Emerging Trends in Metalloprotein Inhibition

PubMed Central

Rouffet, Matthieu

2013-01-01

Numerous metalloproteins are important therapeutic targets that are gaining increased attention in the medicinal and bioinorganic chemistry communities. This perspectives article describes some emerging trends and recent findings in the area of metalloprotein inhibitor discovery and development. In particular, the increasing recognition of the importance of the metal-ligand interactions in these systems calls for more input and consideration from the bioinorganic community to address questions traditionally confined to the medicinal chemistry community. PMID:21290034

Emerging Trends in Supply Chain Emissions Engagement

EPA Pesticide Factsheets

This report discusses emerging trends over the last decade in companies’ ability to manage their supply chain greenhouse gas emissions and focuses on how leading companies are engaging their suppliers in order to quantify the full impact of businesses

Laparoscopic Colorectal Surgery in the Emergency Setting: Trends in the Province of Ontario.

PubMed

Musselman, Reilly P; Gomes, Tara; Chan, Beverley P; Auer, Rebecca C; Moloo, Husein; Mamdani, Muhammad; Al-Omran, Mohammed; Al-Obeed, Omar; Boushey, Robin P

2015-10-01

The purpose of this study was to examine the adoption trends of emergency laparoscopic colorectal surgery in the province of Ontario. We conducted a retrospective time-series analysis examining rates of emergency colorectal surgery among 10.5 million adults in Ontario, Canada from April 1, 2002 to December 31, 2009. We linked administrative claims databases and the Ontario Cancer Registry to assess procedure rates over time. Procedure trends were assessed using time-series analysis. Over the 8-year period, 29,676 emergency colorectal procedures were identified. A total of 2582 (8.7%) were performed laparoscopically and 27,094 (91.3%) were open. Open and laparoscopic patients were similar with respect age, sex, and Charlson Comorbidity Index. The proportion of surgery for benign (63.8% of open cases vs. 65.6% laparoscopic, standardized difference=0.04) and malignant disease (36.2% open vs. 34.4% laparoscopic, standardized difference=0.04) was equal between groups. The percentage of emergency colorectal surgery performed laparoscopically increased from 5.7% in 2002 to 12.0% in 2009 (P<0.01). The use of laparoscopy increased for both benign and malignant disease. Statistically significant upward trends in laparoscopic surgery were seen for inflammatory bowel disease (P<0.01), obstruction (P<0.01), and colon cancer (P<0.01). From 2002 to 2009, annual procedure rates increased at a greater rate in nonacademic centers (P<0.01). Laparoscopic emergency colorectal surgery has increased significantly between 2002 and 2009 for both benign and malignant disease and for a wide range of diagnoses. This was driven in part by steadily rising usage of laparoscopy in nonacademic centers.

Research fronts analysis : A bibliometric to identify emerging fields of research

NASA Astrophysics Data System (ADS)

Miwa, Sayaka; Ando, Satoko

Research fronts analysis identifies emerging areas of research through observing co-clustering in highly-cited papers. This article introduces the concept of research fronts analysis, explains its methodology and provides case examples. It also demonstrates developing research fronts in Japan by looking at the past winners of Thomson Reuters Research Fronts Awards. Research front analysis is currently being used by the Japanese government to determine new trends in science and technology. Information professionals can also utilize this bibliometric as a research evaluation tool.

Non-target time trend screening: a data reduction strategy for detecting emerging contaminants in biological samples.

PubMed

Plassmann, Merle M; Tengstrand, Erik; Åberg, K Magnus; Benskin, Jonathan P

2016-06-01

Non-targeted mass spectrometry-based approaches for detecting novel xenobiotics in biological samples are hampered by the occurrence of naturally fluctuating endogenous substances, which are difficult to distinguish from environmental contaminants. Here, we investigate a data reduction strategy for datasets derived from a biological time series. The objective is to flag reoccurring peaks in the time series based on increasing peak intensities, thereby reducing peak lists to only those which may be associated with emerging bioaccumulative contaminants. As a result, compounds with increasing concentrations are flagged while compounds displaying random, decreasing, or steady-state time trends are removed. As an initial proof of concept, we created artificial time trends by fortifying human whole blood samples with isotopically labelled standards. Different scenarios were investigated: eight model compounds had a continuously increasing trend in the last two to nine time points, and four model compounds had a trend that reached steady state after an initial increase. Each time series was investigated at three fortification levels and one unfortified series. Following extraction, analysis by ultra performance liquid chromatography high-resolution mass spectrometry, and data processing, a total of 21,700 aligned peaks were obtained. Peaks displaying an increasing trend were filtered from randomly fluctuating peaks using time trend ratios and Spearman's rank correlation coefficients. The first approach was successful in flagging model compounds spiked at only two to three time points, while the latter approach resulted in all model compounds ranking in the top 11 % of the peak lists. Compared to initial peak lists, a combination of both approaches reduced the size of datasets by 80-85 %. Overall, non-target time trend screening represents a promising data reduction strategy for identifying emerging bioaccumulative contaminants in biological samples. Graphical abstract

Trends in emerging and high risk activities

Treesearch

Robert C. White; Richard Schreyer; Kent Downing

1980-01-01

Newly emerging and high risk activities have increased markedly in the last generation, yet little is known about trends in participation. Factors such as technological innovation and creative experimentation with traditional activities appear to play a major role in the development of new activities. Christy's criteria for mass demand in recreation are used to...

Characteristics and trends of emergency patients with drug overdose in Osaka

PubMed Central

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

2015-01-01

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

Physician's emerging roles relating to trends in health information technology.

PubMed

David Johnson, J

2014-08-12

Objective: To determine the new roles that physicians will adopt in the near future to adjust to accelerating trends from managed care to outcome-based practice to health care reform to health information technology to the evolving role of health consumers. Methods: Trends and related developments concerning the changing roles of physicians based on prior literature reviews. Results: Six possible roles, traditional, gatekeeper, coach, navigator, informatician and one voice among many, are discussed in terms of physician's centrality, patient autonomy, decision-making and uncertainty, information seeking, satisfaction and outcomes, particularly those related to compliance. Conclusion: A greater understanding of these emerging roles could lead to more efficacious outcomes in our ever changing, increasingly complex medical system. Patients often have little understanding of emerging trends that lead to the development of specialized roles such as hospitalist and navigators and, relatedly, the evolving roles of physicians.

The Detection of Emerging Trends Using Wikipedia Traffic Data and Context Networks.

PubMed

Kämpf, Mirko; Tessenow, Eric; Kenett, Dror Y; Kantelhardt, Jan W

2015-01-01

Can online media predict new and emerging trends, since there is a relationship between trends in society and their representation in online systems? While several recent studies have used Google Trends as the leading online information source to answer corresponding research questions, we focus on the online encyclopedia Wikipedia often used for deeper topical reading. Wikipedia grants open access to all traffic data and provides lots of additional (semantic) information in a context network besides single keywords. Specifically, we suggest and study context-normalized and time-dependent measures for a topic's importance based on page-view time series of Wikipedia articles in different languages and articles related to them by internal links. As an example, we present a study of the recently emerging Big Data market with a focus on the Hadoop ecosystem, and compare the capabilities of Wikipedia versus Google in predicting its popularity and life cycles. To support further applications, we have developed an open web platform to share results of Wikipedia analytics, providing context-rich and language-independent relevance measures for emerging trends.

The Detection of Emerging Trends Using Wikipedia Traffic Data and Context Networks

PubMed Central

Kämpf, Mirko; Tessenow, Eric; Kenett, Dror Y.; Kantelhardt, Jan W.

2015-01-01

Can online media predict new and emerging trends, since there is a relationship between trends in society and their representation in online systems? While several recent studies have used Google Trends as the leading online information source to answer corresponding research questions, we focus on the online encyclopedia Wikipedia often used for deeper topical reading. Wikipedia grants open access to all traffic data and provides lots of additional (semantic) information in a context network besides single keywords. Specifically, we suggest and study context-normalized and time-dependent measures for a topic’s importance based on page-view time series of Wikipedia articles in different languages and articles related to them by internal links. As an example, we present a study of the recently emerging Big Data market with a focus on the Hadoop ecosystem, and compare the capabilities of Wikipedia versus Google in predicting its popularity and life cycles. To support further applications, we have developed an open web platform to share results of Wikipedia analytics, providing context-rich and language-independent relevance measures for emerging trends. PMID:26720074

Using spatial statistics to identify emerging hot spots of forest loss

NASA Astrophysics Data System (ADS)

Harris, Nancy L.; Goldman, Elizabeth; Gabris, Christopher; Nordling, Jon; Minnemeyer, Susan; Ansari, Stephen; Lippmann, Michael; Bennett, Lauren; Raad, Mansour; Hansen, Matthew; Potapov, Peter

2017-02-01

As sources of data for global forest monitoring grow larger, more complex and numerous, data analysis and interpretation become critical bottlenecks for effectively using them to inform land use policy discussions. Here in this paper, we present a method that combines big data analytical tools with Emerging Hot Spot Analysis (ArcGIS) to identify statistically significant spatiotemporal trends of forest loss in Brazil, Indonesia and the Democratic Republic of Congo (DRC) between 2000 and 2014. Results indicate that while the overall rate of forest loss in Brazil declined over the 14-year time period, spatiotemporal patterns of loss shifted, with forest loss significantly diminishing within the Amazonian states of Mato Grosso and Rondônia and intensifying within the cerrado biome. In Indonesia, forest loss intensified in Riau province in Sumatra and in Sukamara and West Kotawaringin regencies in Central Kalimantan. Substantial portions of West Kalimantan became new and statistically significant hot spots of forest loss in the years 2013 and 2014. Similarly, vast areas of DRC emerged as significant new hot spots of forest loss, with intensified loss radiating out from city centers such as Beni and Kisangani. While our results focus on identifying significant trends at the national scale, we also demonstrate the scalability of our approach to smaller or larger regions depending on the area of interest and specific research question involved. When combined with other contextual information, these statistical data models can help isolate the most significant clusters of loss occurring over dynamic forest landscapes and provide more coherent guidance for the allocation of resources for forest monitoring and enforcement efforts.

Emerging Trends of Research on Transfer of Learning

ERIC Educational Resources Information Center

Subedi, Bhawani Shankar

2004-01-01

The terms "transfer of learning" and "transfer of training" are usually found mutually exclusive in training and development literature. Transfer is a key concept in adult learning theories because most education and training aspires to transfer. The end goals of training and education are not achieved unless transfer occurs. Emerging trends of…

Emerging and continuing trends in psychotherapy: views from an editor's eye.

PubMed

Gelso, Charles J

2011-06-01

It is proposed that six major trends in psychotherapy have continued or emerged over the course of the author's editorship of Psychotherapy, the past seven years. These trends are (a) the increasing integration of techniques and the therapeutic relationship; (b) increasing focus on theoretical integration; (c) increasing efforts at research-practice integration; (d) increases in more specific, integrative reviews; (e) integration of biological, neuroscience understandings; and (f) integration of diversity and cultural considerations into psychotherapy. Each trend is described and its impact on the field is discussed. Cautions about each trend are also noted. The six trends are discussed in the context of integration.

New trends in emerging pathogens.

PubMed

Skovgaard, Niels

2007-12-15

The emergence of pathogens is the result of a number of impact in all parts of the food chain. The emerging technologies in food production explain how new pathogens can establish themselves in the food chain and compromise food safety. The impact of the food technology is analysed for several bacteria, such as Yersinia, Campylobacter, Arcobacter, Helicobacter pullorum, Enterobacter sakazakii, Mycobacterium avium spp. paratuberculosis, prions related to vCJD and others. The importance of the ability of many microbes to form VBNC forms is elaborated on. Research on culture independent methods may address this outstanding issue to the better understanding of emerging pathogens. The "demerging" of pathogens also occur, and examples of this are explained. The reaction of bacteria to stresses and sublethal treatments, and how exposure to one stress factor can confer resistance to other stresses, literally speaking causing contagious resistance, are explained. The implication of this e.g. in modern approaches of food preservation, such as Minimally processed Foods, is considerable. Intestinal colonization of EHEC may be regulated by Quorum sensing, and this ability of microbes plays an important role in the colonization of microbes in food and on food processing equipment, an important factor in the emergence of pathogens. The emergence of Saccharomyces cerevisiae, as an opportunistic human pathogen, used for centuries for food and production of alcoholic beverages, calls for research in molecular tools to distinguish between probiotic and clinical strains. Cyclospora cayetanensis and Norovirus outbreaks can no longer be designated as emerging pathogens, they share however one characteristic in the epidemiology of emerging nature, the importance of the hygiene in the primary production stage, including supply of potable water, and the application of GMP and the HACCP principles in the beginning of the food chain. Hepatitis E virus is a potential emerging food borne

Emerging trends in salmonid RAS - Part II. System enhancements

USDA-ARS?s Scientific Manuscript database

Dozens of land-based, closed containment systems are coming on line to produce salmon. New projects are bringing new principles into the salmon industry. Depuration systems maximize the removal of earthy and musty flavors in harvested fish. An emerging trend has been to apply technologies that incre...

Food habits of the Egyptians: newly emerging trends.

PubMed

Hassan-Wassef, H

2004-11-01

Accelerated changes are taking place in the food habits of the present day Egyptians. Examples are drawn from foods that continue to be consumed by those considered guardians of the Egyptian tradition (Coptic Christians and isolated farming communities) and from interpretation of archaeological evidence. Recent decades have witnessed the progressive erosion of the traditional Egyptian diet and the introduction of new foods and eating habits. Sociocultural and economic changes are accelerating this erosion. The main features of the traditional Egyptian way of eating are presented along with a review of the emerging trends and of some of the important factors underlying food consumption patterns. Attention is drawn to the potential risk to health that these new trends represent, in particular to child nutrition and development.

Distance Education Programs in Social Work: Current and Emerging Trends

ERIC Educational Resources Information Center

Vernon, Robert; Vakalahi, Halaevalu; Pierce, Dean; Pittman-Munke, Peggy; Adkins, Lynn Frantz

2009-01-01

This article reports on current and emerging trends in the use of distance education technologies in social work education. Areas studied include the extent of distance education programs, curricular areas covered, technologies used, pedagogical approaches, intentions for degree-program development, sources of pressure to adopt distance education…

Identifying trends in climate: an application to the cenozoic

NASA Astrophysics Data System (ADS)

Richards, Gordon R.

1998-05-01

The recent literature on trending in climate has raised several issues, whether trends should be modeled as deterministic or stochastic, whether trends are nonlinear, and the relative merits of statistical models versus models based on physics. This article models trending since the late Cretaceous. This 68 million-year interval is selected because the reliability of tests for trending is critically dependent on the length of time spanned by the data. Two main hypotheses are tested, that the trend has been caused primarily by CO2 forcing, and that it reflects a variety of forcing factors which can be approximated by statistical methods. The CO2 data is obtained from model simulations. Several widely-used statistical models are found to be inadequate. ARIMA methods parameterize too much of the short-term variation, and do not identify low frequency movements. Further, the unit root in the ARIMA process does not predict the long-term path of temperature. Spectral methods also have little ability to predict temperature at long horizons. Instead, the statistical trend is estimated using a nonlinear smoothing filter. Both of these paradigms make it possible to model climate as a cointegrated process, in which temperature can wander quite far from the trend path in the intermediate term, but converges back over longer horizons. Comparing the forecasting properties of the two trend models demonstrates that the optimal forecasting model includes CO2 forcing and a parametric representation of the nonlinear variability in climate.

Is it possible to identify a trend in problem/failure data

NASA Technical Reports Server (NTRS)

Church, Curtis K.

1990-01-01

One of the major obstacles in identifying and interpreting a trend is the small number of data points. Future trending reports will begin with 1983 data. As the problem/failure data are aggregated by year, there are just seven observations (1983 to 1989) for the 1990 reports. Any statistical inferences with a small amount of data will have a large degree of uncertainty. Consequently, a regression technique approach to identify a trend is limited. Though trend determination by failure mode may be unrealistic, the data may be explored for consistency or stability and the failure rate investigated. Various alternative data analysis procedures are briefly discussed. Techniques that could be used to explore problem/failure data by failure mode are addressed. The data used are taken from Section One, Space Shuttle Main Engine, of the Calspan Quarterly Report dated April 2, 1990.

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

PubMed

Gottlieb, Michael; Riddell, Jeff; Njie, Abdoulie

2017-01-01

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

Temporal factors in violence related injuries--An 11 year trend analysis of violence-related injuries from a Swiss Emergency Department.

PubMed

Clément, Nicolas; Businger, Adrian; Lindner, Gregor; Müller, Wolfgang P; Hüsler, J; Zimmermann, Heinz; Exadaktylos, Aristomenis K

2012-12-01

Injury from interpersonal violence is a major social and medical problem in the industrialized world. Little is known about the trends in prevalence and injury pattern or about the demographic characteristics of the patients involved. In this retrospective analysis, we screened the database of the Emergency Department of a large university hospital for all patients who were admitted for injuries due to interpersonal violence over an 11 year period. For all patients identified, we gathered data on age, country of origin, quality of injury, and hospitalization or outpatient management. A trend analysis was performed using Kendall's tau-b correlation coefficients for regression analysis. The overall number of patients admitted to our Emergency Department remained stable over the study period. Non-Swiss nationals were overrepresented in comparison to the demographics of the region where the study was conducted. There was a trend toward a more severe pattern of injury, such as an increase in the number of severe head injuries. Although the overall number of patients remained stable over the study period, there was an alarming trend toward a more severe pattern of injury, expressed by an increase in severe head traumas.

Emerging Trends in Science Education in a Dynamic Academic Environment

ERIC Educational Resources Information Center

Avwiri, H. E.

2016-01-01

Emerging Trends in Science Education in a Dynamic Academic Environment highlights the changes that have occurred in science education particularly in institutions of higher learning in southern Nigeria. Impelled by the fact that most Nigerian Universities and Colleges of Education still adhere to the practices and teaching methodologies of the…

A discrete wavelet spectrum approach for identifying non-monotonic trends in hydroclimate data

NASA Astrophysics Data System (ADS)

Sang, Yan-Fang; Sun, Fubao; Singh, Vijay P.; Xie, Ping; Sun, Jian

2018-01-01

The hydroclimatic process is changing non-monotonically and identifying its trends is a great challenge. Building on the discrete wavelet transform theory, we developed a discrete wavelet spectrum (DWS) approach for identifying non-monotonic trends in hydroclimate time series and evaluating their statistical significance. After validating the DWS approach using two typical synthetic time series, we examined annual temperature and potential evaporation over China from 1961-2013 and found that the DWS approach detected both the warming and the warming hiatus in temperature, and the reversed changes in potential evaporation. Further, the identified non-monotonic trends showed stable significance when the time series was longer than 30 years or so (i.e. the widely defined climate timescale). The significance of trends in potential evaporation measured at 150 stations in China, with an obvious non-monotonic trend, was underestimated and was not detected by the Mann-Kendall test. Comparatively, the DWS approach overcame the problem and detected those significant non-monotonic trends at 380 stations, which helped understand and interpret the spatiotemporal variability in the hydroclimatic process. Our results suggest that non-monotonic trends of hydroclimate time series and their significance should be carefully identified, and the DWS approach proposed has the potential for wide use in the hydrological and climate sciences.

Fracture trends identified by ERTS-1 imagery in Utah and Nevada

NASA Technical Reports Server (NTRS)

Jensen, M. L. (Principal Investigator); Erickson, M. P.; Smith, M. R.

1973-01-01

The author has identified the following significant results. In the Utah-Nevada area, linear structural trends recorded on ERTS-1 imagery conform in part to previously recognized structures. In addition, the ERTS-1 imagery reveals cryptic structures not previously identified and not readily apparent in other imagery. These structures are illustrated by prominent east-west trending structures which appear to be concentrated in pre-volcanic rocks. This suggests that the structures are older than many of those with other trends which are equally prominent in volcanic and non-volcanic terrain. Since the older east-west structures may have controlled early Tertiary emplacement of magma or the ascent of mineralizing fluids, their recognition is important in minerial exploration. Soil-gas sampling and analysis for mercury content is being continued over structures, and projected trends of buried structures which appear, from studies of ERTS-1 imagery, to be favorable to mineralization. Comparison of ERTS-1 and Skylab imagery indicated that ERTS-1 imagery records more previously unrecognized linear structures than the Skylab imagery. In differentiating and identifying different rock types, the Skylab imagery appears to be more effective.

Trends in Instructional Technology and Distance Education.

ERIC Educational Resources Information Center

Abromitis, Jacky

This paper discusses trends in instructional technology and distance education (ITDE). The most notable trends are the lack of funding and resources for technology training, the lack of administrative support for ITDE issues, and faculty who are reluctant to adopt technology and distance learning. This paper identifies seven emerging trends as…

Center for Corporate Climate Leadership: Emerging Trends in Supply Chain Emissions Engagement

EPA Pesticide Factsheets

This report discusses emerging trends over the last decade in companies’ ability to manage their supply chain greenhouse gas emissions and focuses on how leading companies are engaging their suppliers in order to quantify the full impact of businesses

The Use of Citation Counting to Identify Research Trends

ERIC Educational Resources Information Center

Rothman, Harry; Woodhead, Michael

1971-01-01

The analysis and application of manpower statistics to identify some long-term international research trends in economic entomology and pest conrol are described. Movements in research interests, particularly towards biological methods of control, correlations between these sectors, and the difficulties encountered in the construction of a…

Men and Cosmetics: Social and Psychological Trends of an Emerging Demographic.

PubMed

Rieder, Evan A; Mu, Euphemia W; Brauer, Jeremy A

2015-09-01

Though still accounting for a small fraction of all cosmetic procedures in the United States, men are an emerging and rapidly expanding demographic in the field of aesthetic medicine. In this article we highlight the trends contributing to the rise of male aesthetic procedures in dermatology, touching on social influences, psychological motivations, and treatment outcomes.

Critical differences between elective and emergency surgery: identifying domains for quality improvement in emergency general surgery.

PubMed

Columbus, Alexandra B; Morris, Megan A; Lilley, Elizabeth J; Harlow, Alyssa F; Haider, Adil H; Salim, Ali; Havens, Joaquim M

2018-04-01

The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed. Using a grounded theory approach, emergency general surgery providers were recruited through purposive-criterion-based sampling to participate in semi-structured interviews and focus groups. Participants were asked to identify contributors to emergency general surgery outcomes, to define effective care for EGS patients, and to describe operating room team structure. Interviews were performed to thematic saturation. Transcripts were iteratively coded and analyzed within and across cases to identify emergent themes. Member checking was performed to establish credibility of the findings. A total of 40 participants from 5 academic hospitals participated in either individual interviews (n = 25 [9 anesthesia, 12 surgery, 4 nursing]) or focus groups (n = 2 [15 nursing]). Emergency general surgery was characterized by an exceptionally high level of variability, which can be subcategorized as patient-variability (acute physiology and comorbidities) and system-variability (operating room resources and workforce). Multidisciplinary communication is identified as a modifier to variability in emergency general surgery; however, nursing is often left out of early communication exchanges. Critical variability in emergency general surgery may impact outcomes. Patient-variability and system-variability, with focus on multidisciplinary communication, represent potential domains for quality improvement in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

Emerging trends and new developments in regenerative medicine: a scientometric update (2000 - 2014).

PubMed

Chen, Chaomei; Dubin, Rachael; Kim, Meen Chul

2014-09-01

Our previous scientometric review of regenerative medicine provides a snapshot of the fast-growing field up to the end of 2011. The new review identifies emerging trends and new developments appearing in the literature of regenerative medicine based on relevant articles and reviews published between 2000 and the first month of 2014. Multiple datasets of publications relevant to regenerative medicine are constructed through topic search and citation expansion to ensure adequate coverage of the field. Networks of co-cited references representing the literature of regenerative medicine are constructed and visualized based on a combined dataset of 71,393 articles published between 2000 and 2014. Structural and temporal dynamics are identified in terms of most active topical areas and cited references. New developments are identified in terms of newly emerged clusters and research areas. Disciplinary-level patterns are visualized in dual-map overlays. While research in induced pluripotent stem cells remains the most prominent area in the field of regenerative medicine, research related to clinical and therapeutic applications in regenerative medicine has experienced a considerable growth. In addition, clinical and therapeutic developments in regenerative medicine have demonstrated profound connections with the induced pluripotent stem cell research and stem cell research in general. A rapid adaptation of graphene-based nanomaterials in regenerative medicine is evident. Both basic research represented by stem cell research and application-oriented research typically found in tissue engineering are now increasingly integrated in the scientometric landscape of regenerative medicine. Tissue engineering is an interdisciplinary field in its own right. Advances in multiple disciplines such as stem cell research and graphene research have strengthened the connections between tissue engineering and regenerative medicine.

Socioeconomic factors and mortality in emergency general surgery: trends over a 20-year period.

PubMed

Armenia, Sarah J; Pentakota, Sri Ram; Merchant, Aziz M

2017-05-15

Socioeconomic factors such as race, insurance, and income quartiles have been identified as independent risk factors in emergency general surgery (EGS), but this impact has not been studied over time. We sought to identify trends in disparities in EGS-related operative mortality over a 20-y period. The National Inpatient Sample was used to identify patient encounters coded for EGS in 1993, 2003, and 2013. Logistic regression models were used to examine the adjusted relationship between race, primary payer status, and median income quartiles and in-hospital mortality after adjusting for patients' age, gender, Elixhauser comorbidity score, and hospital region, size, and location-cum-teaching status. We identified 391,040 patient encounters. In 1993, Black race was associated with higher odds of in-hospital mortality (odds ratio [95% confidence interval]: 1.35 [1.20-1.53]) than White race, although this difference dissipated in subsequent years. Medicare, Medicaid, and underinsured patients had a higher odds of mortality than those with private insurance for the entire 20-y period; only the disparity in the underinsured decreased over time (1993, 1.63 [1.35-1.98]; 2013, 1.41 [1.20-1.67]). In 2003 (1.23 [1.10-1.38]) and 2013 (1.23 [1.11-1.37]), patients from the lowest income quartile were more likely to die after EGS than patients from the highest income quartile. Socioeconomic disparities in EGS-related operative morality followed inconsistent trends. Over time, while gaps in in-hospital mortality among Blacks and Whites have narrowed, disparities among patients belonging to lowest income quartile have worsened. Medicare and Medicaid beneficiaries continued to experience higher odds of in-hospital mortality relative to those with private insurance. Copyright © 2017 Elsevier Inc. All rights reserved.

Global Trends in Language Learning in the 21st Century

ERIC Educational Resources Information Center

Eaton, Sarah Elaine

2010-01-01

Today's language classroom is vastly different from that of the mid- to late 20th century. The study is a meta-analysis of recent research which provided the means to identify current and emerging trends in the field. Informed by this research, some identified trends that are shaping the 21st century language classroom are outdated practices such…

Trends in Nationwide Herpes Zoster Emergency Department Utilization From 2006 to 2013.

PubMed

Dommasch, Erica D; Joyce, Cara J; Mostaghimi, Arash

2017-09-01

The effect of vaccination on emergency department (ED) utilization for herpes zoster (HZ) has not been examined to date. To determine trends in US ED utilization and costs associated with HZ. The Nationwide Emergency Department Sample data set was examined for temporal trends in the number of visits and costs for treatment of HZ in EDs in the United States from January 1, 2006, through December 31, 2013. Cases of HZ were identified using validated International Classification of Diseases, Ninth Revision-Clinical Modification diagnosis codes. Patients were stratified by age: less than 20 years (varicella vaccine recommended), 20 to 59 years (no vaccine recommended), and 60 years or older (HZ vaccine recommended). Population-based rates were estimated using sampling weights. Population-based incidence rates of HZ-related ED visits, charge for ED services, and total charges. A total of 1 350 957 ED visits for HZ were identified between 2006 and 2013, representing 0.13% of all US ED visits. Of these patients, 563 200 (51.7%) were male; mean (SE) age was 54.0 (0.1) years. Between 2006 and 2013, the percentage of HZ-related ED visits increased from 0.13% to 0.14% (8.3%). This growth was driven by patients aged 20 to 59 years (increase of 22.8% [from 0.12% to 0.14% of ED visits]) while the proportion of ED HZ visits decreased for patients aged less than 20 years and 60 years or older, from 0.03% to 0.02% (-39.6%) and from 0.28% to 0.25% (-10.9%), respectively. For all age groups, there was an increase from 2006 to 2013 in overall adjusted total (from $92.83 to $202.47 million) and mean charges (from $763 to $1262) for HZ-related ED visits. The number of ED visits and total cost associated with HZ increased between 2006 and 2013. Greater use was driven by an increased number of visits by patients aged 20 to 59 years, but populations recommended for vaccination (<20 and ≥60 years) demonstrated decreased ED utilization. Per-visit and total costs increased across all

Role of Pediatric Emergency Physicians in Identifying Bullying.

PubMed

Waseem, Muhammad; Paul, Audrey; Schwartz, Gerald; Pauzé, Denis; Eakin, Paul; Barata, Isabel; Holtzman, Doug; Benjamin, Lee S; Wright, Joseph L; Nickerson, Amanda B; Joseph, Madeline

2017-02-01

Bullying is an important public health issue with broad implications. Although this issue has been studied extensively, there is limited emergency medicine literature addressing bullying. The emergency department (ED) physician has a unique opportunity to identify children and adolescents that are victims of bullying, and make a difference in their lives. Our aim is to discuss the role of the emergency physician (EP) in identifying patients who have been victims of bullying and how to provide effective management as well as referral for further resources. This document provides a framework for recognizing, stabilizing, and managing children who have experienced bullying. With the advent of social media, bullying behavior is not limited to in-person situations, and often occurs via electronic communication, further complicating recognition because it may not impart any physical harm to the child. Recognition of bullying requires a high level of suspicion, as patients may not offer this history. After the stabilization of any acute or overt indications of physical injury, along with obtaining a history of the mechanism of injury, the EP has the opportunity to identify the existence of bullying as the cause of the injury, and can address the issue in the ED while collaborating with "physician-extenders," such as social workers, toward identifying local resources for further support. The ED is an important arena for the assessment and management of children who have experienced bullying. It is imperative that EPs on the front lines of patient care address this public health epidemic. They have the opportunity to exert a positive impact on the lives of the children and families who are the victims of bullying. Copyright © 2016 Elsevier Inc. All rights reserved.

Current trends in gamma radiation detection for radiological emergency response

NASA Astrophysics Data System (ADS)

Mukhopadhyay, Sanjoy; Guss, Paul; Maurer, Richard

2011-09-01

Passive and active detection of gamma rays from shielded radioactive materials, including special nuclear materials, is an important task for any radiological emergency response organization. This article reports on the current trends and status of gamma radiation detection objectives and measurement techniques as applied to nonproliferation and radiological emergencies. In recent years, since the establishment of the Domestic Nuclear Detection Office by the Department of Homeland Security, a tremendous amount of progress has been made in detection materials (scintillators, semiconductors), imaging techniques (Compton imaging, use of active masking and hybrid imaging), data acquisition systems with digital signal processing, field programmable gate arrays and embedded isotopic analysis software (viz. gamma detector response and analysis software [GADRAS]1), fast template matching, and data fusion (merging radiological data with geo-referenced maps, digital imagery to provide better situational awareness). In this stride to progress, a significant amount of inter-disciplinary research and development has taken place-techniques and spin-offs from medical science (such as x-ray radiography and tomography), materials engineering (systematic planned studies on scintillators to optimize several qualities of a good scintillator, nanoparticle applications, quantum dots, and photonic crystals, just to name a few). No trend analysis of radiation detection systems would be complete without mentioning the unprecedented strategic position taken by the National Nuclear Security Administration (NNSA) to deter, detect, and interdict illicit trafficking in nuclear and other radioactive materials across international borders and through the global maritime transportation-the so-called second line of defense.

A scientometric review of emerging trends and new developments in agricultural ecological compensation.

PubMed

He, Ke; Zhang, Junbiao; Wang, Xueting; Zeng, Yangmei; Zhang, Lu

2018-05-08

Agricultural ecological compensation has drawn an increasingly broad range of interest since early 1990s. In recent years, the volume of the literature grows rapidly. As a result, a systematic review of the diverse research field and its current trends becomes essential. This paper surveys the literature of agricultural ecological compensation between 1990 and 2016. Specifically, by employing CiteSpace information visualization software, we firstly identified the research hotspots and evolution path and then illustrated the frontier and developing trend of the domain in core and broader perspectives. It is found that the focus of the academic community has always been researches on the theoretical policy and application of the payment for agro-ecosystem services, agricultural ecological compensation based on contingent valuation method, and ecological compensation of farmland landscape and organic food production as well as willingness to accept/pay for land use and ecological protection. Meanwhile, we also found that, in recent years, qualitative research has received more and more attention in the field of agricultural ecological compensation, since global warming, agricultural carbon emissions, and other emerging environmental issues have aroused widespread concern of the people around the world. Moreover, we believed that more and more scholars will employ case study methodology to analyze agricultural ecological compensation in specific systems, regions, or circumstances in the future.

Trends in short-stay hospitalizations for older adults from 1990 to 2010: implications for geriatric emergency care.

PubMed

Greenwald, Peter W; Stern, Michael E; Rosen, Tony; Clark, Sunday; Flomenbaum, Neal

2014-04-01

Geriatric patients are more likely than younger patients to be admitted to the hospital when they present to the emergency department (ED). Identifying trends in geriatric short-stay admission may inform the development of interventions designed to improve acute care for the elderly. To evaluate trends in US geriatric short-stay hospitalizations from 1990 to 2010. Retrospective study using the National Hospital Discharge Survey (NHDS). Trends in short-stay hospitalizations were analyzed from 1990 to 2010 for age groups 22 to 64, 65 to 74, 75 to 84, and at least 85 years using linear regression. A total of 4.5 million survey visits representing 580 million adult hospitalizations were available for analysis; 250 million (43%) were among patients 65 years or older. Of these, 12%, 25%, and 40% were ≤ 1, ≤ 2 and ≤ 3 days' short-stay admissions, respectively. Between 1990 and 2010, short-stay admissions increased as a percentage of total hospitalizations for each geriatric age group but remained relatively constant for younger adults. Admissions from NHDS were similar to admissions from the ED for years where ED-specific data were available. The older a patient was (age >65 years), the more likely their admission was to have started in the ED. For all elderly patients, short-stay admissions represented a growing proportion of total admissions, regardless of the definition of short stay. These trends were identified despite the NHDS exclusion of observation status hospitalizations. The increase in short-stay admissions was the most pronounced in the extreme elderly (age ≥ 85 years). Future research is needed to optimize treatment for geriatric patients presenting to the ED, some of whom, with brief observation and appropriate follow-up, may be better cared for without hospitalization. Copyright © 2014 Elsevier Inc. All rights reserved.

Emerging Trends in the Development of School Networking Initiatives. Perspectives on Distance Education

ERIC Educational Resources Information Center

Naidoo, Vis, Ed.; Ramzy, Heba, Ed.

2004-01-01

This collection of research and case studies provides snapshots of developments in school networking in seven regions of the world, and focuses on the variety of school networking models that have emerged in different regions and the resulting trends and issues that need to be considered in terms of supporting the learning, teaching, management…

Temporal effects in trend prediction: identifying the most popular nodes in the future.

PubMed

Zhou, Yanbo; Zeng, An; Wang, Wei-Hong

2015-01-01

Prediction is an important problem in different science domains. In this paper, we focus on trend prediction in complex networks, i.e. to identify the most popular nodes in the future. Due to the preferential attachment mechanism in real systems, nodes' recent degree and cumulative degree have been successfully applied to design trend prediction methods. Here we took into account more detailed information about the network evolution and proposed a temporal-based predictor (TBP). The TBP predicts the future trend by the node strength in the weighted network with the link weight equal to its exponential aging. Three data sets with time information are used to test the performance of the new method. We find that TBP have high general accuracy in predicting the future most popular nodes. More importantly, it can identify many potential objects with low popularity in the past but high popularity in the future. The effect of the decay speed in the exponential aging on the results is discussed in detail.

Temporal Effects in Trend Prediction: Identifying the Most Popular Nodes in the Future

PubMed Central

Zhou, Yanbo; Zeng, An; Wang, Wei-Hong

2015-01-01

Prediction is an important problem in different science domains. In this paper, we focus on trend prediction in complex networks, i.e. to identify the most popular nodes in the future. Due to the preferential attachment mechanism in real systems, nodes’ recent degree and cumulative degree have been successfully applied to design trend prediction methods. Here we took into account more detailed information about the network evolution and proposed a temporal-based predictor (TBP). The TBP predicts the future trend by the node strength in the weighted network with the link weight equal to its exponential aging. Three data sets with time information are used to test the performance of the new method. We find that TBP have high general accuracy in predicting the future most popular nodes. More importantly, it can identify many potential objects with low popularity in the past but high popularity in the future. The effect of the decay speed in the exponential aging on the results is discussed in detail. PMID:25806810

Trends in NRMP Data from 2007-2014 for U.S. Seniors Matching into Emergency Medicine.

PubMed

Manthey, David E; Hartman, Nicholas D; Newmyer, Aileen; Gunalda, Jonah C; Hiestand, Brian C; Askew, Kim L; Lefebvre, Cedric

2017-01-01

Since 1978, the National Residency Matching Program (NRMP) has published data demonstrating characteristics of applicants who have matched into their preferred specialty in the NRMP main residency match. These data have been published approximately every two years. There is limited information about trends within these published data for students matching into emergency medicine (EM). Our objective was to investigate and describe trends in NRMP data to include the following: the ratio of applicants to available EM positions; United State Medical Licensing Examination (USMLE) Step 1 and Step 2 scores (compared to the national means); number of programs ranked; and Alpha Omega Alpha Honor Medical Society (AOA) membership among U.S. seniors matching into EM. This was a retrospective observational review of NRMP data published between 2007 and 2016. We analyzed the data using analysis of variance (ANOVA) or Kruskal-Wallis testing, and Fischer's exact or chi-squared testing, as appropriate to determine statistical significance. The ratio of applicants to available EM positions remained essentially stable from 2007 to 2014 but did increase slightly in 2016. We observed a net upward trend in overall Step 1 and Step 2 scores for EM applicants. However, this did not outpace the national trend increase in Step 1 and 2 scores overall. There was an increase in the mean number of programs ranked by EM applicants over the years studied from 7.8 (SD4.2) to 9.2 (SD5.0, p<0.001), driven predominantly by the cohort of U.S. students successful in the match. Among time intervals, there was a difference in the number of EM applicants with AOA membership (p=0.043) due to a drop in the number of AOA students in 2011. No sustained statistical trend in AOA membership was identified over the seven-year period studied. NRMP data demonstrate trends among EM applicants that are similar to national trends in other specialties for USMLE board scores, and a modest increase in number of programs

Emergency strategies and trends in the management of liver trauma.

PubMed

Jiang, Hongchi; Wang, Jizhou

2012-09-01

The liver is the most frequently injured organ during abdominal trauma. The management of hepatic trauma has undergone a paradigm shift over the past several decades, with mandatory operation giving way to nonoperative treatment. Better understanding of the mechanisms and grade of liver injury aids in the initial assessment and establishment of a management strategy. Hemodynamically unstable patients should undergo focused abdominal sonography for trauma, whereas stable patients may undergo computed tomography, the standard examination protocol. The grade of liver injury alone does not accurately predict the need for operation, and nonoperative management is rapidly becoming popular for high-grade injuries. Hemodynamic instability with positive focused abdominal sonography for trauma and peritonitis is an indicator of the need for emergent operative intervention. The damage control concept is appropriate for the treatment of major liver injuries and is associated with significant survival advantages compared with traditional prolonged surgical techniques. Although surgical intervention for hepatic trauma is not as common now as it was in the past, current trauma surgeons should be familiar with the emergency surgical skills necessary to manage complex hepatic injuries, such as packing, Pringle maneuver, selective vessel ligation, resectional debridement, and parenchymal sutures. The present review presents emergency strategies and trends in the management of liver trauma.

Use of a syndromic surveillance system to describe the trend in cycling-related presentations to emergency departments in Sydney.

PubMed

Dinh, Michael M; Kastelein, Christopher; Bein, Kendall J; Green, Timothy C; Bautovich, Tanya; Ivers, Rebecca

2015-08-01

To describe population-based trends in cycling-related presentations to EDs over the past decade. A retrospective cohort of road trauma patients (motor vehicle, motor cyclist, cyclist and pedestrian) presenting to EDs in the Sydney Greater Metropolitan Area between 2004 and 2013 was obtained using the Public Health Real-time Emergency Department Surveillance System. The outcomes of interest were the cycling-related ED presentation rate per 1000 population, as well as the proportion of cycling-related presentations that died in ED or were admitted to a critical care ward. Trends in ED presentation rates based on presentation counts and Sydney population data were plotted and described. There were 68,438 cycling-related presentations identified, representing 30% of all road trauma patients presenting to EDs in Sydney. There was a 91% increase in cycling-related presentations for the 35 to 64-year-old age group and a 123% increase in cycling-related presentations in the 65-year-old and over age group. All other age groups were associated with a stable or decrease in cycling-related ED presentation rates. The proportion of presentations requiring critical care ward admission or death in ED has decreased by 20%. Using an ED syndromic surveillance system, cycling-related ED presentation rates in Sydney Australia have increased in those aged 35 years and over the past 10 years, with a relative decrease in the proportion of deaths in ED or those requiring critical care admission. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Fracture trends identified by ERTS-1 imagery in Utah and Nevada

NASA Technical Reports Server (NTRS)

Jensen, M. L. (Principal Investigator); Smith, M. R.; Rogers, R. J.

1973-01-01

The author has identified the following significant results. Structures clearly traceable through bed rock are considered most reliable. Continuity, however, is frequently traceable through ranges and across adjoining sedimentary basins where changes in drainage, erosion pattern, soil color, or vegetation suggest that the basin sediments are extremely sensitive to underlying structures. Many large and continuous trends, too smeared by erosion to be visible on the ground or from aircraft photos, become quite evident at the scale of the ERTS-1 images. The study was made with little regard for surface geology. The trends have been retraced to separate and unidirectional sets. These are now being related to surface geology, geophysical studies, volcanic and intrusive centers, and areas of mineralization.

Using Text Analytics of AJPE Article Titles to Reveal Trends In Pharmacy Education Over the Past Two Decades.

PubMed

Pedrami, Farnoush; Asenso, Pamela; Devi, Sachin

2016-08-25

Objective. To identify trends in pharmacy education during last two decades using text mining. Methods. Articles published in the American Journal of Pharmaceutical Education (AJPE) in the past two decades were compiled in a database. Custom text analytics software was written using Visual Basic programming language in the Visual Basic for Applications (VBA) editor of Excel 2007. Frequency of words appearing in article titles was calculated using the custom VBA software. Data were analyzed to identify the emerging trends in pharmacy education. Results. Three educational trends emerged: active learning, interprofessional, and cultural competency. Conclusion. The text analytics program successfully identified trends in article topics and may be a useful compass to predict the future course of pharmacy education.

Identifying Local Hotspots of Pediatric Chronic Diseases Using Emergency Department Surveillance

PubMed Central

Lee, David C.; Yi, Stella S.; Fong, Hiu-Fai; Athens, Jessica K.; Ravenell, Joseph E.; Sevick, Mary Ann; Wall, Stephen P.; Elbel, Brian

2016-01-01

Objective To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. Methods Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available. In addition, we used home addresses to map local variation in pediatric disease burden. Results We identified 549,547 New York City children who visited an emergency department at least once in 2009. Though our sample included more publicly insured and uninsured children, we found moderate to strong correlations of prevalence estimates when compared to health surveys and registry data at pre-specified geographic levels. Strongest correlations were found for asthma and mental health conditions by county among younger children (0.88, p=0.05 and 0.99, p<0.01, respectively). Moderate correlations by neighborhood were identified for obesity and cancer (0.53 and 0.54, p<0.01). Among adolescents, correlations by health districts were strong for obesity (0.95, p=0.05), and depression estimates had a non-significant, but strong negative correlation with suicide attempts (−0.88, p=0.12). Using SaTScan, we also identified local hotspots of pediatric chronic disease. Conclusions For conditions easily identified in claims data, emergency department surveillance may help estimate pediatric chronic disease prevalence with higher geographic resolution. More studies are needed to investigate limitations of these methods and assess reliability of local disease estimates. What’s New This study demonstrated how emergency department surveillance may improve estimates of pediatric disease prevalence with higher geographic resolution. We identified 29% of New York City children with a

Two-Dimensional Nanomaterials for Biomedical Applications: Emerging Trends and Future Prospects.

PubMed

Chimene, David; Alge, Daniel L; Gaharwar, Akhilesh K

2015-12-02

Two-dimensional (2D) nanomaterials are ultrathin nanomaterials with a high degree of anisotropy and chemical functionality. Research on 2D nanomaterials is still in its infancy, with the majority of research focusing on elucidating unique material characteristics and few reports focusing on biomedical applications of 2D nanomaterials. Nevertheless, recent rapid advances in 2D nanomaterials have raised important and exciting questions about their interactions with biological moieties. 2D nanoparticles such as carbon-based 2D materials, silicate clays, transition metal dichalcogenides (TMDs), and transition metal oxides (TMOs) provide enhanced physical, chemical, and biological functionality owing to their uniform shapes, high surface-to-volume ratios, and surface charge. Here, we focus on state-of-the-art biomedical applications of 2D nanomaterials as well as recent developments that are shaping this emerging field. Specifically, we describe the unique characteristics that make 2D nanoparticles so valuable, as well as the biocompatibility framework that has been investigated so far. Finally, to both capture the growing trend of 2D nanomaterials for biomedical applications and to identify promising new research directions, we provide a critical evaluation of potential applications of recently developed 2D nanomaterials. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Temporal trends in emergency department visits for bronchiolitis in the United States, 2006 to 2010.

PubMed

Hasegawa, Kohei; Tsugawa, Yusuke; Brown, David F M; Mansbach, Jonathan M; Camargo, Carlos A

2014-01-01

To examine temporal trends in emergency departments (EDs) visits for bronchiolitis among US children between 2006 and 2010. Serial, cross-sectional analysis of the Nationwide Emergency Department Sample, a nationally representative sample of ED patients. We used International Classification of Diseases, Ninth Revision, Clinical Modification code 466.1 to identify children <2 years of age with bronchiolitis. Primary outcome measures were rate of bronchiolitis ED visits, hospital admission rate and ED charges. Between 2006 and 2010, weighted national discharge data included 1,435,110 ED visits with bronchiolitis. There was a modest increase in the rate of bronchiolitis ED visits, from 35.6 to 36.3 per 1000 person-years (2% increase; Ptrend = 0.008), due to increases in the ED visit rate among children from 12 months to 23 months (24% increase;Ptrend < 0.001). By contrast, there was a significant decline in the ED visit rate among infants (4% decrease; Ptrend < 0.001). Although unadjusted admission rate did not change between 2006 and 2010 (26% in both years), admission rate declined significantly after adjusting for potential patient- and ED-level confounders (adjusted odds ratio for comparison of 2010 with 2006, 0.84; 95% confidence interval: 0.76-0.93; P < 0.001). Nationwide ED charges for bronchiolitis increased from $337 million to $389 million (16% increase; Ptrend < 0.001), adjusted for inflation. This increase was driven by a rise in geometric mean of ED charges per case from $887 to $1059 (19% increase; Ptrend < 0.001). Between 2006 and 2010, we found a divergent temporal trend in the rate of bronchiolitis ED visits by age group. Despite a significant increase in associated ED charges, ED-associated hospital admission rates for bronchiolitis significantly decreased over this same period.

Trends and correlates of cannabis-involved emergency department visits: 2004 to 2011

PubMed Central

Zhu, He; Wu, Li-Tzy

2016-01-01

Objectives To examine trends and correlates of cannabis-involved emergency department (ED) visits in the United States from 2004 to 2011. Methods Data were obtained from the 2004-2011 Drug Abuse Warning Network. We analyzed trend in cannabis-involved ED visits for persons aged ≥12 years and stratified by type of cannabis involvement (cannabis-only, cannabis-polydrug). We used logistic regressions to determine correlates of cannabis-involved hospitalization versus cannabis-involved ED visits only. Results Between 2004 and 2011, the ED visit rate increased from 51 to 73 visits per 100,000 population aged ≥ 12 years for cannabis-only use (P-value for trend=0.004) and from 63 to 100 for cannabis-polydrug use (P-value for trend<0.001). Adolescents aged 12-17 years showed the largest increase in the cannabis-only-involved ED visit rate (Rate difference=80 per 100,000 adolescents). Across racial/ethnic groups, the most prevalent ED visits were noted among non-Hispanic blacks. Among cannabis-involved visits, the odds of hospitalization (versus ED visits only) increased with age strata compared with aged 12-17 years. Conclusions These findings suggest a notable increase in the ED visit numbers and rates for both the use of cannabis-only and cannabis-polydrug during the studied period, particularly among young people and non-Hispanic blacks. PMID:27574753

Attack Methodology Analysis: Emerging Trends in Computer-Based Attack Methodologies and Their Applicability to Control System Networks

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

Bri Rolston

2005-06-01

Threat characterization is a key component in evaluating the threat faced by control systems. Without a thorough understanding of the threat faced by critical infrastructure networks, adequate resources cannot be allocated or directed effectively to the defense of these systems. Traditional methods of threat analysis focus on identifying the capabilities and motivations of a specific attacker, assessing the value the adversary would place on targeted systems, and deploying defenses according to the threat posed by the potential adversary. Too many effective exploits and tools exist and are easily accessible to anyone with access to an Internet connection, minimal technical skills,more » and a significantly reduced motivational threshold to be able to narrow the field of potential adversaries effectively. Understanding how hackers evaluate new IT security research and incorporate significant new ideas into their own tools provides a means of anticipating how IT systems are most likely to be attacked in the future. This research, Attack Methodology Analysis (AMA), could supply pertinent information on how to detect and stop new types of attacks. Since the exploit methodologies and attack vectors developed in the general Information Technology (IT) arena can be converted for use against control system environments, assessing areas in which cutting edge exploit development and remediation techniques are occurring can provide significance intelligence for control system network exploitation, defense, and a means of assessing threat without identifying specific capabilities of individual opponents. Attack Methodology Analysis begins with the study of what exploit technology and attack methodologies are being developed in the Information Technology (IT) security research community within the black and white hat community. Once a solid understanding of the cutting edge security research is established, emerging trends in attack methodology can be identified and the gap

Handbook of Research on Emerging Priorities and Trends in Distance Education: Communication, Pedagogy, and Technology

ERIC Educational Resources Information Center

Yuzer, T. Volkan, Ed.; Eby, Gulsun, Ed.

2014-01-01

With the rise of distance education in the post-modern world, progressive research on the best methods, tools, and technologies in the field is necessary to continue to take advantage of the pedagogical opportunities and improvements offered through remote learning platforms. The "Handbook of Research on Emerging Priorities and Trends in…

Causes and emerging trends of childhood blindness: findings from schools for the blind in Southeast Nigeria.

PubMed

Aghaji, Ada; Okoye, Obiekwe; Bowman, Richard

2015-06-01

To ascertain the causes severe visual impairment and blindness (SVI/BL) in schools for the blind in southeast Nigeria and to evaluate temporal trends. All children who developed blindness at <15 years of age in all the three schools for the blind in southeast Nigeria were examined. All the data were recorded on a WHO/Prevention of Blindness (WHO/PBL) form entered into a Microsoft Access database and transferred to STATA V.12.1 for analysis. To estimate temporal trends in causes of blindness, older (>15 years) children were compared with younger (≤15 years) children. 124 children were identified with SVI/BL. The most common anatomical site of blindness was the lens (33.9%). Overall, avoidable blindness accounted for 73.4% of all blindness. Exploring trends in SVI/BL between children ≤15 years of age and those >15 years old, this study shows a reduction in avoidable blindness but an increase in cortical visual impairment in the younger age group. The results from this study show a statistically significant decrease in avoidable blindness in children ≤15 years old. Corneal blindness appears to be decreasing but cortical visual impairment seems to be emerging in the younger age group. Appropriate strategies for the prevention of avoidable childhood blindness in Nigeria need to be developed and implemented. 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.

Automated data extraction from general practice records in an Australian setting: trends in influenza-like illness in sentinel general practices and emergency departments.

PubMed

Liljeqvist, Gösta T H; Staff, Michael; Puech, Michele; Blom, Hans; Torvaldsen, Siranda

2011-06-06

Influenza intelligence in New South Wales (NSW), Australia is derived mainly from emergency department (ED) presentations and hospital and intensive care admissions, which represent only a portion of influenza-like illness (ILI) in the population. A substantial amount of the remaining data lies hidden in general practice (GP) records. Previous attempts in Australia to gather ILI data from GPs have given them extra work. We explored the possibility of applying automated data extraction from GP records in sentinel surveillance in an Australian setting.The two research questions asked in designing the study were: Can syndromic ILI data be extracted automatically from routine GP data? How do ILI trends in sentinel general practice compare with ILI trends in EDs? We adapted a software program already capable of automated data extraction to identify records of patients with ILI in routine electronic GP records in two of the most commonly used commercial programs. This tool was applied in sentinel sites to gather retrospective data for May-October 2007-2009 and in real-time for the same interval in 2010. The data were compared with that provided by the Public Health Real-time Emergency Department Surveillance System (PHREDSS) and with ED data for the same periods. The GP surveillance tool identified seasonal trends in ILI both retrospectively and in near real-time. The curve of seasonal ILI was more responsive and less volatile than that of PHREDSS on a local area level. The number of weekly ILI presentations ranged from 8 to 128 at GP sites and from 0 to 18 in EDs in non-pandemic years. Automated data extraction from routine GP records offers a means to gather data without introducing any additional work for the practitioner. Adding this method to current surveillance programs will enhance their ability to monitor ILI and to detect early warning signals of new ILI events.

Emerging trends in technology assessment

NASA Technical Reports Server (NTRS)

Coates, V. T.

1975-01-01

Recent trends and problems in technology assessment are discussed briefly. The Congressional Office of Technology Assessment and its performance are reviewed along with technology assessment activity in the National Science Foundation.

Emerging landscape degradation trends in the East African Horn

NASA Astrophysics Data System (ADS)

Pricope, N. G.; Michaelsen, J.; Husak, G. J.; Funk, C. C.; Lopez-Carr, D.

2012-12-01

Increasing climate variability along with declining trends in rainfall represent major risk factors affecting food security in many regions of the world. We identify Africa-wide regions where significant rainfall decreases from 1979-2011 are coupled with significant human population density increases. The rangelands of the East African Horn remain one of the world's most food insecure regions with significantly increasing human populations predominantly dependent on pastoralist and agro-pastoralist livelihoods. Widespread vegetation degradation is occurring, adversely impacting fragile ecosystems and human livelihoods. Using MODIS land cover and normalized difference vegetation index (NDVI) data collected since 2000, we observe significant changes in vegetation patterns and productivity over the last decade across the East African Horn and demonstrate that these two products can be used concurrently at large spatial scales to monitor vegetation dynamics at decadal time scales. Results demonstrate that a near doubling of the population in pastoral regions is linked with hotspots of degradation in vegetation condition. The most significant land cover change and browning trends are observed in areas experiencing drying precipitation trends in addition to increasing population pressures. These findings have serious implications for current and future regional food security monitoring and forecasting and for mitigation and adaptation strategies in a region where population is expected to continue increasing against a backdrop of drying climate trends.Fig.1(a)Change in standardized precipitation index in Africa between 1979-2010 (b)Change in population density at continental scale using the GRUMPv1 1990 and 2000 and AfriPop 2010 population density datasets Fig.2 Land cover change trajectories based on 2001-2009 MOD12Q1 Land Cover product for the East African Horn overlaid over aggregated FEWS Net Livelihoods Zones.

Health Occupations Trends and Issues: Issue Paper.

