory. The newly emerged adults were collected at hourly intervals and released in to separate polythene bags and were held at 4°C till death. Sand flies were segregated sex-wise after the death under a microscope. The emergence of adult was observed throughout the day. However, the male preferred dawn emergence and the female the dusk. Two peaks of emergence were found in a day; first one in the morning (0900h) and the second one in the evening (1800h). The ratio of both sexes was found to be about equal. The emergence of adult was found to be 77% out of total eggs laid, which was completed within 7-10 days from the 1st day of emergence under laboratory conditions (25°C to 31°C and 70% to 75% relative humidity). This study has important bearings to find out the actual time for personal protection against biting of sand flies to prevent the transmission of Kala-azar.

Identification and initial management of intoxication by alcohol and other drugs in the pediatric emergency room.

PubMed

Pianca, Thiago Gatti; Sordi, Anne Orgle; Hartmann, Thiago Casarin; von Diemen, Lisia

To review the screening, diagnosis, evaluation, and treatment of intoxication by alcohol and other drugs in children and adolescents in the emergency scenario. This was a narrative literature review. The detection of this problem in the emergency room can be a challenge, especially when its assessment is not standardized. The intentional and episodic use of large amounts of psychoactive substances by adolescents is a usual occurrence, and unintentional intoxication is more common in children younger than 12 years. The clinical picture in adolescents and children differs from that in adults and some particularities are important in the emergency scenario. After management of the acute condition, interventions targeting the adolescent at risk may be effective. The diagnosis and treatment of intoxication by alcohol and other drugs in adolescents and children in the emergency scenario requires a systematic evaluation of the use of these drugs. There are few specific treatments for intoxication, and the management comprehends support measures and management of related clinical complications. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Plant community, primary productivity, and environmental conditions following wetland re-establishment in the Sacramento-San Joaquin Delta, California

USGS Publications Warehouse

Miller, R.L.; Fujii, R.

2010-01-01

Wetland restoration can mitigate aerobic decomposition of subsided organic soils, as well as re-establish conditions favorable for carbon storage. Rates of carbon storage result from the balance of inputs and losses, both of which are affected by wetland hydrology. We followed the effect of water depth (25 and 55 cm) on the plant community, primary production, and changes in two re-established wetlands in the Sacramento San-Joaquin River Delta, California for 9 years after flooding to determine how relatively small differences in water depth affect carbon storage rates over time. To estimate annual carbon inputs, plant species cover, standing above- and below-ground plant biomass, and annual biomass turnover rates were measured, and allometric biomass models for Schoenoplectus (Scirpus) acutus and Typha spp., the emergent marsh dominants, were developed. As the wetlands developed, environmental factors, including water temperature, depth, and pH were measured. Emergent marsh vegetation colonized the shallow wetland more rapidly than the deeper wetland. This is important to potential carbon storage because emergent marsh vegetation is more productive, and less labile, than submerged and floating vegetation. Primary production of emergent marsh vegetation ranged from 1.3 to 3.2 kg of carbon per square meter annually; and, mid-season standing live biomass represented about half of the annual primary production. Changes in species composition occurred in both submerged and emergent plant communities as the wetlands matured. Water depth, temperature, and pH were lower in areas with emergent marsh vegetation compared to submerged vegetation, all of which, in turn, can affect carbon cycling and storage rates. ?? Springer Science+Business Media B.V. 2009.

Snow Cover Mapping and Ice Avalanche Monitoring from the Satellite Data of the Sentinels

NASA Astrophysics Data System (ADS)

Wang, S.; Yang, B.; Zhou, Y.; Wang, F.; Zhang, R.; Zhao, Q.

2018-04-01

In order to monitor ice avalanches efficiently under disaster emergency conditions, a snow cover mapping method based on the satellite data of the Sentinels is proposed, in which the coherence and backscattering coefficient image of Synthetic Aperture Radar (SAR) data (Sentinel-1) is combined with the atmospheric correction result of multispectral data (Sentinel-2). The coherence image of the Sentinel-1 data could be segmented by a certain threshold to map snow cover, with the water bodies extracted from the backscattering coefficient image and removed from the coherence segment result. A snow confidence map from Sentinel-2 was used to map the snow cover, in which the confidence values of the snow cover were relatively high. The method can make full use of the acquired SAR image and multispectral image under emergency conditions, and the application potential of Sentinel data in the field of snow cover mapping is exploited. The monitoring frequency can be ensured because the areas obscured by thick clouds are remedied in the monitoring results. The Kappa coefficient of the monitoring results is 0.946, and the data processing time is less than 2 h, which meet the requirements of disaster emergency monitoring.

Training in the management of critical problems: teacher's view.

PubMed

van Geijn, H P; Vothknecht, S

1996-03-01

Teaching in critical obstetric problems should have special interest during residency and thereafter. Obstetric emergencies are relatively rare but may occur at any time. The obstetrician at that moment enters a special area requiring a multidisciplinary approach. From experiences in recent years and study of the literature the following recommendations can be summarized; (1) the need to understand (patho)physiologic changes in pregnancy, (2) cultivation of an anticipative attitude towards conditions with elevated risks, (3) adequate knowledge of diagnostic procedures, (4) the discipline to make a differential diagnosis, (5) experience with monitoring of (fetal and) maternal condition, (6) availability of management protocols for emergencies such as shock, eclampsia, uterine rupture, amniotic fluid embolism, thrombo-embolism, sepsis and diabetic ketoacidosis, (7) awareness of pitfalls with inspection of lesions and assessment of blood loss, (8) awareness that caesarean section without prior stabilization can be a life threatening procedure, (9) practice in life-saving measures such as uterine compression, packing, ligation of vessels, postpartum hysterectomy, (10) teaching of postoperative care, (11) insight into the cascade of events finally leading to multi-organ failure. Obstetric emergencies require a disciplined approach, in which teamwork is the cornerstone.

Undermining optimistic denial reactions to domestic and campus emergency warning messages.

PubMed

Thompson, Suzanne C; Schlehofer, Michele M

2014-07-01

Individuals who prepare for public emergencies can mitigate the effects of an incident, but denial of personal susceptibility may reduce the likelihood of preparation. Some denial may be due to a positive self-image that is at odds with being "at risk". The potential for an enhanced warning message that included a positive image of a protector to circumvent this denial was tested in two studies. Optimistic denial threat orientation was measured. Then participants received either a traditional or a positive protector warning message about terrorism (Study 1; nationally representative sample of US adults; N = 587) or campus emergency preparation (Study 2; US college students; N = 179). As predicted, in the enhanced image condition optimistic denial was no longer related to stronger denial reactions and lower intentions to protect oneself. In addition, Study 2 tested explanatory mediators and found that negative perceptions of and low similarity to a protector partially explained the denial of those higher in optimistic denial and why their denial was dampened in the positive image condition. An enhanced message including a positive image of protector may be an effective way to encourage protection for those prone to optimistic denial. © 2014 The International Association of Applied Psychology.

Head Start Preschool Teachers' Commenting Practices during Shared Book Reading Sessions: Describing Learning Opportunities for Children with Varying Vocabulary Abilities

ERIC Educational Resources Information Center

Barnes, Erica Marie

2013-01-01

Descriptive analyses: Approximately one-third of the nearly 7,500 utterances spoken by teachers were comments. Differences in the use of instructional strategies and content emerged in relation to curriculum condition. In contrast to the variability between teachers, little within-teacher variability was observed. On average, teachers used only…

Group formation through indirect reciprocity

NASA Astrophysics Data System (ADS)

Oishi, Koji; Shimada, Takashi; Ito, Nobuyasu

2013-03-01

The emergence of group structure of cooperative relations is studied in an agent-based model. It is proved that specific types of reciprocity norms lead individuals to split into two groups only inside of which they are cooperative. The condition for the evolutionary stability of the norms is also obtained. This result suggests reciprocity norms, which usually promote cooperation, can cause society's separation into multiple groups.

Psychic Energy and Organizational Change. Administrative and Policy Studies Series, Vol. 1.

ERIC Educational Resources Information Center

White, Orion, Jr.

An effort is made at defining the lessons of the sixties as they relate to the understanding of processes of social and organizational change. This essay examines the theory of change that emerged in the sixties, describes how the current condition in the United States indicates the wrongness of this view, and suggests a reformulation based on a…

White-nose syndrome in bats: an overview of current knowledge for land managers

Treesearch

Roger W. Perry

2013-01-01

White-nose syndrome recently emerged as a disease affecting bats that hibernate in caves and abandoned mines during winter. This disease is caused by the fungus Pseudogymnoascus destructans, and has caused the death of millions of bats in the Eastern United States and Canada. This fungus grows in relatively cold conditions with high humidity, which...

The relationship between chinook conditions and women's physical and mental well-being

NASA Astrophysics Data System (ADS)

Verhoef, Marja J.; Rose, M. Sarah; Ramcharan, Savitri

1995-09-01

The objective of this study was (1) to determine the relationship between chinook conditions and physical and psychological symptoms in women aged 20 49 years, and (2) to examine the possibility of subgroups of chinook-sensitive women. The evidence for this relationship is at present merely anecdotal. The study carried out in 1985 1986 in Calgary comprises the secondary analysis of a large survey of various health and health-related factors, including different symptoms, of urban women aged 20 49 years. The interview date was used to link these data to days on which pre-chinook, chinook, post-chinook and non-chinook conditions occurred. Between November 1, 1985 and February 28, 1986, 182 women were interviewed on pre-chinook days, 74 on chinook days, 229 on post-chinook days and 886 on non-chinook days. Autonomic reactions and skin disorders were found to be significantly related to chinook conditions. None of the psychological symptoms was related to chinook conditions. However, a significant relationship was found between symptoms and chinook conditions in women with a history of emotional disorders. This type of information is important to educate chinook-sensitive women and health professionals as well as for hospital emergency departments in order to be able to prepare for potential increases in workload.

A framework for the study of zoonotic disease emergence and its drivers: spillover of bat pathogens as a case study

PubMed Central

Wood, James L. N.; Leach, Melissa; Waldman, Linda; MacGregor, Hayley; Fooks, Anthony R.; Jones, Kate E.; Restif, Olivier; Dechmann, Dina; Hayman, David T. S.; Baker, Kate S.; Peel, Alison J.; Kamins, Alexandra O.; Fahr, Jakob; Ntiamoa-Baidu, Yaa; Suu-Ire, Richard; Breiman, Robert F.; Epstein, Jonathan H.; Field, Hume E.; Cunningham, Andrew A.

2012-01-01

Many serious emerging zoonotic infections have recently arisen from bats, including Ebola, Marburg, SARS-coronavirus, Hendra, Nipah, and a number of rabies and rabies-related viruses, consistent with the overall observation that wildlife are an important source of emerging zoonoses for the human population. Mechanisms underlying the recognized association between ecosystem health and human health remain poorly understood and responding appropriately to the ecological, social and economic conditions that facilitate disease emergence and transmission represents a substantial societal challenge. In the context of disease emergence from wildlife, wildlife and habitat should be conserved, which in turn will preserve vital ecosystem structure and function, which has broader implications for human wellbeing and environmental sustainability, while simultaneously minimizing the spillover of pathogens from wild animals into human beings. In this review, we propose a novel framework for the holistic and interdisciplinary investigation of zoonotic disease emergence and its drivers, using the spillover of bat pathogens as a case study. This study has been developed to gain a detailed interdisciplinary understanding, and it combines cutting-edge perspectives from both natural and social sciences, linked to policy impacts on public health, land use and conservation. PMID:22966143

U.S. Emergency Department Admissions for Nontraumatic Dental Conditions for Individuals with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Chi, Donald L.; Masterson, Erin E.; Wong, Jacqueline J.

2014-01-01

The authors hypothesized that individuals with intellectual and developmental disabilities (IDDs) are more likely to have an emergency department (ED) admission for nontraumatic dental conditions (NTDCs). The authors analyzed 2009 U.S. National Emergency Department Sample data and ran logistic regression models for children ages 3-17 years and…

[Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures].

PubMed

Buschmann, Claas T; Kleber, Christian; Tsokos, Michael; Püschel, Klaus; Hess, Thorsten; Kerner, Thoralf; Stuhr, Markus

2015-06-01

Emergency medical research is subject to special conditions. Emergency patients e.g. are generally considered to be non-capable of giving consent. This results in sparse emergency medical data when compared to clinical observation studies under controlled conditions. After emergency medical treatment, deceased patients are not rarely subject to forensic investigation. The cooperation between emergency and forensic medicine has not only emergency medical training potential in individual cases, but also scientific innovation potential especially with respect to the retrospective evaluation of pre-hospital emergency measures. Such partnerships (like in Berlin at the Charité - Universitätsmedizin Berlin between the Institute of Legal Medicine and the Center for Musculoskeletal Surgery or in Hamburg between the Institute for Legal Medicine at the University Hospital and the Municipal Fire Brigade with the Emergency Medical Service) are yet exceptional in Germany. © Georg Thieme Verlag Stuttgart · New York.

Periodontal manifestations of inflammatory bowel disease: emerging epidemiologic and biologic evidence.

PubMed

Agossa, K; Dendooven, A; Dubuquoy, L; Gower-Rousseau, C; Delcourt-Debruyne, E; Capron, M

2017-06-01

Inflammatory bowel disease and periodontitis are both described as a disproportionate mucosal inflammatory response to a microbial environment in susceptible patients. Moreover, these two conditions share major environmental and lifestyle-related risk factors. Despite this intriguing pathogenic parallel, large-scale studies and basic research have only recently considered periodontal outcomes as relevant data. There are mounting and consistent arguments, from recent epidemiologic studies and animal models, that these two conditions might be related. This article is a comprehensive and critical up-to-date review of the current evidence and future prospects in understanding the biologic and epidemiologic relationships between periodontal status and inflammatory bowel disease. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

How Can eHealth Technology Address Challenges Related to Multimorbidity? Perspectives from Patients with Multiple Chronic Conditions.

PubMed

Zulman, Donna M; Jenchura, Emily C; Cohen, Danielle M; Lewis, Eleanor T; Houston, Thomas K; Asch, Steven M

2015-08-01

Patient eHealth technology offers potential support for disease self-management, but the value of existing applications for patients with multiple chronic conditions (MCCs) is unclear. To understand self-management and health care navigation challenges that patients face due to MCCs and to identify opportunities to support these patients through new and enhanced eHealth technology. After administering a screening survey, we conducted 10 focus groups of 3-8 patients grouped by age, sex, and common chronic conditions. Patients discussed challenges associated with having MCCs and their use of (and desires from) technology to support self-management. Three investigators used standard content analysis methods to code the focus group transcripts. Emergent themes were reviewed with all collaborators, and final themes and representative quotes were validated with a sample of participants. Fifty-three individuals with ≥3 chronic conditions and experience using technology for health-related purposes. Focus group participants had an average of five chronic conditions. Participants reported using technology most frequently to search for health information (96%), communicate with health care providers (92%), track medical information (83%), track medications (77%), and support decision-making about treatment (55%). Three themes emerged to guide eHealth technology development: (1) Patients with MCCs manage a high volume of information, visits, and self-care tasks; (2) they need to coordinate, synthesize, and reconcile health information from multiple providers and about different conditions; (3) their unique position at the hub of multiple health issues requires self-advocacy and expertise. Focus groups identified desirable eHealth resources and tools that reflect these themes. Although patients with multiple health issues use eHealth technology to support self-care for specific conditions, they also desire tools that transcend disease boundaries. By addressing the holistic needs of patients with MCCs, eHealth technology can advance health care from a disease-centered to a patient-centered model.

ESTABLISHING VERBAL REPERTOIRES IN CHILDREN WITH AUTISM USING FUNCTION-BASED VIDEO MODELING

PubMed Central

Plavnick, Joshua B; Ferreri, Summer J

2011-01-01

Previous research suggests that language-training procedures for children with autism might be enhanced following an assessment of conditions that evoke emerging verbal behavior. The present investigation examined a methodology to teach recognizable mands based on environmental variables known to evoke participants' idiosyncratic communicative responses in the natural environment. An alternating treatments design was used during Experiment 1 to identify the variables that were functionally related to gestures emitted by 4 children with autism. Results showed that gestures functioned as requests for attention for 1 participant and as requests for assistance to obtain a preferred item or event for 3 participants. Video modeling was used during Experiment 2 to compare mand acquisition when video sequences were either related or unrelated to the results of the functional analysis. An alternating treatments within multiple probe design showed that participants repeatedly acquired mands during the function-based condition but not during the nonfunction-based condition. In addition, generalization of the response was observed during the former but not the latter condition. PMID:22219527

Establishing verbal repertoires in children with autism using function-based video modeling.

PubMed

Plavnick, Joshua B; Ferreri, Summer J

2011-01-01

Previous research suggests that language-training procedures for children with autism might be enhanced following an assessment of conditions that evoke emerging verbal behavior. The present investigation examined a methodology to teach recognizable mands based on environmental variables known to evoke participants' idiosyncratic communicative responses in the natural environment. An alternating treatments design was used during Experiment 1 to identify the variables that were functionally related to gestures emitted by 4 children with autism. Results showed that gestures functioned as requests for attention for 1 participant and as requests for assistance to obtain a preferred item or event for 3 participants. Video modeling was used during Experiment 2 to compare mand acquisition when video sequences were either related or unrelated to the results of the functional analysis. An alternating treatments within multiple probe design showed that participants repeatedly acquired mands during the function-based condition but not during the nonfunction-based condition. In addition, generalization of the response was observed during the former but not the latter condition.

Surface extra-vehicular activity emergency scenario management: Tools, procedures, and geologically related implications

NASA Astrophysics Data System (ADS)

Zea, Luis; Diaz, Alejandro R.; Shepherd, Charles K.; Kumar, Ranganathan

2010-07-01

Extra-vehicular activities (EVAs) are an essential part of human space exploration, but involve inherently dangerous procedures which can put crew safety at risk during a space mission. To help mitigate this risk, astronauts' training programs spend substantial attention on preparing for surface EVA emergency scenarios. With the help of two Mars Desert Research Station (MDRS) crews (61 and 65), wearing simulated spacesuits, the most important of these emergency scenarios were examined at three different types of locations that geologically and environmentally resemble lunar and Martian landscapes. These three platforms were analyzed geologically as well as topographically (utilizing a laser range finder with slope estimation capabilities and a slope determination software). Emergency scenarios were separated into four main groups: (1) suit issues, (2) general physiological, (3) attacks and (4) others. Specific tools and procedures were developed to address each scenario. The tools and processes were tested in the field under Mars-analog conditions with the suited subjects for feasibility and speed of execution.

Association between diurnal temperature range and respiratory tract infections.

PubMed

Ge, Wen Zhen; Xu, Feng; Zhao, Zhuo Hui; Zhao, Jin Zhuo; Kan, Hai Dong

2013-03-01

This study aimed to assess the association between emergency-room visits for respiratory tract infection (RTI) with diurnal temperature range (DTR), a weather parameter closely associated with urbanization and global climate change. We conducted a semiparametric time-series analysis to estimate the percentage increase in emergency-room visits for RTI associated with changes in DTR after adjustment for daily weather conditions (temperature and relative humidity) and outdoor air pollution. DTR was significantly associated with daily emergency-room visits for RTI. An increase of 1 °C in the current-day (L0) and in the 2-day moving average (L01) DTR corresponded to a 0.94% [95% confidence interval (CI), 0.34%-1.55%] and 2.08% (95% CI, 1.24%-2.93%) increase in emergency-room visits for RTI, respectively. DTR was associated with increased risk of RTI. More studies are needed to understand the impact of DTR on respiratory health. Copyright © 2013 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Emergency Medicine Management of Sickle Cell Disease Complications: An Evidence-Based Update.

PubMed

Simon, Erica; Long, Brit; Koyfman, Alex

2016-10-01

Sickle cell disease (SCD) affects approximately 100,000 individuals in the United States. Due to alterations in the structural conformation of hemoglobin molecules under deoxygenated conditions, patients with SCD are predisposed to numerous sequelae, many of which require acute intervention. Our aim was to provide emergency physicians with an evidence-based update regarding the diagnosis and management of SCD complications. SCD patients experience significant morbidity and mortality secondary to cerebrovascular accident, acute chest syndrome, acute vaso-occlusive pain crises, SCD-related multi-organ failure, cholecystitis, acute intrahepatic cholestasis, acute sickle hepatic crisis, acute hepatic sequestration, priapism, and renal disease. Emergency physicians must recognize acute manifestations of SCD in order to deliver timely management and determine patient disposition. A comprehensive review of the emergency department management of acute SCD complications is provided. Comprehensive understanding of these aspects of SCD can assist physicians in expediting patient evaluation and treatment, thus decreasing the morbidity and mortality associated with this hemoglobinopathy. Copyright © 2016 Elsevier Inc. All rights reserved.

Emergency management of traumatic collateral palmar digital nerve defect inferior to 30 mm by venous grafting. Report of 12 clinical cases.

PubMed

Laveaux, C; Pauchot, J; Obert, L; Choserot, V; Tropet, Y

2011-02-01

When traumatic collateral palmar digital nerve defect occurs, emergency venous grafting is an alternative to the two-step nervous grafting procedure. During the course of a monocentric retrospective study, 12 cases of emergency venous grafting were reviewed by a single independent examiner 11 months, at least, post-intervention. Clinical and functional evaluation was carried out, together with a self-assessment of the results by the patient. Data were compacted using a filtering method and the final result was considered in terms of "good" or "bad". Good result was observed in ten cases out of 12. Bad results were associated with poor sensory recovery in the two other cases. In one of these, the bad result was also related to severe symptoms in cold conditions and a troublesome hyperesthesia. Through a review of the literature, we justify the emergency treatment of nerve defects of the collateral palmar digital nerves with venous grafting. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

The World Trade Center bombing: injury prevention strategies for high-rise building fires.

