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Sample records for mundo em crise

  1. Managing Crises.

    ERIC Educational Resources Information Center

    Eggen, Jerald D.; Mackenzie, R. Alec

    1987-01-01

    To avoid emergency-driven work environments, crises should be anticipated to the extent possible; steps should be taken to prevent them or limit their consequences. Crises have both internal (personal) and external causes based on poor performance, unreasonable demands, or shifting priorities. Administrators need to cushion deadlines, clarify…

  2. Managing Crises.

    ERIC Educational Resources Information Center

    Nation, Carol

    1988-01-01

    Many school systems have started to go beyond programs focused on suicide prevention or drug abuse to encompass all types of school crises. School districts and individual schools across tha nation are formulating crisis management plans and in some states they have become mandatory. Basic procedures drawn from plans adopted by schools include the…

  3. When Crises Call

    ERIC Educational Resources Information Center

    Kisch, Marian

    2012-01-01

    Natural disasters, as well as crises of the man-made variety, call on leaders of school districts to manage scenarios impossible to predict and for which no amount of training can adequately prepare. One thing all major crises hold in common is their far-reaching effects, which can run the gamut from personal safety and mental well-being to the…

  4. When Crises Call

    ERIC Educational Resources Information Center

    Kisch, Marian

    2012-01-01

    Natural disasters, as well as crises of the man-made variety, call on leaders of school districts to manage scenarios impossible to predict and for which no amount of training can adequately prepare. One thing all major crises hold in common is their far-reaching effects, which can run the gamut from personal safety and mental well-being to the…

  5. Review of book vestibular crises

    NASA Technical Reports Server (NTRS)

    Blagoveshchenskaya, N. S.

    1980-01-01

    The etiology, pathogenesis, clinical practice, treatment and rehabilitation of patients with vestibular crises is discussed. Classifications for vestibular disorders are given. Information on the frequency of vestibular crises is given.

  6. Five Potential Crises.

    ERIC Educational Resources Information Center

    Futurist, 1984

    1984-01-01

    Five areas that have great potential for becoming crises in the future are described: a warming of the earth's climate, changing weather patterns and growing seasons; water shortage; the decay of the physical infrastructure, e.g., decay of roads, bridges; breakdown of the international monetary and trading system; and nuclear warfare. (Author/RM)

  7. Five Potential Crises.

    ERIC Educational Resources Information Center

    Futurist, 1984

    1984-01-01

    Five areas that have great potential for becoming crises in the future are described: a warming of the earth's climate, changing weather patterns and growing seasons; water shortage; the decay of the physical infrastructure, e.g., decay of roads, bridges; breakdown of the international monetary and trading system; and nuclear warfare. (Author/RM)

  8. Forecasting potential crises

    SciTech Connect

    Neufeld, W.P.

    1984-04-01

    Recently, the Trend Analysis Program (TAP) of the American Council of Life Insurance commissioned the Futures Group of Glastonbury, Connecticut, to examine the potential for large-scale catastrophic events in the near future. TAP was specifically concerned with five potential crises: the warming of the earth's atmosphere, the water shortage, the collapse of the physical infrastructure, the global financial crisis, and the threat of nuclear war. We are often unprepared to take action; in these cases, we lose an advantage we might have otherwise had. This is the whole idea behind forecasting: to foresee possibilities and to project how we can respond. If we are able to create forecasts against which we can test policy options and choices, we may have the luxury of adopting policies ahead of events. Rather than simply fighting fires, we have the option of creating a future more to our choosing. Short descriptions of these five potential crises and, in some cases, possible solutions are presented.

  9. Managing Classroom Crises. Fastback 465.

    ERIC Educational Resources Information Center

    Hardin, Carlette Jackson; Harris, E. Ann

    This booklet explains the importance of teachers being trained to handle daily crises they face in their classrooms and to see crises as an opportunity for both students and teachers. It discusses the skills and attitudes teachers need in order to be effective crisis managers. After an introduction, three sections examine: "What Is a…

  10. [Demography and crises in Algeria].

    PubMed

    Cherrad, S E

    1996-01-01

    This article argues that demographic factors are an underlying cause of the many political, economic, social, and cultural crises that Algeria has experienced over the course of the 1990s. The author suggests that although the demography of the country is generally ignored when these issues are discussed, the rapid rate of population growth, which has caused the population to double in about 20 years, and the continued dependency burden, due to the fact that over 50% of the population are under age 20, are major causes of the country's current malaise.

  11. Economic crises and the elderly.

    PubMed

    Backes-Gellner, Uschi; Schneider, Martin R

    2012-01-01

    Economic crises in the last decades have swept elderly workers more than younger workers out of employment. But now the tide is turning. In affluent societies, elderly workers will have more opportunities of being employed in meaningful and well-paid jobs than ever before. On account of demographic changes, fewer (younger) workers will be around, and most of the reasons that in the past have induced employers to lay off older rather than younger workers will disappear. Future employment strategies will have to focus more on an optimal age mix and on benefitting from the full potential of the elderly. Copyright © 2011 S. Karger AG, Basel.

  12. Ethical Crises and Cultural Differences

    PubMed Central

    Meleis, Afaf Ibrahim; Jonsen, Albert R.

    1983-01-01

    Generalizations about patients without careful attention to their cultural background, their values and norms could lead to a number of ethical crises. The informed consent, disclosure of diagnosis and prognosis, and discussions of termination of treatment are reflections of Western cultural values. They represent respect for autonomy of clients and respect for openness in communications. For patients from other cultures such practices have different meanings that may violate their own values. The result of such conflict in practices and meanings can render the relationship between patients and health care personnel difficult at best and distrustful at worst. PMID:6613119

  13. The Inevitable School Crises: Are You Ready?

    ERIC Educational Resources Information Center

    Quinn, Terrence

    2002-01-01

    Describes five-point crises-management plan: Assemble a school crises team, assign specific roles to each team member, delineate the responsibilities of each team member, conduct training for all staff members. Shares lessons learned in managing crisis situations. (PKP)

  14. Helping Students Cope with Fears and Crises.

    ERIC Educational Resources Information Center

    Walz, Garry R., Ed.; Bleuer, Jeanne C., Ed.

    This document consists of two modules extracted from a six-module larger work. Module 1 presents six articles on the topic of "helping students to cope with fears and crises." Module 2 contains 17 articles on "programs and practices for helping students cope with fears and crises." Article titles and authors are as follows: (1)…

  15. Deferred School Maintenance Creates National Crises.

    ERIC Educational Resources Information Center

    Geiger, Philip E.

    2002-01-01

    Describes the cost and causes of the school maintenance "crises"; lists seven questions to determine if a school district has a quality maintenance program; describes consequences of deferred school maintenance in Yuma (Arizona) Union High School District. (PKP)

  16. Assessing Chaos in Sickle Cell Anemia Crises

    NASA Astrophysics Data System (ADS)

    Harris, Wesley; Le Floch, Francois

    2006-11-01

    Recent developments in sickle cell research and blood flow modeling allow for new interpretations of the sickle cell crises. With an appropriate set of theoretical and empirical equations describing the dynamics of the red cells in their environment, and the response of the capillaries to major changes in the rheology, a complete mathematical system has been derived. This system of equations is believed to be of major importance to provide new and significant insight into the causes of the disease and related crises. With simulations, it has been proven that the system transition from a periodic solution to a chaotic one, which illustrates the onset of crises from a regular blood flow synchronized with the heart beat. Moreover, the analysis of the effects of various physiological parameters exposes the potential to control chaotic solutions, which, in turn, could lead to the creation of new and more effective treatments for sickle cell anemia. .

  17. A model of international financial crises

    NASA Astrophysics Data System (ADS)

    Kaizoji, Taisei

    2001-10-01

    This paper proposes a model of international financial crises that is based on the statistical mechanics. In our model the international stock market is composed of two groups of traders mutually influencing each other with respect to their decision behavior, and financial contagion between markets occurs as a result of attempts by traders in the domestic market to imitate the behavior of traders who participate into exchange in a foreign market. This provides a channel through which a crisis in one market such as contemporaneous stock market crashes can be transmitted to other markets. We show that the model can explain the stylized facts characterizing periods of recent international financial crises.

  18. Disruption, Disaster, and Death: Helping Students Deal with Crises.

    ERIC Educational Resources Information Center

    Obiakor, Festus E.; And Others

    This book provides strategies for helping atypical students deal with the crises of disruption, disaster, and death. The importance of collaborative networks between school and community agencies in addressing crises is stressed throughout the book. Chapter 1 notes the relationship between crises and special education and the need to utilize a…

  19. Campus Communications in the Age of Crises

    ERIC Educational Resources Information Center

    McGuire, Patricia

    2007-01-01

    Recent catastrophes have brought about numerous critiques and changes to campus communications. In this article, the author shares the lessons she has learned from the crises she experienced during her 18 years of being the president of Trinity (Washington) University. Furthermore, Joan Hinde Stewart, president of Hamilton College, adds her…

  20. Three Campus Crises: Lessons for Administrators.

    ERIC Educational Resources Information Center

    Rothman, Michael

    1992-01-01

    In October 1989-October 1991, Mills College (California) faced three crises: an earthquake; a strike over plans to convert to a coeducational institution; and a devastating fire in the area. The college has learned to focus its structural, human, political, and symbolic frames of reference; communicate; plan; consider the public; and develop…

  1. Phase Synchronization Detection of Financial Market Crises

    NASA Astrophysics Data System (ADS)

    Yang, Chun-Xia; Wu, Hong-Fa; Zhang, Ying-Chao; Xia, Bing-Ying; Itoh, Masaru

    Financial market is a complex system whose characteristic behaviors can be caught in corresponding time series. Analyzing such time series by appropriate methods will aid in making inferences and predictions. Here phase synchronization approach is used for visual pattern recognition of crises. Based on Empirical Mode Decomposition and the Hilbert transform, phase evolution of various rhythmic components exiting in the market is extracted. Then the concept of synchronization can be successfully applied to crises detection. Unlike other approaches, this detection distinguishes crises from normal state according to variations of interaction among rhythmic components. The empirical results mentioned here convince us of the fact that financial crises take place at the time when the adjustment processes of other quasi-periodic oscillations and the trend are out of synchronization. On the contrary, when other rhythmic oscillations can be synchronized with the trend, the market will develop healthily. The presence and duration of synchronization reflect dynamics of financial market. All these results will enlighten people to disclose its reasons and probe methods for controlling its pathological rhythms.

  2. Dealing with Crises: One Principal's Experience.

    ERIC Educational Resources Information Center

    Foley, Charles F.

    1986-01-01

    The principal of Concord High School (New Hampshire) recounts the 1985-86 school year's four crises--the visits of teacher-astronaut Christa McAuliffe and Secretary of Education William Bennett, the shooting of a former student, and the Challenger space shuttle explosion. The greatest challenge was resuming the normal schedule and fielding media…

  3. Dealing with Crises: One Principal's Experience.

    ERIC Educational Resources Information Center

    Foley, Charles F.

    1986-01-01

    The principal of Concord High School (New Hampshire) recounts the 1985-86 school year's four crises--the visits of teacher-astronaut Christa McAuliffe and Secretary of Education William Bennett, the shooting of a former student, and the Challenger space shuttle explosion. The greatest challenge was resuming the normal schedule and fielding media…

  4. Campus Communications in the Age of Crises

    ERIC Educational Resources Information Center

    McGuire, Patricia

    2007-01-01

    Recent catastrophes have brought about numerous critiques and changes to campus communications. In this article, the author shares the lessons she has learned from the crises she experienced during her 18 years of being the president of Trinity (Washington) University. Furthermore, Joan Hinde Stewart, president of Hamilton College, adds her…

  5. Summoning Spectres: Crises and Their Construction

    ERIC Educational Resources Information Center

    Clarke, John; Newman, Janet

    2010-01-01

    The construction of crises is a key analytical and political issue. This paper examines what is at stake in the processes and practices of construction, responding to the arguments made in Andrew Gamble's "The spectres at the feast" (2009). We suggest that there are three areas of critical concern: first, that too little attention has…

  6. Clinical review: The management of hypertensive crises

    PubMed Central

    Varon, Joseph; Marik, Paul E

    2003-01-01

    Hypertension is an extremely common clinical problem, affecting approximately 50 million people in the USA and approximately 1 billion individuals worldwide. Approximately 1% of these patients will develop acute elevations in blood pressure at some point in their lifetime. A number of terms have been applied to severe hypertension, including hypertensive crises, emergencies, and urgencies. By definition, acute elevations in blood pressure that are associated with end-organ damage are called hypertensive crises. Immediate reduction in blood pressure is required only in patients with acute end-organ damage. This article reviews current concepts, and common misconceptions and pitfalls in the diagnosis and management of patients with acutely elevated blood pressure. PMID:12974970

  7. Early Life Crises of Habitable Planets

    SciTech Connect

    Pierrehumbert, Raymond

    2006-02-08

    There are a number of crises that a potentially habitable planet must avoid or surmount if its potential is to be realized. These include the runaway greenhouse, loss of atmosphere by chemical or physical processes, and long-lasting global glaciation. In this lecture I will present research on the climate dynamics governing such processes, with particular emphasis on the lessons to be learned from the cases of Early Mars and the Neoproterozoic Snowball Earth.

  8. Entropy Crises in Glasses and Random Heteropolymers.

    PubMed

    Wolynes, Peter G

    1997-01-01

    The concept of random first order transitions with configurational entropy crises provides a theoretical framework for understanding the glass transition. This paper discusses such transitions in exactly solvable spin glass models and in globular random heteropolymers and their relation to glass transitions in molecular fluids and polymers. The Vogel-Fulcher law is shown to be related to the search time through the energy landscape of an "entropic droplet."

  9. Early Life Crises of Habitable Planets

    ScienceCinema

    Pierrehumbert, Raymond [University of Chicago, Chicago, Illinois, United States

    2016-07-12

    There are a number of crises that a potentially habitable planet must avoid or surmount if its potential is to be realized. These include the runaway greenhouse, loss of atmosphere by chemical or physical processes, and long-lasting global glaciation. In this lecture I will present research on the climate dynamics governing such processes, with particular emphasis on the lessons to be learned from the cases of Early Mars and the Neoproterozoic Snowball Earth.

  10. An Attempt at an Eclectic Model of Nonnormative Crises.

    ERIC Educational Resources Information Center

    Walker, Alexis J.

    This paper addresses the theory and data from differing disciplines regarding the generic aspects of nonnormative crises (those unrelated to ontogeny or stage of the family life cycle) in order to increase understanding of the underlying processes involved. The first part of the paper reviews the literature on the study of family crises,…

  11. Uses of Assertiveness Training for Women in Midlife Crises.

    ERIC Educational Resources Information Center

    Stringer-Moore, Donna M.

    Midlife crises require different behavioral responses for women who have made decisions about marriage, motherhood, and career. For women experiencing midlife crises, assertiveness training has the potential to resolve conflicts. Assertiveness training (AT) consists of three components, i.e., skills training, anxiety reduction, and cognitive…

  12. Constructing event trees for volcanic crises

    USGS Publications Warehouse

    Newhall, C.; Hoblitt, R.

    2002-01-01

    Event trees are useful frameworks for discussing probabilities of possible outcomes of volcanic unrest. Each branch of the tree leads from a necessary prior event to a more specific outcome, e.g., from an eruption to a pyroclastic flow. Where volcanic processes are poorly understood, probability estimates might be purely empirical - utilizing observations of past and current activity and an assumption that the future will mimic the past or follow a present trend. If processes are better understood, probabilities might be estimated from a theoritical model, either subjectively or by numerical simulations. Use of Bayes' theorem aids in the estimation of how fresh unrest raises (or lowers) the probabilities of eruptions. Use of event trees during volcanic crises can help volcanologists to critically review their analysis of hazard, and help officials and individuals to compare volcanic risks with more familiar risks. Trees also emphasize the inherently probabilistic nature of volcano forecasts, with multiple possible outcomes.

  13. Measuring complexity in Brazilian economic crises

    PubMed Central

    Mortoza, Letícia P. D.; Piqueira, José R. C.

    2017-01-01

    Capital flows are responsible for a strong influence on the foreign exchange rates and stock prices macroeconomic parameters. In volatile economies, capital flows can change due to several types of social, political and economic events, provoking oscillations on these parameters, which are recognized as economic crises. This work aims to investigate how these two macroeconomic variables are related with crisis events by using the traditional complex measures due to Lopez-Mancini-Calbet (LMC) and to Shiner-Davison-Landsberg (SDL), that can be applied to any temporal series. Here, Ibovespa (Bovespa Stock Exchange main Index) and the “dollar-real” parity are the background for calculating the LMC and SDL complexity measures. By analyzing the temporal evolution of these measures, it is shown that they might be related to important events that occurred in the Brazilian economy. PMID:28301506

  14. Identifying financial crises in real time

    NASA Astrophysics Data System (ADS)

    da Fonseca, Eder Lucio; Ferreira, Fernando F.; Muruganandam, Paulsamy; Cerdeira, Hilda A.

    2013-03-01

    Following the thermodynamic formulation of a multifractal measure that was shown to enable the detection of large fluctuations at an early stage, here we propose a new index which permits us to distinguish events like financial crises in real time. We calculate the partition function from which we can obtain thermodynamic quantities analogous to the free energy and specific heat. The index is defined as the normalized energy variation and it can be used to study the behavior of stochastic time series, such as financial market daily data. Famous financial market crashes-Black Thursday (1929), Black Monday (1987) and the subprime crisis (2008)-are identified with clear and robust results. The method is also applied to the market fluctuations of 2011. From these results it appears as if the apparent crisis of 2011 is of a different nature to the other three. We also show that the analysis has forecasting capabilities.

  15. Professional conduct of scientists during volcanic crises

    USGS Publications Warehouse

    ,; Newhall, Chris; Aramaki, Shigeo; Barberi, Franco; Blong, Russell; Calvache, Marta; Cheminee, Jean-Louis; Punongbayan, Raymundo; Siebe, Claus; Simkin, Tom; Sparks, Stephen; Tjetjep, Wimpy

    1999-01-01

    Stress during volcanic crises is high, and any friction between scientists can distract seriously from both humanitarian and scientific effort. Friction can arise, for example, if team members do not share all of their data, if differences in scientific interpretation erupt into public controversy, or if one scientist begins work on a prime research topic while a colleague with longer-standing investment is still busy with public safety work. Some problems arise within existing scientific teams; others are brought on by visiting scientists. Friction can also arise between volcanologists and public officials. Two general measures may avert or reduce friction: (a) National volcanologic surveys and other scientific groups that advise civil authorities in times of volcanic crisis should prepare, in advance of crises, a written plan that details crisis team policies, procedures, leadership and other roles of team members, and other matters pertinent to crisis conduct. A copy of this plan should be given to all current and prospective team members. (b) Each participant in a crisis team should examine his or her own actions and contribution to the crisis effort. A personal checklist is provided to aid this examination. Questions fall generally in two categories: Are my presence and actions for the public good? Are my words and actions collegial, i.e., courteous, respectful, and fair? Numerous specific solutions to common crisis problems are also offered. Among these suggestions are: (a) choose scientific team leaders primarily for their leadership skills; (b) speak publicly with a single scientific voice, especially when forecasts, warnings, or scientific disagreements are involved; (c) if you are a would-be visitor, inquire from the primary scientific team whether your help would be welcomed, and, in general, proceed only if the reply is genuinely positive; (d) in publications, personnel evaluations, and funding, reward rather than discourage teamwork. Models are

  16. Scientists' Perceptions of Communicating During Crises

    NASA Astrophysics Data System (ADS)

    Dohaney, J. A.; Hudson-Doyle, E.; Brogt, E.; Wilson, T. M.; Kennedy, B.

    2015-12-01

    To further our understanding of how to enhance student science and risk communication skills in natural hazards and earth science courses, we conducted a pilot study to assess the different perceptions of expert scientists and risk communication practitioners versus the perceptions of students. These differences will be used to identify expert views on best practice, and improve the teaching of communication skills at the University level. In this pilot study, a perceptions questionnaire was developed and validated. Within this, respondents (geoscientists, engineers, and emergency managers; n=44) were asked to determine their agreement with the use and effectiveness of specific communication strategies (within the first 72 hours after a devastating earthquake) when communicating to the public. In terms of strategies and information to the public, the respondents were mostly in agreement, but there were several statements which elicited large differences between expert responses: 1) the role and purpose of the scientific communication during crises (to persuade people to care, to provide advice, to empower people to take action); 2) the scientist's delivery (showing the scientists emotions and enthusiasm for scientific concepts they are discussing); and 3) the amount of data that is discussed (being comprehensive versus 'only the important' data). The most disagreed upon dimension was related to whether to disclose any political influence on the communication. Additionally, scientists identified that being an effective communicator was an important part of their job, and agreed that it is important to practice these skills. Respondents generally indicated that while scientists should be accountable for the science advice provided, they should not be held liable.

  17. Stochastic Modelling of Past Volcanic Crises

    NASA Astrophysics Data System (ADS)

    Woo, Gordon

    2017-04-01

    It is customary to have continuous monitoring of volcanoes showing signs of unrest that might lead to an eruption threatening local populations. Despite scientific progress in estimating the probability of an eruption occurring, the concept of continuously tracking eruption probability remains a future aspiration for volcano risk analysts. During some recent major volcanic crises, attempts have been made to estimate the eruption probability in real time to support government decision-making. These include the possibility of an eruption of Katla linked with the eruption of Eyjafjallajökull in 2010, and the Santorini crisis of 2011-2012. However, once a crisis fades, interest in analyzing the probability that there might have been an eruption tends to wane. There is an inherent outcome bias well known to psychologists: if disaster was avoided, there is perceived to be little purpose in exploring scenarios where a disaster might have happened. Yet the better that previous periods of unrest are understood and modelled, the better that the risk associated with future periods of unrest will be quantified. Scenarios are counterfactual histories of the future. The task of quantifying the probability of an eruption for a past period of unrest should not be merely a statistical calculation, but should serve to elucidate and refine geophysical models of the eruptive processes. This is achieved by using a Bayesian Belief Network approach, in which monitoring observations are used to draw inferences on the underlying causal factors. Specifically, risk analysts are interested in identifying what dynamical perturbations might have tipped an unrest period in history over towards an eruption, and assessing what was the likelihood of such perturbations. Furthermore, in what ways might a historical volcano crisis have turned for the worse? Such important counterfactual questions are addressed in this paper.

  18. Economic crises and mortality: a review of the literature.

    PubMed

    Falagas, M E; Vouloumanou, E K; Mavros, M N; Karageorgopoulos, D E

    2009-08-01

    Studies evaluating the association of economic variables with mortality have produced mixed findings. We sought to evaluate whether economic crises confer increase in mortality. We reviewed studies analysing mortality in the general population in periods of economic crisis compared with periods prior to or after the crisis, by searching PubMed, Scopus, Cochrane and the World Wide Web. Eleven studies were included in this review; they referred to economic crises that occurred in Russia, South Korea, as well as South or Central American, African or European countries (5, 2, 2, 1 and 1 studies respectively). Periods of economic crises were associated with the increase in all-cause mortality in seven out of eight studies that reported specific relevant data and increase in cardiovascular mortality in six out of seven studies. Increase in mortality because of respiratory infections, chronic liver disease, suicides, homicides and mortality in infants was noted in association with economic crises in all 5, 4, 6, 5 and 3 studies, respectively, that reported specific relevant data. Mortality from transport accidents decreased with economic crises in five out of six studies. Economic crises in less affluent countries are accompanied with the increase in all-cause mortality, as well as mortality from most of the major specific causes. Further data are needed to establish the effect of economic crises on mortality in more affluent countries. We believe that the above-mentioned association could be attributed to increased psychosocial stress during such periods, among other factors. Public health authorities should be aware of this issue and consider appropriate preventive and control measures.

  19. Strengthening the evidence base for health programming in humanitarian crises.

    PubMed

    Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

    2014-09-12

    Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial. Copyright © 2014, American Association for the Advancement of Science.

  20. The benefits of flexible team interaction during crises.

    PubMed

    Stachowski, Alicia A; Kaplan, Seth A; Waller, Mary J

    2009-11-01

    Organizations increasingly rely on teams to respond to crises. While research on team effectiveness during nonroutine events is growing, naturalistic studies examining team behaviors during crises are relatively scarce. Furthermore, the relevant literature offers competing theoretical rationales concerning effective team response to crises. In this article, the authors investigate whether high- versus average-performing teams can be distinguished on the basis of the number and complexity of their interaction patterns. Using behavioral observation methodology, the authors coded the discrete verbal and nonverbal behaviors of 14 nuclear power plant control room crews as they responded to a simulated crisis. Pattern detection software revealed systematic differences among crews in their patterns of interaction. Mean comparisons and discriminant function analysis indicated that higher performing crews exhibited fewer, shorter, and less complex interaction patterns. These results illustrate the limitations of standardized response patterns and highlight the importance of team adaptability. Implications for future research and for team training are included.

  1. Foreign exchange rate entropy evolution during financial crises

    NASA Astrophysics Data System (ADS)

    Stosic, Darko; Stosic, Dusan; Ludermir, Teresa; de Oliveira, Wilson; Stosic, Tatijana

    2016-05-01

    This paper examines the effects of financial crises on foreign exchange (FX) markets, where entropy evolution is measured for different exchange rates, using the time-dependent block entropy method. Empirical results suggest that financial crises are associated with significant increase of exchange rate entropy, reflecting instability in FX market dynamics. In accordance with phenomenological expectations, it is found that FX markets with large liquidity and large trading volume are more inert - they recover quicker from a crisis than markets with small liquidity and small trading volume. Moreover, our numerical analysis shows that periods of economic uncertainty are preceded by periods of low entropy values, which may serve as a tool for anticipating the onset of financial crises.

  2. Constraints to addressing food insecurity in protracted crises

    PubMed Central

    Maxwell, Daniel; Russo, Luca; Alinovi, Luca

    2012-01-01

    A substantial portion of the world's people have not made adequate progress toward overcoming hunger or achieving sustainable livelihoods. The classic approach to addressing chronic food insecurity has been a strategy of agricultural development, supplemented by humanitarian assistance in the event of a shock or crisis—an approach predicated on assumptions that do not fit the context of protracted crises. This article describes protracted crises and argues that they are sufficiently different to warrant special consideration, but there are unique constraints to engagement in protracted crises. The article explores the constraints promoting sustainable livelihoods in these contexts and proposes elements of an alternative approach. It evaluates the limited evidence available about such an approach and outlines important questions for further research. PMID:21646522

  3. Mental Health Aspects of Responding to Campus Crises

    ERIC Educational Resources Information Center

    Flynn, Christopher; Sharma, Micky M.

    2016-01-01

    Tragedy can strike a college campus in unpredictable and often horrific ways that may lead to traumatic responses for individuals and the entire campus community. Crises on campus demand an appropriate response to support the community, provide assistance to affected individuals and guide healing efforts.

  4. Preparing for School Crises: Administrator Perceptions on Supports for Teachers

    ERIC Educational Resources Information Center

    Brophy, Chelsey M.; Maras, Melissa A.; Wang, Ze

    2015-01-01

    Traumatic events and crises involving schools and children often become high-profile occurrences; however, little attention is given to teachers and how they cope with crisis. The purpose of this study was to investigate administrators' perceptions of including additional support for teachers in school crisis policies. Specifically, the study…

  5. Danger and Opportunity: Institutional Identity Crises and Transformation

    ERIC Educational Resources Information Center

    Blumenfeld, Warren J.

    2006-01-01

    Using the theoretical lenses of Erik Erikson, Burton Clark, and Sonia Nieto, the author highlights the case of Colgate University--a private liberal arts university in central New York State--to consider larger issues of institutional identity by investigating points of crises bringing to the surface opposing forces, which struggle, on one hand,…

  6. Supporting Students with Disabilities during School Crises: A Teacher's Guide

    ERIC Educational Resources Information Center

    Clarke, Laura S.; Embury, Dusty Columbia; Jones, Ruth E.; Yssel, Nina

    2014-01-01

    Most schools have crisis plans to support student safety, but few plans address the complex needs of students with disabilities. School supports should include analysis of school plans and student strengths and needs to ensure that students with disabilities have the best opportunity to be safe in school crises. Recommendations include developing…

  7. Racial Crises in the Army: Prediction, Prevention, and Intervention

    DTIC Science & Technology

    1981-07-01

    8217- _-__ 4. TITLE (ad Subtitle) S. TYPE OF REPORT & PERIOD COVERED RACIAL CRISES IN THE ARMY: PREDICTION, PREVENTION, AND INTERVENTION 6. PERFORMING ORG...strategy Racial incident Computer simulation Racial climate Race relations Enlisted men Racial crisis Racial tension Intervention strategy Racial...effective command strategies for alleviating racial tension . Soldiers’ perceptions of racial climate were validated successfully against certain records

  8. Supporting Students with Disabilities during School Crises: A Teacher's Guide

    ERIC Educational Resources Information Center

    Clarke, Laura S.; Embury, Dusty Columbia; Jones, Ruth E.; Yssel, Nina

    2014-01-01

    Most schools have crisis plans to support student safety, but few plans address the complex needs of students with disabilities. School supports should include analysis of school plans and student strengths and needs to ensure that students with disabilities have the best opportunity to be safe in school crises. Recommendations include developing…

  9. Responding to the Power Crises in Teacher Education.

    ERIC Educational Resources Information Center

    Bagley, Ayers, Ed.

    This document presents the texts of papers delivered at the 1971 meeting of the Society of Professors of Education. These papers are as follows: "Power Conflicts and Crises in Teacher Education: Some Historical and International Perspectives," by William W. Brickman; "Expectations vs. Reality: Behavioral Science Response to Teacher Education…

  10. An Ecological Momentary Assessment of Relapse Crises in Dieting

    ERIC Educational Resources Information Center

    Carels, Robert A.; Douglass, Olivia M.; Cacciapaglia, Holly M.; O'Brien, William H.

    2004-01-01

    Much of the research on relapse crises in dieting has focused on isolated lapse events and relied heavily on retrospective self-report data. The present study sought to overcome these limitations by using ecological momentary assessment (EMA) techniques to examine situations of dietary temptation and lapse with a sample of obese, formerly…

  11. Danger and Opportunity: Institutional Identity Crises and Transformation

    ERIC Educational Resources Information Center

    Blumenfeld, Warren J.

    2006-01-01

    Using the theoretical lenses of Erik Erikson, Burton Clark, and Sonia Nieto, the author highlights the case of Colgate University--a private liberal arts university in central New York State--to consider larger issues of institutional identity by investigating points of crises bringing to the surface opposing forces, which struggle, on one hand,…

  12. Preparing for School Crises: Administrator Perceptions on Supports for Teachers

    ERIC Educational Resources Information Center

    Brophy, Chelsey M.; Maras, Melissa A.; Wang, Ze

    2015-01-01

    Traumatic events and crises involving schools and children often become high-profile occurrences; however, little attention is given to teachers and how they cope with crisis. The purpose of this study was to investigate administrators' perceptions of including additional support for teachers in school crisis policies. Specifically, the study…

  13. The Crises and Freedoms of Researching Your Own Life

    ERIC Educational Resources Information Center

    Pearce, Caroline

    2010-01-01

    There has been much work highlighting the benefits of autoethnographic research yet little acknowledgement of the demands researching your own life makes on the emotional and mental wellbeing of the researcher. This paper explores the consequences that can arise as a result of autoethnographic research by detailing the crises involved in…

  14. Mental Health Aspects of Responding to Campus Crises

    ERIC Educational Resources Information Center

    Flynn, Christopher; Sharma, Micky M.

    2016-01-01

    Tragedy can strike a college campus in unpredictable and often horrific ways that may lead to traumatic responses for individuals and the entire campus community. Crises on campus demand an appropriate response to support the community, provide assistance to affected individuals and guide healing efforts.

  15. Resilience of natural gas networks during conflicts, crises and disruptions.

    PubMed

    Carvalho, Rui; Buzna, Lubos; Bono, Flavio; Masera, Marcelo; Arrowsmith, David K; Helbing, Dirk

    2014-01-01

    Human conflict, geopolitical crises, terrorist attacks, and natural disasters can turn large parts of energy distribution networks offline. Europe's current gas supply network is largely dependent on deliveries from Russia and North Africa, creating vulnerabilities to social and political instabilities. During crises, less delivery may mean greater congestion, as the pipeline network is used in ways it has not been designed for. Given the importance of the security of natural gas supply, we develop a model to handle network congestion on various geographical scales. We offer a resilient response strategy to energy shortages and quantify its effectiveness for a variety of relevant scenarios. In essence, Europe's gas supply can be made robust even to major supply disruptions, if a fair distribution strategy is applied.

  16. Resilience of Natural Gas Networks during Conflicts, Crises and Disruptions

    PubMed Central

    Carvalho, Rui; Buzna, Lubos; Bono, Flavio; Masera, Marcelo; Arrowsmith, David K.; Helbing, Dirk

    2014-01-01

    Human conflict, geopolitical crises, terrorist attacks, and natural disasters can turn large parts of energy distribution networks offline. Europe's current gas supply network is largely dependent on deliveries from Russia and North Africa, creating vulnerabilities to social and political instabilities. During crises, less delivery may mean greater congestion, as the pipeline network is used in ways it has not been designed for. Given the importance of the security of natural gas supply, we develop a model to handle network congestion on various geographical scales. We offer a resilient response strategy to energy shortages and quantify its effectiveness for a variety of relevant scenarios. In essence, Europe's gas supply can be made robust even to major supply disruptions, if a fair distribution strategy is applied. PMID:24621655

  17. [Political crises in Africa and infant and child mortality].

    PubMed

    Garenne, M

    1997-01-01

    Many African countries experienced severe political crises after independence, and in a number of cases the crises had significant demographic consequences, especially for child mortality. Data based on maternity histories allowed the reconstruction of child mortality trends over the past 20-30 years in Uganda, Ghana, Rwanda, Madagascar, and Mozambique. The indicator used was the child mortality quotient (number of deaths of under-5 children per 1000 births). Uganda's child mortality declined from 227/1000 in 1960 to 154/1000 in 1970, but the trend was reversed in 1971, when Idi Amin Dada came to power, and the rate reached 204/1000 in 1982 before beginning to decline again. The level of mortality remained high, however, and was still 160/1000 in 1988. Ghana suffered a political and economic crisis during 1979-84. Child mortality rose from 130/1000 in 1978 to 175/1000 in 1983. Mortality rates began a rapid decline after structural adjustment programs were begun, possibly due to improved management of health services. The child mortality rate in Rwanda increased from around 220/1000 in 1960 to 240/1000 in 1975, before beginning a decline in the late 1970s that reached 140/1000 by 1990. The period of political stability and relative prosperity during the 15-year reign of Juvenal Habyarimana was associated with the decline. Political crises marked by student and peasant uprisings were associated with Madagascar's child mortality rate increase from about 145/1000 in 1960 to 185/1000 in 1985. Mozambique was beset by civil war after independence, in which destruction of the health infrastructure was a strategy. The child mortality rate increased from 270/1000 to 470/1000 between 1975 and 1986, a peak war year. The factors by which political crises affect mortality so profoundly remain to be explained, but particular attention should be given to studying the health sector.

  18. EPA guidance on mental health and economic crises in Europe.

    PubMed

    Martin-Carrasco, M; Evans-Lacko, S; Dom, G; Christodoulou, N G; Samochowiec, J; González-Fraile, E; Bienkowski, P; Gómez-Beneyto, M; Dos Santos, M J H; Wasserman, D

    2016-03-01

    This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

  19. Crises in clinical care: an approach to management

    PubMed Central

    Runciman, W; Merry, A

    2005-01-01

    

 A "crisis" in health care is "the point in the course of a disease at which a decisive change occurs, leading either to recovery or to death". The daunting challenges faced by clinicians when confronted with a crisis are illustrated by a tragic case in which a teenage boy died after a minor surgical procedure. Crises are challenging for reasons which include: presentation with non-specific signs or symptoms, interaction of complex factors, progressive evolution, new situations, "revenge effects", inadequate assistance, and time constraints. In crises, clinicians often experience anxiety- and overload-induced performance degradation, tend to use "frequency gambling", run out of "rules" and have to work from first principles, and are prone to "confirmation bias". The effective management of crises requires formal training, usually simulator-based, and ideally in the inter-professional groups who will need to function as a team. "COVER ABCD–A SWIFT CHECK" is a precompiled algorithm which can be applied quickly and effectively to facilitate a systematic and effective response to the wide range of potentially lethal problems which may occur suddenly in anaesthesia. A set of 25 articles describing additional precompiled responses collated into a manual for the management of any crisis under anaesthesia has been published electronically as companion papers to this article. This approach to crisis management should be applied to other areas of clinical medicine as well as anaesthesia. PMID:15933309

  20. A Role for Science in Responding to Health Crises

    PubMed Central

    Brothers, Reginald; Murata, Christina E.

    2016-01-01

    The Department of Homeland Security's (DHS) Science and Technology (S&T) Directorate plays a role in public health that extends beyond biodefense. These responsibilities were exercised as part of the 2014-16 Ebola outbreak, leading to productive and beneficial contributions to the international public health response and improved operations in the United States. However, we and others have identified numerous areas for improvement. Based on our successes and lessons learned, we propose a number of ways that DHS, the interagency, and academia can act now to ensure improved responses to future public health crises. These include pre-developing scientific capabilities to respond agnostically to threats, and disease-specific master question lists to organize and inform initial efforts. We are generating DHS-specific playbooks and tools for anticipating future needs and capturing requests from DHS components and our national and international partners, where efforts will also be used to refine and exercise communication and information-sharing practices. These experiences and improvement efforts have encouraged discussions on the role of science in developing government policy, specifically responding to public health crises. We propose specific considerations for both scientists and government decision makers to ensure that the best available science is incorporated into policy and operational decisions to facilitate highly effective responses to future health crises. PMID:27482881

  1. Assessment of economic vulnerability to infectious disease crises.

    PubMed

    Sands, Peter; El Turabi, Anas; Saynisch, Philip A; Dzau, Victor J

    2016-11-12

    Infectious disease crises have substantial economic impact. Yet mainstream macroeconomic forecasting rarely takes account of the risk of potential pandemics. This oversight contributes to persistent underestimation of infectious disease risk and consequent underinvestment in preparedness and response to infectious disease crises. One reason why economists fail to include economic vulnerability to infectious disease threats in their assessments is the absence of readily available and digestible input data to inform such analysis. In this Viewpoint we suggest an approach by which the global health community can help to generate such inputs, and a framework to use these inputs to assess the economic vulnerability to infectious disease crises of individual countries and regions. We argue that incorporation of these risks in influential macroeconomic analyses such as the reports from the International Monetary Fund's Article IV consultations, rating agencies and risk consultancies would simultaneously improve the quality of economic risk forecasting and reinforce individual government and donor incentives to mitigate infectious disease risks. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Palliative care crises in the community: a survey.

    PubMed

    Mantz, M; Crandall, J M

    2000-01-01

    With the rising age of the population, hospital cutbacks, and increased attention to home-based care for the dying, the community can expect to experience more intense care situations and a greater potential for palliative care crises developing in the home setting. Whether the crisis is precipitated by hemorrhage, severe uncontrolled pain, or agitation, the demands placed on the family unit and careprovider can be phenomenal. Only with a greater awareness of the difficulties encountered in the home setting can the community begin to respond to the needs of the family in crisis. An open-question survey regarding palliative care crises in the community was conducted among community visiting RNs, home care case managers, and palliative outreach clinicians in southwestern Ontario, The objectives were: 1) to determine the pattern of events that precipitated a crisis; 2) to understand how crises were managed; 3) to identify barriers to effective crisis management; 4) to investigate the impact on the family unit and careprovider. Participants were also asked to list the essential resources they needed to deal effectively with a crisis situation. This paper highlights the results of the survey and suggests implications for the future direction of palliative care in the home.

  3. Future humanitarian crises: challenges for practice, policy, and public health.

    PubMed

    Burkle, Frederick M

    2010-01-01

    After more than three decades of preoccupation with wars and internal political conflicts, the humanitarian community has the opportunity to reevaluate what humanitarian crises will dominate both policy and practice in the future. In reality, these crises are already active and some are over the tipping point of recovery. These crises share the common thread of being major public health emergencies which, with a preponderance of excess or indirect mortality and morbidity dominating the consequences, requires new approaches, including unprecedented improvements and alterations in education, training, research, strategic planning, and policy and treaty agendas. Unfortunately, political solutions offered up to date are nation-state centric and miss opportunities to provide what must be global solutions. Public health, redefined as the infrastructure and systems necessary to allow communities, urban settings, and nation-states to provide physical and social protections to their populations has become an essential element of all disciplines from medicine, engineering, law, social sciences, and economics. Public health, which must be recognized as a strategic and security issue should take precedence over politics at every level, not be driven by political motives, and be globally monitored.

  4. A systematic review on health resilience to economic crises.

    PubMed

    Glonti, Ketevan; Gordeev, Vladimir S; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard

    2015-01-01

    The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women's mental health appeared more susceptible to crises than men's. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. Despite widespread rhetoric about the importance of resilience, there was a dearth of studies which operationalised resilience factors

  5. A Systematic Review on Health Resilience to Economic Crises

    PubMed Central

    Glonti, Ketevan; Gordeev, Vladimir S.; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard

    2015-01-01

    Background The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. Methods We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. Results From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women’s mental health appeared more susceptible to crises than men’s. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. Conclusions Despite widespread rhetoric about the importance of resilience, there was a dearth of studies

  6. Anticipating Economic Market Crises Using Measures of Collective Panic

    PubMed Central

    2015-01-01

    Predicting panic is of critical importance in many areas of human and animal behavior, notably in the context of economics. The recent financial crisis is a case in point. Panic may be due to a specific external threat or self-generated nervousness. Here we show that the recent economic crisis and earlier large single-day panics were preceded by extended periods of high levels of market mimicry—direct evidence of uncertainty and nervousness, and of the comparatively weak influence of external news. High levels of mimicry can be a quite general indicator of the potential for self-organized crises. PMID:26185988

  7. Anticipating Economic Market Crises Using Measures of Collective Panic.

    PubMed

    Harmon, Dion; Lagi, Marco; de Aguiar, Marcus A M; Chinellato, David D; Braha, Dan; Epstein, Irving R; Bar-Yam, Yaneer

    2015-01-01

    Predicting panic is of critical importance in many areas of human and animal behavior, notably in the context of economics. The recent financial crisis is a case in point. Panic may be due to a specific external threat or self-generated nervousness. Here we show that the recent economic crisis and earlier large single-day panics were preceded by extended periods of high levels of market mimicry--direct evidence of uncertainty and nervousness, and of the comparatively weak influence of external news. High levels of mimicry can be a quite general indicator of the potential for self-organized crises.

  8. Mobile Response Team Saves Lives in Volcano Crises

    USGS Publications Warehouse

    Ewert, John W.; Miller, C. Dan; Hendley, James W.; Stauffer, Peter H.

    1997-01-01

    The world's only volcano crisis response team, organized and operated by the USGS, can be quickly mobilized to assess and monitor hazards at volcanoes threatening to erupt. Since 1986, the team has responded to more than a dozen volcano crises as part of the Volcano Disaster Assistance Program (VDAP), a cooperative effort with the Office of Foreign Disaster Assistance of the U.S. Agency for International Development. The work of USGS scientists with VDAP has helped save countless lives, and the valuable lessons learned are being used to reduce risks from volcano hazards in the United States.

  9. Double crises in two-parameter dynamical systems

    SciTech Connect

    Stewart, H.B.; Ueda, Y.; Grebogi, C.; Yorke, J.A.

    1995-09-25

    A crisis is a sudden discontinuous change in a chaotic attractor as a system parameter is varied. We investigate phenomena observed when two parameters of a dissipative system are varied simultaneously, following a crisis along a curve in the parameter plane. Two such curves intersect at a point we call a double crisis vertex. The phenomena we study include the double crisis vertex at which an interior and a boundary crisis coincide, and related forms of double crisis. We show how an experimenter can infer a crisis from observations of other related crises at a vertex.

  10. Resolution of psychosocial crises associated with flying in space

    NASA Astrophysics Data System (ADS)

    Suedfeld, Peter; Brcic, Jelena

    2011-07-01

    Erikson (1959) proposed a theoretical basis for healthy psychosocial development. His theory posits eight critical conflict situations throughout one's lifetime, each of which can result in a favorable or unfavorable resolution. Autobiographies, memoirs, interviews, personal diaries, and oral histories of 97 international astronauts were content analyzed to assess reported resolutions of Erikson's psychosocial crises, regardless of chronological sequence. We made comparisons across flight phases (before, during, and after), gender, nationality of home space agency, and flight duration. Astronauts reported more favorable than unfavorable outcomes across flight phases and demographic variables. Differences across demographic variables and flight phases, as well as the changes as a result of the flight are discussed.

  11. Medical emergency teams: deciphering clues to crises in hospitals

    PubMed Central

    DeVita, Michael

    2005-01-01

    Cardiac arrest in hospitals is usually preceded by prolonged deterioration. If the deterioration is recognized and treated, often death can be prevented. Medical emergency teams (MET) are a mechanism to fill this need. The epidemiology of patient deteriorations is not well understood. Jones and colleagues provide data regarding the temporal pattern of METs. They describe a diurnal variation to crises that strongly suggests hospital processes may systematically ignore (and find) patient deterioration. Hospitals in the future must develop methodologies to find more reliably patients who are in crisis, and then respond to them swiftly and effectively to prevent unnecessary deaths. PMID:16137372

  12. Medical emergency teams: deciphering clues to crises in hospitals.

    PubMed

    DeVita, Michael

    2005-08-01

    Cardiac arrest in hospitals is usually preceded by prolonged deterioration. If the deterioration is recognized and treated, often death can be prevented. Medical emergency teams (MET) are a mechanism to fill this need. The epidemiology of patient deteriorations is not well understood. Jones and colleagues provide data regarding the temporal pattern of METs. They describe a diurnal variation to crises that strongly suggests hospital processes may systematically ignore (and find) patient deterioration. Hospitals in the future must develop methodologies to find more reliably patients who are in crisis, and then respond to them swiftly and effectively to prevent unnecessary deaths.

  13. Health crises and media relations: relationship management-by-fire.

    PubMed

    Springston, Jeffrey K; Weaver-Lariscy, Ruthann

    2007-01-01

    Media relations is an important function in the operation of any health organization, yet it is often relegated as a simple task function. Such an orientation can be problematic, particularly in times of crisis. This article provides an overview of some of the inherent internal conflicts within health organizations that may mitigate against the best media relations practices in times of crises. The article surveys some of the predominant theoretical models used for crisis management, and suggests directions for the further development of media relations and crisis communication theory and practice.

  14. Propagation of crises in the virtual water trade network

    NASA Astrophysics Data System (ADS)

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2015-04-01

    The international trade of agricultural goods is associated to the displacement of the water used to produce such goods and embedded in trade as a factor of production. Water virtually exchanged from producing to consuming countries, named virtual water, defines flows across an international network of 'virtual water trade' which enable the assessment of environmental forcings and implications of trade, such as global water savings or country dependencies on foreign water resources. Given the recent expansion of commodity (and virtual water) trade, in both displaced volumes and network structure, concerns have been raised about the exposure to crises of individuals and societies. In fact, if one country had to markedly decrease its export following a socio-economical or environmental crisis, such as a war or a drought, many -if not all- countries would be affected due to a cascade effect within the trade network. The present contribution proposes a mechanistic model describing the propagation of a local crisis into the virtual water trade network, accounting for the network structure and the virtual water balance of all countries. The model, built on data-based assumptions, is tested on the real case study of the Argentinean crisis in 2008-09, when the internal agricultural production (measured as virtual water volume) decreased by 26% and the virtual water export of Argentina dropped accordingly. Crisis propagation and effects on the virtual water trade are correctly captured, showing the way forward to investigations of crises impact and country vulnerability based on the results of the model proposed.

  15. Introduction: evidence-based action in humanitarian crises.

    PubMed

    Dijkzeul, Dennis; Hilhorst, Dorothea; Walker, Peter

    2013-07-01

    This introductory paper sets the stage for this special issue of Disasters on evidence-based action in humanitarian crises. It reviews definition(s) of evidence and it examines the different disciplinary and methodological approaches to collecting and analysing evidence. In humanitarian action, the need for evidence-based approaches sometimes is viewed in tension with a principled approach, often unnecessarily. Choosing appropriate research methods depends on the objectives of the researcher, in particular whether the research focuses on the intervention and/or the context and the length and complexity of the causal chains involved. The paper concludes by defining some trends in evidence-based approaches in crises: the move away from inputs and outputs of humanitarian action towards outcomes and impacts; the shift towards a higher degree of partnerships in research, and the participation of users and target groups; and the acceptance of a broad array of approaches to establish evidence. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

  16. Improving communication during volcanic crises on small, vulnerable islands

    NASA Astrophysics Data System (ADS)

    McGuire, W. J.; Solana, M. C.; Kilburn, C. R. J.; Sanderson, D.

    2009-05-01

    Increased exposure to volcanic hazard, particularly at vulnerable small islands, is driving an urgent and growing need for improved communication between monitoring scientists, emergency managers and the media, in advance of and during volcanic crises. Information gathering exercises undertaken on volcanic islands (Guadeloupe, St. Vincent and Montserrat) in the Lesser Antilles (eastern Caribbean), which have recently experienced - or are currently experiencing - volcanic action, have provided the basis for the compilation and publication of a handbook on Communication During Volcanic Emergencies, aimed at the principal stakeholder groups. The findings of the on-island surveys point up the critical importance of (1) bringing together monitoring scientists, emergency managers, and representatives of the media, well in advance of a volcanic crisis, and (2), ensuring that procedures and protocols are in place that will allow, as far as possible, effective and seamless cooperation and coordination when and if a crisis situation develops. Communication During Volcanic Emergencies is designed to promote and encourage both of these priorities through providing the first source-book addressing working relationships and inter-linkages between the stakeholder groups, and providing examples of good and bad practice. While targeting the volcanic islands of the eastern Caribbean, the source-book and its content are largely generic, and the advice and guidelines contained therein have equal validity in respect of improving communication before and during crises at any volcano, and have application to the communication issue in respect of a range of other geophysical hazards.

  17. Crises in EFL Proficiency and Teacher Development in the Context of International Donation and Transformation Discourses

    ERIC Educational Resources Information Center

    Birbirso, Dereje Tadesse

    2014-01-01

    Since 2000, Ethiopia has been working to come out of social crises, modernise itself and achieve the Millennium Development Goals. Although provided with billions of dollars by the West and their international agents, little has been changed and the crises seem never to abate, especially in the educational system. This study, thus, critically…

  18. Preventing crises in palliative care in the home. Role of family physicians and nurses.

    PubMed Central

    Howarth, G.; Willison, K. B.

    1995-01-01

    With the current shift to community care, the need for palliative care in the home involving the family physician has increased. Potential causes of crises in the home care of the dying are identified. Strategies to prevent crises are suggested that rely on a team's providing comprehensive and anticipatory care. PMID:7539653

  19. Classroom Killers? Hallway Hostages? How Schools Can Prevent and Manage School Crises.

    ERIC Educational Resources Information Center

    Trump, Kenneth S.

    This book attempts to dispel the myths and misconceptions surrounding the lessons learned from national school violence crises and shifting security threat trends. Its objective is to deliver balanced, practical, and cost-effective steps for preventing and managing school crises, including how to recognize "red flag" warnings of potential…

  20. Scenarios for Evolving Seismic Crises: Possible Communication Strategies

    NASA Astrophysics Data System (ADS)

    Steacy, S.

    2015-12-01

    Recent advances in operational earthquake forecasting mean that we are very close to being able to confidently compute changes in earthquake probability as seismic crises develop. For instance, we now have statistical models such as ETAS and STEP which demonstrate considerable skill in forecasting earthquake rates and recent advances in Coulomb based models are also showing much promise. Communicating changes in earthquake probability is likely be very difficult, however, as the absolute probability of a damaging event is likely to remain quite small despite a significant increase in the relative value. Here, we use a hybrid Coulomb/statistical model to compute probability changes for a series of earthquake scenarios in New Zealand. We discuss the strengths and limitations of the forecasts and suggest a number of possible mechanisms that might be used to communicate results in an actual developing seismic crisis.

  1. Cinacalcet to prevent parathyrotoxic crises in hypercalcaemic patients awaiting parathyroidectomy

    PubMed Central

    Rostoker, Guy; Bellamy, Jean; Janklewicz, Philippe

    2011-01-01

    Primary hyperparathyroidism is the third most common endocrine disorder. Hypercalcaemia exceeding 3 mmol/l is a major risk factor for parathyrotoxic crises, and management of patients at risk remains a medical challenge. The authors recently managed three such patients referred for severe nephrolithiasis. All had severe hypercalcaemia (at least 3 mmol/l). Instead of the usual management, which involves hospitalisation in an intensive care environment (for about 5–7 days) for rehydration and infusion of intravenous bisphosphonates, followed by emergency parathyroidectomy, the three patients received ambulatory cinacalcet (not an approved indication), 30 mg twice a day. The serum calcium normalised in two cases and declined to a safe level in the third case, allowing minimally invasive parathyroidectomy to be performed at a date chosen according to the patients’ and surgeon’s respective schedules. The authors consider that cinacalcet may benefit severely hypercalcaemic patients awaiting surgery for primary hyperparathyroidism. PMID:22696718

  2. Otto Stern, the Gdh Sum Rule and Various Spin Crises

    NASA Astrophysics Data System (ADS)

    Drechsel, D.

    2001-02-01

    The history of spin and anomalous magnetic moment is full of puzzles and "crises" from the first observations in the 1920's to the present day. The Gerasimov-Drell-Hearn sum rule connects the anomalous magnetic moment with the helicity dependent cross section for photoproduction, and as such checks the internal consistency of our understanding of the nucleon spin structure. Various generalizations of the sum rule have been proposed for the case of virtual photons, thus interpolating from the real photon point to deep inelastic scattering. A series of recent and newly proposed experiments with beam and target/recoil polarization will study this transition between the coherent spin-dependent response and the incoherent response of the partons in the scaling region.

  3. The Measure your World / Mide tu Mundo Project

    NASA Astrophysics Data System (ADS)

    Hojman, S.; Johnson, R. M.; Meymaris, K. K.; Ward, D. L.; Russell, R.; Genyuk, J.; Lagrave, M.; Henderson, S.; Ostrosky, J.; Martinez, M.

    2007-12-01

    Over 22 centuries ago Erathostenes devised a method to determine the Earth radius. Measure your World / Mide tu Mundo is a joint venture lead by Windows to the Universe/Ventanas al Universo in the United States of America, EducaRed in Chile and RedEscolar in Mexico seeking to partner teams of students, teachers and parents from the three countries in a collaborative effort to determine the Earth circumference by sharing the results of their measurements, and exchanging cultural information. Data are collected from September 29 through October 7, 2007. A report of the whole experience will be presented.

  4. Investigation on financial crises with the negative-information-propagation-induced model

    NASA Astrophysics Data System (ADS)

    Fan, Feng-Hua; Deng, Yanbin; Huang, Yong-Chang

    2017-03-01

    We first argue about the similarity between the propagation phenomenon of negative information about potential deterioration of economic situation in group of investors and the propagation phenomenon of infectious disease in crowd Applying the negative-information-propagation-induced model built based on above argument, we investigate the relationship between the generation of financial crises and propagation effects of negative information We introduce the discrimination parameter to distinguish whether or not negative information will be propagated extensively in group of investors. We also introduce the target critical value of financial crises. By comparing the theoretically predicted ratio of the long term projected number of total investors to the total number of investors at some time as initial time with target critical value of financial crises, the model can provide real-time monitoring of whether the curve of total number of investors is progressing toward the direction of generating financial crises or running on track of financial markets safety. If at some time this ratio is computed to be less than the target critical value of financial crises, governments can take relevant measures to prevent the generation of financial crises in advance Governments' interference helps to recover the confidence of investors so that they never will again believe in negative information to continue their investment. Results from theoretical and numerical analysis show that the number of investors who hold the belief of potential deterioration of economic situation, and the number of investors who withdraw capital and depart from financial markets for avoiding business loss when governments make appropriate interference are lowered compared to that without appropriate governments' interference. The results show the effectiveness of governments in preventing financial crises from the viewpoint of the negative information-propagation-induced model, namely governments

  5. Identity and intimacy crises and their relationship to internet dependence among college students.

    PubMed

    Huang, Ya-Rong

    2006-10-01

    In an attempt to test Kandell's proposition that internet dependents used the internet as a coping mechanism against underlying psychological issues, this study investigated the extent to which the fifth and sixth Eriksonian crises (identity, intimacy), were related to internet dependence (online chatting, gaming) among college students. Students spending more than 10 hours per week on chatting/gaming were classified as dependents. On the basis of a national sample of freshmen in Taiwan, this study found that the dependents scored significantly lower on most of the measures that reflected the successful resolution of the crises, and higher on the measures that reflected unsuccessful resolution of the crises. Kandell's proposition was supported.