ERIC Educational Resources Information Center

Covelli, Nicholas J.; And Others

A study was conducted to identify the trends occurring within the health service industry and their impact on the providers of health care; determine shifts or emerging occupational areas within health services; and assess local health service providers' staffing patterns and anticipated needs. The study involved meetings with local hospital…

Task 1.5 Genomic Shift and Drift Trends of Emerging Pathogens

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

Borucki, M

2010-01-05

The Lawrence Livermore National Laboratory (LLNL) Bioinformatics group has recently taken on a role in DTRA's Transformation Medical Technologies Initiative (TMTI). The high-level goal of TMTI is to accelerate the development of broad-spectrum countermeasures. To achieve those goals, TMTI has a near term need to conduct analyses of genomic shift and drift trends of emerging pathogens, with a focused eye on select agent pathogens, as well as antibiotic and virulence markers. Most emerging human pathogens are zoonotic viruses with a genome composed of RNA. The high mutation rate of the replication enzymes of RNA viruses contributes to sequence drift andmore » provides one mechanism for these viruses to adapt to diverse hosts (interspecies transmission events) and cause new human and zoonotic diseases. Additionally, new viral pathogens frequently emerge due to genetic shift (recombination and segment reassortment) which allows for dramatic genotypic and phenotypic changes to occur rapidly. Bacterial pathogens also evolve via genetic drift and shift, although sequence drift generally occurs at a much slower rate for bacteria as compared to RNA viruses. However, genetic shift such as lateral gene transfer and inter- and intragenomic recombination enables bacteria to rapidly acquire new mechanisms of survival and antibiotic resistance. New technologies such as rapid whole genome sequencing of bacterial genomes, ultra-deep sequencing of RNA virus populations, metagenomic studies of environments rich in antibiotic resistance genes, and the use of microarrays for the detection and characterization of emerging pathogens provide mechanisms to address the challenges posed by the rapid emergence of pathogens. Bioinformatic algorithms that enable efficient analysis of the massive amounts of data generated by these technologies as well computational modeling of protein structures and evolutionary processes need to be developed to allow the technology to fulfill its potential.« less

Making processes reliable: a validated pubmed search strategy for identifying new or emerging technologies.

PubMed

Varela-Lema, Leonora; Punal-Riobóo, Jeanette; Acción, Beatriz Casal; Ruano-Ravina, Alberto; García, Marisa López

2012-10-01

Horizon scanning systems need to handle a wide range of sources to identify new or emerging health technologies. The objective of this study is to develop a validated Medline bibliographic search strategy (PubMed search engine) to systematically identify new or emerging health technologies. The proposed Medline search strategy combines free text terms commonly used in article titles to denote innovation within index terms that make reference to the specific fields of interest. Efficacy was assessed by running the search over a period of 1 year (2009) and analyzing its retrieval performance (number and characteristics). For comparison purposes, all article abstracts published during 2009 in six preselected key research journals and eight high impact surgery journals were scanned. Sensitivity was defined as the proportion of relevant new or emerging technologies published in key journals that would be identified in the search strategy within the first 2 years of publication. The search yielded 6,228 abstracts of potentially new or emerging technologies. Of these, 459 were classified as new or emerging (383 truly new or emerging and 76 new indications). The scanning of 12,061 journal abstracts identified 35 relevant new or emerging technologies. Of these, twenty-nine were located within the Medline search strategy during the first 2 years of publication (sensitivity = 83 percent). The current search strategy, validated against key journals, has demonstrated to be effective for horizon scanning. Even though it can require adaptations depending on the scope of the horizon scanning system, it could serve to simplify and standardize scanning processes.

Oral cancer: enduring characteristics and emerging trends.

PubMed

Rosebush, Molly S; Rao, Shailaja Kishan; Samant, Sandeep; Gu, Weikuan; Handorf, Charles R; Pfeffer, Lawrence M; Nosrat, Christopher A

2011-01-01

Oral cancer is arguably the most serious condition that dental providers may encounter in their practice. The relatively poor prognosis associated with oral cancer highlights the importance of the dental team's awareness of the disease. While many characteristics of oral cancer have endured over time, new research is revealing trends that are changing the way we approach its screening, diagnosis and treatment. In this report, we provide a translational overview of oral cancer, including risk factors, signs and symptoms, clinical management, as well as our recent findings on the role of chronic inflammation in the development of the disease. In addition, our recent genetic profiling approach in both cancer cell lines and in patients has identified potential biomarkers, molecular pathways and therapeutic drugs (Velcade and Aspirin) for oral squamous cell carcinomas. This comprehensive review should be of interest to all dental professionals.

Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

PubMed Central

Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

2015-01-01

Background Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. Objective This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. Design A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. Results The importance of PHLP has grown during the past decade and focuses mainly on infection–disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States’ utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. Conclusions The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended. PMID:26449204

Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis.

PubMed

Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

2015-01-01

Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. The importance of PHLP has grown during the past decade and focuses mainly on infection-disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States' utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended.

The Future of Learning: 12 Views on Emerging Trends in Higher Education

ERIC Educational Resources Information Center

Flynn, William J.; Vredevoogd, Jeff

2010-01-01

In 2009, Herman Miller, Inc., a Zeeland, Michigan-based furniture manufacturer, convened a leadership roundtable intended to identify trends that would affect higher education in the year 2015. Representatives from research universities, state colleges, community colleges, private institutions, and architectural and design firms participated in…

Identifying emerging issues in forestry as a tool for research planning.

Treesearch

Hans M. Gregersen; Allen L. Lundgren; Pamela J. Jakes; David N. Bengston

1989-01-01

A Delphi exercise is used to identify emerging issues in National Forest management and use, the relative importance of the issues, and barriers to resolving issues. USDA Forest Service managers agree on the importance of the 11 issues identified; however, researchers and National Forest managers do not always agree on the importance of issues or barriers.

International trends in health science librarianship: Part 7. Taking stock.

PubMed

Murphy, Jeannette

2013-09-01

This article reviews the six papers published so far in this series on global trends in health science librarianship. Starting with a retrospective review of trends in the twentieth-century, the series has covered 6 different regions, with contributions from 21 countries. As this is the half-way point in the survey, it seems a useful point at which to reflect on what has emerged so far. The method of content analysis is used to identify key trends. The top five trends are explored. © 2013 The author. Health Information and Libraries Journal © 2013 Health Libraries Group.

Is secondary preventive care improving? Observational study of 10-year trends in emergency admissions for conditions amenable to ambulatory care

PubMed Central

Bardsley, Martin; Blunt, Ian; Davies, Sian; Dixon, Jennifer

2013-01-01

Objective To identify trends in emergency admissions for patients with clinical conditions classed as ‘ambulatory care sensitive’ (ACS) and assess if reductions might be due to improvements in preventive care. Design Observational study of routinely collected hospital admission data from March 2001 to April 2011. Admission rates were calculated at the population level using national population estimates for area of residence. Participants All emergency admissions to National Health Service (NHS) hospitals in England from April 2001 to March 2011 for people residents in England. Main outcome measures Age-standardised emergency admissions rates for each of 27 specific ACS conditions (ICD-10 codes recorded as primary or secondary diagnoses). Results Between April 2001 and March 2011 the number of admissions for ACS conditions increased by 40%. When ACS conditions were defined solely on primary diagnosis, the increase was less at 35% and similar to the increase in emergency admissions for non-ACS conditions. Age-standardised rates of emergency admission for ACS conditions had increased by 25%, and there were notable variations by age group and by individual condition. Overall, the greatest increases were for urinary tract infection, pyelonephritis, pneumonia, gastroenteritis and chronic obstructive pulmonary disease. There were significant reductions in emergency admission rates for angina, perforated ulcers and pelvic inflammatory diseases but the scale of these successes was relatively small. Conclusions Increases in rates of emergency admissions suggest that efforts to improve the preventive management of certain clinical conditions have failed to reduce the demand for emergency care. Tackling the demand for hospital care needs more radical approaches than those adopted hitherto if reductions in emergency admission rates for ACS conditions overall are to be seen as a positive outcome of for NHS. PMID:23288268

Trends in statewide long-range transportation plans : core and emerging topics in 2017

DOT National Transportation Integrated Search

2017-10-01

This report synthesizes key findings and trends from the 2017 Statewide Long-Range Transportation Plan (SLRTP) Database, which represents key observations identified through a review of all 52 SLRTPs and Statewide Transportation Improvement Programs ...

Identifying barriers to emergency care services.

PubMed

Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

2012-01-01

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

Converging social trends - emerging outdoor recreation issues

Treesearch

Carl H. Reidel

1980-01-01

I can't recall when I have attended a national conference with a more clearly defined objective than this one. We are here to document outdoor recreation trends and explore their meaning for the future. The word "trend" appears no less than 45 times in the conference brochure, and the symposium organizers are determined that the proceedings will be...

Lightweight Adaptation of Classifiers to Users and Contexts: Trends of the Emerging Domain

PubMed Central

Vildjiounaite, Elena; Gimel'farb, Georgy; Kyllönen, Vesa; Peltola, Johannes

2015-01-01

Intelligent computer applications need to adapt their behaviour to contexts and users, but conventional classifier adaptation methods require long data collection and/or training times. Therefore classifier adaptation is often performed as follows: at design time application developers define typical usage contexts and provide reasoning models for each of these contexts, and then at runtime an appropriate model is selected from available ones. Typically, definition of usage contexts and reasoning models heavily relies on domain knowledge. However, in practice many applications are used in so diverse situations that no developer can predict them all and collect for each situation adequate training and test databases. Such applications have to adapt to a new user or unknown context at runtime just from interaction with the user, preferably in fairly lightweight ways, that is, requiring limited user effort to collect training data and limited time of performing the adaptation. This paper analyses adaptation trends in several emerging domains and outlines promising ideas, proposed for making multimodal classifiers user-specific and context-specific without significant user efforts, detailed domain knowledge, and/or complete retraining of the classifiers. Based on this analysis, this paper identifies important application characteristics and presents guidelines to consider these characteristics in adaptation design. PMID:26473165

Emerging Trends in International Law Concerning Global Infectious Disease Control1

PubMed Central

2003-01-01

International cooperation has become critical in controlling infectious diseases. In this article, I examine emerging trends in international law concerning global infectious disease control. The role of international law in horizontal and vertical governance responses to infectious disease control is conceptualized; the historical development of international law regarding infectious diseases is described; and important shifts in how states, international institutions, and nonstate organizations use international law in the context of infectious disease control today are analyzed. The growing importance of international trade law and the development of global governance mechanisms, most prominently in connection with increasing access to drugs and other medicines in unindustrialized countries, are emphasized. Traditional international legal approaches to infectious disease control—embodied in the International Health Regulations—may be moribund. PMID:12643821

Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change.

PubMed

Burkett, Ellen; Martin-Khan, Melinda G; Scott, Justin; Samanta, Mayukh; Gray, Leonard C

2017-07-01

Objectives The aim of the present study was to describe trends in and age and gender distributions of presentations of older people to Australian emergency departments (EDs) from July 2006 to June 2011, and to develop ED utilisation projections to 2050. Methods A retrospective analysis of data collected in the National Non-admitted Patient Emergency Department Care Database was undertaken to assess trends in ED presentations. Three standard Australian Bureau of Statistics population growth models, with and without adjustment for current trends in ED presentation growth and effects of climate change, were examined with projections of ED presentations across three age groups (0-64, 65-84 and ≥85 years) to 2050. Results From 2006-07 to 2010-11, ED presentations increased by 12.63%, whereas the Australian population over this time increased by only 7.26%. Rates of presentation per head of population were greatest among those aged ≥85 years. Projections of ED presentations to 2050 revealed that overall ED presentations are forecast to increase markedly, with the rate of increase being most marked for older people. Conclusion Growth in Australian ED presentations from 2006-07 to 2010-11 was greater than that expected from population growth alone. The predicted changes in demand for ED care will only be able to be optimally managed if Australian health policy, ED funding instruments and ED models of care are adjusted to take into account the specific care and resource needs of older people. What is known about the topic? Rapid population aging is anticipated over coming decades. International studies and specific local-level Australian studies have demonstrated significant growth in ED presentations. There have been no prior national-level Australian studies of ED presentation trends by age group. What does this paper add? The present study examined national ED presentation trends from July 2006 to June 2011, with specific emphasis on trends in presentation by age

Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

PubMed Central

Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

2016-01-01

Objectives To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. Setting A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Participants Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants. Main outcome measures For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. Results In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). Conclusions ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. PMID:27279477

Emerging Trends on the Topic of Information Technology in the Field of Educational Sciences: A Bibliometric Exploration

ERIC Educational Resources Information Center

González-Valiente, Carlos Luis

2015-01-01

The paper presents a bibliometric analysis on the topic of Information Technology (IT) in the field of Educational Sciences, aimed at envisioning the research emerging trends. The ERIC database is used as a consultation source; the results were subjected to productivity by authors, journals, and term co-occurrence analysis indicators for the…

Human Brucellosis Trends: Re-emergence and Prospects for Control Using a One Health Approach in Azerbaijan (1983-2009).

PubMed

Kracalik, I T; Abdullayev, R; Asadov, K; Ismayilova, R; Baghirova, M; Ustun, N; Shikhiyev, M; Talibzade, A; Blackburn, J K

2016-06-01

Brucellosis is one of the most common and widely spread zoonotic diseases in the world. Control of the disease in humans is dependent upon limiting the infection in animals through surveillance and vaccination. Given the dramatic economic and political changes that have taken place in the former Soviet Union, which have limited control, evaluating the status of human brucellosis in former Soviet states is crucial. We assessed annual spatial and temporal trends in the epidemiology of human brucellosis in Azerbaijan, 1983-2009, in conjunction with data from a livestock surveillance and control programme (2002-2009). To analyse trends, we used a combination of segmented regression and spatial analysis. From 1983 to 2009, a total of 11 233 cases of human brucellosis were reported. Up to the mid-1990s, the incidence of human brucellosis showed a pattern of re-emergence, increasing by 25% annually, on average. Following Soviet governance, the incidence rates peaked, increasing by 1.8% annually, on average, and subsequently decreasing by 5% annually, on average, during the period 2002-2009. Despite recent national declines in human incidence, we identified geographic changes in the case distribution characterized by a geographic expansion and an increasing incidence among districts clustered in the south-east, compared to a decrease of elsewhere in the country. Males were consistently, disproportionately afflicted (71%) and incidence was highest in the 15 to 19 age group (18.1 cases/100 000). During the period 2002-2009, >10 million small ruminants were vaccinated with Rev1. Our findings highlight the improving prospects for human brucellosis control following livestock vaccination; however, the disease appears to be re-emerging in south-eastern Azerbaijan. Sustained one health measures are needed to address changing patterns of brucellosis in Azerbaijan and elsewhere in the former Soviet Union. © 2015 The Authors. Zoonoses and Public Health Published by Blackwell

Animal escapology I: theoretical issues and emerging trends in escape trajectories

PubMed Central

Domenici, Paolo; Blagburn, Jonathan M.; Bacon, Jonathan P.

2011-01-01

Summary Escape responses are used by many animal species as their main defence against predator attacks. Escape success is determined by a number of variables; important are the directionality (the percentage of responses directed away from the threat) and the escape trajectories (ETs) measured relative to the threat. Although logic would suggest that animals should always turn away from a predator, work on various species shows that these away responses occur only approximately 50–90% of the time. A small proportion of towards responses may introduce some unpredictability and may be an adaptive feature of the escape system. Similar issues apply to ETs. Theoretically, an optimal ET can be modelled on the geometry of predator–prey encounters. However, unpredictability (and hence high variability) in trajectories may be necessary for preventing predators from learning a simple escape pattern. This review discusses the emerging trends in escape trajectories, as well as the modulating key factors, such as the surroundings and body design. The main ET patterns identified are: (1) high ET variability within a limited angular sector (mainly 90–180 deg away from the threat; this variability is in some cases based on multiple peaks of ETs), (2) ETs that allow sensory tracking of the threat and (3) ETs towards a shelter. These characteristic features are observed across various taxa and, therefore, their expression may be mainly related to taxon-independent animal design features and to the environmental context in which prey live – for example whether the immediate surroundings of the prey provide potential refuges. PMID:21753039

Culture or Disorder? African American Children Identified as Having Behavioral/Emotional Disorders in Special Education. Data Trends #101

ERIC Educational Resources Information Center

Research and Training Center on Family Support and Children's Mental Health, 2004

2004-01-01

"Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" describes the results of an ethnographic study of expressions of African American culture and coping styles among students identified as having behavioral/emotional disorders…

Market inefficiency identified by both single and multiple currency trends

NASA Astrophysics Data System (ADS)

Tokár, T.; Horváth, D.

2012-11-01

Many studies have shown that there are good reasons to claim very low predictability of currency returns; nevertheless, the deviations from true randomness exist which have potential predictive and prognostic power [J. James, Simple trend-following strategies in currency trading, Quantitative finance 3 (2003) C75-C77]. We analyze the local trends which are of the main focus of the technical analysis. In this article we introduced various statistical quantities examining role of single temporal discretized trend or multitude of grouped trends corresponding to different time delays. Our specific analysis based predominantly on Euro-dollar currency pair data at the one minute frequency suggests the importance of cumulative nonrandom effect of trends on the potential forecasting performance.

Assessing the gap in female authorship in the journal Emergency Radiology: trends over a 20-year period.

PubMed

McKenzie, Kristopher; Ramonas, Milita; Patlas, Michael; Katz, Douglas S

2017-12-01

To examine trends in female authorship in the journal Emergency Radiology from January 1994 to December 2014. We obtained institutional review board approval for our study. We retrospectively reviewed a total of 1617 articles published in the journal Emergency Radiology over a 20-year period. Original articles, case reports, review articles, and pictorial essays were included. The first and last position author's gender was categorized as female or male. We analyzed trends by comparing the first and last position authors of original articles from the first and last year reviewed. We utilized Chi-square test for statistical analysis, with a p value <0.05 noted as significant. One thousand four hundred twenty articles met our inclusion criteria. There were 1420 first position authors and 1295 last position authors. There were 125 articles that had a sole author-these authors were considered as first position authors only. We determined, as best as possible, the gender of 96% of the authors. Overall, female authors were 21% of first position authors (290 of 1368) and 15% of last position authors (183 of 1246). Thirty-two percent of articles with female last position authors also had female first position authors (58 of 183). There was a statistically significant increase in female last position authors, from 12.9% in 1994 to 21.3% in 2014 (p = 0.026), a non-significant increase in female first position authors, from 17.5% in 1994 to 20.9% in 2014 (p = 0.514), and a non-significant increase in articles with both a first and last female author, from 25% in 1994 to 35% in 2014 (p = 0.593). Over the last 20 years, there has been a statistically significant upward trend in female last position authors publishing in the journal Emergency Radiology.

US Emergency Department Trends in Imaging for Pediatric Nontraumatic Abdominal Pain.

PubMed

Niles, Lauren M; Goyal, Monika K; Badolato, Gia M; Chamberlain, James M; Cohen, Joanna S

2017-10-01

To describe national emergency department (ED) trends in computed tomography (CT) and ultrasound imaging for the evaluation of pediatric nontraumatic abdominal pain from 2007 through 2014. We used data from the National Hospital Ambulatory Medical Care Survey to measure trends in CT and ultrasound use among children with nontraumatic abdominal pain. We performed multivariable logistic regression to measure the strength of the association of ED type (pediatric versus general ED) with CT and ultrasound use adjusting for potential confounding variables. Of an estimated 21.1 million ED visits for nontraumatic abdominal pain, 14.6% (95% confidence interval [CI], 13.2%-16.0%) had CT imaging only, 10.9% (95% CI, 9.7%-12.1%) had ultrasound imaging only, and 1.9% (95% CI, 1.4%-2.4%) received both CT and ultrasound. The overall use of CT and ultrasound did not significantly change over the study period ( P trend .63 and .90, respectively). CT use was lower among children treated in pediatric EDs compared with general EDs (adjusted odds ratio 0.34; 95% CI, 0.17-0.69). Conversely, ultrasound use was higher among children treated in pediatric EDs compared with general EDs (adjusted odds ratio 2.14; 95% CI, 1.29-3.55). CT imaging for pediatric patients with nontraumatic abdominal pain has plateaued since 2007 after the steady increase seen in the preceding 9 years. Among this population, an increased likelihood of CT imaging was demonstrated in general EDs compared with pediatric EDs, in which there was a higher likelihood of ultrasound imaging. Dissemination of pediatric-focused radiology protocols to general EDs may help optimize radiation exposure in children. Copyright © 2017 by the American Academy of Pediatrics.

Identifying emerging research collaborations and networks: method development.

PubMed

Dozier, Ann M; Martina, Camille A; O'Dell, Nicole L; Fogg, Thomas T; Lurie, Stephen J; Rubinstein, Eric P; Pearson, Thomas A

2014-03-01

Clinical and translational research is a multidisciplinary, collaborative team process. To evaluate this process, we developed a method to document emerging research networks and collaborations in our medical center to describe their productivity and viability over time. Using an e-mail survey, sent to 1,620 clinical and basic science full- and part-time faculty members, respondents identified their research collaborators. Initial analyses, using Pajek software, assessed the feasibility of using social network analysis (SNA) methods with these data. Nearly 400 respondents identified 1,594 collaborators across 28 medical center departments resulting in 309 networks with 5 or more collaborators. This low-burden approach yielded a rich data set useful for evaluation using SNA to: (a) assess networks at several levels of the organization, including intrapersonal (individuals), interpersonal (social), organizational/institutional leadership (tenure and promotion), and physical/environmental (spatial proximity) and (b) link with other data to assess the evolution of these networks.

The role of surgeons in identifying emerging technologies for health technology assessment.

PubMed

Stafinski, Tania; Topfer, Leigh-Ann; Zakariasen, Ken; Menon, Devidas

2010-04-01

Health technology assessment (HTA) is a tool intended to help policy-makers decide which technologies to fund. However, given the proliferation of new technologies, it is not possible to undertake an HTA of each one before it becomes funded. Consequently, "horizon-scanning" processes have been developed to identify emerging technologies that are likely to have a substantial impact on clinical practice. Although the importance of physicians in the adoption of new technologies is well recognized, their role in horizon scanning in Canada has been limited. The purpose of this project was to pilot an approach to engage physicians, specifically surgeons, in provincial horizon-scanning activities. We invited 18 surgeons from Alberta's 2 medical schools to a horizon-scanning workshop to solicit their views on emerging technologies expected to impact surgical practice within the next 5 years and/or the importance of different attributes or characteristics of new technologies. Surgeons, regardless of specialty, identified developments designed to enhance existing minimally invasive surgical techniques, such as endoscopic, robotic and image-guided surgery. Several nonsurgical areas, including molecular genetics and nano technology, were also identified. Of the 13 technology attributes discussed, safety or risk, effectiveness and feasibility were rated as most important. Lastly, participating surgeons expressed an interest in becoming further involved in local HTA initiatives. Surgeons, as adopters and users of health technologies, represent an important and accessible information source for identifying emerging technologies for HTA. A more formal, ongoing relationship between the government, HTA and surgeons may help to optimize the use of HTA resources.

The role of surgeons in identifying emerging technologies for health technology assessment

PubMed Central

Stafinski, Tania; Topfer, Leigh-Ann; Zakariasen, Ken; Menon, Devidas

2010-01-01

Background Health technology assessment (HTA) is a tool intended to help policy-makers decide which technologies to fund. However, given the proliferation of new technologies, it is not possible to undertake an HTA of each one before it becomes funded. Consequently, “horizon-scanning” processes have been developed to identify emerging technologies that are likely to have a substantial impact on clinical practice. Although the importance of physicians in the adoption of new technologies is well recognized, their role in horizon scanning in Canada has been limited. The purpose of this project was to pilot an approach to engage physicians, specifically surgeons, in provincial horizon-scanning activities. Methods We invited 18 surgeons from Alberta’s 2 medical schools to a horizon-scanning workshop to solicit their views on emerging technologies expected to impact surgical practice within the next 5 years and/or the importance of different attributes or characteristics of new technologies. Results Surgeons, regardless of specialty, identified developments designed to enhance existing minimally invasive surgical techniques, such as endoscopic, robotic and image-guided surgery. Several nonsurgical areas, including molecular genetics and nanotechnology, were also identified. Of the 13 technology attributes discussed, safety or risk, effectiveness and feasibility were rated as most important. Lastly, participating surgeons expressed an interest in becoming further involved in local HTA initiatives. Conclusion Surgeons, as adopters and users of health technologies, represent an important and accessible information source for identifying emerging technologies for HTA. A more formal, ongoing relationship between the government, HTA and surgeons may help to optimize the use of HTA resources. PMID:20334740

Quantitative Analysis of Technological Innovation in Knee Arthroplasty: Using Patent and Publication Metrics to Identify Developments and Trends.

PubMed

Dalton, David M; Burke, Thomas P; Kelly, Enda G; Curtin, Paul D

2016-06-01

Surgery is in a constant continuum of innovation with refinement of technique and instrumentation. Arthroplasty surgery potentially represents an area with highly innovative process. This study highlights key area of innovation in knee arthroplasty over the past 35 years using patent and publication metrics. Growth rates and patterns are analyzed. Patents are correlated to publications as a measure of scientific support. Electronic patent and publication databases were searched over the interval 1980-2014 for "knee arthroplasty" OR "knee replacement." The resulting patent codes were allocated into technology clusters. Citation analysis was performed to identify any important developments missed on initial analysis. The technology clusters identified were further analyzed, individual repeat searches performed, and growth curves plotted. The initial search revealed 3574 patents and 16,552 publications. The largest technology clusters identified were Unicompartmental, Patient-Specific Instrumentation (PSI), Navigation, and Robotic knee arthroplasties. The growth in patent activity correlated strongly with publication activity (Pearson correlation value 0.892, P < .01), but was growing at a faster rate suggesting a decline in vigilance. PSI, objectively the fastest growing technology in the last 5 years, is currently in a period of exponential growth that began a decade ago. Established technologies in the study have double s-shaped patent curves. Identifying trends in emerging technologies is possible using patent metrics and is useful information for training and regulatory bodies. The decline in ratio of publications to patents and the uninterrupted growth of PSI are developments that may warrant further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

Identifying Pregnant Women Experiencing Domestic Violence in an Urban Emergency Department

ERIC Educational Resources Information Center

Datner, Elizabeth M.; Wiebe, Douglas J.; Brensinger, Colleen M.; Nelson, Deborah B.

2007-01-01

The article describes characteristics of pregnant women presenting to the Emergency Department (ED) who are experiencing current violence and presented a screening tool to identify pregnant women experiencing violence. Women completed an in-person interview regarding violence, sociodemo-graphic factors, health status, and drug use. Fifteen percent…

Optimal use of modern antibiotics: emerging trends.

PubMed

Polk, R

1999-08-01

Development of new antimicrobial drugs is an essential component in the effort to remain ahead of emerging microbial resistance. However, when new antibiotics are used with unrestrained enthusiasm, a predictable consequence is the further expansion of resistance. This problem is well known to the infectious diseases specialist and is increasingly appreciated by the nonspecialist and the public. A far more sensible strategy is to identify new ways to use these drugs to increase the duration of their usefulness. New methods to optimize antibiotic selection, dose, and duration of therapy are being investigated, and application of some of these strategies has been shown to have a favorable impact on resistance. Much of the classic thinking of how to use antibiotics is changing, and these newer strategies may result in prolongation of the era of the "antibiotic miracle."

Emerging Workforce Trends and Issues Impacting the Virginia Community College System

ERIC Educational Resources Information Center

Landon, Mary Greer

2009-01-01

The mission of the Virginia Community College workforce development leaders is to expand their training and development services to new and emerging high growth occupational areas in support of Virginia's economic growth and changing workforce needs in each of their regions. This research was designed to identify: high demand occupational skill…

Spatiotemporal hurdle models for zero-inflated count data: Exploring trends in emergency department visits.

PubMed

Neelon, Brian; Chang, Howard H; Ling, Qiang; Hastings, Nicole S

2016-12-01

Motivated by a study exploring spatiotemporal trends in emergency department use, we develop a class of two-part hurdle models for the analysis of zero-inflated areal count data. The models consist of two components-one for the probability of any emergency department use and one for the number of emergency department visits given use. Through a hierarchical structure, the models incorporate both patient- and region-level predictors, as well as spatially and temporally correlated random effects for each model component. The random effects are assigned multivariate conditionally autoregressive priors, which induce dependence between the components and provide spatial and temporal smoothing across adjacent spatial units and time periods, resulting in improved inferences. To accommodate potential overdispersion, we consider a range of parametric specifications for the positive counts, including truncated negative binomial and generalized Poisson distributions. We adopt a Bayesian inferential approach, and posterior computation is handled conveniently within standard Bayesian software. Our results indicate that the negative binomial and generalized Poisson hurdle models vastly outperform the Poisson hurdle model, demonstrating that overdispersed hurdle models provide a useful approach to analyzing zero-inflated spatiotemporal data. © The Author(s) 2014.

Researcher-Identified and Emergent Predictors of Pupil Control Ideologies: A Canadian Beginning Teacher Perspective

ERIC Educational Resources Information Center

Rideout, Glenn; Windle, Sheila

2013-01-01

The objectives of this study were (a) to identify the direction of pupil control ideology (PCI) shifts during participants' beginning teaching years, and (b) to identify a broader range of "emergent" (participant-identified) predictors of PCI that beginning teachers saw as accounting for the tendency for their classroom learning…

Northwest Trends Shaping Education: The 1998 Regional Needs Assessment.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

This regional needs assessment has three objectives: (1) collect and analyze information with the goal of identifying emerging trends and issues in the Northwest that affect public education; (2) use the findings from this analysis as a basis for assessing perceptions of how significantly these issues impact their local schools; and (3) use these…

Emerging deforestation trends in tropical dry forests ecoregions of Mexico and Central America

NASA Astrophysics Data System (ADS)

Portillo, C. A.; Cao, G.; Smith, V.

2015-12-01

Neotropical dry forests (TDF) have experienced an unprecedented deforestation that is leading to the loss of tropical biodiversity at a rapid pace, but information on deforestation dynamics in TDF is scarce. In this study, we present a sub-continental and national level assessment of TDF loss patterns in Mexico and Central America at high spatial and temporal resolution using remote sensing and GIS technologies. We used the Global Forest Change (GFC) dataset published by Hansen et al. (2013) which shows results from time-series analysis of Landsat images in characterizing global forest extent and change from 2000 through 2013. We analyzed forest loss within and around mapped TDF cover mapped by Portillo-Quintero et al. 2010. In order to minimize errors in source data, we overlaid a 25 x 25 km grid on top of the regional dataset and conducted a cell by cell and country by country inspection at multiple scales using high resolution ancillary data. We identified trends in the clustering of space-time TDF deforestation data using ArcGIS, categorizing trends in: new, consecutive, intensifying, persistent, diminishing, sporadic, oscillating and historical hotspots (high frequency of deforestation events) and cold spots (low frequency of deforestation). In general, the region is experiencing less frequent deforestation events with a higher number of intensifying and new cold spots across TDF landscapes. However, an important number of intensifying and persistent hotspots exist so no general trend in forest loss was detected for the period 2001-2013, except for El Salvador which shows a significant decreasing trend in forest loss. Mexico, Nicaragua, Honduras and Guatemala are the major sources of intensifying, persistent and new deforestation hot spots. These were identified in the southern pacific coast and the Yucatan Peninsula in Mexico, northwestern Guatemala, both western and eastern Honduras and around Lake Nicaragua in Nicaragua.

Emerging deforestation trends in tropical dry forests ecoregions of Mexico and Central America

NASA Astrophysics Data System (ADS)

Perez-Rodriguez, I. M.; Sievert, S. M.; Fogel, M. L.; Foustoukos, D.

2014-12-01

Neotropical dry forests (TDF) have experienced an unprecedented deforestation that is leading to the loss of tropical biodiversity at a rapid pace, but information on deforestation dynamics in TDF is scarce. In this study, we present a sub-continental and national level assessment of TDF loss patterns in Mexico and Central America at high spatial and temporal resolution using remote sensing and GIS technologies. We used the Global Forest Change (GFC) dataset published by Hansen et al. (2013) which shows results from time-series analysis of Landsat images in characterizing global forest extent and change from 2000 through 2013. We analyzed forest loss within and around mapped TDF cover mapped by Portillo-Quintero et al. 2010. In order to minimize errors in source data, we overlaid a 25 x 25 km grid on top of the regional dataset and conducted a cell by cell and country by country inspection at multiple scales using high resolution ancillary data. We identified trends in the clustering of space-time TDF deforestation data using ArcGIS, categorizing trends in: new, consecutive, intensifying, persistent, diminishing, sporadic, oscillating and historical hotspots (high frequency of deforestation events) and cold spots (low frequency of deforestation). In general, the region is experiencing less frequent deforestation events with a higher number of intensifying and new cold spots across TDF landscapes. However, an important number of intensifying and persistent hotspots exist so no general trend in forest loss was detected for the period 2001-2013, except for El Salvador which shows a significant decreasing trend in forest loss. Mexico, Nicaragua, Honduras and Guatemala are the major sources of intensifying, persistent and new deforestation hot spots. These were identified in the southern pacific coast and the Yucatan Peninsula in Mexico, northwestern Guatemala, both western and eastern Honduras and around Lake Nicaragua in Nicaragua.

Longitudinal trends in the treatment of abdominal pain in an academic emergency department.

PubMed

Cinar, Orhan; Jay, Loni; Fosnocht, David; Carey, Jessica; Rogers, LeGrand; Carey, Adrienne; Horne, Benjamin; Madsen, Troy

2013-09-01

Abdominal pain is a top chief complaint of patients presenting to Emergency Departments (ED). Historically, uncertainty surrounded correct management. Evidence has shown adequate analgesia does not obscure the diagnosis, making it the standard of care. We sought to evaluate trends in treatment of abdominal pain in an academic ED during a 10-year period. We prospectively evaluated a convenience sample of patients in an urban academic tertiary care hospital ED from September 2000 through April 2010. Adult patients presenting with a chief complaint of abdominal pain were included in this study. Analgesic administration rates and times, pain scores, and patient satisfaction at discharge were analyzed to evaluate trends by year. There were 2,646 patients presenting with abdominal pain who were enrolled during the study period. Rates of analgesic administration generally increased each year from 39.9% in 2000 to 65.5% in 2010 (p value for trend <0.001). Similarly, time to analgesic administration generally decreased by year, from 116 min in 2000 to 81 min in 2009 (p < 0.001). There was no improvement in mean pain scores at discharge by year (p = 0.27) and 48% of patients during the 10-year period still reported moderate to severe pain at discharge. Patient satisfaction with pain treatment increased from a score of 7.1 to 9.0 during the study period (p < 0.005), following the trend of increase in analgesic administration. In patients presenting to the ED with abdominal pain, analgesia administration increased and time to medication decreased during the 10-year period. Despite overall improvements in satisfaction, significant numbers of patients presenting with abdominal pain still reported moderate to severe pain at discharge. Copyright © 2013 Elsevier Inc. All rights reserved.

Real-time analysis application for identifying bursty local areas related to emergency topics.

PubMed

Sakai, Tatsuhiro; Tamura, Keiichi

2015-01-01

Since social media started getting more attention from users on the Internet, social media has been one of the most important information source in the world. Especially, with the increasing popularity of social media, data posted on social media sites are rapidly becoming collective intelligence, which is a term used to refer to new media that is displacing traditional media. In this paper, we focus on geotagged tweets on the Twitter site. These geotagged tweets are referred to as georeferenced documents because they include not only a short text message, but also the documents' posting time and location. Many researchers have been tackling the development of new data mining techniques for georeferenced documents to identify and analyze emergency topics, such as natural disasters, weather, diseases, and other incidents. In particular, the utilization of geotagged tweets to identify and analyze natural disasters has received much attention from administrative agencies recently because some case studies have achieved compelling results. In this paper, we propose a novel real-time analysis application for identifying bursty local areas related to emergency topics. The aim of our new application is to provide new platforms that can identify and analyze the localities of emergency topics. The proposed application is composed of three core computational intelligence techniques: the Naive Bayes classifier technique, the spatiotemporal clustering technique, and the burst detection technique. Moreover, we have implemented two types of application interface: a Web application interface and an android application interface. To evaluate the proposed application, we have implemented a real-time weather observation system embedded the proposed application. we used actual crawling geotagged tweets posted on the Twitter site. The weather observation system successfully detected bursty local areas related to observed emergency weather topics.

Emerging trends in peer review—a survey

PubMed Central

Walker, Richard; Rocha da Silva, Pascal

2015-01-01

“Classical peer review” has been subject to intense criticism for slowing down the publication process, bias against specific categories of paper and author, unreliability, inability to detect errors and fraud, unethical practices, and the lack of recognition for unpaid reviewers. This paper surveys innovative forms of peer review that attempt to address these issues. Based on an initial literature review, we construct a sample of 82 channels of scientific communication covering all forms of review identified by the survey, and analyze the review mechanisms used by each channel. We identify two major trends: the rapidly expanding role of preprint servers (e.g., ArXiv) that dispense with traditional peer review altogether, and the growth of “non-selective review,” focusing on papers' scientific quality rather than their perceived importance and novelty. Other potentially important developments include forms of “open review,” which remove reviewer anonymity, and interactive review, as well as new mechanisms for post-publication review and out-of-channel reader commentary, especially critical commentary targeting high profile papers. One of the strongest findings of the survey is the persistence of major differences between the peer review processes used by different disciplines. None of these differences is likely to disappear in the foreseeable future. The most likely scenario for the coming years is thus continued diversification, in which different review mechanisms serve different author, reader, and publisher needs. Relatively little is known about the impact of these innovations on the problems they address. These are important questions for future quantitative research. PMID:26074753

Identifying and Planning for New and Emerging Occupations: A Suggested Guide.

ERIC Educational Resources Information Center

Meleen, Paulette; And Others

Intended for use by State vocational education directors and curriculum planners, this guide documents the results of a project which developed and applied a process for identifying new and emerging occupations for skilled and technical areas, part of a larger effort to assist the alignment of vocational and technical program offerings with new…

Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study.

PubMed

Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

2016-06-08

To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Adult ED visits (aged ≥18 years) during 2009-2013, with or without receiving CT, were enrolled as the study participants. For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). ED CT utilisation rates increased significantly during 2009-2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. 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/

Emergency extracorporeal membrane oxygenation in transcatheter aortic valve implantation: A two-center experience of incidence, outcome and temporal trends from 2010 to 2015.

PubMed

Trenkwalder, Teresa; Pellegrini, Costanza; Holzamer, Andreas; Philipp, Alois; Rheude, Tobias; Michel, Jonathan; Reinhard, Wibke; Joner, Michael; Kasel, Albert M; Kastrati, Adnan; Schunkert, Heribert; Endemann, Dierk; Debl, Kurt; Mayr, N Patrick; Hilker, Michael; Hengstenberg, Christian; Husser, Oliver

2017-11-11

Although the incidence of periprocedural complications has decreased in transcatheter aortic valve implantation (TAVI), life-threatening complications occur and emergency veno-arterial extracorporeal membrane oxygenation (vaECMO) can provide immediate circulatory stabilization. We report our two-center experience of vaECMO during life-threatening complications in TAVI. From January 2010 to December 2015, 1,810 consecutive patients underwent TAVI at two centers. Clinical characteristics, type of complication, outcome and temporal trends in the requirement of emergency vaECMO were evaluated. Life-threatening complications requiring vaECMO occurred in 1.8% of cases (33 patients; 22 transfemoral, 11 transapical). Indications for vaECMO were ventricular rupture (30%, 10/33), low output (15%, 5/33), bleeding (12%, 4/33), coronary artery impairment (9%, 3/33), ventricular arrhythmias (6%, 2/33), severe aortic regurgitation (6%, 2/33), aortic annular rupture (6%, 2/33), and aortic dissection (3%, 1/33). In 4 cases, no definite cause for hemodynamic instability was identified. Conversion to open heart surgery was necessary in 42% of patients (14/33). Percutaneous coronary intervention was performed in all cases with coronary artery impairment (9%, 3/33). Patients with severe aortic regurgitation (6%, 2/33) underwent emergency valve-in-valve implantation. Other patients received, in addition to vaECMO support conservative treatment (42%, 14/33). In-hospital mortality and 30-day mortality were 46% (15/33). Of patients discharged, 67% (12/18) had no neurological impairment, whereas mild and severe neurological impairment was found in 11% (2/18) and 22% (4/18), respectively. From 2010 to 2015, with increasing procedures (from n = 43 to n = 553) requirement of vaECMO decreased from 9.3% to 0.9% (P for the trend <0.001). Over a 6-year period, need for emergency vaECMO during TAVI significantly decreased over time. Despite high in-hospital mortality, vaECMO represents a

System Study: Emergency Power System 1998–2013

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

Schroeder, John Alton

2015-02-01

This report presents an unreliability evaluation of the emergency power system (EPS) at 104 U.S. commercial nuclear power plants. Demand, run hours, and failure data from fiscal year 1998 through 2013 for selected components were obtained from the Institute of Nuclear Power Operations (INPO) Consolidated Events Database (ICES). The unreliability results are trended for the most recent 10-year period, while yearly estimates for system unreliability are provided for the entire active period. No statistically significant trends were identified in the EPS results.

Emerging Trends in Parent-School Communication.

ERIC Educational Resources Information Center

Seibert, Jane B.; And Others

School and home communication is of increasing interest in an era of concern for educational accountability. A review of research shows that landmark studies of the 1960s concentrated on the educational needs of the disadvantaged child and the influence of the home on school achievement. The current trend is toward attempting to unite the…

Research Trends in Emerging Contaminants on the Aquatic Environments of Tanzania

PubMed Central

Miraji, H.; Othman, O. C.; Ngassapa, F. N.; Mureithi, E. W.

2016-01-01

The continuity for discovery and production of new chemicals, allied products, and uses has currently resulted into generation of recent form of contaminants known as Emerging Contaminants (ECs). Once in the aquatic environment ECs are carcinogenic and cause other threats to both human's and animals' health. Due to their effects this study was aimed at investigating research trends of ECs in Tanzania. Findings revealed that USA and EU countries were leading in ECs researches, little followed by Asia, South Africa, and then Zambia. Only few guidelines from USA-EPA, WHO, Canada, and Australia existed. Neither published guidelines nor regulations for ECs existed in Tanzania; rather only the occurrence of some disinfection by-products and antibiotics was, respectively, reported in Arusha and Dar es Salaam, Tanzania. As these reports had a limited coverage of ECs, henceforth, these findings constitute the first-line reference materials for ECs research in Tanzania which shall be useful for future monitoring and regulation planning. PMID:26998381

Survey identifies trends in equipment acquisitions.

PubMed

Anderson, H J

1990-09-20

Automated laboratory equipment, medical imaging equipment, and patient monitors top the list of hospitals' priorities for equipment acquisition during the next year. This is according to an exclusive survey sponsored by the Linc Group, Inc., Chicago, and Hospitals magazine. The new survey also found that equipment acquisitions are most often financed with internal funds and gifts; that equipment purchasing budgets are on the rise; and that executives believe that most equipment makes money for their hospitals. Find out what your peers have to say about anticipated trends in equipment acquisition and financing during the next year.

Identifying the trends in wound-healing patents for successful investment strategies

PubMed Central

Gwak, Jae Ha

2017-01-01

Background Recently, the need for rapid wound-healing has significantly increased because of the increasing number of patients who are diagnosed with diabetes and obesity. These conditions have contributed to a surge in the number of patients with chronic wounds worldwide. Furthermore, many cost-effective wound-healing technologies have been developed in order to keep up with the increased demand. In this paper, we performed a quantitative study of the trends associated with wound-healing technologies using patent data. Methodology We analyzed the trends considering four different groups of patent applicants: firms, universities, research institutes, and individuals using a structural topic model. In addition, we analyzed the knowledge flow between patent applicants using citation analysis, and confirmed the role of applicants in the knowledge-flow network using k-means clustering. As a result, the primary wound-healing technology patents applied for by the four groups varied considerably, and we classified the roles of patent applicants were found in the knowledge-flow network. Conclusions Our results showed the organizations that are leading each area of wound-healing technology. Furthermore, from the results, we identified specific institutions that are efficient for spreading knowledge related to wound-healing technology based on the patents. This information can contribute to the planning of investment strategies and technology policies related to wound-healing. PMID:28306732

Sea-Level Trend Uncertainty With Pacific Climatic Variability and Temporally-Correlated Noise

NASA Astrophysics Data System (ADS)

Royston, Sam; Watson, Christopher S.; Legrésy, Benoît; King, Matt A.; Church, John A.; Bos, Machiel S.

2018-03-01

Recent studies have identified climatic drivers of the east-west see-saw of Pacific Ocean satellite altimetry era sea level trends and a number of sea-level trend and acceleration assessments attempt to account for this. We investigate the effect of Pacific climate variability, together with temporally-correlated noise, on linear trend error estimates and determine new time-of-emergence (ToE) estimates across the Indian and Pacific Oceans. Sea-level trend studies often advocate the use of auto-regressive (AR) noise models to adequately assess formal uncertainties, yet sea level often exhibits colored but non-AR(1) noise. Standard error estimates are over- or under-estimated by an AR(1) model for much of the Indo-Pacific sea level. Allowing for PDO and ENSO variability in the trend estimate only reduces standard errors across the tropics and we find noise characteristics are largely unaffected. Of importance for trend and acceleration detection studies, formal error estimates remain on average up to 1.6 times those from an AR(1) model for long-duration tide gauge data. There is an even chance that the observed trend from the satellite altimetry era exceeds the noise in patches of the tropical Pacific and Indian Oceans and the south-west and north-east Pacific gyres. By including climate indices in the trend analysis, the time it takes for the observed linear sea-level trend to emerge from the noise reduces by up to 2 decades.

Predictive Ability of an Emergency Medical Dispatch Stroke Diagnostic Tool in Identifying Hospital-Confirmed Strokes.

PubMed

Clawson, Jeff J; Scott, Greg; Gardett, Isabel; Youngquist, Scott; Taillac, Peter; Fivaz, Conrad; Olola, Christopher

2016-08-01

Early hospital notification of a possible stroke arriving via emergency medical services (EMS) can prepare stroke center personnel for timely treatment, especially timely administration of tissue plasminogen activator. Stroke center notification from the emergency dispatch center-before responders reach the scene-may promote even earlier and faster system activation, meaning that stroke center teams may be ready to receive patients as soon as the ambulance arrives. This study evaluates the use of a Medical Priority Dispatch System (MPDS; Priority Dispatch Corp., Salt Lake City, UT) Stroke Diagnostic Tool (SDxT) to identify possible strokes early by comparing the tools' results to on-scene and hospital findings. The retrospective descriptive study utilized stroke data from 3 sources: emergency medical dispatch, EMS, and emergency department/hospital. A total of 830 cases were collected between June 2012 and December 2013, of which 603 (72.7%) had matching dispatch records. Of the 603 cases, 304 (50.4%) were handled using MPDS Stroke Protocol 28. The SDxT had an 86.4% ability (OR [95% CI]: 2.3 [1.5, 3.5]) to effectively identify strokes among all the hospital-confirmed stroke cases (sensitivity), and a 26.6% ability to effectively identify nonstrokes among all the hospital-confirmed nonstroke cases (specificity). The SDxT demonstrated a very high sensitivity, compared to similar tools used in the field and at dispatch. The specificity was somewhat low, but this was expected-and is intended in the creation of protocols to be used over the phone in emergency situations. The tool is a valuable method for identifying strokes early and may allow early hospital notification. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Atraumatic headache in US emergency departments: recent trends in CT/MRI utilisation and factors associated with severe intracranial pathology.

PubMed

Gilbert, John W; Johnson, Kevin M; Larkin, Gregory L; Moore, Christopher L

2012-07-01

To estimate recent trends in CT/MRI utilisation among patients seeking emergency care for atraumatic headache in the USA and to identify factors associated with a diagnosis of significant intracranial pathology (ICP) in these patients. Data were obtained from the USA National Hospital Ambulatory Medical Care Survey of emergency department (ED) visits between 1998 and 2008. A cohort of atraumatic headache-related visits were identified using preassigned 'reason-for-visit' codes. Sample visits were weighted to provide national estimates. Between 1998 and 2008 the percentage of patients presenting to the ED with atraumatic headache who underwent imaging increased from 12.5% to 31.0% (p < 0.01) while the prevalence of ICP among those visits decreased from 10.1% to 3.5% (p < 0.05). The length of stay in the ED was 4.6 h (95% CI 4.4 to 4.8) for patients with headache who received imaging compared with 2.7 (95% CI 2.6 to 2.9) for those who did not. Of 18 factors evaluated in patients with headache, 10 were associated with a significantly increased odds of an ICP diagnosis: age ≥ 50 years, arrival by ambulance, triage immediacy <15 min, systolic blood pressure ≥ 160 mm Hg or diastolic blood pressure ≥ 100 mm Hg and disturbance in sensation, vision, speech or motor function including neurological weakness. The use of CT/MRI for evaluation of atraumatic headache increased dramatically in EDs in the USA between 1998 and 2008. The prevalence of ICP among patients who received CT/MRI declined concurrently, suggesting a role for clinical decision support to guide more judicious use of imaging.

Identifying trends in sediment discharge from alterations in upstream land use

USGS Publications Warehouse

Parker, R.S.; Osterkamp, W.R.

1995-01-01

Environmental monitoring is a primary reason for collecting sediment data. One emphasis of this monitoring is identification of trends in suspended sediment discharge. A stochastic equation was used to generate time series of annual suspended sediment discharges using statistics from gaging stations with drainage areas between 1606 and 1 805 230 km2. Annual sediment discharge was increased linearly to yield a given increase at the end of a fixed period and trend statistics were computed for each simulation series using Kendal's tau (at 0.05 significance level). A parameter was calculated from two factors that control trend detection time: (a) the magnitude of change in sediment discharge, and (b) the natural variability of sediment discharge. In this analysis the detection of a trend at most stations is well over 100 years for a 20% increase in sediment discharge. Further research is needed to assess the sensitivity of detecting trends at sediment stations.

Using conditional probability to identify trends in intra-day high-frequency equity pricing

NASA Astrophysics Data System (ADS)

Rechenthin, Michael; Street, W. Nick

2013-12-01

By examining the conditional probabilities of price movements in a popular US stock over different high-frequency intra-day timespans, varying levels of trend predictability are identified. This study demonstrates the existence of predictable short-term trends in the market; understanding the probability of price movement can be useful to high-frequency traders. Price movement was examined in trade-by-trade (tick) data along with temporal timespans between 1 s to 30 min for 52 one-week periods for one highly-traded stock. We hypothesize that much of the initial predictability of trade-by-trade (tick) data is due to traditional market dynamics, or the bouncing of the price between the stock’s bid and ask. Only after timespans of between 5 to 10 s does this cease to explain the predictability; after this timespan, two consecutive movements in the same direction occur with higher probability than that of movements in the opposite direction. This pattern holds up to a one-minute interval, after which the strength of the pattern weakens.

Emerging and continuing trends in vaccine opposition website content.

PubMed

Bean, Sandra J

2011-02-24

Anti-vaccination websites appeal to persons searching the Internet for vaccine information that reinforces their predilection to avoid vaccination for themselves or their children. Few published studies have systematically examined these sites. The aim of this study was to employ content analysis as a useful tool for examining and comparing anti-vaccination websites for recurring and changing emphases in content, design, and credibility themes since earlier anti-vaccination website content analyses were conducted. Between February and May 2010, using a commonly available search engine followed by a deep web search, 25 websites that contained anti-vaccination content were reviewed and analyzed for 24 content, 14 design, and 13 credibility attributes. Although several content claims remained similar to earlier analyses, two new themes emerged: (1) the 2009 H1N1 epidemic threat was "manufactured," and (2) the increasing presence of so-called "expert" testimony in opposing vaccination. Anti-vaccination websites are constantly changing in response to the trends in public health and the success of vaccination. Monitoring the changes can permit public health workers to mount programs more quickly to counter the opposition arguments. Additionally, opposition claims commonly appeal to emotions whereas the supporting claims appeal to reason. Effective vaccine support may be better served by including more emotionally compelling content. Copyright © 2011 Elsevier Ltd. All rights reserved.

Finding and identifying the viral needle in the metagenomic haystack: trends and challenges

PubMed Central

Soueidan, Hayssam; Schmitt, Louise-Amélie; Candresse, Thierry; Nikolski, Macha

2015-01-01

Collectively, viruses have the greatest genetic diversity on Earth, occupy extremely varied niches and are likely able to infect all living organisms. Viral infections are an important issue for human health and cause considerable economic losses when agriculturally important crops or husbandry animals are infected. The advent of metagenomics has provided a precious tool to study viruses by sampling them in natural environments and identifying the genomic composition of a sample. However, reaching a clear recognition and taxonomic assignment of the identified viruses has been hampered by the computational difficulty of these problems. In this perspective paper we examine the trends in current research for the identification of viral sequences in a metagenomic sample, pinpoint the intrinsic computational difficulties for the identification of novel viral sequences within metagenomic samples, and suggest possible avenues to overcome them. PMID:25610431

Emerging trends in alternative aviation fuels

NASA Astrophysics Data System (ADS)

Corbett, Cody

The days of petroleum-based aviation fuels are numbered. New regulations to be set in place in the coming years will force current fuels to be phased out in favor of cleaner fuels with less toxic emissions. The alternative fuel industry has already taken its foothold in other modes of transportation, and aviation will soon follow suit. Many companies have cropped up over the last decade, and a few have been around longer, that work hard to develop the alternative aviation fuels of the future. It is important, however, for the aviation community to know what to expect and when to expect it concerning alternative fuels. This study investigates where various companies in the alternative aviation fuel industry currently stand in their development and production processes, and how their products will affect aircraft owners and operators. By interviewing representatives from these companies and analyzing their responses to identify trends, an educated prediction can be made about where the industry is headed and when the aviation community can expect these fuel to be available. The findings of this study indicate that many companies are still in their developmental stages, with a few notable outliers, and that most of these companies expect to see production of their product by 2017. Also, the fuel manufacturers are dealing with all the legal hurdles regarding alternative fuels, so little to no effort will be required on the part of the consumer. These findings, along with their analysis, will enable the aviation community to make educated decisions concerning fuel and their aircraft, as well and do their part to help these beneficial fuels get to market.

[Spanish doctoral theses in emergency medicine (1978-2013)].

PubMed

Fernández-Guerrero, Inés María

2015-01-01

To quantitatively analyze the production of Spanish doctoral theses in emergency medicine. Quantitative synthesis of productivity indicators for 214 doctoral theses in emergency medicine found in the database (TESEO) for Spanish universities from 1978 to 2013. We processed the data in 3 ways as follows: compilation of descriptive statistics, regression analysis (correlation coefficients of determination), and modeling of linear trend (time-series analysis). Most of the thesis supervisors (84.1%) only oversaw a single project. No major supervisor of 10 or more theses was identified. Analysis of cosupervision indicated there were 1.6 supervisors per thesis. The theses were defended in 67 departments (both general and specialist departments) because no emergency medicine departments had been established. The most productive universities were 2 large ones (Universitat de Barcelona and Universidad Complutense de Madrid) and 3 medium-sized ones (Universidad de Granada, Universitat Autónoma de Barcelona, and Universidad de La Laguna). Productivity over time analyzed as the trend for 2-year periods in the time-series was expressed as a polynomial function with a correlation coefficient of determination of R2 = 0.80. Spanish doctoral research in emergency medicine has grown markedly. Work has been done in various university departments in different disciplines and specialties. The findings confirm that emergency medicine is a disciplinary field.

Emergence of trend trading and its effects in minority game

NASA Astrophysics Data System (ADS)

Liu, Xing-Hua; Liang, Xiao-Bei; Wang, Nai-Jing

2006-09-01

In this paper, we extended Minority Game (MG) by equipping agents with both value and trend strategies. In the new model, agents (we call them strong-adaptation agents) can autonomically select to act as trend trader or value trader when they game and learn in system. So the new model not only can reproduce stylized factors but also has the potential to investigate into the process of some problems of securities market. We investigated the dynamics of trend trading and its impacts on securities market based on the new model. Our research found that trend trading is inevitable when strong-adaptation agents make decisions by inductive reasoning. Trend trading (of strong-adaptation agents) is not irrational behavior but shows agent's strong-adaptation intelligence, because strong-adaptation agents can take advantage of the pure value agents when they game together in hybrid system. We also found that strong-adaptation agents do better in real environment. The results of our research are different with those of behavior finance researches.

Total ozone trends from 1979 to 2016 derived from five merged observational datasets - the emergence into ozone recovery

NASA Astrophysics Data System (ADS)

Weber, Mark; Coldewey-Egbers, Melanie; Fioletov, Vitali E.; Frith, Stacey M.; Wild, Jeannette D.; Burrows, John P.; Long, Craig S.; Loyola, Diego

2018-02-01

analysis. Consequently, the retrieved trends can be only considered to be at the brink of becoming significant, but there are indications that we are about to emerge into the expected recovery phase. However, the recent trends are still considerably masked by the observed large year-to-year dynamical variability in total ozone.