PubMed

Quenemoen, L E; Davis, Y M; Malilay, J; Sinks, T; Noji, E K; Klitzman, S

1996-06-01

The WTC disaster provided an opportunity to look for ways to prevent morbidity among occupants of high-rise buildings during fires. This paper first describes the overall morbidity resulting from the explosion and fire, and second, presents the results of a case-control study carried out to identify risk factors for smoke-related morbidity. The main ones include: increased age, presence of a pre-existing cardio-pulmonary condition, entrapment in a lift and prolonged evacuation time. Study results point to the importance of the following safety systems during high-rise building fires: smoke-control systems with separate emergency power sources; lift-cars, lift-car position-monitoring systems, and lift-car communication systems with separate emergency power sources; two-way emergency communication systems on all floors and in stairwells; stairwells with emergency lighting and designed for the rapid egress of crowds; evacuation systems/equipment to assist in the evacuation of vulnerable people (elderly, infirm). Also important are evacuation plans that include regularly scheduled safety training and evacuation drills.

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

Code of Federal Regulations, 2011 CFR

2011-01-01

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

Emotional body-word conflict evokes enhanced n450 and slow potential.

PubMed

Ma, Jianling; Liu, Chang; Zhong, Xin; Wang, Lu; Chen, Xu

2014-01-01

Emotional conflict refers to the influence of task irrelevant affective stimuli on current task set. Previously used emotional face-word tasks have produced certain electrophysiological phenomena, such as an enhanced N450 and slow potential; however, it remains unknown whether these effects emerge in other tasks. The present study used an emotional body-word conflict task to investigate the neural dynamics of emotional conflict as reflected by response time, accuracy, and event-related potentials, which were recorded with the aim of replicating the previously observed N450 and slow potential effect. Results indicated increased response time and decreased accuracy in the incongruent condition relative to the congruent condition, indicating a robust interference effect. Furthermore, the incongruent condition evoked pronounced N450 amplitudes and a more positive slow potential, which might be associated with conflict-monitoring and conflict resolution. The present findings extend our understanding of emotional conflict to the body-word domain.

Seedling Emergence and Phenotypic Response of Common Bean Germplasm to Different Temperatures under Controlled Conditions and in Open Field.

PubMed

De Ron, Antonio M; Rodiño, Ana P; Santalla, Marta; González, Ana M; Lema, María J; Martín, Isaura; Kigel, Jaime

2016-01-01

Rapid and uniform seed germination and seedling emergence under diverse environmental conditions is a desirable characteristic for crops. Common bean genotypes (Phaseolus vulgaris L.) differ in their low temperature tolerance regarding growth and yield. Cultivars tolerant to low temperature during the germination and emergence stages and carriers of the grain quality standards demanded by consumers are needed for the success of the bean crop. The objectives of this study were (i) to screen the seedling emergence and the phenotypic response of bean germplasm under a range of temperatures in controlled chamber and field conditions to display stress-tolerant genotypes with good agronomic performances and yield potential, and (ii) to compare the emergence of bean seedlings under controlled environment and in open field conditions to assess the efficiency of genebanks standard germination tests for predicting the performance of the seeds in the field. Three trials were conducted with 28 dry bean genotypes in open field and in growth chamber under low, moderate, and warm temperature. Morpho-agronomic data were used to evaluate the phenotypic performance of the different genotypes. Cool temperatures resulted in a reduction of the rate of emergence in the bean genotypes, however, emergence and early growth of bean could be under different genetic control and these processes need further research to be suitably modeled. Nine groups arose from the Principal Component Analysis (PCA) representing variation in emergence time and proportion of emergence in the controlled chamber and in the open field indicating a trend to lower emergence in large and extra-large seeded genotypes. Screening of seedling emergence and phenotypic response of the bean germplasm under a range of temperatures in controlled growth chambers and under field conditions showed several genotypes, as landraces 272, 501, 593, and the cultivar Borlotto, with stress-tolerance at emergence, and high yield potential that could be valuable genetic material for breeding programs. Additionally, the potential genetic erosion in genebanks was assessed. Regarding bean commercial traits, under low temperature at sowing time seed reached larger size, and crop yield was higher compared to warmer temperatures at the sowing time. Therefore, early sowing of bean is strongly recommended.

Seedling Emergence and Phenotypic Response of Common Bean Germplasm to Different Temperatures under Controlled Conditions and in Open Field

PubMed Central

De Ron, Antonio M.; Rodiño, Ana P.; Santalla, Marta; González, Ana M.; Lema, María J.; Martín, Isaura; Kigel, Jaime

2016-01-01

Rapid and uniform seed germination and seedling emergence under diverse environmental conditions is a desirable characteristic for crops. Common bean genotypes (Phaseolus vulgaris L.) differ in their low temperature tolerance regarding growth and yield. Cultivars tolerant to low temperature during the germination and emergence stages and carriers of the grain quality standards demanded by consumers are needed for the success of the bean crop. The objectives of this study were (i) to screen the seedling emergence and the phenotypic response of bean germplasm under a range of temperatures in controlled chamber and field conditions to display stress-tolerant genotypes with good agronomic performances and yield potential, and (ii) to compare the emergence of bean seedlings under controlled environment and in open field conditions to assess the efficiency of genebanks standard germination tests for predicting the performance of the seeds in the field. Three trials were conducted with 28 dry bean genotypes in open field and in growth chamber under low, moderate, and warm temperature. Morpho-agronomic data were used to evaluate the phenotypic performance of the different genotypes. Cool temperatures resulted in a reduction of the rate of emergence in the bean genotypes, however, emergence and early growth of bean could be under different genetic control and these processes need further research to be suitably modeled. Nine groups arose from the Principal Component Analysis (PCA) representing variation in emergence time and proportion of emergence in the controlled chamber and in the open field indicating a trend to lower emergence in large and extra-large seeded genotypes. Screening of seedling emergence and phenotypic response of the bean germplasm under a range of temperatures in controlled growth chambers and under field conditions showed several genotypes, as landraces 272, 501, 593, and the cultivar Borlotto, with stress-tolerance at emergence, and high yield potential that could be valuable genetic material for breeding programs. Additionally, the potential genetic erosion in genebanks was assessed. Regarding bean commercial traits, under low temperature at sowing time seed reached larger size, and crop yield was higher compared to warmer temperatures at the sowing time. Therefore, early sowing of bean is strongly recommended. PMID:27532005

Affective temperament and executive functions in emergency medicine professionals.

PubMed

Jaracz, Marcin; Paciorek, Przemysław; Buciński, Adam; Borkowska, Alina

2014-10-01

Recent studies indicate that choice of profession is related to differences in affective temperament, which is probably due to various predispositions needed to efficiently perform particular professions. The aim of the present study was to assess affective temperament and executive functions in a sample of emergency medicine professionals. 75 emergency medicine professionals were enrolled in the study. Affective temperament was assessed by means of TEMPS-A. Executive functions were assessed by means of Trail Making Test and Stroop Color Word Interference Test. Subjects showed significantly higher rates of hyperthymic, compared to depressive, cyclothymic, irritable and anxious temperaments. The principal component analysis revealed that hyperthymic temperament contributes to a different factor, than the remaining ones. Higher rates of depressive, cyclothymic, irritable and anxious temperaments were related to poorer performance in Trail Making Test, whereas hyperthymic temperament had the opposite effect. Due to the size of the sample, results of the present study may have lacked power to show all the relationships between tested variables. Hyperthymic temperament promotes efficient performance of complex tasks under time pressure. Depressive, cyclothymic, irritable and anxious temperaments have the opposite effect. This makes hyperthymic temperament a desirable trait in emergency medicine professionals, performing complex medical tasks under extreme conditions. Copyright © 2014 Elsevier B.V. All rights reserved.

Geriatric emergency general surgery: Survival and outcomes in a low-middle income country.

PubMed

Shah, Adil A; Haider, Adil H; Riviello, Robert; Zogg, Cheryl K; Zafar, Syed Nabeel; Latif, Asad; Rios Diaz, Arturo J; Rehman, Zia; Zafar, Hasnain

2015-08-01

Geriatric patients remain largely unstudied in low-middle income health care settings. The purpose of this study was to compare the epidemiology and outcomes of older versus younger adults with emergency general surgical conditions in South Asia. Discharge data from March 2009 to April 2014 were obtained for all adult patients (≥16 years) with an International Classification of Diseases, 9th revision, Clinical Modification diagnosis codes consistent with an emergency general surgery condition as defined by the American Association for the Surgery of Trauma. Multivariable regression analyses compared patients >65 years of age with patients ≤65 years for differences in all-cause mortality, major complications, and duration of hospital stay. Models were adjusted for potential confounding owing to patient demographic and clinical case-mix data with propensity scores. We included 13,893 patients; patients >65 years constituted 15% (n = 2,123) of the cohort. Relative to younger patients, older adults were more likely to present with a number of emergency general surgery conditions, including gastrointestinal bleeding (odds ratio OR [95% CI], 2.63[1.99-3.46]), resuscitation (2.17 [1.67-2.80]), and peptic ulcer disease (2.09 [1.40-3.10]). They had an 89% greater risk-adjusted odds (1.89 [1.55-2.29]) of complications and a 63% greater odds (1.63 [1.21-2.20]) of mortality. Restricted to patients undergoing operative interventions, older adults had 95% greater odds (1.95 [1.29-2.94]) of complications and 117% greater odds (2.17 [1.62-2.91]) of mortality. Understanding unique needs of geriatric patients is critical to enhancing the management and prioritization of appropriate care in developing settings. Copyright © 2015 Elsevier Inc. All rights reserved.

Hippocampal theta activity is selectively associated with contingency detection but not discrimination in rabbit discrimination-reversal eyeblink conditioning.

PubMed

Nokia, Miriam S; Wikgren, Jan

2010-04-01

The relative power of the hippocampal theta-band ( approximately 6 Hz) activity (theta ratio) is thought to reflect a distinct neural state and has been shown to affect learning rate in classical eyeblink conditioning in rabbits. We sought to determine if the theta ratio is mostly related to the detection of the contingency between the stimuli used in conditioning or also to the learning of more complex inhibitory associations when a highly demanding delay discrimination-reversal eyeblink conditioning paradigm is used. A high hippocampal theta ratio was not only associated with a fast increase in conditioned responding in general but also correlated with slow emergence of discriminative responding due to sustained responding to the conditioned stimulus not paired with an unconditioned stimulus. The results indicate that the neural state reflected by the hippocampal theta ratio is specifically linked to forming associations between stimuli rather than to the learning of inhibitory associations needed for successful discrimination. This is in line with the view that the hippocampus is responsible for contingency detection in the early phase of learning in eyeblink conditioning. (c) 2009 Wiley-Liss, Inc.

Sporulation and Germination patterns - hedging a bet on long term microbial survivability in dry soil

NASA Astrophysics Data System (ADS)

Claes, N.; Or, D.

2012-04-01

Soil hosts unparalleled diversity of microbial life that is constantly challenged by the vagaries of fluctuating ambient conditions. Desiccation stresses play a key role not only by directly affecting individual bacterial cells, but also by shaping diffusion pathways and cell dispersion. The gradual thinning and fragmentation of the aqueous environment during drying have led to different survival mechanisms including dormancy and sporulation, resulting in a highly resistive state capable of surviving extreme and prolonged environmental stresses until conditions improve in the future. Our aim is to investigate how temporal changes in hydration status shape microbial communities over time, based on simple survival strategy rules for each individual bacterium. The two survival strategies considered are dormancy and sporulation. Dormancy is the state in which bacterial cells significantly reduce their metabolism with minor morphological adaptations. The required energy and time for attaining this state are low relative to sporulation costs. Sporulation involves several morphological and biochemical changes that result in a resistive capsule that endures extreme stresses over long periods of time. The working hypothesis is that different micro-ecological conditions and community compositions would result from temporal patterns and magnitude of desiccation stresses. An Individual Based Model (IBM) considering habitats on rough soil surfaces and local effects of micro-hydrological conditions on dispersion and nutrient diffusion would enable systematic study of emerging communities over extended periods. Different population compositions are expected to emerge based on low and high frequency, duration and amplitudes of wetting-drying cycles reflecting relative success or failure of survival strategy.

A Systematic Approach to Emergencies in Uveitis

PubMed Central

Al-Dhibi, Hassan A.; Al-Mahmood, Ammar M.; Arevalo, J. Fernando

2014-01-01

Uveitis is a common cause of preventable blindness although it is consider a sight-threatening condition particularly in cases with posterior segment inflammation. To deal with emergency conditions in uveitis, we must aware of the essential signs and symptoms that reflect a true uveitic emergency. Failure to recognize these essential signs and symptoms of a true uveitic emergency may result in a devastating visual outcome. This review provides general ophthalmologists and residents, clinical guidelines for the main uveitic entities that require immediate recognition and urgent intervention in the emergency room to prevent severe permanent visual loss. PMID:25100911

Frequency of emergency room visits for childhood asthma in Ottawa, Canada: the role of weather

NASA Astrophysics Data System (ADS)

Villeneuve, Paul J.; Leech, Judy; Bourque, Denis

2005-09-01

The aim of this study was to evaluate associations between meteorological conditions and the number of emergency department visits for asthma in a children's hospital in Ottawa, Canada. A case-crossover study design was used. Hospital emergency department visits for asthma between 1992 and 2000 were identified based on patients' presenting complaints. We obtained hourly measures for the following meteorological variables: wind speed, temperature, atmospheric pressure, relative humidity, and visibility. Particular emphasis was placed on exploring the association between asthma visits and fog, thunderstorms, snow, and liquid and freezing forms of precipitation. In total, there were 18,970 asthma visits among children between 2 and 15 years of age. The number of visits and weather characteristics were grouped into 6 h case and control intervals. The occurrence of fog or liquid precipitation was associated with an increased number of asthma visits, while snow was associated with a reduced number (P<0.05). Stratified analyses by season found no association in any of the four calendar intervals between the number of asthma visits and visibility, change in relative humidity and change in temperature. In contrast, summertime thunderstorm activity was associated with an odds ratio of 1.35 (95% CI=1.02-1.77) relative to summer periods with no activity. Models that incorporate calendar and meteorological data may help emergency departments to more efficiently allocate resources needed to treat children presenting with respiratory distress.

The Meaning of Patient Empowerment in the Digital Age: The Role of Online Patient-Communities.

PubMed

Lamas, Eugenia; Salinas, Rodrigo; Coquedano, Carla; Simon, Marie-Pierre; Bousquet, Cedric; Ferrer, Marcela; Zorrilla, Sergio

2017-01-01

Traditionally, patient empowerment has been used as a strategy for health promotion. The rise of online communities of patients represents a good example of how patient empowerment occurs, independently of the intervention of existing healthcare providers and insurers, allowing thus a more accurate definition of meaning of this concept. We describe two situations related with the development of health-related social networks: (1) The emergence of a new biomedical research model in which patients lead research, shifting the equilibrium of power from the professionals to research subjects themselves, and (2) The emergence of Lay Crowd-Sourced Expertise in these communities, arising from the daily exchange among patients affected by chronic conditions and their relatives, giving place to a new era of bottom-up data generation, previously unknown in biomedical sciences. We enrich these descriptions by analyzing interviews to key actors of these "on line" communities": Michael Chekroun, founder of "Carenity, France", and Paul Wicks Vice President at "PatientsLikeMe, USA".

Sex and age differences in hibernation patterns of common hamsters: adult females hibernate for shorter periods than males.

PubMed

Siutz, Carina; Franceschini, Claudia; Millesi, Eva

2016-08-01

In this study, we investigated the timing and duration of hibernation as well as body temperature patterns in free-ranging common hamsters (Cricetus cricetus) with regard to sex and age differences. Body temperature was recorded using subcutaneously implanted data loggers. The results demonstrate that although immergence and vernal emergence sequences of sex and age groups resembled those of most hibernators, particularly adult females delayed hibernation onset until up to early January. Thus, in contrast to other hibernators, female common hamsters hibernated for shorter periods than males and correspondingly spent less time in torpor. These sex differences were absent in juvenile hamsters. The period between the termination of hibernation and vernal emergence varied among individuals but did not differ between the sex and age groups. This period of preemergence euthermy was related to emergence body mass: individuals that terminated hibernation earlier in spring and had longer euthermic phases prior to emergence started the active season in a better condition. In addition, males with longer periods of preemergence euthermy had larger testes at emergence. In conclusion, females have to rely on sufficient food stores but may adjust the use of torpor in relation to the available external energy reserves, whereas males show a more pronounced energy-saving strategy by hibernating for longer periods. Nonetheless, food caches seem to be important for both males and females as indicated by the euthermic preemergence phase and the fact that some individuals, mainly yearlings, emerged with a higher body mass than shortly before immergence in autumn.

Pathways and consequences of contaminant flux to Acadian flycatchers (Empidonax virescens) in urbanizing landscapes of Ohio, USA.

PubMed

Rowse, Linnea M; Rodewald, Amanda D; Sullivan, S Mažeika P

2014-07-01

A prevalent environmental contaminant, mercury (Hg) is mobile and persistent in aquatic systems, where it often occurs in its bioavailable form methylmercury. Because methylmercury can bioaccumulate in aquatic insects and then transfer to terrestrial food webs, riparian consumers reliant upon aquatic emergent insects, should be disproportionately affected. Using the aerial insectivore Acadian flycatcher (Empidonax virescens) as a focal species, we examined (1) the extent to which total Hg loads in breeding flycatchers affected body condition and reproductive output and (2) potential pathways of contaminant flux in 19 riparian forest fragments distributed across an urban-to-rural landscape gradient in Ohio, USA. From April-August 2011-2012, we collected blood samples from adult (n=76) and nestling (n=17 from 7 nests) flycatchers, monitored their annual reproductive success (i.e., total number of fledglings), and sampled water, sediment, and aquatic emergent insects at each site. Hg concentrations in adult flycatcher blood (47 to 584 μg/kg, x¯=211.8, SD=95.5) were low relative to published advisory levels and not related to body condition. However, even at low concentrations, blood Hg was negatively related to reproductive success, with a 0.83 decline in the number of fledglings per μg/kg (loge) increase of blood Hg. Adult flycatchers had 11× greater concentrations of blood Hg than their offspring. Hg levels in flycatcher blood were not predicted by Hg concentrations in sediment, water, or aquatic emergent insects, with the exception of rural landscapes alone, in which flycatcher Hg was negatively related to sediment Hg. In addition to illustrating the difficulty of predicting exposure pathways that may vary among landscape contexts, our study provides evidence that even trace levels of contaminants may impair reproductive success of free-living songbirds. Copyright © 2014 Elsevier B.V. All rights reserved.

Pictures as a neurological tool: lessons from enhanced and emergent artistry in brain disease.

PubMed

Schott, G D

2012-06-01

Pictures created spontaneously by patients with brain disease often display impaired or diminished artistry, reflecting the patient's cerebral damage. This article explores the opposite: those pictures created in the face of brain disease that show enhanced or enduring artistry, and those that emerge for the first time in artistically naïve patients. After comments on background issues relating to the patient and the viewer, the paintings and drawings are considered in relation to the heterogeneous conditions in which this artistic creativity is seen. These conditions include various dementias-most notably frontotemporal lobar dementia, stroke, Parkinson's disease, autism and related disorders and psychiatric disease, epilepsy, migraine and trauma. In the discussion, it is argued that evidence of underlying brain dysfunction revealed by these pictures often rests on the abnormal context in which the pictures are created, or on changes in artistry demonstrated by a sequence of pictures. In the former, the compulsive element and sensory and emotional accompaniments are often important features; in the latter, evolving changes are evident, and have included depiction of increasing menace in portrayal of faces. The occurrence of synaesthesia, and its relation to creativity, are briefly discussed in respect of two unusual patients, followed by considering the role of the anterior and frontal lobes, mesolimbic connections and the right hemisphere. In at least some patients, impaired inhibition leading to paradoxical functional facilitation, with compensatory changes particularly in the right posterior hemisphere, is likely to be pivotal in enabling unusual artistry to emerge; preservation of language, however, is not a prerequisite. Many patients studied have been artists, and it appears possible that some of those with an artistic predisposition may be more likely to experience pathologically obsessive creativity. The discussion concludes that occasionally pictures created by these rare individuals unexpectedly prove to be an invaluable but little studied tool for investigating the dysfunctioning brain.

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.

Dynamic Environmental Photosynthetic Imaging Reveals Emergent Phenotypes

DOE PAGES

Cruz, Jeffrey A.; Savage, Linda J.; Zegarac, Robert; ...

2016-06-22

Understanding and improving the productivity and robustness of plant photosynthesis requires high-throughput phenotyping under environmental conditions that are relevant to the field. Here we demonstrate the dynamic environmental photosynthesis imager (DEPI), an experimental platform for integrated, continuous, and high-throughput measurements of photosynthetic parameters during plant growth under reproducible yet dynamic environmental conditions. Using parallel imagers obviates the need to move plants or sensors, reducing artifacts and allowing simultaneous measurement on large numbers of plants. As a result, DEPI can reveal phenotypes that are not evident under standard laboratory conditions but emerge under progressively more dynamic illumination. We show examples inmore » mutants of Arabidopsis of such “emergent phenotypes” that are highly transient and heterogeneous, appearing in different leaves under different conditions and depending in complex ways on both environmental conditions and plant developmental age. Finally, these emergent phenotypes appear to be caused by a range of phenomena, suggesting that such previously unseen processes are critical for plant responses to dynamic environments.« less

The 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" Diagnostic Testing Breakout Session Report.

PubMed

Barrett, Tyler W; Rising, Kristin L; Bellolio, M Fernanda; Hall, M Kennedy; Brody, Aaron; Dodd, Kenneth W; Grieser, Mira; Levy, Phillip D; Raja, Ali S; Self, Wesley H; Weingarten, Gail; Hess, Erik P; Hollander, Judd E

2016-12-01

Diagnostic testing is an integral component of patient evaluation in the emergency department (ED). Emergency clinicians frequently use diagnostic testing to more confidently exclude "worst-case" diagnoses rather than to determine the most likely etiology for a presenting complaint. Increased utilization of diagnostic testing has not been associated with reductions in disease-related mortality but has led to increased overall healthcare costs and other unintended consequences (e.g., incidental findings requiring further workup, unnecessary exposure to ionizing radiation or potentially nephrotoxic contrast). Shared decision making (SDM) presents an opportunity for clinicians to discuss the benefits and harms associated with diagnostic testing with patients to more closely tailor testing to patient risk. This article introduces the challenges and opportunities associated with incorporating SDM into emergency care by summarizing the conclusions of the diagnostic testing group at the 2016 Academic Emergency Medicine Consensus Conference on SDM. Three primary domains emerged: 1) characteristics of a condition or test appropriate for SDM, 2) critical elements of and potential barriers to SDM discussions on diagnostic testing, and 3) financial aspects of SDM applied to diagnostic testing. The most critical research questions to improve engagement of patients in their acute care diagnostic decisions were determined by consensus. © 2016 by the Society for Academic Emergency Medicine.