  6. Multiple crises and global health: New and necessary frontiers of health politics

    PubMed Central

    Schrecker, Ted

    2012-01-01

    The world economy is entering an era of multiple crises, involving finance, food security and global environmental change. This article assesses the implications for global public health, describes the contours of post-2007 crises in food security and finance, and then briefly indicates the probable health impacts. There follows a discussion of the crisis of climate change, one that will unfold over a longer time frame but with manifestations that may already be upon us. The article then discusses the political economy of responses to these crises, noting the formidable obstacles that exist to equitable resolution. The article concludes by noting the threat that such crises present to recent progress in global health, arguing that global health researchers and practitioners must become more familiar with the relevant social processes, and that proposed solutions that neglect the continuing importance of the nation-state are misdirected. PMID:22657093

  7. Multiple crises and global health: new and necessary frontiers of health politics.

    PubMed

    Schrecker, Ted

    2012-01-01

    The world economy is entering an era of multiple crises, involving finance, food security and global environmental change. This article assesses the implications for global public health, describes the contours of post-2007 crises in food security and finance, and then briefly indicates the probable health impacts. There follows a discussion of the crisis of climate change, one that will unfold over a longer time frame but with manifestations that may already be upon us. The article then discusses the political economy of responses to these crises, noting the formidable obstacles that exist to equitable resolution. The article concludes by noting the threat that such crises present to recent progress in global health, arguing that global health researchers and practitioners must become more familiar with the relevant social processes, and that proposed solutions that neglect the continuing importance of the nation-state are misdirected.

  8. The impact of economic crises on social inequalities in health: what do we know so far?

    PubMed

    Bacigalupe, Amaia; Escolar-Pujolar, Antonio

    2014-07-25

    Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of crises, and the type of measures used to analyze the magnitude of social inequalities in health. Social epidemiology should further collaborate with other disciplines to help produce more accurate and useful evidence about the relationship between crises and health equity.

  9. The impact of economic crises on social inequalities in health: what do we know so far?

    PubMed Central

    2014-01-01

    Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of crises, and the type of measures used to analyze the magnitude of social inequalities in health. Social epidemiology should further collaborate with other disciplines to help produce more accurate and useful evidence about the relationship between crises and health equity. PMID:25063518

  10. Science during crisis: the application of social science during major environmental crises

    USGS Publications Warehouse

    Machlis, Gary; Ludwig, Kris; Manfredo, Michael J.; Vaske, Jerry J.; Rechkemmer, Andreas; Duke, Esther

    2014-01-01

    Historical and contemporary experience suggests that science plays an increasingly critical role in governmental and institutional responses to major environmental crises. Recent examples include major western wildfires (2009), the Deepwater Horizon oil spill (2010), the Fukushima nuclear accident (2011), and Hurricane Sandy (2012). The application of science during such crises has several distinctive characteristics, as well as essential requirements if it is to be useful to decision makers. these include scope conditions that include coupled natural/human systems, clear statement of uncertainties and limitations, description of cascading consequences, accurate sense of place, estimates of magnitude of impacts, identification of beneficiaries and those adversely affected, clarity and conciseness, compelling visualization and presentation, capacity to speak "truth to power", and direct access to decision makers. In this chapter, we explore the role and significance of science – including all relevant disciplines and focusing attention on the social sciences – in responding to major environmental crises. We explore several important questions: How is science during crisis distinctive? What social science is most useful during crises? What distinctive characteristics are necessary for social science to make meaningful contributions to emergency response and recovery? How might the social sciences be integrated into the strategic science needed to respond to future crises? The authors, both members of the Department of the Interior's innovative Strategic Sciences Group, describe broad principles of engagement as well as specific examples drawn from history, contemporary efforts (such as during the Deepwater Horizon oil spill), and predictions of environmental crises still to be confronted.

  11. Impact of the topology of global macroeconomic network on the spreading of economic crises.

    PubMed

    Lee, Kyu-Min; Yang, Jae-Suk; Kim, Gunn; Lee, Jaesung; Goh, Kwang-Il; Kim, In-mook

    2011-03-31

    Throughout economic history, the global economy has experienced recurring crises. The persistent recurrence of such economic crises calls for an understanding of their generic features rather than treating them as singular events. The global economic system is a highly complex system and can best be viewed in terms of a network of interacting macroeconomic agents. In this regard, from the perspective of collective network dynamics, here we explore how the topology of the global macroeconomic network affects the patterns of spreading of economic crises. Using a simple toy model of crisis spreading, we demonstrate that an individual country's role in crisis spreading is not only dependent on its gross macroeconomic capacities, but also on its local and global connectivity profile in the context of the world economic network. We find that on one hand clustering of weak links at the regional scale can significantly aggravate the spread of crises, but on the other hand the current network structure at the global scale harbors higher tolerance of extreme crises compared to more "globalized" random networks. These results suggest that there can be a potential hidden cost in the ongoing globalization movement towards establishing less-constrained, trans-regional economic links between countries, by increasing vulnerability of the global economic system to extreme crises.

  12. Impact of the Topology of Global Macroeconomic Network on the Spreading of Economic Crises

    PubMed Central

    Lee, Kyu-Min; Yang, Jae-Suk; Kim, Gunn; Lee, Jaesung; Goh, Kwang-Il; Kim, In-mook

    2011-01-01

    Throughout economic history, the global economy has experienced recurring crises. The persistent recurrence of such economic crises calls for an understanding of their generic features rather than treating them as singular events. The global economic system is a highly complex system and can best be viewed in terms of a network of interacting macroeconomic agents. In this regard, from the perspective of collective network dynamics, here we explore how the topology of the global macroeconomic network affects the patterns of spreading of economic crises. Using a simple toy model of crisis spreading, we demonstrate that an individual country's role in crisis spreading is not only dependent on its gross macroeconomic capacities, but also on its local and global connectivity profile in the context of the world economic network. We find that on one hand clustering of weak links at the regional scale can significantly aggravate the spread of crises, but on the other hand the current network structure at the global scale harbors higher tolerance of extreme crises compared to more “globalized” random networks. These results suggest that there can be a potential hidden cost in the ongoing globalization movement towards establishing less-constrained, trans-regional economic links between countries, by increasing vulnerability of the global economic system to extreme crises. PMID:21483794

  13. Managing crises through organisational development: a conceptual framework.

    PubMed

    Lalonde, Carole

    2011-04-01

    This paper presents a synthesis of the guiding principles in crisis management in accordance with the four configurational imperatives (strategy, structure, leadership and environment) defined by Miller (1987) and outlines interventions in organisational development (OD) that may contribute to their achievement. The aim is to build a conceptual framework at the intersection of these two fields that could help to strengthen the resilient capabilities of individuals, organisations and communities to face crises. This incursion into the field of OD--to generate more efficient configurations of practices in crisis management--seems particularly fruitful considering the system-wide application of OD, based on open-systems theory (Burke, 2008). Various interventions proposed by OD in terms of human processes, structural designs and human resource management, as well as strategy, may help leaders, members of organisations and civil society apply effectively, and in a more sustainable way, the crisis management guiding principles defined by researchers. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

  14. Neonatal cardiomyopathies and metabolic crises due to oxidative phosphorylation defects.

    PubMed

    Schiff, Manuel; Ogier de Baulny, Hélène; Lombès, Anne

    2011-08-01

    Neonatal cardiomyopathies due to mitochondrial oxidative phosphorylation (OXPHOS) defects are extremely severe conditions which can be either isolated or included in a multi-organ disease, with or without metabolic crises, of which profound lactic acidosis is the prominent feature. Cardiomyopathy is more often hypertrophic than dilated. Antenatal manifestations such as fetal cardiomyopathy, arrhythmia and/or hydrops have been reported. Pathophysiological mechanisms are complex, going beyond ATP deficiency of the high-energy-consuming neonatal myocardium. Birth is a key metabolic period when the myocardium switches ATP production from anaerobic glycolysis to mitochondrial fatty acid oxidation and OXPHOS. Heart-specificity of the defect may be related to the specific localization of the defect, to the high myocardium dependency on OXPHOS, and/or to interaction between the primary genetic alteration and other factors such as modifier genes. Therapeutic options are limited but standardized diagnostic procedures are mandatory to confirm the OXPHOS defect and to identify its causal mutation, allowing genetic counseling and potential prenatal diagnosis.

  15. [Economic management of health crises affecting production animals in Europe].

    PubMed

    Vandeputte, S; Humblet, M F; Fecher-Bourgeois, F; Gosset, C; Albert, A; Vernaillen, F; Saegerman, C

    2011-12-01

    The importance of animal health crises has considerably increased over the last few years. When a crisis occurs, farmers can receive financial support through various public, private and mixed compensation schemes. Economic losses resulting from diseases may be direct and indirect. If a disease is covered by European Union regulations then countries have a legal obligation to partly compensate farmers for direct losses, either directly through the national budget, or through a specific fund. The European Veterinary Fund also co-finances these losses. Only a few countries provide compensation for indirect losses. The private insurance sector also provides protection against some direct and indirect losses but the risks covered are variable. To encourage farmers to subscribe to this kind of insurance, some public authorities provide subsidies to help pay the premium. Insurance companies do not generally cover the risks linked to contagious diseases, but some companies do extend cover to include this type of risk. Several alternatives, such as mutual funds, are available to improve risk coverage. There is a lack of harmonisation among the various compensation schemes of different countries. Public authorities cannot provide full compensation, but mutual funds and private insurance companies are alternatives that should be further investigated and their use should be extended to other countries. A classification of diseases would harmonise the situation at the European level.

  16. Communications Contingency Plan: Planning for Crises and Controversy. Phase 1

    NASA Technical Reports Server (NTRS)

    Treise, Deborah; Bernstein, Arla G.; Yates, Brad

    1998-01-01

    Interviews were conducted with a variety of Marshall Space Flight Center personnel and local media representatives in Huntsville, Alabama, in order to identify the current perceptions of these individuals regarding communication effectiveness between MSFC and the media. The purposes of the Phase One report are to (1) assess the need for a contingency plan for communicating in situations of crisis and controversy; (2) identify goals and objectives for the planning process; and (3) provide recommendations for future planning activities to achieve the goals and objectives outlined in Phase One. It is strongly recommended that MSFC personnel who are involved in communications with the media participate in a facilitated, strategic communications planning process in order to develop Phase Two of the Communications Contingency Plan (CCP). Phase Two will address (1) the categorizing, ranking and prioritizing of crises and controversies; (2) the development of action steps and implementation strategies for the CCP; and (3) the development of a monitoring and evaluation process for ongoing plan effectiveness.

  17. Preventing food crises using a food policy approach.

    PubMed

    Timmer, C Peter

    2010-01-01

    A food crisis occurs when rates of hunger and malnutrition rise sharply at local, national, or global levels. This definition distinguishes a food crisis from chronic hunger, although food crises are far more likely among populations already suffering from prolonged hunger and malnutrition. A food crisis is usually set off by a shock to either supply or demand for food and often involves a sudden spike in food prices. It is important to remember that in a market economy, food prices measure the scarcity of food, not its value in any nutritional sense. Except in rare circumstances, the straightforward way to prevent a food crisis is to have rapidly rising labor productivity through economic growth and keep food prices stable while maintaining access by the poor. The formula is easier to state than to implement, especially on a global scale, but it is good to have both the objective, reducing short-run spikes in hunger, and the deep mechanisms, pro-poor economic growth and stable food prices, clearly in mind. A coherent food policy seeks to use these mechanisms, and others, to achieve a sustained reduction in chronic hunger over the long run while preventing spikes in hunger in the short run.

  18. ["Snow" and "Walpurgisnacht". Hans Castorp's exemplary maturation crises in "Zauberberg"].

    PubMed

    Heinrich, K; Walter, C

    1995-01-01

    On the occasion of a rather incidental visit in the sanatorium "Berghof" at Davos, Hans Castorp, the--as to his primary personality--asthenic and low-profile protagonist of the "Zauberberg" is gradually getting caught up in the maelstrom of the there prevailing timelessness and irresponsibility, this being interrupted solely by two tapering to crisis episodes: his amouressness to Mme. Chauchat as an erotic crisis and by the visionary daydream during a snowstorm about the abilities of men as a cognitive, mental crisis. Both events are triggered by a pathoid irritability, following the maxim of Th. Mann that illness, decay and death as borderline experiences may be the presupposition for cognition and reversal. Both crises end without consequences--the "Zauberberg" is the negation of the novel of education and development in the narrower sense. The unsuccessfulness and undecidedness of Hans Castorp's existence culminate in the open end of the novel, regarding his surviving on the battle field, and is in strict contrast to Adrian Leverkühn's determined autoinfection with Lues with the aim of artistic perfection and the creative break-through of "Doctor Faustus". Hans Castorp's regression and self-fragmentation within the decadent-morbid atmosphere of the sanatorium lead to his storming into the battles of the First World War as a last and existential crisis; it is here where finally the individual and national fate are merging. Hans Castorp becomes the paradigma of the German pre-war bourgeoisie and its crisis-prone development.

  19. Connecting Worlds/Mundos Unidos Project: End-of-Year Report, 2007-2008

    ERIC Educational Resources Information Center

    Ciriza, Frank

    2008-01-01

    This report presents information on the Connecting Worlds/Mundos Unidos Project and provides a general comparison overview of accomplishments during its five years of operation. The Connecting Worlds/Mundos Unidos Project has been operating in the El Paso Independent School District (EPISD) for eleven years, but in the present format as a Jacob K.…

  20. Abdominal injuries in communal crises: The Jos experience

    PubMed Central

    Ojo, Emmanuel Olorundare; Ozoilo, Kenneth N.; Sule, Augustine Z.; Ugwu, Benjamin T.; Misauno, Michael A.; Ismaila, Bashiru O.; Peter, Solomon D.; Adejumo, Adeyinka A.

    2016-01-01

    Background: Abdominal injuries contribute significantly to battlefield trauma morbidity and mortality. This study sought to determine the incidence, demographics, clinical features, spectrum, severity, management, and outcome of abdominal trauma during a civilian conflict. Materials and Methods: A prospective analysis of patients treated for abdominal trauma during the Jos civil crises between December 2010 and May 2012 at the Jos University Teaching Hospital. Results: A total of 109 victims of communal conflicts with abdominal injuries were managed during the study period with 89 (81.7%) males and 20 (18.3%) females representing about 12.2% of the total 897 combat related injuries. The peak age incidence was between 21 and 40 years (range: 3–71 years). The most frequently injured intra-abdominal organs were the small intestine 69 (63.3%), colon 48 (44%), and liver 41 (37.6%). Forty-four (40.4%) patients had extra-abdominal injuries involving the chest in 17 (15.6%), musculoskeletal 12 (11%), and the head in 9 (8.3%). The most prevalent weapon injuries were gunshot 76 (69.7%), explosives 12 (11%), stab injuries 11 (10.1%), and blunt abdominal trauma 10 (9.2%). The injury severity score varied from 8 to 52 (mean: 20.8) with a fatality rate of 11 (10.1%) and morbidity rate of 29 (26.6%). Presence of irreversible shock, 3 or more injured intra-abdominal organs, severe head injuries, and delayed presentation were the main factors associated with mortality. Conclusion: Abdominal trauma is major life-threatening injuries during conflicts. Substantial mortality occurred with loss of nearly one in every 10 hospitalized victims despite aggressive emergency room resuscitation. The resources expenditure, propensity for death and expediency of timing reinforce the need for early access to the wounded in a concerted trauma care systems. PMID:26957819

  1. Energy crises and cooperation: Do international institutions matter?

    NASA Astrophysics Data System (ADS)

    Chakarova, Vessela P.

    The risk of an oil supply disruption still exists. Oil reserves are increasingly concentrated in a handful of unreliable regimes, plagued by piracy and terrorism. Natural disasters and chokepoint incidents have increased in frequency. In addition, oil is expected to remain a significant part of the energy mix up until 2030. By that time Europe will be importing 90% of its oil. Thus, oil supply security will become an increasingly important feature of European politics. One way to counter the noxious consequences of an oil disruption is to cooperate. International cooperation is a critical factor in any type of crisis, however, it is especially important when it comes to a finite, highly concentrated and critical commodity like oil. The lack of coordination might lead to scrambling and oil hoarding, which dramatically exacerbate the crisis. Yet cooperation in the oil issue-area has been the subject of only a few studies, none of which provides a systematic and comprehensive analysis. They are also limited in their scope and findings. This dissertation aims to partially fill this lacuna. It employs a structured focused comparison to study European consumer countries' cooperation in times of oil supply shortages. There have been fifteen such crises since the Second World War, three of which with dramatic consequences for the world economy. The analysis evaluates European cooperative efforts in seven of these cases, starting with the Abadan crisis in 1951. The cases are selected on the basis of their magnitude and economic impact. In particular, I look at intergovernmental negotiations within existing international bodies prior to, during and immediately after the crisis. The findings suggest that institutions are more likely to facilitate interstate cooperation in the presence of a strong leader (a hegemon) - a role, which in the case of the oil issue-area was assumed by the US until the early 1970s.

  2. Crucial crises in biology: life in the deep biosphere.

    PubMed

    Guerrero, R

    1998-12-01

    The origin and evolution of life on Earth are the result of a series of crises that have taken place on the planet over about 4500 millions of years since it originated. Biopoiesis (origin of life), ecopoiesis (origin of ecosystems) and the first ecosystems (stromatolites and microbial mats), as well as eukaryopoiesis (origin of nucleated cells) are revised. The paper then focuses on the study of the deep biosphere, describing ecosystems never found before, which are independent of solar radiation and have changed previous assumptions about the requirements of life; even the concept of biosphere, as Vernadsky defined it, has increased its scope. Since the discovery, in 1987, of bacteria growing in the crevices of rocks at 500 m deep, in boreholes drilled near the Savanna River, Aiken, South Carolina, other bacteria have been found in the deep subsurface reaching depths of about 3 km (e.g., in the Columbia River Basalt Group, near Richland, Washington state), in an anaerobic, hot, high-pressure environment. Some kinds of microorganisms can thrive at such depths, living in many cases a geochemical existence, by using very specialized metabolisms, which depend on the local environments. The existence of organisms independent from photosynthetic production is the most outstanding, novel feature of the deep biosphere. Living beings might not need other energy and chemical sources than those which occur in the development of all planetary bodies. Life, therefore, could even be an ineluctable outcome of planetary evolution and, as a corollary, a natural continuation of the usual development of physical phenomena in the universe.

  3. GLUTAMINE AND HYPERAMMONEMIC CRISES IN PATIENTS WITH UREA CYCLE DISORDERS

    PubMed Central

    Lee, B.; Diaz, G.A.; Rhead, W.; Lichter-Konecki, U.; Feigenbaum, A.; Berry, S.A.; Le Mons, C.; Bartley, J.; Longo, N.; Nagamani, S.C.; Berquist, W.; Gallagher, R.C.; Harding, C.O.; McCandless, S.E.; Smith, W.; Schulze, A.; Marino, M.; Rowell, R.; Coakley, D.F.; Mokhtarani, M.; Scharschmidt, B.F.

    2016-01-01

    Blood ammonia and glutamine levels are used as biomarkers of control in patients with urea cycle disorders (UCDs). This study was undertaken to evaluate glutamine variability and utility as a predictor of hyperammonemic crises (HACs) in UCD patients. Methods The relationships between glutamine and ammonia levels and the incidence and timing of HACs were evaluated in over 100 adult and pediatric UCD patients who participated in clinical trials of glycerol phenylbutyrate. Results The median (range) intra-subject 24-hour coefficient of variation for glutamine was 15% (8–29%) as compared with 56% (28%–154%) for ammonia, and the correlation coefficient between glutamine and concurrent ammonia levels varied from 0.17 to 0.29. Patients with baseline (fasting) glutamine values >900 µmol/L had higher baseline ammonia levels (mean [SD]: 39.6 [26.2] µmol/L) than patients with baseline glutamine ≤900 µmol/L (26.6 [18.0] µmol/L). Glutamine values >900 µmol/L during the study were associated with an approximately 2-fold higher HAC risk (odds ratio [OR]=1.98; p=0.173). However, glutamine lost predictive significance (OR=1.47; p=0.439) when concomitant ammonia was taken into account, whereas the predictive value of baseline ammonia ≥ 1.0 upper limit of normal (ULN) was highly statistically significant (OR=4.96; p=0.013). There was no significant effect of glutamine >900 µmol/L on time to first HAC crisis (hazard ratio [HR]=1.14; p=0.813), but there was a significant effect of baseline ammonia ≥ 1.0 ULN (HR=4.62; p=0.0011). Conclusions The findings in this UCD population suggest that glutamine is a weaker predictor of HACs than ammonia and that the utility of the predictive value of glutamine will need to take into account concurrent ammonia levels. PMID:26586473

  4. Types of anaemic crises in paediatric patients with sickle cell anaemia seen in Enugu, Nigeria

    PubMed Central

    Juwah, A; Nlemadim, E; Kaine, W

    2004-01-01

    Background: Anaemic crises in paediatric patients with sickle cell anaemia are major causes of morbidity and mortality. Some children admitted to hospitals' emergency rooms or paediatric wards of the hospitals with severe anaemia die before blood transfusion. Aims and Methods: A total of 108 episodes of anaemic crises were prospectively evaluated in 108 patients with sickle cell anaemia attending the paediatric sickle cell clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Results: Hyper-haemolytic crises were the commonest types of anaemic crises in the patients studied. The mean haemoglobin concentration of 44.66 (SD 6.42) g/l in crises was significantly lower than the mean steady state level of 78.69 (SD 8.50) g/l. Reticulocytes, unconjugated serum bilirubin concentrations, and the presence of nucleated red blood cells were also increased. About 4.6% of patients were not jaundiced at presentation even though they were profoundly anaemic. Their haematological indices gradually returned to normal without marked changes in their serum bilirubin concentrations. These patients were probably in the early recovery phase of aplastic crises. The classical presentation of acute splenic sequestration crisis with a rapidly enlarging spleen and hypotension was not observed. This was probably because of its precipitate nature and accompanying circulatory collapse, which carried a high mortality rate. Minor forms of sequestration crises may have occurred in the liver and spleen. Conclusions: Malaria appeared to have played a role in precipitating some of the hyper-haemolytic episodes. Further studies to elucidate this role are required so that appropriate recommendations regarding malaria prophylaxis can be made in patients with sickle cell anaemia. PMID:15155406

  5. Global effects of local food-production crises: a virtual water perspective.

    PubMed

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2016-01-25

    By importing food and agricultural goods, countries cope with the heterogeneous global water distribution and often rely on water resources available abroad. The virtual displacement of the water used to produce such goods (known as virtual water) connects together, in a global water system, all countries participating to the international trade network. Local food-production crises, having social, economic or environmental origin, propagate in this network, modifying the virtual water trade and perturbing local and global food availability, quantified in terms of virtual water. We analyze here the possible effects of local crises by developing a new propagation model, parsimonious but grounded on data-based and statistically-verified assumptions, whose effectiveness is proved on the Argentinean crisis in 2008-09. The model serves as the basis to propose indicators of crisis impact and country vulnerability to external food-production crises, which highlight that countries with largest water resources have the highest impact on the international trade, and that not only water-scarce but also wealthy and globalized countries are among the most vulnerable to external crises. The temporal analysis reveals that global average vulnerability has increased over time and that stronger effects of crises are now found in countries with low food (and water) availability.

  6. Global effects of local food-production crises: a virtual water perspective

    NASA Astrophysics Data System (ADS)

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2016-01-01

    By importing food and agricultural goods, countries cope with the heterogeneous global water distribution and often rely on water resources available abroad. The virtual displacement of the water used to produce such goods (known as virtual water) connects together, in a global water system, all countries participating to the international trade network. Local food-production crises, having social, economic or environmental origin, propagate in this network, modifying the virtual water trade and perturbing local and global food availability, quantified in terms of virtual water. We analyze here the possible effects of local crises by developing a new propagation model, parsimonious but grounded on data-based and statistically-verified assumptions, whose effectiveness is proved on the Argentinean crisis in 2008-09. The model serves as the basis to propose indicators of crisis impact and country vulnerability to external food-production crises, which highlight that countries with largest water resources have the highest impact on the international trade, and that not only water-scarce but also wealthy and globalized countries are among the most vulnerable to external crises. The temporal analysis reveals that global average vulnerability has increased over time and that stronger effects of crises are now found in countries with low food (and water) availability.

  7. Crises Management in the Oil and Gas Industry: The Niger Delta Experience

    NASA Astrophysics Data System (ADS)

    Odemene, Glory C.

    The Niger Delta crises escalated beyond the borders of the Nigerian nation to become an issue that affected individuals and corporations around the world. This study led to the discovery of how the local crises escalated with international implications. This discovery was accomplished by addressing how the Niger Delta crises escalated from villages to international scenes, with notable impacts on the environment, health, safety, security, and financial segments of local, international, private, and corporate entities. Using Sweeny's crisis decision theory and Lazarus and Folkman's coping theory, the study considered the coping strategies of community members, the decisions, and actions they took in response to the management approaches of the government and the oil and gas companies (OGCs). This qualitative study utilized historical narrative to collect data by interviewing 4 participants who lived and worked in the region during the crises. NVivo was used for manual and automatic coding of data, as well as for categorization and connection of codes. Content analysis of identified codes and categories revealed the themes and trends in the experiences narrated by participants. Findings include the root causes, trend of escalation, and management strategies of the government and the OGCs that influenced the crises. These findings will help to influence policies and practices in the region and enhance effective management of current and emerging conflicts, with possibilities of restoring stability and security in the areas and in the nation at large.

  8. Global effects of local food-production crises: a virtual water perspective

    PubMed Central

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2016-01-01

    By importing food and agricultural goods, countries cope with the heterogeneous global water distribution and often rely on water resources available abroad. The virtual displacement of the water used to produce such goods (known as virtual water) connects together, in a global water system, all countries participating to the international trade network. Local food-production crises, having social, economic or environmental origin, propagate in this network, modifying the virtual water trade and perturbing local and global food availability, quantified in terms of virtual water. We analyze here the possible effects of local crises by developing a new propagation model, parsimonious but grounded on data-based and statistically-verified assumptions, whose effectiveness is proved on the Argentinean crisis in 2008–09. The model serves as the basis to propose indicators of crisis impact and country vulnerability to external food-production crises, which highlight that countries with largest water resources have the highest impact on the international trade, and that not only water-scarce but also wealthy and globalized countries are among the most vulnerable to external crises. The temporal analysis reveals that global average vulnerability has increased over time and that stronger effects of crises are now found in countries with low food (and water) availability. PMID:26804492

  9. Glutamine and hyperammonemic crises in patients with urea cycle disorders.

    PubMed

    Lee, B; Diaz, G A; Rhead, W; Lichter-Konecki, U; Feigenbaum, A; Berry, S A; Le Mons, C; Bartley, J; Longo, N; Nagamani, S C; Berquist, W; Gallagher, R C; Harding, C O; McCandless, S E; Smith, W; Schulze, A; Marino, M; Rowell, R; Coakley, D F; Mokhtarani, M; Scharschmidt, B F

    2016-01-01

    Blood ammonia and glutamine levels are used as biomarkers of control in patients with urea cycle disorders (UCDs). This study was undertaken to evaluate glutamine variability and utility as a predictor of hyperammonemic crises (HACs) in UCD patients. The relationships between glutamine and ammonia levels and the incidence and timing of HACs were evaluated in over 100 adult and pediatric UCD patients who participated in clinical trials of glycerol phenylbutyrate. The median (range) intra-subject 24-hour coefficient of variation for glutamine was 15% (8-29%) as compared with 56% (28%-154%) for ammonia, and the correlation coefficient between glutamine and concurrent ammonia levels varied from 0.17 to 0.29. Patients with baseline (fasting) glutamine values >900 μmol/L had higher baseline ammonia levels (mean [SD]: 39.6 [26.2]μmol/L) than patients with baseline glutamine ≤ 900 μmol/L (26.6 [18.0]μmol/L). Glutamine values >900 μmol/L during the study were associated with an approximately 2-fold higher HAC risk (odds ratio [OR]=1.98; p=0.173). However, glutamine lost predictive significance (OR=1.47; p=0.439) when concomitant ammonia was taken into account, whereas the predictive value of baseline ammonia ≥ 1.0 upper limit of normal (ULN) was highly statistically significant (OR=4.96; p=0.013). There was no significant effect of glutamine >900 μmol/L on time to first HAC crisis (hazard ratio [HR]=1.14; p=0.813), but there was a significant effect of baseline ammonia ≥ 1.0 ULN (HR=4.62; p=0.0011). The findings in this UCD population suggest that glutamine is a weaker predictor of HACs than ammonia and that the utility of the predictive value of glutamine will need to take into account concurrent ammonia levels. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Government management of two media-facilitated crises involving dioxin contamination of food.

    PubMed

    Jacob, Casey J; Lok, Corie; Morley, Katija; Powell, Douglas A

    2011-03-01

    Incidents become crises through a constant and intense public scrutiny facilitated by the media. Two incidents involving dioxin contamination of food led to crises in Belgium and the Republic of Ireland in 1999 and 2008, respectively. Thought to cause cancer in humans, dioxins reached the food supply in both incidents through the contamination of fat used for animal feed. The food and agricultural industries connected to each incident relied on crisis management activities of federal governments to limit adverse public reaction. Analysis of the management of the two crises by their respective federal governments, and a subsequent review of crisis management literature, led to the development of an effective crisis management model. Such a model, appropriately employed, may insulate industries associated with a crisis against damaged reputations and financial loss.

  11. How economic crises affect alcohol consumption and alcohol-related health problems: a realist systematic review.

    PubMed

    de Goeij, Moniek C M; Suhrcke, Marc; Toffolutti, Veronica; van de Mheen, Dike; Schoenmakers, Tim M; Kunst, Anton E

    2015-04-01

    Economic crises are complex events that affect behavioral patterns (including alcohol consumption) via opposing mechanisms. With this realist systematic review, we aimed to investigate evidence from studies of previous or ongoing crises on which mechanisms (How?) play a role among which individuals (Whom?). Such evidence would help understand and predict the potential impact of economic crises on alcohol consumption. Medical, psychological, social, and economic databases were used to search for peer-reviewed qualitative or quantitative empirical evidence (published January 1, 1990-May 1, 2014) linking economic crises or stressors with alcohol consumption and alcohol-related health problems. We included 35 papers, based on defined selection criteria. From these papers, we extracted evidence on mechanism(s), determinant, outcome, country-level context, and individual context. We found 16 studies that reported evidence completely covering two behavioral mechanisms by which economic crises can influence alcohol consumption and alcohol-related health problems. The first mechanism suggests that psychological distress triggered by unemployment and income reductions can increase drinking problems. The second mechanism suggests that due to tighter budget constraints, less money is spent on alcoholic beverages. Across many countries, the psychological distress mechanism was observed mainly in men. The tighter budget constraints mechanism seems to play a role in all population subgroups across all countries. For the other three mechanisms (i.e., deterioration in the social situation, fear of losing one's job, and increased non-working time), empirical evidence was scarce or absent, or had small to moderate coverage. This was also the case for important influential contextual factors described in our initial theoretical framework. This realist systematic review suggests that among men (but not among women), the net impact of economic crises will be an increase in harmful

  12. How do economic crises affect migrants' risk of infectious disease? A systematic-narrative review.

    PubMed

    Kentikelenis, Alexander; Karanikolos, Marina; Williams, Gemma; Mladovsky, Philipa; King, Lawrence; Pharris, Anastasia; Suk, Jonathan E; Hatzakis, Angelos; McKee, Martin; Noori, Teymur; Stuckler, David

    2015-12-01

    It is not well understood how economic crises affect infectious disease incidence and prevalence, particularly among vulnerable groups. Using a susceptible-infected-recovered framework, we systematically reviewed literature on the impact of the economic crises on infectious disease risks in migrants in Europe, focusing principally on HIV, TB, hepatitis and other STIs. We conducted two searches in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar, websites of key organizations and grey literature to identify how economic changes affect migrant populations and infectious disease. We perform a narrative synthesis in order to map critical pathways and identify hypotheses for subsequent research. The systematic review on links between economic crises and migrant health identified 653 studies through database searching; only seven met the inclusion criteria. Fourteen items were identified through further searches. The systematic review on links between economic crises and infectious disease identified 480 studies through database searching; 19 met the inclusion criteria. Eight items were identified through further searches. The reviews show that migrant populations in Europe appear disproportionately at risk of specific infectious diseases, and that economic crises and subsequent responses have tended to exacerbate such risks. Recessions lead to unemployment, impoverishment and other risk factors that can be linked to the transmissibility of disease among migrants. Austerity measures that lead to cuts in prevention and treatment programmes further exacerbate infectious disease risks among migrants. Non-governmental health service providers occasionally stepped in to cater to specific populations that include migrants. There is evidence that migrants are especially vulnerable to infectious disease during economic crises. Ring-fenced funding of prevention programs, including screening and treatment, is important for addressing this vulnerability. © The

  13. How do economic crises affect migrants’ risk of infectious disease? A systematic-narrative review

    PubMed Central

    Karanikolos, Marina; Williams, Gemma; Mladovsky, Philipa; King, Lawrence; Pharris, Anastasia; Suk, Jonathan E.; Hatzakis, Angelos; McKee, Martin; Noori, Teymur; Stuckler, David

    2015-01-01

    Background: It is not well understood how economic crises affect infectious disease incidence and prevalence, particularly among vulnerable groups. Using a susceptible-infected-recovered framework, we systematically reviewed literature on the impact of the economic crises on infectious disease risks in migrants in Europe, focusing principally on HIV, TB, hepatitis and other STIs. Methods: We conducted two searches in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar, websites of key organizations and grey literature to identify how economic changes affect migrant populations and infectious disease. We perform a narrative synthesis in order to map critical pathways and identify hypotheses for subsequent research. Results: The systematic review on links between economic crises and migrant health identified 653 studies through database searching; only seven met the inclusion criteria. Fourteen items were identified through further searches. The systematic review on links between economic crises and infectious disease identified 480 studies through database searching; 19 met the inclusion criteria. Eight items were identified through further searches. The reviews show that migrant populations in Europe appear disproportionately at risk of specific infectious diseases, and that economic crises and subsequent responses have tended to exacerbate such risks. Recessions lead to unemployment, impoverishment and other risk factors that can be linked to the transmissibility of disease among migrants. Austerity measures that lead to cuts in prevention and treatment programmes further exacerbate infectious disease risks among migrants. Non-governmental health service providers occasionally stepped in to cater to specific populations that include migrants. Conclusions: There is evidence that migrants are especially vulnerable to infectious disease during economic crises. Ring-fenced funding of prevention programs, including screening and treatment, is important for

  14. [The kallikrein-kinin system of blood in hypertensive crises in hot climate].

    PubMed

    Malaia, L T; Berkelieva, S Ch; Berkeliev, M B; Soltanova, I B

    1991-06-01

    The values of depressive humoral factors drastically decrease in healthy subjects and patients with hypertensive disease running with crisis in the areas of hot climate in summer. After arresting hypertensive crises, the levels of kallikreinogen, kallikrein, kininogen increase. In the crises, there is a significant inverse correlation between the blood pressure and blood kallikrein and kininogen concentrations. The values of kallikrein-kinin system components clearly characterize the clinical status of patients with hypertensive disease running with crisis and are of predictive value for clarification of the body's protective reserves.

  15. The Impact of Prolonged Economic Downturns and Economic Crises on the Nursing Profession.

    PubMed

    Phua, Kai-Lit; Hue, Jia-Wern

    2015-01-01

    Prolonged economic downturns and economic crises are affecting nations around the world, including developed countries such as Portugal, Spain, and Greece. In the United States, recovery from the latest economic crisis has been accompanied by a persistently high rate of unemployment. To a large extent, the impacts on the nursing profession may depend on the severity of economic downturns and their duration in the country of employment of nurses. Nurses in certain areas of patient care (such as mental health) may also be more strongly affected because of the impact of economic crises and high unemployment on morbidity patterns. Emigration of nurses may also increase as a result of prolonged economic crisis.

  16. Crizanlizumab for the Prevention of Pain Crises in Sickle Cell Disease.

    PubMed

    Ataga, Kenneth I; Kutlar, Abdullah; Kanter, Julie; Liles, Darla; Cancado, Rodolfo; Friedrisch, João; Guthrie, Troy H; Knight-Madden, Jennifer; Alvarez, Ofelia A; Gordeuk, Victor R; Gualandro, Sandra; Colella, Marina P; Smith, Wally R; Rollins, Scott A; Stocker, Jonathan W; Rother, Russell P

    2017-02-02

    The up-regulation of P-selectin in endothelial cells and platelets contributes to the cell-cell interactions that are involved in the pathogenesis of vaso-occlusion and sickle cell-related pain crises. The safety and efficacy of crizanlizumab, an antibody against the adhesion molecule P-selectin, were evaluated in patients with sickle cell disease. In this double-blind, randomized, placebo-controlled, phase 2 trial, we assigned patients to receive low-dose crizanlizumab (2.5 mg per kilogram of body weight), high-dose crizanlizumab (5.0 mg per kilogram), or placebo, administered intravenously 14 times over a period of 52 weeks. Patients who were receiving concomitant hydroxyurea as well as those not receiving hydroxyurea were included in the study. The primary end point was the annual rate of sickle cell-related pain crises with high-dose crizanlizumab versus placebo. The annual rate of days hospitalized, the times to first and second crises, annual rates of uncomplicated crises (defined as crises other than the acute chest syndrome, hepatic sequestration, splenic sequestration, or priapism) and the acute chest syndrome, and patient-reported outcomes were also assessed. A total of 198 patients underwent randomization at 60 sites. The median rate of crises per year was 1.63 with high-dose crizanlizumab versus 2.98 with placebo (indicating a 45.3% lower rate with high-dose crizanlizumab, P=0.01). The median time to the first crisis was significantly longer with high-dose crizanlizumab than with placebo (4.07 vs. 1.38 months, P=0.001), as was the median time to the second crisis (10.32 vs. 5.09 months, P=0.02). The median rate of uncomplicated crises per year was 1.08 with high-dose crizanlizumab, as compared with 2.91 with placebo (indicating a 62.9% lower rate with high-dose crizanlizumab, P=0.02). Adverse events that occurred in 10% or more of the patients in either active-treatment group and at a frequency that was at least twice as high as that in the placebo

  17. Crizanlizumab for the Prevention of Pain Crises in Sickle Cell Disease

    PubMed Central

    Ataga, K.I.; Kutlar, A.; Kanter, J.; Liles, D.; Cancado, R.; Friedrisch, J.; Guthrie, T.H.; Knight-Madden, J.; Alvarez, O.A.; Gordeuk, V.R.; Gualandro, S.; Colella, M.P.; Smith, W.R.; Rollins, S.A.; Stocker, J.W.; Rother, R.P.

    2017-01-01

    BACKGROUND The up-regulation of P-selectin in endothelial cells and platelets contributes to the cell–cell interactions that are involved in the pathogenesis of vaso-occlusion and sickle cell–related pain crises. The safety and efficacy of crizanlizumab, an antibody against the adhesion molecule P-selectin, were evaluated in patients with sickle cell disease. METHODS In this double-blind, randomized, placebo-controlled, phase 2 trial, we assigned patients to receive low-dose crizanlizumab (2.5 mg per kilogram of body weight), high-dose crizanlizumab (5.0 mg per kilogram), or placebo, administered intravenously 14 times over a period of 52 weeks. Patients who were receiving concomitant hydroxyurea as well as those not receiving hydroxyurea were included in the study. The primary end point was the annual rate of sickle cell–related pain crises with high-dose crizanlizumab versus placebo. The annual rate of days hospitalized, the times to first and second crises, annual rates of uncomplicated crises (defined as crises other than the acute chest syndrome, hepatic sequestration, splenic sequestration, or priapism) and the acute chest syndrome, and patient-reported outcomes were also assessed. RESULTS A total of 198 patients underwent randomization at 60 sites. The median rate of crises per year was 1.63 with high-dose crizanlizumab versus 2.98 with placebo (indicating a 45.3% lower rate with high-dose crizanlizumab, P = 0.01). The median time to the first crisis was significantly longer with high-dose crizanlizumab than with placebo (4.07 vs. 1.38 months, P = 0.001), as was the median time to the second crisis (10.32 vs. 5.09 months, P = 0.02). The median rate of uncomplicated crises per year was 1.08 with high-dose crizanlizumab, as compared with 2.91 with placebo (indicating a 62.9% lower rate with high-dose crizanlizumab, P = 0.02). Adverse events that occurred in 10% or more of the patients in either active-treatment group and at a frequency that was at least

  18. Seven Destructive Seismic Crises in 12th Century Syria

    NASA Astrophysics Data System (ADS)

    Guidoboni, E.; Bernardini, F.

    2002-12-01

    Between 1114 and 1170 Syria was struck by 7 seismic crises: 5 were great earthquakes (August and November 1114, November 1115, June 1117, June 1170), amongst which that of 29th June 1170 represents one of the most destructive events of the Middle-Eastern and Mediterranean area. Instead 2 were long and violent tremor sequences without a real main shock: the first one went on from October 1138 to June 1139, the second from September 1156 to May 1159. Until now all of these seismic events had been known mostly through Arab sources. However, owing to the particular political and military situation in the Syria of that period, such sources could not provide a complete frame of reference. Indeed, in those years in the territories of Syria and present-day Lebanon, some Latin States had been formed due to the military invasion of the Frankish Crusades. Furthermore, Syria was a privileged territory of travellers from various countries heading towards Palestine. Hence, basing ourselves on complex and diversified types of sources, precious new data have emerged written in Latin, Frankish, Greek, Armenian and Syrian. At the same time, the contribution of the Arab sources has been broadened. The overall picture that has emerged offers a new observational basis that has allowed us to date, differentiate, localise and thoroughly evaluate the elements of at least 5 of these earthquakes (the best documented ones: November 1114, 1115, 1138-39, 1156-59 and 1170). Overall nearly 90 hit locations have been identified, about 30 of which new and unknown to the previous studies. It has thus been possible for the first time to shed light on the intense seismic activity that affected this region in the dark ages. In just less than 60 years all of the vast territory that includes present-day Lebanon, north-eastern Syria and south-eastern Turkey was repeatedly struck. The earthquakes of 13th November 1114 and 29th November 1115 (until today often muddled up), and the sequence in 1138-39 hit

  19. Reacting to Crises: The Risk-Averse Nature of Contemporary American Public Education

    ERIC Educational Resources Information Center

    Moran, Peter

    2015-01-01

    Over the past several decades, numerous arguments have been made advancing the notion that the failings of the public education system in the United States have placed the nation's national security or economic prosperity at risk. This article will examine some of these "crises" and explore how arguments claiming that the shortcomings of…

  20. Give Us This Day Our Daily Bread: Manufacturing Crises in Education.

    ERIC Educational Resources Information Center

    Cizek, Gregory J.

    1999-01-01

    The model currently guiding educational policy development--constructing crises and crafting solutions--has a long, unproductive history. To shrug off American education's perpetual crisis mode, educators should expand their descriptive vocabularies, apply the "so what" test, adopt demonstrably effective solutions, eschew a crisis…

  1. Marketing Crises in Tourism: Communication Strategies in the United States and Spain.

    ERIC Educational Resources Information Center

    Gonzalez-Herrero, Alfonso; Pratt, Cornelius B.

    1998-01-01

    Compares crisis-response strategies of marketing-communication professionals in tourism organizations (TOs) in the United States and Spain. Reports the extent to which they use proven crisis-management strategies. Indicates significant differences between the countries' TOs in both their extant plans for responding to marketing crises and in their…

  2. Comparing emerging and mature markets during times of crises: A non-extensive statistical approach

    NASA Astrophysics Data System (ADS)

    Namaki, A.; Koohi Lai, Z.; Jafari, G. R.; Raei, R.; Tehrani, R.

    2013-07-01

    One of the important issues in finance and economics for both scholars and practitioners is to describe the behavior of markets, especially during times of crises. In this paper, we analyze the behavior of some mature and emerging markets with a Tsallis entropy framework that is a non-extensive statistical approach based on non-linear dynamics. During the past decade, this technique has been successfully applied to a considerable number of complex systems such as stock markets in order to describe the non-Gaussian behavior of these systems. In this approach, there is a parameter q, which is a measure of deviation from Gaussianity, that has proved to be a good index for detecting crises. We investigate the behavior of this parameter in different time scales for the market indices. It could be seen that the specified pattern for q differs for mature markets with regard to emerging markets. The findings show the robustness of the stated approach in order to follow the market conditions over time. It is obvious that, in times of crises, q is much greater than in other times. In addition, the response of emerging markets to global events is delayed compared to that of mature markets, and tends to a Gaussian profile on increasing the scale. This approach could be very useful in application to risk and portfolio management in order to detect crises by following the parameter q in different time scales.

  3. Past Adolescence, into and across Adulthood: Career Crises and Major Decisions

    ERIC Educational Resources Information Center

    Bakshi, Anuradha J.

    2011-01-01

    Career-related crises and major decisions, support for these, and job satisfaction were surveyed in 124 varied individuals from Mumbai, India. All participants were in the post-career-entry stage and engaged in paid work; they differed with regard to age (range 18-75 years), sex, marital status, religion, education, occupation, income, and…

  4. Reacting to Crises: The Risk-Averse Nature of Contemporary American Public Education

    ERIC Educational Resources Information Center

    Moran, Peter

    2015-01-01

    Over the past several decades, numerous arguments have been made advancing the notion that the failings of the public education system in the United States have placed the nation's national security or economic prosperity at risk. This article will examine some of these "crises" and explore how arguments claiming that the shortcomings of…

  5. Prevention of Targeted School Violence by Responding to Students' Psychosocial Crises: The NETWASS Program

    ERIC Educational Resources Information Center

    Leuschner, Vincenz; Fiedler, Nora; Schultze, Martin; Ahlig, Nadine; Göbel, Kristin; Sommer, Friederike; Scholl, Johanna; Cornell, Dewey; Scheithauer, Herbert

    2017-01-01

    The standardized, indicated school-based prevention program "Networks Against School Shootings" combines a threat assessment approach with a general model of prevention of emergency situations in schools through early intervention in student psychosocial crises and training teachers to recognize warning signs of targeted school violence.…

  6. Nine Going on Seventeen: Boundary Crises in the Cultural Map of Childhood/Adolescence.

    ERIC Educational Resources Information Center

    Mitchell, Claudia; Reid-Walsh, Jacqueline

    Boundary crises for girls moving into adolescence were studied by analyzing "Seventeen" magazine to contribute to the discourse around redefining childhood. The border between childhood and adolescence appears to be moving downward, and as the boundary goes down, the moral panic in society often goes up. To analyze "Seventeen,"…

  7. “Hitting the wall”: Lived experiences of mental health crises

    PubMed Central

    Karlsson, Bengt; Lofthus, Ann-Mari; Davidson, Larry

    2011-01-01

    Background As Norway moves toward the provision of home-based crisis response, knowledge is needed about understandings of mental health crisis and effective ways of addressing crises within the home. Objective To elicit and learn from service users’ experiences about the subjective meanings of crisis and what kind of help will be most effective in resolving mental health crises. Theoretical A phenomenological-hermeneutic cooperative inquiry method was used to elicit and analyse focus group responses from mental health service users who had experienced crises. Results Findings clustered into three themes: (1) Crisis as multifaceted and varied experiences; (2) losing the skills and structure of everyday life; and (3) complexities involved in family support. Conclusion Several aspects of crises require an expansion of the biomedical model of acute intervention to include consideration of the personal and familial meaning of the crisis, attention to the home context, and activities of daily living that are disrupted by the crisis, and ways for the person and the family to share in and learn from resolution of the crisis. PMID:22140400

  8. Variations of Young Germans' Informal Conceptions of Financial and Economic Crises Phenomena

    ERIC Educational Resources Information Center

    Aprea, Carmela; Sappa, Viviana

    2014-01-01

    The development of a sound understanding of financial and economic crises phenomena must be considered an important goal within the scope of citizenship, economic and social science education. As with every other educational endeavour, this intention requires solid information about what informal conceptions learners hold about this specific…

  9. Reclaiming Paedeia in an Age of Crises: Education and the Necessity of Wisdom

    ERIC Educational Resources Information Center

    Ozolinš, Janis Talivaldis

    2015-01-01

    Education needs to prepare students to have understanding of themselves, of their relationships to others, to have an ability to make good moral and other judgements and to act on these. If education has a role to play in the alleviation of the crises facing the world, then there is some urgency in reflecting on what kind of education is needed in…

  10. Prevention of Targeted School Violence by Responding to Students' Psychosocial Crises: The NETWASS Program

    ERIC Educational Resources Information Center

    Leuschner, Vincenz; Fiedler, Nora; Schultze, Martin; Ahlig, Nadine; Göbel, Kristin; Sommer, Friederike; Scholl, Johanna; Cornell, Dewey; Scheithauer, Herbert

    2017-01-01

    The standardized, indicated school-based prevention program "Networks Against School Shootings" combines a threat assessment approach with a general model of prevention of emergency situations in schools through early intervention in student psychosocial crises and training teachers to recognize warning signs of targeted school violence.…

  11. The Nigerian State and Global Economic Crises: Socio-Political Implications and Policy Challenges

    ERIC Educational Resources Information Center

    Olaopa, O. R.; Ogundari, I. O.; Akindele, S. T.; Hassan, O. M.

    2012-01-01

    This article discusses how economic reforms, as a reaction to the effects of the global financial crises, have intensified popular unrests and redefined the composition, interests, and socio-economic and political attitudes of Nigeria's increasingly complex social strata. We relied basically on secondary data to analyze some of the fundamental…

  12. Employee Communication during Crises: The Effects of Stress on Information Processing.

    ERIC Educational Resources Information Center

    Pincus, J. David; Acharya, Lalit

    Based on multidisciplinary research findings, this report proposes an information processing model of employees' response to highly stressful information environments arising during organizational crises. The introduction stresses the importance of management's handling crisis communication with employees skillfully. The second section points out…

  13. THE "FREE SPEECH" CRISES AT BERKELEY, 1964-1965--SOME ISSUES FOR SOCIAL AND LEGAL RESEARCH.

    ERIC Educational Resources Information Center

    LUNSFORD, TERRY F.

    AN EXAMINATION WAS MADE OF THE ISSUES AND EVENTS OF THE "FREE SPEECH" CRISES ON THE BERKELEY CAMPUS OF THE UNIVERSITY OF CALIFORNIA IN AN ATTEMPT TO PROVIDE THE BASIS FOR MORE SYSTEMATIC AND DISPASSIONATE STUDY OF CERTAIN ISSUES BEHIND THE STUDENT PROTESTS, AND TO STIMULATE SOCIAL AND LEGAL RESEARCH ON THESE ISSUES. FOLLOWING AN…

  14. Possible Solutions for Financial Crises of the Private Sector of Higher Education.

    ERIC Educational Resources Information Center

    Bolling, Landrum R.

    Our society is at a point where a number of interlocking crises-inflation, ever rising expectations, war, urban problems, youth's discontent-are coming together. Money is needed at every point and the private college cannot rely on the federal government or private sources to save them from financial disaster. The private college can tackle its…

  15. Past Adolescence, into and across Adulthood: Career Crises and Major Decisions

    ERIC Educational Resources Information Center

    Bakshi, Anuradha J.

    2011-01-01

    Career-related crises and major decisions, support for these, and job satisfaction were surveyed in 124 varied individuals from Mumbai, India. All participants were in the post-career-entry stage and engaged in paid work; they differed with regard to age (range 18-75 years), sex, marital status, religion, education, occupation, income, and…

  16. Risks and Crises for Healthcare Providers: The Impact of Cloud Computing

    PubMed Central

    Glasberg, Ronald; Hartmann, Michael; Tamm, Gerrit

    2014-01-01

    We analyze risks and crises for healthcare providers and discuss the impact of cloud computing in such scenarios. The analysis is conducted in a holistic way, taking into account organizational and human aspects, clinical, IT-related, and utilities-related risks as well as incorporating the view of the overall risk management. PMID:24707207

  17. Crises and Opportunities: The Futures of Scholarly Publishing. ACLS Occasional Paper, No. 57

    ERIC Educational Resources Information Center

    Alonso, Carlos J.; Davidson, Cathy N.; Unsworth, John M.; Withey, Lynne

    2003-01-01

    Presented herein are papers presented at a session entitled "Crises and Opportunities: The Future of Scholarly Publishing," from the American Council of Learned Societies (ACLS) Annual Meeting, May 10, 2003. Four speakers approached this topic from different standpoints: as leaders of learned societies, as senior university officials, from the…

  18. Identity Crises in Love and at Work: Dispositional Optimism as a Durable Personal Resource

    ERIC Educational Resources Information Center

    Andersson, Matthew A.

    2012-01-01

    Using the 2004 General Social Survey (N = 453), the identity stress process is investigated in terms of crises in intimate relationships and at the workplace. I discuss dispositional optimism as a psychological resource that is relatively independent of the situation and the self, making it ideal for structurally disadvantaged actors and for…

  19. Exposure to crises and resiliency of health care workers in Singapore.

    PubMed

    Chan, A O M; Chan, Y H; Kee, J P C

    2013-03-01

    Health care workers are exposed to various work-related traumatic incidents and crises, so building emotional resiliency is important. To examine exposure to work-related crises and resiliency of health care workers in public hospitals in Singapore. We sent questionnaires to health care workers in seven public hospitals. Participation was voluntary and anonymous. We asked about mental health training and exposure to work-related and personal crises. We measured resiliency using a pilot 5-point Likert questionnaire reflecting resistance and resilience constructs. We received 496 responses, a response rate of 58%. More than 70% of hospital staff experienced aggression or violence from patients and relatives, and about a third experienced significant personal crises, most commonly interpersonal conflicts. Those with mental health training were twice as likely to be resistant (OR = 1.8, 95% CI 1.2-2.7) and resilient (OR = 1.9, 95% CI 1.3-2.7) and also more likely to have experienced sudden/unexpected patient deaths (OR = 2.7, 95% CI 1.9-4.0) and aggression or violence from patients and relatives (OR = 5.1, 95% CI 3.0-8.7). Mental health training appears to improve individuals' perception of resistance and resilience. Hospitals should consider providing mental health and crisis intervention training to improve the emotional resiliency of health care workers.

  20. Identity Crises in Love and at Work: Dispositional Optimism as a Durable Personal Resource

    ERIC Educational Resources Information Center

    Andersson, Matthew A.

    2012-01-01

    Using the 2004 General Social Survey (N = 453), the identity stress process is investigated in terms of crises in intimate relationships and at the workplace. I discuss dispositional optimism as a psychological resource that is relatively independent of the situation and the self, making it ideal for structurally disadvantaged actors and for…

  1. Bibliography of Selected Literature in the 1970s Related to Crises, Family Stress, Coping and Adaptation.

    ERIC Educational Resources Information Center

    Chesser, Barbara

    This bibliography of literature from the 1970s related to crises, family stress, coping, and adaptation contains references of particular interest to professionals in the areas of counseling, education, and family social, psychological and health services. The bibliography is divided into 26 categories; references are classified according to major…

  2. Identifying the causes, prevention and management of crises in dementia. An online survey of stakeholders.

    PubMed

    Ledgerd, Ritchard; Hoe, Juanita; Hoare, Zoë; Devine, Mike; Toot, Sandeep; Challis, David; Orrell, Martin

    2016-06-01

    Crisis situations in dementia can lead to hospital admission or institutionalisation. Offering immediate interventions may help avoid admission, whilst stabilising measures can help prevent future crises. Our objective was to identify the main causes of crisis and interventions to treat or prevent crisis in persons with dementia based on different stakeholder perspectives. An online questionnaire was developed to identify the causes of crisis and appropriate interventions in a crisis. Participants included people with dementia, family carers and staff working in health and social care, including emergency and voluntary sectors, and academia. The results ranked the main causes of crisis, interventions that can prevent a crisis and interventions that can be useful in a crisis. Wandering, falls and infection were highly rated as risk factors for crises across all stakeholder groups. Consumers rated aggression as less important but severity of memory impairment as much more important than the other groups did. Education and support for family carers and home care staff were highly valued for preventing crises. Well-trained home care staff, communication equipment, emergency contacts and access to respite were highly valued for managing crises. We identified triggers and interventions that different stakeholders see as important for crisis in dementia. Recognition of these may be critical to planning effective and accepted support and care for people with dementia. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Random Acts of Senseless Video: An Organizational Psychology Perspective on the "Identity Crises" of Corporate Television.

    ERIC Educational Resources Information Center

    Gutenko, Gregory

    Corporate television suffers from at least two "identity crises": departmental isolation, and the lack of a legitimate identity for the corporate video product itself. Video departments are not usually viewed and accepted by the organizational whole as natural evolutions of a historically defined and behaviorally integrated system. The…

  4. Reclaiming Paedeia in an Age of Crises: Education and the Necessity of Wisdom

    ERIC Educational Resources Information Center

    Ozolinš, Janis Talivaldis

    2015-01-01

    Education needs to prepare students to have understanding of themselves, of their relationships to others, to have an ability to make good moral and other judgements and to act on these. If education has a role to play in the alleviation of the crises facing the world, then there is some urgency in reflecting on what kind of education is needed in…

  5. Lessons Learned from School Crises and Emergencies, Vol. 1, Issue 2, Fall 2006

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. School and student names have been changed to protect identities. Information for this publication was gathered through a series of interviews with school stakeholders involved in the actual incident. This "Lessons Learned" issue…

  6. Vulnerability of countries to food-production crises propagating in the virtual water trade network

    NASA Astrophysics Data System (ADS)

    Tamea, S.; Laio, F.; Ridolfi, L.