Emerging Global Trends in Advanced Manufacturing

DTIC Science & Technology

2012-03-01

facility. Such distributed manufacturing could be made accessible to large masses even in remote areas (Ehmann 2011). For example, Zara is a Spanish...consumers. It has tightened its supply-chain management so that the consumer “pulls” the design. Zara uses state-of-the-art IT and distribution...systems to collect data daily on trends so they can quickly turn out new designs. Zara keeps costs down by using existing materials in stock and through

Identifying water-quality trends in the Trinity River, Texas, USA, 1969-1992, using sediment cores from Lake Livingston

USGS Publications Warehouse

Van Metre, P.C.; Callender, E.

1996-01-01

Chemical analyses were done on cores of bottom sediment from three locations in Lake Livingston, a reservoir on the Trinity River in east Texas to identify trends in water quality in the Trinity River using the chemical record preserved in bottom sediments trapped by the reservoir. Sediment cores spanned the period from 1969, when the reservoir was impounded, to 1992, when the cores were collected. Chemical concentrations in reservoir sediment samples were compared to concentrations for 14 streambed sediment samples from the Trinity River Basin and to reported concentrations for soils in the eastern United States and shale. These comparisons indicate that sediments deposited in Lake Livingston are representative of the environmental setting of Lake Livingston within the Trinity River Basin. Vertical changes in concentrations within sediment cores indicate temporal trends of decreasing concentrations of lead, sodium, barium, and total DDT (DDT plus its metabolites DDD and DDE) in the Trinity River. Possible increasing temporal trends are indicated for chlordane and dieldrin. Each sediment-derived trend is related to trends in water quality in the Trinity River or known changes in environmental factors in its drainage basin or both.

THE FUKUSHIMA RADIOLOGICAL EMERGENCY AND CHALLENGES IDENTIFIED FOR FUTURE PUBLIC HEALTH RESPONSES

PubMed Central

Miller, Charles W.

2015-01-01

On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of “public health concern.” This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency. PMID:22469934

The Fukushima radiological emergency and challenges identified for future public health responses.

PubMed

Miller, Charles W

2012-05-01

On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of "public health concern." This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency.

Occupational injuries identified by an emergency department based injury surveillance system in Nicaragua

PubMed Central

Noe, R; Rocha, J; Clavel-Arcas, C; Aleman, C; Gonzales, M; Mock, C

2004-01-01

Objectives: To identify and describe the work related injuries in both the formal and informal work sectors captured in an emergency department based injury surveillance system in Managua, Nicaragua. Setting: Urban emergency department in Managua, Nicaragua serving 200–300 patients per day. Methods: Secondary analysis from the surveillance system data. All cases indicating an injury while working and seen for treatment at the emergency department between 1 August 2001 and 31 July 2002 were included. There was no exclusion based on place of occurrence (home, work, school), age, or gender. Results: There were 3801 work related injuries identified which accounted for 18.6% of the total 20 425 injures captured by the surveillance system. Twenty seven work related fatalities were recorded, compared with the 1998 International Labor Organization statistic of 25 occupational fatalities for all of Nicaragua. Injuries occurring outside of a formal work location accounted for more than 60% of the work related injuries. Almost half of these occurred at home, while 19% occurred on the street. The leading mechanisms for work related injuries were falls (30%), blunt objects (28%), and stabs/cuts (23%). Falls were by far the most severe mechanism in the study, causing 37% of the work related deaths and more than half of the fractures. Conclusions: Occupational injuries are grossly underreported in Nicaragua. This study demonstrated that an emergency department can be a data source for work related injuries in developing countries because it captures both the formal and informal workforce injuries. Fall prevention initiatives could significantly reduce the magnitude and severity of occupational injuries in Managua, Nicaragua. PMID:15314050

Development of a novel scoring system for identifying emerging chemical risks in the food chain.

PubMed

Oltmanns, J; Licht, O; Bitsch, A; Bohlen, M-L; Escher, S E; Silano, V; MacLeod, M; Serafimova, R; Kass, G E N; Merten, C

2018-02-21

The European Food Safety Authority (EFSA) is responsible for risk assessment of all aspects of food safety, including the establishment of procedures aimed at the identification of emerging risks to food safety. Here, a scoring system was developed for identifying chemicals registered under the European REACH Regulation that could be of potential concern in the food chain using the following parameters: (i) environmental release based on maximum aggregated tonnages and environmental release categories; (ii) biodegradation in the environment; (iii) bioaccumulation and in vivo and in vitro toxicity. The screening approach was tested on 100 data-rich chemicals registered under the REACH Regulation at aggregated volumes of at least 1000 tonnes per annum. The results show that substance-specific data generated under the REACH Regulation can be used to identify potential emerging risks in the food chain. After application of the screening procedure, priority chemicals can be identified as potentially emerging risk chemicals through the integration of exposure, environmental fate and toxicity. The default approach is to generate a single total score for each substance using a predefined weighting scenario. However, it is also possible to use a pivot table approach to combine the individual scores in different ways that reflect user-defined priorities, which enables a very flexible, iterative definition of screening criteria. Possible applications of the approaches are discussed using illustrative examples. Either approach can then be followed by in-depth evaluation of priority substances to ensure the identification of substances that present a real emerging chemical risk in the food chain.

Regional aerosol trends over the North Atlantic Ocean since 2002: identifying and attributing using satellite, surface, and model datasets

NASA Astrophysics Data System (ADS)

Jongeward, A.; Li, Z.

2017-12-01

Aerosols from natural and anthropogenic sources can influence atmospheric variability and alter Earth's radiative balance through direct and indirect processes. Recently, policies targeting anthropogenic species (e.g. the Clean Air Act) have seen success in improving air quality. The anthropogenic contributions to the total aerosol loading and its spatiotemporal pattern/trend are anticipated to be altered. In this work the aerosol loading and trend over the North Atlantic Ocean since 2002 are examined, a period of significant change due to anthropogenic emissions control measures within the U.S. Monthly mean data from satellite (MODIS), ground (AERONET, IMPROVE), and model (GOCART, MERRA) sources are employed. Two annual trends in aerosol optical depth (AOD) observed by MODIS are present: a -0.020 decade-1 trend in the mid-latitudes and a 0.015 decade-1 trend in the sub-tropics. Trends in GOCART species AOD reveal anthropogenic (natural) species as the likely driver of the mid-latitude (sub-tropical) trend. AERONET AOD trends confirm negative AOD trends at three upwind sites in the Eastern U.S. and IMPROVE particulate matter (PM) observations identifies the role of decreasing ammonium sulfate in the overall PM decrease. Meanwhile, an increasing AOD trend seen during summertime in the eastern sub-tropics is associated with dust aerosol from North Africa. A dust parameterization from Kaufman et al. (2005) allows for changes in the flux transport across the sub-tropics to be calculated and analyzed. Using MERRA reanalysis fields, it is hypothesized that amplified warming and increases in baroclinic instability over the Saharan desert may lead to increased dust mobilization and export from North Africa to the sub-tropical Atlantic. This study provides updated analysis through 2016.

Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

ERIC Educational Resources Information Center

Blackmer, Rachel; Hayes-Harb, Rachel

2016-01-01

We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

Trends in Postdoctoral Dental Education.

ERIC Educational Resources Information Center

Weaver, Richard

1999-01-01

Presents trend data concerning the current number of programs and positions in postdoctoral dental education, and examines applicant trends in postdoctoral dental education, as background for examining needs and issues that will emerge as a mandatory year of postdoctoral dental education is implemented. Factors influencing student plans to pursue…

Total Ozone Trends from 1979 to 2016 Derived from Five Merged Observational Datasets - The Emergence into Ozone Recovery

NASA Technical Reports Server (NTRS)

Weber, Mark; Coldewey-Egbers, Melanie; Fioletov, Vitali E.; Frith, Stacey M.; Wild, Jeannette D.; Burrows, John P.; Loyola, Diego

2018-01-01

ground-based data, are not accounted for in the trend analysis. Consequently, the retrieved trends can be only considered to be at the brink of becoming significant, but there are indications that we are about to emerge into the expected recovery phase. However, the recent trends are still considerably masked by the observed large year-to-year dynamical variability in total ozone.

Emerging Trends Could Exacerbate Health Inequities In The United States.

PubMed

Arcaya, Mariana C; Figueroa, José F

2017-06-01

Health inequities among people of different races and ethnicities, geographical locations, and social classes are not a new phenomenon, although the size of the inequities has changed since researchers first began documenting them. While interventions to improve the health of targeted disadvantaged groups may help combat disparities, broader trends that disproportionately benefit privileged groups or harm vulnerable populations can eclipse the progress made through isolated interventions. These trends threaten equity in health and health care in the United States either through direct effects on health or through impacts on the distribution of resources, risks, and power. We highlight trends in four domains: health care technologies, health reform policies, widening socioeconomic inequality, and environmental hazards. We suggest ways of countering the effects of these trends to promote health equity, focusing on strategies that promise co-benefits across multiple sectors. Project HOPE—The People-to-People Health Foundation, Inc.

Knowledge Domain and Emerging Trends in Organic Photovoltaic Technology: A Scientometric Review Based on CiteSpace Analysis.

PubMed

Xiao, Fengjun; Li, Chengzhi; Sun, Jiangman; Zhang, Lianjie

2017-01-01

To study the rapid growth of research on organic photovoltaic (OPV) technology, development trends in the relevant research are analyzed based on CiteSpace software of text mining and visualization in scientific literature. By this analytical method, the outputs and cooperation of authors, the hot research topics, the vital references and the development trend of OPV are identified and visualized. Different from the traditional review articles by the experts on OPV, this work provides a new method of visualizing information about the development of the OPV technology research over the past decade quantitatively.

Knowledge Domain and Emerging trends in Organic Photovoltaic Technology: A Scientometric Review Based on CiteSpace Analysis

NASA Astrophysics Data System (ADS)

Xiao, Fengjun; Li, Chengzhi; Sun, Jiangman; Zhang, Lianjie

2017-09-01

To study the rapid growth of research on organic photovoltaic (OPV) technology, development trends in the relevant research are analyzed based on CiteSpace software of text mining and visualization in scientific literature. By this analytical method, the outputs and cooperation of authors, the hot research topics, the vital references and the development trend of OPV are identified and visualized. Different from the traditional review articles by the experts on OPV, this work provides a new method of visualizing information about the development of the OPV technology research over the past decade quantitatively.

Identifying nontechnical skills associated with safety in the emergency department: a scoping review of the literature.

PubMed

Flowerdew, Lynsey; Brown, Ruth; Vincent, Charles; Woloshynowych, Maria

2012-05-01

Understanding the nontechnical skills specifically applicable to the emergency department (ED) is essential to facilitate training and more broadly consider interventions to reduce error. The aim of this scoping review is to first identify and then explore in depth the nontechnical skills linked to safety in the ED. The review was conducted in 2 stages. In stage 1, online databases were searched for published empirical studies linking nontechnical skills to safety and performance in the ED. Articles were analyzed to identify key ED nontechnical skills. In stage 2, these key skills were used to generate additional key words, which enabled a second search of the literature to be undertaken and expand on the evidence available for review. In stage 1, 11 articles were retrieved for data analysis and 9 core emergency medicine nontechnical skills were identified. These were communicating, managing workload, anticipating, situational awareness, supervising and providing feedback, leadership, maintaining standards, using assertiveness, and decisionmaking. In stage 2, a secondary search, using these 9 skills and related terms, uncovered a further 21 relevant articles. Therefore, 32 articles were used to describe the main nontechnical skills linked to safety in the ED. This article highlights the challenges of reviewing a topic for which the terms are not clearly defined in the literature. A novel methodological approach is described that provides a structured and transparent process for reviewing the literature in emerging areas of interest. A series of literature reviews focusing on individual nontechnical skills will provide a clearer understanding of how the skills identified contribute to safety in the ED. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Patterns and Emerging Trends in Global Ocean Health

PubMed Central

Halpern, Benjamin S.; Longo, Catherine; Lowndes, Julia S. Stewart; Best, Benjamin D.; Frazier, Melanie; Katona, Steven K.; Kleisner, Kristin M.; Rosenberg, Andrew A.; Scarborough, Courtney; Selig, Elizabeth R.

2015-01-01

International and regional policies aimed at managing ocean ecosystem health need quantitative and comprehensive indices to synthesize information from a variety of sources, consistently measure progress, and communicate with key constituencies and the public. Here we present the second annual global assessment of the Ocean Health Index, reporting current scores and annual changes since 2012, recalculated using updated methods and data based on the best available science, for 221 coastal countries and territories. The Index measures performance of ten societal goals for healthy oceans on a quantitative scale of increasing health from 0 to 100, and combines these scores into a single Index score, for each country and globally. The global Index score improved one point (from 67 to 68), while many country-level Index and goal scores had larger changes. Per-country Index scores ranged from 41–95 and, on average, improved by 0.06 points (range -8 to +12). Globally, average scores increased for individual goals by as much as 6.5 points (coastal economies) and decreased by as much as 1.2 points (natural products). Annual updates of the Index, even when not all input data have been updated, provide valuable information to scientists, policy makers, and resource managers because patterns and trends can emerge from the data that have been updated. Changes of even a few points indicate potential successes (when scores increase) that merit recognition, or concerns (when scores decrease) that may require mitigative action, with changes of more than 10–20 points representing large shifts that deserve greater attention. Goal scores showed remarkably little covariance across regions, indicating low redundancy in the Index, such that each goal delivers information about a different facet of ocean health. Together these scores provide a snapshot of global ocean health and suggest where countries have made progress and where a need for further improvement exists. PMID:25774678

The public health emergency management system in China: trends from 2002 to 2012.

PubMed

Sun, Mei; Xu, Ningze; Li, Chengyue; Wu, Dan; Zou, Jiatong; Wang, Ying; Luo, Li; Yu, Mingzhu; Zhang, Yu; Wang, Hua; Shi, Peiwu; Chen, Zheng; Wang, Jian; Lu, Yueliang; Li, Qi; Wang, Xinhua; Bi, Zhenqiang; Fan, Ming; Fu, Liping; Yu, Jingjin; Hao, Mo

2018-04-11

Public health emergencies have challenged the public health emergency management systems (PHEMSs) of many countries critically and frequently since this century. As the world's most populated country and the second biggest economy in the world, China used to have a fragile PHEMS; however, the government took forceful actions to build PHEMS after the 2003 SARS outbreak. After more than one decade's efforts, we tried to assess the improvements and problems of China's PHEMS between 2002 and 2012. We conducted two rounds of national surveys and collected the data of the year 2002 and 2012, including all 32 provincial, 139 municipal, and 489 county CDCs. The municipal and county CDCs were selected by systematic random sampling. Twenty-one indicators of four stages (preparation, readiness, response and recovery) from the National Assessment Criteria for CDC Performance were chosen to assess the ten-year trends. At the preparation stage, organization, mechanisms, workforce, and stockpile across all levels and regions were significantly improved after one decade's efforts. At the readiness stage, the capability for formulating an emergency plan was also significantly improved during the same period. At the response stage, internet-based direct reporting was 98.8%, and coping scores were nearly full points of ten in 2012. At the recovery stage, the capabilities were generally lower than expected. Due to forceful leadership, sounder regulations, and intensive resources, China's PHEMS has been improved at the preparation, readiness, and response stages; however, the recovery stage was still weak and could not meet the requirements of crisis management and preventive governance. In addition, CDCs in the Western region and counties lagged behind in performance on most indicators. Future priorities should include developing the recovery stage, establishing a closed feedback loop, and strengthening the capabilities of CDCs in Western region and counties.

Spatiotemporal trends in the discovery of new swine infectious agents.

PubMed

Fournié, Guillaume; Kearsley-Fleet, Lianne; Otte, Joachim; Pfeiffer, Dirk Udo

2015-09-28

A literature review was conducted to assess the spatiotemporal trend and diversity of infectious agents that were newly found in pigs between 1985 and 2010. We identified 173 new variants from 91 species, of which 73 species had not been previously described in pigs. These new species, of which one third was zoonotic, were taxonomically diverse. They were identified throughout the study period, predominantly in the main pork producing countries, with the rate of discovery of new virus variants doubling within the last 10 years of the study period. Whilst infectious agent species newly detected in high-income countries were more likely to be associated with higher virulence, zoonotic agents prevailed in low- and middle-income countries. Although this trend is influenced by factors conditioning infectious agent detection - diagnostic methods, surveillance efforts, research interests -, it may suggest that different scales and types of production systems promote emergence of certain types of infectious agents. Considering the rapid transformation of the swine industry, concerted efforts are needed for improving our understanding of the factors influencing the emergence of infectious agents. This information then needs to inform the design of risk-based surveillance systems and strategies directly mitigating the risk associated with these factors.

Accuracy of automatic syndromic classification of coded emergency department diagnoses in identifying mental health-related presentations for public health surveillance.

PubMed

Liljeqvist, Henning T G; Muscatello, David; Sara, Grant; Dinh, Michael; Lawrence, Glenda L

2014-09-23

Syndromic surveillance in emergency departments (EDs) may be used to deliver early warnings of increases in disease activity, to provide situational awareness during events of public health significance, to supplement other information on trends in acute disease and injury, and to support the development and monitoring of prevention or response strategies. Changes in mental health related ED presentations may be relevant to these goals, provided they can be identified accurately and efficiently. This study aimed to measure the accuracy of using diagnostic codes in electronic ED presentation records to identify mental health-related visits. We selected a random sample of 500 records from a total of 1,815,588 ED electronic presentation records from 59 NSW public hospitals during 2010. ED diagnoses were recorded using any of ICD-9, ICD-10 or SNOMED CT classifications. Three clinicians, blinded to the automatically generated syndromic grouping and each other's classification, reviewed the triage notes and classified each of the 500 visits as mental health-related or not. A "mental health problem presentation" for the purposes of this study was defined as any ED presentation where either a mental disorder or a mental health problem was the reason for the ED visit. The combined clinicians' assessment of the records was used as reference standard to measure the sensitivity, specificity, and positive and negative predictive values of the automatic classification of coded emergency department diagnoses. Agreement between the reference standard and the automated coded classification was estimated using the Kappa statistic. Agreement between clinician's classification and automated coded classification was substantial (Kappa = 0.73. 95% CI: 0.58 - 0.87). The automatic syndromic grouping of coded ED diagnoses for mental health-related visits was found to be moderately sensitive (68% 95% CI: 46%-84%) and highly specific at 99% (95% CI: 98%-99.7%) when compared with the

Ultrasound-Mediated Transdermal Drug Delivery: Mechanisms, Scope, and Emerging Trends

PubMed Central

Polat, Baris E.; Hart, Douglas; Langer, Robert; Blankschtein, Daniel

2012-01-01

The use of ultrasound for the delivery of drugs to, or through, the skin is commonly known as sonophoresis or phonophoresis. The use of therapeutic and high frequencies of ultrasound (≥ 0.7 MHz) for sonophoresis (HFS) dates back to as early as the 1950s, while low-frequency sonophoresis (LFS, 20 – 100 kHz) has only been investigated significantly during the past two decades. Although HFS and LFS are similar because they both utilize ultrasound to increase the skin penetration of permeants, the mechanisms associated with each physical enhancer are different. Specifically, the location of cavitation and the extent to which each process can increase skin permeability are quite dissimilar. Although the applications of both technologies are different, they each have strengths that could allow them to improve current methods of local, regional, and systemic drug delivery. In this review, we will discuss the mechanisms associated with both HFS and LFS, specifically concentrating on the key mechanistic differences between these two skin treatment methods. Background on the relevant physics associated with ultrasound transmitted through aqueous media will also be discussed, along with implications of these phenomena on sonophoresis. Finally, a thorough review of the literature is included, dating back to the first published reports of sonophoresis, including a discussion of emerging trends in the field. PMID:21238514

Balanced diets in food systems: emerging trends and challenges for human health.

PubMed

Sammugam, Lakhsmi; Pasupuleti, Visweswara Rao

2018-04-25

Processed foods, generally known as modified raw foods produced by innovative processing technologies alters the food constituents such natural enzymes, fatty acids, micronutrients, macronutrients and vitamins. In contrast to fresh and unprocessed foods, processed foods are guaranteed to be safer, imperishable, long lasting and consist high level of nutrients bioactivity. Currently, the evolution in food processing technologies is necessary to face food security and safety, nutrition demand, its availability and also other global challenges in the food system. In this scenario, this review consists of information on two food processing technologies, which effects on processed foods before and after processing and the impact of food products on human health. It is also very well established that understanding the type and structure of foods to be processed can assist food processing industries towards advancement of novel food products. In connection with this fact, the present article also discusses the emerging trends and possible modifications in food processing technologies with the combination of conventional and modern techniques to get the suitable nutritional and safety qualities in food.

Trends in rates of acetaminophen-related adverse events in the United States

PubMed Central

Major, Jacqueline M.; Zhou, Esther H.; Wong, Hui-Lee; Trinidad, James P.; Pham, Tracy M.; Mehta, Hina; Ding, Yulan; Staffa, Judy A.; Iyasu, Solomon; Wang, Cunlin; Willy, Mary E.

2017-01-01

Purpose The goal of this study is to summarize trends in rates of adverse events attributable to acetaminophen use, including hepatotoxicity and mortality. Methods A comprehensive analysis of data from three national surveillance systems estimated rates of acetaminophen-related events identified in different settings, including calls to poison centers (2008–2012), emergency department visits (2004–2012), and inpatient hospitalizations (1998–2011). Rates of acetaminophen-related events were calculated per setting, census population, and distributed drug units. Results Rates of poison center calls with acetaminophen-related exposures decreased from 49.5/1000 calls in 2009 to 43.5/1000 calls in 2012. Rates of emergency department visits for unintentional acetaminophen-related adverse events decreased from 58.0/1000 emergency department visits for adverse drug events in 2009 to 50.2/1000 emergency department visits in 2012. Rates of hospital inpatient discharges with acetaminophen-related poisoning decreased from 119.8/100 000 hospitalizations in 2009 to 108.6/100 000 hospitalizations in 2011. After 2009, population rates of acetaminophen-related events per 1million census population decreased for poison center calls and hospitalizations, while emergency department visit rates remained stable. However, when accounting for drug sales, the rate of acetaminophen-related events (per 1 million distributed drug units) increased after 2009. Prior to 2009, the rates of acetaminophen-related hospitalizations had been slowly increasing (p-trend = 0.001). Conclusions Acetaminophen-related adverse events continue to be a public health burden. Future studies with additional time points are necessary to confirm trends and determine whether recent risk mitigation efforts had a beneficial impact on acetaminophen-related adverse events. PMID:26530380

Trends in data locality abstractions for HPC systems

DOE PAGES

Unat, Didem; Dubey, Anshu; Hoefler, Torsten; ...

2017-05-10

The cost of data movement has always been an important concern in high performance computing (HPC) systems. It has now become the dominant factor in terms of both energy consumption and performance. Support for expression of data locality has been explored in the past, but those efforts have had only modest success in being adopted in HPC applications for various reasons. However, with the increasing complexity of the memory hierarchy and higher parallelism in emerging HPC systems, locality management has acquired a new urgency. Developers can no longer limit themselves to low-level solutions and ignore the potential for productivity andmore » performance portability obtained by using locality abstractions. Fortunately, the trend emerging in recent literature on the topic alleviates many of the concerns that got in the way of their adoption by application developers. Data locality abstractions are available in the forms of libraries, data structures, languages and runtime systems; a common theme is increasing productivity without sacrificing performance. Furthermore, this paper examines these trends and identifies commonalities that can combine various locality concepts to develop a comprehensive approach to expressing and managing data locality on future large-scale high-performance computing systems.« less

Bibliography on Organizational Trends in Schools.

ERIC Educational Resources Information Center

Anderson, Robert H.

This bibliography on organizational trends in schools lists 386 books, pamphlets, articles, bibliographies, and audiovisual resources published between 1955 and 1968, but mostly since 1965. Topics covered include (1) the educational reform movement and major trends in school organization, (2) cooperative teaching and emerging staff utilization…

Internet of Things in Health Trends Through Bibliometrics and Text Mining.

PubMed

Konstantinidis, Stathis Th; Billis, Antonis; Wharrad, Heather; Bamidis, Panagiotis D

2017-01-01

Recently a new buzzword has slowly but surely emerged, namely the Internet of Things (IoT). The importance of IoT is identified worldwide both by organisations and governments and the scientific community with an incremental number of publications during the last few years. IoT in Health is one of the main pillars of this evolution, but limited research has been performed on future visions and trends. Thus, in this study we investigate the longitudinal trends of Internet of Things in Health through bibliometrics and use of text mining. Seven hundred seventy eight (778) articles were retrieved form The Web of Science database from 1998 to 2016. The publications are grouped into thirty (30) clusters based on abstract text analysis resulting into some eight (8) trends of IoT in Health. Research in this field is obviously obtaining a worldwide character with specific trends, which are worth delineating to be in favour of some areas.

Emergency department and 'Google flu trends' data as syndromic surveillance indicators for seasonal influenza.

PubMed

Thompson, L H; Malik, M T; Gumel, A; Strome, T; Mahmud, S M

2014-11-01

We evaluated syndromic indicators of influenza disease activity developed using emergency department (ED) data - total ED visits attributed to influenza-like illness (ILI) ('ED ILI volume') and percentage of visits attributed to ILI ('ED ILI percent') - and Google flu trends (GFT) data (ILI cases/100 000 physician visits). Congruity and correlation among these indicators and between these indicators and weekly count of laboratory-confirmed influenza in Manitoba was assessed graphically using linear regression models. Both ED and GFT data performed well as syndromic indicators of influenza activity, and were highly correlated with each other in real time. The strongest correlations between virological data and ED ILI volume and ED ILI percent, respectively, were 0·77 and 0·71. The strongest correlation of GFT was 0·74. Seasonal influenza activity may be effectively monitored using ED and GFT data.

Radiology utilization in the emergency department: trends of the past 2 decades.

PubMed

Raja, Ali S; Ip, Ivan K; Sodickson, Aaron D; Walls, Ron M; Seltzer, Steven E; Kosowsky, Joshua M; Khorasani, Ramin

2014-08-01

The objective of our study was to assess radiology utilization trends for emergency department (ED) patients from 1993 through 2012. For this retrospective study, we reviewed radiology utilization at a 793-bed quaternary care academic medical center from January 1, 1993, through December 31, 2012, during which time the number of ED patient visits increased from approximately 48,000 to 61,000, and determined the number of imaging studies by modality (radiography, sonography, CT, MRI, other) and associated relative value units (RVUs). We used linear regression to assess for trends in the number of imaging RVUs and imaging accession numbers, our primary and secondary outcomes, respectively. The total RVUs attributable to ED imaging per 1000 ED visits increased 208% from 1993 to 2007 (p < 0.0001) and then decreased 24.7% by 2012 (p = 0.0019). The total number of imaging accession numbers per 1000 ED visits increased 47.8% from 1993 until 2005 (p = 0.0003) and then decreased 26.9% by 2012 (p < 0.0001). CT RVUs per 1000 ED visits increased 493% until 2007 (p < 0.0001) and then decreased 33.4% (p < 0.0001), and MRI RVUs increased 2475% until 2008 (p < 0.0001) and then decreased 20.6% (p < 0.0032). Sonography RVUs increased 75.7% over the study period (p < 0.0001), whereas radiography RVUs decreased 28.1% (p = 0.0009). After a period of substantial increase from 1993 to 2007, volume-adjusted ED imaging RVUs declined from 2007 through 2012, largely because of the decreasing use of CT and MRI. Additional studies are needed to determine the causes of this decline, which may include quality improvement activities, advocacy for appropriateness by leadership, concerns regarding radiation exposure and cost, and health information technology interventions.

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003-2011.

PubMed

Mazer-Amirshahi, Maryann; Sun, Christie; Mullins, Peter; Perrone, Jeanmarie; Nelson, Lewis; Pines, Jesse M

2016-09-01

In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003-2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in 2003-2004 to 2.9 million (1.1 %) visits in 2010-2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission.

Surveillance of Washington OSHA exposure data to identify uncharacterized or emerging occupational health hazards.

PubMed

Lofgren, Don J; Reeb-Whitaker, Carolyn K; Adams, Darrin

2010-07-01

Chemical substance exposure data from the Washington State Occupational Safety and Health Administration (OSHA) program were reviewed to determine if inspections conducted as a result of a report of a hazard from a complainant or referent may alert the agency to uncharacterized or emerging health hazards. Exposure and other electronically stored data from 6890 health inspection reports conducted between April 2003 and August 2008 were extracted from agency records. A total of 515 (7%) inspections with one or more personal airborne chemical substance samples were identified for further study. Inspections by report of a hazard and by targeting were compared for the following: number of inspections, number and percentage of inspections with workers exposed to substances above an agency's permissible exposure limit, types of industries inspected, and number and type of chemical substances assessed. Report of a hazard inspections documented work sites with worker overexposure at the same rate as agency targeted inspections (approximately 35% of the time), suggesting that complainants and referents are a credible pool of observers capable of directing the agency to airborne chemical substance hazards. Report of a hazard inspections were associated with significantly broader distribution of industries as well as a greater variety of chemical substance exposures than were targeted inspections. Narrative text that described business type and processes inspected was more useful than NAICS codes alone and critical in identifying processes and industries that may be associated with new hazards. Finally, previously identified emerging hazards were found among the report of a hazard data. These findings indicate that surveillance of OSHA inspection data can be a valid tool to identify uncharacterized and emerging health hazards. Additional research is needed to develop criteria for objective review and prioritization of the data for intervention. Federal OSHA and other state

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.

Identifying Preschool Children At-Risk of Later Reading Difficulties: Evaluation of two Emergent Literacy Screening Tools

PubMed Central

Wilson, Shauna B.; Lonigan, Christopher J.

2012-01-01

Emergent literacy skills are predictive of children’s early reading success, and literacy achievement in early schooling declines more rapidly for children who are below-average readers. It is therefore important for teachers to identify accurately children at risk for later reading difficulty so children can be exposed to good emergent literacy interventions. In this study, 176 preschoolers were administered two screening tools, the Revised Get Ready to Read! (GRTR-R) and the Individual Growth and Development Indicators (IGDIs), and a diagnostic measure at two time points. Receiver operating characteristic curve analyses revealed that at optimal cut scores, GRTR-R provided more accurate classification of children’s overall emergent literacy skills than did IGDIs. However, neither measure was particularly good at classifying specific emergent literacy skills. PMID:19822699

Trends in the Incidence of Hypertensive Emergencies in US Emergency Departments From 2006 to 2013.

PubMed

Janke, Alexander T; McNaughton, Candace D; Brody, Aaron M; Welch, Robert D; Levy, Phillip D

2016-12-05

The incidence of hypertensive emergency in US emergency departments (ED) is not well established. This study is a descriptive epidemiological analysis of nationally representative ED visit-level data from the Nationwide Emergency Department Sample for 2006-2013. Nationwide Emergency Department Sample is a publicly available database maintained by the Healthcare Cost and Utilization Project. An ED visit was considered to be a hypertensive emergency if it met all the following criteria: diagnosis of acute hypertension, at least 1 diagnosis indicating acute target organ damage, and qualifying disposition (admission to the hospital, death, or transfer to another facility). The incidence of adult ED visits for acute hypertension increased monotonically in the period from 2006 through 2013, from 170 340 (1820 per million adult ED visits overall) to 496 894 (4610 per million). Hypertensive emergency was rare overall, accounting for 63 406 visits (677 per million adult ED visits overall) in 2006 to 176 769 visits (1670 per million) in 2013. Among adult ED visits that had any diagnosis of hypertension, hypertensive emergency accounted for 3309 per million in 2006 and 6178 per million in 2013. The estimated number of visits for hypertensive emergency and the rate per million adult ED visits has more than doubled from 2006 to 2013. However, hypertensive emergencies are rare overall, occurring in about 2 in 1000 adult ED visits overall, and 6 in 1000 adult ED visits carrying any diagnosis of hypertension in 2013. This figure is far lower than what has been sometimes cited in previous literature. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Trends in the supply of California’s emergency departments and inpatient services, 2005–2014: a retrospective analysis

PubMed Central

Chow, Jessica L; Niedzwiecki, Matthew J; Hsia, Renee Y

2017-01-01

Objectives Given increasing demand for emergency care, there is growing concern over the availability of emergency department (ED) and inpatient resources. Existing studies of ED bed supply are dated and often overlook hospital capacity beyond ED settings. We described recent statewide trends in the capacity of ED and inpatient hospital services from 2005 to 2014. Design Retrospective analysis. Setting Using California hospital data, we examined the absolute and per admission changes in ED beds and inpatient beds in all hospitals from 2005 to 2014. Participants Our sample consisted of all patients inpatient and outpatient) from 501 hospital facilities over 10-year period. Outcome measures We analysed linear trends in the total annual ED visits, ED beds, licensed and staffed inpatient hospital beds and bed types, ED beds per ED visit, and inpatient beds per admission (ED and non-ED). Results Between 2005 and 2014, ED visits increased from 9.8 million to 13.2 million (an increase of 35.0%, p<0.001). ED beds also increased (by 29.8%, p<0.001), with an average annual increase of 195.4 beds. Despite this growth, ED beds per visit decreased by 3.9%, from 6.0 ED beds per 10 000 ED visits in 2005 to 5.8 beds in 2014 (p=0.01). While overall admission numbers declined by 4.9% (p=0.06), inpatient medical/surgical beds per visit grew by 11.3%, from 11.6 medical/surgical beds per 1000 admissions in 2005 to 12.9 beds in 2014 (p<0.001). However, there were reductions in psychiatric and chemical dependency beds per admission, by −15.3% (p<0.001) and −22.4% (p=0.05), respectively. Conclusions These trends suggest that, in its current state, inadequate supply of ED and specific inpatient beds cannot keep pace with growing patient demand for acute care. Analysis of ED and inpatient supply should capture dynamic variations in patient demand. Our novel ‘beds pervisit’ metric offers improvements over traditional supply measures. PMID:28495813

Research Trends in Mobile Learning in Higher Education: A Systematic Review of Articles (2011-2015)

ERIC Educational Resources Information Center

Krull, Greig; Duart, Josep M.

2017-01-01

The potential and use of mobile devices in higher education has been a key issue for educational research and practice since the widespread adoption of these devices. Due to the evolving nature and affordances of mobile technologies, it is an area that requires ongoing investigation. This study aims to identify emerging trends in mobile learning…

Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

ERIC Educational Resources Information Center

Gustavsson, Maria; Ekberg, Kerstin

2015-01-01

This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

Trends in the Global Small Satellite Ecosystem: Implications for Science Missions

NASA Astrophysics Data System (ADS)

Behrens, J.; Lal, B.

2017-12-01

Activity in the small satellite industry has increased in the recent years. New actors and nations have joined the evolving market globally in both the private and public sector. Progress in the smallsat sector has been driven, in part, by growing capabilities and falling costs of smallsats. Advancements include the miniaturization of technology for the small satellite platform, increased data processing capabilities, the ubiquitous presence of GPS enabling location and attitude determination, improvements in ground system costs and signal processing capabilities, and the deployment of inexpensive COTS parts. The emerging trends in the state of the art for smallsat technology, paired with planned smallsat constellation missions by both private and public actors, open the opportunity for new earth and remote sensing scientific endeavors. This presentation will characterize the drivers influencing the development of smallsat technology and the industry more generally. An overview will be provided for trends in the state of the art of smallsat technology, and secondary trends that influence the smallsat sector including infrastructure, demand, the satellite launch market, and the policy environment. These trends are mapped onto current and projected Earth observation needs, as identified by academic and governmental communities, to identify those that could be fulfilled by smallsats in the near and long term. A set of notional science missions that could be enabled, based on the various drivers identified, will be presented for both the near (3 years) and farther term (10 years).

Current and emerging screening methods to identify post-head-emergence frost adaptation in wheat and barley.

PubMed

Frederiks, T M; Christopher, J T; Harvey, G L; Sutherland, M W; Borrell, A K

2012-09-01

Cereal crops can suffer substantial damage if frosts occur at heading. Identification of post-head-emergence frost (PHEF) resistance in cereals poses a number of unique and difficult challenges. Many decades of research have failed to identify genotypes with PHEF resistance that could offer economically significant benefit to growers. Research and breeding gains have been limited by the available screening systems. Using traditional frost screening systems, genotypes that escape frost injury in trials due to spatial temperature differences and/or small differences in phenology can be misidentified as resistant. We believe that by improving techniques to minimize frost escapes, such 'false-positive' results can be confidently identified and eliminated. Artificial freezing chambers or manipulated natural frost treatments offer many potential advantages but are not yet at the stage where they can be reliably used for frost screening in breeding programmes. Here we describe the development of a novel photoperiod gradient method (PGM) that facilitates screening of genotypes of different phenology under natural field frosts at matched developmental stages. By identifying frost escapes and increasing the efficiency of field screening, the PGM ensures that research effort can be focused on finding genotypes with improved PHEF resistance. To maximize the likelihood of identifying PHEF resistance, we propose that the PGM form part of an integrated strategy to (i) source germplasm;(ii) facilitate high throughput screening; and (iii) permit detailed validation. PGM may also be useful in other studies where either a range of developmental stages and/or synchronized development are desired.

Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

PubMed

Parker, Miles; Acland, Andrew; Armstrong, Harry J; Bellingham, Jim R; Bland, Jessica; Bodmer, Helen C; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D; Cope, David; Costanzo, Lucia; Dolan, James A; Doubleday, Robert; Feng, Wai Yi; Godfray, H Charles J; Good, David A; Grant, Jonathan; Green, Nick; Groen, Arnoud J; Guilliams, Tim T; Gupta, Sunjai; Hall, Amanda C; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A; Lueshi, Leila M; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P; Watkinson, Andrew R; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K A; Worts, Kim; Sutherland, William J

2014-01-01

Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

Identifying the Science and Technology Dimensions of Emerging Public Policy Issues through Horizon Scanning

PubMed Central

Parker, Miles; Acland, Andrew; Armstrong, Harry J.; Bellingham, Jim R.; Bland, Jessica; Bodmer, Helen C.; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D.; Cope, David; Costanzo, Lucia; Dolan, James A.; Doubleday, Robert; Feng, Wai Yi; Godfray, H. Charles J.; Good, David A.; Grant, Jonathan; Green, Nick; Groen, Arnoud J.; Guilliams, Tim T.; Gupta, Sunjai; Hall, Amanda C.; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A.; Lueshi, Leila M.; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J.; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A.; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P.; Watkinson, Andrew R.; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K. A.; Worts, Kim; Sutherland, William J.

2014-01-01

Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security. PMID:24879444

Identifying priorities for quality improvement at an emergency Department in Ghana.

PubMed

DeWulf, Annelies; Otchi, Elom H; Soghoian, Sari

2017-08-30

Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization's (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program. Semi-structured interviews were conducted with ED staff using open-ended questions to probe their understanding and valuation of the six dimensions of quality defined by the WHO. Participants were then asked to rank the dimensions in order of importance for QI. Qualitative responses were thematically analyzed, and ordinal rank-order was determined for quantitative data regarding QI priorities. Twenty (20) members of staff of different cadres participated, including ED physicians, nurses, orderlies, a security officer, and an accountant. A majority of participants (61%) ranked access to emergency healthcare as high priority for QI. Two recurrent themes - financial accessibility and hospital bed availability - accounted for the majority of discussions, each linked to all the dimensions of healthcare quality. ED staff related all of the WHO quality dimensions to their work, and prioritized access to emergency care as the most important area for improvement. Participants expressed a high degree of motivation to improve healthcare quality, and the study helped with the development of a departmental QI program focused on the broad topic of access to ED services.

Emerging trends in the finance and delivery of long-term care: public and private opportunities and challenges.

PubMed

Cohen, M A

1998-02-01

A number of key trends are emerging in long-term care related to financing, new models of service delivery, and shifts in consumer expectations and preferences. Taken together, changes occurring in these areas point to a rapidly transforming long-term care landscape. Financing responsibility is shifting away from the federal government to states, individuals, and their families; providers are integrating and managing acute and long-term care services and adding new services to the continuum of care; and consumers are thinking more seriously about how to plan and pay for their future care needs, as well as how to independently navigate the long-term care system.

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

PubMed

Mahler, Simon A; Riley, Robert F; Hiestand, Brian C; Russell, Gregory B; Hoekstra, James W; Lefebvre, Cedric W; Nicks, Bret A; Cline, David M; Askew, Kim L; Elliott, Stephanie B; Herrington, David M; Burke, Gregory L; Miller, Chadwick D

2015-03-01

The HEART Pathway is a decision aid designed to identify emergency department patients with acute chest pain for early discharge. No randomized trials have compared the HEART Pathway with usual care. Adult emergency department patients with symptoms related to acute coronary syndrome without ST-elevation on ECG (n=282) were randomized to the HEART Pathway or usual care. In the HEART Pathway arm, emergency department providers used the HEART score, a validated decision aid, and troponin measures at 0 and 3 hours to identify patients for early discharge. Usual care was based on American College of Cardiology/American Heart Association guidelines. The primary outcome, objective cardiac testing (stress testing or angiography), and secondary outcomes, index length of stay, early discharge, and major adverse cardiac events (death, myocardial infarction, or coronary revascularization), were assessed at 30 days by phone interview and record review. Participants had a mean age of 53 years, 16% had previous myocardial infarction, and 6% (95% confidence interval, 3.6%-9.5%) had major adverse cardiac events within 30 days of randomization. Compared with usual care, use of the HEART Pathway decreased objective cardiac testing at 30 days by 12.1% (68.8% versus 56.7%; P=0.048) and length of stay by 12 hours (9.9 versus 21.9 hours; P=0.013) and increased early discharges by 21.3% (39.7% versus 18.4%; P<0.001). No patients identified for early discharge had major adverse cardiac events within 30 days. The HEART Pathway reduces objective cardiac testing during 30 days, shortens length of stay, and increases early discharges. These important efficiency gains occurred without any patients identified for early discharge suffering MACE at 30 days. URL: http://www.clinicaltrials.gov. Unique Identifier: NCT01665521. © 2015 American Heart Association, Inc.

An Overview of OCTAV-UTLS (Observed Composition Trends and Variability in the UTLS), a SPARC Emerging Activity

NASA Astrophysics Data System (ADS)

Petropavlovskikh, I. V.; Manney, G. L.; Hoor, P. M.; Bourassa, A. E.; Braathen, G.; Chang, K. L.; Hegglin, M. I.; Kramarova, N. A.; Kunkel, D.; Lawrence, Z. D.; Leblanc, T.; Livesey, N. J.; Millan Valle, L. F.; Stiller, G. P.; Tegtmeier, S.; Thouret, V.; Voigt, C.; Walker, K. A.

2017-12-01

The distribution of tracers in the upper troposphere and lower stratosphere (UTLS) shows large spatial and temporal variability because of interactions of transport, chemical, and mixing processes near the tropopause, as well as variations in the location of the tropopause itself. This strongly affects quantitative estimates of the impact of radiatively active substances, including ozone and water vapour, on surface temperatures, and complicates diagnosis of dynamical processes such as stratosphere troposphere exchange (STE). The Stratosphere-troposphere Processes And their Role in Climate (SPARC) emerging activity OCTAV-UTLS (Observed Composition Trends and Variability in the UTLS) aims to reduce the uncertainties in trend estimates by accounting for these dynamically induced sources of variability. Achieving these goals by using existing UTLS trace gas observations from aircraft, ground-based, balloon and satellite platforms requires a consistent analysis of these different data with respect to the tropopause or the jets. As a central task for OCTAV-UTLS, we are developing and applying common metrics, calculated using the same reanalysis datasets, to compare UTLS data using geophysically-based coordinate systems including tropopause and upper tropospheric jet relative coordinates. In addition to assessing present day measurement capabilities, OCTAV-UTLS will assess gaps in current geographical / temporal sampling of the UTLS that limit our ability to determine atmospheric composition variability and trends. This talk will provide an overview of the OCTAV-UTLS activity and some examples of initial calculations of geophysically-based coordinates and comparisons of remapped data.

Epidemiology and recent trends of geriatric fractures presenting to the emergency department for United States population from year 2004-2014.

PubMed

Baidwan, N K; Naranje, S M

2017-01-01

Fractures in geriatric age group (over 65 years of age) are an important public health issue and frequent causes of emergency room visits. The purpose of this descriptive epidemiological study was to present the epidemiology of geriatric fractures and their trends in the USA using National Electronic Injury Surveillance System (NEISS) database from year 2004-2014. National Electronic Injury Surveillance System (NEISS) Database was queried for all fracture injuries from 2004 to 2014 for ages 65 years and above. The proportions of fractures based on NEISS national estimates were calculated and their trends using linear regression over last 11 years were studied. Lower trunk (pelvis, hip and lower spine) fractures were the most common (34% for year 2014) type of fractures in this age group. Upper trunk (upper spine, clavicle and ribs) fractures were the second most common type of fractures (13% for year 2014). Other body parts commonly fractured involved the upper arm and wrist with an average of 7% fractures in both during the study period. About 5% of geriatric fractures pertained to shoulder and upper leg. Although less common, there was also about 2% increase in fractures to face and neck in 2014 as compared to about 3.2% and 1% respectively in 2004. Fractures to other body parts were less common with no major variations during the study period. Overall, lower trunk (hip, pelvic and lower spine) fractures were the most common geriatric fractures followed by upper trunk (upper spine, clavicle and rib) fractures. We suggest that there were decreasing trends for incidence of lower trunk, wrist and upper body fractures over the last 11 years (2004-2014). Approximately half of the geriatric fractures presenting to Emergency Department needed hospitalizations. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Natural orifice translumenal endoscopic surgery (NOTES): emerging trends and specifications for a virtual simulator.

PubMed

Schwaitzberg, Steven D; Dorozhkin, Denis; Sankaranarayanan, Ganesh; Matthes, Kai; Jones, Daniel B; De, Suvranu

2016-01-01

A virtual translumenal endoscopic surgical trainer (VTEST) is being developed to accelerate the development of natural orifice translumenal endoscopic surgery (NOTES) procedures and devices in a safe and risk-free environment. For a rapidly developing field such as NOTES, a needs analysis must be conducted regularly to discover emerging research trends and areas of potential high impact for a virtual simulator. This paper presents a survey-based study which follows a similar study conducted by this group in 2011 (Sankaranarayanan et al. in Surg Endosc 27:1607-1616, 2013). A 32-point questionnaire was distributed at the 2012 Natural Orifice Surgery Consortium for Assessment and Research annual meeting. These data were subsequently augmented by an identical online survey, targeted at the members of the American Society for Gastrointestinal Endoscopy and the Society of American Gastrointestinal and Endoscopic Surgeons, and analyzed. Twenty-eight NOTES experts participated in the 2012 study. Cholecystectomy (CE) procedure remained the most commonly performed NOTES technique, with 18 positive responses (64%). In contrast to 2011, the popularity of the NOTES appendectomy (AE) was significantly lower, with only 2 (7%) instances (CE vs. AE, p < 0.001), while the number of peroral endoscopic myotomy (POEM, PE) cases had increased significantly, with 11 (39%) positive responses, respectively (PE vs. AE, p = 0.013). Strong preference toward hybrid rather than pure NOTES techniques (82 vs. 11%, p < 0.001) was also expressed. Other responses were similar to those in the 2011 study, with the VTEST™ utility in developing and testing new techniques and instruments ranked particularly high. Based on the results of this study, a decision was made to focus exclusively on the transvaginal hybrid NOTES cholecystectomy procedure, including both rigid and flexible scope techniques. The importance of developing a virtual NOTES simulator was reaffirmed, with POEM identified as a

Amphibian breeding phenology trends under climate change: predicting the past to forecast the future.

PubMed

Green, David M

2017-02-01

Global climate warming is predicted to hasten the onset of spring breeding by anuran amphibians in seasonal environments. Previous data had indicated that the breeding phenology of a population of Fowler's Toads (Anaxyrus fowleri) at their northern range limit had been progressively later in spring, contrary to generally observed trends in other species. Although these animals are known to respond to environmental temperature and the lunar cycle to commence breeding, the timing of breeding should also be influenced by the onset of overwintering animals' prior upward movement through the soil column from beneath the frost line as winter becomes spring. I used recorded weather data to identify four factors of temperature, rainfall and snowfall in late winter and early spring that correlated with the toads' eventual date of emergence aboveground. Estimated dates of spring emergence of the toads calculated using a predictive model based on these factors, as well as the illumination of the moon, were highly correlated with observed dates of emergence over 24 consecutive years. Using the model to estimate of past dates of spring breeding (i.e. retrodiction) indicated that even three decades of data were insufficient to discern any appreciable phenological trend in these toads. However, by employing weather data dating back to 1876, I detected a significant trend over 140 years towards earlier spring emergence by the toads by less than half a day/decade, while, over the same period of time, average annual air temperature and annual precipitation had both increased. Changes in the springtime breeding phenology for late-breeding species, such as Fowler's Toads, therefore may conform to expectations of earlier breeding under global warming. Improved understanding of the environmental cues that bring organisms out of winter dormancy will enable better interpretation of long-term phenological trends. © 2016 John Wiley & Sons Ltd.

The changing model of big pharma: impact of key trends.

PubMed

Gautam, Ajay; Pan, Xiaogang

2016-03-01

Recent years have seen exciting breakthroughs in biomedical sciences that are producing truly novel therapeutics for unmet patient needs. However, the pharmaceutical industry is also facing significant barriers in the form of pricing and reimbursement, continued patent expirations and challenging market dynamics. In this article, we have analyzed data from the 1995-2015 period, on key aspects such as revenue distribution, research units, portfolio mix and emerging markets to identify four key trends that help to understand the change in strategic focus, realignment of R&D footprint, the shift from primary care toward specialty drugs and biologics and the growth of emerging markets as major revenue drivers for big pharma. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Trends in academic health sciences libraries and their emergence as the "knowledge nexus" for their academic health centers.

PubMed

Kronenfeld, Michael R

2005-01-01

The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or "nexus" for the organization, access, and use of an increasingly digital-based knowledgebase. This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process.

Diversity in the Emerging Critical Care Workforce: Analysis of Demographic Trends in Critical Care Fellows From 2004 to 2014.

PubMed

Lane-Fall, Meghan B; Miano, Todd A; Aysola, Jaya; Augoustides, John G T

2017-05-01

Diversity in the physician workforce is essential to providing culturally effective care. In critical care, despite the high stakes and frequency with which cultural concerns arise, it is unknown whether physician diversity reflects that of critically ill patients. We sought to characterize demographic trends in critical care fellows, who represent the emerging intensivist workforce. We used published data to create logistic regression models comparing annual trends in the representation of women and racial/ethnic groups across critical care fellowship types. United States Accreditation Council on Graduate Medical Education-approved residency and fellowship training programs. Residents and fellows employed by Accreditation Council on Graduate Medical Education-accredited training programs from 2004 to 2014. None. From 2004 to 2014, the number of critical care fellows increased annually, up 54.1% from 1,606 in 2004-2005 to 2,475 in 2013-2014. The proportion of female critical care fellows increased from 29.5% (2004-2005) to 38.3% (2013-2014) (p < 0.001). The absolute number of black fellows increased each year but the percentage change was not statistically significantly different (5.1% in 2004-2005 vs 3.9% in 2013-2014; p = 0.92). Hispanic fellows increased in number from 124 (7.7%) in 2004-2005 to 216 (8.4%) in 2013-2014 (p = 0.015). The number of American Indian/Alaskan Native/Native Hawaiian/Pacific Islander fellows decreased from 15 (1.0%) to seven (0.3%) (p < 0.001). When compared with population estimates, female critical care fellows and those from racial/ethnic minorities were underrepresented in all years. The demographics of the emerging critical care physician workforce reflect underrepresentation of women and racial/ethnic minorities. Trends highlight increases in women and Hispanics and stable or decreasing representation of non-Hispanic underrepresented minority critical care fellows. Further research is needed to elucidate the reasons underlying

Earlier warning: a multi-indicator approach to monitoring trends in the illicit use of medicines.

PubMed

Mounteney, Jane; Haugland, Siren

2009-03-01

The availability of medicines on the illicit drug market is currently high on the international policy agenda, linked to adverse health consequences including addiction, drug related overdoses and injection related problems. Continuous surveillance of illicit use of medicines allows for earlier identification and reporting of emerging trends and increased possibilities for earlier intervention to prevent spread of use and drug related harm. This paper aims to identify data sources capable of monitoring the illicit use of medicines; present trend findings for Rohypnol and Subutex using a multi-indicator monitoring approach; and consider the relevance of such models for policy makers. Data collection and analysis were undertaken in Bergen, Norway, using the Bergen Earlier Warning System (BEWS), a multi-indicator drug monitoring system. Data were gathered at six monthly intervals from April 2002 to September 2006. Drug indicator data from seizures, treatment, pharmacy sales, helplines, key informants and media monitoring were triangulated and an aggregated differential was used to plot trends. Results for the 4-year period showed a decline in the illicit use of Rohypnol and an increase in the illicit use of Subutex. Multi-indicator surveillance models can play a strategic role in the earlier identification and reporting of emerging trends in illicit use of medicines.

Identifying Geographic Disparities in Diabetes Prevalence Among Adults and Children Using Emergency Claims Data

PubMed Central

Lee, David C; Gallagher, Mary Pat; Gopalan, Anjali; Osorio, Marcela; Vinson, Andrew J; Wall, Stephen P; Ravenell, Joseph E; Sevick, Mary Ann; Elbel, Brian

2018-01-01

Abstract Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department surveillance to investigate geographic disparities in type 1 and type 2 diabetes prevalence among adults and children. Using all-payer emergency claims data from 2009 to 2013, we identified unique New York City residents with diabetes and geocoded their location using home addresses. Geospatial analysis was performed to estimate diabetes prevalence by New York City Census tract. We also used multivariable regression to identify neighborhood-level factors associated with higher diabetes prevalence. We estimated type 1 and type 2 diabetes prevalence at 0.23% and 10.5%, respectively, among adults and 0.20% and 0.11%, respectively, among children in New York City. Pediatric type 1 diabetes was associated with higher income (P = 0.001), whereas adult type 2 diabetes was associated with lower income (P < 0.001). Areas with a higher proportion of nearby restaurants categorized as fast food had a higher prevalence of all types of diabetes (P < 0.001) except for pediatric type 2 diabetes. Type 2 diabetes among children was only higher in neighborhoods with higher proportions of African American residents (P < 0.001). Our findings identify geographic disparities in diabetes prevalence that may require special attention to address the specific needs of adults and children living in these areas. Our results suggest that the food environment may be associated with higher type 1 diabetes prevalence. However, our analysis did not find a robust association with the food environment and pediatric type 2 diabetes, which was predominantly focused in African American neighborhoods. PMID:29719877

Drug-induced seizures in children and adolescents presenting for emergency care: current and emerging trends.

PubMed

Finkelstein, Y; Hutson, J R; Freedman, S B; Wax, P; Brent, J

2013-01-01

Seizures may be the presenting manifestation of acute poisoning in children. Knowledge of the etiologic agent, or likely drug-class exposure, is crucial to minimize morbidity and optimize care. To describe the agents most commonly responsible for pediatric drug-induced seizures, whose evaluation included a medical toxicology consultation in the United States. Using the 37 participating sites of the Toxicology Investigators Consortium (ToxIC) Case Registry, a cross-country surveillance tool, we conducted an observational study of a prospectively collected cohort. We identified all pediatric (younger than 18 years) reports originating from an Emergency Department (ED) which included a chemical or drug-induced seizure, and required a medical toxicology consultation between April 1, 2010 and March 31, 2012. Results. We identified 142 pediatric drug-induced seizure cases (56% male), which represent nearly 5% of pediatric cases requiring bedside consultation by medical toxicologists. One-hundred and seven cases (75%) occurred in children aged 13-18 years, and 86 (61%) resulted from intentional ingestions. Antidepressants were the most commonly identified agents ingested (n = 61; 42%), of which bupropion was the leading drug (n = 30; 50% of antidepressants), followed by anticholinergics/antihistamines (n = 31; 22%). All antidepressant-induced seizures in teenagers were intentional and represented self-harm behavior. Sympathomimetic agents, including street drugs, represent the most common agents in children younger than 2 years (n = 4/19). Antidepressants, and specifically bupropion, are presently the most common medications responsible for pediatric drug-induced seizures requiring medical toxicology consultation in the United States. In teenagers presenting with new-onset seizures of unknown etiology, the possibility of deliberate self-poisoning should be explored, since most drug-induced seizures in this age group resulted from intentional ingestion.