Limited period of graviresponsiveness in germinating spores of Ceratopteris richardii

NASA Technical Reports Server (NTRS)

Edwards, E. S.; Roux, S. J.

1994-01-01

Rhizoids of the fern Ceratopteris richardii Brogn. usually emerge 40 h after germination is initiated by light, and more than 90% of them emerge growing in a downward direction. However, when the spores are germinated on a clinostat, the emerging rhizoids show no preferential orientation. This indicates that under normal 1 g conditions the initial growth direction of rhizoids can be oriented by gravity. If the orientation of the spores is changed 3 h or less after the start of germination, the growth direction of most emerging rhizoids becomes downward relative to the new orientation. However, if the orientation of the spores is changed by 180 degrees 8 h or more after germination is initiated by light, most rhizoids emerge growing upward; i.e., the same direction as if there had been no orientation change. Emerged rhizoids also do not change their direction of growth if their orientation is changed. These results indicate that the growth direction of emerging rhizoids is set by gravity prior to actual emergence, and that the time of full orientation responsiveness is limited to a period ranging from the initiation of germination to about 3-4 h after the start of germination. There is a gravity-oriented nuclear movement beginning at about 13 h after germination, and this movement appears to predict the initial growth direction of rhizoids.

Limited period of graviresponsiveness in germinating spores of Ceratopteris richardii.

PubMed

Edwards, E S; Roux, S J

1994-01-01

Rhizoids of the fern Ceratopteris richardii Brogn. usually emerge 40 h after germination is initiated by light, and more than 90% of them emerge growing in a downward direction. However, when the spores are germinated on a clinostat, the emerging rhizoids show no preferential orientation. This indicates that under normal 1 g conditions the initial growth direction of rhizoids can be oriented by gravity. If the orientation of the spores is changed 3 h or less after the start of germination, the growth direction of most emerging rhizoids becomes downward relative to the new orientation. However, if the orientation of the spores is changed by 180 degrees 8 h or more after germination is initiated by light, most rhizoids emerge growing upward; i.e., the same direction as if there had been no orientation change. Emerged rhizoids also do not change their direction of growth if their orientation is changed. These results indicate that the growth direction of emerging rhizoids is set by gravity prior to actual emergence, and that the time of full orientation responsiveness is limited to a period ranging from the initiation of germination to about 3-4 h after the start of germination. There is a gravity-oriented nuclear movement beginning at about 13 h after germination, and this movement appears to predict the initial growth direction of rhizoids.

Inertial Measures of Motion for Clinical Biomechanics: Comparative Assessment of Accuracy under Controlled Conditions - Effect of Velocity

PubMed Central

Lebel, Karina; Boissy, Patrick; Hamel, Mathieu; Duval, Christian

2013-01-01

Background Inertial measurement of motion with Attitude and Heading Reference Systems (AHRS) is emerging as an alternative to 3D motion capture systems in biomechanics. The objectives of this study are: 1) to describe the absolute and relative accuracy of multiple units of commercially available AHRS under various types of motion; and 2) to evaluate the effect of motion velocity on the accuracy of these measurements. Methods The criterion validity of accuracy was established under controlled conditions using an instrumented Gimbal table. AHRS modules were carefully attached to the center plate of the Gimbal table and put through experimental static and dynamic conditions. Static and absolute accuracy was assessed by comparing the AHRS orientation measurement to those obtained using an optical gold standard. Relative accuracy was assessed by measuring the variation in relative orientation between modules during trials. Findings Evaluated AHRS systems demonstrated good absolute static accuracy (mean error < 0.5o) and clinically acceptable absolute accuracy under condition of slow motions (mean error between 0.5o and 3.1o). In slow motions, relative accuracy varied from 2o to 7o depending on the type of AHRS and the type of rotation. Absolute and relative accuracy were significantly affected (p<0.05) by velocity during sustained motions. The extent of that effect varied across AHRS. Interpretation Absolute and relative accuracy of AHRS are affected by environmental magnetic perturbations and conditions of motions. Relative accuracy of AHRS is mostly affected by the ability of all modules to locate the same global reference coordinate system at all time. Conclusions Existing AHRS systems can be considered for use in clinical biomechanics under constrained conditions of use. While their individual capacity to track absolute motion is relatively consistent, the use of multiple AHRS modules to compute relative motion between rigid bodies needs to be optimized according to the conditions of operation. PMID:24260324

Synoptic evolution of Atmospheric River landfalls in Northern California and the pre-conditioning of their characteristics by the climate state

NASA Astrophysics Data System (ADS)

Gershunov, A.; Guirguis, K.; Shulgina, T.; Clemesha, R.; Ralph, M.

2017-12-01

Atmospheric Rivers (ARs) contribute the lion's share of water resources for California, but can also cause flooding and draw heavily on emergency resources of state and local governments. Comprehensive probabilistic tools relating landfalling ARs to pre-existing weather/climate conditions could be useful for subseasonal forecasting, emergency preparedness and water resource management. We examine ARs targeting the Northern California coast using long-term observations of synoptic-scale circulation, high-resolution precipitation, and a seven-decade-long catalog of AR landfalls to quantify distinct orientations of landfalling ARs. Using a probabilistic approach to relate these historic events to precursor weather patterns, we identify synoptic circulation patterns that precede AR landfalls at various lead times in the range of 0-30 days. Examination of the evolution of these precursor patterns reveals subtle but important differences in the atmospheric states that lead to AR landfalls versus those that don't. Synoptic precursors can also differentiate between orientations of ARs at landfall, which produce rather different precipitation patterns over the region's complex topography. Moreover, low-frequency climate forcing appears to modulate the likelihood of AR landfalls, as well as their preferred orientations. These results provide a link between seasonal and subseasonal timescales and suggest a new approach toward extended-range prediction of land-falling atmospheric rivers and their related precipitation.

Perceptions of Heat-Susceptibility in Older Persons: Barriers to Adaptation

PubMed Central

Hansen, Alana; Bi, Peng; Nitschke, Monika; Pisaniello, Dino; Newbury, Jonathan; Kitson, Alison

2011-01-01

The increase in the frequency of very hot weather that is a predicted consequence of climate change poses an emerging threat to public health. Extreme heat can be harmful to the health of older persons who are known to be amongst the most vulnerable in the community. This study aimed to investigate factors influencing the ability of older persons to adapt to hot conditions, and barriers to adaptation. A qualitative study was conducted in Adelaide, Australia, involving focus groups and interviews with stakeholders including key personnel involved in aged care, community services, government sectors, emergency services and policy making. Findings revealed a broad range of factors that underpin the heat-susceptibility of the aged. These were categorized into four broad themes relating to: physiology and an age-related decline in health; socioeconomic factors, particularly those influencing air conditioning use; psychological issues including fears and anxieties about extreme heat; and adaptive strategies that could be identified as both enablers and barriers. As a consequence, the ability and willingness to undertake behavior change during heatwaves can therefore be affected in older persons. Additionally, understanding the control panels on modern air conditioners can present challenges for the aged. Improving heat-health knowledge and addressing the social and economic concerns of the older population will assist in minimizing heat-related morbidity and mortality in a warming climate. PMID:22408598

An Overview of Occupational Risks From Climate Change.

PubMed

Applebaum, Katie M; Graham, Jay; Gray, George M; LaPuma, Peter; McCormick, Sabrina A; Northcross, Amanda; Perry, Melissa J

2016-03-01

Changes in atmosphere and temperature are affecting multiple environmental indicators from extreme heat events to global air quality. Workers will be uniquely affected by climate change, and the occupational impacts of major shifts in atmospheric and weather conditions need greater attention. Climate change-related exposures most likely to differentially affect workers in the USA and globally include heat, ozone, polycyclic aromatic hydrocarbons, other chemicals, pathogenic microorganisms, vector-borne diseases, violence, and wildfires. Epidemiologic evidence documents a U-, J-, or V-shaped relationship between temperature and mortality. Whereas heat-related morbidity and mortality risks are most evident in agriculture, many other outdoor occupational sectors are also at risk, including construction, transportation, landscaping, firefighting, and other emergency response operations. The toxicity of chemicals change under hyperthermic conditions, particularly for pesticides and ozone. Combined with climate-related changes in chemical transport and distribution, these interactions represent unique health risks specifically to workers. Links between heat and interpersonal conflict including violence require attention because they pose threats to the safety of emergency medicine, peacekeeping and humanitarian relief, and public safety professionals. Recommendations for anticipating how US workers will be most susceptible to climate change include formal monitoring systems for agricultural workers; modeling scenarios focusing on occupational impacts of extreme climate events including floods, wildfires, and chemical spills; and national research agenda setting focusing on control and mitigation of occupational susceptibility to climate change.

Legal issues affecting children with preexisting conditions during public health emergencies.

PubMed

Rutkow, Lainie; Vernick, Jon S; Wissow, Lawrence S; Tung, Gregory J; Marum, Felicity; Barnett, Daniel J

2013-06-01

Among the millions of children in the United States exposed to public health emergencies in recent years, those with preexisting health conditions face particular challenges. A public health emergency may, for example, disrupt treatment regimens or cause children to be separated from caregivers. Ongoing shortages of pediatricians and pediatric subspecialists may further exacerbate the risks that children with preexisting conditions face in disaster circumstances. The US Department of Homeland Security recently called for better integration of children's needs into all preparedness activities. To aid in this process, multiple legal concerns relevant to pediatricians and pediatric policymakers must be identified and addressed. Obtaining informed consent from children and parents may be particularly challenging during certain public health emergencies. States may need to invoke legal protections for children who are separated from caregivers during emergencies. Maintaining access to prescription medications may also require pediatricians to use specific legal mechanisms. In addition to practitioners, recommendations are given for policymakers to promote effective pediatric response to public health emergencies.

A Brief Interview to Detect Panic Attacks and Panic Disorder in Emergency Department Patients with Cardiopulmonary Complaints.

PubMed

Sung, Sharon C; Rush, A John; Earnest, Arul; Lim, Leslie E C; Pek, Maeve P P; Choi, Joen M F; Ng, Magdalene P K; Ong, Marcus E H

2018-01-01

Patients with panic-related anxiety often initially present to the emergency department (ED) complaining of respiratory or cardiac symptoms, but rates of detection of panic symptoms by ED physicians remain low. This study was undertaken to evaluate the relevance of panic attacks and panic disorder in ED patients who present with cardiopulmonary symptoms and to determine whether a brief symptom-based tool could be constructed to assist in rapid recognition of panic-related anxiety in the ED setting. English-speaking adult ED patients with a chief complaint of palpitations, chest pain, dizziness, or difficulty breathing were evaluated for the presence of panic attacks and panic disorder with the Structured Clinical Interview for DSM-IV Axis I Disorders. Participants completed self-report measures to assess panic-related symptoms, comorbid psychiatric conditions, health-related disability, and health service use. In this sample (N=200), 23.5% had panic attacks and 23.0% had panic disorder. Both groups reported higher rates of panic attack symptoms, greater psychiatric comorbidity, greater health-related disability, and higher rates of ED and mental health service use compared with those without either condition. A brief 7-item tool consisting of panic symptoms identified patients with panic attacks or panic disorder with 85% accuracy (area under the curve=0.90, sensitivity=82%, specificity=88%). Patients with panic attacks or panic disorder commonly present to the ED, but often go unrecognized. A brief 7-item clinician rating scale accurately identifies these patients among those ED patients presenting with cardiopulmonary complaints.

Adverse drug event-related emergency department visits associated with complex chronic conditions.

PubMed

Feinstein, James A; Feudtner, Chris; Kempe, Allison

2014-06-01

Outpatient adverse drug events (ADEs) can result in serious outcomes requiring emergency department (ED) visits and hospitalizations. The incidence and severity of ADEs in children with complex chronic conditions (CCCs), who often take multiple medications, is unknown. We sought to describe the characteristics of ADE-related ED visits, including association with CCC status; determine the implicated medications; and determine if CCC status increased the risk of ADE-related admission. Retrospective cohort study of ED visits by patients aged 0 to 18 years using a national sample. ADEs were identified by external cause of injury codes; cases with overdose, wrongful administration, self-harm, or diagnosis of malignancy were excluded. Multivariable logistic regression was used to test outcomes of having an ADE-related ED visit and of subsequent admission. All statistics accounted for the complex survey design. Of 144 million ED visits, 0.5% were associated with ADEs. Adjusting for age, gender, insurance type, day of week, and location of hospital, ADEs were associated with the presence of a CCC (odds ratio 4.76; 95% confidence interval: 4.45-5.10). The implicated medications differed significantly by CCC status. Adjusting for the same variables, ADEs were associated with subsequent inpatient admission (odds ratio 2.18; 95% confidence interval: 2.04-2.32) for all children; an interaction between ADE and CCC status was not significant. ED visits associated with ADEs were more likely to occur for children with CCCs, and the implicated drugs differed, but ADE-related admissions were not differentially affected by CCC status. Copyright © 2014 by the American Academy of Pediatrics.

Clinical profile of dermatological emergencies and intensive care unit admissions in a tertiary care center - an Indian perspective.

PubMed

Samudrala, Suvarna; Dandakeri, Sukumar; Bhat, Ramesh M

2018-05-01

Although dermatology is largely considered as an outpatient specialty, dermatological conditions comprise 5-8% of cases presenting to the emergency department. The need for a dermatological intensive care unit is widely acknowledged due to the increasing incidence of acute skin failure. Very few studies have been done to characterize the common conditions seen in the emergency department and intensive care units. We undertook this study to analyze the spectrum of dermatological conditions presenting to the emergency department and the clinical profile of patients admitted to the intensive care unit. A prospective study was conducted for 9 months. Patients requiring primary dermatological consultation in the emergency department and patients admitted in the dermatology intensive care unit were examined, and their clinical variables were statistically analyzed. A total of 248 cases were seen in the emergency department, out of which 72 (29.1%) cases were admitted and 176 (70.9%) were treated in the emergency department on an outpatient basis. The most common condition seen in non-admitted patients was acute urticaria (28.9%). The most common cause for admission in patients presenting to the emergency department was erythroderma (23.6%). Sixty-two patients were admitted to the intensive care unit, the most common diagnosis being erythroderma (40.3%). This prospective study aimed to provide an insight into the types of cases evaluated in the emergency department by dermatologists in a large tertiary care hospital in coastal Karnataka in South India. © 2018 The International Society of Dermatology.

Parental and Child Psychopathology: Moderated Mediation by Gender and Parent-Child Relationship Quality.

PubMed

Franz, Annabel O; McKinney, Cliff

2018-03-26

Previous literature has not examined the processes underlying the relations among parent-child relationship quality, parental psychopathology, and child psychopathology in the context of gender. Further, research examining these variables in emerging adulthood is lacking. The current study examined whether parent-child relationship quality would mediate the relation between parental and child psychopathology, and whether gender moderated these associations. Participants were emerging adults (N = 665) who reported on perceptions of their parents' and their own psychological problems as well as their parent-child relationship quality. Results indicated that the relation between parental internalizing problems and parent-child relationship quality was positive for males, and that mother-child relationship quality was related positively to psychological problems in males. This suggests that sons may grow closer to their parents (particularly their mother) who are exhibiting internalizing problems; in turn, this enmeshed relationship may facilitate transmission of psychopathology. Mediational paths were conditional upon gender, suggesting moderated mediation. Overall, the current study emphasizes that the complexities of parenting must be understood in the context of gender. Further, the mother-son dyad may particularly warrant further attention.

Bell's palsy: excluding serious illness in urgent and emergency care settings.

PubMed

Mower, Sean

2017-04-13

Bell's palsy is a relatively benign condition that affects about 20 in every 100,000 patients a year, and in most cases the signs and symptoms resolve fully within around six months. The defining characteristic of the condition is a unilateral facial palsy, but this is also apparent in other conditions with a more serious prognosis, including strokes, some viral infections and tumours. This article reviews the literature on recognition of Bell's palsy, examines the underlying pathology, and compares it with other conditions associated with facial palsy. The article critically analyses the evidence and guidelines to identify best practice, and considers areas for improvement. Finally, it discusses how this information can be incorporated into practice, and provides guidance for clinicians on differentiating between conditions in which patients present with facial palsy to ensure they are managed appropriately.

Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

PubMed

Musey, Paul I; Linnstaedt, Sarah D; Platts-Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A

2014-12-01

Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender differences in the assessment and treatment of pain conditions in emergency care settings. © 2014 by the Society for Academic Emergency Medicine.

Students With Chronic Conditions: Experiences and Challenges of Regular Education Teachers.

PubMed

Selekman, Janice

2017-08-01

School nurses have observed the increasing prevalence of children with chronic conditions in the school setting; however, little is known about teacher experiences with these children in their regular classrooms. The purpose of this mixed-method study was to describe the experiences and challenges of regular education teachers when they have students with chronic conditions in their classroom and implications for the school nurse. The national sample consisted of regular education teachers. The methodologies consisted of focus groups and an online survey. Seven themes emerged: Teachers want to be informed about their students with chronic conditions, teachers lack information about the conditions, there is a lack of preparation in preteacher education programs about students with chronic conditions, teachers feel frustration and stress in working effectively with these students, teachers shared concerns about their students, teachers are asked to perform health-related tasks for students, and teachers made recommendations of what they need from the school nurse.

Magnetic resonance imaging - A troubleshooter in obstetric emergencies: A pictorial review

PubMed Central

Gupta, Rohini; Bajaj, Sunil Kumar; Kumar, Nishith; Chandra, Ranjan; Misra, Ritu Nair; Malik, Amita; Thukral, Brij Bhushan

2016-01-01

The application of magnetic resonance imaging (MRI) in pregnancy faced initial skepticism of physicians because of fetal safety concerns. The perceived fetal risk has been found to be unwarranted and of late, the modality has attained acceptability. Its role in diagnosing fetal anomalies is well recognized and following its safety certification in pregnancy, it is finding increasing utilization during pregnancy and puerperium. However, the use of MRI in maternal emergency obstetric conditions is relatively limited as it is still evolving. In early gestation, ectopic implantation is one of the major life-threatening conditions that are frequently encountered. Although ultrasound (USG) is the accepted mainstay modality, the diagnostic predicament persists in many cases. MRI has a role where USG is indeterminate, particularly in the extratubal ectopic pregnancy. Later in gestation, MRI can be a useful adjunct in placental disorders like previa, abruption, and adhesion. It is a good problem-solving tool in adnexal masses such as ovarian torsion and degenerated fibroid, which have a higher incidence during pregnancy. Catastrophic conditions like uterine rupture can also be preoperatively and timely diagnosed. MRI has a definite role to play in postpartum and post-abortion life-threatening conditions, e.g., retained products of conception, and gestational trophoblastic disease, especially when USG is inconclusive or inadequate. PMID:27081223

An Unusual Case of Alternating Ventricular Morphology on the 12-Lead Electrocardiogram.

PubMed

Sammon, Maura; Dawood, Alveena; Beaudoin, Scott; Harrigan, Richard A

2017-03-01

One of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions. We describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose. A systematic approach to the electrocardiogram led to the rare diagnosis of Wolff-Parkinson-White (WPW) alternans. We review the differential diagnosis of this dysrhythmia and the initial evaluation of a patient with the WPW pattern present on their electrocardiogram. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be prepared to use a systematic approach to an undifferentiated dysrhythmia to identify potentially life-threatening conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

Herzberg, Hygiene and the Motivation to Reuse: Towards a Three-Factor Theory to Explain Motivation to Share and Use OER

ERIC Educational Resources Information Center

Pegler, Chris

2012-01-01

The list of barriers and enablers that influence the use of open educational resources (OER) is extensive. Factors and influences relating to reuse may have been noted within projects, operating within a short time span, or within specific conditions which limit generalizability. Evidence of reuse in practice has often emerged as isolated examples…

Defense Mechanisms and Utilization in Cancer Patients Undergoing Radiation Therapy: A Pilot Study.

PubMed

Porcerelli, John H; Cramer, Phebe; Porcerelli, Daniel J; Arterbery, V Elayne

2017-06-01

A group of 49 patients who had been diagnosed with cancer during the preceding year and who were receiving radiation therapy were assessed for their use of defense mechanisms, as well as for their level of psychological distress. In addition, their utilization of medical services was determined. It was predicted that the use of services that were under the patients' control-namely, requesting extra outpatient visits and making trips to the emergency department-would be related to the patients' use of defense mechanisms, whereas a treatment option not under the patients' control-overnight hospitalization based on physicians' assessment of condition-would not be related to defense use. The findings confirmed the hypotheses. Outpatient visits were strongly predicted by defense use, whereas hospitalization was determined by psychological distress. However, emergency department visits were determined by both defense use and psychological distress. In addition, an interaction between defense and distress was found to predict hospitalization.

Penile fracture at Tribhuvan University Teaching Hospital: a retrospective analysis.

PubMed

Athar, Z; Chalise, P R; Sharma, U K; Gyawali, P R; Shrestha, G K; Joshi, B R

2010-06-01

Fracture of the penis is rupture of the tunica albuginea and the usual cause is abrupt bending of the erect penis by blunt trauma. Trauma during sexual relation is responsible for approximately one third of all cases. The incidence of urethral injuries associated with this condition ranged from 2.0% to 38.0%. Twelve patients who presented to emergency over a period of 4 years with diagnosis of penile fracture were reviewed retrospectively. Patient's profile and all relevant data were noted from charts. The etiology of fracture was related to coital activity in 6 (50.0%) cases while other denied such act. Surgery was performed on all the patients and discharged from hospital on removal of urethral catheter. Follow up continued until restoration of normal penile function without complaint. So fracture of the penis is an injury that can be diagnosed clinically and needs emergency surgical correction for better result.

Post-traumatic Stress Disorder and Cardiovascular Disease.

