Sample records for important emerging area

  1. Assessment of hospital emergency management in the Beijing area.

    PubMed

    Yantao, Xin

    2011-06-01

    In recent years, the number of public health emergencies has increased. Improving hospital emergency management is an important challenge. This is a pilot study intended to assess hospital emergency management in the Beijing area, make recommendations to government health authorities and hospital managers, and offer references for similar studies. This was an observational, cross-sectional survey. Forty-five hospitals in the Beijing area were selected randomly. A self-administered questionnaire was used as a data collection tool. It comprised of three sections: (1) Section A was the introduction; (2) Section B asked for the respondent's personal information; and (3) Section C comprised the major part of the questionnaire and was intended to gather information regarding the hospital's general emergency management situation. The survey response rate was 44%, accounting for 29% of total hospitals that the study targeted. No hospital had an established emergency management department or full-time staff for emergency management. A total of 15-45% of the hospitals had established a hospital emergency management committee, performed a vulnerability analysis, or evaluated emergency management regularly. Twenty-five percent of respondents thought that the local government health authority had established an integrated hospital incident command system. A total of 40%-55% of hospitals contracted with outside institutions for supplements, backup of key functional systems and professional support. After the occurrence of the 2003 severe acute respiratory syndrome (SARS) epidemic, Chinese hospital managers took many measures to improve hospital resilience. However, most of these efforts lacked the guidance of theories, concepts, principles, and methods. An integrated, standardized, operational hospital emergency management model has not been established. Although the survey response rate was relatively low, some clues for further study were discovered, and suggestions to the

  2. Integrating emerging areas of nursing science into PhD programs.

    PubMed

    Henly, Susan J; McCarthy, Donna O; Wyman, Jean F; Stone, Patricia W; Redeker, Nancy S; McCarthy, Ann Marie; Alt-White, Anna C; Dunbar-Jacob, Jacqueline; Titler, Marita G; Moore, Shirley M; Heitkemper, Margaret M; Conley, Yvette P

    2015-01-01

    The Council for the Advancement of Nursing Science aims to "facilitate and recognize life-long nursing science career development" as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2010 American Association of Colleges of Nursing Position Statement "The Research-Focused Doctoral Program in Nursing: Pathways to Excellence," Idea Festival Advisory Committee members focused on emerging areas of science and technology that impact the ability of research-focused doctoral programs to prepare graduates for competitive and sustained programs of nursing research using scientific advances in emerging areas of science and technology. The purpose of this article is to describe the educational and scientific contexts for the Idea Festival, which will serve as the foundation for recommendations for incorporating emerging areas of science and technology into research-focused doctoral programs in nursing. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Establishing an NP-staffed minor emergency area.

    PubMed

    Buchanan, L; Powers, R D

    1997-04-01

    Patients with problems of high acuity need fully trained emergency physicians and nurses. Some patients with nonurgent problems can be cared for within the emergency department (ED) in a lower-cost setting designed and staffed specifically for this purpose. Staffing a fast track or minor emergency area (MEA) with nurse practitioners (NPs) is one way to satisfy the ED's care needs. One site analysis of the effectiveness of NPs indicates that patients are satisfied with their care, that nurses' interpersonal skills are better than those of physicians, that technical skills are equivalent, that patient outcomes are equivalent or superior and that NPs improve access to care. A nurse practitioner-staffed minor emergency area provides high quality care for approximately 21% of this site's adult emergency department population. Patients are triaged based on set criteria, allowing for short treatment times. The physical layout, triage criteria, and the NPs' scope of practice in the level 1 trauma center's ED are detailed.

  4. Re-emerging schistosomiasis in hilly and mountainous areas of Sichuan, China.

    PubMed Central

    Liang, Song; Yang, Changhong; Zhong, Bo; Qiu, Dongchuan

    2006-01-01

    Despite great strides in schistosomiasis control over the past several decades in Sichuan Province, China the disease has re-emerged in areas where it was previously controlled. We reviewed historical records and found that schistosomiasis had re-emerged in eight counties by the end of 2004 - seven of 21 counties with transmission control and one of 25 with transmission interruption as reported in 2001 were confirmed to have local disease transmission. The average "return time" (from control to re-emergence) was about eight years. The onset of re-emergence was commonly signalled by the occurrence of acute infections. Our survey results suggest that environmental and sociopolitical factors play an important role in re-emergence. The main challenge would be to consolidate and maintain effective control in the longer term until "real" eradication is achieved. This would be possible only by the formulation of a sustainable surveillance and control system. PMID:16501732

  5. Major emerging vector-borne zoonotic diseases of public health importance in Canada

    PubMed Central

    Kulkarni, Manisha A; Berrang-Ford, Lea; Buck, Peter A; Drebot, Michael A; Lindsay, L Robbin; Ogden, Nicholas H

    2015-01-01

    In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response. PMID:26954882

  6. Major emerging vector-borne zoonotic diseases of public health importance in Canada.

    PubMed

    Kulkarni, Manisha A; Berrang-Ford, Lea; Buck, Peter A; Drebot, Michael A; Lindsay, L Robbin; Ogden, Nicholas H

    2015-06-10

    In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response.

  7. 50 CFR 17.106 - Emergency establishment of protection areas.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Simultaneously with the publication required by paragraph (b) of this section, the Director shall publish the...) Manatee Protection Areas § 17.106 Emergency establishment of protection areas. (a) The Director may... involved or the nature of a particular emergency situation, failure to publish notice in the Federal...

  8. 48 CFR 52.226-4 - Notice of Disaster or Emergency Area Set-Aside.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Emergency Area Set-Aside. 52.226-4 Section 52.226-4 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.226-4 Notice of Disaster or Emergency Area Set-Aside. As prescribed in 26.206(b), insert the following clause: Notice of Disaster or Emergency Area Set-Aside (NOV 2007) (a) Set-aside area...

  9. 48 CFR 52.226-4 - Notice of Disaster or Emergency Area Set-Aside.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Emergency Area Set-Aside. 52.226-4 Section 52.226-4 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.226-4 Notice of Disaster or Emergency Area Set-Aside. As prescribed in 26.206(b), insert the following clause: Notice of Disaster or Emergency Area Set-Aside (NOV 2007) (a) Set-aside area...

  10. 48 CFR 52.226-4 - Notice of Disaster or Emergency Area Set-Aside.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Emergency Area Set-Aside. 52.226-4 Section 52.226-4 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.226-4 Notice of Disaster or Emergency Area Set-Aside. As prescribed in 26.206(b), insert the following clause: Notice of Disaster or Emergency Area Set-Aside (NOV 2007) (a) Set-aside area...

  11. 48 CFR 52.226-4 - Notice of Disaster or Emergency Area Set-Aside.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Emergency Area Set-Aside. 52.226-4 Section 52.226-4 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.226-4 Notice of Disaster or Emergency Area Set-Aside. As prescribed in 26.206(b), insert the following clause: Notice of Disaster or Emergency Area Set-Aside (NOV 2007) (a) Set-aside area...

  12. 48 CFR 52.226-4 - Notice of Disaster or Emergency Area Set-Aside.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Emergency Area Set-Aside. 52.226-4 Section 52.226-4 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.226-4 Notice of Disaster or Emergency Area Set-Aside. As prescribed in 26.206(b), insert the following clause: Notice of Disaster or Emergency Area Set-Aside (NOV 2007) (a) Set-aside area...

  13. 50 CFR 17.106 - Emergency establishment of protection areas.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (CONTINUED) Manatee Protection Areas § 17.106 Emergency establishment of protection areas. (a) The Director may establish a manatee protection area under the provisions of paragraphs (b) and (c) of this section... one or more manatees, and that such establishment is necessary to prevent such a taking. (b) The...

  14. 50 CFR 17.106 - Emergency establishment of protection areas.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Manatee Protection Areas § 17.106 Emergency establishment of protection areas. (a) The Director may establish a manatee protection area under the provisions of paragraphs (b) and (c) of this section at any... more manatees, and that such establishment is necessary to prevent such a taking. (b) The establishment...

  15. 50 CFR 17.106 - Emergency establishment of protection areas.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (CONTINUED) Manatee Protection Areas § 17.106 Emergency establishment of protection areas. (a) The Director may establish a manatee protection area under the provisions of paragraphs (b) and (c) of this section... one or more manatees, and that such establishment is necessary to prevent such a taking. (b) The...

  16. 50 CFR 17.106 - Emergency establishment of protection areas.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Manatee Protection Areas § 17.106 Emergency establishment of protection areas. (a) The Director may establish a manatee protection area under the provisions of paragraphs (b) and (c) of this section at any... more manatees, and that such establishment is necessary to prevent such a taking. (b) The establishment...

  17. Development of urban planning guidelines for improving emergency response capacities in seismic areas of Iran.

    PubMed

    Hosseini, Kambod Amini; Jafari, Mohammad Kazem; Hosseini, Maziar; Mansouri, Babak; Hosseinioon, Solmaz

    2009-10-01

    This paper presents the results of research carried out to improve emergency response activities in earthquake-prone areas of Iran. The research concentrated on emergency response operations, emergency medical care, emergency transportation, and evacuation-the most important issues after an earthquake with regard to saving the lives of victims. For each topic, some guidelines and criteria are presented for enhancing emergency response activities, based on evaluations of experience of strong earthquakes that have occurred over the past two decades in Iran, notably Manjil (1990), Bam (2003), Firouz Abad-Kojour (2004), Zarand (2005) and Broujerd (2006). These guidelines and criteria are applicable to other national contexts, especially countries with similar seismic and social conditions as Iran. The results of this study should be incorporated into comprehensive plans to ensure sustainable development or reconstruction of cities as well as to augment the efficiency of emergency response after an earthquake.

  18. AUTOMATED UTILITY SERVICE AREA ASSESSMENT UNDER EMERGENCY CONDITIONS

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

    G. TOOLE; S. LINGER

    2001-01-01

    All electric utilities serve power to their customers through a variety of functional levels, notably substations. The majority of these components consist of distribution substations operating at lower voltages while a small fraction are transmission substations. There is an associated geographical area that encompasses customers who are served, defined as the service area. Analysis of substation service areas is greatly complicated by several factors: distribution networks are often highly interconnected which allows a multitude of possible switching operations; also, utilities dynamically alter the network topology in order to respond to emergency events. As a result, the service area for amore » substation can change radically. A utility will generally attempt to minimize the number of customers outaged by switching effected loads to alternate substations. In this manner, all or a portion of a disabled substation's load may be served by one or more adjacent substations. This paper describes a suite of analytical tools developed at Los Alamos National Laboratory (LANL), which address the problem of determining how a utility might respond to such emergency events. The estimated outage areas derived using the tools are overlaid onto other geographical and electrical layers in a geographic information system (GIS) software application. The effects of a power outage on a population, other infrastructures, or other physical features, can be inferred by the proximity of these features to the estimated outage area.« less

  19. Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas.

    PubMed

    Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl

    2018-03-01

    To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.

  20. 48 CFR 52.226-5 - Restrictions on Subcontracting Outside Disaster or Emergency Area.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Subcontracting Outside Disaster or Emergency Area. 52.226-5 Section 52.226-5 Federal Acquisition Regulations... CLAUSES Text of Provisions and Clauses 52.226-5 Restrictions on Subcontracting Outside Disaster or Emergency Area. As prescribed in 26.206(c), insert the following clause: Restrictions on Subcontracting...

  1. 48 CFR 52.226-5 - Restrictions on Subcontracting Outside Disaster or Emergency Area.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Subcontracting Outside Disaster or Emergency Area. 52.226-5 Section 52.226-5 Federal Acquisition Regulations... CLAUSES Text of Provisions and Clauses 52.226-5 Restrictions on Subcontracting Outside Disaster or Emergency Area. As prescribed in 26.206(c), insert the following clause: Restrictions on Subcontracting...

  2. 48 CFR 52.226-5 - Restrictions on Subcontracting Outside Disaster or Emergency Area.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Subcontracting Outside Disaster or Emergency Area. 52.226-5 Section 52.226-5 Federal Acquisition Regulations... CLAUSES Text of Provisions and Clauses 52.226-5 Restrictions on Subcontracting Outside Disaster or Emergency Area. As prescribed in 26.206(c), insert the following clause: Restrictions on Subcontracting...

  3. 48 CFR 52.226-5 - Restrictions on Subcontracting Outside Disaster or Emergency Area.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Subcontracting Outside Disaster or Emergency Area. 52.226-5 Section 52.226-5 Federal Acquisition Regulations... CLAUSES Text of Provisions and Clauses 52.226-5 Restrictions on Subcontracting Outside Disaster or Emergency Area. As prescribed in 26.206(c), insert the following clause: Restrictions on Subcontracting...

  4. 48 CFR 52.226-5 - Restrictions on Subcontracting Outside Disaster or Emergency Area.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Subcontracting Outside Disaster or Emergency Area. 52.226-5 Section 52.226-5 Federal Acquisition Regulations... CLAUSES Text of Provisions and Clauses 52.226-5 Restrictions on Subcontracting Outside Disaster or Emergency Area. As prescribed in 26.206(c), insert the following clause: Restrictions on Subcontracting...

  5. Patient handover in the emergency department: 'How' is as important as 'what'.

    PubMed

    de Lange, Santel; van Eeden, Ilze; Heyns, Tanya

    2018-01-01

    We explored the existing patient handover practices between emergency care practitioners and healthcare professionals in the emergency department. In the emergency department, patient handover between emergency care practitioner's and healthcare professionals is a complex process involving multiple functions, such as the transfer of information, responsibility and accountability from one person to another. We used a qualitative study design. Emergency care practitioners and healthcare professionals were identified using purposive and convenience sampling data. Data were collected through unstructured participant observation. We conducted 20 observation sessions, varying between 15 and 20min. The data were analysed using a creative hermeneutic approach. The 'how' or manner of patient handover observed between emergency care practitioners and health professionals was perceived as important. A diagnosis of disrespectful behaviour was made which could negatively influence patient handover and ultimately patient outcome. Disrespectful behaviour stemmed from the two signs that supported the diagnosis: task-orientated behaviour and the use of indigenous language. Involving the emergency care practitioners and healthcare professionals in observing and analysing the existing patient handover practices in the ED raised their awareness of the current workplace culture. Transforming behaviour from disrespectful to respectful should include greeting one another, listening attentively to the patient handover and include emergency care practitioners, patients and their significant other in the handover process that should be conducted in a commonly understood language. Emergency care practitioners and healthcare professionals should recognise that during patient handover 'how' is as important as 'what'. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. 10 CFR 63.161 - Emergency plan for the geologic repository operations area through permanent closure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Emergency plan for the geologic repository operations area... OF HIGH-LEVEL RADIOACTIVE WASTES IN A GEOLOGIC REPOSITORY AT YUCCA MOUNTAIN, NEVADA Emergency Planning Criteria § 63.161 Emergency plan for the geologic repository operations area through permanent...

  7. Visualizing diurnal population change in urban areas for emergency management.

    PubMed

    Kobayashi, Tetsuo; Medina, Richard M; Cova, Thomas J

    2011-01-01

    There is an increasing need for a quick, simple method to represent diurnal population change in metropolitan areas for effective emergency management and risk analysis. Many geographic studies rely on decennial U.S. Census data that assume that urban populations are static in space and time. This has obvious limitations in the context of dynamic geographic problems. The U.S. Department of Transportation publishes population data at the transportation analysis zone level in fifteen-minute increments. This level of spatial and temporal detail allows for improved dynamic population modeling. This article presents a methodology for visualizing and analyzing diurnal population change for metropolitan areas based on this readily available data. Areal interpolation within a geographic information system is used to create twenty-four (one per hour) population surfaces for the larger metropolitan area of Salt Lake County, Utah. The resulting surfaces represent diurnal population change for an average workday and are easily combined to produce an animation that illustrates population dynamics throughout the day. A case study of using the method to visualize population distributions in an emergency management context is provided using two scenarios: a chemical release and a dirty bomb in Salt Lake County. This methodology can be used to address a wide variety of problems in emergency management.

  8. Remote sensing and geospatial support to burned area emergency response teams

    USGS Publications Warehouse

    McKinley, Randy; Clark, Jess

    2011-01-01

    A major concern of land managers in the United States is the response of watersheds to weather after a wildfire. With an ever-expanding wildland-urban interface (WUI), land managers must be cognizant of potential damage to private property and other values at risk. In the United States, land-management agencies from the U.S. Department of Agriculture (USDA) and the U.S. Department of the Interior (DOI) deploy Burned Area Emergency Response (BAER) teams to address these concerns and to “prescribe and implement emergency treatments to minimize threats to life or property or to stabilize and prevent unacceptable degradation to natural and cultural resources resulting from the effects of a fire” (USDA Forest Service 2004, p. 17). BAER teams’ objective is emergency stabilization of burned areas, rather than long-term restoration of the landscape after a fire.

  9. Emerging Trends in Healthcare Adoption of Wireless Body Area Networks.

    PubMed

    Rangarajan, Anuradha

    2016-01-01

    Real-time personal health monitoring is gaining new ground with advances in wireless communications. Wireless body area networks (WBANs) provide a means for low-powered sensors, affixed either on the human body or in vivo, to communicate with each other and with external telecommunication networks. The healthcare benefits of WBANs include continuous monitoring of patient vitals, measuring postacute rehabilitation time, and improving quality of medical care provided in medical emergencies. This study sought to examine emerging trends in WBAN adoption in healthcare. To that end, a systematic literature survey was undertaken against the PubMed database. The search criteria focused on peer-reviewed articles that contained the keywords "wireless body area network" and "healthcare" or "wireless body area network" and "health care." A comprehensive review of these articles was performed to identify adoption dimensions, including underlying technology framework, healthcare subdomain, and applicable lessons-learned. This article benefits healthcare technology professionals by identifying gaps in implementation of current technology and highlighting opportunities for improving products and services.

  10. 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.

  11. North/South Differences Among Italian Emerging Adults Regarding Criteria Deemed Important for Adulthood and Life Satisfaction

    PubMed Central

    Piumatti, Giovanni; Garro, Maria; Pipitone, Laura; Di Vita, Angela Maria; Rabaglietti, Emanuela

    2016-01-01

    The main goal of this study was to compare Northern and Southern Italian emerging adult university students, regarding the importance attributed to criteria for adulthood and the levels of life and education satisfaction. Self-report questionnaires were filled by 475 Northern and Southern Italian University students (Age M = 22.91, 76% females, n = 359). Multivariate analysis of variance revealed that Southern emerging adults were more likely to place importance on family capacities, norm compliance, interdependence and role transitions as criteria for achieving adulthood than Northern emerging adults. Regarding gender differences, females were more likely to believe in the importance of norm compliance than males, while males were more likely to espouse the importance of legal transitions. Finally, emerging adults from the North reported higher levels of life satisfaction than their Southern counterparts. We interpreted these findings in light of socio-economical and gender socialization differences among Northern and Southern Italian emerging adults. PMID:27298636

  12. Outcomes following major emergency gastric surgery: the importance of specialist surgeons.

    PubMed

    Khan, O A; McGlone, E R; Mercer, S J; Somers, S S; Toh, S K C

    2015-01-01

    The increasing subspecialisation of general surgeons in their elective work may result in problems for the provision of expert care for emergency cases. There is very little evidence of the impact of subspecialism on outcomes following emergency major upper gastrointestinal surgery. This prospective study investigated whether elective subspecialism of general surgeon is associated with a difference in outcome following major emergency gastric surgery. Between February 1994 and June 2010, the data from all emergency major gastric procedures (defined as patients who underwent laparotomy within 12 hours of referral to the surgical service for bleeding gastroduodenal ulcer and/or undergoing major gastric resection) was prospectively recorded. The sub-specialty interest of operating surgeon was noted and related to post-operative outcomes. Over the study period, a total of 63 major gastric procedures were performed of which 23 (37%) were performed by specialist upper gastrointestinal (UGI) consultants. Surgery performed by a specialist UGI surgeon was associated with a significantly lower surgical complication (4% vs. 28% of cases; p=0.04) and in-patient mortality rate (22% vs. 50%; p=0.03). Major emergency gastric surgery has significantly better clinical outcomes when performed by a specialist UGI surgeon. These results have important implications for provision of an emergency general surgical service. Copyright© Acta Chirurgica Belgica.

  13. 48 CFR 52.226-3 - Disaster or Emergency Area Representation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Disaster or Emergency Area Representation. 52.226-3 Section 52.226-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52...

  14. 48 CFR 52.226-3 - Disaster or Emergency Area Representation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 2 2013-10-01 2013-10-01 false Disaster or Emergency Area Representation. 52.226-3 Section 52.226-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52...

  15. A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System.

    PubMed

    Li, Chun-Ta; Lee, Cheng-Chi; Weng, Chi-Yao

    2016-05-01

    Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients' health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients' lives. Since the patient's data is sensitive and private, it is important to provide strong security and protection on the patient's medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring.

  16. Neuronal correlates of decisions to speak and act: Spontaneous emergence and dynamic topographies in a computational model of frontal and temporal areas

    PubMed Central

    Garagnani, Max; Pulvermüller, Friedemann

    2013-01-01

    The neural mechanisms underlying the spontaneous, stimulus-independent emergence of intentions and decisions to act are poorly understood. Using a neurobiologically realistic model of frontal and temporal areas of the brain, we simulated the learning of perception–action circuits for speech and hand-related actions and subsequently observed their spontaneous behaviour. Noise-driven accumulation of reverberant activity in these circuits leads to their spontaneous ignition and partial-to-full activation, which we interpret, respectively, as model correlates of action intention emergence and action decision-and-execution. Importantly, activity emerged first in higher-association prefrontal and temporal cortices, subsequently spreading to secondary and finally primary sensorimotor model-areas, hence reproducing the dynamics of cortical correlates of voluntary action revealed by readiness-potential and verb-generation experiments. This model for the first time explains the cortical origins and topography of endogenous action decisions, and the natural emergence of functional specialisation in the cortex, as mechanistic consequences of neurobiological principles, anatomical structure and sensorimotor experience. PMID:23489583

  17. An overview of mosquitoes and emerging arboviral infections in the Zagreb area, Croatia.

    PubMed

    Klobucar, Ana; Benic, Nikola; Krajcar, Darko; Kosanovic-Licina, Mirjana Lana; Tesic, Vanja; Merdic, Enrih; Vrucina, Ivana; Savic, Vladimir; Barbic, Ljubo; Stevanovic, Vladimir; Pem-Novosel, Iva; Vilibic-Cavlek, Tatjana

    2016-12-30

    Mosquito control in the Zagreb area has been conducted for many years, whereas the fauna has only been investigated in the last 20 years. So far 30 mosquito species have been detected in the city area. Culex pipiens form molestus is the dominant mosquito species in indoor breeding sites. In forested areas and areas exposed to flooding, the active period is early spring and the dominant species are Ochlerotatus sticticus, Ochlerotatus cantans, Ochlerotatus geniculatus and Aedes vexans. The eudominant mosquito species found in the artificial breeding sites are Culex pipiens and the Asian tiger mosquito, Aedes albopictus. Invasive Ae. albopictus, present in the Zagreb area since 2004, has expanded to a larger area of the city during the last three years. The recent emergence of the human West Nile virus and Usutu virus neuroinvasive disease in Zagreb and its surroundings highlighted the role of mosquitoes as vectors of emerging arboviruses. The paper focuses on mosquito species and arboviral infections detected in humans and animals in the Zagreb area, Croatia.

  18. 47 CFR 11.55 - EAS operation during a State or Local Area emergency.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... day-to-day emergency situations posing a threat to life and property. Examples of natural emergencies... Participants providing foreign language programming should transmit all EAS announcements in the same language as the primary language of the EAS Participant. (5) Upon completion of the State or Local Area EAS...

  19. 47 CFR 11.55 - EAS operation during a State or Local Area emergency.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... day-to-day emergency situations posing a threat to life and property. Examples of natural emergencies... Participants providing foreign language programming should transmit all EAS announcements in the same language as the primary language of the EAS Participant. (5) Upon completion of the State or Local Area EAS...

  20. 47 CFR 11.55 - EAS operation during a State or Local Area emergency.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... day-to-day emergency situations posing a threat to life and property. Examples of natural emergencies... Participants providing foreign language programming should transmit all EAS announcements in the same language as the primary language of the EAS Participant. (5) Upon completion of the State or Local Area EAS...

  1. Identifying marine Important Bird Areas using at-sea survey data

    USGS Publications Warehouse

    Smith, Melanie A.; Walker, Nathan J.; Free, Christopher M.; Kirchhoff, Matthew J.; Drew, Gary S.; Warnock, Nils; Stenhouse, Iain J.

    2014-01-01

    Effective marine bird conservation requires identification of at-sea locations used by populations for foraging, staging, and migration. Using an extensive database of at-sea survey data spanning over 30 years, we developed a standardized and data-driven spatial method for identifying globally significant marine Important Bird Areas in Alaska. To delineate these areas we developed a six-step process: binning data and accounting for unequal survey effort, filtering input data for persistence of species use, using a moving window analysis to produce maps representing a gradient from low to high abundance, drawing core area boundaries around major concentrations based on abundance thresholds, validating the results, and combining overlapping boundaries into important areas for multiple species. We identified 126 bird core areas which were merged into 59 pelagic sites important to 45 out of 57 species assessed. The final areas included approximately 34–38% of all marine birds in Alaska waters, within just 6% of the total area. We identified globally significant Important Bird Areas spanning 20 degrees of latitude and 56 degrees of longitude, in two different oceans, with climates ranging from temperate to polar. Although our maps did suffer from some data gaps, these gaps did not preclude us from identifying sites that incorporated 13% of the assessed continental waterbird population and 9% of the assessed global seabird population. The application of this technique over a large and productive region worked well for a wide range of birds, exhibiting a variety of foraging strategies and occupying a variety of ecosystem types.

  2. Are some areas more equal than others? Socioeconomic inequality in potentially avoidable emergency hospital admissions within English local authority areas.

    PubMed

    Sheringham, Jessica; Asaria, Miqdad; Barratt, Helen; Raine, Rosalind; Cookson, Richard

    2017-04-01

    Objectives Reducing health inequalities is an explicit goal of England's health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000). We measured absolute inequality gradients nationally and within each administrative area using neighbourhood-level linear models of the relationship between national deprivation and age-sex-adjusted emergency admission rates. We assessed local equity performance by comparing local inequality against national inequality to identify areas significantly more or less equal than expected; evaluated stability over time; and identified where equity performance was steadily improving or worsening. We then examined associations between change in socioeconomic inequalities and change in within-area deprivation (gentrification). Finally, we used administrative area-level random and fixed effects models to examine the contribution of primary care to inequalities in admissions. Results Data on 316 administrative areas were included in the analysis. Local inequalities were fairly stable between consecutive years, but 32 areas (10%) showed steadily improving or worsening equity. In the 21 improving areas, the gap between most and least deprived fell by 3.9 admissions per 1000 (six times the fall nationally) between 2004/5 and 2011/12, while in the 11 areas worsening, the gap widened by 2.4. There was no indication that measured improvements in local equity were an artefact of gentrification or that changes in primary care supply or quality contributed to changes in

  3. Are some areas more equal than others? Socioeconomic inequality in potentially avoidable emergency hospital admissions within English local authority areas

    PubMed Central

    Asaria, Miqdad; Barratt, Helen; Raine, Rosalind; Cookson, Richard

    2016-01-01

    Objectives Reducing health inequalities is an explicit goal of England’s health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000). We measured absolute inequality gradients nationally and within each administrative area using neighbourhood-level linear models of the relationship between national deprivation and age–sex-adjusted emergency admission rates. We assessed local equity performance by comparing local inequality against national inequality to identify areas significantly more or less equal than expected; evaluated stability over time; and identified where equity performance was steadily improving or worsening. We then examined associations between change in socioeconomic inequalities and change in within-area deprivation (gentrification). Finally, we used administrative area-level random and fixed effects models to examine the contribution of primary care to inequalities in admissions. Results Data on 316 administrative areas were included in the analysis. Local inequalities were fairly stable between consecutive years, but 32 areas (10%) showed steadily improving or worsening equity. In the 21 improving areas, the gap between most and least deprived fell by 3.9 admissions per 1000 (six times the fall nationally) between 2004/5 and 2011/12, while in the 11 areas worsening, the gap widened by 2.4. There was no indication that measured improvements in local equity were an artefact of gentrification or that changes in primary care supply or quality contributed to changes in

  4. [Emergencies of the external genital area].

    PubMed

    Kaminsky, A; Sperling, H

    2016-04-01

    In addition to epididymitis and testicular torsion, emergencies of the external genital are rare. Rapid diagnosis and therapy are essential so that immediate therapy can be provided, which is important for survival (Fournier gangrene) of the patient or for the preservation of erectile function (priapism and penile fracture). A detailed patient history and clinical examination are generally sufficient for correct diagnosis. Under certain circumstances, it might be useful to perform ultrasound, computed tomography scan or magnetic resonance imaging or retrograde urethrography. A urine analysis is obligatory. In case of penetrating injuries and genital trauma in females, additional imaging should be performed because these are often associated with concomitant injuries of the rectum, vagina, or bladder. Special cases are gunshot wounds, in which caliber and type of weapon play an important role for the degree of damage, and animal or human bites. For animal bites, the risk for rabies infection and in case of a human bite the risk for transmission of HIV and hepatitis should be taken into consideration and post-exposure prophylaxis should possibly be offered.

  5. [Imported dengue: an emerging arbovirosis in Spain].

    PubMed

    Ramos Geldres, T T; García López-Hortelano, M; Baquero-Artigao, F; Montero Vega, D; López Quintana, B; Mellado Peña, M J

    2015-01-01

    Dengue is caused by one of 4 serotypes of dengue virus. Only imported cases have been reported in Spain. The main clinical findings are fever and exanthema, although there may be severe forms, particularly in secondary infections. Five children with a primary, non severe dengue infection are presented. The diagnosis was based on clinical suspicion and epidemiological history, and confirmed by immunochromatography and ELISA tests. The outcome was favourable in all cases. It is important to consider this diagnosis in international travellers that present with fever within the 14 days of returning from an endemic area, in order to get an early diagnosis, adequate treatment and a good prognosis. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  6. Experiences of counselling in the emergency department during the waiting period: importance of family participation.

    PubMed

    Paavilainen, Eija; Salminen-Tuomaala, Mari; Kurikka, Sirpa; Paussu, Paula

    2009-08-01

    To describe patients' experiences of counselling, defined as information giving and advice by nursing staff, in the emergency department. A particular focus was on the waiting period and on the importance of family participation in counselling. Counselling is a widely studied topic in nursing. Too little is known about counselling in emergency departments and especially about participation of family members and suitability of counselling for the patient's life situation. Descriptive quantitative study. Data were collected by questionnaires from patients (n = 107) visiting a hospital emergency department. The data were subjected to statistical analysis. Forty-two per cent of patients arrived at the emergency department with a family member: spouse or cohabiting partner, mother, father or daughter. Patients were fairly satisfied with the counselling. The presence of a family member was important to the majority of patients (75%). About half of the patients wanted information concerning their illness, condition and treatment to be given to their family members. Those visiting the department with a family member were more satisfied with counselling and felt that it promoted their participation in care. It is to encourage patients' family members to participate in counselling situations in emergency departments. However, the type of information passed on to family members should be carefully discussed and prepared. Patients' family members seem to be important partners in counselling situations. The presence of family members supports patients in the emergency department during the waiting period and helps them orientate in their situation. When family members are present, issues which patients wish to discuss should be carefully planned. Family presence should be encouraged in emergency departments.

  7. Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

    PubMed

    Aftyka, Anna; Rybojad, Beata; Rudnicka-Drozak, Ewa

    2014-10-01

    To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. Two emergency medical service substations: one in the city and the other in a rural area. Medical emergency teams. Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings. © 2014 National Rural Health Alliance Inc.

  8. Surveillance for pneumonic plague in the United States during an international emergency: a model for control of imported emerging diseases.

    PubMed Central

    Fritz, C. L.; Dennis, D. T.; Tipple, M. A.; Campbell, G. L.; McCance, C. R.; Gubler, D. J.

    1996-01-01

    In September 1994, in response to a reported epidemic of plague in India, the Centers for Disease Control and Prevention (CDC) enhanced surveillance in the United States for imported pneumonic plague. Plague information materials were rapidly developed and distributed to U.S. public health officials by electronic mail, facsimile, and expedited publication. Information was also provided to medical practitioners and the public by recorded telephone messages and facsimile transmission. Existing quarantine protocols were modified to effect active surveillance for imported plague cases at U.S. airports. Private physicians and state and local health departments were relied on in a passive surveillance system to identify travelers with suspected plague not detected at airports. From September 27 to October 27, the surveillance system identified 13 persons with suspected plague; no case was confirmed. This coordinated response to an international health emergency may serve as a model for detecting other emerging diseases and preventing their importation. PMID:8964057

  9. Surveillance for pneumonic plague in the United States during an international emergency: a model for control of imported emerging diseases.

    PubMed

    Fritz, C L; Dennis, D T; Tipple, M A; Campbell, G L; McCance, C R; Gubler, D J

    1996-01-01

    In September 1994, in response to a reported epidemic of plague in India, the Centers for Disease Control and Prevention (CDC) enhanced surveillance in the United States for imported pneumonic plague. Plague information materials were rapidly developed and distributed to U.S. public health officials by electronic mail, facsimile, and expedited publication. Information was also provided to medical practitioners and the public by recorded telephone messages and facsimile transmission. Existing quarantine protocols were modified to effect active surveillance for imported plague cases at U.S. airports. Private physicians and state and local health departments were relied on in a passive surveillance system to identify travelers with suspected plague not detected at airports. From September 27 to October 27, the surveillance system identified 13 persons with suspected plague; no case was confirmed. This coordinated response to an international health emergency may serve as a model for detecting other emerging diseases and preventing their importation.

  10. The Importance of Rotational Crops for Biodiversity Conservation in Mediterranean Areas.

    PubMed

    Chiatante, Gianpasquale; Meriggi, Alberto

    2016-01-01

    Nowadays we are seeing the largest biodiversity loss since the extinction of the dinosaurs. To conserve biodiversity it is essential to plan protected areas using a prioritization approach, which takes into account the current biodiversity value of the sites. Considering that in the Mediterranean Basin the agro-ecosystems are one of the most important parts of the landscape, the conservation of crops is essential to biodiversity conservation. In the framework of agro-ecosystem conservation, farmland birds play an important role because of their representativeness, and because of their steady decline in the last Century in Western Europe. The main aim of this research was to define if crop dominated landscapes could be useful for biodiversity conservation in a Mediterranean area in which the landscape was modified by humans in the last thousand years and was affected by the important biogeographical phenomenon of peninsula effect. To assess this, we identify the hotspots and the coldspots of bird diversity in southern Italy both during the winter and in the breeding season. In particular we used a scoring method, defining a biodiversity value for each cell of a 1-km grid superimposed on the study area, using data collected by fieldwork following a stratified random sampling design. This value was analysed by a multiple linear regression analysis and was predicted in the whole study area. Then we defined the hotspots and the coldspots of the study area as 15% of the cells with higher and lower value of biodiversity, respectively. Finally, we used GAP analysis to compare hotspot distribution with the current network of protected areas. This study showed that the winter hotspots of bird diversity were associated with marshes and water bodies, shrublands, and irrigated crops, whilst the breeding hotspots were associated with more natural areas (e.g. transitional wood/shrubs), such as open areas (natural grasslands, pastures and not irrigated crops). Moreover, the

  11. The Importance of Rotational Crops for Biodiversity Conservation in Mediterranean Areas

    PubMed Central

    Chiatante, Gianpasquale; Meriggi, Alberto

    2016-01-01

    Nowadays we are seeing the largest biodiversity loss since the extinction of the dinosaurs. To conserve biodiversity it is essential to plan protected areas using a prioritization approach, which takes into account the current biodiversity value of the sites. Considering that in the Mediterranean Basin the agro-ecosystems are one of the most important parts of the landscape, the conservation of crops is essential to biodiversity conservation. In the framework of agro-ecosystem conservation, farmland birds play an important role because of their representativeness, and because of their steady decline in the last Century in Western Europe. The main aim of this research was to define if crop dominated landscapes could be useful for biodiversity conservation in a Mediterranean area in which the landscape was modified by humans in the last thousand years and was affected by the important biogeographical phenomenon of peninsula effect. To assess this, we identify the hotspots and the coldspots of bird diversity in southern Italy both during the winter and in the breeding season. In particular we used a scoring method, defining a biodiversity value for each cell of a 1-km grid superimposed on the study area, using data collected by fieldwork following a stratified random sampling design. This value was analysed by a multiple linear regression analysis and was predicted in the whole study area. Then we defined the hotspots and the coldspots of the study area as 15% of the cells with higher and lower value of biodiversity, respectively. Finally, we used GAP analysis to compare hotspot distribution with the current network of protected areas. This study showed that the winter hotspots of bird diversity were associated with marshes and water bodies, shrublands, and irrigated crops, whilst the breeding hotspots were associated with more natural areas (e.g. transitional wood/shrubs), such as open areas (natural grasslands, pastures and not irrigated crops). Moreover, the

  12. Burned area emergency watershed rehabilitation: Program goals, techniques, effectiveness, and future directions in the 21st Century

    Treesearch

    Daniel G. Neary; Peter R. Robichaud; Jan L. Beyers

    2000-01-01

    Following wildfires, burned areas are assessed by special teams to determine if emergency watershed rehabilitation measures are required to restore watershed function and minimize damage to soil resources. The objective of burned area emergency rehabilitation (BAER) treatments is to restore watershed condition and reduce erosional losses on hillslopes, in channels, and...

  13. Risk Factors Detection for Strategic Importance Objectives in Littoral Areas

    NASA Astrophysics Data System (ADS)

    Slămnoiu, G.; Radu, O.; Roşca, V.; Pascu, C.; Surdu, G.; Curcă, E.; Damian, R. G.; Rădulescu, A.

    2017-06-01

    With the invention and development of underwater explosive devices the need to neutralize them has also appeared, both for enemy and for own devices once conflicts are finished. The fight against active underwater explosive devices is a very complicated action that requires a very careful approach. Also, in the current context, strategic importance objectives located in the littoral areas can also become targets for divers or fast boats (suicidal actions).The system for detection, localization, tracking and identification of risk factors for strategic importance objectives in littoral areas has as one of its components an AUV and a hydro-acoustic sub-system for determining the ‘fingerprints’ of potential targets. The overall system will provide support for main missions such as underwater environment surveillance (detection, monitoring) in harbor areas and around other coast objectives, ship anchorage areas, mandatory pass points and also provide warnings about the presence of underwater and surface dangers in the interest areas.

  14. Climate Influence on Emerging Risk Areas for Rift Valley Fever Epidemics in Tanzania.

    PubMed

    Mweya, Clement N; Mboera, Leonard E G; Kimera, Sharadhuli I

    2017-07-01

    Rift Valley Fever (RVF) is a climate-related arboviral infection of animals and humans. Climate is thought to represent a threat toward emerging risk areas for RVF epidemics globally. The objective of this study was to evaluate influence of climate on distribution of suitable breeding habitats for Culex pipiens complex, potential mosquito vector responsible for transmission and distribution of disease epidemics risk areas in Tanzania. We used ecological niche models to estimate potential distribution of disease risk areas based on vectors and disease co-occurrence data approach. Climatic variables for the current and future scenarios were used as model inputs. Changes in mosquito vectors' habitat suitability in relation to disease risk areas were estimated. We used partial receiver operating characteristic and the area under the curves approach to evaluate model predictive performance and significance. Habitat suitability for Cx. pipiens complex indicated broad-scale potential for change and shift in the distribution of the vectors and disease for both 2020 and 2050 climatic scenarios. Risk areas indicated more intensification in the areas surrounding Lake Victoria and northeastern part of the country through 2050 climate scenario. Models show higher probability of emerging risk areas spreading toward the western parts of Tanzania from northeastern areas and decrease in the southern part of the country. Results presented here identified sites for consideration to guide surveillance and control interventions to reduce risk of RVF disease epidemics in Tanzania. A collaborative approach is recommended to develop and adapt climate-related disease control and prevention strategies.

  15. A consensus-established set of important indicators of pediatric emergency department performance.

    PubMed

    Hung, Geoffrey R; Chalut, Dominic

    2008-01-01

    Quality assurance is a new and important area of research in pediatric emergency medicine (PEM). There are few studies that describe which performance indicators best represent the PEM practice. The primary study objective is to construct a set of performance indicators that have been selected by current and former pediatric emergency department (PED) medical directors as most useful in assessing PED performance. The secondary objective is to assess which indicators are currently measured to assess performance in PEDs. Current and former directors of accredited Canadian PEM programs were considered as eligible participants. A list of indicators was generated by a survey (item pool generation); this list was refined by clarifying unclear terms or eliminating redundant and unquantifiable performance indicators (item scaling); PED directors were asked to rate each item of this refined list to indicate which indicators were more useful in assessing PED performance (item prioritization). A novel ranking formula was used to prioritize those items considered most useful by a larger proportion of respondents, using the provided rating scores. Fourteen current and former medical directors were considered eligible participants. Indicators related to patient morbidity and mortality, adverse outcomes, return visits, patient length of stay (LOS), and waiting times were considered to be more useful. Less useful indicators included the number of deaths, daily census, number of incident reports, and individual physicians' admission rates. The most commonly measured PED performance indicators included the rate of patients who left without being seen, patient LOS, and the waiting time until being seen by a physician by triage category. The top quartile of performance indicators considered most useful by participants included indicators that reflected clinical outcomes, LOS, and waiting times. A dichotomy may exist between those performance indicators that PED directors considered

  16. The perpetual state of emergency that sacrifices protected areas in a changing climate.

    PubMed

    Twidwell, Dirac; Wonkka, Carissa L; Bielski, Christine H; Allen, Craig R; Angeler, David G; Drozda, Jacob; Garmestani, Ahjond S; Johnson, Julia; Powell, Larkin A; Roberts, Caleb P

    2018-02-23

    A modern challenge for conservation biology is to assess the consequences of policies that adhere to assumptions of stationarity (e.g., historic norms) in an era of global environmental change. Such policies may result in unexpected and surprising levels of mitigation given future climate-change trajectories, especially as agriculture looks to protected areas to buffer against production losses during periods of environmental extremes. We assessed the potential impact of climate-change scenarios on the rates at which grasslands enrolled in the Conservation Reserve Program (CRP) are authorized for emergency harvesting (i.e., biomass removal) for agricultural use, which can occur when precipitation for the previous 4 months is below 40% of the normal or historical mean precipitation for that 4-month period. We developed and analyzed scenarios under the condition that policy will continue to operate under assumptions of stationarity, thereby authorizing emergency biomass harvesting solely as a function of precipitation departure from historic norms. Model projections showed the historical likelihood of authorizing emergency biomass harvesting in any given year in the northern Great Plains was 33.28% based on long-term weather records. Emergency biomass harvesting became the norm (>50% of years) in the scenario that reflected continued increases in emissions and a decrease in growing-season precipitation, and areas in the Great Plains with higher historical mean annual rainfall were disproportionately affected and were subject to a greater increase in emergency biomass removal. Emergency biomass harvesting decreased only in the scenario with rapid reductions in emissions. Our scenario-impact analysis indicated that biomass from lands enrolled in the CRP would be used primarily as a buffer for agriculture in an era of climatic change unless policy guidelines are adapted or climate-change projections significantly depart from the current consensus. Published 2018. This

  17. Emerging areas of science: Recommendations for Nursing Science Education from the Council for the Advancement of Nursing Science Idea Festival.

    PubMed

    Henly, Susan J; McCarthy, Donna O; Wyman, Jean F; Heitkemper, Margaret M; Redeker, Nancy S; Titler, Marita G; McCarthy, Ann Marie; Stone, Patricia W; Moore, Shirley M; Alt-White, Anna C; Conley, Yvette P; Dunbar-Jacob, Jacqueline

    2015-01-01

    The Council for the Advancement of Nursing Science aims to "facilitate and recognize life-long nursing science career development" as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee (IFAC) to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2005 National Research Council report Advancing The Nation's Health Needs and the 2010 American Association of Colleges of Nursing Position Statement on the Research-Focused Doctorate Pathways to Excellence, the IFAC specifically addressed the capacity of PhD programs to prepare nursing scientists to conduct cutting-edge research in the following key emerging and priority areas of health sciences research: omics and the microbiome; health behavior, behavior change, and biobehavioral science; patient-reported outcomes; big data, e-science, and informatics; quantitative sciences; translation science; and health economics. The purpose of this article is to (a) describe IFAC activities, (b) summarize 2014 discussions hosted as part of the Idea Festival, and (c) present IFAC recommendations for incorporating these emerging areas of science and technology into research-focused doctoral programs committed to preparing graduates for lifelong, competitive careers in nursing science. The recommendations address clearer articulation of program focus areas; inclusion of foundational knowledge in emerging areas of science in core courses on nursing science and research methods; faculty composition; prerequisite student knowledge and skills; and in-depth, interdisciplinary training in supporting area of science content and methods. Copyright © 2015 Elsevier Inc

  18. Emergency Medicine Gender-specific Education.

    PubMed

    Ashurst, John V; McGregor, Alyson J; Safdar, Basmah; Weaver, Kevin R; Quinn, Shawn M; Rosenau, Alex M; Goyke, Terrence E; Roth, Kevin R; Greenberg, Marna R

    2014-12-01

    The 2014 Academic Emergency Medicine consensus conference has taken the first step in identifying gender-specific care as an area of importance to both emergency medicine (EM) and research. To improve patient care, we need to address educational gaps in this area concurrent with research gaps. In this article, the authors highlight the need for sex- and gender-specific education in EM and propose guidelines for medical student, resident, and faculty education. Specific examples of incorporating this content into grand rounds, simulation, bedside teaching, and journal club sessions are reviewed. Future challenges and strategies to fill the gaps in the current education model are also described. © 2014 by the Society for Academic Emergency Medicine.

  19. Identifying Important Atlantic Areas for the conservation of Balearic shearwaters: Spatial overlap with conservation areas

    NASA Astrophysics Data System (ADS)

    Pérez-Roda, Amparo; Delord, Karine; Boué, Amélie; Arcos, José Manuel; García, David; Micol, Thierry; Weimerskirch, Henri; Pinaud, David; Louzao, Maite

    2017-07-01

    Marine protected areas (MPAs) are considered one of the main tools in both fisheries and conservation management to protect threatened species and their habitats around the globe. However, MPAs are underrepresented in marine environments compared to terrestrial environments. Within this context, we studied the Atlantic non-breeding distribution of the southern population of Balearic shearwaters (Puffinus mauretanicus) breeding in Eivissa during the 2011-2012 period based on global location sensing (GLS) devices. Our objectives were (1) to identify overall Important Atlantic Areas (IAAs) from a southern population, (2) to describe spatio-temporal patterns of oceanographic habitat use, and (3) to assess whether existing conservation areas (Natura 2000 sites and marine Important Bird Areas (IBAs)) cover the main IAAs of Balearic shearwaters. Our results highlighted that the Atlantic staging (from June to October in 2011) dynamic of the southern population was driven by individual segregation at both spatial and temporal scales. Individuals ranged in the North-East Atlantic over four main IAAs (Bay of Biscay: BoB, Western Iberian shelf: WIS, Gulf of Cadiz: GoC, West of Morocco: WoM). While most individuals spent more time on the WIS or in the GoC, a small number of birds visited IAAs at the extremes of their Atlantic distribution range (i.e., BoB and WoM). The chronology of the arrivals to the IAAs showed a latitudinal gradient with northern areas reached earlier during the Atlantic staging. The IAAs coincided with the most productive areas (higher chlorophyll a values) in the NE Atlantic between July and October. The spatial overlap between IAAs and conservation areas was higher for Natura 2000 sites than marine IBAs (areas with and without legal protection, respectively). Concerning the use of these areas, a slightly higher proportion of estimated positions fell within marine IBAs compared to designated Natura 2000 sites, with Spanish and Portuguese conservation

  20. Emergency evacuation study for the Greater Jackson Area : evacuation traffic from New Orleans.

    DOT National Transportation Integrated Search

    2011-05-21

    In response to both natural and man-made disasters, more and more emergency evacuation plans have been put : forward and consistently aims to move a large disaster affected population through a highway network towards safer : areas as quickly and eff...

  1. Development of emergency response tools for accidental radiological contamination of French coastal areas.

    PubMed

    Duffa, Céline; Bailly du Bois, Pascal; Caillaud, Matthieu; Charmasson, Sabine; Couvez, Céline; Didier, Damien; Dumas, Franck; Fievet, Bruno; Morillon, Mehdi; Renaud, Philippe; Thébault, Hervé

    2016-01-01

    The Fukushima nuclear accident resulted in the largest ever accidental release of artificial radionuclides in coastal waters. This accident has shown the importance of marine assessment capabilities for emergency response and the need to develop tools for adequately predicting the evolution and potential impact of radioactive releases to the marine environment. The French Institute for Radiological Protection and Nuclear Safety (IRSN) equips its emergency response centre with operational tools to assist experts and decision makers in the event of accidental atmospheric releases and contamination of the terrestrial environment. The on-going project aims to develop tools for the management of marine contamination events in French coastal areas. This should allow us to evaluate and anticipate post-accident conditions, including potential contamination sites, contamination levels and potential consequences. In order to achieve this goal, two complementary tools are developed: site-specific marine data sheets and a dedicated simulation tool (STERNE, Simulation du Transport et du transfert d'Eléments Radioactifs dans l'environNEment marin). Marine data sheets are used to summarize the marine environment characteristics of the various sites considered, and to identify vulnerable areas requiring implementation of population protection measures, such as aquaculture areas, beaches or industrial water intakes, as well as areas of major ecological interest. Local climatological data (dominant sea currents as a function of meteorological or tidal conditions) serving as the basis for an initial environmental sampling strategy is provided whenever possible, along with a list of possible local contacts for operational management purposes. The STERNE simulation tool is designed to predict radionuclide dispersion and contamination in seawater and marine species by incorporating spatio-temporal data. 3D hydrodynamic forecasts are used as input data. Direct discharge points or

  2. Oncological emergencies: clinical importance and principles of management.

    PubMed

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

    2010-11-01

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

  3. Wargame Simulation Theory and Evaluation Method for Emergency Evacuation of Residents from Urban Waterlogging Disaster Area

    PubMed Central

    Chen, Peng; Zhang, Jiquan; Sun, Yingyue; Liu, Xiaojing

    2016-01-01

    Urban waterlogging seriously threatens the safety of urban residents and properties. Wargame simulation research on resident emergency evacuation from waterlogged areas can determine the effectiveness of emergency response plans for high risk events at low cost. Based on wargame theory and emergency evacuation plans, we used a wargame exercise method, incorporating qualitative and quantitative aspects, to build an urban waterlogging disaster emergency shelter using a wargame exercise and evaluation model. The simulation was empirically tested in Daoli District of Harbin. The results showed that the wargame simulation scored 96.40 points, evaluated as good. From the simulation results, wargame simulation of urban waterlogging emergency procedures for disaster response can improve the flexibility and capacity for command, management and decision-making in emergency management departments. PMID:28009805

  4. On the importance of a correct divulgation of monitoring results for an efficient management of landslide emergencies

    NASA Astrophysics Data System (ADS)

    Giordan, Daniele; Manconi, Andrea; Allasia, Paolo

    2015-04-01

    In the last decades, technological evolution has strongly increased the number of instruments that can be used to monitor landslide phenomena. Robotized Total Stations, GB-InSAR, and GPS are only few examples of the systems that can be used for the control of the topographic changes due to the landslide activity. These monitoring systems are often merged in a complex network, aimed at controlling the most important physical parameters influencing the evolution of landslide activity. The technological level reached by these systems allows us to use them for early warning purposes. Critical thresholds are identified and, when overcome, emergency actions are associated to protect population living in areas potentially involved by landslide failure. The use of these early warning systems can be very useful for the decision makers, which have to manage emergency conditions due to a landslide acceleration likely precursor of a collapse. At this stage, every instrument has a proper management system and the dataset obtained is often not compatible with the results of the others systems. The level of complexity increases with the number of monitoring systems and often could generate a paradox: the source of data are so numerous and difficult to interpret that a full understanding of the phenomenon could be hampered. Nowadays, a correct divulgation of the recent evolution of a landslide potentially dangerous for the population is very important. The Geohazard Monitoring Group of CNR IRPI developed a communication strategy to divulgate the monitoring network results based on both, a dedicated web page (for the publication in near real time of last updates), and periodical bulletins (for a deeper analysis of the available dataset). To manage the near real time application we developed a system called ADVICE (ADVanced dIsplaCement monitoring system for Early warning) that collects all the available data of a monitoring network and creates user-friendly representations of the

  5. An overview of aldehyde oxidase: an enzyme of emerging importance in novel drug discovery.

    PubMed

    Rashidi, Mohammad-Reza; Soltani, Somaieh

    2017-03-01

    Given the rising trend in medicinal chemistry strategy to reduce cytochrome P450-dependent metabolism, aldehyde oxidase (AOX) has recently gained increased attention in drug discovery programs and the number of drug candidates that are metabolized by AOX is steadily growing. Areas covered: Despite the emerging importance of AOX in drug discovery, there are certain major recognized problems associated with AOX-mediated metabolism of drugs. Intra- and inter-species variations in AOX activity, the lack of reliable and predictive animal models using the common experimental animals, and failure in the predictions of in vivo metabolic activity of AOX using traditional in vitro methods are among these issues that are covered in this article. A comprehensive review of computational human AOX (hAOX) related studies are also provided. Expert opinion: Following the recent progress in the stem cell field, the authors recommend the application of organoids technology as an effective tool to solve the fundamental problems associated with the evaluation of AOX in drug discovery. The recent success in resolving the hAOX crystal structure can too be another valuable data source for the study of AOX-catalyzed metabolism of new drug candidates, using computer-aided drug discovery methods.

  6. Emerging importance of holobionts in evolution and in probiotics

    PubMed Central

    2013-01-01

    The existence of microbe free animals or plants in nature is virtually impossible as they and plants have a certain degree of symbiotic association with microbes. This symbiotic association leads to the formation of holobiont (host and its symbionts). This mutual coexistence is not merely at the physical or chemical level but also at the genetic level leading to the emergence of the concept of hologenome (gene pool of host and its associated symbionts). The abundance of symbionts with the associated gene diversity contributes to the fitness of the holobiont under varying environmental conditions. The hologenome theory of evolution considers the dynamic holobiont as a single unit for natural selection and provides a more accommodating view of evolution blending Darwinism and Lamarkism. Additionally, holobionts are providing scientific basis to our understanding of the growing importance of probiotics in human health and in disease management. PMID:23694677

  7. [Emergent viral infections].

    PubMed

    Galama, J M

    2001-03-31

    The emergence and re-emergence of viral infections is an ongoing process. Large-scale vaccination programmes led to the eradication or control of some viral infections in the last century, but new viruses are always emerging. Increased travel is leading to a rise in the importation of exotic infections such as dengue and hepatitis E, but also of hepatitis A, which is no longer endemic. Apart from import diseases new viruses have appeared (Nipah-virus and transfusion-transmitted virus). Existing viruses may suddenly cause more severe diseases, e.g. infection by enterovirus 71. The distribution area of a virus may change, e.g. in case of West Nile virus, an Egyptian encephalitis virus that appears to have established itself in the USA. Furthermore, there is no such thing as a completely new virus; it is always an existing virus that has adapted itself to another host or that was already present in humans but has only recently been discovered. A number of factors facilitate the emergence of new infectious diseases. These include intensive animal husbandry and the transport of animals. The unexpected appearance of West Nile virus in the western hemisphere was possibly due to animal transportation.