Annual Trends in Follow-Up Visits for Pediatric Concussion in Emergency Departments and Physicians' Offices.

PubMed

Fridman, Liraz; Scolnik, Michal; Macpherson, Alison; Rothman, Linda; Guttmann, Astrid; Grool, Anne M; Rodriguez Duque, Daniel; Zemek, Roger L

2018-01-01

To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits. A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care. The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important. Copyright © 2017 Elsevier Inc. All rights reserved.

Canadian trends in filicide by gender of the accused, 1961-2011.

PubMed

Dawson, Myrna

2015-09-01

This paper provides a comprehensive historical and contemporary picture of filicide in Canada for more than half a century. Focusing on 1,612 children under age 18 that were killed by their parents between 1961 and 2011, regional and temporal trends in the gender of accused are examined as well as differences in maternal and paternal filicides by the gender and age of the victim, the age and marital status of the accused, type of parental relationship, cause of death, motive, history of family violence, and clearance status. Results show that there are significant differences in filicides by mothers and fathers. Five possible emerging trends were identified: an increasing gender gap in accused, increasing presence of relationship breakdown, growing number of cases involving stepfathers and a prior history of family violence, and declines in accused who committed suicide. Implications of these trends for interventions and prevention are discussed and future research priorities highlighted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Global trends in emerging viral diseases of wildlife origin

USGS Publications Warehouse

Sleeman, Jonathan M.; Ip, Hon S.

2015-01-01

The following article provides examples of recently emerged viral diseases of wildlife origin. The examples have been selected to illustrate the drivers of emerging viral diseases, both novel pathogens and previously known diseases, the impacts of these diseases, as well as the role of wildlife both as “villains” or reservoirs as well as “victims” of these viral diseases. The article also discusses potential management strategies for emerging viral diseases in wildlife populations and future science directions in wildlife health to prevent, prepare, respond to, and recover from these disease events. Finally, the concept of One Health and its potential role in developing solutions to these issues of mutual concern is discussed.

Identifying pneumonia outbreaks of public health importance: can emergency department data assist in earlier identification?

PubMed

Hope, Kirsty; Durrheim, David N; Muscatello, David; Merritt, Tony; Zheng, Wei; Massey, Peter; Cashman, Patrick; Eastwood, Keith

2008-08-01

To retrospectively review the performance of a near real-time Emergency Department (ED) Syndromic Surveillance System operating in New South Wales for identifying pneumonia outbreaks of public health importance. Retrospective data was obtained from the NSW Emergency Department data collection for a rural hospital that has experienced a cluster of pneumonia diagnoses among teenage males in August 2006. ED standard reports were examined for signals in the overall count for each respiratory syndrome, and for elevated counts in individual subgroups including; age, sex and admission to hospital status. Using the current thresholds, the ED syndromic surveillance system would have trigged a signal for pneumonia syndrome in children aged 5-16 years four days earlier than the notification by a paediatrician and this signal was maintained for 14 days. If the ED syndromic surveillance system had been operating it could have identified the outbreak earlier than the paediatrician's notification. This may have permitted an earlier public health response. By understanding the behaviour of syndromes during outbreaks of public health importance, response protocols could be developed to facilitate earlier implementation of control measures.

Workplace Learning: Emerging Trends and New Perspectives

ERIC Educational Resources Information Center

Fenwick, Tara

2008-01-01

This chapter focuses on "learning processes" in the workplace from concepts emerging in the field of adult education, without straying into pedagogies and programs that can enhance learning. It discusses four topics on learning processes that seem to be particularly important for addressing key purposes and issues of workplace learning from an…

The Climate-Population Nexus in the East African Horn: Emerging Degradation Trends in Rangeland and Pastoral Livelihood Zones

NASA Astrophysics Data System (ADS)

Pricope, N. G.; Husak, G. J.; Funk, C. C.; Lopez-Carr, D.

2014-12-01

Increasing climate variability and extreme weather conditions along with declining trends in both rainfall and temperature represent major risk factors affecting agricultural production and food security in many regions of the world. We identify regions where significant rainfall decrease from 1979-2011 over the entire continent of Africa couples with significant human population density increase. The rangelands of Ethiopia, Kenya, and Somalia in the East African Horn remain one of the world's most food insecure regions, yet have significantly increasing human populations predominantly dependent on pastoralist and agro-pastoralist livelihoods. Vegetation in this region is characterized by a variable mosaic of land covers, generally dominated by grasslands necessary for agro-pastoralism, interspersed by woody vegetation. Recent assessments indicate that widespread degradation is occurring, adversely impacting fragile ecosystems and human livelihoods. Using two underutilized MODIS products, we observe significant changes in vegetation patterns and productivity over the last decade all across the East African Horn. We observe significant vegetation browning trends in areas experiencing drying precipitation trends in addition to increasing population pressures. We also found that the drying precipitation trends only partially statistically explain the vegetation browning trends, further indicating that other factors such as population pressures and land use changes are responsible for the observed declining vegetation health. Furthermore, we show that the general vegetation browning trends persist even during years with normal rainfall conditions such as 2012, indicating potential long-term degradation of rangelands on which approximately 10 million people depend. These findings have serious implications for current and future regional food security monitoring and forecasting as well as for mitigation and adaptation strategies in a region where population is expected

Comparison of the h-Index Scores Among Pathogens Identified as Emerging Hazards in North America.

PubMed

Cox, R; McIntyre, K M; Sanchez, J; Setzkorn, C; Baylis, M; Revie, C W

2016-02-01

Disease surveillance must assess the relative importance of pathogen hazards. Here, we use the Hirsch index (h-index) as a novel method to identify and rank infectious pathogens that are likely to be a hazard to human health in the North American region. This bibliometric index was developed to quantify an individual's scientific research output and was recently used as a proxy measure for pathogen impact. Analysis of more than 3000 infectious organisms indicated that 651 were human pathogen species that had been recorded in the North American region. The h-index of these pathogens ranged from 0 to 584. The h-index of emerging pathogens was greater than non-emerging pathogens as was the h-index of frequently pathogenic pathogens when compared to non-pathogenic pathogens. As expected, the h-index of pathogens varied over time between 1960 and 2011. We discuss how the h-index can contribute to pathogen prioritization and as an indicator of pathogen emergence. © 2014 Blackwell Verlag GmbH.

Marketing Trends to Watch

ERIC Educational Resources Information Center

Circle, Alison

2009-01-01

This article identifies 13 cultural trends that libraries can turn into opportunites to reach patrons. These trends include: Twitter, online reputation management, value added content, mobile marketing, and emotional connection.

Destabilising automobility? The emergent mobilities of generation Y.

PubMed

Hopkins, Debbie

2017-04-01

This paper uses empirical material gathered with young adults in New Zealand to examine a potential sustainability transition-in-practice. It draws from two frameworks; the actor-centred Energy Cultures Framework to explore mobility behaviours, and the multi-level perspective (MLP) to situate behaviour change within the socio-technical transitions literature. The MLP has traditionally been used to analyse historical transitions (e.g. from the horse and cart to the motor vehicle), but in this paper, it is used to explore an on-going change trend; the emergent mobilities of young adults who appear to be aspiring for different types of mobility. A series of mobility trends are described, which emerged from a programme of qualitative interviews (n = 51). The material culture, norms and practices that constitute these trends are articulated. These are then considered through the lens of the MLP. The evidence points to emergent trends of multimodality that, if leveraged upon and supported, could contribute to a systemic sustainability transition.

Decades of Data: Extracting Trends from Microgravity Crystallization History

NASA Technical Reports Server (NTRS)

Judge, Russell A.; Snell, Edward H.; Kephart, Richard; vanderWoerd, Mark; Curreri, Peter A. (Technical Monitor)

2002-01-01

The reduced acceleration environment of an orbiting spacecraft has been posited as an ideal environment for biological crystal growth since buoyancy driven convection and sedimentation are greatly reduced. Since the first sounding rocket flight in 1981 many crystallization experiments have flown with some showing improvement and others not. To further explore macromolecule crystal improvement in microgravity we have accumulated data from published reports and reports submitted by individual investigators to NASA, forming a database called BIOSEArCH (Biological Space Experiment Archive of Crystallization History). To date it contains information from 63 missions including, the Space Shuttle program, unmanned satellites, the Russian Space Station MIR and sounding rocket experiments, containing reports for more than 736 macromolecule experiments. While it is not at this point in time a comprehensive record of all flight crystallization experimental results, there is however sufficient information for emerging trends to be identified. These trends will be highlighted.

Integrating text mining, data mining, and network analysis for identifying genetic breast cancer trends.

PubMed

Jurca, Gabriela; Addam, Omar; Aksac, Alper; Gao, Shang; Özyer, Tansel; Demetrick, Douglas; Alhajj, Reda

2016-04-26

Breast cancer is a serious disease which affects many women and may lead to death. It has received considerable attention from the research community. Thus, biomedical researchers aim to find genetic biomarkers indicative of the disease. Novel biomarkers can be elucidated from the existing literature. However, the vast amount of scientific publications on breast cancer make this a daunting task. This paper presents a framework which investigates existing literature data for informative discoveries. It integrates text mining and social network analysis in order to identify new potential biomarkers for breast cancer. We utilized PubMed for the testing. We investigated gene-gene interactions, as well as novel interactions such as gene-year, gene-country, and abstract-country to find out how the discoveries varied over time and how overlapping/diverse are the discoveries and the interest of various research groups in different countries. Interesting trends have been identified and discussed, e.g., different genes are highlighted in relationship to different countries though the various genes were found to share functionality. Some text analysis based results have been validated against results from other tools that predict gene-gene relations and gene functions.

An environmental scan of academic pediatric emergency medicine at Canadian medical schools: Identifying variability across Canada.

PubMed

Artz, Jennifer D; Meckler, Garth; Argintaru, Niran; Lim, Roderick; Stiell, Ian G

2018-01-28

To complement our environmental scan of academic emergency medicine departments, we conducted a similar environmental scan of the academic pediatric emergency medicine programs offered by the Canadian medical schools. We developed an 88-question form, which was distributed to pediatric academic leaders at each medical school. The responses were validated via email to ensure that the questions were answered completely and consistently. Fourteen of the 17 Canadian medical schools have some type of pediatric emergency medicine academic program. None of the pediatric emergency medicine units have full departmental status, while nine are divisions, two are sections, and three have no status. Canadian academic pediatric emergency medicine is practised at 13 major teaching hospitals and one specialized pediatric emergency department. There are 394 pediatric emergency medicine faculty members, including 13 full professors and 64 associate professors. Eight sites regularly take pediatric undergraduate clinical clerks, and all 14 provide resident education. Fellowship training is offered at 10 sites, with five offering advanced pediatric emergency medicine fellowship training. Half of the sites have at least one physician with a Master's degree in education, totalling 18 faculty members across Canada. There are 31 clinical researchers with salary support at nine universities. Eleven sites have published peer-reviewed papers (n=423) in the past five years, ranging from two to 102 per site. Annual academic budgets range from $10,000 to $2,607,515. This comprehensive review of academic activities in pediatric emergency medicine across Canada identifies the variability across the country, including the recognition of sites above and below the national average, which may prompt change at individual sites. Sharing these academic practices may inspire sites to provide more support to teachers, educators, and researchers.

Trends in academic health sciences libraries and their emergence as the “knowledge nexus” for their academic health centers*

PubMed Central

Kronenfeld, Michael R.

2005-01-01

Objectives: The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. Methods: The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Results: Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or “nexus” for the organization, access, and use of an increasingly digital-based knowledgebase. Conclusion: This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process. PMID:15685271

[Current Situation and Prospects of Emergency Medical Equipment in Our Country].

PubMed

Qi, Lijing; Cheng, Feng

2016-03-01

This article analyzes the new demand of emergency medical equipment in the current development trend based on the analysis of the development and current situation of emergency medicine in our country. At the same time it introduces the current industrial characteristics of our country. Finally it analyzes the development trend of this kind of equipment in the new emergency medicine field.

Conscious Sedation: Emerging Trends in Pediatric Dentistry

PubMed Central

Attri, Joginder Pal; Sharan, Radhe; Makkar, Vega; Gupta, Kewal Krishan; Khetarpal, Ranjana; Kataria, Amar Parkash

2017-01-01

Dental fear and anxiety is a common problem in pediatric patients. There is considerable variation in techniques used to manage them. Various sedation techniques using many different anesthetic agents have gained considerable popularity over the past few years. Children are not little adults; they differ physically, psychologically, and emotionally. The purpose of this review is to survey recent trends and concerning issues in the rapidly changing field of pediatric sedation. We will study the topic from the perspective of an anesthesiologist. It will also provide information to practitioners on the practice of conscious sedation in dentistry and will also outline the route of administration, pharmacokinetics, and pharmacodynamics of various drugs used. PMID:28663606

Global Health and Emergency Care: Defining Clinical Research Priorities.

PubMed

Hansoti, Bhakti; Aluisio, Adam R; Barry, Meagan A; Davey, Kevin; Lentz, Brian A; Modi, Payal; Newberry, Jennifer A; Patel, Melissa H; Smith, Tricia A; Vinograd, Alexandra M; Levine, Adam C

2017-06-01

Despite recent strides in the development of global emergency medicine (EM), the field continues to lag in applying a scientific approach to identifying critical knowledge gaps and advancing evidence-based solutions to clinical and public health problems seen in emergency departments (EDs) worldwide. Here, progress on the global EM research agenda created at the 2013 Academic Emergency Medicine Global Health and Emergency Care Consensus Conference is evaluated and critical areas for future development in emergency care research internationally are identified. A retrospective review of all studies compiled in the Global Emergency Medicine Literature Review (GEMLR) database from 2013 through 2015 was conducted. Articles were categorized and analyzed using descriptive quantitative measures and structured data matrices. The Global Emergency Medicine Think Tank Clinical Research Working Group at the Society for Academic Emergency Medicine 2016 Annual Meeting then further conceptualized and defined global EM research priorities utilizing consensus-based decision making. Research trends in global EM research published between 2013 and 2015 show a predominance of observational studies relative to interventional or descriptive studies, with the majority of research conducted in the inpatient setting in comparison to the ED or prehospital setting. Studies on communicable diseases and injury were the most prevalent, with a relative dearth of research on chronic noncommunicable diseases. The Global Emergency Medicine Think Tank Clinical Research Working Group identified conceptual frameworks to define high-impact research priorities, including the traditional approach of using global burden of disease to define priorities and the impact of EM on individual clinical care and public health opportunities. EM research is also described through a population lens approach, including gender, pediatrics, and migrant and refugee health. Despite recent strides in global EM research and

Pain Management for Sickle Cell Disease in the Pediatric Emergency Department: Medications and Hospitalization Trends.

PubMed

Cacciotti, Chantel; Vaiselbuh, Sarah; Romanos-Sirakis, Eleny

2017-10-01

The majority of emergency department (ED) visits and hospitalizations for patients with sickle cell disease (SCD) are pain related. Adequate and timely pain management may improve quality of life and prevent worsening morbidities. We conducted a retrospective chart review of pediatric patients with SCD seen in the ED, selected by sickle cell-related ICD-9 codes. A total of 176 encounters were reviewed from 47 patients to record ED pain management and hospitalization trends. Mean time to pain medication administration was 63 minutes. Patients received combination (nonsteroidal anti-inflammatory drug [NSAID] + narcotic) pain medications for initial treatment at a minority of ED encounters (19%). A higher percentage of patients who received narcotics alone as initial treatment were hospitalized as compared with those who received combination treatment initially ( P= 0.0085). Improved patient education regarding home pain management as well as standardized ED guidelines for assessment and treatment of sickle cell pain may result in superior and more consistent patient care.

Identifying Preschool Children at Risk of Later Reading Difficulties: Evaluation of Two Emergent Literacy Screening Tools

ERIC Educational Resources Information Center

Wilson, Shauna B.; Lonigan, Christopher J.

2010-01-01

Emergent literacy skills are predictive of children's early reading success, and literacy achievement in early schooling declines more rapidly for children who are below-average readers. It is therefore important for teachers to identify accurately children at risk for later reading difficulty so children can be exposed to effective emergent…

Team knowledge research: emerging trends and critical needs.

PubMed

Wildman, Jessica L; Thayer, Amanda L; Pavlas, Davin; Salas, Eduardo; Stewart, John E; Howse, William R

2012-02-01

This article provides a systematic review of the team knowledge literature and guidance for further research. Recent research has called attention to the need for the improved study and understanding of team knowledge. Team knowledge refers to the higher level knowledge structures that emerge from the interactions of individual team members. We conducted a systematic review of the team knowledge literature, focusing on empirical work that involves the measurement of team knowledge constructs. For each study, we extracted author degree area, study design type, study setting, participant type, task type, construct type, elicitation method, aggregation method, measurement timeline, and criterion domain. Our analyses demonstrate that many of the methodological characteristics of team knowledge research can be linked back to the academic training of the primary author and that there are considerable gaps in our knowledge with regard to the relationships between team knowledge constructs, the mediating mechanisms between team knowledge and performance, and relationships with criteria outside of team performance, among others. We also identify categories of team knowledge not yet examined based on an organizing framework derived from a synthesis of the literature. There are clear opportunities for expansion in the study of team knowledge; the science of team knowledge would benefit from a more holistic theoretical approach. Human factors researchers are increasingly involved in the study of teams. This review and the resulting organizing framework provide researchers with a summary of team knowledge research over the past 10 years and directions for improving further research.

Global trends in infectious diseases at the wildlife-livestock interface.

PubMed

Wiethoelter, Anke K; Beltrán-Alcrudo, Daniel; Kock, Richard; Mor, Siobhan M

2015-08-04

The role and significance of wildlife-livestock interfaces in disease ecology has largely been neglected, despite recent interest in animals as origins of emerging diseases in humans. Scoping review methods were applied to objectively assess the relative interest by the scientific community in infectious diseases at interfaces between wildlife and livestock, to characterize animal species and regions involved, as well as to identify trends over time. An extensive literature search combining wildlife, livestock, disease, and geographical search terms yielded 78,861 publications, of which 15,998 were included in the analysis. Publications dated from 1912 to 2013 and showed a continuous increasing trend, including a shift from parasitic to viral diseases over time. In particular there was a significant increase in publications on the artiodactyls-cattle and bird-poultry interface after 2002 and 2003, respectively. These trends could be traced to key disease events that stimulated public interest and research funding. Among the top 10 diseases identified by this review, the majority were zoonoses. Prominent wildlife-livestock interfaces resulted largely from interaction between phylogenetically closely related and/or sympatric species. The bird-poultry interface was the most frequently cited wildlife-livestock interface worldwide with other interfaces reflecting regional circumstances. This review provides the most comprehensive overview of research on infectious diseases at the wildlife-livestock interface to date.

Global trends in infectious diseases at the wildlife–livestock interface

PubMed Central

Wiethoelter, Anke K.; Beltrán-Alcrudo, Daniel; Kock, Richard; Mor, Siobhan M.

2015-01-01

The role and significance of wildlife–livestock interfaces in disease ecology has largely been neglected, despite recent interest in animals as origins of emerging diseases in humans. Scoping review methods were applied to objectively assess the relative interest by the scientific community in infectious diseases at interfaces between wildlife and livestock, to characterize animal species and regions involved, as well as to identify trends over time. An extensive literature search combining wildlife, livestock, disease, and geographical search terms yielded 78,861 publications, of which 15,998 were included in the analysis. Publications dated from 1912 to 2013 and showed a continuous increasing trend, including a shift from parasitic to viral diseases over time. In particular there was a significant increase in publications on the artiodactyls–cattle and bird–poultry interface after 2002 and 2003, respectively. These trends could be traced to key disease events that stimulated public interest and research funding. Among the top 10 diseases identified by this review, the majority were zoonoses. Prominent wildlife–livestock interfaces resulted largely from interaction between phylogenetically closely related and/or sympatric species. The bird–poultry interface was the most frequently cited wildlife–livestock interface worldwide with other interfaces reflecting regional circumstances. This review provides the most comprehensive overview of research on infectious diseases at the wildlife–livestock interface to date. PMID:26195733

How Does the United States Rank According to the World Breastfeeding Trends Initiative?

PubMed

Cadwell, Karin; Turner-Maffei, Cynthia; Blair, Anna; Brimdyr, Kajsa; OʼConnor, Barbara

The World Breastfeeding Trends Initiative is an assessment process designed to facilitate an ongoing national appraisal of progress toward the goals of the United Nations Children's Fund (UNICEF)/World Health Organization (WHO) Global Strategy for Infant and Young Child Feeding. More than 80 countries have completed this national assessment, including the United States of America. This article describes the process undertaken by the US World Breastfeeding Trends Initiative team, the findings of the expert panel related to infant and young child feeding policies, programs, and practices and the ranking of the United States compared with the 83 other participating nations. Identified strengths of the United States include data collection and monitoring, especially by the Centers for Disease Control and Prevention, the US Baby-Friendly Hospital Initiative, and the United States Breastfeeding Committee. The absence of a national infant feeding policy, insufficient maternity protection, and lack of preparation for infant and young children feeding in emergencies are key targets identified by the assessment requiring concerted national effort.

Alarming Prevalence of Emergency Hypertension Levels in the General Public Identified by a Hypertension Awareness Campaign.

PubMed

Caligiuri, Stephanie P B; Austria, Jose Alejandro; Pierce, Grant N

2017-03-01

Hypertension is a major cause of mortality and morbidity today. The "silent" nature of hypertension makes it critical to determine its prevalence and its severity in the general public and to identify strategies to identify people unaware of its presence. A mobile hypertension awareness campaign was created to: (i) determine the prevalence and types of hypertension in an urban North American center, (ii) increase hypertension awareness, and (iii) identify reasons for lack of therapy adherence. Mobile clinics were provided at shopping malls, workplaces, hospitals, and community centres to measure blood pressure in the public. Blood pressure recordings were done on a voluntary basis. Of 1097 participants, 50% presented with high blood pressure which was higher than expected. Of particular clinical significance, an unexpectedly large number of participants (2%) exhibited a hypertensive urgency/emergency. Most of these people were not adherent to medications (if their hypertension was detected previously), were unaware of their hypertensive state, and/or unwilling to acknowledge or ignored the clinical significance of the extremely high blood pressure readings. Reasons for lack of adherence included: denial, being unaware of health consequences, and proper management of hypertension. A relatively large segment of an urban population lives unaware of severe emergency levels of hypertension. A public mobile hypertension clinic provides a valuable strategy for identifying hypertension in the general public and for knowledge translation of hypertension management. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Venoms of Micrurus coral snakes: Evolutionary trends in compositional patterns emerging from proteomic analyses.

PubMed

Lomonte, Bruno; Rey-Suárez, Paola; Fernández, Julián; Sasa, Mahmood; Pla, Davinia; Vargas, Nancy; Bénard-Valle, Melisa; Sanz, Libia; Corrêa-Netto, Carlos; Núñez, Vitelbina; Alape-Girón, Alberto; Alagón, Alejandro; Gutiérrez, José María; Calvete, Juan J

2016-11-01

The application of proteomic tools to the study of snake venoms has led to an impressive growth in the knowledge about their composition (venomics), immunogenicity (antivenomics), and toxicity (toxicovenomics). About one-third of all venomic studies have focused on elapid species, especially those of the Old World. The New World elapids, represented by coral snakes, have been less studied. In recent years, however, a number of venomic studies on Micrurus species from North, Central, and South America have been conducted. An overview of these studies is presented, highlighting the emergence of some patterns and trends concerning their compositional, functional, and immunological characteristics. Results gathered to date, encompassing 18 out of the approximately 85 species of Micrurus, reveal a dichotomy of venom phenotypes regarding the relative abundance of the omnipresent phospholipases A 2 (PLA 2 ) and 'three-finger' toxins (3FTx): a group of species express a PLA 2 -predominant venom composition, while others display a 3FTx-predominant compositional pattern. These two divergent toxin expression phenotypes appear to be related to phylogenetic positions and geographical distributions along a North-South axis in the Americas, but further studies encompassing a higher number of species are needed to assess these hypotheses. The two contrasting phenotypes also show correlations with some toxic functionalities, complexity in the diversity of proteoforms, and immunological cross-recognition patterns. The biological significance for the emergence of a dichotomy of venom compositions within Micrurus, in some cases observed even among sympatric species that inhabit relatively small geographic areas, represents a puzzling and challenging area of research which warrants further studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

PubMed

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-06-04

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

A decade of emerging indications: deep brain stimulation in the United States.

PubMed

Youngerman, Brett E; Chan, Andrew K; Mikell, Charles B; McKhann, Guy M; Sheth, Sameer A

2016-08-01

OBJECTIVE Deep brain stimulation (DBS) is an emerging treatment option for an expanding set of neurological and psychiatric diseases. Despite growing enthusiasm, the patterns and implications of this rapid adoption are largely unknown. National trends in DBS surgery performed for all indications between 2002 and 2011 are reported. METHODS Using a national database of hospital discharges, admissions for DBS for 14 indications were identified and categorized as either FDA approved, humanitarian device exempt (HDE), or emerging. Trends over time were examined, differences were analyzed by univariate analyses, and outcomes were analyzed by hierarchical regression analyses. RESULTS Between 2002 and 2011, there were an estimated 30,490 discharges following DBS for approved indications, 1647 for HDE indications, and 2014 for emerging indications. The volume for HDE and emerging indications grew at 36.1% annually in comparison with 7.0% for approved indications. DBS for emerging indications occurred at hospitals with more neurosurgeons and neurologists locally, but not necessarily at those with the highest DBS caseloads. Patients treated for HDE and emerging indications were younger with lower comorbidity scores. HDE and emerging indications were associated with greater rates of reported complications, longer lengths of stay, and greater total costs. CONCLUSIONS DBS for HDE and emerging indications underwent rapid growth in the last decade, and it is not exclusively the most experienced DBS practitioners leading the charge to treat the newest indications. Surgeons may be selecting younger and healthier patients for their early experiences. Differences in reported complication rates warrant further attention and additional costs should be anticipated as surgeons gain experience with new patient populations and targets.

Trends and Characteristics of Emergency Department Visits for Fall-Related Injuries in Older Adults, 2003–2010

PubMed Central

Shankar, Kalpana N.; Liu, Shan W.; Ganz, David A.

2017-01-01

Introduction One third of older adults fall each year, and falls are costly to both the patient in terms of morbidity and mortality and to the health system. Given that falls are a preventable cause of injury, our objective was to understand the characteristics and trends of emergency department (ED) fall-related visits among older adults. We hypothesize that falls among older adults are increasing and examine potential factors associated with this rise, such as race, ethnicity, gender, insurance and geography. Methods We conducted a secondary analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to determine fall trends over time by examining changes in ED visit rates for falls in the United States between 2003 and 2010, detailing differences by gender, sociodemographic characteristics and geographic region. Results Between 2003 and 2010, the visit rate for falls and fall-related injuries among people age ≥ 65 increased from 60.4 (95% confidence interval [CI][51.9–68.8]) to 68.8 (95% CI [57.8–79.8]) per 1,000 population (p=0.03 for annual trend). Among subgroups, visits by patients aged 75–84 years increased from 56.2 to 82.1 per 1,000 (P <.01), visits by women increased from 67.4 to 81.3 (p = 0.04), visits by non-Hispanic Whites increased from 63.1 to 73.4 (p < 0.01), and visits in the South increased from 54.4 to 71.1 (p=0.03). Conclusion ED visit rates for falls are increasing over time. There is a national movement to increase falls awareness and prevention. EDs are in a unique position to engage patients on future fall prevention and should consider ways they can also partake in such initiatives in a manner that is feasible and appropriate for the ED setting. PMID:28874929

The Many Hazards of Trend Evaluation

NASA Astrophysics Data System (ADS)

Henebry, G. M.; de Beurs, K.; Zhang, X.; Kimball, J. S.; Small, C.

2014-12-01

Given the awareness in the scientific community of global scale drivers such as population growth, globalization, and climatic variation and change, many studies seek to identify temporal patterns in data that may be plausibly related to one or more aspect of global change. Here we explore two questions: "What constitutes a trend in a time series?" and "How can a trend be misinterpreted?" There are manifold hazards—both methodological and psychological—in detecting a trend, quantifying its magnitude, assessing its significance, identifying probable causes, and evaluating the implications of the trend. These hazards can combine to elevate the risk of misinterpreting the trend. In contrast, evaluation of multiple trends within a biogeophysical framework can attenuate the risk of misinterpretation. We review and illustrate these hazards and demonstrate the efficacy of an approach using multiple indicators detecting significant trends (MIDST) applied to time series of remote sensing data products.

Natural gas 1998: Issues and trends

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

NONE

Natural Gas 1998: Issues and Trends provides a summary of the latest data and information relating to the US natural gas industry, including prices, production, transmission, consumption, and the financial and environmental aspects of the industry. The report consists of seven chapters and five appendices. Chapter 1 presents a summary of various data trends and key issues in today`s natural gas industry and examines some of the emerging trends. Chapters 2 through 7 focus on specific areas or segments of the industry, highlighting some of the issues associated with the impact of natural gas operations on the environment. 57 figs.,more » 18 tabs.« less

Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008.

PubMed

Ting, Sarah A; Sullivan, Ashley F; Boudreaux, Edwin D; Miller, Ivan; Camargo, Carlos A

2012-01-01

The objective was to describe the epidemiology of emergency department (ED) visits for attempted suicide and self-inflicted injury over a 16-year period. Data were obtained from the National Hospital Ambulatory Medical Care Survey including all visits for attempted suicide and self-inflicted injury (E950-E959) during 1993-2008. Over the 16-year period, there was an average of 420,000 annual ED visits for attempted suicide and self-inflicted injury [1.50 (95% confidence interval, 1.33-1.67) visits per 1000 US population], and the average annual number for these ED visits more than doubled from 244,000 in 1993-1996 to 538,000 in 2005-2008. During the same time frame, ED visits for these injuries per 1000 US population almost doubled for males (0.84 to 1.62), females (1.04 to 1.96), whites (0.94 to 1.82) and blacks (1.14 to 2.10). Visits were most common among ages 15-19, and the number of visits coded as urgent/emergent decreased from 0.95 in 1993-1996 to 0.70 in 2005-2008. ED visit volume for attempted suicide and self-inflicted injury has increased over the past two decades in all major demographic groups. Awareness of these longitudinal trends may assist efforts to increase research on suicide prevention. In addition, this information may be used to inform current suicide and self-injury related ED interventions and treatment programs. Copyright © 2012 Elsevier Inc. All rights reserved.

STEPS: lean thinking, theory of constraints and identifying bottlenecks in an emergency department.

PubMed

Ryan, A; Hunter, K; Cunningham, K; Williams, J; O'Shea, H; Rooney, P; Hickey, F

2013-04-01

This study aimed to identify the bottlenecks in patients' journeys through an emergency department (ED). For each stage of the patient journey, the average times were compared between two groups divided according to the four hour time frame and disproportionate delays were identified using a significance test These bottlenecks were evaluated with reference to a lean thinking value-stream map and the five focusing steps of the theory of constraints. A total of 434 (72.5%) ED patients were tracked over one week. Logistic regression showed that patients who had radiological tests, blood tests or who were admitted were 4.4, 4.1 and 7.7 times more likely, respectively, to stay over four hours in the ED than those who didn't The stages that were significantly delayed were the time spent waiting for radiology (p = 0.001), waiting for the in-patient team (p = 0.004), waiting for a bed (p < 0.001) and ED doctor turnaround time (p < 0.001).

Approaches to Identifying the Emerging Innovative Water Technology Industry in the United States

PubMed Central

WOOD, ALLISON R.; HARTEN, TERESA; GUTIERREZ, SALLY C.

2018-01-01

Clean water is vital to sustaining our natural environment, human health, and our economy. As infrastructure continues to deteriorate and water resources become increasingly threatened, new technologies will be needed to ensure safe and sustainable water in the future. Though the US water industry accounts for approximately 1% gross domestic product and regional “clusters” for water technology exist throughout the country, this emerging industry has not been captured by recent studies. As use of the term “cluster” becomes more prevalent, regional mapping efforts have revealed international differences in definition yet showcase this industry’s economic impact. In reality, institutional processes may inhibit altering industry coding to better describe water technology. Forgoing the benefits of national economic tracking, alternative data sets are available, which may support new ways of identifying these clusters. This work provides cluster definitions; summarizes current approaches to identifying industry activity using data, interviews, and literature; and sets a foundation for future research. PMID:29937546

Approaches to Identifying the Emerging Innovative Water Technology Industry in the United States.

PubMed

Wood, Allison R; Harten, Teresa; Gutierrez, Sally C

2018-04-25

Clean water is vital to sustaining our natural environment, human health, and our economy. As infrastructure continues to deteriorate and water resources become increasingly threatened, new technologies will be needed to ensure safe and sustainable water in the future. Though the US water industry accounts for approximately 1% gross domestic product and regional "clusters" for water technology exist throughout the country, this emerging industry has not been captured by recent studies. As use of the term "cluster" becomes more prevalent, regional mapping efforts have revealed international differences in definition yet showcase this industry's economic impact. In reality, institutional processes may inhibit altering industry coding to better describe water technology. Forgoing the benefits of national economic tracking, alternative data sets are available, which may support new ways of identifying these clusters. This work provides cluster definitions; summarizes current approaches to identifying industry activity using data, interviews, and literature; and sets a foundation for future research.

Traumatic brain injury in the Netherlands, trends in emergency department visits, hospitalization and mortality between 1998 and 2012.

PubMed

Van den Brand, Crispijn L; Karger, Lennard B; Nijman, Susanne T M; Hunink, Myriam G M; Patka, Peter; Jellema, Korné

2017-03-06

Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. The effects of epidemiological changes such as ageing of the population and increased traffic safety on the incidence of TBI are unknown. The objective of this study was to evaluate trends in TBI-related emergency department (ED) visits, hospitalization and mortality in the Netherlands between 1998 and 2012. This was a retrospective observational, longitudinal study. The main outcome measures were TBI-related ED visits, hospitalization and mortality. Between 1998 and 2012, there were 500 000 TBI-related ED visits in the Netherlands. In the same period, there were 222 000 TBI-related admissions and 17 000 TBI-related deaths. During this period, there was a 75% increase in ED visits for TBI and a 95% increase for TBI-related hospitalization; overall mortality because of TBI did not change significantly. Despite the overall increase in TBI-related ED visits, this increase was not evenly distributed among age groups or trauma mechanisms. In patients younger than 65 years, a declining trend in ED visits for TBI caused by road traffic accidents was observed. Among patients 65 years or older, ED visits for TBI caused by a fall increased markedly. TBI-related mortality shifted from mainly young (67%) and middle-aged individuals (<65 years) to mainly elderly (63%) individuals (≥65 years) between 1998 and 2012. The conclusions of this study did not change when adjusting for changes in age, sex and overall population growth. The incidence of TBI-related ED visits and hospitalization increased markedly between 1998 and 2012 in the Netherlands. TBI-related mortality occurred at an older age. These observations are probably the result of a change in aetiology of TBI, specifically a decrease in traffic accidents and an increase in falls in the ageing population. This hypothesis is supported by our data. However, ageing of the population is not the only cause of the changes observed; the

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

PubMed

Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

2017-10-01

Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

Workforce Trends, Workplace Trends: How They Dictate a Changing Education and Training Strategy.

ERIC Educational Resources Information Center

Plewes, Thomas J.

Four trends will alter the way the education and training system and other human resource agencies will do business. Themes that reflect them are captured in four words: flexibility, quality, diversity, and scope. The reaction to the current economic downturn remains one of flexibility. Flexibility has emerged as the way in which employers look at…

"You got to love rosin: Solventless dabs, pure, clean, natural medicine." Exploring Twitter data on emerging trends in Rosin Tech marijuana concentrates.

PubMed

Lamy, Francois R; Daniulaityte, Raminta; Zatreh, Mussah; Nahhas, Ramzi W; Sheth, Amit; Martins, Silvia S; Boyer, Edward W; Carlson, Robert G

2018-02-01

"Rosin tech" is an emerging solventless method consisting in applying moderate heat and constant pressure on marijuana flowers to prepare marijuana concentrates referred to as "rosin." This paper explores rosin concentrate-related Twitter data to describe tweet content and analyze differences in rosin-related tweeting across states with varying cannabis legal statuses. English language tweets were collected between March 15, 2015 and April 17, 2017, using Twitter API. U.S. geolocated unique (no retweets) tweets were manually coded to evaluate the content of rosin-related tweets. Adjusted proportions of Twitter users and personal communication tweets per state related to rosin concentrates were calculated. A permutation test was used to analyze differences in normalized proportions between U.S. states with different cannabis legal statuses. eDrugTrends collected 8389 tweets mentioning rosin concentrates/technique. 4164 tweets (49.6% of total sample) posted by 1264 unique users had identifiable state-level geolocation. Content analysis of 2010 non-retweeted tweets revealed a high proportion of media-related tweets (44.2%) promoting rosin as a safer and solventless production method. Tweet-volume-adjusted percentages of geolocated Twitter users and personal communication tweets about rosin were respectively up to seven and sixteen times higher between states allowing recreational use of cannabis and states where cannabis is illegal. Our results indicate that there are higher proportions of personal communication tweets and Twitter users tweeting about rosin in U.S. states where cannabis is legalized. Rosin concentrates are advertised as a safer, more natural form of concentrates, but more research on this emerging form of marijuana concentrate is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

Quantification of burnout in emergency nurses: A systematic review and meta-analysis.

PubMed

Li, Hong; Cheng, Bin; Zhu, Xiao Ping

2018-01-17

Previous studies showed increased levels of absenteeism, drug abuse, depression, and symptoms allied with burnout in emergency nurses. This meta-analysis aimed to quantify the three dimensions of burnout in emergency nurses and estimate the proportion of nurses who experience higher than tolerable levels of burnout. A systematic search was conducted on PubMed, Scielo, Xueshu Baidu and Informa databases with a cut-off time between 1997 and 2017 to retrieve published papers in any language that had estimated the burnout levels in emergency nurses by using MBI scale. We identified a total of 11 eligible studies. The total mean estimate was moderate for emotional exhaustion (25.552), but clearly trending towards higher level, whereas depersonalization (10.383) and lack of personal accomplishment (30.652) showed higher burnouts levels. The proportion of emergency nurses suffering from high emotional exhaustion, high depersonalization, and low personal accomplishment was 40.5%, 44.3%, and 42.7%, respectively. Burnout is detrimental to achieving high-quality healthcare services and causes a loss of productivity. It is high time for nursing leader and management personnel to identify appropriate measures to counteract burnout. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in methodological differences

Treesearch

Daniel J. Stynes; Malcolm I. Bevins; Tommy L. Brown

1980-01-01

Inconsistency in data collection has confounded attempts to identify and forecast outdoor recreation trends. Problems are highlighted through an evaluation of the methods employed in national outdoor recreation participation surveys and projections. Recommendations are advanced for improving data collection, trend measurement, and forecasting within outdoor recreation...

Trends in CT scan rates in children and pregnant women: teaching, private, public and nonprofit facilities.

PubMed

Hoshiko, Sumi; Smith, Daniel; Fan, Cathyn; Jones, Carrie R; McNeel, Sandra V; Cohen, Ronald A

2014-05-01

Radiation exposure from medical sources now equals or exceeds that from natural background sources, largely attributable to a 20-fold increase in CT use since 1980. Increasing exposure to children and fetuses is of most concern due to their heightened susceptibility. More recently, CT use may be leveling or decreasing, but it is unclear whether this change is widespread or varies by type of institution. We sought to characterize trends in CT utilization in California hospitals and emergency departments among children and pregnant women, looking at different types of facilities, such as teaching, private, public and nonprofit institutions. We examined frequency of CT examinations by year from 229 facilities reporting CT usage in routinely collected California statewide data for 2005-2012. We modeled trends overall and by facility type. CT scans for pediatric and pregnant patient visits in the emergency department increased initially, then started to decline after 2008. Among hospital admissions, rates declined or leveled after 2005. In the emergency department, CT rates varied between types of facilities, with teaching hospitals reducing use sooner and more sharply than other types of facilities. CT utilization in California among children and pregnant women has begun to level or decline. Still, population exposure remains at historically high levels, warranting consideration of potential public health implications. Further examination of reasons for trends among hospital types, particularly how teaching hospitals have reduced rates of CT utilization, may help identify strategies for CT reduction without compromising patient care.

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders

PubMed Central

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-01-01

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as “relatively low”, contrasting with 21.4% rated as “relatively high”. Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders. PMID:28587226

Horizon scanning for emergence of new viruses: from constructing complex scenarios to online games.

PubMed

Gale, P; Breed, A C

2013-10-01

Horizon scanning techniques can be developed to identify novel routes and sources for the emergence of viruses in the medium to long term. Central to horizon scanning is prediction of the complex scenarios through which viruses could emerge before they occur. One approach involves 'spidergrams' in which complex scenarios are generated by combining factors randomly selected from different categories of events. Spidergrams provide a framework for how different factors could interact, irrespective of the virus, and also enable testing of combinations not previously considered but which would be 'tested' in nature by a virus. The emergence of viruses through new routes is often related to changes, for example, in environmental and social factors, and the Internet will undoubtedly be used to identify long-term trends for consideration. In addition, online games may provide horizon scanners with suggestions for new routes and strategies that could be used by emerging viruses. © 2012 Crown copyright Reproduced with the permission of the Controller of Her Majesty's Stationery Office and Animal Health and Veterinary Laboratories Agency.

Global Survey on Future Trends in Human Spaceflight: the Implications for Space Tourism

NASA Astrophysics Data System (ADS)

Gurtuna, O.; Garneau, S.

2002-01-01

With the much-publicized first ever space tourist flight, of Dennis Tito, and the announcement of the second space tourist flight to take place in April 2002, it is clear that an alternative motivation for human spaceflight has emerged. Human spaceflight is no longer only about meeting the priorities of national governments and space agencies, but is also about the tangible possibility of ordinary people seeing the Earth from a previously exclusive vantage point. It is imperative that major space players look beyond the existing human spaceflight rationale to identify some of the major driving forces behind space tourism, including the evolving market potential and developments in enabling technologies. In order to determine the influence of these forces on the future of commercial human spaceflight, the responses of a Futuraspace survey on future trends in human spaceflight are analyzed and presented. The motivation of this study is to identify sought-after space destinations, explore the expected trends in enabling technologies, and understand the future role of emerging space players. The survey will reflect the opinions of respondents from around the world including North America, Europe (including Russia) and Asia. The profiles of targeted respondents from space industry, government and academia are high-level executives/managers, senior researchers, as well as former and current astronauts. The survey instrument is a questionnaire which is validated by a pilot study. The sampling method is non-probabilistic, targeting as many space experts as possible who fit our intended respondent profile. Descriptive and comparative statistical analysis methods are implemented to investigate both global and regional perceptions of future commercial trends in human spaceflight. This study is not intended to be a formal market study of the potential viability of the space tourism market. Instead, the focus is on the future trends of human spaceflight, by drawing on the

Future trends in picture archiving and communication system (PACS)

NASA Astrophysics Data System (ADS)

Al-Hajeri, Mona; Clarke, Malcolm

2015-03-01

Objective: This research investigates the needs and opinions of radiologists on the use of enhanced information technologies and approaches to improve the functionality of Picture Archiving and Communication Systems (PACS). Method: Six interviews were conducted in the main governmental hospital in Kuwait (AL-Sabah Hospital) with radiologists, including two senior radiologists, two junior radiologists, and two trainee radiologists undertaking the Irish radiology board. Results: The radiologists identified a number of limitations that exist in current PACS and requirements to enhance usability and functionality. However, it was the case that some of the radiologists had little knowledge about the advanced trends in PACS. Four themes emerged from the thematic analysis of the data: (1) limitations of traditional PACS; (2) Features and requirements that can increase PACS functionality; (3) web based solutions of PACS; (4) PACS in mobile phones. Conclusion: It is widely recognized that PACS has limitations. This research has identified themes that, when incorporated, will enhance the functionality of PACS and provide better quality clinical practice. This research has determined the important future trends of PACS. Primarily web based solutions and use in mobile phones. The findings from this research can be used as recommendations to vendors, for product development and medical institutes to consider when undertaking implementation of PACS and training future radiologists.

Highlights in emergency medicine medical education research: 2008.

PubMed

Farrell, Susan E; Coates, Wendy C; Khun, Gloria J; Fisher, Jonathan; Shayne, Philip; Lin, Michelle

2009-12-01

The purpose of this article is to highlight medical education research studies published in 2008 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine. Through a PubMed search of the English language literature in 2008, 30 medical education research studies were independently identified as hypothesis-testing investigations and measurements of educational interventions. Six reviewers independently rated and scored all articles based on eight anchors, four of which related to methodologic criteria. Articles were ranked according to their total rating score. A ranking agreement among the reviewers of 83% was established a priori as a minimum for highlighting articles in this review. Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Four of these employed experimental or quasi-experimental methodology. Although technology was not a component of the structured literature search employed to identify the candidate articles for this review, 14 of the articles identified, including four of the five highlighted articles, employed or studied technology as a focus of the educational research. Overall, 36% of the reviewed studies were supported by funding; three of the highlighted articles were funded studies. This review highlights quality medical education research studies published in 2008, with outcomes of relevance to teaching and education in emergency medicine. It focuses on research methodology, notes current trends in the use of technology for learning in emergency medicine, and suggests future avenues for continued rigorous study in education.

Foresight Infectious Diseases China Project--a novel approach to anticipating future trends in risk of infectious diseases in China: methodology and results from an initial application.

PubMed

Nicoll, A; Huang, J; Xie, Z

2009-07-09

The project devised a simple but novel methodology for identifying possible future trends in infectious diseases in animals and humans in China, of priority concern to the Chinese authorities. It used a model of disease drivers (social, economic, biological or environmental factors that affect disease outcomes, by changing the behaviour of diseases, sources or pathways) devised for the Foresight Programme in the United Kingdom. Nine families of drivers were adapted to Chinese circumstances and matrices were constructed to identify the likely relationship of single infectious diseases or families of diseases to the drivers. The likely future trends in those drivers in China were determined by interviews with 36 independent Chinese experts. These trends included not only potentially adverse animal and human movements but also opportunities for innovative surveillance methods, more use of hospitals, antimicrobials and vaccines. Some human behaviours and social trends were expected to increase the risk of infections (in particular sexually transmitted and healthcare-associated infections) while at the same time the experts thought the awareness of risk in the Chinese population would increase. The results suggested a number of areas where the Chinese authorities may experience difficulties in the future, such as rising numbers of healthcare-associated infections, zoonoses and other emerging diseases and sexually transmitted infections (including HIV). Not making firm predictions, this work identifies priority disease groups requiring surveillance and consideration of countermeasures as well as recommending strengthening basic surveillance and response mechanisms for unanticipatable zoonoses and other emerging disease threats.

Trends in fall-related injuries among older adults treated in emergency departments in the USA.

PubMed

Orces, Carlos H; Alamgir, Hasanat

2014-12-01

To examine national trends in fall-related injuries among older adults treated in emergency departments (ED) and project these injuries until the year 2030. The Web-based Injury Statistics Query and Reporting System was used to generate data on fall-related injuries treated in ED. Joinpoint regression analysis was used to examine the average annual change in injury rates over time. Fall-related injury and hospitalisation rates increased on average by 2% (95% CI 1.5% to 2.7%) and by 4% (95% CI 2.9% to 5.0%) per year, respectively. Assuming the increase in fall-related injury rates remains unchanged, the number of fall-related injuries may increase to 5.7 million by the year 2030. Fall-related injuries among older adults treated in ED increased in the USA during the study period. Moreover, a marked increase in the number of these injuries may occur over the next decades. 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.

The Perceived Role of Spirituality in the Academic Persistence of Self-Identifying African-American Emerging Adult Learners in Higher Education

ERIC Educational Resources Information Center

Cummings, Arturo M.

2017-01-01

Little research has been done regarding the role of spirituality from the perceptive of self-identifying African-American emerging adult learners and how it contributes to their academic persistence, even though isolation, lack of peer support, and identity issues can decrease motivation of self-identifying African-American students. This study…

Publication trends in Naunyn-Schmiedeberg's Archives of Pharmacology: focus on pharmacology in Egypt.

PubMed

El-Mas, Mahmoud M; El-Gowelli, Hanan M; Michel, Martin C

2013-11-01

In a previous analysis of the country of origin of papers published in Naunyn-Schmiedeberg's Archives of Pharmacology, a major shift toward contributions from emerging market countries, was noticed in comparison of 2010 to 2001 publications. Repeating such analysis for 2012 publications in the journal confirmed this trend. An interesting new trend was the emerging presence of papers from a variety of Islamic countries including Egypt. Based on this trend, we shortly review the history and current structure of pharmacology in Egypt. It appears that the presence of Egyptian pharmacology in international journals including pharmacology journals has sharply been increasing over the last two decades. Challenges for a continuation of this encouraging trend are being discussed.

Identifying barriers for out of hospital emergency care in low and low-middle income countries: a systematic review.

PubMed

Kironji, Antony Gatebe; Hodkinson, Peter; de Ramirez, Sarah Stewart; Anest, Trisha; Wallis, Lee; Razzak, Junaid; Jenson, Alexander; Hansoti, Bhakti

2018-04-19

Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income countries to identify barriers to and key interventions for OHEC delivery. We performed a systematic review of the peer reviewed literature from January 2005 to March 2015 in PubMed, Embase, Cochrane, and Web of Science. All articles referencing research from low and low-middle income countries addressing OHEC, emergency medical services, or transport/transfer of patients were included. We identified themes in the literature to form six categories of OHEC barriers. Data were collected using an electronic form and results were aggregated to produce a descriptive summary. A total 1927 titles were identified, 31 of which met inclusion criteria. Barriers to OHEC were divided into six categories that included: culture/community, infrastructure, communication/coordination, transport, equipment and personnel. Lack of transportation was a common problem, with 55% (17/31) of articles reporting this as a hindrance to OHEC. Ambulances were the most commonly mentioned (71%, 22/31) mode of transporting patients. However, many patients still relied on alternative means of transportation such as hired cars, and animal drawn carts. Sixty-one percent (19/31) of articles identified a lack of skilled personnel as a key barrier, with 32% (10/31) of OHEC being delivered by laypersons without formal training. Forty percent (12/31) of the systems identified in the review described a uniform access phone number for emergency medical service activation. Policy makers and researchers seeking to improve OHEC in low and low-middle income countries should focus on increasing the availability of transport and trained providers while improving patient access to the OHEC system. The review yielded articles with a primary focus in Africa, highlighting a need for future research in diverse

Emerging Trends in Anterior Cruciate Ligament Reconstruction.

PubMed

Budny, Jacob; Fox, Joseph; Rauh, Michael; Fineberg, Marc

2017-01-01

Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed and researched orthopedic procedures. As technology and comparative research have advanced, surgical practices have changed to achieve a superior outcome. Our group performed a survey of orthopedic surgeons to evaluate current practice trends and techniques as a follow-up to similar surveys performed in 1999 and 2006. In a survey between 2013 and 2014 consisting of 35 questions regarding the surgical technique, graft choice, fixation method, and perioperative care in ACL reconstruction was sent electronically to the members of the American Orthopaedic Society of Sports Medicine and the Arthroscopy Association of North America. Responses were recorded and compared with previous results. Survey responses were received from 824 active surgeons. Of the respondents, 89.4% are subspecialty trained, 98% of which in sports medicine. Preoperatively, full-knee extension was the only "very significant" factor in surgical timing. Approach preference via an arthroscopic-assisted single-incision approach predominated (89%)-similar to earlier results. Bone-patellar-tendon-bone use decreased relative to hamstring allograft at 45 and 41%, respectively. Tibial tunnel placement shifted anteriorly and femoral tunnel placement shifted posterosuperiorly as compared with the results obtained 5 years ago. Femoral drilling through a low medial portal was preferred in 47% of responses, increased from 15%. Preferred fixation on both the tibial and femoral sides was either metal or bioabsorbable interference screws. The use of transfixation pins and other devices decreased. Postoperative rehab protocols did not significantly change, 68.7% preferred full-weight bearing, 55% using a range of motion knee brace locked in extension, 66.4% starting physical therapy 1 week postoperatively, with unrestricted activity at 6 to 9 months. Overall, an increasing trend toward using hamstring autograft and drilling the

Visualization of e-Health Research Topics and Current Trends Using Social Network Analysis.

PubMed

Son, Youn-Jung; Jeong, Senator; Kang, Byeong-Gwon; Kim, Sun-Hyung; Lee, Soo-Kyoung

2015-05-01

E-health has been grown rapidly with significant impact on quality and safety of healthcare. However, there is a large gap between the postulated and empirically demonstrated benefits of e-health technologies and a need for a clearer mapping of its conceptual domains. Therefore, this study aimed to critically review the main research topics and trends of international e-health through social network analysis. Medical subject heading terms were used to retrieve 3,023 research articles published from 1979 through 2014 in the PubMed database. We extracted n-grams from the corpus using a text analysis program, generated co-occurrence networks, and then analyzed and visualized the networks using Pajek software. The hub and authority measures identified the most important research topics in e-health. Newly emerging topics by 4-year period units were identified as research trends. The most important research topics in e-health are personal health records (PHR), health information technology, primary care, mobile health, clinical decision support systems (CDSS), and so on. The eight groups obtained through ego network analysis can be divided into four semantically different areas, as follows: information technology, infrastructure, services, and subjects. Also, four historical trends in e-health research are identified: the first focusing on e-health and telemedicine; the second, PHR and monitoring; the third, CDSS and alert; and the fourth, mobile health and health literacy. This study promotes a systematic understanding of e-health by identifying topic networks, thereby contributing to the future direction of e-health research and education.

Curriculum Trends, Special Education, and Reform: Refocusing the Conversation. Special Education Series.

ERIC Educational Resources Information Center

Pugach, Marleen C., Ed.; Warger, Cynthia L., Ed.

This book describes curriculum trends and the impact of the trends on providing equitable educational programs to all students, especially students with mild disabilities. The text begins by describing current curriculum renewal efforts and common themes that have emerged. The impact of major trends is considered in the context of special…

Information Technology: Perspectives and Trends.

ERIC Educational Resources Information Center

Robinson, Doug

The full impact of the current information technology and networking revolution remains unknown, but the experiences of organizations and individuals who are using the tools and resources offered by information technology suggest that it may change our social fabric. Some of the current and emerging trends in information technology include: the…

Understanding Evapotranspiration Trends and their Driving Mechanisms: An investigation across CONUS based on numerical modeling

NASA Astrophysics Data System (ADS)

Parr, D.; Wang, G.; Fu, C.

2015-12-01

As shown by climate models, increasing global temperatures and enhanced greenhouse gas concentration such as CO2 have had major effects on the dynamics of the hydrologic cycle and the surface energy budget, in particular, on evapotranspiration (ET). ET has significant decadal variations whether it be regionally or globally and variations of ET have major environmental and socioeconomic impacts. A number of recent studies have found a global increase in annual mean ET around 7mm per year per decade from about 1982 to the late 1990s. These results correspond with what is expected from an intensification of the hydrological cycle. However, the increasing ET trend did not continue after 1998 and from 1998-2008 this global trend was replaced with a decreasing trend of similar magnitude. This study uses numerical modeling to investigate if similar changing ET trends emerge in the continental U.S and part of northern Mexico. After validating model simulated evaporative fluxes and comparing spatial patterns to the aforementioned studies, various changing trends of different signs are identified across the U.S., and specific regions with strong signals of change are chosen for further examination with the purpose of identifying the root causes of these changing trends and which variables are most influential towards change. Experimental simulations conducted to isolate the most influential factors towards ET reveal that precipitation amount as well as its characteristics have the greatest impact on the ET trends discovered, with other factors like wind and air temperatures displaying less influence over inter-annual trends. This study helps better understand terrestrial ET and it's interactions which will help facilitate better predictions of change in surface climate such as heatwaves and droughts as well as impacts on water resources.