PubMed

Burg, Matthew M; Soufer, Robert

2016-10-01

Post-traumatic stress disorder (PTSD) is a disabling condition that develops consequent to trauma exposure such as natural disasters, sexual assault, automobile accidents, and combat that independently increases risk for early incident cardiovascular disease (CVD) and cardiovascular (CV) mortality by over 50 % and incident hypertension risk by over 30 %. While the majority of research on PTSD and CVD has concerned initially healthy civilian and military veteran samples, emerging research is also demonstrating that PTSD consequent to the trauma of an acute cardiac event significantly increases risk for early recurrence and mortality and that patient experiences in the clinical pathway that are related to the emergency department environment may provide an opportunity to prevent PTSD onset and thus improve outcomes. Future directions for clinical and implementation science concern broad PTSD and trauma screening in the context of primary care medical environments and the testing of PTSD treatments with CVD-related surrogates and endpoints.

Wage and Salary Stabilization in a National Security Emergency

DTIC Science & Technology

1984-10-01

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

Emergence of multiple ocean ecosystem drivers in a large ensemble suite with an Earth system model

NASA Astrophysics Data System (ADS)

Rodgers, K. B.; Lin, J.; Frölicher, T. L.

2015-06-01

Marine ecosystems are increasingly stressed by human-induced changes. Marine ecosystem drivers that contribute to stressing ecosystems - including warming, acidification, deoxygenation and perturbations to biological productivity - can co-occur in space and time, but detecting their trends is complicated by the presence of noise associated with natural variability in the climate system. Here we use large initial-condition ensemble simulations with an Earth system model under a historical/RCP8.5 (representative concentration pathway 8.5) scenario over 1950-2100 to consider emergence characteristics for the four individual and combined drivers. Using a 1-standard-deviation (67% confidence) threshold of signal to noise to define emergence with a 30-year trend window, we show that ocean acidification emerges much earlier than other drivers, namely during the 20th century over most of the global ocean. For biological productivity, the anthropogenic signal does not emerge from the noise over most of the global ocean before the end of the 21st century. The early emergence pattern for sea surface temperature in low latitudes is reversed from that of subsurface oxygen inventories, where emergence occurs earlier in the Southern Ocean. For the combined multiple-driver field, 41% of the global ocean exhibits emergence for the 2005-2014 period, and 63% for the 2075-2084 period. The combined multiple-driver field reveals emergence patterns by the end of this century that are relatively high over much of the Southern Ocean, North Pacific, and Atlantic, but relatively low over the tropics and the South Pacific. For the case of two drivers, the tropics including habitats of coral reefs emerges earliest, with this driven by the joint effects of acidification and warming. It is precisely in the regions with pronounced emergence characteristics where marine ecosystems may be expected to be pushed outside of their comfort zone determined by the degree of natural background variability to which they are adapted. The results underscore the importance of sustained multi-decadal observing systems for monitoring multiple ecosystems drivers.

The role of personal models in clinical management: Exploring health care providers' beliefs about psoriasis.

PubMed

Chisholm, Anna; Nelson, Pauline A; Pearce, Christina J; Keyworth, Chris; Griffiths, Christopher E M; Cordingley, Lis; Bundy, Christine

2016-02-01

Individuals' illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers' illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers' beliefs, emotions, as well as their knowledge, experiences and behaviours ('personal models') in this is unexplored. This study aimed explore health care providers' personal models of psoriasis. Qualitative analysis of 23 semi-structured interviews with health care professionals providing care for psoriasis patients was performed. Purposive sampling achieved maximum variation regarding participant discipline, level of experience, gender and age. The self-regulatory/common sense model informed data collection and initial data analysis. Principles of framework analysis were used to generate predetermined and emergent key issues related to practitioners' personal models. Three types of personal model emerged. Sophisticated-Linear Model: 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition. Mixed Model: 17% of practitioners recognized/managed some elements of psoriasis as complex and some as a skin condition. Sophisticated-Sophisticated Model: 13% recognized and managed psoriasis as a complex condition. Across the data set, five themes emerged illustrating key patterns underpinning these different models including (1) Recognising complexity, (2) Putting skin first, (3) Taking on the complexities of psoriasis with the patient, (4) Aiming for clearance, and (5) Affective experiences within psoriasis consultations. Health care providers recognized psoriasis as a complex condition but commonly reported managing psoriasis as a simple skin condition. Providers' beliefs and management approaches varied in the extent to which they were consistent with one another; and their emotional experiences during consultations may vary depending upon their personal model. Findings could inform future dermatology training programmes by highlighting the role of health care providers' illness representations in clinical management of the condition. What is already known on this subject? Health behaviour is predicted by underlying beliefs and emotions associated with an illness and its treatment. Few studies have examined health care providers' beliefs and emotions about the illnesses they manage in clinical practice. Many patients are dissatisfied with dermatology consultations and wish to be treated holistically. What does this study add? Qualitative exploration of health care providers' beliefs/emotions revealed their personal models of psoriasis. Providers' personal models of psoriasis vary in coherence and are often skin rather than whole person focused. Further investigation of health care providers' models of psoriasis and their impact on health outcomes is needed. © 2015 The British Psychological Society.

49 CFR 234.303 - Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and...

Code of Federal Regulations, 2013 CFR

2013-10-01

... reporting of unsafe conditions at highway-rail and pathway grade crossings. 234.303 Section 234.303... at Highway-Rail and Pathway Grade Crossings § 234.303 Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and pathway grade crossings. (a) Duty of dispatching railroad...

49 CFR 234.303 - Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and...

Code of Federal Regulations, 2014 CFR

2014-10-01

... reporting of unsafe conditions at highway-rail and pathway grade crossings. 234.303 Section 234.303... at Highway-Rail and Pathway Grade Crossings § 234.303 Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and pathway grade crossings. (a) Duty of dispatching railroad...

49 CFR 234.303 - Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and...

Code of Federal Regulations, 2012 CFR

2012-10-01

... reporting of unsafe conditions at highway-rail and pathway grade crossings. 234.303 Section 234.303... at Highway-Rail and Pathway Grade Crossings § 234.303 Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and pathway grade crossings. (a) Duty of dispatching railroad...

Emergency general surgery in Rwandan district hospitals: a cross-sectional study of spectrum, management, and patient outcomes.

PubMed

Mpirimbanyi, Christophe; Nyirimodoka, Alexandre; Lin, Yihan; Hedt-Gauthier, Bethany L; Odhiambo, Jackline; Nkurunziza, Theoneste; Havens, Joaquim M; Omondi, Jack; Rwamasirabo, Emile; Ntirenganya, Faustin; Toma, Gabriel; Mubiligi, Joel; Bayitondere, Scheilla; Riviello, Robert

2017-12-01

Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions. We describe patient demographics, clinical characteristics, management and outcomes. In 2015, 356 patients presented with emergency general surgical conditions. The majority were male (57.2%) and adults aged 15-60 years (54.5%). The most common diagnostic group was soft tissue infections (71.6%), followed by acute abdominal conditions (14.3%). The median length of symptoms prior to diagnosis differed significantly by diagnosis type (p < 0.001), with the shortest being urological emergencies at 1.5 days (interquartile range (IQR):1, 6) and the longest being complicated hernia at 17.5 days (IQR: 1, 208). Of all patients, 54% were operated on at the district hospital, either by a general surgeon or general practitioner. Patients were more likely to receive surgery if they presented to a hospital with a general surgeon compared to a hospital with only general practitioners (75% vs 43%, p < 0.001). In addition, the general surgeon was more likely to treat patients with complex diagnoses such as acute abdominal conditions (33.3% vs 4.1%, p < 0.001) compared to general practitioners. For patients who received surgery, 73.3% had no postoperative complications and 3.2% died. While acute abdominal conditions are often considered the most common emergency general surgical condition in sub-Saharan Africa, soft tissue infections were the most common in our setting. This could represent a true difference in epidemiology in rural settings compared to referral facilities in urban settings. Patients were more likely to receive an operation in a hospital with a general surgeon as opposed to a general practitioner. This provides evidence to support increasing the surgical workforce in district hospitals in order to increase surgical availability for patients.

Design, construction and operation features of high-rise structures

NASA Astrophysics Data System (ADS)

Mylnik, Alexey; Mylnik, Vladimir; Zubeeva, Elena; Mukhamedzhanova, Olga

2018-03-01

The article considers design, construction and operation features of high-rise facilities. The analysis of various situations, that come from improper designing, construction and operation of unique facilities, is carried out. The integrated approach is suggested, when the problems of choosing acceptable constructional solutions related to the functional purpose, architectural solutions, methods of manufacturing and installation, operating conditions for unique buildings and structures are being tackled. A number of main causes for the emergency destruction of objects under construction and operation is considered. A number of measures are proposed on the basis of factor classification in order to efficiently prevent the situations, when various negative options of design loads and emergency impacts occur.

Novel and emerging strategies for longitudinal data collection.

PubMed

Udtha, Malini; Nomie, Krystle; Yu, Erica; Sanner, Jennifer

2015-03-01

To describe novel and emerging strategies practiced globally in research to improve longitudinal data collection. In research studies, numerous strategies such as telephone interviews, postal mailing, online questionnaires, and electronic mail are traditionally utilized in longitudinal data collection. However, due to technological advances, novel and emerging strategies have been applied to longitudinal data collection, such as two-way short message service, smartphone applications (or "apps"), retrieval capabilities applied to the electronic medical record, and an adapted cloud interface. In this review, traditional longitudinal data collection strategies are briefly described, emerging and novel strategies are detailed and explored, and information regarding the impact of novel methods on participant response rates, the timeliness of participant responses, and cost is provided. We further discuss how these novel and emerging strategies affect longitudinal data collection and advance research, specifically nursing research. Evidence suggests that the novel and emerging longitudinal data collection strategies discussed in this review are valuable approaches to consider. These strategies facilitate collecting longitudinal research data to better understand a variety of health-related conditions. Future studies, including nursing research, should consider using novel and emerging strategies to advance longitudinal data collection. A better understanding of novel and emerging longitudinal data collection strategies will ultimately improve longitudinal data collection as well as foster research efforts. Nurse researchers, along with all researchers, must be aware of and consider implementing novel and emerging strategies to ensure future healthcare research success. © 2014 Sigma Theta Tau International.

Magnetic stimulation of marigold seed

NASA Astrophysics Data System (ADS)

Afzal, I.; Mukhtar, K.; Qasim, M.; Basra, S. M. A.; Shahid, M.; Haq, Z.

2012-10-01

The effects of magnetic field treatments of French marigold seeds on germination, early seedling growth and biochemical changes of seedlings were studied under controlled conditions. For this purpose, seeds were exposed to five different magnetic seed treatments for 3 min each. Most of seed treatments resulted in improved germination speed and spread, root and shoot length, seed soluble sugars and a-amylase activity. Magnetic seed treatment with 100 mT maximally improved germination, seedling vigour and starch metabolism as compared to control and other seed treatments. In emergence experiment, higher emergence percentage (4-fold), emergence index (5-fold) and vigorous seedling growth were obtained in seeds treated with 100 mT. Overall, the enhancement of marigold seeds by magnetic seed treatment with 100 mT could be related to enhanced starch metabolism. The results suggest that magnetic field treatments of French marigold seeds have the potential to enhance germination, early growth and biochemical parameters of seedlings.

A neural substrate for object permanence in monkey inferotemporal cortex

PubMed Central

Puneeth, N. C.; Arun, S. P.

2016-01-01

We take it for granted that objects continue to exist after being occluded. This knowledge – known as object permanence – is present even in childhood, but its neural basis is not fully understood. Here, we show that monkey inferior temporal (IT) neurons carry potential signals of object permanence even in animals that received no explicit behavioral training. We compared two conditions with identical visual stimulation: the same object emerged from behind an occluder as expected following its occlusion, or unexpectedly after occlusion of a different object. Some neurons produced a larger (surprise) signal when the object emerged unexpectedly, whereas other neurons produced a larger (match) signal when the object reappeared as expected. Neurons carrying match signals also reinstated selective delay period activity just before the object emerged. Thus, signals related to object permanence are present in IT neurons and may arise through an interplay of memory and match computations. PMID:27484111

A neural substrate for object permanence in monkey inferotemporal cortex.

PubMed

Puneeth, N C; Arun, S P

2016-08-03

We take it for granted that objects continue to exist after being occluded. This knowledge - known as object permanence - is present even in childhood, but its neural basis is not fully understood. Here, we show that monkey inferior temporal (IT) neurons carry potential signals of object permanence even in animals that received no explicit behavioral training. We compared two conditions with identical visual stimulation: the same object emerged from behind an occluder as expected following its occlusion, or unexpectedly after occlusion of a different object. Some neurons produced a larger (surprise) signal when the object emerged unexpectedly, whereas other neurons produced a larger (match) signal when the object reappeared as expected. Neurons carrying match signals also reinstated selective delay period activity just before the object emerged. Thus, signals related to object permanence are present in IT neurons and may arise through an interplay of memory and match computations.

Experimental econophysics: Complexity, self-organization, and emergent properties

NASA Astrophysics Data System (ADS)

Huang, J. P.

2015-03-01

Experimental econophysics is concerned with statistical physics of humans in the laboratory, and it is based on controlled human experiments developed by physicists to study some problems related to economics or finance. It relies on controlled human experiments in the laboratory together with agent-based modeling (for computer simulations and/or analytical theory), with an attempt to reveal the general cause-effect relationship between specific conditions and emergent properties of real economic/financial markets (a kind of complex adaptive systems). Here I review the latest progress in the field, namely, stylized facts, herd behavior, contrarian behavior, spontaneous cooperation, partial information, and risk management. Also, I highlight the connections between such progress and other topics of traditional statistical physics. The main theme of the review is to show diverse emergent properties of the laboratory markets, originating from self-organization due to the nonlinear interactions among heterogeneous humans or agents (complexity).

Entering adulthood in a recession tempers later narcissism.

PubMed

Bianchi, Emily C

2014-07-01

Despite widespread interest in narcissism, relatively little is known about the conditions that encourage or dampen it. Drawing on research showing that macroenvironmental conditions in emerging adulthood can leave a lasting imprint on attitudes and behaviors, I argue that people who enter adulthood during recessions are less likely to be narcissistic later in life than those who come of age in more prosperous times. Using large samples of American adults, Studies 1 and 2 showed that people who entered adulthood during worse economic times endorsed fewer narcissistic items as older adults. Study 3 extended these findings to a behavioral manifestation of narcissism: the relative pay of CEOs. CEOs who came of age in worse economic times paid themselves less relative to other top executives in their firms. These findings suggest that macroenvironmental experiences at a critical life stage can have lasting implications for how unique, special, and deserving people believe themselves to be. © The Author(s) 2014.

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

Code of Federal Regulations, 2010 CFR

2010-01-01

... Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of Vessels... Emergency Relating to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and... north of Cuba. In July 1996 and on subsequent occasions, the Cuban government stated its intent to...

Spatial and temporal variation in emergency transport during periods of extreme heat in Japan: A nationwide study.

PubMed

Onozuka, Daisuke; Hagihara, Akihito

2016-02-15

Several studies have reported the burden of climate change on extreme heat-related mortality or morbidity. However, few studies have investigated the spatial and temporal variation in emergency transport during periods of extreme heat on a national scale. Daily emergency ambulance dispatch data from 2007 to 2010 were acquired from all 47 prefectures of Japan. The temporal variability in the relationship between heat and morbidity in each prefecture was estimated using Poisson regression combined with a distributed lag non-linear model and adjusted for time trends. The spatial variability in the heat-morbidity relationships between prefectures was estimated using a multivariate meta-analysis. A total of 5,289,660 emergency transports were reported during the summer months (June through September) within the study period. The overall cumulative relative risk (RR) at the 99th percentile vs. the minimum morbidity percentile was 1.292 (95% CI: 1.251-1.333) for all causes, 1.039 (95% CI: 0.989-1.091) for cardiovascular diseases, and 1.287 (95% CI: 1.210-1.368) for respiratory diseases. Temporal variation in the estimated effects indicated a non-linear relationship, and there were differences in the temporal variations between heat and all-cause and cause-specific morbidity. Spatial variation between prefectures was observed for all causes (Cochran Q test, p<0.001; I(2)=45.8%); however, there was no significant spatial heterogeneity for cardiovascular (Cochran Q test, p=0.054; I(2)=15.1%) and respiratory (Cochran Q test, p=0.681; I(2)=1.0%) diseases. Our nationwide study demonstrated differences in the spatial and temporal variations in the relative risk for all-cause and cause-specific emergency transport during periods of extreme heat in Japan between 2007 and 2010. Our results suggest that public health strategies aimed at controlling heat-related morbidity should be tailored according to region-specific weather conditions. Copyright © 2015 Elsevier B.V. All rights reserved.

Modular forms, Schwarzian conditions, and symmetries of differential equations in physics

NASA Astrophysics Data System (ADS)

Abdelaziz, Y.; Maillard, J.-M.

2017-05-01

We give examples of infinite order rational transformations that leave linear differential equations covariant. These examples are non-trivial yet simple enough illustrations of exact representations of the renormalization group. We first illustrate covariance properties on order-two linear differential operators associated with identities relating the same {}_2F1 hypergeometric function with different rational pullbacks. These rational transformations are solutions of a differentially algebraic equation that already emerged in a paper by Casale on the Galoisian envelopes. We provide two new and more general results of the previous covariance by rational functions: a new Heun function example and a higher genus {}_2F1 hypergeometric function example. We then focus on identities relating the same {}_2F1 hypergeometric function with two different algebraic pullback transformations: such remarkable identities correspond to modular forms, the algebraic transformations being solution of another differentially algebraic Schwarzian equation that also emerged in Casale’s paper. Further, we show that the first differentially algebraic equation can be seen as a subcase of the last Schwarzian differential condition, the restriction corresponding to a factorization condition of some associated order-two linear differential operator. Finally, we also explore generalizations of these results, for instance, to {}_3F2 , hypergeometric functions, and show that one just reduces to the previous {}_2F1 cases through a Clausen identity. The question of the reduction of these Schwarzian conditions to modular correspondences remains an open question. In a _2F1 hypergeometric framework the Schwarzian condition encapsulates all the modular forms and modular equations of the theory of elliptic curves, but these two conditions are actually richer than elliptic curves or {}_2F1 hypergeometric functions, as can be seen on the Heun and higher genus example. This work is a strong incentive to develop more differentially algebraic symmetry analysis in physics.

Wildlife health in a rapidly changing North: focus on avian disease

USGS Publications Warehouse

Van Hemert, Caroline R.; Pearce, John M.; Handel, Colleen M.

2014-01-01

Climate-related environmental changes have increasingly been linked to emerging infectious diseases in wildlife. The Arctic is facing a major ecological transition that is expected to substantially affect animal and human health. Changes in phenology or environmental conditions that result from climate warming may promote novel species assemblages as host and pathogen ranges expand to previously unoccupied areas. Recent evidence from the Arctic and subarctic suggests an increase in the spread and prevalence of some wildlife diseases, but baseline data necessary to detect and verify such changes are still lacking. Wild birds are undergoing rapid shifts in distribution and have been implicated in the spread of wildlife and zoonotic diseases. Here, we review evidence of current and projected changes in the abundance and distribution of avian diseases and outline strategies for future research. We discuss relevant climatic and environmental factors, emerging host–pathogen contact zones, the relationship between host condition and immune function, and potential wildlife and human health outcomes in northern regions.

Symptoms in patients with skin changes due to chronic venous insufficiency often lead to emergency care service: an Italian observational study.

PubMed

Ruggiero, Michele; Grande, Raffaele; Naso, Agostino; Butrico, Lucia; Rubino, Paolo; Placida, Girolamo Domenico; Cannistrà, Marco; Serra, Raffaele

2016-10-01

Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition. Data were evaluated by consulting the medical records, during a 16-month period, available with three Continuous Assistance Services of the Italian territory. The overall population of the referring centres consisted of 1186 patients [739 females (62·31%) and 447 males (37·69%)]. Seventy-nine patients (6·66%) consulted the emergency unit for venous symptoms related to CVD. Patients with more severe disease (CVI, categories C4-C6) represented the majority accounting for 60·75%, while patients with moderate disease (C3) accounted for 35·44% and patients with mild disease (C1-C2 stages) accounted for 3·79%. The main finding of this study is that despite CVI not being a disease that commonly requires medical emergency/urgency intervention, patients with CVI, especially in advanced stage with skin changes, may turn to Continuous Assistance Service for treating bothersome symptoms related to their condition. © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Emergence of Swarming Behavior: Foraging Agents Evolve Collective Motion Based on Signaling.

PubMed

Witkowski, Olaf; Ikegami, Takashi

2016-01-01

Swarming behavior is common in biology, from cell colonies to insect swarms and bird flocks. However, the conditions leading to the emergence of such behavior are still subject to research. Since Reynolds' boids, many artificial models have reproduced swarming behavior, focusing on details ranging from obstacle avoidance to the introduction of fixed leaders. This paper presents a model of evolved artificial agents, able to develop swarming using only their ability to listen to each other's signals. The model simulates a population of agents looking for a vital resource they cannot directly detect, in a 3D environment. Instead of a centralized algorithm, each agent is controlled by an artificial neural network, whose weights are encoded in a genotype and adapted by an original asynchronous genetic algorithm. The results demonstrate that agents progressively evolve the ability to use the information exchanged between each other via signaling to establish temporary leader-follower relations. These relations allow agents to form swarming patterns, emerging as a transient behavior that improves the agents' ability to forage for the resource. Once they have acquired the ability to swarm, the individuals are able to outperform the non-swarmers at finding the resource. The population hence reaches a neutral evolutionary space which leads to a genetic drift of the genotypes. This reductionist approach to signal-based swarming not only contributes to shed light on the minimal conditions for the evolution of a swarming behavior, but also more generally it exemplifies the effect communication can have on optimal search patterns in collective groups of individuals.

Early development and the emergence of individual differences in behavior among littermates of wild rabbit pups.