    2015-12-01

    In recent years, the international trade of food and agricultural commodities has undergone a marked increase of exchanged volumes and an expansion of the trade network. This globalization of trade has both positive and negative effects, but the interconnectedness and external dependency of countries generate complex dynamics which are often difficult to understand and model. In this study we consider the volume of water used for the production of agricultural commodities, virtually exchanged among countries through commodity trade, i.e. the virtual water trade. Then, we set up a parsimonious mechanistic model describing the propagation, into the global trade network, of food-production crises generated locally by a social, economic or environmental event (such as war, economic crisis, drought, pest). The model, accounting for the network structure and the virtual water balance of all countries, bases on rules derived from observed virtual water flows and on data-based and statistically verified assumption. It is also tested on real case studies that prove its capability to capture the main features of crises propagation. The model is then employed as the basis for the development of an index of country vulnerability, measuring the exposure of countries to crises propagating in the virtual water trade network. Results of the analysis are discussed within the context of socio-economic and environmental conditions of countries, showing that not only water-scarce, but also wealthy and globalized countries, are among the most vulnerable to external crises. The temporal analysis for the period 1986-2011 reveals that the global average vulnerability has strongly increased over time, confirming the increased exposure of countries to external crises which may occur in the virtual water trade network.

  7. Re-evaluation of bone pain in patients with type 1 Gaucher disease suggests that bone crises occur in small bones as well as long bones.

    PubMed

    Baris, Hagit N; Weisz Hubshman, Monika; Bar-Sever, Zvi; Kornreich, Liora; Shkalim Zemer, Vered; Cohen, Ian J

    2016-09-01

    Bone crises in type 1 Gaucher disease are reported in long bones and occasionally in weight bearing bones and other bones, but rarely in small bones of the hands and feet. We retrospectively examined the incidence of bone pain in patients followed at the Rabin Medical Center, Israel, before and following the initiation of enzyme replacement therapy (ERT) and evaluated them for bone crises. Of 100 type I Gaucher disease patients, 30 (30%) experienced one or more bone crises. Small bone crises represented 31.5% of all bone crises and were always preceded by crises in other bones. While the incidence of long bone crises reduced after the initiation of ERT, small bone crises increased. Almost 60% of patients with bone crises were of the N370S/84GG genotype suggesting a greater susceptibility of N370S/84GG patients to severe bone complications. These patients also underwent the greatest number of splenectomies (70.6% of splenectomised patients). Splenectomised patients showed a trend towards increased long and small bone crises after surgery. Active investigation of acute pain in the hands and feet in patients in our cohort has revealed a high incidence of small bone crises. Physicians should consider imaging studies to investigate unexplained pain in these areas. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Piracetam for reducing the incidence of painful sickle cell disease crises.

    PubMed

    Al Hajeri, A A; Fedorowicz, Z; Omran, A; Tadmouri, G O

    2007-04-18

    Sickle cell disease is one of the most common genetic disorders. Sickle cell crises in which irregular and dehydrated cells contribute to blocking of blood vessels are characterised by episodes of pain. Treatment is mainly supportive and symptomatic. In vitro studies with piracetam indicate that it has the potential for inhibition and a reversal of the process of sickling of erythrocytes. To assess the effectiveness of piracetam for reducing the incidence of painful sickle cell disease crises. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register which comprises of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of the last search of the Group's Haemoglobinopathies Trials Register: February 2007. Randomised controlled trials comparing orally administered piracetam to placebo or standard care in people, of all ages and both sexes, with sickle cell disease. Two authors independently assessed trial quality and extracted data. Trial authors were contacted for additional information. Adverse effects data were collected from the trials. Three trials involving 169 participants were included in the review. A limited amount of data addressing some of the primary and some of the secondary outcomes were provided, but data were incomplete and based on unvalidated assumptions used in the evaluation of outcomes. One trial reported a reduction in the number of pain crises and their severity with active intervention than placebo but presented no data to confirm these results. A second trial presented a monthly global pain score based on the number of sickle cell crises and severity of pain but included no separate data for these primary outcomes. Although there was no significant difference between the piracetam and placebo periods for the number of days of hospitalisation (P = 0.87) in one trial, inconsistencies in the

  9. Piracetam for reducing the incidence of painful sickle cell disease crises.

    PubMed

    Al Hajeri, Amani; Fedorowicz, Zbys

    2016-02-12

    Sickle cell disease is one of the most common genetic disorders. Sickle cell crises in which irregular and dehydrated cells contribute to blocking of blood vessels are characterised by episodes of pain. Treatment is mainly supportive and symptomatic. In vitro studies with piracetam indicate that it has the potential for inhibition and a reversal of the process of sickling of erythrocytes. This is an update of a previously published Cochrane review. To assess the effectiveness of piracetam for reducing the incidence of painful sickle cell disease crises. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register which comprises of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Last search of the Group's Haemoglobinopathies Trials Register: 21 September 2015. Randomised controlled trials comparing orally administered piracetam to placebo or standard care in people, of all ages and both sexes, with sickle cell disease. Two authors independently assessed trial quality and extracted data. Trial authors were contacted for additional information. Adverse effects data were collected from the trials. Three trials involving 169 participants were included in the review. A limited amount of data addressing some of the primary and some of the secondary outcomes were provided, but data were incomplete and based on un-validated assumptions used in the evaluation of outcomes. One trial reported a reduction in the number of pain crises and their severity with active intervention than placebo but presented no data to confirm these results. A second trial presented a monthly global pain score based on the number of sickle cell crises and severity of pain but included no separate data for these primary outcomes. Although there was no significant difference between the piracetam and placebo periods for the number of days of

  10. Outcomes of crises before and after introduction of a crisis resolution team.

    PubMed

    Johnson, Sonia; Nolan, Fiona; Hoult, John; White, Ian R; Bebbington, Paul; Sandor, Andrew; McKenzie, Nigel; Patel, Sejal N; Pilling, Stephen

    2005-07-01

    Crisis resolution teams (CRTs) are being introduced throughout England, but their evidence base is limited. To compare outcomes of crises before and after introduction of a CRT. A new methodology was developed for identification and operational definition of crises. A quasi-experimental design was used to compare cohorts presenting just before and just after a CRT was established. Following introduction of the CRT, the admission rate in the 6 weeks after a crisis fell from 71% to 49% (OR 0.38, 95% CI 0.21-0.70). A difference of 5.6 points (95% CI 2.0-8.3) on mean Client Satisfaction Questionnaire (CSQ-8) score favoured the CRT. These findings remained significant after adjustment for baseline differences. No clear difference emerged in involuntary hospitalisations, symptoms, social functioning or quality of life. CRTs may prevent some admissions and patients prefer them, although other outcomes appear unchanged in the short term.

  11. Currency crises and the evolution of foreign exchange market: Evidence from minimum spanning tree

    NASA Astrophysics Data System (ADS)

    Jang, Wooseok; Lee, Junghoon; Chang, Woojin

    2011-02-01

    We examined the time series properties of the foreign exchange market for 1990-2008 in relation to the history of the currency crises using the minimum spanning tree (MST) approach and made several meaningful observations about the MST of currencies. First, around currency crises, the mean correlation coefficient between currencies decreased whereas the normalized tree length increased. The mean correlation coefficient dropped dramatically passing through the Asian crisis and remained at the lowered level after that. Second, the Euro and the US dollar showed a strong negative correlation after 1997, implying that the prices of the two currencies moved in opposite directions. Third, we observed that Asian countries and Latin American countries moved away from the cluster center (USA) passing through the Asian crisis and Argentine crisis, respectively.

  12. An integrated approach for solving urban water and wastewater crises in the Arabian Gulf States.

    PubMed

    Nouh, M

    2005-01-01

    Various environmental and economic aspects of urban water and wastewater crises in a number of the Arabian Gulf States are discussed. An integrated approach, which considers simultaneously the problems of urban waters (shortage of water supply and problems associated with urban drainage) and those in connection with wastewater (i.e. environmental impact) is proposed. The feasible link between the main factors affecting these problems and the anticipated results encourage the implementation of the proposed approach. The conclusions suggest immediate municipal legislation.

  13. The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review.

    PubMed

    Ruby, Alexander; Knight, Abigail; Perel, Pablo; Blanchet, Karl; Roberts, Bayard

    2015-01-01

    Non-communicable diseases (NCDs) are of increasing concern in low- and middle-income countries (LMICs) affected humanitarian crises. Humanitarian agencies and governments are increasingly challenged with how to effectively tackle NCDs. Reviewing the evidence of interventions for NCDs in humanitarian crises can help guide future policies and research by identifying effective interventions and evidence gaps. The aim of this paper is to systematically review evidence on the effectiveness of interventions targeting NCDs during humanitarian crises in LMICs. A systematic review methodology was followed using PRISMA standards. Studies were selected on NCD interventions with civilian populations affected by humanitarian crises in low- and middle-income countries. Five bibliographic databases and a range of grey literature sources were searched. Descriptive analysis was applied and a quality assessment conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Risk of Bias Tool for experimental studies. The search yielded 4919 references of which 8 studies met inclusion criteria. Seven of the 8 studies were observational, and one study was a non-blinded randomised-controlled trial. Diseases examined included hypertension, heart failure, diabetes mellitus, chronic kidney disease, thalassaemia, and arthritis. Study settings included locations in the Middle East, Eastern Europe, and South Asia. Interventions featuring disease-management protocols and/or cohort monitoring demonstrated the strongest evidence of effectiveness. No studies examined intervention costs. The quality of studies was limited, with a reliance on observational study designs, limited use of control groups, biases associated with missing data and inadequate patient-follow-up, and confounding was poorly addressed. The review highlights the extremely limited quantity and quality of evidence on this topic. Interventions that incorporate standardisation and

  14. Markets during world oil supply crises: an analysis of industry, consumer, and governmental response

    SciTech Connect

    Erfle, Stephen; Pound, John; Kalt, Joseph

    1981-04-01

    An analysis of the response of American markets to supply crises in world oil markets is presented. It addresses four main issues: the efficiency of the operation of American oil markets during oil supply crises; the problems of both economic efficiency and social equity which arise during the American adaptation process; the propriety of the Federal government's past policy responses to these problems; and the relationship between perceptions of the problems caused by world oil crises and the real economic natures of these problems. Specifically, Chapter 1 presents a theoretical discussion of the effects of a world supply disruption on the price level and supply availability of the world market oil to any consuming country including the US Chapter 2 provides a theoretical and empirical analysis of the efficiency of the adaptations of US oil product markets to higher world oil prices. Chapter 3 examines the responses of various groups of US oil firms to the alterations observed in world markets, while Chapter 4 presents a theoretical explanation for the price-lagging behavior exhibited by firms in the US oil industry. Chapter 5 addresses the nature of both real and imagined oil market problems in the US during periods of world oil market transition. (MCW)

  15. Clinical characteristics of hyperglycemic crises in patients without a history of diabetes.

    PubMed

    Chou, Willy; Chung, Min-Hsien; Wang, Hsien-Yi; Chen, Jiann-Hwa; Chen, Wei-Lung; Guo, How-Ran; Lin, Hung-Jung; Su, Shih-Bin; Huang, Chien-Cheng; Hsu, Chien-Chin

    2014-11-01

    Hyperglycemic crises without a history of diabetes have not been well studied. We compared the clinical characteristics of patients with and without a history of diabetes, and evaluated the glycated hemoglobin levels. Consecutive adult patients (aged >18 years) visiting the emergency department (ED) between January 2004 and December 2010 were enrolled if they met the criteria for a hyperglycemic crisis. Patients were separated into those without and those with a history of diabetes. The 30-day mortality was the primary end-point. We enrolled 295 patients who made 330 visits to the ED. Patients without a history of diabetes made up 24.5% (81/330) of the hyperglycemic crises. Patients without a history of diabetes were more prone than patients with a history of diabetes to be younger and male, and to have better consciousness and renal function, more significant diabetic signs and symptoms (e.g., thirst, polydipsia, polyuria and bodyweight loss), higher blood sugar, and less opportunity of infection and mortality. Most of the patients (93.8%, 76/81) had glycated hemoglobin of ≥6.5%. The present study delineates the clinical characteristics of patients with hyperglycemic crises, but without a history of diabetes. Most patients had glycated hemoglobin ≥6.5%, which raises the argument of using this biomarker for routine screening of diabetes.

  16. Subsequent biotic crises delayed marine recovery following the late Permian mass extinction event in northern Italy.

    PubMed

    Foster, William J; Danise, Silvia; Price, Gregory D; Twitchett, Richard J

    2017-01-01

    The late Permian mass extinction event was the largest biotic crisis of the Phanerozoic and has the longest recovery interval of any extinction event. It has been hypothesised that subsequent carbon isotope perturbations during the Early Triassic are associated with biotic crises that impeded benthic recovery. We test this hypothesis by undertaking the highest-resolution study yet made of the rock and fossil records of the entire Werfen Formation, Italy. Here, we show that elevated extinction rates were recorded not only in the Dienerian, as previously recognised, but also around the Smithian/Spathian boundary. Functional richness increases across the Smithian/Spathian boundary associated with elevated origination rates in the lower Spathian. The taxonomic and functional composition of benthic faunas only recorded two significant changes: (1) reduced heterogeneity in the Dienerian, and (2) and a faunal turnover across the Smithian/Spathian boundary. The elevated extinctions and compositional shifts in the Dienerian and across the Smithian/Spathian boundary are associated with a negative and positive isotope excursion, respectively, which supports the hypothesis that subsequent biotic crises are associated with carbon isotope shifts. The Spathian fauna represents a more advanced ecological state, not recognised in the previous members of the Werfen Formation, with increased habitat differentiation, a shift in the dominant modes of life, appearance of stenohaline taxa and the occupation of the erect and infaunal tiers. In addition to subsequent biotic crises delaying the recovery, therefore, persistent environmental stress limited the ecological complexity of benthic recovery prior to the Spathian.

  17. Subsequent biotic crises delayed marine recovery following the late Permian mass extinction event in northern Italy

    PubMed Central

    Danise, Silvia; Price, Gregory D.; Twitchett, Richard J.

    2017-01-01

    The late Permian mass extinction event was the largest biotic crisis of the Phanerozoic and has the longest recovery interval of any extinction event. It has been hypothesised that subsequent carbon isotope perturbations during the Early Triassic are associated with biotic crises that impeded benthic recovery. We test this hypothesis by undertaking the highest-resolution study yet made of the rock and fossil records of the entire Werfen Formation, Italy. Here, we show that elevated extinction rates were recorded not only in the Dienerian, as previously recognised, but also around the Smithian/Spathian boundary. Functional richness increases across the Smithian/Spathian boundary associated with elevated origination rates in the lower Spathian. The taxonomic and functional composition of benthic faunas only recorded two significant changes: (1) reduced heterogeneity in the Dienerian, and (2) and a faunal turnover across the Smithian/Spathian boundary. The elevated extinctions and compositional shifts in the Dienerian and across the Smithian/Spathian boundary are associated with a negative and positive isotope excursion, respectively, which supports the hypothesis that subsequent biotic crises are associated with carbon isotope shifts. The Spathian fauna represents a more advanced ecological state, not recognised in the previous members of the Werfen Formation, with increased habitat differentiation, a shift in the dominant modes of life, appearance of stenohaline taxa and the occupation of the erect and infaunal tiers. In addition to subsequent biotic crises delaying the recovery, therefore, persistent environmental stress limited the ecological complexity of benthic recovery prior to the Spathian. PMID:28296886

  18. Entre Dos Mundos/Between Two Worlds: Youth Violence Prevention for Acculturating Latino Families

    ERIC Educational Resources Information Center

    Smokowski, Paul R.; Bacallao, Martica

    2009-01-01

    Objective: This study evaluated the efficacy of Entre Dos Mundos/Between Two Worlds (EDM) prevention for Latino adolescents. Method: In an experimental trial to compare implementation formats, 41 Latino families were randomly assigned to EDM action-oriented skills training groups, and 47 families were randomly assigned to unstructured EDM support…

  19. Entre Dos Mundos/Between Two Worlds: Youth Violence Prevention for Acculturating Latino Families

    ERIC Educational Resources Information Center

    Smokowski, Paul R.; Bacallao, Martica

    2009-01-01

    Objective: This study evaluated the efficacy of Entre Dos Mundos/Between Two Worlds (EDM) prevention for Latino adolescents. Method: In an experimental trial to compare implementation formats, 41 Latino families were randomly assigned to EDM action-oriented skills training groups, and 47 families were randomly assigned to unstructured EDM support…

  20. Early Cretaceous CO2 Pulses: Trigger of Carbon Cycle Perturbations and of Biocalcification Crises

    NASA Astrophysics Data System (ADS)

    Weissert, H.; Wissler, L.; Hennig, S.

    2003-04-01

    The Early Cretaceous C-isotope curve is marked by several positive carbon isotope anomalies with an amplitude of 2-3 ppm and lasting up to millions of years. The two most prominent of these excursions are of Late Valanginian and Aptian age. Isotopic mass balance models suggest that positive carbon isotope excursions reflect altered partitioning of carbon between the oxidized and reduced carbon sinks and that these changes occurred in response to elevated atmospheric CO_2 levels and coupled climate change. Both carbon isotope anomalies coincide with episodes of increased volcanic activity, which is regarded as the source of excess atmospheric carbon dioxide. The Aptian carbon isotope anomaly is preceded by a short-lived negative carbon isotope pulse of up to 2 ppm amplitude while a comparable pulse is not recognized at the base of the Valanginian carbon isotope excursion. This C- isotope event may record a climate-induced destabilisation of sedimentary gas hydrates and the sudden release of methane to oceans and atmosphere. Both, the Aptian and the Valanginian carbon isotope excursions are accompanied by biocalcification crises on carbonate platforms and in pelagic environments. The Valanginian carbonate platform drowning, the nannoconid crisis and the disappearance of calpionellids coincide with the beginning of the positive carbon isotope anomaly. The Aptian biocalcification crises on platforms and in pelagic environments started before the negative carbon isotope spike. Both crises in biocalcification may have been triggered by p CO_2-induced changes in surface water chemistry and/or by sudden changes in temperatures and/or by changes in nutrient levels. Available paleoclimate data and the bulk oxygen isotope records show no evidence for major low latitude ocean paleotemperature changes at the base of the Valanginian isotope anomaly. Partial choking of carbonate production during the Aptian occurred at a time of decreasing oxygen isotope values in pelagic bulk

  1. Functional and genetic characterization of clinical malignant hyperthermia crises: a multi-centre study

    PubMed Central

    2014-01-01

    Background Malignant hyperthermia (MH) is a rare pharmacogenetic disorder which is characterized by life-threatening metabolic crises during general anesthesia. Classical triggering substances are volatile anesthetics and succinylcholine (SCh). The molecular basis of MH is excessive release of Ca2+ in skeletal muscle principally by a mutated ryanodine receptor type 1 (RyR1). To identify factors explaining the variable phenotypic presentation and complex pathomechanism, we analyzed proven MH events in terms of clinical course, muscle contracture, genetic factors and pharmocological triggers. Methods In a multi-centre study including seven European MH units, patients with a history of a clinical MH episode confirmed by susceptible (MHS) or equivocal (MHE) in vitro contracture tests (IVCT) were investigated. A test result is considered to be MHE if the muscle specimens develop pathological contractures in response to only one of the two test substances, halothane or caffeine. Crises were evaluated using a clinical grading scale (CGS), results of IVCT and genetic screening. The effects of SCh and volatile anesthetics on Ca2+ release from sarcoplasmic reticulum (SR) were studied in vitro. Results A total of 200 patients met the inclusion criteria. Two MH crises (1%) were triggered by SCh (1 MHS, 1 MHE), 18% by volatile anesthetics and 81% by a combination of both. Patients were 70% male and 50% were younger than 12 years old. Overall, CGS was in accord with IVCT results. Crises triggered by enflurane had a significantly higher CGS compared to halothane, isoflurane and sevoflurane. Of the 200 patients, 103 carried RyR1 variants, of which 14 were novel. CGS varied depending on the location of the mutation within the RyR1 gene. In contrast to volatile anesthetics, SCh did not evoke Ca2+ release from isolated rat SR vesicles. Conclusions An MH event could depend on patient-related risk factors such as male gender, young age and causative RyR1 mutations as well as on the use

  2. Protecting pro-poor health services during financial crises: lessons from experience.

    PubMed

    Gottret, Pablo; Gupta, Vaibhav; Sparkes, Susan; Tandon, Ajay; Moran, Valerie; Berman, Peter

    2009-01-01

    This chapter assesses the extent to which previous economic and financial crises had a negative impact on health outcomes and health financing. In addition, we review evidence related to the effectiveness of different policy measures undertaken in past crises to protect access to health services, especially for the poor and vulnerable. The current global crisis is unique both in terms of its scale and origins. Unlike most previous instances, the current crisis has its origins in developed countries, initially the United States, before it spread to middle- and lower-income countries. The current crisis is now affecting almost all countries at all levels of income. This chapter addresses several key questions aimed at helping inform possible policy responses to the current crisis from the perspective of the health sector: What is the nature of the current crisis and in what ways does it differ from previous experiences? What are some of the key. lessons from previous crises? How have governments responded previously to protect health from such macroeconomic shocks? How can we improve the likelihood of positive action today? The chapter reviews the literature on the impact of financial crises on health outcomes and health expenditures and on the effectiveness of past policy efforts to protect human development during periods of economic downturn. It also presents analysis of household surveys and health expenditure data to track health seeking behavior and out-of-pocket expenditures by households during times of financial crisis. Evidence from previous crises indicates that health-related impacts during economic downturns can occur through various channels. The impact in households experiencing reductions in employment and income could be manifest in terms of poorer nutritional outcomes and lower levels of utilization of health care when needed. Households may become impoverished, reduce needed health services, and experience reductions in consumption as a result of

  3. Perturbation of Aptian and Valanginian Carbon Cycle and Marine Biocalcification Crises

    NASA Astrophysics Data System (ADS)

    Weissert, H.; Burla, S.

    2005-12-01

    The mid-Cretaceous is known as a time of major perturbations of the global carbon cycle, which coincided with widespread biocalcification crises. Detailed Ccarbonate and Corganic carbon isotope records through the early Aptian show a prominent negative spike followed by a positive carbon isotope anomaly with amplitude of up to 3permil. Based on cyclostratigraphy, the negative C-isotope anomaly lasted up to a few hundred thousand years while the positive excursion had duration of up to millions of years. The negative spike coincides with low oxygen isotope values documented from the Pacific and Tethys Oceans. Tethyan carbon isotope data indicate that fractionation between marine organic matter and carbonate was largest during the time of most negative carbon isotope values. These data provide evidence that atmospheric carbon dioxide levels were highest during the time of the negative spike. The negative carbon isotope spike coincides with a major biocalcification crisis which is recorded in pelagic, neritic and coastal environments. New carbon and strontium isotope data from Aptian coastal successions in Portugal confirm that the most severe Aptian biocalcification crisis started before but culminated during negative carbon isotope anomaly. The widespread Aptian biocalcifcation crisis seems to have been triggered by elevated atmospheric CO2 values related to volcanic activity. Sudden methane release contributed to an amplification of greenhouse climate and it led to further weakening of marine calcification. Comparable calcification crises are recognized in the Valanginian. There, a negative carbon isotope anomaly recoding a methane pulse is not observed. Volcanic degassing alone seems to have triggered this calcification crisis. The positive carbon isotope excursions in the early Aptian and in the Valanginian following the biocalcification crises record the response of oceans and biota to greenhouse climate. Increased organic carbon burial and an accelerated

  4. A review of pharmaceutical policies in response to economic crises and sanctions

    PubMed Central

    Kheirandish, Mehrnaz; Rashidian, Arash; Kebriaeezade, Abbas; Cheraghali, Abdol Majid; Soleymani, Fatemeh

    2015-01-01

    An economic crisis has been defined as a situation in which the scale of a country's economy becomes smaller in a period of time. Economic crises happen for various reasons, including economic sanctions. Economic crises in a country may affect national priorities for investment and expenditure and reduce available resources, and hence may affect the health care sector including access to medicines. We reviewed the pharmaceutical policies that the countries adopted in order to mitigate the potential negative effects on access to medicines. We reviewed published reports and articles after conducting a comprehensive search of the PubMed and the Google Scholar. After extracting relevant data from the identified articles, we used the World Health Organization (WHO) access to medicines framework as a guide for the categorization of the policies. We identified a total of 40 studies, of which 10 reported the national pharmaceutical policies adopted to reduce the negative impacts of economic crises on access to medicines in high-income and middle-income countries. We identified 89 policies adopted in the 11 countries and categorized them into 12 distinct policy directions. Most of the policies focused on financial aspects of the pharmaceutical sector. In some cases, countries adopted policies that potentially had negative effects on access to medicines. Only Italy had adopted policies encompassing all four accesses to medicine factors recommended by the WHO. While the countries have adopted many seemingly effective policies, little evidence exists on the effectiveness of these policies to improve access to medicines at a time of an economic crisis. PMID:26312250

  5. A review of pharmaceutical policies in response to economic crises and sanctions.

    PubMed

    Kheirandish, Mehrnaz; Rashidian, Arash; Kebriaeezade, Abbas; Cheraghali, Abdol Majid; Soleymani, Fatemeh

    2015-01-01

    An economic crisis has been defined as a situation in which the scale of a country's economy becomes smaller in a period of time. Economic crises happen for various reasons, including economic sanctions. Economic crises in a country may affect national priorities for investment and expenditure and reduce available resources, and hence may affect the health care sector including access to medicines. We reviewed the pharmaceutical policies that the countries adopted in order to mitigate the potential negative effects on access to medicines. We reviewed published reports and articles after conducting a comprehensive search of the PubMed and the Google Scholar. After extracting relevant data from the identified articles, we used the World Health Organization (WHO) access to medicines framework as a guide for the categorization of the policies. We identified a total of 40 studies, of which 10 reported the national pharmaceutical policies adopted to reduce the negative impacts of economic crises on access to medicines in high-income and middle-income countries. We identified 89 policies adopted in the 11 countries and categorized them into 12 distinct policy directions. Most of the policies focused on financial aspects of the pharmaceutical sector. In some cases, countries adopted policies that potentially had negative effects on access to medicines. Only Italy had adopted policies encompassing all four accesses to medicine factors recommended by the WHO. While the countries have adopted many seemingly effective policies, little evidence exists on the effectiveness of these policies to improve access to medicines at a time of an economic crisis.

  6. Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models

    PubMed Central

    Lotfi, Tamara; Bou-Karroum, Lama; Darzi, Andrea; Hajjar, Rayan; El Rahyel, Ahmed; El Eid, Jamale; Itani, Mira; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; El-Jardali, Fadi; Akl, Elie

    2016-01-01

    Background: Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. Methods: We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology. Results: Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the “Cluster Approach” (with 16 case studies), the 4Ws “Who is Where, When, doing What” mapping tool (with four case studies), the “Sphere Project” (with two case studies), the “5x5” model (with one case study), and the “model of information coordination” (with one case study). The 4Ws and the 5x5 focus on coordination of services for mental health, the remaining models do not focus on a specific health topic. The Cluster approach appears to be the most widely used. One case study was a mixed implementation of the Cluster approach and the Sphere model. We identified no model of coordination for funding of health service. Conclusion: This systematic review identified five proposed coordination models that have been implemented by entities funding or delivering health service in humanitarian crises. There is a need to compare the effect of these different models on outcomes such as availability of and access to health services. PMID:27617167

  7. Role of the police in linking individuals experiencing mental health crises with mental health services.

    PubMed

    van den Brink, Rob H S; Broer, Jan; Tholen, Alfons J; Winthorst, Wim H; Visser, Ellen; Wiersma, Durk

    2012-10-17

    The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services.

  8. Role of the police in linking individuals experiencing mental health crises with mental health services

    PubMed Central

    2012-01-01

    Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services. PMID:23072687

  9. Thyroid crises.

    PubMed

    Gavin, L A

    1991-01-01

    In the setting of characteristic features of thyrotoxicosis, the timely diagnosis and aggressive management of thyroid storm should result in a successful outcome. However, severe storm may lead to irreversible cardiovascular collapse, especially in the older patient who may have atypical features of thyrotoxicosis. The fundamental approach is prompt and optimal treatment in the emergency department once the presenting clinical features suggest its presence. Delay in the introduction of therapy while awaiting laboratory confirmation may result in further decompensation and death. The prevention of myxedema coma entails paying special attention to certain high-risk patient groups. These groups include older women with a history of Hashimoto's thyroiditis, or previous irradiation or thyroid surgery for hyperthyroidism. Inform such patients of the symptoms and signs of hypothyroidism, and perform annual thyroid function tests, such as a serum TSH, in order to provide early, adequate treatment once the test becomes positive.

  10. The role of motivation, responsibility, and integrative complexity in crisis escalation: comparative studies of war and peace crises.

    PubMed

    Winter, David G

    2007-05-01

    Drawing on D. G. Winter's (1993) comparison of 1914 and the Cuban Missile Crisis, the author identified 8 paired crises (1 escalating to war, 1 peacefully resolved). Documents (diplomatic messages, speeches, official media commentary) from each crisis were scored for power, affiliation, and achievement motivation; text measures of responsibility and activity inhibition; and integrative complexity. Aggregated effect-size results show that war crises had significantly higher levels of power motivation and responsibility, whereas peace crises showed trends toward higher integrative complexity and achievement motivation. Follow-up analyses suggested that these results are robust with respect to both sides in a crisis, type of material scored, and historical time. The power motive results extend previous findings, but the responsibility results suggest that responsibility plays a paradoxical role in war. Future research directions are sketched, and the role of psychological content analysis in monitoring the danger of war is discussed.

  11. Crises and Collective Socio-Economic Phenomena: Simple Models and Challenges

    NASA Astrophysics Data System (ADS)

    Bouchaud, Jean-Philippe

    2013-05-01

    Financial and economic history is strewn with bubbles and crashes, booms and busts, crises and upheavals of all sorts. Understanding the origin of these events is arguably one of the most important problems in economic theory. In this paper, we review recent efforts to include heterogeneities and interactions in models of decision. We argue that the so-called Random Field Ising model ( rfim) provides a unifying framework to account for many collective socio-economic phenomena that lead to sudden ruptures and crises. We discuss different models that can capture potentially destabilizing self-referential feedback loops, induced either by herding, i.e. reference to peers, or trending, i.e. reference to the past, and that account for some of the phenomenology missing in the standard models. We discuss some empirically testable predictions of these models, for example robust signatures of rfim-like herding effects, or the logarithmic decay of spatial correlations of voting patterns. One of the most striking result, inspired by statistical physics methods, is that Adam Smith's invisible hand can fail badly at solving simple coordination problems. We also insist on the issue of time-scales, that can be extremely long in some cases, and prevent socially optimal equilibria from being reached. As a theoretical challenge, the study of so-called "detailed-balance" violating decision rules is needed to decide whether conclusions based on current models (that all assume detailed-balance) are indeed robust and generic.

  12. Finite-time singularities in the dynamics of Mexican financial crises

    NASA Astrophysics Data System (ADS)

    Alvarez-Ramirez, Jose; Ibarra-Valdez, Carlos

    2004-01-01

    Historically, symptoms of Mexican financial crises have been strongly reflected in the dynamics of the Mexican peso to the dollar exchange currency market. Specifically, in the Mexican financial crises during 1990's, the peso suffered significant depreciation processes, which has important impacts in the macro- and micro-economical environment. In this paper, it is shown that the peso depreciation growth was greater than an exponential and that these growth rates are compatible with a spontaneous singularity occurring at a critical time, which signals an abrupt transition to new dynamical conditions. As in the major 1990's financial crisis in 1994-1995, some control actions (e.g., increasing the USA dollar supply) are commonly taken to decelerate the degree of abruptness of peso depreciation. Implications of these control actions on the crisis dynamics are discussed. Interestingly, by means of a simple model, it is demonstrated that the time at which the control actions begin to apply is critical to moderate the adverse effects of the financial crisis.

  13. Role of Social Media and Networking in Volcanic Crises and Communication

    NASA Astrophysics Data System (ADS)

    Sennert, S.; Klemetti, E. W.; Bird, D. K.

    2016-12-01

    The growth of social media as a primary and often preferred news source has led to the rapid dissemination of information about volcanic eruptions and potential volcanic crises as they begin, evolve, and end. This information comes from a variety of sources: news organisations, emergency management personnel, individuals (both members of the public and official representatives), and volcano monitoring agencies. Once posted, this information is easily shared, increasing the reach to a much broader population than more traditional forms of media, such as radio and newspapers. The onset and popularity of social media as a vehicle for dissemination of eruption information points toward the need to systematically incorporate social media into the official channels that volcano observatories use to distribute activity statements, forecasts, and images. We explore two examples of projects that collect/disseminate information regarding volcanic crises and eruptive activity via social media sources; the Smithsonian/USGS Weekly Volcanic Activity Report (WVAR), which summarizes new and on-going volcanic activity globally and on a weekly basis, and Eruptions, a blog that discusses eruptions as well as other volcanic topics. Based on these experiences, recommendations are made to volcanic observatories in relation to the use of social media as a communication tool. These recommendations include: using social media as a two-way dialogue to communicate and receive information directly from the public and other sources; stating that the social media account is from an official source; and posting types of information that users want to see such as images, videos, and figures.

  14. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies.

    PubMed

    Patel, Nirali H; Romero, Sarah K; Kaelber, David C

    2012-01-01

    Hypertension (HTN) in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1) safely lower blood pressure, and (2) treat/minimize acute end organ damage, while (3) identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8-hour period.

  15. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    PubMed Central

    Patel, Nirali H; Romero, Sarah K; Kaelber, David C

    2012-01-01

    Hypertension (HTN) in the pediatric population is estimated to have a world-wide prevalence of 2%–5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1) safely lower blood pressure, and (2) treat/minimize acute end organ damage, while (3) identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8-hour period. PMID:27147865

  16. International crises and global health electives: lessons for faculty and institutions.

    PubMed

    Steiner, Beat D; Carlough, Martha; Dent, Georgette; Peña, Rodolfo; Morgan, Douglas R

    2010-10-01

    Student participation in global health electives and community service initiatives is associated with a number of favorable outcomes, and student interest in participating in such experiences is high. Increasingly, medical schools are facilitating and supervising global health opportunities. The inherent risks and uncertainties of global community service deserve careful consideration as schools engage more actively in this area. This article presents how one institution managed three crises in three electives in a single year. The H1N1 flu epidemic impacted a group of students bound for Mexico, a political upheaval affected a student group working in Honduras, and a hurricane threatened a student group in Nicaragua. This article outlines lessons learned from responding to these crises. Well-defined institutional travel policies, clear communication plans in the event of an emergency, a responsible administrative entity for global experiences, and formal predeparture training for students and faculty can help institutions better respond to unpredictable events. A comprehensive examination of these lessons and reflections on how to institutionalize the various components may help other institutions prepare for such events and lessen negative impact on student learning.

  17. A Numeric Scorecard Assessing the Mental Health Preparedness for Large-Scale Crises at College and University Campuses: A Delphi Study

    ERIC Educational Resources Information Center

    Burgin, Rick A.

    2012-01-01

    Large-scale crises continue to surprise, overwhelm, and shatter college and university campuses. While the devastation to physical plants and persons is often evident and is addressed with crisis management plans, the number of emotional casualties left in the wake of these large-scale crises may not be apparent and are often not addressed with…

  18. A Numeric Scorecard Assessing the Mental Health Preparedness for Large-Scale Crises at College and University Campuses: A Delphi Study

    ERIC Educational Resources Information Center

    Burgin, Rick A.

    2012-01-01

    Large-scale crises continue to surprise, overwhelm, and shatter college and university campuses. While the devastation to physical plants and persons is often evident and is addressed with crisis management plans, the number of emotional casualties left in the wake of these large-scale crises may not be apparent and are often not addressed with…

  19. Magnetic Resonance Imaging Assessment of Kidney Oxygenation and Perfusion During Sickle Cell Vaso-occlusive Crises.

    PubMed

    Deux, Jean-François; Audard, Vincent; Brugières, Pierre; Habibi, Anoosha; Manea, Elena-Maria; Guillaud-Danis, Constance; Godeau, Bertrand; Galactéros, Frédéric; Stehlé, Thomas; Lang, Philippe; Grimbert, Philippe; Audureau, Etienne; Rahmouni, Alain; Bartolucci, Pablo

    2017-01-01

    Our understanding of the pathophysiologic processes underlying sickle cell nephropathy remains incomplete. We performed a pilot study to investigate the potential value of magnetic resonance imaging (MRI) for the assessment of kidney oxygenation and detection of potential changes to tissue perfusion and cellular integrity during a vaso-occlusive crisis. A case-control study. 10 homozygous patients with sickle cell disease (SCD), without kidney disease (based on estimated glomerular filtration rate and albuminuria), underwent renal MRI during a vaso-occlusive crisis episode. The imaging data obtained were compared with those for a second MRI performed at steady state (median, 56 [IQR, 37-72] days after the vaso-occlusive crisis MRI). The control group consisted of 10 apparently healthy individuals. Deoxyhemoglobin level assessed by R2* value was calculated using the blood oxygen level-dependent technique. The intravoxel incoherent motion diffusion-weighted imaging technique was used to calculate D, D*, and F parameters. Median medullary R2* values on steady-state MRI were significantly higher for patients with SCD than for controls (P=0.01) and did not change significantly during the vaso-occlusive crisis. No significant differences in median cortical R2* values were observed. Both cellular integrity (D) and local perfusion (D* and F) were significantly altered in medullary and cortical areas during vaso-occlusive crises in comparison to steady state in patients with SCD. These parameters did not differ significantly between patients with SCD assessed at steady state and the control group. Small sample size, estimation of glomerular filtration rate according to CKD-EPI creatinine equation without adjustment for race. Deoxyhemoglobin levels in the medullary area are higher in patients with SCD, during vaso-occlusive crises and at steady state, than in controls. Alterations to the tissue perfusion and cellular integrity of renal parenchyma are a common finding

  20. Association between adenotonsillar hypertrophy, tonsillitis and painful crises in sickle cell disease.

    PubMed

    Salles, Cristina; Ramos, Regina Terse T; Daltro, Carla; Nascimento, Valma Maria; Matos, Marcos Almeida

    2009-01-01

    To determine the prevalence of obstructive adenotonsillar hypertrophy in children and adolescents with sickle cell anemia; to investigate possible association between the presence of more than five episodes of tonsillitis in the last 12 months and episodes of painful crises in the same period; and to compare the mean annual hemoglobin level in children and adolescents with and without obstructive adenotonsillar hypertrophy. Prospective, observational, cross-sectional study involving 85 children and adolescents with sickle cell anemia. All patients answered a questionnaire and underwent a standard otolaryngology examination, including endoscopic endonasal approach. The diagnosis of obstructive adenotonsillar hypertrophy was made according to the Brodsky scale. The prevalence of obstructive adenotonsillar hypertrophy was 55.3%. Obstructive adenotonsillar hypertrophy was associated with history of difficulty in eating (76.7 vs. 23.5%, p = 0.003), presence of more than five episodes of tonsillitis in the last 12 months (70.6 vs. 29.4%, p = 0.021), loud snoring (73.0 vs. 27.0%, p = 0.004), and sleep apnea (71.8 vs. 28.2%, p = 0.005). Patients with obstructive adenotonsillar hypertrophy had more episodes of recurrent upper airway tract infection (62.5 vs. 37.5; p = 0.010). The presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises (median = 12 vs. 2, p = 0.017). There was no significant difference between mean annual hemoglobin levels of patients with obstructive adenotonsilar hypertrophy vs. nonobstructive adenotonsillar hypertrophy: 7.6 vs. 8.2 g/dL, p = 0.199. The prevalence of obstructive adenotonsillar hypertrophy was 55.3% in children and adolescents with sickle cell anemia; the presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises in the same period; and there was no difference in the mean annual hemoglobin value among those with or

  1. Managing an Infectious Disease Outbreak in a School. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 3

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an infectious disease incident, which resulted in the death of a student, closure of area schools and the operation of an on-site school vaccine clinic. The report highlights the critical need…

  2. Responding To School Walkout Demonstrations. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 1, 2008

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue examines the incidence of student walkout demonstrations and the various ways in which administrators, school staff, law enforcement, and the community at large can help keep youths…

  3. Educating Children in the Midst of Health Crises: A Phenomenological Study of Teachers in Children's Hospital Schools

    ERIC Educational Resources Information Center

    Burns, Johnna N.

    2013-01-01

    Purpose, Scope, and Method of Study: Hospital school teachers are a unique population of educators highly qualified and experienced in teaching students who are facing health crises. The purpose of this phenomenological study was to describe the lived experience of teaching seriously ill students in the hospital school setting. The study was…

  4. Coping with Multiple Suicides among Middle School Students. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 2

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue addresses the experience of a school district where three middle school students hung themselves within a three-week timeframe. Although deaths were apparently unconnected, the school district is part of a…

  5. Incorporating Chemical Hazards into an Emergency Management Plan. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 4

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on a chemical spill that went unreported for approximately seven years, setting off a series of responses from the school district's Environmental Health and Safety Department (EHS) and the state…

  6. Improving Responses to Individual and Family Crises. Learning Guide 10. Project Connect. Linking Self-Family-Work.

    ERIC Educational Resources Information Center

    Emily Hall Tremaine Foundation, Inc., Hartford, CT.

    This learning guide on improving responses to individual and family crises is part of a series of learning guides developed for competency-based adult consumer and homemaking education programs in community colleges, adult education centers, community centers, and the workplace. Focus is on the connections among personal, family, and job…

  7. Educating Children in the Midst of Health Crises: A Phenomenological Study of Teachers in Children's Hospital Schools

    ERIC Educational Resources Information Center

    Burns, Johnna N.

    2013-01-01

    Purpose, Scope, and Method of Study: Hospital school teachers are a unique population of educators highly qualified and experienced in teaching students who are facing health crises. The purpose of this phenomenological study was to describe the lived experience of teaching seriously ill students in the hospital school setting. The study was…

  8. Prevention of Targeted School Violence by Responding to Students' Psychosocial Crises: The NETWASS Program.

    PubMed

    Leuschner, Vincenz; Fiedler, Nora; Schultze, Martin; Ahlig, Nadine; Göbel, Kristin; Sommer, Friederike; Scholl, Johanna; Cornell, Dewey; Scheithauer, Herbert

    2017-01-01

    The standardized, indicated school-based prevention program "Networks Against School Shootings" combines a threat assessment approach with a general model of prevention of emergency situations in schools through early intervention in student psychosocial crises and training teachers to recognize warning signs of targeted school violence. An evaluation study in 98 German schools with 3,473 school staff participants (Mage  = 46.2 years) used a quasi-experimental comparison group design with three measurement points (pre, post, and 7 months followup) with schools randomly allocated to implementation conditions. The study found increases in teachers' expertise and evaluation skills, enhanced abilities to identify students experiencing a psychosocial crisis, and positive secondary effects (e.g., teacher-student interaction, feelings of safety). © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  9. Perioperative Anaesthetic Approach in a Homozygous Sickle Cell Anaemia Patient with Frequent Pain Crises.

    PubMed

    Tuzcu, Kasım; Karcıoğlu, Murat; Davarcı, Işıl; Hakimoğlu, Sedat; Akküçük, Seçkin

    2014-12-01

    Sickle cell disease (HbS) is a haemolytic anaemia characterized by the formation of abnormal haemoglobin. In patients with sickle cell disease, high rates of erythrocyte generation, degradation, and hyperbilirubinemia increase the risk for cholelithiasis. Previous studies have found that the incidence of cholelithiasis is 70% in adult patients. In sickle cell disease, decreased oxygen concentration leads to the sickling of erythrocytes by causing aggregation and polymerization. Sickle erythrocytes can have devastating effects on many vital organs by causing microvascular occlusion. In patients with sickle cell anaemia, anaesthetic technique, anaesthetic agents, and surgical trauma may cause additional risk. In this case report, we present a perioperative anaesthetic approach in the laparoscopic cholecystectomy of a patient with HbS, elevated liver function tests, and frequent pain crises.

  10. Architectures engender crises: The emergence of power laws in social networks

    NASA Astrophysics Data System (ADS)

    Tohmé, Fernando; Larrosa, Juan M. C.

    2016-05-01

    Recent financial crises posed a number of questions. The most salient were related to the cogency of derivatives and other sophisticated hedging instruments. One claim is that all those instruments rely heavily on the assumption that events in the world are guided by normal distributions while, instead, all the evidence shows that they actually follow fat-tailed power laws. Our conjecture is that it is the very financial architecture that engenders extreme events. Not on purpose but just because of its complexity. That is, the system has an internal connection structure that is able to propagate and enhance initially small disturbances. The final outcome ends up not being correlated with its triggering event. To support this claim, we appeal to the intuition drawn from the behavior of social networks. Most of the interesting cases constitute scale-free structures. In particular, we contend, those that arise from strategic decisions of the agents.

  11. Organizational collaborative capacity in fighting pandemic crises: a literature review from the public management perspective.

    PubMed

    Lai, Allen Y

    2012-01-01

    Collaborative capacity serves for organizations as the capacity to collaborate with other network players. Organizational capacity matters as collaboration outcomes usually go beyond single-shot implementation efforts or a single-minded focus on either the vertical dimension of program or the horizontal component. This review article explores organizational collaborative capacities from the perspective of public management, in particular, network theory. By applying the 5 attributes of network theory-interdependence, membership, resources, information, and learning-to the explanation of collaborative capacity in fighting pandemic crises, I argue in some ways organizational collaborative capacity is very much like an organization in its own right. Studying collaborative capacity in the battle against pandemics facilitate our understanding of multisectoral collaboration in technical, political, and institutional dimensions, and greatly advances the richness of capacity vocabulary in pandemic response and preparedness.

  12. When Health Diplomacy Serves Foreign Policy: Use of Soft Power to Quell Conflict and Crises.

    PubMed

    Hosseini Divkolaye, Nasim Sadat; Radfar, Mohammad Hadi; Seighali, Fariba; Burkle, Frederick M

    2016-10-01

    Health diplomacy has increasingly become a crucial element in forging political neutrality and conflict resolution and the World Health Organization has strongly encouraged its use. Global turmoil has heightened, especially in the Middle East, and with it, political, religious, and cultural differences have become major reasons to incite crises. The authors cite the example of the human stampede and the deaths of over 2000 pilgrims during the 2015 annual Haj pilgrimage in Mecca. The resulting political conflict between Iran and Saudi Arabia had the potential to escalate into a more severe political and military crisis had it not been for the ministers of health from both countries successfully exercising "soft power" options. Global health security demands critical health diplomacy skills and training for all health providers. (Disaster Med Public Health Preparedness. 2016;page 1 of 4).

  13. Energy security in the post-Cold War era: Identifying future courses for crises

    SciTech Connect

    Freund, M.T.; Wise, J.A.; Ulibarri, C.A.; Shaw, B.R.; Seely, H.E.; Roop, J.M.

    1994-11-01

    This paper addresses US energy security in the post-Cold War era for a conference on energy security jointly sponsored by the Department of Energy and the National Defense University. It examines the evolving nature of energy security based on analysis of past crisis-inducing events and-discusses potentially important geopolitical, environmental, regulatory, and economic developments during the next twenty-five years. The paper steps beyond the traditional economic focus of energy security issues to examine the interplay between fundamental economic and technical drivers on the one hand, and political, environmental, and perceptual phenomena, on the other hand, that can combine to create crises where none were expected. The paper expands on the premise that the recent demise of the Soviet Union and other changing world conditions have created a new set of energy dynamics, and that it is imperative that the United States revise its energy security perspective accordingly. It proceeds by reviewing key factors that comprise the concepts of ``energy security`` and ``energy crisis`` and how they may fit into the new world energy security equation. The study also presents a series of crisis scenarios that could develop during the next twenty-five years, paying particular attention to mechanisms and linked crisis causes and responses. It concludes with a discussion of factors that may serve to warn analysts and decision makers of impending future crises conditions. The crisis scenarios contained in this report should be viewed only as a representative sample of the types of situations that could occur. They serve to illustrate the variety of factors that can coalesce to produce a ``crisis.``

  14. Health impacts of macroeconomic crises and policies: determinants of variation in childhood malnutrition trends in Cameroon.

    PubMed

    Pongou, Roland; Salomon, Joshua A; Ezzati, Majid

    2006-06-01

    It is generally hypothesized that macro economic shocks worsen child health by lowering household economic status and limiting access to health care, but this proposition seldom has been tested empirically. We examined the effects of economic crises and adjustment programmes during the 1990s in Cameroon on childhood malnutrition in population subgroups and evaluated the household and health system mediators of these effects. We used pooled cross-sectional data from two Demographic and Health Surveys conducted in 1991 and 1998. In multivariate analysis, we stratified data on child sex and age, maternal education, and place and region of residence. We used a linear regression model to estimate the net effects of changes in average household economic status and maternal health seeking behaviour (MHSB) on changes in the prevalence of malnutrition for each stratum, adjusting for all other variables. The prevalence of malnutrition in children younger than 3 years increased from 16 to 23% (P < 0.001) between 1991 and 1998. The increase in urban areas, from 13 to 15% (P = 0.391), mostly occurred in children of low-educated mothers. The increase in rural areas, from 19 to 25% (P < 0.001), mostly occurred in boys, children older than 6 months of age, those born to low-educated mothers, and those of low economic status. In urban areas, the advantage associated with higher maternal education was robust to all controls, and declines in economic status and MHSB were the mediators of increasing malnutrition. In rural areas, increase in malnutrition was higher in children with lower baseline economic status; decline in MHSB was a significant mediator of worsening nutritional status. The negative nutritional effects during economic crises and adjustment programmes of the 1990s in Cameroon were largest among children of low socioeconomic status. Declines in household economic status and access to health care were the mediators of increasing malnutrition.

  15. Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review.

    PubMed

    Ramesh, Anita; Blanchet, Karl; Ensink, Jeroen H J; Roberts, Bayard

    2015-01-01

    Water, sanitation, and hygiene (WASH) interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear. To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts. A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980-2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed. Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU) water quality interventions, with 50% using safe water storage (SWS) and 35% using household water treatment (HWT). All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions). 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap) as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence. The current evidence base on the impact of WASH interventions on health outcomes in humanitarian

  16. Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review

    PubMed Central

    Ramesh, Anita; Blanchet, Karl; Ensink, Jeroen H. J.; Roberts, Bayard

    2015-01-01

    Background Water, sanitation, and hygiene (WASH) interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear. Aim To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts. Methods A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980–2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed. Results Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU) water quality interventions, with 50% using safe water storage (SWS) and 35% using household water treatment (HWT). All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions). 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap) as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence. Conclusion The current evidence base on the impact of WASH

  17. C3I for Crisis, Emergency and Consequence Management (C3I pour la gestion des crises, des urgences et de leurs consequences)

    DTIC Science & Technology

    2009-05-01

    May 2009 C3I for Crisis, Emergency and Consequence Management (C3I pour la gestion des crises , des urgences et de leurs conséquences) Research and...consequence management. ES - 2 RTO-MP-IST-086 C3I pour la gestion des crises , des urgences et de leurs conséquences (RTO-MP-IST-086...contre-terrorisme, de sécurité nationale/publique et de réponse collective face aux situations d’urgence (à la fois gestion des crises et gestion de leurs

  18. Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

    PubMed

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

    2016-01-01

    Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

  19. The Nature of Punctuational Crises and the Spenglerian Model of Civilization

    NASA Astrophysics Data System (ADS)

    Clube, S. V. M.

    acknowledged dispensers of prognosis and mitigation who endorsed the adverse implications of 'blazing stars' (astrologers, soothsayers etc.) were commonly impugned and censured. Nowadays, of course, we are able to recognise that the Earth's environment is not only one of essentially uniformitarian calm, as formerly assumed, but one that is also interrupted by 'punctuational crises', each crisis being the sequence of events which arises due to the fragmentation of an individual comet whose orbit intersects the Earth's. That even modest crises can arouse apprehension is known through the circumstances of the nineteenth century break-up of Comet Biela. Indeed it seems that these crises are rather frequently characterized by relatively violent (paradigm shifting) transmutations of human society such as were originally proposed by Spengler and Toynbee more than sixty years ago on the basis of historical analysis alone. It would appear, then, that the historical fear of comets which has been with us since the foundation of civilization, far from being the reflection of an astrological perception of the cosmos which was deranged and therefore abandoned, has a perfectly rational basis in occasional cometary fragmentation events. Such events recur and evidently have quite serious implications for society and government today. Thus when cosmic danger returns and there is growing awareness of the fact, we find that society is capable of becoming uncontrollably convulsed as 'enlightenment' spreads. A revival of millenarian expectations under these circumstances, for example, is not so much an underlying consequence but a deviant manifestation of the violent turmoil into which society falls, often to revolutionary effect.

  20. Being in two minds: the neural basis of experiencing action crises in personal long-term goals.

    PubMed

    Herrmann, Marcel; Baur, Volker; Brandstätter, Veronika; Hänggi, Jürgen; Jäncke, Lutz

    2014-01-01

    Although the successful pursuit of long-term goals constitutes an essential prerequisite to personal development, health, and well-being, little research has been devoted to the understanding of its underlying neural processes. A critical phase in the pursuit of long-term goals is defined as an action crisis, conceptualized as the intra-psychic conflict between further goal pursuit and disengagement from the goal. In the present research, we applied an interdisciplinary (cognitive and neural) approach to the analysis of processes underlying the experience of an action crisis. In Study 1, a longitudinal field study, action crises in personal goals gave rise to an increased and unbiased (re)evaluation of the costs and benefits (i.e., rewards) of the goal. Study 2 was a magnetic resonance imaging study examining resting-state functional connectivity. The extent of experienced action crises was associated with enhanced fronto-accumbal connectivity signifying increased reward-related impact on prefrontal action control. Action crises, furthermore, mediated the relationship between a dispositional measure of effective goal pursuit (action orientation) and fronto-accumbal connectivity. The converging and complementary results from two methodologically different approaches advance the understanding of the neurobiology of personal long-term goals, especially with respect to the role of rewards in the context of goal-related conflicts.

  1. The impact of digital technology on health of populations affected by humanitarian crises: Recent innovations and current gaps.

    PubMed

    Mesmar, Sandra; Talhouk, Reem; Akik, Chaza; Olivier, Patrick; Elhajj, Imad H; Elbassuoni, Shady; Armoush, Sarah; Kalot, Joumana; Balaam, Madeline; Germani, Aline; Ghattas, Hala

    2016-11-01

    Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports, we identified 50 digital technologies used by humanitarian actors, and/or populations affected by crises. We organized them according to the stage of the humanitarian cycle that they were used in, and the health outcomes or determinants of health they affected. Digital technologies were found to facilitate communication, coordination, and collection and analysis of data, enabling timely responses in humanitarian contexts. A lack of evaluation of these technologies, a paternalistic approach to their development, and issues of privacy and equity constituted major challenges. We highlight the need to create a space for dialogue between technology designers and populations affected by humanitarian crises.

  2. Collaboration in crisis: Carer perspectives on police and mental health professional's responses to mental health crises.

    PubMed

    Brennan, Alice; Warren, Narelle; Peterson, Violeta; Hollander, Yitzchak; Boscarato, Kara; Lee, Stuart

    2016-10-01

    For many situations involving a mental health crisis, carers (e.g. family or friends) are present and either attempt to help the person overcome the crisis or request assistance from professional services (e.g. mental health or police). Comparatively, little research has explored how carers experience the crisis, the professional response and how the nature of the response, in turn, impacts carers. The current study was conducted to explore these issues during individual interviews with nine carers who had previous contact with police and mental health services during a crisis response. Collected data described the definition and perceived impact of a mental health crisis for carers, how carers had experienced a crisis response from police and mental health services, and how the professional response had impacted on carers. Of importance was the finding that carers were often themselves traumatized by witnessing or being involved in the crisis, however, were rarely offered direct education or support to help them cope or prevent future crises. A number of carers described a reluctance to request assistance from professional services due to previous poor experiences. This highlighted the importance of implementing strategies to deliver more timely, respectful, specialist and collaborative crisis responses to improve carer and consumer outcomes. © 2016 Australian College of Mental Health Nurses Inc.

  3. Cross-border Portfolio Investment Networks and Indicators for Financial Crises

    PubMed Central

    Joseph, Andreas C.; Joseph, Stephan E.; Chen, Guanrong

    2014-01-01

    Cross-border equity and long-term debt securities portfolio investment networks are analysed from 2002 to 2012, covering the 2008 global financial crisis. They serve as network-proxies for measuring the robustness of the global financial system and the interdependence of financial markets, respectively. Two early-warning indicators for financial crises are identified: First, the algebraic connectivity of the equity securities network, as a measure for structural robustness, drops close to zero already in 2005, while there is an over-representation of high-degree off-shore financial centres among the countries most-related to this observation, suggesting an investigation of such nodes with respect to the structural stability of the global financial system. Second, using a phenomenological model, the edge density of the debt securities network is found to describe, and even forecast, the proliferation of several over-the-counter-traded financial derivatives, most prominently credit default swaps, enabling one to detect potentially dangerous levels of market interdependence and systemic risk. PMID:24510060

  4. Entropies of negative incomes, Pareto-distributed loss, and financial crises.

    PubMed

    Gao, Jianbo; Hu, Jing; Mao, Xiang; Zhou, Mi; Gurbaxani, Brian; Lin, Johnny

    2011-01-01

    Health monitoring of world economy is an important issue, especially in a time of profound economic difficulty world-wide. The most important aspect of health monitoring is to accurately predict economic downturns. To gain insights into how economic crises develop, we present two metrics, positive and negative income entropy and distribution analysis, to analyze the collective "spatial" and temporal dynamics of companies in nine sectors of the world economy over a 19 year period from 1990-2008. These metrics provide accurate predictive skill with a very low false-positive rate in predicting downturns. The new metrics also provide evidence of phase transition-like behavior prior to the onset of recessions. Such a transition occurs when negative pretax incomes prior to or during economic recessions transition from a thin-tailed exponential distribution to the higher entropy Pareto distribution, and develop even heavier tails than those of the positive pretax incomes. These features propagate from the crisis initiating sector of the economy to other sectors.