Identify temporal trend of air temperature and its impact on forest stream flow in Lower Mississippi River Alluvial Valley using wavelet analysis

Treesearch

Ying Ouyang; Prem B. Parajuli; Yide Li; Theodor D. Leininger; Gary Feng

2017-01-01

Characterization of stream flow is essential to water resource management, water supply planning, environmental protection, and ecological restoration; while air temperature variation due to climate change can exacerbate stream flow and add instability to the flow. In this study, the wavelet analysis technique was employed to identify temporal trend of air temperature...

Recent Research Trends in Testing

ERIC Educational Resources Information Center

Reynolds, William M.; Sundberg, Norman D.

1976-01-01

As measured by references in Buros' Mental Measurement Yearbooks, recent trends in test research are measured. The 24 tests with the greatest number of publications are identified, and growth trends of 5 major tests are shown. (Author/DEP)

Demand for Emergency Services Trends in New South Wales Years 2010-2014 (DESTINY): Age and Clinical Factors Associated with Ambulance Transportation to Emergency Departments.

PubMed

Dinh, Michael M; Muecke, Sandy; Berendsen Russell, Saartje; Chalkley, Dane; Bein, Kendall J; Muscatello, David; Nagaraj, Guruprasad; Paoloni, Richard; Ivers, Rebecca

2016-01-01

The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses. This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department data collection (EDCC) collects patient level data on presentations to designated EDs across NSW. Patients that presented to EDs by ambulance between January 2010 and December 2014 were included. Patients dead on arrival, transferred from another hospital, or planned ED presentations were excluded. A total of 10.8 million ED attendances were identified of which 2.6 million (23%) were transported to ED by ambulance. The crude rate of ambulance transportations to EDs across all ages increased by 3.0% per annum over the five years with the highest rate observed in those 85 years and over (620.5 presentations per 1,000 population). There was an increase in the proportion of category 1 and 2 (life-threatening or potentially life-threatening) cases from 18.1% to 24.0%. Demand for ambulance services appears to be driven by older patients presenting with higher acuity problems. Alternative models of acute care for elderly patients need to be planned and implemented to address these changes.

The impact of new and emerging technologies in the commercial aviation maintenance, repair, and overhaul industry a Delphi study

NASA Astrophysics Data System (ADS)

Gray, Janet

Purpose. The purpose of this study was to identify new or emerging technological trends and events that are likely to occur between now and 2017 that will have an impact on the commercial aviation maintenance, repair, and overhaul (MRO) industry. Further, it was the purpose of this study to examine those technological trends and events believed to provide the greatest impact and, given the experts' analysis, identify the feasibility of implementation. Methodology. This descriptive study utilized the Delphi method with a panel of twenty-four experts comprised of practitioners, theorists, and futurists. A priority matrix was utilized to determine the impact and feasibility of trend and events. Findings. The experts identified fifty-three trends and events that will impact the commercial aviation maintenance, repair, and overhaul (MRO) industry. Analysis of the priority matrix revealed eighteen trends and events were of high priority and high feasibility. Conclusions. The responses from the expert panel were examined and the findings analyzed. The following are the conclusions constructed from the data provided by the Delphi panel of experts: (1) the need to respond to the demands of the maintenance, repair, and overhaul (MRO) industry such as down time, efficiency, cost, and environmental concerns by implementing new technology, (2) the demand to integrate and implement new technology as indicative of the priority matrix scoring high importance/high feasibility, (3) to proactively address the inadequate professional development in new technologies, and (4) the consensus reached by the panel of experts of importance and feasibility of implementation of new technologies encompass eighteen trends and events. Implications and recommendations for action. The implementation of new and emerging technological advances in the commercial aviation maintenance, repair, and overhaul (MRO) industry between now and 2017 will be dependent on the technologies' capacity to reduce

Global research trends of World Health Organization's top eight emerging pathogens.

PubMed

Sweileh, Waleed M

2017-02-08

On December 8 th , 2015, World Health Organization published a priority list of eight pathogens expected to cause severe outbreaks in the near future. To better understand global research trends and characteristics of publications on these emerging pathogens, we carried out this bibliometric study hoping to contribute to global awareness and preparedness toward this topic. Scopus database was searched for the following pathogens/infectious diseases: Ebola, Marburg, Lassa, Rift valley, Crimean-Congo, Nipah, Middle Eastern Respiratory Syndrome (MERS), and Severe Respiratory Acute Syndrome (SARS). Retrieved articles were analyzed to obtain standard bibliometric indicators. A total of 8619 journal articles were retrieved. Authors from 154 different countries contributed to publishing these articles. Two peaks of publications, an early one for SARS and a late one for Ebola, were observed. Retrieved articles received a total of 221,606 citations with a mean ± standard deviation of 25.7 ± 65.4 citations per article and an h-index of 173. International collaboration was as high as 86.9%. The Centers for Disease Control and Prevention had the highest share (344; 5.0%) followed by the University of Hong Kong with 305 (4.5%). The top leading journal was Journal of Virology with 572 (6.6%) articles while Feldmann, Heinz R. was the most productive researcher with 197 (2.3%) articles. China ranked first on SARS, Turkey ranked first on Crimean-Congo fever, while the United States of America ranked first on the remaining six diseases. Of retrieved articles, 472 (5.5%) were on vaccine - related research with Ebola vaccine being most studied. Number of publications on studied pathogens showed sudden dramatic rise in the past two decades representing severe global outbreaks. Contribution of a large number of different countries and the relatively high h-index are indicative of how international collaboration can create common health agenda among distant different countries.

Trends in community violence in England and Wales 2005-2009.

PubMed

Sivarajasingam, Vaseekaran; Page, Nicholas; Morgan, Peter; Matthews, Kent; Moore, Simon; Shepherd, Jonathan

2014-03-01

Injury records from Emergency Departments (EDs) have been studied over the last decade as part of the work of the National Violence Surveillance Network (NVSN) and provide information about local, regional and national violence levels and trends in England and Wales. The purpose of the current study is to evaluate overall, gender, age-specific and regional trends in community violence in England and Wales from an ED perspective from January 2005 to December 2009. Violence-related injury data were collected prospectively in a stratified sample of 77 EDs (Types 1, 3 and 4) in the nine Government Office Regions in England and in Wales. All 77 EDs were recruited on the basis that they had implemented and continued to comply with the provisions of the 1998 Data Protection Act and Caldicott guidance. Attendance date, age and gender of patients who reported injury in violence were identified using assault-related attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. In total 221,673 (163,384 males: 74%) violence-related attendances were identified. Overall estimated annual injury rate was 6.5 per 1000 resident population (males 9.8 and females 3.4 per 1000). Violence affecting males and females decreased significantly in England and Wales over the 5-year period, with an overall estimated annual decrease of 3% (95% CI: 1.8-4.1%, p<0.05). Attendances decreased significantly for both genders across four out of the five age groups studied. Attendances were found to be highest during the months of May and July and lowest in February. Substantial differences in violence-related ED attendances were identified at the regional level. From this ED perspective overall violence in England and Wales decreased over the period 2005-2009 but increased in East Midlands, London and South West regions. Since 2006, overall trends according to Crime Survey for England and Wales (CSEW), police and ED measures were

The structure and emerging trends of construction safety management research: a bibliometric review.

PubMed

Liang, Huakang; Zhang, Shoujian; Su, Yikun

2018-03-29

Recently, construction safety management (CSM) practices and systems have become important topics for stakeholders to take care of human resources. However, few studies have attempted to map the global research on CSM. A comprehensive bibliometric review was conducted in this study based on multiple methods. In total, 1172 CSM-related papers from the Web of Science Core Collection database were examined. The analyses focused on publication year, country-institute, publication source, author and research topics. The results indicated that the USA, China, Australia and the UK took leading positions in CSM research. Two branches of journals were identified, namely the branch of engineering science and that of safety science and social science. Additionally, seven themes together with 28 specific topics were detected to allow researchers to track the main structure and temporal evolution of CSM research. Finally, the main research trends and potential research directions were discussed to guide the future research.

Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

PubMed

Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

2010-12-01

We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Medical Emergency Education in Dental Hygiene Programs.

ERIC Educational Resources Information Center

Stach, Donna J.; And Others

1995-01-01

A survey of 169 dental hygiene training programs investigated the curriculum content and instruction concerning medical emergency treatment, related clinical practice, and program policy. Several trends are noted: increased curriculum hours devoted to emergency care; shift in course content to more than life-support care; and increased emergency…

Ozone Trend Detectability

NASA Technical Reports Server (NTRS)

Campbell, J. W. (Editor)

1981-01-01

The detection of anthropogenic disturbances in the Earth's ozone layer was studied. Two topics were addressed: (1) the level at which a trend in total ozoning is detected by existing data sources; and (2) empirical evidence in the prediction of the depletion in total ozone. Error sources are identified. The predictability of climatological series, whether empirical models can be trusted, and how errors in the Dobson total ozone data impact trend detectability, are discussed.

Phylogenetic Analysis and Antimicrobial Profiles of Cultured Emerging Opportunistic Pathogens (Phyla Actinobacteria and Proteobacteria) Identified in Hot Springs

PubMed Central

Jardine, Jocelyn Leonie; Mavumengwana, Vuyo

2017-01-01

Hot spring water may harbour emerging waterborne opportunistic pathogens that can cause infections in humans. We have investigated the diversity and antimicrobial resistance of culturable emerging and opportunistic bacterial pathogens, in water and sediment of hot springs located in Limpopo, South Africa. Aerobic bacteria were cultured and identified using 16S ribosomal DNA (rDNA) gene sequencing. The presence of Legionella spp. was investigated using real-time polymerase chain reaction. Isolates were tested for resistance to ten antibiotics representing six different classes: β-lactam (carbenicillin), aminoglycosides (gentamycin, kanamycin, streptomycin), tetracycline, amphenicols (chloramphenicol, ceftriaxone), sulphonamides (co-trimoxazole) and quinolones (nalidixic acid, norfloxacin). Gram-positive Kocuria sp. and Arthrobacter sp. and gram-negative Cupriavidus sp., Ralstonia sp., Cronobacter sp., Tepidimonas sp., Hafnia sp. and Sphingomonas sp. were isolated, all recognised as emerging food-borne pathogens. Legionella spp. was not detected throughout the study. Isolates of Kocuria, Arthrobacter and Hafnia and an unknown species of the class Gammaproteobacteria were resistant to two antibiotics in different combinations of carbenicillin, ceftriaxone, nalidixic acid and chloramphenicol. Cronobacter sp. was sensitive to all ten antibiotics. This study suggests that hot springs are potential reservoirs for emerging opportunistic pathogens, including multiple antibiotic resistant strains, and highlights the presence of unknown populations of emerging and potential waterborne opportunistic pathogens in the environment. PMID:28914802

Phylogenetic Analysis and Antimicrobial Profiles of Cultured Emerging Opportunistic Pathogens (Phyla Actinobacteria and Proteobacteria) Identified in Hot Springs.

PubMed

Jardine, Jocelyn Leonie; Abia, Akebe Luther King; Mavumengwana, Vuyo; Ubomba-Jaswa, Eunice

2017-09-15

Hot spring water may harbour emerging waterborne opportunistic pathogens that can cause infections in humans. We have investigated the diversity and antimicrobial resistance of culturable emerging and opportunistic bacterial pathogens, in water and sediment of hot springs located in Limpopo, South Africa. Aerobic bacteria were cultured and identified using 16S ribosomal DNA (rDNA) gene sequencing. The presence of Legionella spp. was investigated using real-time polymerase chain reaction. Isolates were tested for resistance to ten antibiotics representing six different classes: β-lactam (carbenicillin), aminoglycosides (gentamycin, kanamycin, streptomycin), tetracycline, amphenicols (chloramphenicol, ceftriaxone), sulphonamides (co-trimoxazole) and quinolones (nalidixic acid, norfloxacin). Gram-positive Kocuria sp. and Arthrobacter sp. and gram-negative Cupriavidus sp., Ralstonia sp., Cronobacter sp., Tepidimonas sp., Hafnia sp. and Sphingomonas sp. were isolated, all recognised as emerging food-borne pathogens. Legionella spp. was not detected throughout the study. Isolates of Kocuria , Arthrobacter and Hafnia and an unknown species of the class Gammaproteobacteria were resistant to two antibiotics in different combinations of carbenicillin, ceftriaxone, nalidixic acid and chloramphenicol. Cronobacter sp. was sensitive to all ten antibiotics. This study suggests that hot springs are potential reservoirs for emerging opportunistic pathogens, including multiple antibiotic resistant strains, and highlights the presence of unknown populations of emerging and potential waterborne opportunistic pathogens in the environment.

Issues and Trends in Literacy Education.

ERIC Educational Resources Information Center

Robinson, Richard D., Ed.; And Others

Developed with practicing teachers in mind, this book presents reprints of 22 articles and excerpts from longer works that deal with the most significant trends and issues facing literacy educators--whole language, phonics, literacy materials, emergent literacy, spelling, assessment, content literacy, vocabulary instruction, national standards,…

Identifying and Prioritizing Information Needs and Research Priorities of Public Health Emergency Preparedness and Response Practitioners.

PubMed

Siegfried, Alexa L; Carbone, Eric G; Meit, Michael B; Kennedy, Mallory J; Yusuf, Hussain; Kahn, Emily B

2017-10-01

This study describes findings from an assessment conducted to identify perceived knowledge gaps, information needs, and research priorities among state, territorial, and local public health preparedness directors and coordinators related to public health emergency preparedness and response (PHPR). The goal of the study was to gather information that would be useful for ensuring that future funding for research and evaluation targets areas most critical for advancing public health practice. We implemented a mixed-methods approach to identify and prioritize PHPR research questions. A web survey was sent to all state, city, and territorial health agencies funded through the Public Health Emergency Preparedness (PHEP) Cooperative Agreement program and a sample of local health departments (LHDs). Three focus groups of state and local practitioners and subject matter experts from the Centers for Disease Control and Prevention (CDC) were subsequently conducted, followed by 3 meetings of an expert panel of PHPR practitioners and CDC experts to prioritize and refine the research questions. We identified a final list of 44 research questions that were deemed by study participants as priority topics where future research can inform PHPR programs and practice. We identified differences in perceived research priorities between PHEP awardees and LHD survey respondents; the number of research questions rated as important was greater among LHDs than among PHEP awardees (75%, n=33, compared to 24%, n=15). The research questions identified provide insight into public health practitioners' perceived knowledge gaps and the types of information that would be most useful for informing and advancing PHPR practice. The study also points to a higher level of information need among LHDs than among PHEP awardees. These findings are important for CDC and the PHPR research community to ensure that future research studies are responsive to practitioners' needs and provide the information

Identifying barriers to the provision of bystander cardiopulmonary resuscitation (CPR) in high-risk regions: a qualitative review of emergency calls.

PubMed

Case, Rosalind; Cartledge, Susie; Siedenburg, Josine; Smith, Karen; Straney, Lahn; Barger, Bill; Finn, Judith; Bray, Janet E

2018-06-01

Understanding regional variation in bystander cardiopulmonary resuscitation (CPR) is important to improving out-of-hospital cardiac arrest (OHCA) survival. In this study we aimed to identify barriers to providing bystander CPR in regions with low rates of bystander CPR and where OHCA was recognised in the emergency call. We retrospectively reviewed emergency calls for adults in regions of low bystander CPR in the Australian state of Victoria. Included calls were those where OHCA was identified during the call but no bystander CPR was given. A thematic content analysis was independently conducted by two investigators. Saturation of themes was reached after listening to 139 calls. Calls progressed to the point of compression instructions before EMS arrival in only 26 (18.7%) of cases. Three types of barriers were identified: procedural barriers (time lost due to language barriers and communication issues; telephone problems), CPR knowledge (skill deficits; perceived benefit) and personal factors (physical frailty or disability; patient position; emotional factors). A range of factors are associated with barriers to delivering bystander CPR even in the presence of dispatcher instructions -some of which are modifiable. To overcome these barriers in high-risk regions, targeted public education needs to provide information about what occurs in an emergency call, how to recognise an OHCA and to improve CPR knowledge and skills. Copyright © 2018. Published by Elsevier B.V.

Indirect child mortality estimation technique to identify trends of under-five mortality in Ethiopia.

PubMed

Ayele, Dawit G; Zewotir, Temesgen; Mwambi, Henry

2016-03-01

In sub-Saharan African countries, the chance of a child dying before the age of five years is high. The problem is similar in Ethiopia, but it shows a decrease over years. The 2000; 2005 and 2011 Ethiopian Demographic and Health Survey results were used for this work. The purpose of the study is to detect the pattern of under-five child mortality overtime. Indirect child mortality estimation technique is adapted to examine the under-five child mortality trend in Ethiopia. From the result, it was possible to see the trend of under-five child mortality in Ethiopia. The under-five child mortality shows a decline in Ethiopia. From the study, it can be seen that there is a positive correlation between mother and child survival which is almost certain in any population. Therefore, this study shows the trend of under-five mortality in Ethiopia and decline over time.

Emerging trends in vibration control of wind turbines: a focus on a dual control strategy.

PubMed

Staino, Andrea; Basu, Biswajit

2015-02-28

The paper discusses some of the recent developments in vibration control strategies for wind turbines, and in this context proposes a new dual control strategy based on the combination and modification of two recently proposed control schemes. Emerging trends in the vibration control of both onshore and offshore wind turbines are presented. Passive, active and semi-active structural vibration control algorithms have been reviewed. Of the existing controllers, two control schemes, active pitch control and active tendon control, have been discussed in detail. The proposed new control scheme is a merger of active tendon control with passive pitch control, and is designed using a Pareto-optimal problem formulation. This combination of controllers is the cornerstone of a dual strategy with the feature of decoupling vibration control from optimal power control as one of its main advantages, in addition to reducing the burden on the pitch demand. This dual control strategy will bring in major benefits to the design of modern wind turbines and is expected to play a significant role in the advancement of offshore wind turbine technologies. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Recent Trends and Innovations in the Early Childhood Education Curriculum.

ERIC Educational Resources Information Center

Saracho, Olivia N.; Spodek, Bernard

2003-01-01

Examines recent trends in early childhood education practice: the education of all children in inclusive classes, the management of vertical and horizontal transitions, the emergence of early childhood education and care programs, the development of school-family-community partnerships, the emphasis on language learning and emergent literacy, the…

Temporal Trends in Epinephrine Dispensing and Allergy/Immunology Follow-up Among Emergency Department Anaphylaxis Patients in the United States, 2005-2014.

PubMed

Motosue, Megan S; Bellolio, M Fernanda; Van Houten, Holly K; Shah, Nilay D; Bellamkonda, Venkatesh R; Nestler, David M; Campbell, Ronna L

Anaphylaxis is a potentially life-threatening allergic reaction; measures including prescription of an epinephrine autoinjector (EAI) and allergy/immunology (A/I) follow-up may prevent future morbidity. The objective of this study was to evaluate trends in outpatient management of anaphylaxis by studying EAI dispensing and A/I follow-up among patients seen in the emergency department (ED) for anaphylaxis from 2005 through 2014. We analyzed administrative claims data from the OptumLabs Data Warehouse database using an expanded International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code algorithm. The study cohort comprised 18,279 patients with a mean age of 39 years; 58% were female, and 86% were discharged from an ED. Within 1 year after discharge, 46% had filled an EAI prescription and 29% had A/I follow-up. Overall, from 2005 to 2014, annual rates of filled EAI prescriptions and A/I follow-up did not change. Among children (aged <18 years), rates increased for filled EAI prescriptions (16.1% increase; P = .02 for trend) and A/I follow-up (18.8% increase; P = .048 for trend). Rates decreased for A/I follow-up among adults (15.4% decrease; P = .002 for trend). Overall rates of filled EAI prescriptions were highest in those with venom-induced (73.9 per 100 ED visits) and food-induced anaphylaxis (69.4 per 100 ED visits); the lowest rates were among those with medication-related anaphylaxis (18.2 per 100 ED visits). Over the past decade, rates of EAI dispensing and A/I follow-up after an ED visit for anaphylaxis have remained low, suggesting that patients may not be prepared to manage future episodes. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Demographic trends, the wildland-urban interface, and wildfire management

Treesearch

Roger B. Hammer; Susan I. Stewart; Volker C. Radeloff

2009-01-01

In this article, we provide an overview of the demographic trends that have impacted and will continue to impact the "wicked" wildfire management problem in the United States, with particular attention to the emergence of the wildland-urban interface (WUI). Although population growth has had an impact on the emergence of the WUI, the deconcentration of...

Zika pandemic online trends, incidence and health risk communication: a time trend study.

PubMed

Adebayo, Gbenga; Neumark, Yehuda; Gesser-Edelsburg, Anat; Abu Ahmad, Wiessam; Levine, Hagai

2017-01-01

We aimed to describe the online search trends of Zika and examine their association with Zika incidence, assess the content of Zika-related press releases issued by leading health authorities and examine the association between online trends and press release timing. Using Google Trends, the 1 May 2015 to 30 May 2016 online trends of Zika and associated search terms were studied globally and in the five countries with the highest numbers of suspected cases. Correlations were then examined between online trends and Zika incidence in these countries. All Zika-related press releases issued by WHO/Pan America Health Organization (PAHO) and Centers for Disease Control and Prevention (CDC) during the study period were assessed for transparency, uncertainty and audience segmentation. Witte's Extended Parallel Process Model was applied to assess self-efficacy, response efficacy, susceptibility and severity. AutoRegressive Integrated Moving Average with an eXogenous predictor variable (ARIMAX) (p,d,q) regression modelling was used to quantify the association between online trends and the timing of press releases. Globally, Zika online search trends were low until the beginning of 2016, when interest rose steeply. Strong correlations (r=0.748-0.922; p<0.001) were observed between online trends and the number of suspected Zika cases in four of the five countries studied. Compared with press releases issued by WHO/PAHO, CDC press releases were significantly more likely to provide contact details and links to other resources, include figures/graphs, be risk-advisory in nature and be more readable and briefer. ARIMAX modelling results indicate that online trends preceded by 1 week press releases by WHO (stationary-R 2 =0.345; p<0.001) and CDC (stationary-R 2 =0.318; p=0.014). These results suggest that online trends can aid in pandemic surveillance. Identification of shortcomings in the content and timing of Zika press releases can help guide health communication efforts in

Zika pandemic online trends, incidence and health risk communication: a time trend study

PubMed Central

Neumark, Yehuda; Gesser-Edelsburg, Anat; Abu Ahmad, Wiessam

2017-01-01

Objectives We aimed to describe the online search trends of Zika and examine their association with Zika incidence, assess the content of Zika-related press releases issued by leading health authorities and examine the association between online trends and press release timing. Design Using Google Trends, the 1 May 2015 to 30 May 2016 online trends of Zika and associated search terms were studied globally and in the five countries with the highest numbers of suspected cases. Correlations were then examined between online trends and Zika incidence in these countries. All Zika-related press releases issued by WHO/Pan America Health Organization (PAHO) and Centers for Disease Control and Prevention (CDC) during the study period were assessed for transparency, uncertainty and audience segmentation. Witte's Extended Parallel Process Model was applied to assess self-efficacy, response efficacy, susceptibility and severity. AutoRegressive Integrated Moving Average with an eXogenous predictor variable (ARIMAX) (p,d,q) regression modelling was used to quantify the association between online trends and the timing of press releases. Results Globally, Zika online search trends were low until the beginning of 2016, when interest rose steeply. Strong correlations (r=0.748–0.922; p<0.001) were observed between online trends and the number of suspected Zika cases in four of the five countries studied. Compared with press releases issued by WHO/PAHO, CDC press releases were significantly more likely to provide contact details and links to other resources, include figures/graphs, be risk-advisory in nature and be more readable and briefer. ARIMAX modelling results indicate that online trends preceded by 1 week press releases by WHO (stationary-R2=0.345; p<0.001) and CDC (stationary-R2=0.318; p=0.014). Conclusions These results suggest that online trends can aid in pandemic surveillance. Identification of shortcomings in the content and timing of Zika press releases can help

Emerging US Space Launch, Trends and Space Solar Power

NASA Technical Reports Server (NTRS)

Zapata, Edgar

2015-01-01

Reviews the state of the art of emerging US space launch and spacecraft. Reviews the NASA budget ascontext, while providing example scenarios. Connects what has been learned in space systems commercial partnershipsto a potential path for consideration by the space solar power community.

Guidelines for infertility counselling in different countries: is there an emerging trend?

PubMed

Blyth, Eric

2012-07-01

It is widely accepted that infertility and involuntary childlessness, and the decision to engage with assisted reproduction technology (ART) services as a patient, donor or surrogate can entail wide-ranging psychosocial issues. Psychosocial counselling has, therefore, become valued as an integral element of ART services. The objective of this study was to begin to map out what exists globally by the way of guidelines for infertility counselling. Data were analysed from formal guidelines produced by seven national infertility counselling bodies, onetransnational infertility counselling organization, reports of the American Society for Reproductive Medicine Ethics Committee and Practice Committee and the ESHRE Task Force on Ethics and Law. Additional sources of data were the International Infertility Counseling Organization and counselling colleagues internationally. Four broad areas concerning contemporary practice in infertility counselling are identified: (i) the legal mandate for counselling; (ii) eligibility credentials for individuals carrying out professional counselling activities; (iii) different forms of counselling and (iv) counselling practice in relation to specific elements of assisted reproduction treatment. Internationally, the development of infertility guidelines is best described as a 'work in progress', although key trends are evident.

Identifying causes of laboratory turnaround time delay in the emergency department.

PubMed

Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

2012-12-01

Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

Trends in high temperature gas turbine materials

NASA Technical Reports Server (NTRS)

Grisaffe, S. J.; Dreshfield, R. L.

1981-01-01

High performance - high technology materials are among the technologies that are required to allow the fruition of such improvements. Materials trends in hot section components are reviewed, and materials for future use are identified. For combustors, airfoils, and disks, a common trend of using multiple material construction to permit advances in technology is identified.

Addressing barriers to emergency anaphylaxis care: from emergency medical services to emergency department to outpatient follow-up.

PubMed

Fineman, Stanley M; Bowman, Steven H; Campbell, Ronna L; Dowling, Paul; O'Rourke, Dianne; Russell, W Scott; Sublett, J Wesley; Wallace, Dana

2015-10-01

Anaphylaxis is a systemic life-threatening allergic reaction that presents unique challenges for emergency care practitioners. Allergists and emergency physicians have a history of collaborating to promote an evidence-based, multidisciplinary approach to improve the emergency management and follow-up of patients with or at risk of anaphylaxis. To review recent scientific literature about anaphylaxis, discuss barriers to care, and recommend strategies to support improvement in emergency anaphylaxis care. An expert panel of allergists and emergency physicians was convened by the American College of Allergy, Asthma and Immunology in November 2014 to discuss current knowledge about anaphylaxis, identify opportunities for emergency practitioners and allergists to partner to address barriers to care, and recommend strategies to improve medical management of anaphylaxis along the continuum of care: from emergency medical systems and emergency department practitioners for acute management through appropriate outpatient follow-up with allergists to confirm diagnosis, identify triggers, and plan long-term care. The panel identified key barriers to anaphylaxis care, including difficulties in making an accurate diagnosis, low rates of epinephrine administration during acute management, and inadequate follow-up. Strategies to overcome these barriers were discussed and recommendations made for future allergist/emergency physician collaborations, and key messages to be communicated to emergency practitioners were proposed. The panel recommended that allergists and emergency physicians continue to work in partnership, that allergists be proactive in outreach to emergency care practitioners, and that easy-to-access educational programs and materials be developed for use by emergency medical systems and emergency department practitioners in the training environment and in practice. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All

Future Trends in the Kinesiology Sciences

ERIC Educational Resources Information Center

Knudson, Duane

2016-01-01

Kinesiology emerged from its preventative medicine and education roots to establish itself as a recognized field of inquiry with numerous sub-disciplines. This article presents four trends in modern science that will likely influence the future of kinesiology sciences. Will recent increases in greater scientific specialization be overcome by the…

Trends In Susceptibility To Single-Event Upset

NASA Technical Reports Server (NTRS)

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

1989-01-01

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

Recent Trends in Information Literacy and Instruction.

ERIC Educational Resources Information Center

Arp, Lori, Ed.; Woodard, Beth S., Ed.

2002-01-01

Discusses recent trends in information literacy and instruction. Topics include the emergence of standards and guidelines; standards in elementary and secondary schools; accreditation standards, certification, and mandates; defining what librarians do, particularly as teachers; plagiarism, copyright, and ethical behavior; and the impact of…

Current Trends in Retirement: Implications for Career Counseling and Vocational Psychology

ERIC Educational Resources Information Center

Lytle, Megan C.; Clancy, Megan E.; Foley, Pamela F.; Cotter, Elizabeth W.

2015-01-01

This article provides an overview of emerging trends in retirement, examines demographic trends in the labor force, and provides practical recommendations for working with older workers across cultures (e.g., women and racial/ethnic minorities, and among others). Increasingly, older workers in the United States remain in the workforce for reasons…

Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

PubMed

Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

2017-10-31

The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies.

PubMed

Bosscher, Marianne R F; Bastiaannet, Esther; van Leeuwen, Barbara L; Hoekstra, Harald J

2016-06-01

The clinical outcome of patients with oncologic emergencies is often poor and mortality is high. It is important to determine which patients may benefit from invasive treatment, and for whom conservative treatment and/or palliative care would be appropriate. In this study, prognostic factors for clinical outcome are identified in order to facilitate the decision-making process for patients with surgical oncologic emergencies. This was a prospective registration study for patients over 18 years of age, who were consulted for surgical oncologic emergencies between November 2013 and April 2014. Multiple variables were registered upon emergency consultation, and the follow-up period was 90 days. Multivariate logistic regression analysis was performed to identify factors associated with 30- and 90-day mortality. During the study period, 207 patients experienced surgical oncologic emergencies-101 (48.8 %) men and 106 (51.2 %) women, with a median age of 64 years (range 19-92). The 30-day mortality was 12.6 % and 90-day mortality was 21.7 %. Factors significantly associated with 30-day mortality were palliative intent of cancer treatment prior to emergency consultation (p = 0.006), Eastern Cooperative Oncology Group performance score (ECOG-PS) >0 (p for trend: p = 0.03), and raised lactate dehydrogenase (LDH) (p < 0.001). Additional factors associated with 90-day mortality were low handgrip strength (HGS) (p = 0.01) and low albumin (p = 0.002). Defining the intent of prior cancer treatment and the ECOG-PS are of prognostic value when deciding on treatment for patients with surgical oncologic emergencies. Additional measurements of HGS, LDH, and albumin levels can serve as objective parameters to support the clinical assessment of individual prognosis.

Identification of potentially emerging food safety issues by analysis of reports published by the European Community's Rapid Alert System for Food and Feed (RASFF) during a four-year period.

PubMed

Kleter, G A; Prandini, A; Filippi, L; Marvin, H J P

2009-05-01

The SAFE FOODS project undertakes to design a new approach towards the early identification of emerging food safety hazards. This study explored the utility of notifications filed through RASFF, the European Commission's Rapid Alert System for Food and Feed, to identify emerging trends in food safety issues. RASFF information and alert notifications published in the four-year period of July 2003-June 2007 were assigned to categories of products and hazards. For chronological trend analysis, a basic time unit of three months was chosen. Data within each hazard category were analyzed for chronological trends, relationships between product and hazard categories, regions of origin, and countries filing the notifications. Conspicuous trends that were observed included a rise in the incidence of food contact substances, particularly 2-isopropyl-thioxanthone, as well as of chemical substances migrating from utensils and fraud-related issues. Temporary increases were noted in the incidences of the unauthorized dye Para Red, genetically modified organisms, the pesticide isophenfos-methyl, and herring worm, Anisakis simplex. National and European authorities themselves have signaled these conspicuous trends and taken measures. It is recommended to add complementary data to RASFF data, including safety assessments, risk management measures, background data on hazards and surveillance patterns, for a holistic approach towards early identification of emerging hazards.

Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

PubMed Central

Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

2015-01-01

Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

Identifying sources of emerging organic contaminants in a mixed use watershed using principal components analysis.

PubMed

Karpuzcu, M Ekrem; Fairbairn, David; Arnold, William A; Barber, Brian L; Kaufenberg, Elizabeth; Koskinen, William C; Novak, Paige J; Rice, Pamela J; Swackhamer, Deborah L

2014-01-01

Principal components analysis (PCA) was used to identify sources of emerging organic contaminants in the Zumbro River watershed in Southeastern Minnesota. Two main principal components (PCs) were identified, which together explained more than 50% of the variance in the data. Principal Component 1 (PC1) was attributed to urban wastewater-derived sources, including municipal wastewater and residential septic tank effluents, while Principal Component 2 (PC2) was attributed to agricultural sources. The variances of the concentrations of cotinine, DEET and the prescription drugs carbamazepine, erythromycin and sulfamethoxazole were best explained by PC1, while the variances of the concentrations of the agricultural pesticides atrazine, metolachlor and acetochlor were best explained by PC2. Mixed use compounds carbaryl, iprodione and daidzein did not specifically group with either PC1 or PC2. Furthermore, despite the fact that caffeine and acetaminophen have been historically associated with human use, they could not be attributed to a single dominant land use category (e.g., urban/residential or agricultural). Contributions from septic systems did not clarify the source for these two compounds, suggesting that additional sources, such as runoff from biosolid-amended soils, may exist. Based on these results, PCA may be a useful way to broadly categorize the sources of new and previously uncharacterized emerging contaminants or may help to clarify transport pathways in a given area. Acetaminophen and caffeine were not ideal markers for urban/residential contamination sources in the study area and may need to be reconsidered as such in other areas as well.

Governance: current trends in board education, competencies, and qualifications.

PubMed

Nash, David B; Murphy, Sean Patrick; Mullaney, Anne D

2011-01-01

Hospitals and health system boards have been under enormous pressure to be more accountable. However, there is now an emerging trend of voluntary, mandatory, and payer-driven board education programs. Currently, 13 states have some type of formal, organized board education and development initiative, 10 of which are classified as "director and/ or board certificate" or "certification" programs; the American Hospital Association (through and with its affiliated Center for Healthcare Governance) has issued a Blue Ribbon Panel Report on core competencies. Finally, both Congress and the Securities and Exchange Commission require publicly traded companies to disclose board and director qualifications. This article reviews these emerging trends and posits that these developments are a necessary prerequisite not only for accountability and better governance but also for quality care.

Transformative Processes in Marriage: An Analysis of Emerging Trends

ERIC Educational Resources Information Center

Fincham, Frank D.; Stanley, Scott M.; Beach, Steven R. H.

2007-01-01

The study of conflict has dominated psychological research on marriage. This article documents its move from center stage, outlining how a broader canvas accommodates a richer picture of marriage. A brief sampling of new constructs such as forgiveness and sacrifice points to an organizing theme of transformative processes in emerging marital…

Emerging trends in the sea state of the Beaufort and Chukchi seas

NASA Astrophysics Data System (ADS)

Thomson, Jim; Fan, Yalin; Stammerjohn, Sharon; Stopa, Justin; Rogers, W. Erick; Girard-Ardhuin, Fanny; Ardhuin, Fabrice; Shen, Hayley; Perrie, Will; Shen, Hui; Ackley, Steve; Babanin, Alex; Liu, Qingxiang; Guest, Peter; Maksym, Ted; Wadhams, Peter; Fairall, Chris; Persson, Ola; Doble, Martin; Graber, Hans; Lund, Bjoern; Squire, Vernon; Gemmrich, Johannes; Lehner, Susanne; Holt, Benjamin; Meylan, Mike; Brozena, John; Bidlot, Jean-Raymond

2016-09-01

The sea state of the Beaufort and Chukchi seas is controlled by the wind forcing and the amount of ice-free water available to generate surface waves. Clear trends in the annual duration of the open water season and in the extent of the seasonal sea ice minimum suggest that the sea state should be increasing, independent of changes in the wind forcing. Wave model hindcasts from four selected years spanning recent conditions are consistent with this expectation. In particular, larger waves are more common in years with less summer sea ice and/or a longer open water season, and peak wave periods are generally longer. The increase in wave energy may affect both the coastal zones and the remaining summer ice pack, as well as delay the autumn ice-edge advance. However, trends in the amount of wave energy impinging on the ice-edge are inconclusive, and the associated processes, especially in the autumn period of new ice formation, have yet to be well-described by in situ observations. There is an implicit trend and evidence for increasing wave energy along the coast of northern Alaska, and this coastal signal is corroborated by satellite altimeter estimates of wave energy.

Ten new and emerging trends in residential group living environments.

PubMed

Regnier, Victor; Denton, Alexis

2009-01-01

Residential styled environments for physically challenged people with neuro disabilities are rapidly replacing the standard institutional skilled nursing home. Ten trends are described that utilize residential design approaches to the physical environment while relying on home-care style methods for service delivery. Combined these two forces create powerful differentiators which make group residential settings more friendly and humane. Northern European, as well as, US best practices and prototypes are described that combine housing with services in a range of contexts. The success of northern Europeans in promulgating models of aging-in-place that keep those at risk more independent in the community or within family settings are remarkable. Topics like the impact of small group living clusters, interior design treatments, access to landscape gardens, life skill management methods, movement systems for circulation and exercise, shared space priorities, unit design trends and innovative care giving techniques are introduced. The focus of the article is on specific practices gleaned from cultures and exemplars that appear to increase autonomy, independence and privacy for those who are threatened because of their disabilities with the loss of these lifestyle attributes. Promising concepts of service organization and community outreach are combined with detailed recommendations that address the need for lift technology and safety features in bathrooms and kitchens.

Streamflow trends in the United States

USGS Publications Warehouse

Lins, H.F.; Slack, J.R.

1999-01-01

Secular trends in streamflow are evaluated for 395 climate-sensitive streamgaging stations in the conterminous United States using the non-parametric Mann-Kendall test. Trends are calculated for selected quantiles of discharge, from the 0th to the 100th percentile, to evaluate differences between low-, medium-, and high-flow regimes during the twentieth century. Two general patterns emerge; trends are most prevalent in the annual minimum (Q0) to median (Q50) flow categories and least prevalent in the annual maximum (Q100) category; and, at all but the highest quantiles, streamflow has increased across broad sections of the United States. Decreases appear only in parts of the Pacific Northwest and the Southeast. Systematic patterns are less apparent in the Q100 flow. Hydrologically, these results indicate that the conterminous U.S. is getting wetter, but less extreme.

Current trends in satellite based emergency mapping - the need for harmonisation

NASA Astrophysics Data System (ADS)

Voigt, Stefan

2013-04-01

During the past years, the availability and use of satellite image data to support disaster management and humanitarian relief organisations has largely increased. The automation and data processing techniques are greatly improving as well as the capacity in accessing and processing satellite imagery in getting better globally. More and more global activities via the internet and through global organisations like the United Nations or the International Charter Space and Major Disaster engage in the topic, while at the same time, more and more national or local centres engage rapid mapping operations and activities. In order to make even more effective use of this very positive increase of capacity, for the sake of operational provision of analysis results, for fast validation of satellite derived damage assessments, for better cooperation in the joint inter agency generation of rapid mapping products and for general scientific use, rapid mapping results in general need to be better harmonized, if not even standardized. In this presentation, experiences from various years of rapid mapping gained by the DLR Center for satellite based Crisis Information (ZKI) within the context of the national activities, the International Charter Space and Major Disasters, GMES/Copernicus etc. are reported. Furthermore, an overview on how automation, quality assurance and optimization can be achieved through standard operation procedures within a rapid mapping workflow is given. Building on this long term rapid mapping experience, and building on the DLR initiative to set in pace an "International Working Group on Satellite Based Emergency Mapping" current trends in rapid mapping are discussed and thoughts on how the sharing of rapid mapping information can be optimized by harmonizing analysis results and data structures are presented. Such an harmonization of analysis procedures, nomenclatures and representations of data as well as meta data are the basis to better cooperate within

Does active dissemination of evidence result in faster knowledge transfer than passive diffusion?: An analysis of trends of the management of pediatric asthma and croup in US emergency departments from 1995 to 2009.

PubMed

Knapp, Jane F; Simon, Stephen D; Sharma, Vidya

2015-03-01

This study aimed to compare knowledge transfer (KT) in the emergency department (ED) management of pediatric asthma and croup by measuring trends in corticosteroid use for both conditions in EDs. A retrospective, cross-sectional study of the National Hospital Ambulatory Medical Care Survey data between 1995 and 2009 of corticosteroid use at ED visits for asthma or croup was conducted. Odds ratios (OR) were calculated using logistic regression. Trends over time were compared using an interaction term between disease and year and were adjusted for all other covariates in the model. We included children aged 2 to 18 years with asthma who received albuterol and were triaged emergent/urgent. Children aged between 3 months to 6 years with croup were included. The main outcome measure was the administration of corticosteroids in the ED or as a prescription at the ED visit. The corticosteroid use in asthma visits increased from 44% to 67% and from 32% to 56% for croup. After adjusting for patient and hospital factors, this trend was significant both for asthma (OR, 1.07; 95% confidence interval [CI], 1.04-1.10) and croup (OR, 1.07; 95% CI, 1.03-1.12). There was no statistical difference between the 2 trends (P = 0.69). Hospital location in a metropolitan statistical area was associated with increased corticosteroid use in asthma (OR, 1.76; 95% CI, 1.10-2.82). Factors including sex, ethnicity, insurance, or region of the country were not significantly associated with corticosteroid use. During a 15-year period, knowledge transfer by passive diffusion or active guideline dissemination resulted in similar trends of corticosteroid use for the management of pediatric asthma and croup.

NAEP Trends: Main NAEP vs. Long-Term Trend

ERIC Educational Resources Information Center

Beaton, Albert E.; Chromy, James R.

2010-01-01

The objectives of this research are to (a) compare the trend lines after some adjustments for level and scale only and determine if and how they differ; (b) describe the methodology of each assessment and identify similarities and differences; and (c) attempt to explain any observed differences based on comparable subsets or on special analysis.…

Diversity and Dynamics of the Canadian Coastal Vibrio Community: An Emerging Trend Detected in the Temperate Regions.

PubMed

Banerjee, Swapan K; Rutley, Rebecca; Bussey, Jeff

2018-05-07

Vibrio s pecies are indigenous to the marine and estuarine environments around the world and are the leading cause of water and seafood-borne illnesses due to conditions favouring the transmission and growth of the species. Horizontal gene transfer, recombination and mutation enable Vibrio spp to adapt rapidly to environmental challenges from biotic and abiotic parameters, including temperature, salinity and nutrient status of the coastal waters. This surveillance study provides evidence of V. cholerae emerging in the temperate estuaries of Canada, thereby redefining the diversity and dynamics of its coastal Vibrio population. Presence of the pathogenic context in V. parahaemolyticus was also detected with an increasing trend during the study period. IMPORTANCE Proliferation and abundance of the harmful biotypes of Vibrio spp. in the estuaries of Canada indicate the possibility of producing contaminated seafood for human consumption. The findings of this surveillance study may lead to awareness which may help in efforts to reduce the occurrence of illnesses or outbreaks caused by Vibrio spp. in seafood. © Crown copyright 2018.

Trends in Video Game Play through Childhood, Adolescence, and Emerging Adulthood

PubMed Central

Ream, Geoffrey L.; Elliott, Luther C.; Dunlap, Eloise

2013-01-01

This study explored the relationship between video gaming and age during childhood, adolescence, and emerging adulthood. It also examined whether “role incompatibility,” the theory that normative levels of substance use decrease through young adulthood as newly acquired adult roles create competing demands, generalizes to video gaming. Emerging adult video gamers (n = 702) recruited from video gaming contexts in New York City completed a computer-assisted personal interview and life-history calendar. All four video gaming indicators—days/week played, school/work day play, nonschool/work day play, and problem play—had significant curvilinear relationships with age. The “shape” of video gaming's relationship with age is, therefore, similar to that of substance use, but video gaming appears to peak earlier in life than substance use, that is, in late adolescence rather than emerging adulthood. Of the four video gaming indicators, role incompatibility only significantly affected school/work day play, the dimension with the clearest potential to interfere with life obligations. PMID:24236277

Emerging Drug Use Trends in Kelantan, Malaysia.

PubMed

Desrosiers, Alethea; Chooi, Weng-Tink; Zaharim, Norzarina Mohd; Ahmad, Imran; Mohd Yasin, Mohd Azhar; Syed Jaapar, Sharifah Z; Schottenfeld, Richard S; Vicknasingam, Balasingam; Chawarski, Marek C

2016-01-01

The primarily rural and agrarian Kelantan province of Malaysia has high rates of drug use and is characterized by unique sociocultural factors. Combining qualitative and ethnographic methods, we investigated drug use and treatment needs of people who use drugs (PWUD) in rural areas of Kelantan. In February 2014, field visits, participant observation, and focus group discussions (FGDs) with 27 active PWUD were conducted in rural areas surrounding the capital city of Kelantan. The findings indicate a high prevalence of opiate and amphetamine type stimulants (ATS) use in these areas. FGD participants reported initiating drug use at early ages due to peer influences, to relieve boredom, to cope with problems, and a high saturation of villages with other PWUD was reported as a major contributor to their own continued drug use. They reported a trend of drug use initiation at younger ages and increased drug use among females. Participants were interested in treatment; however, their limited knowledge about treatment options and perceived limited availability of services were barriers to treatment seeking. Easy access to drugs, primarily from Thailand and facilitated by the use of mobile phones, resulted in an expanding prevalence of drug use that underscores the need to bolster education and prevention efforts and accessibility of treatment services in Kelantan.

Arizona Hospital Discharge and Emergency Department Database: Implications for Occupational Health Surveillance.

PubMed

Harber, Philip; Ha, Jennifer; Roach, Matthew

2017-04-01

The objective of the project was to identify trends in emergency department visits and inpatient admissions for occupational injury and disease frequency and describe the financial impact from specific clinical groups known to have occupational risk factors. Workers compensation cases among 19 million records in the Arizona statewide hospital discharge database (HDD) were assessed for seven clinical groups from 2008 to 2014, including back, cardiac, carpal tunnel syndrome, heat-related, psychiatric, pulmonary, and trauma. Cases with cardiac, psychiatric, and pulmonary diagnoses were both frequent and expensive. Although incidence was generally stable, charges per case rose significantly over the time period. Inpatient and emergency department records provide valuable data that complement other surveillance approaches for both occupational illnesses and injuries. Tracking charge as well as incidence data is useful.

Dynamic spatiotemporal trends of dengue transmission in the Asia-Pacific region, 1955-2004.

PubMed

Banu, Shahera; Hu, Wenbiao; Guo, Yuming; Naish, Suchithra; Tong, Shilu

2014-01-01

Dengue fever (DF) is one of the most important emerging arboviral human diseases. Globally, DF incidence has increased by 30-fold over the last fifty years, and the geographic range of the virus and its vectors has expanded. The disease is now endemic in more than 120 countries in tropical and subtropical parts of the world. This study examines the spatiotemporal trends of DF transmission in the Asia-Pacific region over a 50-year period, and identified the disease's cluster areas. The World Health Organization's DengueNet provided the annual number of DF cases in 16 countries in the Asia-Pacific region for the period 1955 to 2004. This fifty-year dataset was divided into five ten-year periods as the basis for the investigation of DF transmission trends. Space-time cluster analyses were conducted using scan statistics to detect the disease clusters. This study shows an increasing trend in the spatiotemporal distribution of DF in the Asia-Pacific region over the study period. Thailand, Vietnam, Laos, Singapore and Malaysia are identified as the most likely clusters (relative risk = 13.02) of DF transmission in this region in the period studied (1995 to 2004). The study also indicates that, for the most part, DF transmission has expanded southwards in the region. This information will lead to the improvement of DF prevention and control strategies in the Asia-Pacific region by prioritizing control efforts and directing them where they are most needed.

Deriving spatial trends of air pollution at a neighborhood-scale through mobile monitoring

EPA Science Inventory

Abstract: Measuring air pollution in real-time using an instrumented vehicle platform has been an emerging strategy to resolve air pollution trends at a very fine spatial scale (10s of meters). Achieving second-by-second data representative of urban air quality trends requires a...

Pilot Study of Kano "Attractive Quality" Techniques to Identify Change in Emergency Department Patient Experience.

PubMed

Bellamkonda, Venkatesh R; Kumar, Rishi; Scanlan-Hanson, Lori N; Hess, Jennifer J; Hellmich, Thomas R; Bellamkonda, Erica; Campbell, Ronna L; Hess, Erik P; Nestler, David M

2016-11-01

We describe the use of the Kano Attractive Quality analytic tool to improve an identified patient experience gap in perceived compassion by emergency department (ED) providers. In phase 1, point-of-service surveying assessed baseline patient perception of ED provider compassion. Phase 2 deployed Kano surveys to predict the effect of 4 proposed interventions on patient perception. Finally, phase 3 compared patients receiving standard care versus the Kano-identified intervention to assess the actual effect on patient experience. In phase 1, 193 of 200 surveys (97%) were completed, showing a baseline median score of 4 out of 5 (interquartile range [IQR] 3 to 5), with top box percentage of 33% for patients' perception of receiving compassionate care. In phase 2, 158 of 180 surveys (88%) using Kano-formatted questions were completed, and the data predicted that increasing shared decisionmaking would cause the greatest improvement in the patient experience. Finally, in phase 3, 45 of 49 surveys (92%) were returned and demonstrated a significant improvement in perceived concern and sensitivity, 5 (IQR 5 to 5) versus 4 (IQR 3 to 5) with a difference of 1 (95% CI 0.1-1.9) and a top box rating of 79% versus 35% with a difference of 44% (95% CI 12-66) by patients who received dedicated shared decisionmaking interventions versus those receiving standard of care. Kano analysis is likely predictive of change in patient experience. Kano methods may prove as useful in changing management of the health care industry as it has been in other industries. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Emergency Nurses Association

MedlinePlus

... medications to treat a medical emergency. Study: Workplace bullying is underestimated driver of nurse and patient outcomes ... Emergency Nurses Association theory helps identify and correct bullying behavior. Join the Emergency Nurses Week Celebration Led ...

Recent Trends in Imaging Use in Hospital Settings: Implications for Future Planning.

PubMed

Levin, David C; Parker, Laurence; Rao, Vijay M

2017-03-01

To compare trends in utilization rates of imaging in the three hospital-based settings where imaging is conducted. The nationwide Medicare Part B databases for 2004-2014 were used. All discretionary noninvasive diagnostic imaging (NDI) CPT codes were selected and grouped by modality. Procedure volumes of each code were available from the databases and converted to utilization rates per 1,000 Medicare enrollees. Medicare's place-of-service codes were used to identify imaging examinations done in hospital inpatients, hospital outpatient departments (HOPDs), and emergency departments (EDs). Trends were observed over the life of the study. Trendlines were strongly affected by code bundling in echocardiography in 2009, nuclear imaging in 2010, and CT in 2011. However, even aside from these artifactual effects, important trends could be discerned. Inpatient imaging utilization rates of all modalities are trending downward. In HOPDs, the utilization rate of conventional radiographic examinations (CREs) is declining but rates of CT, MRI, echocardiography, and noncardiac ultrasound (US) are increasing. In EDs, utilization rates of CREs, CT, and US are increasing. In the 3 years after 2011, when no further code bundling occurred, the total inpatient NDI utilization rate dropped 15%, whereas the rate in EDs increased 12% and that in HOPDs increased 1%. The trends in utilization of NDI in the three hospital-based settings where imaging occurs are distinctly different. Radiologists and others who are involved in deciding what kinds of equipment to purchase and where to locate it should be cognizant of these trends in making their decisions. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Trends in initial management of prostate cancer in New Hampshire.

PubMed

Ingimarsson, Johann P; Celaya, Maria O; Laviolette, Michael; Rees, Judy R; Hyams, Elias S

2015-06-01

Prostate cancer management strategies are evolving with increased understanding of the disease. Specifically, there is emerging evidence that "low-risk" cancer is best treated with observation, while localized "high-risk" cancer requires aggressive curative therapy. In this study, we evaluated trends in management of prostate cancer in New Hampshire to determine adherence to evidence-based practice. From the New Hampshire State Cancer Registry, cases of clinically localized prostate cancer diagnosed in 2004-2011 were identified and classified according to D'Amico criteria. Initial treatment modality was recorded as surgery, radiation therapy, expectant management, or hormone therapy. Temporal trends were assessed by Chi-square for trend. Of 6,203 clinically localized prostate cancers meeting inclusion criteria, 34, 30, and 28% were low-, intermediate-, and high-risk disease, respectively. For low-risk disease, use of expectant management (17-42%, p < 0.001) and surgery (29-39%, p < 0.001) increased, while use of radiation therapy decreased (49-19 %, p < 0.001). For intermediate-risk disease, use of surgery increased (24-50%, p < 0.001), while radiation decreased (58-34%, p < 0.001). Hormonal therapy alone was rarely used for low- and intermediate-risk disease. For high-risk patients, surgery increased (38-47%, p = 0.003) and radiation decreased (41-38%, p = 0.026), while hormonal therapy and expectant management remained stable. There are encouraging trends in the management of clinically localized prostate cancer in New Hampshire, including less aggressive treatment of low-risk cancer and increasing surgical treatment of high-risk disease.

Impact of specialist care on clinical outcomes for medical emergencies.

PubMed

Moore, Stuart; Gemmell, Islay; Almond, Solomon; Buchan, Iain; Osman, Isameldin; Glover, Andrew; Williams, Peter; Carroll, Nadine; Rhodes, Jonathan

2006-01-01

General hospitals have commonly involved a wide range of medical specialists in the care of unselected medical emergency admissions. In 1999, the Royal Liverpool University Hospital, a 915-bed hospital with a busy emergency service, changed its system of care for medical emergencies to allow early placement of admitted patients under the care of the most appropriate specialist team, with interim care provided by specialist acute physicians on an acute medicine unit - a system we have termed 'specialty triage'. Here we describe a retrospective study in which all 133,509 emergency medical admissions from February 1995 to January 2003 were analysed by time-series analysis with correction for the underlying downward trend from 1995 to 2003. This showed that the implementation of specialty triage in May 1999 was associated with a subsequent additional reduction in the mortality of the under-65 age group by 0.64% (95% CI 0.11 to 1.17%; P=0.021) from the 2.4% mortality rate prior to specialty triage, equivalent to approximately 51 fewer deaths per year. No significant effect was seen for those over 65 or all age groups together when corrected for the underlying trend. Length of stay and readmission rates showed a consistent downward trend that was not significantly affected by specialty triage. The data suggest that appropriate specialist management improves outcomes for medical emergencies, particularly amongst younger patients.

Decades of Data: Extracting Trends from Microgravity Crystallization History

NASA Technical Reports Server (NTRS)

Judge, R. A.; Snell, E. H.; Kephart, R.; vanderWoerd, M.

2004-01-01

The reduced acceleration environment of an orbiting spacecraft has been proposed as an ideal environment for biological crystal growth as the first sounding rocket flight in 1981 many crystallization experiments have flown with some showing improvement and others not. To further explore macromolecule crystal improvement in microgravity we have accumulated data from published reports and reports submitted by 63 missions including the Space Shuttle program, unmanned satellites, the Russian Space Station MIR and sounding rocket experiments. While it is not at this point in time a comprehensive record of all flight crystallization experimental results, there is however sufficient information for emerging trends to be identified. In this study the effects of the acceleration environment, the techniques of crystallization, sample molecular weight and the response of individual macromolecules to microgravity crystallization will be investigated.

Emerging trends in nutraceutical applications of whey protein and its derivatives.

PubMed

Patel, Seema

2015-11-01

The looming food insecurity demands the utilization of nutrient-rich residues from food industries as value-added products. Whey, a dairy industry waste has been characterized to be excellent nourishment with an array of bioactive components. Whey protein comprises 20 % of total milk protein and it is rich in branched and essential amino acids, functional peptides, antioxidants and immunoglobulins. It confers benefits against a wide range of metabolic diseases such as cardiovascular complications, hypertension, obesity, diabetes, cancer and phenylketonuria. The protein has been validated to boost recovery from resistance exercise-injuries, stimulate gut physiology and protect skin against detrimental radiations. Apart from health invigoration, whey protein has proved its suitability as fat replacer and emulsifier. Further, its edible and antimicrobial packaging potential renders its highly desirable in food as well as pharmaceutical sectors. Considering the enormous nutraceutical worth of whey protein, this review emphasizes on its established and emerging biological roles. Present and future scopes in food processing and dietary supplement formulation are discussed. Associated hurdles are identified and how technical advancement might augment its applications are explored. This review is expected to provide valuable insight on whey protein-fortified functional foods, associated technical hurdles and scopes of improvement.

Emergence of a New Lineage of Dengue Virus Type 2 Identified in Travelers Entering Western Australia from Indonesia, 2010-2012

PubMed Central

Ernst, Timo; McCarthy, Suzi; Chidlow, Glenys; Luang-Suarkia, Dagwin; Holmes, Edward C.; Smith, David W.; Imrie, Allison

2015-01-01

Dengue virus (DENV) transmission is ubiquitous throughout the tropics. More than 70% of the current global dengue disease burden is borne by people who live in the Asia-Pacific region. We sequenced the E gene of DENV isolated from travellers entering Western Australia between 2010–2012, most of whom visited Indonesia, and identified a diverse array of DENV1-4, including multiple co-circulating viral lineages. Most viruses were closely related to lineages known to have circulated in Indonesia for some time, indicating that this geographic region serves as a major hub for dengue genetic diversity. Most notably, we identified a new lineage of DENV-2 (Cosmopolitan genotype) that emerged in Bali in 2011–2012. The spread of this lineage should clearly be monitored. Surveillance of symptomatic returned travellers provides important and timely information on circulating DENV serotypes and genotypes, and can reveal the herald wave of dengue and other emerging infectious diseases. PMID:25635775

Trends in computer hardware and software.

PubMed

Frankenfeld, F M

1993-04-01

Previously identified and current trends in the development of computer systems and in the use of computers for health care applications are reviewed. Trends identified in a 1982 article were increasing miniaturization and archival ability, increasing software costs, increasing software independence, user empowerment through new software technologies, shorter computer-system life cycles, and more rapid development and support of pharmaceutical services. Most of these trends continue today. Current trends in hardware and software include the increasing use of reduced instruction-set computing, migration to the UNIX operating system, the development of large software libraries, microprocessor-based smart terminals that allow remote validation of data, speech synthesis and recognition, application generators, fourth-generation languages, computer-aided software engineering, object-oriented technologies, and artificial intelligence. Current trends specific to pharmacy and hospitals are the withdrawal of vendors of hospital information systems from the pharmacy market, improved linkage of information systems within hospitals, and increased regulation by government. The computer industry and its products continue to undergo dynamic change. Software development continues to lag behind hardware, and its high cost is offsetting the savings provided by hardware.

The emerging trend of non-operative treatment in paediatric type I open forearm fractures.

PubMed

Zhang, H; Fanelli, M; Adams, C; Graham, J; Seeley, M

2017-08-01

Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures. An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention. A fixed-effect meta-analysis, weighting each study based on the number of patients, and a pooled estimate of infection risk (with 95% confidence interval (CI)) was performed. The search results yielded five studies that were eligible for inclusion. No included patients had operative debridement and all were treated with antibiotics. The number of patients in each study ranged from 3 to 45, with a total of 127 paediatric patients in the meta-analysis. The infection rate was 0% for all patients included. The meta-analysis estimated a pooled infection risk of 0% (95% CI 0 to 2.9). The five included studies had a total of 127 patients with no cases of infection after non-operative management of Type I open paediatric forearm fractures. The infection rate of Type I fractures among operatively managed patients is 1.9%. The trend in literature towards non-operative treatment of paediatric Type I open fractures holds true in this meta-analysis.

Today's Recruitment Trends.

ERIC Educational Resources Information Center

Sugarman, Joe

1996-01-01

Five trends in the creation of college student recruitment publications are identified: (1) using market research and marketing principles; (2) targeting specific groups; (3) honesty about campus personality and reputation; (4) cost-effectiveness; and (5) creativity in using effective copy and design. (MSE)

Drug use as a driver of HIV Risks: Re-emerging and emerging issues

PubMed Central

El-Bassel, Nabila; Shaw, Stacey A.; Dasgupta, Anindita; Strathdee, Steffanie A.

2014-01-01

Purpose of Review We reviewed papers published in 2012–2013 that focused on re-emerging and emerging injection and non-injection drug use trends driving HIV risk behaviors and transmission in some parts of the world. Recent Findings While HIV incidence has declined in many countries, HIV epidemics remain at troubling levels among key drug using populations including females who inject drugs (FWID), FWID who trade sex, sex partners of people who inject drugs (SP-PWID), young PWID, and people who use non-injection drugs in a number of low- and middle- income countries such as in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa. Summary HIV epidemics occur within contexts of global economic and political forces, including poverty, human rights violations, discrimination, drug policies, trafficking, and other multi-level risk environments. Trends of injection and non-injection drug use and risk environments driving HIV epidemics in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa call for political will to improve HIV and substance use service delivery, access to combination HIV prevention, and harm reduction programs. PMID:24406532

Assistive Technology and Older Adults in Disasters: Implications for Emergency Management.

PubMed

McSweeney-Feld, Mary Helen

2017-02-01

This article identifies concepts, trends, and policy gaps in the availability and service delivery of assistive technology utilized by older adults in disasters, as well as implications for emergency management planning and shelter administration. Definitions of types of assistive technology, as well as views of older adults using technology as at-risk individuals for emergency management service provision, are provided. An overview of peer-reviewed articles and gray literature is conducted, focusing on publications from 2001 to the present in the United States. Analytical frameworks used by emergency management organizations as well as regulations such as the Americans with Disabilities Act and recent court decisions on emergency shelter accessibility in disasters are reviewed. Research on the use of assistive technology by older adults during disasters is a neglected issue. The current and potential benefits of defining standards for provision and use of assistive technology for older adults during disasters has received limited recognition in emergency management planning. Older adults with disabilities utilize assistive technology to maintain their independence and dignity, and communities as well as emergency services managers need to become more aware of the needs and preferences of these older adults in their planning processes and drills as well as in service delivery during actual events. (Disaster Med Public Health Preparedness. 2017;11:135-139).

Actual vs. Ideal Attraction: Trends in the Mobility of Korean International Students

ERIC Educational Resources Information Center

Ghazarian, Peter G.

2014-01-01

In the Republic of Korea (Korea), pressures emerging from the domestic education system seem to drive growing numbers of tertiary students abroad. This trend creates an outward flow of resources and has a number of impacts on Korean society. This study examines trends in the movement of tertiary students out of Korea from 2001 to 2010 and compares…

Trends in the quality of water in New Jersey streams, water years 1998-2007

USGS Publications Warehouse

Hickman, R. Edward; Gray, Bonnie J.

2010-01-01

Trends were determined in flow-adjusted values of selected water-quality characteristics measured year-round during water years 1998-2007 (October 1, 1997, through September 30, 2007) at 70 stations on New Jersey streams. Water-quality characteristics included in the analysis are dissolved oxygen, pH, total dissolved solids, total phosphorus, total organic nitrogen plus ammonia, and dissolved nitrate plus nitrite. In addition, trend tests also were conducted on measurements of dissolved oxygen made only during the growing season, April to September. Nearly all the water-quality data analyzed were collected by the New Jersey Department of Environmental Protection and the U.S. Geological Survey as part of the New Jersey Department of Environmental Protection Ambient Surface-Water Quality Monitoring Network. Monotonic trends in flow-adjusted values of water quality were determined by use of procedures in the ESTREND computer program. A 0.05 level of significance was selected to indicate a trend. Results of tests were not reported if there were an insufficient number of measurements or insufficient number of detected concentrations, or if the results of the tests were affected by a change in data-collection methods. Trends in values of dissolved oxygen, pH, and total dissolved solids were identified using the Seasonal Kendall test. Trends or no trends in year-round concentrations of dissolved oxygen were determined for 66 stations; decreases at 4 stations and increases at 0 stations were identified. Trends or no trends in growing-season concentrations of dissolved oxygen were determined for 65 stations; decreases at 4 stations and increases at 4 stations were identified. Tests of pH values determined trends or no trends at 26 stations; decreases at 2 stations and increases at 3 stations were identified. Trends or no trends in total dissolved solids were reported for all 70 stations; decreases at 0 stations and increases at 24 stations were identified. Trends in total

National Trends in Emergency Room Visits of Dialysis Patients for Adverse Drug Reactions.

PubMed

Chan, Lili; Saha, Aparna; Poojary, Priti; Chauhan, Kinsuk; Naik, Nidhi; Coca, Steven; Garimella, Pranav S; Nadkarni, Girish N

2018-06-12

Various medications are cleared by the kidneys, therefore patients with impaired renal function, especially dialysis patients are at risk for adverse drug events (ADEs). There are limited studies on ADEs in maintenance dialysis patients. We utilized a nationally representative database, the Nationwide Emergency Department Sample, from 2008 to 2013, to compare emergency department (ED) visits for dialysis and propensity matched non-dialysis patients. Log binomial regression was used to calculate relative risk of hospital admission and logistic regression to calculate ORs for in-hospital mortality while adjusting for patient and hospital characteristics. While ED visits for ADEs decreased in both groups, they were over 10-fold higher in dialysis patients than non-dialysis patients (65.8-88.5 per 1,000 patients vs. 4.6-5.4 per 1,000 patients respectively, p < 0.001). The top medication category associated with ED visits for ADEs in dialysis patients is agents primarily affecting blood constituents, which has increased. After propensity matching, patient admission was higher in dialysis patients than non-dialysis patients, (88 vs. 76%, p < 0.001). Dialysis was associated with a 3% increase in risk of admission and 3 times the odds of in-hospital mortality (adjusted OR 3, 95% CI 2.7-2.3.3). ED visits for ADEs are substantially higher in dialysis patients than non-dialysis patients. In dialysis patients, ADEs associated with agents primarily affecting blood constituents are on the rise. ED visits for ADEs in dialysis patients have higher inpatient admissions and in-hospital mortality. Further studies are needed to identify and implement measures aimed at reducing ADEs in dialysis patients. © 2018 S. Karger AG, Basel.

Identifying Key Drivers of Return Reversal with Dynamical Bayesian Factor Graph

PubMed Central

Zhao, Shuai; Tong, Yunhai; Wang, Zitian; Tan, Shaohua

2016-01-01

In the stock market, return reversal occurs when investors sell overbought stocks and buy oversold stocks, reversing the stocks’ price trends. In this paper, we develop a new method to identify key drivers of return reversal by incorporating a comprehensive set of factors derived from different economic theories into one unified dynamical Bayesian factor graph. We then use the model to depict factor relationships and their dynamics, from which we make some interesting discoveries about the mechanism behind return reversals. Through extensive experiments on the US stock market, we conclude that among the various factors, the liquidity factors consistently emerge as key drivers of return reversal, which is in support of the theory of liquidity effect. Specifically, we find that stocks with high turnover rates or high Amihud illiquidity measures have a greater probability of experiencing return reversals. Apart from the consistent drivers, we find other drivers of return reversal that generally change from year to year, and they serve as important characteristics for evaluating the trends of stock returns. Besides, we also identify some seldom discussed yet enlightening inter-factor relationships, one of which shows that stocks in Finance and Insurance industry are more likely to have high Amihud illiquidity measures in comparison with those in other industries. These conclusions are robust for return reversals under different thresholds. PMID:27893780

Identifying Key Drivers of Return Reversal with Dynamical Bayesian Factor Graph.

PubMed

Zhao, Shuai; Tong, Yunhai; Wang, Zitian; Tan, Shaohua

2016-01-01

In the stock market, return reversal occurs when investors sell overbought stocks and buy oversold stocks, reversing the stocks' price trends. In this paper, we develop a new method to identify key drivers of return reversal by incorporating a comprehensive set of factors derived from different economic theories into one unified dynamical Bayesian factor graph. We then use the model to depict factor relationships and their dynamics, from which we make some interesting discoveries about the mechanism behind return reversals. Through extensive experiments on the US stock market, we conclude that among the various factors, the liquidity factors consistently emerge as key drivers of return reversal, which is in support of the theory of liquidity effect. Specifically, we find that stocks with high turnover rates or high Amihud illiquidity measures have a greater probability of experiencing return reversals. Apart from the consistent drivers, we find other drivers of return reversal that generally change from year to year, and they serve as important characteristics for evaluating the trends of stock returns. Besides, we also identify some seldom discussed yet enlightening inter-factor relationships, one of which shows that stocks in Finance and Insurance industry are more likely to have high Amihud illiquidity measures in comparison with those in other industries. These conclusions are robust for return reversals under different thresholds.

Pharmacogenomics in Asia: a systematic review on current trends and novel discoveries.

PubMed

Ang, Hazel Xiaohui; Chan, Sze Ling; Sani, Levana L; Quah, Clarissa Bernice; Brunham, Liam R; Tan, Boon Ooi Patrick; Winther, Michael D

2017-06-01

While early pharmacogenomic studies have primarily been carried out in Western populations, there has been a notable increase in the number of Asian studies over the past decade. We systematically reviewed all pharmacogenomic studies conducted in Asia published before 2016 to highlight trends and identify research gaps in Asia. We observed that pharmacogenomic research in Asia was dominated by larger developed countries, notably Japan and Korea, and mainly driven by local researchers. Studies were focused on drugs acting on the CNS, chemotherapeutics and anticoagulants. Significantly, several novel pharmacogenomic associations have emerged from Asian studies. These developments are highly encouraging for the strength of regional scientific and clinical community and propound the importance of discovery studies in different populations.

Aerosol optical depth trend over the Middle East

NASA Astrophysics Data System (ADS)

Klingmueller, Klaus; Pozzer, Andrea; Metzger, Swen; Abdelkader, Mohamed; Stenchikov, Georgiy; Lelieveld, Jos

2016-04-01

We use the combined Dark Target/Deep Blue aerosol optical depth (AOD) satellite product of the Moderate-resolution Imaging Spectroradiometer (MODIS) collection 6 to study trends over the Middle East between 2000 and 2015. Our analysis corroborates a previously identified positive AOD trend over large parts of the Middle East during the period 2001 to 2012. By relating the annual AOD to precipitation, soil moisture and surface wind, being the main factors controlling the dust cycle, we identify regions where these attributes are significantly correlated to the AOD over Saudi Arabia, Iraq and Iran. The Fertile Crescent turns out to be of prime importance for the AOD trend over these countries. Using multiple linear regression we show that AOD trend and interannual variability can be attributed to the above mentioned dust cycle parameters, confirming that the AOD increase is predominantly driven by dust. In particular, the positive AOD trend relates to a negative soil moisture trend. This suggests that increasing temperature and decreasing relative humidity in the last decade have promoted soil drying, leading to increased dust emissions and AOD; consequently an AOD increase is expected due to climate change. Based on simulations using the ECHAM/MESSy atmospheric chemistry-climate model (EMAC), we interpret the correlations identified in the observational data in terms of causal relationships.

[Psychiatric Emergencies in the Emergency Room of the Ulm University Hospital in 2000 and 2010].

PubMed

Freudenmann, Roland W; Espe, Johannes; Lang, Dirk; Klaus, Jochen; Gahr, Maximilian; Schönfeldt-Lecuona, Carlos

2017-01-01

Objective: Despite of the importance of psychiatric emergencies (PE) requiring treatment at an emergency room (ER) little is known about their frequency and current trends in terms of quantity and quality. Methods: A retrospective analysis of all PE treated at the ER of the University Hospital Ulm (Germany) in 2000 and 2010. Results: 6 % (2000) or 5 % (2010) of the ER cases were PE. Despite an increase from 369 to 430 cases (+ 16,5 %) their share decreased because of an even stronger increase of other emergencies (+ 33 %). The most frequent PE in 2000 was alcohol intoxication (37,7 %), while it was intoxication with prescribed and/or illicit drugs in 2010 (47,9 %). Patients with alcohol intoxications were significantly younger in 2010 as compared with 2000. Suicide attempts were seen in every fourth PE. They were significantly more frequent in 2010. PEs were generally more frequent in the evening and over the night. Conclusion: This study provides first insight into current trends in PE treated at the ER in Germany. Our data provide an empirical starting point for optimizing clinical care, although the study is limited by its retrospective and mono-centric design. © Georg Thieme Verlag KG Stuttgart · New York.

Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.

PubMed

Bank, Ilana; Snell, Linda; Bhanji, Farhan

2014-12-01

Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients. Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop. Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P < 0.008), delegating tasks appropriately (P < 0.009), and ability to ensure closed-loop communication (P < 0.008). There was a significant improvement in identification of CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P < 0.006). The pediatric CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.

Adult sepsis - A nationwide study of trends and outcomes in a population of 23 million people.

PubMed

Lee, Chien-Chang; Yo, Chia-Hung; Lee, Meng-Tse Gabriel; Tsai, Kuang-Chau; Lee, Shih-Hao; Chen, Yueh-Sheng; Lee, Wan-Chien; Hsu, Tzu-Chun; Lee, Sie-Hue; Chang, Shy-Shin

2017-11-01

To determine the trend of incidence and outcome of sepsis based on a nationwide administrative database. We analyzed the incidence and mortality of both emergency department treated and hospital treated sepsis from 2002 through 2012 using the entire health insurance claims data of Taiwan. The national health insurance covers 99% of residents in Taiwan. Sepsis patients were identified using a set of validated ICD-9CM codes conforming to the sepsis-3 definition. The 30-day all-cause mortality was verified by linked death certificate database. During the 11-year study period, a total of 1,259,578 episodes of sepsis was identified. The mean incidence rate was 639 per 100,000 person-years, increasing from 637.8/100,000 persons in 2002 to 772.1/100,000 persons in 2012 (annual increase: 1.9%). The mortality rate, however, has decreased from 27.8% in 2002 to 22.8% in 2012 (annual decrease: 0.45%). The trend of incidence and mortality did not change after standardization by age and gender using 2002 as the reference standard. We showed that the incidence of sepsis has increased while the mortality has decreased in Taiwan. Despite the decreasing trend in sepsis mortality, the total number of sepsis mortality remains increasing due to the rapid increase in sepsis incidence. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Forecasting Hospitalization and Emergency Department Visit Rates for Chronic Obstructive Pulmonary Disease. A Time-Series Analysis.

PubMed

Gershon, Andrea; Thiruchelvam, Deva; Moineddin, Rahim; Zhao, Xiu Yan; Hwee, Jeremiah; To, Teresa

2017-06-01

Knowing trends in and forecasting hospitalization and emergency department visit rates for chronic obstructive pulmonary disease (COPD) can enable health care providers, hospitals, and health care decision makers to plan for the future. We conducted a time-series analysis using health care administrative data from the Province of Ontario, Canada, to determine previous trends in acute care hospitalization and emergency department visit rates for COPD and then to forecast future rates. Individuals aged 35 years and older with physician-diagnosed COPD were identified using four universal government health administrative databases and a validated case definition. Monthly COPD hospitalization and emergency department visit rates per 1,000 people with COPD were determined from 2003 to 2014 and then forecasted to 2024 using autoregressive integrated moving average models. Between 2003 and 2014, COPD prevalence increased from 8.9 to 11.1%. During that time, there were 274,951 hospitalizations and 290,482 emergency department visits for COPD. After accounting for seasonality, we found that monthly COPD hospitalization and emergency department visit rates per 1,000 individuals with COPD remained stable. COPD prevalence was forecasted to increase to 12.7% (95% confidence interval [CI], 11.4-14.1) by 2024, whereas monthly COPD hospitalization and emergency department visit rates per 1,000 people with COPD were forecasted to remain stable at 2.7 (95% CI, 1.6-4.4) and 3.7 (95% CI, 2.3-5.6), respectively. Forecasted age- and sex-stratified rates were also stable. COPD hospital and emergency department visit rates per 1,000 people with COPD have been stable for more than a decade and are projected to remain stable in the near future. Given increasing COPD prevalence, this means notably more COPD health service use in the future.

Comprehensive genomic studies: emerging regulatory, strategic, and quality assurance challenges for biorepositories.

PubMed

McDonald, Sandra A; Mardis, Elaine R; Ota, David; Watson, Mark A; Pfeifer, John D; Green, Jonathan M

2012-07-01

As part of the molecular revolution sweeping medicine, comprehensive genomic studies are adding powerful dimensions to medical research. However, their power exposes new regulatory, strategic, and quality assurance challenges for biorepositories. A key issue is that unlike other research techniques commonly applied to banked specimens, nucleic acid sequencing, if sufficiently extensive, yields data that could identify a patient. This evolving paradigm renders the concepts of anonymized and anonymous specimens increasingly outdated. The challenges for biorepositories in this new era include refined consent processes and wording, selection and use of legacy specimens, quality assurance procedures, institutional documentation, data sharing, and interaction with institutional review boards. Given current trends, biorepositories should consider these issues now, even if they are not currently experiencing sample requests for genomic analysis. We summarize our current experiences and best practices at Washington University Medical School, St Louis, MO, our perceptions of emerging trends, and recommendations.

Comprehensive Genomic Studies: Emerging Regulatory, Strategic, and Quality Assurance Challenges for Biorepositories

PubMed Central

McDonald, Sandra A.; Mardis, Elaine R.; Ota, David; Watson, Mark A.; Pfeifer, John D.; Green, Jonathan M.

2012-01-01

As part of the molecular revolution sweeping medicine, comprehensive genomic studies are adding powerful dimensions to medical research. However, their power exposes new regulatory, strategic, and quality assurance challenges for biorepositories. A key issue is that unlike other research techniques commonly applied to banked specimens, nucleic acid sequencing, if sufficiently extensive, yields data that could identify a patient. This evolving paradigm renders the concepts of anonymized and anonymous specimens increasingly outdated. The challenges for biorepositories in this new era include refined consent processes and wording, selection and use of legacy specimens, quality assurance procedures, institutional documentation, data sharing, and interaction with institutional review boards. Given current trends, biorepositories should consider these issues now, even if they are not currently experiencing sample requests for genomic analysis. We summarize our current experiences and best practices at Washington University Medical School, St Louis, MO, our perceptions of emerging trends, and recommendations. PMID:22706855

Knowledge and use of emergency contraception: a multicountry analysis.

PubMed

Palermo, Tia; Bleck, Jennifer; Westley, Elizabeth

2014-06-01

Globally, evidence on knowledge and use of emergency contraception from population-based data is limited, though such information would be helpful in increasing access to the method. We examined knowledge and use of emergency contraception in 45 countries using population-based survey data. Demographic and Health Survey (DHS) data on women aged 15-49 were analyzed by country in logistic regressions to identify associations between women's characteristics and their having heard of emergency contraception or having ever used it. Trends were examined, by region and globally, according to individual, household and community descriptors, including women's age, education, marital status, socioeconomic status, and urban or rural location. The proportion of women who had heard of emergency contraception ranged from 2% in Chad to 66% in Colombia, and the proportion of sexually experienced women who had used it ranged from less than 0.1% in Chad to 12% in Colombia. The odds of having heard of or used the method generally increased with wealth, and although the relationship between marital status and knowing of the method varied by region, never-married women were more likely than married women to have used emergency contraception in countries where significant differences existed. In some countries, urban residence was associated with having heard of the method, but in only three countries were women from urban areas more likely to have used it. Our findings support the need for broader dissemination of information on emergency contraception, particularly among low-income individuals. Variations in use and knowledge within regions suggest a need for programs to be tailored to country-level characteristics.

System Study: Emergency Power System 1998-2014

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

Schroeder, John Alton

2015-12-01

This report presents an unreliability evaluation of the emergency power system (EPS) at 104 U.S. commercial nuclear power plants. Demand, run hours, and failure data from fiscal year 1998 through 2014 for selected components were obtained from the Institute of Nuclear Power Operations (INPO) Consolidated Events Database (ICES). The unreliability results are trended for the most recent 10 year period while yearly estimates for system unreliability are provided for the entire active period. An extremely statistically significant increasing trend was observed for EPS system unreliability for an 8-hour mission. A statistically significant increasing trend was observed for EPS system start-onlymore » unreliability.« less

The Electrification of Energy: Long-Term Trends and Opportunities

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

Tsao, Jeffrey Y.; Fouquet, Roger; Schubert, E. Fred

Here, we present and analyze three powerful long-term historical trends in energy, particularly electrical energy, as well as the opportunities and challenges associated with these trends. The first trend is from a world containing a diversity of energy currencies to one whose predominant currency is electricity, driven by electricity’s transportability, exchangeability, and steadily decreasing cost. The second trend is from electricity generated from a diversity of sources to electricity generated predominantly by free-fuel sources, driven by their steadily decreasing cost and long-term abundance. These trends necessitate a just-emerging third trend: from a grid in which electricity is transported uni-directionally, tradedmore » at near-static prices, and consumed under direct human control; to a grid in which electricity is transported bi-directionally, traded at dynamic prices, and consumed under human-tailored agential control. Early acceptance and appreciation of these trends will accelerate their remaking of humanity’s energy landscape into one in which energy is much more affordable, abundant and efficiently deployed than it is today; with major economic, geo-political, and environmental benefits to human society.« less

Post-head-emergence frost in wheat and barley: defining the problem, assessing the damage, and identifying resistance.

PubMed

Frederiks, T M; Christopher, J T; Sutherland, M W; Borrell, A K

2015-06-01

Radiant frost is a significant production constraint to wheat (Triticum aestivum) and barley (Hordeum vulgare), particularly in regions where spring-habit cereals are grown through winter, maturing in spring. However, damage to winter-habit cereals in reproductive stages is also reported. Crops are particularly susceptible to frost once awns or spikes emerge from the protection of the flag leaf sheath. Post-head-emergence frost (PHEF) is a problem distinct from other cold-mediated production constraints. To date, useful increased PHEF resistance in cereals has not been identified. Given the renewed interest in reproductive frost damage in cereals, it is timely to review the problem. Here we update the extent and impacts of PHEF and document current management options to combat this challenge. We clarify terminology useful for discussing PHEF in relation to chilling and other freezing stresses. We discuss problems characterizing radiant frost, the environmental conditions leading to PHEF damage, and the effects of frost at different growth stages. PHEF resistant cultivars would be highly desirable, to both reduce the incidence of direct frost damage and to allow the timing of crop maturity to be managed to maximize yield potential. A framework of potential adaptation mechanisms is outlined. Clarification of these critical issues will sharpen research focus, improving opportunities to identify genetic sources for improved PHEF resistance. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Identification and characteristics of victims of violence identified by emergency physicians, triage nurses, and the police

PubMed Central

Howe, A; Crilly, M

2002-01-01

Objectives: The objectives of the study were threefold—to evaluate the identification and characteristics of victims of assault who attend an accident and emergency (A&E) department; to compare the total number of assaults recorded in the A&E department with the number recorded by the police; and to assess a system for collecting the location and method of assault. Setting: The A&E department of Chorley and South Ribble Hospital Trust, Lancashire, England. Methods: A three month prospective study was performed. Victims of violence recorded on computer by doctors at discharge were compared with those identified at initial nurse triage. A comparison of police data with the A&E data relating to Chorley residents was performed. Additional information on the method and location of assault was also collected. Results: During the period 305 (2.6%) of the patients attending A&E were identified as having been assaulted. Of the 305 individuals, 236 (77%) were identified by a doctor while 173 (57%) such patients were identified by a triage nurse. A&E identified twice the number of assaults involving Chorley residents as the police. Both men and women were most likely to have been injured on the street (44% and 37% respectively), although a greater proportion of women were injured at home (24%) than men (10%). The majority of injuries were sustained by blows from fists, feet, and heads (73%). Conclusions: A&E doctors identify significantly more patients as the victims of violence than do nurses at triage. Using A&E data identifies assaulted individuals not identified by the police. Computer systems can be used in A&E to provide a more complete picture of the occurrence of violence in the community. PMID:12460971

Epigenetic Research in Cancer Epidemiology: Trends, Opportunities, and Challenges

PubMed Central

Verma, Mukesh; Rogers, Scott; Divi, Rao L.; Schully, Sheri D.; Nelson, Stefanie; Su, L. Joseph; Ross, Sharon; Pilch, Susan; Winn, Deborah M.; Khoury, Muin J.

2014-01-01

Epigenetics is emerging as an important field in cancer epidemiology that promises to provide insights into gene regulation and facilitate cancer control throughout the cancer care continuum. Increasingly, investigators are incorporating epigenetic analysis into the studies of etiology and outcomes. To understand current progress and trends in the inclusion of epigenetics in cancer epidemiology, we evaluated the published literature and the National Cancer Institute (NCI) supported research grant awards in this field to identify trends in epigenetics research. We present a summary of the epidemiological studies in NCI’s grant portfolio (from January 2005 through December 2012) and in the scientific literature published during the same period, irrespective of support from NCI. Blood cells and tumor tissue were the most commonly used biospecimens in these studies, although buccal cells, cervical cells, sputum, and stool samples also were used. DNA methylation profiling was the focus of the majority of studies, but several studies also measured microRNA profiles. We illustrate here the current status of epidemiologic studies that are evaluating epigenetic changes in large populations. The incorporation of epigenomic assessments in cancer epidemiology studies has and is likely to continue to provide important insights into the field of cancer research. PMID:24326628

Progress and Trends in AIE-Based Bioprobes: A Brief Overview.

PubMed

Mei, Ju; Huang, Youhong; Tian, He

2018-04-18

Luminescent bioprobes are powerful analytical means for biosensing and optical imaging. Luminogens featured with aggregation-induced emission (AIE) attributes have emerged as ideal building blocks for high-performance bioprobes. Bioprobes constructed with AIE luminogens have been identified to be a novel class of FL light-up probing tools. In contrast to conventional bioprobes based on the luminophores with aggregation-caused quenching (ACQ) effect, the AIE-based bioprobes enjoy diverse superiorities, such as lower background, higher signal-to-noise ratio and sensitivity, better accuracy, and more outstanding resistance to photobleaching. AIE-based bioprobes have been tailored for a vast variety of purposes ranging from biospecies sensing to bioimaging to theranostics (i.e., image-guided therapies). In this review, recent five years' advances in AIE-based bioprobes are briefly overviewed in a perspective distinct from other reviews, focusing on the most appealing trends and progresses in this flourishing research field. There are altogether 11 trends outlined, which have been classified into four aspects: the probe composition and form (bioconjugtes, nanoprobes), the output signal of probe (far-red/near-infrared luminescence, two/three-photon excited fluorescence, phosphorescence), the modality and functionality of probing system (dual-modality, dual/multifunctionality), the probing object and application outlet (specific organelles, cancer cells, bacteria, real samples). Typical examples of each trend are presented and specifically demonstrated. Some important prospects and challenges are pointed out as well in the hope of intriguing more interests from researchers working in diverse areas into this exciting research field.

Trending of Overboard Leakage of ISS Cabin Atmosphere

NASA Technical Reports Server (NTRS)

Schaezler, Ryan N.; Cook, Anthony J.; Leonard, Daniel J.; Ghariani, Ahmed

2011-01-01

The International Space Station (ISS) overboard leakage of cabin atmosphere is continually tracked to identify new or aggravated leaks and to provide information for planning of nitrogen supply to the ISS. The overboard leakage is difficult to trend with various atmosphere constituents being added and removed. Changes to nitrogen partial pressure is the nominal means of trending the overboard leakage. This paper summarizes the method of the overboard leakage trending and presents findings from the trending.

Trends in Preventable Inpatient and Emergency Department Utilization in California Between 2012 and 2015: The Role of Health Insurance Coverage and Primary Care Supply.

PubMed

Cunningham, Peter; Sheng, Yaou

2018-06-01

Expansions of health insurance coverage tend to increase hospital emergency department (ED) utilization and inpatient admissions. However, provisions in the Affordable Care Act that expanded primary care supply were intended in part to offset the potential for increased hospital utilization. To examine the association between health insurance coverage, primary care supply, and ED and inpatient utilization, and to assess how both factors contributed to trends in utilization in California between 2012 and 2015. Population-based measures of ED and inpatient utilization, insurance coverage, and primary care supply were constructed for California counties for the years 2012 through 2015. Fixed effects regression analysis is used to examine the association between health insurance coverage, primary care supply, and rates of preventable ED and inpatient utilization. Higher levels of Medicaid coverage in a county are associated with higher levels of preventable ED and inpatient utilization, although greater numbers of primary care practitioners and Federally Qualified Health Centers reduce this type of utilization. Increases in coverage accelerated a long-term increase in ED visits and prevented an even larger decrease in inpatient admissions, but changes in coverage do not fully explain these underlying trends. Increases in primary care supply offset the effects of coverage changes only modestly. Policymakers should not overstate the impact of the Affordable Care Act on increasing ED visits, and should focus on better understanding the underlying factors that are driving the trends.

44 CFR 5.27 - Deletion of identifying details.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Deletion of identifying details. 5.27 Section 5.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY..., FEMA may delete identifying details when making available or publishing an opinion, statement of policy...

Evaluation of State Plans and the Livestock Emergency Response Plan (LERP).

PubMed

Schaffer, Amy M; Burton, Kenneth R

The Livestock Emergency Response Plan (LERP) was published in 2014 as a toolkit to assist state agricultural emergency planners in writing or modifying state foreign animal disease/high-consequence disease (FAD/HCD) plans. This research serves as a follow-up to and expands on an initial survey conducted in 2011 by the Department of Homeland Security Office of Health Affairs, Food, Ag, and Veterinary Defense Branch. The purpose of this project is to describe the status of current state animal disease response plans in relation to how closely their content, order, and terminology relate to that described in the LERP template. The analysis was compared to the 2011 study to identify advances, trends, continued areas for increased alignment, and fulfillment of planning gaps in individual state plans. While vast improvements were made in the status of state animal disease response plans from 2011 to 2016, there is nonetheless significant room for enhancing consistency between and identifying gaps in FAD/HCD plans. As awareness of the LERP toolkit grows, the authors hope its use as a template by the states will expand accordingly, thereby increasing consistency between plans and more thoroughly addressing challenges in an FAD/HCD outbreak. The results of this study support the need for curriculum planning resources at the state level. Development of a training curriculum and planning workshops for state agriculture emergency planners will produce a consistent planning philosophy and skill set among state planners-another means of indirectly addressing current planning gaps in agricultural emergency response.

Trends that FCS Education Should Address: A Delphi Study Reveals Top 16

ERIC Educational Resources Information Center

Alexander, Karen L.; Davis, Kimberlee

2011-01-01

This study used the Delphi method to identify trends of importance to family and consumer sciences (FCS) education. A panel of 21 FCS education experts identified 16 trends and evaluated them by importance, desirability, feasibility, and confidence in validity of the trend. Nutrition appeared as a top priority, followed by consumer economics. The…

Safety pharmacology — Current and emerging concepts

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

Hamdam, Junnat; Sethu, Swaminathan; Smith, Trevor

2013-12-01

Safety pharmacology (SP) is an essential part of the drug development process that aims to identify and predict adverse effects prior to clinical trials. SP studies are described in the International Conference on Harmonisation (ICH) S7A and S7B guidelines. The core battery and supplemental SP studies evaluate effects of a new chemical entity (NCE) at both anticipated therapeutic and supra-therapeutic exposures on major organ systems, including cardiovascular, central nervous, respiratory, renal and gastrointestinal. This review outlines the current practices and emerging concepts in SP studies including frontloading, parallel assessment of core battery studies, use of non-standard species, biomarkers, and combiningmore » toxicology and SP assessments. Integration of the newer approaches to routine SP studies may significantly enhance the scope of SP by refining and providing mechanistic insight to potential adverse effects associated with test compounds. - Highlights: • SP — mandatory non-clinical risk assessments performed during drug development. • SP organ system studies ensure the safety of clinical participants in FiH trials. • Frontloading in SP facilitates lead candidate drug selection. • Emerging trends: integrating SP-Toxicological endpoints; combined core battery tests.« less

Responses to a Fire Emergency: Students' Knowledge and Willingness to Assist Another Student

ERIC Educational Resources Information Center

Varghese, Susan

2010-01-01

Recent statistics have shown an increasing trend in the frequency and severity of emergency situations around the world, with women and people with disabilities being disproportionally impacted by these emergencies. A review of the literature suggests that college campuses are particularly vulnerable during emergencies. With the increasing…

Regional Trends Sustainable Development. ASPBAE Courier No. 51.

ERIC Educational Resources Information Center

ASPBAE Courier, 1991

1991-01-01

This issue contains six articles about the practice of adult and nonformal education in the Asian South Pacific region, as well as committee reports, policy statements, and regular features. The articles on adult and nonformal education, and other entries are as follows: "Emerging Trends, Concerns and Issues in Educational Development in…

Interfractional trend analysis of dose differences based on 2D transit portal dosimetry

NASA Astrophysics Data System (ADS)

Persoon, L. C. G. G.; Nijsten, S. M. J. J. G.; Wilbrink, F. J.; Podesta, M.; Snaith, J. A. D.; Lustberg, T.; van Elmpt, W. J. C.; van Gils, F.; Verhaegen, F.

2012-10-01

Dose delivery of a radiotherapy treatment can be influenced by a number of factors. It has been demonstrated that the electronic portal imaging device (EPID) is valuable for transit portal dosimetry verification. Patient related dose differences can emerge at any time during treatment and can be categorized in two types: (1) systematic—appearing repeatedly, (2) random—appearing sporadically during treatment. The aim of this study is to investigate how systematic and random information appears in 2D transit dose distributions measured in the EPID plane over the entire course of a treatment and how this information can be used to examine interfractional trends, building toward a methodology to support adaptive radiotherapy. To create a trend overview of the interfractional changes in transit dose, the predicted portal dose for the different beams is compared to a measured portal dose using a γ evaluation. For each beam of the delivered fraction, information is extracted from the γ images to differentiate systematic from random dose delivery errors. From the systematic differences of a fraction for a projected anatomical structures, several metrics are extracted like percentage pixels with |γ| > 1. We demonstrate for four example cases the trends and dose difference causes which can be detected with this method. Two sample prostate cases show the occurrence of a random and systematic difference and identify the organ that causes the difference. In a lung cancer case a trend is shown of a rapidly diminishing atelectasis (lung fluid) during the course of treatment, which was detected with this trend analysis method. The final example is a breast cancer case where we show the influence of set-up differences on the 2D transit dose. A method is presented based on 2D portal transit dosimetry to record dose changes throughout the course of treatment, and to allow trend analysis of dose discrepancies. We show in example cases that this method can identify the causes of

Use of a forensic technique to identify blood contamination of emergency department and ambulance trauma equipment.

PubMed

Lee, J B; Levy, M; Walker, A

2006-01-01

Using a Kastle-Meyer (KM) technique, the following equipment from the emergency departments of six UK hospitals (four trusts) and three regional ambulance services was tested for blood contamination: extrication ("spinal") boards, cervical collars, straps, box splints, head blocks, and headboards. Only equipment ready for patient use was tested. Over half of trauma equipment (57%) tested positive for blood, including 15% of equipment that was visibly stained with blood. There have been no recorded cases of infection from contaminated trauma equipment but our study has identified the potential risk. Disposable covers for boards, disposable straps, and disposable radiolucent head blocks which are currently available provide a solution but have resource implications.

Water-quality trends in the Scituate reservoir drainage area, Rhode Island, 1983-2012

USGS Publications Warehouse

Smith, Kirk P.

2015-01-01

Upward trends in pH were identified for nearly half of the monitoring stations for WYs 1983-2012 and may reflect regional reductions in acid precipitation. Many upward trends in alkalinity also were identified for both the WYs 1983-2012 and for WYs 2003-12 periods and are likely related to the natural weathering of structures containing concrete or, in some cases, the application of lime or fertilizers on agriculture lands. Significant trends in chloride concentrations at most stations during WYs 1983-2012 were upward; however, results for WYs 2003-12 substantiate few significant upward trends and, in a few cases, downward trends were identified in several tributary drainage areas.

Adoption Research: Trends, Topics, Outcomes

ERIC Educational Resources Information Center

Palacios, Jesus; Brodzinsky, David

2010-01-01

The current article provides a review of adoption research since its inception as a field of study. Three historical trends in adoption research are identified: the first focusing on risk in adoption and identifying adoptee-nonadoptee differences in adjustment; the second examining the capacity of adopted children to recover from early adversity;…

How to Identify E-Learning Trends in Academic Teaching: Methodological Approaches and the Analysis of Scientific Discourses

ERIC Educational Resources Information Center

Fischer, Helge; Heise, Linda; Heinz, Matthias; Moebius, Kathrin; Koehler, Thomas

2015-01-01

Purpose: The purpose of this paper is to introduce methodology and findings of a trend study in the field of e-learning. The overall interest of the study was the analysis of scientific e-learning discourses. What comes next in the field of academic e-learning? Which e-learning trends dominate the discourse at universities? Answering such…

Relationship Between Sea Surface Temperature and Surface Heat Balance Trends in the Tropical Oceans: The Crucial Role of Surface Wind Trends

NASA Astrophysics Data System (ADS)

Cook, K. H.; Vizy, E. K.; Sun, X.

2016-12-01

Multiple atmospheric and ocean reanalyses are analyzed for 1980-2015 to understand annual-mean adjustments of the surface heat balance over the tropical oceans as the climate warms. Linear trends are examined, with statistical significance evaluated. While surface heat budgets and sea surface temperatures are mutually adjusted fields, insights into the physical processes of this adjustment and the implications for temperature trends can be identified. Two second-generation reanalyses, ERA-Interim and JRA-55, agree well on the distributions and magnitudes of trends in the net heat flux from the atmosphere to the ocean. Trends in the net longwave and sensible heat fluxes are generally small, and trends in solar radiation absorbed are only influential regionally and vary among the reanalyses. The largest contribution is from latent heat flux trends. Contributions to these trends associated with surface temperature (thermal-driving), 10-m wind (dynamical-driving) and specific humidity (hydrological-driving) trends are estimated. The dynamically-driven latent heat flux dominates and explains much of the regionality of the multi-decadal heat flux trends. However, trends in the net surface heat flux alone do not match the observed SSTs trends well, indicating that the redistribution of heat within the ocean mixed layer is also important. Ocean mixed layer heat budgets in various ocean reanalyses are examined to understand this redistribution, and we again identify a crucial role for changes in the surface wind. Acceleration of the tropical easterlies is associated with strengthening of the equatorial undercurrents in both the tropical Pacific and Atlantic. In the Pacific, where the EUC is also shoaling, the result is enhanced warm-water advection into the central Pacific. This advective warming is superimposed on cooling due to enhanced evaporation and equatorial upwelling, which are also associated with wind trends, to determine the observed pattern of SST trends.

Use of selected ambulatory dental services in Taiwan before and after global budgeting: a longitudinal study to identify trends in hospital and clinic-based services

PubMed Central

2012-01-01

Background The Taiwan government adopted National Health Insurance (NHI) in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. Methods This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Results Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. Conclusions The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan. PMID:23009095

Use of selected ambulatory dental services in Taiwan before and after global budgeting: a longitudinal study to identify trends in hospital and clinic-based services.

PubMed

Lin, Chienhung; Chao, Hailun

2012-09-25

The Taiwan government adopted National Health Insurance (NHI) in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan.

Modeling and managing urban water demand through smart meters: Benefits and challenges from current research and emerging trends

NASA Astrophysics Data System (ADS)

Cominola, A.; Giuliani, M.; Castelletti, A.; Piga, D.; Rizzoli, A. E.

2015-12-01

Urban population growth, climate and land use change are expected to boost residential water demand in urban contexts in the next decades. In such a context, developing suitable demand-side management strategies is essential to meet future water demands, pursue water savings, and reduce the costs for water utilities. Yet, the effectiveness of water demand management strategies (WDMS) relies on our understanding of water consumers' behavior, their consumption habits, and the water use drivers. While low spatial and temporal resolution water consumption data, as traditionally gathered for billing purposes, hardly support this understanding, the advent of high-resolution, smart metering technologies allowed for quasi real-time monitoring water consumption at the single household level. This, in turn, is advancing our ability in characterizing consumers' behavior, modeling, and designing user-oriented residential water demand management strategies. Several water smart metering programs have been rolled-out in the last two decades worldwide, addressing one or more of the following water demand management phases: (i) data gathering, (ii) water end-uses characterization, (iii) user modeling, (iv) design and implementation of personalized WDMS. Moreover, the number of research studies in this domain is quickly increasing and big economic investments are currently being devoted worldwide to smart metering programs. With this work, we contribute the first comprehensive review of more than 100 experiences in the field of residential water demand modeling and management, and we propose a general framework for their classification. We revise consolidated practices, identify emerging trends and highlight the challenges and opportunities for future developments given by the use of smart meters advancing residential water demand management. Our analysis of the status quo of smart urban water demand management research and market constitutes a structured collection of information

International perspectives on emergency department crowding.

PubMed

Pines, Jesse M; Hilton, Joshua A; Weber, Ellen J; Alkemade, Annechien J; Al Shabanah, Hasan; Anderson, Philip D; Bernhard, Michael; Bertini, Alessio; Gries, André; Ferrandiz, Santiago; Kumar, Vijaya Arun; Harjola, Veli-Pekka; Hogan, Barbara; Madsen, Bo; Mason, Suzanne; Ohlén, Gunnar; Rainer, Timothy; Rathlev, Niels; Revue, Eric; Richardson, Drew; Sattarian, Mehdi; Schull, Michael J

2011-12-01

The maturation of emergency medicine (EM) as a specialty has coincided with dramatic increases in emergency department (ED) visit rates, both in the United States and around the world. ED crowding has become a public health problem where periodic supply and demand mismatches in ED and hospital resources cause long waiting times and delays in critical treatments. ED crowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. This article describes emergency care systems and the extent of crowding across 15 countries outside of the United States: Australia, Canada, Denmark, Finland, France, Germany, Hong Kong, India, Iran, Italy, The Netherlands, Saudi Arabia, Catalonia (Spain), Sweden, and the United Kingdom. The authors are local emergency care leaders with knowledge of emergency care in their particular countries. Where available, data are provided about visit patterns in each country; however, for many of these countries, no national data are available on ED visits rates or crowding. For most of the countries included, there is both objective evidence of increases in ED visit rates and ED crowding and also subjective assessments of trends toward higher crowding in the ED. ED crowding appears to be worsening in many countries despite the presence of universal health coverage. Scandinavian countries with robust systems to manage acute care outside the ED do not report crowding is a major problem. The main cause for crowding identified by many authors is the boarding of admitted patients, similar to the United States. Many hospitals in these countries have implemented operational interventions to mitigate crowding in the ED, and some countries have imposed strict limits on ED length of stay (LOS), while others have no clear plan to mitigate crowding. An understanding of the causes and potential solutions implemented in these countries can provide a lens into how to mitigate ED crowding in the United States

Social conditions and trends in southeast Alaska.

Treesearch

Rhonda Mazza; Linda E. Kruger

2005-01-01

In 1997, scientists at the Pacific Northwest Research Station initiated several social science studies in response to information gaps identified while developing the Tongass Land Management Plan. Results presented here summarize findings from studies of demographic trends and tourism trends in the region based on data available through 2002. Demographic...

Historical trends in organochlorine compounds in river basins identified using sediment cores from reservoirs

USGS Publications Warehouse

Van Metre, P.C.; Callender, E.; Fuller, C.C.

1997-01-01

This study used chemical analyses of dated sediment cores from reservoirs to define historical trends in water quality in the influent river basins. This work applies techniques from paleolimnology to reservoirs, and in the process, highlights differences between sediment-core interpretations for reservoirs and natural lakes. Sediment cores were collected from six reservoirs in the central and southeastern United States, sectioned, and analyzed for 137Cs and organochlorine compounds. 137Cs analyses were used to demonstrate limited post-depositional mixing, to indicate sediment deposition dates, and to estimate sediment focusing factors. Relative lack of mixing, high sedimentation rates, and high focusing factors distinguish reservoir sediment cores from cores collected in natural lakes. Temporal trends in concentrations of PCBs, total DDT (DDT + DDD + DDE), and chlordane reflect historical use and regulation of these compounds and differences in land use between reservoir drainages. PCB and total DDT core burdens, normalized for sediment focusing, greatly exceed reported cumulative regional atmospheric fallout of PCBs and total DDT estimated using cores from peat hogs and natural lakes, indicating the dominance of fluvial inputs of both groups of compounds to the reservoirs.This study used chemical analyses of dated sediment cores from reservoirs to define historical trends in water quality in the influent river basins. This work applies techniques from paleolimnology to reservoirs, and in the process, highlights differences between sediment-core interpretations for reservoirs and natural lakes. Sediment cores were collected from six reservoirs in the central and southeastern United States, sectioned, and analyzed for 137Cs and organochlorine compounds. 137Cs analyses were used to demonstrate limited post-depositional mixing, to indicate sediment deposition dates, and to estimate sediment focusing factors. Relative lack of mixing, high sedimentation rates, and high

Trends in camping participation

Treesearch

Wilbur F. LaPage; Dale P. Ragain; Dale P. Ragain

1971-01-01

Several years ago the Northeastern Forest Experiment Station began a long-term study of per-capita camping participation. The objectives of the research were to identify campers with increasing or decreasing camping participation and to determine the causes of those trends.

Trends in violence in England and Wales 2010-2014.

PubMed

Sivarajasingam, Vaseekaran; Page, Nicholas; Wells, John; Morgan, Peter; Matthews, Kent; Moore, Simon; Shepherd, Jonathan

2016-06-01

The National Violence Surveillance Network (NVSN) of emergency departments (ED), minor injuries units and walk-in-centres in England and Wales has brought clarity to contradictory violence trends derived from crime survey and police data. Gender, age-specific and regional trends in violence-related injury in England and Wales since 2010 have not been studied. Data on violence-related injury were collected from a structured sample of 151 EDs in England and Wales. ED attendance date and age and gender of patients who reported injury in violence from 1 January 2010 to 31 December 2014 were identified from attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. In total, 247 016 (178 709 males: 72.3%) violence-related attendances were identified. Estimated annual injury rate across England and Wales was 4.4/1000 population (95% CI 3.9 to 4.9); males 6.5/1000 (95% CI 5.6 to 7.2) and females 2.4/1000 (95% CI 2.1 to 2.6). On average, overall attendances decreased by 13.8% per year over the 5 years (95% CI -14.8 to -12.1). Attendances decreased significantly for both genders and all age groups (0-10, 11-17, 18-30, 31-50, 51+ years); declines were greatest among children and adolescents. Significant decreases in violence-related injury were found in all but two regions. Violence peaked in May and July. From an ED perspective, violence in England and Wales decreased substantially between 2010 and 2014, especially among children and adolescents. Violence prevention efforts should focus on regions with the highest injury rates and during the period May-July. 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/

Measuring Frailty Can Help Emergency Departments Identify Independent Seniors at Risk of Functional Decline After Minor Injuries

PubMed Central

Griffith, Lauren; Perry, Jeffrey; Daoust, Raoul; Veillette, Nathalie; Lee, Jacques; Pelletier, Mathieu; Wilding, Laura; Émond, Marcel

2017-01-01

Background. This study aims to (i) describe frailty in the subgroup of independent community-dwelling seniors consulting emergency departments (EDs) for minor injuries, (ii) examine the association between frailty and functional decline 3 months postinjury, (iii) ascertain the predictive accuracy of frailty measures and emergency physicians’ for functional decline. Method. Prospective cohort in 2011–2013 among 1,072 seniors aged 65 years or older, independent in basic daily activities, evaluated in Canadian EDs for minor injuries. Frailty was assessed at EDs using the Canadian Study of Health and Aging-Clinical Frailty scale (CSHA-CFS) and the Study of Osteoporotic Fracture frailty index (SOF). Functional decline was defined as a loss ≥2/28 on the Older American Resources Services scale 3 months postinjury. Generalized mixed models were used to explore differences in functional decline across frailty levels. Areas under the receiver operating characteristic curve were used to ascertain the predictive accuracy of frailty measures and emergency physicians’ clinical judgment. Results. The SOF and CSHA-CFS were available in 342 and 1,058 participants, respectively. The SOF identified 55.6%, 32.7%, 11.7% patients as robust, prefrail, and frail. These CSHA-CFS (n = 1,058) proportions were 51.9%, 38.3%, and 9.9%. The 3-month incidence of functional decline was 12.1% (10.0%−14.6%). The Areas under the receiver operating characteristic curves of the CSHA-CFS and the emergency physicians’ were similar (0.548–0.777), while the SOF was somewhat higher (0.704–0.859). Conclusion. Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed. PMID:26400735

Over the Horizon: Potential Impact of Emerging Trends in Information and Communication Technology on Disability Policy and Practice

ERIC Educational Resources Information Center

Vanderheiden, Gregg

2006-01-01

This policy paper explores key trends in information and communication technology, highlights the potential opportunities and problems these trends present for people with disabilities, and suggests some strategies to maximize opportunities and avoid potential problems and barriers. Specifically, this paper discusses technology trends that present…

Trends in HFE Methods and Tools and Their Applicability to Safety Reviews

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

O'Hara, J.M.; Plott, C.; Milanski, J.

2009-09-30

The U.S. Nuclear Regulatory Commission's (NRC) conducts human factors engineering (HFE) safety reviews of applicant submittals for new plants and for changes to existing plants. The reviews include the evaluation of the methods and tools (M&T) used by applicants as part of their HFE program. The technology used to perform HFE activities has been rapidly evolving, resulting in a whole new generation of HFE M&Ts. The objectives of this research were to identify the current trends in HFE methods and tools, determine their applicability to NRC safety reviews, and identify topics for which the NRC may need additional guidance tomore » support the NRC's safety reviews. We conducted a survey that identified over 100 new HFE M&Ts. The M&Ts were assessed to identify general trends. Seven trends were identified: Computer Applications for Performing Traditional Analyses, Computer-Aided Design, Integration of HFE Methods and Tools, Rapid Development Engineering, Analysis of Cognitive Tasks, Use of Virtual Environments and Visualizations, and Application of Human Performance Models. We assessed each trend to determine its applicability to the NRC's review by considering (1) whether the nuclear industry is making use of M&Ts for each trend, and (2) whether M&Ts reflecting the trend can be reviewed using the current design review guidance. We concluded that M&T trends that are applicable to the commercial nuclear industry and are expected to impact safety reviews may be considered for review guidance development. Three trends fell into this category: Analysis of Cognitive Tasks, Use of Virtual Environments and Visualizations, and Application of Human Performance Models. The other trends do not need to be addressed at this time.« less

National Trends in Trace Metals Concentrations in Ambient Particulate Matter

NASA Astrophysics Data System (ADS)

McCarthy, M. C.; Hafner, H. R.; Charrier, J. G.

2007-12-01

Ambient measurements of trace metals identified as hazardous air pollutants (HAPs, air toxics) collected in the United States from 1990 to 2006 were analyzed for long-term trends. Trace metals analyzed include lead, manganese, arsenic, chromium, nickel, cadmium, and selenium. Visual and statistical analyses were used to identify and quantify temporal variations in air toxics at national and regional levels. Trend periods were required to be at least five years. Lead particles decreased in concentration at most monitoring sites, but trends in other metals were not consistent over time or spatially. In addition, routine ambient monitoring methods had method detection limits (MDLs) too high to adequately measure concentrations for trends analysis. Differences between measurement methods at urban and rural sites also confound trends analyses. Improvements in MDLs, and a better understanding of comparability between networks, are needed to better quantify trends in trace metal concentrations in the future.

Feasibility Testing of an Emergency Department Screening Tool To Identify Older Adults Appropriate for Palliative Care Consultation.

PubMed

Ouchi, Kei; Block, Susan D; Schonberg, Mara A; Jamieson, Emily S; Aaronson, Emily L; Pallin, Daniel J; Tulsky, James A; Schuur, Jeremiah D

2017-01-01

Seriously ill older adults in the emergency department (ED) may benefit from palliative care referral, yet little is known about how to identify these patients. To assess the performance and determine the acceptability of a content-validated palliative care screening tool. We surveyed Emergency Medicine (EM) attending physicians at the end of their shifts using the screening tool and asked them to retrospectively apply it to all patients ≥65 years whom they had cared for. We conducted the survey for three consecutive weeks in October 2015. EM attending physicians at an urban, university-affiliated ED. Patient characteristics, acceptability rating, and time per patient screened. We approached 38 attending physicians to apply the screening tool for 69 eligible shifts. Physicians agreed to participate during 55 shifts (80%) and screened 207 patients. On 14 shifts (20%), physicians declined to participate. Mean age of the screened patients was 75 years, 51% were male, and 45% had at least one life-limiting illness. Overall, 67 patients (32%) screened positive for palliative care needs. Seventy percent of physicians (n = 33) found the screening tool acceptable to use and the average time of completion was 1.8 minutes per patient screened. A rapid screen of older adults for palliative care needs was acceptable to a majority of EM physicians and identified a significant number of patients who may benefit from palliative care referral. Further research is needed to improve acceptability and determine the appropriate care pathway for patients with palliative care needs.

Trends in Library and Information Science: 1989. ERIC Digest.

ERIC Educational Resources Information Center

Eisenberg, Michael B.

Based on a content analysis of professional journals, conference proceedings, ERIC documents, annuals, and dissertations in library and information science, the following current trends in the field are discussed: (1) there are important emerging roles and responsibilities for information professionals; (2) the status and image of librarians…

Trends and Topics in Autism Spectrum Disorders Research

ERIC Educational Resources Information Center

Matson, Johnny L.; LoVullo, Santino V.

2009-01-01

The field of autism spectrum disorders (ASDs) is expanding at an exponential rate. New topics for study are forming and journals are emerging rapidly to handle the ever-increasing volume of publications. This study was undertaken to provide an overview of past and current research trends. Representative studies were evaluated for type of content…

2014 Survey of States: Initiatives, Trends, and Accomplishments

ERIC Educational Resources Information Center

Shyyan, Vitaliy; Lazarus, Sheryl S.; Thurlow, Martha L.

2015-01-01

This report summarizes the fourteenth survey of states by the National Center on Educational Outcomes (NCEO) at the University of Minnesota. Results are presented for the 50 regular states and eight of the 11 unique states. The purpose of this report is to provide a snapshot of the new initiatives, trends, accomplishments, and emerging issues…

Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

PubMed

Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

2017-11-01

Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] < 1.3), which identified patients who were low risk for a variceal source of hemorrhage. For the bootstrapped samples, the rule performed with 97% sensitivity (95% confidence interval [CI] = 91%-100%) and 49% specificity (95% CI = 44%-53%). Although this derivation study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of <1.3 may be at very low risk for a variceal source of their upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

Time Trends in Bullying Behavior in Italy

ERIC Educational Resources Information Center

Vieno, Alessio; Lenzi, Michela; Gini, Gianluca; Pozzoli, Tiziana; Cavallo, Franco; Santinello, Massimo

2015-01-01

Background: Given the severity of outcomes associated with involvement in bullying and the resources spent in an effort to reduce its prevalence, it is important to investigate trends in the bullying's occurrence. The main aim of this study was to identify trends from 2002 to 2010 in prevalence of bullying and victimization among Italian…

Analysis of The Planning Education in the Light of the Contemporary Trends in Planning

NASA Astrophysics Data System (ADS)

Husar, Milan; Ceren Varis, Sila; Ondrejicka, Vladimir

2017-12-01

This paper examines the way the planning education is taught and examines the recent trends in the curricula of planning education institutions. The introduction of changing economic systems and planning in the field of education is discussed against these changes. Additionally, the evolution in the planner’s role and how it affects the planning education is discussed. The paper is addressing trends and challenges the countries and their planning changes are facing in 21st century. The trends such as increasing globalization, fuzziness of spatial structures and their borders, complexity and uncertainty and the growing interconnectedness of the world are discussed. Another aim is to prepare a common ground, a platform at the university level for scientific cooperation in the field of planning. This study aims at examining the situation of planning in the contemporary world. The identified challenges include the need for more flexibility in planning and planning education, the emergence of innovations and creativity in planners and planning projects, the necessity of promoting soft skills while keeping the existing technical nature of planning and lastly, the need for more interdisciplinary work. The final part of the paper is discussing the future planning education and recommendations on how the schools of planning should reflect these changes.

Use of a forensic technique to identify blood contamination of emergency department and ambulance trauma equipment

PubMed Central

Lee, J B; Levy, M; Walker, A

2006-01-01

Using a Kastle‐Meyer (KM) technique, the following equipment from the emergency departments of six UK hospitals (four trusts) and three regional ambulance services was tested for blood contamination: extrication (“spinal”) boards, cervical collars, straps, box splints, head blocks, and headboards. Only equipment ready for patient use was tested. Over half of trauma equipment (57%) tested positive for blood, including 15% of equipment that was visibly stained with blood. There have been no recorded cases of infection from contaminated trauma equipment but our study has identified the potential risk. Disposable covers for boards, disposable straps, and disposable radiolucent head blocks which are currently available provide a solution but have resource implications PMID:16373813

Transformative processes in marriage: An analysis of emerging trends

PubMed Central

Fincham, Frank D.; Stanley, Scott M.; Beach, Steven R.H.

2009-01-01

The study of conflict has dominated psychological research on marriage. This article documents its move from center stage, outlining how a broader canvas accommodates a richer picture of marriage. A brief sampling of new constructs such as forgiveness and sacrifice points to an organizing theme of transformative processes in emerging marital research. The implications of marital transformations are explored including spontaneous remission of distress, nonlinear dynamic systems that may produce unexpected and discontinuous change, possible nonarbitrary definitions of marital discord, and the potential for developing other constructs related to self-transformation in marital research. PMID:19890466

Long-term trends in adolescent and young adult smoking in the United States: metapatterns and implications.

PubMed

Nelson, David E; Mowery, Paul; Asman, Kat; Pederson, Linda L; O'Malley, Patrick M; Malarcher, Ann; Maibach, Edward W; Pechacek, Terry F

2008-05-01

We sought to describe long-term adolescent and young adult smoking trends and patterns. We analyzed adolescent data from Monitoring the Future, 1976 to 2005, and young adult (aged 18-24 years) data from the National Health Interview Survey, 1974 to 2005, overall and in subpopulations to identify trends in current cigarette smoking prevalence. Five metapatterns emerged: we found (1) a large increase and subsequent decrease in overall smoking over the past 15 years, (2) a steep decline in smoking among Blacks through the early 1990s, (3) a gender gap reversal among older adolescents and young adults who smoked over the past 15 years, (4) similar trends in smoking for most subgroups since the early 1990s, and (5) a large decline in smoking among young adults with less than a high school education. Long-term patterns for adolescent and young adult cigarette smoking were decidedly nonlinear, and we found evidence of a cohort effect among young adults. Continued strong efforts and a long-term societal commitment to tobacco use prevention are needed, given the unprecedented declines in smoking among most subpopulations since the mid- to late 1990s.

Trends of Diversification and Expansion in Israeli Higher Education.

ERIC Educational Resources Information Center

Guri-Rozenblit, Sarah

1993-01-01

A discussion of recent changes in Israeli higher education looks at the system's structure, emergence of private law schools, the upgrading of some vocationally oriented postsecondary institutions to academic status, academic tracks of study within regional colleges, and possible future developments. Some comparisons are made with trends in other…

Sources of trends in water-quality data for selected streams in Texas, 1975-89 water years

USGS Publications Warehouse

Schertz, T.L.; Wells, F.C.; Ohe, D.J.

1994-01-01

The probable source of trend patterns in nutrients and measures of oxygen in the Trinity River Basin was changes in the wastewater treatment facilities in the Dallas-Fort Worth metropolitan area. A pattern of increased concentrations of inorganic constituents in the upper Colorado River Basin resulted from emergency releases of water from the Natural Darn Lake, a salinity control structure. Trend patterns in inorganic constituents in the Rio Grande Basin were a result of increasing concentrations in the Pecos River and, to a lesser extent, the Rio Grande above the Amistad Reservoir, combined with the effects of reservoir regulation. A pattern of increasing concentrations of organic plus ammonia nitrogen and ammonia nitrogen was detected for the 1975-86 water years for stations with low concentrations (generally less than 5 milligrams per liter) of these nitrogen species. The trends were no longer evident when the period of trend analysis was extended to the 1989 water year. A positive bias in the data caused by the addition of mercuric chloride tablets to preserve nutrient samples during 1980-86 was the probable source of this trend pattern. A pattern of increasing concentrations in dissolved sulfate in the eastern part of the State was a result of a positive bias in the analytical results of a turbidimetric method of sulfate analysis. The source of a statewide pattern of increased pH in streams could not be identified.

Experts' Perceptions on China's Capacity to Manage Emerging and Re-emerging Zoonotic Diseases in an Era of Climate Change.

PubMed

Hansen, A; Xiang, J; Liu, Q; Tong, M X; Sun, Y; Liu, X; Chen, K; Cameron, S; Hanson-Easey, S; Han, G-S; Weinstein, P; Williams, C; Bi, P

2017-11-01

Zoonotic diseases transmitted by arthropods and rodents are a major public health concern in China. However, interventions in recent decades have helped lower the incidence of several diseases despite the country's large, frequently mobile population and socio-economic challenges. Increasing globalization, rapid urbanization and a warming climate now add to the complexity of disease control and prevention and could challenge China's capacity to respond to threats of emerging and re-emerging zoonoses. To investigate this notion, face-to-face interviews were conducted with 30 infectious disease experts in four cities in China. The case study diseases under discussion were malaria, dengue fever and haemorrhagic fever with renal syndrome, all of which may be influenced by changing meteorological conditions. Data were analysed using standard qualitative techniques. The study participants viewed the current disease prevention and control system favourably and were optimistic about China's capacity to manage climate-sensitive diseases in the future. Several recommendations emerged from the data including the need to improve health literacy in the population regarding the transmission of infectious diseases and raising awareness of the health impacts of climate change amongst policymakers and health professionals. Participants thought that research capacity could be strengthened and human resources issues for front-line staff should be addressed. It was considered important that authorities are well prepared in advance for outbreaks such as dengue fever in populous subtropical areas, and a prompt and coordinated response is required when outbreaks occur. Furthermore, health professionals need to remain skilled in the identification of diseases for which incidence is declining, so that re-emerging or emerging trends can be rapidly identified. Recommendations such as these may be useful in formulating adaptation plans and capacity building for the future control and

Probiotics for human health –new innovations and emerging trends

PubMed Central

2012-01-01

The role of the gut microbiome in human health and disease with a particular emphasis on therapeutic use of probiotics under specific medical conditions was mainly highlighted in 1st Annual conference of Probiotic Association of India (PAi) and International Symposium on “Probiotics for Human Health - New Innovations and Emerging Trends” held on 27th-28th August, 2012 at New Delhi, India. There is increasing recognition of the fact that dysbiosis or alteration of this gut microbiome may be implicated in gastro-intestinal disorders including diarrheal diseases, ulcerative colitis, inflammatory bowel diseases, life style diseases viz. Diabetes Mellitus-2 and obesity etc. This report summarizes the proceedings of the conference and the symposium comprehensively. Although, research on probiotics has been continuing for the past few decades, the subject has been currently the major focus of attention across the world due to recent advances and new developments in genomics, transcriptomics, proteomics, metabolomics and emergence of new generation of high through put sequencing technologies that have immensely helped in understanding the probiotic functionality and mode of action from nutritional and health perspectives. There is now sufficient evidence backed up with good quality scientific clinical data to suggest that probiotic interventions could indeed be effective in various types of diarrheal diseases, other chronic gastrointestinal inflammatory disorders like pouchitis, necrotizing entero-colitis, allergic responses and lactose intolerance etc. This report makes a modest attempt to give all the stake holders involved in development of probiotic based functional/health foods an overview of the current status of probiotics research at the Global and National level. The most crucial issues that emerged from the lead talks delivered by the eminent speakers from India and abroad were the major focus of discussions in different plenary and technical sessions. By

Management of Patients With Hypertensive Urgencies and Emergencies

PubMed Central

Cherney, David; Straus, Sharon

2002-01-01

BACKGROUND Hypertensive urgencies and emergencies are common clinical occurrences in hypertensive patients. Treatment practices vary considerably to because of the lack of evidence supporting the use of one therapeutic agent over another. This paper was designed to review the evidence for various pharmacotherapeutic regimens in the management of hypertensive urgencies and emergencies, in terms of the agents' abilities to reach predetermined “safe” goal blood pressures (BPs), and to prevent adverse events. METHODS medline was searched from 1966 to 2001, and the reference lists of all the articles were retrieved and searched for relevant references, and experts in the field were contacted to identify other relevant studies. The Cochrane Library was also searched. Studies that were eligible for inclusion in this review were systematic reviews of randomized control trials (RCTs) and individual RCTs, all-or-none studies, systematic reviews of cohort studies and individual cohort studies, and outcomes research. No language restrictions were used. RESULTS None of the trials included in this review identified an optimal rate of BP lowering in hypertensive emergencies and urgencies. The definitions of hypertensive emergencies and urgencies were not consistent, but emergencies always involved target end-organ damage, and urgencies were without such damage. Measures of outcome were not uniform between studies. The 4 hypertensive emergency and 15 hypertensive urgency studies represented 236 and 1,074 patients, respectively. The evidence indicated a nonsignificant trend toward increased efficacy with urapidil compared to nitroprusside for hypertensive emergencies (number needed to treat [NNT] for urapidil to achieve target BP, 12; 95% confidence interval [95% CI], number of patients needed to harm [NNH], 5 to NNT, 40 compared to nitroprusside). Several medications were efficacious in treating hypertensive urgencies, including: nicardipine (NNT for nicardipine compared to

Antimicrobial resistance trends among Escherichia coli isolates obtained from dairy cattle in the northeastern United States, 2004-2011.

PubMed

Cummings, Kevin J; Aprea, Victor A; Altier, Craig

2014-01-01

Monitoring antimicrobial resistance trends among bacteria isolated from food animals and people is necessary to inform risk analyses and guide public policy regarding antimicrobial use. Our objectives were to describe the antimicrobial resistance status of Escherichia coli isolates from dairy cattle in the northeastern United States and to identify trends in resistance to selected antimicrobial agents over time. We collected data retrospectively for all bovine E. coli isolates that were obtained from samples submitted to Cornell University's Animal Health Diagnostic Center between January 1, 2004 and December 31, 2011. We investigated temporal trends in the prevalence of resistant E. coli for each antimicrobial agent using the Cochran-Armitage trend test. Antimicrobial susceptibility testing was performed on 3373 bovine E. coli isolates from clinical samples submitted during the study period. Overall resistance to each antimicrobial agent ranged from 2.7% (enrofloxacin) to 91.3% (oxytetracycline). There was evidence of a significantly decreasing trend in prevalence of resistance to several agents: chlortetracycline, florfenicol, neomycin, oxytetracycline, spectinomycin, and trimethoprim/sulfamethoxazole. However, a significantly increasing trend in prevalence of resistance to enrofloxacin was also evident. These results do not support the idea that current antimicrobial use practices on dairy operations are driving a general increase in the emergence and dissemination of drug-resistant E. coli in the region served by the laboratory. However, resistance to some drugs remained consistently high during the study period, and increasing resistance to enrofloxacin is a key area of concern.

Trends in antibiotic resistance over time among pathogens from Canadian hospitals: results of the CANWARD study 2007-11.

PubMed

Lagacé-Wiens, Philippe R S; Adam, Heather J; Low, Donald E; Blondeau, Joseph M; Baxter, Melanie R; Denisuik, Andrew J; Nichol, Kimberly A; Walkty, Andrew; Karlowsky, James A; Mulvey, Michael R; Hoban, Daryl J; Zhanel, George G

2013-05-01

Antimicrobial resistance patterns change over time and longitudinal surveillance studies provide insight into these trends. We sought to describe the important trends in antimicrobial resistance in key pathogens across Canada to provide useful information to clinicians, policy makers and industry, to assist in optimizing antimicrobial therapy, formulary choices and drug development. We analysed longitudinal data from the CANWARD study using a multivariate regression model to control for possible effects of patient demographics on resistance, in order to assess the impact of time on antimicrobial resistance independent of other measured variables. We identified several key trends in common pathogens. In particular, we observed a statistically significant increase in the proportion of Escherichia coli isolates that were resistant to extended-spectrum cephalosporins and fluoroquinolones, an increase in the proportion of Klebsiella pneumoniae isolates that were resistant to extended-spectrum cephalosporins, a reduction in the proportion of Staphylococcus aureus that were methicillin, clindamycin and trimethoprim/sulfamethoxazole resistant, and a reduction in the proportion of Pseudomonas aeruginosa that were fluoroquinolone and gentamicin resistant. Although some of these trends, such as the dramatic increase in fluoroquinolone and cephalosporin resistance in E. coli, can be attributed to the emergence and global spread of resistant clones (e.g. ST131 E. coli), others remain unexplained. However, recognizing these trends remains important to guide changes in empirical antimicrobial therapy and drug development.

RNA transcriptional biosignature analysis for identifying febrile infants with serious bacterial infections in the emergency department: a feasibility study.

PubMed

Mahajan, Prashant; Kuppermann, Nathan; Suarez, Nicolas; Mejias, Asuncion; Casper, Charlie; Dean, J Michael; Ramilo, Octavio

2015-01-01

To develop the infrastructure and demonstrate the feasibility of conducting microarray-based RNA transcriptional profile analyses for the diagnosis of serious bacterial infections in febrile infants 60 days and younger in a multicenter pediatric emergency research network. We designed a prospective multicenter cohort study with the aim of enrolling more than 4000 febrile infants 60 days and younger. To ensure success of conducting complex genomic studies in emergency department (ED) settings, we established an infrastructure within the Pediatric Emergency Care Applied Research Network, including 21 sites, to evaluate RNA transcriptional profiles in young febrile infants. We developed a comprehensive manual of operations and trained site investigators to obtain and process blood samples for RNA extraction and genomic analyses. We created standard operating procedures for blood sample collection, processing, storage, shipping, and analyses. We planned to prospectively identify, enroll, and collect 1 mL blood samples for genomic analyses from eligible patients to identify logistical issues with study procedures. Finally, we planned to batch blood samples and determined RNA quantity and quality at the central microarray laboratory and organized data analysis with the Pediatric Emergency Care Applied Research Network data coordinating center. Below we report on establishment of the infrastructure and the feasibility success in the first year based on the enrollment of a limited number of patients. We successfully established the infrastructure at 21 EDs. Over the first 5 months we enrolled 79% (74 of 94) of eligible febrile infants. We were able to obtain and ship 1 mL of blood from 74% (55 of 74) of enrolled participants, with at least 1 sample per participating ED. The 55 samples were shipped and evaluated at the microarray laboratory, and 95% (52 of 55) of blood samples were of adequate quality and contained sufficient RNA for expression analysis. It is possible to

The Sound Games: Introducing Gamification into Stanford's Orientation on Emergency Ultrasound.

PubMed

Lobo, Viveta; Stromberg, Andrew Q; Rosston, Peter

2017-09-18

Point-of-care ultrasound is a critical component of graduate medical training in emergency medicine. Innovation in ultrasound teaching methods is greatly needed to keep up with a changing medical landscape. A field-wide trend promoting simulation and technology-enhanced learning is underway in an effort to improve patient care, as well as patient safety. In an effort to both motivate students and increase their skill retention, training methods are shifting towards a friendly competition model and are gaining popularity nationwide. In line with this emerging trend, Stanford incorporated the Sound Games - an educational ultrasound event with a distinctly competitive thread - within its existing two-day point-of-care ultrasound orientation course for emergency medicine interns. In this study, we demonstrate successful implementation of the orientation program, significant learning gains in participants, and overall student satisfaction with the course.

Gender Differences in Expressed Interests in Engineering-Related Fields ACT 30-Year Data Analysis Identified Trends and Suggested Avenues to Reverse Trends

ERIC Educational Resources Information Center

Iskander, E. Tiffany; Gore, Paul A., Jr.; Furse, Cynthia; Bergerson, Amy

2013-01-01

Historically, women have been underrepresented in the Science, Technology, Engineering, and Math (STEM) fields both as college majors and in the professional community. This disturbing trend, observed in many countries, is more serious and evident in American universities and is reflected in the U.S. workforce statistics. In this article, we…

Publishing trends in Chinese medicine and related subjects documented in WorldCat.

PubMed

Leung, Shirley; Chan, Kylie; Song, Lisa

2006-03-01

Chinese medicine (CM) has been the subject of increasing interest in the past 30 years, both as a discipline and in the larger context of alternative medicine. It has steadily been accepted by and integrated into the medical and health-care fields in many countries. This study aims to gain an overview of how CM has been interpreted and presented to the world outside China and to identify emerging trends. This study is designed to analyse the publishing trends of CM and related subjects in all languages except Chinese, ranging from books and serials to audio-visual and electronic resources found in WorldCat, the world's largest bibliographic database produced by OnLine Computer Library Center (OCLC). The findings showed a flourishing growth of publications in CM and related subjects beginning in the 1970s with greater coverage on acupuncture. The materials in English language constitute the major portion of total output. We conclude that Chinese medicine has steadily gained recognition in the world based on the analysis of publication records. The translation of original works and analysis of journal literature and conference proceedings on Chinese medicine merit further study.

Preventable injury deaths: identifying opportunities to improve timeliness and reach of emergency healthcare services in New Zealand.

PubMed

Lilley, Rebbecca; Kool, Bridget; Davie, Gabrielle; de Graaf, Brandon; Ameratunga, Shanthi N; Reid, Pararangi; Civil, Ian; Dicker, Bridget; Branas, Charles C

2017-02-09

Traumatic injury is a leading cause of premature death and health loss in New Zealand. Outcomes following injury are very time sensitive, and timely access of critically injured patients to advanced hospital trauma care services can improve injury survival. This cross-sectional study will investigate the epidemiology and geographic location of prehospital fatal injury deaths in relation to access to prehospital emergency services for the first time in New Zealand. Electronic Coronial case files for the period 2008-2012 will be reviewed to identify cases of prehospital fatal injury across New Zealand. The project will combine epidemiological and geospatial methods in three research phases: (1) identification, enumeration, description and geocoding of prehospital injury deaths using existing electronic injury data sets; (2) geocoding of advanced hospital-level care providers and emergency land and air ambulance services to determine the current theoretical service coverage in a specified time period and (3) synthesising of information from phases I and II using geospatial methods to determine the number of prehospital injury deaths located in areas without timely access to advanced-level hospital care. The findings of this research will identify opportunities to optimise access to advanced-level hospital care in New Zealand to increase the chances of survival from serious injury. The resulting epidemiological and geospatial analyses will represent an advancement of knowledge for injury prevention and health service quality improvement towards better patient outcomes following serious injury in New Zealand and similar countries. 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/.

Rediscovering the Alcoholism Field: New Trends and Needs.

ERIC Educational Resources Information Center

Dolan, Joseph S.

1987-01-01

Outlines trends developing in the alcoholism field including: youth, treatment, public policy, education, research, and the Rand Report. Identifies two needs: the need to look at the interrelationships of programs and trends and the need to foster an environment which does not tolerate drunkenness or intoxication. (Author/ABB)

Current and Emerging Forces Impacting Special Education.

ERIC Educational Resources Information Center

Yates, James R.

Using the methodology of force field analysis, the paper develops possible futures for special education based on current trends. Demographic forces impacting special education include age changes, ethnicity changes, the needs of emerging language minorities, specific change in the youth population, environmental factors and the incidence of…

Google Flu Trends Spatial Variability Validated Against Emergency Department Influenza-Related Visits.

PubMed

Klembczyk, Joseph Jeffrey; Jalalpour, Mehdi; Levin, Scott; Washington, Raynard E; Pines, Jesse M; Rothman, Richard E; Dugas, Andrea Freyer

2016-06-28

Influenza is a deadly and costly public health problem. Variations in its seasonal patterns cause dangerous surges in emergency department (ED) patient volume. Google Flu Trends (GFT) can provide faster influenza surveillance information than traditional CDC methods, potentially leading to improved public health preparedness. GFT has been found to correlate well with reported influenza and to improve influenza prediction models. However, previous validation studies have focused on isolated clinical locations. The purpose of the study was to measure GFT surveillance effectiveness by correlating GFT with influenza-related ED visits in 19 US cities across seven influenza seasons, and to explore which city characteristics lead to better or worse GFT effectiveness. Using Healthcare Cost and Utilization Project data, we collected weekly counts of ED visits for all patients with diagnosis (International Statistical Classification of Diseases 9) codes for influenza-related visits from 2005-2011 in 19 different US cities. We measured the correlation between weekly volume of GFT searches and influenza-related ED visits (ie, GFT ED surveillance effectiveness) per city. We evaluated the relationship between 15 publically available city indicators (11 sociodemographic, two health care utilization, and two climate) and GFT surveillance effectiveness using univariate linear regression. Correlation between city-level GFT and influenza-related ED visits had a median of .84, ranging from .67 to .93 across 19 cities. Temporal variability was observed, with median correlation ranging from .78 in 2009 to .94 in 2005. City indicators significantly associated (P<.10) with improved GFT surveillance include higher proportion of female population, higher proportion with Medicare coverage, higher ED visits per capita, and lower socioeconomic status. GFT is strongly correlated with ED influenza-related visits at the city level, but unexplained variation over geographic location and time

Understanding drivers of Demand for Emergency Service Trends in Years 2010-2014 in New South Wales: An initial overview of the DESTINY project.

PubMed

Dinh, Michael M; Berendsen Russell, Saartje; Bein, Kendall J; Chalkley, Dane; Muscatello, David; Paoloni, Richard; Ivers, Rebecca

2016-04-01

This study aims to describe the general characteristics and data definitions used in a population-based data set of ED presentations in New South Wales (NSW), used to form the basis of future-trend analyses. Retrospective analysis of the Emergency Department Data Collection registry, which provided clinical and demographic information of ED presentations across all EDs in NSW between 2010 and 2014. Presenting problems and ED diagnoses were classified using broad clinical categories including injury/musculoskeletal, respiratory, cardiovascular, ear nose and throat, and mental health. Presentations were linked by patient to allow for analysis of representations, and population data were obtained from the Australian Bureau of Statistics. There were 11.8 million presentations that were analysed from 150 EDs (80.6% of all EDs). The rate of ED presentations was highest in those aged 85 years and older and appears to increase across all age groups between 2010 and 2014. The most common ED diagnosis categories were injury/musculoskeletal (27.5%) followed by abdominal/gastrointestinal (12.3%), respiratory (9%) and cardiovascular (8%). Both the Systematised Nomenclature of Medicine Clinical Terms (66%) and the International Classification of Diseases (24%) were used to code ED diagnoses. The elderly population had the highest rate of ED attendances. The use of diverse diagnosis classifications and source information systems may present problems with further analysis. Patterns and characteristics of ED presentations in NSW were broadly consistent with those reported in other states in Australia. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Emerging Trends

ERIC Educational Resources Information Center

Black, James R.

2009-01-01

The campus security standard of care continues to evolve. Technology plays a more important role than ever before, and manufacturers want their equipment to become the solution of choice at education facilities across the nation. Campus administrators need to know more about these security technologies and how they might fit into a campus security…

Emerging Trends

DTIC Science & Technology

2013-08-08

theft in the CERT Insider Threat Database were associated with foreign social network connections. 1 Verizon. “The 2013 Data Breach Investigations...passwords, opening infected attachments or web sites, etc. 1 Verizon. “The 2013 Data Breach Investigations Report.” http...were experienced by 38% of respondents1 •  The 2013 Verizon Data Breach Report2 reveals •  29% of breaches studied leveraged social tactics •  A

A climate trend analysis of Kenya-August 2010

USGS Publications Warehouse

Funk, Christopher C.

2010-01-01

Introduction This brief report draws from a multi-year effort by the United States Agency for International Development's Famine Early Warning System Network (FEWS NET) to monitor and map rainfall and temperature trends over the last 50 years (1960-2009) in Kenya. Observations from seventy rainfall gauges and seventeen air temperature stations were analyzed for the long rains period, corresponding to March through June (MAMJ). The data were quality controlled, converted into 1960-2009 trend estimates, and interpolated using a rigorous geo-statistical technique (kriging). Kriging produces standard error estimates, and these can be used to assess the relative spatial accuracy of the identified trends. Dividing the trends by the associated errors allows us to identify the relative certainty of our estimates (Funk and others, 2005; Verdin and others, 2005; Brown and Funk, 2008; Funk and Verdin, 2009). Assuming that the same observed trends persist, regardless of whether or not these changes are due to anthropogenic or natural cyclical causes, these results can be extended to 2025, providing critical, and heretofore missing information about the types and locations of adaptation efforts that may be required to improve food security.

Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses — United States, July 2016–September 2017

PubMed Central

Seth, Puja; Gladden, R. Matthew; Mattson, Christine L.; Baldwin, Grant T.; Kite-Powell, Aaron; Coletta, Michael A.

2018-01-01

Introduction From 2015 to 2016, opioid overdose deaths increased 27.7%, indicating a worsening of the opioid overdose epidemic and highlighting the importance of rapid data collection, analysis, and dissemination. Methods Emergency department (ED) syndromic and hospital billing data on opioid-involved overdoses during July 2016–September 2017 were examined. Temporal trends in opioid overdoses from 52 jurisdictions in 45 states were analyzed at the regional level and by demographic characteristics. To assess trends based on urban development, data from 16 states were analyzed by state and urbanization level. Results From July 2016 through September 2017, a total of 142,557 ED visits (15.7 per 10,000 visits) from 52 jurisdictions in 45 states were suspected opioid-involved overdoses. This rate increased on average by 5.6% per quarter. Rates increased across demographic groups and all five U.S. regions, with largest increases in the Southwest, Midwest, and West (approximately 7%–11% per quarter). In 16 states, 119,198 ED visits (26.7 per 10,000 visits) were suspected opioid-involved overdoses. Ten states (Delaware, Illinois, Indiana, Maine, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, and Wisconsin) experienced significant quarterly rate increases from third quarter 2016 to third quarter 2017, and in one state (Kentucky), rates decreased significantly. The highest rate increases occurred in large central metropolitan areas. Conclusions and Implications for Public Health Practice With continued increases in opioid overdoses, availability of timely data are important to inform actions taken by EDs and public health practitioners. Increases in opioid overdoses varied by region and urbanization level, indicating a need for localized responses. Educating ED physicians and staff members about appropriate services for immediate care and treatment and implementing a post-overdose protocol that includes naloxone provision and linking persons into treatment could

Trends in incidence and risk markers of student emergency department visits with alcohol intoxication in a U.S. public university-A longitudinal data linkage study.

PubMed

Ngo, Duc Anh; Rege, Saumitra V; Ait-Daoud, Nassima; Holstege, Christopher P

2018-05-08

To examine the trends in incidence and socio-demographic, organizational, academic, and clinical risk markers of student alcohol intoxication associated with emergency department (ED) visits. Student admission data from 2009 to 2015 were linked to primary healthcare data and subsequent ED visits with alcohol intoxication identified using ICD-9 codes within one year following the first (index) enrollment each year. Incidence rate per 10,000 person-years was calculated. Cox proportional hazard regression provided adjusted hazard ratios (HR) (95 % CIs) for the association between student characteristics and subsequent ED visits with alcohol intoxication. Of 177,128 students aged 16-49 enrolled, 889 had at least one ED visit with alcohol intoxication, resulting in an incidence rate of 59/10,000 person-years. Incidence increased linearly from 45/10,000 person-years in 2009-10 to 71/10,000 person-years in the 2014-15 academic year (p < 0.001). HRs (95%CIs) of student characteristics associated with this outcome were: males (versus females): 1.38 (1.21-1.58); below 20 years of age (versus 25-30 years): 3.36 (1.99-5.65); Hispanic (versus Asian) students: 1.61 (1.16-2.25); parental tax dependency: 1.49 (1.16-1.91); Greek life member: 1.96 (1.69-2.26); member of an athletic team: 0.51 (0.36-0.72); undergraduate (versus graduate) students: 2.65 (1.88-3.74). Past year alcohol use or having been diagnosed with depression or anxiety were also significant predictors. Adjustments for campus-related factors strongly attenuated the associations between student socio-demographic characteristics with this outcome. Linking student admission data with ED clinical data can help monitor student alcohol intoxication associated with ED visits and identify student groups at higher risk who subsequently can be targeted for intervention efforts. Copyright © 2018 Elsevier B.V. All rights reserved.

Are we prepared for emerging and re-emerging diseases? Experience and lessons from epidemics that occurred in Tanzania during the last five decades.

PubMed

Karimuribo, Esron D; Mboera, Leonard E G; Mbugi, Erasto; Simba, Azma; Kivaria, Fredrick M; Mmbuji, Peter; Rweyemamu, Mark M

2011-12-01

This paper reviews preparedness for containing and controlling emerging and re-emerging diseases drawing lessons from disease events that occurred in animal and human populations in the last five decades (1961-2011). A comprehensive analysis based on retrieval and analysis of grey and published literature as well as reported cases was carried out to document type and trend of occurrence of emerging and re-emerging infectious diseases in different parts of Tanzania. Overall, the majority of diseases reported in the country were viral in nature followed by bacterial diseases. The trend for the occurrence shows a number of new emerging diseases as well as re-occurrence of old diseases in both animal (domestic and wild) and human populations. In humans, the major disease epidemics reported in the last five decades include cholera, influenza A H1N1, plague and rubella. In animals, the major epidemic diseases reported were Contagious Bovine Pleuropneumonia, Contagious Caprine Pleuropneumonia, Peste des petits ruminants and Giraffe Ear and Skin Diseases. Some epidemics have been reported in both human and animal populations including Rift Valley fever and anthrax. The emergence of the 'fit-for purpose' approaches and technologies such as the discipline of One Health, use of participatory epidemiology and disease surveillance and mobile technologies offers opportunity for optimal use of limited resources to improve early detection, diagnosis and response to disease events and consequently reduced impact of such diseases in animal and human populations.

Mapping the Evolution of Elearning from 1977-2005 to Inform Understandings of e-Learning Historical Trends

ERIC Educational Resources Information Center

Sun, Pei Chen; Finger, Glenn; Liu, Zhen Lan

2014-01-01

While there have been very limited studies of the educational computing literature to analyze the research trends since the early emergence of educational computing technologies, the authors argue that it is important for both researchers and educators to understand the major, historical educational computing trends in order to inform…

Declines in Crime and Teen Childbearing: Identifying Potential Explanations for Contemporaneous Trends

PubMed Central

Colen, Cynthia G.; Ramey, David M.; Browning, Christopher R.

2016-01-01

Objectives The previous 25 years have witnessed remarkable upheavals in the social landscape of the United States. Two of the most notable trends have been dramatic declines in levels of crime as well as teen childbearing. Much remains unknown about the underlying conditions that might be driving these changes. More importantly, we do not know if the same distal factors that are responsible for the drop in the crime rate are similarly implicated in falling rates of teen births. We examine four overarching potential explanations: fluctuations in economic opportunity, shifting population demographics, differences in state-level policies, and changes in expectations regarding health and mortality. Methods We combine state-specific data from existing secondary sources and model trajectories of violent crime, homicides, robberies, and teen fertility over a 20-year period from 1990 to 2010 using simultaneous fixed-effects regression models. Results We find that 4 of the 21 predictors examined - growth in the service sector of the labor market, increasing racial diversity especially among Hispanics, escalating levels of migration, and the expansion of family planning services to low-income women – offer the most convincing explanations for why rates of violent crime and teen births have been steadily decreasing over time. Moreover, we are able to account for almost a quarter of the joint declines in violent crime and teen births. Conclusions Our conclusions underscore the far reaching effects that aggregate level demographic conditions and policies are likely to have on important social trends that might, at first glance, seem unrelated. Furthermore, the effects of policy efforts designed to target outcomes in one area are likely to spill over into other domains. PMID:27695160

The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio.

PubMed

Weiner, Scott G; Baker, Olesya; Poon, Sabrina J; Rodgers, Ann F; Garner, Chad; Nelson, Lewis S; Schuur, Jeremiah D

2017-12-01

The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. We used Ohio's prescription drug monitoring program data from January 1, 2010, to December 31, 2014, and included the 5 most commonly prescribed opioids (hydrocodone, oxycodone, tramadol, codeine, and hydromorphone). The primary outcome was the monthly statewide prescription total of opioids written by emergency physicians in Ohio. We used an interrupted time series analysis to compare pre- and postguideline level and trend in number of opioid prescriptions dispensed by emergency physicians per month, number of prescriptions stratified by 5 commonly prescribed opioids, and number of prescriptions for greater than 3 days' supply of opioids. Beginning in January 2010, the number of prescriptions dispensed by all emergency physicians in Ohio decreased by 0.3% per month (95% confidence interval [CI] -0.49% to -0.15%). The implementation of the guidelines in April 2012 was associated with a 12% reduction (95% CI -17.7% to -6.3%) in the level of statewide total prescriptions per month and an additional decline of 0.9% (95% CI -1.1% to -0.7%) in trend relative to the preguideline trend. The estimated effect of the guidelines on total monthly prescriptions greater than a 3-day supply was an 11.2% reduction in level (95% CI -18.8% to -3.6%) and an additional 0.9% (95% CI -1.3% to -0.5%) decline in trend per month after the guidelines. Guidelines were also associated with a reduction in prescribing for each of the 5 individual opioids, with various effect. In Ohio, emergency physician opioid prescribing guidelines were associated with a decrease in the quantity of opioid prescriptions written by emergency physicians. Although introduction of the guidelines occurred in parallel with other opioid-related interventions, our

Emerging materials: what will durable materials look like in 2020?

Treesearch

Jerrold E. Winandy

2002-01-01

What materials will emerge from today’s research ideas to become the commonly accepted building products of 2020? What will durable materials look like in 2020? This paper attempts to address these questions by considering some current trends and then presenting a series of ideas of what the next 2 decades may hold from an emerging materials standpoint for North...

Trends of communication skills education in medical schools.

PubMed

Han, Hong Hee; Kim, Sun

2009-03-01

To investigate the past and current status of teaching communication skills in undergraduate medical education and to review how medical education is progressing. A selective search was conducted of the literature that was published from 1960 to Jun 2008 in the MEDLINE, EMBASE, ERIC, Psychlnfo, and KMbase databases using "communication." All articles in 13 medical journals (including Academic Medicine, Medical Education, Teaching and Learning in Medicine, Medical Teacher, and Korean Journal of Medical Education) were reviewed. Each article was categorized according to 5 subjects (curriculum, methods, assessment, student factors, and research type). A total of 306 studies met the inclusion criteria for this study. Curriculum was the most frequent subject (n=85), followed by assessment (n=71), student factors (n=48), and methods (n=23). According to this research, the current trends of teaching communication skills in medical school are characterized by curriculum development,' 'blended-methods,' 'multisource assessment,' 'student attitudes,' and 'comparative studies' of education. It is time to figure it out optimistic ways to design a formal course. Now, 4 current trends in teaching and learning are emerging in communication skills. Curriculum development is stabilizing a variety of teaching methods are being adopted; a method of multisource assessment is being identified and the need to consider student attitudesis being recognized. In the near future, objective, comprehensive, and sophisticated evaluation is going to be the top priority in teaching communication skills with a variety of research types.

[Emerging noninfectious diseases].

PubMed

Consiglio, Ezequiel

2008-11-01

In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

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

PubMed

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

2014-11-01

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

An Evaluation of a Natural Language Processing Tool for Identifying and Encoding Allergy Information in Emergency Department Clinical Notes

PubMed Central

Goss, Foster R.; Plasek, Joseph M.; Lau, Jason J.; Seger, Diane L.; Chang, Frank Y.; Zhou, Li

2014-01-01

Emergency department (ED) visits due to allergic reactions are common. Allergy information is often recorded in free-text provider notes; however, this domain has not yet been widely studied by the natural language processing (NLP) community. We developed an allergy module built on the MTERMS NLP system to identify and encode food, drug, and environmental allergies and allergic reactions. The module included updates to our lexicon using standard terminologies, and novel disambiguation algorithms. We developed an annotation schema and annotated 400 ED notes that served as a gold standard for comparison to MTERMS output. MTERMS achieved an F-measure of 87.6% for the detection of allergen names and no known allergies, 90% for identifying true reactions in each allergy statement where true allergens were also identified, and 69% for linking reactions to their allergen. These preliminary results demonstrate the feasibility using NLP to extract and encode allergy information from clinical notes. PMID:25954363

Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.

PubMed

Manley, Kim; Martin, Anne; Jackson, Carolyn; Wright, Toni

2016-08-09

Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust. Data sources included 14 clinical settings where upstream or downstream pinch points are likely to occur including discharge planning and rapid response teams; ten regional stakeholder events (n = 102); a qualitative survey (n = 48); and a review of literature and analysis of policy documents including care pathways and protocols. The key workforce enablers for whole systems urgent and emergency care delivery identified were: clinical systems leadership, a single integrated career and competence framework and skilled facilitation of work based learning. In this study, participants agreed that whole systems urgent and emergency care allows for the design and implementation of care delivery models that meet complexity of population healthcare needs, reduce duplication and waste and improve healthcare outcomes and patients' experiences. For this to be achieved emphasis needs to be placed on holistic changes in structures, processes and patterns of the urgent and emergency care system. Often overlooked, patterns that drive the thinking and behavior in the workplace directly impact on staff recruitment and retention and the overall effectiveness of the organization. These also need to be attended to for transformational change to be achieved and sustained. Research to refine and validate a single

Trends in the Information Industry.

ERIC Educational Resources Information Center

Hogan, Thomas H.

1987-01-01

The current president of the American Society for Information Science shares his observations about the information industry, identifying positive and negative trends, and discusses the role ASIS can play in the continuing growth of the industry. (Author/CLB)

Measuring Frailty Can Help Emergency Departments Identify Independent Seniors at Risk of Functional Decline After Minor Injuries.

PubMed

Sirois, Marie-Josée; Griffith, Lauren; Perry, Jeffrey; Daoust, Raoul; Veillette, Nathalie; Lee, Jacques; Pelletier, Mathieu; Wilding, Laura; Émond, Marcel

2017-01-01

This study aims to (i) describe frailty in the subgroup of independent community-dwelling seniors consulting emergency departments (EDs) for minor injuries, (ii) examine the association between frailty and functional decline 3 months postinjury, (iii) ascertain the predictive accuracy of frailty measures and emergency physicians' for functional decline. Prospective cohort in 2011-2013 among 1,072 seniors aged 65 years or older, independent in basic daily activities, evaluated in Canadian EDs for minor injuries.Frailty was assessed at EDs using the Canadian Study of Health and Aging-Clinical Frailty scale (CSHA-CFS) and the Study of Osteoporotic Fracture frailty index (SOF). Functional decline was defined as a loss ≥2/28 on the Older American Resources Services scale 3 months postinjury. Generalized mixed models were used to explore differences in functional decline across frailty levels. Areas under the receiver operating characteristic curve were used to ascertain the predictive accuracy of frailty measures and emergency physicians' clinical judgment. The SOF and CSHA-CFS were available in 342 and 1,058 participants, respectively. The SOF identified 55.6%, 32.7%, 11.7% patients as robust, prefrail, and frail. These CSHA-CFS (n = 1,058) proportions were 51.9%, 38.3%, and 9.9%. The 3-month incidence of functional decline was 12.1% (10.0%-14.6%). The Areas under the receiver operating characteristic curves of the CSHA-CFS and the emergency physicians' were similar (0.548-0.777), while the SOF was somewhat higher (0.704-0.859). Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions

Refining adverse drug reaction signals by incorporating interaction variables identified using emergent pattern mining.

PubMed

Reps, Jenna M; Aickelin, Uwe; Hubbard, Richard B

2016-02-01

To develop a framework for identifying and incorporating candidate confounding interaction terms into a regularised cox regression analysis to refine adverse drug reaction signals obtained via longitudinal observational data. We considered six drug families that are commonly associated with myocardial infarction in observational healthcare data, but where the causal relationship ground truth is known (adverse drug reaction or not). We applied emergent pattern mining to find itemsets of drugs and medical events that are associated with the development of myocardial infarction. These are the candidate confounding interaction terms. We then implemented a cohort study design using regularised cox regression that incorporated and accounted for the candidate confounding interaction terms. The methodology was able to account for signals generated due to confounding and a cox regression with elastic net regularisation correctly ranking the drug families known to be true adverse drug reactions above those that are not. This was not the case without the inclusion of the candidate confounding interaction terms, where confounding leads to a non-adverse drug reaction being ranked highest. The methodology is efficient, can identify high-order confounding interactions and does not require expert input to specify outcome specific confounders, so it can be applied for any outcome of interest to quickly refine its signals. The proposed method shows excellent potential to overcome some forms of confounding and therefore reduce the false positive rate for signal analysis using longitudinal data. Copyright © 2015 Elsevier Ltd. All rights reserved.

Organizational Change, Informal Learning, and Adaptation: Emerging Trends in Training and Continuing Education.

ERIC Educational Resources Information Center

Kozlowski, Steve W. J.

1995-01-01

Trends such as technological innovation, downsizing, self-managed teams, and continuous learning imply that in continuing education technical content must be considered in the context in which skills are used. Knowledge of learning processes and workplace socialization suggests that formal training and informal learning must be integrated to…

Emerging phleboviruses.

PubMed

Elliott, Richard M; Brennan, Benjamin

2014-04-01

The Bunyavidae family is the largest grouping of RNA viruses and arguably the most diverse. Bunyaviruses have a truly global distribution and can infect vertebrates, invertebrates and plants. The majority of bunyaviruses are vectored by arthropods and thus have the remarkable capability to replicate in hosts of disparate phylogeny. The family has provided many examples of emerging viruses including Sin Nombre and related viruses responsible for hantavirus cardiopulmonary syndrome in the Americas, first identified in 1993, and Schmallenberg virus which emerged in Europe in 2011, causing foetal malformations in ruminants. In addition, some well-known bunyaviruses like Rift Valley fever and Crimean-Congo haemorrhagic fever viruses continue to emerge in new geographical locations. In this short review we focus on newly identified viruses associated with severe haemorrhagic disease in humans in China and the US. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Emerging Information Societies in an Interdependent World.

ERIC Educational Resources Information Center

Bernasconi, F. A.

Commenting on the trends toward the interlocking of emerging information societies and the growing interdependence of countries, this paper suggests the role that "informatics" (the rational and systematic use of information for planning and decision making) may play in the transition of societies into the information age. Two paradoxes…

Current trends in nursing theories.

PubMed

Im, Eun-Ok; Chang, Sun Ju

2012-06-01

To explore current trends in nursing theories through an integrated literature review. The literature related to nursing theories during the past 10 years was searched through multiple databases and reviewed to determine themes reflecting current trends in nursing theories. The trends can be categorized into six themes: (a) foci on specifics; (b) coexistence of various types of theories; (c) close links to research; (d) international collaborative works; (e) integration to practice; and (f) selective evolution. We need to make our continuous efforts to link research and practice to theories, to identify specifics of our theories, to develop diverse types of theories, and to conduct international collaborative works. Our paper gives implications for future theoretical development in diverse clinical areas of nursing research and practice. © 2012 Sigma Theta Tau International.

The effect of malpractice reform on emergency department care.

PubMed

Waxman, Daniel A; Greenberg, Michael D; Ridgely, M Susan; Kellermann, Arthur L; Heaton, Paul

2014-10-16

Many believe that fear of malpractice lawsuits drives physicians to order otherwise unnecessary care and that legal reforms could reduce such wasteful spending. Emergency physicians practice in an information-poor, resource-rich environment that may lend itself to costly defensive practice. Three states, Texas (in 2003), Georgia (in 2005), and South Carolina (in 2005), enacted legislation that changed the malpractice standard for emergency care to gross negligence. We investigated whether these substantial reforms changed practice. Using a 5% random sample of Medicare fee-for-service beneficiaries, we identified all emergency department visits to hospitals in the three reform states and in neighboring (control) states from 1997 through 2011. Using a quasi-experimental design, we compared patient-level outcomes, before and after legislation, in reform states and control states. We controlled for characteristics of the patients, time-invariant hospital characteristics, and temporal trends. Outcomes were policy-attributable changes in the use of computed tomography (CT) or magnetic resonance imaging (MRI), per-visit emergency department charges, and the rate of hospital admissions. For eight of the nine state-outcome combinations tested, no policy-attributable reduction in the intensity of care was detected. We found no reduction in the rates of CT or MRI utilization or hospital admission in any of the three reform states and no reduction in charges in Texas or South Carolina. In Georgia, reform was associated with a 3.6% reduction (95% confidence interval, 0.9 to 6.2) in per-visit emergency department charges. Legislation that substantially changed the malpractice standard for emergency physicians in three states had little effect on the intensity of practice, as measured by imaging rates, average charges, or hospital admission rates. (Funded by the Veterans Affairs Office of Academic Affiliations and others.).

A Review of Current and Emerging Approaches to Pain Management in the Emergency Department.

PubMed

Todd, Knox H

2017-12-01

Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches. For some of these therapies, sparse evidence exists to support their efficacy for emergency department use. The purpose of this paper is to review historical trends and emerging approaches to emergency department analgesia, with a particular focus on the USA and Canada. We conducted a qualitative review of past and current descriptive studies of emergency department pain practice, as well as clinical trials of emerging pain treatment modalities. The review considers the increasing use of non-opioid and multimodal analgesic therapies, including migraine therapies, regional anesthesia, subdissociative-dose ketamine, nitrous oxide, intravenous lidocaine and gabapentinoids, as well as broad programmatic initiatives promoting the use of non-opioid analgesics and nonpharmacologic interventions. While migraine therapies, regional anesthesia, nitrous oxide and subdissociative-dose ketamine are supported by a relatively robust evidence base, data supporting the emergency department use of intravenous lidocaine, gabapentinoids and various non-pharmacologic analgesic interventions remain sparse. Additional research on the relative safety and efficacy of non-opioid approaches to emergency department analgesia is needed. Despite a limited research base, it is likely that non-opioid analgesic modalities will be employed with increasing frequency. A new generation of emergency

Identifying a need for more focused treatment of chlamydia and gonorrhoea in the emergency department.

PubMed

Wilson, Sean P; Knych, McKenna; Iordanova, Rossitza; Mahan, Meredith; Vohra, Taher

2016-10-01

The indolent nature of chlamydia and gonorrhoea, along with the time delay associated with current diagnostic testing, makes definitive diagnosis while in the emergency department impossible. We therefore sought to determine the proportion of patients who receive accurate, presumptive antimicrobial treatment for these infections. A retrospective chart review was performed on all patient encounters that underwent chlamydia and gonorrhoea testing at an urban emergency department during a single month in 2012. Each encounter was reviewed for nucleic acid amplification test results and whether presumptive antibiotics were given during the initial visit. A total of 639 patient encounters were reviewed; 87.2% were female and the mean age was 26.7 years. Chlamydia was present in 11.1%, with women and men having similar infection rates: 10.6% vs. 14.6% (p = 0.277). Gonorrhoea was present in 5.0%, with a lower prevalence among women than men: 3.2% vs. 17.1% (p < 0.001). Women received presumptive treatment less often than men: 37.7% vs. 82.9% (p < 0.001). Presumptive treatment was less accurate in women than men: 7.9% vs. 25.6% (p < 0.001). After combining genders, 10.2% received accurate presumptive treatment; 33.3% were overtreated and 4.4% missed treatment. Presumptive treatment for chlamydia and gonorrhoea was more frequent and more accurate in men than in women. Overall, one-third of patients received unnecessary antibiotics, yet nearly 5% missed treatment. Better methods are needed for identifying patients who need treatment. © The Author(s) 2016.

[Severe infection in critical emergency care].

PubMed

Matsuda, Naoyuki; Takatani, Yudai; Higashi, Tomoko; Inaba, Masato; Ejima, Tadashi

2016-02-01

In the emergency and critical care medicine, infection is easy to merge to various basic conditions and diseases. In the social structure aging in critical care, the immune weakness was revealed as the result of severe infection and septic shock in the reduced function of neutrophils and lymphocytes. In the life-saving emergency care, cardiovascular diseases, diabetes, chronic renal failure and lever dysfunction are often observed, and the underlying diseases have the foundation of biological invasion after a first inflammatory attack of surgery, trauma, burn, and systemic injury. It will be placed into a susceptible situation such as artificial respiratory management. In this review, we discussed severe infection in emergency and critical care. It is necessary to pay attention to the drug resistance bacterias in own critical care setting by trends.

Nanotechnology patenting trends through an environmental lens: analysis of materials and applications

NASA Astrophysics Data System (ADS)

Leitch, Megan E.; Casman, Elizabeth; Lowry, Gregory V.

2012-12-01

Many international groups study environmental health and safety (EHS) concerns surrounding the use of engineered nanomaterials (ENMs). These researchers frequently use the "Project on Emerging Nanotechnologies" (PEN) inventory of nano-enabled consumer products to prioritize types of ENMs to study because estimates of life-cycle ENM releases to the environment can be extrapolated from the database. An alternative "snapshot" of nanomaterials likely to enter commerce can be determined from the patent literature. The goal of this research was to provide an overview of nanotechnology intellectual property trends, complementary to the PEN consumer product database, to help identify potentially "risky" nanomaterials for study by the nano-EHS community. Ten years of nanotechnology patents were examined to determine the types of nano-functional materials being patented, the chemical compositions of the ENMs, and the products in which they are likely to appear. Patenting trends indicated different distributions of nano-enabled products and materials compared to the PEN database. Recent nanotechnology patenting is dominated by electrical and information technology applications rather than the hygienic and anti-fouling applications shown by PEN. There is an increasing emphasis on patenting of nano-scale layers, coatings, and other surface modifications rather than traditional nanoparticles, and there is widespread use of nano-functional semiconductor, ceramic, magnetic, and biological materials that are currently less studied by EHS professionals. These commonly patented products and the nano-functional materials they contain may warrant life-cycle evaluations to determine the potential for environmental exposure and toxicity. The patent and consumer product lists contribute different and complementary insights into the emerging nanotechnology industry and its potential for introducing nanomaterials into the environment.

Emerging Trends in the Sea State of the Beaufort and Chukchi Seas

DTIC Science & Technology

2016-07-06

Beaufort and Chukchi seas is controlled by the wind forcing and the amount of ice-free water available to generate surface waves. Clear trends in...the annual duration of the open water season and in the extent of the seasonal sea ice minimum suggest that the sea state should be increasing...In particular, larger waves are more common in years with less summer sea ice and/or a longer open water season, and peak wave periods are generally

Needs and emerging trends of remote sensing

NASA Astrophysics Data System (ADS)

McNair, Michael

2014-06-01

From the earliest need to be able to see an enemy over a hill to sending semi-autonomous platforms with advanced sensor packages out into space, humans have wanted to know more about what is around them. Issues of distance are being minimized through advances in technology to the point where remote control of a sensor is useful but sensing by way of a non-collocated sensor is better. We are not content to just sense what is physically nearby. However, it is not always practical or possible to move sensors to an area of interest; we must be able to sense at a distance. This requires not only new technologies but new approaches; our need to sense at a distance is ever changing with newer challenges. As a result, remote sensing is not limited to relocating a sensor but is expanded into possibly deducing or inferring from available information. Sensing at a distance is the heart of remote sensing. Much of the sensing technology today is focused on analysis of electromagnetic radiation and sound. While these are important and the most mature areas of sensing, this paper seeks to identify future sensing possibilities by looking beyond light and sound. By drawing a parallel to the five human senses, we can then identify the existing and some of the future possibilities. A further narrowing of the field of sensing causes us to look specifically at robotic sensing. It is here that this paper will be directed.

Enhanced Component Performance Study: Emergency Diesel Generators 1998–2014

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

Schroeder, John Alton

2015-11-01

This report presents an enhanced performance evaluation of emergency diesel generators (EDGs) at U.S. commercial nuclear power plants. This report evaluates component performance over time using (1) Institute of Nuclear Power Operations (INPO) Consolidated Events Database (ICES) data from 1998 through 2014 and (2) maintenance unavailability (UA) performance data from Mitigating Systems Performance Index (MSPI) Basis Document data from 2002 through 2014. The objective is to show estimates of current failure probabilities and rates related to EDGs, trend these data on an annual basis, determine if the current data are consistent with the probability distributions currently recommended for use inmore » NRC probabilistic risk assessments, show how the reliability data differ for different EDG manufacturers and for EDGs with different ratings; and summarize the subcomponents, causes, detection methods, and recovery associated with each EDG failure mode. Engineering analyses were performed with respect to time period and failure mode without regard to the actual number of EDGs at each plant. The factors analyzed are: sub-component, failure cause, detection method, recovery, manufacturer, and EDG rating. Six trends with varying degrees of statistical significance were identified in the data.« less

Identifying emerging trends for implementing learning technology in special education: a state-of-the-art review of selected articles published in 2008-2012.

PubMed

Liu, Gi-Zen; Wu, No-Wei; Chen, Yi-Wen

2013-10-01

As electronic learning (e-learning) becomes increasingly popular in education worldwide, learning technology (LT) has been applied in various learning environments and activities to promote meaningful, efficient, and effective learning. LT has also been adopted by researchers and teacher-practitioners in the field of special education, but as yet little review-based research has been published. This review research thus carefully examined the trends of LT implementations in special education, providing a comprehensive analysis of 26 studies published in indexed journals in the past five years (2008-2012). Two research questions were addressed: (a) What are the major research aims, methodologies, and outcomes in these studies of implementing LT in the field of special education? and (b) What types of LT are mainly used with special education students, and for what kinds of students? Major findings include that examining the learning effectiveness of LT using was the most common research purpose (75%); researchers primarily relied on experimental studies (46%, 12 studies), followed by interviews and questionnaires (19%, 5 studies). Moreover, the most common use of LT was computer-assisted technology (such as web-based mentoring, educational computer games, laptop computers) in special education; studies investigating the use of LT with mentally disabled students were more than those with physically disabled ones. It is expected that the findings of this work and their implications will serve as valuable references with regard to the use of LT with special education students. Copyright © 2013 Elsevier Ltd. All rights reserved.

Health transitions in sub-Saharan Africa: overview of mortality trends in children under 5 years old (1950-2000).

PubMed Central

Garenne, Michel; Gakusi, Enéas

2006-01-01

OBJECTIVE: To reconstruct and analyse mortality trends in children younger than 5 years in sub-Saharan Africa between 1950 and 2000. METHODS: We selected 66 Demographic and Health Surveys and World Fertility Surveys from 32 African countries for analysis. Death rates were calculated by yearly periods for each survey. When several surveys were available for the same country, overlapping years were combined. Country-specific time series were analysed to identify periods of monotonic trends, whether declining, steady or increasing. We tested changes in trends using a linear logistic model. FINDINGS: A quarter of the countries studied had monotonic declining mortality trends: i.e. a smooth health transition. Another quarter had long-term declines with some minor rises over short periods of time. Eight countries had periods of major increases in mortality due to political or economic crises, and in seven countries mortality stopped declining for several years. In eight other countries mortality has risen in recent years as a result of paediatric AIDS. Reconstructed levels and trends were compared with other estimates made by international organizations, usually based on indirect methods. CONCLUSION: Overall, major progress in child survival was achieved in sub-Saharan Africa during the second half of the twentieth century. However, transition has occurred more slowly than expected, with an average decline of 1.8% per year. Additionally, transition was chaotic in many countries. The main causes of mortality increase were political instability, serious economic downturns, and emerging diseases. PMID:16799731

Day Service Provision for People with Intellectual Disabilities: A Case Study Mapping 15-Year Trends in Ireland

ERIC Educational Resources Information Center

Fleming, Padraic; McGilloway, Sinead; Barry, Sarah

2017-01-01

Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…

On the Emergence of New Computer Technologies

ERIC Educational Resources Information Center

Asaolu, Olumuyiwa Sunday

2006-01-01

This work presents a review of the development and application of computers. It traces the highlights of emergent computing technologies shaping our world. Recent trends in hardware and software deployment are chronicled as well as their impact on various segments of the society. The expectations for the future are also discussed along with…

Mega trends in business create mega changes for training and education

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

Shealy, R.E.; Moore, N.E.

1996-12-31

Four mega-trends for business organizations are clearly emerging: globalization, computerization, information economy, and management. These mega-trends will have a profound impact on the human resources of business organizations, particularly related to new skill requirements that will be more complex, more in-depth, and broader in scope. New skill requirements, coupled with new technological advances in the delivery of employee development programs, will have significant ramifications for internal training departments and educational institutions. This paper explores the ramifications for those involved in the training and education of employees in business organizations.

Surveillance of vector-borne diseases in Germany: trends and challenges in the view of disease emergence and climate change.

PubMed

Jansen, Andreas; Frank, Christina; Koch, Judith; Stark, Klaus

2008-12-01

The changing epidemiology of vector-borne diseases represents a growing threat to human health. Contemporary surveillance systems have to adapt to these changes. We describe temporal trends and geographic origins of vector-borne diseases in Germany with regard to strengths of existing disease surveillance and to areas marked for improvement. We focused on hantavirus infection (endemic in Germany), chikungunya fever (recently emerging in Europe) and dengue fever (imported from tropical regions), representing important subgroups of vector-borne infections. Routine surveillance data on demographics, origin of infection and the date of reporting were analysed. From 2001 through 2007, 3,005 symptomatic hantavirus infections, and 85 cases of chikungunya fever were reported, similarly 1,048 cases of dengue fever in 2002 through 2007. The geographic origin of hantavirus infection was reported for 95.5% of all cases (dengue virus, 98.4%; chikungunya virus, 100%). Hantavirus infections were acquired in Germany in 97.6% of cases (n = 2800). In 2007, there was a marked increase of hantavirus cases, mainly in areas known to be endemic for hantavirus. In 2006, imported cases of chikungunya fever primarily returned from several islands of the Indian Ocean, while the majority of imported cases in 2007 came from India. The reported number of dengue fever cases have increased since 2004. Thailand contributed the largest proportion of cases (17-43% in individual years), followed by India, Brazil and Indonesia. Surveillance of notifiable vector-borne diseases in Germany is able to timely detect spatial and temporal changes of autochthonous an imported infections. Geographic and temporal data obtained by routine surveillance served as a basis for public health recommendations. In addition to surveillance of vector-borne infections in humans, nationwide monitoring programs and inventory techniques for emerging and reemerging vectors and for wildlife disease are warranted.

Emerging Patterns for Engineered Nanomaterials in the Environment: A Review of Fate and Toxicity Studies

NASA Astrophysics Data System (ADS)

Garner, K.; Keller, A. A.

2014-12-01

The technical complexity of measuring ENM fate and transport processes in all environments necessitates identifying trends in these same processes. As part of our research, we collected emerging information on the environmental fate and toxicity of many ENMs and investigated transportation and transformation processes in air, water, and soil. Generally, studies suggest that (i) ENMs will have limited transport in the atmosphere, because they settle rapidly; (ii) ENMs are more stable in freshwater and stormwater than in seawater or groundwater primarily due to variations in ionic strength and the presence of natural organic matter; and (iii) in soil, the fate of ENMs strongly depends on the size of the ENM aggregates and groundwater chemistry, as well as pore and soil particle size. Emerging patterns regarding ENM fate, transport, and exposure combined with emerging information on toxicity indicate the risk is low for most ENMs although current exposure estimates compared with current data on toxicity indicate that at current production and release levels, exposure to Ag, nZVI, and ZnO may cause a toxic response to freshwater and marine species.

TRENDS: The aeronautical post-test database management system

NASA Technical Reports Server (NTRS)

Bjorkman, W. S.; Bondi, M. J.

1990-01-01

TRENDS, an engineering-test database operating system developed by NASA to support rotorcraft flight tests, is described. Capabilities and characteristics of the system are presented, with examples of its use in recalling and analyzing rotorcraft flight-test data from a TRENDS database. The importance of system user-friendliness in gaining users' acceptance is stressed, as is the importance of integrating supporting narrative data with numerical data in engineering-test databases. Considerations relevant to the creation and maintenance of flight-test database are discussed and TRENDS' solutions to database management problems are described. Requirements, constraints, and other considerations which led to the system's configuration are discussed and some of the lessons learned during TRENDS' development are presented. Potential applications of TRENDS to a wide range of aeronautical and other engineering tests are identified.

Water quality status and trends in the United States

USGS Publications Warehouse

Larsen, Matthew C.; Hamilton, Pixie A.; Werkheiser, William H.; Ahuja, Satinder

2013-01-01

Information about water quality is vital to ensure long-term availability and sustainability of water that is safe for drinking and recreation and suitable for industry, irrigation, fish, and wildlife. Protecting and enhancing water quality is a national priority, requiring information on water-quality status and trends, progress toward clean water standards, continuing problems, and emerging challenges. In this brief review, we discuss U.S. Geological Survey assessments of nutrient pollution, pesticides, mixtures of organic wastewater compounds (known as emerging contaminants), sediment-bound contaminants (like lead and DDT), and mercury, among other contaminants. Additionally, aspects of land use and current and emerging challenges associated with climate change are presented. Climate change must be considered, as water managers continue their efforts to maintain sufficient water of good quality for humans and for the ecosystem.

Trends in prevalence of multi drug resistant tuberculosis in sub-Saharan Africa: A systematic review and meta-analysis

PubMed Central

Adamu, Aishatu L.; Galadanci, Najibah A.; Zubayr, Bashir; Odoh, Chisom N.; Aliyu, Muktar H.

2017-01-01

Background Multidrug resistant tuberculosis (MDR-TB), is an emerging public health problem in sub-Saharan Africa (SSA). This study aims to determine the trends in prevalence of MDR-TB among new TB cases in sub-Saharan Africa over two decades. Methods We searched electronic data bases and accessed all prevalence studies of MDR-TB within SSA between 2007 and 2017. We determined pooled prevalence estimates using random effects models and determined trends using meta-regression. Results Results: We identified 915 studies satisfying inclusion criteria. Cumulatively, studies reported on MDR-TB culture of 34,652 persons. The pooled prevalence of MDR-TB in new cases was 2.1% (95% CI; 1.7–2.5%). There was a non-significant decline in prevalence by 0.12% per year. Conclusion We found a low prevalence estimate of MDR-TB, and a slight temporal decline over the study period. There is a need for continuous MDR-TB surveillance among patients with TB. PMID:28945771

A Novel Tool for Assessment of Emergency Medicine Resident Skill in Determining Diagnosis and Management for Emergent Electrocardiograms: A Multicenter Study.

PubMed

Hartman, Nicholas D; Wheaton, Natasha B; Williamson, Kelly; Quattromani, Erin N; Branzetti, Jeremy B; Aldeen, Amer Z

2016-12-01

Reading emergent electrocardiograms (ECGs) is one of the emergency physician's most crucial tasks, yet no well-validated tool exists to measure resident competence in this skill. To assess validity of a novel tool measuring emergency medicine resident competency for interpreting, and responding to, critical ECGs. In addition, we aim to observe trends in this skill for resident physicians at different levels of training. This is a multi-center, prospective study of postgraduate year (PGY) 1-4 residents at five emergency medicine (EM) residency programs in the United States. An assessment tool was created that asks the physician to identify either the ECG diagnosis or the best immediate management. One hundred thirteen EM residents from five EM residency programs submitted completed assessment surveys, including 43 PGY-1s, 33 PGY-2s, and 37 PGY-3/4s. PGY-3/4s averaged 74.6% correct (95% confidence interval [CI] 70.9-78.4) and performed significantly better than PGY-1s, who averaged 63.2% correct (95% CI 58.0-68.3). PGY-2s averaged 69.0% (95% CI 62.2-73.7). Year-to-year differences were more pronounced in management than in diagnosis. Residency training in EM seems to be associated with improved ability to interpret "critical" ECGs as measured by our assessment tool. This lends validity evidence for the tool by correlating with a previously observed association between residency training and improved ECG interpretation. Resident skill in ECG interpretation remains less than ideal. Creation of this sort of tool may allow programs to assess resident performance as well as evaluate interventions designed to improve competency. Copyright © 2016 Elsevier Inc. All rights reserved.

Modeling defect trends for iterative development

NASA Technical Reports Server (NTRS)

Powell, J. D.; Spanguolo, J. N.

2003-01-01

The Employment of Defects (EoD) approach to measuring and analyzing defects seeks to identify and capture trends and phenomena that are critical to managing software quality in the iterative software development lifecycle at JPL.

Antimicrobial resistance trends among Salmonella isolates obtained from horses in the northeastern United States (2001-2013).

PubMed

Cummings, Kevin J; Perkins, Gillian A; Khatibzadeh, Sarah M; Warnick, Lorin D; Aprea, Victor A; Altier, Craig

2016-05-01

OBJECTIVE To describe the antimicrobial resistance patterns of Salmonella isolates obtained from horses in the northeastern United States and to identify trends in resistance to select antimicrobials over time. SAMPLE 462 Salmonella isolates from horses. PROCEDURES Retrospective data were collected for all Salmonella isolates obtained from equine specimens that were submitted to the Cornell University Animal Health Diagnostic Center between January 1, 2001, and December 31, 2013. Temporal trends in the prevalence of resistant Salmonella isolates were investigated for each of 13 antimicrobials by use of the Cochran-Armitage trend test. RESULTS The prevalence of resistant isolates varied among antimicrobials and ranged from 0% (imipenem) to 51.5% (chloramphenicol). During the observation period, the prevalence of resistant isolates decreased significantly for amoxicillin-clavulanic acid, ampicillin, cefazolin, cefoxitin, ceftiofur, chloramphenicol, and tetracycline and remained negligible for amikacin and enrofloxacin. Of the 337 isolates for which the susceptibility to all 13 antimicrobials was determined, 138 (40.9%) were pansusceptible and 192 (57.0%) were multidrug resistant (resistant to ≥ 3 antimicrobial classes). The most common serovar isolated was Salmonella Newport, and although the annual prevalence of that serovar decreased significantly over time, that decrease had only a minimal effect on the observed antimicrobial resistance trends. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that current antimicrobial use in horses is not promoting the emergence and dissemination of antimicrobial-resistant Salmonella strains in the region served by the laboratory.

[Burnout syndrome in pre-hospital and hospital emergency. Cognitive study in two cohorts of nurses].

PubMed

Cicchitti, Chiara; Cannizzaro, Giorgia; Rosi, Fabrizio; Maccaroni, Roberto; Menditto, Vincenzo G

2014-01-01

Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties. The emergency department and the pre-hospital healthcare services are highly stressful environments. Little is known about the BOS in critical care nursing staff. The objective of the study is to compare the incidence of BOS and its three domains, namely, emotional exhaustion, depersonalization and reduced professional accomplishment, in two cohorts of critical care nurses: a pre-hospital and a hospital emergency service. A survey using a questionnaire (the Maslach Burnout Inventory-General Survey, MBI-GS), among nurses of two Italian emergency services has been performed: a hospital emergency service (HES, Emergency Department or "Pronto Soccorso") and a pre-hospital emergency service (PHES, territorial healthcare service or "Centrale Operativa 118"). All 60 nurses surveyed (82% female) filled the questionnaires. BOS-related symptoms have been identified in at least 50% of the nurses in the HES: 50% suffered a medium-high emotional exhaustion, 75% had a medium-high depersonalization and 92.5% had a medium-high reduced professional accomplishment. Among the PEHS nurses, BOS-related symptoms have been identified in at least 60% of the respondents: 60% had a medium-high emotional exhaustion, 70% had a medium-high depersonalization and 95% had a medium-high reduced professional accomplishment. Moreover, the likelihood that a nurse has a severe BOS, that is at least one degree of high burnout or ≥2 degrees of medium burnout, is significantly higher in the group of the PHES than in the HES (90% vs 60%, p <0.02). At least two-thirds of critical care nursing staff had a severe BOS. The incidence of BOS appeared to be similar among PHES and HES nurses with a higher trend for the former. Further interventional studies are needed to investigate the determinants of BOS among critical care nurses and the potentially preventive strategies.

Using social media for disaster emergency management

NASA Astrophysics Data System (ADS)

Wang, Y. D.; Wang, T.; Ye, X. Y.; Zhu, J. Q.; Lee, J.

2016-06-01

Social media have become a universal phenomenon in our society (Wang et al., 2012). As a new data source, social media have been widely used in knowledge discovery in fields related to health (Jackson et al., 2014), human behaviour (Lee, 2014), social influence (Hong, 2013), and market analysis (Hanna et al., 2011). In this paper, we report a case study of the 2012 Beijing Rainstorm to investigate how emergency information was timely distributed using social media during emergency events. We present a classification and location model for social media text streams during emergency events. This model classifies social media text streams based on their topical contents. Integrated with a trend analysis, we show how Sina-Weibo fluctuated during emergency events. Using a spatial statistical analysis method, we found that the distribution patterns of Sina-Weibo were related to the emergency events but varied among different topics. This study helps us to better understand emergency events so that decision-makers can act on emergencies in a timely manner. In addition, this paper presents the tools, methods, and models developed in this study that can be used to work with text streams from social media in the context of disaster management.

Trends in gel dosimetry: Preliminary bibliometric overview of active growth areas, research trends and hot topics from Gore’s 1984 paper onwards

NASA Astrophysics Data System (ADS)

Baldock, C.

2017-05-01

John Gore’s seminal 1984 paper on gel dosimetry spawned a vibrant research field ranging from fundamental science through to clinical applications. A preliminary bibliometric study was undertaken of the gel dosimetry family of publications inspired by, and resulting from, Gore’s original 1984 paper to determine active growth areas, research trends and hot topics from Gore’s paper up to and including 2016. Themes and trends of the gel dosimetry research field were bibliometrically explored by way of co-occurrence term maps using the titles and abstracts text corpora from the Web of Science database for all relevant papers from 1984 to 2016. Visualisation of similarities was used by way of the VOSviewer visualisation tool to generate cluster maps of gel dosimetry knowledge domains and the associated citation impact of topics within the domains. Heat maps were then generated to assist in the understanding of active growth areas, research trends, and emerging and hot topics in gel dosimetry.

The Trend-in-trend Research Design for Causal Inference.

PubMed

Ji, Xinyao; Small, Dylan S; Leonard, Charles E; Hennessy, Sean

2017-07-01

Cohort studies can be biased by unmeasured confounding. We propose a hybrid ecologic-epidemiologic design called the trend-in-trend design, which requires a strong time trend in exposure, but is unbiased unless there are unmeasured factors affecting outcome for which there are time trends in prevalence that are correlated with time trends in exposure across strata with different exposure trends. Thus, the conditions under which the trend-in-trend study is biased are a subset of those under which a cohort study is biased. The trend-in-trend design first divides the study population into strata based on the cumulative probability of exposure given covariates, which effectively stratifies on time trend in exposure, provided there is a trend. Next, a covariates-free maximum likelihood model estimates the odds ratio (OR) using data on exposure prevalence and outcome frequency within cumulative probability of exposure strata, across multiple periods. In simulations, the trend-in-trend design produced ORs with negligible bias in the presence of unmeasured confounding. In empiric applications, trend-in-trend reproduced the known positive association between rofecoxib and myocardial infarction (observed OR: 1.2, 95% confidence interval: 1.1, 1.4), and known null associations between rofecoxib and severe hypoglycemia (OR = 1.1 [0.92, 1.3]) and nonvertebral fracture (OR = 0.84 [0.64, 1.1]). The trend-in-trend method may be useful in settings where there is a strong time trend in exposure, such as a newly approved drug or other medical intervention. See video abstract at, http://links.lww.com/EDE/B178.

Innovation in nursing education: which trends should you adopt?

PubMed

Murray, Teri A

2007-01-01

The author identifies trends that challenge the status quo in academic nursing education. She further provides a theoretical framework that can be used by nursing program administrators to determine the potential adoptability of the trend in nursing education programs. Leader behaviors that are crucial in leading and managing change are highlighted.

Reconnecting to Spirituality: Christian-Identified Adolescents and Emerging Adult Young Men's Journey from Diagnosis of HIV to Coping.

PubMed

Smith, Sharon T; Blanchard, Jennifer; Kools, Susan; Butler, Derrick

2017-02-01

Spirituality is important to holistic health, yet little is known about its impact on young people with HIV. To address this knowledge deficit, a grounded theory study used semi-structured interviews of 20 Christian-identified adolescent and emerging adult gay males and one perinatally infected male. This study revealed that, to cope with HIV health issues, participants used a process of reconnecting with their spirituality. In order to successfully reconnect with their spirituality, study participants reported a need to re-embrace and re-engage in spiritual practices, hold onto hope, believe they are normal, and commit to beliefs and practices despite rejection from the church.

Teaching and Learning Content in the Social Studies: The ERIC/ChESS Perspective on Trends and Issues.

ERIC Educational Resources Information Center

Patrick, John J.

This paper focuses on the current trends and issues in social studies education based on the literature that passes through the ERIC Clearinghouse for Social Studies/Social Science Education (Indiana). Four trends pertaining to teaching content in history, geography, civics, and science in society have emerged from a review of the literature.…

An Analysis of the Top-cited Articles in Emergency Medicine Education Literature

PubMed Central

Munzer, Brendan W.; Love, Jeffery; Shipman, Barbara L.; Byrne, Brendan; Cico, Stephen J.; Furlong, Robert; Khandelwal, Sorabh; Santen, Sally A.

2017-01-01

Introduction Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. Methods Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms. We searched 19 EM journals for education articles as well as all other literature for EM education-related articles. Articles identified were reviewed for citation count, article type, journal, authors, and publication year. Results With regards to EM journals, the greatest number of articles were classified as articles/reviews, followed by research articles on topics such as deliberate practice (cited 266 times) and cognitive errors (cited 201 times). In contrast in the non-EM journals, research articles were predominant. Both searches found several simulation and ultrasound articles to be included. The most common EM journal was Academic Emergency Medicine (n = 18), and Academic Medicine was the most common non-EM journal (n=5). A reasonable number of articles included external funding sources (6 EM articles and 13 non-EM articles.) Conclusion This study identified the most frequently cited medical education articles in the field of EM education, published in EM journals as well as all other journals indexed in Web of Science. The results identify impactful articles to medical education, providing a resource to educators while identifying trends that may be used to guide EM educational research and publishing efforts. PMID:28116010

An Analysis of the Top-cited Articles in Emergency Medicine Education Literature.

PubMed

Munzer, Brendan W; Love, Jeffery; Shipman, Barbara L; Byrne, Brendan; Cico, Stephen J; Furlong, Robert; Khandelwal, Sorabh; Santen, Sally A

2017-01-01

Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms. We searched 19 EM journals for education articles as well as all other literature for EM education-related articles. Articles identified were reviewed for citation count, article type, journal, authors, and publication year. With regards to EM journals, the greatest number of articles were classified as articles/reviews, followed by research articles on topics such as deliberate practice (cited 266 times) and cognitive errors (cited 201 times). In contrast in the non-EM journals, research articles were predominant. Both searches found several simulation and ultrasound articles to be included. The most common EM journal was Academic Emergency Medicine (n = 18), and Academic Medicine was the most common non-EM journal (n=5). A reasonable number of articles included external funding sources (6 EM articles and 13 non-EM articles.). This study identified the most frequently cited medical education articles in the field of EM education, published in EM journals as well as all other journals indexed in Web of Science. The results identify impactful articles to medical education, providing a resource to educators while identifying trends that may be used to guide EM educational research and publishing efforts.

National Educational Technology Trends: 2010. Innovation Through State Leadership

ERIC Educational Resources Information Center

State Educational Technology Directors Association, 2010

2010-01-01

This annual report provides a national perspective on Title II-D for federal fiscal year (FY) 2008 (2008-09 school year), as well as emergent trends based on data from the past seven years. Title II-D is the only federal education program with funds explicitly targeted to support state and local effective uses of educational technology in the …

U.S. Coastal Flood Damage Reduction Projects: Federal Authorization and Investment Trends

NASA Astrophysics Data System (ADS)

Carter, N. T.

2015-12-01

The 2015 U.S. Environmental Protection Agency report Climate Change in the United States: Benefits of Global Action estimated the potential cumulative future economic impacts of storm surge and sea-level rise on U.S. coasts during this century at 5 trillion (2014 dollars) if no adaptation measures are implemented. These impacts drop to 0.8 trillion if investments are made in cost-effective adaptations and protections. Awareness of flood risk and its long-term fiscal impact historically has proven insufficient to motivate pre-disaster land use changes and investments in mitigation and protection. While many adaptations and protections fall largely under state and local authority, some stakeholders are interested in federal coastal flood protection projects, including projects by the U.S. Army Corps of Engineers. Since the 1950s, Congress has authorized the Corps to construct specific coastal projects. The broad vision, strategy, and priorities for the federal role in coastal flood damage reduction projects nonetheless remain ill-defined. This research analyzes (1) the authorization and appropriations trends for Corps coastal storm damage reduction projects, and (2) how Corps feasibility studies account for and address coastal flood hazards. Identified trends include: emergency appropriations for storm-damaged areas outstrip annual investments in coastal flood projects; the rate at which projects are congressionally approved for construction outpaces the rate at which construction is funded; and how coastal protection projects are evaluated in Corps feasibility studies shows variation and change in agency practices. These trends have consequences; they affect public and local expectations when projects begin providing protection benefits, and may influence investments in other adaptation measures. These trends also raise questions for policymakers at all levels and for scientists and practitioners interested in coastal flood resilience.

Cancer Incidence and Survival Trends by Subtype Using Data from the Surveillance Epidemiology and End Results Program, 1992-2013.

PubMed

Noone, Anne-Michelle; Cronin, Kathleen A; Altekruse, Sean F; Howlader, Nadia; Lewis, Denise R; Petkov, Valentina I; Penberthy, Lynne

2017-04-01

Background: Cancers are heterogeneous, comprising distinct tumor subtypes. Therefore, presenting the burden of cancer in the population and trends over time by these tumor subtypes is important to identify patterns and differences in the occurrence of these subtypes, especially to generalize findings to the U.S. general population. Methods: Using SEER Cancer Registry Data, we present incidence rates according to subtypes for diagnosis years (1992-2013) among men and women for five major cancer sites: breast (female only), esophagus, kidney and renal pelvis, lung and bronchus, and thyroid. We also describe estimates of 5-year relative survival according to subtypes and diagnosis year (1992-2008). We used Joinpoint models to identify years when incidence rate trends changed slope. Finally, recent 5-year age-adjusted incidence rates (2009-2013) are presented for each subtype by race and age. Results: Hormone receptor-positive and HER2-negative was the most common subtype (about 74%) of breast cancers. Adenocarcinoma made up about 69% of esophagus cases among men. Adenocarcinoma also is the most common lung subtype (43% in men and 52% in women). Ninety percent of thyroid subtypes were papillary. Distinct incidence and survival patterns emerged by these subtypes over time among men and women. Conclusions: Histologic or molecular subtype revealed different incidence and/or survival trends that are masked when cancer is considered as a single disease on the basis of anatomic site. Impact: Presenting incidence and survival trends by subtype, whenever possible, is critical to provide more detailed and meaningful data to patients, providers, and the public. Cancer Epidemiol Biomarkers Prev; 26(4); 632-41. ©2016 AACR . ©2016 American Association for Cancer Research.

Emergency Medical Service (EMS): Rotorcraft Technology Workshop

NASA Technical Reports Server (NTRS)

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

1981-01-01

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

Legislation--Impact and Trends in Nutrition Labeling: A Global Overview.

PubMed

Kasapila, William; Shaarani, Sharifudin Md

2016-01-01

The need for accurate nutrition labeling on food products has never been greater. Obesity has assumed near-epidemic levels in both industrialized and emerging nations in recent years, and governments and consumer groups around the world are looking for ways to improve the nutritional choices for their citizenry while simultaneously balancing their freedom of choice through the use of nutrition labeling. Despite increasingly aggressive efforts by government and industry organizations to raise consumer awareness, though, many consumers either do not consult nutrition labels or they are not in a position to interpret the information on these labels accurately. To gain some fresh insights into nutrition labeling practices worldwide, this paper provides a review of the relevant peer-reviewed, scholarly, and government literature to describe regulations enacted to date, evolving and future trends, and the likely impact of food product labels. In this regard, the paper highlights similarities and discrepancies that exist, identifies gaps, and gives directions for the future.

A case study in nonconformance and performance trend analysis

NASA Technical Reports Server (NTRS)

Maloy, Joseph E.; Newton, Coy P.

1990-01-01

As part of NASA's effort to develop an agency-wide approach to trend analysis, a pilot nonconformance and performance trending analysis study was conducted on the Space Shuttle auxiliary power unit (APU). The purpose of the study was to (1) demonstrate that nonconformance analysis can be used to identify repeating failures of a specific item (and the associated failure modes and causes) and (2) determine whether performance parameters could be analyzed and monitored to provide an indication of component or system degradation prior to failure. The nonconformance analysis of the APU did identify repeating component failures, which possibly could be reduced if key performance parameters were monitored and analyzed. The performance-trending analysis verified that the characteristics of hardware parameters can be effective in detecting degradation of hardware performance prior to failure.

Trends in Fetal Medicine: A 10-Year Bibliometric Analysis of Prenatal Diagnosis

PubMed Central

Dhombres, Ferdinand; Bodenreider, Olivier

2018-01-01

The objective is to automatically identify trends in Fetal Medicine over the past 10 years through a bibliometric analysis of articles published in Prenatal Diagnosis, using text mining techniques. We processed 2,423 full-text articles published in Prenatal Diagnosis between 2006 and 2015. We extracted salient terms, calculated their frequencies over time, and established evolution profiles for terms, from which we derived falling, stable, and rising trends. We identified 618 terms with a falling trend, 2,142 stable terms, and 839 terms with a rising trend. Terms with increasing frequencies include those related to statistics and medical study design. The most recent of these terms reflect the new opportunities of next- generation sequencing. Many terms related to cytogenetics exhibit a falling trend. A bibliometric analysis based on text mining effectively supports identification of trends over time. This scalable approach is complementary to analyses based on metadata or expert opinion. PMID:29295220

Accuracy in identifying patients with loss of consciousness in a police-operated emergency call centre - first step in the chain of survival.

PubMed

Bach, A; Christensen, E F

2007-07-01

The first link in the 'chain of survival' is the activation of Emergency Medical Services (EMS). In the major part of Denmark, police officers operate the alarm 1-1-2 centre, including calls for EMS. Our aim was to study the police 1-1-2 operators' accuracy in identifying calls concerning patients with loss of consciousness as a key symptom of life-threatening conditions. 'Unconsciousness' was defined as patients with a Glasgow Coma Scale (GCS) score of < 9, scored by the on-scene anaesthesiologist from the Mobile Emergency Care Unit (MECU). This study was an observational cohort study based on data from the Police 1-1-2 Database and the Aarhus County Pre-hospital Database containing data from MECU cases during 6 months in 2004-05. Two thousand, three hundred and forty-three emergency calls with MECU dispatch were identified. In 1655 cases, both 1-1-2 data and the GCS score were recorded. Two hundred and ninety-five patients were found with a GCS score of < 9 at MECU arrival, 243 of whom were reported 'unconscious' by 1-1-2, giving a sensitivity of 82%. One thousand, three hundred and sixty patients were found with a GCS score of > or = 9, 972 of whom were reported 'awake', giving a specificity of 72%. The positive predictive value (percentage of patients found with a GCS score of < 9 at MECU arrival amongst patients reported as 'unconscious') was 39%. The accuracy was moderate with room for improvement. The positive predictive value was low, indicating over-triage of MECU.

Emergency Exercise Participation and Evaluation

ERIC Educational Resources Information Center

Smith, Julie; Black, Lynette; Williams, Linda

2012-01-01

Extension is uniquely positioned to participate in emergency exercises, formally or informally, with the goal of engaging community members in emergency and disaster preparedness. With their knowledge of community needs, Extension personnel are valuable resources and can assist emergency managers in the process of identifying local risks and…

Using Chief Complaint in Addition to Diagnosis Codes to Identify Falls in the Emergency Department.

PubMed

Patterson, Brian W; Smith, Maureen A; Repplinger, Michael D; Pulia, Michael S; Svenson, James E; Kim, Michael K; Shah, Manish N

2017-09-01

To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme. Retrospective electronic record review. Academic medical center ED. Individuals aged 65 and older seen in the ED between January 1, 2013, and September 30, 2015. Two fall definitions were applied (individually and together) to the cohort: an ICD-9-based definition and a chief complaint definition. Admission rates and 30-day mortality (per encounter) were measured for each definition. Twenty-three thousand eight hundred eighty older adult visits occurred during the study period. Using the most-inclusive definition (ICD-9 code or chief complaint indicating a fall), 4,363 visits (18%) were fall related. Of these visits, 3,506 (80%) met the ICD-9 definition for a fall-related visit, and 2,664 (61%) met the chief complaint definition. Of visits meeting the chief complaint definition, 857 (19.6%) were missed when applying the ICD-9 definition alone. Encounters missed using the ICD-9 definition were less likely to lead to an admission (42.9%, 95% confidence interval (CI) = 39.7-46.3%) than those identified (54.4%, 95% CI = 52.7-56.0%). Identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls. Individuals missed according to the code-based definition were less likely to have been admitted than those who were captured. These findings call attention to the value of using chief complaint information to identify individuals who have fallen in the ED-for research, clinical care, or policy reasons. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Trends in Microfabrication Capabilities & Device Architectures.

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

Bauer, Todd; Jones, Adam; Lentine, Anthony L.

The last two decades have seen an explosion in worldwide R&D, enabling fundamentally new capabilities while at the same time changing the international technology landscape. The advent of technologies for continued miniaturization and electronics feature size reduction, and for architectural innovations, will have many technical, economic, and national security implications. It is important to anticipate possible microelectronics development directions and their implications on US national interests. This report forecasts and assesses trends and directions for several potentially disruptive microfabrication capabilities and device architectures that may emerge in the next 5-10 years.

Hydrologic and Undernourisment Trends In Food Insecurity Hotspots

NASA Astrophysics Data System (ADS)

Funk, C. C.; Mishra, V.; Davenport, F.

2011-12-01

As food prices rise, per capita harvested area diminishes and competition for limited resources mounts, the number of undernourished people has risen to more than a billion people. In this study, we target 80 potentially food insecure countries, examining hydrologic and undernourishment trends. For each country, primary cultivation areas are identified, and hydrologic variables extracted from simulations based on the Variable Infiltration Capacity model driven with the Princeton University climate data. Trends in runoff, soil moisture, precipitation, evapotranspiration, and temperature are evaluated. In addition to precipitation driven-aridity, the analysis also evaluates possible temperature-related shifts in sensible versus latent heat fluxes during energy-limited portions of the growing seasons. Changes in the timing and magnitude of streamflow are also investigated. The undernourishment trends are explored using the FAO percent under-nourished formulation, which determines the fraction of the population falling below a critical caloric threshold by using national food balance sheets (quantity) and a caloric distribution based on economic equality. Trends in quantity and equity, and their effects on undernourishment are evaluated, and vulnerability to price volatility quantified. Finally, a sub-set of countries facing both hydrologic declines and undernourishment increases are identified as food security hotspots.

Global and Regional Trends of Aerosol Optical Depth over Land and Ocean Using SeaWiFS Measurements from 1997 to 2010

NASA Technical Reports Server (NTRS)

Hsu, N. C.; Gautam, R.; Sayer, A. M.; Bettenhausen, C.; Li, C.; Jeong, M. J.; Tsay, S. C.; Holben, B. N.

2012-01-01

Both sensor calibration and satellite retrieval algorithm play an important role in the ability to determine accurately long-term trends from satellite data. Owing to the unprecedented accuracy and long-term stability of its radiometric calibration, the SeaWiFS measurements exhibit minimal uncertainty with respect to sensor calibration. In this study, we take advantage of this well-calibrated set of measurements by applying a newly-developed aerosol optical depth (AOD) retrieval algorithm over land and ocean to investigate the distribution of AOD, and to identify emerging patterns and trends in global and regional aerosol loading during its 13-year mission. Our results indicate that the averaged AOD trend over global ocean is weakly positive from 1998 to 2010 and comparable to that observed by MODIS but opposite in sign to that observed by AVHRR during overlapping years. On a smaller scale, different trends are found for different regions. For example, large upward trends are found over the Arabian Peninsula that indicate a strengthening of the seasonal cycle of dust emission and transport processes over the whole region as well as over downwind oceanic regions. In contrast, a negative-neutral tendency is observed over the desert/arid Saharan region as well as in the associated dust outflow over the north Atlantic. Additionally, we found decreasing trends over the eastern US and Europe, and increasing trends over countries such as China and India that are experiencing rapid economic development. In general, these results are consistent with those derived from ground-based AERONET measurements.

Monitoring of non-cigarette tobacco use using Google Trends.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Lowery, Ashley; Grucza, Richard A; Chaloupka, Frank J; Bierut, Laura Jean

2015-05-01

Google Trends is an innovative monitoring system with unique potential to monitor and predict important phenomena that may be occurring at a population level. We sought to validate whether Google Trends can additionally detect regional trends in youth and adult tobacco use. We compared 2011 Google Trends relative search volume data for cigars, cigarillos, little cigars and smokeless tobacco with state prevalence of youth (grades 9-12) and adult (age 18 and older) use of these products using data from the 2011 United States state-level Youth Risk Behaviors Surveillance System and the 2010-2011 United States National Survey on Drug Use and Health (NSDUH), respectively. We used the Pearson correlation coefficient to measure the associations. We found significant positive correlations between state Google Trends cigar relative search volume and prevalence of cigar use among youth (r=0.39, R(2) = 0.154, p=0.018) and adults (r=0.49, R(2) = 0.243, p<0.001). Similarly, we found that the correlations between state Google Trends smokeless tobacco relative search volume and prevalence of smokeless tobacco use among youth and adults were both positive and significant (r=0.46, R(2) = 0.209, p=0.003 and r=0.48, R(2) = 0.226, p<0.001, respectively). The results of this study validate that Google Trends has the potential to be a valuable monitoring tool for tobacco use. The near real-time monitoring features of Google Trends may complement traditional surveillance methods and lead to faster and more convenient monitoring of emerging trends in tobacco use. 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.

Current economic trends in equine practice.

PubMed

Clark, Andrew R

2009-12-01

Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions.

Identifying inaccuracies on emergency medicine residency applications

PubMed Central

Katz, Eric D; Shockley, Lee; Kass, Lawrence; Howes, David; Tupesis, Janis P; Weaver, Christopher; Sayan, Osman R; Hogan, Victoria; Begue, Jason; Vrocher, Diamond; Frazer, Jackie; Evans, Timothy; Hern, Gene; Riviello, Ralph; Rivera, Antonio; Kinoshita, Keith; Ferguson, Edward

2005-01-01

Background Previous trials have showed a 10–30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. Methods This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans and the NRMP. Results Nine residencies reviewed 493 applications (28.6% of all applicants who applied to any EM program). 56 applications (11.4%, 95%CI 8.6–14.2%) contained at least one error. Excluding "benign" errors, 9.8% (95% CI 7.2–12.4%), contained at least one error. 41% (95% CI 35.0–47.0%) of all publications contained an error. All AOA membership claims were verified, but 13.7% (95%CI 4.4–23.1%) of claimed advanced degrees were inaccurate. Inter-rater reliability of evaluations was good. Investigators were reluctant to notify applicants' dean's offices and the NRMP. Conclusion This is the largest study to date of accuracy on application for residency and the first such multi-centered trial. High rates of incorrect data were found on applications. This data will serve as a baseline for future years of the project, with emphasis on reporting inaccuracies and warning applicants of the project's goals. PMID:16105178

[Emerging infectious agents].

PubMed

Chidiac, C; Ferry, T

2016-11-01

Emergence of many emerging or re-emerging infectious diseases have occurred over the past decade, some of which are major public threat. SARS, MERS-CoV, highly pathogenic avian influenza A(H5N1), Ebola virus disease have raised concerns because of their virulence, their mortality, and/or their modality of transmission, or their impact on maternofoetal transmission (Zika virus). The witness of these emergences have conducted health authorities to have policies and plans and to imagine new organizations for health systems in order to identify any case of highly communicable virulent disease for immediate isolation, and adequate management. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Pluripotent stem cells for cardiac regeneration: Overview of recent advances & emerging trends

PubMed Central

Pawani, Harsha; Bhartiya, Deepa

2013-01-01

Cell based regenerative therapy has emerged as one of the most promising options of treatment for patients suffering from heart failure. Various adult stem cells types have undergone extensive clinical trials with limited success which is believed to be more of a cytokine effect rather than cell therapy. Pluripotent human embryonic stem cells (hESCs) have emerged as an attractive candidate stem cell source for obtaining cardiomyocytes (CMs) because of their tremendous capacity for expansion and unquestioned potential to differentiate into CMs. Studies carried out in animal models indicate that ES-derived CMs can partially remuscularize infarcted hearts and improve contractile function; however, the effect was not sustained over long follow up periods due to their limited capacity of cell division in vivo. Thus, the concept of transplanting multipotent cardiovascular progenitors derived from ES cells has emerged since the progenitors retain robust proliferative ability and multipotent nature enabling repopulation of other myocardial elements also in addition to CMs. Transplantation of CMs (progenitors) seeded in biodegradable scaffold and gel based engineered constructs has met with modest success due to issues like cell penetration, nutrient and oxygen availability and inflammation triggered during scaffold degradation inversely affecting the seeded cells. Recently cell sheet based tissue engineering involving culturing cells on ‘intelligent’ polymers has been evolved. Generation of a 3-D pulsatile myocardial tissue has been achieved. However, these advances have to be looked at with cautious optimism as many challenges need to be overcome before using these in clinical practice. PMID:23563370

Emerging trends in evolving networks: Recent behaviour dominant and non-dominant model

NASA Astrophysics Data System (ADS)

Abbas, Khushnood; Shang, Mingsheng; Luo, Xin; Abbasi, Alireza

2017-10-01

Novel phenomenon receives similar attention as popular one. Therefore predicting novelty is as important as popularity. Emergence is the side effect of competition and ageing in evolving systems. Recent behaviour or recent link gain in networks plays an important role in emergence. We exploited this wisdom and came up with two models considering different scenarios and systems. Where recent behaviour dominates over total behaviour (total link gain) in the first one, and recent behaviour is as important as total behaviour for future link gain in the second one. It supposes that random walker walks on a network and can jump to any node, the probability of jumping or making a connection to other node is based on which node is recently more active or receiving more links. In our assumption, the random walker can also jump to the node which is already popular but recently not popular. We are able to predict emerging nodes which are generally suppressed under preferential attachment effect. To show the performance of our model we have conducted experiments on four real data sets namely, MovieLens, Netflix, Facebook and Arxiv High Energy Physics paper citation. For testing our model we used four information retrieval indices namely Precision, Novelty, Area Under Receiving Operating Characteristic (AUC) and Kendal's rank correlation coefficient. We have used four benchmark models for validating our proposed models. Although our model does not perform better in all the cases but, it has theoretical significance in working better for recent behaviour dominated systems.

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

PubMed

Boyd, Douglas D; Macchiarella, Nickolas D

2016-01-01

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

Emerging technologies and web accessibility: research challenges and opportunities focussing on vision issues.

PubMed

Harper, Simon; Yesilada, Yeliz

2012-01-01

This is a technological review paper focussed on identifying both the research challenges and opportunities for further investigation arising from emerging technologies, and it does not aim to propose any recommendation or standard. It is focussed on blind and partially sighted World Wide Web (Web) users along with others who use assistive technologies. The Web is a fast moving interdisciplinary domain in which new technologies, techniques and research is in perpetual development. It is often difficult to maintain a holistic view of new developments within the multiple domains which together make up the Web. This suggests that knowledge of the current developments and predictions of future developments are additionally important for the accessibility community. Web accessibility has previously been characterised by the correction of our past mistakes to make the current Web fulfil the original vision of access for all. New technologies were not designed with accessibility in mind and technologies that could be useful for addressing accessibility issues were not identified or adopted by the accessibility community. We wish to enable the research community to undertake preventative measures and proactively address challenges, while recognising opportunities, before they become unpreventable or require retrospective technological enhancement. This article then reviews emerging trends within the Web and Web Accessibility domains.

The IAEA stopping power database, following the trends in stopping power of ions in matter

NASA Astrophysics Data System (ADS)

Montanari, C. C.; Dimitriou, P.

2017-10-01

The aim of this work is to present an overview of the state of art of the energy loss of ions in matter, based on the new developments in the stopping power database of the International Atomic Energy Agency (IAEA). This exhaustive collection of experimental data, graphs, programs and comparisons, is the legacy of Helmut Paul, who made it accessible to the global scientific community, and has been extensively employed in theoretical and experimental research during the last 25 years. The field of stopping power in matter is evolving, with new trends in materials of interest, including oxides, nitrides, polymers, and biological targets. Our goal is to identify areas of interest and emerging data needs to meet the requirements of a continuously developing user community.

[Management of attention to emergency rooms and the federal role].

PubMed

O'Dwyer, Gisele

2010-08-01

Attention to the emergency care has been criticized, and since 2002 the Brazilian State has assumed the efforts to standardize the level of attention. It was proposed the analysis of documents and acts based on the Structuration Theory that considers the mobilization of allocative and authoritarian resources as dimensions of structure in interaction, which would justify the legitimacy exercised since the establishment of regulations. The National Emergency Plan (PNAU) had as guides: the federal funding, regionalization, professional education, management by urgency committees, and the expansion of the network. It was identified the density of the documental proposals as the facilitator trend of the structural resource, innovative due to the regionalization and responsibilization proposals presented by the several actors and by the alleged centrality of the user. The financing of SUS, despite its persistent state of embarrassment, had no coercive action on the technology investment. Under the current administration there was a vigorous expansion and structuring of the network, which was made by a strong inflow of federal funds. The management by committees should be investigated and points out how fragile the management of labor is.

Future Mission Trends and their Implications for the Deep Space Network

NASA Technical Reports Server (NTRS)

Abraham, Douglas S.

2006-01-01

Planning for the upgrade and/or replacement of Deep Space Network (DSN) assets that typically operate for forty or more years necessitates understanding potential customer needs as far into the future as possible. This paper describes the methodology Deep Space Network (DSN) planners use to develop this understanding, some key future mission trends that have emerged from application of this methodology, and the implications of the trends for the DSN's future evolution. For NASA's current plans out to 2030, these trends suggest the need to accommodate: three times as many communication links, downlink rates two orders of magnitude greater than today's, uplink rates some four orders of magnitude greater, and end-to-end link difficulties two-to-three orders of magnitude greater. To meet these challenges, both DSN capacity and capability will need to increase.

Current Trends in Retirement: Implications for Career Counseling and Vocational Psychology

PubMed Central

Lytle, Megan C.; Clancy, Megan E.; Foley, Pamela F.; Cotter, Elizabeth W.

2015-01-01

This paper provides an overview of emerging trends in retirement, examines demographic trends in the labor force, and provides practical recommendations for working with older workers across cultures (e.g., women and racial/ethnic minorities, among others). Increasingly, older workers in the United States remain in the workforce for reasons related to financial security, healthcare, and personal fulfillment. Although retirement trends have become more complex, there is limited empirical literature addressing this issue and the research available does not attend to the needs of a diverse workforce. Therefore, implications for training, practice, advocacy, and research with regards to working with older workers across cultures (e.g., women and racial/ethnic minorities, among others) are provided. Keywords: Cross-cultural/multicultural career issues, career development stages, elderly employees, career/vocational education/guidance PMID:26034345

Crisis Resources for Emergency Workers (CREW II): results of a pilot study and simulation-based crisis resource management course for emergency medicine residents.

PubMed

Hicks, Christopher M; Kiss, Alex; Bandiera, Glen W; Denny, Christopher J

2012-11-01

Emergency department resuscitation requires the coordinated efforts of an interdisciplinary team. Aviation-based crisis resource management (CRM) training can improve safety and performance during complex events. We describe the development, piloting, and multilevel evaluation of "Crisis Resources for Emergency Workers" (CREW), a simulation-based CRM curriculum for emergency medicine (EM) residents. Curriculum development was informed by an a priori needs assessment survey. We constructed a 1-day course using simulated resuscitation scenarios paired with focused debriefing sessions. Attitudinal shifts regarding team behaviours were assessed using the Human Factors Attitude Survey (HFAS). A subset of 10 residents participated in standardized pre- and postcourse simulated resuscitation scenarios to quantify the effect of CREW training on our primary outcome of CRM performance. Pre/post scenarios were videotaped and scored by two blinded reviewers using a validated behavioural rating scale, the Ottawa CRM Global Rating Scale (GRS). Postcourse survey responses were highly favourable, with the majority of participants reporting that CREW training can reduce errors and improve patient safety. There was a nonsignificant trend toward improved team-based attitudes as assessed by the HFAS (p  =  0.210). Postcourse performance demonstrated a similar trend toward improved scores in all categories on the Ottawa GRS (p  =  0.16). EM residents find simulation-based CRM instruction to be useful, effective, and highly relevant to their practice. Trends toward improved performance and attitudes may have arisen because our study was underpowered to detect a difference. Future efforts should focus on interdisciplinary training and recruiting a larger sample size.

Upper ocean O2 trends: 1958-2015

NASA Astrophysics Data System (ADS)

Ito, Takamitsu; Minobe, Shoshiro; Long, Matthew C.; Deutsch, Curtis

2017-05-01

Historic observations of dissolved oxygen (O2) in the ocean are analyzed to quantify multidecadal trends and variability from 1958 to 2015. Additional quality control is applied, and the resultant oxygen anomaly field is used to quantify upper ocean O2 trends at global and hemispheric scales. A widespread negative O2 trend is beginning to emerge from the envelope of interannual variability. Ocean reanalysis data are used to evaluate relationships with changes in ocean heat content (OHC) and oxygen solubility (O2,sat). Global O2 decline is evident after the 1980s, accompanied by an increase in global OHC. The global upper ocean O2 inventory (0-1000 m) changed at the rate of -243 ± 124 T mol O2 per decade. Further, the O2 inventory is negatively correlated with the OHC (r = -0.86; 0-1000 m) and the regression coefficient of O2 to OHC is approximately -8.2 ± 0.66 nmol O2 J-1, on the same order of magnitude as the simulated O2-heat relationship typically found in ocean climate models. Variability and trends in the observed upper ocean O2 concentration are dominated by the apparent oxygen utilization component with relatively small contributions from O2,sat. This indicates that changing ocean circulation, mixing, and/or biochemical processes, rather than the direct thermally induced solubility effects, are the primary drivers for the observed O2 changes. The spatial patterns of the multidecadal trend include regions of enhanced ocean deoxygenation including the subpolar North Pacific, eastern boundary upwelling systems, and tropical oxygen minimum zones. Further studies are warranted to understand and attribute the global O2 trends and their regional expressions.

The invisible trauma patient: emergency department discharges.

PubMed

Reilly, Patrick M; Schwab, C William; Kauder, Donald R; Dabrowski, G Paul; Gracias, Vicente; Gupta, Rajan; Pryor, John P; Braslow, Benjamin M; Kim, Patrick; Wiebe, Douglas J

2005-04-01

As the malpractice and financial environment has changed, injured patients evaluated by the trauma team and discharged from the emergency department (ED) are now commonplace. The evaluation, care, and disposition of this population has become a significant workload component but is not reported to accrediting organizations and is relatively invisible to hospital administrators. Our objective was to quantify and begin to qualify the evolving picture of the trauma ED discharge population as a work component of trauma service function in an urban, Level I trauma center with an aeromedical program. Trauma registry (contacts, mechanism, transport, injuries, and disposition) and hospital databases (ED closure, occupancy rates) were queried for a 5-year period (1999-2003). Trend analysis provided statistical comparisons for questions of interest. During the 5-year study period, the total number of trauma contacts rose by 18.1% (2,220 in 1999 vs. 2,622 in 2003; trend p < 0.05). This increase in total contacts was not a manifestation of an increase in admissions (1,672 in 1999 vs. 1,544 in 2003) but rather a reflection of a marked increase in patients seen primarily by the trauma team and discharged from the ED (473 in 1999 vs. 1,000 in 2003; trend p < 0.05). These ED discharge patients were increasingly transported by helicopter (12.3% in 1999 vs. 29.2% in 2003; trend p < 0.05) and less frequently from urban areas (57.1% in 1999 vs. 48.1% in 2003; trend p < 0.05) over the course of the study period. Average injury severity of this group increased over the study period (Injury Severity Score of 2.7 +/- 0.1 in 1999 vs. 3.3 +/- 0.1 in 2003; trend p < 0.05). ED length of stay for this group increased 19.8% over the study period (trend p < 0.05), averaging nearly 5 hours in 2003. The total number, relative percentage, and injury severity of patients evaluated by the trauma team and discharged from the ED has significantly increased over the last 5 years, representing nearly 5

Multidimensional attitudes of emergency medicine residents toward older adults.

PubMed

Hogan, Teresita M; Chan, Shu B; Hansoti, Bhakti

2014-07-01

The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score). Attitudes trended to more negative in successive post-graduate year (PGY) levels. EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels.

Epidemiology of bronchiolitis: a description of emergency department visits and hospitalizations in Puerto Rico, 2010-2014.

PubMed

Rivera-Sepulveda, Andrea; Garcia-Rivera, Enid J

2017-01-01

Little is known about the epidemiology of bronchiolitis as a clinical diagnosis and its impact on emergency department visits and hospitalizations in tropical and semitropical regions. We described the epidemiology of bronchiolitis emergency visits and hospitalizations, its temporal trend and geographic distribution in Puerto Rico between 2010 and 2014. We performed a retrospective descriptive analysis of a representative sample of privately insured children with bronchiolitis from January 2010 to December 2014. Data was provided by the largest private health insurer in Puerto Rico and identified children < 24 months of age with bronchiolitis by International Classification of Diseases, Ninth Revision code 466, 466.11, and 466.19. Chi-square and one-way ANOVA compared sex, age, diagnosis, and severity across the years. Joinpoint Poisson regression analysis evaluated the temporal trend distribution of bronchiolitis hospitalizations per calendar year. A P value less than 0.05 was statistically significant. During the study period, the annual proportion of emergency department visits and hospitalizations due to bronchiolitis increased from 3 to 5%, and 26 to 38%, respectively. The annual incidence rate of hospitalizations was 3.2 per 1000 privately insured children < 24 months. Non-RSV bronchiolitis was the most frequent diagnosis (51%). Hospitalizations occurred year-round, but increased significantly from August through December. Most children hospitalized resided in the metropolitan San Juan (35%) and surrounding urban areas. Total hospital charges decreased from $3.78 to $3.74 million, with an average cost per hospitalization of $4320.12 (11.3% increase; P  = 0.0015). This is the first study that evaluates the epidemiological characteristics of bronchiolitis in a primarily Hispanic population, living in a tropical country, and using data from a privately insured population. We found a small but significant increase in proportion of emergency visits and

Thoracotomy in the emergency department for resuscitation of the mortally injured.

PubMed

DiGiacomo, J Christopher; Angus, L D George

2017-06-01

Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room. A retrospective review of all patients at a suburban level I trauma center who underwent emergency department resuscitative thoracotomy as an adjunct to the resuscitation efforts normally delivered in the trauma receiving area over a 22 year period was performed. Survival of emergency department resuscitative thoracotomy was defined as restoration of vital signs and transport out of the trauma resuscitation area to the operating room. Sixty-eight patients were identified, of whom 27 survived the emergency department resuscitative thoracotomy and were transported to the operating room. Review of pre-hospital and initial hospital data between these potential long term survivors and those who died in the emergency department failed to demonstrate trends which were predictive of survival of emergency department resuscitative thoracotomy. The only subgroup which failed to respond to emergency department resuscitative thoracotomy was patients without signs of life at the scene who arrived to the treatment facility without signs of life. The patient population of the "potential survivor" has been expanded due to advances in critical care practices, technology, and surgical technique and every opportunity for survival should be provided at the outset. Emergency department resuscitative thoracotomy is warranted for any patient with thoracic or subdiaphragmatic trauma who presents in extremis with a history of signs of life at the scene or organized cardiac activity upon arrival

Safeguarding production agriculture and natural ecosystems against biological terrorism. A U.S. Department of Agriculture emergency response framework.

PubMed

Sequeira, R

1999-01-01

Foreign pest introductions and outbreaks represent threats to agricultural productivity and ecosystems, and, thus, to the health and national security of the United States. It is advisable to identify relevant techniques and bring all appropriate strategies to bear on the problem of controlling accidentally and intentionally introduced pest outbreaks. Recent political shifts indicate that the U.S. may be at increased risk for biological terrorism. The existing emergency-response strategies of the Animal and Plant Health Inspection Services (APHIS) will evolve to expand activities in coordination with other emergency management agencies. APHIS will evolve its information superstructure to include extensive application of simulation models for forecasting, meteorological databases and analysis, systems analysis, geographic information systems, satellite image analysis, remote sensing, and the training of specialized cadres within the emergency-response framework capable of managing the necessary information processing and analysis. Finally, the threat of key pests ranked according to perceived risk will be assessed with mathematical models and "what-if" scenarios analyzed to determine impact and mitigation practices. An infrastructure will be maintained that periodically surveys ports and inland regions for the presence of exotic pest threats and will identify trend abnormalities. This survey and monitoring effort will include cooperation from industry groups, federal and state organizations, and academic institutions.

A single-center retrospective study of pregnancy outcomes after emergency cerclage for cervical insufficiency.