PubMed

Rödel, Heiko G; Bautista, Amando; Roder, Manuel; Gilbert, Caroline; Hudson, Robyn

2017-05-01

The ontogeny of associated individual differences in behavior and physiology during early postnatal life, and in particular the emergence of such differences among litter siblings, has been hardly explored in mammals under natural conditions. We studied such within-litter differences in behavior in European rabbit pups Oryctolagus cuniculus prior to weaning, and whether and how these differences co-varied with other individual characteristics such as postnatal body temperature and early growth. The study was conducted under semi-natural conditions in a colony of rabbits of wild origin, where the young were born and developed in nursery burrows. We equipped two siblings per litter with interscapular skin temperature loggers on postnatal day 2 and recorded temperature profiles for 48h. Individual body (skin) temperatures of pups within litters were repeatable across time, indicating the existence of consistent individual differences. Such differences within litters were associated with relative differences in pre-weaning growth, revealing that relatively warmer pups showed a greater increase in body mass during the nest period. Between postnatal days 12 and 17, after the pups had reached a developmental stage of greater mobility, we carried out different behavioral tests: a handling-restraint test, an open field test and a jump-down test from a platform. Individual responses in the former two tests were associated, as those pups showing a quicker struggling response to restraint during handling also exhibited greater exploratory activity in the open field. This correlation across contexts suggests the existence of personality types in wild rabbits at an early developmental stage. Furthermore, pups' behavioral responses were strongly associated with their relative within-litter body mass at testing. Animals with a lower body mass compared to their siblings showed a relatively quicker struggle response to handling restraint and covered a relatively larger distance in the open field, suggesting greater reactivity and responsiveness of relatively lighter pups in these tests. In contrast, relatively heavier pups jumped sooner from the platform, which may have been due to their greater physical maturation. In conclusion, our study shows that individual differences in behavior and associated differences in body temperature and growth are already present during early postnatal life, although such relationships can be easily overlooked, as they predominantly emerge as relative differences among littermates. Copyright © 2017 Elsevier Inc. All rights reserved.

The Statistics of Urban Scaling and Their Connection to Zipf’s Law

PubMed Central

Gomez-Lievano, Andres; Youn, HyeJin; Bettencourt, Luís M. A.

2012-01-01

Urban scaling relations characterizing how diverse properties of cities vary on average with their population size have recently been shown to be a general quantitative property of many urban systems around the world. However, in previous studies the statistics of urban indicators were not analyzed in detail, raising important questions about the full characterization of urban properties and how scaling relations may emerge in these larger contexts. Here, we build a self-consistent statistical framework that characterizes the joint probability distributions of urban indicators and city population sizes across an urban system. To develop this framework empirically we use one of the most granular and stochastic urban indicators available, specifically measuring homicides in cities of Brazil, Colombia and Mexico, three nations with high and fast changing rates of violent crime. We use these data to derive the conditional probability of the number of homicides per year given the population size of a city. To do this we use Bayes’ rule together with the estimated conditional probability of city size given their number of homicides and the distribution of total homicides. We then show that scaling laws emerge as expectation values of these conditional statistics. Knowledge of these distributions implies, in turn, a relationship between scaling and population size distribution exponents that can be used to predict Zipf’s exponent from urban indicator statistics. Our results also suggest how a general statistical theory of urban indicators may be constructed from the stochastic dynamics of social interaction processes in cities. PMID:22815745

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

PubMed

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

2012-12-31

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

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

PubMed Central

2012-01-01

Background Hypertensive crisis in children is a relatively rare condition presenting with elevated blood pressure (BP) and related symptoms, and it is potentially life-threatening. The aim of this study was to survey children with first attacks of hypertensive crisis arriving at the emergency department (ED), and to determine the related parameters that predicted the severity of hypertensive crisis in children by age group. Methods This was a retrospective study conducted from 2000 to 2007 in pediatric patients aged 18 years and younger with a diagnosis of hypertensive crisis at the ED. All patients were divided into four age groups (infants, preschool age, elementary school age, and adolescents), and two severity groups (hypertensive urgency and hypertensive emergency). BP levels, etiology, severity, and clinical manifestations were analyzed by age group and compared between the hypertensive emergency and hypertensive urgency groups. Results The mean systolic/diastolic BP in the hypertensive crisis patients was 161/102 mmHg. The major causes of hypertensive crisis were essential hypertension, renal disorders and endocrine/metabolic disorders. Half of all patients had a single underlying cause, and 8 had a combination of underlying causes. Headache was the most common symptom (54.5%), followed by dizziness (45.5%), nausea/vomiting (36.4%) and chest pain (29.1%). A family history of hypertension was a significant predictive factor for the older patients with hypertensive crisis. Clinical manifestations and severity showed a positive correlation with age. In contrast to diastolic BP, systolic BP showed a significant trend in the older children. Conclusions Primary clinicians should pay attention to the pediatric patients who present with elevated blood pressure and related clinical hypertensive symptoms, especially headache, nausea/vomiting, and altered consciousness which may indicate that appropriate and immediate antihypertensive medications are necessary to prevent further damage. PMID:23272766

High Correlated Paternity Leads to Negative Effects on Progeny Performance in Two Mediterranean Shrub Species

PubMed Central

Nora, Sofia; Aparicio, Abelardo; Albaladejo, Rafael G.

2016-01-01

Anthropogenic habitat deterioration can promote changes in plant mating systems that subsequently may affect progeny performance, thereby conditioning plant recruitment for the next generation. However, very few studies yet tested mating system parameters other than outcrossing rates; and the direct effects of the genetic diversity of the pollen received by maternal plants (i.e. correlated paternity) has often been overlooked. In this study, we investigated the relation between correlated paternity and progeny performance in two common Mediterranean shrubs, Myrtus communis and Pistacia lentiscus. To do so, we collected open-pollinated progeny from selected maternal plants, calculated mating system parameters using microsatellite genotyping and conducted sowing experiments under greenhouse and field conditions. Our results showed that some progeny fitness components were negatively affected by the high correlated paternity of maternal plants. In Myrtus communis, high correlated paternity had a negative effect on the proportion and timing of seedling emergence in the natural field conditions and in the greenhouse sowing experiment, respectively. In Pistacia lentiscus, seedling emergence time under field conditions was also negatively influenced by high correlated paternity and a progeny survival analysis in the field experiment showed greater mortality of seedlings from maternal plants with high correlated paternity. Overall, we found effects of correlated paternity on the progeny performance of Myrtus communis, a self-compatible species. Further, we also detected effects of correlated paternity on the progeny emergence time and survival in Pistacia lentiscus, an obligate outcrossed species. This study represents one of the few existing empirical examples which highlight the influence that correlated paternity may exert on progeny performance in multiple stages during early seedling growth. PMID:27835658

Burden of disease, research funding and innovation in the UK: Do new health technologies reflect research inputs and need?

PubMed

Ward, Derek; Martino, Orsolina; Packer, Claire; Simpson, Sue; Stevens, Andrew

2013-04-01

New and emerging health technologies (innovation outputs) do not always reflect conditions representing the greatest disease burden. We examine the role of research and development (R&D) funding in this relationship, considering whether areas with fewer innovative outputs receive an appropriate share of funding relative to their disease burden. We report a retrospective observational study, comparing burden of disease with R&D funding and innovation output. UK disability-adjusted life years (DALYs) and deaths came from the World Health Organization (WHO) 2004 Global Burden of Disease estimates; funding estimates from the UK Clinical Research Collaboration's 2006 Health Research Analysis; and innovation output was estimated by the number of new and emerging technologies reported by the National Institute for Health Research (NIHR) Horizon Scanning Centre between 2000 and 2009. Disease areas representing the biggest burden were generally associated with the most funding and innovation output; cancer, neuropsychiatric conditions and cardiovascular disease together comprised approximately two-thirds of DALYs, funding and reported technologies. Compared with DALYs, funding and technologies were disproportionately high for cancer, and technologies alone were disproportionately high for musculoskeletal conditions and endocrine/metabolic diseases. Neuropsychiatric conditions had comparatively few technologies compared to both DALYs and funding. The relationship between DALYs and innovation output appeared to be mediated by R&D funding. The relationship between burden of disease and new and emerging health technologies for different disease areas is partly dependent on the associated level of R&D funding (input). Discrepancies among key groups may reflect differential focus of research funding across disease areas. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

High Correlated Paternity Leads to Negative Effects on Progeny Performance in Two Mediterranean Shrub Species.

PubMed

Nora, Sofia; Aparicio, Abelardo; Albaladejo, Rafael G

2016-01-01

Anthropogenic habitat deterioration can promote changes in plant mating systems that subsequently may affect progeny performance, thereby conditioning plant recruitment for the next generation. However, very few studies yet tested mating system parameters other than outcrossing rates; and the direct effects of the genetic diversity of the pollen received by maternal plants (i.e. correlated paternity) has often been overlooked. In this study, we investigated the relation between correlated paternity and progeny performance in two common Mediterranean shrubs, Myrtus communis and Pistacia lentiscus. To do so, we collected open-pollinated progeny from selected maternal plants, calculated mating system parameters using microsatellite genotyping and conducted sowing experiments under greenhouse and field conditions. Our results showed that some progeny fitness components were negatively affected by the high correlated paternity of maternal plants. In Myrtus communis, high correlated paternity had a negative effect on the proportion and timing of seedling emergence in the natural field conditions and in the greenhouse sowing experiment, respectively. In Pistacia lentiscus, seedling emergence time under field conditions was also negatively influenced by high correlated paternity and a progeny survival analysis in the field experiment showed greater mortality of seedlings from maternal plants with high correlated paternity. Overall, we found effects of correlated paternity on the progeny performance of Myrtus communis, a self-compatible species. Further, we also detected effects of correlated paternity on the progeny emergence time and survival in Pistacia lentiscus, an obligate outcrossed species. This study represents one of the few existing empirical examples which highlight the influence that correlated paternity may exert on progeny performance in multiple stages during early seedling growth.

The acute physiological stress response to an emergency alarm and mobilization during the day and at night.

PubMed

Hall, Sarah J; Aisbett, Brad; Tait, Jamie L; Turner, Anne I; Ferguson, Sally A; Main, Luana C

2016-01-01

The purpose of this study was to investigate the acute physiological stress response to an emergency alarm and mobilization during the day and at night. Sixteen healthy males aged 25 ± 4 years (mean ± SD) spent four consecutive days and nights in a sleep laboratory. This research used a within-participants design with repeated measures for time, alarm condition (alarm or control), and trial (day or night). When an alarm sounded, participants were required to mobilize immediately. Saliva samples for cortisol analysis were collected 0 min, 15 min, 30 min, 45 min, 60 min, 90 min, and 120 min after mobilization, and at corresponding times in control conditions. Heart rate was measured continuously throughout the study. Heart rate was higher in the day (F(20,442) = 9.140, P < 0.001) and night (F(23,459) = 8.356, P < 0.001) alarm conditions compared to the respective control conditions. There was no difference in saliva cortisol between day alarm and day control conditions. Cortisol was higher (F(6,183) = 2.450, P < 0.001) following the night alarm and mobilization compared to the night control condition. The magnitude of difference in cortisol between night control and night alarm conditions was greater (F(6,174) = 4.071, P < 0.001) than the magnitude of difference between the day control and day alarm conditions. The augmented heart rate response to the day and night alarms supports previous observations in field settings. Variations in the cortisol responses between conditions across the day and night may relate to differences in participants' ability to interpret the alarm when sleeping versus when awake.

The acute physiological stress response to an emergency alarm and mobilization during the day and at night

PubMed Central

Hall, Sarah J; Aisbett, Brad; Tait, Jamie L; Turner, Anne I; Ferguson, Sally A; Main, Luana C

2016-01-01

The purpose of this study was to investigate the acute physiological stress response to an emergency alarm and mobilization during the day and at night. Sixteen healthy males aged 25 ± 4 years (mean ± SD) spent four consecutive days and nights in a sleep laboratory. This research used a within-participants design with repeated measures for time, alarm condition (alarm or control), and trial (day or night). When an alarm sounded, participants were required to mobilize immediately. Saliva samples for cortisol analysis were collected 0 min, 15 min, 30 min, 45 min, 60 min, 90 min, and 120 min after mobilization, and at corresponding times in control conditions. Heart rate was measured continuously throughout the study. Heart rate was higher in the day (F20,442 = 9.140, P < 0.001) and night (F23,459 = 8.356, P < 0.001) alarm conditions compared to the respective control conditions. There was no difference in saliva cortisol between day alarm and day control conditions. Cortisol was higher (F6,183 = 2.450, P < 0.001) following the night alarm and mobilization compared to the night control condition. The magnitude of difference in cortisol between night control and night alarm conditions was greater (F6,174 = 4.071, P < 0.001) than the magnitude of difference between the day control and day alarm conditions. The augmented heart rate response to the day and night alarms supports previous observations in field settings. Variations in the cortisol responses between conditions across the day and night may relate to differences in participants’ ability to interpret the alarm when sleeping versus when awake. PMID:27157688

Antisocial Behavioral Syndromes and Past-Year Physical Health Among Adults in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Goldstein, Risë B.; Dawson, Deborah A.; Chou, S. Patricia; Ruan, W. June; Saha, Tulshi D.; Pickering, Roger P.; Stinson, Frederick S.; Grant, Bridget F.

2010-01-01

Objective To describe associations of DSM-IV antisocial personality disorder (ASPD), conduct disorder without progression to ASPD (“CD only”), and syndromal antisocial behavior in adulthood without CD before age 15 (AABS, not a DSM-IV diagnosis) with past-year physical health status and hospital care utilization in the general U.S. adult population. Methods This report is based on the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n=43,093, response rate=81%). Respondents were classified according to whether they met criteria for ASPD, AABS, “CD only,” or no antisocial syndrome. Associations of antisocial syndromes with physical health status and care utilization were examined using normal-theory and logistic regression. Results ASPD and AABS were significantly but modestly associated with total past-year medical conditions, coronary heart and gastrointestinal diseases, and numbers of inpatient hospitalizations, inpatient days, emergency department visits, and clinically significant injuries. ASPD was also associated with liver disease, arthritis, and lower scores on the Short Form-12 version 2 (SF-12v2) Physical Component, Role Physical, and Bodily Pain Scales. AABS was associated with noncoronary heart disease, lower scores on the SF-12v2 General Health and Vitality Scales, and, among men, arthritis. “CD only” was associated with single but not multiple inpatient hospitalizations, emergency department visits, and clinically significant injuries. Conclusions Estimates of burden related to antisocial behavioral syndromes need to consider associated physical health problems. Prevention and treatment guidelines for injuries and common chronic diseases may need to address comorbid antisociality, and interventions targeting antisociality may need to consider general health status, including prevention and management of injuries and chronic diseases. PMID:18348594

Understanding Health Workers' Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment.

PubMed

Smitz, Marc-Francois; Witter, Sophie; Lemiere, Christophe; Eozenou, Patrick Hoang-Vu; Lievens, Tomas; Zaman, Rashid U; Engelhardt, Kay; Hou, Xiaohui

2016-01-01

Timor-Leste built its health workforce up from extremely low levels after its war of independence, with the assistance of Cuban training, but faces challenges as the first cohorts of doctors will shortly be freed from their contracts with government. Retaining doctors, nurses and midwives in remote areas requires a good understanding of health worker preferences. The article reports on a discrete choice experiment (DCE) carried out amongst 441 health workers, including 173 doctors, 150 nurses and 118 midwives. Qualitative methods were conducted during the design phase. The attributes which emerged were wages, skills upgrading/specialisation, location, working conditions, transportation and housing. One of the main findings of the study is the relative lack of importance of wages for doctors, which could be linked to high intrinsic motivation, perceptions of having an already highly paid job (relative to local conditions), and/or being in a relatively early stage of their career for most respondents. Professional development provides the highest satisfaction with jobs, followed by the working conditions. Doctors with less experience, males and the unmarried are more flexible about location. For nurses and midwives, skill upgrading emerged as the most cost effective method. The study is the first of its kind conducted in Timor-Leste. It provides policy-relevant information to balance financial and non-financial incentives for different cadres and profiles of staff. It also augments a thin literature on the preferences of working doctors (as opposed to medical students) in low and middle income countries and provides insights into the ability to instil motivation to work in rural areas, which may be influenced by rural recruitment and Cuban-style training, with its emphasis on community service.

Understanding Health Workers’ Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment

PubMed Central

Smitz, Marc-Francois; Witter, Sophie; Lemiere, Christophe; Eozenou, Patrick Hoang-Vu; Lievens, Tomas; Zaman, Rashid U.; Engelhardt, Kay; Hou, Xiaohui

2016-01-01

Background Timor-Leste built its health workforce up from extremely low levels after its war of independence, with the assistance of Cuban training, but faces challenges as the first cohorts of doctors will shortly be freed from their contracts with government. Retaining doctors, nurses and midwives in remote areas requires a good understanding of health worker preferences. Methods The article reports on a discrete choice experiment (DCE) carried out amongst 441 health workers, including 173 doctors, 150 nurses and 118 midwives. Qualitative methods were conducted during the design phase. The attributes which emerged were wages, skills upgrading/specialisation, location, working conditions, transportation and housing. Findings One of the main findings of the study is the relative lack of importance of wages for doctors, which could be linked to high intrinsic motivation, perceptions of having an already highly paid job (relative to local conditions), and/or being in a relatively early stage of their career for most respondents. Professional development provides the highest satisfaction with jobs, followed by the working conditions. Doctors with less experience, males and the unmarried are more flexible about location. For nurses and midwives, skill upgrading emerged as the most cost effective method. Conclusions The study is the first of its kind conducted in Timor-Leste. It provides policy-relevant information to balance financial and non-financial incentives for different cadres and profiles of staff. It also augments a thin literature on the preferences of working doctors (as opposed to medical students) in low and middle income countries and provides insights into the ability to instil motivation to work in rural areas, which may be influenced by rural recruitment and Cuban-style training, with its emphasis on community service. PMID:27846242

Differentials and trends in emergency department visits due to alcohol intoxication and co-occurring conditions among students in a U.S. public university.

PubMed

Ngo, Duc Anh; Ait-Daoud, Nassima; Rege, Saumitra V; Ding, Christopher; Gallion, Lauren; Davis, Susan; Holstege, Christopher P

2018-02-01

Few studies have explored the epidemiology of students presenting to the emergency department (ED) as a consequence of hazardous drinking. This study examined differentials and trends in ED visits following alcohol intoxication and co-occurring conditions among students presenting to a major U.S. university health system. The ED electronic medical records from academic years 2010-2015 were queried for student visits and their records were linked to the university's student admission datasets. Student alcohol-related visits were identified based on ICD-9 codes. Student characteristics and trends in the rate of alcohol intoxication per 100 ED student visits were analyzed. A random sample of 600 student clinical records were reviewed to validate diagnostic codes. There were 9616 student ED visits (48% males) to the ED of which 1001 (10.4%) visits involved alcohol intoxication. Two thirds of ED visits with alcohol intoxication had a co-occurring diagnosis, with injuries (24%) being the most common condition. The rate of alcohol intoxication varied greatly by student demographics and campus-related factors. There was a linear increase in the rate of alcohol intoxication from 7.9% in 2009-10 to 12.3% in 2014-15 (p<0.01). The increase was greater among female students, students below 20 years of age, Asian students, and student athletes. In the sample reviewed, only two thirds of ED visits with alcohol intoxication were recorded by diagnostic codes. The rate of ED visits following alcohol intoxication varied by student demographic characteristics and campus-related factors with a rising trend over the study period. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of Autumn and Spring Heat Waves on Seed Germination of High Mountain Plants.

PubMed

Orsenigo, Simone; Abeli, Thomas; Rossi, Graziano; Bonasoni, Paolo; Pasquaretta, Cristian; Gandini, Maurizia; Mondoni, Andrea

2015-01-01

Alpine plants are considered to be particularly vulnerable to climate change and related extreme episodes, such as heat waves. Despite growing interest in the impact of heat waves on alpine plants, knowledge about their effects on regeneration is still fragmentary. Recruitment from seeds will be crucial for the successful migration and survival of these species and will play a key role in their future adaptation to climate change. In this study, we assessed the impacts of heat waves on the seed germination of 53 high mountain plants from the Northern Apennines (Italy). The seeds were exposed to laboratory simulations of three seasonal temperature treatments, derived from real data recorded at a meteorological station near the species growing site, which included two heat wave episodes that occurred both in spring 2003 and in autumn 2011. Moreover, to consider the effect of increasing drought conditions related to heat waves, seed germination was also investigated under four different water potentials. In the absence of heat waves, seed germination mainly occurred in spring, after seeds had experienced autumn and winter seasons. However, heat waves resulted in a significant increase of spring germination in c. 30% of the species and elicited autumn germination in 50%. When heat waves were coupled with drought, seed germination decreased in all species, but did not stop completely. Our results suggest that in the future, heat waves will affect the germination phenology of alpine plants, especially conditionally dormant and strictly cold-adapted chorotypes, by shifting the emergence time from spring to autumn and by increasing the proportion of emerged seedlings. The detrimental effects of heat waves on recruitment success is less likely to be due to the inhibition of seed germination per se, but rather due to seedling survival in seasons, and temperature and water conditions that they are not used to experiencing. Changes in the proportion and timing of emergence suggest that there may be major implications for future plant population size and structure.

Effects of Autumn and Spring Heat Waves on Seed Germination of High Mountain Plants

PubMed Central

Orsenigo, Simone; Abeli, Thomas; Rossi, Graziano; Bonasoni, Paolo; Pasquaretta, Cristian; Gandini, Maurizia; Mondoni, Andrea

2015-01-01

Alpine plants are considered to be particularly vulnerable to climate change and related extreme episodes, such as heat waves. Despite growing interest in the impact of heat waves on alpine plants, knowledge about their effects on regeneration is still fragmentary. Recruitment from seeds will be crucial for the successful migration and survival of these species and will play a key role in their future adaptation to climate change. In this study, we assessed the impacts of heat waves on the seed germination of 53 high mountain plants from the Northern Apennines (Italy). The seeds were exposed to laboratory simulations of three seasonal temperature treatments, derived from real data recorded at a meteorological station near the species growing site, which included two heat wave episodes that occurred both in spring 2003 and in autumn 2011. Moreover, to consider the effect of increasing drought conditions related to heat waves, seed germination was also investigated under four different water potentials. In the absence of heat waves, seed germination mainly occurred in spring, after seeds had experienced autumn and winter seasons. However, heat waves resulted in a significant increase of spring germination in c. 30% of the species and elicited autumn germination in 50%. When heat waves were coupled with drought, seed germination decreased in all species, but did not stop completely. Our results suggest that in the future, heat waves will affect the germination phenology of alpine plants, especially conditionally dormant and strictly cold-adapted chorotypes, by shifting the emergence time from spring to autumn and by increasing the proportion of emerged seedlings. The detrimental effects of heat waves on recruitment success is less likely to be due to the inhibition of seed germination per se, but rather due to seedling survival in seasons, and temperature and water conditions that they are not used to experiencing. Changes in the proportion and timing of emergence suggest that there may be major implications for future plant population size and structure. PMID:26197387

Current and Emerging Technology Approaches in Genomics

PubMed Central

Conley, Yvette P.; Biesecker, Leslie G.; Gonsalves, Stephen; Merkle, Carrie J.; Kirk, Maggie; Aouizerat, Bradley E.