  8. [Use of emergency departments in rural and urban areas in Spain].

    PubMed

    Sarría-Santamera, A; Prado-Galbarro, J; Ramallo-Farina, Y; Quintana-Díaz, M; Martínez-Virto, A; Serrano-Aguilar, P

    2015-03-01

    Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas. Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with making one visit to the ED were also evaluated, in order to determine the effect of the population size of place of residence. A higher use of ED is observed in persons with a higher frequency of use of Primary Care and hospital admissions, and increases with worse self-perceived health and functional status, with more chronic diseases, in people from lower social classes, and younger ages. Adjusting for the other variables, residents in larger cities have a higher use of ED than residents in rural areas, who show a higher use of public and non-hospital based ED, than residents in urban areas. There is a higher use of ED by inhabitants of urban areas that cannot be justified by a worst health status of that population. This tends to indicate that the use of ED is not under-used in rural areas, but overused in urban areas. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  9. The importance of improving the quality of emergency surgery for a regional quality collaborative.

    PubMed

    Smith, Margaret; Hussain, Adnan; Xiao, Jane; Scheidler, William; Reddy, Haritha; Olugbade, Kola; Cummings, Dustin; Terjimanian, Michael; Krapohl, Greta; Waits, Seth A; Campbell, Darrell; Englesbe, Michael J

    2013-04-01

    wide variation in compliance with SCIP-1 and SCIP-2 measures and overall compliance (42.0%) was markedly lower than that for elective colon surgery (81.7%). Emergency surgical procedures are an important target for future quality improvement efforts within Michigan. Future work will identify best practices within high-performing hospitals and disseminate these practices within the collaborative.

  10. 50 CFR 216.191 - Designation of Offshore Biologically Important Marine Mammal Areas.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Detailed information on the biology of marine mammals within the area, including estimated population size... Important Marine Mammal Areas. 216.191 Section 216.191 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS...

  11. 50 CFR 216.191 - Designation of Offshore Biologically Important Marine Mammal Areas.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Detailed information on the biology of marine mammals within the area, including estimated population size... Important Marine Mammal Areas. 216.191 Section 216.191 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS...

  12. An On-Demand Emergency Packet Transmission Scheme for Wireless Body Area Networks.

    PubMed

    Al Ameen, Moshaddique; Hong, Choong Seon

    2015-12-04

    The rapid developments of sensor devices that can actively monitor human activities have given rise to a new field called wireless body area network (BAN). A BAN can manage devices in, on and around the human body. Major requirements of such a network are energy efficiency, long lifetime, low delay, security, etc. Traffic in a BAN can be scheduled (normal) or event-driven (emergency). Traditional media access control (MAC) protocols use duty cycling to improve performance. A sleep-wake up cycle is employed to save energy. However, this mechanism lacks features to handle emergency traffic in a prompt and immediate manner. To deliver an emergency packet, a node has to wait until the receiver is awake. It also suffers from overheads, such as idle listening, overhearing and control packet handshakes. An external radio-triggered wake up mechanism is proposed to handle prompt communication. It can reduce the overheads and improve the performance through an on-demand scheme. In this work, we present a simple-to-implement on-demand packet transmission scheme by taking into considerations the requirements of a BAN. The major concern is handling the event-based emergency traffic. The performance analysis of the proposed scheme is presented. The results showed significant improvements in the overall performance of a BAN compared to state-of-the-art protocols in terms of energy consumption, delay and lifetime.

  13. An On-Demand Emergency Packet Transmission Scheme for Wireless Body Area Networks

    PubMed Central

    Al Ameen, Moshaddique; Hong, Choong Seon

    2015-01-01

    The rapid developments of sensor devices that can actively monitor human activities have given rise to a new field called wireless body area network (BAN). A BAN can manage devices in, on and around the human body. Major requirements of such a network are energy efficiency, long lifetime, low delay, security, etc. Traffic in a BAN can be scheduled (normal) or event-driven (emergency). Traditional media access control (MAC) protocols use duty cycling to improve performance. A sleep-wake up cycle is employed to save energy. However, this mechanism lacks features to handle emergency traffic in a prompt and immediate manner. To deliver an emergency packet, a node has to wait until the receiver is awake. It also suffers from overheads, such as idle listening, overhearing and control packet handshakes. An external radio-triggered wake up mechanism is proposed to handle prompt communication. It can reduce the overheads and improve the performance through an on-demand scheme. In this work, we present a simple-to-implement on-demand packet transmission scheme by taking into considerations the requirements of a BAN. The major concern is handling the event-based emergency traffic. The performance analysis of the proposed scheme is presented. The results showed significant improvements in the overall performance of a BAN compared to state-of-the-art protocols in terms of energy consumption, delay and lifetime. PMID:26690161

  14. Interactive emergency communication involving persons in crisis.

    PubMed

    Nordby, Halvor; Nøhr, Øyvind

    2009-01-01

    We studied the dialogue between telephone operators at medical emergency communication centres in Norway and parents of children later diagnosed with sudden infant death syndrome. The aim was to understand how the parents experienced the communication with the telephone operators. The qualitative method involved semi-structured interviews. We interviewed six respondents from urban areas and five from rural areas. An important finding was that all the parents were satisfied with the resuscitation instructions they received. It was also perceived as important that the emergency operators expressed empathy and care. We believe that it is not merely the quality of the resuscitation attempts that the operators' efforts should be measured against. It is also important that the operators provide good explanations and express emotional support. Our findings indicate that this will be enormously appreciated, even if callers do not feel that they are capable of performing optimum resuscitation.

  15. The impact of the TelEmergency program on rural emergency care: An implementation study.

    PubMed

    Sterling, Sarah A; Seals, Samantha R; Jones, Alan E; King, Melissa H; Galli, Robert L; Isom, Kristen C; Summers, Richard L; Henderson, Kristi A

    2017-07-01

    Introduction Timely, appropriate intervention is key to improving outcomes in many emergent conditions. In rural areas, it is particularly challenging to assure quality, timely emergency care. The TelEmergency (TE) program, which utilizes a dual nurse practitioner and emergency medicine-trained, board-certified physician model, has the potential to improve access to quality emergency care in rural areas. The objective of this study was to examine how the implementation of the TE program impacts rural hospital Emergency Department (ED) operations. Methods Methods included a before and after study of the effect of the TE program on participating rural hospitals between January 2007 and December 2008. Data on ED and hospital operations were collected one year prior to and one year following the implementation of TE. Data from participating hospitals were combined and compared for the two time periods. Results Nine hospitals met criteria for inclusion and participated in the study. Total ED volumes did not significantly change with TE implementation, but ED admissions to the same rural hospital significantly increased following TE implementation (6.7% to 8.1%, p-value = 0.02). Likewise, discharge rates from the ED declined post-initiation (87.1% to 80.0%, p-value = 0.003). ED deaths and transfer rates showed no significant change, while the rate of patient discharge against medical advice significantly increased with TE use. Discussion In this analysis, we found a significant increase in the rate of ED admissions to rural hospitals with TE use. These findings may have important implications for the quality of emergency care in rural areas and the sustainability of rural hospitals' EDs.

  16. Physiotherapists in emergency departments: responsibilities, accountability and education.

    PubMed

    Crane, Jacqueline; Delany, Clare

    2013-06-01

    Emergency physiotherapy roles have evolved within the UK and are increasingly being adopted in Australia in response to a need for greater workforce flexibility and improved service provision to meet growing patient demand. This paper discusses the need for the physiotherapy profession to develop evidence-based regulatory, ethical and educative frameworks to keep pace with the changing clinical environment and service delivery in emergency departments. Definitions of Emergency Physiotherapy as either advanced practice or extended scope of practice are identified, and the implications for both regulation of practice and education are highlighted. Suggestions for education in areas of clinical skills, ethical understanding and legal and professional knowledge are highlighted as important areas to support physiotherapists moving into this area of practice. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  17. [Measurement of the importance of user satisfaction dimensions in healthcare provision].

    PubMed

    Murillo, Carles; Saurina, Carme

    2013-01-01

    Identifying users' perceptions of the quality of care is essential to improve health services delivery. The main objective of this article was to describe the application of a methodology to identify factors that facilitate the identification of areas for improvement. A questionnaire was applied in three health areas in Catalonia (Spain) (primary care [n=332], outpatient specialty care [n=410] and hospital emergency care [n=413]) to measure user satisfaction and assess the importance given to the aspects analyzed. The main areas for improvement in primary care identified by an importance-performance analysis involved the time devoted to patients as well as health professionals' willingness to listen to their views. In hospital emergency care, the main area of improvement was related to the hospital's physical conditions. The tools designed and implemented by the Catalan Health Service (Spain) have proved to be valid for the detection of priority areas to improve service delivery and promote regional equity. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Emergency Communications Console

    NASA Technical Reports Server (NTRS)

    1978-01-01

    NASA has applied its communications equipment expertise to development of a communications console that provides, in a compact package only slightly larger than an electric typewriter, all the emergency medical services communications functions needed for a regional hospital. A prototype unit, built by Johnson Space Center, has been installed in the Odessa (Texas) Medical Center Hospital. The hospital is the medical control center for the 17-county Permian Basin Emergency Medical System in west Texas. The console project originated in response to a request to NASA from the Texas governor's office, which sought a better way of providing emergency medical care in rural areas. Because ambulance travel time is frequently long in remote areas of west Texas, it is important that treatment begin at the scene of the emergency rather than at the hospital emergency room. A radio and telephone system linking ambulance emergency technicians and hospital staff makes this possible. But earlier equipment was complex, requiring specialized operators. A highly reliable system was needed to minimize breakdowns and provide controls of utmost simplicity, so that the system could be operated by physicians and nurses rather than by communications specialists. The resulting console has both radio and telephone sections. With the radio equipment, hospital personnel can communicate with ambulance drivers and paramedics, receive incoming electrocardiagrams, consult with other hospitals, page hospital staff and set up a radio-to-telephone "patch." The telephone portion of the system includes a hotline from the Permian Basin Emergency Medical Service's resource control center, an automatic dialer for contacting special care facilities in the Permian Basin network, a hospital intercom terminal and a means of relaying cardioscope displays and other data between hospitals. The integrated system also provides links with local disaster and civil defense organizations and with emergency "Dial 911

  19. The Emerging Importance of IgG Fab Glycosylation in Immunity.

    PubMed

    van de Bovenkamp, Fleur S; Hafkenscheid, Lise; Rispens, Theo; Rombouts, Yoann

    2016-02-15

    Human IgG is the most abundant glycoprotein in serum and is crucial for protective immunity. In addition to conserved IgG Fc glycans, ∼15-25% of serum IgG contains glycans within the variable domains. These so-called "Fab glycans" are primarily highly processed complex-type biantennary N-glycans linked to N-glycosylation sites that emerge during somatic hypermutation. Specific patterns of Fab glycosylation are concurrent with physiological and pathological conditions, such as pregnancy and rheumatoid arthritis. With respect to function, Fab glycosylation can significantly affect stability, half-life, and binding characteristics of Abs and BCRs. Moreover, Fab glycans are associated with the anti-inflammatory activity of IVIgs. Consequently, IgG Fab glycosylation appears to be an important, yet poorly understood, process that modulates immunity. Copyright © 2016 by The American Association of Immunologists, Inc.

  20. Emerging souvenirs-clinical presentation of the returning traveller with imported arbovirus infections in Europe.

    PubMed

    Eckerle, I; Briciu, V T; Ergönül, Ö; Lupşe, M; Papa, A; Radulescu, A; Tsiodras, S; Tsitou, C; Drosten, C; Nussenblatt, V R; Reusken, C B; Sigfrid, L A; Beeching, N J

    2018-03-01

    Arboviruses are an emerging group of viruses that are causing increasing health concerns globally, including in Europe. Clinical presentation usually consists of a nonspecific febrile illness that may be accompanied by rash, arthralgia and arthritis, with or without neurological or haemorrhagic syndromes. The range of differential diagnoses of other infectious and noninfectious aetiologies is broad, presenting a challenge for physicians. While knowledge of the geographical distribution of pathogens and the current epidemiological situation, incubation periods, exposure risk factors and vaccination history can help guide the diagnostic approach, the nonspecific and variable clinical presentation can delay final diagnosis. This narrative review aims to summarize the main clinical and laboratory-based findings of the three most common imported arboviruses in Europe. Evidence is extracted from published literature and clinical expertise of European arbovirus experts. We present three cases that highlight similarities and differences between some of the most common travel-related arboviruses imported to Europe. These include a patient with chikungunya virus infection presenting in Greece, a case of dengue fever in Turkey and a travel-related case of Zika virus infection in Romania. Early diagnosis of travel-imported cases is important to reduce the risk of localized outbreaks of tropical arboviruses such as dengue and chikungunya and the risk of local transmission from body fluids or vertical transmission. Given the global relevance of arboviruses and the continuous risk of (re)emerging arbovirus events, clinicians should be aware of the clinical syndromes of arbovirus fevers and the potential pitfalls in diagnosis. Copyright © 2018. Published by Elsevier Ltd.

  1. The impact of an emergency hiring plan on the shortage and distribution of nurses in Kenya: the importance of information systems

    PubMed Central

    Gross, JM; Riley, PL; Kiriinya, R; Rakuom, C; Willy, R; Kamenju, A; Oywer, E; Wambua, D; Waudo, A

    2010-01-01

    Abstract Objective To analyse the effect of Kenya’s Emergency Hiring Plan for nurses on their inequitable distribution in rural and underserved areas. Methods We used data from the Kenya Health Workforce Informatics System on the nursing workforce to determine the effect of the Emergency Hiring Plan on nurse shortages and maldistribution. The total number of nurses, the number of nurses per 100 000 population and the opening of previously closed or new heath facilities were recorded. Findings Of the 18 181 nurses employed in Kenya’s public sector in 2009, 1836 (10%) had been recruited since 2005 through the Emergency Hiring Plan. Nursing staff increased by 7% in hospitals, 13% in health centres and 15% in dispensaries. North Eastern province, which includes some of the most remote areas, benefited most: the number of nurses per 100 000 population increased by 37%. The next greatest increase was in Nyanza province, which has the highest prevalence of HIV infection in Kenya. Emergency Hiring Plan nurses enabled the number of functioning public health facilities to increase by 29%. By February 2010, 94% of the nurses hired under pre-recruitment absorption agreements had entered the civil service. Conclusion The Emergency Hiring Plan for nurses significantly increased health services in Kenya’s rural and underserved areas over the short term. Preliminary indicators of sustainability are promising, as most nurses hired are now civil servants. However, continued monitoring will be necessary over the long term to evaluate future nurse retention. The accurate workforce data provided by the Kenya Health Workforce Informatics System were essential for evaluating the effect of the Emergency Hiring Plan. PMID:21076563

  2. A strategy to implement and support pre-hospital emergency medical systems in developing, resource-constrained areas of South Africa.

    PubMed

    Sun, Jared H; Shing, Rachel; Twomey, Michele; Wallis, Lee A

    2014-01-01

    Resource-constrained countries are in extreme need of pre-hospital emergency care systems. However, current popular strategies to provide pre-hospital emergency care are inappropriate for and beyond the means of a resource-constrained country, and so new ones are needed-ones that can both function in an under-developed area's particular context and be done with the area's limited resources. In this study, we used a two-location pilot and consensus approach to develop a strategy to implement and support pre-hospital emergency care in one such developing, resource-constrained area: the Western Cape province of South Africa. Local community members are trained to be emergency first aid responders who can provide immediate, on-scene care until a Transporter can take the patient to the hospital. Management of the system is done through local Community Based Organizations, which can adapt the model to their communities as needed to ensure local appropriateness and feasibility. Within a community, the system is implemented in a graduated manner based on available resources, and is designed to not rely on the whole system being implemented first to provide partial function. The University of Cape Town's Division of Emergency Medicine and the Western Cape's provincial METRO EMS intend to follow this model, along with sharing it with other South African provinces. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. 13 CFR 123.4 - What is a disaster area and why is it important?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What is a disaster area and why is it important? 123.4 Section 123.4 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION DISASTER LOAN PROGRAM Overview § 123.4 What is a disaster area and why is it important? Each disaster...

  4. The Role of Religious Beliefs and Practices on Emerging Adults' Perceived Competencies, Perceived Importance Ratings, and Global Self-Worth

    ERIC Educational Resources Information Center

    Barry, Carolyn McNamara; Nelson, Larry J.

    2008-01-01

    Although religious participation declines during emerging adulthood (18 years through middle 20s), most emerging adults still claim that their religious beliefs are important to them. However, little research has been conducted to examine the role that religious beliefs and practices may play in the development of self-perceptions during emerging…

  5. Emerging governance approaches for tourism in the protected areas of china.

    PubMed

    Su, Dan; Wall, Geoffrey; Eagles, Paul F J

    2007-06-01

    This paper examines the recent evolution in the governance of protected area tourism in China. China now sees cooperation in the form of public-private partnerships occurring between authorized private tourism enterprises in various organizational forms and the public managers from specific portfolio departments of governments at different levels. Three types of governance models are visible: the Leasing Model, the Non-listed Share-holding Model, and the Public-listed Share-holding Model. Theories of corporate governance were applied to these models to analyze the internal and external mechanisms of supervision and incentives for both the government agencies and the authorized tourism enterprises for nature-based tourism operations. The Principal-Agent problem and the supervision mechanism are the focus of the analysis. The emerging governance approaches for tourism in protected areas of China are all theoretically viable, as explained by the theory of property rights and corporate governance, and practically viable as elaborated in the cases of the three types of governance models summarized in this paper.

  6. 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

  7. 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.

  8. Volcanic risk perception of young people in the urban areas of Vesuvius: Comparisons with other volcanic areas and implications for emergency management

    USGS Publications Warehouse

    Carlino, S.; Somma, R.; Mayberry, G.C.

    2008-01-01

    More than 600 000 people are exposed to volcanic risk in the urban areas near the volcano, Vesuvius, and may need to be evacuated if there is renewed volcanic activity. The success of a future evacuation will strongly depend on the level of risk perception and preparedness of the at-risk communities during the current period of quiescence. The volcanic risk perception and preparedness of young people is of particular importance because hazard education programs in schools have been shown to increase the clarity of risk perception and students often share their knowledge with their parents. In order to evaluate young people's risk perception and preparedness for a volcanic crisis, a multiple choice questionnaire was distributed to 400 high-school students in three municipalities located close to the volcano. The overall results suggest that despite a 60-year period of quiescence at Vesuvius, the interviewed students have an accurate perception of the level of volcanic risk. On the other hand, the respondents demonstrate a clear lack of understanding of volcanic processes and their related hazards. Also, the interviewed students show high levels of fear, poor perceived ability to protect themselves from the effects of a future eruption, and insufficient knowledge of the National Emergency Plan for Vesuvian Area (NEPVA). The latter result suggests that in comparison with volcanic crises in other regions, during a future eruption of Vesuvius, there may not be enough time to educate the large number of people living near the volcano about how to appropriately respond. The inadequate risk education and preparedness of respondents implies that a strong effort is needed to improve communication strategies in order to facilitate successful evacuations. Therefore, it is important to take advantage of the present period of quiescence at Vesuvius to improve the accuracy of risk perception of youth in local communities. ?? 2008.

  9. Quantifying the relative irreplaceability of important bird and biodiversity areas.

    PubMed

    Di Marco, Moreno; Brooks, Thomas; Cuttelod, Annabelle; Fishpool, Lincoln D C; Rondinini, Carlo; Smith, Robert J; Bennun, Leon; Butchart, Stuart H M; Ferrier, Simon; Foppen, Ruud P B; Joppa, Lucas; Juffe-Bignoli, Diego; Knight, Andrew T; Lamoreux, John F; Langhammer, Penny F; May, Ian; Possingham, Hugh P; Visconti, Piero; Watson, James E M; Woodley, Stephen

    2016-04-01

    World governments have committed to increase the global protected areas coverage by 2020, but the effectiveness of this commitment for protecting biodiversity depends on where new protected areas are located. Threshold- and complementarity-based approaches have been independently used to identify important sites for biodiversity. We brought together these approaches by performing a complementarity-based analysis of irreplaceability in important bird and biodiversity areas (IBAs), which are sites identified using a threshold-based approach. We determined whether irreplaceability values are higher inside than outside IBAs and whether any observed difference depends on known characteristics of the IBAs. We focused on 3 regions with comprehensive IBA inventories and bird distribution atlases: Australia, southern Africa, and Europe. Irreplaceability values were significantly higher inside than outside IBAs, although differences were much smaller in Europe than elsewhere. Higher irreplaceability values in IBAs were associated with the presence and number of restricted-range species; number of criteria under which the site was identified; and mean geographic range size of the species for which the site was identified (trigger species). In addition, IBAs were characterized by higher irreplaceability values when using proportional species representation targets, rather than fixed targets. There were broadly comparable results when measuring irreplaceability for trigger species and when considering all bird species, which indicates a good surrogacy effect of the former. Recently, the International Union for Conservation of Nature has convened a consultation to consolidate global standards for the identification of key biodiversity areas (KBAs), building from existing approaches such as IBAs. Our results informed this consultation, and in particular a proposed irreplaceability criterion that will allow the new KBA standard to draw on the strengths of both threshold- and

  10. Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

    PubMed

    Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

    2017-12-01

    Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. A Longitudinal Emergency Medical Services Track in Emergency Medicine Residency.

    PubMed

    Adams, Daniel; Bischof, Jason; Larrimore, Ashley; Krebs, William; King, Andrew

    2017-03-30

    Emergency medicine residency programs offer Emergency Medical Services (EMS) curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. While some programs offer advanced clinical tracks in EMS, no standard curriculum exists. We sought to establish a well-defined EMS curriculum to allow interested residents to develop advanced clinical skills and scholarship within this subspecialty. Core EMS fellowship trained faculty were recruited to help develop the curriculum. Building on ACGME graduation requirements and milestones, important elements of EMS fellowship training were incorporated into the curriculum to develop the final document. The final curriculum focuses on scholarly activities relating to the four core areas of EMS identified by The American Board of Emergency Medicine and serves as an intermediary between ACGME graduation requirements for education in EMS and fellowship level training. Standardization of the EMS scholarly track can provide residents with the potential to obtain competency beyond ACGME requirements and prepare them for success in fellowship training and/or leadership within EMS on graduation.

  12. A Longitudinal Emergency Medical Services Track in Emergency Medicine Residency

    PubMed Central

    Bischof, Jason; Larrimore, Ashley; Krebs, William; King, Andrew

    2017-01-01

    Emergency medicine residency programs offer Emergency Medical Services (EMS) curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. While some programs offer advanced clinical tracks in EMS, no standard curriculum exists. We sought to establish a well-defined EMS curriculum to allow interested residents to develop advanced clinical skills and scholarship within this subspecialty. Core EMS fellowship trained faculty were recruited to help develop the curriculum. Building on ACGME graduation requirements and milestones, important elements of EMS fellowship training were incorporated into the curriculum to develop the final document. The final curriculum focuses on scholarly activities relating to the four core areas of EMS identified by The American Board of Emergency Medicine and serves as an intermediary between ACGME graduation requirements for education in EMS and fellowship level training. Standardization of the EMS scholarly track can provide residents with the potential to obtain competency beyond ACGME requirements and prepare them for success in fellowship training and/or leadership within EMS on graduation. PMID:28465874

  13. Emergence of tick-borne encephalitis in new endemic areas in Austria: 42 years of surveillance.

    PubMed

    Heinz, F X; Stiasny, K; Holzmann, H; Kundi, M; Sixl, W; Wenk, M; Kainz, W; Essl, A; Kunz, C

    2015-04-02

    Human infections with tick-borne encephalitis (TBE)virus are a public health concern in certain regions of Europe, central and eastern Asia. Expansions of endemic areas and increased incidences have been associated with different factors including ecological changes supporting tick reproduction, socioeconomic changes increasing human outdoor activities and climatic changes favouring virus circulation in natural foci. Austria is among the most strongly affected countries in Central Europe, but the annual number of cases has strongly declined due to vaccination. Here,we have analysed changes of the incidence of TBE in the unvaccinated population of all federal states of Austria over a period of 42 years. The overall incidence in Austria has remained constant, but new strongly affected endemic regions have emerged in alpine valleys in the west of Austria. In parallel, the incidence in low-land regions in the north-east of the country is decreasing. There is no evidence for a shift to higher altitudes of infection sites in the traditional TBE zones,but the average altitudes of some newly established endemic areas in the west are significantly higher. Our analyses underscore the focal nature of TBE endemic areas and the potential of TBE virus to emerge in previously unaffected regions.

  14. Examining the importance of incorporating emergency preparedness and disaster training core competencies into allied health curricula.

    PubMed

    Curtis, Tammy

    2015-01-01

    Preparation for responding to emergency events that does not warrant outside help beyond the local community resources or responding to disaster events that is beyond the capabilities of the local community both require first responders and healthcare professionals to have interdisciplinary skills needed to function as a team for saving lives. To date, there is no core emergency preparedness and disaster planning competencies that have been standardized at all levels across the various allied health curricula disciplines. To identify if emergency preparedness and disaster training content are currently being taught in allied health program courses, to identify possible gaps within allied health curricula, and to explore the perceptions of allied health college educators for implementing emergency preparedness and disaster training core competencies into their existing curricula, if not already included. A quantitative Internet-based survey was conducted in 2013. Convenient sample. Fifty-one allied health college educators completed the survey. Descriptive statistics indicated that the majority of allied health college instructors do not currently teach emergency preparedness and disaster training core competency content within their current allied health discipline; however, their perceived level of importance for inclusion of the competencies was high. The results of this study supported the need for developing and establishing a basic national set of standardized core emergency preparedness and disaster planning competencies at all levels across various allied health curricula disciplines to ensure victims receive the best patient care and have the best possible chance of survival.

  15. Heavy Precipitation impacts and emergency planning - developing applicable strategies for a metropolitan area

    NASA Astrophysics Data System (ADS)

    Kutschker, Thomas; Glade, Thomas

    2016-04-01

    Heavy rainfall in central Europe is one of the assumed effects of climate change, which occurs with large seasonal and regional differences in its magnitude. The extent of loss depends on natural parameters (e.g. topography and vegetation) as well as on socio-economic factors like urbanized and industrialized areas and population density. Dangerous cascade effects appear, if critical infrastructure like the electrical power supply is affected. In some cases mudflows and flash floods cause inundated or undercut roads and cause a high demand for fast and effective assistance of the authorities. The civil protection in Germany is based on a federal system with a bottom-up command-structure and responsibility to the local community. Commonly this responsibility is taken by the fire brigades and civil protection units of the community or district. After heavy rainfall in an urban area, numerous incidents and emergency calls appearing at a time are overstressing the human and technical resources of the fire brigades within the local authority frequently. In this study, a method of comprehensive evaluation of meteorological data and the operation data from local fire brigades shall be developed for the Rhine-Main-Area in order to identify particular affected spots of heavy rain and bundle resources of the fire brigades. It is to be found out if the study area contains regions with a particularly high exposure to heavy rain and high application numbers of the fire department and whether there is a relationship of rainfall and frequency of use. To evaluate particular local effects on the fire brigades capability, a brief analysis of the meteorological data provided by the German Meteorological Service (DWD) as well as the evaluation of the incident data of the affected fire brigades, is used to frame a realistic approach. In particular fire brigade operation data can be used accordingly to describe the intensity of the aftermath when heavy precipitation strikes a certain

  16. The importance of source area mapping for rockfall hazard analysis

    NASA Astrophysics Data System (ADS)

    Valagussa, Andrea; Frattini, Paolo; Crosta, Giovanni B.

    2013-04-01

    A problem in the characterization of the area affected by rockfall is the correct source areas definition. Different positions or different size of the source areas along a cliff result in different possibilities of propagation and diverse interaction with passive countermeasures present in the area. Through the use of Hy-Stone (Crosta et al., 2004), a code able to perform 3D numerical modeling of rockfall processes, different types of source areas were tested on a case study slope along the western flank of the Mt. de La Saxe (Courmayeur, AO), developing between 1200 and 2055 m s.l.m. The first set of source areas consists of unstable rock masses identified on the basis of field survey and Terrestrial Laser Scanning (IMAGEO, 2011). A second set of source areas has been identified by using different thresholds of slope gradient. We tested slope thresholds between 50° and 75° at 5° intervals. The third source area dataset has been generating by performing a kinematic stability analysis. For this analysis, we mapped the join sets along the rocky cliff by means of the software COLTOP 3D (Jaboyedoff, 2004), and then we identified the portions of rocky cliff where planar/wedge and toppling failures are possible assuming an average friction angle of 35°. Through the outputs of the Hy-Stone models we extracted and analyzed the kinetic energy, height of fly and velocity of the blocks falling along the rocky cliff in order to compare the controls of different source areas. We observed strong variations of kinetic energy and fly height among the different models, especially when using unstable masses identified through Terrestrial Laser Scanning. This is mainly related to the size of the blocks identified as susceptible to failure. On the contrary, the slope gradient thresholds does not have a strong impact on rockfall propagation. This contribution highlights the importance of a careful and appropriate mapping of rockfall source area for rockfall hazard analysis and the

  17. Public nutrition in complex emergencies.

    PubMed

    Young, Helen; Borrel, Annalies; Holland, Diane; Salama, Peter

    Public nutrition is a broad-based, problem-solving approach to addressing malnutrition in complex emergencies that combines analysis of nutritional risk and vulnerability with action-oriented strategies, including policies, programmes, and capacity development. This paper focuses on six broad areas: nutritional assessment, distribution of a general food ration, prevention and treatment of moderate malnutrition, treatment of severe malnutrition in children and adults, prevention and treatment of micronutrient deficiency diseases, and nutritional support for at-risk groups, including infants, pregnant and lactating women, elderly people, and people living with HIV. Learning and documenting good practice from previous emergencies, the promotion of good practice in current emergencies, and adherence to international standards and guidelines have contributed to establishing the field of public nutrition. However, many practical challenges reduce the effectiveness of nutritional interventions in complex emergencies, and important research and programmatic questions remain.

  18. [Hantavirus as important emerging agents in South America].

    PubMed

    Ondoño, Andrés F; Levis, Silvana; Rodas, Juan D

    2011-01-01

    The dawning of the 20th century was marked by the emergence of new infectious disease agents and the appearance of others previously thought controlled. Both phenomena were possibly connected with ecological disturbances that led to the recognition of a dramatic climate change, of which the effects are only now becoming noticeable. Among the variety of agents to be considered, the many new viruses stand out, not only for their numerical proliferation, but also for their genetic versatility. It is this quality that provides them dexterity for evolving new strategies and adaptations to changing environmental conditions. Recently, some of the most ubiquitous and well-publicized viral agents in the American continents have been the rodent-borne viruses, and among these are the hantaviruses, etiological agents of pulmonary syndromes. Approximately 18 hantaviruses (belonging to the family Bunyaviridae), have been discovered in South America during the last 20 years, and although most of them cause persistent infections and subclinical infections in wild rodents (particularly members of the subfamily Sigmodontinae) and humans respectively; some others might also be highly lethal for humans. The goal herein is to review the state of the art regarding general aspects of hantaviruses and the diseases they cause around the world, highlighting the most recent findings in Colombia. Finally, the many unanswered questions will be recognized and highlighted concerning clinical importance and socio-economic impact of these agents on quality of public health in Colombia.

  19. Emerging and re-emerging infections.

    PubMed

    Lim, V K

    1999-06-01

    An emerging infection is defined as an infection which has newly appeared in a population while a re-emerging infection is one which has existed in the past but its incidence is rapidly increasing. The reasons for the emergence and re-emergence of infections are not well understood but appear to be associated with factors that involve the pathogen, the host and the environment. These factors are often inter-related and act together in a complex manner to bring about changes in patterns of infection. Pathogens are extremely resourceful and possess mechanisms to adapt to new hosts and environments as well as to acquire new virulence traits. Host factors include herd immunity, social behaviour and demographics. Environmental factors like the climate, deforestation and new technologies have an impact on the emergence of infections. The challenge is to contain an infection when it emerges but more importantly to prevent its emergence in the first place. As the emergence of an infection is complex and multifactorial, a multidisciplinary approach is required. Health based strategies alone are insufficient. Social, economic and environmental measures and the political will to implement appropriate policies are equally important.

  20. Remote sensing and GIS analyses for emergency manouvering and forced landing areas definition as a support for general aviation flights

    NASA Astrophysics Data System (ADS)

    Skocki, Krzysztof

    2016-08-01

    This paper summarizes the preliminary analyses of using existing remote sensing data, medium and high-resolution satellite and airborne data to define safe emergency landing and maneuvering areas to be used by small aircrafts operating from small airports and airfields in Poland. The pilots need to know such places in the interest of safe flight operations. In common practice, flying instructors typically show the student pilot fields around the airfield supposed to be suitable for emergency or precautionary landing (or ditching) in the initial phase of the training. Although it looks to cover the most basic needs, the problem still exists in relation to guest pilots. To fill this gap, the unified safety map document covering the safe emergency areas around the airfields is proposed in this research. Use of satellite high resolution data, as well as aerial photos, infrastructure information, with use of GIS tools (like buffer zones, distance, equal-time circles or position lines) enable to check the terrain around selected airfields and define possible areas suitable for emergency operations. In the second phase of work, selected areas will be described in terms of easy navigation, possible infrastructure around them, rescue possibilities, radio signal coverage, and others. The selected areas should be also checked for typical cover and surface hardness and stability (eg. with use of moisture estimation on the base of middle-resolution satellite data). Its planned to prepare one combined and separate sheets of the final map for various aircraft characteristics (`classes' of small Cessna-related, big Cessna-related, fast low-wing Diamond-like, two-engine Piper-like). The presented concept should highly increase the safety operations for small aviation in secondary airports and airfields, where the information available is limited. There is also a possibility to make a similar maps for `cruise', which means the areas with dense traffic between the airports/airfields.

  1. [Intervention to reduce the impact of light and noise on sleep in an emergency department observation area].

    PubMed

    Villamor Ordozgoiti, Alberto; Priu Parra, Inmaculada; España Salvador, María Carmen; Torres Valdés, Constancia; Bas Ciutad, María Pilar; Ponce Quílez, María Rosa

    2017-02-01

    To study quality of patient rest before and after an intervention to reduce nighttime light and noise in the emergency department observation area of an urban hospital. Quasi-experimental study in 2 groups before and after the intervention in the observation area of the Hospital Clínic de Barcelona. We administered a questionnaire about the quality of nighttime rest to assess the effect of light and noise on sleep. Light and noise were reduced by means of structural changes to the environment and through the introduction of protocols to modify how care plans were carried out at night. Fifty nurses participated in the pre-intervention study and 371 in the post-intervention study. Seventy-two percent and 91.37% of the patients reported resting well before and after the intervention, respectively (P< .001). Factors like pain, nursing care, or daytime naps do not affect sleep quality. Nighttime rest in emergency department observation areas is affected by ambient light and noise more than by other variables. Reducing light and noise at night can measurably improve patients' rest.

  2. Avitourism and Australian Important Bird and Biodiversity Areas.

    PubMed

    Steven, Rochelle; Morrison, Clare; Arthur, J Michael; Castley, J Guy

    2015-01-01

    Formal protected areas will not provide adequate protection to conserve all biodiversity, and are not always designated using systematic or strategic criteria. Using a systematic process, the Important Bird and Biodiversity Area (IBA) network was designed to highlight areas of conservation significance for birds (i.e. IBA trigger species), and more recently general biodiversity. Land use activities that take place in IBAs are diverse, including consumptive and non-consumptive activities. Avitourism in Australia, generally a non-consumptive activity, is reliant on the IBA network and the birds IBAs aim to protect. However, companies tend not to mention IBAs in their marketing. Furthermore, avitourism, like other nature-based tourism has the potential to be both a threatening process as well as a conservation tool. We aimed to assess the current use of IBAs among Australian-based avitour companies' marketing, giving some indication of which IBAs are visited by avitourists on organised tours. We reviewed online avitour itineraries, recorded sites featuring in descriptions of avitours and which IBA trigger species are used to sell those tours. Of the 209 avitours reviewed, Queensland is the most featured state (n = 59 tours), and 73% feature at least one IBA. Daintree (n = 22) and Bruny Island (n = 17) IBAs are the most popular, nationally. Trigger species represent 34% (n = 254 out of 747) of species used in avitour descriptions. The most popular trigger species' are wetland species including; Brolga (n = 37), Black-necked Stork (n = 30) and Magpie Goose (n = 27). Opportunities exist to increase collaboration between avitour companies and IBA stakeholders. Our results can provide guidance for managing sustainability of the avitourism industry at sites that feature heavily in avitour descriptions and enhance potential cooperation between avitour companies, IBA stakeholders and bird conservation organisations.

  3. Avitourism and Australian Important Bird and Biodiversity Areas

    PubMed Central

    Steven, Rochelle; Morrison, Clare; Arthur, J. Michael; Castley, J. Guy

    2015-01-01

    Formal protected areas will not provide adequate protection to conserve all biodiversity, and are not always designated using systematic or strategic criteria. Using a systematic process, the Important Bird and Biodiversity Area (IBA) network was designed to highlight areas of conservation significance for birds (i.e. IBA trigger species), and more recently general biodiversity. Land use activities that take place in IBAs are diverse, including consumptive and non-consumptive activities. Avitourism in Australia, generally a non-consumptive activity, is reliant on the IBA network and the birds IBAs aim to protect. However, companies tend not to mention IBAs in their marketing. Furthermore, avitourism, like other nature-based tourism has the potential to be both a threatening process as well as a conservation tool. We aimed to assess the current use of IBAs among Australian-based avitour companies’ marketing, giving some indication of which IBAs are visited by avitourists on organised tours. We reviewed online avitour itineraries, recorded sites featuring in descriptions of avitours and which IBA trigger species are used to sell those tours. Of the 209 avitours reviewed, Queensland is the most featured state (n = 59 tours), and 73% feature at least one IBA. Daintree (n = 22) and Bruny Island (n = 17) IBAs are the most popular, nationally. Trigger species represent 34% (n = 254 out of 747) of species used in avitour descriptions. The most popular trigger species’ are wetland species including; Brolga (n = 37), Black-necked Stork (n = 30) and Magpie Goose (n = 27). Opportunities exist to increase collaboration between avitour companies and IBA stakeholders. Our results can provide guidance for managing sustainability of the avitourism industry at sites that feature heavily in avitour descriptions and enhance potential cooperation between avitour companies, IBA stakeholders and bird conservation organisations. PMID:26701779

  4. Important bird areas of the Madrean Archipelago: A conservation strategy for avian communities

    Treesearch

    Vashti (Tice) Supplee; Jennie MacFarland

    2013-01-01

    The Important Bird Areas (IBA) Program is a worldwide program through BirdLife International that identifies sites considered to provide important habitats for avian species. Criteria for designation are species abundance, diversity, and range restriction. As the United States Partner of BirdLife International, the National Audubon Society administers the IBA Program...

  5. Northern protected areas will become important refuges for biodiversity tracking suitable climates.

    PubMed

    Berteaux, Dominique; Ricard, Marylène; St-Laurent, Martin-Hugues; Casajus, Nicolas; Périé, Catherine; Beauregard, Frieda; de Blois, Sylvie

    2018-03-15

    The Northern Biodiversity Paradox predicts that, despite its globally negative effects on biodiversity, climate change will increase biodiversity in northern regions where many species are limited by low temperatures. We assessed the potential impacts of climate change on the biodiversity of a northern network of 1,749 protected areas spread over >600,000 km 2 in Quebec, Canada. Using ecological niche modeling, we calculated potential changes in the probability of occurrence of 529 species to evaluate the potential impacts of climate change on (1) species gain, loss, turnover, and richness in protected areas, (2) representativity of protected areas, and (3) extent of species ranges located in protected areas. We predict a major species turnover over time, with 49% of total protected land area potentially experiencing a species turnover >80%. We also predict increases in regional species richness, representativity of protected areas, and species protection provided by protected areas. Although we did not model the likelihood of species colonising habitats that become suitable as a result of climate change, northern protected areas should ultimately become important refuges for species tracking climate northward. This is the first study to examine in such details the potential effects of climate change on a northern protected area network.

  6. A GIS-based model to estimate flood consequences and the degree of accessibility and operability of strategic emergency response structures in urban areas

    NASA Astrophysics Data System (ADS)

    Albano, R.; Sole, A.; Adamowski, J.; Mancusi, L.

    2014-11-01

    Efficient decision-making regarding flood risk reduction has become a priority for authorities and stakeholders in many European countries. Risk analysis methods and techniques are a useful tool for evaluating costs and benefits of possible interventions. Within this context, a methodology to estimate flood consequences was developed in this paper that is based on GIS, and integrated with a model that estimates the degree of accessibility and operability of strategic emergency response structures in an urban area. The majority of the currently available approaches do not properly analyse road network connections and dependencies within systems, and as such a loss of roads could cause significant damages and problems to emergency services in cases of flooding. The proposed model is unique in that it provides a maximum-impact estimation of flood consequences on the basis of the operability of the strategic emergency structures in an urban area, their accessibility, and connection within the urban system of a city (i.e. connection between aid centres and buildings at risk), in the emergency phase. The results of a case study in the Puglia region in southern Italy are described to illustrate the practical applications of this newly proposed approach. The main advantage of the proposed approach is that it allows for defining a hierarchy between different infrastructure in the urban area through the identification of particular components whose operation and efficiency are critical for emergency management. This information can be used by decision-makers to prioritize risk reduction interventions in flood emergencies in urban areas, given limited financial resources.

  7. Evaluating the effectiveness of burned area emergency response (BAER) efforts after the 2003 wildfires, southern California

    Treesearch

    Peter M. Wohlgemuth; Ken R. Hubbert; Jan L. Beyers; David R. Weise

    2007-01-01

    Wildfires burned approximately 300,000 hectares (750,000 acres) across southern California in the fall of 2003. Over 10 million dollars were spent on Burned Area Emergency Response (BAER) treatments following these fires. To support the BAER efforts, we designed a comprehensive strategy with standardized protocols to evaluate the effectiveness of various erosion...

  8. Quantifying area changes of internationally important wetlands due to water consumption in LCA.

    PubMed

    Verones, Francesca; Pfister, Stephan; Hellweg, Stefanie

    2013-09-03

    Wetlands harbor diverse species assemblages but are among the world's most threatened ecosystems. Half of their global area was lost during the last century. No approach currently exists in life cycle impact assessment that acknowledges the vulnerability and importance of wetlands globally and provides fate factors for water consumption. We use data from 1184 inland wetlands, all designated as sites of international importance under the Ramsar Convention, to develop regionalized fate factors (FF) for consumptive water use. FFs quantify the change of wetland area caused per m(3)/yr water consumed. We distinguish between surface water-fed and groundwater-fed wetlands and develop FFs for surface water and groundwater consumption. FFs vary over 8 (surface water-fed) and 6 (groundwater-fed) orders of magnitude as a function of the site characteristics, showing the importance of local conditions. Largest FFs for surface water-fed wetlands generally occur in hyper-arid zones and smallest in humid zones, highlighting the dependency on available surface water flows. FFs for groundwater-fed wetlands depend on hydrogeological conditions and vary largely with the total amount of water consumed from the aquifer. Our FFs translate water consumption into wetland area loss and thus become compatible with life cycle assessment methodologies of land use.

  9. Parallel imports and innovation in an emerging economy: the case of Indian pharmaceuticals.

    PubMed

    Mantovani, Andrea; Naghavi, Alireza

    2012-11-01

    This paper studies the impact of the re-importation of imitated pharmaceuticals as a by-product of an open policy toward parallel import (PI) on process innovation. Foreign investment by a firm to exploit a new unregulated market with weak intellectual property rights can give rise to imitation. These products can potentially re-enter the original country when PI is allowed influencing research and development (R&D) incentives. In an emerging economy with technologically heterogeneous firms, trade costs shift PI-related market share losses from the more to the less R&D efficient firm, inducing the former to strategically increase R&D. PI accompanied by tariffs also induces higher R&D effort by the technologically inferior firm when it results in an expansion of its sales abroad. A tariff on PI is most likely to increase welfare when the technological gap between the two firms at home is sufficiently large. Copyright © 2011 John Wiley & Sons, Ltd.

  10. Love Canal Emergency Declaration Area habitability study. Volume 2. Air assessment: indicator chemicals. Final report

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

    Not Available

    Environmental studies were conducted to provide data that could be used by the Commissioner of Health for the State of New York in determining whether the Emergency Declaration Area (EDA) surrounding the Love Canal hazardous-waste site is habitable. An air assessment was conducted for Love Canal Indicator Chemicals. Homes throughout the EDA were sampled using the Trace Atmospheric Gas Analyzer Model 6000E.

  11. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    PubMed Central

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  12. [Study on effect of 3 types of drinking water emergent disinfection models in flood/waterlog areas].

    PubMed

    Ban, Haiqun; Li, Jin; Li, Xinwu; Zhang, Liubo

    2010-09-01

    To establish 3 drinking water emergent disinfection processing models, separated medicate dispensing, specific duty medicate dispensing, and centralized filtering, in flood/waterlog areas, and compare the effects of these 3 models on the drinking water disinfection processing. From October to December, 2008, 18 villages were selected as the trial field in Yanglinwei town, Xiantao city, Hubei province, which were divided into three groups, separated medicate dispensing, specific duty medicate dispensing, and centralized filtering. Every 2 weeks, drinking water source water, yielding water of emergency central filtrate water equipment (ECFWE) and container water in the kitchen were sampled and microbe indices of the water sample, standard plate-count bacteria, total coliforms, thermotolerant coliform bacteria, Escherichia coli were measured. The microbe pollution of the water of these 3 water source groups are heavy, all failed. The eliminating rate of the standard plate-count bacteria of the drinking water emergent centralized processing equipment is 99.95%; those of the separate medicate dispensing, specific duty medicate dispensing and centralized filtering are 81.93%, 99.67%, and 98.28%, respectively. The passing rates of the microbe indice of the resident contained water are 13.33%, 70.00%, and 43.33%, respectively. The difference has statistical significance. The drinking water disinfection effects of the centralized filtering model and of the specific duty medicate dispensing model are better than that of the separated medicate dispensing model in the flood/waterlog areas.

  13. Educating Emergency Managers About Weather -Related Hazards

    NASA Astrophysics Data System (ADS)

    Spangler, T. C.; Johnson, V.

    2006-12-01

    The most common crises that emergency managers face are those related to hazardous weather - snowstorms, floods, hurricanes, heat waves, tornadoes, etc. However, man-made disasters, such as accidental releases of hazardous substances or terrorist acts, also often have a weather component. For example, after the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, emergency managers were concerned that thunderstorms in the area might cause the building to collapse, putting rescuers in further danger. Training emergency managers to recognize the importance of weather in disaster planning and response has been a small but important focus of the COMET Program's educational development effort. Topics addressed in COMET training modules that are pertinent to emergency management include fire weather, hurricanes, flood events, and air contaminant dispersion. Additionally, the module entitled Anticipating Hazardous Weather and Community Risk provides an overview of basic meteorological processes, describes a broad range of weather phenomenon, and then addresses what forecast products are available to emergency managers to assess a threat to their community. In many of the modules, learners are presented with scenarios that give them the opportunity to practice decision-making in hazardous weather situations. We will demonstrate some of those scenarios and discuss how training can be used to model good emergency management skills. We will discuss ways to communicate with the emergency management community and provide examples of how distance learning can be used to educate and train emergency managers.

  14. Underground storage of imported water in the San Gorgonio Pass area, southern California

    USGS Publications Warehouse

    Bloyd, Richard M.

    1971-01-01

    The San Gorgonio Pass ground-water basin is divided into the Beaumont, Banning, Cabazon, San Timoteo, South Beaumont, Banning Bench, and Singleton storage units. The Beaumont storage unit, centrally located in the agency area, is the largest in volume of the storage units. Estimated long-term average annual precipitation in the San Gorgonio Pass Water Agency drainage area is 332,000 acre-feet, and estimated average annual recoverable water is 24,000 acre-feet, less than 10 percent of the total precipitation. Estimated average annual surface outflow is 1,700 acre-feet, and estimated average annual ground-water recharge is 22,000 acre-feet. Projecting tack to probable steady-state conditions, of the 22.000 acre-feet of recharge, 16,003 acre-feet per year became subsurface outflow into Coachella Valley, 6,000 acre-feet into the Redlands area, and 220 acre-feet into Potrero Canyon. After extensive development, estimated subsurface outflow from the area in 1967 was 6,000 acre-feet into the Redlands area, 220 acre-feet into Potrero Canyon, and 800 acre-feet into the fault systems south of the Banning storage unit, unwatered during construction of a tunnel. Subsurface outflow into Coachella Valley in 1967 is probably less than 50 percent of the steady-state flow. An anticipated 17,000 .acre-feet of water per year will be imported by 1980. Information developed in this study indicates it is technically feasible to store imported water in the eastern part of the Beaumont storage unit without causing waterlogging in the storage area and without losing any significant quantity of stored water.

  15. The importance of protected areas for the forest and endemic avifauna of Sulawesi (Indonesia).

    PubMed

    Lee, Tien Ming; Sodhi, Navjot S; Prawiradilaga, Dewi M

    2007-09-01

    Protected areas are critical for the conservation of residual tropical forest biodiversity, yet many of these are being deforested by humans both within and outside of their administrative boundaries. Therefore, it is critical to document the significance of protected areas for conserving tropical biodiversity, particularly in mega-diverse Southeast Asia. We evaluated the importance of protected areas (national parks [NP], nature reserves [NR], and wildlife reserves [WR]) in preserving avifaunal diversity, particularly the endemic and forest species, on the island of Sulawesi. This island has one of the highest numbers of endemic avifauna genera (12) globally and is also experiencing heavy deforestation. Rarefaction analyses and species estimators showed that parks and reserves consistently recorded higher number of forest, endemic, and endemic forest bird species, in addition to larger population densities, than in their surrounding human-modified areas across eight protected areas (Gunung Manembo-nembo WR, Tangkoko-Batu Angus and Dua Saudara NR, Gunung Ambang NR, Bogani Nani Wartabone NP, Gunung Tinombala NR, Gunung Sojol NR, Lore Lindu NP, and Rawa Aopa Watumohai NP). This implies that protecting natural forests must remain as one of the fundamental conservation strategies in Sulawesi. Two small reserves (Gunung Manembo-nembo WR and Tangkoko-Batu Angus and Dua Saudara NR), however, had high number of forest and endemic bird species both within and outside their boundaries, suggesting the importance of buffer areas for augmenting small reserves so as to improve their conservation value. Ordination analyses revealed the differential response of bird species to different environmental factors (e.g., native tree cover), highlighting the significance of forested habitats with dense native vegetation cover for effective conservation of forest dependent and endemic avifauna. In addition, the distinctiveness in bird species composition among protected areas highlights

  16. SEDIMENT HAZARD ASSESSMENT FOR NEAR-COASTAL AREAS OF THE GULF OF MEXICO

    EPA Science Inventory

    Sediment contamination is a major problem in many coastal areas in the U.S. and has emerged as an important ecological issue for several geographic areas. Sediment chemical and biological quality is unknown in many areas of the Gulf of Mexico. To provide some information on this ...

  17. Towards emergency management of natural disasters and critical accidents: the Greek experience.

    PubMed

    Nivolianitou, Zoe; Synodinou, Barbara

    2011-10-01

    This paper presents the findings of a prototype study which sought to identify factors that contribute to effective emergency management in Greece and other European states regarding both natural disasters and critical accidents. The parameters for proper action and successful intervention in operational and logistical are identified based on the document analysis and interviews with emergency responders. The interviews are conducted between state-owned and voluntary organizations. They were asked to rate in terms of their importance for effective emergency response efforts. This paper offers useful information of the organization and management of emergency response in Greece, as well as provides interesting responders' opinions data concerning important priorities in the emergency management area. Despite the fact that the data come from the Greek experience, the conclusions may be applied for a broader use in the emergency planning of disasters. The whole study has been undertaken within the European Pre-Emergencies (PreEm) project. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. International importance of the eastern Chukchi Sea as a staging area for migrating king eiders

    USGS Publications Warehouse

    Oppel, S.; Dickson, D.L.; Powell, A.N.

    2009-01-01

    The evaluation of habitats used by arctic birds on migration is crucial for their conservation. We explored the importance of the eastern Chukchi Sea (ECS) as a staging area for king eiders (Somateria spectabilis) migrating between breeding areas in Siberia and western North America and wintering areas in the Bering Sea. We tracked 190 king eiders with satellite transmitters between 1997 and 2007. In late summer, 74% of satellite-tracked king eiders migrating south staged in the ECS for 13 ?? 13 (SD) days between late June and early November. During spring migration, king eiders staged in the ECS between mid-April and early June for 21 ?? 10 days. All instrumented birds migrating to breeding grounds in western North America (n = 62), and 6 of 11 males migrating to breeding grounds in Siberia, used this area for at least 1 week during spring migration. The importance of this staging area renders it possible that industrial development could adversely affect king eider populations in both Siberia and North America. ?? 2009 US Government.

  19. Defining an emerging disease.

    PubMed

    Moutou, F; Pastoret, P-P

    2015-04-01

    Defining an emerging disease is not straightforward, as there are several different types of disease emergence. For example, there can be a 'real' emergence of a brand new disease, such as the emergence of bovine spongiform encephalopathy in the 1980s, or a geographic emergence in an area not previously affected, such as the emergence of bluetongue in northern Europe in 2006. In addition, disease can emerge in species formerly not considered affected, e.g. the emergence of bovine tuberculosis in wildlife species since 2000 in France. There can also be an unexpected increase of disease incidence in a known area and a known species, or there may simply be an increase in our knowledge or awareness of a particular disease. What all these emerging diseases have in common is that human activity frequently has a role to play in their emergence. For example, bovine spongiform encephalopathy very probably emerged as a result of changes in the manufacturing of meat-and-bone meal, bluetongue was able to spread to cooler climes as a result of uncontrolled trade in animals, and a relaxation of screening and surveillance for bovine tuberculosis enabled the disease to re-emerge in areas that had been able to drastically reduce the number of cases. Globalisation and population growth will continue to affect the epidemiology of diseases in years to come and ecosystems will continue to evolve. Furthermore, new technologies such as metagenomics and high-throughput sequencing are identifying new microorganisms all the time. Change is the one constant, and diseases will continue to emerge, and we must consider the causes and different types of emergence as we deal with these diseases in the future.

  20. Love Canal Emergency Declaration Area habitability study. Volume 3. Soil assessment: indicator chemicals. Final report

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

    Not Available

    Environmental studies were conducted to provide data that could be used by the Commissioner of Health for the State of New York in determining whether the Emergency Declaration Area (EDA) surrounding the Love Canal hazardous-waste site is habitable. The soil assessment compared concentrations of the Love Canal Indicator Chemicals found in the EDA to concentrations found in similar western New York communities. An analytical technique was developed to detect the indicator chemicals at very low levels, i.e. 1.0 ppb. The analytical technique utilized a gas chromatograph/mass spectrometer operating in the selected ion monitoring mode. The analytical results were statistically comparedmore » between the EDA and the comparison areas using a modified Wilcoxon rank sum test.« less

  1. Emergent Issues in Enterprise Education: The Educator's Perspective

    ERIC Educational Resources Information Center

    Carey, Charlotte; Matlay, Harry

    2011-01-01

    Recent research suggests that important issues are emerging among enterprise educators in higher education institutions (HEIs). This paper examines four key areas of debate. The first of these is the assessment of entrepreneurship ideas and related activities (Pittaway and Cope, 2007). Penaluna and Penaluna (2008, 2009a, b), for example, focus on…

  2. Emerging Technologies and Techniques for Wide Area Radiological Survey and Remediation

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

    Sutton, M.; Zhao, P.

    2016-03-24

    Technologies to survey and decontaminate wide-area contamination and process the subsequent radioactive waste have been developed and implemented following the Chernobyl nuclear power plant release and the breach of a radiological source resulting in contamination in Goiania, Brazil. These civilian examples of radioactive material releases provided some of the first examples of urban radiological remediation. Many emerging technologies have recently been developed and demonstrated in Japan following the release of radioactive cesium isotopes (Cs-134 and Cs-137) from the Fukushima Dai-ichi nuclear power plant in 2011. Information on technologies reported by several Japanese government agencies, such as the Japan Atomic Energymore » Agency (JAEA), the Ministry of the Environment (MOE) and the National Institute for Environmental Science (NIES), together with academic institutions and industry are summarized and compared to recently developed, deployed and available technologies in the United States. The technologies and techniques presented in this report may be deployed in response to a wide area contamination event in the United States. In some cases, additional research and testing is needed to adequately validate the technology effectiveness over wide areas. Survey techniques can be deployed on the ground or from the air, allowing a range of coverage rates and sensitivities. Survey technologies also include those useful in measuring decontamination progress and mapping contamination. Decontamination technologies and techniques range from non-destructive (e.g., high pressure washing) and minimally destructive (plowing), to fully destructive (surface removal or demolition). Waste minimization techniques can greatly impact the long-term environmental consequences and cost following remediation efforts. Recommendations on technical improvements to address technology gaps are presented together with observations on remediation in Japan.« less

  3. The role of ground water in water-supply emergency planning

    NASA Astrophysics Data System (ADS)

    Reichard, E. G.; Li, Z.; Hermans, C.

    2008-12-01

    Catastrophic events, such as earthquakes or floods, can result in water-supply disruptions. Such disruptions can cause large economic losses and pose threats to public health. Water managers seek to develop cost- effective strategies for reducing these risks and ensuring water security. In many areas, ground water can play an important role in such water-supply emergency planning. We present a probabilistic framework for estimating the hydraulic impacts and associated costs of using ground water as a backup supply in the event of a disruption in imported-water deliveries. We also estimate the benefits of ground-water management strategies, such as artificial recharge, in terms of reduced costs of responding to water-supply emergencies. The magnitude of these benefits will depend on the expected severity and duration of the imported-water disruption, the functioning of the hydrogeologic system, and economic parameters. We apply the framework to address water-supply emergency planning in the Los Angeles area. A simulation model is used to generate response functions, which relate emergency ground-water pumpage to potential adverse effects, such as increased pumping lifts, subsidence, and seawater intrusion. These response functions are incorporated into a Monte Carlo analysis, along with cost coefficients and information on the probable severity of the disruption. Disruption severity is represented by a probability distribution, which can be elicited from water managers. In the example, the primary emergency-related benefits of artificial recharge are reductions in potential subsidence costs. The framework could be extended to consider additional engineering factors (e.g., well capacities and integrity of local distribution systems), institutional arrangements, and regulatory requirements.

  4. Importance of participation in major life areas matters for return to work.

    PubMed

    Kvam, Lisbeth; Vik, Kjersti; Eide, Arne Henning

    2015-06-01

    The complexity of the process and outcome of vocational rehabilitation yearns for a multifaceted approach. This article investigates whether importance of participation in major life areas for men and women predicts the outcome of vocational rehabilitation. This longitudinal study provides measure points at the start of the intervention (T1), at the end of the intervention (T2) and at a follow-up 6-12 months after completing the rehabilitation program (T3). Associations were assessed by nominal logistic regression. The importance of participation in work was positively associated to return to work (RTW), while the importance of participation in leisure activities and importance of participation in family was negatively associated with RTW after the rehabilitation. Gender and number of children also contributed significantly to the regression model. To identify individuals' subjective evaluation of the importance of participation may be of value in explaining return or not RTW and contribute to explain gender differences in outcomes. It may also inform rehabilitation counselors in collaboration with clients and facilitate tailoring interventions to the individual's needs.

  5. Emergency motorcycle: has it a place in a medical emergency system?

    PubMed

    Soares-Oliveira, Miguel; Egipto, Paula; Costa, Isabel; Cunha-Ribeiro, Luis Manuel

    2007-07-01

    In an emergency medical service system, response time is an important factor in determining the prognosis of a victim. There are well-documented increases in response time in urban areas, mainly during rush hour. Because prehospital emergency care is required to be efficient and swift, alternative measures to achieve this goal should be addressed. We report our experience with a medical emergency motorcycle (MEM) and propose major criteria for dispatching it. This work presents a prospective analysis of the data relating to MEM calls from July 2004 to December 2005. The analyzed parameters were age, sex, reason for call, action, and need for subsequent transport. A comparison was made of the need to activate more means and, if so, whether the MEM was the first to arrive. There were 1972 calls. The average time of arrival at destination was 4.4 +/- 2.5 minutes. The main action consisted of administration of oxygen (n = 626), immobilization (n = 118), and control of hemorrhage (n = 101). In 63% of cases, MEM arrived before other emergency vehicles. In 355 cases (18%), there was no need for transport. The MEM can intervene in a wide variety of clinical situations and a quick response is guaranteed. Moreover, in specific situations, MEM safely and efficiently permits better management of emergency vehicles. We propose that it should be dispatched mainly in the following situations: true life-threatening cases and uncertain need for an ambulance.

  6. Three-dimensional Virtual Simulation of Oil Spill of Yangtze River in Chongqing Area Based on Emergency Decision

    NASA Astrophysics Data System (ADS)

    Chen, Shuzhe; Huang, Liwen

    the river of Yangtze River in Chongqing area is continuous curved. Hydrology and channel situation is complex, and the transportation is busy. With the increasing of shipments of hazardous chemicals year by year, oil spill accident risk is rising. So establishment of three-dimensional virtual simulation of oil spill and its application in decision-making has become an urgent task. This paper detailed the process of three-dimensional virtual simulation of oil spill and established a system of three-dimensional virtual Simulation of oil spill of Yangtze River in Chongqing area by establishing an oil spill model of the Chongqing area based on oil particles model, and the system has been used in emergency decision to provide assistance for the oil spill response.

  7. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Charles Street, part of the Emergency Preparedness team at KSC, uses a phone on the specially equipped emergency response vehicle. The vehicle, nicknamed '''The Brute,''' serves as a mobile command center for emergency preparedness staff and other support personnel when needed. It features a conference room, computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  8. Physiological Importance of Hydrogen Sulfide: Emerging Potent Neuroprotector and Neuromodulator

    PubMed Central

    Chung, Hyung-Joo

    2016-01-01

    Hydrogen sulfide (H2S) is an emerging neuromodulator that is considered to be a gasotransmitter similar to nitrogen oxide (NO) and carbon monoxide (CO). H2S exerts universal cytoprotective effects and acts as a defense mechanism in organisms ranging from bacteria to mammals. It is produced by the enzymes cystathionine β-synthase (CBS), cystathionine ϒ-lyase (CSE), 3-mercaptopyruvate sulfurtransferase (MST), and D-amino acid oxidase (DAO), which are also involved in tissue-specific biochemical pathways for H2S production in the human body. H2S exerts a wide range of pathological and physiological functions in the human body, from endocrine system and cellular longevity to hepatic protection and kidney function. Previous studies have shown that H2S plays important roles in peripheral nerve regeneration and degeneration and has significant value during Schwann cell dedifferentiation and proliferation but it is also associated with axonal degradation and the remyelination of Schwann cells. To date, physiological and toxic levels of H2S in the human body remain unclear and most of the mechanisms of action underlying the effects of H2S have yet to be fully elucidated. The primary purpose of this review was to provide an overview of the role of H2S in the human body and to describe its beneficial effects. PMID:27413423

  9. Important Bird Areas as a Conservation tool: implementation at the state level

    Treesearch

    Michael F. Burger; Jillian M. Liner

    2005-01-01

    In the mid 1990s, Audubon New York initiated an Important Bird Areas (IBA) program that had two goals, 1) to identify sites most critical for the protection of birds and 2) to take positive and coordinated action to promote the conservation of those sites. The first goal was achieved in 1997 when 127 IBAs were identified across New York State. Since then, in order to...

  10. Effects of temperature and heat waves on emergency department visits and emergency ambulance dispatches in Pudong New Area, China: a time series analysis.

    PubMed

    Sun, Xiaoming; Sun, Qiao; Yang, Minjuan; Zhou, Xianfeng; Li, Xiaopan; Yu, Aiqing; Geng, Fuhai; Guo, Yuming

    2014-10-02

    In July 2013, an extended heat episode with extreme high temperature covered Pudong New Area, the largest district in Shanghai. The current study estimates the impacts of temperature and heat waves on emergency department visits (EDV) and emergency ambulance dispatches (EAD) using time-series approaches in Pudong, from 2011 to 2013. An over-dispersed Poisson generalized additive model was used to examine the association between temperature and EDV and EAD. Heat wave effects with different heat wave definitions considering both the intensity and durations were also estimated. Immediate effects of temperature on EDV and EAD were detected, after controlling for trends of time and day of week. The exposure-response relationships showed J-shaped curves with higher threshold temperature of EDV than that of EAD visually. When estimating risk changes on heat days compared with non-heat days using different percentiles of daily mean temperature in definition, EAD showed significant increases while non-significant or even negative associations were found for EDV. Heat wave with intensity above the 90th percentile had 2.62% (95% CI: 1.78%, 3.46%) and 0.95% (95% CI: 0.22%, 1.69%) increases in EDV for a duration of at least 2 days and 3 days respectively. The relative increase of EAD were 4.85% (95% CI: 1.42%, 8.39%) and 3.94% (95% CI: 0.88%, 7.10%). Varied effects of temperature and heat waves on emergency department visits and emergency ambulance dispatches were investigated. This wider view of the health effect of temperature indicated that interventions for both public health education and health services management should be considered in the study region.

  11. The emergence of ECM mechanics and cytoskeletal tension as important regulators of cell function.

    PubMed

    Peyton, Shelly R; Ghajar, Cyrus M; Khatiwala, Chirag B; Putnam, Andrew J

    2007-01-01

    The ability to harvest and maintain viable cells from mammalian tissues represented a critical advance in biomedical research, enabling individual cells to be cultured and studied in molecular detail. However, in these traditional cultures, cells are grown on rigid glass or polystyrene substrates, the mechanical properties of which often do not match those of the in vivo tissue from which the cells were originally derived. This mechanical mismatch likely contributes to abrupt changes in cellular phenotype. In fact, it has been proposed that mechanical changes in the cellular microenvironment may alone be responsible for driving specific cellular behaviors. Recent multidisciplinary efforts from basic scientists and engineers have begun to address this hypothesis more explicitly by probing the effects of ECM mechanics on cell and tissue function. Understanding the consequences of such mechanical changes is physiologically relevant in the context of a number of tissues in which altered mechanics may either correlate with or play an important role in the onset of pathology. Examples include changes in the compliance of blood vessels associated with atherosclerosis and intimal hyperplasia, as well as changes in the mechanical properties of developing tumors. Compelling evidence from 2-D in vitro model systems has shown that substrate mechanical properties induce changes in cell shape, migration, proliferation, and differentiation, but it remains to be seen whether or not these same effects translate to 3-D systems or in vivo. Furthermore, the molecular "mechanotransduction" mechanisms by which cells respond to changes in ECM mechanics remain unclear. Here, we provide some historical context for this emerging area of research, and discuss recent evidence that regulation of cytoskeletal tension by changes in ECM mechanics (either directly or indirectly) may provide a critical switch that controls cell function.

  12. Countertransference. Its continued importance in psychiatric education

    PubMed Central

    Rao, Nyapati R.; Meinzer, Arthur E.; Berman, Sheldon S.

    1997-01-01

    Psychotherapy is likely to play a minor or nonexistent role in the future general psychiatrist's training and practice. However, the component skills of recognition and management of the countertransference will remain important. Because psychotherapy training and supervision have been the venues for countertransference learning, the field is in danger of losing its teaching laboratory and hence losing these skills. The authors examine the concept of countertransference and discuss its importance in four increasingly significant areas: managed care, psychopharmacological treatment, emergency intervention, and the management of professional boundaries regarding sexual misconduct. Methods are discussed for enhancing residents' countertransference skills through supervision, training groups, and the resident's personal psychotherapy. PMID:9058556

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

    PubMed

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

    2014-10-31

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

  14. Impact of Vehicular Networks on Emergency Medical Services in Urban Areas

    PubMed Central

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

    2014-01-01

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

  15. Recent research on emergent verbal behavior: clinical applications and future directions.

    PubMed

    Grow, Laura L; Kodak, Tiffany

    2010-01-01

    This paper describes recent studies that have evaluated the functional independence of verbal operants. Procedures that facilitate the emergence of untrained verbal operants and important areas of future research to increase efficiency of language programs for children diagnosed with developmental disabilities are discussed.

  16. Geographical variation of diabetic emergencies attended by prehospital Emergency Medical Services is associated with measures of ethnicity and socioeconomic status.

    PubMed

    Villani, Melanie; Earnest, Arul; Smith, Karen; de Courten, Barbora; Zoungas, Sophia

    2018-03-23

    Geographical variation of diabetic emergencies attended by prehospital emergency medical services (EMS) and the relationship between area-level social and demographic factors and risk of a diabetic emergency were examined. All cases of hypoglycaemia and hyperglycaemia attended by Ambulance Victoria between 1/01/2009 and 31/12/2015 were tabulated by Local Government Area (LGA). Conditional autoregressive models were used to create smoothed maps of age and gender standardised incidence ratio (SIR) of prehospital EMS attendance for a diabetic emergency. Spatial regression models were used to examine the relationship between risk of a diabetic emergency and area-level factors. The areas with the greatest risk of prehospital EMS attendance for a diabetic emergency were disperse. Area-level factors associated with risk of a prehospital EMS-attended diabetic emergency were socioeconomic status (SIR 0.70 95% CrI [0.51, 0.96]), proportion of overseas-born residents (SIR 2.02 95% CrI [1.37, 2.91]) and motor vehicle access (SIR 1.47 95% CrI [1.08, 1.99]). Recognition of areas of increased risk of prehospital EMS-attended diabetic emergencies may be used to assist prehospital EMS resource planning to meet increased need. In addition, identification of associated factors can be used to target preventative interventions tailored to individual regions to reduce demand.

  17. The flex track: flexible partitioning between low- and high-acuity areas of an emergency department.

    PubMed

    Laker, Lauren F; Froehle, Craig M; Lindsell, Christopher J; Ward, Michael J

    2014-12-01

    Emergency departments (EDs) with both low- and high-acuity treatment areas often have fixed allocation of resources, regardless of demand. We demonstrate the utility of discrete-event simulation to evaluate flexible partitioning between low- and high-acuity ED areas to identify the best operational strategy for subsequent implementation. A discrete-event simulation was used to model patient flow through a 50-bed, urban, teaching ED that handles 85,000 patient visits annually. The ED has historically allocated 10 beds to a fast track for low-acuity patients. We estimated the effect of a flex track policy, which involved switching up to 5 of these fast track beds to serving both low- and high-acuity patients, on patient waiting times. When the high-acuity beds were not at capacity, low-acuity patients were given priority access to flexible beds. Otherwise, high-acuity patients were given priority access to flexible beds. Wait times were estimated for patients by disposition and Emergency Severity Index score. A flex track policy using 3 flexible beds produced the lowest mean patient waiting time of 30.9 minutes (95% confidence interval [CI] 30.6 to 31.2 minutes). The typical fast track approach of rigidly separating high- and low-acuity beds produced a mean patient wait time of 40.6 minutes (95% CI 40.2 to 50.0 minutes), 31% higher than that of the 3-bed flex track. A completely flexible ED, in which all beds can accommodate any patient, produced mean wait times of 35.1 minutes (95% CI 34.8 to 35.4 minutes). The results from the 3-bed flex track scenario were robust, performing well across a range of scenarios involving higher and lower patient volumes and care durations. Using discrete-event simulation, we have shown that adding some flexibility into bed allocation between low and high acuity can provide substantial reductions in overall patient waiting and a more efficient ED. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc

  18. The globalization of emergency medicine and its importance for public health.

    PubMed Central

    Anderson, Philip; Petrino, Roberta; Halpern, Pinchas; Tintinalli, Judith

    2006-01-01

    Emergency medicine (EM) is a global discipline that provides secondary disease prevention and is also a tool for primary prevention. It is a horizontally integrated system of emergency care consisting of access to EM care; provision of EM care in the community and during transportation of patients; and provision of care at the receiving facility or hospital emergency department. EM can offer many tools to improve public health. These tools include primary disease prevention; interventions for addressing substance abuse and interpersonal violence; education about safety practices; epidemiological surveillance; enrolment of patients in clinical research trials focusing on acute interventions; education and clinical training of health-care providers; and participation in local and regional responses to natural and man-made disasters. Public health advocates and health policy-makers can benefit from the opportunities of EM and can help overcome its challenges. Advocating the establishment and recognition of the specialty of EM worldwide can result in benefits for health-care education, help in incorporating the full scope of EM care into the system of public health, and expand the capabilities of EM for primary and secondary prevention for the benefit of the health of the public. PMID:17128364

  19. Imported leishmaniasis in a dog in a sandfly-populated area in northeastern Romania.

    PubMed

    Pavel, Geta; Timofte, Dorina; Mocanu, Diana; Malancus, Razvan; Solcan, Carmen

    2017-09-01

    We report the importation of a clinical case of canine leishmaniasis (CanL) in Romania, a country where several types of sandflies are present with the potential to develop a new focus of CanL. The Staffordshire Bull Terrier dog was imported into Romania from Spain 1.5 y before he developed clinical symptomatology that included proliferative dermatitis, lymphadenomegaly, and bilateral uveitis. Hematologic analyses showed regenerative anemia and subacute inflammation. Cytologic examination of lymph node fine-needle aspirates revealed Leishmania spp. amastigotes that were confirmed as L. infantum by PCR. The importation of canine leishmania cases into nonendemic areas in which the vector exists could potentially lead to the silent spread of a disease posing a significant public health threat.

  20. Priority setting for bird conservation in Mexico: the role of the Important Bird Areas program

    Treesearch

    Ma. del Coro Arizmendi; Laura Marquez Valdelamar; Humberto Berlanga

    2005-01-01

    Many species in Mexico are threatened and in need of protection. At least seventy species are considered to be globally threatened, yet conservation actions have been scarce and not coordinated. In 1996 BirdLife International’s Important Bird Areas Program was initiated in Mexico to identify a network of the most important places in Mexico for birds, with the...

  1. Yellow fever in Brazil: thoughts and hypotheses on the emergence in previously free areas.

    PubMed

    Vasconcelos, Pedro Fernando da Costa

    2010-12-01

    This article describes and discusses factors associated to the reemergence of yellow fever and its transmission dynamics in the states of São Paulo (Southeastern Brazil) and Rio Grande do Sul (Southern) during 2008 and 2009. The following factors have played a pivotal role for the reemergence of yellow fever in these areas: large susceptible human population; high prevalence of vectors and primary hosts (non-human primates); favorable climate conditions, especially increased rainfall; emergence of a new genetic lineage; and circulation of people and/or monkeys infected by virus. There is a need for an effective surveillance program to prevent the reemergence of yellow fever in other Brazilian states.

  2. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Robert ZiBerna, Roger Scheidt and Charles Street, the Emergency Preparedness team at KSC, practice for an emergency scenario inside the Mobile Command Center, a specially equipped vehicle. It features a conference room, computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  3. "Grey" Areas and "Organized Chaos" in Emergency Response

    ERIC Educational Resources Information Center

    Taber, Nancy; Plumb, Donovan; Jolemore, Shawn

    2008-01-01

    Purpose: The purpose of this research is to explore the interaction between organizational policies and daily work practices of paramedics and firefighters within two emergency response organizations. Design/methodology/approach: Data were collected in a case study consisting of interviews, focus groups, and observations. The theoretical grounding…

  4. RECENT RESEARCH ON EMERGENT VERBAL BEHAVIOR: CLINICAL APPLICATIONS AND FUTURE DIRECTIONS

    PubMed Central

    Grow, Laura L; Kodak, Tiffany

    2010-01-01

    This paper describes recent studies that have evaluated the functional independence of verbal operants. Procedures that facilitate the emergence of untrained verbal operants and important areas of future research to increase efficiency of language programs for children diagnosed with developmental disabilities are discussed. PMID:21541166

  5. The Student Volunteer Army: a 'repeat emergent' emergency response organisation.

    PubMed

    Carlton, Sally; Mills, Colleen E

    2017-10-01

    This paper seeks to contribute to understanding of the factors associated with an effective emergent emergency response organisation and to provide new insights into this understudied area. It examines, through an analysis of a range of textual resources, the emergence and re-emergence of the Student Volunteer Army (SVA) during the devastating earthquakes in Canterbury, New Zealand, in 2010-11. This evaluation is conducted in relation to the four key features of an effective emergency response organisation: adaptability; direction; leadership; and communication. In addition, the paper aims to further understanding of 'emergency entrepreneurship' and thus of the values and strategies that underpin social entrepreneur organisations in times of normalcy. The paper concludes that the unique position of the SVA as a 'repeat emergent' emergency response organisation enabled it to innovate continually and to improve repeatedly its systems, relationships, and image, such that it exhibited features common to emergent and established emergency response organisations. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  6. Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective.

    PubMed

    Epping-Jordan, JoAnne E; van Ommeren, Mark; Ashour, Hazem Nayef; Maramis, Albert; Marini, Anita; Mohanraj, Andrew; Noori, Aqila; Rizwan, Humayun; Saeed, Khalid; Silove, Derrick; Suveendran, T; Urbina, Liliana; Ventevogel, Peter; Saxena, Shekhar

    2015-01-01

    Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development. Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste. These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders. Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

  7. Lessons from SARS in an age of emerging infections.

    PubMed

    Ooi, Peng L I M; Lim, S; Tham, K W

    2006-01-01

    SARS, the first pandemic of this century, commanded the world's attention and required public health actions at the national and international levels. In an age of emerging infections, the lessons learnt from combating SARS can be used to improve our preparedness capabilities in three key areas to effectively tackle a public health emergency of international concern. The first area is in outbreak alert, which encompasses use of surveillance to detect, assess, notify and report events involving death or disease, and share information widely to enable proper risk assessment. The system must able to build up a comprehensive picture with appropriate warning for zoonotic diseases, environmental health and food safety. The second area is in public health response. In the event of an outbreak alert, the authorities must be able to quickly investigate cases/deaths and institute comprehensive control measures to break the chain of transmission. Protection of healthcare workers and reducing the opportunities for spread of infection through contact tracing and quarantine are important. The third area is in international health. This comprises health requirements for inbound and outbound travellers at the border checkpoints and global information exchange to mitigate the risks of travel abroad. Extrapolating these lessons to a wider public health context, our rapidly changing global infectious diseases situation mandates that we evaluate all available public health tools and build institutional capacity to effectively manage emerging infections.

  8. American Bird conservancy's approach to the U.S. Important Bird Area Program - identifying the top 500 global sites

    Treesearch

    Robert M. Chipley

    2005-01-01

    The idea for the Important Bird Area Program originated in a series of studies in the early 1980s conducted by BirdLife International. Recognizing that these studies could become a powerful tool for conservation, BirdLife International began an effort to identify and gather data regarding the most important areas for birds in Europe and to make this information...

  9. Research on the Improvements of the Assembly Areas, Evacuation Routes, and Shelters against Multiple Disasters

    NASA Astrophysics Data System (ADS)

    Jin, S.; Lee, Y. M.; Jeong, S. Y.; Hong, S. J.

    2016-12-01

    The considerable casualties were resulted at the tsunami shelters during the Great East Japan Tsunami on 11 March 2011. The one of the important lessons learned from the Great East Japan Tsunami and the Fukushima NPP accidents provided the nuclear power plant emergency plan should consider the natural disaster. However, most of cases, the nuclear emergency preparedness strategies have not incorporated the natural disaster management plan. In this study, we reviewed the safety of the assembly areas, evacuation routes, and shelters of some nuclear emergency planning zone using the new tsunami hazard mapping results through the characteristic inundation analysis. As the result of this study, the improvements can be achieved by considering both natural and nuclear disaster to set up the assembly areas, evacuation routes, and shelters against the multiple disasters. Also, The most important protective measures can be achieved by integrating and linking the emergency preparedness strategy both natural disasters and nuclear disaster in the future.

  10. Emerging and reemerging diseases of avian wildlife

    USGS Publications Warehouse

    Pello, Susan J.; Olsen, Glenn H.

    2013-01-01

    Of the many important avian wildlife diseases, aspergillosis, West Nile virus, avipoxvirus, Wellfleet Bay virus, avian influenza, and inclusion body disease of cranes are covered in this article. Wellfleet Bay virus, first identified in 2010, is considered an emerging disease. Avian influenza and West Nile virus have recently been in the public eye because of their zoonotic potential and links to wildlife. Several diseases labeled as reemerging are included because of recent outbreaks or, more importantly, recent research in areas such as genomics, which shed light on the mechanisms whereby these adaptable, persistent pathogens continue to spread and thrive.

  11. Virtual reality and simulation: training the future emergency physician.

    PubMed

    Reznek, Martin; Harter, Phillip; Krummel, Thomas

    2002-01-01

    The traditional system of clinical education in emergency medicine relies on practicing diagnostic, therapeutic, and procedural skills on live patients. The ethical, financial, and practical weaknesses of this system are well recognized, but the alternatives that have been explored to date have shown even greater flaws. However, ongoing progress in the area of virtual reality and computer-enhanced simulation is now providing educational applications that show tremendous promise in overcoming most of the deficiencies associated with live-patient training. It will be important for academic emergency physicians to become more involved with this technology to ensure that our educational system benefits optimally.

  12. Emergency primary repair of grade V bladder neck injury complicating pelvic fracture

    PubMed Central

    2014-01-01

    We report a case of a grade V bladder injury complicating an open-book pelvic fracture following a road traffic accident. The bladder neck injury was primarily repaired in the emergency setting of a poor-resourced area with successful outcome. The dangers of urinary extravasation are still to be considered of importance and we advocate and encourage immediate/emergency open intervention although it remains controversial to say the least in a lesser resourced healthcare set up. PMID:25076980

  13. Bat assemblages in conservation areas of a metropolitan region in Southeastern Brazil, including an important karst habitat.

    PubMed

    Talamoni, S A; Coelho, D A; Dias-Silva, L H; Amaral, A S

    2013-05-01

    Species richness and abundance of bats were studied in four nature reserves, including a karst area which has many potential rocky shelters for bats, such as caves and rock crevices. The reserves were located in the greater Belo Horizonte metropolitan area, one of the most populated regions of Brazil, within the Atlantic Forest, and Cerrado (Brazilian savanna) ecological domains. Bats were sampled using mist-nets and, in the karst area, also by active searches in shelters. A total of 1,599 bats were captured representing 30 species belonging to four families. There was little similarity among the four chiropteran faunas. The greatest species richness was found in the karst area with 22 species recorded whereas richness estimates in the other areas indicated the need for further studies. Two hundred and sixty-five individuals of 14 species were captured from 56 shelters. Most of the shelters were frequently used for diurnal roosts, and all the bats found belonged to the Phyllostomidae, with the exception of Myotis nigricans (Vespertilionidae), Nyctinomops laticaudatus (Molossidae) and Peropteryx macrotis (Emballonuridae). The sanguinivorous Desmodus rotundus was the most common species in the shelters. The results of this study demonstrate the importance of maintaining multiple protected areas to ensure a representative fauna of bats in a region characterized by a vegetation transition zone and with intense economic activity and high environmental impact. This study also demonstrates the importance of rock shelters for maintaining local bat richness and the importance of active searches for bats in their diurnal roosts for a more thorough sampling of the bat fauna at a given locality.

  14. Leader emergence through interpersonal neural synchronization

    PubMed Central

    Jiang, Jing; Chen, Chuansheng; Dai, Bohan; Shi, Guang; Ding, Guosheng; Liu, Li; Lu, Chunming

    2015-01-01

    The neural mechanism of leader emergence is not well understood. This study investigated (i) whether interpersonal neural synchronization (INS) plays an important role in leader emergence, and (ii) whether INS and leader emergence are associated with the frequency or the quality of communications. Eleven three-member groups were asked to perform a leaderless group discussion (LGD) task, and their brain activities were recorded via functional near infrared spectroscopy (fNIRS)-based hyperscanning. Video recordings of the discussions were coded for leadership and communication. Results showed that the INS for the leader–follower (LF) pairs was higher than that for the follower–follower (FF) pairs in the left temporo-parietal junction (TPJ), an area important for social mentalizing. Although communication frequency was higher for the LF pairs than for the FF pairs, the frequency of leader-initiated and follower-initiated communication did not differ significantly. Moreover, INS for the LF pairs was significantly higher during leader-initiated communication than during follower-initiated communications. In addition, INS for the LF pairs during leader-initiated communication was significantly correlated with the leaders’ communication skills and competence, but not their communication frequency. Finally, leadership could be successfully predicted based on INS as well as communication frequency early during the LGD (before half a minute into the task). In sum, this study found that leader emergence was characterized by high-level neural synchronization between the leader and followers and that the quality, rather than the frequency, of communications was associated with synchronization. These results suggest that leaders emerge because they are able to say the right things at the right time. PMID:25831535

  15. Leader emergence through interpersonal neural synchronization.

    PubMed

    Jiang, Jing; Chen, Chuansheng; Dai, Bohan; Shi, Guang; Ding, Guosheng; Liu, Li; Lu, Chunming

    2015-04-07

    The neural mechanism of leader emergence is not well understood. This study investigated (i) whether interpersonal neural synchronization (INS) plays an important role in leader emergence, and (ii) whether INS and leader emergence are associated with the frequency or the quality of communications. Eleven three-member groups were asked to perform a leaderless group discussion (LGD) task, and their brain activities were recorded via functional near infrared spectroscopy (fNIRS)-based hyperscanning. Video recordings of the discussions were coded for leadership and communication. Results showed that the INS for the leader-follower (LF) pairs was higher than that for the follower-follower (FF) pairs in the left temporo-parietal junction (TPJ), an area important for social mentalizing. Although communication frequency was higher for the LF pairs than for the FF pairs, the frequency of leader-initiated and follower-initiated communication did not differ significantly. Moreover, INS for the LF pairs was significantly higher during leader-initiated communication than during follower-initiated communications. In addition, INS for the LF pairs during leader-initiated communication was significantly correlated with the leaders' communication skills and competence, but not their communication frequency. Finally, leadership could be successfully predicted based on INS as well as communication frequency early during the LGD (before half a minute into the task). In sum, this study found that leader emergence was characterized by high-level neural synchronization between the leader and followers and that the quality, rather than the frequency, of communications was associated with synchronization. These results suggest that leaders emerge because they are able to say the right things at the right time.

  16. Analysis of safety reports involving area navigation and required navigation performance procedures.

    DOT National Transportation Integrated Search

    2010-11-03

    In order to achieve potential operational and safety benefits enabled by Area Navigation (RNAV) and Required Navigation Performance (RNP) procedures it is important to monitor emerging issues in their initial implementation. Reports from the Aviation...

  17. The auditory and non-auditory brain areas involved in tinnitus. An emergent property of multiple parallel overlapping subnetworks

    PubMed Central

    Vanneste, Sven; De Ridder, Dirk

    2012-01-01

    Tinnitus is the perception of a sound in the absence of an external sound source. It is characterized by sensory components such as the perceived loudness, the lateralization, the tinnitus type (pure tone, noise-like) and associated emotional components, such as distress and mood changes. Source localization of quantitative electroencephalography (qEEG) data demonstrate the involvement of auditory brain areas as well as several non-auditory brain areas such as the anterior cingulate cortex (dorsal and subgenual), auditory cortex (primary and secondary), dorsal lateral prefrontal cortex, insula, supplementary motor area, orbitofrontal cortex (including the inferior frontal gyrus), parahippocampus, posterior cingulate cortex and the precuneus, in different aspects of tinnitus. Explaining these non-auditory brain areas as constituents of separable subnetworks, each reflecting a specific aspect of the tinnitus percept increases the explanatory power of the non-auditory brain areas involvement in tinnitus. Thus, the unified percept of tinnitus can be considered an emergent property of multiple parallel dynamically changing and partially overlapping subnetworks, each with a specific spontaneous oscillatory pattern and functional connectivity signature. PMID:22586375

  18. Alien plant invasions--incorporating emerging invaders in regional prioritization: a pragmatic approach for Southern Africa.

    PubMed

    Mgidi, Theresa N; Le Maitre, David C; Schonegevel, Lucille; Nel, Jeanne L; Rouget, Mathieu; Richardson, David M

    2007-07-01

    Plant invasions are a serious threat to natural and semi-natural ecosystems worldwide. Most management-orientated research on invasions focuses on invaders that are already widespread and often have major impacts. This paper deals with "emerging" invaders-those alien species with the potential to become important problems without timely intervention. A climate matching procedure was developed to define areas of South Africa, Lesotho and Swaziland that could be invaded by 28 plant species that had previously been classified as emerging invaders. Information on the location of populations of these species in the study area was combined with information on their distributions (as native or alien) in parts of Australia and the United States of America. These two countries had the best available distribution data for this study. They also share many invasive alien plant species with South Africa. Climatic data obtained for weather stations near points of known occurrence in these countries were used to define the climatically suitable areas for each species in the study area. Almost 80% of the remaining natural environment in southern Africa was found to be vulnerable to invasion by at least one of these species, 50% by six or more and 24% by 16 or more species. The most vulnerable areas are the highveld grasslands and the eastern escarpment. The emerging invaders with the greatest potential range included Acacia podalyriifolia and Cortaderia selloana. The globally important invaders Ulex europaeus and Lythrum salicaria had a more limited invasion potential but could still become major invaders. There was no relationship between the extent of the climatically suitable areas for the different species and an expert ranking of their invasion potential, emphasising the uncertainties inherent in making expert assessments based on very little information. The methods used in this analysis establish a protocol for future modelling exercises to assess the invasion potential of

  19. Methodology of determining soil structure in important groundwater areas: case studies in Kauvonkangas, Finnish Lapland

    NASA Astrophysics Data System (ADS)

    Kupila, Juho

    2016-04-01

    Finland is fully self-sufficient in clean groundwater and even has a capacity of exportation. There are approx. 6000 groundwater areas with a total yield of 5.4 million m3/day. Currently only 10% of this groundwater resource is in use. For the efficient and safe exploitation of these areas in the future, detailed modeling of soil structure is an important method in groundwater surveys. 3D -models improve the general knowledge of linkage between land use planning and groundwater protection. Results can be used as a base information in water supply service development and when performing the measures needed in case of environmental accidents. Also, when creating the groundwater flow models the collected information is utilized and is usually the main data source. Geological Survey of Finland has carried out soil structure studies in co-operation with authorities, municipalities and the local water suppliers. The main objectives of these projects are to determine the geological structure of groundwater area for estimating the validity of the present exclusion area, the quantity of ground water volume and recharge capability and possible risks to the groundwater. Research areas are usually under an active water supply service. Kauvonkangas groundwater area is located in the municipality of Tervola, in Southern part of Finnish Lapland. Extent of the area is 7.9 km2 and it is an important water source for the local and nearby population centers. There are two active water supply companies in the area. Field studies in the project will include general geological and hydrological mapping, soil drilling with observation pipe installation, test pumping and water sampling. Geophysical measures will play a key-role, including ground penetrating radar (GPR) and gravimetric measurements. Studies will be carried out in spring and summer 2016. The main results will be the models of the bedrock and groundwater level and main characteristics of the soil layers in the area. Results

  20. Important historical efforts at emergency department categorization in the United States and implications for regionalization.

    PubMed

    Mehrotra, Abhishek; Sklar, David P; Tayal, Vivek S; Kocher, Keith E; Handel, Daniel A; Myles Riner, R

    2010-12-01

    This article is drawn from a report created for the American College of Emergency Physicians (ACEP) Emergency Department (ED) Categorization Task Force and also reflects the proceedings of a breakout session, "Beyond ED Categorization-Matching Networks to Patient Needs," at the 2010 Academic Emergency Medicine consensus conference, "Beyond Regionalization: Integrated Networks of Emergency Care." The authors describe a brief history of the significant national and state efforts at categorization and suggest reasons why many of these efforts failed to persevere or gain wider implementation. The history of efforts to categorize hospital (and ED) emergency services demonstrates recognition of the potential benefits of categorization, but reflects repeated failures to implement full categorization systems or limited excursions into categorization through licensing of EDs or designation of receiving and referral facilities. An understanding of the history of hospital and ED categorization could better inform current efforts to develop categorization schemes and processes. 2010 by the Society for Academic Emergency Medicine.

  1. Emerging markets for imported beef in China: Results from a consumer choice experiment in Beijing.

    PubMed

    Ortega, David L; Hong, Soo Jeong; Wang, H Holly; Wu, Laping

    2016-11-01

    The purpose of this study is to explore emerging markets for imported beef in China by assessing Beijing consumer demand for quality attributes. This study utilizes data from an in-store choice experiment to evaluate consumer willingness-to-pay for select food quality attributes (food safety, animal welfare, Green Food and Organic certification) taking into account country-of-origin information. Our results show that Beijing consumers value food safety information the most, and are willing to pay more for Australian beef products than for US or domestic (Chinese) beef. We explore the various relationships between the quality attributes, find evidence of preference heterogeneity and discuss agribusiness and marketing implications of our findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Functional sub-division of the Drosophila genome via chromatin looping: the emerging importance of CP190.

    PubMed

    Ahanger, Sajad H; Shouche, Yogesh S; Mishra, Rakesh K

    2013-01-01

    Insulators help in organizing the eukaryotic genomes into physically and functionally autonomous regions through the formation of chromatin loops. Recent findings in Drosophila and vertebrates suggest that insulators anchor multiple loci through long-distance interactions which may be mechanistically linked to insulator function. Important to such processes in Drosophila is CP190, a common co-factor of insulator complexes. CP190 is also known to associate with the nuclear matrix, components of the RNAi machinery, active promoters and borders of the repressive chromatin domains. Although CP190 plays a pivotal role in insulator function in Drosophila, vertebrates lack a probable functional equivalent of CP190 and employ CTCF as the major factor to carry out insulator function/chromatin looping. In this review, we discuss the emerging role of CP190 in tethering genome, specifically in the perspective of insulator function in Drosophila. Future studies aiming genome-wide role of CP190 in chromatin looping is likely to give important insights into the mechanism of genome organization.

  3. Eusocial insects as emerging models for behavioural epigenetics.

    PubMed

    Yan, Hua; Simola, Daniel F; Bonasio, Roberto; Liebig, Jürgen; Berger, Shelley L; Reinberg, Danny

    2014-10-01

    Understanding the molecular basis of how behavioural states are established, maintained and altered by environmental cues is an area of considerable and growing interest. Epigenetic processes, including methylation of DNA and post-translational modification of histones, dynamically modulate activity-dependent gene expression in neurons and can therefore have important regulatory roles in shaping behavioural responses to environmental cues. Several eusocial insect species - with their unique displays of behavioural plasticity due to age, morphology and social context - have emerged as models to investigate the genetic and epigenetic underpinnings of animal social behaviour. This Review summarizes recent studies in the epigenetics of social behaviour and offers perspectives on emerging trends and prospects for establishing genetic tools in eusocial insects.

  4. Diagnostic Dilemmas and Cultural Diversity in Emergency Rooms

    PubMed Central

    Weaver, Charlotte; Sklar, David

    1980-01-01

    Language and cultural beliefs play an extremely important role in the interaction between patients from diverse cultural groups and physicians. Especially in emergency rooms, there are many dangers in missed communications. A patient from a foreign culture, especially one who does not speak English, often expresses symptoms in ways that are unfamiliar to many American physicians. Specific areas of cultural vulnerability can be identified for the major ethnic groups in the United States as they interact with the scientific medical system. A short review of folk medical beliefs and recommendations for improving diagnostic accuracy and treatment may assist emergency room staffs in offering care that is culturally acceptable to patients of diverse ethnic backgrounds. PMID:7347053

  5. Emergency Preparedness in the 10-Mile Emergency Planning Zone Surrounding Nuclear Power Plants

    PubMed Central

    Adalja, Amesh A.; Sell, Tara Kirk; Ravi, Sanjana J.; Minton, Katie; Morhard, Ryan

    2015-01-01

    Objectives Each of the nuclear power plants in the US is encircled by an Emergency Planning Zone (EPZ). Within each EPZ, government officials, utility professionals, emergency managers, and public health practitioners collectively conduct extensive planning, exercises, and outreach to better protect their communities in the event of a nuclear accident. Our objective was to conduct a cross-sectional study of off-site public health preparedness within EPZs to better understand the dynamics of nuclear preparedness and uncover lessons for all-hazards preparedness. Methods Using a qualitative, interview-based method, we consulted 120 county emergency managers, state health preparedness officers, state radiation health officials, and industry officials from 17 EPZs in ten different states. Results Interviewees reflected that EPZ emergency preparedness is generally robust, results from strong public-private partnership between nuclear plants and emergency management agencies, and enhances all-hazard preparedness. However, there exist a few areas which merit further study and improvement. These areas include cross-state coordination, digital public communication, and optimizing the level of public education within EPZs. Conclusions This first-of-its-kind study provides a cross-sectional snapshot of emergency preparedness in the 10-mile EPZ surrounding nuclear power plants. PMID:26692825

  6. Emergency Preparedness in the 10-Mile Emergency Planning Zone Surrounding Nuclear Power Plants.

    PubMed

    Adalja, Amesh A; Sell, Tara Kirk; Ravi, Sanjana J; Minton, Katie; Morhard, Ryan

    2014-12-01

    Each of the nuclear power plants in the US is encircled by an Emergency Planning Zone (EPZ). Within each EPZ, government officials, utility professionals, emergency managers, and public health practitioners collectively conduct extensive planning, exercises, and outreach to better protect their communities in the event of a nuclear accident. Our objective was to conduct a cross-sectional study of off-site public health preparedness within EPZs to better understand the dynamics of nuclear preparedness and uncover lessons for all-hazards preparedness. Using a qualitative, interview-based method, we consulted 120 county emergency managers, state health preparedness officers, state radiation health officials, and industry officials from 17 EPZs in ten different states. Interviewees reflected that EPZ emergency preparedness is generally robust, results from strong public-private partnership between nuclear plants and emergency management agencies, and enhances all-hazard preparedness. However, there exist a few areas which merit further study and improvement. These areas include cross-state coordination, digital public communication, and optimizing the level of public education within EPZs. This first-of-its-kind study provides a cross-sectional snapshot of emergency preparedness in the 10-mile EPZ surrounding nuclear power plants.

  7. Rural Emergency Department Staffing and Participation in Emergency Certification and Training Programs

    ERIC Educational Resources Information Center

    Casey, Michelle M.; Wholey, Douglas; Moscovice, Ira S.

    2008-01-01

    Context: The practice of emergency medicine presents many challenges in rural areas. Purpose: We describe how rural hospitals nationally are staffing their Emergency Departments (EDs) and explore the participation of rural ED physicians and other health care professionals in selected certification and training programs that teach skills needed to…

  8. Emerging and reemerging diseases of avian wildlife.

    PubMed

    Pello, Susan J; Olsen, Glenn H

    2013-05-01

    Of the many important avian wildlife diseases, aspergillosis, West Nile virus, avipoxvirus, Wellfleet Bay virus, avian influenza, and inclusion body disease of cranes are covered in this article. Wellfleet Bay virus, first identified in 2010, is considered an emerging disease. Avian influenza and West Nile virus have recently been in the public eye because of their zoonotic potential and links to wildlife. Several diseases labeled as reemerging are included because of recent outbreaks or, more importantly, recent research in areas such as genomics, which shed light on the mechanisms whereby these adaptable, persistent pathogens continue to spread and thrive. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Importance of nonverbal expression to the emergence of emotive artificial intelligence systems

    NASA Astrophysics Data System (ADS)

    Pioggia, Giovanni; Hanson, David; Dinelli, Serena; Di Francesco, Fabio; Francesconi, R.; De Rossi, Danilo

    2002-07-01

    The nonverbal expression of the emotions, especially in the human face, has rapidly become an area of intense interest in computer science and robotics. Exploring the emotions as a link between external events and behavioural responses, artificial intelligence designers and psychologists are approaching a theoretical understanding of foundational principles which will be key to the physical embodiment of artificial intelligence. In fact, it has been well demonstrated that many important aspects of intelligence are grounded in intimate communication with the physical world- so-called embodied intelligence . It follows naturally, then, that recent advances in emotive artificial intelligence show clear and undeniable broadening in the capacities of biologically-inspired robots to survive and thrive in a social environment. The means by which AI may express its foundling emotions are clearly integral to such capacities. In effect: powerful facial expressions are critical to the development of intelligent, sociable robots. Following discussion the importance of the nonverbal expression of emotions in humans and robots, this paper describes methods used in robotically emulating nonverbal expressions using human-like robotic faces. Furthermore, it describes the potentially revolutionary impact of electroactive polymer (EAP) actuators as artificial muscles for such robotic devices.

  10. Emergency Presentations to an Inner-City Psychiatric Service for Children and Adolescents

    ERIC Educational Resources Information Center

    Dil, L. M.; Vuijk, P. J.

    2012-01-01

    Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…

  11. The role of the emergency physician in emergency medical services for children.

    PubMed

    Gausche-Hill, Marianne; Johnson, Ramon W; Warden, Craig R; Brennan, John A

    2003-08-01

    Emergency physicians have a duty to advance the care of pediatric patients in the emergency medical services (EMS) system. This policy resource and education paper, designed to support the American College of Emergency Physicians policy paper "The Role of the Emergency Physician in Emergency Medical Services for Children," describes the development of the federal EMS for Children Program, the importance of the integration of EMS for children into EMS systems, and the role of the emergency physician in EMS for children.

  12. [Assessment on the ability of emergency response at the county center for disease control and prevention level in flooding-prone areas].

    PubMed

    Chen, Wei; Zeng, Guang

    2006-02-01

    To establish a comprehensive assessment model on the ability of emergency response within the public health system in flooding-prone areas. A hierarchy process theory was used to establish the initial assessing framework. Delphi method was used to screen and choose the ultimate indicators and their weights before an assessment model was set up under the 'synthetic scored method' to assess the ability of the emergency response among twenty county public health units. We then used the 'analysis of variation (ANOVA)' methodology to test the feasibility of distinguishing the ability of emergency response among different county health units and correlation analysis was used to assess the independence of indicators in the assessing model. A comprehensive model was then established including twenty first-class indicators and fifty-six second-class indicators and the degree of ability to emergency response with flooding of public health units was evaluated. There were five public health units having higher, ten having moderate but five with lower levels on emergency response. The assessment model was proved to be a good method in differentiating the ability of public health units, using independent indicators. The assessment model which we established seemed to be practical and reliable.

  13. Factors that influence patient satisfaction in the emergency department.

    PubMed

    Bruce, T A; Bowman, J M; Brown, S T

    1998-12-01

    This descriptive correlation study examined the satisfaction levels of urgent and nonurgent patients in relation to nursing care, the emergency department (ED) environment, ancillary services, and information received. The sample consisted of 28 subjects, with the majority of patients being very satisfied with nursing care. The primary area of concern was information about the length of waiting time. The satisfaction levels of ED patients with the care they receive has become increasingly important in today's health care environment. ED nurses play an important role in ensuring that patients are satisfied and receive quality care.

  14. Dealing with office emergencies. Stepwise approach for family physicians.

    PubMed Central

    Sempowski, Ian P.; Brison, Robert J.

    2002-01-01

    OBJECTIVE: To develop a simple stepwise approach to initial management of emergencies in family physicians' offices; to review how to prepare health care teams and equipment; and to illustrate a general approach to three of the most common office emergencies. QUALITY OF EVIDENCE: MEDLINE was searched from January 1980 to December 2001. Articles were selected based on their clinical relevance, quality of evidence, and date of publication. We reviewed American family medicine, pediatric, dental, and dermatologic articles, but found that the area has not been well studied from a Canadian family medicine perspective. Consensus statements by specialty professional groups were used to identify accepted emergency medical treatments. MAIN MESSAGE: Family medicine offices are frequently poorly equipped and inadequately prepared to deal with emergencies. Straightforward emergency response plans can be designed and tailored to an office's risk profile. A systematic team approach and effective use of skills, support staff, and equipment is important. The general approach can be modified for specific patients or conditions. CONCLUSION: Family physicians can plan ahead and use a team approach to develop a simple stepwise response to emergency situations in the office. PMID:12371305

  15. Dynamic spatiotemporal trends of imported dengue fever in Australia

    PubMed Central

    Huang, Xiaodong; Yakob, Laith; Devine, Gregor; Frentiu, Francesca D.; Fu, Shiu-Yun; Hu, Wenbiao

    2016-01-01

    Dengue fever (DF) epidemics in Australia are caused by infected international travellers and confined to Northern Queensland where competent vectors exist. Recent analyses suggest that global trade and climate change could lead to the re-establishment of Ae. aegypti across the country and promote the spread of dengue nationally. This study aimed to describe the dynamic spatiotemporal trends of imported DF cases and their origins, identify the current and potential future high-risk regions and locate areas that might be at particular risk of dengue transmission should competent mosquito vectors expand their range. Our results showed that the geographical distribution of imported DF cases has significantly expanded in mainland Australia over the past decade. In recent years, the geographical distribution of source countries of DF has expanded from the Pacific region and Asia to include Africa and the Americas. Australia is now exposed to dengue importations from all of the regions involved in the current global pandemic. The public health implications of a range expansion of dengue mosquito vectors are severe. Enhanced mosquito surveillance in those areas that have high imported cases is called for to reduce emerging threats from this globally expanding pathogen. PMID:27460696

  16. Exploring the key predictors of retention in emergency nurses.

    PubMed

    Sawatzky, Jo-Ann V; Enns, Carol L

    2012-07-01

    To explore the factors that predict the retention of nurses working in emergency departments. The escalating shortage of nurses is one of the most critical issues facing specialty areas, such as the emergency department. Therefore, it is important to identify the key influencing and intermediary factors that affect emergency department nurses' intention to leave. As part of a larger study, a cross-sectional survey was completed by 261 registered nurses working in the 12 designated emergency departments within rural, urban community and tertiary hospitals in Manitoba, Canada. Twenty-six per cent of the respondents will probably/definitely leave their current emergency department jobs within the next year. Engagement was the key predictor of intention to leave (P < 0.001). Engagement was also associated with job satisfaction, compassion satisfaction, compassion fatigue, and burnout (P < 0.05). In an ordinal least-squares model (R(2) = 0.44), nursing management, professional practice, collaboration with physicians, staffing resources and shift work emerged as significant influencing factors for engagement. Engagement plays a central role in emergency department nurses intention to leave. Addressing the factors that influence engagement may reduce emergency department nurses' intention to leave. This study highlights the value of research-based evidence as the foundation for developing innovative strategies for the retention of emergency department nurses. © 2012 Blackwell Publishing Ltd.

  17. Attitudes and practices of pharmacists towards emergency contraception in Durban, South Africa.

    PubMed

    Hariparsad, N

    2001-06-01

    Emergency contraception, which is used to prevent pregnancy following unprotected intercourse, could prove invaluable to a country like South Africa which has high fertility and pregnancy rates. However, the success of emergency contraception is dependent on the awareness, knowledge, attitudes and practices amongst health-care providers and the public towards it. The aim of this study was to assess the attitudes and practices of community pharmacists towards emergency contraception. The study was conducted in North and South Central Durban, South Africa. This questionnaire-based study sought from pharmacists the frequency of demand and supply of emergency contraception, as well as their attitudes and practices towards it. The sample included all 182 pharmacies located in the study area. A total of 96% of pharmacists had received requests for emergency contraception within the last year. On average, each pharmacist received 177 requests for emergency contraception. Sixty-nine per cent of pharmacists were in favor of making emergency contraceptive pills available without a prescription, 62% were already supplying emergency contraceptive pills without a prescription and 67% felt that it was important to increase public awareness regarding emergency contraception. Ninety-one per cent of pharmacists did not have any literature regarding emergency contraception to hand to clients, 68% had a private area in their pharmacy to counsel patients and 86% of pharmacists indicated that they discussed long-term contraception with clients. This study is the first in South Africa aimed at determining the utilization of emergency contraception. However, further studies are required in order to ascertain information that will assist in changing current health policies to improve those in reproductive health care.

  18. Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol

    PubMed Central

    Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

    2013-01-01

    Introduction Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. Methods and analysis To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. Ethics and dissemination This protocol has been approved by the CSSS Alphonse–Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific

  19. Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol.

    PubMed

    Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

    2013-01-01

    Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. This protocol has been approved by the CSSS Alphonse-Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

  20. Emergency contraception in a public health emergency: exploring pharmacy availability in Brazil.

    PubMed

    Tavares, Marilia P; Foster, Angel M

    2016-08-01

    Dedicated progestin-only emergency contraceptive pills (ECPs) have been available with a prescription in Brazil since 1999. However, utilization of emergency contraception has been limited. We conducted a mystery client study at retail pharmacies in three regions to assess current availability. Using a predetermined client profile, we approached a random sample of chain and independent pharmacies in urban areas in the southeastern, northeastern and central-west regions. We documented product availability, price and the client-pharmacy representative interaction at each site. We analyzed these data with descriptive statistics and for content and themes. We visited 122 pharmacies in early 2016. All but three pharmacies (97.5%) had ECPs in stock at the time of the interaction and offered our client the medication without a prescription. In general, pharmacy representatives did not ask questions or provide our client with information about emergency contraception. When prompted, over one third of the pharmacy representatives (37.7%) inaccurately reported that levonorgestrel ECPs could only be used immediately or within 12, 24 or 48h from the time of intercourse. Despite the current regulatory status, our findings suggest that progestin-only ECPs are widely available without a prescription. Additional efforts to ensure that women have up-to-date and medically accurate information about progestin-only ECPs appear warranted. Our findings suggest that more work needs to be done to align national regulatory policies with international standards and evidence-based practices. The Zika virus epidemic has shined a spotlight on the importance of providing timely access to emergency contraception in Latin America. This public health emergency offers a window of opportunity to advance national policies and practices to ensure that Brazilian women have access to a full range of reproductive health services. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Sediment Properties as Important Predictors of Carbon Storage in Zostera marina Meadows: A Comparison of Four European Areas

    PubMed Central

    Dahl, Martin; Deyanova, Diana; Gütschow, Silvia; Asplund, Maria E.; Lyimo, Liberatus D.; Karamfilov, Ventzislav; Santos, Rui; Björk, Mats; Gullström, Martin

    2016-01-01

    Seagrass ecosystems are important natural carbon sinks but their efficiency varies greatly depending on species composition and environmental conditions. What causes this variation is not fully known and could have important implications for management and protection of the seagrass habitat to continue to act as a natural carbon sink. Here, we assessed sedimentary organic carbon in Zostera marina meadows (and adjacent unvegetated sediment) in four distinct areas of Europe (Gullmar Fjord on the Swedish Skagerrak coast, Askö in the Baltic Sea, Sozopol in the Black Sea and Ria Formosa in southern Portugal) down to ~35 cm depth. We also tested how sedimentary organic carbon in Z. marina meadows relates to different sediment characteristics, a range of seagrass-associated variables and water depth. The seagrass carbon storage varied greatly among areas, with an average organic carbon content ranging from 2.79 ± 0.50% in the Gullmar Fjord to 0.17 ± 0.02% in the area of Sozopol. We found that a high proportion of fine grain size, high porosity and low density of the sediment is strongly related to high carbon content in Z. marina sediment. We suggest that sediment properties should be included as an important factor when evaluating high priority areas in management of Z. marina generated carbon sinks. PMID:27936111

  2. Mortality and ST resolution in patients admitted with STEMI: the MOMI survey of emergency service experience in a complex urban area.

    PubMed

    Grieco, Niccolò; Sesana, Giovanni; Corrada, Elena; Ieva, Francesca; Paganoni, Annamaria; Marzegalli, Maurizio

    2012-09-01

    Since 2001, the urban area of Milan has been operating a network among 23 cardiac care units, the 118 dispatch centre (national free number for medical emergencies), and the county government health agency called Group for Prehospital Cardiac Emergency. In order to monitor the network activity, time to treatment, and clinical outcome, a periodic survey, called MOMI(2), was repeated two or three times a year. Each survey lasted 30 days and was repeated in comparable periods. Data were stratified for hospital admission mode. We collected data concerning 708 consecutive ST-elevation myocardial infarction (STEMI) patients (male 72.6%; mean age 64.4 years). In these six surveys, we observed a high rate of primary percutaneous coronary intervention (73.2%) and a mortality rate of 6.3%. Using advanced statistical models, we identified age, Killip class, and the symptom onset-to-balloon time as most relevant prognostic factors. Nonparametric test showed that the modality of hospital admittance was the most critical determinant of door-to-balloon time. 12-lead ECG tele-transmission and activation of a fast track directly to the catheterization laboratory are easy action to reduce time to treatment. The experience of the Milan network for cardiac emergency shows how a network coordinating the community, rescue units, and hospitals in a complex urban area and making use of medical technology contributes to the health care of patients with STEMI.

  3. Behavioral emergencies in India: a population based epidemiological study.

    PubMed

    Saddichha, Sahoo; Vibha, Pandey; Saxena, Mukul Kumar; Methuku, Mithilesh

    2010-05-01

    Behavioral emergencies constitute an important but neglected part of emergencies seen worldwide in both emergency departments and by emergency services. Yet research on behavioral emergencies in India has been scarce. The study aimed to evaluate the occurrence of acute behavioral problems as an emergency attended by our emergency management service-108 services. During the period of August 1st 2007-July 31st 2008, all behavioral emergencies presenting to our emergency services in the states of Gujarat and Andhra Pradesh, which together account for more than 15% of India's population, were reviewed for data completeness and validity. Key word analysis of recorded case details was carried out to determine cause of emergency. Survival to hospital and 48-h outcome was also evaluated to study risk factors for mortality. A total of 40,541 cases of behavioral emergencies were recorded, in which the male:female ratio was 1.3:1. Most victims were in the 20 and 30 years (42%), from a poor socio-economic background (93%), rural area (74.3%), and backward caste (42.6%). Suicidal attempts, whether in the form of poisoning (60.5%) or otherwise (30.7%) was the most common emergency, followed by acute psychiatric causes (4%) and alcohol intoxication (3%). Victims, who met a fatal outcome, were more likely to be male (p = 0.02), having a better socio-economic condition (p < 0.001) and older (p < 0.001). Suicidal attempts, which form the largest chunk of behavioral emergencies, need to be tackled on a war-footing, given the sensitivity it deserves. Acute psychiatric emergencies, which form about 9% of all emergencies, require the emerging role of emergency psychiatric services.

  4. Leaf area and photosynthesis of newly emerged trifoliolate leaves are regulated by mature leaves in soybean.

    PubMed

    Wu, Yushan; Gong, Wanzhuo; Wang, Yangmei; Yong, Taiwen; Yang, Feng; Liu, Weigui; Wu, Xiaoling; Du, Junbo; Shu, Kai; Liu, Jiang; Liu, Chunyan; Yang, Wenyu

    2018-03-29

    Leaf anatomy and the stomatal development of developing leaves of plants have been shown to be regulated by the same light environment as that of mature leaves, but no report has yet been written on whether such a long-distance signal from mature leaves regulates the total leaf area of newly emerged leaves. To explore this question, we created an investigation in which we collected data on the leaf area, leaf mass per area (LMA), leaf anatomy, cell size, cell number, gas exchange and soluble sugar content of leaves from three soybean varieties grown under full sunlight (NS), shaded mature leaves (MS) or whole plants grown in shade (WS). Our results show that MS or WS cause a marked decline both in leaf area and LMA in newly developing leaves. Leaf anatomy also showed characteristics of shade leaves with decreased leaf thickness, palisade tissue thickness, sponge tissue thickness, cell size and cell numbers. In addition, in the MS and WS treatments, newly developed leaves exhibited lower net photosynthetic rate (Pn), stomatal conductance (Gs) and transpiration rate (E), but higher carbon dioxide (CO 2 ) concentration in the intercellular space (Ci) than plants grown in full sunlight. Moreover, soluble sugar content was significantly decreased in newly developed leaves in MS and WS treatments. These results clearly indicate that (1) leaf area, leaf anatomical structure, and photosynthetic function of newly developing leaves are regulated by a systemic irradiance signal from mature leaves; (2) decreased cell size and cell number are the major cause of smaller and thinner leaves in shade; and (3) sugars could possibly act as candidate signal substances to regulate leaf area systemically.

  5. Nonemergency Medicine-Trained Physician Coverage in Rural Emergency Departments

    ERIC Educational Resources Information Center

    Peterson, Lars E.; Dodoo, Martey; Bennett, Kevin J.; Bazemore, Andrew; Phillips, Robert L., Jr.

    2008-01-01

    Context: Rural areas have fewer physicians compared to urban areas, and rural emergency departments often rely on community or contracted providers for staffing. The emergency department workforce is composed of a variety of physician specialties and clinicians. Purpose: To determine the distribution of emergency department clinicians and the…

  6. Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology.

    PubMed

    Bhargava, Rohit; Madabhushi, Anant

    2016-07-11

    Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area.

  7. Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology

    PubMed Central

    Bhargava, Rohit; Madabhushi, Anant

    2017-01-01

    Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area. PMID:27420575

  8. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Charles Street, Roger Scheidt and Robert ZiBerna, the Emergency Preparedness team at KSC, sit in the conference room inside the Mobile Command Center, a specially equipped vehicle. Nicknamed '''The Brute,''' it also features computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  9. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This new specially equipped vehicle serves as a mobile command center for emergency preparedness staff and other support personnel when needed at KSC or Cape Canaveral Air Force Station. It features a conference room, computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or CCAFS.

  10. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This camper-equipped truck known as '''Old Blue''' served as mobile field command center for the Emergency Preparedness team at KSC. It has been replaced with a larger vehicle that includes a conference room, computer work stations, mobile telephones and a fax machine, plus its own onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  11. Mother-Father Dyad Conflict Strategy Clusters: Implications for Emerging Adults.

    PubMed

    McKinney, Cliff; Walker, Courtney S; Kwan, Janet W

    2016-12-01

    Research has examined the different parenting styles that are present during emerging adulthood; however, less is known about potential parental conflict strategies that emerging adults may be experiencing during this developmental time period. Conflict strategies are conceptualized in the current study as parents' efforts to regulate, correct, or enforce a consequence in response to their emerging adult child's behavior. Previous research on discipline during childhood and adolescence has suggested the use of harsh discipline (e.g., use of physical force) leads to negative outcomes for children. Despite evidence linking harsh discipline methods to harmful outcomes in various developmental periods and suggested influence of parents in emerging adulthood, very little is known about how parents handle conflict with their emerging adult children. Thus, the present study investigated parental conflict strategies and mental health outcomes of emerging adults. Results revealed a significant parent-child gender interaction for non-violent strategies and psychological aggression. Moreover, results indicated that emerging adult children of parents who utilize similar levels of aggressive methods reported greater psychological problems. The findings from the current study underscore parents' use of conflict strategies when interacting with their emerging adult children, and further emphasize the importance of future research in this area.

  12. The perspectives of adults with aphasia and their team members regarding the importance of nine life areas for rehabilitation: a pilot investigation.

    PubMed

    Pettit, Lauren K; Tönsing, Kerstin M; Dada, Shakila

    2017-03-01

    Client-centred rehabilitation implies that persons with aphasia and their significant others are actively involved in all decisions regarding rehabilitation, including the setting of rehabilitation priorities and goals. This study aimed to describe and compare the perspectives of adults with aphasia, their significant others and their speech-language pathologists (SLPs) regarding the importance of nine life areas for the rehabilitation of adults with aphasia. A total of 15 adults with expressive aphasia rated the importance of nine life areas using the Talking Mats™ framework. A questionnaire was used to obtain the ratings of 15 of their significant others and the 15 SLPs treating them. Most life areas were rated as important to work on in rehabilitation by most participants. The adults with aphasia rated the areas as important more frequently than their significant others and SLPs. All participants rated Communication as important. Statistically significant differences were noted for three of the nine life areas. The life areas which the participants were questioned about seem to provide a good starting point for rehabilitation teams to find common ground for collaborative goal setting. The Talking Mats™ approach allowed adults with aphasia to participate in the process. It can be a useful tool to promote client-centred rehabilitation for adults with expressive communication difficulties.

  13. Emergency Management of Myasthenia Gravis

    MedlinePlus

    ... to weakened throat muscles and accumulated secretions. EMERGENCY MANAGEMENT OF MG The MGFA mission is to facilitate ... fax mgfa@myasthenia.org • www.myasthenia.org EMERGENCY MANAGEMENT OF MG Emergency Management Important information for the ...

  14. Trade-off between early emergence and herbivore susceptibility mediates exotic success in an experimental California plant community.

    PubMed

    Waterton, Joseph; Cleland, Elsa E

    2016-12-01

    Ecological trade-offs are fundamental to theory in community ecology; critical for understanding species coexistence in diverse plant communities, as well as the evolution of diverse life-history strategies. Invasions by exotic species can provide insights into the importance of trade-offs in community assembly, because the ecological strategies of invading species often differ from those present in the native species pool. Exotic annual species have invaded many Mediterranean-climate areas around the globe, and often germinate and emerge earlier in the growing season than native species. Early-season growth can enable exotic annual species to preempt space and resources, competitively suppressing later-emerging native species; however, early-emerging individuals may also be more apparent to herbivores. This suggests a potential trade-off between seasonal phenology and susceptibility to herbivory. To evaluate this hypothesis, we monitored the emergence and growth of 12 focal species (six each native and exotic) in monoculture and polyculture, while experimentally excluding generalist herbivores both early and later in the growing season. Consistent with past studies, the exotic species emerged earlier than native species. Regardless of species origin, earlier-emerging species achieved greater biomass by the end of the experiment, but were more negatively impacted by herbivory, particularly in the early part of the growing season. This greater impact of early-season herbivory on early-active species led to a reduction in the competitive advantage of exotic species growing in polyculture, and improved the performance of later-emerging natives. Such a trade-off between early growth and susceptibility to herbivores could be an important force in community assembly in seasonal herbaceous-dominated ecosystems. These results also show how herbivore exclusion favors early-active exotic species in this system, with important implications for management in many areas invaded

  15. Development of emergency department load relief area--gauging benefits in empirical terms.

    PubMed

    Rasheed, Farrukh; Lee, Young Hoon; Kim, Seung Ho; Park, In Cheol

    2012-12-01

    The primary goal of this investigation was to develop a simulation model to evaluate the various internal and external factors affecting patient flow and crowding in the emergency department (ED). In addition, a few recommendations are proposed to reconfigure the patient flow to improve ED capacity while maintaining service quality. In this research, we present a simulation study conducted in the ED at the "S Hospital" located in Seoul. Based on patient flow data and process analysis, a simulation model of patient throughput in the ED has been developed. We evaluated simulations of diverting the specific patient load in the light of our proposed recommendations to a separately managed area named as the ED load relief area (ED-LRA) and analyzing potential effects on overall length of stay (LOS) and waiting time (WT). What-if analyses have been proposed to identify key issues and investigate the improvements as per our proposed recommendations. The simulation results suggest that specific patient load diversion is needed to ensure desired outcomes. With the diversion of specific patient load to ED-LRA, there is a reduction of 40.60% in mean LOS and 42.5% in WT with improved resource utilization. As a result, opening of an ED-LRA is justified. Real-world systems are often too intricate for analytical models and often too expensive to trial with directly. Simulation models allow the modeling of this intricacy and enable experimentation to make inferences about how the actual system might perform. Our simulation study modeled that diverting the specific patient load to ED-LRA produced an improvement in overall ED's LOS and WT.

  16. Distribution and fate of legacy and emerging contaminants along the Adriatic Sea: A comparative study.

    PubMed

    Combi, Tatiane; Pintado-Herrera, Marina G; Lara-Martin, Pablo A; Miserocchi, Stefano; Langone, Leonardo; Guerra, Roberta

    2016-11-01

    The spatial distributions and fates of selected legacy and emerging compounds were investigated and compared in surface sediments sampled along the Adriatic mud-wedge and in deep-sea regions from the southern Adriatic basin. Results indicated that the concentrations of legacy contaminants (PAHs, PCBs and DDTs) and emerging contaminants (tonalide, galaxolide, EHMC, octocrylene, BP3 and NP) ranged from 0.1 to 572 ng g -1 and from importance of the Po River as the major contributor for the inputs of legacy and emerging contaminants to sediments in the Adriatic Sea. Nevertheless, the prevalence of some UV filters and fragrances in the central and southern Adriatic indicates that the proximity to tourist areas and WWTPs discharges seems to affect the distribution of those compounds. The accumulation of contaminants in the deep-sea areas supports the inference that this region may act as an important repository for contaminants within the Adriatic Sea. Estimated annual contaminant accumulation reveals that both, legacy and emerging contaminants accumulate preferentially in the northern Adriatic (40-60% of the total annual contaminant accumulation), where the presence of legacy, and to a lesser extent emerging contaminants, are likely to pose an immediate or long-term hazard to resident biota. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Tularaemia in an emergent area in Sweden: an analysis of 234 cases in five years.

    PubMed

    Eliasson, Henrik; Bäck, Erik

    2007-01-01

    A retrospective study of clinical tularaemia in an emergent area in Sweden is presented. 234 patients seen during the y 2000-2004 were studied, using case files and a questionnaire. There was a predominance of ulceroglandular tularaemia (89%), occurring in late summer and early autumn, reflecting the dominance of mosquito-borne transmission. The incubation period varied from a few hours to 11 d, with a median of 3 d. Cutaneous manifestations of tularaemia, apart from primary lesions, were noted in 43% of the cases. Coughing was common, even in patients with ulceroglandular tularaemia, supporting the view that haematogenous spread to the respiratory system occurs. Regular laboratory tests, such as WBC, ESR and C-reactive protein, were in general only moderately elevated. In the earlier y studied, the Doctor's Delay was substantial as was the misdiagnosis and prescription of inadequate antibiotics. In the later y, however, the delay and misdiagnosis were significantly lower, reflecting the increased recognition of the disease by the physicians in the area. A few relapses occurred, all in patients treated with doxycycline. No lethality was seen, reflecting the benign course of tularaemia type B infection.

  18. Return to normality after a radiological emergency.

    PubMed

    Lochard, J; Prêtre, S

    1995-01-01

    Some preliminary considerations from the management of post-accident situations connected to large scale and high land contamination are presented. The return to normal, or at least acceptable living conditions, as soon as reasonably achievable, and the prevention of the possible emergence of a post-accident crisis is of key importance. A scheme is proposed for understanding the dynamics of the various phases after an accident. An attempt is made to characterize some of the parameters driving the acceptability of post-accident situations. Strategies to return to normal living conditions in contaminated areas are considered.

  19. Refining the Enrolment Process in Emergency Medicine Research.

    PubMed

    Sahan, Kate M; Channon, Keith M; Choudhury, Robin P; Kharbanda, Rajesh K; Lee, Regent; Sheehan, Mark

    2016-04-01

    Research in the emergency setting involving patients with acute clinical conditions is needed if there are to be advances in diagnosis and treatment. But research in these areas poses ethical and practical challenges. One of these is the general inability to obtain informed consent due to the patient's lack of mental capacity and insufficient time to contact legal representatives. Regulatory frameworks which allow this research to proceed with a consent 'waiver', provided patients lack mental capacity, miss important ethical subtleties. One of these is the varying nature of mental capacity among emergency medicine patients. Not only is their capacity variable and often unclear, but some patients are also likely to be able to engage with the researcher and the context to varying degrees. In this paper we describe the key elements of a novel enrolment process for emergency medicine research that refines the consent waiver and fully engages with the ethical rationale for consent and, in this context, its waiver. The process is verbal but independently documented during the 'emergent' stages of the research. It provides appropriate engagement with the patient, is context-sensitive and better addresses ethical subtleties. In line with regulation, full written consent for on-going participation in the research is obtained once the emergency is passed.

  20. SDN-enabled hybrid emergency message transmission architecture in internet-of-vehicles

    NASA Astrophysics Data System (ADS)

    Zhu, Wanting; Gao, Deyun; Zhao, Weicheng; Zhang, Hongke; Chiang, Hua-Pei

    2018-04-01

    With the increasing number of vehicles connected to the Internet-of-Things (IoT), Internet-of-Vehicles (IoV) is becoming a hot research topic. It can improve traffic safety and efficiency and promote the development of the intelligent transportation that is a very important element in Smart Cities. As an important part of the safety application in IoV, the emergency message transmission is designed to inform all the vehicles in the relevant area timely of the accident information through the multi-hop broadcast communication. In this paper, we propose a hybrid emergency message transmission (HEMT), which introduces the SDN technology into the vehicular network environment and utilizes the flexibility of inter-vehicle communication. By deploying SDN-enabled central controller and RSU switches, we can obtain reliable and fast emergency message dissemination. Moreover, considering the space between the coverages of RSUs caused by the sparse deployment, we also use inter-vehicle multi-hop broadcast communication to improve the message coverage ratio by adding the packet modification module on the RSU switch. Simulation results show the feasibility and effectiveness of our proposed scheme.

  1. The association between the availability of ambulatory care and non-emergency treatment in emergency medicine departments: a comprehensive and nationwide validation.

    PubMed

    Chan, Chien-Lung; Lin, Wender; Yang, Nan-Ping; Huang, Hsin-Tsung

    2013-05-01

    To quantify dynamic availability of ambulatory care, and to examine possible associations with non-emergency treatments in emergency departments (EDs). Longitudinal data from the Taiwan National health Insurance Research Database were used to evaluate 749,584 emergency-medicine cases occurring between 2005 and 2010 according to a modified New York University algorithm. Multivariable-cumulative-logistic-regression analysis with generalized estimating-equation methods was used to determine associations between availability of ambulatory care and the urgency of patients' medical needs during ED visits. More than half (53.04%) of the ED visits that were evaluated in our study were classified as non-emergencies, and over half of these occurred despite a high availability of ambulatory care facilities (median > 96%). Compared with patients in areas with a low availability of ambulatory care, patients in areas of medium to high availability showed approximately 0.8 times lower odds ratios for associations with non-emergency ED visits. Non-emergency ED visits may be reduced by increasing the availability of ambulatory care facilities in areas with deficits in the availability of such facilities. However, increasing the availability of ambulatory care by raising the number of available ambulatory care physicians or the number of ambulatory care facilities may not reduce non-emergency ED visits in areas with medium to high availability of ambulatory care facilities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. An Analysis of the Emerging Roles of the Paraprofessional School-Community Aide with Implications for Strategies of Social Change in Disadvantaged Areas.

    ERIC Educational Resources Information Center

    Hadden, Marise Alvena Tabor Bell

    This study analyzed the use of paraprofessionals as school-community workers (Community Counselors) by the Flint (Michigan) Community Schools. The purpose was to examine perceptions and expectations of this position in order to: organize a framework for the emerging role of the indigenous school-community worker in urban disadvantaged areas; make…

  3. Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

    PubMed

    Rockwell, Kimberly Lovett; Gilroy, Alexis

    2018-03-12

    Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

  4. Operational Research during the Ebola Emergency.

    PubMed

    Fitzpatrick, Gabriel; Decroo, Tom; Draguez, Bertrand; Crestani, Rosa; Ronsse, Axelle; Van den Bergh, Rafael; Van Herp, Michel

    2017-07-01

    Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare. Importantly, operational research questions were decided to a large extent by returning volunteers who had first-hand knowledge of the immediate issues facing teams in the field. Such a method is appropriate for an emergency medical organization. Many challenges were also identified while carrying out operational research across 3 different countries, including the basic need for collecting data in standardized format to enable comparison of findings among treatment centers.

  5. Risks of emerging infectious diseases: evolving threats in a changing area, the mediterranean basin.

    PubMed

    Vittecoq, M; Thomas, F; Jourdain, E; Moutou, F; Renaud, F; Gauthier-Clerc, M

    2014-02-01

    The Mediterranean basin is a biodiversity hotspot; it has historically had a large human presence that has shaped ecosystems for millennia. As the cradle of many civilizations, the area was one of the main theatres for transitions that punctuated both human and pathogen histories, which are intimately linked. Today we are living through another great historical transition summarized in the expression 'global changes'. In this context, we are witnessing a rise in the emergence of pathogens widely associated with aforementioned global changes. The Mediterranean basin might be especially vulnerable to this phenomenon due to the acute consequences global changes will have in this key intercontinental interface region. In addition, Arab revolutions and European economic crisis are creating both sanitary issues and presenting new opportunities to improve infectious disease control and prevention in the region. The aim of this review is to identify the impacts that ongoing changes might have on the risk of infectious disease emergence in the Mediterranean basin. We focussed on three key domains undergoing transformations: (i) resources, namely safe drinking water and animal products, (ii) socio-economic factors including health inequalities within countries and poor sanitary conditions linked to ongoing conflicts and (iii) movements of people and goods that are reshaped by current changes and are intimately linked to the risk of disease proliferation. Building on recent examples, we try to identify upcoming challenges and discuss ways to meet them in the light of existing international human and veterinary health guidelines and their possible improvements. © 2012 Blackwell Verlag GmbH.

  6. PFP Emergency Lighting Study

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

    BUSCH, M.S.

    2000-02-02

    NFPA 101, section 5-9 mandates that, where required by building classification, all designated emergency egress routes be provided with adequate emergency lighting in the event of a normal lighting outage. Emergency lighting is to be arranged so that egress routes are illuminated to an average of 1.0 footcandle with a minimum at any point of 0.1 footcandle, as measured at floor level. These levels are permitted to drop to 60% of their original value over the required 90 minute emergency lighting duration after a power outage. The Plutonium Finishing Plant (PFP) has two designations for battery powered egress lights ''Emergencymore » Lights'' are those battery powered lights required by NFPA 101 to provide lighting along officially designated egress routes in those buildings meeting the correct occupancy requirements. Emergency Lights are maintained on a monthly basis by procedure ZSR-12N-001. ''Backup Lights'' are battery powered lights not required by NFPA, but installed in areas where additional light may be needed. The Backup Light locations were identified by PFP Safety and Engineering based on several factors. (1) General occupancy and type of work in the area. Areas occupied briefly during a shiftly surveillance do not require backup lighting while a room occupied fairly frequently or for significant lengths of time will need one or two Backup lights to provide general illumination of the egress points. (2) Complexity of the egress routes. Office spaces with a standard hallway/room configuration will not require Backup Lights while a large room with several subdivisions or irregularly placed rooms, doors, and equipment will require Backup Lights to make egress safer. (3) Reasonable balance between the safety benefits of additional lighting and the man-hours/exposure required for periodic light maintenance. In some plant areas such as building 236-Z, the additional maintenance time and risk of contamination do not warrant having Backup Lights installed in

  7. Development traumatic brain injury computer user interface for disaster area in Indonesia supported by emergency broadband access network.

    PubMed

    Sutiono, Agung Budi; Suwa, Hirohiko; Ohta, Toshizumi; Arifin, Muh Zafrullah; Kitamura, Yohei; Yoshida, Kazunari; Merdika, Daduk; Qiantori, Andri; Iskandar

    2012-12-01

    Disasters bring consequences of negative impacts on the environment and human life. One of the common cause of critical condition is traumatic brain injury (TBI), namely, epidural (EDH) and subdural hematoma (SDH), due to downfall hard things during earthquake. We proposed and analyzed the user response, namely neurosurgeon, general doctor/surgeon and nurse when they interacted with TBI computer interface. The communication systems was supported by TBI web based applications using emergency broadband access network with tethered balloon and simulated in the field trial to evaluate the coverage area. The interface consisted of demography data and multi tabs for anamnesis, treatment, follow up and teleconference interfaces. The interface allows neurosurgeon, surgeon/general doctors and nurses to entry the EDH and SDH patient's data during referring them on the emergency simulation and evaluated based on time needs and their understanding. The average time needed was obtained after simulated by Lenovo T500 notebook using mouse; 8-10 min for neurosurgeons, 12-15 min for surgeons/general doctors and 15-19 min for nurses. By using Think Pad X201 Tablet, the time needed for entry data was 5-7 min for neurosurgeon, 7-10 min for surgeons/general doctors and 12-16 min for nurses. We observed that the time difference was depending on the computer type and user literacy qualification as well as their understanding on traumatic brain injury, particularly for the nurses. In conclusion, there are five data classification for simply TBI GUI, namely, 1) demography, 2) specific anamnesis for EDH and SDH, 3) treatment action and medicine of TBI, 4) follow up data display and 5) teleneurosurgery for streaming video consultation. The type of computer, particularly tablet PC was more convenient and faster for entry data, compare to that computer mouse touched pad. Emergency broadband access network using tethered balloon is possible to be employed to cover the communications systems in

  8. A circular analysis of chronobiology of Schistosoma japonicum cercarial emergence from hilly areas of Anhui, China.

    PubMed

    Su, Jing; Zhou, Feng; Lu, Da-Bing

    2013-10-01

    About 46 mammal species have been suspected as reservoir hosts for Schistosoma japonicum and therefore the track of the target parasites, in relation to definitive host species, may be of great importance in terms of theoretical and practical implications. The circadian rhythm of cercariae emergence, a genetically controlled behavior for parasites to adapt to their definitive hosts, may seem to be a perfect biological marker for S. japonicum. In this study, a late (or nocturnal) cercarial emergence pattern was observed on the parasites from one hilly region in Anhui of China, where rodents serve as reservoirs, and on the first generation of the parasites. Moreover, by using the circular statistics, the homogeneity of parasites in such trait was also demonstrated. All these provide evidence for the genetically controlled biological trait, which seems essential in the investigation of macro- or micro-dynamics of parasite transmission of interest. This is particularly true in the case of S. japonicum when multiple parasite isolates or strains are more likely to exist. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. The assessment of language and the emergence from disorders of consciousness.

    PubMed

    Pundole, Amy; Crawford, Sarah

    2017-04-06

    In order to demonstrate emergence from a disorder of consciousness (DoC) an individual is currently required to demonstrate functional object use of two objects, or functional communication defined as accurately answering six yes/no questions on two consecutive occasions (Giacino et al., 2002 ). In practice, experienced speech and language therapists (SLTs) working with this group often focus on facilitating object use or employ other language tasks, since achieving a 100% accurate yes/no response can be difficult for patients following an extensive brain injury due to language and/or cognitive impairments. There is an increasing awareness of this issue in the literature and in practice and there is discussion about reviewing the current definition of emergence. This paper outlines the traditional definition of emergence and recent updates, discusses some of the problems and implications associated with current assessment, highlights the importance of getting it right, explores potential other ways to determine emergence, and suggests further areas for research.

  10. Athletic Trainers' Perceptions of the Importance, Preparation and Time Spent in the Athletic Training Content Areas

    ERIC Educational Resources Information Center

    Donahue, Martin

    2009-01-01

    Context: Graduates of professional programs accredited by the Commission on Accreditation of Athletic Training Education are expected to be competent and proficient in the athletic training content areas. Objective: The unique skills and knowledge that an athletic trainer (AT) must possess may have more importance in one clinical setting than in…

  11. Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast

    PubMed Central

    2014-01-01

    Background Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. Methods A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Results Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Conclusions Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. PMID:25047177

  12. Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast.

    PubMed

    Dos-Santos, João C K; Angerami, Rodrigo N; Castiñeiras, Catarina M S; Lopes, Stefanie C P; Albrecht, Letusa; Garcia, Márcia T; Levy, Carlos E; Moretti, Maria L; Lacerda, Marcus V G; Costa, Fabio T M

    2014-07-22

    Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment.

  13. Emergent Runaway into an Avoidance Area in a Swarm of Soldier Crabs

    PubMed Central

    Murakami, Hisashi; Tomaru, Takenori; Nishiyama, Yuta; Moriyama, Toru; Niizato, Takayuki; Gunji, Yukio-Pegio

    2014-01-01

    Emergent behavior that arises from a mass effect is one of the most striking aspects of collective animal groups. Investigating such behavior would be important in order to understand how individuals interact with their neighbors. Although there are many experiments that have used collective animals to investigate social learning or conflict between individuals and society such as that between a fish and a school, reports on mass effects are rare. In this study, we show that a swarm of soldier crabs could spontaneously enter a water pool, which are usually avoided, by forming densely populated part of a swarm at the edge of the water pool. Moreover, we show that the observed behavior can be explained by the model of collective behavior based on inherent noise that is individuals’ different velocities in a directed group. Our results suggest that inherent noise, which is widely seen in collective animals, can contribute to formation and/or maintenance of a swarm and that the dense swarm can enter the pool by means of enhanced inherent noise. PMID:24839970

  14. Spatiotemporal analysis of indigenous and imported dengue fever cases in Guangdong province, China.

    PubMed

    Li, Zhongjie; Yin, Wenwu; Clements, Archie; Williams, Gail; Lai, Shengjie; Zhou, Hang; Zhao, Dan; Guo, Yansha; Zhang, Yonghui; Wang, Jinfeng; Hu, Wenbiao; Yang, Weizhong

    2012-06-12

    Dengue fever has been a major public health concern in China since it re-emerged in Guangdong province in 1978. This study aimed to explore spatiotemporal characteristics of dengue fever cases for both indigenous and imported cases during recent years in Guangdong province, so as to identify high-risk areas of the province and thereby help plan resource allocation for dengue interventions. Notifiable cases of dengue fever were collected from all 123 counties of Guangdong province from 2005 to 2010. Descriptive temporal and spatial analysis were conducted, including plotting of seasonal distribution of cases, and creating choropleth maps of cumulative incidence by county. The space-time scan statistic was used to determine space-time clusters of dengue fever cases at the county level, and a geographical information system was used to visualize the location of the clusters. Analysis were stratified by imported and indigenous origin. 1658 dengue fever cases were recorded in Guangdong province during the study period, including 94 imported cases and 1564 indigenous cases. Both imported and indigenous cases occurred more frequently in autumn. The areas affected by the indigenous and imported cases presented a geographically expanding trend over the study period. The results showed that the most likely cluster of imported cases (relative risk = 7.52, p < 0.001) and indigenous cases (relative risk = 153.56, p < 0.001) occurred in the Pearl River Delta Area; while a secondary cluster of indigenous cases occurred in one district of the Chao Shan Area (relative risk = 471.25, p < 0.001). This study demonstrated that the geographic range of imported and indigenous dengue fever cases has expanded over recent years, and cases were significantly clustered in two heavily urbanised areas of Guangdong province. This provides the foundation for further investigation of risk factors and interventions in these high-risk areas.

  15. Development of Rural Emergency Medical System (REMS) with Geospatial Technology in Malaysia

    NASA Astrophysics Data System (ADS)

    Ooi, W. H.; Shahrizal, I. M.; Noordin, A.; Nurulain, M. I.; Norhan, M. Y.

    2014-02-01

    Emergency medical services are dedicated services in providing out-of-hospital transport to definitive care or patients with illnesses and injuries. In this service the response time and the preparedness of medical services is of prime importance. The application of space and geospatial technology such as satellite navigation system and Geographical Information System (GIS) was proven to improve the emergency operation in many developed countries. In collaboration with a medical service NGO, the National Space Agency (ANGKASA) has developed a prototype Rural Emergency Medical System (REMS), focusing on providing medical services to rural areas and incorporating satellite based tracking module integrated with GIS and patience database to improve the response time of the paramedic team during emergency. With the aim to benefit the grassroots community by exploiting space technology, the project was able to prove the system concept which will be addressed in this paper.

  16. From Civil Protection Plan to Disaster Management. PETer evolution from GIS tool to multi-area Emergency Management System

    NASA Astrophysics Data System (ADS)

    Frigerio, Simone; Sterlacchini, Simone; Malet, Jean-Philippe; Glade, Thomas

    2010-05-01

    PETer (Protection and Emergency of the Territory) has been developed since 2006 as a tool to manage all the information available to perform a wide range of Civil Protection activities. Based on MapObjects spatial support, it was relied on capacity to manage data from different sources and at different scale, offering practical GIS-tools for a technical and practical use during crisis state. At the first stages of the development, after different assessment, critical on-field analysis and a direct proof on test area, the approach came into sight like a valid database management for the entire dataset, but quite static, not full-blown for every emergency necessity, too complicate and not enough user-friendly, considering people in charge during emergency management, the quick change of state with many parameters involved and also uncertainty, hesitation, confusion or general panic among decision makers. As a second step of research, a more down-to-earth methodology targeted to cope with the aftermath of critical events is presented here. It takes advantage of Geographical Information Systems (GIS), Decision Support Systems (DSS), and Information and Communication Technology (ICT) to prepare, apply and coordinate Civil Protection plans. The main aim was to set up and manage contingency plans in advance; that is, to identify and prepare people in charge to take action to define the activities to be performed, to be aware of available resources and to optimize the communication system among the people involved, in order to efficiently face a prospective crisis phase. A disaster preparedness plan should anticipate the demands for a disaster relief operation and indicate the most effective way of joining those requirements. Through scientific and technical co-operation between public and private research groups, a new platform was planned and set up, in order to test the aims of the project. The application was based on a cooperative organizational structure by which

  17. Clinical and translational research in global health and emergency care: a research agenda.

    PubMed

    Runyon, Michael S; Sawe, Hendry R; Levine, Adam C; Pousson, Amelia; House, Darlene R; Agrawal, Pooja; Osei-Ampofo, Maxwell; Weiner, Scott G; Douglass, Katherine

    2013-12-01

    As policy-makers increasingly recognize emergency care to be a global health priority, the need for high-quality clinical and translational research in this area continues to grow. As part of the proceedings of the 2013 Academic Emergency Medicine consensus conference, this article discusses the importance of: 1) including clinical and translational research in the initial emergency care development plan, 2) defining the burden of acute disease and the barriers to conducting research in resource-limited settings, 3) assessing the appropriateness and effectiveness of local and global acute care guidelines within the local context, 4) studying the local research infrastructure needs to understand the best methods to build a sustainable research infrastructure, and 5) studying the long-term effects of clinical research programs on health care systems. © 2013 by the Society for Academic Emergency Medicine.

  18. An emerging paradigm for managing protected areas with examples from Europe and the United States

    Treesearch

    James Absher; Carsten Mann

    2010-01-01

    Parks and Protected Areas (PPA) have become increasingly important for societal well-being in Europe and the United States. Urbanization, detachment from nature, and demographic changes are fostering discussions about strengthening the social and cultural dimensions of management. The complexities and subtleties of incorporating PPAs into existing government and...

  19. Therapeutic Approach to Hypertension Urgencies and Emergencies in the Emergency Room.

    PubMed

    Maloberti, Alessandro; Cassano, Giulio; Capsoni, Nicolò; Gheda, Silvia; Magni, Gloria; Azin, Giulia Maria; Zacchino, Massimo; Rossi, Adriano; Campanella, Carlo; Beretta, Andrea Luigi Roberto; Bellone, Andrea; Giannattasio, Cristina

    2018-05-18

    Hypertensive urgencies-emergencies are important and common events. They are defined as a severe elevation in BP, higher than 180/120 mmHg, associated or not with the evidence of new or worsening organ damage for emergencies and urgencies respectively. Anamnestic information, physical examination and instrumental evaluation determine the following management that could need oral (for urgencies) or intravenous (for emergencies) anti-hypertensives drugs. The choice of the specific drugs depend on the underlying causes of the crisis, patient's demographics, cardiovascular risk and comorbidities. For emergencies a maximum BP reduction of 20-25% within the first hour and then to 160/110-100 over next 2-6 h, is considered appropriate with a further gradual decrease over the next 24-48 h to reach normal BP levels. In the case of hypertensive urgencies, a gradual lowering of BP over 24-48 h with an oral medication is the best approach and an aggressive BP lowering should be avoided. Subsequent management with particular attention on chronic BP values control is important as the right treatment of the acute phase.

  20. Monitoring emerging diseases of fish and shellfish using electronic sources.

    PubMed

    Thrush, M A; Dunn, P L; Peeler, E J

    2012-10-01

    New and emerging fish and shellfish diseases represent an important constraint to the growth and sustainability of many aquaculture sectors and have also caused substantial economic and environmental impacts in wild stocks. This paper details the results of 8 years of a monitoring programme for emerging aquatic animal diseases reported around the world. The objectives were to track global occurrences and, more specifically, to identify and provide advanced warning of disease threats that may affect wild and farmed fish stocks in the UK. A range of electronic information sources, including Internet newsletters, alerting services and news agency releases, was systematically searched for reports of new diseases, new presentations of known pathogens and known diseases occurring in new geographic locations or new host species. A database was established to log the details of key findings, and 250 emerging disease events in 52 countries were recorded during the period of study. These included 14 new diseases and a further 16 known diseases in new species. Viruses and parasites accounted for the majority of reports (55% and 24%, respectively), and known diseases occurring in new locations were the most important emerging disease category (in which viruses were dominant). Emerging diseases were reported disproportionally in salmonid species (33%), in farmed populations (62%) and in Europe and North America (80%). The lack of reports from some regions with significant aquaculture or fishery production may indicate that emerging diseases are not being recognized in these areas owing to insufficient surveillance or testing or that these events are being under-reported. The results are discussed in relation to processes underpinning disease emergence in the aquatic environment. © 2011 Crown Copyright. Reproduced with the permission of the Controller of Her Majesty’s Stationery Office and Centre for Environment Fisheries & Aquaculture Science.

  1. Self-esteem and illness self-concept in emerging adults with Type 1 diabetes: Long-term associations with problem areas in diabetes.

    PubMed

    Luyckx, Koen; Rassart, Jessica; Aujoulat, Isabelle; Goubert, Liesbet; Weets, Ilse

    2016-04-01

    This long-term prospective study examined whether illness self-concept (or the degree to which chronic illness becomes integrated in the self) mediated the pathway from self-esteem to problem areas in diabetes in emerging adults with Type 1 diabetes. Having a central illness self-concept (i.e. feeling overwhelmed by diabetes) was found to relate to lower self-esteem, and more treatment, food, emotional, and social support problems. Furthermore, path analyses indicated that self-esteem was negatively related to both levels and relative changes in these problem areas in diabetes over a period of 5 years. Illness self-concept fully mediated these associations. © The Author(s) 2014.

  2. [Wireless digital radiography detectors in the emergency area: an efficacious solution].

    PubMed

    Garrido Blázquez, M; Agulla Otero, M; Rodríguez Recio, F J; Torres Cabrera, R; Hernando González, I

    2013-01-01

    To evaluate the implementation of a flat panel digital radiolography (DR) system with WiFi technology in an emergency radiology area in which a computed radiography (CR) system was previously used. We analyzed aspects related to image quality, radiation dose, workflow, and ergonomics. We analyzed the results obtained with the CR and WiFi DR systems related with the quality of images analyzed in images obtained using a phantom and after radiologists' evaluation of radiological images obtained in real patients. We also analyzed the time required for image acquisition and the workflow with the two technological systems. Finally, we analyzed the data related to the dose of radiation in patients before and after the implementation of the new equipment. Image quality improved in both the tests carried out with a phantom and in radiological images obtained in patients, which increased from 3 to 4.5 on a 5-point scale. The average time required for image acquisition decreased by 25 seconds per image. The flat panel required less radiation to be delivered in practically all the techniques carried out using automatic dosimetry, although statistically significant differences were found in only some of the techniques (chest, thoracic spine, and lumbar spine). Implementing the WiFi DR system has brought benefits. Image quality has improved and the dose of radiation to patients has decreased. The new system also has advantages in terms of functionality, ergonomics, and performance. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  3. Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms.

    PubMed

    Exadaktylos, Aristomenis K; Evangelopoulos, Dimitrios S; Wullschleger, Marcel; Bürki, Leo; Zimmermann, Heinz

    2008-11-17

    Healthcare professionals and the public have increasing concerns about the ability of emergency departments to meet current demands. Increased demand for emergency services, mainly caused by a growing number of minor and moderate injuries has reached crisis proportions, especially in the United Kingdom. Numerous efforts have been made to explore the complex causes because it is becoming more and more important to provide adequate healthcare within tight budgets. Optimisation of patient pathways in the emergency department is therefore an important factor.This paper explores the possibilities offered by dynamic simulation tools to improve patient pathways using the emergency department of a busy university teaching hospital in Switzerland as an example.

  4. Comparing Methodologies for Evaluating Emergency Medical Services Ground Transport Access to Time-critical Emergency Services: A Case Study Using Trauma Center Care.

    PubMed

    Doumouras, Aristithes G; Gomez, David; Haas, Barbara; Boyes, Donald M; Nathens, Avery B

    2012-09-01

    The regionalization of medical services has resulted in improved outcomes and greater compliance with existing guidelines. For certain "time-critical" conditions intimately associated with emergency medicine, early intervention has demonstrated mortality benefits. For these conditions, then, appropriate triage within a regionalized system at first diagnosis is paramount, ideally occurring in the field by emergency medical services (EMS) personnel. Therefore, EMS ground transport access is an important metric in the ongoing evaluation of a regionalized care system for time-critical emergency services. To our knowledge, no studies have demonstrated how methodologies for calculating EMS ground transport access differ in their estimates of access over the same study area for the same resource. This study uses two methodologies to calculate EMS ground transport access to trauma center care in a single study area to explore their manifestations and critically evaluate the differences between the methodologies. Two methodologies were compared in their estimations of EMS ground transport access to trauma center care: a routing methodology (RM) and an as-the-crow-flies methodology (ACFM). These methodologies were adaptations of the only two methodologies that had been previously used in the literature to calculate EMS ground transport access to time-critical emergency services across the United States. The RM and ACFM were applied to the nine Level I and Level II trauma centers within the province of Ontario by creating trauma center catchment areas at 30, 45, 60, and 120 minutes and calculating the population and area encompassed by the catchments. Because the methodologies were identical for measuring air access, this study looks specifically at EMS ground transport access. Catchments for the province were created for each methodology at each time interval, and their populations and areas were significantly different at all time periods. Specifically, the RM calculated

  5. Telemedicine in neurosurgical emergency: Indian perspective

    PubMed Central

    Sinha, Virendra Deo; Tiwari, Rahul Nath; Kataria, Rashim

    2012-01-01

    Telemedicine is rapidly developing telecommunication technology to provide medical information and services. The importance of telemedicine for neurosurgical emergencies was established with the fact that majority of the neurosurgical specialists are practicing in urban settings and in most of the rural areas, neurosurgical care is far off or non-existing. Countries with inadequate health care must incorporate telemedicine in their health care system. Telemedicine offers real benefits in a country as vast as India, where the majority of the population lives in remote areas with no access to even the most basic healthcare. Issues pertaining security, privacy, maintaining standards, and legal aspects are relevant. A recommended set of standards and guidelines for telemedicine needs to be set in place and constantly refined to promote the integrated growth of telemedicine in the country. The paper discusses various issues, shortcomings, and utility of telemedicine in India. PMID:22870155

  6. Conserving the grassland Important Bird Areas (IBAs) of southern South America: Argentina, Uruguay, Paraguay, and Brazil

    Treesearch

    Adrian S. Di Giacomo; Santiago Krapovickas

    2005-01-01

    In the southern part of South America, knowledge about bird species distribution is still not used as a tool for land use planning and conservation priority-setting. BirdLife International’s Important Bird Areas (IBA) Program is an appropriate vehicle for analyzing existing information about birds, and to generate new data where necessary. IBA inventories...

  7. The Importance of the Eye Area in Face Identification Abilities and Visual Search Strategies in Persons with Asperger Syndrome

    ERIC Educational Resources Information Center

    Falkmer, Marita; Larsson, Matilda; Bjallmark, Anna; Falkmer, Torbjorn

    2010-01-01

    Partly claimed to explain social difficulties observed in people with Asperger syndrome, face identification and visual search strategies become important. Previous research findings are, however, disparate. In order to explore face identification abilities and visual search strategies, with special focus on the importance of the eye area, 24…

  8. Pediatric emergency care capabilities of Indian Health Service emergency medical service agencies serving American Indians/Alaska Natives in rural and frontier areas.

    PubMed

    Genovesi, A L; Hastings, B; Edgerton, E A; Olson, L M

    2014-01-01

    In the USA, the emergency medical services (EMS) system is vital for American Indians and Alaska Natives, who are disproportionately burdened by injuries and diseases and often live in rural areas geographically far from hospitals. In rural areas, where significant health disparities exist, EMS is often a primary source of healthcare providing a safety net for uninsured individuals or families who otherwise lack access to health-related services. EMS is frequently the first entry point for children and their families into the healthcare system. The Indian Health Service (IHS) supports the federally funded, tribally operated EMS agencies to help meet the affiliated American Indian and Alaska Natives' pre-hospital needs. While periodic assessments of state EMS agencies capabilities to care for children occur, it appears a systematic assessment of IHS EMS agencies in regards to children had not been previously conducted. A consensus process, involving stakeholders, was used to identify topic areas for a survey for assessing the pediatric capabilities of IHS EMS. The survey was sent to 75 of 88 IHS EMS agency contacts. Sixty-one agencies (81%) responded. Nine agencies (15%) did not have a medical director. Agencies without a medical director were less likely to report the availability of online (p=0.1) or offline (p<0.01) pediatric medical direction. Half (51%) of the agencies had a mass casualties plan; however, 29% reported responding to a mass casualty incident, involving a large number of pediatric patients, that overwhelmed their service. Most agencies were well integrated with their state EMS system with almost all (95%) collecting EMS patient care data and 47% using national standard data elements. In some areas, IHS EMS agencies did not have the infrastructure to treat pediatric patients during day-to-day operations as well as disasters. Similar to operational challenges faced by rural EMS agencies, the IHS agencies lacked a medical director, were unable to

  9. Emergent insect production in post-harvest flooded agricultural fields used by waterbirds

    USGS Publications Warehouse

    Moss, Richard C.; Blumenshine, Steven C.; Yee, Julie; Fleskes, Joseph P.

    2009-01-01

    California’s Tulare Lake Basin (TLB) is one of the most important waterbird areas in North America even though most wetlands there have been converted to cropland. To guide management programs promoting waterbird beneficial agriculture, which includes flooding fields between growing periods, we measured emergence rates of insects, an important waterbird food, in three crop types (tomato, wheat, alfalfa) in the TLB relative to water depth and days flooded during August–October, 2003 and 2004. We used corrected Akaike’s Information Criterion values to compare a set of models that accounted for our repeated measured data. The best model included crop type and crop type interacting with days flooded and depth flooded. Emergence rates (mg m−2 day−1) were greater in tomato than wheat or alfalfa fields, increased with days flooded in alfalfa and tomato but not wheat fields, and increased with water depth in alfalfa and wheat but not tomato fields. To investigate the relationship between the range of diel water temperatures and insect emergence rates, we rearedChironomus dilutus larvae in environmental chambers under high (15–32°C) and low fluctuation (20–26°C) temperature regimes that were associated with shallow and deep (respectively) sampling sites in our fields. Larval survival (4×) and biomass (2×) were greater in the low thermal fluctuation treatment suggesting that deeply flooded areas would support greater insect production.

  10. The challenge of implementing the Important Bird Area program in a megadiversity and mega-threatened country

    Treesearch

    Jaqueline M. Goerck; David C. Wege

    2005-01-01

    Brazil is a megadiversity country but also has the highest number of threatened bird species in the neotropics. There are over 100 species of birds threatened with extinction in Brazil. Some of the most threatened birds occur in the highly threatened Atlantic Forest hotspot of Brazil. BirdLife International started an Important Bird Areas (IBA) program in Brazil by...

  11. Magnetic Nanoparticles: Material Engineering and Emerging Applications in Lithography and Biomedicine

    PubMed Central

    Bao, Yuping; Wen, Tianlong; Samia, Anna Cristina S.; Khandhar, Amit; Krishnan, Kannan M.

    2015-01-01

    We present an interdisciplinary overview of material engineering and emerging applications of iron oxide nanoparticles. We discuss material engineering of nanoparticles in the broadest sense, emphasizing size and shape control, large-area self-assembly, composite/hybrid structures, and surface engineering. This is followed by a discussion of several non-traditional, emerging applications of iron oxide nanoparticles, including nanoparticle lithography, magnetic particle imaging, magnetic guided drug delivery, and positive contrast agents for magnetic resonance imaging. We conclude with a succinct discussion of the pharmacokinetics pathways of iron oxide nanoparticles in the human body –– an important and required practical consideration for any in vivo biomedical application, followed by a brief outlook of the field. PMID:26586919

  12. Magnetic Nanoparticles: Material Engineering and Emerging Applications in Lithography and Biomedicine.

    PubMed

    Bao, Yuping; Wen, Tianlong; Samia, Anna Cristina S; Khandhar, Amit; Krishnan, Kannan M

    2016-01-01

    We present an interdisciplinary overview of material engineering and emerging applications of iron oxide nanoparticles. We discuss material engineering of nanoparticles in the broadest sense, emphasizing size and shape control, large-area self-assembly, composite/hybrid structures, and surface engineering. This is followed by a discussion of several non-traditional, emerging applications of iron oxide nanoparticles, including nanoparticle lithography, magnetic particle imaging, magnetic guided drug delivery, and positive contrast agents for magnetic resonance imaging. We conclude with a succinct discussion of the pharmacokinetics pathways of iron oxide nanoparticles in the human body -- an important and required practical consideration for any in vivo biomedical application, followed by a brief outlook of the field.

  13. Emerging Dental Specialties and Ethics.

    PubMed

    Brown, Ronald S; Mashni, Michael

    2015-01-01

    This paper discusses ethical dimensions related to the formal recognition of emerging dental specialties. It explores several issues related to the potential emergence of several new dental specialty areas. There are good reasons that dentistry should open the door to these new specialties, and patients would benefit. The ethical considerations for and against formal acceptance are examined.

  14. Social networks and substance use among at-risk emerging adults living in disadvantaged urban areas in the southern United States: a cross-sectional naturalistic study.

    PubMed

    Tucker, Jalie A; Cheong, JeeWon; Chandler, Susan D; Crawford, Scott M; Simpson, Cathy A

    2015-09-01

    Substance use and risk-taking are common during emerging adulthood, a transitional period when peer influences often increase and family influences decrease. Investigating relationships between social network features and substance use can inform community-based prevention programs. This study investigated whether substance use among emerging adults living in disadvantaged urban areas was influenced by peer and family social network messages that variously encouraged and discouraged substance use. Cross-sectional, naturalistic field study. Lower-income neighborhoods in Birmingham, Alabama, USA with 344 participants (110 males, 234 females, ages 15-25 years; mean = 18.86 years), recruited via respondent-driven sampling. During structured interviews conducted in community locations, the Alcohol, Smoking and Substance Involvement Screening Test assessed substance use and related problems. Predictor variables were network characteristics, including presence of substance-using peers, messages from friends and family members about substance use and network sources for health information. Higher substance involvement was associated with friend and family encouragement of use and having close peer network members who used substances (Ps < 0.001). Peer discouragement of substance use was associated with reduced risk (b = - 1.46, P < 0.05), whereas family discouragement had no protective association. Social networks appear to be important in both promoting and preventing substance use in disadvantaged young adults in the United States. © 2015 Society for the Study of Addiction.

  15. The Evolution of Public Health Emergency Management as a Field of Practice.

    PubMed

    Rose, Dale A; Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

    2017-09-01

    The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve.

  16. The Evolution of Public Health Emergency Management as a Field of Practice

    PubMed Central

    Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

    2017-01-01

    The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve. PMID:28892444

  17. Reliability of emerging bonded interface materials for large-area attachments

    DOE PAGES

    Paret, Paul P.; DeVoto, Douglas J.; Narumanchi, Sreekant

    2015-12-30

    In this study, conventional thermal interface materials (TIMs), such as greases, gels, and phase change materials, pose bottlenecks to heat removal and have long caused reliability issues in automotive power electronics packages. Bonded interface materials (BIMs) with superior thermal performance have the potential to be a replacement to the conventional TIMs. However, due to coefficient of thermal expansion mismatches between different components in a package and resultant thermomechanical stresses, fractures or delamination could occur, causing serious reliability concerns. These defects manifest themselves in increased thermal resistance in the package. In this paper, the results of reliability evaluation of emerging BIMsmore » for large-area attachments in power electronics packaging are reported. Thermoplastic (polyamide) adhesive with embedded near-vertical-aligned carbon fibers, sintered silver, and conventional lead solder (Sn 63Pb 37) materials were bonded between 50.8 mm x 50.8 mm cross-sectional footprint silicon nitride substrates and copper base plate samples, and were subjected to accelerated thermal cycling until failure or 2500 cycles. Damage in the BIMs was monitored every 100 cycles by scanning acoustic microscopy. Thermoplastic with embedded carbon fibers performed the best with no defects, whereas sintered silver and lead solder failed at 2300 and 1400 thermal cycles, respectively. Besides thermal cycling, additional lead solder samples were subjected to thermal shock and thermal cycling with extended dwell periods. A finite element method (FEM)-based model was developed to simulate the behavior of lead solder under thermomechanical loading. Strain energy density per cycle results were calculated from the FEM simulations. A predictive lifetime model was formulated for lead solder by correlating strain energy density results extracted from modeling with cycles-to-failure obtained from experimental accelerated tests. A power-law-based approach

  18. Revisiting the hierarchy of urban areas in the Brazilian Amazon: a multilevel approach

    PubMed Central

    Costa, Sandra; Brondízio, Eduardo

    2012-01-01

    The Legal Brazilian Amazon, while the largest rainforest in the world, is also a region where most residents are urban. Despite close linkages between rural and urban processes in the region, rural areas have been the predominant focus of Amazon-based population-environment scholarship. Offering a focus on urban areas within the Brazilian Amazon, this paper examines the emergence of urban hierarchies within the region. Using a combination of nationally representative data and community based surveys, applied to a multivariate cluster methodology (Grade of Membership), we observe the emergence of sub-regional urban networks characterized by economic and political inter-dependency, population movement, and provision of services. These networks link rural areas, small towns, and medium and large cities. We also identify the emergence of medium-size cities as important nodes at a sub-regional level. In all, the work provides insight on the proposed model of ‘disarticulated urbanization’ within the Amazon by calling attention to the increasing role of regional and sub-regional urban networks in shaping the future expansion of land use and population distribution in the Amazon. We conclude with a discussion of implications for increasing intra-regional connectivity and fragmentation of conservation areas and ecosystems in the region. PMID:23129877

  19. Emergency Operations Center at Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Caylor, Gary C.

    1997-01-01

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

  20. Ethical issues in the response to Ebola virus disease in US emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine.

    PubMed

    Venkat, Arvind; Wolf, Lisa; Geiderman, Joel M; Asher, Shellie L; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

    2015-03-01

    The 2014 outbreak of Ebola Virus Disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged US emergency departments to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to US emergency physicians, emergency nurses and other stakeholders in the healthcare system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to US emergency departments in how they approach preparation for and management of potential patients with EVD. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  1. Decision Support for Emergency Operations Centers

    NASA Technical Reports Server (NTRS)

    Harvey, Craig; Lawhead, Joel; Watts, Zack

    2005-01-01

    The Flood Disaster Mitigation Decision Support System (DSS) is a computerized information system that allows regional emergency-operations government officials to make decisions regarding the dispatch of resources in response to flooding. The DSS implements a real-time model of inundation utilizing recently acquired lidar elevation data as well as real-time data from flood gauges, and other instruments within and upstream of an area that is or could become flooded. The DSS information is updated as new data become available. The model generates realtime maps of flooded areas and predicts flood crests at specified locations. The inundation maps are overlaid with information on population densities, property values, hazardous materials, evacuation routes, official contact information, and other information needed for emergency response. The program maintains a database and a Web portal through which real-time data from instrumentation are gathered into the database. Also included in the database is a geographic information system, from which the program obtains the overlay data for areas of interest as needed. The portal makes some portions of the database accessible to the public. Access to other portions of the database is restricted to government officials according to various levels of authorization. The Flood Disaster Mitigation DSS has been integrated into a larger DSS named REACT (Real-time Emergency Action Coordination Tool), which also provides emergency operations managers with data for any type of impact area such as floods, fires, bomb

  2. Contaminants of emerging concern: Mass balance and comparison of wastewater effluent and upstream sources in a mixed-use watershed

    USDA-ARS?s Scientific Manuscript database

    Understanding the sources, transport, and spatiotemporal variability of contaminants of emerging concern (CECs) is important for understanding risks and developing monitoring and mitigation strategies. This study compared CEC loading and transport from a wastewater treatment plant and upstream areas...

  3. American College of Emergency Physicians Ethics Manual.

    PubMed

    1991-10-01

    Ethical concerns are a major part of the clinical practice of emergency medicine. The emergency physician must make hard choices, not only with regard to the scientific/technical aspects but also with regard to the moral aspects of caring for emergency patients. By the nature of the specialty, emergency physicians face ethical dilemmas often requiring prompt decisions with limited information. This manual identifies important moral principles and values in emergency medicine. The underlying assumption is that a knowledge of moral principles and ethical values helps the emergency physician make responsible moral choices. Neither the scientific nor the moral aspects of clinical decision making can be reduced to simple formulas. Nevertheless, decisions must be made. Emergency physicians should, therefore, be cognizant of the ethical principles that are important for emergency medicine, understand the process of ethical reasoning, and be capable of making rational moral decisions based on a stable framework of values.

  4. Consumer-defined health plans: emerging challenges from tort and contract.

    PubMed

    Morreim, E Haavi

    2006-01-01

    The emergence of Consumer-Defined Health Plans with large deductibles means that many people will be financially responsible for all or most of their healthcare during any given year. This increasing exposure to costs will bring important changes in the physician-patient relationship, as patients seek more information about the care their physicians propose. Litigation can be anticipated in two areas. First, in tort law, informed consent claims may allege that providers failed to disclose the likely costs and medical importance of their care. Second, in contract law, patients may challenge the reasonableness of the prices they are charged. This Article explores potential causes of action in both areas. Ultimately, increasing transparency of pricing may lend greater rationality not only to pricing structures but also, it is to be hoped, to healthcare itself, as cost-worthiness of care assumes higher priority in medical decisionmaking.

  5. Importance of holographic light in the emerging field of mind-body healing

    NASA Astrophysics Data System (ADS)

    Booth, Roberta

    2000-10-01

    Healing with color has been researched and documented worldwide for centuries. Every single part of the brain and every cell in the body is effected by light. Chinese and Russian scientists demonstrated that the acupuncture meridians transmit light. Dr. Peter Mandel, German chiropractic physician and acupuncturist, states that the acupuncture points are especially sensitive to electromagnetic waves within the spectrum of visible light and microwave energy, and all cells constantly emit and absorb small pockets of electromagnetic radiation or light, called biophotons. The harmony or disharmony of cells has been documented. Kirlian photography, to photography the aura was invented by Russians Semyon and Valentina Kirlian. Photo therapy and light research are being practiced worldwide. In the United States, Dr. Jacob Lieberman has written an influential book Light Medicine of the Future. In 1992 the first Light Years Ahead conference was held. (#5 1996) Dr. Brian Breiling and Dr. Lee Hartley brought together experts in the field to discuss the many potentials of light therapy. My present research in this area has focused on narrow band frequencies through the use of holography. Its therapeutic applications of color healing in this research are both critical and fundamental. My current work, The Chakras, seven reflection holograms on silver halide, relate to the wheels of light described in the earliest recorded Indian history. I will discus the chakras, this ancient metaphysical system under the new light of popular western metaphors and visionary art, how the chakras relate to the seven colors of the rainbow, the electromagnetic waves, and the connection to color holography in healing light therapy. I will be citing concurrent research in color healing, and the important areas of research that are necessary to have significant impact on future directions. Holography in the future will constitute a major frontier in discovery.

  6. 49 CFR 172.604 - Emergency response telephone number.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 2 2013-10-01 2013-10-01 false Emergency response telephone number. 172.604... telephone number. (a) A person who offers a hazardous material for transportation must provide an emergency response telephone number, including the area code, for use in an emergency involving the hazardous...

  7. Emerging feed markets for ruminant production in urban and peri-urban areas of Northern Ghana.

    PubMed

    Konlan, S P; Ayantunde, A A; Addah, W; Dei, H K; Karbo, N

    2018-01-01

    Feed shortage in urban and peri-urban areas has triggered the emergence of feed markets in Northern Ghana. These markets were surveyed at three locations (Tamale, Bolgatanga, and Wa markets) to determine types and prices of feedstuffs sold across seasons; early dry (November-January), late dry (February-April), early wet (May-July), and main wet (August-October). Semi-structured questionnaire was used for data collection. Three samples of each feed type in the markets were bought from three different sellers per market in each season. The samples were oven dried to constant weight and price/kg DM of each feed determined. The total respondents were 169. Out of this number, 41% were feed sellers, 46% buyers, and 13% retailers. The feedstuffs found were crop residues (groundnut haulm and cowpea haulm), agro-industrial by-products (bran of maize, rice, and sorghum), fresh grasses (Rotteboellia cochinchinensis), and local browses (Ficus sp. and Pterocarpus erinaceous). Prices of feeds differed (P < 0.05) among markets and were higher in Bolgatanga than Tamale and Wa markets. Prices of cereal bran were not different (P > 0.05) in all seasons but that of crop residues were higher (P < 05) in early to late dry season than the wet season. Majority (90%) of respondents opined that the feed market will expand due to increasing number of livestock population in the peri-urban areas.

  8. BUILDING 122 CONTAINS THREE GENERAL AREAS: OFFICE AREAS, INTERNAL DOSIMETRY, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    BUILDING 122 CONTAINS THREE GENERAL AREAS: OFFICE AREAS, INTERNAL DOSIMETRY, AND MEDICAL/HEALTH. BUILDING 122 SHARES A COMMON WALL WITH BUILDING 121, THE PLANT SECURITY BUILDING. THE TWO-STORY BUILDING IN THE BACKGROUND IS BUILDING 111. (9/26/52) - Rocky Flats Plant, Emergency Medical Services Facility, Southwest corner of Central & Third Avenues, Golden, Jefferson County, CO

  9. Pediatric emergencies.

    PubMed

    Ryan, Erin

    2015-03-01

    It is important that pediatric critical care nurses possess a thorough understanding of their patient and be able to provide exceptional care, especially during emergent situations in the operating room. This care is accomplished by assessing the pediatric patient, dosing medications accurately and effectively, and performing effective Pediatric Advanced Life Support. Pediatric patients present with unique anatomy, physiology, and pathophysiology. Emergencies are reviewed according to organ system, with a focus on definition, presentation, pathophysiology, management, and special considerations. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Emergency Communications Network for Disasters Management in Venezuela

    NASA Astrophysics Data System (ADS)

    Burguillos, C.; Deng, H.

    2018-04-01

    The integration and use of different space technology applications for disasters management, play an important role at the time of prevents the causes and mitigates the effects of the natural disasters. Nevertheless, the space technology counts with the appropriate technological resources to provide the accurate and timely information required to support in the decision making in case of disasters. Considering the aforementioned aspects, in this research is presented the design and implementation of an Emergency Communications Network for Disasters Management in Venezuela. Network based on the design of a topology that integrates the satellites platforms in orbit operation under administration of Venezuelan state, such as: the communications satellite VENESAT-1 and the remote sensing satellites VRSS-1 and VRSS-2; as well as their ground stations with the aim to implement an emergency communications network to be activated in case of disasters which affect the public and private communications infrastructures in Venezuela. In this regard, to design the network several technical and operational specifications were formulated, between them: Emergency Strategies to Maneuver the VRSS-1 and VRSS-2 satellites for optimal images capture and processing, characterization of the VENESAT-1 transponders and radiofrequencies for emergency communications services, technologies solutions formulation and communications links design for disaster management. As result, the emergency network designed allows to put in practice diverse communications technologies solutions and different scheme or media for images exchange between the areas affected for disasters and the entities involved in the disasters management tasks, providing useful data for emergency response and infrastructures recovery.

  11. 49 CFR 172.604 - Emergency response telephone number.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 2 2011-10-01 2011-10-01 false Emergency response telephone number. 172.604... telephone number. (a) A person who offers a hazardous material for transportation must provide an emergency response telephone number, including the area code, for use in the event of an emergency involving the...

  12. Pediatric mental health emergencies in the emergency medical services system. American College of Emergency Physicians.

    PubMed

    Dolan, Margaret A; Mace, Sharon E

    2006-10-01

    Emergency departments (EDs) are vital in the management of pediatric patients with mental health emergencies (MHE). Pediatric MHE are an increasing part of emergency medical practice because EDs have become the safety net for a fragmented mental health infrastructure which is experiencing critical shortages in services in all sectors. EDs must safely, humanely, and in a culturally and developmentally appropriate manner manage pediatric patients with undiagnosed and known mental illnesses including those with mental retardation, autistic spectrum disorders, attention deficit hyperactivity disorder (ADHD), and those experiencing a behavioral crisis. EDs also manage patients with suicidal ideation, depression, escalating aggression, substance abuse, post traumatic stress disorder, maltreatment, and those exposed to violence and unexpected deaths. EDs must address not only the physical but also the mental health needs of patients during and after mass casualty incidents and disasters. The American Academy of Pediatrics and the American College of Emergency Physicians support the following actions: advocacy for increased mental health resources, including improved pediatric mental health tools for the ED, increased mental health insurance coverage, adequate reimbursement at all levels; acknowledgment of the importance of the child's medical home, and promotion of education and research for mental health emergencies.

  13. Sensitivity of burned area in Europe to climate change, atmospheric CO2 levels, and demography: A comparison of two fire-vegetation models

    NASA Astrophysics Data System (ADS)

    Wu, Minchao; Knorr, Wolfgang; Thonicke, Kirsten; Schurgers, Guy; Camia, Andrea; Arneth, Almut

    2015-11-01

    Global environmental changes and human activity influence wildland fires worldwide, but the relative importance of the individual factors varies regionally and their interplay can be difficult to disentangle. Here we evaluate projected future changes in burned area at the European and sub-European scale, and we investigate uncertainties in the relative importance of the determining factors. We simulated future burned area with LPJ-GUESS-SIMFIRE, a patch-dynamic global vegetation model with a semiempirical fire model, and LPJmL-SPITFIRE, a dynamic global vegetation model with a process-based fire model. Applying a range of future projections that combine different scenarios for climate changes, enhanced CO2 concentrations, and population growth, we investigated the individual and combined effects of these drivers on the total area and regions affected by fire in the 21st century. The two models differed notably with respect to the dominating drivers and underlying processes. Fire-vegetation interactions and socioeconomic effects emerged as important uncertainties for future burned area in some European regions. Burned area of eastern Europe increased in both models, pointing at an emerging new fire-prone region that should gain further attention for future fire management.

  14. Exploring the burden of emergency care: predictors of stress-health outcomes in emergency nurses.

    PubMed

    Adriaenssens, Jef; De Gucht, Veronique; Van Der Doef, Margot; Maes, Stan

    2011-06-01

    This paper is a report of a study that examines (1) whether emergency nurses differ from a general hospital nursing comparison group in terms of job and organizational characteristics and (2) to what extent these characteristics predict job satisfaction, turnover intention, work engagement, fatigue and psychosomatic distress in emergency nurses. The work environment and job characteristics of nurses are important predictors of stress-health outcomes. Emergency nurses are particularly exposed to stressful events and unpredictable work conditions. This cross-sectional study (N = 254) was carried out in 15 emergency departments of Belgian general hospitals in 2007-2008 by means of the Leiden Quality of Work Questionnaire for Nurses, the Checklist Individual Strength, the Utrecht Work Engagement Scale and the Brief Symptom Inventory. Emergency nurses report more time pressure and physical demands, lower decision authority, less adequate work procedures and less reward than a general hospital nursing population. They report, however, more opportunity for skill discretion and better social support by colleagues. Work-time demands appear to be important determinants of psychosomatic complaints and fatigue in emergency nurses. Apart from personal characteristics, decision authority, skill discretion, adequate work procedures, perceived reward and social support by supervisors prove to be strong determinants of job satisfaction, work engagement and lower turnover intention in emergency nurses. Emergency departments should be screened regularly on job and organizational characteristics to identify determinants of stress-health outcomes that can be the target of preventive interventions. © 2011 Blackwell Publishing Ltd.

  15. Protected areas as social-ecological systems: perspectives from resilience and social-ecological systems theory.

    PubMed

    Cumming, Graeme S; Allen, Craig R

    2017-09-01

    Conservation biology and applied ecology increasingly recognize that natural resource management is both an outcome and a driver of social, economic, and ecological dynamics. Protected areas offer a fundamental approach to conserving ecosystems, but they are also social-ecological systems whose ecological management and sustainability are heavily influenced by people. This editorial, and the papers in the invited feature that it introduces, discuss three emerging themes in social-ecological systems approaches to understanding protected areas: (1) the resilience and sustainability of protected areas, including analyses of their internal dynamics, their effectiveness, and the resilience of the landscapes within which they occur; (2) the relevance of spatial context and scale for protected areas, including such factors as geographic connectivity, context, exchanges between protected areas and their surrounding landscapes, and scale dependency in the provision of ecosystem services; and (3) efforts to reframe what protected areas are and how they both define and are defined by the relationships of people and nature. These emerging themes have the potential to transform management and policy approaches for protected areas and have important implications for conservation, in both theory and practice. © 2017 by the Ecological Society of America.

  16. Protected areas as social-ecological systems: perspectives from resilience and social-ecological systems theory

    USGS Publications Warehouse

    Cumming, Graeme S.; Allen, Craig R.

    2017-01-01

    Conservation biology and applied ecology increasingly recognize that natural resource management is both an outcome and a driver of social, economic, and ecological dynamics. Protected areas offer a fundamental approach to conserving ecosystems, but they are also social-ecological systems whose ecological management and sustainability are heavily influenced by people. This editorial, and the papers in the invited feature that it introduces, discuss three emerging themes in social-ecological systems approaches to understanding protected areas: (1) the resilience and sustainability of protected areas, including analyses of their internal dynamics, their effectiveness, and the resilience of the landscapes within which they occur; (2) the relevance of spatial context and scale for protected areas, including such factors as geographic connectivity, context, exchanges between protected areas and their surrounding landscapes, and scale dependency in the provision of ecosystem services; and (3) efforts to reframe what protected areas are and how they both define and are defined by the relationships of people and nature. These emerging themes have the potential to transform management and policy approaches for protected areas and have important implications for conservation, in both theory and practice.

  17. Emergency care in 59 low- and middle-income countries: a systematic review

    PubMed Central

    Abujaber, Samer; Makar, Maggie; Stoll, Samantha; Kayden, Stephanie R; Wallis, Lee A; Reynolds, Teri A

    2015-01-01

    Abstract Objective To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). Methods We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. Findings We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. Conclusion Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings. PMID:26478615

  18. Emerging multidrug-resistant Candida duobushaemulonii infections in Panama hospitals: importance of laboratory surveillance and accurate identification.

    PubMed

    Ramos, Ruben; Caceres, Diego H; Perez, Marilyn; Garcia, Nicole; Castillo, Wendy; Santiago, Erika; Borace, Jovanna; Lockhart, Shawn R; Berkow, Elizabeth L; Hayer, Lizbeth; Espinosa-Bode, Andres; Moreno, Jose; Jackson, Brendan R; Moran, Jackeline; Chiller, Tom; de Villarreal, Gloriela; Sosa, Nestor; Vallabhaneni, Snigdha

    2018-04-25

    Candida duobushaemulonii , a yeast closely related to Candida auris, is thought to rarely cause infections, and is often misidentified. In October 2016, the Panamanian Ministry of Health implemented laboratory surveillance for C. auris Suspected C. auris isolates were forwarded to the national reference laboratory for identification by Matrix Assisted Laser Desorption Ionization-Time of Flight mass spectrometry and antifungal susceptibility testing. During November 2016-May 2017, 17 of 36 (47%) isolates suspected to be C. auris were identified as C. duobushaemulonii. These 17 isolates were obtained from 14 patients at six hospitals. Ten patients, including three children, had bloodstream infections, MICs for fluconazole, voriconazole, and amphotericin B were elevated. No resistance to echinocandins was observed. C. duobushaemulonii causes more invasive infections than previously appreciated, and poses a substantial problem given it is resistant to multiple antifungals. Expanded laboratory surveillance is an important step in the detection and control of such emerging pathogens. Copyright © 2018 American Society for Microbiology.

  19. 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

  20. 10 CFR 590.403 - Emergency interim orders.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Opinions and Orders § 590.403 Emergency interim... and issue an emergency interim order authorizing the import or export of natural gas. After issuance...

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  3. 46 CFR 112.15-1 - Temporary emergency loads.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... independent batteries separately charged by solar cells). (r) Each general emergency alarm system required by... AND POWER SYSTEMS Emergency Loads § 112.15-1 Temporary emergency loads. On vessels required by § 112... the area of the water where it is to be launched. (h) Electric communication systems that are...

  4. [Injuries from pepper spray used for self defense: analysis of 15 cases managed in an emergency chemical decontamination area].

    PubMed

    Amigó, Montserrat; Fernández, Fuensanta; Velasco, Verónica; Nogué, Santiago

    2016-10-01

    We analyzed epidemiologic and clinical characteristics, treatment received, and clinical course in cases of pepper spray injury treated in the chemical decontamination area of an emergency department over a 5-year period. A total of 15 patients with a mean (SD) age of 25 (8.3) years were included. Thirteen were men and 53% were foreign-born. All uses of pepper spray occurred during muggings that to place mainly in the early hours of the morning (66.7% between 4:30 and 6:30 AM). Two or more attackers were injured in 60% of the events. Seventy-three percent of the attacks took place on the street and the median delay in reaching the emergency department was 30 minutes. The face and eyes were usually injured, and symptoms included itching, irritation, burning, and pain. On arrival, the patients were treated immediately (mean delay, 3 minutes) with hypertonic saline, an amphoteric surfactant, and a chelating agent in 80% of the cases, in which improvement was substantial as mean pain scale scores changed from 7.2 on admission to 3 on discharge (P=.009). Patients spent an average of 40 minutes in the treatment area. Eleven patients required further care from an ophthalmologist and topical medication for symptoms. Outcomes were good and there were no complications in any of the cases. We conclude that pepper sprays are being used as an aid to self defense in muggings in our community. Decontamination measures have priority as they alleviate symptoms and prevent long-lasting effects.

  5. Assessment of a group of nigerian dental students' education on medical emergencies.

    PubMed

    Ehigiator, O; Ehizele, Ao; Ugbodaga, Pi

    2014-03-01

    The training of dental students in the management of medical emergencies is of utmost importance as they may encounter some of these emergencies at some point in their career. The aim of this study was to evaluate the medical emergency education in a Nigerian Dental School. This descriptive cross-sectional study was carried out among 124 final year dental students of the University of Benin, Benin City. Data was collected using a self-administered questionnaire. The questionnaire elicited information on demography, knowledge of inclusion of a medical emergency in the dental curriculum, knowledge of guidelines on medical emergency formulated by any dental authority, opinion on the comprehensiveness of the present training on medical emergency, type of medical emergency training received, previous encounter with a medical emergency, previous participation in emergency drills and knowledge of the content of an emergency kit. Descriptive statistics was carried out on the collected data. Only 58.1% (72/124) respondents were aware of the inclusion of a medical emergency in the dental curriculum and fewer, 17.7% (22/124), were aware of guidelines on medical emergency formulated by any dental authority. Fifty-two out of all the respondents (41.9%) claimed not to have received any form of training on medical emergency. Only 22.6% (28/123) had previously participated in an emergency drills and just 34.7% (43/124) had ever seen an emergency kit. It can be concluded from this study that the level of training and level of knowledge on medical emergencies of the studied dental students is below desirable standard. It is therefore necessary to put proper strategies in place to strengthen their identified areas of weakness.

  6. Love Canal Emergency Declaration Area habitability study. Volume 5. Peer review summary: TRC (Technical Review Committee) responses. Final report

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

    Not Available

    Environmental studies were conducted to provide data that could be used by the Commissioner of Health for the State of New York in determining whether the Emergency Declaration Area surrounding the Love Canal hazardous-waste site is habitable. These volumes (II through IV) were reviewed by a peer-review panel of expert scientists. The scientists concluded that each of the three environmental studies was well planned and well executed. Volume V summarizes the peer review and gives additional information or clarifications as requested during the peer review. Volume V also provides additional supplemental statistical analyses requested by the peer reviewer panel.

  7. 15 CFR 705.9 - Emergency action.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Emergency action. 705.9 Section 705.9 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... IMPORTED ARTICLES ON THE NATIONAL SECURITY § 705.9 Emergency action. In emergency situations, or when in...

  8. 15 CFR 705.9 - Emergency action.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Emergency action. 705.9 Section 705.9 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... IMPORTED ARTICLES ON THE NATIONAL SECURITY § 705.9 Emergency action. In emergency situations, or when in...

  9. Delayed bedtime due to screen time in schoolchildren: importance of area deprivation.

    PubMed

    Ogunleye, Ayodele A; Voss, Christine; Sandercock, Gavin R

    2015-01-01

    Sleep duration is an important predictor of obesity and health. This study evaluated the association between late bedtime and screen time, and the role of geographical deprivation in English schoolchildren. We collected bedtime and waking time, screen time, sociodemographic data and measured body mass index in a cross-section of 1332 11-15-year-old schoolchildren (45.7% female) participating in the East of England healthy heart study. Logistic regression was used to determine the likelihood of late bedtime in schoolchildren with different screen time and from a different geographic location. Mean differences were assessed either on ANOVA or t-test. Approximately 42% of boys went to bed late at night compared with 37% of girls. When compared to those with <2 h of daily screen time, schoolchildren with 2-4 h of screen time were more likely [odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.07-2.09] to go to bed late at night while those with >4 h of daily screen time were most likely to go to sleep late at night (OR, 1.97; 95%CI: 1.34-2.89). Late bedtime was associated with deprivation in schoolchildren. High screen time and deprivation may explain lateness in bedtime in English schoolchildren. This explanation may vary according to area deprivation and geographic location. Family-centered interventions and parental support are important to reduce screen time, late bedtime and increase sleep duration. © 2014 Japan Pediatric Society.

  10. Handbook, Living Life's Emergencies: A Guide for Home Preparedness.

    ERIC Educational Resources Information Center

    Lavalla, Patrick

    Although not intended as a complete manual, the guide gives families a better chance of surviving and recovering from a major emergency by helping them learn what emergencies and disasters could occur in the area, how to prepare for them, what action to take in emergencies, and how to develop emergency skills. The guide explains what supplies to…

  11. The importance of geoethics in the "Land of Fires"

    NASA Astrophysics Data System (ADS)

    Manzo, Ciro

    2014-05-01

    How was it possible that one of the most fertile soil worldwide called by Romans "Campania Felix", became one of the largest mass poisoning in a Western country? Answer is in the tons of toxic wastes illegally dumped into the fields all around area between Naples and Caserta, which now is known as "Terra dei Fuochi" (The Land of Fires - due to illegal wastes burning). In last 25 years two main emergencies affected Campania, one official started in 1994 due to local waste management system problems, another more hidden and older due to criminal gangs which earn money by illegal disposal of toxic wastes. Those two emergencies are interconnected and have grown in absence of respect for people's health and unknowledge of environmental themes. Apart from judging legal issues, the only evidence visible to public opinion is that during waste emergencies in Campania, decision makers, admitting also their good faith, didn't consider enough environmental risks and decided, in order to solve emergency, to dump wastes in not geological feasible sites, such as landfills at the feet of Vesuvio national park or in abandoned quarries such as Chiaiano tuff pit, exposing local inhabitant and economic activities to high risks. This work wants to underline that geoethics is fundamental as much as the need of geologists participation to whole remediation processes and to raising environmental awareness in the society. Maybe these themes seems to be trivial but geological competences are very important in understanding of pollution risks. This knowledge is practically obscure to decision makers and people, often media provides uncorrected informations which improve the fear of population. In example the idea that whole groundwater in the area is polluted is wrong and is strongly reducing the purchase of agricultural products of the area, and the only way to assess real contamination is site-specific characterization. Indeed Campania plain has a complex stratigraphic architecture with

  12. Sacramento Regional Response Guide to Radiation Emergencies

    DTIC Science & Technology

    2006-09-01

    emergency operations. Additionally, the utilization of thermo luminescence dosimeters ( TLD ) may be beneficial to track long term exposure for...a radiation area. Stakeholder agency emergency response equipment have been issued electronic dosimeters The purpose of the radiation dosimeter is...Incident.............................................................................84 2. Detection/ Dosimeter Equipment

  13. Emerging Propulsion Technologies

    NASA Technical Reports Server (NTRS)

    Keys, Andrew S.

    2006-01-01

    The Emerging Propulsion Technologies (EPT) investment area is the newest area within the In-Space Propulsion Technology (ISPT) Project and strives to bridge technologies in the lower Technology Readiness Level (TRL) range (2 to 3) to the mid TRL range (4 to 6). A prioritization process, the Integrated In-Space Transportation Planning (IISTP), was developed and applied in FY01 to establish initial program priorities. The EPT investment area emerged for technologies that scored well in the IISTP but had a low technical maturity level. One particular technology, the Momentum-eXchange Electrodynamic-Reboost (MXER) tether, scored extraordinarily high and had broad applicability in the IISTP. However, its technical maturity was too low for ranking alongside technologies like the ion engine or aerocapture. Thus MXER tethers assumed top priority at EPT startup in FY03 with an aggressive schedule and adequate budget. It was originally envisioned that future technologies would enter the ISP portfolio through EPT, and EPT developed an EPT/ISP Entrance Process for future candidate ISP technologies. EPT has funded the following secondary, candidate ISP technologies at a low level: ultra-lightweight solar sails, general space/near-earth tether development, electrodynamic tether development, advanced electric propulsion, and in-space mechanism development. However, the scope of the ISPT program has focused over time to more closely match SMD needs and technology advancement successes. As a result, the funding for MXER and other EPT technologies is not currently available. Consequently, the MXER tether tasks and other EPT tasks were expected to phased out by November 2006. Presentation slides are presented which provide activity overviews for the aerocapture technology and emerging propulsion technology projects.

  14. Client counseling in orthopedic emergencies.

    PubMed

    Brackenridge, S S; Kirby, B M; Johnson, S W

    1995-09-01

    Important client communication issues associated with most orthopedic emergencies are addressed. Information on client communication and support, providing a prognosis, discussing economic concerns, discharge planning, euthanasia, and client grief is presented. The issue of animal abuse as a cause of orthopedic emergencies also is examined.

  15. Pathophysiologic study of chronic infarcts with I-123 isopropyl iodo-amphetamine (IMP): the importance of periinfarct area

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

    Raynaud, C.; Rancurel, G.; Samson, Y.

    1987-01-01

    Seventeen chronic cerebral infarcts were investigated by a highly sensitive, dedicated brain single photon emission computerized tomography system using /sup 123/I-isopropyl iodoamphetamine (IMP) and /sup 133/Xe. IMP uptake was measured 10 minutes, 2 hours, and 5 hours after injection, and regional cerebral blood flow was measured with 133Xe. In 4 cases a positron emission tomography system was used to measure the rCBF and the regional metabolic rate of oxygen with C15O2 and 15O2. The results obtained allowed us to identify 2 abnormal zones. One, the central area, was characterized by a severe decrease in IMP uptake and rCBF averaging 34%more » and 46% respectively and by a hypodense image on the x-ray computerized tomography scan. The second, the periinfarct or ''peripheral area'' was characterized by a moderate decrease in IMP uptake and regional cerebral blood flow averaging 13 and 19% respectively; this area extended around the central area and had a normal density on computerized tomography scan. The IMP hypofixation of the peripheral area observed at the 10th minute tended to disappear at the 5th hour. The volume of this area was often found to be quite large, covering more than 30% of a hemisphere whereas the central area did not exceed 25%. Volume appeared to be correlated with the neurological status of the patient. The nature of the peripheral area is not established with certainty. It may be caused by deafferentation of areas not directly affected by the ischemic insult and/or selective ischemic neuronal loss. The results stress the important role played by the peripheral area, which may be useful in establishing the prognosis and evaluating the efficacy of therapy in individual stroke cases.« less

  16. Where is the UK's pollinator biodiversity? The importance of urban areas for flower-visiting insects.

    PubMed

    Baldock, Katherine C R; Goddard, Mark A; Hicks, Damien M; Kunin, William E; Mitschunas, Nadine; Osgathorpe, Lynne M; Potts, Simon G; Robertson, Kirsty M; Scott, Anna V; Stone, Graham N; Vaughan, Ian P; Memmott, Jane

    2015-03-22

    Insect pollinators provide a crucial ecosystem service, but are under threat. Urban areas could be important for pollinators, though their value relative to other habitats is poorly known. We compared pollinator communities using quantified flower-visitation networks in 36 sites (each 1 km(2)) in three landscapes: urban, farmland and nature reserves. Overall, flower-visitor abundance and species richness did not differ significantly between the three landscape types. Bee abundance did not differ between landscapes, but bee species richness was higher in urban areas than farmland. Hoverfly abundance was higher in farmland and nature reserves than urban sites, but species richness did not differ significantly. While urban pollinator assemblages were more homogeneous across space than those in farmland or nature reserves, there was no significant difference in the numbers of rarer species between the three landscapes. Network-level specialization was higher in farmland than urban sites. Relative to other habitats, urban visitors foraged from a greater number of plant species (higher generality) but also visited a lower proportion of available plant species (higher specialization), both possibly driven by higher urban plant richness. Urban areas are growing, and improving their value for pollinators should be part of any national strategy to conserve and restore pollinators.

  17. Where is the UK's pollinator biodiversity? The importance of urban areas for flower-visiting insects

    PubMed Central

    Baldock, Katherine C. R.; Goddard, Mark A.; Hicks, Damien M.; Kunin, William E.; Mitschunas, Nadine; Osgathorpe, Lynne M.; Potts, Simon G.; Robertson, Kirsty M.; Scott, Anna V.; Stone, Graham N.; Vaughan, Ian P.; Memmott, Jane

    2015-01-01

    Insect pollinators provide a crucial ecosystem service, but are under threat. Urban areas could be important for pollinators, though their value relative to other habitats is poorly known. We compared pollinator communities using quantified flower-visitation networks in 36 sites (each 1 km2) in three landscapes: urban, farmland and nature reserves. Overall, flower-visitor abundance and species richness did not differ significantly between the three landscape types. Bee abundance did not differ between landscapes, but bee species richness was higher in urban areas than farmland. Hoverfly abundance was higher in farmland and nature reserves than urban sites, but species richness did not differ significantly. While urban pollinator assemblages were more homogeneous across space than those in farmland or nature reserves, there was no significant difference in the numbers of rarer species between the three landscapes. Network-level specialization was higher in farmland than urban sites. Relative to other habitats, urban visitors foraged from a greater number of plant species (higher generality) but also visited a lower proportion of available plant species (higher specialization), both possibly driven by higher urban plant richness. Urban areas are growing, and improving their value for pollinators should be part of any national strategy to conserve and restore pollinators. PMID:25673686

  18. 31 CFR 9.8 - Emergency action.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  19. Emergency readmission following acute upper gastrointestinal bleeding.

    PubMed

    Strömdahl, Martin; Helgeson, Johan; Kalaitzakis, Evangelos

    2017-01-01

    To assess the occurrence, clinical predictors, and associated mortality of all-cause emergency readmissions after acute upper gastrointestinal bleeding (AUGIB). All patients with AUGIB from an area of 600 000 inhabitants in Sweden admitted in a single institution in 2009-2011 were retrospectively identified. All medical records were scrutinized and relevant data (such as comorbid illness and medications, endoscopy, rebleeding, inhospital mortality, and 30-day emergency readmission) were extracted. The Charlson comorbidity index was calculated. A total of 174 out of 1056 patients discharged alive following AUGIB (16.5%) had an emergency readmission within 30 days. Nineteen percent of readmissions were because of rebleeding, whereas the rest were because of other reasons, mainly bacterial infections (9.8%) and cardiovascular events (8%). Inhospital mortality did not differ significantly between index admissions and readmissions (13.7 vs. 9.8%, P=0.181). In logistic regression analysis, only a higher Charlson comorbidity index [odds ratio (OR): 1.154, 95% confidence interval (CI): 1.056-1.261] was related to emergency readmission. Bisphosphonate use (OR: 3.933, 95% CI: 1.264-12.233), previous AUGIB (OR: 2.407, 95% CI: 1.157-5.009), and length of stay at index admission (>5 days; OR: 0.246, 95% CI: 0.093-0.649) were found to be independent predictors of postdischarge rebleeding. All-cause emergency readmission following AUGIB is frequent. It is related to rebleeding in one-fifth of cases and mortality is similar to that in index admissions. The presence of comorbid illness appears to predict readmissions. Reduced length of stay and bisphosphonate use appear to be important, potentially modifiable, predictors of postdischarge rebleeding.

  20. Social media best practices in emergency management.

    PubMed

    Siskey, Ashley; Islam, Tanveer

    2016-01-01

    Social media platforms have become popular as means of communications in emergency management. Many people use social media sites such as Facebook and Twitter on a daily basis including during disaster events. Emergency management agencies (EMAs) need to recognize the value of not only having a presence on social media but also actively engaging stakeholders and the public on these sites. However, identifying best practices for the use of social media in emergency management is still in its infancy. The objective of this article is to begin to create or further define best practices for emergency managers to use social media sites particularly Facebook and Twitter in four key areas: 1) implementation, 2) education, 3) collaboration, and 4) communication. A list of recommendations of best practices is formulated for each key area and results from a nationwide survey on the use of social media by county EMAs are discussed in this article.

  1. Treatment of palliative care emergencies by prehospital emergency physicians in Germany: an interview based investigation.

    PubMed

    Wiese, C H R; Bartels, U E; Ruppert, D; Marung, H; Luiz, T; Graf, B M; Hanekop, G G

    2009-06-01

    Palliative care medical emergencies as a consequence of advanced cancer account for approximately 3% of all prehospital emergency cases. Therefore, prehospital emergency physicians (EP) are confronted with 'end of life decisions'. No educational content exists concerning palliative medicine in emergency medicine curricula. Over the course of 6 months, we interviewed 150 EPs about their experiences in 'end of life decisions' using a specific questionnaire. The total response rate was 69% (n = 104). Most of the interviewed EPs (89%, n = 93) had been confronted with palliative care medical emergencies and expressed uncertainties in dealing with these difficult situations, especially in the area of psychosocial care of the patients (50%). The emergency treatment of palliative care patients can become a particular challenge for any EP. A large percentage of interviewed EPs felt uncertain about aspects of social care and in the assessment of decisions at the end of life. Further information and training are necessary to amenable EPs to provide adequate patient-oriented care to palliative care patients and their relatives in emergency situations.

  2. Groundwater Molybdenum from Emerging Industries in Taiwan.

    PubMed

    Tsai, Kuo-Sheng; Chang, Yu-Min; Kao, Jimmy C M; Lin, Kae-Long

    2016-01-01

    This study determined the influence of emerging industries development on molybdenum (Mo) groundwater contamination. A total of 537 groundwater samples were collected for Mo determination, including 295 samples from potentially contaminated areas of 3 industrial parks in Taiwan and 242 samples from non-potentially contaminated areas during 2008-2014. Most of the high Mo samples are located downstream from a thin film transistor-liquid crystal display (TFT-LCD) panel factory. Mean groundwater Mo concentrations from potentially contaminated areas (0.0058 mg/L) were significantly higher (p < 0.05) than those from non-potentially contaminated areas (0.0022 mg/L). The highest Mo wastewater concentrations in the effluent from the optoelectronics industry and following wastewater batch treatment were 0.788 and 0.0326 mg/L, respectively. This indicates that wastewater containing Mo is a possible source of both groundwater and surface water contamination. Nine samples of groundwater exceed the World Health Organization's suggested drinking water guideline of 0.07 mg/L. A non-carcinogenic risk assessment for Mo in adults and children using the Mo concentration of 0.07 mg/L yielded risks of 0.546 and 0.215, respectively. These results indicate the importance of the development of a national drinking water quality standard for Mo in Taiwan to ensure safe groundwater for use. According to the human health risk calculation, the groundwater Mo standard is suggested as 0.07 mg/L. Reduction the discharge of Mo-contaminated wastewater from factories in the industrial parks is also the important task in the future.

  3. Emergency thoracotomies: Two center study.

    PubMed

    Sersar, Sameh Ibrahim; Alanwar, Mohammed Adel

    2013-01-01

    Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoracic aorta to redistribute blood flow and maybe to limit sub-diaphragmatic haemorrhage, bleeding and iatrogenic injury are the common risk factors. We aimed to review our experience in the field of emergency thoracotomies, identify the predictors of death, analyze the early results, detect the risk factors and asses the mortalities and their risk factors. Our hospital records of 197 patients who underwent emergency thoracotomy were reviewed. We retrospectively analyzed a piece of the extensive experience of the Mansoura University Hospitals and Mansoura Emergency Hospital; Egypt and Saudi German Hospitals; Jeddah in the last 12 years in the management of trauma cases for whom emergency thoracotomy. The aim was to analyse the early results of such cases and to detect the risk factors of dismal prognosis. Our series included 197 cases of emergency thoractomies in Mansoura; Egypt and SGH; Jeddah; KSA in the last 12 years. The mean age of the victims was 28 years and ranged between 5 and 62 years. Of the 197 patients with emergency thoracotomy, the indications were both penetrating and blunt chest trauma, iatrogenic and postoperative hemodynamito a surgical cause. The commonest indication was stab heart followed by traumatic diaphragmatic ruptures. The results of emergency thoracotomy in our series were cooping with the results of other reports, mainly due to our aggressive measures to achieve rapid stabilization of the hemodynamic condition. We emphasize the importance of emergency medicine education programs on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory support. Emergency thoracotomy has an important role in emergency big volume

  4. Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study

    PubMed Central

    Delgado, Carmen; Sánchez-Prada, Andrés; Parra-Vidales, Esther; de Leo, Diego; Franco-Martín, Manuel

    2018-01-01

    Background This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ

  5. Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study.

    PubMed

    Muñoz-Sánchez, Juan-Luis; Delgado, Carmen; Parra-Vidales, Esther; Franco-Martín, Manuel

    2018-01-24

    This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Although all

  6. Importance of bottom-up approach in water management - sustainable development of catchment areas in Croatia

    NASA Astrophysics Data System (ADS)

    Pavic, M.; Cosic-Flajsig, G.; Petricec, M.; Blazevic, Z.

    2012-04-01

    Association for preservation of Croatian waters and sea SLAP is a non-governmental organization (NGO) that gathers more than 150 scientist, hydrologist and civil engineers. SLAP has been established in 2006 and since then had organized many conferences and participated in projects dealing with water management. We have started our work developing plans to secure water supply to the 22 (21) villages in the rural parts of Dubrovnik (Pozega) area and trough the years we have accumulated knowledge and experience in dealing with stakeholders in hydrology and water management. Within this paper we will present importance of bottom-up approach to the stakeholders in water management in Croatia on two case studies: (1) Management of River Trebizat catchment area - irrigation of the Imotsko-Bekijsko rural parts; (2) Development of multipurpose water reservoirs at the River Orljava catchment area. Both projects were designed in the mid and late 1980's but due to the war were forgotten and on halt. River Trebizat meanders between Croatia and Bosnia and Herzegovina and acquires joint management by both countries. In 2010 and 2011 SLAP has organized conferences in both countries gathering all the relevant stakeholders from representatives of local and state governments, water management companies and development agencies to the scientist and interested NGO's. The conferences gave firm scientific background of the topic including presentation of all previous studies and measurements as well as model results but presented in manner appropriate to the stakeholders. The main result of the conference was contribution to the development of joint cross-border project sent to the EU Pre-Accession funds in December 2011 with the aim to strengthen capacities of both countries and prepare larger project dealing with management of the whole Trebizat catchment area to EU structural funds once Croatia enters EU in 2013. Similar approach was taken for the Orljava catchment in the northern

  7. Physical design correlates of efficiency and safety in emergency departments: a qualitative examination.

    PubMed

    Pati, Debajyoti; Harvey, Thomas E; Pati, Sipra

    2014-01-01

    The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency.

  8. Situational awareness and information flow in prehospital emergency medical care from the perspective of paramedic field supervisors: a scenario-based study.

    PubMed

    Norri-Sederholm, Teija; Paakkonen, Heikki; Kurola, Jouni; Saranto, Kaija

    2015-01-16

    In prehospital emergency medical services, one of the key factors in the successful delivery of appropriate care is the efficient management and supervision of the area's emergency medical services units. Paramedic field supervisors have an important role in this task. One of the key factors in the daily work of paramedic field supervisors is ensuring that they have enough of the right type of information when co-operating with other authorities and making decisions. However, a gap in information sharing still exists especially due to information overload. The aim of this study was to find out what type of critical information paramedic field supervisors need during multi-authority missions in order to manage their emergency medical services area successfully. The study also investigated both the flow of information, and interactions with the paramedic field supervisors and the differences that occur depending on the incident type. Ten paramedic field supervisors from four Finnish rescue departments participated in the study in January-March 2012. The data were collected using semi-structured interviews based on three progressive real-life scenarios and a questionnaire. Data were analysed using deductive content analysis. Data management and analysis were performed using Atlas.ti 7 software. Five critical information categories were formulated: Incident data, Mission status, Area status, Safety at work, and Tactics. Each category's importance varied depending on the incident and on whether it was about information needed or information delivered by the paramedic field supervisors. The main communication equipment used to receive information was the authority radio network (TETRA). However, when delivering information, mobile phones and TETRA were of equal importance. Paramedic field supervisors needed more information relating to area status. Paramedic field supervisors communicate actively with EMS units and other authorities such as Emergency Medical Dispatch

  9. [Nurses and social care workers in emergency teams in Norway].

    PubMed

    Hilpüsch, Frank; Parschat, Petra; Fenes, Sissel; Aaraas, Ivar J; Gilbert, Mads

    2011-01-07

    The Norwegian counties Troms and Finnmark are dominated by large areas with widespread habitation and rather long response times for ambulances and doctors. We wished to investigate the extent to which the municipal preparedness in these counties use employees from the municipal nursing and social care services and if these are part of local emergency teams. In the autumn of 2008, we sent a questionnaire to the district medical officers and the leaders for municipal nursing and social care services in all 44 municipalities in Troms and Finnmark. The answers were analyzed manually. 41 municipalities responded. In 34 of these the municipal nurses and social care workers practice emergency medicine procedures. The content in these training sessions is much more comprehensive than that in a typical first aid course. In three of four municipalities ambulance personnel do not participate in this training. In 31 municipalities the inhabitants contact nurses and social care workers directly if they are acutely ill. In only 10 of the municipalities the nurses and social care workers are organized in local teams including a doctor and an ambulance. In the districts, nursing and social care services are a resource in an emergency medicine context. The potential within these professions can be exploited better and be an important supplement in emergencies. In emergencies, cooperation across disciplines requires a clear organizational and economical structure, local basis and leadership.

  10. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

    PubMed

    Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

    2015-05-01

    The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. © 2015 by the Society for Academic Emergency Medicine.

  11. Update on emergency contraception.

    PubMed

    Fok, Wing Kay; Blumenthal, Paul D

    2016-12-01

    Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG. Repeated use of both LNG and ulipristal acetate (UPA) is well tolerated. Hormonal contraception can be immediately started following LNG use, but should be delayed for 5 days after UPA use to avoid dampening the efficacy of UPA. The copper intrauterine device (IUD) is the only IUD approved for emergency contraception (and the most effective method of emergency contraception), but use of LNG IUD as emergency contraception is currently being investigated. Accurate knowledge about emergency contraception remains low both for patients and healthcare providers. Emergency contraception is an important yet underutilized tool available to women to prevent pregnancy. Current options including copper IUD and emergency contraceptive pills are safe and well tolerated. Significant gaps in knowledge of emergency contraception on both the provider and user level exist, as do barriers to expedient access of emergency contraception.

  12. Species-area curves indicate the importance of habitats' contributions to regional biodiversity

    USGS Publications Warehouse

    Chong, G.W.; Stohlgren, T.J.

    2007-01-01

    We examined species-area curves, species composition and similarity (Jaccard's coefficients), and species richness in 17 vegetation types to develop a composite index of a vegetation type's contribution to regional species richness. We collected data from 1 to 1000 m2 scales in 147 nested plots in Rocky Mountain National Park, Colorado, USA to compare three species-area curve models' abilities to estimate the number of species observed in each vegetation type. The log(species)-log(area) curve had the largest adjusted coefficients of determination (r2 values) in 12 of the 17 types, followed by the species-log(area) curve with five of the highest values. When the slopes of the curves were corrected for species overlap among plots with Jaccard's coefficients, the species-log(area) curves estimated values closest to those observed. We combined information from species-area curves and measures of heterogeneity with information on the area covered by each vegetation type and found that the types making the greatest contributions to regional biodiversity covered the smallest areas. This approach may provide an accurate and relatively rapid way to rank hotspots of plant diversity within regions of interest.

  13. 76 FR 60512 - New York; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    .... FEMA-3328-EM; Docket ID FEMA-2011-0001] New York; Emergency and Related Determinations AGENCY: Federal... of an emergency for the State of New York (FEMA-3328-EM), dated August 26, 2011, and related...: I have determined that the emergency conditions in certain areas of the State of New York resulting...

  14. 76 FR 61727 - New York; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    .... FEMA-3341-EM; Docket ID FEMA-2011-0001] New York; Emergency and Related Determinations AGENCY: Federal... of an emergency for the State of New York (FEMA-3341-EM), dated September 8, 2011, and related...: I have determined that the emergency conditions in certain areas of the State of New York resulting...

  15. Rural transportation emergency preparedness plans.

    DOT National Transportation Integrated Search

    2009-07-01

    Improving the emergency preparedness of rural transportation systems is the overall goal of this research. Unique characteristics exist in rural transportation systems including widely dispersed and diverse populations and geographic areas. Exploring...

  16. Emergencies and IAQ

    EPA Pesticide Factsheets

    Preparation and response to weather-related and man-made emergencies is particularly important when it comes to indoor environments, since humans spend most of their time indoors, and rely on indoor spaces for shelter.

  17. Reducing Opioid Prescribing Rates in Emergency Medicine.

    PubMed

    Guarisco, Joseph; Salup, Adam

    2018-01-01

    Pain management is one of the most common reasons patients visit the emergency department. Understanding the contributions of emergency medicine-and specifically Ochsner Health System's emergency providers-to the opioid crisis is important. Benchmark prescribing data indicated that Ochsner Health System emergency medicine providers' opioid prescription rates were significantly higher than the national average in emergency medicine. Data relevant to visit and opioid prescription counts were extracted from the organization's electronic health record system. Opioid prescription rates were calculated for each provider. A data transparency project was initiated in which provider opioid prescription rates were unblinded and distributed among the provider group. Opioid prescription rates declined in aggregate for the emergency services from 22% to 14% during the 1-year project timeline. Some physicians demonstrated a 70% reduction in prescription rates. Importantly, patient satisfaction scores were not negatively impacted by declining opioid prescription rates. Provider performance transparency using unblinded and transparent data analytics can efficiently and significantly alter provider practice.

  18. 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.

  19. 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

  20. Why on the snow? Winter emergence strategies of snow-active Chironomidae (Diptera) in Poland.

    PubMed

    Soszyńska-Maj, Agnieszka; Paasivirta, Lauri; Giłka, Wojciech

    2016-10-01

    A long-term study of adult non-biting midges (Chironomidae) active in winter on the snow in mountain areas and lowlands in Poland yielded 35 species. The lowland and mountain communities differed significantly in their specific composition. The mountain assemblage was found to be more diverse and abundant, with a substantial contribution from the subfamily Diamesinae, whereas Orthocladiinae predominated in the lowlands. Orthocladius wetterensis Brundin was the most characteristic and superdominant species in the winter-active chironomid communities in both areas. Only a few specimens and species of snow-active chironomids were recorded in late autumn and early winter. The abundance of chironomids peaked in late February in the mountain and lowland areas with an additional peak in the mountain areas in early April. However, this second peak of activity consisted mainly of Orthocladiinae, as Diamesinae emerged earliest in the season. Most snow-active species emerged in mid- and late winter, but their seasonal patterns differed between the 2 regions as a result of the different species composition and the duration of snow cover in these regions. Spearman's rank correlation coefficient tests yielded positive results between each season and the number of chironomid individuals recorded in the mountain area. A positive correlation between air temperature, rising to +3.5 °C, and the number of specimens recorded on the snow in the mountain community was statistically significant. The winter emergence and mate-searching strategies of chironomids are discussed in the light of global warming, and a brief compilation of most important published data on the phenomena studied is provided. © 2015 Institute of Zoology, Chinese Academy of Sciences.

  1. Chapter 1: Reliably Measuring the Performance of Emerging Photovoltaic Solar Cells

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

    Rumbles, Garry; Reese, Matthew O; Marshall, Ashley

    Determining the power conversion efficiency of photovoltaic solar cells, especially those from new, emerging areas of technology, is important if advances in performance are to be made. However, although precise measurements are important, it is the accuracy of these types of measurements that can cause issues. Accurate measurements not only promote the development of new technology platforms, but they also enable comparisons with established technologies and allow assessments of advancements within the same field. This chapter provides insights into how measurements can be made with reasonable accuracy using both the components of the measuring system and a good protocol tomore » acquire good data. The chapter discusses how to measure a calibrated lamp spectrum, determine a spectral mismatch factor, identify the correct reference cell and filter, define the illuminated active area, measure J-V curves to avoid any hysteresis effects, take note of sample degradation issues and avoid the temptation to artificially enhance efficiency data.« less

  2. Analysis of Food Safety and Security Challenges in Emerging African Food Producing Areas through a One Health Lens: The Dairy Chains in Mali.

    PubMed

    Cheng, Rachel; Mantovani, Alberto; Frazzoli, Chiara

    2017-01-01

    Challenges posed by changes in livestock production in emerging food producing areas and demographic development and climate change require new approaches and responsibilities in the management of food chains. The increasingly recognized role of primary food producers requires the support of the scientific community to instruct effective approaches based on scientific data, tools, and expertise. Mali is an emerging food producing area, and this review covers (i) the dairy farming scenario and its environment, (ii) the role of dairy production in food security, including the greatly different animal rearing systems in the Sahel and tropical regions, (iii) risk management pillars as modern infrastructures, effective farmer organizations, and institutional systems to guarantee animal health and safety of products, and (iv) feasible interventions based on good practices and risk assessment at the farm level (e.g., sustainable use of fertilizers, feeds, veterinary drugs, and pesticides) to protect consumers from food safety hazards. Social innovation based on the empowerment of the primary food producers emerges as crucial for sustainable and safe food production. Sustainable policies should be supported by the mobilization of stakeholders of One Health, which is a science-based approach to linking human health and nutrition with the health and management of food producing animals and environmental safety. In the context of the complex, multifaceted scenario of Mali dairy production, this article presents how a cost-effective animal health and food safety scheme could be established in the dairy production chain. Because milk is a major commodity in this country, benefits could be derived in food security, public health, the resilience of the farming system, animal husbandry, and international trade.

  3. Reptile Critical Care and Common Emergencies.

    PubMed

    Music, Meera Kumar; Strunk, Anneliese

    2016-05-01

    Reptile emergencies are an important part of exotic animal critical care, both true emergencies and those perceived as emergencies by owners. The most common presentations for reptile emergencies are addressed here, with information on differential diagnoses, helpful diagnostics, and approach to treatment. In many cases, reptile emergencies are actually acute presentations originating from a chronic problem, and the treatment plan must include both clinical treatment and addressing husbandry and dietary deficiencies at home. Accurate owner expectations must be set in order to have owner compliance to long-term treatment plans. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2014-08-01

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

  5. Emerging diseases and implications for Millennium Development Goals in Africa by 2015 - an overview.

    PubMed

    Aluwong, Tagang; Bello, Mohammed

    2010-01-01

    Emerging zoonotic diseases have assumed increasing fundamental importance in both public and animal health, as the last few years have seen a steady increase of new cases, each emerging from an unsuspected geographic area and causing serious problems, often leading to mortalities among animals and humans. The reasons for disease emergence or re-emergence are multiple and include certain major factors, such as expansion of the human population, climate change and globalisation of trade. Further contributing issues, such as the increased movement of animal species, microbial evolution, ecological disruption, changes in human behaviour, all imply that emerging diseases will not only continue to occur, but the rate of their emergence will also increase. These will constitute constraints for the attainment of the Millennium Development Goals by African Governments by 2015. There is no doubt that the current trend calls for more and stronger partnerships between national and international organisations, veterinary and medical communities, environmentalists, academics and policy-makers of various governments on the continent within the context of the global 'One Health' movement. This article attempts to analyse the impact of emerging diseases and the implications for the achievement of the Millennium Development Goals in Africa by the year 2015.

  6. Is Traffic Still an Important Emitter of Monoaromatic Organic Compounds in European Urban Areas?

    PubMed

    Borbon, Agnès; Boynard, Anne; Salameh, Thérèse; Baudic, Alexia; Gros, Valérie; Gauduin, Julie; Perrussel, Olivier; Pallares, Cyril

    2018-01-16

    Trends of long-term observations and emission inventories suggest that traffic emissions will no longer dominate the concentrations of monoaromatic compounds (i.e., TEX - toluene, xylenes, and ethylbenzene) in European urban areas. But the split limit between traffic and other emission sector contributions such as solvent use remains tenuous. Here long-term observations of an extensive set of hydrocarbons, including TEX, at traffic and urban background sites in London, Paris and Strasbourg were combined to estimate the relative importance of traffic emissions on TEX in every city. When analyzing the urban enhancement emission ratios of TEX-to-benzene on a seasonal basis, two potential source signatures other than traffic could be differentiated in all cities (1) summertime evaporation from fuel and/or solvent and (2) wintertime domestic heating. However, traffic emissions still unambiguously dominate the concentration levels of TEX in every city despite the reduction of their emissions at exhaust pipe over the last two decades. Traffic explains between 60% and 96% (at ±20%) of TEX levels while it is less clear for xylenes at some locations. Our results provide a basis to evaluate regional emission inventories. The method is applicable at any urban area where speciated hydrocarbon monitoring is available.

  7. Communications between local health departments and the public during emergencies: the importance of standardized web sites.

    PubMed

    Fallon, L Fleming; Schmalzried, Hans D; Hasan, Nausheen

    2011-01-01

    Of the 2790 local health departments (LHDs) in the United States, Internet homepages were located for 1986. We reviewed each homepage to document the presence of 9 elements deemed to be critical for effective communications during emergency or disaster situations. LHD Web site homepages had a mean of 4.1 (±1.4) elements. Among the findings, this review revealed that 4 of 5 (80.5%) of the LHDs included the agency phone number, half (49.4%) provided links to emergency information, and about 1 in 5 (19.6%) listed an agency e-mail address. Fewer than 1 in 20 (4.3%) of the LHD homepages reviewed allowed visitors to sign up for automatic alerts or notifications. We suggest that these results be used as a starting point in developing a standardized template containing the 9 homepage elements. Such a template complements National Incident Management System protocols and can provide a recognizable source of consistent and reliable information for people during a public health emergency or disaster.

  8. Communal visual histories to detect environmental change in northern areas: Examples of emerging North American and Eurasian practices.

    PubMed

    Mustonen, Tero

    2015-12-01

    This article explores the pioneering potential of communal visual-optic histories which are recorded, painted, documented, or otherwise expressed. These materials provide collective meanings of an image or visual material within a specific cultural group. They potentially provide a new method for monitoring and documenting changes to ecosystem health and species distribution, which can effectively inform society and decision makers of Arctic change. These visual histories can be positioned in a continuum that extends from rock art to digital photography. They find their expressions in forms ranging from images to the oral recording of knowledge and operate on a given cultural context. For monitoring efforts in the changing boreal zone and Arctic, a respectful engagement with visual histories can reveal emerging aspects of change. The examples from North America and case studies from Eurasia in this article include Inuit sea ice observations, Yu'pik visual traditions of masks, fish die-offs in a sub-boreal catchment area, permafrost melt in the Siberian tundra and early, first detection of a scarabaeid beetle outbreak, a Southern species in the Skolt Sámi area. The pros and cons of using these histories and their reliability are reviewed.

  9. The emergency first aid responder system model: using community members to assist life-threatening emergencies in violent, developing areas of need.

    PubMed

    Sun, Jared H; Wallis, Lee A

    2012-08-01

    As many as 90% of all trauma-related deaths occur in developing nations, and this is expected to get worse with modernisation. The current method of creating an emergency care system by modelling after that of a Western nation is too resource-heavy for most developing countries to handle. A cheaper, more community-based model is needed to establish new emergency care systems and to support them to full maturity. A needs assessment was undertaken in Manenberg, a township in Cape Town with high violence and injury rates. Community leaders and successfully established local services were consulted for the design of a first responder care delivery model. The resultant community-based emergency first aid responder (EFAR) system was implemented, and EFARs were tracked over time to determine skill retention and usage. The EFAR system model and training curriculum. Basic EFARs are spread throughout the community with the option of becoming stationed advanced EFARs. All EFARs are overseen by a local organisation and a professional body, and are integrated with the local ambulance response if one exists. On competency examinations, all EFARs tested averaged 28.2% before training, 77.8% after training, 71.3% 4 months after training and 71.0% 6 months after training. EFARs reported using virtually every skill taught them, and further review showed that they had done so adequately. The EFAR system is a low-cost, versatile model that can be used in a developing region both to lay the foundation for an emergency care system or support a new one to maturity.

  10. Characterizing the influence of transportation infrastructure on Emergency Medical Services (EMS) in urban area-A case study of Seoul, South Korea.

    PubMed

    Cho, Jungwoo; You, Myoungsoon; Yoon, Yoonjin

    2017-01-01

    In highly urbanized area where traffic condition fluctuates constantly, transportation infrastructure is one of the major contributing factors to Emergency Medical Service (EMS) availability and patient outcome. In this paper, we assess the impact of traffic fluctuation to the EMS first response availability in urban area, by evaluating the k-minute coverage under 21 traffic scenarios. The set of traffic scenarios represents the time-of-day and day-of-week effects, and is generated by combining road link speed information from multiple historical speed databases. In addition to the k-minute area coverage calculation, the k-minute population coverage is also evaluated for every 100m by 100m grid that partitions the case study area of Seoul, South Korea. In the baseline case of traveling at the speed limit, both the area and population coverage reached nearly 100% when compared to the five-minute travel time national target. Employing the proposed LoST (Loss of Serviceability due to Traffic) index, which measures coverage reduction in percentage compared to the baseline case, we find that the citywide average LoST for area and population coverage are similar at 34.2% and 33.8%. However, district-wise analysis reveals that such reduction varies significantly by district, and the magnitude of area and population coverage reduction is not always proportional. We conclude that the effect of traffic variation is significant to successful urban EMS first response performance, and regional variation is evident among local districts. Complexity in the urban environment requires a more adaptive approach in public health resource management and EMS performance target determination.

  11. Developing protocols for obstetric emergencies.

    PubMed

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

    2014-01-01

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

  12. An Emergency Medicine Research Priority Setting Partnership to establish the top 10 research priorities in emergency medicine.

    PubMed

    Smith, Jason; Keating, Liza; Flowerdew, Lynsey; O'Brien, Rachel; McIntyre, Sam; Morley, Richard; Carley, Simon

    2017-07-01

    Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Prehospital emergency medicine services in Europe: structure and equipment.

    PubMed

    Huemer, G; Pernerstorfer, T; Mauritz, W

    1994-06-01

    In order to get an update on prehospital emergency medicine practice all over Europe we submitted questionnaires with a total of 61 questions concerning prehospital emergency medicine in Europe, to 123 European members of the World Association of Emergency and Disaster Medicine (WAEDM). Sixty (49%) questionnaires were returned. One up to seven questionnaires from 22 European countries were analysed: 37 (62%) from urban and 23 (38%) suburban or rural areas; 12 being from former Eastern European countries. Sixteen of the questions--those concerning rescue systems and equipment--are analysed and presented in this paper. A fleet of ambulance cars staffed with paramedics/nurses based at the emergency organization is the most frequently used system in 59% (10/17) of the countries. The same percentage claims to have a ground-based coverage of its area of 80-100%. Airborne coverage between 80-100% and below 60% of the areas is given in the same percentage of 35% (6/17). Physicians are frequently involved in prehospital emergency care in the Eastern European Countries, France, Germany, Italy, Belgium and Turkey, rarely in Switzerland, Denmark, the United Kingdom, Greece, Ireland and Finland, never in the Netherlands and Sweden. In more than 50%, a combination of national, regional and local organizations provide emergency care, which results in large differences of standards. We discovered remarkable differences which could be overcome by enhanced co-ordination and information exchange provided by the European Society for Emergency Medicine, WAEDM, the European Red Cross or the European Academy of Anaesthesiologists.

  14. Imported submicroscopic malaria in Madrid.

    PubMed

    Ramírez-Olivencia, Germán; Rubio, José Miguel; Rivas, Pablo; Subirats, Mercedes; Herrero, María Dolores; Lago, Mar; Puente, Sabino

    2012-09-12

    Submicroscopic malaria (SMM) can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM.The goals of this study were two-fold: a) to know the frequency of imported SMM, and b) to describe epidemiological, laboratorial and clinical features of imported SMM. A retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia. SMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95%) was 40.38 years (37.41-43.34), and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%). Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients), fever (60%) and arthromialgias (53.3%). The associated laboratory abnormalities were anaemia (27.9%), leukopaenia (15.4%) and thrombopaenia (15.4%). Co-morbidity was described in 75 cases (72.1%). Results from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has been previously described in endemic zones, and presence of

  15. Imported submicroscopic malaria in Madrid

    PubMed Central

    2012-01-01

    Background Submicroscopic malaria (SMM) can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM. The goals of this study were two-fold: a) to know the frequency of imported SMM, and b) to describe epidemiological, laboratorial and clinical features of imported SMM. Methods A retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia. Results SMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95%) was 40.38 years (37.41-43.34), and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%). Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients), fever (60%) and arthromialgias (53.3%). The associated laboratory abnormalities were anaemia (27.9%), leukopaenia (15.4%) and thrombopaenia (15.4%). Co-morbidity was described in 75 cases (72.1%). Conclusions Results from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has been previously

  16. Value-Based Emergency Management.

    PubMed

    Corrigan, Zachary; Winslow, Walter; Miramonti, Charlie; Stephens, Tim

    2016-02-01

    This article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives. Hope and faith in doing good is no longer enough for preparedness and health care coalitions; understanding how physicians are employed and health care is delivered and paid for is now necessary. Incentivizing preparedness through value-based compensation systems will become the new standard for emergency management.

  17. 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

  18. Emergency Medicine

    PubMed Central

    Binder, Louis S.; Chappell, James A.

    1991-01-01

    The Scientific Board of the California Medical Association presents the following inventory of items of progress in emergency medicine. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, or scholars to stay abreast of these items of progress in emergency medicine that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another. The items of progress listed below were selected by the Advisory Panel to the Section on Emergency Medicine of the California Medical Association, and the summaries were prepared under its direction. PMID:1949777

  19. 48 CFR 52.226-3 - Disaster or Emergency Area Representation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... offeror represents that it ___does ____ does not reside or primarily do business in the set-aside area. (c) An offeror is considered to be residing or primarily doing business in the set-aside area if, during..., factors to be considered in determining whether an offeror resides or primarily does business in the set...

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

    PubMed

    Dick, W

    1994-01-01

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

  1. Paralympic sport: an emerging area for research and consultancy in sports biomechanics.

    PubMed

    Keogh, Justin W L

    2011-09-01

    The Paralympic Games are the pinnacle of sport for many athletes with a disability. The overall purpose of this paper is to highlight the role that the field of sports biomechanics specifically (and sports science in general) may play in improving performance in various summer Paralympic sports through research and consultancy. To achieve this broad aim, this review provides some history and background on the Summer Paralympic Games, discusses the eligibility and classification rules, describes the potential for the constraints-led approach of dynamical systems theory to inform practice and research in this area, and reviews selected studies examining the biomechanics of the primary forms of Paralympic locomotion. Some recommendations on how sports biomechanics can help facilitate improvements in Paralympic athletic performance through applied research and consultancy are provided, along with commentary on what may be some of the most important issues addressing Paralympic sport.

  2. Drinking water turbidity and emergency department visits for gastrointestinal illness in Atlanta, 1993-2004.

    PubMed

    Tinker, Sarah C; Moe, Christine L; Klein, Mitchel; Flanders, W Dana; Uber, Jim; Amirtharajah, Appiah; Singer, Philip; Tolbert, Paige E

    2010-01-01

    The extent to which drinking water turbidity measurements indicate the risk of gastrointestinal illness is not well understood. Despite major advances in drinking water treatment and delivery, infectious disease can still be transmitted through drinking water in the United States, and it is important to have reliable indicators of microbial water quality to inform public health decisions. The objective of our study was to assess the relationship between gastrointestinal illness, quantified through emergency department visits, and drinking water quality, quantified as raw water and filtered water turbidity measured at the treatment plant. We examined the relationship between turbidity levels of raw and filtered surface water measured at eight major drinking water treatment plants in the metropolitan area of Atlanta, Georgia, and over 240,000 emergency department visits for gastrointestinal illness during 1993-2004 among the population served by these plants. We fit Poisson time-series statistical regression models that included turbidity in a 21-day distributed lag and that controlled for meteorological factors and long-term time trends. For filtered water turbidity, the results were consistent with no association with emergency department visits for gastrointestinal illness. We observed a modest association between raw water turbidity and emergency department visits for gastrointestinal illness. Our results suggest that source water quality may contribute modestly to endemic gastrointestinal illness in the study area. The association between turbidity and emergency department visits for gastrointestinal illness was only observed when raw water turbidity was considered; filtered water turbidity may not serve as a reliable indicator of modest pathogen risk at all treatment plants.

  3. Development of a Conceptual Chum Salmon Emergence Model for Ives Island

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

    Murray, Christopher J.; Geist, David R.; Arntzen, Evan V.

    2011-02-09

    The objective of the study described herein was to develop a conceptual model of chum salmon emergence that was based on empirical water temperature of the riverbed and river in specific locations where chum salmon spawn in the Ives Island area. The conceptual model was developed using water temperature data that have been collected in the past and are currently being collected in the Ives Island area. The model will be useful to system operators who need to estimate the complete distribution of chum salmon emergence (first emergence through final emergence) in order to balance chum salmon redd protection andmore » power system operation.« less

  4. Emergency and backup power supplies at Department of Energy facilities: Augmented Evaluation Team -- Final report

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

    Not Available

    This report documents the results of the Defense Programs (DP) Augmented Evaluation Team (AET) review of emergency and backup power supplies (i.e., generator, uninterruptible power supply, and battery systems) at DP facilities. The review was conducted in response to concerns expressed by former Secretary of Energy James D. Watkins over the number of incidents where backup power sources failed to provide electrical power during tests or actual demands. The AET conducted a series of on-site reviews for the purpose of understanding the design, operation, maintenance, and safety significance of emergency and backup power (E&BP) supplies. The AET found that themore » quality of programs related to maintenance of backup power systems varies greatly among the sites visited, and often among facilities at the same site. No major safety issues were identified. However, there are areas where the AET believes the reliability of emergency and backup power systems can and should be improved. Recommendations for improving the performance of E&BP systems are provided in this report. The report also discusses progress made by Management and Operating (M&O) contractors to improve the reliability of backup sources used in safety significant applications. One area that requires further attention is the analysis and understanding of the safety implications of backup power equipment. This understanding is needed for proper graded-approach implementation of Department of Energy (DOE) Orders, and to help ensure that equipment important to the safety of DOE workers, the public, and the environment is identified, classified, recognized, and treated as such by designers, users, and maintainers. Another area considered important for improving E&BP system performance is the assignment of overall ownership responsibility and authority for ensuring that E&BP equipment performs adequately and that reliability and availability are maintained at acceptable levels.« less

  5. Physician staffed helicopter emergency medical systems can provide advanced trauma life support in mountainous and remote areas.

    PubMed

    Ausserer, Julia; Moritz, Elizabeth; Stroehle, Matthias; Brugger, Hermann; Strapazzon, Giacomo; Rauch, Simon; Mair, Peter

    2017-01-01

    In remote and mountainous areas, helicopter emergency medical systems (HEMS) are used to expedite evacuation and provide pre-hospital advanced trauma life support (ATLS) in major trauma victims. Aim of the study was to investigate feasibility of ATLS in HEMS mountain rescue missions and its influence on patient condition at hospital admission. 58 major trauma victims (Injury Severity Score ≥16), evacuated by physician staffed HEMS from remote and mountainous areas in the State of Tyrol, Austria between 1.1.2011 and 31.12.2013. Pre-hospital time exceeded 90min in 24 (44%) cases. 31 (53%) patients suffered critical impairment of at least one vital function (systolic blood pressure <90mmHg, GCS <10, or respiratory rate <10 or >30). 4 (6.9%) of 58 patients died prior to hospital admission. Volume resuscitation was restrictive: 18 (72%) of 25 hypotensive patients received ≤500ml fluids and blood pressure was increased >90mmHg at hospital admission in only 9 (36%) of these 25 patients. 8 (50%) of 16 brain trauma patients with a blood pressure <90mmHg remained hypotensive at hospital admission. Endotracheal intubation was accomplished without major complications in 15 (79%) of 19 patients with a Glasgow Coma Scale score <10. Rope operations were necessary in 40 (69%) of 58 cases and ATLS was started before hoist evacuation in 30 (75%) of them. The frequent combination of prolonged pre-hospital times, with critical impairment of vital functions, supports the need for early ATLS in HEMS mountain rescue missions. Pre-hospital endotracheal intubation is possible with a high success and low complication rate also in a mountain rescue scenario. Pre-hospital volume resuscitation is restrictive and hypotension is reversed at hospital admission in only one third of patients. Prolonged pre-hospital hypotension remains an unresolved problem in half of all brain trauma patients and indicates the difficulties to increase blood pressure to a desired level in a mountain rescue

  6. Emergencies in Hematology and Oncology.

    PubMed

    Halfdanarson, Thorvardur R; Hogan, William J; Madsen, Bo E

    2017-04-01

    The development of medical emergencies related to the underlying disease or as a result of complications of therapy are common in patients with hematologic or solid tumors. These oncological emergencies can occur as an initial presentation or in a patient with an established diagnosis and are encountered in all medical care settings, ranging from primary care to the emergency department and various subspecialty environments. Therefore, it is critically important that all physicians have a working knowledge of the potential oncological emergencies that may present in their practice and how to provide the most effective care without delay. This article reviews the most common oncological emergencies and provides practical guidance for initial management of these patients. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  7. Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia.

    PubMed

    Tesfaye, Tatek; Tilahun, Tizta; Girma, Eshetu

    2012-03-12

    In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH). Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011 Data was collected using structured questionnaire and analyzed using SPSS version 17.0. In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.

  8. Characteristics of Emergency Gastrointestinal Stromal Tumor (GIST).

    PubMed

    Uçar, Ahmet Deniz; Oymaci, Erkan; Carti, Erdem Bariş; Yakan, Savaş; Vardar, Enver; Erkan, Nazif; Mehmet, Yildirim

    2015-05-01

    Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract (GIT). Importance of GISTs is increasing while surgeons are facing with more frequent either in emergency setting of elective cases. Delineating the presentation and management of emergency GIST is important. From 2005 to 2014, emergency cases with final diagnosis of GIST were examined retrospectively. Total of 13 operated cases were evaluated by patients characteristics, clinical presentation, operational findings and postoperative prognosis. There were 9 male and 4 female with the mean age of 48.15 years. The most frequent presentations are ileus and GIT hemorrhage both covering the 84% of patients. Small bowel was the dominating site with ileus. Stomach was the second frequent site of the disease with the finding of hemorrhage. Emergency patients are more likely to come with small bowel GIST and obstruction symptoms. Hemorrhage is the most frequent symptom for emergency GIST of stomach and duodenum.

  9. Anthropogenic radiofrequency electromagnetic fields as an emerging threat to wildlife orientation.

    PubMed

    Balmori, Alfonso

    2015-06-15

    The rate of scientific activity regarding the effects of anthropogenic electromagnetic radiation in the radiofrequency (RF) range on animals and plants has been small despite the fact that this topic is relevant to the fields of experimental biology, ecology and conservation due to its remarkable expansion over the past 20 years. Current evidence indicates that exposure at levels that are found in the environment (in urban areas and near base stations) may particularly alter the receptor organs to orient in the magnetic field of the earth. These results could have important implications for migratory birds and insects, especially in urban areas, but could also apply to birds and insects in natural and protected areas where there are powerful base station emitters of radiofrequencies. Therefore, more research on the effects of electromagnetic radiation in nature is needed to investigate this emerging threat. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Development of vegetable farming: a cause of the emergence of insecticide resistance in populations of Anopheles gambiae in urban areas of Benin.

    PubMed

    Yadouleton, Anges William M; Asidi, Alex; Djouaka, Rousseau F; Braïma, James; Agossou, Christian D; Akogbeto, Martin C

    2009-05-14

    A fast development of urban agriculture has recently taken place in many areas in the Republic of Benin. This study aims to assess the rapid expansion of urban agriculture especially, its contribution to the emergence of insecticide resistance in populations of Anopheles gambiae. The protocol was based on the collection of sociological data by interviewing vegetable farmers regarding various agricultural practices and the types of pesticides used. Bioassay tests were performed to assess the susceptibility of malaria vectors to various agricultural insecticides and biochemical analysis were done to characterize molecular status of population of An. gambiae. This research showed that:(1) The rapid development of urban agriculture is related to unemployment observed in cities, rural exodus and the search for a balanced diet by urban populations;(2) Urban agriculture increases the farmers' household income and their living standard;(3) At a molecular level, PCR revealed the presence of three sub-species of An. gambiae (An. gambiae s.s., Anopheles melas and Anopheles arabiensis) and two molecular forms (M and S). The kdr west mutation recorded in samples from the three sites and more specifically on the M forms seems to be one of the major resistance mechanisms found in An. gambiae from agricultural areas. Insecticide susceptibility tests conducted during this research revealed a clear pattern of resistance to permethrin (76% mortality rate at Parakou; 23.5% at Porto-Novo and 17% at Cotonou). This study confirmed an increase activity of the vegetable farming in urban areas of Benin. This has led to the use of insecticide in an improper manner to control vegetable pests, thus exerting a huge selection pressure on mosquito larval population, which resulted to the emergence of insecticide resistance in malaria vectors.

  11. Development of vegetable farming: a cause of the emergence of insecticide resistance in populations of Anopheles gambiae in urban areas of Benin

    PubMed Central

    Yadouleton, Anges William M; Asidi, Alex; Djouaka, Rousseau F; Braïma, James; Agossou, Christian D; Akogbeto, Martin C

    2009-01-01

    Background A fast development of urban agriculture has recently taken place in many areas in the Republic of Benin. This study aims to assess the rapid expansion of urban agriculture especially, its contribution to the emergence of insecticide resistance in populations of Anopheles gambiae. Methods The protocol was based on the collection of sociological data by interviewing vegetable farmers regarding various agricultural practices and the types of pesticides used. Bioassay tests were performed to assess the susceptibility of malaria vectors to various agricultural insecticides and biochemical analysis were done to characterize molecular status of population of An. gambiae. Results This research showed that: (1) The rapid development of urban agriculture is related to unemployment observed in cities, rural exodus and the search for a balanced diet by urban populations; (2) Urban agriculture increases the farmers' household income and their living standard; (3) At a molecular level, PCR revealed the presence of three sub-species of An. gambiae (An. gambiae s.s., Anopheles melas and Anopheles arabiensis) and two molecular forms (M and S). The kdr west mutation recorded in samples from the three sites and more specifically on the M forms seems to be one of the major resistance mechanisms found in An. gambiae from agricultural areas. Insecticide susceptibility tests conducted during this research revealed a clear pattern of resistance to permethrin (76% mortality rate at Parakou; 23.5% at Porto-Novo and 17% at Cotonou). Conclusion This study confirmed an increase activity of the vegetable farming in urban areas of Benin. This has led to the use of insecticide in an improper manner to control vegetable pests, thus exerting a huge selection pressure on mosquito larval population, which resulted to the emergence of insecticide resistance in malaria vectors. PMID:19442297

  12. A fatal case of Brazilian spotted fever in a non-endemic area in Brazil: the importance of having health professionals who understand the disease and its areas of transmission.

    PubMed

    Oliveira, Stefan Vilges de; Caldas, Eduardo Pacheco de; Colombo, Silvia; Gazeta, Gilberto Salles; Labruna, Marcelo Bahia; Santos, Fabiana Cristina Pereira Dos; Angerami, Rodrigo Nogueira

    2016-01-01

    Brazilian spotted fever (BSF) is caused by the bacterium Rickettsia rickettsii. Because of its high case-fatality rate and apparent increase in areas of transmission, it is considered to be the rickettsial illness of primary public health interest. Cases of this disease have historically occurred in Southeastern Brazil. This article reports the first fatal case of BSF in Southern Brazil. This case high lights the importance of BSF to be considered as a differential diagnosis for acute hemorrhagic fever in areas where cases of BSF may not be expected.

  13. Integration of social vulnerability into emergency management plans: designing of evacuation routes against flood disasters

    NASA Astrophysics Data System (ADS)

    Aroca-Jimenez, Estefanía; Bodoque, Jose Maria; Garcia, Juan Antonio; Diez-Herrero, Andres

    2017-04-01

    Flash floods are highly spatio-temporal localized flood events characterized by reaching a high peak flow in a very short period of time, i.e., generally with times of concentration lower than six hours. Its short duration, which limits or even voids any warning time, means that flash floods are considered to be one of the most destructive natural hazards with the greatest capacity to generate risk, either in terms of the number of people affected globally or the proportion of individual fatalities. The above highlights the importance of a realistic and appropriate design of evacuation strategies in order to reduce flood-related losses, being evacuation planning considered of critical importance for disaster management. Traditionally, evacuation maps have been based on flood-prone areas, shelters or emergency residences location and evacuation routes information. However, evacuation plans rarely consider the spatial distribution of vulnerable population (i.e., people with special needs, mobility constraints or economic difficulties), which usually require assistance from emergency responders. The goal of this research is to elaborate an evacuation map against the occurrence of flash floods by combining geographic information (e.g. roads, health facilities location, sanitary helicopters) and social vulnerability patterns, which are previously obtained from socioeconomic variables (e.g. population, unemployment, dwelling characteristics). To do this, ArcGis Network Analyst tool is used, which allows to calculate the optimal evacuation routes. The methodology proposed here is implemented in the region of Castilla y León (94,230 km2). Urban areas prone to flash flooding are identified taking into account the following requirements: i) city centers are crossed by rivers or streams with a longitudinal slope higher than 0.01 m m-1; ii) city centers are potentially affected by flash floods; and iii) city centers are affected by an area with low or exceptional probability

  14. Sustainability and the local emergency manager.

    PubMed

    Jensen, Jessica; Chauvet, Regine Laurence

    2014-01-01

    The objective of this study was to explore how local county emergency managers conceptualize sustainability and apply the concept within their jobs. Qualitative, semistructured telephone and face-to-face interviews were used to collect data from a purposive and convenience sample of local county emergency managers. Interviews were conducted with Florida and North Dakota emergency managers. Twenty-five local county emergency managers participated in this study. The study demonstrated that there is a lack of definitional clarity in emergency manager conceptualizations of sustainability. Nevertheless, emergency managers apply the concept to their jobs in important ways. Emergency management has the opportunity to further define its role vis-à-vis sustainability and how it does so will have implications for the communities it serves, the professionals who will be tasked with it, and the educators who will support the development of future generations of emergency management professionals.

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

    PubMed Central

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

    2005-01-01

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

  16. Does Playing Sports Video Games Predict Increased Involvement in Real-Life Sports Over Several Years Among Older Adolescents and Emerging Adults?

    PubMed

    Adachi, Paul J C; Willoughby, Teena

    2016-02-01

    Given the extreme popularity of video games among older adolescents and emerging adults, the investigation of positive outcomes of video game play during these developmental periods is crucial. An important direction for research in this area is the investigation of a link between sports video game play and involvement in real-life sports among youth. Yet, this association has not been examined in the long-term among older adolescents and emerging adults, and thus represents an exciting new area for discovery. The primary goal of the current study, therefore, was to examine the long-term association between sports video game play and involvement in real-life sports clubs among older adolescents and emerging adults. In addition, we examined whether self-esteem was an underlying mechanism of this longitudinal association. We surveyed older adolescents and emerging adults (N = 1132; 70.6 % female; M age = 19.06 years, range of 17-25 years at the first assessment) annually over 3 years about their video game play, self-esteem, and involvement in real-life sports. We found a long-term predictive effect of sports video game play on increased involvement in real-life sports over the 3 years. Furthermore, we demonstrated that self-esteem was an underlying mechanism of this long-term association. Our findings make an important contribution to an emerging body of literature on the positive outcomes of video game play, as they suggest that sports video game play may be an effective tool to promote real-life sports participation and physical activity among older adolescents and emerging adults.

  17. Clinical and epidemiological characteristics of imported infectious diseases in Spanish travelers.

    PubMed

    Zamarrón Fuertes, Pilar; Pérez-Ayala, Ana; Pérez Molina, José A; Norman, Francesca F; Monge-Maíllo, Begoña; Navarro, Miriam; López-Vélez, Rogelio

    2010-01-01

    Spain could be a potential area in Europe for the development and spread of emerging diseases from the tropics due to its geoclimatic characteristics, but there is little information on infectious diseases imported by travelers. The aim of this article was to analyze clinical-epidemiological characteristics of infectious diseases imported by Spanish travelers from the tropics. A retrospective descriptive study of 2,982 travelers seeking medical advice who return ill from the tropics was conducted. Demographic data, details of travel (destination, type, and duration), preventive measures, clinical syndromes, and diagnoses were analyzed. Nearly half (46.5%) the travelers had traveled to sub-Saharan Africa; 46.5% reported a stay exceeding 1 month (and almost a quarter more than 6 months). Following pre-travel advice, 69.1% received at least one vaccine and 35.5% took malarial chemoprophylaxis with variations according to geographical area of travel. In all, 58.8% of this took chemoprophylaxis correctly. Most common syndromes were fever 1,028 (34.5%), diarrhea 872 (29.3%), and cutaneous syndrome 684 (22.9%). Most frequent diagnoses were traveler's diarrhea (17.2%), malaria (17%), and intestinal parasites (10.4%). The three main syndromes in travelers to the Caribbean-Central America, Indian subcontinent-Southeast Asia, and other areas were diarrhea, fever, and cutaneous syndrome (p < 0.05); in sub-Saharan Africa were fever, cutaneous syndrome, and diarrhea (p < 0.05); and in South America were cutaneous syndrome, diarrhea, and fever (p < 0.05). Travelers to sub-Saharan Africa showed a higher frequency of malaria, rickettsiosis, filariasis, and schistosomiasis (p < 0.05); those to South America showed cutaneous larva migrants, other ectoparasitosis, and cutaneous/mucocutaneous leishmaniasis; and those to the Indian subcontinent-Southeast Asia showed intestinal parasitosis, arboviriasis, and enteric fever (p < 0.05). Increased international travel is a key factor for the

  18. [Similarities between disaster areas and developing countries in terms of the lack of facilities for clinical examinations].

    PubMed

    Suganami, Shigeru

    2012-03-01

    From the experience of more than 130 emergency medical relief missions in over 50 countries/areas, the AMDA would like to propose a system of mobile clinical examinations to prepare for possible natural disasters in Japan. Such a system will require the development of vehicles equipped with a full range of laboratory equipment, which I believe will become a public property in the world, and contribute to the enhancement of medical services in disaster areas as well as in areas with less developed medical technologies. AMDA's recent medical relief activities include the support of the victims of the earthquakes in Haiti (2010) and Turkey (2011), and the flood in Thailand (2012). In these countries, the AMDA faced the lack of a clinical examination system which resulted in a huge number of patients who could not receive proper treatment after injury, or those who suffered from infectious diseases. Domestically, when the AMDA sent medical teams to the affected areas of the Great East Japan Earthquake and tsunami (2011), their activities took place mainly in evacuation shelters, where survivors needed treatment for chronic diseases and preventive care. All of these experiences highlight the importance of clinical examination in disaster areas, as well as in developing countries/areas similarly lacking basic medical services. The Japanese Society of Laboratory Medicine will surely play an important role in the development of the proposed system of mobile clinical examinations. The AMDA would like to collaborate with the JSLM in emergency relief activities and medical aid projects in areas affected by disasters or lack basic medical services.

  19. The safety of available and emerging options for emergency contraception.

    PubMed

    Lee, Jessica K; Schwarz, Eleanor Bimla

    2017-10-01

    Emergency contraception (EC) is a way to significantly reduce the chance of becoming pregnant after an episode of unprotected intercourse. Considerable data support the safety of all available and emerging options for EC. Areas covered: This review presents a comprehensive summary of the literature regarding the safety of EC as well as directions for further study. PubMed was searched for all relevant studies published prior to June 2017. Expertopinion: All available methods of EC (i.e., ulipristal acetate pills, levonorgestrel pills, and the copper-IUD), carry only mild side effects and serious adverse events are essentially unknown. The copper IUD has the highest efficacy of EC methods. Given the excellent safety profiles of mifepristone and the levonorgestrel IUD, research is ongoing related to use of these products for EC.

  20. How dynamic number of evacuee affects the multi-objective optimum allocation for earthquake emergency shelters: A case study in the central area of Beijing, China

    NASA Astrophysics Data System (ADS)

    Ma, Y.; Xu, W.; Zhao, X.; Qin, L.

    2016-12-01

    Accurate location and allocation of earthquake emergency shelters is a key component of effective urban planning and emergency management. A number of models have been developed to solve the complex location-allocation problem with diverse and strict constraints, but there still remain a big gap between the model and the actual situation because the uncertainty of earthquake, damage rate of buildings and evacuee behaviors have been neglected or excessively simplified in the existing models. An innovative model was first developed to estimate the hourly dynamic changes of the number of evacuees under two damage scenarios of earthquake by considering these factors at the community level based on a location-based service data, and then followed by a multi-objective model for the allocation of residents to earthquake shelters using the central area of Beijing, China as a case study. The two objectives of this shelter allocation model were to minimize the total evacuation distance from communities to a specified shelter and to minimize the total area of all the shelters with the constraints of shelter capacity and service radius. The modified particle swarm optimization algorithm was used to solve this model. The results show that increasing the shelter area will result in a large decrease of the total evacuation distance in all of the schemes of the four scenarios (i.e., Scenario A and B in daytime and nighttime respectively). According to the schemes of minimum distance, parts of communities in downtown area needed to be reallocated due to the insufficient capacity of the nearest shelters, and the numbers of these communities sequentially decreased in scenarios Ad, An, Bd and Bn due to the decreasing population. According to the schemes of minimum area in each scenario, 27 or 28 shelters, covering a total area of approximately 37 km2, were selected; and the communities almost evacuated using the same routes in different scenarios. The results can be used as a

  1. Core Noise - Increasing Importance

    NASA Technical Reports Server (NTRS)

    Hultgren, Lennart S.

    2011-01-01

    This presentation is a technical summary of and outlook for NASA-internal and NASA-sponsored external research on core (combustor and turbine) noise funded by the Fundamental Aeronautics Program Subsonic Fixed Wing (SFW) Project. Sections of the presentation cover: the SFW system-level noise metrics for the 2015, 2020, and 2025 timeframes; turbofan design trends and their aeroacoustic implications; the emerging importance of core noise and its relevance to the SFW Reduced-Perceived-Noise Technical Challenge; and the current research activities in the core-noise area, with additional details given about the development of a high-fidelity combustor-noise prediction capability as well as activities supporting the development of improved reduced-order, physics-based models for combustor-noise prediction. The need for benchmark data for validation of high-fidelity and modeling work and the value of a potential future diagnostic facility for testing of core-noise-reduction concepts are indicated. The NASA Fundamental Aeronautics Program has the principal objective of overcoming today's national challenges in air transportation. The SFW Reduced-Perceived-Noise Technical Challenge aims to develop concepts and technologies to dramatically reduce the perceived aircraft noise outside of airport boundaries. This reduction of aircraft noise is critical to enabling the anticipated large increase in future air traffic. Noise generated in the jet engine core, by sources such as the compressor, combustor, and turbine, can be a significant contribution to the overall noise signature at low-power conditions, typical of approach flight. At high engine power during takeoff, jet and fan noise have traditionally dominated over core noise. However, current design trends and expected technological advances in engine-cycle design as well as noise-reduction methods are likely to reduce non-core noise even at engine-power points higher than approach. In addition, future low-emission combustor

  2. USGS standard quadrangle maps for emergency response

    USGS Publications Warehouse

    Moore, Laurence R.

    2009-01-01

    The 1:24,000-scale topographic quadrangle was the primary product of the U.S. Geological Survey's (USGS) National Mapping Program from 1947-1992. This map series includes about 54,000 map sheets for the conterminous United States, and is the only uniform map series ever produced that covers this area at such a large scale. This map series partially was revised under several programs, starting as early as 1968, but these programs were not adequate to keep the series current. Through the 1990s the emphasis of the USGS mapping program shifted away from topographic maps and toward more specialized digital data products. Topographic map revision dropped off rapidly after 1999, and stopped completely by 2004. Since 2001, emergency-response and homeland security requirement have revived the question of whether a standard national topographic series is needed. Emergencies such as Hurricane Katrina in 2005 and California wildfires in 2007-08 demonstrated that familiar maps are important to first responders. Maps that have a standard scale, extent, and grids help reduce confusion and save time in emergencies. Traditional maps are designed to allow the human brain to quickly process large amounts of information, and depend on artistic layout and design that cannot be fully automated. In spite of technical advances, creating a traditional, general-purpose topographic map is still expensive. Although the content and layout of traditional topographic maps probably is still desirable, the preferred packaging and delivery of maps has changed. Digital image files are now desired by most users, but to be useful to the emergency-response community, these files must be easy to view and easy to print without specialized geographic information system expertise or software.

  3. Emergency and disaster planning at Ohio animal shelters.

    PubMed

    Decker, Shanna M; Lord, Linda K; Walker, William L; Wittum, Thomas E

    2010-01-01

    Results of a cross-sectional study to determine the level of emergency and disaster response planning at Ohio nonhuman animal shelters and the role Ohio agencies have in emergency and disaster response planning in their communities indicated a lack of preparedness coupled with underutilization of the agencies as a resource. A total of 115 agencies (68%) responded to a standardized survey mailed to 170 Ohio agencies. Most (68%) agencies agreed that emergency and disaster response planning was important to their organization, although only 13% of agencies had completed a written emergency and disaster response plan. The majority (80%) of agencies indicated they would provide critical resources in an emergency or disaster in their community. Only 38 (33%) of the responding agencies were aware of the PETS Act of 2006. Although many agencies indicated the importance of an emergency and disaster plan, there may be insufficient resources, including time and proper training, available to ensure plans are developed. Improved coordination among veterinarians, local veterinary medical associations, emergency preparedness agencies, and animal shelters would enhance the relief efforts in a crisis.

  4. Emergency preparedness training preferences and perceived barriers to training among various healthcare providers and public health practitioners in Massachusetts.

    PubMed

    Broach, John; Smith, Mary-Elise

    2017-01-01

    Emergency preparedness training is vital to a wide range of healthcare and public health disciplines. Although agencies may try to tailor their training efforts based on perceived need, the topics and methods of instruction may be misguided, resulting in wasted effort and poor participation in training events. The objective of this study was to understand in a rigorous way, the training preferences and barriers to training among practitioners in Massachusetts. In August 2013, the Massachusetts Department of Public Health distributed an online survey to health professionals in Massachusetts regarding their emergency preparedness training topic preferences and any perceived barriers and challenges associated with obtaining this training. A total of 796 healthcare and public health professionals responded to the survey and answered some or all of the questions asked. The results of the survey identified important differences in preference for some topics based on a provider's practice location and discipline. However, Community Recovery and Community Preparedness were seen as desirable by all disciplines with more than 80 percent of respondents rating each of these issues as being highly important. Barriers to training were also assessed. Time spent away from work was the most commonly identified barrier (77.41 percent). Travel distance and financial constraints were also rated highly with scores of 65.48 and 63.71 percent, respectively. This study demonstrates important areas of agreement with respect to desired training topics and points out areas where providers in different disciplines and from different geographic areas may have differing educational preferences. Even within the limitation of this investigation, we expect that this study will be a valuable tool for those attempting to effectively target emergency preparedness training and structure course offerings in ways that minimize the impact of barriers to training.

  5. The importance of evaluating metal exposure and predicting human health risks in urban-periurban environments influenced by emerging industry.

    PubMed

    Yousaf, Balal; Amina; Liu, Guijian; Wang, Ruwei; Imtiaz, Muhammad; Rizwan, Muhammad Shahid; Zia-Ur-Rehman, Muhammad; Qadir, Abdul; Si, Youbin

    2016-05-01

    The human population boom, urbanization and rapid industrialization have either directly or indirectly resulted in the serious environmental toxification of the soil-food web by metal exposure from anthropogenic sources in most of the developing industrialized world. The present study was conducted to analyze concentrations of Cd, Cr, Cu, Mn, Ni, Pb, and Zn in soil and vegetables in the urban-periurban areas influenced by emerging industry. Vegetables and their corresponding soil samples were collected and analyzed for heavy metals contents from six random sites. According to the results, the potential health risks from metals to the local communities were assessed by following the methodology described by the US-EPA. In general, the total non-carcinogenic risks were shown to be less than the limits set by the US-EPA. However, the potential risk of developing carcinogenicity in humans over a lifetime of exposure could be increased through the dietary intake of Cd, Cr and Ni. In some cases, Pb was also marginally higher than the safe level. It was concluded that some effective remedial approaches should be adopted to mitigate the risks of Cd, Cr, Ni and Pb in the study area because these metal levels have exceeded the safe limits for human health. However, new studies on gastrointestinal bioaccessibility in human are required to heighten our understanding about metals exposure and health risk assessment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Building a Better Trojan Horse: Emerging Army Roles in Joint Urban Operations

    DTIC Science & Technology

    2001-01-01

    Building a Better Trojan Horse : Emerging Army Roles in Joint Urban Operations A Monograph by MAJ Christopher H. Beckert Infantry, U.S. Army School...xx-xx-2000 to xx-xx-2000 5a. CONTRACT NUMBER 5b. GRANT NUMBER 4. TITLE AND SUBTITLE Building a Better Trojan Horse : Emerging Army Roles in Joint...TELEPHONE NUMBER International Area Code Area Code Telephone Number 703 767-9007 DSN 427-9007 2 Abstract BUILDING A BETTER TROJAN HORSE : EMERGING ARMY

  7. Appendicular robusticity and the paleobiology of modern human emergence.

    PubMed

    Trinkaus, E

    1997-11-25

    The emergence of modern humans in the Late Pleistocene, whatever its phylogenetic history, was characterized by a series of behaviorally important shifts reflected in aspects of human hard tissue biology and the archeological record. To elucidate these shifts further, diaphyseal cross-sectional morphology was analyzed by using cross-sectional areas and second moments of area of the mid-distal humerus and midshaft femur. The humeral diaphysis indicates a gradual reduction in habitual load levels from Eurasian late archaic, to Early Upper Paleolithic early modern, to Middle Upper Paleolithic early modern hominids, with the Levantine Middle Paleolithic early modern humans being a gracile anomalous outlier. The femoral diaphysis, once variation in ecogeographically patterned body proportions is taken into account, indicates no changes across the pre-30,000 years B.P. samples in habitual locomotor load levels, followed by a modest decrease through the Middle Upper Paleolithic.

  8. Selected emerging infectious diseases of squamata.

    PubMed

    Latney, La'toya V; Wellehan, James

    2013-05-01

    It is important that reptile clinicians have an appreciation for the epidemiology, clinical signs, pathology, diagnostic options, and prognostic parameters for novel and emerging infectious diseases in squamates. This article provides an update on emerging squamate diseases reported in the primary literature within the past decade. Updates on adenovirus, iridovirus, rhabdovirus, arenavirus, and paramyxovirus epidemiology, divergence, and host fidelity are presented. A new emerging bacterial disease of Uromastyx species, Devriesea agamarum, is reviewed. Chrysosporium ophiodiicola-associated mortality in North American snakes is discussed. Cryptosporidium and pentastomid infections in squamates are highlighted among emerging parasitic infections. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013-2014.

    PubMed

    Roberts, Megan E; Doogan, Nathan J; Stanton, Cassandra A; Quisenberry, Amanda J; Villanti, Andrea C; Gaalema, Diann E; Keith, Diana R; Kurti, Allison N; Lopez, Alexa A; Redner, Ryan; Cepeda-Benito, Antonio; Higgins, Stephen T

    2017-10-01

    To examine urban-rural differences in US prevalences of traditional and emerging tobacco product use as well as dual or polytobacco use of these products. Our data were derived from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. We estimated weighted prevalences of adult tobacco use across urban-rural geographies and examined prevalences classified by gender, poverty level, and region of the country. Nationally, cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas. Conversely, cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas. There was no significant urban-rural difference in use of e-cigarettes. Gender, poverty, and region of the country did not seem to be driving most urban-rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates. Our findings highlight important urban-rural differences in tobacco use. Whether the changing tobacco product landscape will contribute to a continuation of rural health disparities remains to be seen.

  10. Emerging foodborne pathogens

    USDA-ARS?s Scientific Manuscript database

    The emergence of new foodborne pathogens is due to a number of factors. An important factor is the globalization of the food supply with the possibility of the introduction of foodborne pathogens from other countries. Animal husbandry, food production, food processing, and food distribution system...

  11. Hurricane-related emergency department visits in an inland area: an analysis of the public health impact of Hurricane Hugo in North Carolina.

    PubMed

    Brewer, R D; Morris, P D; Cole, T B

    1994-04-01

    To evaluate the public health impact of a hurricane on an inland area. Descriptive study. Seven hospital emergency departments. Patients who were treated from September 22 to October 6, 1989, for an injury or illness related to Hurricane Hugo. None. Over the two-week study period, 2,090 patients were treated for injuries or illnesses related to the hurricane. Of these, 1,833 (88%) were treated for injuries. Insect stings and wounds accounted for almost half of the total cases. A substantial proportion (26%) of the patients suffering from stings had a generalized reaction (eg, hives, wheezing, or both). Nearly one-third of the wounds were caused by chain saws. Hurricanes can lead to substantial morbidity in an inland area. Disaster plans should address risks associated with stinging insects and hazardous equipment and should address ways to improve case reporting.

  12. Development and feasibility testing of the Pediatric Emergency Discharge Interaction Coding Scheme.

    PubMed

    Curran, Janet A; Taylor, Alexandra; Chorney, Jill; Porter, Stephen; Murphy, Andrea; MacPhee, Shannon; Bishop, Andrea; Haworth, Rebecca

    2017-08-01

    Discharge communication is an important aspect of high-quality emergency care. This study addresses the gap in knowledge on how to describe discharge communication in a paediatric emergency department (ED). The objective of this feasibility study was to develop and test a coding scheme to characterize discharge communication between health-care providers (HCPs) and caregivers who visit the ED with their children. The Pediatric Emergency Discharge Interaction Coding Scheme (PEDICS) and coding manual were developed following a review of the literature and an iterative refinement process involving HCP observations, inter-rater assessments and team consensus. The coding scheme was pilot-tested through observations of HCPs across a range of shifts in one urban paediatric ED. Overall, 329 patient observations were carried out across 50 observational shifts. Inter-rater reliability was evaluated in 16% of the observations. The final version of the PEDICS contained 41 communication elements. Kappa scores were greater than .60 for the majority of communication elements. The most frequently observed communication elements were under the Introduction node and the least frequently observed were under the Social Concerns node. HCPs initiated the majority of the communication. Pediatric Emergency Discharge Interaction Coding Scheme addresses an important gap in the discharge communication literature. The tool is useful for mapping patterns of discharge communication between HCPs and caregivers. Results from our pilot test identified deficits in specific areas of discharge communication that could impact adherence to discharge instructions. The PEDICS would benefit from further testing with a different sample of HCPs. © 2017 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  13. 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.

  14. Consensus statement on advancing research in emergency department operations and its impact on patient care.

    PubMed

    Yiadom, Maame Yaa A B; Ward, Michael J; Chang, Anna Marie; Pines, Jesse M; Jouriles, Nick; Yealy, Donald M

    2015-06-01

    The consensus conference on "Advancing Research in Emergency Department (ED) Operations and Its Impact on Patient Care," hosted by The ED Operations Study Group (EDOSG), convened to craft a framework for future investigations in this important but understudied area. The EDOSG is a research consortium dedicated to promoting evidence-based clinical practice in emergency medicine. The consensus process format was a modified version of the NIH Model for Consensus Conference Development. Recommendations provide an action plan for how to improve ED operations study design, create a facilitating research environment, identify data measures of value for process and outcomes research, and disseminate new knowledge in this area. Specifically, we call for eight key initiatives: 1) the development of universal measures for ED patient care processes; 2) attention to patient outcomes, in addition to process efficiency and best practice compliance; 3) the promotion of multisite clinical operations studies to create more generalizable knowledge; 4) encouraging the use of mixed methods to understand the social community and human behavior factors that influence ED operations; 5) the creation of robust ED operations research registries to drive stronger evidence-based research; 6) prioritizing key clinical questions with the input of patients, clinicians, medical leadership, emergency medicine organizations, payers, and other government stakeholders; 7) more consistently defining the functional components of the ED care system, including observation units, fast tracks, waiting rooms, laboratories, and radiology subunits; and 8) maximizing multidisciplinary knowledge dissemination via emergency medicine, public health, general medicine, operations research, and nontraditional publications. © 2015 by the Society for Academic Emergency Medicine.

  15. Low-acuity presentations to regional emergency departments: What is the issue?

    PubMed

    Cheek, Colleen; Allen, Penny; Shires, Lizzi; Parry, Denise; Ruigrok, Marielle

    2016-04-01

    To explore GP-referrals and self-referrals to EDs and factors associated with patients seeking low-acuity care at ED. Retrospective analysis of all ED presentations to Mersey Community Hospital and North West Regional Hospital (Tasmania) between 1 January 2009 and 31 December 2013. Cross-sectional survey of patients presenting to the EDs for care triaged as low-acuity. There were 255,365 ED presentations in the retrospective data: 11,252 (4.4%) GP-referrals and 218,205 (85.4%) self-referrals. At ED 49% of GP-referrals were triaged ATS 4 or 5 and 35% of self-referrals were triaged ATS 1-3. There were 138 (84.2%) low-acuity patients who completed the survey; predominantly, all attended for acute injury or illness. Single point-of-care convenience was most commonly selected (71%) as a reason for attending ED. Over 85% of patients who seek emergency care in this region self-refer, so understanding health-seeking behaviour is important. Most low-acuity patients are acutely injured or unwell, and the decision to go to ED is based on their perception of accessibility of expertise aligned with their need. The term 'GP-type' is misleading in this context and should not be used. Providing low-acuity care in parallel with providing a specialised emergency service meets the needs of the local community and is likely to be the lowest cost model in a regional and rural area. Funding models must reflect the actual cost of delivering this important service rather than presentation types. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  16. The Importance of the Assistant Principal.

    ERIC Educational Resources Information Center

    Landmeier, Ralph W.

    Because of the difficulty of current and emerging school problems, the assistant principal needs to be knowledgeable in such diverse areas as accounting, school finance, school law, student rights, book censorship, and women's equity. In addition, it is necessary that the assistant principal be involved in curriculum improvement, evaluations,…

  17. Acanthamoeba keratitis: an emerging disease gathering importance worldwide?

    PubMed

    Lorenzo-Morales, Jacob; Martín-Navarro, Carmen María; López-Arencibia, Atteneri; Arnalich-Montiel, Francisco; Piñero, José E; Valladares, Basilio

    2013-04-01

    Acanthamoeba keratitis (AK) is increasingly being recognized as a severe sight-threatening ocular infection worldwide. Although contact lens wear is the leading risk factor for AK, Acanthamoeba parasites are also an important cause of keratitis in non-contact lens wearers. Diagnosis of AK is challenging, and the available treatments are lengthy and not fully effective against all strains. The pathogenesis of Acanthamoeba is still under study, and the identification of the key factors involved in this process should be useful for the development of fully effective therapies. This review focuses on recent developments on AK pathogenesis and diagnosis as well as novel strategies for the evaluation of anti-amoebic agents that could be applied in the near future against these pathogens. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Relative importance of fuel management, ignition management and weather for area burned: Evidence from five landscape-fire-succession models

    Treesearch

    Geoffrey J. Cary; Mike D. Flannigan; Robert E. Keane; Ross A. Bradstock; Ian D. Davies; James M. Lenihan; Chao Li; Kimberley A. Logan; Russell A. Parsons

    2009-01-01

    The behaviour of five landscape fire models (CAFE, FIRESCAPE, LAMOS(HS), LANDSUM and SEMLAND) was compared in a standardised modelling experiment. The importance of fuel management approach, fuel management effort, ignition management effort and weather in determining variation in area burned and number of edge pixels burned (a measure of potential impact on assets...

  19. Environment and Spatial Influences on Aquatic Insect Communities in Cerrado Streams: the Relative Importance of Conductivity, Altitude, and Conservation Areas.

    PubMed

    Godoy, B S; Queiroz, L L; Lodi, S; Oliveira, L G

    2017-04-01

    The aquatic insect community is an important element for stream functionality and diversity, but the effects of altitude and conservation areas on the aquatic insect community have been poorly explored in neotropical ecozone. The lack of studies about the relative importance of space and environment on community structure is another obstacle within aquatic insect ecology, which precludes the inclusion of these studies in more current frameworks, like the metacommunity dynamics. We evaluated the relationship between the aquatic insect community structure at 19 streams in the Brazilian Cerrado and spatial and environmental variables, namely geographical distance among sites, stream altitude, chemical variables, and environmental protection areas. We partitioned the variance explained by spatial and environmental components using a partial redundancy analysis. The environment exhibited a strong spatial structure for abundance and number of genera, increasing these community parameters with elevated water conductivity. Only community composition had a large unexplained portion of variance, with a small portion constrained by environmental (altitude and conductivity) and spatial factors. A relevant point in the result was the streams with high conductivity were located outside of the conservation areas. These results suggest that the relationship between number of genera and abundance with environmental conditions is always associated with spatial configuration of streams. Our study shows that altitude is an important determinant of community structure, as it exerts indirect influences, and electrical conductivity directly determines community composition, and that some national parks may be inefficient in maintaining the diversity of aquatic insects in the Cerrado region.

  20. Social network and census tract-level influences on substance use among emerging adult males: An activity spaces approach

    PubMed Central

    Gibson, Crystal; Perley, Lauren; Bailey, Jonathan; Barbour, Russell; Kershaw, Trace

    2015-01-01

    Social network and area level characteristics have been linked to substance use. We used snowball sampling to recruit 90 predominantly African American emerging adult men who provided typical locations visited (n=510). We used generalized estimating equations to examine social network and area level predictors of substance use. Lower social network quality was associated with days of marijuana use (B=-0.0037, p<0.0001) and problem alcohol use (B=-0.0050, p=0.0181). The influence of area characteristics on substance use differed between risky and non-risky spaces. Peer and area influences are important for substance use among men, and may differ for high and low risk places. PMID:26176810

  1. A study of satellite emergency locator systems

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Satellite emergency locator systems were studied. The objective of the study was to determine the feasibility and hardware requirements for satellite systems capable of identifying and locating the position emergency locator transmitters and emergency position indicating radio beacons. Both geosynchronous and near-polar-orbiting satellites were considered. One of the most important aspects of the study was to minimize the cost of the hardware required.

  2. Committee Opinion No 707: Access to Emergency Contraception.

    PubMed

    2017-07-01

    Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

  3. Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations.

    PubMed

    Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R

    2017-11-01

    Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2014-12-01

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

  5. Inflight medical emergencies.

    PubMed

    Lyznicki, J M; Williams, M A; Deitchman, S D; Howe, J P

    2000-08-01

    This report responds to resolutions asking the American Medical Association (AMA) to develop recommendations for the use of medical equipment and technology onboard commercial airlines. Information for the report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with experts in aerospace and emergency medicine. Based on this information, the AMA Council on Scientific Affairs determined that, while inflight morbidity and mortality are uncommon, serious events do occur, which require immediate emergency care. Management of serious problems requires an integrated emergency response system that ensures rapid notification of medical personnel on the ground, assistance from appropriately trained flight crews and passenger volunteers (if available), and adequate medical supplies and equipment to stabilize the victim. Physicians have an important role in the preflight evaluation and counseling of potential passengers who are at risk of inflight medical complications, and in providing inflight medical assistance. Some U.S. and foreign air carriers are upgrading inflight emergency medical kits and placing automated external defibrillators aboard aircraft. Few data are available regarding the effectiveness of such improvements in improving health or survival outcomes. Recent federal legislation requires assessment of the extent of inflight medical emergencies, including the adequacy of emergency medical supplies and equipment carried onboard commercial airliners. This legislation also should alleviate liability concerns by providing immunity for physicians and others who render inflight medical assistance.

  6. Emergency Vehicle Siren Noise Effectiveness

    NASA Astrophysics Data System (ADS)

    D'Angela, Peter

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

  7. An exploration of emergency nurses' perceptions, attitudes and experience of teamwork in the emergency department.

    PubMed

    Grover, Elise; Porter, Joanne E; Morphet, Julia

    2017-05-01

    Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim. Transcripts were analysed using thematic analysis. Three major themes emerged from the data. The first theme 'when teamwork works' supported the notion that emergency nurses perceived teamwork as a positive and effective construct in four key areas; resuscitation, simulation training, patient outcomes and staff satisfaction. The second theme 'team support' revealed that back up behaviour and leadership were critical elements of team effectiveness within the study setting. The third theme 'no time for teamwork' centred around periods when teamwork practices failed due to various contributing factors including inadequate resources and skill mix. Outcomes of effective teamwork were valued by emergency nurses. Teamwork is about performance, and requires a certain skill set not necessarily naturally possessed among emergency nurses. Building a resilient team inclusive of strong leadership and communication skills is essential to being able to withstand the challenging demands of the ED. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  8. Emerging issues, challenges, and changing epidemiology of fungal disease outbreaks.

    PubMed

    Benedict, Kaitlin; Richardson, Malcolm; Vallabhaneni, Snigdha; Jackson, Brendan R; Chiller, Tom

    2017-12-01

    Several high-profile outbreaks have drawn attention to invasive fungal infections (IFIs) as an increasingly important public health problem. IFI outbreaks are caused by many different fungal pathogens and are associated with numerous settings and sources. In the community, IFI outbreaks often occur among people without predisposing medical conditions and are frequently precipitated by environmental disruption. Health-care-associated IFI outbreaks have been linked to suboptimal hospital environmental conditions, transmission via health-care workers' hands, contaminated medical products, and transplantation of infected organs. Outbreak investigations provide important insights into the epidemiology of IFIs, uncover risk factors for infection, and identify opportunities for preventing similar events in the future. Well recognised challenges with IFI outbreak recognition, response, and prevention include the need for improved rapid diagnostic methods, the absence of routine surveillance for most IFIs, adherence to infection control practices, and health-care provider awareness. Additionally, IFI outbreak investigations have revealed several emerging issues, including new populations at risk because of travel or relocation, occupation, or immunosuppression; fungal pathogens appearing in geographical areas in which they have not been previously recognised; and contaminated compounded medications. This report highlights notable IFI outbreaks in the past decade, with an emphasis on these emerging challenges in the USA. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. 48 CFR 26.202 - Local area preference.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Local area preference. 26... PROGRAMS OTHER SOCIOECONOMIC PROGRAMS Disaster or Emergency Assistance Activities 26.202 Local area... feasible and practicable, to local firms. Preference may be given through a local area set-aside or an...

  10. 48 CFR 26.202 - Local area preference.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Local area preference. 26... PROGRAMS OTHER SOCIOECONOMIC PROGRAMS Disaster or Emergency Assistance Activities 26.202 Local area... feasible and practicable, to local firms. Preference may be given through a local area set-aside or an...

  11. Development of a competency framework for the nutrition in emergencies sector.

    PubMed

    Meeker, Jessica; Perry, Abigail; Dolan, Carmel; Emary, Colleen; Golden, Kate; Abla, Caroline; Walsh, Anne; Maclaine, Ali; Seal, Andrew

    2014-03-01

    There is a recognised need to strengthen capacity in the nutrition in emergencies sector and for greater clarity on the role of emergency nutritionists and the skills they require. Competency frameworks are an important tool for human resource development and have been developed for several other humanitarian sectors. We therefore developed a technical competency framework for practitioners in nutrition in emergencies. Existing competency frameworks were reviewed and interviews conducted to explore methods used in developing competency frameworks for other sectors. Competencies were identified through interviews with field experts, feedback from course trainees, academic course content and job specifications. Competencies were then categorised and behavioural indicators developed for each. The draft framework was then reviewed by members of the Global Nutrition Cluster and modified in an iterative process. Global. Not applicable. A wide range of competencies were identified as essential for nutritionists working in emergencies, covering technical skills and general core competencies. The proposed framework contains twenty competency areas with 161 behavioural indicators categorised into three levels, corresponding to the requirements of progressively more senior roles. Many of the competencies are common across development and emergency nutrition. The proposed technical competency framework should prove to be a valuable tool in creating standards within the sector and promoting effective capacity strengthening and professionalisation. Continued research is needed to validate the framework, optimise methods for assessment, develop approaches to integrate it within the sector and measure its impact on performance.

  12. Delivering quality care: what can emergency gynaecology learn from acute obstetrics?

    PubMed

    Bika, O H; Edozien, L C

    2014-08-01

    Emergency obstetric care in the UK has been systematically developed over the years to high quality standards. More recently, advances have been made in the organisation and delivery of care for women presenting with acute gynaecological problems, but a lot remains to be done, and emergency gynaecology has a lot to learn from the evolution of its sister special interest area: acute obstetric care. This paper highlights areas such as consultant presence, risk management, patient flow pathways, out-of-hours care, clinical guidelines and protocols, education and training and facilities, where lessons from obstetrics are transferrable to emergency gynaecology.

  13. Lyme Disease: Emergency Department Considerations.

    PubMed

    Applegren, Nathan D; Kraus, Chadd K

    2017-06-01

    Lyme disease (LD) is the most common vector-borne illness in North America. Reported cases of LD have increased from approximately 10,000 cases annually in 1991 to >25,000 cases in 2014. Greater recognition, enhanced surveillance, and public education have contributed to the increased prevalence, as have geographic expansion and the number of infected ticks. Cases are reported primarily in the Northeastern United States, Wisconsin, and Minnesota, with children having the highest incidence of LD among all age groups. The increased incidence and prevalence of LD in the United States makes it increasingly more common for patients to present to the emergency department (ED) for tick bites and LD-related chief complaints, such as the characteristic erythema migrans skin manifestation. We sought to review the etiology of LD, describe its clinical presentations and sequela, and provide a practical classification and approach to ED management of patients with LD-related presentations. In this review, ED considerations for LD are presented and clinical presentations and management of the disease at different stages is discussed. Delayed sequelae that have significant morbidity, including Lyme carditis and Lyme neuroborreliosis, are discussed. Diagnostic tests and management are described in detail. The increasing prevalence and growing geographic reach of Lyme disease makes it critically important for emergency physicians to consider the diagnosis in patients presenting with symptoms suggestive of LD and to initiate appropriate treatment to minimize the potential of delayed sequelae. Special consideration should be made for the epidemiology of LD and a high clinical suspicion should be present for patients in endemic areas or with known exposures to ticks. Emergency physicians can play a critical role in the recognition, diagnosis, and treatment of LD. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Family needs of critically ill patients in the emergency department.

    PubMed

    Hsiao, Ping-Ru; Redley, Bernice; Hsiao, Ya-Chu; Lin, Chun-Chih; Han, Chin-Yen; Lin, Hung-Ru

    2017-01-01

    Family members' experience a range of physiological, psychological and emotional impacts when accompanying a critically ill relative in the emergency department. Family needs are influenced by their culture and the context of care, and accurate clinician understanding of these needs is essential for patient- and family-centered care delivery. The aim of this study was to describe the needs of Taiwanese family members accompanying critically ill patients in the emergency department while waiting for an inpatient bed and compare these to the perceptions of emergency nurses. A prospective cross-sectional survey was conducted in a large medical center in Taiwan. Data were collected from 150 family members and 150 emergency nurses who completed a Chinese version of the Critical Care Family Needs Inventory. Family members ranked needs related to 'communication with family members,' as most important, followed by 'family member participation in emergency department care', 'family member support' and 'organizational comfort'; rankings were similar to those of emergency nurses. Compared to nurses, family members reported higher scores for the importance of needs related to 'communication with family members' and 'family members' participation in emergency department care'. Family members place greater importance than emergency nurses on the need for effective communication. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Causes and outcomes of emergency presentation of rectal cancer.

    PubMed

    Comber, Harry; Sharp, Linda; de Camargo Cancela, Marianna; Haase, Trutz; Johnson, Howard; Pratschke, Jonathan

    2016-09-01

    Emergency presentation of rectal cancer carries a relatively poor prognosis, but the roles and interactions of causative factors remain unclear. We describe an innovative statistical approach which distinguishes between direct and indirect effects of a number of contextual, patient and tumour factors on emergency presentation and outcome of rectal cancer. All patients diagnosed with rectal cancer in Ireland 2004-2008 were included. Registry information, linked to hospital discharge data, provided data on patient demographics, comorbidity and health insurance; population density and deprivation of area of residence; tumour type, site, grade and stage; treatment type and optimality; and emergency presentation and hospital caseload. Data were modelled using a structural equation model with a discrete-time survival outcome, allowing us to estimate direct and mediated effects of the above factors on hazard, and their inter-relationships. Two thousand seven hundred and fifty patients were included in the analysis. Around 12% had emergency presentations, which increased hazard by 80%. Affluence, private patient status and being married reduced hazard indirectly by reducing emergency presentation. Older patients had more emergency presentations, while married patients, private patients or those living in less deprived areas had fewer than expected. Patients presenting as an emergency were less likely to receive optimal treatment or to have this in a high caseload hospital. Apart from stage, emergency admission was the strongest determinant of poor survival. The factors contributing to emergency admission in this study are similar to those associated with diagnostic delay. The socio-economic gradient found suggests that patient education and earlier access to endoscopic investigation for public patients could reduce emergency presentation. © 2016 UICC.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  17. The Importance and Justifications for Astronomy Teaching: A Look at the Researches on the Area

    NASA Astrophysics Data System (ADS)

    Soler, D. R.; Leite, C.

    2013-08-01

    Many researchers in Astronomy Teaching often refer to Astronomy as an object of great curiosity. In this paper, we will present a survey concerning the importance and justifications researchers have given to Astronomy Teaching. In a universe of 180 papers about Astronomy Teaching, found in periodicals from the areas of Science, Physics and Astronomy Teaching in the last decade, in 29 of them, discussions about the importance or justifications to Astronomy Teaching were found. As the main result of this work, all the elements related to the importance and the justification for the Astronomy Teaching were organized and grouped in four categories of analysis, which indicate the nature of the justifications presented by the authors: Awakening of feelings and curiosities; Socio-historic-cultural relevance; World view and awareness expansion and Interdisciplinarity. In each category, related elements were grouped. By doing so, we could produce an articulation among the elements taken from different papers, matching them in a way that enabled us to obtain new inferences not individually present in any of the papers. Furthermore, when all the research was analyzed, it was also revealed that there were no papers that aimed at the investigation of the importance and justifications for Astronomy Teaching. It was still noticed that, in general, when researchers invoke the interdisciplinary character of Astronomy, they make it superficially. Since the researches do not show how they get the idea presented to the justifications for teaching Astronomy, some questions could have surfaced, such as: would it be possible to exist a kind of “common sense” for teaching and disseminating Astronomy that would make researchers understand Astronomy as a differential science? Would the "born interest" in Astronomy - pointed by some people - be something real? Does Astronomy really differ from other sciences?

  18. Emergency medicine in the developing world: a Delphi study.

    PubMed

    Hodkinson, Peter W; Wallis, Lee A

    2010-07-01

    Emergency medicine (EM) as a specialty has developed rapidly in the western world, but remains largely immature in developing nations. There is an urgent need for emergency services, but no clear guidelines are available on the priorities for establishing EM in the developing world. This study seeks to establish consensus on key areas of EM development in developing world settings, with respect to scope of EM, staffing needs, training requirements, and research priorities. A three-round Delphi study was conducted via e-mail. A panel was convened of 50 EM specialists or equivalent, with experience in or interest in EM in the developing world. In the first round, panelists provided free-text statements on scope, staffing, training, and research priorities for EM in the developing world. A five-point Likert scale was used to rate agreement with the statements in Rounds 2 and 3. Consensus statements are presented as a series of synopsis statements for each of the four major themes. A total of 168 of 208 statements (81%) had reached consensus at the end of the study. Key areas in which consensus was reached included EM being a specialist-driven service, with substantial role for nonphysicians. International training courses should be adapted to local needs. EM research in developing countries should be clinically driven and focus on local issues of importance. The scope and function of EM and relationships with other specialties are defined. Unambiguous principles are laid out for the development of the specialty in developing world environments. The next step required in this process is translation into practical guidelines for the development of EM in developing world settings where they may be used to drive policy, protocols, and research. 2010 by the Society for Academic Emergency Medicine

  19. [Emergency contraception in Latin America and the Caribbean].

    PubMed

    Martin, Antonieta

    2004-12-01

    Introducing the post-coital birth control method in the family-planning services of Latin American countries has not been an easy task. Catholic and other conservative groups with great influence in the political arena have time and again stopped it from being adopted as an alternative method and have even succeeded in having it removed from official directives after formal acceptance by health authorities. The main objections are triggered by the erroneous supposition that "emergency contraception" pills are abortifacients. However, a large dose of cultural discrimination against women seems also to be involved. It has been extremely difficult to register dedicated products and make them available in drug-stores and even more difficult to distribute them without charge at public health centers. They are hard to find, expensive, and unavailable to adolescents at risk for unwanted pregnancies and to most low-income women, especially in rural areas. Dissemination of appropriate information has been scarce and slow and there are still great numbers of people that do not understand how or why the method works. Brazil has been the only exception, as its open society has readily accepted this method of contraception. The Latin American Consortium on Emergency Contraception founded in the year 2000 and its regional conference two years later had an important impact on the situation, as they encouraged the coordination of efforts by governmental and nongovernmental entities with those of women's groups to fight for sexual and reproductive rights. A number of studies have shown that the more people learn about emergency contraception, the more they find it acceptable and necessary, and radio spots and other media techniques have begun to educate the public about this matter. In spite of the many difficulties encountered, in the last few years several countries have made strides to include this method in their public health guidelines. However, because of the powerful forces

  20. The attitudes and awareness of emergency department (ED) physicians towards the management of common dentofacial emergencies.

    PubMed

    Trivedy, Chetan; Kodate, Naonori; Ross, Alastair; Al-Rawi, Harrith; Jaiganesh, Thiagarajan; Harris, Tim; Anderson, Janet E

    2012-04-01

    Dentofacial emergencies are a common presentation to the emergency department (ED) but there is little recent data on physicians' knowledge, confidence and attitudes in handling these cases. A questionnaire was administered to 103 ED physicians. The sample was primarily drawn from London hospitals as well a smaller contribution from around the UK and included physicians with a range of experience and at different grades. The majority of the 102 participants (76.5%) did not receive any formal training in managing dentofacial emergencies. The percentage of participants who were happy to manage common dentofacial emergencies is as follows: dental trauma (20.4%); major facial trauma (39.8%); interpreting facial X-rays (68.0%); and facial suturing (85.4%). When questioned 12.1% of the participants felt that ED physicians should be responsible for managing dental emergencies compared to 22.4% who felt that ED physicians should manage maxillofacial emergencies. Only 3.9% of the participants would opt to be treated by an ED doctor in the event of them presenting to the ED with a dental injury. The remaining 72.5% would prefer to be seen by a maxillofacial surgeon, 23.5% by a dentist and none of the participants opted to be seen by the emergency nurse practitioner. ED physicians do not feel confident in managing some dentofacial emergencies. This may be attributed to a lack of training in this area as well as exposure to these types of emergencies. There is a need for greater awareness, validated guidelines and training resources for ED physicians to treat dentofacial emergencies as well more research in this field of emergency medicine. © 2011 John Wiley & Sons A/S.

  1. The Important Bird Areas Program in the United States: building a network of sites for conservation, state by state

    Treesearch

    Jeffrey V. Wells; Daniel K. Niven; John Cecil

    2005-01-01

    The Important Bird Area (IBA) program is an international effort to identify, conserve, and monitor a network of sites that provide essential habitat for bird populations. BirdLife International began the IBA program in Europe in 1985. Since that time, BirdLife partners in more than 100 countries have joined together to build the global IBA network. Audubon (BirdLife...

  2. Emerging Leadership Experiences: A Study of Lived Leadership Origins

    ERIC Educational Resources Information Center

    Burgett, Michael J.

    2012-01-01

    This phenomenological study of the lived experience of leadership emergence was initiated to answer the question, "Where does leadership come from?" Leadership emergence was explored as the result of a nexus of contextual and structural influences. In response to these questions, a sample of leaders from a metropolitan area in a…

  3. 19 CFR 358.103 - Importation of supplies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Importation of supplies. 358.103 Section 358.103 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE SUPPLIES FOR USE IN EMERGENCY RELIEF WORK § 358.103 Importation of supplies. (a) Where the President, acting under section 318 of the...

  4. Board-certified emergency physicians comprise a minority of the emergency department workforce in iowa.

    PubMed

    Groth, Heather; House, Hans; Overton, Rachel; Deroo, Eric

    2013-03-01

    physicians, large areas of the state would be unable to provide adequate emergency care. Board-certified emergency physicians remain concentrated in urban areas of the state, where patient volumes and acuity support their hiring.

  5. Board-Certified Emergency Physicians Comprise a Minority of the Emergency Department Workforce in Iowa

    PubMed Central

    Groth, Heather; House, Hans; Overton, Rachel; DeRoo, Eric

    2013-01-01

    staffed by APPs. Without the contribution of family physicians, large areas of the state would be unable to provide adequate emergency care. Board-certified emergency physicians remain concentrated in urban areas of the state, where patient volumes and acuity support their hiring. PMID:23599868

  6. State Emergency Response and Field Observation Activities in California (USA) during the March 11, 2011, Tohoku Tsunami

    NASA Astrophysics Data System (ADS)

    Miller, K. M.; Wilson, R. I.; Goltz, J.; Fenton, J.; Long, K.; Dengler, L.; Rosinski, A.; California Tsunami Program

    2011-12-01

    This poster will present an overview of successes and challenges observed by the authors during this major tsunami response event. The Tohoku, Japan tsunami was the most costly to affect California since the 1964 Alaskan earthquake and ensuing tsunami. The Tohoku tsunami caused at least $50 million in damage to public facilities in harbors and marinas along the coast of California, and resulted in one fatality. It was generated by a magnitude 9.0 earthquake which occurred at 9:46PM PST on Thursday, March 10, 2011 in the sea off northern Japan. The tsunami was recorded at tide gages monitored by the West Coast/Alaska Tsunami Warning Center (WCATWC), which projected tsunami surges would reach California in approximately 10 hours. At 12:51AM on March 11, 2011, based on forecasted tsunami amplitudes, the WCATWC placed the California coast north of Point Conception (Santa Barbara County) in a Tsunami Warning, and the coast south of Point Conception to the Mexican border in a Tsunami Advisory. The California Emergency Management Agency (CalEMA) activated two Regional Emergency Operation Centers (REOCs) and the State Operation Center (SOC). The California Geological Survey (CGS) deployed a field team which collected data before, during and after the event through an information clearinghouse. Conference calls were conducted hourly between the WCATWC and State Warning Center, as well as with emergency managers in the 20 coastal counties. Coordination focused on local response measures, public information messaging, assistance needs, evacuations, emergency shelters, damage, and recovery issues. In the early morning hours, some communities in low lying areas recommended evacuation for their citizens, and the fishing fleet at Crescent City evacuated to sea. The greatest damage occurred in the harbors of Crescent City and Santa Cruz. As with any emergency, there were lessons learned and important successes in managing this event. Forecasts by the WCATWC were highly accurate

  7. Disaster Emergency Rapid Assessment Based on Remote Sensing and Background Data

    NASA Astrophysics Data System (ADS)

    Han, X.; Wu, J.

    2018-04-01

    The period from starting to the stable conditions is an important stage of disaster development. In addition to collecting and reporting information on disaster situations, remote sensing images by satellites and drones and monitoring results from disaster-stricken areas should be obtained. Fusion of multi-source background data such as population, geography and topography, and remote sensing monitoring information can be used in geographic information system analysis to quickly and objectively assess the disaster information. According to the characteristics of different hazards, the models and methods driven by the rapid assessment of mission requirements are tested and screened. Based on remote sensing images, the features of exposures quickly determine disaster-affected areas and intensity levels, and extract key disaster information about affected hospitals and schools as well as cultivated land and crops, and make decisions after emergency response with visual assessment results.

  8. Emergency response health physics.

    PubMed

    Mena, Rajah; Pemberton, Wendy; Beal, William

    2012-05-01

    Health physics is an important discipline with regard to understanding the effects of radiation on human health. This paper aims to illustrate the unique challenges presented to the health physicist or analyst of radiological data in a large-scale emergency.

  9. Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study.

    PubMed

    Balikuddembe, Joseph Kimuli; Ardalan, Ali; Khorasani-Zavareh, Davoud; Nejati, Amir; Raza, Owais

    2017-10-03

    Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims' pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions respectively. Data was descriptively analyzed, and after the principal component analysis was employed to identify the most influential weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTI in the GKMA. From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 2016, 4 and 5 key weaknesses and capacities respectively were identified to affect the pre-hospital emergency care for RTI victims in the GKMA. Although some strengths exist like ambulance facilitation, EMS structuring, coordination and others), the key weaknesses affecting the pre-hospital care for victims were noted to relate to absence of predefined EMS systems particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment; insufficient skills/training of the first responders; inadequate EMS resources; and avoidable delays to respond and transport RTI victims to medical facilities. Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.

  10. DRINKING WATER TURBIDITY AND EMERGENCY DEPARTMENT VISITS FOR GASTROINTESTINAL ILLNESS IN ATLANTA, 1993 – 2004

    PubMed Central

    Tinker, Sarah C.; Moe, Christine L.; Klein, Mitchel; Flanders, W. Dana; Uber, Jim; Amirtharajah, Appiah; Singer, Philip; Tolbert, Paige E.

    2013-01-01

    Background The extent to which drinking water turbidity measurements indicate the risk of gastrointestinal illness is not well-understood. Despite major advances in drinking water treatment and delivery, infectious disease can still be transmitted through drinking water in the U.S., and it is important to have reliable indicators of microbial water quality to inform public health decisions. The objective of our study was to assess the relationship between gastrointestinal illness, quantified through emergency department visits, and drinking water quality, quantified as raw water and filtered water turbidity measured at the treatment plant. Methods We examined the relationship between turbidity levels of raw and filtered surface water measured at eight major drinking water treatment plants in the metropolitan area of Atlanta, Georgia, and over 240 000 emergency department visits for gastrointestinal illness during 1993–2004 among the population served by these plants. We fit Poisson time-series statistical regression models that included turbidity in a 21-day distributed lag and that controlled for meteorological factors and long-term time trends. Results For filtered water turbidity, the results were consistent with no association with emergency department visits for gastrointestinal illness. We observed a modest association between raw water turbidity and emergency department visits for gastrointestinal illness. This association was not observed for all treatment plants in plant-specific analyses. Conclusions Our results suggest that source water quality may contribute modestly to endemic gastrointestinal illness in the study area. The association between turbidity and emergency department visits for gastrointestinal illness was only observed when raw water turbidity was considered; filtered water turbidity may not serve as a reliable indicator of modest pathogen risk at all treatment plants. PMID:18941478

  11. Off-site Emergency Planning at UK Nuclear Licensed Sites.

    PubMed

    Leonard, Paul; Thomas, Gareth

    2017-04-01

    Nuclear emergency planning arrangements in the UK are continually kept under review. This work proposes to outline how experience from nuclear exercises and undertaking emergency response duties can be based on radiological knowledge of specific sites and utilised in the future. In 2014, the UK regulator, the Office for Nuclear Regulation (ONR) revised their principles for the determination of off-site emergency planning areas around nuclear sites where predetermined countermeasures and other protection measures are applied to protect those people who may be affected by a radiation emergency. The revised principles also enhanced communication from the nuclear site operators and local authorities to the public. This updated ONR's application of the UK Radiation (Emergency Preparedness and Public Information) Regulations 2001 (REPPIR) http://www.hse.gov.uk/radiation/ionising/reppir.htm, which includes details of minimising potential doses to the public, as well as assessment and reassurance, linked to other concurrent risks such as flooding. ONR undertakes site-specific assessments of each operators' hazard identification and risk evaluation, which include consideration of whether the public might receive a significant radiation dose in the year following the emergency (excluding countermeasures in the first 24 hours). In defining the areas for off-site emergency planning, practical and strategic factors are then considered, which include other local non-nuclear emergency planning arrangements and experience, and whether local geographic and demographic aspects could aid public credibility and confidence. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Paediatric emergency and acute care in resource poor settings.

    PubMed

    Duke, Trevor; Cheema, Baljit

    2016-02-01

    Acute care of seriously ill children is a global public health issue, and there is much scope for improving quality of care in hospitals at all levels in many developing countries. We describe the current state of paediatric emergency and acute care in the least developed regions of low and middle income countries and identify gaps and requirements for improving quality. Approaches are needed which span the continuum of care: from triage and emergency treatment, the diagnostic process, identification of co-morbidities, treatment, monitoring and supportive care, discharge planning and follow-up. Improvements require support and training for health workers and quality processes. Effective training is that which is ongoing, combining good technical training in under-graduate courses and continuing professional development. Quality processes combine evidence-based guidelines, essential medicines, appropriate technology, appropriate financing of services, standards and assessment tools and training resources. While initial emergency treatment is based on common clinical syndromes, early differentiation is required for specific treatment, and this can usually be carried out clinically without expensive tests. While global strategies are important, it is what happens locally that makes a difference and is too often neglected. In rural areas in the poorest countries in the world, public doctors and nurses who provide emergency and acute care for children are revered by their communities and demonstrate daily that much can be carried out with little. © 2016 The Authors. Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  13. Highway Safety Program Manual: Volume 11: Emergency Medical Services.

    ERIC Educational Resources Information Center

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

    Volume 11 of the 19-volume Highway Safety Program Manual (which provides guidance to State and local governments on preferred highway safety practices) concentrates on emergency medical services. The purpose of the program, Federal authority in the area of medical services, and policies related to an emergency medical services (EMS) program are…

  14. Natural hazards in Slovene karst areas: Flood risk areas in the Upper Pivka valley

    NASA Astrophysics Data System (ADS)

    Ravbar, N.; Kovacic, G.

    2009-04-01

    An overview of exceptional natural processes or natural hazards from the human perspective in Slovene karst areas is made. Some types of natural hazards are typical for karst due to the process of karstification and resulting geomorphological and hydrological characteristics of karst landscapes (presence of voids within the rock, absence of superficial flow and presence of specific karst groundwater flow system), while the others occur evenly in all types of landscapes. However, their impact is different in karst as it is in the non-karst landscapes. Examples of particular phenomenon or events, their frequency of occurrence, expansion and caused damage are presented. Special emphasis is laid on high waters in karst poljes, shallow karst areas or contact karst, where flooding emerges due to the raise of karst groundwater table as a consequence of intensive precipitation or snowmelt. Flooding in karst can also appear due to insufficient swallow capacities of the underground channels, which are not capable of conducting surpluses of inflowing water. In opposite to flash floods, the karst floods are more predictable, since they usually occur in the same areas to the same elevation and in the same season of the year. Inhabitants are easily adapted to this phenomenon, setting the settlements and other important infrastructure on elevations above the highest recorded water level. Usually such flooding does not pose serious threat and causes no serious flood damage, except during extreme events, as it was in the case of the autumn 2000 floods. Case study of the Upper Pivka valley, where floods usually cover around 6.6 km2, is treated and explained. During the intensive rain period from September to November 2000, the groundwater table rose for about 20-35 m above the usual level, causing flooding also in the areas, where they have never been recorded before. Precise mapping of the flooded area extents in the discussed area and the height of the water levels was performed

  15. Investigation on legal problems encountered by emergency medicine physicians in Turkey.

    PubMed

    Kayipmaz, Afsin Emre; Kavalci, Cemil; Gulalp, Betul; Kocalar, Ummu Gulsum; Giray, Tufan Akin; Yesilagac, Hasan; Ozel, Betul Akbuga; Celikel, Elif; Karagun, Ozlem

    2015-01-01

    Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases. An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant. 294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments. We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and periodical reviews might

  16. Hyalomma anatolicum as the Main Infesting Tick in an Important Livestock Rearing Region, Central Area of Iran.

    PubMed

    Biglari, Peyvand; Bakhshi, Hasan; Chinikar, Sadegh; Belqeiszadeh, Hamid; Ghaffari, Masoud; Javaherizadeh, Siavash; Faghihi, Faezeh; Telmadarraiy, Zakkyeh

    2018-05-01

    This study was carried out to determine the infestation of domestic ruminants to ticks in an important livestock-rearing region, located in central part of Iran. Ticks were collected from cattle, sheep, and goats and then were identified with appropriate identification keys to species level in two different ecological regions of plains and mountain in 4 seasons in 2015. Totally 492 ticks from cattle, sheep, and goats in 34 herds were collected. Totally, 18.53% of domestic animals were infected by ticks. All ticks were belonged to family Ixodidae and classified into three genera and six species comprising Hyalomma anatolicum (38.83%) , Hy. Asiaticum (23.37%), Hy. marginatum (2.85%), Hy. sp. (3.45%), Rhipicephalus sanguineus (14.02%) and Haemaphysalis sulcata (10.98%). Sex ratio of the collected specimens showed 241 (48.99%) male, 219 (44.51%) female and 32 (6.5%) nymph. Studied area is important for production of livestock and dairy products. Annually, many livestock products are exported to other parts from this region; therefore, it is very important to identify the infection rate of tick-borne diseases as well as safety factors on livestock.

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

    PubMed

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

    2016-08-01

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

  18. Coastal emergency managers' preferences for storm surge forecast communication.

    PubMed

    Morrow, Betty Hearn; Lazo, Jeffrey K

    2014-01-01

    Storm surge, the most deadly hazard associated with tropical and extratropical cyclones, is the basis for most evacuation decisions by authorities. One factor believed to be associated with evacuation noncompliance is a lack of understanding of storm surge. To address this problem, federal agencies responsible for cyclone forecasts are seeking more effective ways of communicating storm surge threat. To inform this process, they are engaging various partners in the forecast and warning process.This project focuses on emergency managers. Fifty-three emergency managers (EMs) from the Gulf and lower Atlantic coasts were surveyed to elicit their experience with, sources of, and preferences for storm surge information. The emergency managers-who are well seasoned in hurricane response and generally rate the surge risk in their coastal areas above average or extremely high-listed storm surge as their major concern with respect to hurricanes. They reported a general lack of public awareness about surge. Overall they support new ways to convey the potential danger to the public, including the issuance of separate storm surge watches and warnings, and the expression of surge heights using feet above ground level. These EMs would like more maps, graphics, and visual materials for use in communicating with the public. An important concern is the timing of surge forecasts-whether they receive them early enough to be useful in their evacuation decisions.

  19. [Monkey-pox, a model of emergent then reemergent disease].

    PubMed

    Georges, A J; Matton, T; Courbot-Georges, M C

    2004-01-01

    The recent emergence of monkey pox in the United States of America highlights the problem (known for other infectious agents) of dissemination of pathogens outside their endemic area, and of subsequent global threats of variable gravity according to agents. It is a real emergency since monkey pox had been confined to Africa for several decades, where small epidemics occurred from time to time, monkey pox is a "miniature smallpox" which, in Africa, evolves on an endemic (zoonotic) mode with, as reservoirs, several species of wild rodents (mainly squirrels) and some monkey species. It can be accidentally transmitted to man then develops as epidemics, sometimes leading to death. The virus was imported in 2003 in the United States of America, via Gambia rats and wild squirrels (all African species), and infected prairie dogs (which are now in fashion as pets), then crossed the species barrier to man. In the United States of America, screening campaigns, epidemiological investigations, and subsequent treatments led to a rapid control of the epidemic, which is a model of emergent disease for this country. Therapeutic and preventive measures directly applicable to monkey pox are discussed. They can also be applied against other pox virus infections (including smallpox). The risk of criminal introduction of pox viruses is discussed since it is, more than ever, a real worldwide threat.

  20. Phthalate esters (PAEs): emerging organic contaminants in agricultural soils in peri-urban areas around Guangzhou, China.

    PubMed

    Zeng, Feng; Cui, Kunyan; Xie, Zhiyong; Wu, Lina; Liu, Min; Sun, Guoquan; Lin, Yujun; Luo, Danling; Zeng, Zunxiang

    2008-11-01

    This study reports the first data on the concentrations and distribution of phthalate esters (PAEs) in the agricultural soils from the peri-urban areas of Guangzhou city. Sigma(16)PAEs concentrations ranged from 0.195 to 33.6 microg g(-1)-dry weight (dw). Elevated levels of PAEs were recorded in the vegetable fields located next to the urban districts, and a decreasing trend exists following the distance away from the urban center. Diisobutyl phthalate (DiBP), Di-n-butyl phthalate (DnBP), and Di(2-ethylhexyl) phthalate (DEHP) dominated the PAEs in the agricultural soils. Significant relationship (correlation coefficient R(2)=0.85, p<0.01, n=40) was present between the accumulation of PAEs and total organic carbons in agricultural soils. In addition, both pH and texture of soils are found to be important factors affecting the level of PAEs. This study shows that the agricultural soils in the peri-urban area of Guangzhou city were moderately polluted by PAEs.

  1. RTSTEP regional transportation simulation tool for emergency planning - final report.

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

    Ley, H.; Sokolov, V.; Hope, M.

    2012-01-20

    Large-scale evacuations from major cities during no-notice events - such as chemical or radiological attacks, hazardous material spills, or earthquakes - have an obvious impact on large regions rather than on just the directly affected area. The scope of impact includes the accommodation of emergency evacuation traffic throughout a very large area; the planning of resources to respond appropriately to the needs of the affected population; the placement of medical supplies and decontamination equipment; and the assessment and determination of primary escape routes, as well as routes for incoming emergency responders. Compared to events with advance notice, such as evacuationsmore » based on hurricanes approaching an affected area, the response to no-notice events relies exclusively on pre-planning and general regional emergency preparedness. Another unique issue is the lack of a full and immediate understanding of the underlying threats to the population, making it even more essential to gain extensive knowledge of the available resources, the chain of command, and established procedures. Given the size of the area affected, an advanced understanding of the regional transportation systems is essential to help with the planning for such events. The objectives of the work described here (carried out by Argonne National Laboratory) is the development of a multi-modal regional transportation model that allows for the analysis of different evacuation scenarios and emergency response strategies to build a wealth of knowledge that can be used to develop appropriate regional emergency response plans. The focus of this work is on the effects of no-notice evacuations on the regional transportation network, as well as the response of the transportation network to the sudden and unusual demand. The effects are dynamic in nature, with scenarios changing potentially from minute to minute. The response to a radiological or chemical hazard will be based on the time

  2. Hazardous materials responses in a mid-sized metropolitan area.

    PubMed

    Walter, Frank G; Bates, Gerry; Criss, Elizabeth A; Bey, Tareg; Spaite, Daniel W; Valenzuela, Terence

    2003-01-01

    To determine the chemicals involved in fire department hazardous materials (hazmat) responses and analyze the concomitant emergency medical services' patient care needs. The setting was a mid-sized metropolitan area in the southwestern United States with a population base of 400,000 and an incorporated area of 165 square miles. The authors conducted a retrospective evaluation of all fire department hazmat reports, with associated emergency medical services patient encounter forms, and in-patient hospital records from January 1, 1992, through December 31, 1994. The fire department hazardous materials control team responded to 468 hazmat incidents, involving 62 chemicals. The majority of incidents occurred on city streets, with a mean incident duration of 46 minutes. More than 70% of the responses involved flammable gases or liquids. A total of 32 incidents generated 85 patients, 53% of whom required transport for further evaluation and care. Most patients were exposed to airborne toxicants. Only two patients required hospital admission for carbon monoxide poisoning. Most hazmat incidents result in few exposed patients who require emergency medical services care. Most patients were exposed to airborne toxicants and very few required hospitalization. Routine data analysis such as this provides emergency response personnel with the opportunity to evaluate current emergency plans and identify areas where additional training may be necessary.

  3. Research to support design and siting of deposition areas for dredged material from the Rodanthe Emergency Channel

    DOT National Transportation Integrated Search

    2017-06-30

    The Rodanthe Emergency Ferry Channel (REFC) is essential for transporting emergency personnel, equipment, and supplies to Hatteras Island communities following any event that renders the Herbert C. Bonner Bridge and/or North Carolina Highway 12 impas...

  4. Information infrastructure for emergency medical services.

    PubMed

    Orthner, Helmuth; Mishra, Ninad; Terndrup, Thomas; Acker, Joseph; Grimes, Gary; Gemmill, Jill; Battles, Marcie

    2005-01-01

    The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We propose a conceptual model to enable improved clinical decision making in the pre-hospital environment using these change agents.

  5. Education in Emergencies: A Review of Theory and Research

    ERIC Educational Resources Information Center

    Burde, Dana; Kapit, Amy; Wahl, Rachel L.; Guven, Ozen; Skarpeteig, Margot Igland

    2017-01-01

    In this article, we conduct an integrative and rigorous review of theory and research on education in emergencies programs and interventions as international agencies implement them in areas of armed conflict. We ask several questions. How did this subfield emerge and what are the key conceptual frameworks that shape it today? How do education in…

  6. The crisis in United States hospital emergency services.

    PubMed

    Harrison, Jeffrey P; Ferguson, Emily D

    2011-01-01

    Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

  7. Do emergency nurses have enough emotional intelligence?

    PubMed

    Codier, Estelle; Codier, David

    2015-06-01

    A significant body of research suggests there is a correlation between measured emotional intelligence (EI) abilities and performance in nursing. The four critical elements of EI, namely the abilities to identify emotions correctly in self and others, using emotions to support reasoning, understanding emotions and managing emotions, apply to emergency care settings and are important for safe patient care, teamwork, retention and burnout prevention. This article describes 'emotional labour' and the importance of EI abilities for emergency nurses, and suggests that such abilities should be considered core competencies for the profession.

  8. Committee Opinion No. 707 Summary: Access to Emergency Contraception.

    PubMed

    2017-07-01

    Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

  9. Chagas’ Disease: An Emergent Urban Zoonosis. The Caracas Valley (Venezuela) as an Epidemiological Model

    PubMed Central

    Urdaneta-Morales, Servio

    2014-01-01

    The unprecedented emergence of important public health and veterinary zoonoses is usually a result of exponential population growth and globalization of human activities. I characterized Chagas’ disease as an emergent zoonosis in the Caracas Valley (Venezuela) due to the following findings: the presence of reservoirs (Didelphis marsupialis, Rattus rattus) and vectors (Panstrongylus geniculatus, Panstrongylus rufotuberculatus) infected with Trypanosoma cruzi in urbanized or marginalized areas; the elevated contact between P. geniculatus and human beings detected by parasitological and molecular examinations of triatomine feces demonstrated the possibility of transmission risks; a study of outbreaks of urban Chagas’ disease reported the first proven case of oral transmission of T. cruzi to human beings; the risk of transmission of glandular metacyclic stages from marsupials by experimental ocular and oral instillation; mice genitalia infected with T. cruzi contaminated blood resulted in the formation of amastigotes very close to the lumen suggesting that there may be a possibility of infection via their release into the urine and thence to the exterior; the ubiquitous histotropism and histopathology of T. cruzi was demonstrated using a mouse model; the presence of experimental T. cruzi pseudocysts in adipose, bone-cartilage, and eye tissue indicated a potential risk for transplants. Socio-sanitary programs that include improvements in housing, vector control, and access to medical treatment, as well as strategies aimed at combating social inequalities, poverty, and underdevelopment should be undertaken in those areas where zoonoses are most prevalent. Disciplines, such as Ecology, Epidemiology, Medical Entomology, Human and Veterinary Medicine, Environmental Studies, Public Health, Social and Political Studies, Immunology, Microbiology, and Pharmacology could all provide important contributions that aim to reduce the occurrence of factors governing the spread of

  10. Optimizing diagnostic imaging in the emergency department.

    PubMed

    Mills, Angela M; Raja, Ali S; Marin, Jennifer R

    2015-05-01

    While emergency diagnostic imaging use has increased significantly, there is a lack of evidence for corresponding improvements in patient outcomes. Optimizing emergency department (ED) diagnostic imaging has the potential to improve the quality, safety, and outcomes of ED patients, but to date, there have not been any coordinated efforts to further our evidence-based knowledge in this area. The objective of this article is to discuss six aspects of diagnostic imaging to provide background information on the underlying framework for the 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The consensus conference aims to generate a high priority research agenda for emergency diagnostic imaging that will inform the design of future investigations. The six components herein will serve as the group topics for the conference: 1) patient-centered outcomes research; 2) clinical decision rules; 3) training, education, and competency; 4) knowledge translation and barriers to image optimization; 5) use of administrative data; and 6) comparative effectiveness research: alternatives to traditional CT use. © 2015 by the Society for Academic Emergency Medicine.

  11. Emergency Response Virtual Environment for Safe Schools

    NASA Technical Reports Server (NTRS)

    Wasfy, Ayman; Walker, Teresa

    2008-01-01

    An intelligent emergency response virtual environment (ERVE) that provides emergency first responders, response planners, and managers with situational awareness as well as training and support for safe schools is presented. ERVE incorporates an intelligent agent facility for guiding and assisting the user in the context of the emergency response operations. Response information folders capture key information about the school. The system enables interactive 3D visualization of schools and academic campuses, including the terrain and the buildings' exteriors and interiors in an easy to use Web..based interface. ERVE incorporates live camera and sensors feeds and can be integrated with other simulations such as chemical plume simulation. The system is integrated with a Geographical Information System (GIS) to enable situational awareness of emergency events and assessment of their effect on schools in a geographic area. ERVE can also be integrated with emergency text messaging notification systems. Using ERVE, it is now possible to address safe schools' emergency management needs with a scaleable, seamlessly integrated and fully interactive intelligent and visually compelling solution.

  12. 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.

  13. Emergency neurological care of strokes and bleeds.

    PubMed

    Birenbaum, Dale

    2010-01-01

    Ischemic stroke and brain hemorrhage are common and challenging problems faced by emergency physicians. In this article, important details in the diagnosis and clinical management of these neurological emergencies are presented with the following goals: 1) To provide a more comprehensive understanding of the approach to the identification and management of patients who have sustained ischemic and hemorrhagic strokes; 2) to explain the importance and application of commonly used national stroke scoring and outcome scales; 3) to improve the ability to recognize important aspects in the approach and comprehensive treatment of ruptured and unruptured intracranial aneurysms; and 4) to demonstrate the difficulties in the neurological, neurosurgical, and endovascular treatment of these catastrophic diseases.

  14. Current threats to the Lake Texcoco globally important bird area

    Treesearch

    Jose L. Alcantara; Patricia Escalante Pliego

    2005-01-01

    Lake Texcoco was reported as almost dry in the late 1960s, and as a consequence the aquatic life has been considered gone since then. However, the government undertook a reclamation/restoration project in the area beginning in 1971 to help alleviate some of the environmental problems of Mexico City. Although Lake Texcoco was not completely dry in that period, the basin...

  15. Firefighting for Civil Defense Emergencies; Support Assistants for Fire Emergencies. Instructor Guide--Part B.

    ERIC Educational Resources Information Center

    International Association of Fire Chiefs, New York, NY.

    This guide has been developed for use in presenting part "B" of the course of instruction for Support Assistance for Fire Emergencies. It is arranged by class sessions of three hours each. Some of the sessions are divided into two or more sections covering specific subject areas. The intention is to include instruction which will extend the…

  16. Recommended emergency preparedness guidelines for elderly and disabled rail-transit passengers. Final report, November 1987-March 1989

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

    Hathaway, W.T.; Markos, S.H.; Balog, J.N.

    1989-08-01

    Rail transit has become an important source of transportation for many elderly and disabled persons. The principal reasons for the increased use are improved accessibility, low cost, and expanded areas of service. For the purposes of the report, 'elderly' is defined as any member of the population who is 60 years of age or older, and 'disabled' is defined as any person who has some type of disability. The Urban Mass Transportation Administration (UMTA) has recognized the need to consider the unique characteristics of elderly and disabled passengers in rail-transit emergency response planning. The needs of these passengers can bemore » addressed through carefully planned emergency response procedures, proper training of transit and emergency-response personnel, and effective use of equipment. The recommendations contained herein are therefore intended to assist rail-transit and emergency response organization personnel in evaluating their emergency response plans in terms of the needs of elderly and disabled passengers and, if necessary, to modify or supplement those plans accordingly. The report is intended to supplement the UMTA publication Recommended Emergency Preparedness Guidelines for Rail Transit Systems. That report contains general guidelines designed to assist rail-transit systems in assessing, developing, documenting, and improving their capabilities for responding to emergencies and in coordinating those efforts with emergency response organizations.« less

  17. Impact of human mobility on the emergence of dengue epidemics in Pakistan

    PubMed Central

    Wesolowski, Amy; Qureshi, Taimur; Boni, Maciej F.; Sundsøy, Pål Roe; Johansson, Michael A.; Rasheed, Syed Basit; Engø-Monsen, Kenth; Buckee, Caroline O.

    2015-01-01

    The recent emergence of dengue viruses into new susceptible human populations throughout Asia and the Middle East, driven in part by human travel on both local and global scales, represents a significant global health risk, particularly in areas with changing climatic suitability for the mosquito vector. In Pakistan, dengue has been endemic for decades in the southern port city of Karachi, but large epidemics in the northeast have emerged only since 2011. Pakistan is therefore representative of many countries on the verge of countrywide endemic dengue transmission, where prevention, surveillance, and preparedness are key priorities in previously dengue-free regions. We analyze spatially explicit dengue case data from a large outbreak in Pakistan in 2013 and compare the dynamics of the epidemic to an epidemiological model of dengue virus transmission based on climate and mobility data from ∼40 million mobile phone subscribers. We find that mobile phone-based mobility estimates predict the geographic spread and timing of epidemics in both recently epidemic and emerging locations. We combine transmission suitability maps with estimates of seasonal dengue virus importation to generate fine-scale dynamic risk maps with direct application to dengue containment and epidemic preparedness. PMID:26351662

  18. Emergency nurses' knowledge of pain management principles.

    PubMed

    Tanabe, P; Buschmann, M

    2000-08-01

    The purpose of this study was to determine areas of emergency nurses' knowledge deficit regarding pain management, and to identify barriers to pain management as perceived by emergency nurses. Data were collected anonymously in a mail survey using a 52-item knowledge questionnaire addressing pain management principles and asking emergency nurses (Illinois Emergency Nurses Association members) to rate various barriers as to how often they affect their practice. Questionnaires were mailed to all Illinois ENA members (n = 1000). Three hundred five emergency nurses' questionnaires were returned. A significant deficit existed on 2 domains of knowledge: understanding of the terms "addiction," "tolerance," and "dependence"; and knowledge of various pharmacologic analgesic principles. Nurses with a master's degree or higher, or those who attended a 1-day seminar on pain management, achieved statistically significantly higher scores. The 2 barriers identified by emergency nurses as the most common were the inability to administer medication until a diagnosis is made (53%), and inadequate assessment of pain and pain relief (48%) (the percentage indicates how often the emergency nurses believed the barrier was present in their practice). The data indicate that emergency nurses may not have a good understanding of the management of pain with drugs, or of such issues as risk of addiction.

  19. Rural Emergency Medical Services (EMS) and Trauma

    MedlinePlus

    ... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... to the 2015 WWAMI Rural Health Research Center report, Prehospital Emergency Medical Services Personnel in Rural Areas: ...

  20. Utilization of Norway’s Emergency Wards: The Second 5 Years after the Introduction of the Patient List System

    PubMed Central

    Goth, Ursula S.; Hammer, Hugo L.; Claussen, Bjørgulf

    2014-01-01

    Utilization of services is an important indicator for estimating access to healthcare. In Norway, the General Practitioner Scheme, a patient list system, was established in 2001 to enable a stable doctor-patient relationship. Although satisfaction with the system is generally high, people often choose a more accessible but inferior solution for routine care: emergency wards. The aim of the article is to investigate contact patterns in primary health care situations for the total population in urban and remote areas of Norway and for major immigrant groups in Oslo. The primary regression model had a cross-sectional study design analyzing 2,609,107 consultations in representative municipalities across Norway, estimating the probability of choosing the emergency ward in substitution to a general practitioner. In a second regression model comprising 625,590 consultations in Oslo, we calculated this likelihood for immigrants from the 14 largest groups. We noted substantial differences in emergency ward utilization between ethnic Norwegians both in rural and remote areas and among the various immigrant groups residing in Oslo. Oslo utilization of emergency ward services for the whole population declined, and so did this use among all immigrant groups after 2009. Other municipalities, while overwhelmingly ethnically Norwegian, showed diverse patterns including an increase in some and a decrease in others, results which we were unable to explain. PMID:24662997

  1. 43 CFR 423.12 - How will Reclamation notify the public of additional closed areas?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... additional closed areas? 423.12 Section 423.12 Public Lands: Interior Regulations Relating to Public Lands..., LANDS, AND WATERBODIES Areas Open and Closed to Public Use § 423.12 How will Reclamation notify the public of additional closed areas? (a) Non-emergency situations. In non-emergency situations, an...

  2. 43 CFR 423.12 - How will Reclamation notify the public of additional closed areas?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... additional closed areas? 423.12 Section 423.12 Public Lands: Interior Regulations Relating to Public Lands..., LANDS, AND WATERBODIES Areas Open and Closed to Public Use § 423.12 How will Reclamation notify the public of additional closed areas? (a) Non-emergency situations. In non-emergency situations, an...

  3. 75 FR 55594 - North Carolina; Amendment No. 1 to Notice of an Emergency Declaration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    .... FEMA-3314-EM; Docket ID FEMA-2010-0002] North Carolina; Amendment No. 1 to Notice of an Emergency... notice of an emergency declaration for the State of North Carolina (FEMA-3314-EM), dated September 1... the State of North Carolina is hereby amended to include the following areas among those areas...

  4. Emergency response planning in hospitals, United States: 2003-2004.

    PubMed

    Niska, Richard W; Burt, Catharine W

    2007-08-20

    This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

  5. Improving European Wildfire Emergency Information Services

    NASA Astrophysics Data System (ADS)

    Bielski, Conrad; Whitmore, Ceri; O'Brien, Victoria; Zeug, Gunter; Kalas, Milan; Porras, Ignasi; Solé, Josep Maria; Gálvez, Pedro; Navarro, Maria; Nurmi, Pertti; Kilpinen, Juha; Ylinen, Kaisa; Furllanelo, Cesare; Maggio, Valerio; Alikadic, Azra; Dolci, Claudia

    2017-04-01

    European wildfires are a seasonal natural hazard that many regions must battle regularly. However, as European urbanization continues to encroach on natural areas and the climate changes it is likely that the frequency of wildfires will increase likewise the number of areas prone to wildfires. It is therefore paramount not only to increase public awareness of this natural hazard but also to be prepared by improving wildfire hazard forecasting, monitoring, and mapping. As part of the H2020 funded project entitled Improving Resilience to Emergencies through Advanced Cyber Technologies: I-REACT (Grant Agreement #700256) , there is a task with the goal to develop models and implement technologies to improve the support around the entire emergency management cycle with respect to wildfire hazards. Based on operational weather forecasts, pan-European geospatial data as well as regularly acquired Earth Observation imagery through the Copernicus program, and other sources of information such as social media channels a European wildfire service is being developed. This will be achieved by improving on the successes of the European Forest Fire Information Service (EFFIS) and the guidance of emergency managers experienced in wildfire hazards. Part of the research will be to reduce the number of false alarms. However, once a wildfire has been identified, the system focuses on the disaster region to provide situational information to the decision makers applying state-of-the-art approaches to improve disaster response. Post-wildfire information will continue to be produced for damage and recovery assessments. Ultimately, I-REACT expects to reduce wildfire costs to life, property and livelihood. This work will improve wildfire disaster emergency management through the development and integration of new data and technologies respectively as well as the knowledge from emergency managers who not only understand the hazard itself but also can provide insights into the information

  6. Consensus Statement on Advancing Research in Emergency Department Operations and Its Impact on Patient Care

    PubMed Central

    Ward, Michael J.; Chang, Anna Marie; Pines, Jesse M.; Jouriles, Nick; Yealy, Donald M.

    2016-01-01

    The Consensus Conference on “Advancing Research in Emergency Department (ED) Operations and Its Impact on Patient Care,” hosted by The ED Operations Study Group (EDOSG), convened to craft a framework for future investigations in this important but underserved area. The EDOSG is a research consortium dedicated to promoting evidence based clinical practice in Emergency Medicine. The consensus process format was a modified version of the NIH Model for Consensus Conference Development. Recommendations provide an action plan for how to improve ED operations study design, create a facilitating research environment, identify data measures of value for process and outcomes research, and disseminate new knowledge in this area. Specifically, we called for eight key initiatives: 1) the development of universal measures for ED patient care processes; 2) attention to patient outcomes, in addition to process efficiency and best practice compliance; 3) the promotion of multi-site clinical operations studies to create more generalizable knowledge; 4) encouraging the use of mixed methods to understand the social community and human behavior factors that influence ED operations; 5) the creation of robust ED operations research registries to drive stronger evidence based research, 6) prioritizing key clinical questions with the input of patients, clinicians, medical leadership, emergency medicine organizations, payers, and other government stakeholders; 7) more consistently defining the functional components of the ED care system including observation units, fast tracks, waiting rooms, laboratories and radiology sub-units; and 8) maximizing multidisciplinary knowledge dissemination via emergency medicine, public health, general medicine, operations research and nontraditional publications. PMID:26014365

  7. Predicting field weed emergence with empirical models and soft computing techniques

    USDA-ARS?s Scientific Manuscript database

    Seedling emergence is the most important phenological process that influences the success of weed species; therefore, predicting weed emergence timing plays a critical role in scheduling weed management measures. Important efforts have been made in the attempt to develop models to predict seedling e...

  8. Meeting the needs of new graduates in the emergency department: a qualitative study evaluating a new graduate internship program.

    PubMed

    Glynn, Penelope; Silva, Sheila

    2013-03-01

    The purpose of this study was to explore the experiences of new graduate emergency nurses participating in a structured internship program. In order to meet the needs of new graduate nurses in emergency departments, these departments have developed a variety of orientation programs, some more successful than others. One type of program involves a combination of didactic content and hands-on clinical experience. This study examines the experiences of new graduate nurses in an internship program at a 200-bed community hospital. A qualitative design was used. Interviews with 8 of 9 nurses who participated in the new graduate internship program between 2006 and 2007 were conducted. Content analysis was used to analyze the data. Three themes were identified from the experiences and expectations reported in the interviews: (1) the acquisition of new knowledge and skills in a specialty area, (2) becoming more proficient, and (3) assistance with role transition. The significant role and importance of the unit-base clinical nurse specialist (CNS) and the nurse preceptors were also identified. The findings of this study suggest that a structured internship program is helpful to new graduate nurses when orienting to a critical care area such as the emergency department. Furthermore, the combination of didactic and clinical content, and the roles of the preceptor and unit-base CNS appear to be key factors in the successful transition from new graduate to emergency nurse. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  9. 40 CFR 231.7 - Emergency procedure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., or recreational areas, and that the public health, interest, or safety requires, the Administrator... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Emergency procedure. 231.7 Section 231.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c...

  10. 40 CFR 231.7 - Emergency procedure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., or recreational areas, and that the public health, interest, or safety requires, the Administrator... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Emergency procedure. 231.7 Section 231.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c...

  11. 40 CFR 231.7 - Emergency procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., or recreational areas, and that the public health, interest, or safety requires, the Administrator... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Emergency procedure. 231.7 Section 231.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c...

  12. 40 CFR 231.7 - Emergency procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., or recreational areas, and that the public health, interest, or safety requires, the Administrator... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Emergency procedure. 231.7 Section 231.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c...

  13. 44 CFR 206.40 - Designation of affected areas and eligible assistance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Designation of affected areas and eligible assistance. 206.40 Section 206.40 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The...

  14. 44 CFR 206.40 - Designation of affected areas and eligible assistance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Designation of affected areas and eligible assistance. 206.40 Section 206.40 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The...

  15. 44 CFR 206.40 - Designation of affected areas and eligible assistance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Designation of affected areas and eligible assistance. 206.40 Section 206.40 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The...

  16. 44 CFR 206.40 - Designation of affected areas and eligible assistance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Designation of affected areas and eligible assistance. 206.40 Section 206.40 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The...

  17. 44 CFR 206.40 - Designation of affected areas and eligible assistance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Designation of affected areas and eligible assistance. 206.40 Section 206.40 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The...

  18. ACOG Committee Opinion Number 542: Access to emergency contraception.

    PubMed

    2012-11-01

    Emergency contraception includes contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to access to emergency contraception remain. The purpose of this Committee Opinion is to examine the barriers to the use of oral emergency contraception methods and to highlight the importance of increasing access.

  19. Model of Rescue Units Control in Event of Potential Emergency

    NASA Astrophysics Data System (ADS)

    Kalach, A. V.; Kravchenko, A. S.; Soloviev, A. S.; Nesterov, A. A.

    2018-05-01

    A problem of organization and efficiency improvement of the system controlling the rescue units of the Ministry of Civil Defense and Emergency Response of the Russian Federation considered using the example of potential hydrological emergency, a model of a system for controlling rescue units in the event of potential hydrological emergency. The problem solution is based on mathematical models of operational control of rescue units and assessment of a hydrological situation of area flooding.

  20. An assessment of the faculty development needs of junior clinical faculty in emergency medicine.

    PubMed

    Farley, Heather; Casaletto, Jennifer; Ankel, Felix; Young, Kelly D; Hockberger, Robert

    2008-07-01

    Academic physicians must be able to access the resources necessary to support their ongoing professional development and meet requirements for continued academic advancement. The authors sought to determine the self-perceived career development needs of junior clinical faculty in emergency medicine (EM) and the availability of educational resources to meet those needs. An educational "needs assessment" survey was distributed to 954 American College of Emergency Physicians (ACEP) members listed in the ACEP database as being faculty at EM residency programs in the United States and having graduated from an EM residency within the past 7 years. Respondents were asked to rank the importance of 22 areas of faculty development to their own professional growth and then to indicate whether educational resources in each area were available to them. Respondents were also asked to note the educational formats they prefer. A search for currently available resources in each topic area was undertaken and compared to the survey results. A total of 240 responses were received. Self-perceived career development needs were identified in the following areas: bedside teaching, lecture development, business skills, managerial skills, educational research, mentorship and career counseling, interpersonal skills, leadership skills, scholarly writing skills, physician wellness, and knowledge of the faculty development process. While a review of currently available educational resources revealed lectures, conferences, and online materials pertinent to most of these topics, a relative lack of resources in the areas of mentorship and physician wellness was identified. Junior clinical faculty in EM perceive a lack of educational resources in a number of areas of faculty development. The academic community of EM should strive to improve awareness of and access to currently existing resources and to develop additional resources to address the area of physician wellness. The lack of mentorship in

  1. The Flex Track: Flexible Partitioning between Low- and High-Acuity Areas of an Emergency Department

    PubMed Central

    Laker, Lauren F.; Froehle, Craig M.; Lindsell, Christopher J.; Ward, Michael J.

    2014-01-01

    Study Objective EDs with both low- and high-acuity treatment areas often have fixed allocation of resources, regardless of demand. We demonstrate the utility of discrete-event simulation to evaluate flexible partitioning between low- and high-acuity ED areas to identify the best operational strategy for subsequent implementation. Methods A discrete-event simulation was used to model patient flow through a 50-bed, urban, teaching ED that handles 85,000 patient visits annually. The ED has historically allocated ten beds to a Fast Track for low-acuity patients. We estimated the effect of a Flex Track policy, which involved switching up to five of these Fast Track beds to serving both low- and high-acuity patients, on patient waiting times. When the high-acuity beds were not at capacity, low-acuity patients were given priority access to flexible beds. Otherwise, high-acuity patients were given priority access to flexible beds. Wait times were estimated for patients by disposition and emergency severity index (ESI) score. Results A Flex Track policy using three flexible beds produced the lowest mean patient waiting of 30.9 (95% CI 30.6–31.2) minutes. The typical Fast Track approach of rigidly separating high- and low–acuity beds produced a mean patient wait time of 40.6 (95% CI 40.2–50.0) minutes, 31% higher than the three-bed Flex Track. A completely flexible ED, where all beds can accommodate any patient, produced mean wait times of 35.1 (95% CI 34.8–35.4) minutes. The results from the three-bed Flex Track scenario were robust, performing well across a range of scenarios involving higher and lower patient volumes and care durations. Conclusion Using discrete-event simulation, we have shown that adding some flexibility into bed allocation between low- and high-acuity can provide substantial reductions in overall patient waiting and a more efficient ED. PMID:24954578

  2. Emerging oomycete threats to plants and animals

    PubMed Central

    Chaparro-Garcia, Angela

    2016-01-01

    Oomycetes, or water moulds, are fungal-like organisms phylogenetically related to algae. They cause devastating diseases in both plants and animals. Here, we describe seven oomycete species that are emerging or re-emerging threats to agriculture, horticulture, aquaculture and natural ecosystems. They include the plant pathogens Phytophthora infestans, Phytophthora palmivora, Phytophthora ramorum, Plasmopara obducens, and the animal pathogens Aphanomyces invadans, Saprolegnia parasitica and Halioticida noduliformans. For each species, we describe its pathology, importance and impact, discuss why it is an emerging threat and briefly review current research activities. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’. PMID:28080985

  3. Rates and features of methamphetamine-related presentations to emergency departments: An integrative literature review.

    PubMed

    Jones, Rikki; Woods, Cindy; Usher, Kim

    2018-07-01

    To review the clinical impact methamphetamine has on emergency departments by assessing the available research on the rates and features of methamphetamine-related presentations. Globally, methamphetamine availability, distribution and use have rapidly increased. As a result, the number of methamphetamine-related presentations to emergency departments has also increased. In this context, it is timely to review the rate and features of methamphetamine-related presentations to understand the impact of methamphetamine on emergency departments and facilitate the allocation of services, staff and resources. An integrative literature review. This study presents an integrated literature review, following the systematic review process as outlined in the PRISMA flow chart. Several databases were searched using a combination of search terms. Articles were measured against inclusion and exclusion criteria, and the final ten articles were subjected to quality appraisal and outcomes reported. Methamphetamine accounted for 2.3% or less of all emergency departments presentations. The majority of methamphetamine users presenting to emergency departments were males, with a mean age 31-37. Methamphetamine-related presentations to emergency departments were more likely to present with trauma, psychosis, and be placed on 24-hr psychiatric hold. Methamphetamine-related presentations were more likely to present with agitation, aggression and homicidal behaviour and present to emergency departments out of hours and accompanied by police compared with other emergency departments substance-related presentations. Several important themes were highlighted in this review that has an impact on emergency departments services, resources and staff. Understanding the rate and patterns of methamphetamine-related presentations can help to provide evidence for policy development and staff education in emergency departments. Methamphetamine-related presenters are more aggressive and agitated and more

  4. 77 FR 69645 - New Hampshire; Amendment No. 1 to Notice of an Emergency Declaration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-20

    .... FEMA-3360-EM; Docket ID FEMA-2012-0002] New Hampshire; Amendment No. 1 to Notice of an Emergency... notice of an emergency declaration for the State of New Hampshire (FEMA-3360-EM), dated October 30, 2012... the State of New Hampshire is hereby amended to include the following areas among those areas...

  5. An Examination of Important Competencies Necessary for Vocational Agriculture in Selected Senior Secondary Students in Ijebu North Local Government Area, Nigeria

    ERIC Educational Resources Information Center

    Onanuga, Peter Abayomi

    2015-01-01

    The study analyses the relationship existing between some specified competencies important to vocational agriculture and preparation for occupation between male and female students in senior secondary schools in Ijebu-North Local Government Area, Nigeria. It adopted the classical design for change experiment (i.e. before and after measures) with…

  6. Response of Solar Irradiance to Sunspot-area Variations

    NASA Astrophysics Data System (ADS)

    Dudok de Wit, T.; Kopp, G.; Shapiro, A.; Witzke, V.; Kretzschmar, M.

    2018-02-01

    One of the important open questions in solar irradiance studies is whether long-term variability (i.e., on timescales of years and beyond) can be reconstructed by means of models that describe short-term variability (i.e., days) using solar proxies as inputs. Preminger & Walton showed that the relationship between spectral solar irradiance and proxies of magnetic-flux emergence, such as the daily sunspot area, can be described in the framework of linear system theory by means of the impulse response. We significantly refine that empirical model by removing spurious solar-rotational effects and by including an additional term that captures long-term variations. Our results show that long-term variability cannot be reconstructed from the short-term response of the spectral irradiance, which questions the extension of solar proxy models to these timescales. In addition, we find that the solar response is nonlinear in a way that cannot be corrected simply by applying a rescaling to a sunspot area.

  7. Natural Areas Analysis and Evaluation: Oak Ridge Reservation

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

    Baranski, Micahel J

    elements; are relatively large in size with mature or old-growth community composition; lack current disturbance factors or potential threats and disturbances; are in excellent condition with good buffers; are places where ecological and evolutionary processes can occur relatively unaffected by humans; and can be reasonably defended and maintained as natural areas in an undeveloped condition. Highly ranked sites are the most significant and should receive the greatest protections. Composite scores of the ranked areas ranged from 1-25.5, with a mean score of 12. The ranked areas were divided into three Priority Groups. Group I, the most highly ranked group, included 20 sites and covered 5189 acres or 15.4% of Reservation lands; Group II included 31 sites and covered 4108 acres; Group III included 19 sites covering 400 acres of Reservation lands. All sites together comprise 9697 acres or 28.8% of Reservation lands. Six sites emerged as clearly the most significant natural areas on the Reservation. The study developed a number of recommendations that should be implemented in order to enhance and refine the natural areas data for the Reservation. There is a clear need for better and standardized ecological community classification and identification. Several areas are proposed for merger into larger units, and some new areas are proposed for inclusion and recognition in a natural areas system. Various gaps and discrepancies in the existing data are described and should be corrected. Other recommendations are made, including the development of a corollary system that can accommodate aquatic natural areas. The study relied primarily on the synthesis of information from many sources and from limited reconnaissance and direct observation during field work to produce a methodology for assessing natural area importance and assigning priorities for protection. Many instances of incomplete, missing or conflicting information made it difficult to complete thorough analysis. Further

  8. Developing native plant nurseries in emerging market areas

    Treesearch

    Elliott Duemler

    2012-01-01

    The importance of developing a market for quality native plant materials in a region prior to the establishment of a nursery is crucial to ensure its success. Certain tactics can be applied to help develop a demand for native plant materials in a region. Using these tactics will help create a new market for native plant materials.

  9. Imported malaria in an area in southern Madrid, 2005-2008

    PubMed Central

    2010-01-01

    Background In Spain, malaria cases are mostly due to migrants and travellers returning from endemic areas. The objective of this work was to describe the malaria cases diagnosed at the Severo Ochoa University Hospital (HUSO) in Leganés in the south of the Madrid Region from 2005 to 2008. Methods Descriptive retrospective study performed at HUSO. Data sources are registries from the Microbiology Department and malaria cases notified to the Preventive Medicine Department. Analysed parameters were: administrative, demographical, related to the stay at the endemic country, clinical, microbiological diagnosis method, pregnancy, treatment and prophylaxis, co-infections, and days of hospital stay. Results Fifty-seven patients diagnosed with malaria were studied. Case distribution per year was 13 in 2005, 15 in 2006, 15 in 2007 and 14 in 2008. Thirty-three patients were female (57.9%) and 24 male (42.1%). Mean age was 27.8 years. Most of the malaria cases were acquired in Nigeria (49.1%) and Equatorial Guinea (32.7%). 29.1% of the patients were immigrants who had arrived recently, and 61.8% acquired malaria when travelling to their countries of origin to visit friends and relatives (VFR). Majority of cases were diagnosed between June and September. Microscopy was positive in 39 cases (68.4%) immunochromatography in 42 (73.7%) and PCR in the 55 cases where performed. Plasmodium falciparum was responsible for 94.7% of the cases. The more frequent symptoms were fever (77.2%), followed by headache and gastrointestinal symptoms (33.3%). Nine cases needed hospital admittance, a pregnant woman, three children, four VFR and an African tourist, but all evolved favourably. Chemoprophylaxis data was known from 55 patients. It was taken correctly in one case (1.8%), in five (9.1%) the prophylaxis was improper while the others 49 (89.1%) cases had not followed any anti-malarial prophylaxis. Conclusions Children, pregnant women and the VFR have the highest risk to present severe

  10. Imported malaria in an area in southern Madrid, 2005-2008.

    PubMed

    Rey, Sonia; Zuza, Inés; Martínez-Mondéjar, Belén; Rubio, José M; Merino, Francisco J

    2010-10-20

    In Spain, malaria cases are mostly due to migrants and travellers returning from endemic areas. The objective of this work was to describe the malaria cases diagnosed at the Severo Ochoa University Hospital (HUSO) in Leganés in the south of the Madrid Region from 2005 to 2008. Descriptive retrospective study performed at HUSO. Data sources are registries from the Microbiology Department and malaria cases notified to the Preventive Medicine Department. Analysed parameters were: administrative, demographical, related to the stay at the endemic country, clinical, microbiological diagnosis method, pregnancy, treatment and prophylaxis, co-infections, and days of hospital stay. Fifty-seven patients diagnosed with malaria were studied. Case distribution per year was 13 in 2005, 15 in 2006, 15 in 2007 and 14 in 2008. Thirty-three patients were female (57.9%) and 24 male (42.1%). Mean age was 27.8 years. Most of the malaria cases were acquired in Nigeria (49.1%) and Equatorial Guinea (32.7%). 29.1% of the patients were immigrants who had arrived recently, and 61.8% acquired malaria when travelling to their countries of origin to visit friends and relatives (VFR). Majority of cases were diagnosed between June and September. Microscopy was positive in 39 cases (68.4%) immunochromatography in 42 (73.7%) and PCR in the 55 cases where performed. Plasmodium falciparum was responsible for 94.7% of the cases. The more frequent symptoms were fever (77.2%), followed by headache and gastrointestinal symptoms (33.3%). Nine cases needed hospital admittance, a pregnant woman, three children, four VFR and an African tourist, but all evolved favourably. Chemoprophylaxis data was known from 55 patients. It was taken correctly in one case (1.8%), in five (9.1%) the prophylaxis was improper while the others 49 (89.1%) cases had not followed any anti-malarial prophylaxis. Children, pregnant women and the VFR have the highest risk to present severe malaria and to need hospital admittance

  11. Identification of Emerging Science Competencies in Agriculture. Vocational Education Research.

    ERIC Educational Resources Information Center

    Louisiana State Univ., Baton Rouge. School of Vocational Education.

    A research project identified new and emerging science concepts that should be taught in high school vocational agriculture. Agricultural scientists on an advisory panel identified the emerging science concepts. The majority were in the areas of plant science and animal science. Animal science was completely reorganized with greater emphasis on…

  12. What is needed for taking emergency obstetric and neonatal programmes to scale?

    PubMed

    Bergh, Anne-Marie; Allanson, Emma; Pattinson, Robert C

    2015-11-01

    Scaling up an emergency obstetric and neonatal care (EmONC) programme entails reaching a larger number of people in a potentially broader geographical area. Multiple strategies requiring simultaneous attention should be deployed. This paper provides a framework for understanding the implementation, scale-up and sustainability of such programmes. We reviewed the existing literature and drew on our experience in scaling up the Essential Steps in the Management of Obstetric Emergencies (ESMOE) programme in South Africa. We explore the non-linear change process and conditions to be met for taking an existing EmONC programme to scale. Important concepts cutting across all components of a programme are equity, quality and leadership. Conditions to be met include appropriate awareness across the board and a policy environment that leads to the following: commitment, health systems-strengthening actions, allocation of resources (human, financial and capital/material), dissemination and training, supportive supervision and monitoring and evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Code orange: Towards transformational leadership of emergency management systems.

    PubMed

    Caro, Denis H J

    2015-09-01

    The 21(st) century calls upon health leaders to recognize and respond to emerging threats and systemic emergency management challenges through transformative processes inherent in the LEADS in a caring environment framework. Using a grounded theory approach, this qualitative study explores key informant perspectives of leaders in emergency management across Canada on pressing needs for relevant systemic transformation. The emerging model points to eight specific attributes of transformational leadership central to emergency management and suggests that contextualization of health leadership is of particular import. © 2015 The Canadian College of Health Leaders.

  14. Measuring risk/benefit perceptions of emerging technologies and their potential impact on communication of public opinion toward science.

    PubMed

    Binder, Andrew R; Cacciatore, Michael A; Scheufele, Dietram A; Shaw, Bret R; Corley, Elizabeth A

    2012-10-01

    This study presents a systematic comparison of two alternative measures of citizens' perceptions of risks and benefits of emerging technologies. By focusing on two specific issues (nanotechnology and biofuels), we derive several insights for the measurement of public views of science. Most importantly, our analyses reveal that relying on global, single-item measures may lead to invalid inferences regarding external influences on public perceptions, particularly those related to cognitive schema and media use. Beyond these methodological implications, this analysis suggests several reasons why researchers in the area of public attitudes toward science must revisit notions of measurement in order to accurately inform the general public, policymakers, scientists, and journalists about trends in public opinion toward emerging technologies.

  15. Ultra-Scale Computing for Emergency Evacuation

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

    Bhaduri, Budhendra L; Nutaro, James J; Liu, Cheng

    2010-01-01

    Emergency evacuations are carried out in anticipation of a disaster such as hurricane landfall or flooding, and in response to a disaster that strikes without a warning. Existing emergency evacuation modeling and simulation tools are primarily designed for evacuation planning and are of limited value in operational support for real time evacuation management. In order to align with desktop computing, these models reduce the data and computational complexities through simple approximations and representations of real network conditions and traffic behaviors, which rarely represent real-world scenarios. With the emergence of high resolution physiographic, demographic, and socioeconomic data and supercomputing platforms, itmore » is possible to develop micro-simulation based emergency evacuation models that can foster development of novel algorithms for human behavior and traffic assignments, and can simulate evacuation of millions of people over a large geographic area. However, such advances in evacuation modeling and simulations demand computational capacity beyond the desktop scales and can be supported by high performance computing platforms. This paper explores the motivation and feasibility of ultra-scale computing for increasing the speed of high resolution emergency evacuation simulations.« less

  16. Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

    PubMed

    Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

    2017-04-28

    Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

  17. Review of Spaceflight Dental Emergencies

    NASA Technical Reports Server (NTRS)

    Menon, Anil

    2012-01-01

    All exploration class missions--extending beyond earth's orbit--differ from existing orbital missions by being of longer duration and often not having a means of evacuation. If an exploration mission extends beyond a year, then there will be a greater lapse since the crewmembers last terrestrial dental exams, which routinely occur each year. This increased time since professional dental care could increase the chance of a dental emergency such as intractable pain, dental decay requiring a temporary filling, crown replacement, exposed pulp, abscess, tooth avulsion, or toothache. Additionally, any dental emergency will have to be treated in-flight with available resources and personnel who may not have extensive training in dental care. Thus, dental emergencies are an important risk to assess in preparation for exploration missions.

  18. Current opinions and recommendations of paediatric healthcare professionals – The importance of tablets: Emerging orally disintegrating versus traditional tablets

    PubMed Central

    Alyami, Hamad; Koner, Jasdip; Terry, David; Mohammed, Afzal R.

    2018-01-01

    The appropriate prescribing of paediatric dosage forms is paramount in providing the desired therapeutic effect alongside successful medication adherence with the paediatric population. Often it is the opinion of the healthcare practitioner that dictates which type of dosage form would be most appropriate for the paediatric patient, with liquids being both the most commonly available and most commonly used. Orally disintegrating tablets (ODTs) are an emerging dosage form which provide many benefits over traditional dosage forms for paediatric patients, such as rapid disintegration within the oral cavity, and the reduction in the risk of choking. However the opinion and professional use of healthcare practitioners regarding ODT’s is not known. This study was designed to assess the opinions of several types of healthcare professionals (n = 41) regarding ODTs, using a survey across two hospital sites. Results reaffirmed the popularity of liquids for prescribing in paediatrics, with 58.0% of participants preferring this dosage form. ODTs emerged as the second most popular dosage form (30.0%), with healthcare practitioners indicating an increasing popularity amongst patients in the hospital setting, belief with 63.0% of practitioners agreeing that many liquid formulations could be substituted with a suitable ODT. The desired properties of an ideal ODT were also identified by healthcare practitioners preferring a small, fast disintegrating tablet (90.2% and 95.1% respectively), with the taste, disintegration time and flavour being the three most important attributes identified (29.5%, 28.7% and 21.7% respectively). This study provided a pragmatic approach in assessing healthcare professional’s opinions on ODTs, highlighting the ideas and thoughts of practitioners who are on the frontline of paediatric prescribing and treatment and gave an indication to their preference for ODT properties. PMID:29489871

  19. The emergence of place-based conservation [Chapter 1

    Treesearch

    Daniel R. Williams; William P. Stewart; Linda E. Kruger

    2013-01-01

    Place has emerged as a significant topic within conservation research and practice. The transformative changes connected to contemporary conservation are related to recognition of multi-scaled, social-ecological dynamics; emergent, multiscaled governance structures; and rising importance of place-specific meanings and local knowledge. These transformative changes are...

  20. Energy Drinks: Topical Domain in the Emerging Literature and Neglected Areas of Research

    ERIC Educational Resources Information Center

    Piotrowski, Chris

    2014-01-01

    Prevalence statistics indicate that consumption of Energy drinks (EDs), often in combination with alcohol, is quite popular in the younger generation and particularly with college students. As literature on this topic is advancing at a rapid pace, it seemed instructive to examine which topics are emphasized in emerging EDs research. To that end, a…

  1. Virtual reality for emergency training

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

    Altinkemer, K.

    1995-12-31

    Virtual reality is a sequence of scenes generated by a computer as a response to the five different senses. These senses are sight, sound, taste, touch, smell. Other senses that can be used in virtual reality include balance, pheromonal, and immunological senses. Many application areas include: leisure and entertainment, medicine, architecture, engineering, manufacturing, and training. Virtual reality is especially important when it is used for emergency training and management of natural disasters including earthquakes, floods, tornados and other situations which are hard to emulate. Classical training methods for these extraordinary environments lack the realistic surroundings that virtual reality can provide.more » In order for virtual reality to be a successful training tool the design needs to include certain aspects; such as how real virtual reality should be and how much fixed cost is entailed in setting up the virtual reality trainer. There are also pricing questions regarding the price per training session on virtual reality trainer, and the appropriate training time length(s).« less

  2. Effect of tele-emergency services on recruitment and retention of US rural physicians.

    PubMed

    Potter, Andrew J; Mueller, Keith J; Mackinney, A Clinton; Ward, Marcia M

    2014-01-01

    As competition for physicians intensifies in the USA, rural areas are at a disadvantage due to challenges unique to rural medical practice. Telemedicine improves access to care not otherwise available in rural settings. Previous studies have found that telemedicine also has positive effects on the work environment, suggesting that telemedicine may improve rural physician recruitment and retention, although few have specifically examined this. Using a mixed-method approach, clients of a single telemedicine service in the Upper Midwestern USA were surveyed and interviewed about their views of the impact of tele-emergency on physician recruitment and retention and the work environment. Surveys were completed by 292 clinical and administrative staff at 71 hospitals and semi-structured interviews were conducted with clinicians and administrators at 16 hospitals. Survey respondents agreed that tele-emergency had a positive effect on physician recruitment and retention and related workplace factors. Interviewees elucidated how the presence of tele-emergency played an important role in enhancing physician confidence, providing educational opportunities, easing burden, and supplementing care, workplace factors that interviewees believed would impact recruitment and retention. However, gains were limited by hospitals' interpretation of the Emergency Medical Treatment and Labor Act as requiring on-site physician coverage even if tele-emergency was used. Results indicate that, all other factors being equal, tele-emergency increases the likelihood of physicians entering and remaining in rural practice. New regulatory guidance by the Centers for Medicare and Medicaid Services related to on-site physician coverage will likely accelerate implementation of tele-emergency services in rural hospitals. Telemedicine may prove to be an increasingly valuable recruitment and retention tool for rural hospitals as competition for physicians intensifies.

  3. Emerging issues in public health genomics

    PubMed Central

    Roberts, J. Scott

    2014-01-01

    This review highlights emerging areas of interest in public health genomics. First, recent advances in newborn screening (NBS) are described, with a focus on practice and policy implications of current and future efforts to expand NBS programs (e.g., via next-generation sequencing). Next, research findings from the rapidly progressing field of epigenetics and epigenomics are detailed, highlighting ways in which our emerging understanding in these areas could guide future intervention and research efforts in public health. We close by considering various ethical, legal and social issues posed by recent developments in public health genomics; these include policies to regulate access to personal genomic information; the need to enhance genetic literacy in both health professionals and the public; and challenges in ensuring that the benefits (and burdens) from genomic discoveries and applications are equitably distributed. Needs for future genomics research that integrates across basic and social sciences are also noted. PMID:25184533

  4. Clinician's gaze behaviour in simulated paediatric emergencies.

    PubMed

    McNaughten, Ben; Hart, Caroline; Gallagher, Stephen; Junk, Carol; Coulter, Patricia; Thompson, Andrew; Bourke, Thomas

    2018-03-07

    Differences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency. Clinicians from four clinical areas undertook a simulated emergency. Participants wore SMI (SensoMotoric Instruments) eye tracking glasses. We measured the fixation count and dwell time on predefined areas of interest and the time taken to key clinical interventions. Paediatric intensive care unit (PICU) consultants performed best and focused longer on the chest and airway. Paediatric consultants and trainees spent longer looking at the defibrillator and algorithm (51 180 ms and 50 551 ms, respectively) than the PICU and paediatric emergency medicine consultants. This study is the first to describe differences in the gaze behaviour between experts and novices in a resuscitation. They mirror those described in aviation and surgery. Further research is needed to evaluate the potential use of eye tracking as an educational tool. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. [Record of epidemiologically important Culicidae in the rural area of Manaus, Amazonas].

    PubMed

    Barbosa, Maria das Graças Vale; Fé, Nelson Ferreira; Marcião, Alexandre Herculano Ribera; Silva, Ana Paula Thomé da; Monteiro, Wuelton Marcelo; Guerra, Marcus Vinitius de Farias; Guerra, Jorge Augusto de Oliveira

    2008-01-01

    The biodiversity of the Amazon region includes many species of arthropod vectors in different ecotopes, thus enabling occurrences of diseases like malaria, filariasis and arbovirosis. From August 2001 to July 2002, we gathered culicids from inside homes, from areas surrounding these homes and from forested areas of the São João Community, in the rural zone of Manaus, State of Amazonas. 1240 specimens were collected, belonging to the Culicinae (99%) and Anophelinae (1%) subfamilies, with 50 species. The Culicini tribe clearly predominated, with 904 specimens (72.9%), and the species Culex usquatus (22.6%) and Culex quinquefasciatus (17.7%) were prominent. Out of the total number of culicids, 1,077 (86.9%) were caught in the forests, 101 (8.1%) in the areas surrounding homes and 62 (5%) inside homes. Forests were the ecotope that presented the highest species diversity. The presence of Anopheles darlingi, Anopheles triannulatus, Aedes aegypti, Haemagogus janthinomys and other proven or potential vectors was recorded.

  6. Determining the relative importance of climatic drivers on spring phenology in grassland ecosystems of semi-arid areas.

    PubMed

    Zhu, Likai; Meng, Jijun

    2015-02-01

    Understanding climate controls on spring phenology in grassland ecosystems is critically important in predicting the impacts of future climate change on grassland productivity and carbon storage. The third-generation Global Inventory Monitoring and Modeling System (GIMMS3g) normalized difference vegetation index (NDVI) data were applied to derive the start of the growing season (SOS) from 1982-2010 in grassland ecosystems of Ordos, a typical semi-arid area in China. Then, the conditional Granger causality method was utilized to quantify the directed functional connectivity between key climatic drivers and the SOS. The results show that the asymmetric Gaussian (AG) function is better in reducing noise of NDVI time series than the double logistic (DL) function within our study area. The southeastern Ordos has earlier occurrence and lower variability of the SOS, whereas the northwestern Ordos has later occurrence and higher variability of the SOS. The research also reveals that spring precipitation has stronger causal connectivity with the SOS than other climatic factors over different grassland ecosystem types. There is no statistically significant trend across the study area, while the similar pattern is observed for spring precipitation. Our study highlights the link of spring phenology with different grassland types, and the use of coupling remote sensing and econometric tools. With the dramatic increase in global change research, Granger causality method augurs well for further development and application of time-series modeling of complex social-ecological systems at the intersection of remote sensing and landscape changes.

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

    PubMed

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

    2013-05-23

    to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings.

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

    PubMed Central

    2013-01-01

    the reduction of time needed to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. Results The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. Conclusions By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings. PMID:23702566

  9. Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

    PubMed

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

    The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging use and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified before the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with the planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were a total of 164 individuals involved in the conference and spanned various specialties, including general emergency medicine, pediatric emergency medicine, radiology, surgery, medical physics, and the decision sciences.

  10. Knowledge of TIA among general practitioners and emergency department physicians. A questionnaire survey in a French semi-rural area.

    PubMed

    Massengo, Serge A; Cisse, M; Guiziou, C; Leray, E; Rajabally, Yusuf A; Edan, G

    2013-08-01

    Management of transient ischemic attacks (TIAs) is of vital importance in an attempt to prevent stroke. However, suboptimal management still raise concern among general practitioners (GPs) and emergency department (ED) physicians-the first medical contact of most TIA patients. This may relate to their poorly updated knowledge about TIA. The study was designed to assess knowledge of TIA among these non-neurologists. The study was a post-mailed questionnaire survey among GPs and ED physicians. The questionnaire related to selective clinical aspects on TIA. There were a total of 85 respondents for analysis, mostly GPs (n=64; 75.3%), out of 177 mailed physicians. Response rate was 52.7%. Many of these respondents were unaware of the newly proposed TIA definition (59%), unfamiliar with TIA mimics and predictors of post-TIA early stroke recurrence and therefore with the rationales underlying the need of emergency management of TIA. More than one third (39%) were unaware of the relevant national guidelines. Guidelines-aware respondents performed better in most part of the mailed questionnaire. Our results show that poorly updated knowledge about TIA among non-neurologists represents a potential contributing factor to the persisting sub-optimal management of the disorder. Although further studies are needed to confirm this, improved continuous medical education of this group of health care professionals appears warranted. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. The internal audit of clinical areas: a pilot of the internal audit methodology in a health service emergency department.

    PubMed

    Brown, Alison; Santilli, Mario; Scott, Belinda

    2015-12-01

    Governing bodies of health services need assurance that major risks to achieving the health service objectives are being controlled. Currently, the main assurance mechanisms generated within the organization are through the review of implementation of policies and procedures and review of clinical audits and quality data. The governing bodies of health services need more robust, objective data to inform their understanding of the control of clinical risks. Internal audit provides a methodological framework that provides independent and objective assurance to the governing body on the control of significant risks. The article describes the pilot of the internal audit methodology in an emergency unit in a health service. An internal auditor was partnered with a clinical expert to assess the application of clinical criteria based on best practice guidelines. The pilot of the internal audit of a clinical area was successful in identifying significant clinical risks that required further management. The application of an internal audit methodology to a clinical area is a promising mechanism to gain robust assurance at the governance level regarding the management of significant clinical risks. This approach needs further exploration and trial in a range of health care settings. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  12. NewSpace: The Emerging Commercial Space Industry

    NASA Technical Reports Server (NTRS)

    Martin, Gary L.

    2014-01-01

    Presenter will give a lecture on the emerging commercial space industry at International Space University's 2014 Space Studies Program (SSP) at McGill University in Montreal, Canada. The presentation consists of 38 Powerpoint slides and describes the emerging commercial space sector, key players and capabilities. The slides explain which areas that the commercial sector is taking hold, what new markets are attracting start up companies, and which companies are participating. A discussion of how governments can help with the new industry's development is offered.

  13. Emergent "Quantum" Theory in Complex Adaptive Systems.

    PubMed

    Minic, Djordje; Pajevic, Sinisa

    2016-04-30

    Motivated by the question of stability, in this letter we argue that an effective quantum-like theory can emerge in complex adaptive systems. In the concrete example of stochastic Lotka-Volterra dynamics, the relevant effective "Planck constant" associated with such emergent "quantum" theory has the dimensions of the square of the unit of time. Such an emergent quantum-like theory has inherently non-classical stability as well as coherent properties that are not, in principle, endangered by thermal fluctuations and therefore might be of crucial importance in complex adaptive systems.

  14. Pharmacy Access to Emergency Contraception in Rural and Frontier Communities

    ERIC Educational Resources Information Center

    Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

    2007-01-01

    Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

  15. Emergency service: a strategy for hospital-sponsored ambulatory care satellites.

    PubMed

    Gregory, D; Klegon, D; Steinhauer, B

    1984-01-01

    This analysis of the overall market position of free-standing emergency care was based on a telephone survey of 300 randomly chosen households in a southeastern metropolitan area. Results show that consumer preferences for cost and convenience create a strong market for free-standing emergency facilities. Emergicare centers are in an ideal situation to capture the market for acute and minor emergency care. To be worthwhile, the emergency room in a more comprehensive ambulatory care facility should serve as a feeder of new patients and be profitable in its own right. However, free-standing emergency facilities must not only attract patients through convenience and price, but they must also maintain patients through assuring quality care and satisfaction.

  16. Emerging Connections: Quantum & Classical Optics Incubator Program Book

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

    Lesky, Marcia

    The Emerging Connections: Quantum & Classical Optics Incubator was a scientific meeting held in Washington, DC on 6-8 November 2016. This Incubator provided unique and focused experiences and valuable opportunities to discuss advances, challenges and opportunities regarding this important area of research. Quantum optics and classical optics have coexisted for nearly a century as two distinct, but consistent descriptions of light in their respective domains. Recently, a number of detailed examinations of the structure of classical light beams have revealed that effects widely thought to be solely quantum in origin also have a place in classical optics. These new quantum-classicalmore » connections are informing classical optics in meaningful ways specifically by expanding understanding of optical coherence. Simultaneously, relationships discovered with classical light beams now also serve as a vehicle to illuminate concepts that no longer solely belong to the quantum realm. Interference, polarization, coherence, complementarity and entanglement are a partial list of elementary notions that now appear to belong to both quantum and classical optics. The goal of this meeting was to bring emerging quantum-classical links into wider view and to indicate directions in which forthcoming and future work would promote discussion and lead to a more unified understanding of optics.« less

  17. Rapidly deployable emergency communication system

    DOEpatents

    Gladden, Charles A.; Parelman, Martin H.

    1979-01-01

    A highly versatile, highly portable emergency communication system which permits deployment in a very short time to cover both wide areas and distant isolated areas depending upon mission requirements. The system employs a plurality of lightweight, fully self-contained repeaters which are deployed within the mission area to provide communication between field teams, and between each field team and a mobile communication control center. Each repeater contains a microcomputer controller, the program for which may be changed from the control center by the transmission of digital data within the audible range (300-3,000 Hz). Repeaters are accessed by portable/mobile transceivers, other repeaters, and the control center through the transmission and recognition of digital data code words in the subaudible range.

  18. Dingoes (Canis dingo Meyer, 1793) continue to be an important reservoir host of Dirofilaria immitis in low density housing areas in Australia.

    PubMed

    Smout, Felicity A; Skerratt, Lee F; Butler, James R A; Johnson, Christopher N; Congdon, Bradley C

    2016-01-15

    Heartworm (Dirofilaria immitis) is a parasitic nematode responsible for canine and feline cardiopulmonary dirofilariasis and human zoonotic filariosis in both tropical and temperate regions throughout the world. Importantly, this study in the Wet Tropics of Far North Queensland found D. immitis remains at high prevalence (72.7%) in wild dingoes in low density housing areas in Australia. This prevalence is equivalent to the highest levels seen in wild dogs in Australia and represents an ongoing risk to domestic dogs, cats and humans. In contrast, in higher density residential areas prevalence was significantly lower (16.7%, p=0.001). It is possible that chemotherapeutic heartworm (HW) prevention in domestic dogs in these higher density housing areas is helping to control infection in the resident dingo population. Five dingoes killed in council control operations around Atherton, a non-endemic HW region in the Wet Tropics, were all negative for HW likely due to the colder climate of the region restricting transmission of the disease. This survey highlights the importance of dingoes as reservoir hosts of HW disease and that the subsequent risk of infection to companion animals and humans depends on local factors such as housing density, possibly linked to chemotherapeutic HW control in domestic dogs and climate. Our findings show that veterinary clinicians need to ensure that pet owners are aware of HW disease and do not become complacent about HW chemoprohylaxis in areas which support dingo populations. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Optimizing Diagnostic Imaging in the Emergency Department

    PubMed Central

    Mills, Angela M.; Raja, Ali S.; Marin, Jennifer R.

    2015-01-01

    While emergency diagnostic imaging use has increased significantly, there is a lack of evidence for corresponding improvements in patient outcomes. Optimizing emergency department (ED) diagnostic imaging has the potential to improve the quality, safety, and outcomes of ED patients, but to date, there have not been any coordinated efforts to further our evidence-based knowledge in this area. The objective of this article is to discuss six aspects of diagnostic imaging in order to provide background information on the underlying framework for the 2015 Academic Emergency Medicine consensus conference, “Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization.” The consensus conference aims to generate a high priority research agenda for emergency diagnostic imaging that will inform the design of future investigations. The six components herein will serve as the group topics for the conference: 1) patient-centered outcomes research; 2) clinical decision rules; 3) training, education, and competency; 4) knowledge translation and barriers to image optimization; 5) use of administrative data; and 6) comparative effectiveness research: alternatives to traditional CT use. PMID:25731864

  20. Synopsis of emergent approaches

    Treesearch

    Malcolm North; Brandon Collins; John Keane; Jonathan W. Long; Carl Skinner; Bill Zielinski

    2014-01-01

    This synopsis presents three integrated themes that emerged from synthesizing information about biological resources. These themes become particularly important when managing forests to promote resilience at large landscape scales and long timeframes. This synopsis summarizes ideas in the longer chapter 1.2, “Integrative Approaches: Promoting Socioecological Resilience...

  1. Emergency medicine in the United Arab Emirates

    PubMed Central

    2014-01-01

    It has been a decade since emergency medicine was recognized as a specialty in the United Arab Emirates (UAE). In this short time, emergency medicine has established itself and developed rapidly in the UAE. Large, well-equipped emergency departments (EDs) are usually located in government hospitals, some of which function as regional trauma centers. Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as consultants overseeing care. Prehospital care and emergency medical services (EMS) operate under the auspices of the police department. Standardized protocols have been established for paramedic certification, triage, and destination decisions. The majority of ambulances offer basic life support (BLS/Type 2) with a growing minority offering advanced life support (ALS/Type 3). Medicine residency programs were established 5 years ago and form the foundation for training emergency medicine specialists for UAE. This article describes the full spectrum of emergency medicine in the UAE: prehospital care, EMS, hospital-based emergency care, training in emergency medicine, and disaster preparedness. We hope that our experience, our understanding of the challenges faced by the specialty, and the anticipated future directions will be of importance to others advancing emergency medicine in their region and across the globe. PMID:24401695

  2. The effect of lifestyle choices on emergency department use in Australia.

    PubMed

    Johar, Meliyanni; Jones, Glenn; Savage, Elizabeth

    2013-05-01

    Much attention has been paid to patient access to emergency services, focusing on hospital reforms, yet very little is known about the characteristics of those presenting to emergency departments. By exploiting linkage of emergency records and a representative survey of the 45 and older population in Australia, we provide unique insights into the role of lifestyle in predicting emergency presentations. A generalized linear regression model is used to estimate the impact of lifestyles on emergency presentations one year ahead. We control for extensive individual characteristics and area fixed-effects. Not smoking, having healthy body weight, taking vitamins, and exercising vigorously and regularly can reduce emergency presentations and also prevent subsequent admissions from emergency. There is no evidence that heavy drinking leads to more frequent emergency visits, but we find a high tendency for heavy drinkers to smoke and be in poor health, which are both major predictors of emergency visits. Targeted public health interventions on smoking, body mass and exercise may reduce emergency visits. Effective public health interventions which target body mass, exercise, current smoking and smoking initiation, may have the effect of reducing ED usage and subsequent admission. Individual-level data linking a survey of the population 45 and older in Australia with their emergency department (ED) records is exploited to provide unique insights into the role of lifestyle in predicting emergency care. Controlling for demographic and socioeconomic characteristics, as well as chronic conditions, we find that being a non-smoker, having a healthy body weight, taking vitamins, and doing a vigorous exercise at least once a week can prevent ED presentations. Being a non-smoker, taking vitamins and exercising also prevent subsequent admissions from ED. We do not find a similar protective effect from complying with dietary recommendations. There is no evidence that heavy drinking alone

  3. Clinical audit of emergency unit before and after establishment of the emergency medicine department.

    PubMed

    Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

    2012-02-01

    To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

  4. Hobi emergent pestivirus: Its impact in animal health and importance as a contaminant in biotechnological products

    USDA-ARS?s Scientific Manuscript database

    “Hobi-like” viruses are a group of emerging Pestiviruses which affect cattle and water buffaloes and are common contaminants of biological products. After the first detection from Brazilian samples in Germany in 2004, several Hobi-like isolates have been reported in Italy and some countries of Asia....

  5. 44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

  6. 44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

  7. 44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

  8. 44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

  9. Bridging the gap between guidelines and practice in the management of emerging infectious diseases: a qualitative study of emergency nurses.

    PubMed

    Lam, Stanley Kk; Kwong, Enid Wy; Hung, Maria Sy; Pang, Samantha Mc

    2016-10-01

    To explore the difficulties and strategies regarding guideline implementation among emergency nurses. Emerging infectious diseases remain an underlying source of global health concern. Guidelines for accident and emergency departments would require adjustments for infectious disease management. However, disparities between guidelines and nurses' practice are frequently reported, which undermines the implementation of these guidelines into practice. This article explores the experience of frontline emergency nurses regarding guideline implementation and provides an in-depth account of their strategies in bridging guideline-practice gaps. A qualitative descriptive design was used. Semi-structured, face-to-face, individual interviews were conducted between November 2013-May 2014. A purposive sample of 12 frontline emergency nurses from five accident and emergency departments in Hong Kong were recruited. The audio-recorded interviews were transcribed verbatim and analysed with a qualitative content analysis approach. Four key categories associated with guideline-practice gaps emerged, including getting work done, adapting to accelerated infection control measures, compromising care standards and resolving competing clinical judgments across collaborating departments. The results illustrate that the guideline-practice gaps could be associated with inadequate provision of corresponding organisational supports after guidelines are established. The nurses' experiences have uncovered the difficulties in the implementation of guidelines in emergency care settings and the corresponding strategies used to address these problems. The nurses' experiences reflect their endeavour in adjusting accordingly and adapting themselves to their circumstances in the face of unfeasible guidelines. It is important to customise guidelines to the needs of frontline nurses. Maintaining cross-departmental consensus on guideline interpretation and operation is also indicated as an important

  10. Emerging Technologies as Cognitive Tools for Authentic Learning

    ERIC Educational Resources Information Center

    Herrington, Jan; Parker, Jenni

    2013-01-01

    Employing emerging technologies in learning is becoming increasingly important as a means to support the development of digital media literacy. Using a theoretical framework of authentic learning and technology as cognitive tools, this paper examined student responses to the infusion of emerging technologies in a large first year teacher education…

  11. Status of imported malaria on Réunion Island in 2016.

    PubMed

    Pagès, Frédéric; Houze, Sandrine; Kurtkowiak, Brian; Balleydier, Elsa; Chieze, François; Filleul, Laurent

    2018-05-24

    Autochthonous malaria has been eliminated from Réunion in 1979. To prevent secondary transmission and re-emergence of autochthonous malaria, permanent epidemiologic and entomological surveillance and vector control measures are conducted around imported malaria cases. Results of local malaria surveillance (clinical data and results of epidemiological and entomological investigations around cases) were collected for 2013-2016 and were analysed according to historical data and to the exchanges with malaria-affected areas (estimated by airport data). Form 2013 to 2016, 95 imported malaria cases have been detected in Reunion Island: 42% of cases occurred in the area of repartition of Anopheles arabiensis, but Anopheles mosquitoes were present only around seven cases including one gametocyte carrier. No autochthonous or introduced case has occurred during this period. The lack of chemoprophylaxis or poor adherence was found in the majority (96%) of malaria cases between 2013 and 2016, regardless of trip type. Affinity tourism in Madagascar and Comoros was the cause of 65% of imported malaria cases. The incidence of imported malaria and the incidence rate per 100,000 travellers has continuously decreased since 2001. Now with the drastic decrease of malaria transmission in the Comoros archipelago, most of imported malaria cases in Reunion Island have been contaminated in Madagascar. Immigrants regularly resident in Reunion Island, which travel to malaria endemic countries (mainly Madagascar) to visit their friends and relatives (VFRs) represent a high-risk group of contracting malaria. VFRs, low adherence to pre-travel recommendations, in particular, the compliance on the use of chemoprophylaxis are the main drivers of imported malaria in Reunion Island. Furthermore as previously described, some general practitioners in Reunion Island are always not sufficiently aware of the official recommendations for prescriptions of prophylactic treatments. Social mobilization

  12. A survey of the wetlands and floodplains of the borrow area and wetland/shorebird complex for the remedial action at the chemical plant area of the Weldon Spring Site

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

    Van Lonkhuyzen, R.; Yin, S.; Hlohowskyj, I.

    1995-02-01

    The US Department of Energy is conducting cleanup operations at the Weldon Spring site, St. Charles, Missouri, that will include development of a 77-ha (191-acre) soil borrow area. Eight wetlands, including riverine and palustrine emergent wetland types and totaling 0.9 ha (2.2 acres), will be eliminated during excavation of the borrow area. A 23-ha (57-acre) wetland/shorebird complex will be created at the Busch Conservation Area. The complex will include 2 ha (5 acres) of palustrine emergent wetland as mitigation for wetland losses in the borrow area.

  13. Wireless local area networking for linking a PC reporting system and PACS: clinical feasibility in emergency reporting.

    PubMed

    Yoshihiro, Akiko; Nakata, Norio; Harada, Junta; Tada, Shimpei

    2002-01-01

    Although local area networks (LANs) are commonplace in hospital-based radiology departments today, wireless LANs are still relatively unknown and untried. A linked wireless reporting system was developed to improve work throughput and efficiency. It allows radiologists, physicians, and technologists to review current radiology reports and images and instantly compare them with reports and images from previous examinations. This reporting system also facilitates creation of teaching files quickly, easily, and accurately. It consists of a Digital Imaging and Communications in Medicine 3.0-based picture archiving and communication system (PACS), a diagnostic report server, and portable laptop computers. The PACS interfaces with magnetic resonance imagers, computed tomographic scanners, and computed radiography equipment. The same kind of functionality is achievable with a wireless LAN as with a wired LAN, with comparable bandwidth but with less cabling infrastructure required. This wireless system is presently incorporated into the operations of the emergency and radiology departments, with future plans calling for applications in operating rooms, outpatient departments, all hospital wards, and intensive care units. No major problems have been encountered with the system, which is in constant use and appears to be quite successful. Copyright RSNA, 2002

  14. Radiographers' areas of professional competence related to good nursing care.

    PubMed

    Andersson, Bodil T; Fridlund, Bengt; Elgán, Carina; Axelsson, Asa B

    2008-09-01

    Radiographers' ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer's work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession. The aim was to describe the radiographer's areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions. A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden. The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives. The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers' skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient's immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient. The study highlights the different areas of the radiographer's unique professional competence. The findings provide insight into the radiographer's profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer's work encompasses a variety of components--from caring for the patient to handling and checking the technical equipment.

  15. Coordination of short-term and long-term mitigation measures of hydro-meteorological risks: the importance of establishing a link between emergency management and spatial planning

    NASA Astrophysics Data System (ADS)

    Prenger-Berninghoff, Kathrin; Cortes, V. Juliette; Aye, Zar Chi; Sprague, Teresa

    2013-04-01

    The management of natural hazards involves, as generally known, the four stages of the risk management cycle: Prevention, preparedness, response and recovery. Accordingly, the mitigation of disasters can be performed in terms of short-term and long-term purposes. Whereas emergency management or civil protection helps to strengthen a community's capacity to be better prepared for natural hazards and to better respond in case a disaster strikes, thus addressing the short-term perspective, spatial planning serves long-term planning goals and can therefore implement long-term prevention measures. A purposefully applied risk mitigation strategy requires coordination of short-term and long-term mitigation measures and thus an effective coordination of emergency management and spatial planning. Several actors are involved in risk management and should consequently be linked throughout the whole risk management cycle. However, these actors, partly because of a historically fragmented administrative system, are hardly connected to each other, with spatial planning only having a negligible role compared to other actors1, a problem to which Young (2002) referred to as the "problem of interplay". In contrast, information transfer and decision-taking happen at the same time and are not coordinated among different actors. This applies to the prevention and preparedness phase as well as to the recovery phase, which basically constitutes the prevention phase for the next disaster2. Since investments in both risk prevention and emergency preparedness and response are considered necessary, a better coordination of the two approaches is required. In this regard, Decision Support Systems (DSS) can be useful in order to provide support in the decision-making aspect of risk management. The research work currently undertaken examines the problem of interplay in the four case study areas of the Marie Curie ITN, CHANGES3. The link between different risk management actors will be explored

  16. Coaching Teachers: An Important Principal Role. Research into Practice

    ERIC Educational Resources Information Center

    Williamson, Ronald

    2012-01-01

    A principal's most important role is instructional leader. There is a growing recognition of the importance of working with teachers, serving as a mentor and coach. Coaching has emerged as one of the more effective professional development options for adult learners. It is an important tool because it is an investment in human capital and in the…

  17. Study Designs and Evaluation Models for Emergency Department Public Health Research

    PubMed Central

    Broderick, Kerry B.; Ranney, Megan L.; Vaca, Federico E.; D’Onofrio, Gail; Rothman, Richard E.; Rhodes, Karin V.; Becker, Bruce; Haukoos, Jason S.

    2011-01-01

    Public health research requires sound design and thoughtful consideration of potential biases that may influence the validity of results. It also requires careful implementation of protocols and procedures that are likely to translate from the research environment to actual clinical practice. This article is the product of a breakout session from the 2009 Academic Emergency Medicine consensus conference entitled “Public Health in the ED: Screening, Surveillance, and Intervention” and serves to describe in detail aspects of performing emergency department (ED)-based public health research, while serving as a resource for current and future researchers. In doing so, the authors describe methodologic features of study design, participant selection and retention, and measurements and analyses pertinent to public health research. In addition, a number of recommendations related to research methods and future investigations related to public health work in the ED are provided. Public health investigators are poised to make substantial contributions to this important area of research, but this will only be accomplished by employing sound research methodology in the context of rigorous program evaluation. PMID:20053232

  18. Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

    PubMed

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

    The 2015 Academic Emergency Medicine (AEM) consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to: 1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; 2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and 3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified prior to the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were 164 individuals involved in the conference spanning various specialties, including emergency medicine (EM), radiology, surgery, medical physics, and the decision sciences. This issue of AEM is dedicated to the proceedings of the 16th annual AEM consensus conference as well as original research related to emergency diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

  19. Understanding Emergency Care Delivery Through Computer Simulation Modeling.

    PubMed

    Laker, Lauren F; Torabi, Elham; France, Daniel J; Froehle, Craig M; Goldlust, Eric J; Hoot, Nathan R; Kasaie, Parastu; Lyons, Michael S; Barg-Walkow, Laura H; Ward, Michael J; Wears, Robert L

    2018-02-01

    In 2017, Academic Emergency Medicine convened a consensus conference entitled, "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes." This article, a product of the breakout session on "understanding complex interactions through systems modeling," explores the role that computer simulation modeling can and should play in research and development of emergency care delivery systems. This article discusses areas central to the use of computer simulation modeling in emergency care research. The four central approaches to computer simulation modeling are described (Monte Carlo simulation, system dynamics modeling, discrete-event simulation, and agent-based simulation), along with problems amenable to their use and relevant examples to emergency care. Also discussed is an introduction to available software modeling platforms and how to explore their use for research, along with a research agenda for computer simulation modeling. Through this article, our goal is to enhance adoption of computer simulation, a set of methods that hold great promise in addressing emergency care organization and design challenges. © 2017 by the Society for Academic Emergency Medicine.

  20. A new era of emergency care: planning and design consideration.

    PubMed

    Zilm, Frank

    2007-01-01

    Emergency care is one of the most complex, rapidly growing areas of ambulatory care. Providers need to consider new issues related to management of low-acuity patients, capacity for surge events, and the need to integrate patient focused care into the emergency department environment. This article explores these issues and discusses basic organizational topologies for facilities.