  5. From famine to food crisis: what history can teach us about local and global subsistence crises.

    PubMed

    Vanhaute, Eric

    2011-01-01

    The number of famine prone regions in the world has been shrinking for centuries. It is currently mainly limited to sub-Saharan Africa. Yet the impact of endemic hunger has not declined and the early twenty-first century seems to be faced with a new threat: global subsistence crises. In this essay I question the concepts of famine and food crisis from different analytical angles: historical and contemporary famine research, food regime theory, and peasant studies. I will argue that only a more integrated historical framework of analysis can surpass dualistic interpretations grounded in Eurocentric modernization paradigms. This article successively debates historical and contemporary famine research, the contemporary food regime and the new global food crisis, the lessons from Europe's 'grand escape' from hunger, and the peasantry and 'depeasantization' as central analytical concepts. Dualistic histories of food and famine have been dominating developmentalist stories for too long. This essay shows how a blending of historical and contemporary famine research, food regime theory and new peasant studies can foster a more integrated perspective.

  6. Midlife Crises in Dwarf Galaxies in the NGC 5353/4 Group

    NASA Astrophysics Data System (ADS)

    Tully, R. Brent; Trentham, Neil

    2008-04-01

    This third paper in a series about the dwarf galaxy populations in groups within the Local Supercluster concerns the intermediate mass (2.1 × 1013 M sun) NGC 5353/4 Group with a core dominated by S0 systems and a periphery of mostly spiral systems. Dwarf galaxies are strongly concentrated toward the core. The mass-to-light ratio M/LR = 105 M sun/L sun is a factor of 3 lower than for the two groups studied earlier in the series. The properties of the group suggest it is much less dynamically evolved than those two groups of early-type galaxies. By comparison, the NGC 5353/4 Group lacks superluminous systems but has a large fraction of intermediate-luminosity galaxies; or equivalently, a luminosity function with a flatter faint-end slope. The luminosity function for the NGC 5353/4 Group should steepen as the intermediate-luminosity galaxies merge. Evidence for the ongoing collapse of the group is provided by the unusually large incidence of star-formation activity in small galaxies with early morphological types. The pattern in the distribution of galaxies with activity suggests a succession of infall events. Residual gas in dwarfs that enter the group is used up in sputtering events. The resolution of midlife crises is exhaustion.

  7. EDs credit drills, community engagement with helping them manage casualties from tornado crises.

    PubMed

    2011-07-01

    Emergency department leaders at DCH Regional Medical Center in Tuscaloosa, AL, and Cullman Regional Medical Center in Cullman, AL, credit their regular practice drills with helping them deal with unprecedented demand when deadly tornadoes swept through the South this past April. Both facilities used the hospital instant command structure (HICS) to mobilize the resources needed to care for the surge in patients, and say the approach worked well in helping them meet the needs of their communities. However, the crises also showcased opportunities for improvement. The ED at DCH Regional Medical Center saw more than 600 patients on the day of the storm, a three-fold increase in the hospital's typical volume. CRMC treated 99 patients in the seven hours immediately following the storm when it usually treats 114 patients per day. In addition to a big surge in patients, both hospitals dealt with power outages that limited access to some services such as radiology. Triage proved particularly challenging at DCH Regional Medical Center, as patients flowed into the hospital from numerous access points. The hospital plans to assign coordinators to each area of the hospital to better manage the influx in the future. When reviewing emergency operations plans, Joint Commission reviewers often find deficiencies in hazard vulnerability analyses as well as the processes used to determine the emergency credentials of licensed independent practitioners.

  8. Long-range dependence in returns and volatility of global gold market amid financial crises

    NASA Astrophysics Data System (ADS)

    Omane-Adjepong, Maurice; Boako, Gideon

    2017-04-01

    Using sampled historical daily gold market data from 07-03-1985 to 06-01-2015, and building on a related work by Bentes (2016), this paper examines the presence of long-range dependence (LRD) in the world's gold market returns and volatility, accounting for structural breaks. The sampled gold market data was divided into subsamples based on four global crises: the September 1992 collapse of the European Exchange Rate Mechanism (ERM), the Asian financial crisis of mid-1997, the Subprime meltdown of 2007, and the recent European sovereign debt crisis, which hit the world's market with varying effects. LRD test was carried-out on the full-sample and subsample periods using three semiparametric methods-before and after adjusting for structural breaks. The results show insignificant evidence of LRD in gold returns. However, very diminutive evidence is found for periods characterized by financial/economic shocks, with no significant detections for post-shock periods. Collectively, this is indicative that the gold market is less speculative, and hence could be somehow less risky for hedging and portfolio diversification.

  9. Cross-border Portfolio Investment Networks and Indicators for Financial Crises

    NASA Astrophysics Data System (ADS)

    Joseph, Andreas C.; Joseph, Stephan E.; Chen, Guanrong

    2014-02-01

    Cross-border equity and long-term debt securities portfolio investment networks are analysed from 2002 to 2012, covering the 2008 global financial crisis. They serve as network-proxies for measuring the robustness of the global financial system and the interdependence of financial markets, respectively. Two early-warning indicators for financial crises are identified: First, the algebraic connectivity of the equity securities network, as a measure for structural robustness, drops close to zero already in 2005, while there is an over-representation of high-degree off-shore financial centres among the countries most-related to this observation, suggesting an investigation of such nodes with respect to the structural stability of the global financial system. Second, using a phenomenological model, the edge density of the debt securities network is found to describe, and even forecast, the proliferation of several over-the-counter-traded financial derivatives, most prominently credit default swaps, enabling one to detect potentially dangerous levels of market interdependence and systemic risk.

  10. Cross-border portfolio investment networks and indicators for financial crises.

    PubMed

    Joseph, Andreas C; Joseph, Stephan E; Chen, Guanrong

    2014-02-10

    Cross-border equity and long-term debt securities portfolio investment networks are analysed from 2002 to 2012, covering the 2008 global financial crisis. They serve as network-proxies for measuring the robustness of the global financial system and the interdependence of financial markets, respectively. Two early-warning indicators for financial crises are identified: First, the algebraic connectivity of the equity securities network, as a measure for structural robustness, drops close to zero already in 2005, while there is an over-representation of high-degree off-shore financial centres among the countries most-related to this observation, suggesting an investigation of such nodes with respect to the structural stability of the global financial system. Second, using a phenomenological model, the edge density of the debt securities network is found to describe, and even forecast, the proliferation of several over-the-counter-traded financial derivatives, most prominently credit default swaps, enabling one to detect potentially dangerous levels of market interdependence and systemic risk.

  11. Metahabilitation: Transforming Life Crises: A Story of Enhanced Recovery Involving Addiction and Dependency.

    PubMed

    2015-01-01

    Individuals experience crisis when their estimation of resources needed to successfully manage traumatic situations such as addiction and dependency is greater than their perception of resources available. Some recovery models are limited in their perspective on enhanced outcomes, failing to put the individual in a position of strength and on the path to a positive, more meaningful future. Rehabilitation can be too general, failing to incorporate personal experiences of trauma into the therapeutic plan. Recovery models must address these insufficiencies and promote an individual's biological, psychological, and spiritual abilities to transform and experience higher levels of functioning-actually brought about by traumas and personal life crises such as addictions and dependencies. These conditions become vehicles, providing opportunities to creatively restructure the self and find significant existential meaning. A heuristic study revealed insights into advanced recovery. The results identified limitations of current rehabilitative models and informed the development of the unique recovery concept and process: metahabilitation. A case study provides an overview and shows the model as it applies to addiction and dependency.

  12. The role of igneous and metamorphic processes in triggering mass extinctions and Earth crises

    NASA Astrophysics Data System (ADS)

    Svensen, Henrik; Planke, Sverre; Polozov, Alexander G.; Jerram, Dougal; Jones, Morgan T.

    2016-04-01

    Mass extinctions and transient climate events commonly coincide in time with the formation of Large igneous provinces (LIPs). The end-Permian event coincides with the Siberian Traps, the end-Triassic with the Central Atlantic Magmatic Event (CAMP), the Toarcian with the Karoo LIP, and the Paleocene-Eocene Thermal Maximum (PETM) with the North Atlantic Igneous Province. Although the temporal relationship between volcanism and the environmental crises has been known for decades, the geological processes linking LIPs to these environmental events are strongly debated: Explosive LIP volcanism should lead to short term cooling (not long term warming), mantle CO2 is too 13C-enriched to explain negative 13C carbon isotope excursions from sedimentary sequences, the LIP volcanism is poorly dated and apparently lasts much longer that the associated environmental events, large portions of the LIPs remain poorly explored, especially the sub-volcanic parts where sills and dikes are emplaced in sedimentary host rocks, and thus gas flux estimates from contact aureoles around sill intrusions are often poorly constrained. In this presentation, we discuss the status of LIP research with an emphasis on the sub volcanic processes. We show that potential for degassing of greenhouse gases, aerosols, and ozone destructive gases is substantial and can likely explain the triggering of both climatic events and mass extinctions.

  13. Changes in labor regulations during economic crises: does deregulation favor health and safety?

    PubMed

    Jhang, Won Gi

    2011-01-01

    The regulatory changes in Korea during the national economic crisis 10 years ago and in the current global recession were analyzed to understand the characteristics of deregulation in labor policies. Data for this study were derived from the Korean government's official database for administrative regulations and a government document reporting deregulation. A great deal of business-friendly deregulation took place during both economic crises. Occupational health and safety were the main targets of deregulation in both periods, and the regulation of employment promotion and vocational training was preserved relatively intact. The sector having to do with working conditions and the on-site welfare of workers was also deregulated greatly during the former economic crisis, but not in the current global recession. Among the three main areas of labor policy, occupational health and safety was most vulnerable to the deregulation in economic crisis of Korea. A probable reason for this is that the impact of deregulation on the health and safety of workers would not be immediately disclosed after the policy change.

  14. Effusive Crises at Piton de la Fournaise 2014-2015: A Multi-National Response Model

    NASA Astrophysics Data System (ADS)

    Harris, Andrew; Di Muro, Andrea; Villeneuve, Nicolas; Ferrazzini, Valerie; Peltier, Aline; Coppola, Diego; Favalli, Massimiliano; Bachèlery, Patrick; Froger, Jean-Luc; Gurioli, Lucia; Moune, Séverine; Vlastelic, Ivan; Galle, Bo; Arellano, Santiago

    2017-04-01

    Many active European volcanoes and volcano observatories are island-based and located far from their administrative "mainland". Consequently, Governments have developed multisite approaches, in which monitoring is performed by a network of individuals distributed across several national research centers. At a transnational level, multinational networks are also progressively emerging. Piton de la Fournaise (La Réunion Island, France) is one such example. Piton de la Fournaise is one of the most active volcanoes of the World, and is located at the greatest distance from its "mainland" than any other vulnerable "overseas" site, the observatory being 9365 km from its governing body in Paris. Effusive risk is high, so that a well-coordinated and rapid response involving near-real time delivery of trusted, validated and operational product for hazard assessment is critical. Here we report how near-real time assessments of lava flow propagation were developed using rapid provision, and update, of key source terms through a dynamic and open integration of near-real time remote sensing, modeling and measurement capabilities on both the national and international level. The multi-national system evolved during the five effusive crises of 2014-2015, and is now mature for Piton de la Fournaise. This exercise allows us to identify strong and weak points of the existing system, and demonstrates that enhanced multi-national integration at European level can have fundamental implications in scientific hazard assessment and response during an on-going effusive crisis.

  15. Identifying the causes of water crises: A configurational frequency analysis of 22 basins world wide

    NASA Astrophysics Data System (ADS)

    Srinivasan, V.; Gorelick, S.; Lambin, E.; Rozelle, S.; Thompson, B.

    2010-12-01

    Freshwater "scarcity" has been identified as being a major problem world-wide, but it is surprisingly hard to assess if water is truly scarce at a global or even regional scale. Most empirical water research remains location specific. Characterizing water problems, transferring lessons across regions, to develop a synthesized global view of water issues remains a challenge. In this study we attempt a systematic understanding of water problems across regions. We compared case studies of basins across different regions of the world using configurational frequency analysis. Because water crises are multi-symptom and multi-causal, a major challenge was to categorize water problems so as to make comparisons across cases meaningful. In this study, we focused strictly on water unsustainability, viz. the inability to sustain current levels of the anthropogenic (drinking water, food, power, livelihood) and natural (aquatic species, wetlands) into the future. For each case, the causes of three outcome variables, groundwater declines, surface water declines and aquatic ecosystem declines, were classified and coded. We conducted a meta-analysis in which clusters of peer-reviewed papers by interdisciplinary teams were considered to ensure that the results were not biased towards factors privileged by any one discipline. Based on our final sample of 22 case study river basins, some clear patterns emerged. The meta-analysis suggests that water resources managers have long overemphasized the factors governing supply of water resources and while insufficient attention has been paid to the factors driving demand. Overall, uncontrolled increase in demand was twice as frequent as declines in availability due to climate change or decreased recharge. Moreover, groundwater and surface water declines showed distinct causal pathways. Uncontrolled increases in demand due to lack of credible enforcement were a key factor driving groundwater declines; while increased upstream abstractions

  16. Chaos and crises in a model for cooperative hunting: A symbolic dynamics approach

    NASA Astrophysics Data System (ADS)

    Duarte, Jorge; Januário, Cristina; Martins, Nuno; Sardanyés, Josep

    2009-12-01

    In this work we investigate the population dynamics of cooperative hunting extending the McCann and Yodzis model for a three-species food chain system with a predator, a prey, and a resource species. The new model considers that a given fraction σ of predators cooperates in prey's hunting, while the rest of the population 1-σ hunts without cooperation. We use the theory of symbolic dynamics to study the topological entropy and the parameter space ordering of the kneading sequences associated with one-dimensional maps that reproduce significant aspects of the dynamics of the species under several degrees of cooperative hunting. Our model also allows us to investigate the so-called deterministic extinction via chaotic crisis and transient chaos in the framework of cooperative hunting. The symbolic sequences allow us to identify a critical boundary in the parameter spaces (K ,C0) and (K ,σ) which separates two scenarios: (i) all-species coexistence and (ii) predator's extinction via chaotic crisis. We show that the crisis value of the carrying capacity Kc decreases at increasing σ, indicating that predator's populations with high degree of cooperative hunting are more sensitive to the chaotic crises. We also show that the control method of Dhamala and Lai [Phys. Rev. E 59, 1646 (1999)] can sustain the chaotic behavior after the crisis for systems with cooperative hunting. We finally analyze and quantify the inner structure of the target regions obtained with this control method for wider parameter values beyond the crisis, showing a power law dependence of the extinction transients on such critical parameters.

  17. Chaos and crises in a model for cooperative hunting: a symbolic dynamics approach.

    PubMed

    Duarte, Jorge; Januário, Cristina; Martins, Nuno; Sardanyés, Josep

    2009-12-01

    In this work we investigate the population dynamics of cooperative hunting extending the McCann and Yodzis model for a three-species food chain system with a predator, a prey, and a resource species. The new model considers that a given fraction sigma of predators cooperates in prey's hunting, while the rest of the population 1-sigma hunts without cooperation. We use the theory of symbolic dynamics to study the topological entropy and the parameter space ordering of the kneading sequences associated with one-dimensional maps that reproduce significant aspects of the dynamics of the species under several degrees of cooperative hunting. Our model also allows us to investigate the so-called deterministic extinction via chaotic crisis and transient chaos in the framework of cooperative hunting. The symbolic sequences allow us to identify a critical boundary in the parameter spaces (K,C(0)) and (K,sigma) which separates two scenarios: (i) all-species coexistence and (ii) predator's extinction via chaotic crisis. We show that the crisis value of the carrying capacity K(c) decreases at increasing sigma, indicating that predator's populations with high degree of cooperative hunting are more sensitive to the chaotic crises. We also show that the control method of Dhamala and Lai [Phys. Rev. E 59, 1646 (1999)] can sustain the chaotic behavior after the crisis for systems with cooperative hunting. We finally analyze and quantify the inner structure of the target regions obtained with this control method for wider parameter values beyond the crisis, showing a power law dependence of the extinction transients on such critical parameters.

  18. [Health threats and health system crises. An approach to early warning and response. 2008 SESPAS Report].

    PubMed

    Simón Soria, Fernando; Guillén Enríquez, Francisco Javier

    2008-04-01

    The world is changing more and faster than ever before. New diseases are coming to light each year, controlled diseases are reemerging as potential threats, and natural or man-made disasters are increasingly affecting human health. The "International Health Regulations (2005)" reflect the changes in the response of public health to this new situation. Surveillance of specific diseases and predefined control measures have been replaced by surveillance of public health events of international concern and control measures adapted to each situation. The public health events of international interest are characterized by their seriousness, predictability, the risk of international spread and potential for travel or trade restrictions. The development of the European Early Warning and Response System in 1998 and the creation of the European Center for Disease Prevention and Control in 2005 demonstrate political commitment in Europe, with early detection of and response to public health threats. However, timely risk evaluation and response at a national level requires improved data digitalization and accessibility, automatic notification processes, data analysis and dissemination of information, the combination of information from multiple sources and adaptation of public health services. The autonomous regions in Spain are initiating this adaptation process, but interoperability between systems and the development of guidelines for a coordinated response should be steered by the National Interregional Health Council and coordinated by the Ministry of Health. Efficient early warning systems of health threats that allow for a timely response and reduce uncertainty about information would help to minimize the risk of public health crises. The profile of public health threats is nonspecific. Early detection of threats requires access to information from multiple sources and efficient risk assessment. Key factors for improving the response to public health threats are the

  19. BLOOD AMMONIA AND GLUTAMINE AS PREDICTORS OF HYPERAMMONEMIC CRISES IN UREA CYCLE DISORDER PATIENTS

    PubMed Central

    Lee, Brendan; Diaz, George A.; Rhead, William; Lichter-Konecki, U.; Feigenbaum, Annette; Berry, Susan A.; Le Mons, C.; Bartley, James A; Longo, Nicola; Nagamani, Sandesh C.; Berquist, William; Gallagher, Renata; Bartholomew, Dennis; Harding, Cary O.; Korson, Mark S.; McCandless, Shawn E.; Smith, Wendy; Cederbaum, Stephen; Wong, Derek; Merritt, J. Lawrence; Schulze, A.; Vockley, Gerard.; Kronn, David; Zori, Roberto; Summar, Marshall; Milikien, D.A.; Marino, M.; Coakley, D.F.; Mokhtarani, M.; Scharschmidt, B.F.

    2014-01-01

    Purpose To examine predictors of ammonia exposure and hyperammonemic crises (HAC) in patients with urea cycle disorders (UCDs). Methods The relationships between fasting ammonia, daily ammonia exposure, and HACs were analyzed in >100 UCD patients. Results Fasting ammonia correlated strongly with daily ammonia exposure (r=0.764, p<0.001). For patients with fasting ammonia levels <0.5 ULN, 0.5 to <1.0 ULN, and ≥1.0 ULN, the probability of a normal average daily ammonia value was 87%, 60%, and 39%, respectively, and 10.3%, 14.1%, and 37.0% of these patients experienced ≥1 HAC over 12 months. Time to first HAC was shorter (p=0.008) and relative risk (4.5×; p=0.011) and rate (~5×, p=0.006) of HACs higher in patients with fasting ammonia ≥1.0 ULN vs. <0.5ULN; relative risk was even greater (20×; p=0.009) in patients ≥6 years. A 10 or 25 μmol/L increase in ammonia exposure increased the relative risk of a HAC by 50% and >200% (p<0.0001), respectively. The relationship between ammonia and HAC risk appeared independent of treatment, age, UCD subtype, dietary protein intake, or blood urea nitrogen. Fasting glutamine correlated weakly with AUC0-24 and was not a significant predictor of HACs. Conclusions Fasting ammonia correlates strongly and positively with daily ammonia exposure and with the risk and rate of HACs, suggesting that UCD patients may benefit from tight ammonia control. PMID:25503497

  20. Non-technical skills of surgeons and anaesthetists in simulated operating theatre crises.

    PubMed

    Doumouras, A G; Hamidi, M; Lung, K; Tarola, C L; Tsao, M W; Scott, J W; Smink, D S; Yule, S

    2017-07-01

    Deficiencies in non-technical skills (NTS) have been increasingly implicated in avoidable operating theatre errors. Accordingly, this study sought to characterize the impact of surgeon and anaesthetist non-technical skills on time to crisis resolution in a simulated operating theatre. Non-technical skills were assessed during 26 simulated crises (haemorrhage and airway emergency) performed by surgical teams. Teams consisted of surgeons, anaesthetists and nurses. Behaviour was assessed by four trained raters using the Non-Technical Skills for Surgeons (NOTSS) and Anaesthetists' Non-Technical Skills (ANTS) rating scales before and during the crisis phase of each scenario. The primary endpoint was time to crisis resolution; secondary endpoints included NTS scores before and during the crisis. A cross-classified linear mixed-effects model was used for the final analysis. Thirteen different surgical teams were assessed. Higher NTS ratings resulted in significantly faster crisis resolution. For anaesthetists, every 1-point increase in ANTS score was associated with a decrease of 53·50 (95 per cent c.i. 31·13 to 75·87) s in time to crisis resolution (P < 0·001). Similarly, for surgeons, every 1-point increase in NOTSS score was associated with a decrease of 64·81 (26·01 to 103·60) s in time to crisis resolution in the haemorrhage scenario (P = 0·001); however, this did not apply to the difficult airway scenario. Non-technical skills scores were lower during the crisis phase of the scenarios than those measured before the crisis for both surgeons and anaesthetists. A higher level of NTS of surgeons and anaesthetists led to quicker crisis resolution in a simulated operating theatre environment. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  1. Barriers to implementing infection prevention and control guidelines during crises: experiences of health care professionals.

    PubMed

    Timen, Aura; Hulscher, Marlies E J L; Rust, Laura; van Steenbergen, Jim E; Akkermans, Reinier P; Grol, Richard P T M; van der Meer, Jos W M

    2010-11-01

    Communicable disease crises can endanger the health care system and often require special guidelines. Understanding reasons for nonadherence to crisis guidelines is needed to improve crisis management. We identified and measured barriers and conditions for optimal adherence as perceived by 4 categories of health care professionals. In-depth interviews were performed (n = 26) to develop a questionnaire for a cross-sectional survey of microbiologists (100% response), infection preventionists (74% response), public health physicians (96% response), and public health nurses (82% response). The groups were asked to appraise barriers encountered during 4 outbreaks (severe acute respiratory syndrome [SARS], Clostridium difficile ribotype 027, rubella, and avian influenza) according to a 5-point Likert scale. When at least 33% of the participants responded "strongly agree," "agree," or "rather agree than disagree," a barrier was defined as "often experienced." The common ("generic") barriers were included in a univariate and multivariate model. Barriers specific to the various groups were studied as well. Crisis guidelines were found to have 4 generic barriers to adherence: (1) lack of imperative or precise wording, (2) lack of easily identifiable instructions specific to each profession, (3) lack of concrete performance targets, and (4) lack of timely and adequate guidance on personal protective equipment and other safety measures. The cross-sectional study also yielded profession-specific sets of often-experienced barriers. To improve adherence to crisis guidelines, the generic barriers should be addressed when developing guidelines, irrespective of the infectious agent. Profession-specific barriers require profession-specific strategies to change attitudes, ensure organizational facilities, and provide an adequate setting for crisis management. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights

  2. On the dynamics of the world demographic transition and financial-economic crises forecasts

    NASA Astrophysics Data System (ADS)

    Akaev, A.; Sadovnichy, V.; Korotayev, A.

    2012-05-01

    The article considers dynamic processes involving non-linear power-law behavior in such apparently diverse spheres, as demographic dynamics and dynamics of prices of highly liquid commodities such as oil and gold. All the respective variables exhibit features of explosive growth containing precursors indicating approaching phase transitions/catastrophes/crises. The first part of the article analyzes mathematical models of demographic dynamics that describe various scenarios of demographic development in the post-phase-transition period, including a model that takes the limitedness of the Earth carrying capacity into account. This model points to a critical point in the early 2050s, when the world population, after reaching its maximum value may decrease afterward stabilizing then at a certain stationary level. The article presents an analysis of the influence of the demographic transition (directly connected with the hyperexponential growth of the world population) on the global socioeconomic and geopolitical development. The second part deals with the phenomenon of explosive growth of prices of such highly liquid commodities as oil and gold. It is demonstrated that at present the respective processes could be regarded as precursors of waves of the global financial-economic crisis that will demand the change of the current global economic and political system. It is also shown that the moments of the start of the first and second waves of the current global crisis could have been forecasted with a model of accelerating log-periodic fluctuations superimposed over a power-law trend with a finite singularity developed by Didier Sornette and collaborators. With respect to the oil prices, it is shown that it was possible to forecast the 2008 crisis with a precision up to a month already in 2007. The gold price dynamics was used to calculate the possible time of the start of the second wave of the global crisis (July-August 2011); note that this forecast has turned out

  3. Incidence of health crises in tourists visiting Jamaica, west indies, 1998 to 2000.

    PubMed

    Thompson, Danielle T; Ashley, David V M; Dockery-Brown, Cheryl A; Binns, Alvin; Jolly, Curtis M; Jolly, Pauline E

    2003-01-01

    Tourism is important to the Jamaican economy accounting for approximately 25% of the gross domestic product. Health problems in tourists could have significant impact on the health of the local population, the scarce health service resources, and the tourist industry. This study was conducted to identify health problems most commonly occurring in tourists visiting Jamaica and examine how these problems are managed. Records of health problems occurring in tourists who visited principal tourist areas on the north coast from June 1998 to June 2002 were reviewed for the type of illness and how the problem was handled. The data were analyzed using Epi-Info software (Centers for Disease Control and Prevention, Atlanta, GA) and Statistical Analysis System software (SAS Institute, Cary, NC). Accidents were the most common health crises reported by tourists. Gastrointestinal, respiratory, and cardiovascular problems occurred less frequently. Those less than 40 years of age more frequently reported accidents or injury, gastrointestinal problems, and drug abuse, whereas respiratory and cardiovascular problems were more common among those above 40 years of age. Cardiovascular problems, drug abuse, and death were more common in men than in women. Hotel nurses handled most of the cases and were more likely to refer patients to private physicians or hospitals than to public hospitals (p <.05). Factors influencing the way the crisis was handled were age (p =.0441); who handled the crisis (p <.0001); and the method of payment (p =.0072). The factors that influenced hospitalization were gender (p =.0615); who handled the crisis at the onset (p =.0497); how the crisis was dealt with (p =.0336); and previous health problems (p =.0056). Men were more likely to be hospitalized and to be referred to a public hospital than women. Medical insurance covered the costs for 11% of tourists, and 75% paid out of pocket. The information provided by this study can be used to implement changes to

  4. Rig Side Online Drilling Support System for Prediction and Prevention of Upcoming Crises

    NASA Astrophysics Data System (ADS)

    Jandl, B.; Winter, M.; Fruhwirth, R.; Riedel, F.; Zeiner, H.

    2012-04-01

    Safety requirements play a central role in drilling operations worldwide. Especially, protecting the crew from injury, preventing damage to equipment and avoiding environmental pollution are of utmost importance. Prevailing drilling procedures already provide a high degree of safety; but uncertainties hinder efficient and accurate risk assessment. Uncertainties are primarily introduced due to the unknown structure of the rock formation and other unknowns in the drilling process. Insufficient insight into ongoing processes may therefore lead to unexpected and unwanted critical drilling situations. To support drilling engineers in the early detection and subsequently in the prevention of upcoming crises, we present a modular drilling support system for in-situ usage on rigs which improves insight into processes and current drilling operations. In our case, the system consists of a complete data processing chain including several modules for data acquisition from sensors on the drilling platform, feature generation, online learning and problem-specific visualization. While data acquisition modules collect data from sensors at the rig and produce a live data stream in an appropriate format, the data processing algorithms analyze the data streams in real time and classify the drilling operations, detect emerging potentially critical situations and give appropriate advice to the drilling crew, if possible. A (geo-)physically motivated extended feature generator produces additional features to improve the quality-performance (recognition rate) of the algorithms. Finally, all sensor data streams as well as the output of the extended feature generator, the results of several adaptive online learning algorithms and a set of sensor data quality indicators of the rig are visualized in a novel user interface to support drilling employees at the rig. As a result, the current drilling situation is presented in a comprehensive manner and in real time.

  5. [Fundación Mundo Bipolar: learning among peers in the service of recovery].

    PubMed

    Morales Cano, Guadalupe

    2013-01-01

    Due to severe mental illness, such as a diagnosis of bipolar disorder, people's quality of life may be seriously compromised and they may bear the risk of losing opportunities and being socially isolated as a result of stigma and discrimination. Early diagnosis is crucial, as a recovery process is possible with appropriate medical and psychosocial treatment. A person affected by such circumstances, with adequate training, can learn to handle his condition by himself and become expert by experience. This article depicts how learning among peers, based to a large degree on empathy, enables and promotes self management and, at the same time, a larger political and social consciousness. This has been affirmed by the virtual community of bipolarweb since 2002 and, subsequently, as a further development by the Fundación Mundo Bipolar. This foundation, which offers a training program for people affected by bipolar disorder, engages in several activities and goals which are described in this paper. It also has developed a multidisciplinary program for the training of trainers. Some features of these programs are summarized, with a special emphasis on the fact that trained students are encouraged to give lectures for high school students. This paper summarizes qualitative evaluations made by participants that have followed each of the sessions of the training programs.

  6. Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises

    PubMed Central

    Warren, Emily; Post, Nathan; Hossain, Mazeda; Blanchet, Karl; Roberts, Bayard

    2015-01-01

    Objectives This systematic review aims to evaluate evidence on the effectiveness of sexual and reproductive health (SRH) interventions delivered in humanitarian crises. Setting Crisis affected low-income or middle-income countries. Participants Crisis-affected populations in low-income or middle-income countries. Method Peer-reviewed and grey literature sources were systematically searched for relevant papers detailing interventions from 1 January 1980 until the search date on 30 April 2013. Data from included studies were then extracted, and the papers’ quality evaluated using criteria based on modified STROBE and CONSORT checklists. Primary and secondary outcome measures Primary outcomes include, but are not limited to, changes in morbidity, mortality, sexually transmitted infection (STI) diagnosis or gender-based violence. Secondary outcomes include, but are not limited to, reported condom use or skilled attendance at birth. Primary outputs include, but are not limited to, condoms distributed or education courses taught. Results Of 7149 returned citations, 15 studies met the inclusion criteria. Only one randomised controlled trial was identified. The remaining observational studies were of moderate quality, demonstrating limited use of controls and inadequate attempts to address bias. Evidence of effectiveness was available for the following interventions: impregnated bed nets for pregnant women, subsidised refugee healthcare, female community health workers, and tiered community reproductive health services. Conclusions The limited evidence base for SRH interventions highlights the need for improved research on the effectiveness of public health interventions in humanitarian crises. While interventions proven efficacious in stable settings are being used in humanitarian efforts, more evidence is required to demonstrate the effectiveness of delivering and scaling-up such interventions in humanitarian crises. PMID:26685020

  7. Organizational preparedness for and management of volcanic crises at Kīlauea and Mauna Loa volcanoes, Hawaii

    NASA Astrophysics Data System (ADS)

    Gregg, C. E.; Reeves, A.; Lindell, M. K.; Prater, C.; Joyner, T. A.; Eggert, S.

    2016-12-01

    The eruption of Kīlauea volcano since 1983 has produced a series of crises, the latest one occurring in 2014 and 2015 when a new vent sent lava flows northeastward toward developed areas in the lower Puna District of Kīlauea. The June 27 lava flow took about 2 months to advance to the edge of developed areas in Puna, prompting widespread reaction. Volcanic eruptions often have large economic consequences out of proportion with their magnitudes, and uncertainties about the physical and organizational communication of risk information amplify these losses. This study aims to improve tools to communicate uncertainty of volcanic activity and organizational and individual response, offering clearer and more reliable information to guide civic leaders in issuing appropriate warnings. One significant impediment to risk communication is limited knowledge about the most effective ways to communicate scientific uncertainty through verbal, numeric and graphic methods. The public's demand for near-real time information updates during the June 27 lava crisis, including both written messages and graphics, required some agencies to provide information at a faster rate than in any previous eruption. In order to understand how these and other stakeholders involved with the crisis can better plan for and manage future crises, including implementing evacuation decisions, we conducted a series of interviews and a mental model exercise with stakeholders. We explored their knowledge of local risk communication messages and hazard mitigation efforts and their experiences during the June 27 lava flow crisis. Stakeholders represented county, state and federal agencies and included elected officials, emergency managers, scientists, and other professionals involved with the crisis (traffic engineers, land use planners, police officers, fire fighters). We also assessed factors that influence individual and household preparedness to implement officials' protective action recommendations

  8. Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises.

    PubMed

    Warren, Emily; Post, Nathan; Hossain, Mazeda; Blanchet, Karl; Roberts, Bayard

    2015-12-18

    This systematic review aims to evaluate evidence on the effectiveness of sexual and reproductive health (SRH) interventions delivered in humanitarian crises. Crisis affected low-income or middle-income countries. Crisis-affected populations in low-income or middle-income countries. Peer-reviewed and grey literature sources were systematically searched for relevant papers detailing interventions from 1 January 1980 until the search date on 30 April 2013. Data from included studies were then extracted, and the papers' quality evaluated using criteria based on modified STROBE and CONSORT checklists. Primary outcomes include, but are not limited to, changes in morbidity, mortality, sexually transmitted infection (STI) diagnosis or gender-based violence. Secondary outcomes include, but are not limited to, reported condom use or skilled attendance at birth. Primary outputs include, but are not limited to, condoms distributed or education courses taught. Of 7149 returned citations, 15 studies met the inclusion criteria. Only one randomised controlled trial was identified. The remaining observational studies were of moderate quality, demonstrating limited use of controls and inadequate attempts to address bias. Evidence of effectiveness was available for the following interventions: impregnated bed nets for pregnant women, subsidised refugee healthcare, female community health workers, and tiered community reproductive health services. The limited evidence base for SRH interventions highlights the need for improved research on the effectiveness of public health interventions in humanitarian crises. While interventions proven efficacious in stable settings are being used in humanitarian efforts, more evidence is required to demonstrate the effectiveness of delivering and scaling-up such interventions in humanitarian crises. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Evaluation of the return periods of water crises and evaporation in Monte Cotugno reservoir (Southern Italy)

    NASA Astrophysics Data System (ADS)

    Copertino, Vito; Lo Vecchio, Giuseppina; Marotta, Lucia; Pastore, Vittoria; Ponzio, Giuseppe; Scavone, Giuseppina; Telesca, Vito; Vita, Michele

    2010-05-01

    In the past water resources management has been dealt and solved increasing water availabilities; today such opportunities have been considerably reduced and the technical-scientific perspectives are addressed above all to improve water system effectiveness and to promote an use of water resources that holds account of the droughts frequency and based on a correct estimate of the hydrologic balance. In this work a study on the water stored in Monte Cotugno reservoir in Sinni river - Basilicata (Southern Italy) - is proposed, estimating water crises return periods and reservoir evaporation. For such purpose the runs method was applied, based on the comparison between the temporal series of the "water volume" hydrological variable and a threshold representative of the "normal" conditions regarding which the availability in excess or defect was estimated. This allowed to individualize the beginning and the end of a water crisis event and to characterize the droughts in terms of duration, sum deficit and intensity. Therefore the return period was evaluated by means of the methodology proposed by Shiau and Shen in 2001, turned out equal approximately to 6 years. Such value was then verified with a frequency analysis of the "water volume" random variable, using the Weibull's distribution. Subsequently, the Fourier's analysis in the last twenty years was carried out, obtaining the same result of the previous methods. Moreover, in proximity of the Monte Cotugno reservoir the weather station of Senise is located, managed by ALSIA (Agenzia Lucana di Sviluppo e Innovazione in Agricultura), that provides in continuous measurements of air temperature and humidity, wind speed and direction, and global solar radiation since 2000. Such parameters allowed to apply five methods for reservoir evaporation estimate selected from those proposed in the literature, of which the first three, the Jensen-Haise's method, Makkink's method and Stephens-Stewart's one are based on solar radiation

  10. A Distributed Architecture for Tsunami Early Warning and Collaborative Decision-support in Crises

    NASA Astrophysics Data System (ADS)

    Moßgraber, J.; Middleton, S.; Hammitzsch, M.; Poslad, S.

    2012-04-01

    The presentation will describe work on the system architecture that is being developed in the EU FP7 project TRIDEC on "Collaborative, Complex and Critical Decision-Support in Evolving Crises". The challenges for a Tsunami Early Warning System (TEWS) are manifold and the success of a system depends crucially on the system's architecture. A modern warning system following a system-of-systems approach has to integrate various components and sub-systems such as different information sources, services and simulation systems. Furthermore, it has to take into account the distributed and collaborative nature of warning systems. In order to create an architecture that supports the whole spectrum of a modern, distributed and collaborative warning system one must deal with multiple challenges. Obviously, one cannot expect to tackle these challenges adequately with a monolithic system or with a single technology. Therefore, a system architecture providing the blueprints to implement the system-of-systems approach has to combine multiple technologies and architectural styles. At the bottom layer it has to reliably integrate a large set of conventional sensors, such as seismic sensors and sensor networks, buoys and tide gauges, and also innovative and unconventional sensors, such as streams of messages from social media services. At the top layer it has to support collaboration on high-level decision processes and facilitates information sharing between organizations. In between, the system has to process all data and integrate information on a semantic level in a timely manner. This complex communication follows an event-driven mechanism allowing events to be published, detected and consumed by various applications within the architecture. Therefore, at the upper layer the event-driven architecture (EDA) aspects are combined with principles of service-oriented architectures (SOA) using standards for communication and data exchange. The most prominent challenges on this layer

  11. Socioeconomic status and length of hospital stay in children with vaso-occlusive crises of sickle cell disease.

    PubMed Central

    Ellison, Angela M.; Bauchner, Howard

    2007-01-01

    OBJECTIVE: To examine the association between socioeconomic status and length of hospital stay for vaso-occlusive crises in children with sickle cell disease. METHODS: 19,174 discharges (aged 1-20 years), with a primary diagnosis of sickle cell disease with crisis were analyzed from the Healthcare Cost and Utilization Project Kid Inpatient Database 2000. Socioeconomic status was assessed using an area-based measure, median household income by ZIP code and an individual-level measure, insurance status. We adjusted for age, gender, hospital location/teaching status, presence of pneumonia, number of diagnoses on record and number of procedures performed. Negative binomial regression models using generalized estimating equations (GEE) were used to assess length of stay. RESULTS: Socioeconomic status as measured by income was not associated with length of stay (incidence rate ratio (highest versus lowest category) = 1.04 (95% CI: 0.98, 1.11)). In contrast, socioeconomic status as measured by insurance was associated with length of stay [adjusted incidence rate ratio = 1.04 (95% CI: 1.01, 1.08)), although the magnitude of this difference is small and not likely to be clinically important. CONCLUSIONS: We found no evidence to suggest that socioeconomic status has any clinically important effect on length of hospital stay in children with vaso-occlusive crises in sickle cell disease. PMID:17393942

  12. The Impact of Economic Crises on Communicable Disease Transmission and Control: A Systematic Review of the Evidence

    PubMed Central

    Suhrcke, Marc; Stuckler, David; Suk, Jonathan E.; Desai, Monica; Senek, Michaela; McKee, Martin; Tsolova, Svetla; Basu, Sanjay; Abubakar, Ibrahim; Hunter, Paul; Rechel, Boika; Semenza, Jan C.

    2011-01-01

    There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the “SIR” (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control. PMID:21695209

  13. The reactions to macro-economic crises in Nordic health system policies: Denmark, Finland and Sweden, 1980-2013.

    PubMed

    Lehto, Juhani; Vrangbæk, Karsten; Winblad, Ulrika

    2015-01-01

    Denmark, Finland and Sweden have experienced two major recessions during the last 25 years. The adjustments to the earlier crisis in the late 1980s (Denmark) and early 1990s (Finland and Sweden) resembled the policies in many other European countries during the present crisis. The analysis of relationship of deep economic crises and growth period between them to the health system policies and institutions in the three countries from the 1980s to 2013 is based on a categorisation of reactions to external shocks as path conforming or path breaking. The results of the empirical long-term trends show that the reactions to deep recessions have been mainly temporary adjustments and acceleration of changes already prepared before economic crisis. The economic crisis in the three countries has not been 'good enough' to enable paradigmatic changes in the Nordic public, decentralised and equity-oriented health systems. Changes such as the slow privatisation in care funding and production and the adoption of new management practices indicate an ongoing paradigmatic change related to longer-term societal, ideological and political developments rather than directly to economic crises or growth.

  14. Management of Mental Health Crises Among Youths With and Without ASD: A National Survey of Child Psychiatrists.

    PubMed

    Kalb, Luther G; Stuart, Elizabeth A; Mandell, David S; Olfson, Mark; Vasa, Roma A

    2017-10-01

    This study compared management by child psychiatrists of mental health crises among youths with and without autism spectrum disorder (ASD). A custom online mental health crisis services survey was administered to members of the American Academy of Child and Adolescent Psychiatry. The survey probed three domains of crisis management: willingness to work with youths with a history of mental health crisis, comfort level in managing a mental health crisis, and availability of external resources during a crisis. Child psychiatrists reporting on management of youths with ASD (N=492) and without ASD (N=374) completed the survey. About 75% of psychiatrists in both groups were willing to accept a child with a history of a mental health crisis in their practice. During a crisis, psychiatrists caring for youths with ASD had less access to external consultation resources, such as a crisis evaluation center or other mental health professionals, compared with those caring for youths without ASD. Psychiatrists also expressed concerns about the ability of emergency department professionals and emergency responders to manage mental health crises among youths in a safe and developmentally appropriate manner, particularly among those with ASD. Child psychiatrists are in need of more external resources to manage youths with ASD who are experiencing a mental health crisis. There is also a need to develop best practice procedures for emergency responders who are working with youths experiencing a mental health crisis.

  15. EMS Student Handbook.

    ERIC Educational Resources Information Center

    Ogle, Patrick

    This student guide is one of a series of self-contained materials for students enrolled in an emergency medical services (EMS) training program. Discussed in the individual sections of the guide are the following topics: the purpose and history of EMS professionals; EMS training, certification and examinations (national and state certification and…

  16. Management of natural crises with choreography and orchestration of federated warning-systems

    NASA Astrophysics Data System (ADS)

    Haener, Rainer; Waechter, Joachim; Hammitzsch, Martin

    2013-04-01

    The project Collaborative, Complex and Critical Decision-Support in Evolving Crises (TRIDEC), co-funded by the European Commission in its Seventh Framework Programme focuses on real-time intelligent information management in earth management. The addressed challenges include the design and implementation of a robust and scalable service infrastructure supporting the integration of existing resources, components and systems. Key challenge for TRIDEC is establishing a network of independent systems, cooperatively interacting as a collective in a system-of-systems (SoS). For this purpose TRIDEC adopts enhancements of service-oriented architecture (SOA) principles in terms of an event-driven architecture (EDA) design (SOA 2.0). In this way TRIDEC establishes large-scale concurrent and intelligent information management of a manifold of crisis types by focusing on the integration of autonomous, task-oriented and geographically distributed systems. To this end TRIDEC adapts both ways SOA 2.0 offers: orchestration and choreography. In orchestration, a central knowledge-based processing framework takes control over the involved services and coordinates their execution. Choreography on the other hand avoids central coordination. Rather, each system involved in the SoS follows a global scenario without a single point of control but specifically defined (enacted, agreed upon) trigger conditions. More than orchestration choreography allows collaborative business processes of various heterogeneous sub-systems (e.g. cooperative decision making) by concurrent Complex Event Processing (CEP) and asynchronous communication. These types of interaction adapt the concept of decoupled relationships between information producers (e.g. sensors and sensor systems) and information consumers (e.g. warning systems and warning dissemination systems). Asynchronous communication is useful if a participant wants to trigger specific actions by delegating the responsibility (separation of concerns

  17. EM International. Volume 1

    SciTech Connect

    Not Available

    1993-07-01

    It is the intent of EM International to describe the Office of Environmental Restoration and Waste Management`s (EM`s) various roles and responsibilities within the international community. Cooperative agreements and programs, descriptions of projects and technologies, and synopses of visits to international sites are all highlighted in this semiannual journal. Focus on EM programs in this issue is on international collaboration in vitrification projects. Technology highlights covers: in situ sealing for contaminated sites; and remote sensors for toxic pollutants. Section on profiles of countries includes: Arctic contamination by the former Soviet Union, and EM activities with Germany--cooperative arrangements.

  18. Responding To Infectious Disease: Multiple Cases of Staph Infections in a Rural School District. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 3, 2008

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an incident involving several cases of Methicillin-resistant Staphylococcus aureus (MRSA) at a rural high school. MRSA is a specific strain of Staphylococcus aureus bacteria (often called staph)…

  19. Responding To and Recovering From an Active Shooter Incident That Turns Into a Hostage Situation. Lessons Learned From School Crises and Emergencies, Volume 2, Issue 6, 2007

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an active shooter situation that escalated to a hostage situation that required multiple law enforcement agencies and other first responders and agencies to coordinate response and recovery…

  20. The Impact of Economic Crises on Women's Employment: A Comparison of the Great Depression (1930s) and the Current Crisis (1970s-1980s).

    ERIC Educational Resources Information Center

    Sokoloff, Natalie J.

    Two areas in which the impact of economic crises on women's employment in the Great Depression of 1930 and during the 1970's and 1980's appear to be similar are examined: (1) the actual changes in female employment; and (2) the ideological campaigns and policies generated and/or reinforced, especially by the federal government, blaming women for…

  1. A Manual-Based Intervention to Address Clinical Crises and Retain Patients in the Treatment of Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    May, Diane E.; Kratochvil, Christopher J.; Puumala, Susan E.; Silva, Susan G.; Rezac, Amy J.; Hallin, Mary J.; Reinecke, Mark A.; Vitiello, Benedetto; Weller, Elizabeth B.; Pathak, Sanjeev; Simons, Anne D.; March, John S.

    2007-01-01

    Objective: To describe a manual-based intervention to address clinical crises and retain participants in the Treatment for Adolescents with Depression Study (TADS). Method: The use of adjunct services for attrition prevention (ASAP) is described for adolescents (ages 12-17 years) during the 12-week acute treatment in TADS, from 2000 to 2003.…

  2. A Manual-Based Intervention to Address Clinical Crises and Retain Patients in the Treatment of Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    May, Diane E.; Kratochvil, Christopher J.; Puumala, Susan E.; Silva, Susan G.; Rezac, Amy J.; Hallin, Mary J.; Reinecke, Mark A.; Vitiello, Benedetto; Weller, Elizabeth B.; Pathak, Sanjeev; Simons, Anne D.; March, John S.

    2007-01-01

    Objective: To describe a manual-based intervention to address clinical crises and retain participants in the Treatment for Adolescents with Depression Study (TADS). Method: The use of adjunct services for attrition prevention (ASAP) is described for adolescents (ages 12-17 years) during the 12-week acute treatment in TADS, from 2000 to 2003.…

  3. Communication and Collaboration During Natural Disasters: The Lessons Learned From Past Experience. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 2, 2008

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on the response and recovery efforts to wildfires by the San Diego County Office of Education (SDCOE) and its school and community partners. Natural disasters such as floods,…

  4. Livelihoods, power, and food insecurity: adaptation of social capital portfolios in protracted crises--case study Burundi.

    PubMed

    Vervisch, Thomas G A; Vlassenroot, Koen; Braeckman, Johan

    2013-04-01

    The failure of food security and livelihood interventions to adapt to conflict settings remains a key challenge in humanitarian responses to protracted crises. This paper proposes a social capital analysis to address this policy gap, adding a political economy dimension on food security and conflict to the actor-based livelihood framework. A case study of three hillsides in north Burundi provides an ethnographic basis for this hypothesis. While relying on a theoretical framework in which different combinations of social capital (bonding, bridging, and linking) account for a diverse range of outcomes, the findings offer empirical insights into how social capital portfolios adapt to a protracted crisis. It is argued that these social capital adaptations have the effect of changing livelihood policies, institutions, and processes (PIPs), and clarify the impact of the distribution of power and powerlessness on food security issues. In addition, they represent a solid way of integrating political economy concerns into the livelihood framework.

  5. Bi-allelic Truncating Mutations in TANGO2 Cause Infancy-Onset Recurrent Metabolic Crises with Encephalocardiomyopathy.

    PubMed

    Kremer, Laura S; Distelmaier, Felix; Alhaddad, Bader; Hempel, Maja; Iuso, Arcangela; Küpper, Clemens; Mühlhausen, Chris; Kovacs-Nagy, Reka; Satanovskij, Robin; Graf, Elisabeth; Berutti, Riccardo; Eckstein, Gertrud; Durbin, Richard; Sauer, Sascha; Hoffmann, Georg F; Strom, Tim M; Santer, René; Meitinger, Thomas; Klopstock, Thomas; Prokisch, Holger; Haack, Tobias B

    2016-02-04

    Molecular diagnosis of mitochondrial disorders is challenging because of extreme clinical and genetic heterogeneity. By exome sequencing, we identified three different bi-allelic truncating mutations in TANGO2 in three unrelated individuals with infancy-onset episodic metabolic crises characterized by encephalopathy, hypoglycemia, rhabdomyolysis, arrhythmias, and laboratory findings suggestive of a defect in mitochondrial fatty acid oxidation. Over the course of the disease, all individuals developed global brain atrophy with cognitive impairment and pyramidal signs. TANGO2 (transport and Golgi organization 2) encodes a protein with a putative function in redistribution of Golgi membranes into the endoplasmic reticulum in Drosophila and a mitochondrial localization has been confirmed in mice. Investigation of palmitate-dependent respiration in mutant fibroblasts showed evidence of a functional defect in mitochondrial β-oxidation. Our results establish TANGO2 deficiency as a clinically recognizable cause of pediatric disease with multi-organ involvement.

  6. Bi-allelic Truncating Mutations in TANGO2 Cause Infancy-Onset Recurrent Metabolic Crises with Encephalocardiomyopathy

    PubMed Central

    Kremer, Laura S.; Distelmaier, Felix; Alhaddad, Bader; Hempel, Maja; Iuso, Arcangela; Küpper, Clemens; Mühlhausen, Chris; Kovacs-Nagy, Reka; Satanovskij, Robin; Graf, Elisabeth; Berutti, Riccardo; Eckstein, Gertrud; Durbin, Richard; Sauer, Sascha; Hoffmann, Georg F.; Strom, Tim M.; Santer, René; Meitinger, Thomas; Klopstock, Thomas; Prokisch, Holger; Haack, Tobias B.

    2016-01-01

    Molecular diagnosis of mitochondrial disorders is challenging because of extreme clinical and genetic heterogeneity. By exome sequencing, we identified three different bi-allelic truncating mutations in TANGO2 in three unrelated individuals with infancy-onset episodic metabolic crises characterized by encephalopathy, hypoglycemia, rhabdomyolysis, arrhythmias, and laboratory findings suggestive of a defect in mitochondrial fatty acid oxidation. Over the course of the disease, all individuals developed global brain atrophy with cognitive impairment and pyramidal signs. TANGO2 (transport and Golgi organization 2) encodes a protein with a putative function in redistribution of Golgi membranes into the endoplasmic reticulum in Drosophila and a mitochondrial localization has been confirmed in mice. Investigation of palmitate-dependent respiration in mutant fibroblasts showed evidence of a functional defect in mitochondrial β-oxidation. Our results establish TANGO2 deficiency as a clinically recognizable cause of pediatric disease with multi-organ involvement. PMID:26805782

  7. Low-molecular-weight heparins for managing vaso-occlusive crises in people with sickle cell disease.

    PubMed

    van Zuuren, Esther J; Fedorowicz, Zbys

    2015-12-18

    Sickle cell disease is one of the most common and severe genetic disorders in the world. It can be broadly divided into two distinct clinical phenotypes characterized by either haemolysis or vaso-occlusion. Pain is the most prominent symptom of vaso-occlusion, and hypercoagulability is a well-established pathogenic phenomenon in people with sickle cell disease. Low-molecular-weight heparins might control this hypercoagulable state through their anticoagulant effect. This is an update of a previously published version of this review. To assess the effects of low-molecular-weight heparins for managing vaso-occlusive crises in people with sickle cell disease. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register comprising references identified from comprehensive electronic database searches. We also searched abstract books of conference proceedings and several online trials registries for ongoing trials.Date of the last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 28 September 2015. Randomised controlled clinical trials and controlled clinical trials that assessed the effects of low-molecular-weight heparins in the management of vaso-occlusive crises in people with sickle cell disease. Study selection, data extraction, assessment of risk of bias and analyses were carried out independently by the two review authors. Two studies comprising 287 participants were included. One study (with an overall unclear to high risk of bias) involved 253 participants and the quality of the evidence for most outcomes was very low. This study, reported that pain severity at day two and day three was lower in the tinzaparin group than in the placebo group (P < 0.01, analysis of variance (ANOVA)) and additionally at day 4 (P < 0.05 (ANOVA)). Thus tinzaparin resulted in more rapid resolution of pain, as measured with a numerical pain scale. The mean difference in duration of

  8. Low-molecular-weight heparins for managing vaso-occlusive crises in people with sickle cell disease.

    PubMed

    van Zuuren, Esther J; Fedorowicz, Zbys

    2013-06-12

    Sickle cell disease is one of the most common and severe genetic disorders in the world. It can be broadly divided into two distinct clinical phenotypes characterized by either haemolysis or vaso-occlusion. Pain is the most prominent symptom of vaso-occlusion, and hypercoagulability is a well-established pathogenic phenomenon in people with sickle cell disease. Low-molecular-weight heparins might control this hypercoagulable state through their anticoagulant effect. To assess the effects of low-molecular-weight heparins for managing vaso-occlusive crises in people with sickle cell disease. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register comprising references identified from comprehensive electronic database searches. We also searched abstract books of conference proceedings and several online trials registries for ongoing trials.Date of the last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 6 December 2012. Randomised controlled clinical trials and controlled clinical trials that assessed the effects of low-molecular-weight heparins in the management of vaso-occlusive crises in people with sickle cell disease. Study selection, data extraction, assessment of risk of bias and analyses were carried out independently by the two review authors. One study (with an overall unclear to high risk of bias) comprising 253 participants was included. This study, with limited data, reported that pain severity at day two and day three was lower in the tinzaparin group than in the placebo group (P < 0.01, analysis of variance (ANOVA)) and additionally at day 4 (P < 0.05 (ANOVA)). Thus tinzaparin resulted in more rapid resolution of pain, as measured with a numerical pain scale. The mean difference in duration of painful crises was statistically significant at -1.78 days in favour of the tinzaparin group (95% confidence interval -1.94 to -1.62). Participants treated

  9. Pneumomédiastin compliquant une crise d’éclampsie: à propos d'un cas

    PubMed Central

    Doumiri, Mouhssine; Motiaa, Youssef; Oudghiri, Nezha; Saoud, Anas Tazi

    2014-01-01

    Le pneumomédiastin associé à l'emphysème sous cutané et le pneumothorax, sont des complications rares de la grossesse et surviennent au cours du travail obstétrical. Nous rapportons l'observation d'une parturiente de 25ans, sans antécédent pathologique particulier, admise pour une crise d’éclampsie à 36 semaines d'aménorrhées avec une mort fœtale et trouble de la conscience. L'examen clinique a montré un emphysème sous cutané étendu du visage jusqu’à l'abdomen sans notion de traumatisme et un score de Glasgow à 10. Après mise en condition, traitement de la crise d’éclampsie, stabilisation de la tension artérielle et retour à l’état de conscience, une TDM cervico-thoraco-abdominale a été demandée et a révélé la présence d'un pneumomédiastin important avec un discret pneumothorax droit postérieur et un pneumopéritoine important qui n'ont pas nécessité de drainage pleural. Deux jours après son admission, la patiente a expulsé un mort-né d'un poids de 1800 grammes avec forceps et sans efforts d'expulsions sous analgésie péridurale. Le contrôle radiologique à une semaine a noté une nette diminution de l'emphysème sous cutané et du pneumomédiastin. La patiente a quitté l'hôpital après dix jours. PMID:25838864

  10. Leveraging EMS and VPP

    DTIC Science & Technology

    2009-05-01

    Elements of EMS  International Standards Organization ( ISO ) 14001 , Environmental Management Systems  The Key Elements of EMS: - Policy - Planning...wingman-- ON and OFF duty Fully Conforming vs. Fully Implemented  “Fully Conforming”  Meets standards established in ISO 14001  ESOH council...e n c e Every airman looking out for his wingman-- ON and OFF duty EMS & VPP Commonalities Environmental Management System ISO 14001 : 2004 Voluntary

  11. EMBO workshop al fin del mundo: a meeting on membrane trafficking and its implication for polarity and diseases.

    PubMed

    Marzolo, María-Paz; Faundez, Victor; Galli, Thierry

    2015-07-01

    The EMBO worskhop at the "end of the world'" (al fin del mundo), a meeting on membrane trafficking and its implication for polarity and diseases, took place in the Chilean Patagonia surrounded by the landscapes once witnessed by Charles Darwin. The meeting showcased some of the best membrane trafficking science with an emphasis in neuroscience and disease models. Speakers from Europe, USA, South America and the graduate students behind it; embarked on an enthusiastic and eclectic dialog where a wide range of cell types, model genetic systems, and diseases where discussed. This meeting demonstrated the power of trafficking concepts to integrate diverse biology and to formulate mechanisms of normal and disease cells. © 2015 Société Française des Microscopies and Société de Biologie Cellulaire de France. Published by John Wiley & Sons Ltd.

  12. Institutional and relational determinants in high- and medium-extent food product crises: the inner perspective of a public health crisis.

    PubMed

    Charlebois, Sylvain; Horan, Hilary

    2010-08-01

    In 2008, Canada enacted its biggest-ever food recall in response to a Listeria crisis, stemming from a Maple Leaf Foods plant, that killed 22 Canadians. Afterwards, Maple Leaf's market share quickly returned to pre-crisis levels, but the long-term repercussions of the scare still reverberate in Maple Leaf's brand. In this case study, which offers an organizational perspective on the food recall, data was collected, through in-depth interviews of persons involved in the crisis response, and analyzed. The aim of this paper is to make transparent the ways in which Maple Leaf Foods organized their resources to manage the 2008 food recall. Results reveal that institutional and relational determinants are the most important factors in high- and medium-extent food product crises, whereas external and internal effects primarily influence an organization's capacity to cope with severe crises. Based on these findings, a conceptual framework is presented and managerial implications are discussed.

  13. ET-1 and ecNOS gene polymorphisms andsusceptibility to acute chest syndrome and painful vaso-occlusive crises in children with sickle cell anemia.

    PubMed

    Chaar, Vicky; Tarer, Vanessa; Etienne-Julan, Maryse; Diara, Jean Pierre; Elion, Jacques; Romana, Marc

    2006-09-01

    The association of endothelin 1 (ET-1) and endothelial constitutive nitric oxide synthase (ecNOS) gene polymorphisms (G5665T and T8002C, VNTR and T-786C respectively) with the occurrence of acute chest syndrome and painful vaso-occlusive crises was evaluated in homozygous SS children. This retrospective study reveals that ET-1 T8002 and ecNOS C-786 alleles are associated with, respectively, an increased and a decreased risk of acute chest syndrome.

  14. Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

    PubMed

    Akl, Elie A; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

    2015-01-01

    Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination

  15. Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review

    PubMed Central

    Akl, Elie A.; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

    2015-01-01

    Background Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. Methods We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Results Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. Conclusion This systematic review provides evidence of possible effectiveness of information coordination

  16. EMS in the pueblos.

    PubMed

    Vigil, M A

    1994-02-01

    Imagine creating a movie by excerpting scenes from "Dances With Wolves," splicing it with footage from "Code 3" or "Emergency Response" and then flavoring the script with the mystery of a Tony Hillerman novel. A film producer would probably find it quite difficult to choreograph a finished product from such a compilation of material. To hundreds of Native American EMS providers, however, such a movie is played out every day in Indian country. And with this movie come some real-life problems, including trauma, which is the number-one cause of premature death among Native Americans. But a high trauma rate is just one of the challenges facing tribal EMS responders. There's also prolonged response and transport, the problems involved in maintaining the unique culture and standard of care, the challenges of tribal EMS administration and EMS education of Native American students, and the unsure future of Native American EMS. Beyond that, there's the fact that EMS is a s unique to each Indian reservation as are the cultures of the native peoples who reside on these lands. Yet while no two systems are alike, most tribal EMS providers face similar challenges.

  17. Evidence of Large Fluctuations of Stock Return and Financial Crises from Turkey: Using Wavelet Coherency and Varma Modeling to Forecast Stock Return

    NASA Astrophysics Data System (ADS)

    Oygur, Tunc; Unal, Gazanfer

    Shocks, jumps, booms and busts are typical large fluctuation markers which appear in crisis. Models and leading indicators vary according to crisis type in spite of the fact that there are a lot of different models and leading indicators in literature to determine structure of crisis. In this paper, we investigate structure of dynamic correlation of stock return, interest rate, exchange rate and trade balance differences in crisis periods in Turkey over the period between October 1990 and March 2015 by applying wavelet coherency methodologies to determine nature of crises. The time period includes the Turkeys currency and banking crises; US sub-prime mortgage crisis and the European sovereign debt crisis occurred in 1994, 2001, 2008 and 2009, respectively. Empirical results showed that stock return, interest rate, exchange rate and trade balance differences are significantly linked during the financial crises in Turkey. The cross wavelet power, the wavelet coherency, the multiple wavelet coherency and the quadruple wavelet coherency methodologies have been used to examine structure of dynamic correlation. Moreover, in consequence of quadruple and multiple wavelet coherence, strongly correlated large scales indicate linear behavior and, hence VARMA (vector autoregressive moving average) gives better fitting and forecasting performance. In addition, increasing the dimensions of the model for strongly correlated scales leads to more accurate results compared to scalar counterparts.

  18. Health-related quality of life and post-traumatic stress disorder symptoms in accident and emergency attenders suffering from psychosocial crises: a longitudinal study

    PubMed Central

    Senneseth, Mette; Alsaker, Kjersti; Natvig, Gerd Karin

    2012-01-01

    Aims This paper is a report of a study of health-related quality of life and post-traumatic stress disorder symptoms in patients attending an Accident and Emergency department because of psychosocial crises. Background Psychosocial crises are commonplace globally, but there is little knowledge about patients attending Accident and Emergency departments because of psychosocial crises. Methods Data were collected at an Accident and Emergency department in Norway from September 2008 to June 2009. A total of 99 adults participated in the baseline study and 41 of these participated at 2 months follow-up. The Short Form-36 Health Survey and the Post Traumatic Symptom Scale were used to obtain data. Findings Participants reported significantly lower scores in all health-related quality of life domains at baseline compared with the general Norwegian population. The mental health score was two standard deviations below the norm. Health-related quality of life scores were improved and post-traumatic stress disorder symptoms were reduced after 2 months. High levels of post-traumatic stress disorder symptoms were reported by 78% of the participants at baseline and 59% at follow-up. Participants with high levels of post-traumatic stress disorder symptoms at follow-up also reported low health-related quality of life scores. Conclusion This study suggests a need for an acute psychosocial intervention and an opportunity to receive follow-up support at Accident and Emergency departments. PMID:21740459

  19. Is there a statistical relationship between economic crises and changes in government health expenditure growth? an analysis of twenty-four European countries.

    PubMed

    Cylus, Jonathan; Mladovsky, Philipa; McKee, Martin

    2012-12-01

    To identify whether, by what means, and the extent to which historically, government health care expenditure growth in Europe has changed following economic crises. Organization for Economic Cooperation and Development Health Data 2011. Cross-country fixed effects multiple regression analysis is used to determine whether statutory health care expenditure growth in the year after economic crises differs from that which would otherwise be predicted by general economic trends. Better understanding of the mechanisms involved is achieved by distinguishing between policy responses which lead to cost-shifting and all others. In the year after an economic downturn, public health care expenditure grows more slowly than would have been expected given the longer term economic climate. Cost-shifting and other policy responses are both associated with these slowdowns. However, while changes in tax-derived expenditure are associated with both cost-shifting and other policy responses following a crisis, changes in expenditure derived from social insurance have been associated only with changes in cost-shifting. Disproportionate cuts to the health sector, as well as reliance on cost-shifting to slow growth in health care expenditure, serve as a warning in terms of potentially negative effects on equity, efficiency, and quality of health services and, potentially, health outcomes following economic crises. © Health Research and Educational Trust.

  20. Is There a Statistical Relationship between Economic Crises and Changes in Government Health Expenditure Growth? An Analysis of Twenty-Four European Countries

    PubMed Central

    Cylus, Jonathan; Mladovsky, Philipa; McKee, Martin

    2012-01-01

    Objective To identify whether, by what means, and the extent to which historically, government health care expenditure growth in Europe has changed following economic crises. Data Sources Organization for Economic Cooperation and Development Health Data 2011. Study Design Cross-country fixed effects multiple regression analysis is used to determine whether statutory health care expenditure growth in the year after economic crises differs from that which would otherwise be predicted by general economic trends. Better understanding of the mechanisms involved is achieved by distinguishing between policy responses which lead to cost-shifting and all others. Findings In the year after an economic downturn, public health care expenditure grows more slowly than would have been expected given the longer term economic climate. Cost-shifting and other policy responses are both associated with these slowdowns. However, while changes in tax-derived expenditure are associated with both cost-shifting and other policy responses following a crisis, changes in expenditure derived from social insurance have been associated only with changes in cost-shifting. Conclusions Disproportionate cuts to the health sector, as well as reliance on cost-shifting to slow growth in health care expenditure, serve as a warning in terms of potentially negative effects on equity, efficiency, and quality of health services and, potentially, health outcomes following economic crises. PMID:22670771

  1. The Crisis Intervention Team Model of Police Response to Mental Health Crises: A Primer for Mental Health Practitioners.

    PubMed

    Watson, Amy C; Fulambarker, Anjali J

    2012-12-01

    As persons with mental illnesses and law enforcement become increasingly entangled, the collaboration of police and mental health service providers has become critical to appropriately serving the needs of individuals experiencing mental health crises. This article introduces the Crisis Intervention Team (CIT) Model as a collaborative approach to safely and effectively address the needs of persons with mental illnesses, link them to appropriate services, and divert them from the criminal justice system if appropriate. We discuss the key elements of the CIT model, implementation and its related challenges, as well as variations of the model. While this model has not undergone enough research to be deemed an Evidence-Based Practice, it has been successfully utilized in many law enforcement agencies worldwide and is considered a "Best Practice" model in law enforcement. This primer for mental health practitioners serves as an introduction to a model that may already be utilized in their community or serve as a springboard for the development CIT programs where they do not currently exist.

  2. Recurrent Muscle Weakness with Rhabdomyolysis, Metabolic Crises, and Cardiac Arrhythmia Due to Bi-allelic TANGO2 Mutations

    PubMed Central

    Lalani, Seema R.; Liu, Pengfei; Rosenfeld, Jill A.; Watkin, Levi B.; Chiang, Theodore; Leduc, Magalie S.; Zhu, Wenmiao; Ding, Yan; Pan, Shujuan; Vetrini, Francesco; Miyake, Christina Y.; Shinawi, Marwan; Gambin, Tomasz; Eldomery, Mohammad K.; Akdemir, Zeynep Hande Coban; Emrick, Lisa; Wilnai, Yael; Schelley, Susan; Koenig, Mary Kay; Memon, Nada; Farach, Laura S.; Coe, Bradley P.; Azamian, Mahshid; Hernandez, Patricia; Zapata, Gladys; Jhangiani, Shalini N.; Muzny, Donna M.; Lotze, Timothy; Clark, Gary; Wilfong, Angus; Northrup, Hope; Adesina, Adekunle; Bacino, Carlos A.; Scaglia, Fernando; Bonnen, Penelope E.; Crosson, Jane; Duis, Jessica; Maegawa, Gustavo H.B.; Coman, David; Inwood, Anita; McGill, Jim; Boerwinkle, Eric; Graham, Brett; Beaudet, Art; Eng, Christine M.; Hanchard, Neil A.; Xia, Fan; Orange, Jordan S.; Gibbs, Richard A.; Lupski, James R.; Yang, Yaping

    2016-01-01

    The underlying genetic etiology of rhabdomyolysis remains elusive in a significant fraction of individuals presenting with recurrent metabolic crises and muscle weakness. Using exome sequencing, we identified bi-allelic mutations in TANGO2 encoding transport and Golgi organization 2 homolog (Drosophila) in 12 subjects with episodic rhabdomyolysis, hypoglycemia, hyperammonemia, and susceptibility to life-threatening cardiac tachyarrhythmias. A recurrent homozygous c.460G>A (p.Gly154Arg) mutation was found in four unrelated individuals of Hispanic/Latino origin, and a homozygous ∼34 kb deletion affecting exons 3–9 was observed in two families of European ancestry. One individual of mixed Hispanic/European descent was found to be compound heterozygous for c.460G>A (p.Gly154Arg) and the deletion of exons 3–9. Additionally, a homozygous exons 4–6 deletion was identified in a consanguineous Middle Eastern Arab family. No homozygotes have been reported for these changes in control databases. Fibroblasts derived from a subject with the recurrent c.460G>A (p.Gly154Arg) mutation showed evidence of increased endoplasmic reticulum stress and a reduction in Golgi volume density in comparison to control. Our results show that the c.460G>A (p.Gly154Arg) mutation and the exons 3–9 heterozygous deletion in TANGO2 are recurrent pathogenic alleles present in the Latino/Hispanic and European populations, respectively, causing considerable morbidity in the homozygotes in these populations. PMID:26805781

  3. The food, fuel, and financial crises affect the urban and rural poor disproportionately: a review of the evidence.

    PubMed

    Ruel, Marie T; Garrett, James L; Hawkes, Corinna; Cohen, Marc J

    2010-01-01

    The vulnerability of the urban poor to the recent food and fuel price crisis has been widely acknowledged. The unfolding global financial crisis, which brings higher unemployment and underemployment, is likely to further intensify this vulnerability. This paper reviews the evidence concerning the disproportionate vulnerability of the urban compared with the rural poor to these types of shocks. It reviews some of the unique characteristics of urban life that could make the urban poor particularly susceptible to price and financial shocks and summarizes the evidence regarding the disproportionate vulnerability of the urban poor. The focus is on impacts on poverty, food insecurity, and malnutrition. The review shows that although the urban poor are clearly one of the population groups most affected by the current (and previous) crises, the rural poor, landless, and net buyers are in no better position to confront the crisis without significant suffering. The poorest of the poor are the ones who will be most affected, irrespective of the continent, country, or urban or rural area where they live. The magnitude and severity of their suffering depends on their ability to adapt and on the specific nature, extent, and duration of the coping strategies they adopt. A better understanding of how these coping strategies are used and staggered is critical to help design triggers for action that can prevent households from moving to more desperate measures. Using these early coping strategies as early warning indicators could help prevent dramatic losses in welfare.

  4. The Crisis Intervention Team Model of Police Response to Mental Health Crises: A Primer for Mental Health Practitioners

    PubMed Central

    Watson, Amy C.; Fulambarker, Anjali J.

    2013-01-01

    As persons with mental illnesses and law enforcement become increasingly entangled, the collaboration of police and mental health service providers has become critical to appropriately serving the needs of individuals experiencing mental health crises. This article introduces the Crisis Intervention Team (CIT) Model as a collaborative approach to safely and effectively address the needs of persons with mental illnesses, link them to appropriate services, and divert them from the criminal justice system if appropriate. We discuss the key elements of the CIT model, implementation and its related challenges, as well as variations of the model. While this model has not undergone enough research to be deemed an Evidence-Based Practice, it has been successfully utilized in many law enforcement agencies worldwide and is considered a “Best Practice” model in law enforcement. This primer for mental health practitioners serves as an introduction to a model that may already be utilized in their community or serve as a springboard for the development CIT programs where they do not currently exist. PMID:24039557

  5. The Opportunities of Crises and Emergency Risk Communication in Activities of Serbian Public Health Workforce in Emergencies

    PubMed Central

    Radović, V; Ćurčić, L

    2012-01-01

    Background: The aim of the study was a recommendation and establishment the concept of the appropriate communication between public health, other competent services and population in emergency as the corner stone which guarantee that all goals which are important for community life will be achieved. Methods: We used methodology appropriate for social science: analyses of documents, historical approach and comparative analysis. Results: The finding shows the urgent need for accepting of crises and emergency risk communication principles, or some similar concepts, in Serbia, and implementing effective two way communication especially in multiethnic region. The pragmatic value of the paper lays in information about the recent improvement of health workforce and emergency services in emergencies using new concept of communication and as source of numerous useful documents published in USA and few recent Serbian examples. Conclusion: Health workforce has significant role in the process of protection of population in emergencies. Policy makers should work on finding a way to improve their coordination and communication, creating new academic programs, providing of adequate training, and financial means in order to give them different role in society and provide visibility. From other side health workforce should build back to the citizen trust in what they are doing for society welfare using all their skills and abilities. PMID:23308348

  6. The opportunities of crises and emergency risk communication in activities of serbian public health workforce in emergencies.

    PubMed

    Radović, V; Curčić, L

    2012-01-01

    The aim of the study was a recommendation and establishment the concept of the appropriate communication between public health, other competent services and population in emergency as the corner stone which guarantee that all goals which are important for community life will be achieved. WE USED METHODOLOGY APPROPRIATE FOR SOCIAL SCIENCE: analyses of documents, historical approach and comparative analysis. The finding shows the urgent need for accepting of crises and emergency risk communication principles, or some similar concepts, in Serbia, and implementing effective two way communication especially in multiethnic region. The pragmatic value of the paper lays in information about the recent improvement of health workforce and emergency services in emergencies using new concept of communication and as source of numerous useful documents published in USA and few recent Serbian examples. Health workforce has significant role in the process of protection of population in emergencies. Policy makers should work on finding a way to improve their coordination and communication, creating new academic programs, providing of adequate training, and financial means in order to give them different role in society and provide visibility. From other side health workforce should build back to the citizen trust in what they are doing for society welfare using all their skills and abilities.

  7. The impact of critical event checklists on medical management and teamwork during simulated crises in a surgical daycare facility.

    PubMed

    Everett, T C; Morgan, P J; Brydges, R; Kurrek, M; Tregunno, D; Cunningham, L; Chan, A; Forde, D; Tarshis, J

    2017-03-01

    Although the incidence of major adverse events in surgical daycare centres is low, these critical events may not be managed optimally due to the absence of resources that exist in larger hospitals. We aimed to study the impact of operating theatre critical event checklists on medical management and teamwork during whole-team operating theatre crisis simulations staged in a surgical daycare facility. We studied 56 simulation encounters (without and with a checklist available) divided between an initial session and then a retention session several months later. Medical management and teamwork were quantified via percentage adherence to key processes and the Team Emergency Assessment Measure, respectively. In the initial session, medical management was not improved by the presence of a checklist (56% without checklist vs. 62% with checklist; p = 0.50). In the retention session, teams performed significantly worse without the checklists (36% without checklist vs. 60% with checklist; p = 0.04). We did not observe a change in non-technical skills in the presence of a checklist in either the initial or retention sessions (68% without checklist vs. 69% with checklist (p = 0.94) and 69% without checklist vs. 65% with checklist (p = 0.36), respectively). Critical events checklists do not improve medical management or teamwork during simulated operating theatre crises in an ambulatory surgical daycare setting.

  8. Crise convulsive chez les abuseurs de Tramadol et caféine: à propos de 8 cas et revue de la littérature

    PubMed Central

    Maiga, Djibo Douma; Seyni, Houdou; Sidikou, Amadou; Azouma, Alfazazi

    2012-01-01

    Nous rapportons Huit cas de crises convulsives diagnostiquées comme maladie épileptique après ingestion de Tramadol et d'autres substances psychotropes dont la Caféine dans une région ou maladie épileptique et addiction au café sont fréquentes. L'objectif de ce travail était d'informer les praticiens sur le risque de convulsion lié à la consommation du Tramadol seul ou en association avec d'autres psychotropes en s'appuyant sur les données de la littérature. Il s'agissait d'une étude rétrospective et exhaustive de patients vus en consultation ambulatoire pour crise convulsive et consommation de Tramadol et de caféine de janvier à mai 2012. Les données collectées étaient les caractéristiques sociodémographiques et de la consommation de Tramadol. Le diagnostic de crise convulsive a été posé sur les renseignements obtenus à l'anamnèse. Tous les patients ont été soumis à un examen neurologique et aux critères de dépendance du Diagnostic and Statistical Manual of Mental Disorders (DSMIV)-R par rapport à leur consommation de Tramadol. Nous n'avons pas trouvé dans la littérature médicale de cas de consommation concomitante de Tramadol et de Caféine. Les données expérimentales suggèrent une action synergique du Tramadol et de la Caféine sur la douleur et le seuil épileptogène. Nos observations plaident également en faveur d'une synergie d'action de ces deux molécules dans la survenue des crises convulsives. La fréquence des crises convulsives suite à une intoxication par le Tramadol et la caféine est susceptible d'augmenter en Afrique en raison du mésusage croissant de ces substances. Une étude comparative usagers de Tramadol associé à la Caféine et usagers du Tramadol seul devrait permettre d’évaluer le risque. PMID:23308329

  9. Autopsy statistics on the relative frequency of acute myocardial infarction in the Japanese mental workers and the unemployed during the two oil-crises periods.

    PubMed

    Chang, N C; Kawai, S; Okada, R

    1989-03-20

    In order to investigate whether job induced emotional stress, arising from socioenvironmental disasters would act as a trigger for the onset of AMI, the author reviewed all pathological autopsies throughout Japan 15 years old and over. Data was obtained from publications of the "Annual of the Pathological Autopsy Cases in Japan" for the years 1966-1968 (a period of high economic growth), 1973-1975 (1974, the year of the first oil crisis), and 1978-1980 (1979, the year of the second oil crisis). Relative frequencies of AMI were significantly higher during the years of both oil crises than in both the preceding and following years (2.6% in 1973, 3.7% in 1974, 3.0% in 1975; 2.8% in 1978, 3.2% in 1979, and 2.0% in 1980), and in each of three years of the high economic growth period (1.9-2.2% in 1966-1968). The proportions of managers and officials among AMI victims were significantly higher in the years of both oil crises than in both the preceding and following years (13.4% in 1973, 17.5% in 1974, 12.5% in 1975; 11.6% in 1978, 15.8% in 1979, and 11.1% in 1980). Moreover, there was a significantly higher value in the year of first oil crisis than in each of three years of the high economic growth period (11.7-13.1% in 1966-1968). The proportions of "out of job" persons were also significantly higher in the years of both oil crises than in the preceding years (24.0% in 1973, 29.3% in 1974, 27.8% in 1975; 24.1% in 1978, 29.1% in 1979, and 27.4% in 1980). For 11,199 randomly selected autopsies, the proportions of AMI in the above two occupational groups were significantly higher in the years of both oil crises than in the preceding years. Moreover, the proportion of "out of job" persons was significantly higher in the year of first oil crisis than in each of three years of the high economic growth period. A similar trend was noted among professional and technical workers, with more AMI occurring in this group during the years of both oil crises than in both the preceding

  10. EMS in Mauritius.

    PubMed

    Ramalanjaona, Georges; Brogan, Gerald X

    2009-02-01

    Mauritius lies in the southwest Indian Ocean about 1250 miles from the African coast and 500 miles from Madagascar. Mauritius (estimated population 1,230,602) became independent from the United Kingdom in 1968 and has one of the highest GDP per capita in Africa. Within Mauritius there is a well established EMS system with a single 999 national dispatch system. Ambulances are either publicly or privately owned. Public ambulances are run by the Government (SAMU). Megacare is a private subscriber only ambulance service. The Government has recently invested in new technology such as telemedicine to further enhance the role of EMS on the island. This article describes the current state of EMS in Mauritius and depicts its development in the context of Government effort to decentralise and modernise the healthcare system.

  11. EMS -- Error Message Service

    NASA Astrophysics Data System (ADS)

    Rees, P. C. T.; Chipperfield, A. J.; Draper, P. W.

    This document describes the Error Message Service, EMS, and its use in system software. The purpose of EMS is to provide facilities for constructing and storing error messages for future delivery to the user -- usually via the Starlink Error Reporting System, ERR (see SUN/104). EMS can be regarded as a simplified version of ERR without the binding to any software environment (e.g., for message output or access to the parameter and data systems). The routines in this library conform to the error reporting conventions described in SUN/104. A knowledge of these conventions, and of the ADAM system (see SG/4), is assumed in what follows. This document is intended for Starlink systems programmers and can safely be ignored by applications programmers and users.

  12. "Peer2Peer" – A university program for knowledge transfer and consultation in dealing with psychosocial crises in med-school and medical career

    PubMed Central

    Vajda, Christian

    2016-01-01

    Objective: Medical students are exposed to various psychosocial problems and challenges. Specific consultations services and programs can support them. “Peer2Peer” is such a consultation program and was implemented at the Medical University of Graz. It focusses on crisis intervention, psychosocial stress management, junior mentoring as well as student education in this field. Besides, it also offers student tutors of the program practical skills trainings. The program was restructured in winter term 2014/15. Methods: On the one hand, “Peer2Peer” gives insights into topics such as the current state of research concerning the students’ psychological strain and psychosocial crises in acutely stressful situations and preventive approaches for coping with these kinds of situations on the other hand. These aspects are taught by means of elective courses, lectures and workshops. Furthermore, “Peer2Peer” provides consultation services by student tutors who give face-to-face advice if required. These tutors receive ongoing training in organizational and professional issues. Results: Since the summer term of 2015, 119 students have been trained (via lectures and elective courses), while 61 contacts (short consultation) and 33 contacts (full consultation) have been supervisied. In total, two psychotherapeutic and one psychosocial follow ups were recommended. There are seven students who participate as tutors in the program. Conclusions: The “Peer2Peer” program is intended to enable a low-threshold access for medical students facing psychosocial crises situations and to help them in dealing with stress and learning problems. An increase in support contacts from the summer term of 2015 to the winter term of 2015/16 can be considered a success. A first evaluation of the different components of the program started in the winter semester of 2015/16. The student tutors have not only acquired practical skills in dealing with students in crises situations but also

  13. Forecasting of magnitude and duration of currency crises based on the analysis of distortions of fractal scaling in exchange rate fluctuations

    NASA Astrophysics Data System (ADS)

    Uritskaya, Olga Y.

    2005-05-01

    Results of fractal stability analysis of daily exchange rate fluctuations of more than 30 floating currencies for a 10-year period are presented. It is shown for the first time that small- and large-scale dynamical instabilities of national monetary systems correlate with deviations of the detrended fluctuation analysis (DFA) exponent from the value 1.5 predicted by the efficient market hypothesis. The observed dependence is used for classification of long-term stability of floating exchange rates as well as for revealing various forms of distortion of stable currency dynamics prior to large-scale crises. A normal range of DFA exponents consistent with crisis-free long-term exchange rate fluctuations is determined, and several typical scenarios of unstable currency dynamics with DFA exponents fluctuating beyond the normal range are identified. It is shown that monetary crashes are usually preceded by prolonged periods of abnormal (decreased or increased) DFA exponent, with the after-crash exponent tending to the value 1.5 indicating a more reliable exchange rate dynamics. Statistically significant regression relations (R=0.99, p<0.01) between duration and magnitude of currency crises and the degree of distortion of monofractal patterns of exchange rate dynamics are found. It is demonstrated that the parameters of these relations characterizing small- and large-scale crises are nearly equal, which implies a common instability mechanism underlying these events. The obtained dependences have been used as a basic ingredient of a forecasting technique which provided correct in-sample predictions of monetary crisis magnitude and duration over various time scales. The developed technique can be recommended for real-time monitoring of dynamical stability of floating exchange rate systems and creating advanced early-warning-system models for currency crisis prevention.

  14. National EMS Research Agenda.

    PubMed

    Sayre, M R; White, L J; Brown, L H; McHenry, S D

    2002-01-01

    Now, more than ever before, the spirit of the emergency services professional is recognized by people everywhere. Individuals from every walk of life comprehend the reality of the job these professionals do each day. Placing the safety of others above their own is their acknowledged responsibility. Rescue and treatment of ill and injured patients are their purpose as well as their gratification. The men and women who provide prehospital care are well aware of the unpredictable nature of emergency medical services (EMS). Prehospital care is given when and where it is needed: in urban settings with vertical challenges and gridlock; in rural settings with limited access; in confined spaces; within entrapments; or simply in the street, exposed to the elements. Despite the challenges, EMS professionals rise to the occasion to do their best with the resources available. Despite more than 30 years of dedicated service by thousands of EMS professionals, academic researchers, and public policy makers, the nation's EMS system is treating victims of illness and injury with little or no evidence that the care they provide is optimal. A national investment in the EMS research infrastructure is necessary to overcome obstacles currently impeding the accumulation of essential evidence of the effectiveness of EMS practice. Funding is required to train new researchers and to help them establish their careers. Financial backing is needed to support the development of effective prehospital treatments for the diseases that drive the design of the EMS system, including injury and sudden cardiac arrest. Innovative strategies to make EMS research easier to accomplish in emergency situations must be implemented. Researchers must have access to patient outcome information in order to evaluate and improve prehospital care. New biomedical and technical advances must be evaluated using scientific methodology. Research is the key to maintaining focus on improving the overall health of the

  15. Energy Crises in Perspective

    ERIC Educational Resources Information Center

    Fisher, John C.

    1973-01-01

    Discusses some long-range aspects of energy resources and consumption, including the history of current energy crisis, resource and reserve estimates, and future of the energy industry. Indicates that the United States of American has enough fossil and nuclear fuel to last, respectively, for 500 years and a million years. (CC)

  16. Averting comfortable lifestyle crises.

    PubMed

    Bilton, Rod

    2013-01-01

    How have climate change and diet shaped the evolution of human energy metabolism, and responses to vitamin C, fructose and uric acid? Through the last three millennia observant physicians have noted the association of inappropriate diets with increased incidence of obesity, heart disease, diabetes and cancer, and over the past 300 years doctors in the UK observed that overeating increased the incidence of these diseases. Anthropological studies of the Inuit culture in the mid-nineteenth century revealed that humans can survive and thrive in the virtual absence of dietary carbohydrate. In the 1960s, Cahill revealed the flexibility of human metabolism in response to partial and total starvation and demonstrated that type 2 diabetics were better adapted than healthy subjects to conserving protein during fasting. The potential role for brown adipose tissue thermogenesis in temperature maintenance and dietary calorie control was suggested by Rothwell and Stock from their experiments with 'cafeteria fed rats' in the 1980s. Recent advances in gene array studies and PET scanning support a role for this process in humans. The industrialisation of food processing in the twentieth century has led to increases in palatability and digestibility with a parallel loss of quality leading to overconsumption and the current obesity epidemic. The switch from animal to vegetable fats at the beginning of the twentieth century, followed by the rapid increase in sugar and fructose consumption from 1979 is mirrored by a steep increase in obesity in the 1980s, in the UK and USA. Containment of the obesity epidemic is compounded by the addictive properties of sugar which involve the same dopamine receptors in the pleasure centres of the brain as for cocaine, nicotine and alcohol. Of the many other toxic effects of excessive sugar consumption, immunocompromisation, kidney damage, atherosclerosis, oxidative stress and cancer are highlighted. The WHO and guidelines on sugar consumption include: alternative non-sugar sweeteners; toxic side-effects of aspartame. Stevia and xylitol as healthy sugar replacements; the role of food processing in dietary health; and beneficial effects of resistant starch in natural and processed foods. The rise of maize and soya-based vegetable oils have led to omega-6 fat overload and imbalance in the dietary ratio of omega-3 to omega-6 fats. This has led to toxicity studies with industrial trans fats; investigations on health risks associated with stress and comfort eating; and abdominal obesity. Other factors to consider are: diet, cholesterol and oxidative stress, as well as the new approaches to the chronology of eating and the health benefits of intermittent fasting.

  17. Forecasting Potential Crises.

    ERIC Educational Resources Information Center

    Neufeld, William P.

    1984-01-01

    By foreseeing the possibility of crisis, we can plan how to respond. Five potential crisis areas are identified and possible consequences discussed. The areas are the warming of the earth; water shortage; collapse of the physical infrastructure, e.g., decay of roads; global financial crisis; and the threat of nuclear war. (Author/RM)

  18. Energy Crises in Perspective

    ERIC Educational Resources Information Center

    Fisher, John C.

    1973-01-01

    Discusses some long-range aspects of energy resources and consumption, including the history of current energy crisis, resource and reserve estimates, and future of the energy industry. Indicates that the United States of American has enough fossil and nuclear fuel to last, respectively, for 500 years and a million years. (CC)

  19. Forecasting Potential Crises.

    ERIC Educational Resources Information Center

    Neufeld, William P.

    1984-01-01

    By foreseeing the possibility of crisis, we can plan how to respond. Five potential crisis areas are identified and possible consequences discussed. The areas are the warming of the earth; water shortage; collapse of the physical infrastructure, e.g., decay of roads; global financial crisis; and the threat of nuclear war. (Author/RM)

  20. A GCH1 haplotype confers sex-specific susceptibility to pain crises and altered endothelial function in adults with sickle cell anemia

    PubMed Central

    Belfer, Inna; Youngblood, Victoria; Darbari, Deepika S.; Wang, Zhengyuan; Diaw, Lena; Freeman, Lita; Desai, Krupa; Dizon, Michael; Allen, Darlene; Cunnington, Colin; Channon, Keith M.; Milton, Jacqueline; Hartley, Stephen W.; Nolan, Vikki; Kato, Gregory J.; Steinberg, Martin H.; Goldman, David; Taylor, James G.

    2014-01-01

    GTP cyclohydrolase (GCH1) is rate limiting for tetrahydrobiopterin (BH4) synthesis, where BH4 is a cofactor for nitric oxide (NO) synthases and aromatic hydroxylases. GCH1 polymorphisms are implicated in the pathophysiology of pain, but have not been investigated in African populations. We examined GCH1 and pain in sickle cell anemia where GCH1 rs8007267 was a risk factor for pain crises in discovery (n = 228; odds ratio [OR] 2.26; P = 0.009) and replication (n = 513; OR 2.23; P = 0.004) cohorts. In vitro, cells from sickle cell anemia subjects homozygous for the risk allele produced higher BH4. In vivo physiological studies of traits likely to be modulated by GCH1 showed rs8007267 is associated with altered endothelial dependent blood flow in females with SCA (8.42% of variation; P = 0.002). The GCH1 pain association is attributable to an African haplotype with where its sickle cell anemia pain association is limited to females (OR 2.69; 95% CI 1.21–5.94; P = 0.01) and has the opposite directional association described in Europeans independent of global admixture. The presence of a GCH1 haplotype with high BH4 in populations of African ancestry could explain the association of rs8007267 with sickle cell anemia pain crises. The vascular effects of GCH1 and BH4 may also have broader implications for cardiovascular disease in populations of African ancestry. PMID:24136375

  1. Probabilistic approach to decision making under uncertainty during volcanic crises. Retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands

    NASA Astrophysics Data System (ADS)

    Sobradelo, Rosa; Martí, Joan; Kilburn, Christopher; López, Carmen

    2014-05-01

    Understanding the potential evolution of a volcanic crisis is crucial to improving the design of effective mitigation strategies. This is especially the case for volcanoes close to densely-populated regions, where inappropriate decisions may trigger widespread loss of life, economic disruption and public distress. An outstanding goal for improving the management of volcanic crises, therefore, is to develop objective, real-time methodologies for evaluating how an emergency will develop and how scientists communicate with decision makers. Here we present a new model BADEMO (Bayesian Decision Model) that applies a general and flexible, probabilistic approach to managing volcanic crises. The model combines the hazard and risk factors that decision makers need for a holistic analysis of a volcanic crisis. These factors include eruption scenarios and their probabilities of occurrence, the vulnerability of populations and their activities, and the costs of false alarms and failed forecasts. The model can be implemented before an emergency, to identify actions for reducing the vulnerability of a district; during an emergency, to identify the optimum mitigating actions and how these may change as new information is obtained; and after an emergency, to assess the effectiveness of a mitigating response and, from the results, to improve strategies before another crisis occurs. As illustrated by a retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands, BADEMO provides the basis for quantifying the uncertainty associated with each recommended action as an emergency evolves, and serves as a mechanism for improving communications between scientists and decision makers.

  2. A GCH1 haplotype confers sex-specific susceptibility to pain crises and altered endothelial function in adults with sickle cell anemia.

    PubMed

    Belfer, Inna; Youngblood, Victoria; Darbari, Deepika S; Wang, Zhengyuan; Diaw, Lena; Freeman, Lita; Desai, Krupa; Dizon, Michael; Allen, Darlene; Cunnington, Colin; Channon, Keith M; Milton, Jacqueline; Hartley, Stephen W; Nolan, Vikki; Kato, Gregory J; Steinberg, Martin H; Goldman, David; Taylor, James G

    2014-02-01

    GTP cyclohydrolase (GCH1) is rate limiting for tetrahydrobiopterin (BH4) synthesis, where BH4 is a cofactor for nitric oxide (NO) synthases and aromatic hydroxylases. GCH1 polymorphisms are implicated in the pathophysiology of pain, but have not been investigated in African populations. We examined GCH1 and pain in sickle cell anemia where GCH1 rs8007267 was a risk factor for pain crises in discovery (n = 228; odds ratio [OR] 2.26; P = 0.009) and replication (n = 513; OR 2.23; P = 0.004) cohorts. In vitro, cells from sickle cell anemia subjects homozygous for the risk allele produced higher BH4. In vivo physiological studies of traits likely to be modulated by GCH1 showed rs8007267 is associated with altered endothelial dependent blood flow in females with SCA (8.42% of variation; P = 0.002). The GCH1 pain association is attributable to an African haplotype with where its sickle cell anemia pain association is limited to females (OR 2.69; 95% CI 1.21-5.94; P = 0.01) and has the opposite directional association described in Europeans independent of global admixture. The presence of a GCH1 haplotype with high BH4 in populations of African ancestry could explain the association of rs8007267 with sickle cell anemia pain crises. The vascular effects of GCH1 and BH4 may also have broader implications for cardiovascular disease in populations of African ancestry.

  3. The EM Earthquake Precursor

    NASA Astrophysics Data System (ADS)

    Jones, K. B., II; Saxton, P. T.

    2013-12-01

    Many attempts have been made to determine a sound forecasting method regarding earthquakes and warn the public in turn. Presently, the animal kingdom leads the precursor list alluding to a transmission related source. By applying the animal-based model to an electromagnetic (EM) wave model, various hypotheses were formed, but the most interesting one required the use of a magnetometer with a differing design and geometry. To date, numerous, high-end magnetometers have been in use in close proximity to fault zones for potential earthquake forecasting; however, something is still amiss. The problem still resides with what exactly is forecastable and the investigating direction of EM. After the 1989 Loma Prieta Earthquake, American earthquake investigators predetermined magnetometer use and a minimum earthquake magnitude necessary for EM detection. This action was set in motion, due to the extensive damage incurred and public outrage concerning earthquake forecasting; however, the magnetometers employed, grounded or buried, are completely subject to static and electric fields and have yet to correlate to an identifiable precursor. Secondly, there is neither a networked array for finding any epicentral locations, nor have there been any attempts to find even one. This methodology needs dismissal, because it is overly complicated, subject to continuous change, and provides no response time. As for the minimum magnitude threshold, which was set at M5, this is simply higher than what modern technological advances have gained. Detection can now be achieved at approximately M1, which greatly improves forecasting chances. A propagating precursor has now been detected in both the field and laboratory. Field antenna testing conducted outside the NE Texas town of Timpson in February, 2013, detected three strong EM sources along with numerous weaker signals. The antenna had mobility, and observations were noted for recurrence, duration, and frequency response. Next, two

  4. Cretaceous tropical carbonate platform changes used as paleoclimatic and paleoceanic indicators: the three lower Cretaceous platform crises

    NASA Astrophysics Data System (ADS)

    Arnaud-Vanneau, A.; Vrielynck, B.

    2009-04-01

    Carbonate platform sediments are of biogenic origin. More commonly the bioclasts are fragments of shells and skeletons. The bioclastic composition of a limestone may reflect the nature of biota inhabiting the area and a carbonate platform can be estimated as a living factory, which reflects the prevailing ecological factors. The rate of carbonate production is highest in the tropics, in oligotrophic environments, and in the photic zone. The rate of carbonate production varies greatly with temperature and nutrient input. Three types of biotic carbonate platform can be distinguished. The highest carbonate production is linked to oligotrophic carbonate platform characterized by the presence of assemblages with hermatypic corals. This type of platform is developed in shallow marine environment, nutrient poor water and warm tropical sea. A less efficient production of carbonate platform is related to mesotrophic environments in cooler and/or deeper water and associated to nutrient flux with, sometime, detrital input. The biota includes red algae, solitary coral and branching ahermatypic corals, common bryozoans, crinoids and echinoids. The less productive carbonate platform is the eutrophic muddy platform where the mud is due to the intense bacterial activity, probably related to strong nutrient flux. All changes of type of carbonate platform can be related to climatic and oceanic changes. Three platform crises occurred during lower Cretaceous time. They are followed by important turnover of microfauna (large benthic foraminifers) and microflora (marine algae). They start with the demise of the previous oligotrophic platform, they continue with oceanic perturbations, expression of which was the widespread deposition of organic-rich sediments, well expressed during Late Aptian/Albian and Cenomanian Turonian boundary and the replacement of previous oligotrophic platforms by mesotrophic to eutrophic platforms. The first crisis occurred during Valanginian and Hauterivian

  5. Tsunamis as geomorphic crises: Lessons from the December 26, 2004 tsunami in Lhok Nga, West Banda Aceh (Sumatra, Indonesia)

    NASA Astrophysics Data System (ADS)

    Paris, Raphaël; Wassmer, Patrick; Sartohadi, Junun; Lavigne, Franck; Barthomeuf, Benjamin; Desgages, Emilie; Grancher, Delphine; Baumert, Philippe; Vautier, Franck; Brunstein, Daniel; Gomez, Christopher

    2009-03-01

    Large tsunamis are major geomorphic crises, since they imply extensive erosion, sediment transport and deposition in a few minutes and over hundreds of kilometres of coast. Nevertheless, little is known about their geomorphologic imprints. The December 26, 2004 tsunami in Sumatra (Indonesia) was one of the largest and deadliest tsunamis in recorded human history. We present a description of the coastal erosion and boulder deposition induced by the 2004 tsunami in the Lhok Nga Bay, located to the West of Banda Aceh (northwest Sumatra). The geomorphological impact of the tsunami is evidenced by: beach erosion (some beaches have almost disappeared); destruction of sand barriers protecting the lagoons or at river mouths; numerous erosion escarpments typically in the order of 0.5-1.5 m when capped by soil and more than 2 m in dunes; bank erosion in the river beds (the retreat along the main river is in the order of 5-15 m, with local retreats exceeding 30 m); large scars typically 20-50 cm deep on slopes; dislodgement of blocks along fractures and structural ramps on cliffs. The upper limit of erosion appears as a continuous trimline at 20-30 m a.s.l., locally reaching 50 m. The erosional imprints of the tsunami extend to 500 m from the shoreline and exceed 2 km along riverbeds. The overall coastal retreat from Lampuuk to Leupung was 60 m (550,000 m 2) and locally exceeded 150 m. Over 276,000 m 3 of coastal sediments were eroded by the tsunami along the 9.2 km of sandy coast. The mean erosion rate of the beaches was ~ 30 m 3/m of coast and locally exceeded 80 m 3/m. The most eroded coasts were tangent to the tsunami wave train, which was coming from the southwest. The fringing reefs were not efficient in reducing the erosional impact of the tsunami. The 220 boulders measured range from 0.3 to 7.2 m large (typically 0.7-1.5 m), with weights from over 50 kg up to 85 t. We found one boulder, less than 1 m large, at 1 km from the coastline, but all the others were

  6. EMS & the DEA.

    PubMed

    Beeson, Jeff; Ayres, Chris

    2010-01-01

    It's clear that EMS medical directors and management staff must be vigilant in their oversight of implementation, administration and monitoring of controlled substances within their agencies to best serve the public and avoid running afoul of investigation and incurring significant penalties. Those potentially affected by the need for individual registrations of both emergency vehicles and central inventory systems should carefully monitor upcoming developments in the interpretation od DEA regulations.

  7. Why do Emergency Medical Services (EMS) Professionals Leave EMS?

    PubMed

    Blau, Gary; Chapman, Susan A

    2016-12-01

    The objective was to determine why Emergency Medical Technician (EMT)-Basics and Paramedics leave the Emergency Medical Services (EMS) workforce. Data were collected through annual surveys of nationally registered EMT-Basics and Paramedics from 1999 to 2008. Survey items dealing with satisfaction with the EMS profession, likelihood of leaving the profession, and likelihood of leaving their EMS job were assessed for both EMT-Basics and Paramedics, along with reasons for leaving the profession. Individuals whose responses indicated that they were not working in EMS were mailed a special exit survey to determine the reasons for leaving EMS. The likelihood of leaving the profession in the next year was low for both EMT-Basics and Paramedics. Although overall satisfaction levels with the profession were high, EMT-Basics were significantly more satisfied than Paramedics. The most important reasons for leaving the profession were choosing to pursue further education and moving to a new location. A desire for better pay and benefits was a significantly more important reason for EMT-Paramedics' exit decisions than for EMT-Basics. Given the anticipated increased demand for EMS professionals in the next decade, continued study of issues associated with retention is strongly recommended. Some specific recommendations and suggestions for promoting retention are provided. Blau G , Chapman SA . Why do Emergency Medical Services (EMS) professionals leave EMS? Prehosp Disaster Med. 2016;31(Suppl. 1):s105-s111.

  8. What Good Are Positive Emotions in Crises? A Prospective Study of Resilience and Emotions Following the Terrorist Attacks on the United States on September 11th, 2001

    PubMed Central

    Fredrickson, Barbara L.; Tugade, Michele M.; Waugh, Christian E.; Larkin, Gregory R.

    2009-01-01

    Extrapolating from B. L. Fredrickson's (1998, 2001) broaden-and-build theory of positive emotions, the authors hypothesized that positive emotions are active ingredients within trait resilience. U.S. college students (18 men and 28 women) were tested in early 2001 and again in the weeks following the September 11th terrorist attacks. Mediational analyses showed that positive emotions experienced in the wake of the attacks— gratitude, interest, love, and so forth—fully accounted for the relations between (a) precrisis resilience and later development of depressive symptoms and (b) precrisis resilience and postcrisis growth in psychological resources. Findings suggest that positive emotions in the aftermath of crises buffer resilient people against depression and fuel thriving, consistent with the broaden-and-build theory. Discussion touches on implications for coping. PMID:12585810

  9. What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001.

    PubMed

    Fredrickson, Barbara L; Tugade, Michele M; Waugh, Christian E; Larkin, Gregory R

    2003-02-01

    Extrapolating from B. L. Fredrickson's (1998, 2001) broaden-and-build theory of positive emotions, the authors hypothesized that positive emotions are active ingredients within trait resilience. U.S. college students (18 men and 28 women) were tested in early 2001 and again in the weeks following the September 11th terrorist attacks. Mediational analyses showed that positive emotions experienced in the wake of the attacks--gratitude, interest, love, and so forth--fully accounted for the relations between (a) precrisis resilience and later development of depressive symptoms and (b) precrisis resilience and postcrisis growth in psychological resources. Findings suggest that positive emotions in the aftermath of crises buffer resilient people against depression and fuel thriving, consistent with the broaden-and-build theory. Discussion touches on implications for coping.

  10. What evidence exists for initiatives to reduce risk and incidence of sexual violence in armed conflict and other humanitarian crises? A systematic review.

    PubMed

    Spangaro, Jo; Adogu, Chinelo; Ranmuthugala, Geetha; Powell Davies, Gawaine; Steinacker, Léa; Zwi, Anthony

    2013-01-01

    Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings

  11. What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review

    PubMed Central

    Spangaro, Jo; Adogu, Chinelo; Ranmuthugala, Geetha; Powell Davies, Gawaine; Steinacker, Léa; Zwi, Anthony

    2013-01-01

    Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings

  12. Identified EM Earthquake Precursors

    NASA Astrophysics Data System (ADS)

    Jones, Kenneth, II; Saxton, Patrick

    2014-05-01

    Many attempts have been made to determine a sound forecasting method regarding earthquakes and warn the public in turn. Presently, the animal kingdom leads the precursor list alluding to a transmission related source. By applying the animal-based model to an electromagnetic (EM) wave model, various hypotheses were formed, but the most interesting one required the use of a magnetometer with a differing design and geometry. To date, numerous, high-end magnetometers have been in use in close proximity to fault zones for potential earthquake forecasting; however, something is still amiss. The problem still resides with what exactly is forecastable and the investigating direction of EM. After a number of custom rock experiments, two hypotheses were formed which could answer the EM wave model. The first hypothesis concerned a sufficient and continuous electron movement either by surface or penetrative flow, and the second regarded a novel approach to radio transmission. Electron flow along fracture surfaces was determined to be inadequate in creating strong EM fields, because rock has a very high electrical resistance making it a high quality insulator. Penetrative flow could not be corroborated as well, because it was discovered that rock was absorbing and confining electrons to a very thin skin depth. Radio wave transmission and detection worked with every single test administered. This hypothesis was reviewed for propagating, long-wave generation with sufficient amplitude, and the capability of penetrating solid rock. Additionally, fracture spaces, either air or ion-filled, can facilitate this concept from great depths and allow for surficial detection. A few propagating precursor signals have been detected in the field occurring with associated phases using custom-built loop antennae. Field testing was conducted in Southern California from 2006-2011, and outside the NE Texas town of Timpson in February, 2013. The antennae have mobility and observations were noted for

  13. EPA LABORATORIES IMPLEMENT EMS PROGRAM

    EPA Science Inventory

    This paper highlights the breadth and magnitude of carrying out an effective Environmental Management System (EMS) program at the U.S. EPA's research and development laboratories. Federal research laboratories have unique operating challenges compared to more centralized industr...

  14. Formulation and in vitro evaluation of a fast-disintegrating/sustained dual release bucoadhesive bilayer tablet of captopril for treatment of hypertension crises

    PubMed Central

    Abbasi, Sahar; Yousefi, Gholamhossein; Ansari, Ali Asghar; Mohammadi-Samani, Soliman

    2016-01-01

    Hypertension crisis is one of the main health problems and its effective treatment is of high importance. For this purpose, fast-disintegrating and sustained release formulations of captopril, as a drug of choice, were prepared using conventional mucoadhesive polymers hydroxypropyl methylcellulose (HPMC), sodium carboxymethyl cellulose (Na-CMC), hydroxypropyl cellulose (HPC), Carbopol 934 (CP934) and sodium alginate (Na-alg). The optimum sustained release formulations were selected based on mean dissolution time (MDT). The swellability and mucoadhesive properties of selected formulations were assessed and compared. A direct relationship between swelling and release rates/adhesiveness of sustained release formulations was observed. The results showed that formulations containing combination of CP934 and cellulose-based polymers had the highest swellability, sustainability and adhesion strength. These formulations prolonged drug release up to 8 h showing good fitness to Korsemeyer-Peppas model. Moreover, the adopted fast-disintegrating tablet could release up to 100% of drug within 3 min in oral pH. Finally, a dual fast-disintegrating/sustained release bucoadhesive bilayer tablet consisting of optimized formulations was prepared releasing 30% of the drug initially within 15 min and the remaining up to 8 h which could be considered as an appropriate formulation for the treatment of hypertension crises. PMID:27651807

  15. Which side of the balance determines the frequency of vaso-occlusive crises in children with sickle cell anemia: Blood viscosity or microvascular dysfunction?

    PubMed

    Charlot, Keyne; Romana, Marc; Moeckesch, Berenike; Jumet, Stéphane; Waltz, Xavier; Divialle-Doumdo, Lydia; Hardy-Dessources, Marie-Dominique; Petras, Marie; Tressières, Benoît; Tarer, Vanessa; Hue, Olivier; Etienne-Julan, Maryse; Antoine-Jonville, Sophie; Connes, Philippe

    2016-01-01

    Vascular resistance and tissue perfusion may be both affected by impaired vascular function and increased blood viscosity. Little is known about the effects of vascular function on the occurrence of painful vaso-occlusive crises (VOC) in children with sickle cell anemia (SCA). The aim of the present study was to determine which side of the balance (blood viscosity or vascular function) is the most deleterious in SCA and increases the risk for frequent hospitalized VOC. Microvascular function, microcirculatory oxygenation and blood viscosity were determined in a group of 22 SCA children/adolescents at steady state and a group of 13 healthy children/adolescents. Univariate analyses demonstrated blunted microvascular reactivity during local thermal heating test and decreased microcirculatory oxygenation in SCA children compared to controls. Multivariate analysis revealed that increased blood viscosity and decreased microcirculatory oxygenation were independent risk factors of frequent VOC in SCA. In contrast, the level of microvascular dysfunction does not predict VOC rate. In conclusion, increased blood viscosity is usually well supported in healthy individuals where vascular function is not impaired. However, in the context of SCA, microvascular function is impaired and any increase of blood viscosity or decrease in microcirculatory oxygenation would increase the risks for frequent VOC.

  16. Low-molecular-weight heparins for managing vasoocclusive crises in people with sickle cell disease: a summary of a cochrane systematic review.

    PubMed

    van Zuuren, Esther J; Fedorowicz, Zbys

    2014-01-01

    We summarize a Cochrane systematic review that was conducted to assess the effects of low-molecular-weight heparins (LMWH) for managing vasoocclusive crises (VOC) in people with sickle cell disease. Sickle cell disease is one of the most common and severe genetic disorders in the world. It can be divided into three broadly distinct clinical phenotypes characterized by either hemolysis, pain syndromes or organ damage. Pain is the most prominent symptom of vasoocclusion, and hypercoagulability is a well-established pathogenic phenomenon in people with sickle cell disease. Searches included the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, abstract books of conference proceedings and several online trials registries (December 2012). One study (with an overall unclear to high risk of bias) comprising 253 participants was included. This study provided limited data, but concluded that tinzaparin resulted in a more rapid resolution of pain, and in a statistically significant lower number of hospitalization days compared to a placebo. Two minor bleeding events were reported as adverse events in the tinzaparin group. Based on the results from this single study, there is incomplete evidence to either support or refute the effectiveness of LMWH in people with sickle cell disease.

  17. Managing Community Resilience to Climate Extremes, Rapid Unsustainable Urbanization, Emergencies of Scarcity, and Biodiversity Crises by Use of a Disaster Risk Reduction Bank.

    PubMed

    Canyon, Deon V; Burkle, Frederick M; Speare, Rick

    2015-12-01

    Earth's climate is changing and national and international decision-makers are recognizing that global health security requires urgent attention and a significant investment to protect the future. In most locations, current data are inadequate to conduct a full assessment of the direct and indirect health impacts of climate change. All states require this information to evaluate community-level resilience to climate extremes and climate change. A model that is being used successfully in the United Kingdom, Australia, and New Zealand is recommended to generate rapid information to assist decision-makers in the event of a disaster. The model overcomes barriers to success inherent in the traditional ''top-down'' approach to managing crises and recognizes the capacity of capable citizens and community organizers to facilitate response and recovery if provided the opportunity and resources. Local information is a prerequisite for strategic and tactical statewide planning. Time and resources are required to analyze risks within each community and what is required to prevent (mitigate), prepare, respond, recover (rehabilitate), anticipate, and assess any threatening events. Specific requirements at all levels from state to community must emphasize community roles by focusing on how best to maintain, respond, and recover public health protections and the infrastructure necessary for health security.

  18. CHESS: a computer-based system for providing information, referrals, decision support and social support to people facing medical and other health-related crises.

    PubMed

    Gustafson, D H; Bosworth, K; Hawkins, R P; Boberg, E W; Bricker, E

    1992-01-01

    CHESS (the Comprehensive Health Enhancement Support System) is an interactive, computer-based system to support people facing health-related crises or concerns. CHESS provides information, referral to service providers, support in making tough decisions and networking to experts and others facing the same concerns. CHESS will improve access to health and human services for people who would otherwise face psychological, social, economic or geographic barriers to receiving services. CHESS has developed programs in five specific topic areas: Academic Crisis, Adult Children of Alcoholics, AIDS/HIV Infection, Breast Cancer and Sexual Assault. The lessons learned, and the structures developed, will serve as a model for future implementation of CHESS programs in a broad range of other topic areas. CHESS is designed around three major desired outcomes: 1) improving the emotional health status of users; 2) increasing the cost-effective use of health and human services; and 3) reducing the incidence of risk-taking behaviors that can lead to injury or illness. Pilot-testing and initial analysis of controlled evaluation data has shown that CHESS is extensively used, is useful and easy-to-use, and produces positive emotional outcomes. Further evaluation in continuing.

  19. Hypertensive crises in quadriplegic patients. Changes in cardiac output, blood volume, serum dopamine-beta-hydroxylase activity, and arterial prostaglandin PGE2.

    PubMed

    Naftchi, N E; Demeny, M; Lowman, E W; Tuckman, J

    1978-02-01

    The syndrome of autonomic dysreflexia often occurs in quadriplegic subjects and is characterized by paroxysmal hypertension, headache, vasoconstriction below and flushing of the skin above the level of transection, and bradycardia. These attacks may cause hypertnesive encephalopathy, cerebral vascular accidents, and death. In five patients during crises, the mean arterial pressure changed from 95 to 154 mm Hg, heart rate 72 to 45 beats/min, cardiac output 4.76 to 4.70 L/min, and peripheral resistance 1650 to 2660 dynes.sec.cm-5. In eight subjects the control plasma, red cell, and total blood volumes were 19.1, 10.5, and 29.6 ml/cm body height, respectively, and when hypertensive, the plasma protein concentration increased by 9.9% and the hematocrit by 9.5%. Plasma volume was only reduced by an estimated 10-15%. At that time, arterial dopamine-beta-hydroxylase (DbetaH) activity increased 65% and prostaglandin E2 concentration by 68%. Thus, the augmented DbetaH activity presented primarily an elevated sympathetic tone and not hemoconcentration of that protein. The rise in prostaglandin may contribute to the severe headaches during hypertensive episodes.

  20. [Insanity, life crises and longing for a "real life". On the discussion of deviant behavior and mental disorders in psychiatry of the 19th and 20th century].

    PubMed

    Kanis-Seyfried, Uta

    On insanity, life crises and the longing for a "right life". A contribution to the discussion on the deviant behavior and mental disorders in the psychiatry of the 19th and 20th centuries using the example of patient stories. History of psychiatry, understood as social and cultural history, provides the framework for this micro-historical article. Using the example of three patients treated in Wuerttemberg or Baden psychiatric asylums between 1875 and 1912, the article focuses on the critical analysis of types of asylums, their practices of admissions, therapies and power relations between patients and staff. Ways of thinking and acting, subjective experiences and emotions are exemplified by patient records, personal testimonials and contemporary publications again by patients and staff. The article examines options of patients to influence the institutional daily asylum routine against the background of its complexity and dynamics. Borders, manipulations, malingering and querulous paranoia are at stake here. Furthermore, the article reflects various forms of social interaction with the power regulating therapeutic and disciplinary aspects against the backdrop of the "canons of rules" of the asylum as well as the contemporary political and legal framework.

  1. Busca de estruturas em grandes escalas em altos redshifts

    NASA Astrophysics Data System (ADS)

    Boris, N. V.; Sodrã©, L., Jr.; Cypriano, E.

    2003-08-01

    A busca por estruturas em grandes escalas (aglomerados de galáxias, por exemplo) é um ativo tópico de pesquisas hoje em dia, pois a detecção de um único aglomerado em altos redshifts pode por vínculos fortes sobre os modelos cosmológicos. Neste projeto estamos fazendo uma busca de estruturas distantes em campos contendo pares de quasares próximos entre si em z Â3 0.9. Os pares de quasares foram extraídos do catálogo de Véron-Cetty & Véron (2001) e estão sendo observados com os telescópios: 2,2m da University of Hawaii (UH), 2,5m do Observatório de Las Campanas e com o GEMINI. Apresentamos aqui a análise preliminar de um par de quasares observado nos filtros i'(7800 Å) e z'(9500 Å) com o GEMINI. A cor (i'-z') mostrou-se útil para detectar objetos "early-type" em redshifts menores que 1.1. No estudo do par 131046+0006/J131055+0008, com redshift ~ 0.9, o uso deste método possibilitou a detecção de sete objetos candidatos a galáxias "early-type". Num mapa da distribuição projetada dos objetos para 22 < i' < 25 observou-se que estas galáxias estão localizadas próximas a um dos quasares e há indícios de que estejam aglomeradas dentro de um área de ~ 6 arcmin2. Se esse for o caso, estes objetos seriam membros de uma estrutura em grande escala. Um outro argumento em favor dessa hipótese é que eles obedecem uma relação do tipo Kormendy (raio equivalente X brilho superficial dentro desse raio), como a apresentada pelas galáxias elípticas em z = 0.

  2. Raízes pós-mitológicas da Astronomia Clássica

    NASA Astrophysics Data System (ADS)

    di Bartolo, L.; Villas da Rocha, J. F.

    2004-02-01

    Apresentamos como a invenção de um modelo astronômico e cosmológico fundado em causas naturais foi um processo gestado num ambiente cultural específico, o do advento do pensamento pós-mitológico, que tem como sua raiz mais funda a trajetória particular da Grécia Antiga, com ênfase na resolução de uma grave crise social e a evolução do mundo clássico para o contexto espiritual de um império universal.

  3. Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement.

    PubMed

    Guinchat, Vincent; Cravero, Cora; Diaz, Lautaro; Périsse, Didier; Xavier, Jean; Amiet, Claire; Gourfinkel-An, Isabelle; Bodeau, Nicolas; Wachtel, Lee; Cohen, David; Consoli, Angèle

    2015-03-01

    During adolescence, some individuals with autism spectrum disorder (ASD) engage in severe challenging behaviors, such as aggression, self-injury, disruption, agitation and tantrums. We aimed to assess risk factors associated with very acute behavioral crises in adolescents with ASD admitted to a dedicated neurobehavioral unit. We included retrospectively in 2008 and 2009 29 adolescents and young adults with ASD hospitalized for severe challenging behaviors and proposed a guideline (Perisse et al., 2010) that we applied prospectively for 29 patients recruited for the same indications between 2010 and 2012. In total, 58 patients were admitted (n=70 hospitalizations, mean age=15.66 (±4.07) years, 76% male). We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), comorbid organic conditions, etiologic diagnosis of the episode, and treatments. We explored predictors of Global Assessment Functioning Scale (GAFS) score and duration of hospitalization at discharge. All but 2 patients exhibited severe autistic symptoms and intellectual disability (ID), and two-thirds had no functional verbal language. During the inpatient stay (mean=84.3 (±94.9) days), patients doubled on average their GAFS scores (mean=17.66 (±9.05) at admission vs. mean=31.4 (±9.48) at discharge). Most common etiologies for acute behavioral crises were organic causes [n=20 (28%), including epilepsy: n=10 (14%) and painful medical conditions: n=10 (14%)], environmental causes [n=17 (25%) including lack of treatment: n=11 (16%) and adjustment disorder: n=6 (9%)], and non-ASD psychiatric condition [n=33 (48%) including catatonia: n=5 (7%), major depressive episode: n=6 (9%), bipolar disorder: n=4 (6%), schizophrenia: n=6 (9%), other/unknown diagnosis: n=12 (17%)]. We found no influence of age, gender, socio-economic status, migration, level of ID, or history of seizure on improvement of GAFS score at discharge

  4. Early crisis nontechnical skill teaching in residency leads to long-term skill retention and improved performance during crises: A prospective, nonrandomized controlled study.

    PubMed

    Doumouras, Aristithes G; Engels, Paul T

    2017-07-01

    Medical error is common in crises, and the majority of observed errors are nontechnical in nature. The long-term impact of teaching crisis nontechnical skills to residents has not been evaluated. The objective of this study was to determine the effect of simulation-based teaching of crisis nontechnical skills compared to controls one year after initial teaching. This was a prospective study using both historical controls and a before-and-after methodology to evaluate the effect of a high-fidelity simulation curriculum that used crisis resource management principles to teach nontechnical skills. Postgraduate year 2 and 3 residents were invited to take part in a prospective training course over 2 years. The primary outcome was leader performance evaluated by expert raters using the previously validated 7-point Ottawa Global Rating Scale. Overall, 23 residents performed 30 simulations over the 2 years with the intervention group of 7 residents being assessed in both years. After adjustment, the postgraduate year 3 intervention group who received training the previous year had significantly higher overall performance scores than all postgraduate year 2 scores (1.09 95% confidence interval 0.70-1.47, P < .001) and the historical postgraduate year 3 cohort who received no prior training (1.20, 95% confidence interval 0.37-2.03, P = .005). There was no decay of skills noted over the course of the study. Postgraduate year 3 residents who had prior training had significantly improved crisis performance compared to historical postgraduate year 3 controls and untrained postgraduate year 2 residents. There were no significant differences between the crisis performance of postgraduate year 2 residents and the untrained postgraduate year 3 controls. This confirms the beneficial effect and long-term retention after crisis nontechnical skill training. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The Campi Flegrei caldera: historical revision and new data on seismic crises, bradyseisms, the Monte Nuovo eruption and ensuing earthquakes (twelfth century 1582 uc(ad))

    NASA Astrophysics Data System (ADS)

    Guidoboni, Emanuela; Ciuccarelli, Cecilia

    2010-12-01

    This paper presents the results of a systematic historical study of the seismic, bradyseismic and eruptive activity of the Campi Flegrei caldera. The aim is to make a revised historical data available for accurate volcanological interpretation, supplying additional data and highlighting spurious previous data. The analysis begins with the supposed 1198 eruption, which did not actually take place. No information is available for the thirteenth and fourteenth centuries. As far as the fifteenth and sixteenth centuries are concerned, only direct sources were examined for this paper, and they include many different types of evidence. The chronological breadth of the analysis has also provided information about the seismic crises and bradyseisms prior to the eruption of 1538. The exceptional nature of this 1538 eruption attracted the attention of intellectuals, diplomats and natural philosophers, who left valuable accounts, which we have analysed, and which include many that are still available in their original manuscript form. The previous studies concerning the 1538 eruption were based on 23 (variously used) sources. We have examined 35 additional sources bringing the overall corpus of sources analysed to 58. The results provide a more precise scenario of events preceding the 1538 eruption, including bradyseismic activity starting from the end of the fifteenth century. The chronology of the phenomena described comprises the core result of this study, and has been constructed so as to clarify the time, location and impact of each event. For the 1538 eruption, a countdown is included which may also have a predictive value. For the last 36 hours before eruption began, the countdown is hour-by-hour. The effects of the eruption and earthquakes on people, structures and society are also described for Pozzuoli, Agnano and Naples. The areas where heavy materials and ash fell are likewise indicated, as well are the earth tremors felt by the population from the eruptive crisis

  6. The Campi Flegrei caldera: historical revision and new data on seismic crises, bradyseisms, the Monte Nuovo eruption and ensuing earthquakes (twelfth century 1582 AD)

    NASA Astrophysics Data System (ADS)

    Guidoboni, Emanuela; Ciuccarelli, Cecilia

    2011-08-01

    This paper presents the results of a systematic historical study of the seismic, bradyseismic and eruptive activity of the Campi Flegrei caldera. The aim is to make a revised historical data available for accurate volcanological interpretation, supplying additional data and highlighting spurious previous data. The analysis begins with the supposed 1198 eruption, which did not actually take place. No information is available for the thirteenth and fourteenth centuries. As far as the fifteenth and sixteenth centuries are concerned, only direct sources were examined for this paper, and they include many different types of evidence. The chronological breadth of the analysis has also provided information about the seismic crises and bradyseisms prior to the eruption of 1538. The exceptional nature of this 1538 eruption attracted the attention of intellectuals, diplomats and natural philosophers, who left valuable accounts, which we have analysed, and which include many that are still available in their original manuscript form. The previous studies concerning the 1538 eruption were based on 23 (variously used) sources. We have examined 35 additional sources bringing the overall corpus of sources analysed to 58. The results provide a more precise scenario of events preceding the 1538 eruption, including bradyseismic activity starting from the end of the fifteenth century. The chronology of the phenomena described comprises the core result of this study, and has been constructed so as to clarify the time, location and impact of each event. For the 1538 eruption, a countdown is included which may also have a predictive value. For the last 36?| hours before eruption began, the countdown is hour-by-hour. The effects of the eruption and earthquakes on people, structures and society are also described for Pozzuoli, Agnano and Naples. The areas where heavy materials and ash fell are likewise indicated, as well are the earth tremors felt by the population from the eruptive

  7. Adrenal Insufficiency in Australia: Is it Possible that the Use of Lower Dose, Short-Acting Glucocorticoids has Increased the Risk of Adrenal Crises?

    PubMed

    Rushworth, R L; Torpy, D J

    2015-06-01

    Morbidity from adrenal insufficiency (AI) in Australia is poorly described. The objective of this study was to evaluate AI morbidity patterns in adults between 1999/2000 and 2011/2012 using national databases. A descriptive study of hospitalisations for AI and adrenal crises (AC) in adults and trends in prescriptions for 2 short-acting glucocorticoids (GC) was designed. The setting was the Australian healthcare system. Main outcome measures are the trends in hospitalisation and prescription rates. There were 7,378 hospital admissions for treatment of AI in adults between 1999/00 and 2011/12. Of these, 29.5% were for an AC. Admission rates for AC increased from 9.5 to 12.4 admissions/10(6)/year (p < 0.05). There was a 5.8% decrease in admission rates for AI (excluding AC), from 27.0 to 25.5/10(6)/year (p = ns). Short-acting GC [hydrocortisone (HCT) and cortisone acetate (CA)] prescription rates increased significantly (p < 0.001) from 3,176.1/10(6) to 3,463.8/10(6). Prescription rates for CA decreased by 22.4% (p < 0.001) but HCT prescription rates increased to 77.1% (p < 0.001). The increase in AC admission rates was positively correlated with the rise in both the total GC prescription rate (r = 0.63, p < 0.05) and the HCT prescription rate (r = 0.74, p< 0.01). Over the 13-year study period, there was a 30.8% increase in hospitalisation rates for ACs and a concomitant 77.1% increase in prescribing of HCT. The association between AC events and HCT use and/or reduced effective GC dose is plausibly causal, but confirmatory studies are required before suggesting any change to GC replacement in AI. © Georg Thieme Verlag KG Stuttgart · New York.

  8. The European Mobile System (EMS)

    NASA Technical Reports Server (NTRS)

    Jongejans, A.; Rogard, R.; Mistretta, I.; Ananasso, F.

    1993-01-01

    The European Space Agency is presently procuring an L band payload in order to promote a regional European L band system coping with the specific needs of the European market. The payload, and the two communications systems to be supported, are described below. The potential market for EMS in Europe is discussed.

  9. Impacts of visitors on soil and vegetation of the recreational area "Nacimiento del Río Mundo" (Castilla-La Mancha, Spain).

    PubMed

    Andrés-Abellán, Manuela; Del Alamo, Javier Benayas; Landete-Castillejos, Tomás; López-Serrano, Francisco R; García-Morote, Francisco A; Del Cerro-Barja, Antonio

    2005-02-01

    This study examines the effects of recreational use on the soil and vegetation at a site of ecological importance (Nacimiento del Río Mundo, Albacete, Spain). The most visited sites showed increased soil compaction of approximately 50%, bare ground increase to 61 +/- 10% and a decrease in richness (from 25 +/- 2 to 15 +/- 2 species), diversity (from 4.0 +/- 0.1 to 2.7 +/- 0.4) and stratification of plant species (from 80 +/- 11 to 21 +/- 4%). The most visited sites had 90% less plant species as compared to the least visited. Intense use was associated with the presence of nitrophilous plant and vegetal species with a morphology adapted to heavy trampling. The recreational areas showed a distribution pattern of impact radiating outwards from the most used and degraded point. At the most visited point, "Los Chorros" (the spring of the river), the impact radiated outwards for about 20 m. A pilot experiment examining the effects of one-year restriction to visitors for access to a formerly impacted area showed a plant cover increase by anthropic and not by native species of 57 percent units.

  10. Cosmic muon induced EM showers in NO$\

    SciTech Connect

    Yadav, Nitin; Duyang, Hongyue; Shanahan, Peter; Mishra, Sanjib; Bhuyan, Bipul

    2016-11-15

    Here, the NuMI Off-Axis ve Appearance (NOvA) experiment is a ne appearance neutrino oscillation experiment at Fermilab. It identifies the ne signal from the electromagnetic (EM) showers induced by the electrons in the final state of neutrino interactions. Cosmic muon induced EM showers, dominated by bremsstrahlung, are abundant in NOvA far detector. We use the Cosmic Muon- Removal technique to get pure EM shower sample from bremsstrahlung muons in data. We also use Cosmic muon decay in flight EM showers which are highly pure EM showers.The large Cosmic-EM sample can be used, as data driven method, to characterize the EM shower signature and provides valuable checks of the simulation, reconstruction, particle identification algorithm, and calibration across the NOvA detector.

  11. Correlation of the NBME advanced clinical examination in EM and the national EM M4 exams.

    PubMed

    Hiller, Katherine; Miller, Emily S; Lawson, Luan; Wald, David; Beeson, Michael; Heitz, Corey; Morrissey, Thomas; House, Joseph; Poznanski, Stacey

    2015-01-01

    Since 2011 two online, validated exams for fourth-year emergency medicine (EM) students have been available (National EM M4 Exams). In 2013 the National Board of Medical Examiners offered the Advanced Clinical Examination in Emergency Medicine (EM-ACE). All of these exams are now in widespread use; however, there are no data on how they correlate. This study evaluated the correlation between the EM-ACE exam and the National EM M4 Exams. From May 2013 to April 2014 the EM-ACE and one version of the EM M4 exam were administered sequentially to fourth-year EM students at five U.S. medical schools. Data collected included institution, gross and scaled scores and version of the EM M4 exam. We performed Pearson's correlation and random effects linear regression. 305 students took the EM-ACE and versions 1 (V1) or 2 (V2) of the EM M4 exams (281 and 24, respectively) [corrected].The mean percent correct for the exams were as follows: EM-ACE 74.9 (SD-9.82), V1 83.0 (SD-6.39), V2 78.5 (SD-7.70) [corrected]. Pearson's correlation coefficient for the V1/EM-ACE was 0.53 (0.43 scaled) and for the V2/EM-ACE was 0.58 (0.41 scaled) [corrected]. The coefficient of determination for V1/ EM-ACE was 0.73 and for V2/EM-ACE 0.71 (0.65 and .49 for scaled scores) [ERRATUM]. The R-squared values were 0.28 and 0.30 (0.18 and 0.13 scaled), respectively [corrected]. There was significant cluster effect by institution. There was moderate positive correlation of student scores on the EM-ACE exam and the National EM M4 Exams.

  12. 3.3 Ga SHRIMP U-Pb zircon age of a felsic metavolcanic rock from the Mundo Novo greenstone belt in the São Francisco craton, Bahia (NE Brazil)

    NASA Astrophysics Data System (ADS)

    Peucat, J. J.; Mascarenhas, J. F.; Barbosa, J. S. F.; de Souza, S. L.; Marinho, M. M.; Fanning, C. M.; Leite, C. M. M.

    2002-07-01

    Felsic metavolcanics associated with supracrustal rocks provide U-Pb zircon and Sm-Nd TDM ages of approximately 3.3 Ga, which establish an Archean age of the Mundo Novo greenstone belt. A granodioritic gneiss from the Mairi complex, located on the eastern boundary of the Mundo Novo greenstone belt, exhibits a zircon evaporation minimum age of 3.04 Ga and a Nd model age of 3.2 Ga. These results constrain the occurrence of at least three major geological units in this area: the Archean Mundo Novo greenstone belt, the Archean Mairi gneisses, and the adjoining Paleoproterozoic (<2.1 Ga) Jacobina sedimentary basin. The Jacobina basin follows the same trend as the Archean structure, extending southward to the Contendas-Mirante belt, in which a similar Archean-Paleoproterozoic association appears. We postulate that during the Paleoproterozoic in the eastern margin of the Gavião block, these Archean greenstone belts constituted a zone of weakness along which a late-stage orogenic sedimentary basin developed.

  13. Cenozoic evolution of the Pamir plateau recorded in surrounding basins, implications on Asian climate, land-sea distribution and biotic crises

    NASA Astrophysics Data System (ADS)

    Dupont Nivet, G.; Yang, W.; Blayney, T.; Bougeois, L.; Manceau, C.; Najman, Y.; Proust, J. N.; Guo, Z.; Grothe, A.; Mandic, O.; Fioroni, C.

    2014-12-01

    The Cenozoic Pamir orogen formed in response to the India-Asia collision. Existing datasets shows that the range grew since ca. 25 Ma, however the early Cenozoic history remains unconstrained. In that period, global climate changed from greenhouse to icehouse, the proto-Paratethys sea retreated out of Asia and continental aridification as well as monsoons established over Asia. These environmental changes are held responsible for major floral and faunal crises. However, the causal relationships between these events remains to be established because of the lack of accurate age constraints on their geological records. Here, we provide well-dated stratigraphic records using magneto- and bio-stratigraphy from the basins surrounding the Pamir. Southeast of the Pamir, along the Kunlun Shan into the southwestern Tarim Basin, Eocene marine deposits are continuously overlain by 41 to 15 Ma continental redbeds themselves overlain by conglomerates in a classic foreland sequence with upward increasing grain-size, accumulation rates and provenance proximity. However, North of the Pamir along the southwestern Tian Shan and West of the Pamir into the Afghan-Tadjik Basin, the entire Oligocene period appears to be missing from the record between the last marine and the first continental sediments dated to the Early Miocene. This supports a simple model in response to initial Eocene Pamir indentation with foreland basin activation in the Southeast related to the Kunlun Shan northward thrusting, followed much later by early Miocene activation of the northern foreland basin related to the southwestern Tian Shan overthrusting. The coeval activation of a lithospheric right-lateral strike-slip system along the Pamir/Tarim boundary may have enabled to transfer deformation from the India-Asia collision to the Tian Shan and possibly the Talas Fergana fault. This simple model suggests the following two-stage paleoenvironmental evolution: (1) Late Eocene sea retreat linked to the onset of

  14. Responding to School Health Crises

    ERIC Educational Resources Information Center

    Gomes, Patricia; Smith, Mary

    2007-01-01

    Today's school administrators face an increasing array of duties. Potentially one of the most serious responsibilities is student health services. It is estimated that 20% to 30% of all school-aged children in the U.S. have a health condition that may require monitoring. A survey of 60 new teachers in a medium-sized school district in California…

  15. Men in Crises: The Widower.

    ERIC Educational Resources Information Center

    Burgess, Jane

    The most critical problems faced by widowers include: (1) dealing with the emotional stress of grief and loneliness; (2) re-establishing identity as a single man; (3) recognizing emotional needs; and (4) coping with the stress of role transition. Unlike the widow, the widower goes through the grieving process alone; he needs help in developing…

  16. Hyperdopaminergic crises in familial dysautonomia

    PubMed Central

    Norcliffe-Kaufmann, Lucy; Martinez, Jose; Axelrod, Felicia

    2013-01-01

    Objective: The purpose of this study was to determine whether carbidopa (Lodosyn), an inhibitor of dopa-decarboxylase that blocks the synthesis of dopamine outside the brain, is an effective antiemetic in patients with familial dysautonomia (FD) and hyperdopaminergic nausea/retching/vomiting attacks. Methods: We enrolled 12 patients with FD in an open-label titration and treatment study to assess the safety of carbidopa. We then conducted a randomized, double-blind, placebo-controlled, crossover study to evaluate its antiemetic efficacy. Results: Previous fundoplication surgery in each patient studied prevented vomiting, but all of the subjects experienced severe cyclical nausea and uncontrollable retching that was refractory to standard treatments. Carbidopa at an average daily dose of 480 mg (range 325–600 mg/day) was well tolerated. In the double-blind phase, patients experienced significantly less nausea and retching while on carbidopa than on placebo (p < 0.03 and p < 0.02, respectively). Twenty-four-hour urinary dopamine excretion was significantly lower while on carbidopa (147 ± 32 µg/gCr) than while on placebo (222 ± 41µg/gCr, p < 0.05). Conclusions: Carbidopa is a safe and effective antiemetic in patients with FD, likely by reducing the formation of dopamine outside the brain. Classification of evidence: This study provides Class II evidence that carbidopa is effective in reducing nausea/retching/vomiting in patients with FD. PMID:23553478

  17. Triangulating Information from Recurrent Crises

    ERIC Educational Resources Information Center

    Verte, Lotte; De Moor, Gerrit

    2013-01-01

    Life Space Crisis Intervention (LSCI) is a therapeutic, verbal strategy for intervention with students in crisis. It explores a student's reactions to stressful events to gain insight into thinking, feelings, and behavior in order to strengthen resilience and self-esteem (Long, Wood, & Fecser, 2001). By exploring timelines of challenging…

  18. Teacher Socialization through Career Crises.

    ERIC Educational Resources Information Center

    Gehrke, Nathalie J.; Taylor, Helen K.

    This study examined the nature of teacher layoffs and their effects on the role enactment and coping strategies of teachers. Fourteen high school teachers, who were employed in a large urban school district plagued by declining enrollment, were interviewed. Each teacher had been "riffed" (reduction in force) and recalled at least once in the…

  19. A Tale of Two Crises.

    ERIC Educational Resources Information Center

    Frymier, Jack

    1990-01-01

    According to these scenarios, the heart attack victim has a better chance of surviving than the child facing grade retention. Despite parental objections and research studies showing that children held back are three time as likely to drop out of school than children who are promoted, the antiquated practice of grade repetition continues. (MLH)

  20. Triangulating Information from Recurrent Crises

    ERIC Educational Resources Information Center

    Verte, Lotte; De Moor, Gerrit

    2013-01-01

    Life Space Crisis Intervention (LSCI) is a therapeutic, verbal strategy for intervention with students in crisis. It explores a student's reactions to stressful events to gain insight into thinking, feelings, and behavior in order to strengthen resilience and self-esteem (Long, Wood, & Fecser, 2001). By exploring timelines of challenging…

  1. Psychosocial Crises of Older Men.

    ERIC Educational Resources Information Center

    Solomon, Kenneth

    Retirement is a major issue facing the older American man. Not only must he give up his work, a source of identity and self-esteem, the retiree must also face new relationships with his spouse, children, and peers; and he must learn to use leisure time appropriately. Widowerhood is a second major issue. Aside from deep emotional loss, the widower…

  2. A Tale of Two Crises.

    ERIC Educational Resources Information Center

    Frymier, Jack

    1990-01-01

    According to these scenarios, the heart attack victim has a better chance of surviving than the child facing grade retention. Despite parental objections and research studies showing that children held back are three time as likely to drop out of school than children who are promoted, the antiquated practice of grade repetition continues. (MLH)

  3. Responding to School Health Crises

    ERIC Educational Resources Information Center

    Gomes, Patricia; Smith, Mary

    2007-01-01

    Today's school administrators face an increasing array of duties. Potentially one of the most serious responsibilities is student health services. It is estimated that 20% to 30% of all school-aged children in the U.S. have a health condition that may require monitoring. A survey of 60 new teachers in a medium-sized school district in California…

  4. Complaints against an EMS system.

    PubMed

    Colwell, Christopher B; Pons, Peter T; Pi, Randy

    2003-11-01

    Complaints against Emergency Medical Services (EMS) agencies represent a concerning and potentially time-consuming problem for all involved in the delivery of prehospital emergency medical care. The objective of this study was to identify the source of complaints against an EMS system to help focus quality and performance improvement and customer service efforts. We conducted a retrospective review of complaints filed against a busy urban EMS agency over a 6-year period. All complaints were included, totaled by season and by year, and categorized by originator and nature of the complaint. A total of 286 complaints were registered during the 6-year period, with an average of 48 per year and 9.3 per 10,000 responses. The most common originators of complaints were patients (53%) followed by medical personnel (19%) and family members or friends (12%). Rude behavior accounted for 23% of the complaints registered, followed by technical skills (20%), transport problems (18%), and loss of belongings (13%). The identification of areas of dissatisfaction will allow focused quality and performance improvement programs directed at customer service and risk management.

  5. Cosmic muon induced EM showers in NO$$\

    DOE PAGES

    Yadav, Nitin; Duyang, Hongyue; Shanahan, Peter; ...

    2016-11-15

    Here, the NuMI Off-Axis ve Appearance (NOvA) experiment is a ne appearance neutrino oscillation experiment at Fermilab. It identifies the ne signal from the electromagnetic (EM) showers induced by the electrons in the final state of neutrino interactions. Cosmic muon induced EM showers, dominated by bremsstrahlung, are abundant in NOvA far detector. We use the Cosmic Muon- Removal technique to get pure EM shower sample from bremsstrahlung muons in data. We also use Cosmic muon decay in flight EM showers which are highly pure EM showers.The large Cosmic-EM sample can be used, as data driven method, to characterize the EMmore » shower signature and provides valuable checks of the simulation, reconstruction, particle identification algorithm, and calibration across the NOvA detector.« less

  6. The Empathic Operating System (emOS)

    DTIC Science & Technology

    2016-06-15

    The Empathic Operating System ( emOS ) Physiological measurements have typically been limited to expensive and cumbersome clinical research equipment...Report: The Empathic Operating System ( emOS ) Report Title Physiological measurements have typically been limited to expensive and cumbersome clinical...C-0043 Proposal number: 62850-LS-DRP Project title: “The Empathic Operating System ( emOS )” Contract performance period: January 1, 2016 – April 7

  7. DOE/EM Criticality Safety Needs Assessment

    SciTech Connect

    Westfall, Robert Michael; Hopper, Calvin Mitchell

    2011-02-01

    The issue of nuclear criticality safety (NCS) in Department of Energy Environmental Management (DOE/EM) fissionable material operations presents challenges because of the large quantities of material present in the facilities and equipment that are committed to storage and/or material conditioning and dispositioning processes. Given the uncertainty associated with the material and conditions for many DOE/EM fissionable material operations, ensuring safety while maintaining operational efficiency requires the application of the most-effective criticality safety practices. In turn, more-efficient implementation of these practices can be achieved if the best NCS technologies are utilized. In 2002, DOE/EM-1 commissioned a survey of criticality safety technical needs at the major EM sites. These needs were documented in the report Analysis of Nuclear Criticality Safety Technology Supporting the Environmental Management Program, issued May 2002. Subsequent to this study, EM safety management personnel made a commitment to applying the best and latest criticality safety technology, as described by the DOE Nuclear Criticality Safety Program (NCSP). Over the past 7 years, this commitment has enabled the transfer of several new technologies to EM operations. In 2008, it was decided to broaden the basis of the EM NCS needs assessment to include not only current needs for technologies but also NCS operational areas with potential for improvements in controls, analysis, and regulations. A series of NCS workshops has been conducted over the past years, and needs have been identified and addressed by EM staff and contractor personnel. These workshops were organized and conducted by the EM Criticality Safety Program Manager with administrative and technical support by staff at Oak Ridge National Laboratory (ORNL). This report records the progress made in identifying the needs, determining the approaches for addressing these needs, and assimilating new NCS technologies into EM

  8. EMS provider determinations of necessity for transport and reimbursement for EMS response, medical care, and transport: combined resource document for the National Association of EMS Physicians position statements.

    PubMed

    Millin, Michael G; Brown, Lawrence H; Schwartz, Brian

    2011-01-01

    With increasing demands for emergency medical services (EMS), many EMS jurisdictions are utilizing EMS provider-initiated nontransport policies as a method to offload potentially nonemergent patients from the EMS system. EMS provider determination of medical necessity, resulting in nontransport of patients, has the potential to avert unnecessary emergency department visits. However, EMS systems that utilize these policies must have additional education for the providers, a quality improvement process, and active physician oversight. In addition, EMS provider determination of nontransport for a specific situation should be supported by evidence in the peer-reviewed literature that the practice is safe. Further, EMS systems that do not utilize these programs should not be financially penalized. Payment for EMS services should be based on the prudent layperson standard. EMS systems that do utilize nontransport policies should be appropriately reimbursed, as this represents potential cost savings to the health care system.

  9. School Budget Hold'em Facilitator's Guide

    ERIC Educational Resources Information Center

    Education Resource Strategies, 2012

    2012-01-01

    "School Budget Hold'em" is a game designed to help school districts rethink their budgeting process. It evolved out of Education Resource Strategies' (ERS) experience working with large urban districts around the country. "School Budget Hold'em" offers a completely new approach--one that can turn the budgeting process into a long-term visioning…

  10. EM Cep: The Be Star

    NASA Astrophysics Data System (ADS)

    Kochiashvili, N.; Kochiashvili, I.; Natsvlishvili, R.; Vardosanidze, M.; Beradze, S.

    2017-07-01

    On the basis of UBVR photometric data, obtained in the Abastumani Observatory during 1991-1999, very interesting and unusual flare of EM Cep has been revealed. Duration of the flare was over two hours. We estimated the percentage of brightness increase during the flare and brightness decrease of the corresponding anti- flare and the minimum amount of the lost mass during this event. We have solved the light curves of the star using the Wilson-Devinney code. But the resulting fraction of calculated brightness of the companion star was not in accordance with spectral data. Then we decided to check the idea of a pulsating single star using new spectral data. Together with our Buyrakan colleagues we obtained and analyzed spectra of the star. We could not find spectral lines of a companion star or any traces of the radial velocities using this data. Hence, we concluded that we need the higher resolution spectra for final resolution of the matter. On the basis of the latest spectral data of Bulgarian astronomers they concluded that EM Cep is a single star. This makes it possible to suggest, that the question of stellar pulsation could be solved using additional photometric observations.

  11. The EM algorithm in medical imaging.

    PubMed

    Kay, J

    1997-03-01

    This article outlines the statistical developments that have taken place in the use of the EM algorithm in emission and transmission tomography during the past decade or so. We discuss the statistical aspects of the modelling of the projection data for both the emission and transmission cases and define the relevant probability models. This leads to the use of the method of maximum likelihood as a means of estimating the relevant unknown parameters within a given region of a patient's body and to the use of the EM algorithm to compute the reconstruction. Various different types of EM algorithm are discussed, including the SAGE algorithms of Fessler and Hero. The limitations of the EM algorithm, per se, are covered and the need for regularization is stressed. A number of different methods for penalizing the likelihood are described and a number of algorithms for the computation of the penalized EM reconstruction are discussed.

  12. Side mounted EMS for aluminium scrap melters

    SciTech Connect

    Eidem, M.; Tallbaeck, G.; Hanley, P.J.

    1996-10-01

    Normally the electromagnetic stirrer (EMS) is placed below the furnace. However it has recently been found that the EMS can also be placed at the side of the furnace, still giving good stirring. This makes it possible to install EMS on most existing furnaces. The side-mounted EMS is compared with the standard bottom-mounted stirrer with respect to installation, melting time and flow pattern in the melt. The major conclusion is that a side-mounted EMS is practical and will give about as good a performance as the bottom-mounted. Melting time estimates are based upon 3-D fluid flow and heat transfer predictions in combination with a simplified scrap melting theory. Predicted melting times are in fair agreement with operational data for mechanically stirred and electromagnetically bottom stirred furnaces.

  13. The HAWK Federation and the Development of Black Adolescent Males: Toward a Solution to the Crises of America's Young Black Men. Testimony before the Select Committee on Children, Youth and Families. Congressional Hearings on America's Young Black Men: Isolated and in Trouble (Washington, D.C., July 25, 1989).

    ERIC Educational Resources Information Center

    Nobles, Wade W.

    Sources of the crises faced by young black men lie not in the young men, but in society which portrays them as stereotypes. Social conditions are at the root of the following problems of black males: (1) lowered life expectancy; (2) risk of criminality; (3) poor economic conditions; (4) inadequate education; (5) drugs and gang violence; and (6)…

  14. The HAWK Federation and the Development of Black Adolescent Males: Toward a Solution to the Crises of America's Young Black Men. Testimony before the Select Committee on Children, Youth and Families. Congressional Hearings on America's Young Black Men: Isolated and in Trouble (Washington, D.C., July 25, 1989).

    ERIC Educational Resources Information Center

    Nobles, Wade W.

    Sources of the crises faced by young black men lie not in the young men, but in society which portrays them as stereotypes. Social conditions are at the root of the following problems of black males: (1) lowered life expectancy; (2) risk of criminality; (3) poor economic conditions; (4) inadequate education; (5) drugs and gang violence; and (6)…

  15. EM International, July 1994, Volume 2

    SciTech Connect

    Not Available

    1994-10-01

    The Office of Environmental Management (EM) at the Department of Energy (DOE) is seeking out and leveraging foreign technology, data, and resources in keeping with EM`s mandate to protect public health and the environment through the safe and cost-effective remediation of the Department`s nuclear weapons sites. EM works closely with foreign governments, industry, and universities to obtain innovative environmental technologies, scientific and engineering expertise, and operations experience that will support EM`s objectives. Where appropriate, these international resources are used to manage the more urgent risks at our sites, secure a safe workplace, help build consensus on critical issues, and strengthen our technology development program. Through international agreements EM engages in cooperative exchange of information, technology, and individuals. Currently, we are managing agreements with a dozen countries in Europe, Latin America, and Asia. These agreements focus on environmental restoration, waste management, transportation of radioactive wastes, and decontamination and decommissioning. This publication contains the following articles: in situ remediation integrated program; in-situ characterization and inspection of tanks; multimedia environmental pollutant assessment system (MEPAS); LLNL wet oxidation -- AEA technology. Besides these articles, this publication covers: EU activities with Russia; technology transfer activities; and international organization activities.

  16. Project X RFQ EM Design

    SciTech Connect

    Romanov, Gennady; Hoff, Matthew; Li, Derun; Staples, John; Virostek, Steve; /LBNL

    2012-05-09

    Project X is a proposed multi-MW proton facility at Fermi National Accelerator Laboratory (FNAL). The Project X front-end would consist of an H- ion source, a low-energy beam transport (LEBT), a CW 162.5 MHz radio-frequency quadrupole (RFQ) accelerator, and a medium-energy beam transport (MEBT). Lawrence Berkeley National Laboratory (LBNL) and FNAL collaboration is currently developing the designs for various components in the Project X front end. This paper reports the detailed EM design of the CW 162.5 MHz RFQ that provides bunching of the 1-10 mA H- beam with acceleration from 30 keV to 2.1 MeV.

  17. NEIC Environmental Management System (EMS) Policy

    EPA Pesticide Factsheets

    National Enforcement Investigations Center (NEIC) Environmental Management System (EMS) Policy. Identification and management of actual and potential environmental impacts of operations and decisions for the purpose of continual improvement of performance

  18. EMS offshore. A new horizon for paramedics.

    PubMed

    Mallard, A S

    1991-10-01

    The difficulty in getting medical aid to offshore drilling platforms can be a source of life-threatening delays. Recently, some companies have charted new waters by actually stationing EMS crews on their rigs.

  19. How good can cryo-EM become?

    SciTech Connect

    Glaeser, Robert M.

    2015-12-30

    The suddenness with which single-particle cryo-electron microscopy (cryo-EM) has emerged as a method for determining high-resolution structures of biological macromolecules invites the questions, how much better can this technology get, and how fast is that likely to happen? While we can rightly celebrate the maturation of cryo-EM as a high-resolution structure-determination tool, I believe there still are many developments to look forward to.

  20. Reassessing training levels for prehospital EMS personnel.

    PubMed

    Briese, G L

    1983-01-01

    One of the major questions confronting prehospital care services today concerns determining the appropriate level of training for EMS personnel that will provide the most cost effective systems. Unfortunately there are no studies which assess this problem. Various communities have modified or expanded the roles of prehospital personnel beyond the traditional training of EMTs and paramedics. Continuing education and skills maintenance are ongoing problems faced by all EMS systems, which have been addressed in various ways by individual locales.

  1. SOFIS FTS EM test results

    NASA Astrophysics Data System (ADS)

    Soucy, Marc-Andre A.; Levesque, Luc E.; Tanii, Jun; Kawashima, Takahiro; Nakajima, Hideaki

    2003-04-01

    The Solar Occultation FTS for Inclined-orbit Satellite (SOFIS) is a solar occultation Fourier transform spectrometer developed by the Ministry of the Environment (MOE) in Japan for the Global Change Observation Mission-A1 (GCOM-A1) satellite. GCOM-A1 will be placed in a 650 km non-sun-synchronous orbit, with an inclination angle of 69 degrees. ABB-Bomem is a sub-contractor of NTSpace (NEC-Toshiba Space) for the design and manufacturing of the FTS Engineering Model of SOFIS. SOFIS measures the vertical profile of the atmospheric constituents with 0.2 cm-1 spectral resolution for the spectral range covering 3-13 μm. The atmospheric vertical resolution of SOFIS is 1 km. The target of SOFIS measurements is a global distribution of O3, HNO3, NO2, N2O, CH4, H2O, CO2, CFC-11, CFC-12, ClONO2, aerosol extinction, atmospheric pressure and temperature. NTSpace in Japan is the prime contractor of SOFIS. The spectrometer is an adapted version of the classical Michelson interferometer using an optimized optical layout and moving retro-reflectors. A solid-state laser diode operating at 1550 nm is used as metrology source of the interferometer. Its highly folded optical design results in a high performance instrument with a compact size. SOFIS FTS implements high performance control techniques to achieve outstanding speed stability of the moving mechanism. This paper describes the test activities of the SOFIS-FTS Engineering Model (EM) and preliminary results. The performances of the FTS are presented in terms of key parameters like signal-to-noise ratio, modulation efficiency and stability. Spectra acquired are shown and test methodology and analyses are presented. Lessons learned during assembly, integration and testing are described as well as improvements planned to be implemented in the Flight Model.

  2. EMS adaptation for climate change

    NASA Astrophysics Data System (ADS)

    Pan, C.; Chang, Y.; Wen, J.; Tsai, M.

    2010-12-01

    The purpose of this study was to find an appropriate scenario of pre-hospital transportation of an emergency medical service (EMS) system for burdensome casualties resulting from extreme climate events. A case of natural catastrophic events in Taiwan, 88 wind-caused disasters, was reviewed and analyzed. A sequential-conveyance method was designed to shorten the casualty transportation time and to promote the efficiency of ambulance services. A proposed mobile emergency medical center was first constructed in a safe area, but nearby the disaster area. The Center consists of professional medical personnel who process the triage of incoming patients and take care of casualties with minor injuries. Ambulances in the Center were ready to sequentially convey the casualties with severer conditions to an assigned hospital that is distant from the disaster area for further treatment. The study suggests that if we could construct a spacious and well-equipped mobile emergency medical center, only a small portion of casualties would need to be transferred to distant hospitals. This would reduce the over-crowding problem in hospital ERs. First-line ambulances only reciprocated between the mobile emergency medical center and the disaster area, saving time and shortening the working distances. Second-line ambulances were highly regulated between the mobile emergency medical center and requested hospitals. The ambulance service of the sequential-conveyance method was found to be more efficient than the conventional method and was concluded to be more profitable and reasonable on paper in adapting to climate change. Therefore, additional practical work should be launched to collect more precise quantitative data.

  3. Subdissociative intranasal ketamine plus standard pain therapy versus standard pain therapy in the treatment of paediatric sickle cell disease vaso-occlusive crises in resource-limited settings: study protocol for a randomised controlled trial

    PubMed Central

    Sawe, Hendry Robert; Mfinanga, Juma A; Nshom, Ernest; Helm, Ethan; Moore, Charity G; Runyon, Michael S; Reynolds, Stacy L

    2017-01-01

    Introduction Pediatric sickle cell disease, highly prevalent in sub-Saharan Africa, carries great morbidity and mortality risk. Limited resources and monitoring make management of acute vaso-occlusive crises challenging. This study aims to evaluate the efficacy and safety of subdissociative intranasal ketamine as a cheap, readily available and easily administered adjunct to standard pain therapy. We hypothesise that subdissociative, intranasal ketamine may significantly augment current approaches to pain management in resource-limited settings in a safe and cost-effective manner. Methods and analysis This is a multicentred, randomised, double-blind, placebo-controlled trial enrolling children 4–16 years of age with sickle cell disease and painful vaso-occlusive pain crises. Study sites include two sub-Saharan teaching and referral hospitals with acute intake areas. All patients receive standard analgesic therapy during evaluation. Patients randomised to the treatment arm receive 1 mg/kg intranasal ketamine at onset of therapy, while placebo arm participants receive volume-matched intranasal normal saline. All participants and clinical staff are blinded to the treatment allocation. Data will be analysed on an intention-to-treat basis. Primary endpoints are changes in self-report pain scales (Faces Pain Scale-Revised) at 30, 60 and 120 minutes and rates of adverse events. Secondary endpoints include hospital length of stay, total analgesia use and quality of life assessment 2–3 weeks postintervention. Ethics and dissemination The research methods for this study have been approved by the Cameroon Baptist Convention Health Board Institutional Review Board (IRB2015-07), the Tanzanian National Institute for Medical Research (NIMR/HQ/R.8a/Vol. IX/2299), Muhimbili National Hospital IRB (MNH/IRB/I/2015/14) and the Tanzanian Food and Drugs Authority (TFDA0015/CTR/0015/9). Data reports will be provided to the Data and Safety Monitoring Board (DSMB) periodically throughout

  4. Filter banks and the EM algorithm

    SciTech Connect

    Mair, B.A.; Carroll, R.B.; Anderson, J.M.M.

    1996-12-31

    In this paper, we present a wavelet based modification of the ML-EM algorithm for reconstructing positron emission tomography images. By using the filter bank implementation of the wavelet transform, this algorithm has the flexibility to incorporate a priori information, while maintaining the same computational complexity as the standard ML-EM algorithm. Thus, it has a significant computational advantage over usual Bayesian methods. It differs from recent wavelet-based Bayesian methods as it achieves {open_quotes}regularization{close_quotes} by an adaptive, wavelet-based method of thresholding which minimizes Stein`s Unbiased Estimate of Risk. The basic method consists of applying Donoho and Johnstone`s SureShrink wavelet denoising of the Poisson data, and then applying the standard ML-EM algorithm to the denoised data. A more elaborate method is discussed in which a wavelet denoising step is inserted after each EM iteration. This technique differs from previous smoothing techniques applied to the ML-EM algorithm since it is able to recover edges in discontinuous images.

  5. Processing of Cryo-EM Movie Data.

    PubMed

    Ripstein, Z A; Rubinstein, J L

    2016-01-01

    Direct detector device (DDD) cameras dramatically enhance the capabilities of electron cryomicroscopy (cryo-EM) due to their improved detective quantum efficiency (DQE) relative to other detectors. DDDs use semiconductor technology that allows micrographs to be recorded as movies rather than integrated individual exposures. Movies from DDDs improve cryo-EM in another, more surprising, way. DDD movies revealed beam-induced specimen movement as a major source of image degradation and provide a way to partially correct the problem by aligning frames or regions of frames to account for this specimen movement. In this chapter, we use a self-consistent mathematical notation to explain, compare, and contrast several of the most popular existing algorithms for computationally correcting specimen movement in DDD movies. We conclude by discussing future developments in algorithms for processing DDD movies that would extend the capabilities of cryo-EM even further. © 2016 Elsevier Inc. All rights reserved.

  6. 7 CFR 1945.35 - Special EM loan training.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... workshop and a test. (c) Objective. The basic objective of this training program is to keep State and... kit, will be used for the EM loan training meetings, and any subsequent EM loan training...

  7. 7 CFR 1945.35 - Special EM loan training.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... workshop and a test. (c) Objective. The basic objective of this training program is to keep State and... kit, will be used for the EM loan training meetings, and any subsequent EM loan training...

  8. Integrating Green Purchasing Into Your Environmental Management System (EMS)

    EPA Pesticide Factsheets

    The goal of this report is to help Federal facilities integrate green purchasing into their EMS. The intended audience includes those tasked with implementing an EMS, reducing environmental impacts, meeting green purchasing requirements.

  9. 10 CFR Appendixes E-M to Part 52 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false E Appendixes E-M to Part 52 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Appendixes E-M to Part 52...

  10. 10 CFR Appendixes E-M to Part 52 - [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false E Appendixes E-M to Part 52 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Appendixes E-M to Part 52 ...

  11. 10 CFR Appendixes E-M to Part 52 - [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false E Appendixes E-M to Part 52 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Appendixes E-M to Part 52 ...

  12. 10 CFR Appendixes E-M to Part 52 - [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false E Appendixes E-M to Part 52 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Appendixes E-M to Part 52 ...

  13. 10 CFR Appendixes E-M to Part 52 - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false E Appendixes E-M to Part 52 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Appendixes E-M to Part 52 ...

  14. Risk Communication Within the EM Program

    SciTech Connect

    Edelson, M.

    2003-02-26

    The U.S. Department of Energy Environmental Management program (EM) conducts the most extensive environmental remediation effort in the world. The annual EM budgets have exceeded $6,000,000,000 for approximately ten years and EM has assumed responsibility for the cleanup of the largest DOE reservations (i.e., at Hanford, Washington, Aiken, South Carolina, and Idaho Falls, Idaho) as well as the facilities at Rocky Flats, Colorado and in Ohio. Each of these sites has areas of extensive radioactive and chemical contamination, numerous surplus facilities that require decontamination and removal, while some have special nuclear material that requires secure storage. The EM program has been criticized for being ineffective (1) and has been repeatedly reorganized to address perceived shortcomings. The most recent reorganization was announced in 2001 to become effective at the beginning of the 2003 Federal Fiscal Year (i.e., October 2002). It was preceded by a ''top to bottom'' review (TTBR) of the program (2) that identified several deficiencies that were to be corrected as a result of the reorganization. One prominent outcome of the TTBR was the identification of ''risk reduction'' as an organizing principle to prioritize the activities of the new EM program. The new program also sought to accelerate progress by identifying a set of critical activities at each site that could be accelerated and result in more rapid site closure, with attendant risk, cost, and schedule benefits. This paper investigates how the new emphasis on risk reduction in the EM program has been communicated to EM stakeholders and regulators. It focuses on the Rocky Flats Environmental Technology Site (RFETS) as a case study and finds that there is little evidence for a new emphasis on risk reduction in EM communications with RFETS stakeholders. Discussions between DOE and RFETS stakeholders often refer to ''risk,'' but the word serves as a placeholder for other concepts. Thus ''risk'' communication

  15. Structural Composites With Tuned EM Chirality

    DTIC Science & Technology

    2014-12-23

    AFRL-OSR-VA-TR-2015-0018 STRUCTURAL COMPOSITES WITH TUNED EM CHIRALITY Siavouche Nemat Nasser UNIVERSITY OF CALIFORNIA SAN DIEGO Final Report 12/23...REPORT Grant/Contract  Title:        STRUCTURAL  COMPOSITES  WITH  TUNED  EM   CHIRALITY     Grant  No.:  FA9550-­‐09-­‐1...structural   composites  with   tunable   chiral   elements   has   produced   some   impressive   results   in   the

  16. Lessons Learned: Integrating EMS and Environmental Compliance Auditing

    DTIC Science & Technology

    2009-05-06

    audit an EMS against the – ISO 14001 :2004 Standard – Installation’s own commitments and procedures established under their EMS (i.e. are they doing...what they said they would do?) – Army Policy • Findings are documented in a Word report (external audits) • ISO 14001 conformance is determined by...regulatory requirements • EMS Findings – Conformance: management system conforms to ISO 14001 standard – Major Nonconformance: EMS is missing element

  17. Do earthquakes generate EM signals?

    NASA Astrophysics Data System (ADS)

    Walter, Christina; Onacha, Stephen; Malin, Peter; Shalev, Eylon; Lucas, Alan

    2010-05-01

    study areas, large swarms of earthquakes were located very close to the electromagnetic coils. This abstract focuses on the data from the Wairakei area. Preliminary data analysis has been carried out by band pass filtering and removing of the harmonics of the 50 Hz power line frequency. The initial results clearly show that electromagnetic signals accompany the seismic P and S waves (coseismic signal). Further data analysis involves the extraction of the seismoelectric signal generated at the onset of the earthquake and at interfaces from the coseismic signal and other ‘noise' sources. This processing step exhibits a major challenge in seismoelectric data processing. Unlike in other studies we measured the EM field and the seismic field at one location. Therefore the seismoelectric wave travelling at the speed of light cannot be determined as easily in the arrival times as when an array of coils is used. This makes the determination of the origin time much more difficult. Hence other processing techniques need to be explored.

  18. EMS response to an airliner crash.

    PubMed

    Dasgupta, Shuvra; French, Simone; Williams-Johnson, Jean; Hutson, Rhonda; Hart, Nicole; Wong, Mark; Williams, Eric; Espinosa, Kurdell; Maycock, Celeste; Edwards, Romayne; McCartney, Trevor; Cawich, Shamir; Crandon, Ivor

    2012-06-01

    This report of an aircraft crash at a major airport in Kingston, Jamaica examines the response of the local Emergency Medical Services (EMS). Factors that impacted the response are discussed, and the need for more disaster simulation exercises is highlighted. The objective of this case report was to document the response of EMS personnel to the crash of American Airlines Flight 331, and to utilize the information to examine and improve the present protocol. While multiple errors can occur during a mass-casualty event, these can be reduced by frequent simulation exercises during which various personnel practice and learn designated roles. Efficient triage, proper communication, and knowledge of the roles are important in ensuring the best possible outcome. While the triage system and response of the EMS personnel were effective for this magnitude of catastrophe, more work is needed in order to meet predetermined standards. Ways in which this can be overcome include: (1) hosting more disaster simulation exercises; (2) encouraging more involvement with first responders; and (3) strengthening the links in the local EMS system. Vigorous public education must be instituted and maintained.

  19. Navigating 3D electron microscopy maps with EM-SURFER.

    PubMed

    Esquivel-Rodríguez, Juan; Xiong, Yi; Han, Xusi; Guang, Shuomeng; Christoffer, Charles; Kihara, Daisuke

    2015-05-30

    The Electron Microscopy DataBank (EMDB) is growing rapidly, accumulating biological structural data obtained mainly by electron microscopy and tomography, which are emerging techniques for determining large biomolecular complex and subcellular structures. Together with the Protein Data Bank (PDB), EMDB is becoming a fundamental resource of the tertiary structures of biological macromolecules. To take full advantage of this indispensable resource, the ability to search the database by structural similarity is essential. However, unlike high-resolution structures stored in PDB, methods for comparing low-resolution electron microscopy (EM) density maps in EMDB are not well established. We developed a computational method for efficiently searching low-resolution EM maps. The method uses a compact fingerprint representation of EM maps based on the 3D Zernike descriptor, which is derived from a mathematical series expansion for EM maps that are considered as 3D functions. The method is implemented in a web server named EM-SURFER, which allows users to search against the entire EMDB in real-time. EM-SURFER compares the global shapes of EM maps. Examples of search results from different types of query structures are discussed. We developed EM-SURFER, which retrieves structurally relevant matches for query EM maps from EMDB within seconds. The unique capability of EM-SURFER to detect 3D shape similarity of low-resolution EM maps should prove invaluable in structural biology.

  20. The association between EMS workplace safety culture and safety outcomes.

    PubMed

    Weaver, Matthew D; Wang, Henry E; Fairbanks, Rollin J; Patterson, Daniel

    2012-01-01

    Prior studies have highlighted wide variation in emergency medical services (EMS) workplace safety culture across agencies. To determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, working conditions, stress recognition, and job satisfaction. A panel of medical directors, emergency medical technicians and paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. Sixteen percent of all respondents reported experiencing an injury in the past three months, four of every 10 respondents reported an error or adverse event (AE), and 89% reported safety-compromising behaviors. Respondents reporting injury scored lower on five of the six domains of safety culture. Respondents reporting an error or AE scored lower for four of the six domains, while respondents reporting safety-compromising behavior had lower safety culture scores for five of the six domains. Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes.

  1. The association between EMS workplace safety culture and safety outcomes

    PubMed Central

    Weaver, Matthew D.; Wang, Henry E.; Fairbanks, Rollin J.; Patterson, Daniel

    2012-01-01

    Objective Prior studies have highlighted wide variation in EMS workplace safety culture across agencies. We sought to determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. Methods We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, perceptions of working conditions, stress recognition, and job satisfaction. A panel of medical directors, paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. Results Sixteen percent of all respondents reported experiencing an injury in the past 3 months, four of every 10 respondents reported an error or adverse event (AE), and 90% reported safety-compromising behaviors. Respondents reporting injury scored lower on 5 of the 6 domains of safety culture. Respondents reporting an error or AE scored lower for 4 of the 6 domains, while respondents reporting safety-compromising behavior had lower safety culture scores for 5 of 6 domains. Conclusions Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes. PMID:21950463

  2. Accuracy of EMS Trauma Transport Destination Plans in North Carolina.

    PubMed

    Moss, Chailee; Cowden, Christopher S; Atterton, Laurie Meyer; Arasaratnam, Meredith H; Fernandez, Antonio R; Evarts, Jeff S; Barrier, Brian; Lerner, E Brooke; Mann, N Clay; Lohmeier, Chad; Shofer, Frances S; Brice, Jane H

    2015-01-01

    Abstract Objective. Planning for time-sensitive injury may allow emergency medical services (EMS) systems to more accurately triage patients meeting accepted criteria to facilities most capable of providing life-saving treatment. In 2010, North Carolina (NC) implemented statewide Trauma Triage and Destination Plans (TTDPs) in all 100 of North Carolina's county-defined EMS systems. Each system was responsible for identifying the specific destination hospitals with appropriate resources to treat trauma patients. We sought to characterize the accuracy of their hospital designations. Methods. In this cross-sectional study, we collected TTDPs for each county-defined EMS system, including their assigned hospital capabilities (i.e., trauma center or community hospital). We conducted a survey with each EMS system to determine how their TTDP was constructed and maintained, as well as with each TTDP-designated hospital to verify their capabilities. We determined the accuracy of the EMS assigned hospital designations by comparing them to the hospital's reported capabilities. Results. The 100 NC EMS systems provided 380 designations for 112 hospitals. TTDPs were created by EMS administrators and medical directors, with only 55% of EMS systems engaging a hospital representative in the plan creation. Compared to the actual hospital capabilities, 97% of the EMS TTDP designations were correct. Twelve hospital designations were incorrect and the majority (10) overestimated hospital capabilities. Of the 100 EMS systems, 7 misclassified hospitals in their TTDP. EMS systems that did not verify their local hospitals' capabilities during TTDP development were more likely to incorrectly categorize a hospital's capabilities (p = 0.001). Conclusions. A small number of EMS systems misclassified hospitals in their TTDP, but most plans accurately reflected hospital capabilities. Misclassification occurred more often in systems that did not consult local hospitals prior to developing their

  3. What Do They Want from Us? A Survey of EM Program Directors on EM Application Criteria

    PubMed Central

    King, Kevin; Kass, Dara

    2017-01-01

    Introduction Although a relatively young specialty, emergency medicine (EM) is popular among medical students and is one of the most competitive large specialties. Consequently, students increasingly seek more opportunity to differentiate themselves from their colleagues by pursuing more clerkships at the cost of taking out additional loans: this despite the fact that those who match in EM typically do so in their top three choices. We sought to ascertain what factors EM program directors seek in their typical candidate. Methods We recruited EM program directors via the Council of Emergency Medicine Residency Directors email listserv to participate in an anonymous survey regarding the United States Medical Licensing Examination (USMLE), the number of standardized letters of evaluation (SLOE), and the number of EM rotations during the fourth year. Results 135 respondents completed the anonymous survey: 59% of respondents stated their program did not have a minimum USMLE Step 1 score, but 39% reported a minimum score of 210 or higher; 95% of programs do not require Step 2 to grant an interview, but 46% require it to place the student on the rank list; 80% require only one EM rotation to grant an interview and none require more than two; 95% of programs will accept two SLOEs for both application and rank list placement. Conclusion For the typical EM applicant, there is likely little benefit to performing more than two rotations and obtaining more than two SLOEs. Students can defer USMLE Step 2 but must complete it by the time rank lists are due. Our study was limited by the anonymity of the survey, and comments by the respondents revealed the questions did not account for some nuances programs apply to their application review process. PMID:28116023

  4. DNA polymorphisms at the BCL11A, HBS1L-MYB, and β-globin loci associate with fetal hemoglobin levels and pain crises in sickle cell disease

    PubMed Central

    Lettre, Guillaume; Sankaran, Vijay G.; Bezerra, Marcos André C.; Araújo, Aderson S.; Uda, Manuela; Sanna, Serena; Cao, Antonio; Schlessinger, David; Costa, Fernando F.; Hirschhorn, Joel N.; Orkin, Stuart H.

    2008-01-01

    Sickle cell disease (SCD) is a debilitating monogenic blood disorder with a highly variable phenotype characterized by severe pain crises, acute clinical events, and early mortality. Interindividual variation in fetal hemoglobin (HbF) expression is a known and potentially heritable modifier of SCD severity. High HbF levels are correlated with reduced morbidity and mortality. Common single nucleotide polymorphisms (SNPs) at the BCL11A and HBS1L-MYB loci have been implicated previously in HbF level variation in nonanemic European populations. We recently demonstrated an association between a BCL11A SNP and HbF levels in one SCD cohort [Uda M, et al. (2008) Proc Natl Acad Sci USA 105:1620–1625]. Here, we genotyped additional BCL11A SNPs, HBS1L-MYB SNPs, and an SNP upstream of Gγ-globin (HBG2; the XmnI polymorphism), in two independent SCD cohorts: the African American Cooperative Study of Sickle Cell Disease (CSSCD) and an SCD cohort from Brazil. We studied the effect of these SNPs on HbF levels and on a measure of SCD-related morbidity (pain crisis rate). We strongly replicated the association between these SNPs and HbF level variation (in the CSSCD, P values range from 0.04 to 2 × 10−42). Together, common SNPs at the BCL11A, HBS1L-MYB, and β-globin (HBB) loci account for >20% of the variation in HbF levels in SCD patients. We also have shown that HbF-associated SNPs associate with pain crisis rate in SCD patients. These results provide a clear example of inherited common sequence variants modifying the severity of a monogenic disease. PMID:18667698

  5. DNA polymorphisms at the BCL11A, HBS1L-MYB, and beta-globin loci associate with fetal hemoglobin levels and pain crises in sickle cell disease.

    PubMed

    Lettre, Guillaume; Sankaran, Vijay G; Bezerra, Marcos André C; Araújo, Aderson S; Uda, Manuela; Sanna, Serena; Cao, Antonio; Schlessinger, David; Costa, Fernando F; Hirschhorn, Joel N; Orkin, Stuart H

    2008-08-19

    Sickle cell disease (SCD) is a debilitating monogenic blood disorder with a highly variable phenotype characterized by severe pain crises, acute clinical events, and early mortality. Interindividual variation in fetal hemoglobin (HbF) expression is a known and potentially heritable modifier of SCD severity. High HbF levels are correlated with reduced morbidity and mortality. Common single nucleotide polymorphisms (SNPs) at the BCL11A and HBS1L-MYB loci have been implicated previously in HbF level variation in nonanemic European populations. We recently demonstrated an association between a BCL11A SNP and HbF levels in one SCD cohort [Uda M, et al. (2008) Proc Natl Acad Sci USA 105:1620-1625]. Here, we genotyped additional BCL11A SNPs, HBS1L-MYB SNPs, and an SNP upstream of (G)gamma-globin (HBG2; the XmnI polymorphism), in two independent SCD cohorts: the African American Cooperative Study of Sickle Cell Disease (CSSCD) and an SCD cohort from Brazil. We studied the effect of these SNPs on HbF levels and on a measure of SCD-related morbidity (pain crisis rate). We strongly replicated the association between these SNPs and HbF level variation (in the CSSCD, P values range from 0.04 to 2 x 10(-42)). Together, common SNPs at the BCL11A, HBS1L-MYB, and beta-globin (HBB) loci account for >20% of the variation in HbF levels in SCD patients. We also have shown that HbF-associated SNPs associate with pain crisis rate in SCD patients. These results provide a clear example of inherited common sequence variants modifying the severity of a monogenic disease.

  6. The E-MS Algorithm: Model Selection with Incomplete Data.

    PubMed

    Jiang, Jiming; Nguyen, Thuan; Rao, J Sunil

    2015-04-04

    We propose a procedure associated with the idea of the E-M algorithm for model selection in the presence of missing data. The idea extends the concept of parameters to include both the model and the parameters under the model, and thus allows the model to be part of the E-M iterations. We develop the procedure, known as the E-MS algorithm, under the assumption that the class of candidate models is finite. Some special cases of the procedure are considered, including E-MS with the generalized information criteria (GIC), and E-MS with the adaptive fence (AF; Jiang et al. 2008). We prove numerical convergence of the E-MS algorithm as well as consistency in model selection of the limiting model of the E-MS convergence, for E-MS with GIC and E-MS with AF. We study the impact on model selection of different missing data mechanisms. Furthermore, we carry out extensive simulation studies on the finite-sample performance of the E-MS with comparisons to other procedures. The methodology is also illustrated on a real data analysis involving QTL mapping for an agricultural study on barley grains.

  7. The E-MS Algorithm: Model Selection with Incomplete Data

    PubMed Central

    Jiang, Jiming; Nguyen, Thuan; Rao, J. Sunil

    2014-01-01

    We propose a procedure associated with the idea of the E-M algorithm for model selection in the presence of missing data. The idea extends the concept of parameters to include both the model and the parameters under the model, and thus allows the model to be part of the E-M iterations. We develop the procedure, known as the E-MS algorithm, under the assumption that the class of candidate models is finite. Some special cases of the procedure are considered, including E-MS with the generalized information criteria (GIC), and E-MS with the adaptive fence (AF; Jiang et al. 2008). We prove numerical convergence of the E-MS algorithm as well as consistency in model selection of the limiting model of the E-MS convergence, for E-MS with GIC and E-MS with AF. We study the impact on model selection of different missing data mechanisms. Furthermore, we carry out extensive simulation studies on the finite-sample performance of the E-MS with comparisons to other procedures. The methodology is also illustrated on a real data analysis involving QTL mapping for an agricultural study on barley grains. PMID:26783375

  8. Applying Recursive EM to Scene Segmentation

    NASA Astrophysics Data System (ADS)

    Bachmann, Alexander

    In this paper a novel approach for the interdependent task of multiple object tracking and scene segmentation is presented. The method partitions a stereo image sequence of a dynamic 3-dimensional (3D) scene into its most prominent moving groups with similar 3D motion. The unknown set of motion parameters is recursively estimated using an iterated extended Kalman filter (IEKF) which will be derived from the expectation-maximization (EM) algorithm. The EM formulation is used to incorporate a probabilistic data association measure into the tracking process. In a subsequent segregation step, each image point is assigned to the object hypothesis with maximum a posteriori (MAP) probability. Within the association process, which is implemented as labeling problem, a Markov Random Field (MRF) is used to express our expectations on spatial continuity of objects.

  9. Intense EM filamentation in relativistic hot plasmas

    NASA Astrophysics Data System (ADS)

    Hu, Qiang-Lin; Chen, Zhong-Ping; Mahajan, Swadesh M.

    2017-03-01

    Through 2D particle-in-cell (PIC) simulations, we demonstrate that the nature of filamentation of a high intensity electromagnetic (EM) pulse propagating in an underdense plasma, is profoundly affected at relativistically high temperatures. The "relativistic" filaments are sharper, are dramatically extended (along the direction of propagation), and live much longer than their lower temperature counterparts. The thermally boosted electron inertia is invoked to understand this very interesting and powerful phenomenon.

  10. Cryo-EM: Spinning the Micelles Away.

    PubMed

    Singh, Satinder K; Sigworth, Fred J

    2015-09-01

    Structural characterization of integral membrane proteins (MPs) demands that the samples be pure, monodisperse, and stable. Detergents are required to extract MPs from the lipid bilayer in which they reside and to stabilize them for downstream biophysical analyses. Some of the best MP-stabilizing detergents pose problems for cryo-EM studies, but in this issue of Structure, Hauer et al. (2015) now offer a solution called GraDeR.

  11. Leukocyte Recognition Using EM-Algorithm

    NASA Astrophysics Data System (ADS)

    Colunga, Mario Chirinos; Siordia, Oscar Sánchez; Maybank, Stephen J.

    This document describes a method for classifying images of blood cells. Three different classes of cells are used: Band Neutrophils, Eosinophils and Lymphocytes. The image pattern is projected down to a lower dimensional sub space using PCA; the probability density function for each class is modeled with a Gaussian mixture using the EM-Algorithm. A new cell image is classified using the maximum a posteriori decision rule.

  12. TandEM: Titan and Enceladus mission

    NASA Astrophysics Data System (ADS)

    Coustenis, A.; Atreya, S. K.; Balint, T.; Brown, R. H.; Dougherty, M. K.; Ferri, F.; Fulchignoni, M.; Gautier, D.; Gowen, R. A.; Griffith, C. A.; Gurvits, L. I.; Jaumann, R.; Langevin, Y.; Leese, M. R.; Lunine, J. I.; McKay, C. P.; Moussas, X.; Müller-Wodarg, I.; Neubauer, F.; Owen, T. C.; Raulin, F.; Sittler, E. C.; Sohl, F.; Sotin, C.; Tobie, G.; Tokano, T.; Turtle, E. P.; Wahlund, J.-E.; Waite, J. H.; Baines, K. H.; Blamont, J.; Coates, A. J.; Dandouras, I.; Krimigis, T.; Lellouch, E.; Lorenz, R. D.; Morse, A.; Porco, C. C.; Hirtzig, M.; Saur, J.; Spilker, T.; Zarnecki, J. C.; Choi, E.; Achilleos, N.; Amils, R.; Annan, P.; Atkinson, D. H.; Bénilan, Y.; Bertucci, C.; Bézard, B.; Bjoraker, G. L.; Blanc, M.; Boireau, L.; Bouman, J.; Cabane, M.; Capria, M. T.; Chassefière, E.; Coll, P.; Combes, M.; Cooper, J. F.; Coradini, A.; Crary, F.; Cravens, T.; Daglis, I. A.; de Angelis, E.; de Bergh, C.; de Pater, I.; Dunford, C.; Durry, G.; Dutuit, O.; Fairbrother, D.; Flasar, F. M.; Fortes, A. D.; Frampton, R.; Fujimoto, M.; Galand, M.; Grasset, O.; Grott, M.; Haltigin, T.; Herique, A.; Hersant, F.; Hussmann, H.; Ip, W.; Johnson, R.; Kallio, E.; Kempf, S.; Knapmeyer, M.; Kofman, W.; Koop, R.; Kostiuk, T.; Krupp, N.; Küppers, M.; Lammer, H.; Lara, L.-M.; Lavvas, P.; Le Mouélic, S.; Lebonnois, S.; Ledvina, S.; Li, J.; Livengood, T. A.; Lopes, R. M.; Lopez-Moreno, J.-J.; Luz, D.; Mahaffy, P. R.; Mall, U.; Martinez-Frias, J.; Marty, B.; McCord, T.; Menor Salvan, C.; Milillo, A.; Mitchell, D. G.; Modolo, R.; Mousis, O.; Nakamura, M.; Neish, C. D.; Nixon, C. A.; Nna Mvondo, D.; Orton, G.; Paetzold, M.; Pitman, J.; Pogrebenko, S.; Pollard, W.; Prieto-Ballesteros, O.; Rannou, P.; Reh, K.; Richter, L.; Robb, F. T.; Rodrigo, R.; Rodriguez, S.; Romani, P.; Ruiz Bermejo, M.; Sarris, E. T.; Schenk, P.; Schmitt, B.; Schmitz, N.; Schulze-Makuch, D.; Schwingenschuh, K.; Selig, A.; Sicardy, B.; Soderblom, L.; Spilker, L. J.; Stam, D.; Steele, A.; Stephan, K.; Strobel, D. F.; Szego, K.; Szopa, C.; Thissen, R.; Tomasko, M. G.; Toublanc, D.; Vali, H.; Vardavas, I.; Vuitton, V.; West, R. A.; Yelle, R.; Young, E. F.

    2009-03-01

    TandEM was proposed as an L-class (large) mission in response to ESA’s Cosmic Vision 2015-2025 Call, and accepted for further studies, with the goal of exploring Titan and Enceladus. The mission concept is to perform in situ investigations of two worlds tied together by location and properties, whose remarkable natures have been partly revealed by the ongoing Cassini-Huygens mission. These bodies still hold mysteries requiring a complete exploration using a variety of vehicles and instruments. TandEM is an ambitious mission because its targets are two of the most exciting and challenging bodies in the Solar System. It is designed to build on but exceed the scientific and technological accomplishments of the Cassini-Huygens mission, exploring Titan and Enceladus in ways that are not currently possible (full close-up and in situ coverage over long periods of time). In the current mission architecture, TandEM proposes to deliver two medium-sized spacecraft to the Saturnian system. One spacecraft would be an orbiter with a large host of instruments which would perform several Enceladus flybys and deliver penetrators to its surface before going into a dedicated orbit around Titan alone, while the other spacecraft would carry the Titan in situ investigation components, i.e. a hot-air balloon (Montgolfière) and possibly several landing probes to be delivered through the atmosphere.

  13. TandEM: Titan and Enceladus mission

    USGS Publications Warehouse

    Coustenis, A.; Atreya, S.K.; Balint, T.; Brown, R.H.; Dougherty, M.K.; Ferri, F.; Fulchignoni, M.; Gautier, D.; Gowen, R.A.; Griffith, C.A.; Gurvits, L.I.; Jaumann, R.; Langevin, Y.; Leese, M.R.; Lunine, J.I.; McKay, C.P.; Moussas, X.; Muller-Wodarg, I.; Neubauer, F.; Owen, T.C.; Raulin, F.; Sittler, E.C.; Sohl, F.; Sotin, Christophe; Tobie, G.; Tokano, T.; Turtle, E.P.; Wahlund, J.-E.; Waite, J.H.; Baines, K.H.; Blamont, J.; Coates, A.J.; Dandouras, I.; Krimigis, T.; Lellouch, E.; Lorenz, R.D.; Morse, A.; Porco, C.C.; Hirtzig, M.; Saur, J.; Spilker, T.; Zarnecki, J.C.; Choi, E.; Achilleos, N.; Amils, R.; Annan, P.; Atkinson, D.H.; Benilan, Y.; Bertucci, C.; Bezard, B.; Bjoraker, G.L.; Blanc, M.; Boireau, L.; Bouman, J.; Cabane, M.; Capria, M.T.; Chassefiere, E.; Coll, P.; Combes, M.; Cooper, J.F.; Coradini, A.; Crary, F.; Cravens, T.; Daglis, I.A.; de Angelis, E.; De Bergh, C.; de Pater, I.; Dunford, C.; Durry, G.; Dutuit, O.; Fairbrother, D.; Flasar, F.M.; Fortes, A.D.; Frampton, R.; Fujimoto, M.; Galand, M.; Grasset, O.; Grott, M.; Haltigin, T.; Herique, A.; Hersant, F.; Hussmann, H.; Ip, W.; Johnson, R.; Kallio, E.; Kempf, S.; Knapmeyer, M.; Kofman, W.; Koop, R.; Kostiuk, T.; Krupp, N.; Kuppers, M.; Lammer, H.; Lara, L.-M.; Lavvas, P.; Le, Mouelic S.; Lebonnois, S.; Ledvina, S.; Li, Ji; Livengood, T.A.; Lopes, R.M.; Lopez-Moreno, J. -J.; Luz, D.; Mahaffy, P.R.; Mall, U.; Martinez-Frias, J.; Marty, B.; McCord, T.; Salvan, C.M.; Milillo, A.; Mitchell, D.G.; Modolo, R.; Mousis, O.; Nakamura, M.; Neish, Catherine D.; Nixon, C.A.; Mvondo, D.N.; Orton, G.; Paetzold, M.; Pitman, J.; Pogrebenko, S.; Pollard, W.; Prieto-Ballesteros, O.; Rannou, P.; Reh, K.; Richter, L.; Robb, F.T.; Rodrigo, R.; Rodriguez, S.; Romani, P.; Bermejo, M.R.; Sarris, E.T.; Schenk, P.; Schmitt, B.; Schmitz, N.; Schulze-Makuch, D.; Schwingenschuh, K.; Selig, A.; Sicardy, B.; Soderblom, L.; Spilker, L.J.; Stam, D.; Steele, A.; Stephan, K.; Strobel, D.F.; Szego, K.; Szopa,

    2009-01-01

    TandEM was proposed as an L-class (large) mission in response to ESA's Cosmic Vision 2015-2025 Call, and accepted for further studies, with the goal of exploring Titan and Enceladus. The mission concept is to perform in situ investigations of two worlds tied together by location and properties, whose remarkable natures have been partly revealed by the ongoing Cassini-Huygens mission. These bodies still hold mysteries requiring a complete exploration using a variety of vehicles and instruments. TandEM is an ambitious mission because its targets are two of the most exciting and challenging bodies in the Solar System. It is designed to build on but exceed the scientific and technological accomplishments of the Cassini-Huygens mission, exploring Titan and Enceladus in ways that are not currently possible (full close-up and in situ coverage over long periods of time). In the current mission architecture, TandEM proposes to deliver two medium-sized spacecraft to the Saturnian system. One spacecraft would be an orbiter with a large host of instruments which would perform several Enceladus flybys and deliver penetrators to its surface before going into a dedicated orbit around Titan alone, while the other spacecraft would carry the Titan in situ investigation components, i.e. a hot-air balloon (Montgolfi??re) and possibly several landing probes to be delivered through the atmosphere. ?? Springer Science + Business Media B.V. 2008.

  14. The US DOE EM international program

    SciTech Connect

    Elmetti, Rosa R.; Han, Ana M.; Roach, Jay A.

    2013-07-01

    The U.S. Department of Energy (DOE) Office of Environmental Management (EM) conducts international collaboration activities in support of U.S. policies and objectives regarding the accelerated risk reduction and remediation of environmental legacy of the nations' nuclear weapons program and government sponsored nuclear energy research. The EM International Program supported out of the EM Office of the Associate Principal Deputy Assistant Secretary pursues collaborations with foreign government organizations, educational institutions and private industry to assist in identifying technologies and promote international collaborations that leverage resources and link international experience and expertise. In fiscal year (FY) 2012, the International Program awarded eight international collaborative projects for work scope spanning waste processing, groundwater and soil remediation, deactivation and decommissioning (D and D) and nuclear materials disposition initiatives to seven foreign organizations. Additionally, the International Program's scope and collaboration opportunities were expanded to include technical as well as non-technical areas. This paper will present an overview of the on-going tasks awarded in FY 2012 and an update of upcoming international activities and opportunities for expansion into the remainder of FY 2013 and beyond. (authors)

  15. 2. HI PAR (ACQUISITION RADAR) TOWER AND ENLISTED MEN (EM) ...

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

    2. HI PAR (ACQUISITION RADAR) TOWER AND ENLISTED MEN (EM) BARRACKS WITH RADAR ATTACHED. - Nike Hercules Missile Battery Summit Site, Battery Control Administration & Barracks Building, Anchorage, Anchorage, AK

  16. The State of Emergency Medical Services (EMS) Systems in Africa.

    PubMed

    Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

    2017-02-23

    Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury.

  17. Recruitment and retention in rural and urban EMS: results from a national survey of local EMS directors.

    PubMed

    Freeman, Victoria A; Slifkin, Rebecca T; Patterson, P Daniel

    2009-01-01

    Maintaining an adequate staff is a challenge for rural emergency medical services (EMS) providers. This national survey of local EMS directors finds that rural EMS are more likely to be freestanding, that is, not affiliated with other public services, to employ only emergency medical technician-basics (EMT-Bs), and to be all volunteer. Rural EMS directors are more likely than urban ones to report that they are not currently fully staffed. The most common barriers to recruitment of EMTs in both urban and rural areas include unwillingness of community members to volunteer and lack of certified EMTs in the area. In rural areas, barriers to EMT training were noted more often than in urban areas as was the lack of employer support for employee volunteers. Similar rural training barriers affected retention of staff. Rural respondents reported that they lose staff to burnout and to difficulty in meeting continuing education requirements. Among rural respondents, those who direct all-volunteer EMS were the most likely to report recruitment and retention problems. The results suggest areas for further study including how volunteer EMS agencies can transition to paid agencies, how to bring EMS education to rural areas, and how EMS can work with other agencies to ensure EMS viability.

  18. Communication - An Effective Tool for Implementing ISO 14001/EMS

    SciTech Connect

    Rachel Damewood; Bowen Huntsman

    2004-04-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) received ISO 14001/EMS certification in June 2002. Communication played an effective role in implementing ISO 14001/EMS at the INEEL. This paper describes communication strategies used during the implementation and certification processes. The INEEL achieved Integrated Safety Management System (ISMS) and Voluntary Protection Program (VPP) Star status in 2001. ISMS implemented a formal process to plan and execute work. VPP facilitated worker involvement by establishing geographic units at various facilities with employee points of contact and management champions. The INEEL Environmental Management System (EMS) was developed to integrate the environmental functional area into its ISMS and VPP. Since the core functions of ISMS, VPP, and EMS are interchangeable, they were easy to integrate. Communication is essential to successfully implement an EMS. (According to ISO 14001 requirements, communication interacts with 12 other elements of the requirements.) We developed communication strategies that integrated ISMS, VPP, and EMS. For example, the ISMS, VPP, and EMS Web sites communicated messages to the work force, such as “VPP emphasizes the people side of doing business, ISMS emphasizes the system side of doing business, and EMS emphasizes the systems to protect the environment; but they all define work, identify and analyze hazards, and mitigate the hazards.” As a result of this integration, the work force supported and implemented the EMS. In addition, the INEEL established a cross-functional communication team to assist with implementing the EMS. The team included members from the Training and Communication organizations, VPP office, Pollution Prevention, Employee and Media Relations, a union representative, facility environmental support, and EMS staff. This crossfunctional team used various communication strategies to promote our EMS to all organization levels and successfully implemented EMS

  19. Improving Emergency Medical Services (EMS) in the United States Through Improved and Centralized Federal Coordination

    DTIC Science & Technology

    2011-03-01

    other emergencies. 4 • Public Awareness of the EMS Discipline. The public at large is not aware of the EMS structure in its community or at a higher...regard for its imperative role in community service. For this reason, placing EMS under the USFA at the federal level would cause EMS to still be...service to include EMS is appropriate, and in some cases, it is not. Not all communities have a dedicated fire service, which can make EMS provision

  20. EM threat analysis for wireless systems.

    SciTech Connect

    Burkholder, R. J. (Ohio State University Electroscience Laboratory); Mariano, Robert J.; Schniter, P. (Ohio State University Electroscience Laboratory); Gupta, I. J. (Ohio State University Electroscience Laboratory)

    2006-06-01

    Modern digital radio systems are complex and must be carefully designed, especially when expected to operate in harsh propagation environments. The ability to accurately predict the effects of propagation on wireless radio performance could lead to more efficient radio designs as well as the ability to perform vulnerability analyses before and after system deployment. In this report, the authors--experts in electromagnetic (EM) modeling and wireless communication theory--describe the construction of a simulation environment that is capable of quantifying the effects of wireless propagation on the performance of digital communication.

  1. Technical Staffing Crises and Managing Systems Projects

    ERIC Educational Resources Information Center

    Davis, Charles K.

    2007-01-01

    Case method teaching is not limited to larger, complex cases. It is often useful to supplement classroom discussions with short cases, ones that have been targeted for one or two discussion points that challenge student thinking beyond the usual lecture or textbook. These shorter cases are called "minicases." The objective of a minicase is to…

  2. Endogenous versus Exogenous Origins of Crises

    NASA Astrophysics Data System (ADS)

    Sornette, Didier

    Are large biological extinctions such as the Cretaceous/Tertiary KT boundary due to a meteorite, extreme volcanic activity or self-organized critical extinction cascades? Are commercial successes due to a progressive reputation cascade or the result of a well orchestrated advertisement? Determining the chain of causality for Xevents in complex systems requires disentangling interwoven exogenous and endogenous contributions with either no clear signature or too many signatures. Here, I review several efforts carried out with collaborators which suggest a general strategy for understanding the organizations of several complex systems under the dual effect of endogenous and exogenous fluctuations. The studied examples are: internet download shocks, book sale shocks, social shocks, financial volatility shocks, and financial crashes. Simple models are offered to quantitatively relate the endogenous organization to the exogenous response of the system. Suggestions for applications of these ideas to many other systems are offered.

  3. Mid-Life Professional Crises: Two Hypotheses.

    ERIC Educational Resources Information Center

    Cardinell, C. F.

    Burnout must be considered as symptomatic of a serious event in a person's life--a mid-life crisis, as it is widely termed. Numerous writings point out that during a period of life, roughly between the ages of 30 and 55, many people reach a crisis brought on by the realization that everyone's career, status, and life are measurable and limited.…

  4. A Strategic Approach to Managing Crises.

    ERIC Educational Resources Information Center

    Burnett, John J.

    1998-01-01

    Incorporates the management literature on crisis to create a model that can be used to assess the seriousness of crisis. Extends the model for use by public-relations managers. Concludes with suggestions that will modify approaches employed and improve the effectiveness of public-relations professionals in their role as crisis managers. (RS)

  5. For aerospace programs, the crises continue.

    PubMed

    Looney, Paul; Beavin, Michael

    2003-05-01

    The Legislative Update column reports on President Bush's supplemental budget request for the war in Iraq, the formation of a defense caucus in the House of Representatives, stabilized funding for airport security, the Department of Homeland Security budget, NASA's budget request, funding for NASA's aeronautics program, and NASA's new authorization. NASA's FY04 budget request is $15.47 billion, less than 1% more than FY03. The aeronautics program budget request for FY04 is $959 million, a decrease of 8.5% from FY03. Congress is working to introduce a multiyear authorization for NASA during the 108th session.

  6. Rural Development: Goals, Dynamics, Crises and Recommendations.

    ERIC Educational Resources Information Center

    Jehlik, Paul J.

    The continuing transition of rural development from its old to present day form is discussed, treating varied perceptions of its goals and the continuing resolution of approaches through legislation and appropriations. Some of the goals are community development, human resources development, natural resources preservation, and a more equitable…

  7. Global Crises, Social Justice, and Teacher Education

    ERIC Educational Resources Information Center

    Apple, Michael W.

    2011-01-01

    When the U.S. government released its 2007 census figures in January 2010, it reported that 12% of the U.S. population--more than 38 million people--were foreign born. First-generation people were now one out of every eight persons in the nation, with 80% coming from Latin America and Asia. This near-record transformation, one in which diasporic…

  8. Crises in a Transforming International System

    DTIC Science & Technology

    1975-01-01

    against Japan to stave off an extended Asian war at the end of World V.’ar II, (and probably also to satisfy the promises made to Stalin at Yalta... world destined for dlspersed power The American v because of the detente as a r as an opera " political les national inter Isolation from...power politics politics have been add Puchala and Pagan consid world affairs as the core change leads the author behavior of other actors mi 1i

  9. [Grief and crises in Norse literature].

    PubMed

    Høyersten, J G

    1993-03-30

    The significance of literature for psychiatry and vice versa is commented on, as an introduction to a study of Norse literature. This was written down mainly in Iceland in the 13th Century on the basis of oral traditions, some of which date back to the 9th century. From a psychological point of view, the Icelandic Sagas, the Royal Sagas of Snorri Sturluson and the earliest hero-poems of the Edda are of particular interest. This literature includes detailed descriptions of grief and crisis reactions, the management and rituals of grief, and the associated rituals. These patterns have a striking similarity to modern principles of crisis intervention.

  10. Black Psyches in Captivity and Crises.

    ERIC Educational Resources Information Center

    Bulhan, Hussein Abdilahi

    1979-01-01

    Blacks who gain consciousness of their ordained factorship have come to terms with both a personal and a collective past tainted with the scars of slavery, colonialism, and cultural capitulation. Genuine rehabilitation and social reconstruction occur only through critical appraisals of the root causes of social reality. (Author/WI)

  11. Contagion: epidemiological models and financial crises.

    PubMed

    Peckham, Robert

    2014-03-01

    Since the 1990s, economists have drawn on the epidemiology of emerging infectious diseases to explain the diffusion of shock through an increasingly complex financial system. The successful coordination of public health responses to disease threats, and in particular the epidemiological modelling underpinning infection control, has influenced economists' understanding of the risks posed to the stability of the financial system by 'contagion'. While the exportation of analytic models and frames of reference can be fruitful, reinvigorating the destination domain, such analogizing can have a distorting effect. There are differences between biological and financial systems. Moreover, the migration of highly context-specific epidemiological models may undermine the basis of the analogy. Finally, there may be repercussions for the efficacy of public health in the way that its aims are misconstrued in financial analyses.

  12. Black Psyches in Captivity and Crises.

    ERIC Educational Resources Information Center

    Bulhan, Hussein Abdilahi

    1979-01-01

    Blacks who gain consciousness of their ordained factorship have come to terms with both a personal and a collective past tainted with the scars of slavery, colonialism, and cultural capitulation. Genuine rehabilitation and social reconstruction occur only through critical appraisals of the root causes of social reality. (Author/WI)

  13. [Suicidal crises at the time of motherhood].

    PubMed

    Bouchiat-Couchouron, Séverine; Geraud-Welby, Marie-Caroline; Caillet, Lionel; Adam, Patrick; Walter, Michel

    2009-10-20

    In collective imagination, motherhood cannot be but a source of joy and self-fulfilment for a woman. Nevertheless, we are reminded by the frequency and/or the severity of some psychic troubles during pregnancy and postpartum that such a phase, so specific in the psycho-affective development of the woman, can be a challenge for the woman going through it, some women will go as far as contemplating death after having given life. In the 2000 consensus conference on the suicidal crisis, there is not a single chapter though devoted to suicide problems amongst women becoming mothers, It is true that suicide at motherhood is not so frequent as during other times in a woman's life. Nevertheless, it is a not so negligible contributor to mothers' mortality at the times of pregnancy and post delivery, being even, according to some authors, the main cause of mothers' mortality. A better knowledge of epidemiology of suicidal crisis at the time of motherhood, of its precipitating and preparing factors, seems to be required so that preventive measures can be taken for the benefit of the personnel--either psychiatrists, obstetricians or midwives--in charge of those suicidal women. The British and Australian authors seem to be particularly involved in the prevention of such an event "above all dramatic" which, as unfrequent as it may be, cannot leave us indifferent.

  14. Liquidity crises on different time scales.

    PubMed

    Corradi, Francesco; Zaccaria, Andrea; Pietronero, Luciano

    2015-12-01

    We present an empirical analysis of the microstructure of financial markets and, in particular, of the static and dynamic properties of liquidity. We find that on relatively large time scales (15 min) large price fluctuations are connected to the failure of the subtle mechanism of compensation between the flows of market and limit orders: in other words, the missed revelation of the latent order book breaks the dynamical equilibrium between the flows, triggering the large price jumps. On smaller time scales (30 s), instead, the static depletion of the limit order book is an indicator of an intrinsic fragility of the system, which is related to a strongly nonlinear enhancement of the response. In order to quantify this phenomenon we introduce a measure of the liquidity imbalance present in the book and we show that it is correlated to both the sign and the magnitude of the next price movement. These findings provide a quantitative definition of the effective liquidity, which proves to be strongly dependent on the considered time scales.

  15. Natural hazard metaphors for financial crises

    NASA Astrophysics Data System (ADS)

    Woo, Gordon

    2001-02-01

    Linguistic metaphors drawn from natural hazards are commonly used at times of financial crisis. A brewing storm, a seismic shock, etc., evoke the abruptness and severity of a market collapse. If the language of windstorms, earthquakes and volcanic eruptions is helpful in illustrating a financial crisis, what about the mathematics of natural catastrophes? Already, earthquake prediction methods have been applied to economic recessions, and volcanic eruption forecasting techniques have been applied to market crashes. The purpose of this contribution is to survey broadly the mathematics of natural catastrophes, so as to convey the range of underlying principles, some of which may serve as mathematical metaphors for financial applications.

  16. Citizenship Education in Times of Crises

    ERIC Educational Resources Information Center

    Krüger, Thomas

    2016-01-01

    The 11th International Conference of the International Association for Citizenship, Social and Economics Education IACSEE, took place the 2nd-4th of July 2015 at Georg-August-Universitaet Goettingen, Germany. The conference addressed the role and potential of citizenship, social and economic education, both theoretically and empirically in the…

  17. Psychologists' Response to Crises: International Perspectives

    ERIC Educational Resources Information Center

    Rees, Paul; Seaton, Niels

    2011-01-01

    Tragically, for many schools, the possibility of a crisis such as a natural disaster, extreme violence or a potentially traumatising threat has become a reality. Specialist input from a local psychology service is often sought at such a time. To help one service within the United Kingdom (UK) learn from the experience of other psychologists a…

  18. Facing Mental Health Crises on Campus

    ERIC Educational Resources Information Center

    Trela, Kimberly

    2008-01-01

    Educating the student body on mental health involves outreach to groups not normally exposed to this information, including athletes, ethnic groups, residence hall inhabitants, fraternities and sororities, and international students. Frontline responders can help facilitate this outreach through initiatives that involve presentations by counselors…

  19. Crises and Turbulence: Sources, Assessments, Management

    DTIC Science & Technology

    1981-02-01

    SUPPLEMENTARY NOTES 19. KEY WORDS (Continue on revero>6 side It necerssazy tuid identity by block number) Crisis Military Behavior Warning Aid Perception Decision...Uses of the Military ......... .. 262 14. Correlational Power of Fundamental Factors for Soviet Behavior ..... ............... ... 263 15. US...Coercive Uses of the Military ........... ... 265 16. Correlational Power of Fundamental Factors for US Behavior ...... ................. ... 267 17

  20. Psychologists' Response to Crises: International Perspectives

    ERIC Educational Resources Information Center

    Rees, Paul; Seaton, Niels

    2011-01-01

    Tragically, for many schools, the possibility of a crisis such as a natural disaster, extreme violence or a potentially traumatising threat has become a reality. Specialist input from a local psychology service is often sought at such a time. To help one service within the United Kingdom (UK) learn from the experience of other psychologists a…

  1. Facing Mental Health Crises on Campus

    ERIC Educational Resources Information Center

    Trela, Kimberly

    2008-01-01

    Educating the student body on mental health involves outreach to groups not normally exposed to this information, including athletes, ethnic groups, residence hall inhabitants, fraternities and sororities, and international students. Frontline responders can help facilitate this outreach through initiatives that involve presentations by counselors…

  2. The Function of Ambiguity in Child Crises

    ERIC Educational Resources Information Center

    Stein, Myron

    1970-01-01

    Discusses the function of ambiguity" (an attitude of hatibual uncertainty, vagueness, and imprecision of communication) in crisis situations involving adult-child interchanges. Makes suggestions for medical and psychiatric counselors. Paper was presented at the meeting of the American Association of Psychiatric Clinics for Children, Boston,…

  3. Narcissistic Crises of Aging and Suicidal Despair.

    ERIC Educational Resources Information Center

    Clark, David C.

    1993-01-01

    Reviews some of dangers inherent in oversimplifying nature of suicide for public education purposes, then outlines model of elderly suicide derived from community-based psychological autopsy study. Hypothesizes that elderly persons who die by suicide have lifelong character fault that remains invisible until aging life-changes force issue into the…

  4. Liquidity crises on different time scales

    NASA Astrophysics Data System (ADS)

    Corradi, Francesco; Zaccaria, Andrea; Pietronero, Luciano

    2015-12-01

    We present an empirical analysis of the microstructure of financial markets and, in particular, of the static and dynamic properties of liquidity. We find that on relatively large time scales (15 min) large price fluctuations are connected to the failure of the subtle mechanism of compensation between the flows of market and limit orders: in other words, the missed revelation of the latent order book breaks the dynamical equilibrium between the flows, triggering the large price jumps. On smaller time scales (30 s), instead, the static depletion of the limit order book is an indicator of an intrinsic fragility of the system, which is related to a strongly nonlinear enhancement of the response. In order to quantify this phenomenon we introduce a measure of the liquidity imbalance present in the book and we show that it is correlated to both the sign and the magnitude of the next price movement. These findings provide a quantitative definition of the effective liquidity, which proves to be strongly dependent on the considered time scales.

  5. [Crises of public health, medicine, society?].

    PubMed

    Thilly, C H

    1995-01-01

    Public health is in crisis. Apart from temporary factors, this crisis could have also its origin in theoretical and conceptual insufficiencies relative to the definition of this scientific domain. Organisational and institutional conditions needed for the strengthening of public health are discussed in relation with the localization of its production sites, taking into account the needed synthesis or consensus to reach and in view of the larger and valuable intellectual traditions to which it belongs. The crisis of public health is only part of a crisis of medicine and of our modern societies.

  6. Managing crises effectively: an intervention model.

    PubMed

    Lawler, T G; Yount, E H

    1987-11-01

    The nature of our work in health care is such that it lends itself to high levels of ambiguity at best and frequently even to the presence of crisis situations. The ability to manage crisis, therefore, is an increasingly vital skill for nurse executives. Creative and productive possibilities can arise from coping well with such serious and unusual events. This article suggests a model for crisis management.

  7. Association between EMS Question Bank Completion and Passing Rates on the EMS Certification Examination.

    PubMed

    Clemency, Brian; Martin-Gill, Christian; Rall, Nicole; May, Paul; Lubin, Jeffrey; Cooley, Craig; Van Dillen, Christine; Silvestri, Salvatore; Portela, Roberto; Cooney, Derek; Knutsen, Christian; March, Juan

    2017-01-01

    A board review question bank was created to assist candidates in their preparation for the 2015 EMS certification examination. We aimed to describe the development of this question bank and evaluate its successes in preparing candidates to obtain EMS subspecialty board certification. An online question bank was developed by 13 subject matter experts who participated as item writers, representing eight different EMS fellowship programs. The online question bank consisted of four practice tests, with each of the tests comprised of 100 questions. The number of candidates who participated in and completed the question bank was calculated. The passing rate among candidates who completed the question bank was calculated and compared to the publicly reported statistics for all candidates. The relationship between candidates' performance on the question bank and subspecialty exam pass rates was determined. A total of 252 candidates took at least one practice test and, of those, 225 candidates completed all four 100-question practice tests. The pass rate on the 2015 EMS certification exam was 79% (95%CI 74-85%) among candidates who completed the question bank, which is 12% higher than the overall pass rate (p = 0.003). Candidates' performance on the question bank was positively associated with overall success on the exam (X(2) = 75.8, p < 0.0001). Achieving a score of ≥ 70% on the question bank was associated with a higher likelihood of passing the exam (OR = 17.8; 95% CI: 8.0-39.6). Completing the question bank program was associated with improved pass rates on the EMS certification exam. Strong performance on the question bank correlated with success on the exam.

  8. Light curve analysis of southern eclipsing binary EM Car

    NASA Astrophysics Data System (ADS)

    Ćiçek, C.; Bulut, I.; Bulut, A.

    2017-02-01

    In this study, ASAS light curve of the eclipsing binary EM Car (Sp = O8V, P = 3.4 days) has been analyzed using the Wilson-Devinney method. The light curve analyses have found that EM Car is a detached eclipsing binary system with small eccentric orbit

  9. Genetic-based EM algorithm for learning Gaussian mixture models.

    PubMed

    Pernkopf, Franz; Bouchaffra, Djamel

    2005-08-01

    We propose a genetic-based expectation-maximization (GA-EM) algorithm for learning Gaussian mixture models from multivariate data. This algorithm is capable of selecting the number of components of the model using the minimum description length (MDL) criterion. Our approach benefits from the properties of Genetic algorithms (GA) and the EM algorithm by combination of both into a single procedure. The population-based stochastic search of the GA explores the search space more thoroughly than the EM method. Therefore, our algorithm enables escaping from local optimal solutions since the algorithm becomes less sensitive to its initialization. The GA-EM algorithm is elitist which maintains the monotonic convergence property of the EM algorithm. The experiments on simulated and real data show that the GA-EM outperforms the EM method since: 1) We have obtained a better MDL score while using exactly the same termination condition for both algorithms. 2) Our approach identifies the number of components which were used to generate the underlying data more often than the EM algorithm.

  10. CryoEM at IUCrJ: a new era

    PubMed Central

    Subramaniam, Sriram; Kühlbrandt, Werner; Henderson, Richard

    2016-01-01

    In this overview, we briefly outline recent advances in electron cryomicroscopy (cryoEM) and explain why the journal IUCrJ, published by the International Union of Crystallography, could provide a natural home for publications covering many present and future developments in the cryoEM field. PMID:26870375

  11. 7 CFR 759.6 - EM to be made available.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... natural disaster has occurred in a county, resulting in severe physical losses. If the FSA Administrator determines that such a natural disaster has occurred, then EM can be made available to eligible farmers for... AGRICULTURE SPECIAL PROGRAMS DISASTER DESIGNATIONS AND NOTIFICATIONS § 759.6 EM to be made available. (a)...

  12. 7 CFR 759.6 - EM to be made available.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... natural disaster has occurred in a county, resulting in severe physical losses. If the FSA Administrator determines that such a natural disaster has occurred, then EM can be made available to eligible farmers for... AGRICULTURE SPECIAL PROGRAMS DISASTER DESIGNATIONS AND NOTIFICATIONS § 759.6 EM to be made available. (a)...

  13. Improvements in haemolysis and indicators of erythrocyte survival do not correlate with acute vaso-occlusive crises in patients with sickle cell disease: a phase III randomized, placebo-controlled, double-blind study of the Gardos channel blocker senicapoc (ICA-17043).

    PubMed

    Ataga, Kenneth I; Reid, Marvin; Ballas, Samir K; Yasin, Zahida; Bigelow, Carolyn; James, Luther St; Smith, Wally R; Galacteros, Frederic; Kutlar, Abdullah; Hull, James H; Stocker, Jonathan W

    2011-04-01

    Red blood cell (RBC) hydration is regulated in part by the Ca(2+) -activated K(+) efflux (Gardos) channel. Senicapoc selectively blocks potassium efflux through the Gardos channel, reducing RBC dehydration and haemolysis, and increasing haemoglobin levels in sickle cell disease (SCD). This randomized, placebo-controlled trial was designed to determine the safety and clinical efficacy of senicapoc in SCD patients. One hundred and forty-five patients were randomized to receive senicapoc and 144 patients to receive placebo for 52 weeks. Consistent with a previous study, patients in the senicapoc group had significantly increased haematocrit, haemoglobin, and decreased numbers of both dense erythrocytes and reticulocytes when compared to the placebo group. The unblinded Data Monitoring Committee terminated this study early due to a lack of efficacy when it determined that, despite improvements in anaemia and haemolysis, no significant improvement in the rate of sickle cell painful crises was observed in patients treated with senicapoc compared to those on placebo (0·38 vs. 0·31, respectively). Comparisons of the times to first, second and third crises between the senicapoc and placebo groups were not statistically significant. Nausea and urinary tract infections occurred more frequently in the senicapoc group than placebo. Serious adverse events were similar in the two groups.

  14. The Post-LBV Supernova 2001em

    NASA Astrophysics Data System (ADS)

    Van Dyk, Schuyler D.; Chornock, R.; Filippenko, A. V.; Foley, R. J.; Lewin, W. H. G.; Li, W.; Panagia, N.; Pooley, D.; Stockdale, C. J.; Weiler, K. W.

    2009-12-01

    The supernova (SN) 2001em in UGC 11794 was classified early as Type Ib/c, i.e., as one arising from a hydrogen-stripped star. As part of a radio survey with the Very Large Array of SNe Ib/c at late times (Stockdale et al. 2003, BAAS, 35, 1346), SN 2001em was detected as a highly luminous radio source ˜2 years after explosion. The SN was also subsequently discovered with Chandra to be a very luminous X-ray source. The properties of both the radio and X-ray emission are more characteristic of the Type II-narrow (IIn) SNe, where the SN shock is interacting with dense, massive circumstellar matter, resulting in bright radio synchrotron emission and thermal bremsstrahlung from the interaction region. In fact, SN 2001em has shown to have spectroscopically transformed to a SN IIn. The premise that this might indicate an off-axis gamma-ray burst has been presented (Granot & Ramirez-Ruiz 2004, ApJ, 609, L9) and later, rather convincingly, refuted (e.g., Schinzel et al. 2009, ApJ, 691, 1380). Chugai & Chevalier (2006, ApJ, 641, 1051) have interpreted the spectral transformation and radio/X-ray emission as the SN shock overtaking the detached hydrogen envelope of the progenitor star, which was shed in a superwind episode many years prior to explosion. Chevalier (2007, RMxAC, 30, 41) has further pointed to the required mass-loss rate in the event being equivalent to what would occur in the eruption of a luminous blue variable (LBV). The optical (ground-based and HST) and radio/X-ray data, together with mid-infrared Spitzer observations, tend to support this scenario of a very massive star that experienced a powerful LBV outburst prior to explosion. Such an event may not be unique, with possible parallels in the cases of SNe 2005bf and 2006jc, and may provide valuable new information about massive stellar evolution.

  15. Refinement of atomic models in high resolution EM reconstructions using Flex-EM and local assessment.

    PubMed

    Joseph, Agnel Praveen; Malhotra, Sony; Burnley, Tom; Wood, Chris; Clare, Daniel K; Winn, Martyn; Topf, Maya

    2016-05-01

    As the resolutions of Three Dimensional Electron Microscopic reconstructions of biological macromolecules are being improved, there is a need for better fitting and refinement methods at high resolutions and robust approaches for model assessment. Flex-EM/MODELLER has been used for flexible fitting of atomic models in intermediate-to-low resolution density maps of different biological systems. Here, we demonstrate the suitability of the method to successfully refine structures at higher resolutions (2.5-4.5Å) using both simulated and experimental data, including a newly processed map of Apo-GroEL. A hierarchical refinement protocol was adopted where the rigid body definitions are relaxed and atom displacement steps are reduced progressively at successive stages of refinement. For the assessment of local fit, we used the SMOC (segment-based Manders' overlap coefficient) score, while the model quality was checked using the Qmean score. Comparison of SMOC profiles at different stages of refinement helped in detecting regions that are poorly fitted. We also show how initial model errors can have significant impact on the goodness-of-fit. Finally, we discuss the implementation of Flex-EM in the CCP-EM software suite. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Refinement of atomic models in high resolution EM reconstructions using Flex-EM and local assessment

    PubMed Central

    Joseph, Agnel Praveen; Malhotra, Sony; Burnley, Tom; Wood, Chris; Clare, Daniel K.; Winn, Martyn; Topf, Maya

    2016-01-01

    As the resolutions of Three Dimensional Electron Microscopic reconstructions of biological macromolecules are being improved, there is a need for better fitting and refinement methods at high resolutions and robust approaches for model assessment. Flex-EM/MODELLER has been used for flexible fitting of atomic models in intermediate-to-low resolution density maps of different biological systems. Here, we demonstrate the suitability of the method to successfully refine structures at higher resolutions (2.5–4.5 Å) using both simulated and experimental data, including a newly processed map of Apo-GroEL. A hierarchical refinement protocol was adopted where the rigid body definitions are relaxed and atom displacement steps are reduced progressively at successive stages of refinement. For the assessment of local fit, we used the SMOC (segment-based Manders’ overlap coefficient) score, while the model quality was checked using the Qmean score. Comparison of SMOC profiles at different stages of refinement helped in detecting regions that are poorly fitted. We also show how initial model errors can have significant impact on the goodness-of-fit. Finally, we discuss the implementation of Flex-EM in the CCP-EM software suite. PMID:26988127

  17. EMS incident management: emergency medical logistics.

    PubMed

    Maniscalco, P M; Christen, H T

    1999-01-01

    If you had to get x amount of supplies to point A or point B, or both, in 10 minutes, how would you do it? The answer lies in the following steps: 1. Develop a logistics plan. 2. Use emergency management as a partner agency for developing your logistics plan. 3. Implement a push logistics system by determining what supplies/medications and equipment are important. 4. Place mass casualty/disaster caches at key locations for rapid deployment. Have medication/fluid caches available at local hospitals. 5. Develop and implement command caches for key supervisors and managers. 6. Anticipate the logistics requirements of a terrorism/tactical violence event based on a community threat assessment. 7. Educate the public about preparing a BLS family disaster kit. 8. Test logistics capabilities at disaster exercises. 9. Budget for logistics needs. 10. Never underestimate the importance of logistics. When logistics support fails, the EMS system fails.

  18. A new preparedness policy for EMS logistics.

    PubMed

    Lee, Seokcheon

    2017-03-01

    Response time in emergency medical services (EMS) is defined as the interval for an ambulance to arrive the scene after receipt of a 911 call. When several ambulances are available upon the receipt of a new call, a decision of selecting an ambulance has to be made in an effort to reduce response time. Dispatching the closest unit available is commonly used in practice; however, recently the Preparedness policy was designed that is in a simplistic form yet being capable of securing a long-term efficiency. This research aims to improve the Preparedness policy, resolving several critical issues inherent in the current form of the policy. The new Preparedness policy incorporates a new metric of preparedness based on the notion of centrality and involves a tuning parameter, weight on preparedness, which has to be appropriately chosen according to operational scenario. Computational experiment shows that the new policy significantly improves the former policy robustly in various scenarios.

  19. Online EM with weight-based forgetting.

    PubMed

    Celaya, Enric; Agostini, Alejandro

    2015-05-01

    In the online version of the EM algorithm introduced by Sato and Ishii ( 2000 ), a time-dependent discount factor is introduced for forgetting the effect of the old estimated values obtained with an earlier, inaccurate estimator. In their approach, forgetting is uniformly applied to the estimators of each mixture component depending exclusively on time, irrespective of the weight attributed to each unit for the observed sample. This causes an excessive forgetting in the less frequently sampled regions. To address this problem, we propose a modification of the algorithm that involves a weight-dependent forgetting, different for each mixture component, in which old observations are forgotten according to the actual weight of the new samples used to replace older values. A comparison of the time-dependent versus the weight-dependent approach shows that the latter improves the accuracy of the approximation and exhibits much greater stability.

  20. DOE EM industry programs robotics development

    SciTech Connect

    Staubly, R.; Kothari, V.

    1997-12-01

    The Office of Science and Technology (OST) manages an aggressive program for RD&D, as well as testing and evaluation for the U.S. Department of Energy`s (DOE) Environmental Management (EM) organization. The goal is to develop new and improved environmental restoration and waste management technologies to clean up the inventory of the DOE weapons complex faster, safer, and cheaper than is possible with currently available technologies. OST has organized technology management activities along focus teams for each major problem area. There are currently five focus areas: decontamination and decommissioning, tanks, subsurface contaminants, mixed waste, and plutonium. In addition, OST is pursuing research and development (R&D) that cuts across these focus areas by having applications in two or more focus areas. Currently, there are three cross-cutting programs: the robotics technology development; characterization, monitoring, and sensor technologies; and efficient separations and processing.

  1. Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments.

    PubMed

    Wijesekera, Olindi; Reed, Amanda; Chastain, Parker S; Biggs, Shauna; Clark, Elizabeth G; Kole, Tamorish; Chakrapani, Anoop T; Ashish, Nandy; Rajhans, Prasad; Breaud, Alan H; Jacquet, Gabrielle A

    2016-12-01

    Introduction Without a universal Emergency Medical Services (EMS) system in India, data on the epidemiology of patients who utilize EMS are limited. This retrospective chart review aimed to quantify and describe the burden of disease and patient demographics of patients who arrived by EMS to four Indian emergency departments (EDs) in order to inform a national EMS curriculum.

  2. Best Practices for Managing Large CryoEM Facilities

    PubMed Central

    Alewijnse, Bart; Ashton, Alun W.; Chambers, Melissa G.; Chen, Songye; Cheng, Anchi; Ebrahim, Mark; Eng, Edward; Hagen, Wim J. H.; Koster, Abraham J.; López, Claudia S.; Lukoyanova, Natalya; Ortega, Joaquin; Renault, Ludovic; Reyntjens, Steve; Rice, William J.; Scapin, Giovanna; Schrijver, Raymond; Siebert, Alistair; Stagg, Scott M.; Grum-Tokars, Valerie; Wright, Elizabeth R.; Wu, Shenping; Yu, Zhiheng; Zhou, Z. Hong; Carragher, Bridget; Potter, Clinton S.

    2017-01-01

    This paper provides an overview of the discussion and presentations from the Workshop on the Management of Large CryoEM Facilities held at the New York Structural Biology Center, New York, NY on February 6–7, 2017. A major objective of the workshop was to discuss best practices for managing cryoEM facilities. The discussions were largely focused on supporting single-particle methods for cryoEM and topics included: user access, assessing projects, workflow, sample handling, microscopy, data management and processing, and user training. PMID:28827185

  3. Environmental Education and Development Division (EM-522). Annual report, Fiscal year 1993

    SciTech Connect

    Not Available

    1993-12-31

    The Environmental Education and Development Division (EM-522) is one of three divisions within the Office of Technology Integration and Environmental Education and Development (EM-52) in Environmental Restoration and Waste Management`s (EM`s) Office of Technology Development (EM-50). The primary design criterion for EM-522 education activities is directly related to meeting EM`s goal of environmental compliance on an accelerated basis and cleanup of the 1989 inventory of inactive sites and facilities by the year 2019. Therefore, EM-522`s efforts are directed specifically toward stimulating knowledge and capabilities to achieve the goals of EM while contributing to DOE`s overall goal of increasing scientific, mathematical, and technical literacy and competency. This report discusses fiscal year 1993 activities.

  4. Transforming EMS Compliance at the Utah National Guard with an Automated Tool

    DTIC Science & Technology

    2009-05-01

    14001 & EMS 16 ISO 14001 EMS Requirements ISO14001 Requirement Condition WebEMIS™ 4.1 General Requirements None Uploads and stores EO 13423, EO...top level management with metrics and performance measures based on media WebEMIS vs. ISO 14001 & EMS 17 ISO 14001 EMS Requirements ISO14001 ...14001 EMS Requirements ISO14001 Requirement Condition WebEMIS 4.4 Implementation and Operation 4.4.1 Resources, Roles, Responsibility and Authority

  5. Learning Astronomy by Playing in a Park. (Spanish Title: Aprender AstronoMía Jugando en Una Plaza.) Aprender Astronomia Brincando em Uma Praça

    NASA Astrophysics Data System (ADS)

    Camino, Néstor

    2012-12-01

    trabalho alguns jogos de praça, considerados como módulos didáticos para imaginar processos astronômicos, a partir da concepção de que a aprendizagem em Astronomia deve-se desenvolver fortalecendo a relação do próprio corpo com o espaço tridimensional e com o tempo, tal como se vive ao observar o céu, construindo um "diálogo" entre o mundo real e as aprendizagens a construir. Os jogos apresentados (carrosséis e tobogãs) foram desenhados para trabalhar sobre a translação da Terra em torno do Sol, as fases da Lua e a gravidade, e sobre o que um observador percebe dos mesmos. Dá-se a descrição de cada jogo, discutem-se seus fundamentos físicos e astronômicos, e desenvolve-se uma crítica didática dos mesmos. Finalmente, comenta-se o papel que deveriam ter os docentes no apoio aos aprendizes no processo de interação com os jogos apresentados.

  6. Recent developments in the CCP-EM software suite

    PubMed Central

    Burnley, Tom

    2017-01-01

    As part of its remit to provide computational support to the cryo-EM community, the Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) has produced a software framework which enables easy access to a range of programs and utilities. The resulting software suite incorporates contributions from different collaborators by encapsulating them in Python task wrappers, which are then made accessible via a user-friendly graphical user interface as well as a command-line interface suitable for scripting. The framework includes tools for project and data management. An overview of the design of the framework is given, together with a survey of the functionality at different levels. The current CCP-EM suite has particular strength in the building and refinement of atomic models into cryo-EM reconstructions, which is described in detail. PMID:28580908

  7. E.M. and Hadronic Shower Simulation with FLUKA

    SciTech Connect

    Battistoni, G.; Fasso, A.; Ferrari, A.; Ranft, J.; Rubbia, A.; Sala, P.R.; /INFN, Milan /SLAC /CERN /Siegen U. /Zurich, ETH

    2005-10-03

    A description of the main features of e.m. and hadronic shower simulation models used in the FLUKA code is summarized and some recent applications are discussed. The general status of the FLUKA project is also reported.

  8. Recent developments in the CCP-EM software suite.

    PubMed

    Burnley, Tom; Palmer, Colin M; Winn, Martyn

    2017-06-01

    As part of its remit to provide computational support to the cryo-EM community, the Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) has produced a software framework which enables easy access to a range of programs and utilities. The resulting software suite incorporates contributions from different collaborators by encapsulating them in Python task wrappers, which are then made accessible via a user-friendly graphical user interface as well as a command-line interface suitable for scripting. The framework includes tools for project and data management. An overview of the design of the framework is given, together with a survey of the functionality at different levels. The current CCP-EM suite has particular strength in the building and refinement of atomic models into cryo-EM reconstructions, which is described in detail.

  9. DOE-EM Science of Safety Robotics Challenge

    SciTech Connect

    Rimando, Rodrigo; Watts, Alex; Bobbitt, John; McLaughlin, Doug; Quigley, Morgan; Gladwell, Scott; McLoughlin, Mike; Kinnamon, Tony; Garcia, Joe; Ansari, Alex; Voyles, Richard; Chambers, David; Pryor, Mitch; Workman, Theresa; Mehling, Joshua; Browning, Kimberly; Deuel, Jake; Profitt, Bryan; Reibold, Marty

    2016-09-20

    During the week of August 22nd, 2016, over 150 technologists, stakeholders, and Department of Energy, Office of Environmental Management workers, met at DOE’s Portsmouth Gaseous Diffusion Plant in Ohio, for the EM Science of Safety Robotics Challenge.

  10. Near-atomic-resolution cryo-EM for molecular virology.

    PubMed

    Hryc, Corey F; Chen, Dong-Hua; Chiu, Wah

    2011-08-01

    Electron cryo-microscopy (cryo-EM) is a technique in structural biology that is widely used to solve the three-dimensional structures of macromolecular assemblies, close to their biological and solution conditions. Recent improvements in cryo-EM and single-particle reconstruction methodologies have led to the determination of several virus structures at near-atomic resolution (3.3 - 4.6 Å). These cryo-EM structures not only resolve the Cα backbones and side-chain densities of viral capsid proteins, but also suggest functional roles that the protein domains and some key amino acid residues play. This paper reviews the recent advances in near-atomic-resolution cryo-EM for probing the mechanisms of virus assembly and morphogenesis.

  11. EMS: A framework for data acquisition and analysis

    NASA Astrophysics Data System (ADS)

    Nogiec, J. M.; Sim, J.; Trombly-Freytag, K.; Walbridge, D.

    2001-08-01

    The Extensible Measurement System (EMS) is a universal Java framework for building data analysis and test systems. The objective of the EMS project is to replace a multitude of different existing systems with a single expandable system, capable of accommodating various test and analysis scenarios and varying algorithms. The EMS framework is based on component technology, graphical assembly of systems, introspection and flexibility to accommodate various data processing and data acquisition components. Core system components, common to many application domains, have been identified and designed together with the domain-specific components for the measurement of accelerator magnets. The EMS employs several modern technologies and the result is a highly portable, configurable, and potentially distributed system, with the capability of parallel signal data processing, parameterized test scripting, and run-time reconfiguration.

  12. EmPOWER Maryland - Leveraging relationships and experience

    EPA Pesticide Factsheets

    DHCD has gained a deep understanding of the needs of Maryland’s low-income residents and therefore was well-positioned to implement the low-income components of the broader EmPOWER Maryland energy efficiency initiative.

  13. Classification of ASASSN-17em/AT2017cts

    NASA Astrophysics Data System (ADS)

    Bersier, David

    2017-04-01

    We obtained a spectrum of the candidate supernova ASASSN-17em/AT2017cts (ATEL #10241), using the SPRAT spectrograph mounted on the robotic 2m Liverpool Telescope at the Roque de los Muchachos observatory (La Palma).

  14. Classification of ASASSN-17em/AT2017cts

    NASA Astrophysics Data System (ADS)

    Bersier, David

    2017-04-01

    We obtained a spectrum of the candidate supernova ASASSN-17em/AT2017cts (ATEL #10241), using the SPRAT spectrograph mounted on the robotic 2m Liverpool Telescope at the Roque de los Muchachos observatory (La Palma).

  15. Analysis of NSWC Ocean EM Observatory Test Data

    DTIC Science & Technology

    2016-09-01

    Analysis of NSWC Ocean EM Observatory test data: final report J. Bradley Nelson Date: September 2016 Contract #: NICOP - N62909-15...From - To) 09/01/2016 Technical Report #2 July 2015 - September 2016 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Analysis of NSWC Ocean EM Observatory...distribution is unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT NSWC-Carderock is leading a defense/academia group to instrument the South Florida Ocean

  16. NASA EM Followup of LIGO-Virgo Candidate Events

    NASA Technical Reports Server (NTRS)

    Blackburn, Lindy L.

    2011-01-01

    We present a strategy for a follow-up of LIGO-Virgo candidate events using offline survey data from several NASA high-energy photon instruments aboard RXTE, Swift, and Fermi. Time and sky-location information provided by the GW trigger allows for a targeted search for prompt and afterglow EM signals. In doing so, we expect to be sensitive to signals which are too weak to be publicly reported as astrophysical EM events.

  17. Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

    NASA Image and Video Library

    2016-10-31

    The right hand aft skirt for NASA's Space Launch System (SLS) rocket has been refurbished and painted and is in a drying cell in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the right hand booster of the SLS for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

  18. Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

    NASA Image and Video Library

    2016-10-28

    A technician with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, preps a section of the right hand aft skirt for primer and paint in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the right hand booster of NASA's SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

  19. Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

    NASA Image and Video Library

    2016-10-29

    The right hand aft skirt for NASA's Space Launch System (SLS) rocket has been painted and is in a drying cell in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the right hand booster of NASA's Space Launch System rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

  20. EM Telemetry Tool for Deep Well Drilling Applications

    SciTech Connect

    Jeffrey M. Gabelmann

    2005-11-15

    This final report discusses the successful development and testing of a deep operational electromagnetic (EM) telemetry system, produced under a cooperative agreement with the United States Department of Energy's National Energy Technology Laboratory. This new electromagnetic telemetry system provides a wireless communication link between sensors deployed deep within oil and gas wells and data acquisition equipment located on the earth's surface. EM based wireless telemetry is a highly appropriate technology for oil and gas exploration in that it avoids the need for thousands of feet of wired connections. In order to achieve the project performance objectives, significant improvements over existing EM telemetry systems were made. These improvements included the development of new technologies that have improved the reliability of the communications link while extending operational depth. A key element of the new design is the incorporation of a data-fusion methodology which enhances the communication receiver's ability to extract very weak signals from large amounts of ambient environmental noise. This innovative data-fusion receiver based system adapts advanced technologies, not normally associated with low-frequency communications, and makes them work within the harsh drilling environments associated with the energy exploration market. Every element of a traditional EM telemetry system design, from power efficiency to reliability, has been addressed. The data fusion based EM telemetry system developed during this project is anticipated to provide an EM tool capability that will impact both onshore and offshore oil and gas exploration operations, for conventional and underbalanced drilling applications.

  1. STEME: efficient EM to find motifs in large data sets.

    PubMed

    Reid, John E; Wernisch, Lorenz

    2011-10-01

    MEME and many other popular motif finders use the expectation-maximization (EM) algorithm to optimize their parameters. Unfortunately, the running time of EM is linear in the length of the input sequences. This can prohibit its application to data sets of the size commonly generated by high-throughput biological techniques. A suffix tree is a data structure that can efficiently index a set of sequences. We describe an algorithm, Suffix Tree EM for Motif Elicitation (STEME), that approximates EM using suffix trees. To the best of our knowledge, this is the first application of suffix trees to EM. We provide an analysis of the expected running time of the algorithm and demonstrate that STEME runs an order of magnitude more quickly than the implementation of EM used by MEME. We give theoretical bounds for the quality of the approximation and show that, in practice, the approximation has a negligible effect on the outcome. We provide an open source implementation of the algorithm that we hope will be used to speed up existing and future motif search algorithms.

  2. STEME: efficient EM to find motifs in large data sets

    PubMed Central

    Reid, John E.; Wernisch, Lorenz

    2011-01-01

    MEME and many other popular motif finders use the expectation–maximization (EM) algorithm to optimize their parameters. Unfortunately, the running time of EM is linear in the length of the input sequences. This can prohibit its application to data sets of the size commonly generated by high-throughput biological techniques. A suffix tree is a data structure that can efficiently index a set of sequences. We describe an algorithm, Suffix Tree EM for Motif Elicitation (STEME), that approximates EM using suffix trees. To the best of our knowledge, this is the first application of suffix trees to EM. We provide an analysis of the expected running time of the algorithm and demonstrate that STEME runs an order of magnitude more quickly than the implementation of EM used by MEME. We give theoretical bounds for the quality of the approximation and show that, in practice, the approximation has a negligible effect on the outcome. We provide an open source implementation of the algorithm that we hope will be used to speed up existing and future motif search algorithms. PMID:21785132

  3. A History and Informal Assessment of the <em>Slacker Astronomyem> Podcast

    NASA Astrophysics Data System (ADS)

    Price, Aaron; Gay, Pamela; Searle, Travis; Brissenden, Gina

    Slacker Astronomyem> is a weekly podcast that covers a recent astronomical news event or discovery. The show has a unique style consisting of irreverent, over-the-top humor combined with a healthy dose of hard science. According to our demographic analysis, the combination of this style and the unique podcasting distribution mechanism allows the show to reach audiences younger and busier than those reached via traditional channels. We report on the successes and challenges of the first year of the show, and provide an informal assessment of its role as a source for astronomical news and concepts for its approximately 15,500 weekly listeners.

  4. A HF EM installation allowing simultaneous whole body and deep local EM hyperthermia.

    PubMed

    Mazokhin, V N; Kolmakov, D N; Lucheyov, N A; Gelvich, E A; Troshin, I I

    1999-01-01

    The structure and main features of a HF EM installation based upon a new approach for creating electromagnetic fields destined for whole body (WBH) and deep local (DLH) hyperthermia are discussed. The HF EM field, at a frequency of 13.56 MHz, is created by a coplanar capacity type applicator positioned under a distilled water filled bolus that the patient is lying on. The EM energy being released directly in the deep tissues ensures effective whole body heating to required therapeutic temperatures of up to 43.5 degrees C, whereas the skin temperature can be maintained as low as 39-40.5 degrees C. For DLH, the installation is equipped with additional applicators and a generator operating at a frequency of 40.68 MHz. High efficiency of the WBH applicator makes it possible to carry out the WBH procedure without any air-conditioning cabin. Due to this, a free access to the patient's body during the WBH treatment is provided and a simultaneous WBH/DLH or WBH/LH procedure by means of additional applicators is possible. Controllable power output in the range of 100-800 W at a frequency of 13.56 MHz and 50-350 W at a frequency of 40.68 MHz allows accurate temperature control during WBH, DLH and WBH/DLH procedures. SAR patterns created by the WBH and DLH applicators in a liquid muscle phantom and measured by means of a non-perturbing E-dipole are investigated. The scattered EM field strength measured in the vicinity of the operating installation during the WBH, DLH and WBH/DLH procedures does not exceed security standards. Examples of temperature versus time graphs in the course of WBH, DLH and WBH/DLH procedures in clinics are presented. The installation is successfully used in leading oncological institutions of Russia and Belarus, though combined WBH/DLH procedures are evidently more complicated and demand thorough planning and temperature measurements to avoid overheating.

  5. Airborne EM for mine infrastructure planning

    NASA Astrophysics Data System (ADS)

    Wijns, Chris

    2016-08-01

    Airborne electromagnetic (AEM) surveys with near-surface vertical resolution provide rapid and comprehensive coverage of a mine site ahead of infrastructure planning. In environments of sufficient electrical conductivity contrast, the data will map variations in the depth to bedrock, providing guidance for expected excavation depths for solid building foundations, or mine pre-strip volumes. Continuous coverage overcomes the severe areal limitation of relying only on drilling and test pits. An AEM survey in northern Finland illustrates the success of this approach for guiding the placement of a mine crusher and related infrastructure. The cost of the EM data collection and interpretation is insignificant in comparison to the US$300 million capital cost of the mine infrastructure. This environment of shallow glacial cover challenges the limits of AEM resolution, yet analysis of subsequently collected three-dimensional (3D) surface seismic data and actual pre-strip excavation depths reinforces the predictive, but qualitative, mapping capability of the AEM. It also highlights the need to tune the modelling via petrophysics for the specific goal of the investigation, and exposes the limitations of visual drill core logging.

  6. Databases and archiving for cryoEM

    PubMed Central

    Patwardhan, Ardan; Lawson, Catherine L.

    2017-01-01

    Cryo-EM in structural biology is currently served by three public archives – EMDB for 3DEM reconstructions, PDB for models built from 3DEM reconstructions and EMPIAR for the raw 2D image data used to obtain the 3DEM reconstructions. These archives play a vital role for both the structural community and the wider biological community in making the data accessible so that results may be reused, reassessed and integrated with other structural and bioinformatics resources. The important role of the archives is underpinned by the fact that many journals mandate the deposition of data to PDB and EMDB on publication. The field is currently undergoing transformative changes where on the one hand high-resolution structures are becoming a routine occurrence while on the other hand electron tomography is enabling the study of macromolecules in the cellular context. Concomitantly the archives are evolving to best serve their stakeholder communities. In this chapter we describe the current state of the archives, resources available for depositing, accessing, searching, visualising and validating data, on-going community-wide initiatives and opportunities and challenges for the future. PMID:27572735

  7. DOE EM industry programs robotics development

    SciTech Connect

    Staubly, R.; Kothari, V.

    1998-12-31

    The Office of Science and Technology (OST) manages an aggressive program for RD and D, as well as testing and evaluation for the Department of Energy`s (DOE`s) Environmental Management (EM) organization. The goal is to develop new and improved environmental restoration and waste management technologies to clean up the inventory of the DOE weapons complex faster, safer, and cheaper than is possible with currently available technologies. Robotic systems reduce worker exposure to the absolute minimum, while providing proven, cost-effective, and, for some applications, the only acceptable technique for addressing challenging problems. Development of robotic systems for remote operations occurs in three main categories: tank waste characterization and retrieval; decontamination and dismantlement; and characterization, mapping, and inspection systems. In addition, the Federal Energy Technology Center (FETC) has some other projects which fall under the heading of supporting R and D. The central objective of all FETC robotic projects is to make robotic systems more attractive by reducing costs and health risks associated with the deployment of robotic technologies in the cleanup of the nuclear weapons complex. This will be accomplished through development of robots that are cheaper, faster, safer, and more reliable, as well as more straightforward to modify/adapt and more intuitive to operate with autonomous capabilities and intelligent controls that prevent accidents and optimize task execution.

  8. Analysis of EM dataset with several sensor configurations obtained by the loop-loop EM survey on magnetic anomalies

    NASA Astrophysics Data System (ADS)

    CHOI, J.; Yi, M. J.; Sasaki, Y.; Son, J.; Nam, M. J.

    2015-12-01

    Most of mineral mines in Korea are located in rugged mountain area embedding small-scale anomalies. Loop-loop EM survey system can be a better choice for exploring those mines because no ground contact is required and portable loops are freely positioned. Survey design is very important for detecting small amount of mineral deposits efficiently and spatial limits of survey lines should be considered. Along a same survey line, surveys with different separations between a transmitter and a receiver are applicable. EM responses are calculated in a layered-earth model embedding magnetic anomalies and analyses considering electric conductivity and magnetic permeability are made for the loop-loop EM survey data. Combining EM dataset with multi-frequency and multi-separation slightly enhanced a reconstructed image. Loop-loop EM survey using PROMOIS system was conducted on a small magnetite mine. Inversion with and without considering magnetic permeability was conducted for EM data with multi-frequency and multi-separation between a transmitter and a receiver.

  9. Image segmentation by EM-based adaptive pulse coupled neural networks in brain magnetic resonance imaging.

    PubMed

    Fu, J C; Chen, C C; Chai, J W; Wong, S T C; Li, I C

    2010-06-01

    We propose an automatic hybrid image segmentation model that integrates the statistical expectation maximization (EM) model and the spatial pulse coupled neural network (PCNN) for brain magnetic resonance imaging (MRI) segmentation. In addition, an adaptive mechanism is developed to fine tune the PCNN parameters. The EM model serves two functions: evaluation of the PCNN image segmentation and adaptive adjustment of the PCNN parameters for optimal segmentation. To evaluate the performance of the adaptive EM-PCNN, we use it to segment MR brain image into gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF). The performance of the adaptive EM-PCNN is compared with that of the non-adaptive EM-PCNN, EM, and Bias Corrected Fuzzy C-Means (BCFCM) algorithms. The result is four sets of boundaries for the GM and the brain parenchyma (GM+WM), the two regions of most interest in medical research and clinical applications. Each set of boundaries is compared with the golden standard to evaluate the segmentation performance. The adaptive EM-PCNN significantly outperforms the non-adaptive EM-PCNN, EM, and BCFCM algorithms in gray mater segmentation. In brain parenchyma segmentation, the adaptive EM-PCNN significantly outperforms the BCFCM only. However, the adaptive EM-PCNN is better than the non-adaptive EM-PCNN and EM on average. We conclude that of the three approaches, the adaptive EM-PCNN yields the best results for gray matter and brain parenchyma segmentation.

  10. FitEM2EM--tools for low resolution study of macromolecular assembly and dynamics.

    PubMed

    Frankenstein, Ziv; Sperling, Joseph; Sperling, Ruth; Eisenstein, Miriam

    2008-01-01

    Studies of the structure and dynamics of macromolecular assemblies often involve comparison of low resolution models obtained using different techniques such as electron microscopy or atomic force microscopy. We present new computational tools for comparing (matching) and docking of low resolution structures, based on shape complementarity. The matched or docked objects are represented by three dimensional grids where the value of each grid point depends on its position with regard to the interior, surface or exterior of the object. The grids are correlated using fast Fourier transformations producing either matches of related objects or docking models depending on the details of the grid representations. The procedures incorporate thickening and smoothing of the surfaces of the objects which effectively compensates for differences in the resolution of the matched/docked objects, circumventing the need for resolution modification. The presented matching tool FitEM2EMin successfully fitted electron microscopy structures obtained at different resolutions, different conformers of the same structure and partial structures, ranking correct matches at the top in every case. The differences between the grid representations of the matched objects can be used to study conformation differences or to characterize the size and shape of substructures. The presented low-to-low docking tool FitEM2EMout ranked the expected models at the top.

  11. Colloidal Oatmeal <em>(Avena Sativa)em> Improves Skin Barrier Through Multi-Therapy Activity.

    PubMed

    Ilnytska, Olha; Kaur, Simarna; Chon, Suhyoun; Reynertson, Kurt A; Nebus, Judith; Garay, Michelle; Mahmood, Khalid; Southall, Michael D

    2016-06-01

    Oats (Avena sativa) are a centuries-old topical treatment for a variety of skin barrier conditions, including dry skin, skin rashes, and eczema; however, few studies have investigated the actual mechanism of action for the skin barrier strengthening activity of colloidal oatmeal. Four extracts of colloidal oatmeal were prepared with various solvents and tested in vitro for skin barrier related gene expression and activity. Extracts of colloidal oatmeal were found to induce the expression of genes related to epidermal differentiation, tight junctions and lipid regulation in skin, and provide pH-buffering capacity. Colloidal oatmeal boosted the expression of multiple target genes related to skin barrier, and resulted in recovery of barrier damage in an in vitro model of atopic dermatitis. In addition, an investigator-blinded study was performed with 50 healthy female subjects who exhibited bilateral moderate to severe dry skin on their lower legs. Subjects were treated with a colloidal oatmeal skin protectant lotion. Clinically, the colloidal oatmeal lotion showed significant clinical improvements in skin dryness, moisturization, and barrier. Taken together, these results demonstrate that colloidal oatmeal can provide clinically effective benefits for dry and compromised skin by strengthening skin barrier.

    <em>J Drugs Dermatolem>. 2016;15(6):684-690.

  12. Emergency medical service (EMS): A unique flight environment

    NASA Technical Reports Server (NTRS)

    Shively, R. Jay

    1993-01-01

    The EMS flight environment is unique in today's aviation. The pilots must respond quickly to emergency events and often fly to landing zones where they have never been before . The time from initially receiving a call to being airborne can be as little as two to three minutes. Often the EMS pilot is the only aviation professional on site, they have no operations people or other pilots to aid them in making decisons. Further, since they are often flying to accident scenes, not airports, there is often complete weather and condition information. Therefore, the initial decision that the pilot must make, accepting or declining a flight, can become very difficult. The accident rate of EMS helicopters has been relatively high over the past years. NASA-Ames research center has taken several steps in an attempt to aid EMS pilots in their decision making and situational awareness. A preflight risk assessment system (SAFE) was developed to aid pilots in their decision making, and was tested at an EMS service. The resutls of the study were promising and a second version incorporating the lessons learned is under development. A second line of research was the development of a low cost electronic chart display (ECD). This is a digital map display to help pilots maintain geographical orientation. Another thrust was undertaken in conjunction with the Aviation Safety Reporting System (ASRS). This involved publicizing the ASRS to EMS pilots and personnel, and calling each of the reporters back to gather additional information. This paper will discuss these efforts and how they may positively impact the safety of EMS operations.

  13. Emergency medical service (EMS): A unique flight environment

    NASA Technical Reports Server (NTRS)

    Shively, R. Jay

    1993-01-01

    The EMS flight environment is unique in today's aviation. The pilots must respond quickly to emergency events and often fly to landing zones where they have never been before . The time from initially receiving a call to being airborne can be as little as two to three minutes. Often the EMS pilot is the only aviation professional on site, they have no operations people or other pilots to aid them in making decisons. Further, since they are often flying to accident scenes, not airports, there is often complete weather and condition information. Therefore, the initial decision that the pilot must make, accepting or declining a flight, can become very difficult. The accident rate of EMS helicopters has been relatively high over the past years. NASA-Ames research center has taken several steps in an attempt to aid EMS pilots in their decision making and situational awareness. A preflight risk assessment system (SAFE) was developed to aid pilots in their decision making, and was tested at an EMS service. The resutls of the study were promising and a second version incorporating the lessons learned is under development. A second line of research was the development of a low cost electronic chart display (ECD). This is a digital map display to help pilots maintain geographical orientation. Another thrust was undertaken in conjunction with the Aviation Safety Reporting System (ASRS). This involved publicizing the ASRS to EMS pilots and personnel, and calling each of the reporters back to gather additional information. This paper will discuss these efforts and how they may positively impact the safety of EMS operations.

  14. Degradation of Benzodiazepines after 120 Days of EMS Deployment

    PubMed Central

    McMullan, Jason T.; Jones, Elizabeth; Barnhart, Bruce; Denninghoff, Kurt; Spaite, Daniel; Zaleski, Erin; Silbergleit, Robert

    2014-01-01

    Introduction EMS treatment of status epilepticus improves outcomes, but the benzodiazepine best suited for EMS use is unclear, given potential high environmental temperature exposures. Objective To describe the degradation of diazepam, lorazepam, and midazolam as a function of temperature exposure and time over 120 days of storage on active EMS units. Methods Study boxes containing vials of diazepam, lorazepam, and midazolam were distributed to 4 active EMS units in each of 2 EMS systems in the southwestern United States during May–August 2011. The boxes logged temperature every minute and were stored in EMS units per local agency policy. Two vials of each drug were removed from each box at 30-day intervals and underwent high-performance liquid chromatography to determine drug concentration. Concentration was analyzed as mean (and 95%CI) percent of initial labeled concentration as a function of time and mean kinetic temperature (MKT). Results 192 samples were collected (2 samples of each drug from each of 4 units per city at 4 time-points). After 120 days, the mean relative concentration (95%CI) of diazepam was 97.0% (95.7–98.2%) and of midazolam was 99.0% (97.7–100.2%). Lorazepam experienced modest degradation by 60 days (95.6% [91.6–99.5%]) and substantial degradation at 90 days (90.3% [85.2-95.4%]) and 120 days (86.5% [80.7–92.3%]). Mean MKT was 31.6°C (95%CI 27.1–36.1). Increasing MKT was associated with greater degradation of lorazepam, but not midazolam or diazepam. Conclusions Midazolam and diazepam experienced minimal degradation throughout 120 days of EMS deployment in high-heat environments. Lorazepam experienced significant degradation over 120 days and appeared especially sensitive to higher MKT exposure. PMID:24548058

  15. Resource Document: Coordination of Pediatric Emergency Care in EMS Systems.

    PubMed

    Remick, Katherine; Gross, Toni; Adelgais, Kathleen; Shah, Manish I; Leonard, Julie C; Gausche-Hill, Marianne

    2017-01-01

    Citing numerous pediatric-specific deficiencies within Emergency Medical Services (EMS) systems, the Institute of Medicine (IOM) recommended that EMS systems appoint a pediatric emergency care coordinator (PECC) to provide oversight of EMS activities related to care of children, to promote the integration of pediatric elements into day-to-day services as well as local and/or regional disaster planning, and to promote pediatric education across all levels of EMS providers. A systematic review of the literature was undertaken to describe the evidence for pediatric coordination across the emergency care continuum. The search strategy was developed by the investigators in consultation with a medical librarian and conducted in OVID, Medline, PubMed, Embase, Web of Science, and CINAHL databases from January 1, 1983 to January 1, 2016. All research articles that measured a patient-related or system-related outcome associated with pediatric coordination in the setting of emergency care, trauma, or disaster were included. Opinion articles, commentaries, and letters to the editors were excluded. Three investigators independently screened citations in a hierarchical manner and abstracted data. Of 149 identified titles, nine were included in the systematic review. The nine articles included one interventional study, five surveys, and three consensus documents. All articles favored the presence of pediatric coordination. The interventional study demonstrated improved documentation, clinical management, and staff awareness of high priority pediatric areas. The current literature supports the identification of pediatric coordination to facilitate the optimal care of children within EMS systems. In order for EMS systems to provide high quality care to children, pediatric components must be integrated into all aspects of care including day-to-day operations, policies, protocols, available equipment and medications, quality improvement efforts, and disaster planning. This systematic

  16. The EM-POGO: A simple, absolute velocity profiler

    NASA Astrophysics Data System (ADS)

    Terker, S. R.; Sanford, T. B.; Dunlap, J. H.; Girton, J. B.

    2013-01-01

    Electromagnetic current instrumentation has been added to the Bathy Systems, Inc. POGO transport sondes to produce a free-falling absolute velocity profiler called EM-POGO. The POGO is a free-fall profiler that measures a depth-averaged velocity using GPS fixes at the beginning and end of a round trip to the ocean floor (or a preset depth). The EM-POGO adds a velocity profile determined from measurements of motionally induced electric fields generated by the ocean current moving through the vertical component of the Earth's magnetic field. In addition to providing information about the vertical structure of the velocity, the depth-dependent measurements improve transport measurements by correcting for the non-constant fall-rate. Neglecting the variable fall rate results in errors O (1 cm s-1). The transition from POGO to EM-POGO included electrically isolating the POGO and electric-field-measuring circuits, installing a functional GPS receiver, finding a pressure case that provided an optimal balance among crush-depth, price and size, and incorporating the electrodes, electrode collar, and the circuitry required for the electric field measurement. The first EM-POGO sea-trial was in July 1999. In August 2006 a refurbished EM-POGO collected 15 absolute velocity profiles; relative and absolute velocity uncertainty was ˜1cms-1 and 0.5-5 cm s-1, respectively, at a vertical resolution of 25 m. Absolute velocity from the EM-POGO compared to shipboard ADCP measurements differed by ˜ 1-2 cm s-1, comparable to the uncertainty in absolute velocity from the ADCP. The EM-POGO is thus a low-cost, easy to deploy and recover, and accurate velocity profiler.

  17. International Space Station (ISS) Emergency Mask (EM) Development

    NASA Technical Reports Server (NTRS)

    Toon, Katherine P.; Hahn, Jeffrey; Fowler, Michael; Young, Kevin

    2011-01-01

    The Emergency Mask (EM) is considered a secondary response emergency Personal Protective Equipment (PPE) designed to provide respiratory protection to the International Space Station (ISS) crewmembers in response to a post-fire event or ammonia leak. The EM is planned to be delivered to ISS in 2012 to replace the current air purifying respirator (APR) onboard ISS called the Ammonia Respirator (AR). The EM is a one ]size ]fits ]all model designed to fit any size crewmember, unlike the APR on ISS, and uses either two Fire Cartridges (FCs) or two Commercial Off-the-Shelf (COTS) 3M(Trademark). Ammonia Cartridges (ACs) to provide the crew with a minimum of 8 hours of respiratory protection with appropriate cartridge swap ]out. The EM is designed for a single exposure event, for either post ]fire or ammonia, and is a passive device that cannot help crewmembers who cannot breathe on their own. The EM fs primary and only seal is around the wearer fs neck to prevent a crewmember from inhaling contaminants. During the development of the ISS Emergency Mask, several design challenges were faced that focused around manufacturing a leak free mask. The description of those challenges are broadly discussed but focuses on one key design challenge area: bonding EPDM gasket material to Gore(Registered Trademark) fabric hood.

  18. Breaking Cryo-EM Resolution Barriers to Facilitate Drug Discovery.

    PubMed

    Merk, Alan; Bartesaghi, Alberto; Banerjee, Soojay; Falconieri, Veronica; Rao, Prashant; Davis, Mindy I; Pragani, Rajan; Boxer, Matthew B; Earl, Lesley A; Milne, Jacqueline L S; Subramaniam, Sriram

    2016-06-16

    Recent advances in single-particle cryoelecton microscopy (cryo-EM) are enabling generation of numerous near-atomic resolution structures for well-ordered protein complexes with sizes ≥ ∼200 kDa. Whether cryo-EM methods are equally useful for high-resolution structural analysis of smaller, dynamic protein complexes such as those involved in cellular metabolism remains an important question. Here, we present 3.8 Å resolution cryo-EM structures of the cancer target isocitrate dehydrogenase (93 kDa) and identify the nature of conformational changes induced by binding of the allosteric small-molecule inhibitor ML309. We also report 2.8-Å- and 1.8-Å-resolution structures of lactate dehydrogenase (145 kDa) and glutamate dehydrogenase (334 kDa), respectively. With these results, two perceived barriers in single-particle cryo-EM are overcome: (1) crossing 2 Å resolution and (2) obtaining structures of proteins with sizes < 100 kDa, demonstrating that cryo-EM can be used to investigate a broad spectrum of drug-target interactions and dynamic conformational states.

  19. Refinement of Atomic Structures Against cryo-EM Maps.

    PubMed

    Murshudov, G N

    2016-01-01

    This review describes some of the methods for atomic structure refinement (fitting) against medium/high-resolution single-particle cryo-EM reconstructed maps. Some of the tools developed for macromolecular X-ray crystal structure analysis, especially those encapsulating prior chemical and structural information can be transferred directly for fitting into cryo-EM maps. However, despite the similarities, there are significant differences between data produced by these two techniques; therefore, different likelihood functions linking the data and model must be used in cryo-EM and crystallographic refinement. Although tools described in this review are mostly designed for medium/high-resolution maps, if maps have sufficiently good quality, then these tools can also be used at moderately low resolution, as shown in one example. In addition, the use of several popular crystallographic methods is strongly discouraged in cryo-EM refinement, such as 2Fo-Fc maps, solvent flattening, and feature-enhanced maps (FEMs) for visualization and model (re)building. Two problems in the cryo-EM field are overclaiming resolution and severe map oversharpening. Both of these should be avoided; if data of higher resolution than the signal are used, then overfitting of model parameters into the noise is unavoidable, and if maps are oversharpened, then at least parts of the maps might become very noisy and ultimately uninterpretable. Both of these may result in suboptimal and even misleading atomic models.

  20. Application of the EM algorithm to radiographic images.

    PubMed

    Brailean, J C; Little, D; Giger, M L; Chen, C T; Sullivan, B J

    1992-01-01

    The expectation maximization (EM) algorithm has received considerable attention in the area of positron emitted tomography (PET) as a restoration and reconstruction technique. In this paper, the restoration capabilities of the EM algorithm when applied to radiographic images is investigated. This application does not involve reconstruction. The performance of the EM algorithm is quantitatively evaluated using a "perceived" signal-to-noise ratio (SNR) as the image quality metric. This perceived SNR is based on statistical decision theory and includes both the observer's visual response function and a noise component internal to the eye-brain system. For a variety of processing parameters, the relative SNR (ratio of the processed SNR to the original SNR) is calculated and used as a metric to compare quantitatively the effects of the EM algorithm with two other image enhancement techniques: global contrast enhancement (windowing) and unsharp mask filtering. The results suggest that the EM algorithm's performance is superior when compared to unsharp mask filtering and global contrast enhancement for radiographic images which contain objects smaller than 4 mm.

  1. Topical Treatment With an Agent Disruptive to <em>P. acnesem> Biofilm Provides Positive Therapeutic Response: Results of a Randomized Clinical Trial.

    PubMed

    Bernhardt, Michael J; Myntti, Matthew F

    2016-06-01

    The traditional disease model of acne has been one of follicular plugging due to 'sticky epithelial cells' associated with increased sebum production with deep follicular anaerobic conditions favoring <em>P. acnesem>- generated inflammation. <em>P. acnesem> biofilms have been found more frequently in patients with acne than controls. Biofilms are genetically coded to create adhesion to the pilosebaceous unit followed by production of a mucopolysaccharide coating capable of binding to lipid surfaces. Traditional therapies for acne have involved mixtures of oral and topical antibiotics admixed with topical keratolytics and retinoids, which are aimed at traditional bacterial reduction as well as downregulating the inflammatory cascade. These approaches are limited by side effect and compliance/tolerability issues. As the <em>P. acnesem> biofilm may, in fact, be the instigator of this process, we studied the use of a topical agent designed to reduce the <em>P. acnesem> biofilm to see if reducing the biofilm would be therapeutically efficacious. We present data of a proprietary topical non-prescription agent with a novel pharmaco mechanism designed to attack the biofilm produced by <em>P. acnesem>. Our data shows a decrease of inflammatory lesions by 44% and non-inflammatory lesions by 32% after 12 weeks and also provided for a meaningful improvement in the quality of life of the patients in the study. These improvements were achieved with a product that was not associated with burning, chafing, irritation, or erythema, which can be seen with topical treatments. It is apparent from this study that by addressing the biofilm which protects the <em>P. acnesem> bacteria through the use of the Acne Gel, the incidence of acne symptoms can be greatly reduced, while having no negative impacts on the patients' skin (ClinicalTrials.gov registry number NCT02404285).

    <em>J Drugs Dermatol. em>2016;15(6):677-683.

  2. Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority.

    PubMed

    Debenham, Sierra; Fuller, Matthew; Stewart, Matthew; Price, Raymond R

    2017-08-11

    By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks. Debenham S , Fuller M , Stewart M , Price RR . Where there is no EMS: lay providers in Emergency Medical Services care - EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):1-3.

  3. EMS Stretcher “Misadventures” in a Large, Urban EMS System: A Descriptive Analysis of Contributing Factors and Resultant Injuries

    PubMed Central

    Goodloe, Jeffrey M.; Crowder, Christopher J.; Arthur, Annette O.; Thomas, Stephen H.

    2012-01-01

    Purpose. There is a paucity of data regarding EMS stretcher-operation-related injuries. This study describes and analyzes characteristics associated with undesirable stretcher operations, with or without resultant injury in a large, urban EMS agency. Methods. In the study agency, all stretcher-related “misadventures” are required to be documented, regardless of whether injury results. All stretcher-related reports between July 1, 2009 and June 30, 2010 were queried in retrospective analysis, avoiding Hawthorne effect in stretcher operations. Results. During the year studied, 129,110 patients were transported. 23 stretcher incidents were reported (0.16 per 1,000 transports). No patient injury occurred. Four EMS providers sustained minor injuries. Among contributing aspects, the most common involved operations surrounding the stretcher-ambulance safety latch, 14/23 (60.9%). From a personnel injury prevention perspective, there exists a significant relationship between combative patients and crew injury related to stretcher operation, Fisher's exact test 0.048. Conclusions. In this large, urban EMS system, the incidence of injury related to stretcher operations in the one-year study period is markedly low, with few personnel injuries and no patient injuries incurred. Safety for EMS personnel and patients could be advanced by educational initiatives that highlight specific events and conditions contributing to stretcher-related adverse events. PMID:22606379

  4. EMS-induced cytomictic variability in safflower (Carthamus tinctorius L.).

    PubMed

    Srivastava, P; Kumar, G

    2011-01-01

    Seeds of safflower (Carthamus tinctorius L.) were subjected to three treatment durations (3h, 5h and 7h) of 0.5 % Ethyl Methane Sulphonate (EMS). Microsporogenesis was carried out in the control as well as in the treated materials. EMS treated plants showed interesting feature of partial inter-meiocyte chromatin migration through channel formation, beak formation or direct cell fusion. Another interesting feature noticed during the study was the fusion among tetrads due to wall dissolution. The phenomenon of cytomixis was recorded at nearly all the stages of microsporogenesis connecting from a few to several meiocytes. Other abnormalities such as laggards, precocious movement, bridge and non-disjunction of chromosomes were also recorded but in very low frequencies. The phenomenon of cytomixis increased along with the increase in treatment duration of EMS. Cells with these types of cytomictic disturbances may probably result in uneven formation of gametes or zygote, heterogenous sized pollen grains or even loss of fertility in future.

  5. Pirmasis lietuvi\\vskas Suvalkijos žemėlapis

    NASA Astrophysics Data System (ADS)

    Girkus, Romualdas; Lukoševičius, Viktoras

    2009-01-01

    Po ilgo paie\\vskos laikotarpio, dr. N. Lietuvninkaitei padedant, KTU bibliotekos Retų knygų skyriaus kartografiniame archyve aptiktas 1915 m. JAV išleistas B. K. Balučio M 1:252 000 Suvalkijos žemėlapis. Lietuvių išeivijos instituto B. K. Balučio fonde žemėlapio sudarymo medžiagos nerasta. Paie\\vska atrodė bevilti\\vska dėl tarpukario Lietuvi\\vskosios enciklopedijos klaidinančios informacijos, kad prasidėjus Pirmajam pasauliniam karui žemėlapis nebuvo išleistas, tad aprašomas ir publikuojamas pirmą kartą.

  6. Recent technical advancements enabled atomic resolution CryoEM

    NASA Astrophysics Data System (ADS)

    Xueming, Li

    2016-01-01

    With recent breakthroughs in camera and image processing technologies single-particle electron cryo-microscopy (CryoEM) has suddenly gained the attention of structural biologists as a powerful tool able to solve the atomic structures of biological complexes and assemblies. Compared with x-ray crystallography, CryoEM can be applied to partially flexible structures in solution and without the necessity of crystallization, which is especially important for large complexes and assemblies. This review briefly explains several key bottlenecks for atomic resolution CryoEM, and describes the corresponding solutions for these bottlenecks based on the recent technical advancements. The review also aims to provide an overview about the technical differences between its applications in biology and those in material science. Project supported by Tsinghua-Peking Joint Center for Life Sciences, China.

  7. Analyses of Subnanometer Resolution Cryo-EM Density Maps

    PubMed Central

    Baker, Matthew L.; Baker, Mariah R.; Hryc, Corey F.; DiMaio, Frank

    2011-01-01

    Today, electron cryomicroscopy (cryo-EM) can routinely achieve subnanometer resolutions of complex macromolecular assemblies. From a density map, one can extract key structural and functional information using a variety of computational analysis tools. At subnanometer resolution, these tools make it possible to isolate individual subunits, identify secondary structures, and accurately fit atomic models. With several cryo-EM studies achieving resolutions beyond 5 Å, computational modeling and feature recognition tools have been employed to construct backbone and atomic models of the protein components directly from a density map. In this chapter, we describe several common classes of computational tools that can be used to analyze and model subnanometer resolution reconstructions from cryo-EM. A general protocol for analyzing subnanometer resolution density maps is presented along with a full description of steps used in analyzing the 4.3 Å resolution structure of Mm-cpn. PMID:20888467

  8. Lietuvos Teritorijos Gravimetrinio Žemėlapio Tikslumo Vertinimas

    NASA Astrophysics Data System (ADS)

    Birvydienė, Rosita; Krikštaponis, Boleslovas; Obuchovski, Romuald; Paršeliūnas, Eimuntas; Petroškevičius, Petras; Šlikas, Dominykas

    2010-01-01

    Remiantis matavimų, atliktų Lietuvos gravimetrinio tinklo punktuose, duomenimis, įvertintas Lietuvos teritorijos 1:200 000 mastelio Bouguer anomalijų gravimetrinio žemėlapio tikslumas. Vertinimui naudota 686 gravimetrinių punktų sunkio pagreičio reikšmės, kurių vidutinė kvadratinė paklaida neviršija 9 μGal. Nustatytos teritorijos, kuriose sunkio pagreitis, apskaičiuotas pagal žemėlapį, turi sistemingąsias paklaidas. Gautas vidutinis skirtumas tarp žemėlapyje taikomos Potsdamo sunkio sistemos ir IGSN 71 sistemos, apibrėžtos Lietuvos gravimetriniame tinkle atliktais absoliučiaisiais gravimetriniais matavimais.

  9. Longitudinal information and radiation damage in EM calorimetry

    SciTech Connect

    Green, D.

    1993-02-05

    The SCC radiation field is higher than that encountered by previous hadron collider detectors. In particular, the electromagnetic (EM) calorimeter compartment sees the highest radiation dose. Since an EM calorimeter also makes the most precise energy measurement, special care must be lavished on this part of a calorimeter. Previous studies have concentrated on Monte Carlo examinations of 2 longitudinal compartments within the EM which can alleviate radiation damage. Recently, it was realized that a ``shower maximum`` detector, such as exists in CDF, also contains information of the conversion point of an electromagnetic shower. As such, it can potentially be used in a fashion analogous to the longitudinal compartments, although it is not designed to be optimized for this role.

  10. Geospatial Analysis of Pediatric EMS Run Density and Endotracheal Intubation

    PubMed Central

    Hansen, Matthew; Loker, William; Warden, Craig

    2016-01-01

    Introduction The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS) run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. Methods This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas. We geocoded scene addresses using the automated address locator created in the cloud-based mapping platform ArcGIS, supplemented with manual address geocoding for remaining cases. We then use the Getis-Ord Gi spatial statistic feature in ArcGIS to map statistically significant spatial clusters (hot spots) of pediatric EMS runs throughout the county. We then superimposed all intubation procedures performed during the study period on maps of pediatric EMS-run hot spots, pediatric population density, fire stations, and hospitals. We also performed multivariable logistic regression to determine if distance traveled to the hospital was associated with intubation after controlling for several confounding variables. Results We identified a total of 7,797 pediatric EMS runs during the study period and 38 endotracheal intubations. In univariate analysis we found that patients who were intubated were similar to those who were not in gender and whether or not they were transported to a children’s hospital. Intubated patients tended to be transported shorter distances and were older than non-intubated patients. Increased distance from the hospital was associated with reduced odds of intubation after controlling for age, sex, scene location, and trauma system entry status in a multivariate logistic regression. The

  11. The photon: EM fields, electrical potentials, and AC charge

    NASA Astrophysics Data System (ADS)

    Meulenberg, A.; Hudgins, W. R.; Penland, R. F.

    2015-09-01

    Photons are here considered to be resonant oscillations (solitons) in four dimensions (space/time) of an undefined `field' otherwise generally existing at a local energy minimum. The photons' constituent EM fields result in elevated energy, and therefore potentials, within that field. It is in the context of the standing waves of and between photons that the EM fields and potentials lead to a description of alternating (AC) `currents' (of some form) of unquantized alternating `charge' (of some sort). The main topic of this paper is the alternating charge.

  12. Geospatial Analysis of Pediatric EMS Run Density and Endotracheal Intubation.

    PubMed

    Hansen, Matthew; Loker, William; Warden, Craig

    2016-09-01

    The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS) run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas. We geocoded scene addresses using the automated address locator created in the cloud-based mapping platform ArcGIS, supplemented with manual address geocoding for remaining cases. We then use the Getis-Ord Gi spatial statistic feature in ArcGIS to map statistically significant spatial clusters (hot spots) of pediatric EMS runs throughout the county. We then superimposed all intubation procedures performed during the study period on maps of pediatric EMS-run hot spots, pediatric population density, fire stations, and hospitals. We also performed multivariable logistic regression to determine if distance traveled to the hospital was associated with intubation after controlling for several confounding variables. We identified a total of 7,797 pediatric EMS runs during the study period and 38 endotracheal intubations. In univariate analysis we found that patients who were intubated were similar to those who were not in gender and whether or not they were transported to a children's hospital. Intubated patients tended to be transported shorter distances and were older than non-intubated patients. Increased distance from the hospital was associated with reduced odds of intubation after controlling for age, sex, scene location, and trauma system entry status in a multivariate logistic regression. The locations of intubations were

  13. A constrained EM algorithm for independent component analysis.

    PubMed

    Welling, M; Weber, M

    2001-03-01

    We introduce a novel way of performing independent component analysis using a constrained version of the expectation-maximization (EM) algorithm. The source distributions are modeled as D one-dimensional mixtures of gaussians. The observed data are modeled as linear mixtures of the sources with additive, isotropic noise. This generative model is fit to the data using constrained EM. The simpler "soft-switching" approach is introduced, which uses only one parameter to decide on the sub- or supergaussian nature of the sources. We explain how our approach relates to independent factor analysis.

  14. Low Bandwidth Vocoding using EM Sensor and Acoustic Signal Processing

    SciTech Connect

    Ng, L C; Holzrichter, J F; Larson, P E

    2001-10-25

    Low-power EM radar-like sensors have made it possible to measure properties of the human speech production system in real-time, without acoustic interference [1]. By combining these data with the corresponding acoustic signal, we've demonstrated an almost 10-fold bandwidth reduction in speech compression, compared to a standard 2.4 kbps LPC10 protocol used in the STU-III (Secure Terminal Unit, third generation) telephone. This paper describes a potential EM sensor/acoustic based vocoder implementation.

  15. Speaker verification using combined acoustic and EM sensor signal processing

    SciTech Connect

    Ng, L C; Gable, T J; Holzrichter, J F

    2000-11-10

    Low Power EM radar-like sensors have made it possible to measure properties of the human speech production system in real-time, without acoustic interference. This greatly enhances the quality and quantity of information for many speech related applications. See Holzrichter, Burnett, Ng, and Lea, J. Acoustic. SOC. Am . 103 ( 1) 622 (1998). By combining the Glottal-EM-Sensor (GEMS) with the Acoustic-signals, we've demonstrated an almost 10 fold reduction in error rates from a speaker verification system experiment under a moderate noisy environment (-10dB).

  16. Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

    NASA Image and Video Library

    2016-10-28

    A paint technician with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, uses an air gun to apply paint to the right hand aft skirt for NASA’s SLS rocket inside a support building at the Hangar AF facility at Cape Canaveral Air Force Station. The space shuttle-era aft skirt, was inspected and resurfaced to prepare it for primer and paint. The aft skirt will be used on the right hand booster of the SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep-space missions, and the journey to Mars.

  17. Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

    NASA Image and Video Library

    2016-10-28

    Technicians with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, prepare the right hand aft skirt for NASA’s SLS rocket for primer and painting inside a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt, was inspected and resurfaced and will be primed and painted for use on the right hand booster of the SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep-space missions, and the journey to Mars.

  18. Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

    NASA Image and Video Library

    2016-10-28

    Technicians with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, prepare a paint mixture for the right hand aft skirt for NASA’s SLS in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt, was inspected and resurfaced, and will be primed and painted for use on the right hand booster of the SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep-space missions, and the Journey to Mars.

  19. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  20. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) into a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  1. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) is in a clean room with protective walls secured around it. The adapter will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  2. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) toward a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  3. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, a Lockheed Martin technician secures a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  4. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) is being moved to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  5. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, a protective cover is installed around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  6. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  7. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians are preparing the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for the move into a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  8. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  9. Orion EM-1 Crew Module Adapter Move to Clean Room

    NASA Image and Video Library

    2016-11-29

    Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians begin to move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

  10. A emissão em 8mm e as bandas de Merrill-Sanford em estrelas carbonadas

    NASA Astrophysics Data System (ADS)

    de Mello, A. B.; Lorenz-Martins, S.

    2003-08-01

    Estrelas carbonadas possuem bandas moleculares em absorção no visível e, no infravermelho (IR) as principais características espectrais se devem a emissão de grãos. Recentemente foi detectada a presença de bandas de SiC2 (Merrill-Sanford, MS) em emissão sendo atribuída à presença de um disco rico em poeira. Neste trabalho analisamos uma amostra de 14 estrelas carbonadas, observadas no telescópio de 1.52 m do ESO em 4 regiões espectrais diferentes, a fim de detectar as bandas de MS em emissão. Nossa amostra é composta de estrelas que apresentam além da emissão em 11.3 mm, outra em 8 mm. Esta última emissão, não usual nestes objetos, tem sido atribuída ou a moléculas de C2H2, ou a um composto sólido ainda indefinido. A detecção de emissões de MS e aquelas no IR, simultaneamente, revelaria um cenário mais complexo que o habitualmente esperado para os ventos destes objetos. No entanto como primeiro resultado, verificamos que as bandas de Merrill-Sanford encontram-se em absorção, não revelando nenhuma conexão com a emissão a 8 mm. Assim, temos duas hipóteses: (a) a emissão a 8 mm se deve à molécula C2H2 ou (b) essa emissão é resultado da emissão térmica de grãos. Testamos a segunda hipótese modelando a amostra com grãos não-homogêneos de SiC e quartzo, o qual emite em aproximadamente 8mm. Este grão seria produzido em uma fase evolutiva anterior a das carbonadas (estrelas S) e por terem uma estrutura cristalina são destruídos apenas na presença de campos de radiação ultravioleta muito intensos. Os modelos para os envoltórios utilizam o método de Monte Carlo para descrever o problema do transporte da radiação. As conclusões deste trabalho são: (1) as bandas de Merrill-Sanford se encontram em absorção, sugerindo um cenário usual para os ventos das estrelas da amostra; (2) neste cenário, a emissão em 8 mm seria resultado de grãos de quartzo com mantos de SiC, indicando que o quartzo poderia sobreviver a fase

  11. Item Parameter Estimation via Marginal Maximum Likelihood and an EM Algorithm: A Didactic.

    ERIC Educational Resources Information Center

    Harwell, Michael R.; And Others

    1988-01-01

    The Bock and Aitkin Marginal Maximum Likelihood/EM (MML/EM) approach to item parameter estimation is an alternative to the classical joint maximum likelihood procedure of item response theory. This paper provides the essential mathematical details of a MML/EM solution and shows its use in obtaining consistent item parameter estimates. (TJH)

  12. An EM System with Dynamic Multi-Axis Transmitter and Tensor Gradiometer Receiver

    DTIC Science & Technology

    2011-06-01

    FINAL REPORT An EM System With Dynamic Multi-Axis Transmitter and Tensor Gradiometer Receiver SERDP Project MR-1534 JUNE 2011 David C...2006- 2010 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER An EM System with Dynamic Multi-Axis transmitter and Tensor Gradiometer W91 2HQ-06-C-0050...239.18 EM Tensor Gradiometer SERDP MM-1532 i Contents Contents

  13. Texas Hold 'em Online Poker: A Further Examination

    ERIC Educational Resources Information Center

    Hopley, Anthony A. B.; Dempsey, Kevin; Nicki, Richard

    2012-01-01

    Playing Texas Hold 'em Online Poker (THOP) is on the rise. However, there is relatively little research examining factors that contribute to problem gambling in poker players. The aim of this study was to extend the research findings of Hopley and Nicki (2010). The negative mood states of depression, anxiety and stress were found to be linked to…

  14. Texas Hold 'em Online Poker: A Further Examination

    ERIC Educational Resources Information Center

    Hopley, Anthony A. B.; Dempsey, Kevin; Nicki, Richard

    2012-01-01

    Playing Texas Hold 'em Online Poker (THOP) is on the rise. However, there is relatively little research examining factors that contribute to problem gambling in poker players. The aim of this study was to extend the research findings of Hopley and Nicki (2010). The negative mood states of depression, anxiety and stress were found to be linked to…

  15. Noise properties of the EM algorithm: II. Monte Carlo simulations.

    PubMed

    Wilson, D W; Tsui, B M; Barrett, H H

    1994-05-01

    In an earlier paper we derived a theoretical formulation for estimating the statistical properties of images reconstructed using the iterative ML-EM algorithm. To gain insight into this complex problem, two levels of approximation were considered in the theory. These techniques revealed the dependence of the variance and covariance of the reconstructed image noise on the source distribution, imaging system transfer function, and iteration number. In this paper a Monte Carlo approach was taken to study the noise properties of the ML-EM algorithm and to test the predictions of the theory. The study also served to evaluate the approximations used in the theory. Simulated data from phantoms were used in the Monte Carlo experiments. The ML-EM statistical properties were calculated from sample averages of a large number of images with different noise realizations. The agreement between the more exact form of the theoretical formulation and the Monte Carlo formulation was better than 10% in most cases examined, and for many situations the agreement was within the expected error of the Monte Carlo experiments. Results from the studies provide valuable information about the noise characteristics of ML-EM reconstructed images. Furthermore, the studies demonstrate the power of the theoretical and Monte Carlo approaches for investigating noise properties of statistical reconstruction algorithms.

  16. EMS-generated Rhizoctonia resistance in an adapted wheat

    USDA-ARS?s Scientific Manuscript database

    We report the first genetic resistance in wheat to Rhizoctonia solani AG-8 and R. oryzae, the causal agents of Rhizoctonia root rot and pre-emergence damping-off. Rhizoctonia resistance was generated in the spring wheat cultivar Scarlet using EMS mutagenesis. Resistant plants, named Scarlet-Rz1, d...

  17. Functionalized Anatomical Models for EM-Neuron Interaction Modeling

    PubMed Central

    Neufeld, Esra; Cassará, Antonino Mario; Montanaro, Hazael; Kuster, Niels; Kainz, Wolfgang

    2017-01-01

    The understanding of interactions between electromagnetic (EM) fields and nerves are crucial in contexts ranging from therapeutic neurostimulation to low frequency EM exposure safety. To properly consider the impact of in-vivo induced field inhomogeneity on non-linear neuronal dynamics, coupled EM-neuronal dynamics modeling is required. For that purpose, novel functionalized computable human phantoms have been developed. Their implementation and the systematic verification of the integrated anisotropic quasi-static EM solver and neuronal dynamics modeling functionality, based on the method of manufactured solutions and numerical reference data, is described. Electric and magnetic stimulation of the ulnar and sciatic nerve were modeled to help understanding a range of controversial issues related to the magnitude and optimal determination of strength-duration (SD) time constants. The results indicate the importance of considering the stimulation-specific inhomogeneous field distributions (especially at tissue interfaces), realistic models of non-linear neuronal dynamics, very short pulses, and suitable SD extrapolation models. These results and the functionalized computable phantom will influence and support the development of safe and effective neuroprosthetic devices and novel electroceuticals. Furthermore they will assist the evaluation of existing low frequency exposure standards for the entire population under all exposure conditions. PMID:27224508

  18. Symmetry-restrained flexible fitting for symmetric EM maps

    PubMed Central

    Chan, Kwok-Yan; Gumbart, James; McGreevy, Ryan; Watermeyer, Jean M.; Sewell, B. Trevor; Schulten, Klaus

    2011-01-01

    Summary Many large biological macromolecules have inherent structural symmetry, being composed of a few distinct subunits, repeated in a symmetric array. These complexes are often not amenable to traditional high-resolution structural determination methods, but can be imaged in functionally relevant states using cryo-electron microscopy (cryo-EM). A number of methods for fitting atomic-scale structures into cryo-EM maps have been developed, including the molecular dynamics flexible fitting (MDFF) method. However, quality and resolution of the cryo-EM map are the major determinants of a method’s success. In order to incorporate knowledge of structural symmetry into the fitting procedure, we developed the symmetry-restrained MDFF method. The new method adds to the cryo-EM map-derived potential further restraints on the allowed conformations of a complex during fitting, thereby improving the quality of the resultant structure. The benefit of using symmetry-based restraints during fitting, particularly for medium to low-resolution data, is demonstrated for three different systems. PMID:21893283

  19. Reservoir characterization and steam flood monitoring with crosshole EM

    SciTech Connect

    Wilt, M.; Torres-Verdin, C.

    1995-06-01

    Crosshole electromagnetic (EM) imaging is applied to reservoir characterization and steam flood monitoring in a central California oil field. Steam was injected into three stacked eastward-dipping, unconsolidated oil sands within the upper 200 m. The steam plume is expected to develop as an ellipse aligned with the regional northwest-southeast strike. EM measurements were made from two fiberglass-cased observation wells straddling the steam injector on a northeast-southwest profile using the LLNL frequency domain crosshole EM system. Field data were collected before the initiation of a steam drive to map the distribution of the oil sands and then 6 and 12 months later to monitor the progress of the steam chest. Resistivity images derived from the EM data before steam injection clearly delineate the distribution and dipping structure on the target oil sands. Difference images, from data collected before and after steam flooding, show resistivity changes that indicate that the steam chest has developed only in the deeper oil sands although steam injection occurred in all three sand layers.

  20. Signs and Guides: Wayfinding Alternatives for the EMS Library.

    ERIC Educational Resources Information Center

    Johnson, Johanna H.

    Concerned with increasing the accessibility of the collection of the Engineering/Math Sciences (EMS) Library at the University of California at Los Angeles through the use of self guidance systems, this practical study focused on the problem context, general library guides, and library signage in reviewing the literature, and conducted a survey of…