2013-01-01

Purpose To introduce current and emerging approaches that are being utilized in the field of genomics so the reader can conceptually evaluate the literature and appreciate how these approaches are advancing our understanding of health-related issues. Organizing Construct Each approach is described and includes information related to how it is advancing research, its potential clinical utility, exemplars of current uses, challenges related to technologies used for these approaches, and when appropriate information related to understanding the evidence base for clinical utilization of each approach is provided. Web-based resources are included for the reader who would like more in-depth information and to provide opportunity to stay up to date with these approaches and their utility. Conclusions The chosen approaches– genome sequencing, genome-wide association studies, epigenomics, and gene expression– are extremely valuable approaches for collecting research data to help us better understand the pathophysiology of a variety of health-related conditions, but they are also gaining in utility for clinical assessment and testing purposes. Clinical Relevance Our increased understanding of the molecular underpinnings of disease will assist with better development of screening tests, diagnostic tests, tests that allow us to prognosticate, tests that allow for individualized treatments, and tests to facilitate post-treatment surveillance. PMID:23294727

Personal experience in pediatric emergency medicine training in Canada and China.

PubMed

Lin, Gang-Xi; Luo, Yi-Ming; Cheng, Adam; Yang, Shu-Yu; Wang, Jian-She; Goldman, Ran-D

2012-10-01

Currently, pediatric emergency medicine (PEM) as practiced in many developed countries is different from ours in China. Chinese pediatric emergency medicine is just children's internal medicine and does not include general surgery, ear-nose-throat, etc. If children have an emergency condition that require specialized treatments they need to go to different departments. However in Canada, the pediatric emergency physicians will first treat the patients whatever the condition, then, if it is a complicated sub specialty problem, they will consult the specialist or let the patient see the specialist later. In addition, resuscitation is done in the pediatric intensive care unit (PICU) in China, but it is done in the emergency room in Canada. This article compares the differences in the pediatric emergency systems in Canada and China and also introduces the international standard system of pediatric triage.

Medicaid dental coverage alone may not lower rates of dental emergency department visits.

PubMed

Fingar, Kathryn R; Smith, Mark W; Davies, Sheryl; McDonald, Kathryn M; Stocks, Carol; Raven, Maria C

2015-08-01

Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers. Project HOPE—The People-to-People Health Foundation, Inc.

Systolic peak detection in acceleration photoplethysmograms measured from emergency responders in tropical conditions.

PubMed

Elgendi, Mohamed; Norton, Ian; Brearley, Matt; Abbott, Derek; Schuurmans, Dale

2013-01-01

Photoplethysmogram (PPG) monitoring is not only essential for critically ill patients in hospitals or at home, but also for those undergoing exercise testing. However, processing PPG signals measured after exercise is challenging, especially if the environment is hot and humid. In this paper, we propose a novel algorithm that can detect systolic peaks under challenging conditions, as in the case of emergency responders in tropical conditions. Accurate systolic-peak detection is an important first step for the analysis of heart rate variability. Algorithms based on local maxima-minima, first-derivative, and slope sum are evaluated, and a new algorithm is introduced to improve the detection rate. With 40 healthy subjects, the new algorithm demonstrates the highest overall detection accuracy (99.84% sensitivity, 99.89% positive predictivity). Existing algorithms, such as Billauer's, Li's and Zong's, have comparable although lower accuracy. However, the proposed algorithm presents an advantage for real-time applications by avoiding human intervention in threshold determination. For best performance, we show that a combination of two event-related moving averages with an offset threshold has an advantage in detecting systolic peaks, even in heat-stressed PPG signals.

Expatriates' Multiple Fears, from Terrorism to Working Conditions: Development of a Model.

PubMed

Giorgi, Gabriele; Montani, Francesco; Fiz-Perez, Javier; Arcangeli, Giulio; Mucci, Nicola

2016-01-01

Companies' internationalization appears to be fundamental in the current globalized and competitive environment and seems important not only for organizational success, but also for societal development and sustainability. On one hand, global business increases the demand for managers for international assignment. On the other hand, emergent fears, such as terrorism, seem to be developing around the world, enhancing the risk of expatriates' potential health problems. The purpose of this paper is to examine the relationships between the emergent concept of fear of expatriation with further workplace fears (economic crisis and dangerous working conditions) and with mental health problems. The study uses a quantitative design. Self-reported data were collected from 265 Italian expatriate workers assigned to both Italian and worldwide projects. Structural equation model analyses showed that fear of expatriation mediates the relationship of mental health with fear of economic crisis and with perceived dangerous working conditions. As expected, in addition to fear, worries of expatriation are also related to further fears. Although, the study is based on self-reports and the cross-sectional study design limits the possibility of making causal inferences, the new constructs introduced add to previous research.

Diagnostic approach for monitoring hydroclimatic conditions related to emergence of west nile virus in west virginia.

PubMed

Jutla, Antarpreet; Huq, Anwar; Colwell, Rita R

2015-01-01

West Nile virus (WNV), mosquito-borne and water-based disease, is increasingly a global threat to public health. Since its appearance in the northeastern United States in 1999, WNV has since been reported in several states in the continental United States. The objective of this study is to highlight role of hydroclimatic processes estimated through satellite sensors in capturing conditions for emergence of the vectors in historically disease free regions. We tested the hypothesis that an increase in surface temperature, in combination with intensification of vegetation, and enhanced precipitation, lead to conditions favorable for vector (mosquito) growth. Analysis of land surface temperature (LST) pattern shows that temperature values >16°C, with heavy precipitation, may lead to abundance of the mosquito population. This hypothesis was tested in West Virginia where a sudden epidemic of WNV infection was reported in 2012. Our results emphasize the value of hydroclimatic processes estimated by satellite remote sensing, as well as continued environmental surveillance of mosquitoes, because when a vector-borne infection like WNV is discovered in contiguous regions, the risk of spread of WNV mosquitoes increase at points where appropriate hydroclimatic processes intersect with the vector niche.

Expatriates’ Multiple Fears, from Terrorism to Working Conditions: Development of a Model

PubMed Central

Giorgi, Gabriele; Montani, Francesco; Fiz-Perez, Javier; Arcangeli, Giulio; Mucci, Nicola

2016-01-01

Companies’ internationalization appears to be fundamental in the current globalized and competitive environment and seems important not only for organizational success, but also for societal development and sustainability. On one hand, global business increases the demand for managers for international assignment. On the other hand, emergent fears, such as terrorism, seem to be developing around the world, enhancing the risk of expatriates’ potential health problems. The purpose of this paper is to examine the relationships between the emergent concept of fear of expatriation with further workplace fears (economic crisis and dangerous working conditions) and with mental health problems. The study uses a quantitative design. Self-reported data were collected from 265 Italian expatriate workers assigned to both Italian and worldwide projects. Structural equation model analyses showed that fear of expatriation mediates the relationship of mental health with fear of economic crisis and with perceived dangerous working conditions. As expected, in addition to fear, worries of expatriation are also related to further fears. Although, the study is based on self-reports and the cross-sectional study design limits the possibility of making causal inferences, the new constructs introduced add to previous research. PMID:27790173

Health Care Use During Transfer to Adult Care Among Youth With Chronic Conditions.

PubMed

Cohen, Eyal; Gandhi, Sima; Toulany, Alene; Moore, Charlotte; Fu, Longdi; Orkin, Julia; Levy, Deborah; Stephenson, Anne L; Guttmann, Astrid

2016-03-01

To compare health care use and costs for youth with chronic health conditions before and after transfer from pediatric to adult health care services. Youth born in Ontario, Canada, between April 1, 1989, and April 1, 1993, were assigned to 11 mutually exclusive, hierarchically arranged clinical groupings, including "complex" chronic conditions (CCCs), non-complex chronic conditions (N-CCCs), and chronic mental health conditions (CMHCs). Outcomes were compared between 2-year periods before and after transfer of pediatric services, the subjects' 18th birthday. Among 104,497 youth, mortality was highest in those with CCCs, but did not increase after transfer (1.3% vs 1.5%, P = .55). Costs were highest among youth with CCCs and decreased after transfer (before and after median [interquartile range]: $4626 [1253-21,435] vs $3733 [950-16,841], P < .001);Costs increased slightly for N-CCCs ($569 [263-1246] vs $589 [262-1333], P < .001), and decreased for CMHCs ($1774 [659-5977] vs $1545 [529-5128], P < .001). Emergency department visits increased only among youth with N-CCCs (P < .001). High-acuity emergency department visits increased CCCs (P = .04) and N-CCCs (P < .001), but not for CMHC (P = .59), who had the highest visit rate. Among the 11 individual conditions, costs only increased in youth with asthma (P < .001), and decreased (P < .05) in those with neurologic impairment, lupus, inflammatory bowel disease, and mood/affective disorders. Pediatric transfer to adult care is characterized by relatively stable short-term patterns of health service use and costs among youth with chronic conditions. Copyright © 2016 by the American Academy of Pediatrics.

The anti-predator role of within-nest emergence synchrony in sea turtle hatchlings.

PubMed

Santos, Robson G; Pinheiro, Hudson Tercio; Martins, Agnaldo Silva; Riul, Pablo; Bruno, Soraya Christina; Janzen, Fredric J; Ioannou, Christos C

2016-07-13

Group formation is a common behaviour among prey species. In egg-laying animals, despite the various factors that promote intra-clutch variation leading to asynchronous hatching and emergence from nests, synchronous hatching and emergence occurs in many taxa. This synchrony may be adaptive by reducing predation risk, but few data are available in any natural system, even for iconic examples of the anti-predator function of group formation. Here, we show for the first time that increased group size (number of hatchlings emerging together from a nest) reduces green turtle (Chelonia mydas) hatchling predation. This effect was only observed earlier in the night when predation pressure was greatest, indicated by the greatest predator abundance and a small proportion of predators preoccupied with consuming captured prey. Further analysis revealed that the effect of time of day was due to the number of hatchlings already killed in an evening; this, along with the apparent lack of other anti-predatory mechanisms for grouping, suggests that synchronous emergence from a nest appears to swamp predators, resulting in an attack abatement effect. Using a system with relatively pristine conditions for turtle hatchlings and their predators provides a more realistic environmental context within which intra-nest synchronous emergence has evolved. © 2016 The Author(s).

Diagnosis of subarachnoid haemorrhage: a survey of Australasian emergency physicians and trainees.

PubMed

Rogers, Andrew; Furyk, Jeremy; Banks, Colin; Chu, Kevin

2014-10-01

This study aims to establish current practice among Australasian emergency physicians and trainees on several aspects of the investigation of suspected subarachnoid haemorrhage (SAH). An electronic questionnaire (SurveyMonkey™) was distributed to emergency physicians and trainees by email through the ACEM. Survey recipients were asked about demographics, followed by a series of questions relating to the investigation of SAH. There were 878 survey respondents (response rate 24%). Our data showed that 47.3% of respondents agreed or strongly agreed that a CT brain within 6 h of headache onset is sufficient to exclude a diagnosis of SAH. For a CT performed within 12 h of ictus, 14.4% were satisfied that SAH could be excluded. After a negative CT scan, for further investigation of SAH, 88% of respondents preferred lumbar puncture to CT angiography. For detection of xanthochromia in the cerebrospinal fluid, 57.7% of respondents felt that spectrophotometry (vs visual inspection) is necessary to accurately diagnose SAH. A range of information was collected regarding the investigation of suspected SAH. We report significant differences in the diagnostic approach of Australasian emergency physicians and trainees to this condition, in particular the utility of CT within 6 h for exclusion of SAH. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

An example of extreme cardiology: chest pain on the high seas and helicoptered medical evacuations: the French Navy experience.

PubMed

Vinsonneau, Ulric; Cavel, Christiane; Bombert, Christophe; Lely, Laurent; Paleiron, Nicolas; Vergez-Larrouget, Claude; Cornily, Jean-Christophe; Castellant, Philippe; Gilard, Martine; Paule, Paule; Bronstein, Jean-Ariel

2012-10-01

Medicalized high sea rescue is very different from prehospital medical evacuation. It requires specifically trained medical teams because the difficulties are marine, aerial, and medically related. The French Navy provides medical evacuations by helicopter on the Atlantic coast, up to 320 km offshore and under all weather conditions. The epidemiology of acute chest pain in the high seas has been poorly described. Therefore, in this retrospective study, we aimed to assess the prevalence and constraints found in the management of these emergencies. From January 1, 2000, to April 30, 2009, 286 medical evacuations by helicopter were performed, 132 of which were due to traumatological emergencies, and 154 to medical emergencies. Acute chest pain, with 36 missions, was the leading cause of medical evacuation. All evacuated patients were men who were either professional sailors or ferry passengers. The median age was 48 years (range, 26-79). The most common prehospital diagnosis was coronary chest pain in 23 patients (64%), including 11 patients with acute coronary syndrome with ST-segment elevation. Thirty-two patients were airlifted by helicopter. All patients benefited from monitoring, electrocardiogram, peripheral venous catheter, and medical management as soon as the technical conditions allowed it. Copyright © 2012 Elsevier Inc. All rights reserved.

Ontology-Driven Monitoring of Patient's Vital Signs Enabling Personalized Medical Detection and Alert

PubMed Central

Hristoskova, Anna; Sakkalis, Vangelis; Zacharioudakis, Giorgos; Tsiknakis, Manolis; De Turck, Filip

2014-01-01

A major challenge related to caring for patients with chronic conditions is the early detection of exacerbations of the disease. Medical personnel should be contacted immediately in order to intervene in time before an acute state is reached, ensuring patient safety. This paper proposes an approach to an ambient intelligence (AmI) framework supporting real-time remote monitoring of patients diagnosed with congestive heart failure (CHF). Its novelty is the integration of: (i) personalized monitoring of the patients health status and risk stage; (ii) intelligent alerting of the dedicated physician through the construction of medical workflows on-the-fly; and (iii) dynamic adaptation of the vital signs’ monitoring environment on any available device or smart phone located in close proximity to the physician depending on new medical measurements, additional disease specifications or the failure of the infrastructure. The intelligence lies in the adoption of semantics providing for a personalized and automated emergency alerting that smoothly interacts with the physician, regardless of his location, ensuring timely intervention during an emergency. It is evaluated on a medical emergency scenario, where in the case of exceeded patient thresholds, medical personnel are localized and contacted, presenting ad hoc information on the patient's condition on the most suited device within the physician's reach. PMID:24445411

Possibility of microscopic liquid water formation at landing sites on Mars and their observational potential

NASA Astrophysics Data System (ADS)

Pál, B.; Kereszturi, Á.

2017-01-01

Microscopic liquid brines, especially calcium-perchlorate could emerge by deliquescence on Mars during night time hours. Using climate model computations and orbital humidity observations, the ideal periods and their annual plus daily characteristics at various past, current and future landing sites were compared. Such results provide context for future analysis and targeting the related observations by the next missions for Mars. Based on the analysis, at most (but not all) past missions' landing sites, microscopic brine could emerge during night time for different durations. Analysing the conditions at ExoMars rover's primary landing site at Oxia Planum, the best annual period was found to be between Ls 115-225, and in Local Time 2-5, after midnight. In an ideal case, 4 h of continuous liquid phase can emerge there. Local conditions might cause values to differ from those estimated by the model. Thermal inertia could especially make such differences (low TI values favour fast cooling and H2O cold trapping at loose surfaces) and the concentration of calcium-perchlorate salt in the regolith also influences the process (it might occur preferentially at long-term exposed surfaces without recent loose dust coverage). These factors should be taken into account while targeting future liquid water observations on Mars.

Effect of psychological tension on pedestrian counter flow via an extended cost potential field cellular automaton model

NASA Astrophysics Data System (ADS)

Li, Xingli; Guo, Fang; Kuang, Hua; Zhou, Huaguo

2017-12-01

Psychology tells us that the different level of tension may lead to different behavior variation for individuals. In this paper, an extended cost potential field cellular automaton is proposed to simulate pedestrian counter flow under an emergency by considering behavior variation of pedestrian induced by psychological tension. A quantitative formula is introduced to describe behavioral changes caused by psychological tension, which also leads to the increasing cost of discomfort. The numerical simulations are performed under the periodic boundary condition and show that the presented model can capture some essential features of pedestrian counter flow, such as lane formation and segregation phenomenon for normal condition. Furthermore, an interesting feature is found that when pedestrians are in an extremely nervous state, a stable lane formation will be broken by a disordered mixture flow. The psychological nervousness under an emergency is not always negative to moving efficiency and a moderate level of tension will delay the occurrence of jamming phase. In addition, a larger asymmetrical ratio of left walkers to right walkers will improve the critical density related to the jamming phase and retard the occurrence of completely jammed phase. These findings will be helpful in pedestrian control and management under an emergency.

Translating new knowledge into practices: reconceptualising stroke as an emergency condition

PubMed Central

Snow, Stephanie J

2013-01-01

Objectives To examine how the new concept of stroke as an emergency condition led to the development of new clinical pathways for stroke patients in Newcastle Upon Tyne, implemented through protocols which were then rapidly adopted across the UK and further afield. Methods Historical analysis using health policy documents, published papers and correspondence on stroke alongside 17 interviews with stroke clinicians and managers in the UK and the US. Results The challenges of implementation stemmed from organisational and professional barriers rather than scientific or technological difficulties. Stroke’s historical status as a non-treatable illness was a barrier to the adoption of acute treatments. Building new pathways for stroke patients by developing protocols for paramedics and emergency room staff originated as a local solution to a local problem but were taken up widely. Discussion Understanding the clinical response to the reconceptualisation of stroke as a treatable disease contributes to our understandings of the relations between clinical research and practice. These findings have implications for how we understand the translation of new knowledge into practice and its transfer across different clinical communities and settings. Protocols are shown to be a particularly valuable tool, bridging knowledge between communities and manifesting a new identity for stroke. PMID:23129788

Relations Between Rainfall and Postfire Debris-Flow and Flood Magnitudes for Emergency-Response Planning, San Gabriel Mountains, Southern California

USGS Publications Warehouse

Cannon, Susan H.; Boldt, Eric M.; Kean, Jason W.; Laber, Jayme; Staley, Dennis M.

2010-01-01

Following wildfires, emergency-response and public-safety agencies are faced often with making evacuation decisions and deploying resources both well in advance of each coming winter storm and during storms themselves. Information critical to this process is provided for recently burned areas in the San Gabriel Mountains of southern California. The National Weather Service (NWS) issues Quantitative Precipitation Forecasts (QPFs) for the San Gabriel Mountains twice a day, at approximately 4 a.m. and 4 p.m., along with unscheduled updates when conditions change. QPFs provide estimates of rainfall totals in 3-hour increments for the first 12-hour period and in 6-hour increments for the second 12-hour period. Estimates of one-hour rainfall intensities can be provided in the forecast narrative, along with probable peak intensities and timing, although with less confidence than rainfall totals. A compilation of information on the hydrologic response to winter storms from recently burned areas in southern California steeplands was used to develop a system for classifying the magnitude of the postfire hydrologic response. The four-class system is based on a combination of the reported volume of individual debris flows, the consequences of these events in an urban setting, and the spatial extent of the response to the triggering storm. Threshold rainfall conditions associated with debris flow and floods of different magnitude classes are defined by integrating local rainfall data with debris-flow and flood magnitude information. The within-storm rainfall accumulations (A) and durations (D) above which magnitude I events are expected are defined by A=0.3D0.6. The function A=0.5D0.6 defines the within-storm rainfall accumulations and durations above which a magnitude III event will occur in response to a regional-scale storm, and a magnitude II event will occur if the storm affects only a few drainage basins. The function A=1.0D0.5defines the rainfall conditions above which magnitude III events can be expected. Rainfall trigger-magnitude relations are linked with potential emergency-response actions in the form of an emergency-response decision chart. The chart leads a user through steps to determine potential event magnitudes, and identify possible evacuation and resource-deployment levels as a function of either individual storm forecasts or measured precipitation during storms. The ability to use this information in the planning and response decision-making process may result in significant financial savings and increased safety for both the public and emergency responders.

A Physics-Based Modeling Framework for Prognostic Studies

NASA Technical Reports Server (NTRS)

Kulkarni, Chetan S.

2014-01-01

Prognostics and Health Management (PHM) methodologies have emerged as one of the key enablers for achieving efficient system level maintenance as part of a busy operations schedule, and lowering overall life cycle costs. PHM is also emerging as a high-priority issue in critical applications, where the focus is on conducting fundamental research in the field of integrated systems health management. The term diagnostics relates to the ability to detect and isolate faults or failures in a system. Prognostics on the other hand is the process of predicting health condition and remaining useful life based on current state, previous conditions and future operating conditions. PHM methods combine sensing, data collection, interpretation of environmental, operational, and performance related parameters to indicate systems health under its actual application conditions. The development of prognostics methodologies for the electronics field has become more important as more electrical systems are being used to replace traditional systems in several applications in the aeronautics, maritime, and automotive fields. The development of prognostics methods for electronics presents several challenges due to the great variety of components used in a system, a continuous development of new electronics technologies, and a general lack of understanding of how electronics fail. Similarly with electric unmanned aerial vehicles, electrichybrid cars, and commercial passenger aircraft, we are witnessing a drastic increase in the usage of batteries to power vehicles. However, for battery-powered vehicles to operate at maximum efficiency and reliability, it becomes crucial to both monitor battery health and performance and to predict end of discharge (EOD) and end of useful life (EOL) events. We develop an electrochemistry-based model of Li-ion batteries that capture the significant electrochemical processes, are computationally efficient, capture the effects of aging, and are of suitable accuracy for reliable EOD prediction in a variety of usage profiles.

Potential sources of intra-population variation in the overwintering strategy of painted turtle (Chrysemys picta) hatchlings.

PubMed

Riley, Julia L; Tattersall, Glenn J; Litzgus, Jacqueline D

2014-12-01

Many temperate animals spend half their lives in a non-active, overwintering state, and multiple adaptations have evolved to enable winter survival. One notable vertebrate model is Chrysemys picta, whose hatchlings display dichotomous overwintering strategies: some hatchlings spend their first winter aquatically after nest emergence in the autumn, whereas others overwinter terrestrially within their natal nest with subsequent emergence in the spring. The occurrence of these strategies varies among populations and temporally within populations; however, factors that determine the strategy employed by a nest in nature are unknown. We examined potential factors that influence intra-population variation in the overwintering strategy of C. picta hatchlings over two winters in Algonquin Park, Ontario. We found that environmental factors may be a trigger for the hatchling overwintering strategy: autumn-emerging nests were sloped towards the water and were surrounded by a relatively higher percentage of bare ground compared with spring-emerging nests. Autumn-emerging hatchlings were also relatively smaller. Overwintering strategy was not associated with clutch oviposition sequence, or mammalian or avian predation attempts. Instead, autumn emergence from the nest was associated with the direct mortality threat of predation by sarcophagid fly larvae. Body condition and righting response, measured as proxies of hatchling fitness, did not differ between overwintering strategies. Costs and benefits of overwintering aquatically versus terrestrially in hatchling C. picta are largely unknown, and have the potential to affect population dynamics. Understanding winter survival has great implications for turtle ecology, thus we emphasize areas for future research on dichotomous overwintering strategies in temperate hatchling turtles. © 2014. Published by The Company of Biologists Ltd.

Mortality related to acute illness and injury in rural Uganda: task shifting to improve outcomes.

PubMed

Chamberlain, Stacey; Stolz, Uwe; Dreifuss, Bradley; Nelson, Sara W; Hammerstedt, Heather; Andinda, Jovita; Maling, Samuel; Bisanzo, Mark

2015-01-01

Due to the dual critical shortages of acute care and healthcare workers in resource-limited settings, many people suffer or die from conditions that could be easily treated if existing resources were used in a more timely and effective manner. In order to address this preventable morbidity and mortality, a novel emergency midlevel provider training program was developed in rural Uganda. This is the first study that assesses this unique application of a task-shifting model to acute care by evaluating the outcomes of 10,105 patients. Nurses participated in a two-year training program to become midlevel providers called Emergency Care Practitioners at a rural district hospital. This is a retrospective analysis of the Emergency Department's quality assurance database, including three-day follow-up data. Case fatality rates (CFRs) are reported as the percentage of cases with a specific diagnosis that died within three days of their Emergency Department visit. Overall, three-day mortality was 2.0%. The most common diagnoses of patients who died were malaria (n=60), pneumonia (n=51), malnutrition (n=21), and trauma (n=18). Overall and under-five CFRs were as follows: malaria, 2.0% and 1.9%; pneumonia, 5.5% and 4.1%; and trauma, 1.2% and 1.6%. Malnutrition-related fatality (all cases <18 years old) was 6.5% overall and 6.8% for under-fives. This study describes the outcomes of emergency patients treated by midlevel providers in a resource-limited setting. Our fatality rates are lower than previously published regional rates. These findings suggest this model of task-shifting can be successfully applied to acute care in order to address the shortage of emergency care services in similar settings as part of an integrated approach to health systems strengthening.

Age-related variation in primary care-type presentations to emergency departments.

PubMed

Freed, Gary; Gafforini, Sarah; Carson, Norman

2015-08-01

A significant amount of attention has been paid to the increase in emergency department (ED) presentations in Australia. Questions have arisen regarding whether all of those presenting to the ED are actually in need of true emergency services. Under-standing the characteristics of those patients who may be cared for in non-emergency settings is important for future health system strategies. The aim of this study was to identify age-related variation in primary care type emergency department (ED) presentations over time. A secondary analysis of data from the Victorian emergency minimum dataset (VEMD) between 2002-13 was conducted. The main outcomes were patterns of primary care type ED presentations for different ages groups over time, age-specific patterns of specific primary care type exclusion criteria and primary care type ED presentations by residents from aged care facilities. The proportion of triage category 4 or 5 ED presentations that met the criteria for a primary care type visit was greatest in the 0-4-year age group and tended to decrease as the age of the patient increased. Triage category 4 or 5 presentation by ambulance was uncommon in the younger age groups, surpassed 10% in the 50-54-year age group, and was >70% for those aged >90 years. The greater proportion of residential aged care facility patients who arrived by ambulance resulted in a much smaller proportion of primary care type visits. There are marked differences by age in the proportion of triage category 4 or 5 ED presentations that met the criteria for primary care type visits. These results indicate it was primarily younger patients who presented to the ED with non-urgent conditions. Most might be able to safely receive care in a primary care setting.

Nursing praxis, compassionate caring and interpersonal relations: an observational study.

PubMed

Fry, Margaret; MacGregor, Casimir; Ruperto, Kate; Jarrett, Kate; Wheeler, Janet; Fong, Jacqueline; Fetchet, Wendy

2013-05-01

The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED). The paper argues that compassionate caring is a core nursing skill that supports CIN interpersonal relations, despite the role's highly clinical nature. Sixteen non-participant observations were undertaken in three EDs in New South Wales, Australia. Nurses were eligible for inclusion if they had two years of emergency experience and had worked in the CIN role for more than one year. All CIN's that were observed were highly experienced with a minimum three year ED experience. The CIN observations revealed how compassionate caring was utilised by CIN's to quickly build a therapeutic relationship with patients and colleagues, and helped to facilitate core communication and interpersonal skills. While the CIN role was viewed as extended practice, the role relied heavily on compassionate care to support interpersonal relationships and to actualise extended practice care. The study supports the contribution made by emergency nurses and demonstrates how compassionate caring is central to nursing praxis. This paper also demonstrates that the CIN role utilises a complex mix between advanced clinical skills and compassion that supports interpersonal and therapeutic relationships. Further research is needed to understand how compassionate care can be optimised within nursing praxis and the duty of care between nurses and patients, nurses and other health care professionals so that future healthcare goals can be realised. Copyright © 2013 College of Emergency Nursing Australasia Ltd. All rights reserved.

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

NASA Technical Reports Server (NTRS)

Connell, Linda J.; Reynard, William D.

1993-01-01

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

[When should a patient with abdominal pain be referred to the emergency ward?].

PubMed

de Saussure, Wassila Oulhaci; Andereggen, Elisabeth; Sarasin, François

2010-08-25

When should a patient with abdominal pain be referred to the emergency ward? The following goals must be achieved upon managing patients with acute abdominal pain: 1) identify vital emergency situations; 2) detect surgical conditions that require emergency referral without further diagnostic procedures; 3) in "non surgical acute abdomen patients" perform appropriate diagnostic procedures, or in selected cases delay tests and reevaluate the patient after an observation period, after which a referral decision is made. Clues from the history and physical examination are critical to perform this evaluation. A good knowledge of the most frequent acute abdominal conditions, and identifying potential severity criteria allow an appropriate management and decision about emergency referral.

Within-population variability influences early seedling establishment in four Mediterranean oaks

NASA Astrophysics Data System (ADS)

González-Rodríguez, Victoria; Barrio, Isabel C.; Villar, Rafael

2012-05-01

Regeneration of Mediterranean forests is severely limited. Multiple abiotic factors are known to constrain the establishment of woody seedlings at its first phases, such as summer drought or excessive incident radiation, but less attention has been paid to the role of intra-specific variation in seedling performance. In this study we investigate the relative influence of environment (light availability, soil moisture and summer irrigation) and intrinsic factors (seed mass and maternal origin) as determinants of within-population variability in the early establishment of four coexisting Mediterranean oaks (Quercus ilex, Quercus suber, Quercus faginea and Quercus pyrenaica), from emergence and early growth to second-year survival in a field experiment. Seed size was a poor predictor of seed and seedling success. Instead, mother identity showed a stronger effect on seedling performance. Time and percentage of emergence, establishment success and morphological traits varied among seedlings from different maternal trees but main drivers for each variable were different for each species. In addition to a direct effect, in many cases mother-related intrinsic traits and seed mass influenced the effects of environmental conditions on seedling performance. The role of intrinsic factors was masked under ameliorated conditions (i.e. summer irrigation), indicating the relevant role of within-population variability to cope with highly heterogeneous and unpredictable Mediterranean environments.

Situation-based social anxiety enhances the neural processing of faces: evidence from an intergroup context

PubMed Central

Ofan, Renana H.; Rubin, Nava

2014-01-01

Social anxiety is the intense fear of negative evaluation by others, and it emerges uniquely from a social situation. Given its social origin, we asked whether an anxiety-inducing social situation could enhance the processing of faces linked to the situational threat. While past research has focused on how individual differences in social anxiety relate to face processing, we tested the effect of manipulated social anxiety in the context of anxiety about appearing racially prejudiced in front of a peer. Visual processing of faces was indexed by the N170 component of the event-related potential. Participants viewed faces of Black and White males, along with nonfaces, either in private or while being monitored by the experimenter for signs of prejudice in a ‘public’ condition. Results revealed a difference in the N170 response to Black and Whites faces that emerged only in the public condition and only among participants high in dispositional social anxiety. These results provide new evidence that anxiety arising from the social situation modulates the earliest stages of face processing in a way that is specific to a social threat, and they shed new light on how anxiety effects on perception may contribute to the regulation of intergroup responses. PMID:23709354

Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

PubMed

Safdar, Basmah; Greenberg, Marna R

2014-12-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the results of the 2014 consensus conference as well as related original research with the goal of bringing high-quality equitable care to male and female emergency patients. © 2014 by the Society for Academic Emergency Medicine.

Evolving Prehospital, Emergency Department, and “Inpatient” Management Models for Geriatric Emergencies

PubMed Central

Carpenter, Christopher R.; Platts-Mills, Timothy F.

2013-01-01

Alternative management methods are essential to ensure high quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols for case-finding and rapid diagnosis to support early condition-specific treatment for older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to look beyond the diagnosis to address the influence of other factors on the patient's health: isolation and depression; finances and transportation; and chronic medical conditions and polypharmacy. This review article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. PMID:23177599

[Factors related to lack of autonomous mobility during out-of-hospital emergency care].

PubMed

Montero García, Antonio; Morales Asencio, José Miguel; Trujillo Illescas, Juan Alfonso; Martí, Celia

2016-10-01

To explore the frequency of lack of autonomous mobility and factors related to it in patients requiring prehospital emergency services. Cross-sectional, observational, retrospective analysis. We identified a stratified random sample of patients attended by the public health emergency service of Andalusia in 2011. The sample included 280 patients with a mean age of 56 years; 63.9% were men. The majority were attended in homes and streets or other public spaces. Most were transported to a hospital in a mobile intensive care unit. The reasons for calling the service were most often related to chest pain or injuries. Loss of autonomous mobility was seen more often in men, when care was required in a public area, when there were injuries or altered vital signs, and when the patient required transport in a mobile intensive care unit. Dependence on others was significantly associated with the presence of a prior condition before the patient required transport (odds ratio [OR], 3.27; 95% CI, 1.60-6.33), the use of immobilization strategies (OR, 7.71; 95% CI, 1.7-34.96], and the use of ambulance transport (OR, 4.35; 95% CI, 1.63-11.60]. The following 2 variables were at the limit of significance: pain during the care process (OR, 1.13; 95% CI, 0.99-1.29) and age (OR, 0.46; 95% CI, 0.97-1.01). The profile we identified for patients and situations in which patients cannot move autonomously during prehospital emergency care can be used to plan preventive strategies to ensure patient safety.

Quantification of hepatic and visceral fat by CT and MR imaging: relevance to the obesity epidemic, metabolic syndrome and NAFLD.

PubMed

Graffy, Peter M; Pickhardt, Perry J

2016-06-01

Trends in obesity have continued to increase in the developed world over the past few decades, along with related conditions such as metabolic syndrome, which is strongly associated with this epidemic. Novel and innovative methods to assess relevant obesity-related biomarkers are needed to determine the clinical significance, allow for surveillance and intervene if appropriate. Aggregations of specific types of fat, specifically hepatic and visceral adiposity, are now known to be correlated with these conditions, and there are a variety of imaging techniques to identify and quantify their distributions and provide diagnostic information. These methods are particularly salient for metabolic syndrome, which is related to both hepatic and visceral adiposity but currently not defined by it. Simpler non-specific fat measurements, such as body weight, abdominal circumference and body mass index are more frequently used but lack the ability to characterize fat location. In addition, non-alcoholic fatty liver disease (NAFLD) is a related condition that carries relevance not only for obesity-related diseases but also for the progression of the liver-specific disease, including non-alcoholic steatohepatitis and cirrhosis, albeit at a much lower frequency. Recent CT and MRI techniques have emerged to potentially optimize diagnosing metabolic syndrome and NAFLD through non-invasive quantification of visceral fat and hepatic steatosis with high accuracy. These imaging modalities should aid us in further understanding the relationship of hepatic and visceral fat to the obesity-related conditions such as metabolic syndrome, NAFLD and cardiovascular disease.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

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

Pedagogy of complex relationality exploring complexity theory, neuro-phenomenology, and attentiveness for education

NASA Astrophysics Data System (ADS)

Khattar, Randa

What do the new sciences of complex relationality offer education? This work draws on complexity theory, neurological understandings of biology and phenomenology, and attentiveness to study what the new sciences might offer education and the possibilities of a pedagogical understanding of embodied knowing. Complexity theory provides understandings of local-global relationality, self-organization, far-from-equilibrium conditions, and emergent dynamics that are important for describing pedagogical relationality. In itself, however, complexity theory is lacking an attention to issues of embodiment that respond directly to an ethical understanding of relationality. Phenomenology provides important views on the human experience of perception, for example, Merleau-Ponty's, whose research opens up possibilities for embodiment and attentiveness. At the level of pedagogical practice, I will pose, following biologists Humberto Maturana and Francisco Varela's autopoietic self-making understanding of life, that attentiveness perspectives, which have been largely absent from western pedagogical theory and practice, are crucial to promoting embodied knowing for education. Maturana and Varela's autopoietic perspective offers an embodied understanding of living---and therefore education---which opens up necessary attentive spaces to listen to one another in non judgmental awareness in the present moment of experience. I offer insights into a relationally complex conception of education drawing on this biological and autopoietically-grounded framework. These insights are framed in the context of five clusters of relations: (1) emergence, far-from-equilibrium, and local-global relationality; (2) autopoietic autonomy, structural determination and sensory-motor coupling; (3) triggering perturbations, structural plasticity, and autopoietic organization; (4) knowing as adequate action, domains of interaction, and blind spots; and (5) attentiveness and responsive relationality. Four examples of pedagogical practices that are illustrative of these clusters are offered: the L'Arche Communities, the conditional teaching of the Mindfulness Research Lab, the purposeless assignment, and the progettazione of the Reggio Emilia approach to early childhood.

[Sanitary and epidemiological conditions in the Lodz region during the period of the second Polish Republic in the XIX and XX centuries].

PubMed

Sadowska, Jolanta

2005-01-01

Throughout history of European agglomerations in the nineteenth and twentieth century the relation between expanding industry and worsening sanitary and epidemiological conditions was seen. These changes, having great impact on public health, were investigated in the present study. Problems related to sanitary and epidemiological conditions in Lodz first emerged during the Russian occupation of Poland in the XIX century. The Russian Governing Council was not overseeing sanitary conditions of the city, and transferred this responsibility to the industrial bourgeoisie of Lodz. In this situation, uncontrolled development of the industry led to serious deterioration in natural environment and increase of risk for acute and chronic infectious diseases. Improvement of the sanitary situation in Lodz commenced in the period of the Second Polish Republic (1918-1939). Sanitary Divisions were created at the Lodz Department of Public Health. Activities in this Department involved, among others, detailed epidemiological examination of potable water, the investigation of manufacturing processes, retail and wholesale groceries, hygienic conditions of public housing. The activity and interventions of Sanitary Divisions contributed substantially to a decrease of incidence of various diseases and improvement of living conditions of the Lodz populations. The improvement of sanitary and epidemiological conditions in Lodz after 1918 was mainly related to the construction of water supply and sewage systems. This led to an approximation of the urban standards of this 500,000 population agglomeration to European standards.

Profile and costs of secondary conditions resulting in emergency department presentations and readmission to hospital following traumatic spinal cord injury.

PubMed

Gabbe, Belinda J; Nunn, Andrew

2016-08-01

People with traumatic spinal cord injury (SCI) face complex challenges in their care, recovery and life. Secondary conditions can develop to involve many body systems and can impact health, function, quality of life, and community participation. These secondary conditions can be costly, and many are preventable. The aim of this study was to describe the type and direct costs of secondary conditions requiring readmission to hospital, or visit to an emergency department (ED), within the first two years following traumatic spinal cord injury (SCI). A retrospective cohort study using population-level linked data from hospital ED and admission datasets was undertaken in Victoria, Australia. The incidence and direct treatment costs of readmission to hospital and ED visit within 2-years post-injury for secondary conditions related to SCI were measured for the 356 persons with traumatic SCI with a date of injury from 2008 to 2011. Of the 356 cases, 141 (40%) experienced 366 (median 2, range 1-11) readmissions to hospital for secondary conditions. 95 (27%) visited an ED at least once, within two years of injury for a secondary condition. The cost of hospital readmissions was AUD$5,553,004 and AUD$87,790 for ED visits. The mean±SD cost was AUD$15,172±$20,957 per readmission and AUD$670±$198 per ED visit. Urological conditions (e.g. urinary tract infection) were most common, followed by pressure areas/ulcers for readmissions, and fractures in the ED. Hospitalisation for complications within two years of traumatic SCI was common and costly in Victoria, Australia. Improved bladder and pressure area management could result in substantial morbidity and cost savings following SCI. Copyright © 2016 Elsevier Ltd. All rights reserved.

Limbic system development underlies the emergence of classical fear conditioning during the 3rd and 4th weeks of life in the rat

PubMed Central

Deal, Alex L.; Erickson, Kristen J.; Shiers, Stephanie I.; Burman, Michael A.

2016-01-01

Classical fear conditioning creates an association between an aversive stimulus and a neutral stimulus. Although the requisite neural circuitry is well understood in mature organisms, the development of these circuits is less well studied. The current experiments examine the ontogeny of fear conditioning and relate it to neuronal activation assessed through immediate early gene (IEG) expression in the amygdala, hippocampus, perirhinal cortex, and hypothalamus of periweanling rats. Rat pups were fear conditioned, or not, during the 3rd or 4th weeks of life. Neuronal activation was assessed by quantifying expression of FBJ osteosarcoma oncogene (FOS) using immunohistochemistry (IHC) in Experiment 1. Fos and early growth response gene-1 (EGR1) expression was assessed using qRT-PCR in Experiment 2. Behavioral data confirm that both auditory and contextual fear continue to emerge between PD 17 and 24. The IEG expression data are highly consistent with these behavioral results. IHC results demonstrate significantly more FOS protein expression in the basal amygdala of fear conditioned PD 23 subjects compared to control subjects, but no significant difference at PD 17. qRT-PCR results suggest specific activation of the amygdala only in older subjects during auditory fear expression. A similar effect of age and conditioning status was also observed in the perirhinal cortex during both contextual and auditory fear expression. Overall, the development of fear conditioning occurring between the 3rd and 4th weeks of life appears to be at least partly attributable to changes in activation of the amygdala and perirhinal cortex during fear conditioning or expression. PMID:26820587

Extreme ambient temperatures and cardiorespiratory emergency room visits: assessing risk by comorbid health conditions in a time series study

PubMed Central

2014-01-01

Background Extreme ambient temperatures are an increasing public health concern. The aim of this study was to assess if persons with comorbid health conditions were at increased risk of adverse cardiorespiratory morbidity during temperature extremes. Methods A time series study design was applied to 292,666 and 562,738 emergency room (ER) visits for cardiovascular and respiratory diseases, respectively, that occurred in Toronto area hospitals between April 1st 2002 and March 31st 2010. Subgroups of persons with comorbid health conditions were identified. Relative risks (RRs) and their corresponding 95% confidence intervals (CIs) were estimated using a Poisson regression model with distributed lag non-linear model, and were adjusted for the confounding influence of seasonality, relative humidity, day-of-the-week, outdoor air pollutants and daily influenza ER visits. Effect modification by comorbid health conditions was tested using the relative effect modification (REM) index. Results Stronger associations of cardiovascular disease ER visits were observed for persons with diabetes compared to persons without diabetes (REM = 1.12; 95% CI: 1.01 – 1.27) with exposure to the cumulative short term effect of extreme hot temperatures (i.e. 99th percentile of temperature distribution vs. 75th percentile). Effect modification was also found for comorbid respiratory disease (REM = 1.17; 95% CI: 1.02 – 1.44) and cancer (REM = 1.20; 95% CI: 1.02 – 1.49) on respiratory disease ER visits during short term hot temperature episodes. The effect of extreme cold temperatures (i.e. 1st percentile of temperature distribution vs. 25th percentile) on cardiovascular disease ER visits were stronger for individuals with comorbid cardiac diseases (REM = 1.47; 95% CI: 1.06 – 2.23) and kidney diseases (REM = 2.43; 95% CI: 1.59 – 8.83) compared to those without these conditions when cumulated over a two-week period. Conclusions The identification of those most susceptible to temperature extremes is important for public health officials to implement adaptation measures to manage the impact of extreme temperatures on population health. PMID:24484632

Vehicle Scheduling Schemes for Commercial and Emergency Logistics Integration

PubMed Central

Li, Xiaohui; Tan, Qingmei

2013-01-01

In modern logistics operations, large-scale logistics companies, besides active participation in profit-seeking commercial business, also play an essential role during an emergency relief process by dispatching urgently-required materials to disaster-affected areas. Therefore, an issue has been widely addressed by logistics practitioners and caught researchers' more attention as to how the logistics companies achieve maximum commercial profit on condition that emergency tasks are effectively and performed satisfactorily. In this paper, two vehicle scheduling models are proposed to solve the problem. One is a prediction-related scheme, which predicts the amounts of disaster-relief materials and commercial business and then accepts the business that will generate maximum profits; the other is a priority-directed scheme, which, firstly groups commercial and emergency business according to priority grades and then schedules both types of business jointly and simultaneously by arriving at the maximum priority in total. Moreover, computer-based simulations are carried out to evaluate the performance of these two models by comparing them with two traditional disaster-relief tactics in China. The results testify the feasibility and effectiveness of the proposed models. PMID:24391724

Vehicle scheduling schemes for commercial and emergency logistics integration.

PubMed

Li, Xiaohui; Tan, Qingmei

2013-01-01

In modern logistics operations, large-scale logistics companies, besides active participation in profit-seeking commercial business, also play an essential role during an emergency relief process by dispatching urgently-required materials to disaster-affected areas. Therefore, an issue has been widely addressed by logistics practitioners and caught researchers' more attention as to how the logistics companies achieve maximum commercial profit on condition that emergency tasks are effectively and performed satisfactorily. In this paper, two vehicle scheduling models are proposed to solve the problem. One is a prediction-related scheme, which predicts the amounts of disaster-relief materials and commercial business and then accepts the business that will generate maximum profits; the other is a priority-directed scheme, which, firstly groups commercial and emergency business according to priority grades and then schedules both types of business jointly and simultaneously by arriving at the maximum priority in total. Moreover, computer-based simulations are carried out to evaluate the performance of these two models by comparing them with two traditional disaster-relief tactics in China. The results testify the feasibility and effectiveness of the proposed models.

[Adverse drug reaction reporting in emergency medicine].

PubMed

Milojevic, Kolia; Chassagnol, Isabelle; Brion, Nathalie; Cléro, Joël; Degrèze, Nathalie; Lambert, Yves

2004-01-01

A regional survey was performed between June and September 2002, to evaluate knowledge and attitudes of emergency physicians regarding adverse drug reaction (ADR) reporting in a French district. 100 questionnaires completed by physicians working in emergency departments and/or mobile intensive care units were analysed. The frequency of ADRs encountered by emergency practitioners was estimated at > or = 0.73 per year and per physician. The ADR notification rate in emergency medicine was estimated at < or = 6%. A minority of physicians were responsible for the majority of ADR reporting. Sixty-four percent of emergency physicians underestimated the conditions required for ADR notification: 28% thought that certain causality was an absolute necessary condition for notification, while 37% considered that notification was required only for ADRs that were both severe and unexpected. Interventions focused on advertising ADR reporting procedures could help to improve the notification rate in emergency medicine.

18 CFR 376.203 - Mailing address of Commission during emergency conditions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REVISED GENERAL RULES ORGANIZATION, MISSION... § 376.203 Mailing address of Commission during emergency conditions. The Chairman may direct that during... Commission shall be addressed to the Federal Energy Regulatory Commission, Official Mail and Messenger...

Testicular microlithiasis and testicular cancer: review of the literature.

PubMed

Pedersen, Malene Roland; Rafaelsen, Søren Rafael; Møller, Henrik; Vedsted, Peter; Osther, Palle Jörn

2016-07-01

To perform a systematic literature review to assess whether the occurrence of testicular microlithiasis (TML) in conjunction with other risk factors is associated with testicular cancer. A systematic literature search was performed of original articles in English published 1998 to 2015. Relevant studies were selected by reading the title and abstract by two of the authors. Studies were included if TML was diagnosed by ultrasonography and a risk condition was reported. Studies were only eligible if the particular risk condition was reported in more than one article. In total, 282 abstracts in were identified. Based on title and abstract the eligibility was assessed and 31 studies were included. Five conditions in relation to TML and testicular cancer emerged: Down syndrome, McCune-Albright syndrome, cryptorchidism, infertility and familial disposition of testicular cancer. Data support the conclusion that TML is not an independent risk factor for testicular cancer but associated with testicular cancer through other conditions. In male infertility, TML appears to be related to an increased risk of testicular cancer possibly as part of a testicular dysgenesis syndrome.

Not just sticks and stones: Indirect ethnic discrimination leads to greater physiological reactivity.

PubMed

Huynh, Virginia W; Huynh, Que-Lam; Stein, Mary-Patricia

2017-07-01

We examined the effect of indirect ethnic discrimination on physiological reactivity (i.e., cortisol, blood pressure, heart rate) in Latino emerging adults. Participants (N = 32) were randomly assigned to be exposed to indirect ethnic discrimination (experimental condition) or not (control condition) while undergoing a cognitive stress task. Greater total cortisol output was observed in participants in the experimental condition, relative to those in the control condition. No significant differences in heart rate or blood pressure were noted. Results suggest that witnessing ethnic discrimination affects cortisol recovery responses, but not cardiovascular reactivity. Words that are not intentionally hurtful or directed at a specific person may still "hurt"-affecting biological processes associated with hypothalamic-pituitary-adrenocortical (HPA) axis and potentially leading to long-term health consequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

47 CFR 22.1007 - Channels for offshore radiotelephone systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... emergency auto alarm and voice transmission pertaining to emergency conditions only. Central Subscriber 488... fixed, surface and/or airborne mobile) as indicated, for emergency auto alarm and voice transmission...

47 CFR 22.1007 - Channels for offshore radiotelephone systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... emergency auto alarm and voice transmission pertaining to emergency conditions only. Central Subscriber 488... fixed, surface and/or airborne mobile) as indicated, for emergency auto alarm and voice transmission...

47 CFR 22.1007 - Channels for offshore radiotelephone systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... emergency auto alarm and voice transmission pertaining to emergency conditions only. Central Subscriber 488... fixed, surface and/or airborne mobile) as indicated, for emergency auto alarm and voice transmission...

Modelling leaf photosynthetic and transpiration temperature-dependent responses in Vitis vinifera cv. Semillon grapevines growing in hot, irrigated vineyard conditions

PubMed Central

Greer, Dennis H.

2012-01-01

Background and aims Grapevines growing in Australia are often exposed to very high temperatures and the question of how the gas exchange processes adjust to these conditions is not well understood. The aim was to develop a model of photosynthesis and transpiration in relation to temperature to quantify the impact of the growing conditions on vine performance. Methodology Leaf gas exchange was measured along the grapevine shoots in accordance with their growth and development over several growing seasons. Using a general linear statistical modelling approach, photosynthesis and transpiration were modelled against leaf temperature separated into bands and the model parameters and coefficients applied to independent datasets to validate the model. Principal results Photosynthesis, transpiration and stomatal conductance varied along the shoot, with early emerging leaves having the highest rates, but these declined as later emerging leaves increased their gas exchange capacities in accordance with development. The general linear modelling approach applied to these data revealed that photosynthesis at each temperature was additively dependent on stomatal conductance, internal CO2 concentration and photon flux density. The temperature-dependent coefficients for these parameters applied to other datasets gave a predicted rate of photosynthesis that was linearly related to the measured rates, with a 1 : 1 slope. Temperature-dependent transpiration was multiplicatively related to stomatal conductance and the leaf to air vapour pressure deficit and applying the coefficients also showed a highly linear relationship, with a 1 : 1 slope between measured and modelled rates, when applied to independent datasets. Conclusions The models developed for the grapevines were relatively simple but accounted for much of the seasonal variation in photosynthesis and transpiration. The goodness of fit in each case demonstrated that explicitly selecting leaf temperature as a model parameter, rather than including temperature intrinsically as is usually done in more complex models, was warranted. PMID:22567220

Legislated emergency locating transmitters and emergency position indicating radio beacons

NASA Technical Reports Server (NTRS)

Wade, William R. (Inventor)

1988-01-01

An emergency locating transmitting (ELT) system is disclosed which comprises a legislated ELT modified with an interface unit and connected by a multiwire cable to a remote control monitor (RCM), typically located at the pilot position. The RCM can remotely test the ELT by disabling the legislated swept tone and allowing transmission of a single tone, turn the ELT on for legislated ELT transmission, and reset the ELT to an armed condition. The RCM also provides visual and audio indications of transmitter operating condition as well as ELT battery condition. Removing the RCM or shorting or opening the interface input connections will not affect traditional ELT operation.

Conceptualizing Autism: The Role for Emergence

ERIC Educational Resources Information Center

Anderson, George M.

2009-01-01

The establishment of a criterion for operationally defining emergent phenomena in autism is needed. Key initial questions for autism researchers include how to define emergent phenomena in order to better diagnosis the condition.

The role of nurse functional types in seedling recruitment dynamics of alternative states in rangelands

NASA Astrophysics Data System (ADS)

López, Dardo R.; Cavallero, Laura

2017-02-01

In arid ecosystems, recruitment dynamics are limited by harsh environmental conditions and greatly depend on the net outcome of the balance between facilitation and competition. This outcome can change as a consequence of degradation caused by livestock overgrazing. Also, distinct plant species may show a differential response to a common neighbour under the same environmental conditions. Therefore, ecosystem degradation could affect the net balance of plant-plant interactions, which can also depend on the functional traits of potential nurse species. The aim of this study is to assess the influence of alternative degradation states on (i) the density of seedlings of perennial species emerging in four microsite types, and on (ii) the relative interaction intensity (RII) between seedlings and potential nurses belonging to three functional types (deep- and shallow-rooted shrubs, and tussock grasses). During three years, we recorded seedling density of perennial species in four alternative degradation states in grass-shrubby steppes from northwestern Patagonia. The density of emerged seedlings of perennial species decreased sharply as degradation increased, showing non-linear responses in most microsites. Seedling density underneath deep-rooted shrubs was higher than underneath shallow-rooted shrubs and tussock grasses. Also, deep-rooted shrubs were the only functional type that recorded seedling emergence in highly degraded states. Deep-rooted shrubs had facilitative effects on the seedlings emerging and surviving underneath them, independently of ecosystem degradation. In contrast, RII between shallow-rooted shrubs and recently emerged seedlings, switched from positive effects in the less degraded states, to negative effects in the most degraded state. Tussock grasses recorded the weakest intensity of facilitative interactions with recently emerged seedlings, switching to competitive interactions as degradation increased. Our results suggest that species with key functional traits should be considered in management and restoration plans for rangelands with different degradation levels, since they have a strong influence in the net outcome of plant-plant interactions and in the recruitment dynamics of arid ecosystems.

Disseminated cytomegalovirus infection complicating active treatment of systemic lupus erythematosus: an emerging problem.

PubMed

Berman, N; Belmont, H M

2017-04-01

Patients with systemic lupus erythematosus (SLE) often require immunosuppression to induce remission of active disease exacerbations. Over the past two decades, treatment modalities for this condition have emerged leading to improved morbidity from disease related outcomes. However, as a result, infection risks and patterns have changed, leading to higher rates of opportunistic infections among this population. We report four cases of cytomegalovirus (CMV) in patients with SLE who received immunosuppressive therapy, including pulse steroids, antimetabolites such as mycophenolate mofetil, and alkylating agents such as cyclophosphamide. We propose that given the rise in prevalence of CMV, there is a need for appropriate screening for this opportunistic pathogen and studies to determine the risks and benefits of prophylactic or preemptive treatment for this virus.

'Health psychology' or 'psychology for health'? A history of psychologists' engagement with health in South Africa.

PubMed

Yen, Jeffery; Vaccarino, Oriana

2018-03-01

In contrast to the institutionalization of health psychology in North America and Europe, much psychological work on health issues in South Africa emerged as part of a critical revitalization of South African psychology as a whole, coinciding with the dismantling of Apartheid and global shifts in health discourse. The field's development reflects attempts to engage with urgent health problems in the context of rapid sociopolitical changes that followed democratic transition in the 1990s, and under new conditions of knowledge production. We provide an account of these issues, as well as reflections on the field's future, as inflected through the experiences of 12 South African psychologists whose careers span the emergence of health-related psychology to the present day.

Obstructive hydrocephalus secondary to odontoid pannus: case report and review of literature.

PubMed

Soon, Wai Cheong; Thanabalasundaram, Gopiga; Thant, Kyaw Zayar; Ogbonnaya, Ebere Sunny; Harrisson, Stuart Edward

2018-04-01

Odontoid pannus or periodontoid pseudotumour is associated with a variety of rheumatological conditions. We report a case of an 80-year old man who presented with acute hydrocephalus following an emergency operation to amputate his infected left big toe. Imaging revealed a large tissue mass causing severe compression at the cervico-medullary junction and obstruction of CSF flow. The acute hydrocephalus was presumed to be related to neck manoeuvring during general anaesthesia. Following an initial emergency CSF diversion through external ventricular drainage catheter insertion, the patient subsequently underwent ventriculo-peritoneal insertion and posterior spinal decompression and fixation. To our knowledge, there have been no reported cases of tophaceous gout of the odontoid pannus causing acute hydrocephalus.

Do vestibular otolith organs participate in human orthostatic blood pressure control?

NASA Technical Reports Server (NTRS)

Watenpaugh, Donald E.; Cothron, Adriena V.; Wasmund, Stephen L.; Wasmund, Wendy L.; Carter, Robert 3rd; Muenter, Nicolette K.; Smith, Michael L.

2002-01-01

We hypothesized that vestibular otolith organ stimulation contributes to human orthostatic responses. Twelve subjects underwent three 60 degrees upright tilts: (1) with the neck flexed from 0 degrees to 30 degrees relative to the body during 60 degrees tilt, such that the head moved from horizontal to 90 degrees above horizontal (0 to 1 Gz otolith stimulation); (2) with the head and body aligned, such that they tilted together to 60 degrees (0 to 0.87 Gz otolith stimulation); and (3) with the neck flexed 30 degrees relative to the body during supine conditions, and the neck then extended to -30 degrees during 60 degrees body tilting, such that the head remained at 30 degrees above horizontal throughout body tilting (constant 0.5 Gz otolith stimulation). All three tilt procedures increased thoracic impedance, sympathetic nerve activity (N = 8 of 12), arterial pressure, and heart rate relative to supine conditions (all P < 0.04). Within the first 20 s of tilt, arterial pressure increased most obviously in the 0 to 1 Gz otolith condition. Thoracic impedance tended to increase more in otolith-constant conditions, but no dependent variable differed significantly between tilt conditions, and no significant time x tilt interactions emerged. Otolith inputs may contribute to early transient adjustments to orthostasis. However, lack of significant main effects of tilt condition and time x tilt interactions suggests that potential otolith effects on the variables we studied are relatively subtle and ephemeral, or that other mechanisms compensate for a lack of change in otolith input with orthostasis.

"Being conditioned, yet becoming strong": Asian American women in menopausal transition.

PubMed

Im, Eun-Ok; Lee, Seung Hee; Chee, Wonshik

2011-07-01

This study aimed to explore the menopausal symptom experiences of Asian American midlife women within the contexts of their daily lives using a feminist approach. This was a qualitative online forum study among 13 Asian American women recruited through the Internet. Seven discussion topics related to the menopausal symptom experience were used, and the data were analyzed using thematic analysis. Five themes emerged: (a) “being conditioned,”(b) “becoming strong,” (c) “appreciating,” (d) “without making a fuss,” and (e) “quiet support.” DISCUSSION, CONCLUSION, AND IMPLICATIONS FOR PRACTICE: These themes represent the women’s marginalized but empowered experience duringmenopausal transition.

Florence Nightingale: light to illuminate the world from the woman with the lantern.

PubMed

Dinc, Gulten; Naderi, Sait; Kanpolat, Yücel

2013-01-01

The Ottoman-Russian war of 1853 to 1855 was significant not only as a war, but also in response to a reflex from the West brought with itself novel approaches related to care of patients under severe health conditions. Florence Nightingale and her associates assigned at that time to care for soldiers in Istanbul who were severely ailing as a result of battle conditions were instrumental in the emergence of a hitherto unknown profession. This article examines the progress of events in the London-Istanbul axis that led to this development. Copyright © 2013 Elsevier Inc. All rights reserved.

Emergent coordination underlying learning to reach to grasp with a brain-machine interface.

PubMed

Vaidya, Mukta; Balasubramanian, Karthikeyan; Southerland, Joshua; Badreldin, Islam; Eleryan, Ahmed; Shattuck, Kelsey; Gururangan, Suchin; Slutzky, Marc; Osborne, Leslie; Fagg, Andrew; Oweiss, Karim; Hatsopoulos, Nicholas G

2018-04-01

The development of coordinated reach-to-grasp movement has been well studied in infants and children. However, the role of motor cortex during this development is unclear because it is difficult to study in humans. We took the approach of using a brain-machine interface (BMI) paradigm in rhesus macaques with prior therapeutic amputations to examine the emergence of novel, coordinated reach to grasp. Previous research has shown that after amputation, the cortical area previously involved in the control of the lost limb undergoes reorganization, but prior BMI work has largely relied on finding neurons that already encode specific movement-related information. In this study, we taught macaques to cortically control a robotic arm and hand through operant conditioning, using neurons that were not explicitly reach or grasp related. Over the course of training, stereotypical patterns emerged and stabilized in the cross-covariance between the reaching and grasping velocity profiles, between pairs of neurons involved in controlling reach and grasp, and to a comparable, but lesser, extent between other stable neurons in the network. In fact, we found evidence of this structured coordination between pairs composed of all combinations of neurons decoding reach or grasp and other stable neurons in the network. The degree of and participation in coordination was highly correlated across all pair types. Our approach provides a unique model for studying the development of novel, coordinated reach-to-grasp movement at the behavioral and cortical levels. NEW & NOTEWORTHY Given that motor cortex undergoes reorganization after amputation, our work focuses on training nonhuman primates with chronic amputations to use neurons that are not reach or grasp related to control a robotic arm to reach to grasp through the use of operant conditioning, mimicking early development. We studied the development of a novel, coordinated behavior at the behavioral and cortical level, and the neural plasticity in M1 associated with learning to use a brain-machine interface.

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

PubMed

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

2011-05-01

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

Emergency care of raptors.

PubMed

Graham, Jennifer E; Heatley, J Jill

2007-05-01

Raptors may present with a variety of conditions, such as trauma, debilitation, and disease, that necessitate emergency care. Emergency treatment should prioritize stabilization of the patient. Diagnostic testing should be delayed until feasible based on patient status. This article reviews emergency medicine in raptors, including appropriate handling and restraint, hospitalization, triage and patient assessment, sample collection, supportive care, and common emergency presentations.

Major depressive disorder, suicidal behaviour, bipolar disorder, and generalised anxiety disorder among emerging adults with and without chronic health conditions.

PubMed

Ferro, M A

2016-10-01

Despite the considerable physical, emotional and social change that occurs during emerging adulthood, there is little research that examines the association between having a chronic health condition and mental disorder during this developmental period. The aims of this study were to examine the sex-specific prevalence of lifetime mental disorder in an epidemiological sample of emerging adults aged 15-30 years with and without chronic health conditions; quantify the association between chronic health conditions and mental disorder, adjusting for sociodemographic and health factors; and, examine potential moderating and mediating effects of sex, level of disability and pain. Data come from the Canadian Community Health Survey-Mental Health. Respondents were 15-30 years of age (n = 5947) and self-reported whether they had a chronic health condition. Chronic health conditions were classified as: respiratory, musculoskeletal/connective tissue, cardiovascular, neurological and endocrine/digestive. The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess the presence of mental disorder (major depressive disorder, suicidal behaviour, bipolar disorder and generalised anxiety disorder). Lifetime prevalence of mental disorder was significantly higher for individuals with chronic health conditions compared with healthy controls. Substantial heterogeneity in the prevalence of mental disorder was found in males, but not in females. Logistic regression models adjusting for several sociodemographic and health factors showed that the individuals with chronic health conditions were at elevated risk for mental disorder. There was no evidence that the level of disability or pain moderated the associations between chronic health conditions and mental disorder. Sex was found to moderate the association between musculoskeletal/connective tissue conditions and bipolar disorder (β = 1.71, p = 0.002). Exploratory analyses suggest that the levels of disability and pain mediate the association between chronic health conditions and mental disorder. Physical and mental comorbidity is prevalent among emerging adults and this relationship is not augmented, but may be mediated, by the level of disability or pain. Findings point to the integration and coordination of public sectors - health, education and social services - to facilitate the prevention and reduction of mental disorder among emerging adults with chronic health conditions.

Age-related Decline in Case-Marker Processing and its Relation to Working Memory Capacity.

PubMed

Sung, Jee Eun

2017-09-01

Purposes of the current study were to investigate whether age-related decline emerged in a case-marker assignment task (CMAT) and to explore the relationship between working-memory (WM) capacity and case-marker processing. A total of 121 individuals participated in the study with 62 younger adults and 59 elderly adults. All were administered a CMAT that consisted of active and passive constructions with canonical and noncanonical word-order conditions. A composite measure of WM tasks served as an index of participants' WM capacity. The older group performed worse than the younger group, and the noncanonical word order elicited worse performance than the canonical condition. The older group demonstrated greater difficulty in case-marker processing under the canonical condition and passive construction. Regression results revealed that age, education, and sentence type were the best predictors to account for performance on the CMAT. The canonicity of word order and passive construction were critical factors related to decline in abilities in a case-marker assignment. The combination of age, education, and sentence type factors accounted for overall performance on case-marker processing. Results indicated the crucial necessity to find a cognitively and linguistically demanding condition that elicits aging effects most efficiently, considering language-specific syntactic features. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Eye Emergencies

MedlinePlus

... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

10 CFR 430.47 - Effective dates of final rules.

Code of Federal Regulations, 2011 CFR

2011-01-01

... such rule is needed to meet an “energy emergency condition or water emergency condition (in the case of faucets, showerheads, water closets, and urinals)” within the State. (2) Three years after such rule is... Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS...

10 CFR 430.47 - Effective dates of final rules.

Code of Federal Regulations, 2014 CFR

2014-01-01

... such rule is needed to meet an “energy emergency condition or water emergency condition (in the case of faucets, showerheads, water closets, and urinals)” within the State. (2) Three years after such rule is... Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS...

10 CFR 430.47 - Effective dates of final rules.

Code of Federal Regulations, 2012 CFR

2012-01-01

... such rule is needed to meet an “energy emergency condition or water emergency condition (in the case of faucets, showerheads, water closets, and urinals)” within the State. (2) Three years after such rule is... Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS...

10 CFR 430.47 - Effective dates of final rules.

Code of Federal Regulations, 2013 CFR

2013-01-01

... such rule is needed to meet an “energy emergency condition or water emergency condition (in the case of faucets, showerheads, water closets, and urinals)” within the State. (2) Three years after such rule is... Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS...