Suicide among the elderly and associated factors in South Korea.

PubMed

Shin, Kyoung Min; Cho, Sun-Mi; Hong, Chang Hyung; Park, Kyung Soon; Shin, Yun Mi; Lim, Ki Young; Koh, Sang Hyun

2013-01-01

With the population of the elderly increasing, suicides among elderly people present a serious problem for global societies. However, there are few studies on suicide among elderly subjects, especially in Asia. The study aimed to determine the relationship between physical health, mental health, social environmental condition, and the suicide behavior among elderly subjects in the city of Suwon, located southeast of Seoul. We analyzed 1548 Korean aged over 60 years from baseline data of a larger prospective study called the Suwon Project. The study protocol included sociodemographic variables, mental health factors, and physical health factors. In the interview, the subjects were asked about suicide ideation and history of suicide attempt. Of the total subjects, 7.42% reported suicide ideation and 1.42% reported a history of suicide attempt. A logistic regression analysis showed that physical illness, five stroke warning signs, anxiety and depression associated with suicide ideation, and depression strongly corresponded to the suicide ideation. Anxiety, depression, and stroke warning signs were associated with history of suicide attempt among the elderly. Additionally, stroke warning signs and depression are independently associated with history of suicide attempt. This study revealed that stroke warning signs have a high correlation with history of suicide attempt in the elderly, independent from the depression factors. This study suggests that there is an independent relationship between physical health status and suicide behavior in the case of elders.

Stroke Warning Signs

MedlinePlus

... person to repeat a simple sentence, like "The sky is blue." Is the person able to correctly ... to Your Doctor to Create a Plan The Life After Stroke Journey Every stroke recovery is different. ...

Age-Group and Gender Differences in Stroke Knowledge in an Israeli Jewish Adult Population.

PubMed

Melnikov, Semyon; Itzhaki, Michal; Koton, Silvia

Stroke is a leading cause of long-term disability and the fifth leading cause of death in Israel. Knowledge of stroke warning signs has been linked to early seeking of medical help. Little is known about knowledge of stroke warning signs in Israeli Jewish adults. Stroke knowledge was examined among Jewish Israeli adults. Using a structured questionnaire, registered nurses interviewed a convenience sample of the respondents, 18 years or older, with no stroke history. Stroke knowledge and demographics were examined by 3 age groups (<45, 45-64, and >64 years) in men and women. In total, 1137 Jewish Israelis were interviewed, 457 (40.2%) men and 680 women (59.8%); 493 (43.4%) were younger than 45 years, 541 (47.6%) were aged 45 to 64 years, and 102 (9%) were older than 64 years; 1 (0.1%) did not report age. On average, each interview lasted for 25 to 30 minutes. Participants younger than 45 years showed the lowest knowledge of stroke cause. Women younger than 45 years were less likely to identify at least 2 stroke warning signs. Participants younger than 45 years were less likely to identify at least 2 risk factors, compared with participants aged 45 to 64 years and older than 64 years. Women younger than 45 years were less likely to identify at least 2 stroke prevention strategies. Participants younger than 45 years showed the lowest levels of stroke knowledge. The highest stroke knowledge was found in the 45 to 64 years age group. Stroke knowledge among different age groups was similar in both genders. Educational campaigns aimed at increasing knowledge of stroke among the general population and targeting the younger population are recommended.

'BeAWARE': supporting non-clinical staff within general practice to promptly identify patients presenting with warning signs of heart attack or stroke.

PubMed

Poulter, Christopher; Stewart, Michelle; Fitzpatrick, Cliona; Keech, Wendy; Stavreski, Bill; Grenfell, Robert

2014-06-01

General practice requires systems to deal with patients presenting with urgent needs. BeAWARE was developed to support non-clinical staff to promptly identify patients with symptoms of heart attack or stroke. Data were collected from May 2012 to December 2012 on participants completing the BeAWARE learning module, including pre- and post-assessments on knowledge, confidence and intended action. From May 2012 to December 2012, 1865 participants completed the module. There were significant increases in recall of heart attack and stroke symptoms among non-clinical participants, including chest tightness (23.4-48.7%, P DISCUSSION: BeAWARE fulfils a practice gap in patient safety by improving non-clinical staff's knowledge, confidence and intended action in response to patients presenting with heart attack or stroke warning signs.

Knowledge, perceptions and thoughts of stroke among Arab-Muslim Israelis.

PubMed

Itzhaki, Michal; Koton, Silvia

2014-02-01

Age-adjusted stroke mortality rates in Israel are higher among Arabs compared with Jews; therefore, knowledge of stroke signs and prevention strategies is especially important in the Arab population. Data on stroke knowledge among Arabs in Israel are lacking. We aimed to examine knowledge, perceptions and thoughts of stroke among Arab-Muslim Israelis. A complementary mixed method design was used. Ninety-nine Arab Muslims living in Israel, older than 40 years, with no history of stroke, were personally interviewed. Knowledge of stroke was assessed using quantitative analysis by a semi-structured interview. Information on perceptions and thoughts evoked by stroke was analyzed using qualitative analysis by the constant comparative method. Rates of reported knowledge-related variables were presented. Mean (SD) age of participants was 50.1 (8.0) years, 52.5% were women. Most of the participants (84.8%) knew the causes of stroke but only 29.3% mentioned sudden weakness or paralysis in one side of the body as a warning sign and other warning signs were even less known. The main known risk factor was hypertension (43.3%). Although knowledge of stroke prevention was poor, 89% were interested in learning about stroke and its prevention. The qualitative findings showed that stroke evokes negative thoughts of mental and physical burden and is associated with death, disability, dependence and depression. Levels of stroke knowledge among Arab-Muslim Israelis are low to moderate. Healthcare professionals should assist high risk populations in controlling and treating risk factors in order to reduce mortality and disability following a stroke.

Community Based Participatory Research: A New approach to engaging community members to rapidly call 911 for Stroke

PubMed Central

Skolarus, Lesli E.; Zimmerman, Marc A.; Murphy, Jillian; Brown, Devin L.; Kerber, Kevin A.; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B.

2014-01-01

Background and Purpose Acute stroke treatments are underutilized primarily due to delayed hospital arrival. Using a community based participatory research approach, we explored stroke self-efficacy, knowledge and perceptions of stroke among a predominately African American population in Flint, Michigan. Methods In March 2010, a survey was administered to youth and adults after religious services at three churches and one church health day. The survey consisted of vignettes (12 stroke, 4 non-stroke) to assess knowledge of stroke warning signs and behavioral intent to call 911. The survey also assessed stroke self-efficacy, personal knowledge of someone who had had a stroke, personal history of stroke and barriers to calling 911. Linear regression models explored the association of stroke self-efficacy with behavioral intent to call 911 among adults. Results Two hundred forty two adults and 90 youth completed the survey. Ninety two percent of adults and 90% of youth respondents were African American. Responding to 12 stroke vignettes, adults would call 911 in 72% (sd=0.26) of the vignettes while youth would call 911 in 54% (sd=0.29) (p<0.001). Adults correctly identified stroke in 51% (sd=0.32) of the stroke vignettes and youth in 46% (sd=0.28) of the stroke vignettes (p=0.28). Stroke self-efficacy predicted behavioral intent to call 911 (p=0.046). Conclusion In addition to knowledge of stroke warning signs, behavioral interventions to increase both stroke self-efficacy and behavioral intent may be useful for helping people make appropriate 911 calls for stroke. A community based participatory research approach may be effective in reducing stroke disparities. PMID:21617148

Community-based participatory research: a new approach to engaging community members to rapidly call 911 for stroke.

PubMed

Skolarus, Lesli E; Zimmerman, Marc A; Murphy, Jillian; Brown, Devin L; Kerber, Kevin A; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B

2011-07-01

Acute stroke treatments are underutilized primarily because of delayed hospital arrival. Using a community-based participatory research approach, we explored stroke self-efficacy, knowledge, and perceptions of stroke among a predominately African American population in Flint, Michigan. In March 2010, a survey was administered to youth and adults after religious services at 3 churches and during 1 church health day. The survey consisted of vignettes (12 stroke, 4 nonstroke) to assess knowledge of stroke warning signs and behavioral intent to call 911. The survey also assessed stroke self-efficacy, personal knowledge of someone who had experienced a stroke, personal history of stroke, and barriers to calling 911. Linear regression models explored the association of stroke self-efficacy with behavioral intent to call 911 among adults. Two hundred forty-two adults and 90 youths completed the survey. Ninety-two percent of adults and 90% of youth respondents were African American. Responding to 12 stroke vignettes, adults would call 911 in 72% (SD, 0.26) of the vignettes, whereas youths would call 911 in 54% of vignettes (SD, 0.29; P<0.001). Adults correctly identified stroke in 51% (SD, 0.32) of the stroke vignettes and youth correctly identified stroke in 46% (SD, 0.28) of the stroke vignettes (P=0.28). Stroke self-efficacy predicted behavioral intent to call 911 (P=0.046). In addition to knowledge of stroke warning signs, behavioral interventions to increase both stroke self-efficacy and behavioral intent may be useful for helping people make appropriate 911 calls for stroke. A community-based participatory research approach may be effective in reducing stroke disparities.

Analysis of using the tongue deviation angle as a warning sign of a stroke

PubMed Central

2012-01-01

Background The symptom of tongue deviation is observed in a stroke or transient ischemic attack. Nevertheless, there is much room for the interpretation of the tongue deviation test. The crucial factor is the lack of an effective quantification method of tongue deviation. If we can quantify the features of the tongue deviation and scientifically verify the relationship between the deviation angle and a stroke, the information provided by the tongue will be helpful in recognizing a warning of a stroke. Methods In this study, a quantification method of the tongue deviation angle was proposed for the first time to characterize stroke patients. We captured the tongue images of stroke patients (15 males and 10 females, ranging between 55 and 82 years of age); transient ischemic attack (TIA) patients (16 males and 9 females, ranging between 53 and 79 years of age); and normal subjects (14 males and 11 females, ranging between 52 and 80 years of age) to analyze whether the method is effective. In addition, we used the receiver operating characteristic curve (ROC) for the sensitivity analysis, and determined the threshold value of the tongue deviation angle for the warning sign of a stroke. Results The means and standard deviations of the tongue deviation angles of the stroke, TIA, and normal groups were: 6.9 ± 3.1, 4.9 ± 2.1 and 1.4 ± 0.8 degrees, respectively. Analyzed by the unpaired Student’s t-test, the p-value between the stroke group and the TIA group was 0.015 (>0.01), indicating no significant difference in the tongue deviation angle. The p-values between the stroke group and the normal group, as well as between the TIA group and the normal group were both less than 0.01. These results show the significant differences in the tongue deviation angle between the patient groups (stroke and TIA patients) and the normal group. These results also imply that the tongue deviation angle can effectively identify the patient group (stroke and TIA patients) and the normal group. With respect to the visual examination, 40% and 32% of stroke patients, 24% and 16% of TIA patients, and 4% and 0% of normal subjects were found to have tongue deviations when physicians “A” and “B” examined them. The variation showed the essentiality of the quantification method in a clinical setting. In the receiver operating characteristic curve (ROC), the Area Under Curve (AUC, = 0.96) indicates good discrimination. The tongue deviation angle more than the optimum threshold value (= 3.2°) predicts a risk of stroke. Conclusions In summary, we developed an effective quantification method to characterize the tongue deviation angle, and we confirmed the feasibility of recognizing the tongue deviation angle as an early warning sign of an impending stroke. PMID:22908956

Analysis of using the tongue deviation angle as a warning sign of a stroke.

PubMed

Wei, Ching-Chuan; Huang, Shu-Wen; Hsu, Sheng-Lin; Chen, Hsing-Chung; Chen, Jong-Shin; Liang, Hsinying

2012-08-21

The symptom of tongue deviation is observed in a stroke or transient ischemic attack. Nevertheless, there is much room for the interpretation of the tongue deviation test. The crucial factor is the lack of an effective quantification method of tongue deviation. If we can quantify the features of the tongue deviation and scientifically verify the relationship between the deviation angle and a stroke, the information provided by the tongue will be helpful in recognizing a warning of a stroke. In this study, a quantification method of the tongue deviation angle was proposed for the first time to characterize stroke patients. We captured the tongue images of stroke patients (15 males and 10 females, ranging between 55 and 82 years of age); transient ischemic attack (TIA) patients (16 males and 9 females, ranging between 53 and 79 years of age); and normal subjects (14 males and 11 females, ranging between 52 and 80 years of age) to analyze whether the method is effective. In addition, we used the receiver operating characteristic curve (ROC) for the sensitivity analysis, and determined the threshold value of the tongue deviation angle for the warning sign of a stroke. The means and standard deviations of the tongue deviation angles of the stroke, TIA, and normal groups were: 6.9 ± 3.1, 4.9 ± 2.1 and 1.4 ± 0.8 degrees, respectively. Analyzed by the unpaired Student's t-test, the p-value between the stroke group and the TIA group was 0.015 (>0.01), indicating no significant difference in the tongue deviation angle. The p-values between the stroke group and the normal group, as well as between the TIA group and the normal group were both less than 0.01. These results show the significant differences in the tongue deviation angle between the patient groups (stroke and TIA patients) and the normal group. These results also imply that the tongue deviation angle can effectively identify the patient group (stroke and TIA patients) and the normal group. With respect to the visual examination, 40% and 32% of stroke patients, 24% and 16% of TIA patients, and 4% and 0% of normal subjects were found to have tongue deviations when physicians "A" and "B" examined them. The variation showed the essentiality of the quantification method in a clinical setting. In the receiver operating characteristic curve (ROC), the Area Under Curve (AUC, = 0.96) indicates good discrimination. The tongue deviation angle more than the optimum threshold value (= 3.2°) predicts a risk of stroke. In summary, we developed an effective quantification method to characterize the tongue deviation angle, and we confirmed the feasibility of recognizing the tongue deviation angle as an early warning sign of an impending stroke.

Public awareness of warning symptoms, risk factors, and treatment of stroke in northwest India.

PubMed

Pandian, Jeyaraj D; Jaison, Ashish; Deepak, Sukhbinder S; Kalra, Guneet; Shamsher, Shivali; Lincoln, Douglas J; Abraham, George

2005-03-01

This study assessed public awareness of warning symptoms, risk factors, and treatment of stroke in Ludhiana, Punjab, North West India. A hospital-based survey was conducted between February 2002 and September 2002 by the Stroke section of Christian Medical College. The study subjects were relatives of patients without history of stroke, attending the outpatient department of the hospital. Trained medical students, interns, and a nurse interviewed subjects using a structured, pretested, open-ended questionnaire. Nine hundred forty-two individuals were interviewed during the study period (56.4% men, mean age 40.1 years, age range 15 to 80 years). Forty-five percent of the subjects did not recognize the brain as the affected organ in stroke. In the multivariate analysis, higher education (P<0.001; odds ratio 2.6; 95%, CI 1.8 to 3.8) and upper socioeconomic status (P<0.005; odds ratio 1.6; CI, 1.1 to 2.2) correlated with a better knowledge of which organ was affected in stroke. Twenty-three percent of the participants did not know a single warning symptom of stroke. Twenty-one percent of the subjects could not identify even a single risk factor for stroke. Seven percent of the study population believed that oil massage would improve stroke victims. A small proportion of subjects believed in witchcraft, faith healing, homeopathic, and ayurvedic treatment (3%). This hospital-based survey reveals a better awareness of stroke warning signs and risk factors. However, knowledge regarding the organ involved, etiology, and treatment of stroke is lacking. Considerable education is needed to increase public awareness in modern concepts of stroke treatment.

Stroke-Related Knowledge, Lifestyle Behaviours and Health Beliefs in Singaporean Chinese: Implications for Health Education

ERIC Educational Resources Information Center

Wong, Wai Pong; Yeung, Meredith; Loh, Susan; Lee, Mina; Ghazali, F.; Chan, C. J.; Feng, S.; Liew, Y. V.; Seah, P. F.; Wee, J.; Wang, J.; Huang, X.; Dean, Elizabeth

2013-01-01

Objective: The objective of the present study was to describe stroke-related knowledge (risk factors, warning signs and emergency response), lifestyle behaviours and health beliefs among Singaporean Chinese, and to identify any factors associated with such knowledge, behaviours and beliefs. Design: This was a cross-sectional study design employing…

Comparison of stroke warning sign campaigns in Australia, England, and Canada.

PubMed

Trobbiani, Kym; Freeman, Kate; Arango, Manuel; Lalor, Erin; Jenkinson, Damian; Thrift, Amanda G

2013-10-01

Public awareness of the signs of stroke is essential to ensure that those affected by stroke arrive at the hospital in time for lifesaving therapies. It is unclear how well stroke awareness campaigns improve awareness of stroke signs and whether people translate this into action. We evaluated stroke awareness campaigns conducted in England, Australia, and Canada using pre- and post-campaign surveys. We assessed the proportion of people who could name the main signs of stroke, and compared the proportion naming these correctly between locations. We also assessed whether people would call emergency services in the event of a stroke. Proportion responding correctly was compared using chi-square analysis. The amount spent on the campaigns was different in each country. The post-campaign survey was conducted among 400 people in Australia, 1921 in England, and 2703 in Canada. Sixty-eight per cent of people in Australia and 57% in Canada could name two or more signs of stroke (P < 0.001). After the campaign, knowledge of each of the elements of the campaign (face, arm, speech, time) was significantly greater in England than in Australia (P < 0.001 for each item). A high proportion of participants reported that they would call emergency services in the event of a stroke (97% in England, 90% in Australia, and 67% in Canada). Knowledge of stroke signs and the action to be taken can be improved with awareness campaigns. The effectiveness of these campaigns may be enhanced by spend on media, media mix, and key messages. It is critical to ensure that campaigns provide the clear and bold message that prompt action is an essential ingredient to reduce death and disability following stroke. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Improving stroke knowledge through a 'volunteer-led' community education program in Australia.

PubMed

Kilkenny, Monique F; Purvis, Tara; Werner, Megan; Reyneke, Megan; Czerenkowski, Jude; Cadilhac, Dominique A

2016-05-01

Public awareness of stroke risks and warning signs remains poor. The National Stroke Foundation (NSF) in Australia has been undertaking a StrokeSafe Ambassador Education program to raise awareness of stroke. The format includes presentations by volunteers trained to be 'ambassadors' to spread standard information about stroke to the public. Our aim was to determine the change in knowledge of participants who attended presentations. Participants completed questionnaires before immediately after presentations, and at 3months following the presentation. Information was collected on knowledge of risk factors and signs of stroke. McNemar's test was used to compare paired-responses over time. A p value of <0.05 was considered significant. Between March and April 2014, 591 participants attended 185 presentations and 591 (100%) completed them before and immediately after presentation questionnaires: 68% were female and 75% were aged 65years or more. 258 consented for further follow-up with 192 completing follow-up. Comparing immediately after with before presentation showed significantly improved knowledge for all 10 stroke risk factors and all signs of stroke. Significantly improved knowledge for 7/10 risk factors and 1/3 signs of stroke was found when comparing follow-up and immediately after presentation results. Knowledge of 5/10 risk factors and 2/3 signs of stroke improved when comparing follow-up and before presentation. This study describes a novel approach to support the use of trained volunteers to provide a community-based, standardised education program for stroke. This program shows that community presentations can improve immediate and short-term knowledge of signs and risk factors for stroke. Copyright © 2016. Published by Elsevier Inc.

Pearls: stroke.

PubMed

Wozniak, Marcella A

2010-02-01

The diagnosis of ischemic stroke continues to be a clinical one, although advances in neuroimaging have expanded our understanding of the correlation between clinical symptoms and neuroanatomical localization. Careful neurologic examination allows localization in both neuroanatomical and vascular space. Findings on neuroimaging are then correlated to assess their clinical relevance. Transient ischemic attack is recognized as a warning sign for impending vascular disease, but even less specific transient neurologic symptoms are associated with increased risk. Stroke can occur at any age. For women, the postpartum period is a time of elevated risk for arterial ischemic stroke. (c) Thieme Medical Publishers.

Calling 911 in response to stroke: a nationwide study assessing definitive individual behavior.

PubMed

Mikulík, Robert; Bunt, Laura; Hrdlicka, Daniel; Dusek, Ladislav; Václavík, Daniel; Kryza, Jirí

2008-06-01

Stroke treatment is time-dependent, yet no study has systematically examined response to individual stroke symptoms in the general population. This nationwide study identifies which specific factors prompt correct response (calling 911) to stroke. Between November and December of 2005, a survey using a 3-stage random-sampling method including area, household, and household member sampling was conducted throughout the Czech Republic. Participants >40 years old were personally interviewed via a structured and standardized questionnaire concerning general knowledge and correct response to stroke as assessed by the Stroke Action Test (STAT). Predictors of scoring >50% on STAT were identified by multiple regression. A total of 650 households were contacted, yielding 592 interviews (response rate 91%). Mean age was 58+/-12, 55% women. Sixty-nine percent thought stroke was serious condition, and 57% thought it could be treated. Also 54% correctly named >/=2 risk factors, and 46% named >/=2 warning signs. Eighteen percent of respondents scored >50% on STAT. The predictors of such a score were age (for each 10-year increment, OR 1.4, 95% CI 1.2 to 1.7), secondary school education (OR 1.7, 95% CI 1.1 to 2.6), knowing that stroke is a serious disease (OR 1.8, 95% CI 1.1 to 3.1), and knowing that stroke is treatable (OR 2.0, 95% CI 1.2 to 3.2). Knowledge about stroke in the Czech Republic was fair, yet response to warning signs was poor. Our study is the first to identify that calling 911 was influenced by knowledge that stroke is a serious and treatable disease and not by recognition of symptoms.

Stroke Outreach in an Inner City Market: A Platform for Identifying African American Males for Stroke Prevention Interventions.

PubMed

Sharrief, Anjail Zarinah; Johnson, Brenda; Urrutia, Victor Cruz

2015-01-01

There are significant racial disparities in stroke incidence and mortality. Health fairs and outreach programs can be used to increase stroke literacy, but they often fail to reach those at highest risk, including African American males. We conducted a stroke outreach and screening program at an inner city market in order to attract a high-risk group for a stroke education intervention. A modified Framingham risk tool was used to estimate stroke risk and a 10-item quiz was developed to assess stroke literacy among 80 participants. We report results of the demographic and stroke risk analyses and stroke knowledge assessment. The program attracted a majority male (70%) and African American (95%) group of participants. Self-reported hypertension (57.5%), tobacco use (40%), and diabetes (23.8%) were prevalent. Knowledge of stroke warning signs, risk factors, and appropriate action to take for stroke symptoms was not poor when compared to the literature. Stroke outreach and screening in an inner city public market may be an effective way to target a high-risk population for stroke prevention interventions. Stroke risk among participants was high despite adequate stroke knowledge.

Knowledge of ischemic stroke risk factors and warning signs after a health education program by medical students.

PubMed

Gutiérrez-Jiménez, Eugenio; Góngora-Rivera, Fernando; Martínez, Héctor R; Escamilla-Garza, Juan M; Villarreal, Héctor Jorge

2011-04-01

A delay in recognizing early warning signs (WS) and risk factors (RF) of ischemic stroke causes a delay in treatment. We evaluated knowledge of RF and WS and the impact of an educational program by medical students. We first surveyed individuals to determine knowledge of WS and RF. Then, after a 6-month education program, knowledge was reassessed. The questionnaire included sociodemographic and comorbidity data. A χ(2) and Mann-Whitney U test, as well as a multivariate logistic regression analysis to determine variables associated with knowledge, were used. We performed 329 baseline and 355 posteducation surveys. Initially, 57.1% mentioned at least 1 RF; this later increased to 65.9%. Mentions of obesity, dyslipidemias, hypertension, and diabetes mellitus increased significantly. With regard to WS, 37.6% mentioned at least 1, which increased to 48.1% who mentioned weakness in 1 limb, in half the body, severe headache, and altered vision. Educational level (OR, 2.53; 95% CI, 1.42-4.53; P=0.001), employment (OR, 1.72; 95% CI, 1.08-2.74; P=0.021), a family history of brain infarction (OR, 2.35; 95% CI, 1.35-4.11; P=0.02), obesity (OR, 1.63; 95% CI, 1.026-2.6; P=0.038), and having received information in the last 6 months (OR, 2.7; 95% CI, 1.51-4.83; P=0.001) were associated with a better understanding of RF and WS. The educational program was cost-effective and had a positive impact on knowledge of RF and WS of ischemic stroke. More education programs are required to improve knowledge of ischemic stroke.

Posterior headache as a warning symptom of vertebral dissection: a case report.

PubMed

Lanfranchi, S; Di Falco, M; Perini, M; Zarcone, D

2005-12-01

Cervicocerebral arterial dissection is an important cause of stroke in young adults; the onset is often characterised by severe occipital headache, followed by nausea, vomiting and vertigo, mimicking a migraine attack. We describe herewith a case of vertebral arterial dissection with cerebellar infarction, which started with a posterior headache and neurovegetative symptoms, without other signs. Recommendations for recognition of similar cases, potentially dangerous and treatable, are discussed.

Stroke-Related Knowledge, Beliefs, and Behaviours of Chinese and European Canadians: Implications for Physical Therapists

PubMed Central

Li, Zhenyi; Jongbloed, Lyn

2014-01-01

ABSTRACT Purpose: To improve cross-cultural health education on risk-reducing behaviour change by examining the stroke-related knowledge, beliefs, and behaviours of Chinese Canadians (CCs). Methods: Participants (103 first-generation CCs and 101 European Canadians [ECs] representing the dominant cultural group in Canada) completed a cross-sectional questionnaire about knowledge, health behaviours, and beliefs related to stroke. Results: Compared with ECs, CCs were less aware of risk factors, warning signs, and appropriate responses to stroke in others. Information sources about stroke included mass media, family, and friends. CCs were less likely to smoke and drink alcohol but were also less likely to be physically active or to participate in structured exercise, less likely to have a healthy diet, and more likely to report stress. Conclusions: Theoretical dimensions of culture may explain variations in stroke-related knowledge, behaviours, and beliefs between CCs and ECs. Awareness of cultural differences can help physical therapists evaluate clients and appropriately tailor lifestyle-related health education. PMID:24799757

Stroke-related knowledge, beliefs, and behaviours of chinese and European canadians: implications for physical therapists.

PubMed

Li, Zhenyi; Jongbloed, Lyn; Dean, Elizabeth

2014-01-01

To improve cross-cultural health education on risk-reducing behaviour change by examining the stroke-related knowledge, beliefs, and behaviours of Chinese Canadians (CCs). Participants (103 first-generation CCs and 101 European Canadians [ECs] representing the dominant cultural group in Canada) completed a cross-sectional questionnaire about knowledge, health behaviours, and beliefs related to stroke. Compared with ECs, CCs were less aware of risk factors, warning signs, and appropriate responses to stroke in others. Information sources about stroke included mass media, family, and friends. CCs were less likely to smoke and drink alcohol but were also less likely to be physically active or to participate in structured exercise, less likely to have a healthy diet, and more likely to report stress. Theoretical dimensions of culture may explain variations in stroke-related knowledge, behaviours, and beliefs between CCs and ECs. Awareness of cultural differences can help physical therapists evaluate clients and appropriately tailor lifestyle-related health education.

33 CFR 150.622 - What are the warning sign requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false What are the warning sign... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Warning Signs § 150.622 What are the warning sign requirements? The construction and use of warning signs must be in...

33 CFR 150.622 - What are the warning sign requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false What are the warning sign... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Warning Signs § 150.622 What are the warning sign requirements? The construction and use of warning signs must be in...

33 CFR 150.622 - What are the warning sign requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false What are the warning sign... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Warning Signs § 150.622 What are the warning sign requirements? The construction and use of warning signs must be in...

33 CFR 150.622 - What are the warning sign requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false What are the warning sign... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Warning Signs § 150.622 What are the warning sign requirements? The construction and use of warning signs must be in...

Warning Signs After Birth

MedlinePlus

... Home > Pregnancy > Postpartum care > Warning signs after birth Warning signs after birth E-mail to a friend ... breast infection Postpartum bleeding Postpartum depression (PPD) What warning signs should you look for? Call your provider ...

Heat stroke internet searches can be a new heatwave health warning surveillance indicator

PubMed Central

Li, Tiantian; Ding, Fan; Sun, Qinghua; Zhang, Yi; Kinney, Patrick L.

2016-01-01

The impact of major heatwave shocks on population morbidity and mortality has become an urgent public health concern. However, Current heatwave warning systems suffer from a lack of validation and an inability to provide accurate health risk warnings in a timely way. Here we conducted a correlation and linear regression analysis to test the relationship between heat stroke internet searches and heat stroke health outcomes in Shanghai, China, during the summer of 2013. We show that the resulting heatstroke index captures much of the variation in heat stroke cases and deaths. The correlation between heat stroke deaths, the search index and the incidence of heat stroke is higher than the correlation with maximum temperature. This study highlights a fast and effective heatwave health warning indicator with potential to be used throughout the world. PMID:27869135

Heat stroke internet searches can be a new heatwave health warning surveillance indicator

NASA Astrophysics Data System (ADS)

Li, Tiantian; Ding, Fan; Sun, Qinghua; Zhang, Yi; Kinney, Patrick L.

2016-11-01

The impact of major heatwave shocks on population morbidity and mortality has become an urgent public health concern. However, Current heatwave warning systems suffer from a lack of validation and an inability to provide accurate health risk warnings in a timely way. Here we conducted a correlation and linear regression analysis to test the relationship between heat stroke internet searches and heat stroke health outcomes in Shanghai, China, during the summer of 2013. We show that the resulting heatstroke index captures much of the variation in heat stroke cases and deaths. The correlation between heat stroke deaths, the search index and the incidence of heat stroke is higher than the correlation with maximum temperature. This study highlights a fast and effective heatwave health warning indicator with potential to be used throughout the world.

Warning Signs of Childhood Emergencies

MedlinePlus

... Health & Safety Tips » Warning Signs of Childhood Emergencies Warning Signs of Childhood Emergencies Because their bodies are ... if your child exhibits any of the following warning signs of a medical emergency: Any significant change ...

Utility of warning signs in guiding admission and predicting severe disease in adult dengue

PubMed Central

2013-01-01

Background The recommendation from the 2009 World Health Organization guidelines for managing dengue suggests that patients with any warning sign can be hospitalized for observation and management. We evaluated the utility of using warning signs to guide hospital admission and predict disease progression in adults. Methods We conducted a prospective cohort study from January 2010 to September 2012. Daily demographic, clinical and laboratory data were collected from adult dengue patients. Warning signs were recorded. The proportion of admitted patients using current admission criteria and warning signs was compared. The sensitivity, specificity, positive and negative predictive values of warning signs in predicting disease progression were also evaluated. Results Four hundred and ninety-nine patients with confirmed dengue were analyzed. Using warning signs instead of the current admission criteria will lead to a 44% and 31% increase in admission for DHF II-IV and SD cases respectively. The proportion of non-severe dengue cases which were admitted also increased by 32% for non DHF II-IV and 33% for non-SD cases. Absence of any warning signs had a NPV of 91%, 100% and 100% for DHF I-IV, DHF II-IV and SD. Of those who progressed to severe illness, 16.3% had warning signs on the same day while 51.3% had warning signs the day before developing severe illness, respectively. Conclusions Our findings demonstrated that patients without any warning signs can be managed safely with ambulatory care to reduce hospital resource burden. No single warning sign can independently predict disease progression. The window from onset of warning sign to severe illness in most cases was within one day. PMID:24152678

46 CFR 35.30-1 - Warning signals and signs-TB/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Warning signals and signs-TB/ALL. 35.30-1 Section 35.30... § 35.30-1 Warning signals and signs—TB/ALL. (a) Red warning signals. During transfer of bulk cargo... displayed. (b) Warning sign at gangway. A sign shall be displayed to warn persons approaching the gangway...

46 CFR 35.30-1 - Warning signals and signs-TB/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Warning signals and signs-TB/ALL. 35.30-1 Section 35.30... § 35.30-1 Warning signals and signs—TB/ALL. (a) Red warning signals. During transfer of bulk cargo... displayed. (b) Warning sign at gangway. A sign shall be displayed to warn persons approaching the gangway...

An exploration of public knowledge of warning signs for cancer.

PubMed

Keeney, Sinead; McKenna, Hugh; Fleming, Paul; McIlfatrick, Sonja

2011-02-01

Warning signs of cancer have long been used as an effective way to summarise and communicate early indications of cancer to the public. Given the increasing global burden of cancer, the communication of these warning signs to the public is more important than ever before. This paper presents part of a larger study which explored the attitudes, knowledge and behaviours of people in mid-life towards cancer prevention. The focus of this paper is on the assessment of the knowledge of members of the public aged between 35 and 54 years of age. A questionnaire was administered to a representative sample of the population listing 17 warning signs of cancer. These included the correct warning signs and distracter signs. Respondents were asked to correctly identify the seven warning signs. Findings show that respondents could identify 4.8 cancer warning signs correctly. Analysis by demographics shows that being female, being older, having a higher level of educational attainment and being in a higher socio-economic group are predictors of better level of knowledge of cancer warning signs. Recommendations are proffered with regard to better targeting, clarification and communication of cancer warning signs. Copyright © 2010 Elsevier Ltd. All rights reserved.

46 CFR 154.1830 - Warning sign.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Warning sign. 154.1830 Section 154.1830 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1830 Warning sign. (a) The master... a warning sign: (1) At the gangway facing the shore so that the sign may be seen from the shore; and...

46 CFR 154.1830 - Warning sign.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Warning sign. 154.1830 Section 154.1830 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1830 Warning sign. (a) The master... a warning sign: (1) At the gangway facing the shore so that the sign may be seen from the shore; and...

46 CFR 154.1830 - Warning sign.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Warning sign. 154.1830 Section 154.1830 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1830 Warning sign. (a) The master... a warning sign: (1) At the gangway facing the shore so that the sign may be seen from the shore; and...

46 CFR 154.1830 - Warning sign.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Warning sign. 154.1830 Section 154.1830 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1830 Warning sign. (a) The master... a warning sign: (1) At the gangway facing the shore so that the sign may be seen from the shore; and...

46 CFR 154.1830 - Warning sign.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Warning sign. 154.1830 Section 154.1830 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1830 Warning sign. (a) The master... a warning sign: (1) At the gangway facing the shore so that the sign may be seen from the shore; and...

49 CFR 193.2917 - Warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Warning signs. 193.2917 Section 193.2917 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Security § 193.2917 Warning signs. (a) Warning signs must be conspicuously placed...

49 CFR 193.2917 - Warning signs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Warning signs. 193.2917 Section 193.2917 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Security § 193.2917 Warning signs. (a) Warning signs must be conspicuously placed...

49 CFR 193.2917 - Warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Warning signs. 193.2917 Section 193.2917 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Security § 193.2917 Warning signs. (a) Warning signs must be conspicuously placed...

49 CFR 193.2917 - Warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Warning signs. 193.2917 Section 193.2917 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Security § 193.2917 Warning signs. (a) Warning signs must be conspicuously placed...

49 CFR 193.2917 - Warning signs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Warning signs. 193.2917 Section 193.2917 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Security § 193.2917 Warning signs. (a) Warning signs must be conspicuously placed...

33 CFR 127.1113 - Warning signs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Warning signs. 127.1113 Section... Waterfront Facilities Handling Liquefied Hazardous Gas Design and Construction § 127.1113 Warning signs. (a) The marine transfer area for LHG must have warning signs that— (1) Meet paragraph (b) of this section...

33 CFR 127.1113 - Warning signs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Warning signs. 127.1113 Section... Waterfront Facilities Handling Liquefied Hazardous Gas Design and Construction § 127.1113 Warning signs. (a) The marine transfer area for LHG must have warning signs that— (1) Meet paragraph (b) of this section...

33 CFR 127.1113 - Warning signs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Warning signs. 127.1113 Section... Waterfront Facilities Handling Liquefied Hazardous Gas Design and Construction § 127.1113 Warning signs. (a) The marine transfer area for LHG must have warning signs that— (1) Meet paragraph (b) of this section...

30 CFR 56.20011 - Barricades and warning signs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Barricades and warning signs. 56.20011 Section... § 56.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

30 CFR 56.20011 - Barricades and warning signs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Barricades and warning signs. 56.20011 Section... § 56.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

30 CFR 56.20011 - Barricades and warning signs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Barricades and warning signs. 56.20011 Section... § 56.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

30 CFR 56.20011 - Barricades and warning signs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Barricades and warning signs. 56.20011 Section... § 56.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

33 CFR 127.1113 - Warning signs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Warning signs. 127.1113 Section... Waterfront Facilities Handling Liquefied Hazardous Gas Design and Construction § 127.1113 Warning signs. (a) The marine transfer area for LHG must have warning signs that— (1) Meet paragraph (b) of this section...

30 CFR 56.20011 - Barricades and warning signs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Barricades and warning signs. 56.20011 Section... § 56.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

33 CFR 127.1113 - Warning signs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Warning signs. 127.1113 Section... Waterfront Facilities Handling Liquefied Hazardous Gas Design and Construction § 127.1113 Warning signs. (a) The marine transfer area for LHG must have warning signs that— (1) Meet paragraph (b) of this section...

Warning Signs of Bullying

MedlinePlus

... of Aggressive Behavior Print Share Warning Signs for Bullying There are many warning signs that may indicate ... Get help right away . Signs a Child is Bullying Others Kids may be bullying others if they: ...

Individual and community determinants of calling 911 for stroke among African Americans in an urban community.

PubMed

Skolarus, Lesli E; Murphy, Jillian B; Zimmerman, Marc A; Bailey, Sarah; Fowlkes, Sophronia; Brown, Devin L; Lisabeth, Lynda D; Greenberg, Emily; Morgenstern, Lewis B

2013-05-01

African Americans receive acute stroke treatment less often than non-Hispanic whites. Interventions to increase stroke preparedness (recognizing stroke warning signs and calling 911) may decrease the devastating effects of stroke by allowing more patients to be candidates for acute stroke therapy. In preparation for such an intervention, we used a community-based participatory research approach to conduct a qualitative study exploring perceptions of emergency medical care and stroke among urban African American youth and adults. Community partners, church health teams, and church leaders identified and recruited focus group participants from 3 black churches in Flint, MI. We conducted 5 youth (11-16 years) and 4 adult focus groups from November 2011 to March 2012. A content analysis approach was taken for analysis. Thirty-nine youth and 38 adults participated. Women comprised 64% of youth and 90% of adult focus group participants. All participants were black. Three themes emerged from the adult and youth data: (1) recognition that stroke is a medical emergency; (2) perceptions of difficulties within the medical system in an under-resourced community, and; (3) need for greater stroke education in the community. Black adults and youth have a strong interest in stroke preparedness. Designs of behavioral interventions to increase stroke preparedness should be sensitive to both individual and community factors contributing to the likelihood of seeking emergency care for stroke.

30 CFR 77.1102 - Warning signs; smoking and open flame.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Warning signs; smoking and open flame. 77.1102 Section 77.1102 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE... COAL MINES Fire Protection § 77.1102 Warning signs; smoking and open flame. Signs warning against...

33 CFR 127.113 - Warning signs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Warning signs. 127.113 Section... Waterfront Facilities Handling Liquefied Natural Gas § 127.113 Warning signs. (a) The marine transfer area for LNG must have warning signs that— (1) Meet paragraph (b) of this section; (2) Can be seen from the...

29 CFR 1915.16 - Warning signs and labels.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 7 2012-07-01 2012-07-01 false Warning signs and labels. 1915.16 Section 1915.16 Labor... Other Dangerous Atmospheres in Shipyard Employment § 1915.16 Warning signs and labels. (a) Employee...) Posting of large work areas. A warning sign or label required by paragraph (a) of this section need not be...

30 CFR 57.20011 - Barricades and warning signs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Barricades and warning signs. 57.20011 Section... Miscellaneous § 57.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

46 CFR 147A.31 - Removal of fumigation material and warning signs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Removal of fumigation material and warning signs. 147A... material and warning signs. After ventilation is completed and a marine chemist or other qualified person... vessel, shall ensure that all warning signs are removed and fumigation containers and materials are...

29 CFR 1915.16 - Warning signs and labels.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Warning signs and labels. 1915.16 Section 1915.16 Labor... Other Dangerous Atmospheres in Shipyard Employment § 1915.16 Warning signs and labels. (a) Employee...) Posting of large work areas. A warning sign or label required by paragraph (a) of this section need not be...

46 CFR 147A.31 - Removal of fumigation material and warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Removal of fumigation material and warning signs. 147A... material and warning signs. After ventilation is completed and a marine chemist or other qualified person... vessel, shall ensure that all warning signs are removed and fumigation containers and materials are...

29 CFR 1915.16 - Warning signs and labels.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Warning signs and labels. 1915.16 Section 1915.16 Labor... Other Dangerous Atmospheres in Shipyard Employment § 1915.16 Warning signs and labels. (a) Employee...) Posting of large work areas. A warning sign or label required by paragraph (a) of this section need not be...

30 CFR 57.20011 - Barricades and warning signs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Barricades and warning signs. 57.20011 Section... Miscellaneous § 57.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

29 CFR 1915.16 - Warning signs and labels.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 7 2014-07-01 2014-07-01 false Warning signs and labels. 1915.16 Section 1915.16 Labor... Other Dangerous Atmospheres in Shipyard Employment § 1915.16 Warning signs and labels. (a) Employee...) Posting of large work areas. A warning sign or label required by paragraph (a) of this section need not be...

46 CFR 147A.31 - Removal of fumigation material and warning signs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Removal of fumigation material and warning signs. 147A... material and warning signs. After ventilation is completed and a marine chemist or other qualified person... vessel, shall ensure that all warning signs are removed and fumigation containers and materials are...

30 CFR 57.20011 - Barricades and warning signs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Barricades and warning signs. 57.20011 Section... Miscellaneous § 57.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

30 CFR 57.20011 - Barricades and warning signs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Barricades and warning signs. 57.20011 Section... Miscellaneous § 57.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

30 CFR 57.20011 - Barricades and warning signs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Barricades and warning signs. 57.20011 Section... Miscellaneous § 57.20011 Barricades and warning signs. Areas where health or safety hazards exist that are not immediately obvious to employees shall be barricaded, or warning signs shall be posted at all approaches...

29 CFR 1915.16 - Warning signs and labels.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 7 2013-07-01 2013-07-01 false Warning signs and labels. 1915.16 Section 1915.16 Labor... Other Dangerous Atmospheres in Shipyard Employment § 1915.16 Warning signs and labels. (a) Employee...) Posting of large work areas. A warning sign or label required by paragraph (a) of this section need not be...

30 CFR 77.1102 - Warning signs; smoking and open flame.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Warning signs; smoking and open flame. 77.1102 Section 77.1102 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE... COAL MINES Fire Protection § 77.1102 Warning signs; smoking and open flame. Signs warning against...

33 CFR 127.113 - Warning signs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Warning signs. 127.113 Section... Waterfront Facilities Handling Liquefied Natural Gas § 127.113 Warning signs. (a) The marine transfer area for LNG must have warning signs that— (1) Meet paragraph (b) of this section; (2) Can be seen from the...

30 CFR 77.1102 - Warning signs; smoking and open flame.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Warning signs; smoking and open flame. 77.1102 Section 77.1102 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE... COAL MINES Fire Protection § 77.1102 Warning signs; smoking and open flame. Signs warning against...

33 CFR 127.113 - Warning signs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Warning signs. 127.113 Section... Waterfront Facilities Handling Liquefied Natural Gas § 127.113 Warning signs. (a) The marine transfer area for LNG must have warning signs that— (1) Meet paragraph (b) of this section; (2) Can be seen from the...

33 CFR 127.113 - Warning signs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Warning signs. 127.113 Section... Waterfront Facilities Handling Liquefied Natural Gas § 127.113 Warning signs. (a) The marine transfer area for LNG must have warning signs that— (1) Meet paragraph (b) of this section; (2) Can be seen from the...

33 CFR 127.113 - Warning signs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Warning signs. 127.113 Section... Waterfront Facilities Handling Liquefied Natural Gas § 127.113 Warning signs. (a) The marine transfer area for LNG must have warning signs that— (1) Meet paragraph (b) of this section; (2) Can be seen from the...

[Reliability and validity of warning signs checklist for screening psychological, behavioral and developmental problems of children].

PubMed

Huang, X N; Zhang, Y; Feng, W W; Wang, H S; Cao, B; Zhang, B; Yang, Y F; Wang, H M; Zheng, Y; Jin, X M; Jia, M X; Zou, X B; Zhao, C X; Robert, J; Jing, Jin

2017-06-02

Objective: To evaluate the reliability and validity of warning signs checklist developed by the National Health and Family Planning Commission of the People's Republic of China (NHFPC), so as to determine the screening effectiveness of warning signs on developmental problems of early childhood. Method: Stratified random sampling method was used to assess the reliability and validity of checklist of warning sign and 2 110 children 0 to 6 years of age(1 513 low-risk subjects and 597 high-risk subjects) were recruited from 11 provinces of China. The reliability evaluation for the warning signs included the test-retest reliability and interrater reliability. With the use of Age and Stage Questionnaire (ASQ) and Gesell Development Diagnosis Scale (GESELL) as the criterion scales, criterion validity was assessed by determining the correlation and consistency between the screening results of warning signs and the criterion scales. Result: In terms of the warning signs, the screening positive rates at different ages ranged from 10.8%(21/141) to 26.2%(51/137). The median (interquartile) testing time for each subject was 1(0.6) minute. Both the test-retest reliability and interrater reliability of warning signs reached 0.7 or above, indicating that the stability was good. In terms of validity assessment, there was remarkable consistency between ASQ and warning signs, with the Kappa value of 0.63. With the use of GESELL as criterion, it was determined that the sensitivity of warning signs in children with suspected developmental delay was 82.2%, and the specificity was 77.7%. The overall Youden index was 0.6. Conclusion: The reliability and validity of warning signs checklist for screening early childhood developmental problems have met the basic requirements of psychological screening scales, with the characteristics of short testing time and easy operation. Thus, this warning signs checklist can be used for screening psychological and behavioral problems of early childhood, especially in community settings.

Wildlife Warning Signs: Public Assessment of Components, Placement and Designs to Optimise Driver Response

PubMed Central

Bond, Amy R. F.; Jones, Darryl N.

2013-01-01

Simple Summary Wildlife warning signs are aimed at reducing wildlife–vehicle collisions but there is little evidence that they are effective. Improving these sign designs to increase driver response may reduce wildlife–vehicle collisions. We examined drivers’ responses to different wildlife warning sign designs through a public survey. The presences of some sign components and sign position were assessed. Drivers’ responses to eight graphically displayed signs and animal- and vehicle-activated signs were ranked and participants indicated the sign to which they were most likely to respond. Three signs ranked highly. Animal- and vehicle-activated signs were also ranked highly by participants. More research into optimising wildlife warning sign designs is needed. Abstract Wildlife warning signs are the most commonly used and widespread form of road impact mitigation, aimed at reducing the incidence of wildlife–vehicle collisions. Evidence of the effectiveness of currently used signs is rare and often indicates minimal change in driver behaviour. Improving the design of these signs to increase the likelihood of appropriate driver response has the potential to reduce the incidence of wildlife–vehicle collisions. This study aimed to examine and assess the opinions of drivers on wildlife warning sign designs through a public opinion survey. Three currently used sign designs and five alternative sign designs were compared in the survey. A total of 134 drivers were surveyed. The presence of temporal specifications and an updated count of road-killed animals on wildlife warning signs were assessed, as well as the position of the sign. Drivers’ responses to the eight signs were scaled separately at three speed limits and participants indicated the sign to which they were most likely to respond. Three signs consistently ranked high. The messages conveyed by these signs and their prominent features were explored. Animal-activated and vehicle speed-activated signs were ranked very highly by participants. Extensive field trials of various sign designs are needed to further this research into optimizing wildlife warning sign designs. PMID:26479756

Knowledge of stroke among stroke patients and their relatives in Northwest India.

PubMed

Pandian, Jeyaraj Durai; Kalra, Guneet; Jaison, Ashish; Deepak, Sukhbinder Singh; Shamsher, Shivali; Singh, Yashpal; Abraham, George

2006-06-01

The knowledge of warning symptoms and risk factors for stroke has not been studied among patients with stroke in developing countries. We aimed to assess the knowledge of stroke among patients with stroke and their relatives. Prospective tertiary referral hospital-based study in Northwest India. Trained nurses and medical interns interviewed patients with stroke and transient ischemic attack and their relatives about their knowledge of stroke symptoms and risk factors. Univariable and multivariable logistic regression were used. Of the 147 subjects interviewed, 102 (69%) were patients and 45 (31%) were relatives. There were 99 (67%) men and 48 (33%) women and the mean age was 59.7+/-14.1 years. Sixty-two percent of respondents recognized paralysis of one side as a warning symptom and 54% recognized hypertension as a risk factor for stroke. In the multivariable logistic regression analysis, higher education was associated with the knowledge of correct organ involvement in stroke (OR 2.6, CI 1.1- 6.1, P =0.02), whereas younger age (OR 2.7, CI 1.1-7.0, P =0.04) and higher education (OR 4.1, CI 1.5-10.9, P =0.005) correlated with a better knowledge regarding warning symptoms of stroke. In this study cohort, in general, there is lack of awareness of major warning symptoms, risk factors, organ involvement and self-recognition of stroke. However younger age and education status were associated with better knowledge. There is an urgent need for awareness programs about stroke in this study cohort.

30 CFR 77.1102 - Warning signs; smoking and open flame.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Warning signs; smoking and open flame. 77.1102... COAL MINES Fire Protection § 77.1102 Warning signs; smoking and open flame. Signs warning against smoking and open flames shall be posted so they can be readily seen in areas or places where fire or...

30 CFR 77.1102 - Warning signs; smoking and open flame.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Warning signs; smoking and open flame. 77.1102... COAL MINES Fire Protection § 77.1102 Warning signs; smoking and open flame. Signs warning against smoking and open flames shall be posted so they can be readily seen in areas or places where fire or...

46 CFR 153.955 - Warning signs during cargo transfer.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Warning signs during cargo transfer. 153.955 Section 153... Transfer Procedures § 153.955 Warning signs during cargo transfer. (a) When transferring cargo while fast to a dock or at anchor in port, the master shall ensure that the tankship displays a warning sign at...

46 CFR 153.955 - Warning signs during cargo transfer.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Warning signs during cargo transfer. 153.955 Section 153... Transfer Procedures § 153.955 Warning signs during cargo transfer. (a) When transferring cargo while fast to a dock or at anchor in port, the master shall ensure that the tankship displays a warning sign at...

46 CFR 153.955 - Warning signs during cargo transfer.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Warning signs during cargo transfer. 153.955 Section 153... Transfer Procedures § 153.955 Warning signs during cargo transfer. (a) When transferring cargo while fast to a dock or at anchor in port, the master shall ensure that the tankship displays a warning sign at...

46 CFR 153.955 - Warning signs during cargo transfer.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Warning signs during cargo transfer. 153.955 Section 153... Transfer Procedures § 153.955 Warning signs during cargo transfer. (a) When transferring cargo while fast to a dock or at anchor in port, the master shall ensure that the tankship displays a warning sign at...

46 CFR 153.955 - Warning signs during cargo transfer.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Warning signs during cargo transfer. 153.955 Section 153... Transfer Procedures § 153.955 Warning signs during cargo transfer. (a) When transferring cargo while fast to a dock or at anchor in port, the master shall ensure that the tankship displays a warning sign at...

A Test of the Effectiveness of a List of Suicide Warning Signs for the Public

ERIC Educational Resources Information Center

Van Orden, Kimberly A.; Joiner, Thomas E., Jr.; Hollar, Daniel; Rudd, M. David; Mandrusiak, Michael; Silverman, Morton M.

2006-01-01

In this study we examined the effect that reading a list of warning signs for suicide has on beliefs about suicide, including the belief that one can recognize a suicidal crisis. All participants read two sets of warning signs (with only the experimental group reading the suicide warning signs) and then answered questions concerning beliefs…

30 CFR 817.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-UNDERGROUND MINING ACTIVITIES § 817.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 817.11. The operator shall...

30 CFR 816.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-SURFACE MINING ACTIVITIES § 816.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 816.11. The operator shall— (1...

30 CFR 817.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-UNDERGROUND MINING ACTIVITIES § 817.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 817.11. The operator shall...

30 CFR 816.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-SURFACE MINING ACTIVITIES § 816.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 816.11. The operator shall— (1...

30 CFR 816.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-SURFACE MINING ACTIVITIES § 816.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 816.11. The operator shall— (1...

30 CFR 817.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-UNDERGROUND MINING ACTIVITIES § 817.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 817.11. The operator shall...

30 CFR 817.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-UNDERGROUND MINING ACTIVITIES § 817.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 817.11. The operator shall...

30 CFR 817.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-UNDERGROUND MINING ACTIVITIES § 817.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 817.11. The operator shall...

30 CFR 816.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-SURFACE MINING ACTIVITIES § 816.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 816.11. The operator shall— (1...

30 CFR 816.66 - Use of explosives: Blasting signs, warnings, and access control.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Use of explosives: Blasting signs, warnings... STANDARDS-SURFACE MINING ACTIVITIES § 816.66 Use of explosives: Blasting signs, warnings, and access control. (a) Blasting signs. Blasting signs shall meet the specifications of § 816.11. The operator shall— (1...

30 CFR 57.4101 - Warning signs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Warning signs. 57.4101 Section 57.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 57.4101 Warning signs. Readily visible signs prohibiting smoking and...

30 CFR 56.4101 - Warning signs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Warning signs. 56.4101 Section 56.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 56.4101 Warning signs. Readily visible signs prohibiting smoking and...

30 CFR 57.4101 - Warning signs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Warning signs. 57.4101 Section 57.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 57.4101 Warning signs. Readily visible signs prohibiting smoking and...

30 CFR 57.4101 - Warning signs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Warning signs. 57.4101 Section 57.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 57.4101 Warning signs. Readily visible signs prohibiting smoking and...

30 CFR 56.4101 - Warning signs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Warning signs. 56.4101 Section 56.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 56.4101 Warning signs. Readily visible signs prohibiting smoking and...

30 CFR 56.4101 - Warning signs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Warning signs. 56.4101 Section 56.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 56.4101 Warning signs. Readily visible signs prohibiting smoking and...

30 CFR 57.4101 - Warning signs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Warning signs. 57.4101 Section 57.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 57.4101 Warning signs. Readily visible signs prohibiting smoking and...

30 CFR 56.4101 - Warning signs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Warning signs. 56.4101 Section 56.4101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Prohibitions/precautions/housekeeping § 56.4101 Warning signs. Readily visible signs prohibiting smoking and...

Individual and community determinants of calling 911 for stroke among African Americans in an urban community

PubMed Central

Skolarus, Lesli E.; Murphy, Jillian B.; Zimmerman, Marc A.; Bailey, Sarah; Fowlkes, Sophronia; Brown, Devin L.; Lisabeth, Lynda D.; Greenberg, Emily; Morgenstern, Lewis B.

2013-01-01

Background African Americans receive acute stroke treatment less often than non-Hispanic Whites. Interventions to increase stroke preparedness (recognizing stroke warning signs and calling 911) may decrease the devastating effects of stroke by allowing more patients to be candidates for acute stroke therapy. In preparation for such an intervention, we used a community-based participatory research approach to conduct a qualitative study exploring perceptions of emergency medical care and stroke among urban African American youth and adults. Methods and Results Community partners, church health teams, and church leaders identified and recruited focus group participants from 3 African American churches in Flint, Michigan. We conducted 5 youth (11-16 years) and 4 adult focus groups from November 2011 to March 2012. A content analysis approach was taken for analysis. Thirty nine youth and 38 adults participated. Women comprised 64% of youth and 90% of adult focus group participants. All participants were African American. Three themes emerged from the adult and youth data: 1) recognition that stroke is a medical emergency; 2) perceptions of difficulties within the medical system in an under resourced community and; 3) need for greater stroke education in the community. Conclusions African American adults and youth have a strong interest in stroke preparedness. Designing behavioral interventions to increase stroke preparedness should be sensitive to both individual and community factors contributing to the likelihood of seeking emergency care for stroke. PMID:23674311

Definitions for warning signs and signs of severe dengue according to the WHO 2009 classification: Systematic review of literature.

PubMed

Morra, Mostafa Ebraheem; Altibi, Ahmed M A; Iqtadar, Somia; Minh, Le Huu Nhat; Elawady, Sameh Samir; Hallab, Asma; Elshafay, Abdelrahman; Omer, Omer Abedlbagi; Iraqi, Ahmed; Adhikari, Purushottam; Labib, Jonair Hussein; Elhusseiny, Khaled Mosaad; Elgebaly, Ahmed; Yacoub, Sophie; Huong, Le Thi Minh; Hirayama, Kenji; Huy, Nguyen Tien

2018-04-24

Since warning signs and signs of severe dengue are defined differently between studies, we conducted a systematic review on how researchers defined these signs. We conducted an electronic search in Scopus to identify relevant articles, using key words including dengue, "warning signs," "severe dengue," and "classification." A total of 491 articles were identified through this search strategy and were subsequently screened by 2 independent reviewers for definitions of any of the warning or severe signs in the 2009 WHO dengue classification. We included all original articles published in English after 2009, classifying dengue by the 2009 WHO classification or providing the additional definition or criterion of warning signs and severity (besides the information of 2009 WHO). Analysis of the extracted data from 44 articles showed wide variations among definitions and cutoff values used by physicians to classify patients diagnosed with dengue infection. The establishment of clear definitions for warning signs and severity is essential to prevent unnecessary hospitalization and harmonizing the interpretation and comparability of epidemiological studies dedicated to dengue infection. Copyright © 2018 John Wiley & Sons, Ltd.

Assessment of advanced warning signs for flagging operations.

DOT National Transportation Integrated Search

1999-05-01

The Virginia Department of Transportation (VDOT) and several other state departments : of transportation have expressed interest in modifying the advanced warning sign for work zone : flagging operations. The advanced warning sign is intended to aler...

Warning Signs.

ERIC Educational Resources Information Center

Our Children, 1999

1999-01-01

Presents various signs that may indicate emotional problems in children or teens, noting that if children exhibit any of the warning signs, it is important to talk to a doctor, counselor, or mental-health professional. The warning signs are categorized as things that trouble the child, things that limit the child, behavior problems, and sudden…

Ten Warning Signs Your Older Family Member May Need Help

MedlinePlus

... Page Resize Text Printer Friendly Online Chat 10 Warning Signs Your Older Family Member May Need Help ... Eldercare Locator has compiled this list of 10 warning signs. Any one of the following behaviors may ...

Population-based study of capsular warning syndrome and prognosis after early recurrent TIA.

PubMed

Paul, Nicola L M; Simoni, Michela; Chandratheva, Arvind; Rothwell, Peter M

2012-09-25

Many guidelines recommend emergency assessment for patients with ≥2 TIAs within 7 days, perhaps in recognition of the capsular warning syndrome. However, it is unclear whether all patients with multiple TIAs are at high early risk of stroke and whether treatable underlying pathologies are more prevalent in this group. We studied clinical characteristics, Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, and risk of stroke in 1,000 consecutive patients with incident and recurrent TIAs in a prospective, population-based study (Oxford Vascular Study). Of 1,000 patients with TIAs, 170 had a further TIA within 7 days (105 within 24 hours). Multiple TIAs were not associated with carotid stenosis or atrial fibrillation, and much of the 10.6 (95% confidence interval [CI] 6.5-15.9) risk of stroke during the 7 days after the first TIA was due to patients with small-vessel disease (SVD) etiology (10 of 24 vs 8 of 146, odds ratio [OR] = 12.3, 95% CI 3.7-41.9, p < 0.0001), particularly those with motor weakness (i.e., capsular warning syndrome) compared with hemisensory events (9 of 15 [60%], 95% CI 35.3-84.7 vs 1 of 9 [11.1%], 95% CI 0-31.7, p = 0.03). The 7-day risk of stroke after a recurrent TIA was similar to the risk after a single TIA in patients with non-SVD TIA (8 of 146 [5.5%] vs 76 of 830 [9.2%], OR = 0.58, 95% CI 0.25-1.3, p = 0.20). Of the 9 patients with stroke after a capsular warning syndrome, all had the recurrent TIA within 24 hours after the first TIA, and the subsequent stroke occurred within 72 hours of the second TIA in 8. The ABCD2 scores of all preceding TIAs were ≥4 in all 9 patients with capsular warning syndrome before stroke. Capsular warning syndrome is rare (1.5% of TIA presentations) but has a poor prognosis (7-day stroke risk of 60%). Otherwise, recurrent TIA within 7 days is not associated with a greater stroke risk than that after a single TIA.

Facilitating Stroke Management using Modern Information Technology.

PubMed

Nam, Hyo Suk; Park, Eunjeong; Heo, Ji Hoe

2013-09-01

Information technology and mobile devices may be beneficial and useful in many aspects of stroke management, including recognition of stroke, transport and triage of patients, emergent stroke evaluation at the hospital, and rehabilitation. In this review, we address the contributions of information technology and mobile health to stroke management. Rapid detection and triage are essential for effective thrombolytic treatment. Awareness of stroke warning signs and responses to stroke could be enhanced by using mobile applications. Furthermore, prehospital assessment and notification could be streamlined for use in telemedicine and teleradiology. A mobile telemedicine system for assessing the National Institutes of Health Stroke Scale scores has shown higher correlation and fast assessment comparing with face-to-face method. Because the benefits of thrombolytic treatment are time-dependent, treatment should be initiated as quickly as possible. In-hospital communication between multidisciplinary team members can be enhanced using information technology. A computerized in-hospital alert system using computerized physician-order entry was shown to be effective in reducing the time intervals from hospital arrival to medical evaluations and thrombolytic treatment. Mobile devices can also be used as supplementary tools for neurologic examination and clinical decision-making. In post-stroke rehabilitation, virtual reality and telerehabilitation are helpful. Mobile applications might be useful for public awareness, lifestyle modification, and education/training of healthcare professionals. Information technology and mobile health are useful tools for management of stroke patients from the acute period to rehabilitation. Further improvement of technology will change and enhance stroke prevention and treatment.

First impression at stroke onset plays an important role in early hospital arrival.

PubMed

Iguchi, Yasuyuki; Wada, Kuniyasu; Shibazaki, Kensaku; Inoue, Takeshi; Ueno, Yuji; Yamashita, Shinji; Kimura, Kazumi

2006-01-01

Treatment for acute ischemic stroke should be administered as soon as possible after symptom onset. The aim of this study was to investigate whether or not the patient's and bystander's first impression at stroke onset was associated with hospital arrival time. To investigate the factors influencing the prehospital delay, we prospectively interviewed consecutive stroke patients and bystanders about their first impression at the stroke onset and assessed the methods of transportation, and clinical characteristics. Early arrival was defined as a hospital arrival of within 2 h from stroke onset. One hundred thirty patients were enrolled: 82% were ischemic stroke and 18% were cerebral hemorrhage. The median interval between symptom onset and the hospital arrival was 7.5 h and 30% of patients presented within 2 h of stroke onset. First impression of stroke (odds ratios [OR] 4.56, 95% confidence interval [CI] 1.54-13.5, p=0.006), presence of consciousness disturbance (OR 4.29, CI 1.39-13.3, p=0.011), arrival through other facilities (OR 0.25, CI 0.08-0.76, p=0.015), a history of diabetes (OR 0.23, CI 0.06-0.80, p=0.028) and nocturnal onset (OR 0.19, CI 0.04-0.88, p=0.042) independently contributed to the early arrival. The first impression of patients and bystanders at stroke onset is important in order to reach hospital earlier in Japan. Public educational systems such as those, which advertise stroke warning signs, are necessary.

46 CFR 105.45-20 - Warning sign at gangway.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Warning sign at gangway. 105.45-20 Section 105.45-20... COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-20 Warning sign at gangway. (a) Warning placards shall be kept at hand for display while a vessel is fast to a...

46 CFR 105.45-20 - Warning sign at gangway.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Warning sign at gangway. 105.45-20 Section 105.45-20... COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-20 Warning sign at gangway. (a) Warning placards shall be kept at hand for display while a vessel is fast to a...

46 CFR 105.45-20 - Warning sign at gangway.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Warning sign at gangway. 105.45-20 Section 105.45-20... COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-20 Warning sign at gangway. (a) Warning placards shall be kept at hand for display while a vessel is fast to a...

46 CFR 105.45-20 - Warning sign at gangway.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Warning sign at gangway. 105.45-20 Section 105.45-20... COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-20 Warning sign at gangway. (a) Warning placards shall be kept at hand for display while a vessel is fast to a...

46 CFR 105.45-20 - Warning sign at gangway.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Warning sign at gangway. 105.45-20 Section 105.45-20... COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-20 Warning sign at gangway. (a) Warning placards shall be kept at hand for display while a vessel is fast to a...

7 Warning Signs of Alzheimer's | Alzheimer's disease | NIH MedlinePlus the Magazine

MedlinePlus

... please turn Javascript on. Feature: Alzheimer's Disease 7 Warning Signs of Alzheimer's Past Issues / Fall 2010 Table ... is to alert the public to the early warning signs of Alzheimer's disease. If someone has several ...

46 CFR 98.30-35 - Warning sign at gangway.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Warning sign at gangway. 98.30-35 Section 98.30-35... Warning sign at gangway. If a vessel is moored, no person may transfer to or from a portable tank a... access that is open for use a warning placard containing the following in letters 2 inches in height or...

46 CFR 98.30-35 - Warning sign at gangway.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Warning sign at gangway. 98.30-35 Section 98.30-35... Warning sign at gangway. If a vessel is moored, no person may transfer to or from a portable tank a... access that is open for use a warning placard containing the following in letters 2 inches in height or...

46 CFR 98.30-35 - Warning sign at gangway.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Warning sign at gangway. 98.30-35 Section 98.30-35... Warning sign at gangway. If a vessel is moored, no person may transfer to or from a portable tank a... access that is open for use a warning placard containing the following in letters 2 inches in height or...

46 CFR 98.30-35 - Warning sign at gangway.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Warning sign at gangway. 98.30-35 Section 98.30-35... Intermediate Bulk Containers § 98.30-35 Warning sign at gangway. If a vessel is moored, no person may transfer... in charge displays at each gangway or access that is open for use a warning placard containing the...

46 CFR 98.30-35 - Warning sign at gangway.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Warning sign at gangway. 98.30-35 Section 98.30-35... Warning sign at gangway. If a vessel is moored, no person may transfer to or from a portable tank a... access that is open for use a warning placard containing the following in letters 2 inches in height or...

Wildlife Warning Signs: Public Assessment of Components, Placement and Designs to Optimise Driver Response.

PubMed

Bond, Amy R F; Jones, Darryl N

2013-12-17

Wildlife warning signs are the most commonly used and widespread form of road impact mitigation, aimed at reducing the incidence of wildlife-vehicle collisions. Evidence of the effectiveness of currently used signs is rare and often indicates minimal change in driver behaviour. Improving the design of these signs to increase the likelihood of appropriate driver response has the potential to reduce the incidence of wildlife-vehicle collisions. This study aimed to examine and assess the opinions of drivers on wildlife warning sign designs through a public opinion survey. Three currently used sign designs and five alternative sign designs were compared in the survey. A total of 134 drivers were surveyed. The presence of temporal specifications and an updated count of road-killed animals on wildlife warning signs were assessed, as well as the position of the sign. Drivers' responses to the eight signs were scaled separately at three speed limits and participants indicated the sign to which they were most likely to respond. Three signs consistently ranked high. The messages conveyed by these signs and their prominent features were explored. Animal-activated and vehicle speed-activated signs were ranked very highly by participants. Extensive field trials of various sign designs are needed to further this research into optimizing wildlife warning sign designs.

49 CFR 176.325 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Smoking or open flame and posting of warning signs... Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in... material. (b) A sign carrying the legend: FLAMMABLE VAPORS KEEP LIGHTS AND FIRE AWAY NO SMOKING must be...

49 CFR 176.325 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Smoking or open flame and posting of warning signs... Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in... material. (b) A sign carrying the legend: FLAMMABLE VAPORS KEEP LIGHTS AND FIRE AWAY NO SMOKING must be...

49 CFR 176.325 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Smoking or open flame and posting of warning signs... Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in... material. (b) A sign carrying the legend: FLAMMABLE VAPORS KEEP LIGHTS AND FIRE AWAY NO SMOKING must be...

49 CFR 176.325 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Smoking or open flame and posting of warning signs... Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in... material. (b) A sign carrying the legend: FLAMMABLE VAPORS KEEP LIGHTS AND FIRE AWAY NO SMOKING must be...

49 CFR 176.325 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Smoking or open flame and posting of warning signs... Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in... material. (b) A sign carrying the legend: FLAMMABLE VAPORS KEEP LIGHTS AND FIRE AWAY NO SMOKING must be...

46 CFR 108.626 - Carbon dioxide warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Carbon dioxide warning signs. 108.626 Section 108.626 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Equipment Markings and Instructions § 108.626 Carbon dioxide warning signs. Each...

46 CFR 131.817 - Carbon dioxide warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Carbon dioxide warning signs. 131.817 Section 131.817 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS OPERATIONS Markings for Fire Equipment and Emergency Equipment § 131.817 Carbon dioxide warning signs. Each entrance...

46 CFR 131.817 - Carbon dioxide warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Carbon dioxide warning signs. 131.817 Section 131.817 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS OPERATIONS Markings for Fire Equipment and Emergency Equipment § 131.817 Carbon dioxide warning signs. Each entrance...

46 CFR 131.817 - Carbon dioxide warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Carbon dioxide warning signs. 131.817 Section 131.817 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS OPERATIONS Markings for Fire Equipment and Emergency Equipment § 131.817 Carbon dioxide warning signs. Each entrance...

46 CFR 108.626 - Carbon dioxide warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Carbon dioxide warning signs. 108.626 Section 108.626 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Equipment Markings and Instructions § 108.626 Carbon dioxide warning signs. Each...

46 CFR 108.626 - Carbon dioxide warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Carbon dioxide warning signs. 108.626 Section 108.626 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Equipment Markings and Instructions § 108.626 Carbon dioxide warning signs. Each...

Warning Signs for Suicide: Theory, Research, and Clinical Applications

ERIC Educational Resources Information Center

Rudd, M. David; Berman, Alan L.; Joiner, Thomas E., Jr.; Nock, Matthew K.; Silverman, Morton M.; Mandrusiak, Michael; Van Orden, Kimberly; Witte, Tracy

2006-01-01

The current article addresses the issue of warning signs for suicide, attempting to differentiate the construct from risk factors. In accordance with the characteristic features discussed, a consensus set of warning signs identified by the American Association of Suicidology working group are presented, along with a discussion of relevant clinical…

30 CFR 57.19108 - Posting warning signs during shaft work.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Posting warning signs during shaft work. 57.19108 Section 57.19108 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Personnel Hoisting Shafts § 57.19108 Posting warning signs during shaft work. When persons are...

46 CFR 97.37-11 - Carbon dioxide warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Carbon dioxide warning signs. 97.37-11 Section 97.37-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-11 Carbon dioxide warning signs. Each...

46 CFR 97.37-11 - Carbon dioxide warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Carbon dioxide warning signs. 97.37-11 Section 97.37-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-11 Carbon dioxide warning signs. Each...

46 CFR 97.37-11 - Carbon dioxide warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Carbon dioxide warning signs. 97.37-11 Section 97.37-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-11 Carbon dioxide warning signs. Each...

30 CFR 57.19108 - Posting warning signs during shaft work.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Posting warning signs during shaft work. 57.19108 Section 57.19108 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Personnel Hoisting Shafts § 57.19108 Posting warning signs during shaft work. When persons are...

Exposure to a mnemonic interferes with recall of suicide warning signs in a community-based suicide prevention program.

PubMed

Bryan, Craig J; Steiner-Pappalardo, Nicole; Rudd, M David

2009-04-01

The incremental impact of adding a mnemonic to remember suicide warning signs to the Air Force Suicide Prevention Program (AFSPP) community awareness briefing was investigated with a sample of young, junior-enlisted airmen. Participants in the standard briefing significantly increased their ability to list suicide warning signs and improved consistency with an expert consensus list, whereas participants in the standard briefing plus mnemonic demonstrated no learning. Both groups demonstrated positive changes in beliefs about suicide. Results suggest that inclusion of the mnemonic in the AFSPP briefing interfered with participants' ability to learn suicide warning signs, and that increased confidence in the perceived ability to recognize suicide risk is not related to actual ability to accurately recall warning signs.

How effective are the 6 European Society of Immunodeficiency warning signs for primary immunodeficiency disease?

PubMed

Arslan, Sevket; Ucar, Ramazan; Caliskaner, Ahmet Zafer; Reisli, Ismail; Guner, Sukru Nail; Sayar, Esra Hazar; Baloglu, Ismail

2016-02-01

The European Society of Immunodeficiency (ESID) developed 6 warning signs to promote the awareness of adult primary immunodeficiency disease (PID). To screen adult patients for the presence of PID using these 6 warning signs to determine the effectiveness of this protocol. Questions related to the ESID warning signs for adult PID were added to the standard outpatient clinic file system and asked of 3,510 patients who were admitted to our clinic for any reason. Patients with signs and/or suspicion of PID based on their medical history underwent immunologic investigation. In total, 24 patients were diagnosed as having a PID. The most common reason that patients with PID were admitted was frequent infection (n=18 [75%]), and the most common PID subgroup was common variable immunodeficiency (n=12 [50%]). Twenty patients with PID had at least one positive finding according to the ESID warning signs. Two patients with gastrointestinal concerns and 2 with dermatologic symptoms were also diagnosed as having a PID, although they did not have any of the ESID warning signs. The ESID warning signs do not specify the need for symptoms to diagnose a PIDs and do not include a comprehensive list of all signs and symptoms of PIDs. As a result, more than infection-centric questions are needed to identify adult patients with immunodeficiencies. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Factors associated with delayed presentation in patients with TIA and minor stroke in China: analysis of data from the China National Stroke Registry (CNSR).

PubMed

Wang, Linyu; Chao, Yangyun; Zhao, Xingquan; Liu, Liping; Wang, Chunxue; Wang, David Z; Meng, Xia; Wang, Anxin; Wang, Yongjun; Xu, Yuming

2013-06-01

We aimed to evaluate the management of patients with transient ischemic attack (TIA) and minor stroke in China. Data from the China National Stroke Registry (CNSR) were used to identify patients who were admitted to 132 urban hospitals across China with TIA or minor stroke. Factors associated with delayed presentation to hospital were evaluated. Univariate and multivariate analyses were performed to analyze relationships between patient characteristics and time of presentation. Of the 7467 patients entered into the CNSR (1204 with TIA, 6263 with minor stroke), 780 patients (64·78%) with TIA and 3467 patients (55·36%) with minor stroke had delayed presentation to hospital (>24 hours). In both groups, factors associated with early presentation (≤24 hours) included transportation by ambulance and direct presentation to the emergency room. In patients with minor stroke, early presentation was associated with older age (65-80 years), motor and sensory symptoms, speech impairment, atrial fibrillation, previous TIA, and living in central or eastern China; and delayed presentation was associated with female sex, cognitive dysfunction, and diabetes. In patients with TIA, early presentation was associated with motor symptoms, and delayed presentation was associated with headache or vertigo. In China, many patients with TIA and minor stroke do not seek medical treatment immediately. Further education is needed to teach members of the public about the warning signs and symptoms of TIA and minor stroke, and encourage the use of ambulance transportation after TIA or stroke.

Which stroke symptoms prompt a 911 call? A population-based study.

PubMed

Kleindorfer, Dawn; Lindsell, Christopher J; Moomaw, Charles J; Alwell, Kathleen; Woo, Daniel; Flaherty, Matthew L; Adeoye, Opeolu; Zakaria, Tarek; Broderick, Joseph P; Kissela, Brett M

2010-06-01

Many studies show that a major barrier to short-term treatment of stroke is patient or bystander delay in responding to stroke symptoms. Most studies have found that less than half of stroke/transient ischemic attack (TIA) events result in a 911 call. We sought to determine which symptoms prompt the public to call 911. A population of 1.3 million within a 5-county region was screened for TIA and all strokes in 1999 using all local hospital International Classification of Diseases, Ninth Edition, codes for stroke (430-436) during 1999. Documented stroke symptoms were abstracted from the medical record. Symptoms were grouped as weakness, numbness, speech/language, confusion/decreased level of consciousness, headache, visual changes, and dizziness/vertigo/coordination. Cases included in this analysis had their strokes at home or work and presented to an emergency department. Logistic regression assessed which symptoms predicted a 911 call, adjusting for age, race, sex, prior stroke, baseline disability, overall stroke severity, home vs work, and stroke subtype. Two thousand nine hundred seventy-five stroke/TIA patients met inclusion criteria, of whom 40% used emergency medical services. After adjustment, symptoms that increased odds of a 911 call were weakness, confusion/decreased level of consciousness, speech/language, and dizziness/coordination/vertigo. Numbness was less likely to result in a 911 call as were visual changes. The presence of headache was not associated with the decision to call 911. The public appears to respond differently based on the type of stroke symptom, independent of overall severity. Public awareness messages regarding stroke warning signs should be designed with this in mind. Copyright (c) 2010 Elsevier Inc. All rights reserved.

46 CFR 78.47-11 - Carbon dioxide warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 3 2014-10-01 2014-10-01 false Carbon dioxide warning signs. 78.47-11 Section 78.47-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-11 Carbon dioxide warning signs. Each entrance to a space...

46 CFR 78.47-11 - Carbon dioxide warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 3 2012-10-01 2012-10-01 false Carbon dioxide warning signs. 78.47-11 Section 78.47-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-11 Carbon dioxide warning signs. Each entrance to a space...

46 CFR 196.37-8 - Carbon dioxide warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Carbon dioxide warning signs. 196.37-8 Section 196.37-8 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-8 Carbon dioxide warning signs. Each entrance to a...

30 CFR 56.19108 - Posting warning signs during shaft work.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Posting warning signs during shaft work. 56.19108 Section 56.19108 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Personnel Hoisting Shafts § 56.19108 Posting warning signs during shaft work. When persons are working in a...

30 CFR 56.19108 - Posting warning signs during shaft work.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Posting warning signs during shaft work. 56.19108 Section 56.19108 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Personnel Hoisting Shafts § 56.19108 Posting warning signs during shaft work. When persons are working in a...

46 CFR 196.37-8 - Carbon dioxide warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Carbon dioxide warning signs. 196.37-8 Section 196.37-8 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-8 Carbon dioxide warning signs. Each entrance to a...

30 CFR 56.19108 - Posting warning signs during shaft work.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Posting warning signs during shaft work. 56.19108 Section 56.19108 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Personnel Hoisting Shafts § 56.19108 Posting warning signs during shaft work. When persons are working in a...

46 CFR 78.47-11 - Carbon dioxide warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 3 2013-10-01 2013-10-01 false Carbon dioxide warning signs. 78.47-11 Section 78.47-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-11 Carbon dioxide warning signs. Each entrance to a space...

30 CFR 56.19108 - Posting warning signs during shaft work.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Posting warning signs during shaft work. 56.19108 Section 56.19108 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Personnel Hoisting Shafts § 56.19108 Posting warning signs during shaft work. When persons are working in a...

46 CFR 196.37-8 - Carbon dioxide warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Carbon dioxide warning signs. 196.37-8 Section 196.37-8 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-8 Carbon dioxide warning signs. Each entrance to a...

Conspicuity, memorability, comprehension, and priming in road hazard warning signs.

PubMed

Charlton, Samuel G

2006-05-01

This study assessed driver reactions to 16 road hazard warning signs of various formats by projecting life-sized video of road scenes to drivers in a driving simulator. A range of measures, including attentional and search conspicuity, implicit and explicit recognition, dynamic and static comprehension, and sign priming were collected. Of the signs tested, road works and school warning signs were most often detected, remembered, and understood. Slippery surface warnings were associated with some of the lowest detection and comprehension rates. The effectiveness of the different formats depended on the type of hazard sign. In the case of road works warnings, a flashing variable message format was only slightly more conspicuous than the large dimension format, equal in comprehensibility, and perhaps somewhat worse in terms of memorability. For the school warnings, however, the flashing variable message format appeared to convey a greater sense of potential hazard, produced superior search conspicuity and priming, and was equal in terms of memorability and comprehensibility. The range of measures worked well as a whole with the two measures of conspicuity and the measure of static comprehension showing the greatest consistency.

Exposure to a Mnemonic Interferes with Recall of Suicide Warning Signs in a Community-Based Suicide Prevention Program

ERIC Educational Resources Information Center

Bryan, Craig J.; Steiner-Pappalardo, Nicole; Rudd, M. David

2009-01-01

The incremental impact of adding a mnemonic to remember suicide warning signs to the Air Force Suicide Prevention Program (AFSPP) community awareness briefing was investigated with a sample of young, junior-enlisted airmen. Participants in the standard briefing significantly increased their ability to list suicide warning signs and improved…

Knowledge, attitude, and practice of stroke among high school students in Nepal.

PubMed

Thapa, Lekhjung; Sharma, Nooma; Poudel, Ramesh Sharma; Bhandari, Tirtha Raj; Bhagat, Riwaz; Shrestha, Ashis; Shrestha, Shakti; Khatiwada, Dipendra; Caplan, Louis R

2016-01-01

Baseline stroke knowledge in a targeted population is indispensable to promote the effective stroke education. We report the baseline knowledge, attitude, and practice (KAP) of high school students with respect to stroke from Nepal. A self-structured questionnaire survey regarding KAP about stroke was conducted in high school students of 33 schools of Bharatpur, Nepal. Descriptive statistics including Chi-square test was used, and the significant variables were subjected to binary logistic regression. Among 1360 participants, 71.1% had heard or read about stroke; 30.2% knew someone with stroke. 39.3% identified brain as the organ affected. Sudden onset limb/s weakness/numbness (72%) and hypertension (74%) were common warning symptom and risk factor identified. 88.9% would take stroke patients to a hospital. Almost half participants (55.5%) felt ayurvedic treatment be effective. 44.8% felt stroke as a hindrance to a happy life and 86.3% believed that family care was helpful for early recovery. Students who identified at least one risk factor were 3.924 times ( P < 0.001, confidence interval [CI] = 1.867-8.247) or those who identified at least one warning symptom were 2.833 times ( P ≤ 0.023, CI = 1.156-6.944) more likely to take stroke patients to a hospital. KAP of high school Nepalese students regarding stroke was satisfactory, and the students having knowledge about the risk factors and warning symptoms were more likely to take stroke patients to a hospital. However, a few misconceptions persisted.

The Emotional Impact and Ease of Recall of Warning Signs for Suicide: A Controlled Study

ERIC Educational Resources Information Center

Rudd, M. David; Mandrusiak, Michael; Joiner, Thomas E., Jr.; Berman, Alan L.; Van Orden, Kimberly A.; Hollar, Daniel

2006-01-01

In light of concerns about potential iatrogenic effects of information about suicide, in the current study we examined the emotional impact of reading a list of warning signs for suicide in comparison to comparable lists for heart attacks and diabetes. All participants read two sets of warning signs, with the experimental group reading the suicide…

49 CFR 176.220 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Smoking or open flame and posting of warning signs... CARRIAGE BY VESSEL Detailed Requirements for Class 2 (Compressed Gas) Materials § 176.220 Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in any hold or...

49 CFR 176.220 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Smoking or open flame and posting of warning signs... CARRIAGE BY VESSEL Detailed Requirements for Class 2 (Compressed Gas) Materials § 176.220 Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in any hold or...

49 CFR 176.220 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Smoking or open flame and posting of warning signs... CARRIAGE BY VESSEL Detailed Requirements for Class 2 (Compressed Gas) Materials § 176.220 Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in any hold or...

49 CFR 176.220 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Smoking or open flame and posting of warning signs... CARRIAGE BY VESSEL Detailed Requirements for Class 2 (Compressed Gas) Materials § 176.220 Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in any hold or...

49 CFR 176.220 - Smoking or open flame and posting of warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Smoking or open flame and posting of warning signs... CARRIAGE BY VESSEL Detailed Requirements for Class 2 (Compressed Gas) Materials § 176.220 Smoking or open flame and posting of warning signs. (a) Smoking or the use of open flame is prohibited in any hold or...

Prognosis of spontaneous hemorrhagic stroke in people under 55 in Senegal, a developing country in Africa: a series of 53 cases.

PubMed

Dieynabou Sow, A; Touré, K; Basse, A M; Ndiaye, M M

2016-05-01

Strokes occur increasingly frequently in people aged 55 years or younger and present a problem of management and therefore of prognosis. The objective of this study was to determine the prognostic factors associated with hemorrhagic stroke in this population in Senegal. This retrospective study concerns 53 patients aged 16 to 55 years, hospitalized for hemorrhage stroke in the neurological department of Fann Teaching Hospital during 2010. The patients' mean age was 42.1 years (16 to 55 years) and the sex ratio 1.30 in favor of women. Hypertension was found in 62% of the patients, and 11% had a history of stroke. Hemiplegia was observed in 76%, associated more or less with impairment of consciousness (43%) and language (38%). Intraparenchymal hematomas were principally supratentorial (78%); only 15% were subtentorial (10% cerebellar and 5% in the brainstem). During the acute phase of hemorrhage, glycemic levels were high among one third of the patients. The mortality rate in our series was 43% and was highest among those of impaired consciousness and abnormal glycemic, cholesterol, and creatinemia levels. Neuropsychological sequelae occurred in 47% of all patients, including 83% of the survivors. Hemorrhagic stroke in people aged 55 years or younger is a public health problem. In view of the high mortality rate, effective control requires prevention of its risk factors and increased awareness of the danger of these factors and of the warning signs of stroke.

46 CFR 151.45-2 - Special operating requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... sign at or on each tank or by a single sign similar to the following example: Tank No. Cargo IP /xxxx... only a single product, the Warning Sign required by paragraph (e)(1) of this section can be considered... spaces shall be closed and secured at all times. (e) Cargo signs and cards. (1) Warning signs shall be...

Disparities in adult awareness of heart attack warning signs and symptoms--14 states, 2005.

PubMed

2008-02-22

In 2005, approximately 920,000 persons in the United States had a myocardial infarction (i.e., heart attack); in 2004, approximately 157,000 heart attacks were fatal. One study indicated that approximately half of cardiac deaths occur within 1 hour of symptom onset, before patients reach a hospital. Timely access to emergency cardiac care, receipt of advanced treatment, and potential for surviving a heart attack all depend on 1) early recognition of warning signs and symptoms of a heart attack by persons who are having a heart attack and bystanders and 2) immediately calling 9-1-1. Healthy People 2010 includes an objective to increase from 46% to 50% the proportion of adults aged > or =20 years who are aware of the early warning signs and symptoms of a heart attack and the importance of accessing rapid emergency care by calling 9-1-1 (objective 12-2). To update estimates of public awareness of heart attack warning signs and symptoms and knowledge of the importance of calling 9-1-1, CDC analyzed 2005 Behavioral Risk Factor Surveillance System (BRFSS) data from the 14 states that included questions on signs and symptoms of a heart attack. This report describes the results of that analysis, which indicated that although the awareness of certain individual warning signs was as high as 93% (i.e., for shortness of breath), awareness of all five warning signs was 31%, underscoring the need for public health measures to increase public awareness of heart attack warning signs and symptoms. In addition, disparities in awareness were observed by race/ethnicity, sex, and level of education, suggesting that new public health measures should target populations with the lowest levels of awareness.

Transportation research synthesis : effectiveness of traffic signs on local roads.

DOT National Transportation Integrated Search

2010-01-01

There does not appear to be significant credible research demonstrating the outright ineffectiveness of particular : traffic warning signs. The research we identified provides support for opposing points of view: that traffic warning : signs have a m...

Are migraine and non-migrainous headache risk factors for stroke in the elderly? Findings from a 12-year cohort follow-up

PubMed Central

Norton, Joanna; Portet, Florence; Gabelle, Audrey; Debette, Stephanie; Ritchie, Karen; Touchon, Jacques; Berr, Claudine

2016-01-01

Background There is evidence that migraine is a risk factor for stroke but little is known about this association in elderly people. Furthermore, non-migrainous headache (NMH) has received little attention as a potential risk factor, despite being the most frequently reported type of headache. Late-life migraine and NMH were examined as candidate risk factors for stroke in a community-dwelling elderly sample over a 12-year follow-up. Methods 1919 non-institutionalized subjects 65+, without dementia (DSM-IV criteria) and no stroke history at baseline were drawn from the 3C-Montpellier cohort (recruitment 1999–2001) for the longitudinal analysis. Ischemic and haemorrhagic stroke was reported at baseline, and at each of the 5 follow-ups, with ICD-10 cases validated by a panel of experts. Migraine and NMH were determined at baseline during a neurological interview and examination using 1988 IHS criteria. Results 110 (5.4%) cases of migraine and 179 (8.9%) cases of NMH were identified at baseline. During the median 8.8 year follow-up, incident stroke was observed in 1.9% of baseline migrainers, 6.2% of NMH and 3.6% of those with no lifetime history of headache. Cox proportional hazard models indicated that migraine was not a risk factor for stroke, however NMH sufferers were twice as likely to have a stroke (Hazard Ratio=2.00, 95% CI: 1.00–3.93, p=0.049). Conclusions This study is one of the first to suggest that late-life NMH rather than migraine could be an independent risk factor for stroke and warning sign. The incidence of stroke in elderly migrainers, seldom reported, is particularly low. PMID:27399611

Stroke awareness in Brazil: alarming results in a community-based study.

PubMed

Pontes-Neto, Octávio Marques; Silva, Gisele Sampaio; Feitosa, Marley Ribeiro; de Figueiredo, Nathalie Lôbo; Fiorot, José Antonio; Rocha, Talitha Nery; Massaro, Ayrton Roberto; Leite, João Pereira

2008-02-01

Stroke is the leading cause of death in Brazil. This community-based study assessed lay knowledge about stroke recognition and treatment and risk factors for cerebrovascular diseases and activation of emergency medical services in Brazil. The study was conducted between July 2004 and December 2005. Subjects were selected from the urban population in transit about public places of 4 major Brazilian cities: São Paulo, Salvador, Fortaleza, and Ribeirão Preto. Trained medical students, residents, and neurologists interviewed subjects using a structured, open-ended questionnaire in Portuguese based on a case presentation of a typical patient with acute stroke at home. Eight hundred fourteen subjects were interviewed during the study period (53.9% women; mean age, 39.2 years; age range, 18 to 80 years). There were 28 different Portuguese terms to name stroke. Twenty-two percent did not recognize any warning signs of stroke. Only 34.6% of subjects answered the correct nationwide emergency telephone number in Brazil (#192). Only 51.4% of subjects would call emergency medical services for a relative with symptoms of stroke. In a multivariate analysis, individuals with higher education called emergency medical services (P=0.038, OR=1.5, 95%, CI: 1.02 to 2.2) and knew at least one risk factor for stroke (P<0.05, OR=2.0, 95% CI: 1.2 to 3.2) more often than those with lower education. Our study discloses alarming lack of knowledge about activation of emergency medical services and availability of acute stroke treatment in Brazil. These findings have implications for public health initiatives in the treatment of stroke and other cardiovascular emergencies.

Clinical and Immunological Markers of Dengue Progression in a Study Cohort from a Hyperendemic Area in Malaysia

PubMed Central

Rathakrishnan, Anusyah; Klekamp, Benjamin; Wang, Seok Mui; Komarasamy, Thamil Vaani; Natkunam, Santha Kumari; Sathar, Jameela; Azizan, Azliyati; Sanchez-Anguiano, Aurora; Manikam, Rishya; Sekaran, Shamala Devi

2014-01-01

Background With its elusive pathogenesis, dengue imposes serious healthcare, economic and social burden on endemic countries. This study describes the clinical and immunological parameters of a dengue cohort in a Malaysian city, the first according to the WHO 2009 dengue classification. Methodology and Findings This longitudinal descriptive study was conducted in two Malaysian hospitals where patients aged 14 and above with clinical symptoms suggestive of dengue were recruited with informed consent. Among the 504 participants, 9.3% were classified as non-dengue, 12.7% without warning signs, 77.0% with warning signs and 1.0% with severe dengue based on clinical diagnosis. Of these, 37% were misdiagnosed as non-dengue, highlighting the importance of both clinical diagnosis and laboratory findings. Thrombocytopenia, prolonged clotting time, liver enzymes, ALT and AST served as good markers for dengue progression but could not distinguish between patients with and without warning signs. HLA-A*24 and -B*57 were positively associated with Chinese and Indians patients with warning signs, respectively, whereas A*03 may be protective in the Malays. HLA-A*33 was also positively associated in patients with warning signs when compared to those without. Dengue NS1, NS2A, NS4A and NS4B were found to be important T cell epitopes; however with no apparent difference between with and without warning signs patients. Distinction between the 2 groups of patients was also not observed in any of the cytokines analyzed; nevertheless, 12 were significantly differentially expressed at the different phases of illness. Conclusion The new dengue classification system has allowed more specific detection of dengue patients, however, none of the clinical parameters allowed distinction of patients with and without warning signs. While the HLA-A*33 may be predictive marker for development of warning signs; larger studies will be needed to support this findings. PMID:24647042

Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil.

PubMed

Sicuro Correa, Luana; Hökerberg, Yara Hahr Marques; Oliveira, Raquel de Vasconcellos Carvalhaes de; Barros, Danielle Martins de Souza; Alexandria, Helenara Abadia Ferreira; Daumas, Regina Paiva; Andrade, Carlos Augusto Ferreira de; Passos, Sonia Regina Lambert; Brasil, Patrícia

2016-01-01

The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system. Cross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0.05). The final sample comprised 474 participants (97%), mean age of 37 years (standard deviation = 10.3), mainly females (83.8%), physicians (40.1%) and from tertiary care (75.1%). The majority (91%) reported using warning signs for dengue in pediatrics clinical practice. The most widely used and highly valued signs were major hemorrhages (gastrointestinal, urinary), abdominal pain, and increase in hematocrit concurrent or not with rapid decrease in platelet count. Persistent vomiting as well as other signs of plasma leakage such as respiratory distress and lethargy/restlessness were not identified as having the same degree of importance, especially by nurse technicians and in primary or secondary care. Although most health care staff reported using dengue warning signs, it would be useful to extend the training for identifying easily recognizable signs of plasma leakage that occur regardless of bleeding.

Evaluation of selected warning signs at skewed railroad-highway crossings.

DOT National Transportation Integrated Search

1986-01-01

A 1984 study by the Research Council recommended that advance warning signs be placed in advance of skewed railroad-highway grade crossings. Several signs were suggested for use, and the study reported here was undertaken to determine the effectivene...

46 CFR 105.45-15 - Warning signals and signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Warning signals and signs. 105.45-15 Section 105.45-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-15 Warning...

46 CFR 105.45-15 - Warning signals and signs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Warning signals and signs. 105.45-15 Section 105.45-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-15 Warning...

46 CFR 105.45-15 - Warning signals and signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Warning signals and signs. 105.45-15 Section 105.45-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-15 Warning...

46 CFR 105.45-15 - Warning signals and signs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Warning signals and signs. 105.45-15 Section 105.45-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-15 Warning...

46 CFR 105.45-15 - Warning signals and signs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Warning signals and signs. 105.45-15 Section 105.45-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-15 Warning...

Awareness of heart attack and stroke symptoms among Hispanic male adults living in the United States.

PubMed

Lutfiyya, May Nawal; Bardales, Ricardo; Bales, Robert; Aguero, Carlos; Brady, Shelly; Tobar, Adriana; McGrath, Cynthia; Zaiser, Julia; Lipsky, Martin S

2010-10-01

There is evidence that Hispanic men are a high risk group for treatment delay for both heart attack and stroke. More targeted research is needed to elucidate this specific population's knowledge of warning signs for these acute events. This study sought to describe within-group disparities in Hispanic men's knowledge of heart attack and stroke symptomology. Multivariate techniques were used to analyze a multi-year Behavioral Risk Factor Surveillance Heart and Stroke module database. The data were cross-sectional and focused on health risk factors and behaviors. The research participants were U.S. male Hispanic adults aged 18-99. The main outcome measure for the study was heart attack and stroke symptom knowledge score. Multivariate logistic regression analysis yielded that Hispanic men aged >or=18 years who earned low scores on the composite heart attack and stroke knowledge questions (range 0-8 points) were more likely to: have less than a high school education, have deferred medical care because of cost, not have an identified health care provider, and be uninsured. There were significant within-group differences. Targeting educational efforts toward older (>or=55 years) Hispanic men with less than high school education, those who do not have an identified health care provider or health insurance, and who defer health care because of cost could be ways to improve the outcome of acute vascular events among the U.S. Hispanic adult male population.

[U.S. Food and Drug Administration (FDA) strengthens warning that non-aspirin non steroidal anti-inflammatory drugs (NSAIDs) can cause myocardial infarctions or strokes: the dentist's perspective].

PubMed

Rosen, E; Tsesis, I; Vered, M

2015-10-01

This short communication is aimed to update dental practitioners regarding the recently published warning of the U.S. Food and Drug Administration (FDA) regarding the risk for severe cardiovascular complications such as myocardial infarction or stroke following the use of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs).

Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

PubMed

Streit, Sven; Baumann, Philippe; Barth, Jürgen; Mattle, Heinrich P; Arnold, Marcel; Bassetti, Claudio L; Meli, Damian N; Fischer, Urs

2015-01-01

Transient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates. We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients. Of the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care. Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

Self-reported awareness of the presence of product warning messages and signs by Hispanics in San Francisco.

PubMed Central

Marín, G

1994-01-01

This study investigated the self-reported awareness of the presence of product warning messages and signs among random samples of Hispanics in San Francisco surveyed in 1990 and in 1991. The messages that were tested related to cigarettes, alcoholic beverages, and other consumer products. A random sample of 1,204 Hispanics (43.5 percent males) were interviewed by telephone in 1990. The corresponding figure for the second survey in 1991 was 1,569 Hispanics (41.1 percent males). In general, respondents reported low levels of awareness of the presence of product warning messages and signs. The exception was warning messages on cigarette packets which approximately 70 percent of the respondents reported having seen within the 12 months before the survey. There was an increase from 1990 to 1991 in the reported awareness of warning messages for wine, beer, and cigarettes. Smokers and drinkers of alcoholic beverages reported the highest levels of awareness of the relevant warning messages and signs. Length of exposure to warning messages and multiplicity of sources (for example, advertisements and products) seem to produce greater levels of awareness of the presence of product warning messages. Less acculturated, Spanish-speaking Hispanics are less likely to report being aware of the warnings, particularly those that appear only in English (for example, alcoholic beverages). PMID:8153279

Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil

PubMed Central

Hökerberg, Yara Hahr Marques; de Oliveira, Raquel de Vasconcellos Carvalhaes; Barros, Danielle Martins de Souza; Alexandria, Helenara Abadia Ferreira; Daumas, Regina Paiva; de Andrade, Carlos Augusto Ferreira; Passos, Sonia Regina Lambert; Brasil, Patrícia

2016-01-01

Objective The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system. Methods Cross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0.05). Results The final sample comprised 474 participants (97%), mean age of 37 years (standard deviation = 10.3), mainly females (83.8%), physicians (40.1%) and from tertiary care (75.1%). The majority (91%) reported using warning signs for dengue in pediatrics clinical practice. The most widely used and highly valued signs were major hemorrhages (gastrointestinal, urinary), abdominal pain, and increase in hematocrit concurrent or not with rapid decrease in platelet count. Persistent vomiting as well as other signs of plasma leakage such as respiratory distress and lethargy/restlessness were not identified as having the same degree of importance, especially by nurse technicians and in primary or secondary care. Discussion Although most health care staff reported using dengue warning signs, it would be useful to extend the training for identifying easily recognizable signs of plasma leakage that occur regardless of bleeding. PMID:27716812

Evaluation of a radar activated speed warning sign for school zone speed control.

DOT National Transportation Integrated Search

2004-01-01

During the fall of 2003, the Maine Department of Transportation tested a radar-activated speed warning : sign at two different locations in different towns near elementary schools. The sign was manufactured by : 3M and was loaned to MaineDOT for test...

Revised text for TxDOT manual procedures for establishing speed zones, chapter 5, section 2.

DOT National Transportation Integrated Search

2010-02-01

Warning signs are intended to improve curve safety by alerting the driver to a change in : geometry that may not be apparent or expected. These signs notify drivers of the change : through the use of one or more of the curve warning signs identified ...

African-Americans and Alzheimer's

MedlinePlus

... Share Plus on Google Plus African-Americans and Alzheimer's alz.org | IHaveAlz Introduction 10 Warning Signs Brain ... African-Americans are at a higher risk for Alzheimer's disease. Many Americans dismiss the warning signs of ...

46 CFR 35.40-8 - Carbon dioxide warning signs-T/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Carbon dioxide warning signs-T/ALL. 35.40-8 Section 35.40-8 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Posting and Marking Requirements-TB/ALL § 35.40-8 Carbon dioxide warning signs—T/ALL. Each entrance to a space storing...

Effect of information education and communication (IEC) programme on knowledge of pregnant mothers regarding prevention and management of warning signs during pregnancy.

PubMed

Takoo, Sarla; Chhugani, Manju; Sharma, Veena

2013-01-01

The present study was conducted to evaluate the effectiveness of an Information, Education and Communication (IEC) programme on knowledge of pregnant mothers regarding prevention and management of warning signs during pregnancy in a selected health care setting at New Delhi. An evaluative research approach with one group pre-test and post-test design was adopted for the present study. A structured interview schedule was prepared. Purposive non-probability sampling technique was employed to interview 30 pregnant mothers who attended antenatal clinic. Data gathered was analysed and interpreted using both descriptive and inferential statistics. The study revealed that there was maximum knowledge deficit regarding warning signs of pregnancy. IEC programme was effective in enhancing the knowledge of pregnant mothers on prevention and management of warning signs during pregnancy.

46 CFR 35.40-8 - Carbon dioxide warning signs-T/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Carbon dioxide warning signs-T/ALL. 35.40-8 Section 35... Marking Requirements-TB/ALL § 35.40-8 Carbon dioxide warning signs—T/ALL. Each entrance to a space storing carbon dioxide cylinders, a space protected by carbon dioxide systems, or any space into which carbon...

46 CFR 35.40-8 - Carbon dioxide warning signs-T/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Carbon dioxide warning signs-T/ALL. 35.40-8 Section 35... Marking Requirements-TB/ALL § 35.40-8 Carbon dioxide warning signs—T/ALL. Each entrance to a space storing carbon dioxide cylinders, a space protected by carbon dioxide systems, or any space into which carbon...

Stroke Genetics Network (SiGN) Study: Design and rationale for a genome-wide association study of ischemic stroke subtypes

PubMed Central

Meschia, James F.; Arnett, Donna K.; Ay, Hakan; Brown, Robert D.; Benavente, Oscar; Cole, John W.; de Bakker, Paul I.W.; Dichgans, Martin; Doheny, Kimberly F.; Fornage, Myriam; Grewal, Raji; Gwinn, Katrina; Jern, Christina; Conde, Jordi Jimenez; Johnson, Julie A.; Jood, Katarina; Laurie, Cathy C.; Lee, Jin-Moo; Lindgren, Arne; Markus, Hugh S.; McArdle, Patrick F.; McClure, Leslie A.; Mitchell, Braxton D.; Schmidt, Reinhold; Rexrode, Kathryn M.; Rich, Stephen S.; Rosand, Jonathan; Rothwell, Peter M.; Rundek, Tatjana; Sacco, Ralph L.; Sharma, Pankaj; Shuldiner, Alan R.; Slowik, Agnieszka; Wassertheil-Smoller, Sylvia; Sudlow, Cathie; Thijs, Vincent; Woo, Daniel; Worrall, Bradford B.; Wu, Ona; Kittner, Steven J.

2014-01-01

Background and Purpose Meta-analyses of extant genome-wide data illustrate the need to focus on subtypes of ischemic stroke for gene discovery. The NINDS Stroke Genetics Network (SiGN) contributes substantially to meta-analyses that focus on specific subtypes of stroke. Methods The NINDS Stroke Genetics Network (SiGN) includes ischemic stroke cases from 24 Genetic Research Centers (GRCs), 13 from the US and 11 from Europe. Investigators harmonize ischemic stroke phenotyping using the web-based Causative Classification of Stroke (CCS) system, with data entered by trained and certified adjudicators at participating GRCs. Through the Center for Inherited Diseases Research (CIDR), SiGN plans to genotype 10,296 carefully phenotyped stroke cases using genome-wide SNP arrays, and add to these another 4,253 previously genotyped cases for a total of 14,549 cases. To maximize power for subtype analyses, the study allocates genotyping resources almost exclusively to cases. Publicly available studies provide most of the control genotypes. CIDR-generated genotypes and corresponding phenotypic data will be shared with the scientific community through dbGaP, and brain MRI studies will be centrally archived. Conclusions The SiGN consortium, with its emphasis on careful and standardized phenotyping of ischemic stroke and stroke subtypes, provides an unprecedented opportunity to uncover genetic determinants of ischemic stroke. PMID:24021684

Do presenting symptoms explain sex differences in emergency department delays among patients with acute stroke?

PubMed

Gargano, Julia Warner; Wehner, Susan; Reeves, Mathew J

2009-04-01

Previous studies report that women with stroke may experience longer delays in diagnostic workup than men after arriving at the emergency department. We hypothesized that presenting symptom differences could explain these delays. Data were collected on 1922 acute stroke cases who presented to 15 hospitals participating in a statewide stroke registry. We evaluated 2 in-hospital time intervals: emergency department arrival to physician examination ("door-to-doctor") and emergency department arrival to brain imaging ("door-to-image"). We used parametric survival models to estimate time ratios, which represent the ratio of average times comparing women to men, after adjusting for symptom presentation and other confounders. Women were significantly less likely than men to present with any stroke warning sign or suspected stroke (87.5% versus 91.4%) or to report trouble with walking, balance, or dizziness (9.5% versus 13.7%). Difficulty speaking and loss of consciousness were associated with shorter door-to-doctor times. Weakness, facial droop, difficulty speaking, and loss of consciousness were associated with shorter door-to-image times, whereas difficulty with walking/balance was associated with longer door-to-image times. In adjusted analyses, women had 11% longer door-to-doctor intervals (time ratio, 1.11; 95%, CI 1.02 to 1.22) and 15% longer door-to-image intervals (time ratio, 1.15; 95% CI, 1.08 to 1.25) after accounting for presenting symptoms, age, and other confounders. Furthermore, these sex differences remained evident after restricting to patients who arrived within 6 or within 2 hours of symptom onset. Women with acute stroke experienced greater emergency department delays than men, which were not attributable to differences in presenting symptoms, time of arrival, age, or other confounders.

A pilot study to assess if urine specific gravity and urine colour charts are useful indicators of dehydration in acute stroke patients.

PubMed

Rowat, Anne; Smith, Laura; Graham, Cat; Lyle, Dawn; Horsburgh, Dorothy; Dennis, Martin

2011-09-01

The purpose of this pilot study was to examine whether urine specific gravity and urine colour could provide an early warning of dehydration in stroke patients compared with standard blood indicators of hydration status. Dehydration after stroke has been associated with increased blood viscosity, venous thrombo-embolism and stroke mortality at 3-months. Earlier identification of dehydration might allow us to intervene to prevent significant dehydration developing or reduce its duration to improve patient outcomes. We recruited 20 stroke patients in 2007 and measured their urine specific gravity with urine test strips, a refractometer, and urine colour of specimens taken daily on 10 consecutive days and compared with the routine blood urea:creatinine ratios over the same period to look for trends and relationships over time. The agreement between the refractometer, test strips and urine colour were expressed as a percentage with 95% confidence intervals. Nine (45%) of the 20 stroke patients had clinical signs of dehydration and had a significantly higher admission median urea:creatinine ratio (P = 0·02, Mann-Whitney U-test). There were no obvious relationships between urine specific gravity and urine colour with the urea:creatinine ratio. Of the 174 urine samples collected, the refractometer agreed with 70/174 (40%) urine test strip urine specific gravity and 117/174 (67%) urine colour measurements. Our results do not support the use of the urine test strip urine specific gravity as an early indicator of dehydration. Further research is required to develop a practical tool for the early detection of dehydration in stroke patients. © 2011 Blackwell Publishing Ltd.

Are migraine and non-migrainous headache risk factors for stroke in the elderly? Findings from a 12-year cohort follow-up.

PubMed

Norton, J; Portet, F; Gabelle, A; Debette, S; Ritchie, K; Touchon, J; Berr, C

2016-09-01

There is evidence that migraine is a risk factor for stroke but little is known about this association in elderly people. Furthermore, non-migrainous headache (NMH) has received little attention despite being the most frequently reported type of headache. Late-life migraine and NMH were examined as candidate risk factors for stroke in a community-dwelling elderly sample over a 12-year follow-up. One thousand nine hundred and nineteen non-institutionalized subjects aged 65+, without dementia (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, DSM-IV criteria) and with no stroke history at baseline, were drawn from the Three-City Montpellier cohort (recruitment 1999-2001) for longitudinal analysis. Ischaemic and haemorrhagic stroke was reported at baseline and at each of the five follow-ups, with cases validated by a panel of experts, according to ICD-10 criteria (International Classification of Diseases, 10th revision). Migraine and NMH were determined at baseline during a neurological interview and examination using 1988 International Headache Society criteria. A total of 110 (5.4%) cases of migraine and 179 (8.9%) cases of NMH were identified at baseline. During the median 8.8-year follow-up, incident stroke was observed in 1.9% of baseline migrainers, 6.2% of NMH and 3.6% of those with no lifetime history of headache. Cox proportional hazard models indicated that migraine was not a risk factor for stroke; however, NMH sufferers were twice as likely to have a stroke (hazard ratio 2.00, 95% confidence interval 1.00-3.93, P = 0.049). This study is one of the first to suggest that late-life NMH rather than migraine could be an independent risk factor for stroke and a warning sign. The incidence of stroke in elderly migrainers, seldom reported, is particularly low. © 2016 EAN.

Gender-specific differences in stroke knowledge, stroke risk perception and the effects of an educational multimedia campaign.

PubMed

Marx, Juergen J; Klawitter, Bianca; Faldum, Andreas; Eicke, Bernhard M; Haertle, Birgit; Dieterich, Marianne; Nedelmann, Max

2010-03-01

This study aimed at identifying gender-specific differences in stroke knowledge, stroke risk perception and the educational effects of a multimodal educational intervention. We performed computer-assisted telephone surveys among an average sample of 500 members of the general public (44.0% male, 56.0% female), before and immediately after an intense 3-month educational stroke campaign in a western German area of 400,000 inhabitants. The intervention was comprised of poster advertisements and various print media. Slogans and stroke interest stories appeared regularly in local newspapers, on television and radio and public events focussed on the subject. Even before the intervention, more women than men were able to name at least one stroke warning sign (71.3 vs. 57.8%, p < 0.01), to name the correct emergency call number (33.3 vs. 24.3%, p < 0.05) or to cite the correct action in acute stroke ("call emergency care", 87.2 vs. 70.1%, p < 0.001). In some aspects women showed a generally better improvement of knowledge after the campaign (e.g. correct emergency call number: +5.7 vs. +1.2%, p < 0.05). Fewer women than men considered themselves as being at risk of stroke (30.9 vs. 36.9%. p < 0.01) with a significant increase following the intervention in both sexes (38.9/46.0%, p < 0.01). The perception of different educational media varied between the sexes. For example, female sex was independently associated with a better recall of poster advertisements and flyers in pharmacies and at the doctor's office (OR 1.44). Our data indicate that educational programs do have gender-specific effects. Women show a better stroke knowledge and in some aspects a better chance to gain information from classical broad educational interventions. Future campaigns should be tailored economically, and should focus different media and educational messages on the two sexes accordingly.

A fundamental conflict of care: Nurses' accounts of balancing patients' sleep with taking vital sign observations at night.

PubMed

Hope, Joanna; Recio-Saucedo, Alejandra; Fogg, Carole; Griffiths, Peter; Smith, Gary B; Westwood, Greta; Schmidt, Paul E

2017-12-21

To explore why adherence to vital sign observations scheduled by an early warning score protocol reduces at night. Regular vital sign observations can reduce avoidable deterioration in hospital. early warning score protocols set the frequency of these observations by the severity of a patient's condition. Vital sign observations are taken less frequently at night, even with an early warning score in place, but no literature has explored why. A qualitative interpretative design informed this study. Seventeen semi-structured interviews with nursing staff working on wards with varying levels of adherence to scheduled vital sign observations. A thematic analysis approach was used. At night, nursing teams found it difficult to balance the competing care goals of supporting sleep with taking vital sign observations. The night-time frequency of these observations was determined by clinical judgement, ward-level expectations of observation timing and the risk of disturbing other patients. Patients with COPD or dementia could be under-monitored, while patients nearing the end of life could be over-monitored. In this study, we found an early warning score algorithm focused on deterioration prevention did not account for long-term management or palliative care trajectories. Nurses were therefore less inclined to wake such patients to take vital sign observations at night. However, the perception of widespread exceptions and lack of evidence regarding optimum frequency risks delegitimising the early warning score approach. This may pose a risk to patient safety, particularly patients with dementia or chronic conditions. Nurses should document exceptions and discuss these with the wider team. Hospitals should monitor why vital sign observations are missed at night, identify which groups are under-monitored and provide guidance on prioritising competing expectations. early warning score protocols should take account of different care trajectories. © 2017 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Know the Warning Signs of a Heart Attack

MedlinePlus

... No. 22 Know the Warning Signs of a Heart Attack What is a heart attack? Aheart attack happens when the blood vessels that ... hurting your heart muscle. Another name for a heart attack is myocardial infarction, or MI. If you have ...

Uniform Traffic Control and Warning Messages for Portable Changeable Message Signs

DOT National Transportation Integrated Search

1996-03-01

The purpose of this study was to develop and test word and symbol traffic control and hazard warning messages for use on portable changeable message signs (PCMSs). The literature was reviewed, State highway engineers were interviewed, PCMS manufactur...

Limited sight distance warning for vertical curves

DOT National Transportation Integrated Search

1984-11-01

This is a summary of the procedures and findings of a study of highway signs to warn of restricted sight distance due to crest vertical curves. Driver awareness, understanding, and response to the existing LIMITED SIGHT DISTANCE (LSD) sign and severa...

Traffic sign recognition by color segmentation and neural network

NASA Astrophysics Data System (ADS)

Surinwarangkoon, Thongchai; Nitsuwat, Supot; Moore, Elvin J.

2011-12-01

An algorithm is proposed for traffic sign detection and identification based on color filtering, color segmentation and neural networks. Traffic signs in Thailand are classified by color into four types: namely, prohibitory signs (red or blue), general warning signs (yellow) and construction area warning signs (amber). A color filtering method is first used to detect traffic signs and classify them by type. Then color segmentation methods adapted for each color type are used to extract inner features, e.g., arrows, bars etc. Finally, neural networks trained to recognize signs in each color type are used to identify any given traffic sign. Experiments show that the algorithm can improve the accuracy of traffic sign detection and recognition for the traffic signs used in Thailand.

Perception of stroke in Croatia--knowledge of stroke signs and risk factors amongst neurological outpatients.

PubMed

Vuković, V; Mikula, I; Kesić, M J; Bedeković, M R; Morović, S; Lovrencić-Huzjan, A; Demarin, V

2009-09-01

The aim of this hospital-based survey was to determine baseline stroke knowledge in Croatian population attending the outpatient services at the Department of Neurology. A multiple choice questionnaire was designed, divided into three sections: (i) demographic data, (ii) knowledge of stroke risk factors and stroke signs and (iii) actions the patients would undertake if confronted with risk of stroke and information resources regarding health. The analysis included 720 respondents (54.9% women). The respondents most frequently indicated stroke symptoms as following: speech disorder 82%, paresthesiae on one side of the body 71%, weakness of arm or leg 55%, unsteady gait 55%, malaise 53%, monocular loss of vision 44%. The risk factors most frequently identified were hypertension 64%, stress 61%, smoking 59%, elevated lipids 53%, obesity 52%, coagulation disorder 47%, alcoholism 45%, low-physical activity 42%, elderly age 39%, cardiac diseases 38%, weather changes 34%, drugs 33% and diabetes 32%. If confronted with stroke signs 37% of respondents would consult the general practitioner and 31% would call 911 or go to a neurologist. Amongst patients with a risk factor, only diabetics were aware that their risk factor might cause stroke (P < 0.001). Respondents with lowest education had the least knowledge regarding stroke signs (P < 0.01). The results of this study indicate that respondents showed a fair knowledge about stroke signs and risk factors for stroke. The results of our study will help to create and plan programmes for improvement of public health in Croatia.

Experimental Design for Evaluating the Safety Benefits of Railroad Advance Warning Signs

DOT National Transportation Integrated Search

1979-04-01

The report presents the findings and conclusions of a study to develop an experimental design and analysis plan for field testing and evaluation of the accident reduction potential of a proposed new railroad grade crossing advance warning sign. Sever...

Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores.

PubMed

Skyttberg, Niclas; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2017-08-30

Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores. The study also provides reference data on triage vital signs in Swedish emergency care. We extracted a dataset including vital signs, demographic and administrative data from emergency care visits (n=335027) at five Swedish emergency hospitals during 2013 using either completely paper-based, completely electronic or mixed documentation practices. Descriptive statistics were used to assess fitness for use in emergency care decision support systems aiming to calculate warning and triage scores, and data quality was described in three categories: currency, completeness and correctness. To estimate correctness, two further categories - plausibility and concordance - were used. The study showed an acceptable correctness of the registered vital signs irrespectively of the type of documentation practice. Completeness was high in sites where registrations were routinely entered into the Electronic Health Record (EHR). The currency was only acceptable in sites with a completely electronic documentation practice. Although vital signs that were recorded in completely electronic documentation practices showed plausible results regarding correctness, completeness and currency, the study concludes that vital signs documented in Swedish emergency care EHRs cannot generally be considered fit for use for calculation of triage and warning scores. Low completeness and currency were found if the documentation was not completely electronic.

Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led UK maternity units.

PubMed

Smith, G B; Isaacs, R; Andrews, L; Wee, M Y K; van Teijlingen, E; Bick, D E; Hundley, V

2017-05-01

Obstetric early warning systems are recommended for monitoring hospitalised pregnant and postnatal women. We decided to compare: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) type of chart used; and (iv) presence of explicit instructions for escalating care. One-hundred-and-twenty obstetric early warning charts and escalation protocols were obtained from consultant-led maternity units in the UK and Channel Islands. These data were extracted: values used to determine normality for each maternal vital sign; chart colour-coding; instructions following early warning system triggering; other criteria used as triggers. There was considerable variation in the charts, warning systems and escalation protocols. Of 120 charts, 89.2% used colour; 69.2% used colour-coded escalation systems. Forty-one (34.2%) systems required the calculation of weighted scores. Seventy-five discrete combinations of 'normal' vital sign ranges were found, the most common being: heart rate=50-99beats/min; respiratory rate=11-20breaths/min; blood pressure, systolic=100-149mmHg, diastolic ≤89mmHg; SpO 2 =95-100%; temperature=36.0-37.9°C; and Alert-Voice-Pain-Unresponsive assessment=Alert. Most charts (90.8%) provided instructions about who to contact following triggering, but only 41.7% gave instructions about subsequent observation frequency. The wide range of 'normal' vital sign values in different systems suggests a lack of equity in the processes for detecting deterioration and escalating care in hospitalised pregnant and postnatal women. Agreement regarding 'normal' vital sign ranges is urgently required and would assist the development of a standardised obstetric early warning system and chart. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical features that identify children with primary immunodeficiency diseases.

PubMed

Subbarayan, Anbezhil; Colarusso, Gloria; Hughes, Stephen M; Gennery, Andrew R; Slatter, Mary; Cant, Andrew J; Arkwright, Peter D

2011-05-01

The 10 warning signs of primary immunodeficiency diseases (PID) have been promoted by various organizations in Europe and the United States to predict PID. However, the ability of these warning signs to identify children with PID has not been rigorously tested. The main goal of this study was to determine the effectiveness of these 10 warning signs in predicting defined PID among children who presented to 2 tertiary pediatric immunodeficiency centers in the north of England. A retrospective survey of 563 children who presented to 2 pediatric immunodeficiency centers was undertaken. The clinical records of 430 patients with a defined PID and 133 patients for whom detailed investigations failed to establish a specific PID were reviewed. Overall, 96% of the children with PID were referred by hospital clinicians. The strongest identifiers of PID were a family history of immunodeficiency disease in addition to use of intravenous antibiotics for sepsis in children with neutrophil PID and failure to thrive in children with T-lymphocyte PID. With these 3 signs, 96% of patients with neutrophil and complement deficiencies and 89% of children with T-lymphocyte immunodeficiencies could be identified correctly. Family history was the only warning sign that identified children with B-lymphocyte PID. PID awareness initiatives should be targeted at hospital pediatricians and families with a history of PID rather than the general public. Our results provide the general pediatrician with a simple refinement of 10 warning signs for identifying children with underlying immunodeficiency diseases.

The development and implementation of stroke risk prediction model in National Health Insurance Service's personal health record.

PubMed

Lee, Jae-Woo; Lim, Hyun-Sun; Kim, Dong-Wook; Shin, Soon-Ae; Kim, Jinkwon; Yoo, Bora; Cho, Kyung-Hee

2018-01-01

The purpose of this study was to build a 10-year stroke prediction model and categorize a probability of stroke using the Korean national health examination data. Then it intended to develop the algorithm to provide a personalized warning on the basis of each user's level of stroke risk and a lifestyle correction message about the stroke risk factors. Subject to national health examinees in 2002-2003, the stroke prediction model identified when stroke was first diagnosed by following-up the cohort until 2013 and estimated a 10-year probability of stroke. It sorted the user's individual probability of stroke into five categories - normal, slightly high, high, risky, very risky, according to the five ranges of average probability of stroke in comparison to total population - less than 50 percentile, 50-70, 70-90, 90-99.9, more than 99.9 percentile, and constructed the personalized warning and lifestyle correction messages by each category. Risk factors in stroke risk model include the age, BMI, cholesterol, hypertension, diabetes, smoking status and intensity, physical activity, alcohol drinking, past history (hypertension, coronary heart disease) and family history (stroke, coronary heart disease). The AUC values of stroke risk prediction model from the external validation data set were 0.83 in men and 0.82 in women, which showed a high predictive power. The probability of stroke within 10 years for men in normal group (less than 50 percentile) was less than 3.92% and those in very risky group (top 0.01 percentile) was 66.2% and over. The women's probability of stroke within 10 years was less than 3.77% in normal group (less than 50 percentile) and 55.24% and over in very risky group. This study developed the stroke risk prediction model and the personalized warning and the lifestyle correction message based on the national health examination data and uploaded them to the personal health record service called My Health Bank in the health information website - Health iN. By doing so, it urged medical users to strengthen the motivation of health management and induced changes in their health behaviors. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Knowledge of signs and symptoms of heart attack and stroke among Singapore residents.

PubMed

Quah, Joy Li Juan; Yap, Susan; Cheah, Si Oon; Ng, Yih Yng; Goh, E Shaun; Doctor, Nausheen; Leong, Benjamin Sieu-Hon; Tiah, Ling; Chia, Michael Yih Chong; Ong, Marcus Eng Hock

2014-01-01

To determine the level of knowledge of signs and symptoms of heart attack and stroke in Singapore resident population, in comparison to the global community. A population based, random sample of 7,840 household addresses was selected from a validated national sampling frame. Each participant was asked eight questions on signs and symptoms of heart attack and 10 questions on stroke. The response rate was 65.2% with 4,192 respondents. The level of knowledge for preselected, common signs and symptoms of heart attack and stroke was 57.8% and 57.1%, respectively. The respondents scored a mean of 5.0 (SD 2.4) out of 8 for heart attack, while they scored a mean of 6.8 (SD 2.9) out of 10 for stroke. Respondents who were ≥ 50 years, with lower educational level, and unemployed/retired had the least knowledge about both conditions. The level of knowledge of signs and symptoms of heart attack and stroke in Singapore is comparable to USA and Canada. We found a comparable knowledge of stroke and heart attack signs and symptoms in the community to countries within the same economic, educational, and healthcare strata. However older persons, those with lower educational level and those who are unemployed/retired, require more public health education efforts.

Understanding Stroke - Know Stroke • Know the Signs • Act in Time

MedlinePlus

... other racial or ethnic group in the United States. "I didn't know a thing about stroke before I had one," she says. "Now, I make sure that all my family knows the signs of stroke, so they can get help if they need it." Stroke occurs when blood flow to your brain is stopped, either by blockage ...

A Mixed Methods Approach to Identify Cognitive Warning Signs for Suicide Attempts.

PubMed

Adler, Abby; Bush, Ashley; Barg, Frances K; Weissinger, Guy; Beck, Aaron T; Brown, Gregory K

2016-01-01

This study used a mixed methods approach to examine pathways to suicidal behavior by identifying cognitive warning signs that occurred within 1 day of a suicide attempt. Transcripts of cognitive therapy sessions from 35 patients who attempted suicide were analyzed using a modified grounded theory approach. Cognitive themes emerging from these transcripts included: state hopelessness, focus on escape, suicide as a solution, fixation on suicide, and aloneness. Differences in demographic and baseline diagnostic and symptom data were explored in relation to each cognitive theme. We propose a potential conceptual model of cognitive warning signs for suicide attempts that requires further testing.

Awareness and impact of New York City's graphic point-of-sale tobacco health warning signs.

PubMed

Coady, Micaela H; Chan, Christina A; Auer, Kari; Farley, Shannon M; Kilgore, Elizabeth A; Kansagra, Susan M

2013-05-01

To increase knowledge of smoking-related health risks and provide smoking cessation information at the point of sale, in 2009, New York City required the posting of graphic point-of-sale tobacco health warnings in tobacco retailers. This study is the first to evaluate the impact of such a policy in the USA. Cross-sectional street-intercept surveys conducted among adult current smokers and recent quitters before and after signage implementation assessed the awareness and impact of the signs. Approximately 10 street-intercept surveys were conducted at each of 50 tobacco retailers in New York City before and after policy implementation. A total of 1007 adults who were either current smokers or recent quitters were surveyed about the awareness and impact of tobacco health warning signs. Multivariate risk ratios (RR) were calculated to estimate awareness and impact of the signs. Most participants (86%) were current smokers, and the sample was 28% African-American, 32% Hispanic/Latino and 27% non-Hispanic white. Awareness of tobacco health warning signs more than doubled after the policy implementation (adjusted RR =2.01, 95% CI 1.74 to 2.33). Signage posting was associated with an 11% increase in the extent to which signs made respondents think about quitting smoking (adjusted RR =1.11, 95% CI 1.01 to 1.22). A policy requiring tobacco retailers to display graphic health warning signs increased awareness of health risks of smoking and stimulated thoughts about quitting smoking. Additional research aimed at evaluating the effect of tobacco control measures in the retail environment is necessary to provide further rationale for implementing these changes.

Early Warning Signs of Suicide in Service Members Who Engage in Unauthorized Acts of Violence

DTIC Science & Technology

2016-06-01

observable to military law enforcement personnel. Statistical analyses tested for differences in warning signs between cases of suicide, violence, or...indicators, (2) Behavioral Change indicators, (3) Social indicators, and (4) Occupational indicators. Statistical analyses were conducted to test for...6 Coding _________________________________________________________________ 7 Statistical

Looking for Trouble

ERIC Educational Resources Information Center

Rice, Mike

2006-01-01

Circuit breakers are the linchpin of an institution's power-distribution system, so it's not surprising that several warning signs of an aging system relate to these devices. When warning signs occur, it's a message to facilities managers and administrators that breakers may need to be upgraded to help the power distribution system meet existing…

Evaluating the effectiveness of regulatory and warning signs on driver behavior near highway/rail crossings : research project capsule.

DOT National Transportation Integrated Search

2016-12-01

The primary objective of this research project is to evaluate the effectiveness of regulatory and warning signs on driver behavior : by analyzing their effectiveness in reducing instances of stopped vehicles within the dynamic envelope zone (i.e., th...

The Warning Signs of Learning Disabilities. ERIC Digest #E603.

ERIC Educational Resources Information Center

Bergert, Susan

This brief paper summarizes warning signs of learning disabilities in preschool children, elementary school children, and secondary school children. It notes that learning disabilities are presumed to arise from dysfunctions in the brain resulting in significant difficulties in perceiving information, processing and/or remembering information,…

Final report for the second train warning sign demonstration project on the Los Angeles Metro Blue Line

DOT National Transportation Integrated Search

2002-01-10

This demonstration project was carried out to investigate the use of a train activated warning sign as a means of reducing the added hazard for pedestrians of two trains in a highway railroad intersection (HRI) at the same time. The demonstration pro...

30 CFR 57.19108 - Posting warning signs during shaft work.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Posting warning signs during shaft work. 57.19108 Section 57.19108 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL...

10 CFR 850.38 - Warning signs and labels.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CANCER HAZARD AUTHORIZED PERSONNEL ONLY (b) Warning labels. (1) The responsible employer must affix... CONTAMINATED WITH BERYLLIUM DO NOT REMOVE DUST BY BLOWING OR SHAKING CANCER AND LUNG DISEASE HAZARD (c) Warning...

10 CFR 850.38 - Warning signs and labels.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CANCER HAZARD AUTHORIZED PERSONNEL ONLY (b) Warning labels. (1) The responsible employer must affix... CONTAMINATED WITH BERYLLIUM DO NOT REMOVE DUST BY BLOWING OR SHAKING CANCER AND LUNG DISEASE HAZARD (c) Warning...

10 CFR 850.38 - Warning signs and labels.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CANCER HAZARD AUTHORIZED PERSONNEL ONLY (b) Warning labels. (1) The responsible employer must affix... CONTAMINATED WITH BERYLLIUM DO NOT REMOVE DUST BY BLOWING OR SHAKING CANCER AND LUNG DISEASE HAZARD (c) Warning...

10 CFR 850.38 - Warning signs and labels.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CANCER HAZARD AUTHORIZED PERSONNEL ONLY (b) Warning labels. (1) The responsible employer must affix... CONTAMINATED WITH BERYLLIUM DO NOT REMOVE DUST BY BLOWING OR SHAKING CANCER AND LUNG DISEASE HAZARD (c) Warning...

10 CFR 850.38 - Warning signs and labels.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CANCER HAZARD AUTHORIZED PERSONNEL ONLY (b) Warning labels. (1) The responsible employer must affix... CONTAMINATED WITH BERYLLIUM DO NOT REMOVE DUST BY BLOWING OR SHAKING CANCER AND LUNG DISEASE HAZARD (c) Warning...

Epidural Steroid Injections are Safe and Effective: Multisociety Letter in Support of the Safety and Effectiveness of Epidural Steroid Injections.

PubMed

Kennedy, David J; Levin, Joshua; Rosenquist, Richard; Singh, Virtaj; Smith, Clark; Stojanovic, Milan P; Vorobeychik, Yakov

2015-05-01

In April 2014, the Food and Drug Administration (FDA) issued a Drug Safety Communication requesting that corticosteroid labeling include warnings that injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death. The International Spine Intervention Society spearheaded a collaboration of more than a dozen other medical societies in submitting the letter below to the FDA on November 7, 2014. We are publishing the letter to ensure that the readership of Pain Medicine is aware of the multisociety support for the safety and effectiveness of these procedures. A special note of thanks to all of the societies who signed on in support of the message. Wiley Periodicals, Inc.

Knowledge of Signs and Symptoms of Heart Attack and Stroke among Singapore Residents

PubMed Central

Quah, Joy Li Juan; Yap, Susan; Cheah, Si Oon; Ng, Yih Yng; Goh, E. Shaun; Doctor, Nausheen; Leong, Benjamin Sieu-Hon; Tiah, Ling; Chia, Michael Yih Chong; Ong, Marcus Eng Hock

2014-01-01

Aim. To determine the level of knowledge of signs and symptoms of heart attack and stroke in Singapore resident population, in comparison to the global community. Methods. A population based, random sample of 7,840 household addresses was selected from a validated national sampling frame. Each participant was asked eight questions on signs and symptoms of heart attack and 10 questions on stroke. Results. The response rate was 65.2% with 4,192 respondents. The level of knowledge for preselected, common signs and symptoms of heart attack and stroke was 57.8% and 57.1%, respectively. The respondents scored a mean of 5.0 (SD 2.4) out of 8 for heart attack, while they scored a mean of 6.8 (SD 2.9) out of 10 for stroke. Respondents who were ≥50 years, with lower educational level, and unemployed/retired had the least knowledge about both conditions. The level of knowledge of signs and symptoms of heart attack and stroke in Singapore is comparable to USA and Canada. Conclusion. We found a comparable knowledge of stroke and heart attack signs and symptoms in the community to countries within the same economic, educational, and healthcare strata. However older persons, those with lower educational level and those who are unemployed/retired, require more public health education efforts. PMID:24812623

Calling 911 in response to stroke: no change following a four-year educational campaign.

PubMed

Mikulík, R; Goldemund, D; Reif, M; Brichta, J; Neumann, J; Jarkovský, J; Krýza, J

2011-01-01

Public awareness campaigns are conducted to increase stroke awareness, yet evidence of their long-term effectiveness is limited. Since 2006, the Czech Stroke Society has conducted an educational campaign throughout the Czech Republic (CR) to increase awareness about stroke. This report evaluates the effectiveness of this campaign by comparing the results of a nationwide survey on stroke awareness in 2009 with the results from 2005. In 2009, a nationwide survey was conducted throughout the CR using the same methodology as in 2005 and employing a 3-stage random sampling method (area, household, and household member sampling). Participants >40 years of age were personally interviewed via a structured questionnaire concerning their knowledge and ability to correctly respond to stroke as assessed by the validated Stroke Action Test (STAT). The primary outcome measure was the difference in a STAT score >50% (i.e. respondents chose to call 911 for >50% of stroke symptoms) between 2005 and 2009. Campaign intensity was characterized by a systematic search for media messages about stroke in the CR. A total of 601 interviews were obtained (90% response rate) in 2009 (592 people were interviewed in 2005). A STAT score >50% was achieved by 18% of the respondents both in 2005 and 2009 (p = 0.89). There was no increase in the knowledge of risk factors or warning signs between 2005 and 2009. Respondents who noticed the campaign (19%) had better STAT scores than respondents who did not (25 vs. 17%; p = 0.038). A systematic search revealed that the campaign had reasonable intensity because there were 978 media reports about stroke between 2006 and 2008. A medium-intensity educational campaign, based on donated advertising media, failed to increase stroke awareness. However, if the campaign had reached more people, it might have been effective. Therefore, in the future, paid advertising media should accompany free media, although such approach would require a substantially larger budget. Awareness campaigns should be constantly evaluated for their effectiveness to develop more successful strategies. Copyright © 2011 S. Karger AG, Basel.

Interpretation and misinterpretation of warning signage: perceptions of rockfalls in a naturalistic setting.

PubMed

Aucote, Helen M; Miner, Anthony; Dahlhaus, Peter

2012-01-01

The aim of the present study was to investigate the factors relating to non-adherence to warning signs about falling rocks from coastal cliff faces. Face-to-face interviews (n = 62) in a naturalistic setting (in the vicinity of a high-risk rockfall area) were conducted to investigate attention to and comprehension of warning signs, as well as beliefs relating to non-adherence of the signage. It was found that, while most participants could correctly identify the danger in the area and had noticed the warning signage, less than half of the participants could correctly interpret the signage. The perception of danger did not differ significantly between the participants who had, or had not, entered the high-risk zone. Differences in knowledge and beliefs between local residents and visitors to the area were identified. It was concluded that the warning signs did not provide enough detail for people to make informed decisions about safe behaviours. Comprehension of the signage may have been hampered by a lack of prior-knowledge of the particular risk, a failure to think carefully about the situation (i.e. low-effort processing), and the pictorial representation on the signs misleading the participants as to the true danger.

46 CFR 147A.31 - Removal of fumigation material and warning signs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Removal of fumigation material and warning signs. 147A.31 Section 147A.31 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DANGEROUS CARGOES INTERIM REGULATIONS FOR SHIPBOARD FUMIGATION After Ventilation § 147A.31 Removal of fumigation...

46 CFR 147A.31 - Removal of fumigation material and warning signs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Removal of fumigation material and warning signs. 147A.31 Section 147A.31 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DANGEROUS CARGOES INTERIM REGULATIONS FOR SHIPBOARD FUMIGATION After Ventilation § 147A.31 Removal of fumigation...

Teen Depression and Suicide: Effective Prevention and Intervention Strategies

ERIC Educational Resources Information Center

King, Keith A.; Vidourek, Rebecca A.

2012-01-01

Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…

How To Spot a CIO in Trouble.

ERIC Educational Resources Information Center

Ayati, M. B.; Curzon, Susan Carol

2003-01-01

Asserts that before failure occurs for chief information officers (CIOs), three major warning signs signal that the CIO is in trouble. Explores the three warning signs, discussing how intervene before problems have gone too far to resolve: (1) the importance of executive support; (2) the significance of strategic directions; and (3) the importance…

Early Warning Signs. A Solution-Finding Report

ERIC Educational Resources Information Center

Sullivan, Robert, Comp.

2017-01-01

This Solution-Finding Report provides information, requested by Tara Zuber with the Great Lakes Comprehensive Center (GLCC) at American Institutes for Research (AIR), for resources with evidence-based practices that look at the social and emotional causes that impact the lack of student learning and engagement, for GLCC's Early Warning Signs work.…

Objective and Subjective Cancer Knowledge Among Faith-Based Chinese Adults.

PubMed

Hou, Su-I; Liu, Ling Jie

2017-10-01

This study examined cancer knowledge between church-going younger versus older Chinese adults. Hou's 8-item validated cancer screening knowledge test (CSKT) and a new 14-item cancer warning signs test (CWST) were used to assess objective knowledge. Subjective knowledge was measured by one overall 5-point Likert scale item. A total of 372 Taiwanese and Chinese Americans from nine churches participated. Although there were no significant differences by age on either the CSKT scores (younger = 5.89 vs. older = 5.71; p = .297) or the CWST (younger = 6.27 vs. older = 5.86; p = .245), subjective knowledge was higher among older Chinese adults (younger = 2.44 vs. older = 3.05, p < .001). Older Chinese adults were also more likely to identify cancer warning signs correctly, while younger adults were more likely to identify false warning signs correctly. Results have implication on tailoring cancer knowledge type (subjective vs. objective) and content domain (screening vs. warning signs). Findings can help health educators better understand cancer education needs among Chinese adults.

Influence of point-of-sale tobacco displays and graphic health warning signs on adults: evidence from a virtual store experimental study.

PubMed

Kim, Annice E; Nonnemaker, James M; Loomis, Brett R; Shafer, Paul R; Shaikh, Asma; Hill, Edward; Holloway, John W; Farrelly, Matthew C

2014-05-01

We tested the impact of banning tobacco displays and posting graphic health warning signs at the point of sale (POS). We designed 3 variations of the tobacco product display (open, enclosed [not visible], enclosed with pro-tobacco ads) and 2 variations of the warning sign (present vs absent) with virtual store software. In December 2011 and January 2012, we randomized a national convenience sample of 1216 adult smokers and recent quitters to 1 of 6 store conditions and gave them a shopping task. We tested for the main effects of the enclosed display, the sign, and their interaction on urge to smoke and tobacco purchase attempts. The enclosed display significantly lowered current smokers' (B = -7.05; 95% confidence interval [CI] = -13.20, -0.91; P < .05) and recent quitters' (Β = -6.00, 95% CI = -11.00, -1.00; P < .01) urge to smoke and current smokers' purchase attempts (adjusted odds ratio = 0.06; 95% CI = 0.03, 0.11; P < .01). The warning sign had no significant main effect on study outcomes or interaction with enclosed display. These data show that POS tobacco displays influence purchase behavior. Banning them may reduce cues to smoke and unplanned tobacco purchases.

Protect Your Baby from Bleeds: Talk to Your Healthcare Provider about Vitamin K

MedlinePlus

... a shot into a muscle in the leg. One shot given after birth will protect your baby from ... warning signs of VKDB? In the majority of cases of VKDB, there are NO WARN- ING SIGNS at all before a ... Vitamin K safe? A study from the early 1990’s found a possible link ...

Do Simple Warning Signs Enhance the Use of Stairs?

ERIC Educational Resources Information Center

Aksay, Ebubekir

2014-01-01

Objective: The aim of this study was to investigate the use of stairways/moving stairways in shopping malls and examine the extent to which simple warning signs determined whether people took the stairs. Design: Large posters that could readily be seen by mall visitors were situated between the stairs and moving stairways in shopping malls.…

77 FR 53898 - Collection of Information Under Review by Office of Management and Budget

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

... following collections of information: 1625-0016, Welding and Hot Work Permits; Posting of Warning Signs.... Title: Welding and Hot Work Permits; Posting of Warning Signs. OMB Control Number: 1625-0016. Type of... facilities and vessels are in compliance with safety standards. A permit must be issued prior to welding or...

Changes in stroke awareness among undergraduate students after an educational intervention.

PubMed

Hwang, Lih-Lian; Lin, Huei-Chia; Tseng, Mei-Chiun

2010-06-01

This study investigated undergraduates'awareness about stroke, the effects of an educational intervention and the difference of measuring tests between recognition and recall. We chose a convenient sample from two classes. One of the classes, the recognition group, was tested by a close-ended questionnaire with multiple choices. The other class, the recall group, was tested via an open-ended questionnaire. Participants completed their pretest and first posttest before and right after the education intervention. Twelve weeks after the intervention, participants were tested again to assess the knowledge retention over time. Fifty six participants in the recognition group and 53 participants in the recall group completed all three tests. Before the intervention, all respondents in the recognition group could recognize three or more risk factors and at least one warning sign, but in the recall group were only 32% and 72% respectively. After the intervention, the mean scores of first posttest and second posttest were all significant higher than that of pretest in both groups (P less 0.001). Comparisons of mean score of same items in both groups, the mean score of recognition group was significantly higher than that of recall group at each test (all P less 0.001). The intervention improved participants'knowledge towards stroke, even twelve weeks later. Participants obtained higher scores with a close-ended questionnaire than those with an open-ended questionnaire.

Low cancer suspicion following experience of a cancer 'warning sign'.

PubMed

Whitaker, Katriina L; Winstanley, Kelly; Macleod, Una; Scott, Suzanne E; Wardle, Jane

2015-11-01

Lower socioeconomic status (SES) is associated with a higher risk of late-stage cancer diagnosis. A number of explanations have been advanced for this, but one which has attracted recent attention is lower patient knowledge of cancer warning signs, leading to delay in help-seeking. However, although there is psychometric evidence of SES differences in knowledge of cancer symptoms, no studies have examined differences in 'cancer suspicion' among people who are actually experiencing a classic warning sign. A 'health survey' was mailed to 9771 adults (⩾50years, no cancer diagnosis) with a symptom list including 10 cancer 'warning signs'. Respondents were asked if they had experienced any of the symptoms in the past 3months, and if so, were asked 'what do you think caused it?' Any mention of cancer was scored as 'cancer suspicion'. SES was indexed by education. Nearly half the respondents (1732/3756) had experienced a 'warning sign', but only 63/1732 (3.6%) mentioned cancer as a possible cause. Lower education was associated with lower likelihood of cancer suspicion: 2.6% of respondents with school-only education versus 7.3% with university education suspected cancer as a possible cause. In multivariable analysis, low education was the only demographic variable independently associated with lower cancer suspicion (odds ratio (OR)=0.34, confidence interval (CI): 0.20-0.59). Levels of cancer suspicion were low overall in this community sample, and even lower in people from less educated backgrounds. This may hinder early symptomatic presentation and contribute to inequalities in stage at diagnosis. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of stressor characteristics on early warning signs of critical transitions and "critical coupling" in complex dynamical systems.

PubMed

Blume, Steffen O P; Sansavini, Giovanni

2017-12-01

Complex dynamical systems face abrupt transitions into unstable and catastrophic regimes. These critical transitions are triggered by gradual modifications in stressors, which push the dynamical system towards unstable regimes. Bifurcation analysis can characterize such critical thresholds, beyond which systems become unstable. Moreover, the stochasticity of the external stressors causes small-scale fluctuations in the system response. In some systems, the decomposition of these signal fluctuations into precursor signals can reveal early warning signs prior to the critical transition. Here, we present a dynamical analysis of a power system subjected to an increasing load level and small-scale stochastic load perturbations. We show that the auto- and cross-correlations of bus voltage magnitudes increase, leading up to a Hopf bifurcation point, and further grow until the system collapses. This evidences a gradual transition into a state of "critical coupling," which is complementary to the established concept of "critical slowing down." Furthermore, we analyze the effects of the type of load perturbation and load characteristics on early warning signs and find that gradient changes in the autocorrelation provide early warning signs of the imminent critical transition under white-noise but not for auto-correlated load perturbations. Furthermore, the cross-correlation between all voltage magnitude pairs generally increases prior to and beyond the Hopf bifurcation point, indicating "critical coupling," but cannot provide early warning indications. Finally, we show that the established early warning indicators are oblivious to limit-induced bifurcations and, in the case of the power system model considered here, only react to an approaching Hopf bifurcation.

75 FR 19885 - Restricted Areas and Danger Zone at Naval Station Mayport, FL

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... will be in place 24 hours a day, seven days a week. Warning signs notifying individuals of the... authorized representative. This restriction will be in place 24 hours a day, seven days a week. Warning signs... areas identified in this section 24 hours a day, 7 days a week. Any person or vessel encroaching within...

Detection of the Early Warning Signs of Cancer by Community Pharmacists: An Evaluation of Training on Professional Behavior

ERIC Educational Resources Information Center

Benfield, William R.; And Others

1977-01-01

In a study of 702 pharmacists in 211 communities, an effort was made to determine the effect of a unit of education on the community pharmacist's ability and/or tendency to detect the early warning signs of cancer when manifested by patrons. The success of such a program is shown. (LBH)

Recognizing Warning Signs of K-12 Christian School Distress That Lead to School Closure

ERIC Educational Resources Information Center

Fellers, Ron

2013-01-01

The objective of this research was to identify statistically significant warning signs of K12 Christian school distress that can lead to school closure in the areas of leadership, homogeneity of vision and culture, finances, and competition, as described by Fitzpatrick (2002) and Nichols (2006). Twenty-four strong, declining, and closed K-12…

33 CFR 334.500 - St. Johns River, Atlantic Ocean, Sherman Creek; restricted areas and danger zone, Naval Station...

Code of Federal Regulations, 2014 CFR

2014-07-01

... north by Perimeter Road, and on the east by Mayport Road. (5) Danger zone. The danger zone shall... hours a day, seven days a week. Warning signs notifying individuals of the restricted area boundary and... will be in place 24 hours a day, seven days a week. Warning signs notifying individuals of the...

Effect of warning devices on curve operating speeds.

DOT National Transportation Integrated Search

2005-08-01

The objective of this study is to evaluate the use of several warning signs and warning methods to identify those that have the greatest impact on reducing vehicle speeds when traversing a horizontal curve. Three sites were selected from a list of pr...

Brief questions highlight the need for melanoma information campaigns.

PubMed

Foote, Janet A; Poole, Catherine M

2013-12-01

Melanoma awareness was briefly assessed at walk/runs held simultaneously in Philadelphia PA, Phoenix AZ, and Seattle WA. Of the participants, 75 % (1521) answered short questions during event registration. Among 1,036 respondents aged 14 years and older, 66 % reported knowing melanoma warning signs. Significantly more respondents with melanoma family history reported having a physician-administered skin exam and knowing warning signs. More than one third of walk/run participants reported no definitive melanoma warning sign knowledge. Self-reported melanoma awareness and detection indices were lowest among Phoenix participants; the event city with the greatest annual sun exposure. Educational efforts for melanoma awareness are critically needed. Selected results of this project were presented in a poster forum at the 2006 Congress for Epidemiology meeting held in Seattle, WA (June 2006).

Influence of Point-of-Sale Tobacco Displays and Graphic Health Warning Signs on Adults: Evidence From a Virtual Store Experimental Study

PubMed Central

Kim, Annice E.; Nonnemaker, James M.; Loomis, Brett R.; Shafer, Paul R.; Shaikh, Asma; Hill, Edward; Holloway, John W.; Farrelly, Matthew C.

2014-01-01

Objectives. We tested the impact of banning tobacco displays and posting graphic health warning signs at the point of sale (POS). Methods. We designed 3 variations of the tobacco product display (open, enclosed [not visible], enclosed with pro-tobacco ads) and 2 variations of the warning sign (present vs absent) with virtual store software. In December 2011 and January 2012, we randomized a national convenience sample of 1216 adult smokers and recent quitters to 1 of 6 store conditions and gave them a shopping task. We tested for the main effects of the enclosed display, the sign, and their interaction on urge to smoke and tobacco purchase attempts. Results. The enclosed display significantly lowered current smokers’ (B = −7.05; 95% confidence interval [CI] = −13.20, −0.91; P < .05) and recent quitters’ (Β = −6.00, 95% CI = −11.00, −1.00; P < .01) urge to smoke and current smokers’ purchase attempts (adjusted odds ratio = 0.06; 95% CI = 0.03, 0.11; P < .01). The warning sign had no significant main effect on study outcomes or interaction with enclosed display. Conclusions. These data show that POS tobacco displays influence purchase behavior. Banning them may reduce cues to smoke and unplanned tobacco purchases. PMID:24625149

Warning Signs of Youth Violence. Just the Facts: Answers to Your Questions about Psychological Health

ERIC Educational Resources Information Center

American Psychological Association (APA), 2002

2002-01-01

Violence. It's the act of purposefully hurting someone. And it's a major issue facing today's young adults. This fact sheet answers questions that those aged 12-24 might ask about violence. This age group faces the highest risk of being the victim of violence. Questions regard the causes of youth violence, warning signs, what to do if someone…

Impacts on State and Local Agencies for Maintaining Traffic Signs within Minimum Retroreflectivity Guidelines

DOT National Transportation Integrated Search

1998-04-01

The Federal Highway Administration (FHWA) has developed guidelines for minimum retroreflectivity levels for four groups of signs: 1) yellow/orange-on-black warning signs, 2) black-on-white regulatory signs, 3) white-on-red regulatory signs, and 4) wh...

Which Fragments of a Sign Enable Its Recognition?

ERIC Educational Resources Information Center

ten Holt, G. A.; Van Doorn, A. J.; de Ridder, H.; Reinders, M. J. T.; Hendriks, E. A.

2009-01-01

In sign language studies, it is generally assumed that a sign can be divided into several phases in time (preparation, stroke, and retraction) and that the stroke contains all of the necessary information. However, this has not been tested empirically. In order to learn where the information truly resides, we present an experiment that…

Gender, Social Networks, and Stroke Preparedness in the Stroke Warning Information and Faster Treatment Study.

PubMed

Madsen, Tracy E; Roberts, Eric T; Kuczynski, Heather; Goldmann, Emily; Parikh, Nina S; Boden-Albala, Bernadette

2017-12-01

The study aimed to investigate the effect of gender on the association between social networks and stroke preparedness as measured by emergency department (ED) arrival within 3 hours of symptom onset. As part of the Stroke Warning Information and Faster Treatment study, baseline data on demographics, social networks, and time to ED arrival were collected from 1193 prospectively enrolled stroke/transient ischemic attack (TIA) patients at Columbia University Medical Center. Logistic regression was conducted with arrival to the ED ≤3 hours as the outcome, social network characteristics as explanatory variables, and gender as a potential effect modifier. Men who lived alone or were divorced were significantly less likely to arrive ≤3 hours than men who lived with a spouse (adjusted odds ratio [aOR]: .31, 95% confidence interval [CI]: .15-0.64) or were married (aOR: .45, 95% CI: .23-0.86). Among women, those who lived alone or were divorced had similar odds of arriving ≤3 hours compared with those who lived with a spouse (aOR: 1.25, 95% CI: .63-2.49) or were married (aOR: .73, 95% CI: .4-1.35). In patients with stroke/TIA, living with someone or being married improved time to arrival in men only. Behavioral interventions to improve stroke preparedness should incorporate gender differences in how social networks affect arrival times. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Working together to ensure safety at hydro projects

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

Bartel, J.W.

Providing for public safety around a hydroelectric facility can be critically important to the welfare of a hydro-power producer. With this in mind, Wisconsin Electric Power Company and Wisconsin Public Service Corporation have worked together to develop consistent safety signage and several for their hydro projects. Although the two utilities sometimes compete for electric customers, they cooperate to ensure the safety to those customers. Both WE and WPS took steps in 1986 to make their operations safer through involvement in the Wisconsin/Michigan Hydro User Group. The organization has 25 members-primarily of electric utilities and paper companies-who operate hydro facilities inmore » the two states. The two areas that the HUG studied in public safety were signs and warning systems. HUG established a sign committee to study how to increase safety of people around hydro plants through signs, explained Ted Handrick, hydro plant superintendent at WPS. The committee's recommendations led to development of a statewide uniform sign system adopted by all HUG members. The committee used Wisconsin Department of Natural Resources' guidelines for warning signs and portages in developing the signage standards. HUG members are converting to these new sign standards as they replace old signs and/or install new signs. Notices describing the new signage system have been placed near each hydro plant, at boat landings, and in campgrounds. The signs are mounted well above ground level so they can be seen and easily read by recreationalists. Warning systems, in accordance with HUG warning standards, were installed at WE and WPS hydro facilities. These systems alert nearby recreational users of rapid increases in water flow when generating units are turned on or when spillway gates are opened. Soon after the authors installed equipment to remotely operate its hydro facilities, the utility experienced a dramatic increase increase in intrusion on dams and other structures at the projects.« less

Clinical profile and warning sign finding in children with severe dengue and non-severe dengue

NASA Astrophysics Data System (ADS)

Adam, A. S.; Pasaribu, S.; Wijaya, H.; Pasaribu, A. P.

2018-03-01

Dengue fever is one of the most important emerging vector-borne viral diseases. Approximately 500,000 out of 100 million cases develop to severe dengue infection. Patient with severe dengue (SD) can be predicted by clinical profile, laboratory and warning sign which could be saved by early interventions.This was a retrospective descriptive-analytic study to investigate clinical manifestations, laboratory and warning signs ofchildren with dengue infection in Haji Adam Malik hospital during January 2014–May 2016. Through medical records, we had selected 140 cases which fulfilled research criteria.Cases were classified as SD (n=28) and NSD (n=112). Most common clinical manifestations for NSD were abdominal pain (39.3%), myalgia (39.3%), headache (37.1%), mucosal bleeding (36.4%) while for SD were shock (15.7%), mucosal bleeding (15.7%), clinical fluid accumulation (15%), shortness of breath (14.3%). SGPT >1000IU/L (5 cases), SGOT >1000IU/L (9 cases), PT (10 cases) and aPTT (16 cases) were abnormal in SD. Severe dengue was frequently found in the range of white cell count 1000-4000/L and platelet count 20,000-50,000mm/uL. Clinical manifestations, warning sign, and laboratoryfinding, were different between SD and NSD.

30 CFR 46.11 - Site-specific hazard awareness training.

Code of Federal Regulations, 2012 CFR

2012-07-01

... workers; (4) Customers, including commercial over-the-road truck drivers; (5) Construction workers or... training through the use of written hazard warnings, oral instruction, signs and posted warnings...

30 CFR 46.11 - Site-specific hazard awareness training.

Code of Federal Regulations, 2014 CFR

2014-07-01

... workers; (4) Customers, including commercial over-the-road truck drivers; (5) Construction workers or... training through the use of written hazard warnings, oral instruction, signs and posted warnings...

30 CFR 46.11 - Site-specific hazard awareness training.

Code of Federal Regulations, 2013 CFR

2013-07-01

... workers; (4) Customers, including commercial over-the-road truck drivers; (5) Construction workers or... training through the use of written hazard warnings, oral instruction, signs and posted warnings...

[Identifying children at risk for cardiorespiratory arrest].

PubMed

Carrillo Alvarez, A; Martínez Gutiérrez, A; Salvat Germán, F

2004-08-01

Cardiorespiratory arrest in children with severe disease does not usually present suddenly or unexpectedly but is often the result of a progressive deterioration of respiratory and/or circulatory function. Before failure of these functions occurs, there is a series of clinical signs that serve as a warning. Health professionals should not only evaluate clinical signs of respiratory and/or circulatory insufficiency but should also be able to identify these warning signs as early as possible, preferably in the compensation phase, given that the possibility that this process can be reversed by therapeutic measures decreases as the process progresses.

Strategies and Pitfalls of Motor-Evoked Potential Monitoring during Supratentorial Aneurysm Surgery.

PubMed

Maruta, Yuichi; Fujii, Masami; Imoto, Hirochika; Nomura, Sadahiro; Tanaka, Nobuhiro; Inamura, Akinori; Sadahiro, Hirokazu; Oka, Fumiaki; Goto, Hisaharu; Shirao, Satoshi; Ideguchi, Makoto; Yoneda, Hiroshi; Suehiro, Eiichi; Koizumi, Hiroyasu; Ishihara, Hideyuki; Suzuki, Michiyasu

2016-02-01

The aims of this study were to reveal the strategies and pitfalls of motor-evoked potential (MEP) monitoring methods during supratentorial aneurysm surgery, and to discuss the drawbacks and advantages of each method by reviewing our experiences. Intraoperative MEP monitoring was performed in 250 patients. Results from 4 monitoring techniques using combinations of 2 stimulation sites and 2 recording sites were analyzed retrospectively. MEP was recorded successfully in 243 patients (97.2%). Direct cortical stimulation (DCS)-spinal recorded MEP (sMEP) was used in 134 patients, DCS-muscle recorded MEP (mMEP) in 97, transcranial electrical stimulation (TES)-mMEP in 11 and TES-sMEP in 1. TES-mMEP during closure of the skull was used in 21 patients. DCS-mMEP was able to detect waveforms from upper and/or lower limb muscles. Alternatively, DCS-sMEP (direct [D]-wave) could accurately estimate amplitude changes. A novel "early warning sign" indicating ischemia was found in 21 patients, which started with a transiently increased amplitude of D-wave and then decreased after proximal interruption of major arteries. False-negative findings in MEP monitoring in 2 patients were caused by a blood insufficiency in the lenticulostriate artery and by a TES-sMEP recording, respectively. The results of this study suggest that to perform accurate MEP monitoring, DCS-mMEP or DCS-sMEP recording should be used as the situation demands, with combined use of TES-mMEP recording during closure of the skull. DCS-sMEP is recommended for accurate analysis of waveforms. We also propose a novel "early warning sign" of blood insufficiency in the D-wave. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Synthesis of Non-MUTCD Traffic Signing

DOT National Transportation Integrated Search

2005-12-01

Most States and many local jurisdictions have developed and routinely use a number of unique traffic sign legends, designs, and symbols. Typically, these signs have been developed because of the need to communicate certain regulatory, warning, and gu...

Field observation of advance warning/advisory signage for passive railway crossings with restricted lateral sightline visibility: an experimental investigation.

PubMed

Ward, N J; Wilde, G J

1995-04-01

This study evaluated a newly proposed series of signs intended for passive crossings with restrictions to lateral sightline visibility. These signs provide advance warning of a crossing and the restriction to lateral visibility. In addition, the signs advise motorists to come to a complete stop before crossing. Motorist behaviour was examined before and after installation of these signs at a rural passive crossing. A second site was observed in parallel to control partially for any confounding effects. Results indicated that motorists reduced speed and searched approach quadrants longer at points in the approachway after installation of the signs. However, there was no reliable increase in the number of motorists coming to complete stop, engaging in search behaviours, or classified as safe. The results are discussed in terms of reasons for the lack of compliance with the sign advisory.

Recovery After Stroke: Dealing with Pain

MedlinePlus

Recovery After Stroke: Dealing with Pain Some survivors have to deal with pain caused by their strokes. In most people, pain is a sign that ... body is being harmed in some way. With stroke, that is not always the case. Sometimes stroke ...

ARC-2007-ACD07-0140-001

NASA Image and Video Library

2007-07-31

David L. Iverson of NASA Ames Research center, Moffett Field, California, led development of computer software to monitor the conditions of the gyroscopes that keep the International Space Station (ISS) properly oriented in space as the ISS orbits Earth. The gyroscopes are flywheels that control the station's attitude without the use of propellant fuel. NASA computer scientists designed the new software, the Inductive Monitoring System, to detect warning signs that precede a gyroscope's failure. According to NASA officials, engineers will add the new software tool to a group of existing tools to identify and track problems related to the gyroscopes. If the software detects warning signs, it will quickly warn the space station's mission control center.

Searching for Effective Training Solutions for Firefighting: The Analysis of Emergency Responses and Line of Duty Death Reports for Low Frequency, High Risk Events

DTIC Science & Technology

2017-09-01

whether emergency incidents connected to low frequency and high risk events contain sufficient warning signs or indicators of imminent catastrophic... high risk events contain sufficient warning signs or indicators of imminent catastrophic events, if firefighters could identify them, and if there...EFFECTIVE TRAINING SOLUTIONS FOR FIREFIGHTING: THE ANALYSIS OF EMERGENCY RESPONSES AND LINE OF DUTY DEATH REPORTS FOR LOW FREQUENCY, HIGH RISK EVENTS

Audit of tobacco retail outlets in Hangzhou, China.

PubMed

Gong, Ting; Lv, Jun; Liu, Qingmin; Ren, Yanjun; Li, Liming; Kawachi, Ichiro

2013-07-01

To determine the prevalence of tobacco advertisements and warning messages at points of sale as well as to examine the density of tobacco retail outlets in neighbourhoods and around schools in Hangzhou, China. Tobacco retail outlets (n=1639) in all food and tobacco specialty stores were observed objectively by trained students. Tobacco advertisements and warning messages were assessed with an audit, and stores' addresses were recorded with Global Positioning System coordinates. The distances (1) between all pairs of tobacco retail outlets (2) between each tobacco retail outlet and 15 middle schools were calculated to assess the density of tobacco retail outlets in neighbourhoods and around schools. Among the 1639 tobacco retail outlets, <1% had 'no sales to minors' signs, 1.5% had tobacco warning messages, 28% had signs indicating tobacco sale and 12.4% had tobacco advertisements. For 48.7% of tobacco retail outlets, the nearest distances to other tobacco retail outlets were <50 m. For 80% of schools, there was at least one tobacco retail outlets within a 100 m radius. Tobacco advertisement in retail outlets is prevalent and the density of tobacco retail outlets is high in Hangzhou, China. Signs indicating 'no sales to minors' and tobacco warning signs are almost non-existent. These findings point to an urgent need for the enforcement of regulations on display of 'no sales to minors' and a new density standard for tobacco retail outlets based on protecting the public's health.

A pre-test post-test study of a brief educational intervention demonstrates improved knowledge of potential acute myocardial infarction symptoms and appropriate responses in cardiac rehabilitation patients.

PubMed

Gallagher, Robyn; Roach, Kellie; Belshaw, Julie; Kirkness, Ann; Sadler, Leonie; Warrington, Darrell

2013-05-01

Patient delay in recognizing and responding to potential acute myocardial infarction (AMI) symptoms is an international issue. Cardiac rehabilitation provides an ideal opportunity to deliver an intervention. This study examines an individual educational intervention on knowledge of heart attack warning signs and specific chest pain action plans for people with coronary heart disease. Cardiac rehabilitation participants at five hospitals were assessed at program entry and tailored education was provided using the Heart Foundation of Australia's Heart Attack Warning Signs campaign educational tool. Participants (n=137) were reassessed at program conclusion (six to eight weeks). Study participants had a mean age of 64.48 years (SD 12.22), were predominantly male (78%) and most commonly presented with a current referral diagnosis of a percutaneous coronary intervention (PCI) (80%) and/or AMI (60%). There were statistically significant improvements in the reporting of 11 of the 14 warning signs of heart attack, with patients reporting 2.56 more warning signs on average at outcome (p<.0001). Patients reported more heart attack warning signs if they had completed high school education (β=1.14) or had better knowledge before the intervention (β=.57). There were statistically significant improvements in reporting of all appropriate actions in response to potential AMI symptoms, with patients reporting an average of 1.3 more actions at outcome (p<.001), with no change in the median time they would tolerate symptoms (p=.16). A brief education session using a single standardised tool and adapted to a patient assessment is effective in improving knowledge of potential AMI symptoms and appropriate responses in cardiac rehabilitation up to two months following. Copyright © 2012 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Nystagmus-based approach to vertebrobasilar stroke presenting as vertigo without initial neurologic signs.

PubMed

Kim, Min-Beom; Boo, Sung Hyun; Ban, Jae Ho

2013-01-01

We aimed to investigate the clinical courses and common nystagmus of isolated vertigo patients with vertebrobasilar stroke. The patients who presented with isolated acute spontaneous vertigo with spontaneous nystagmus (acute vestibular syndrome) at the Emergency Department were retrospectively analyzed. They were referred to the Otolaryngology Department due to the absence of neurologic signs or even of imaging abnormalities after the initial examination at the Emergency Department. Various clinical features, including presenting symptoms, delayed neurologic signs, the site of infarction, and videonystagmographic (VNG) findings were analyzed. Of the 468 cases of acute vestibular syndrome, 23 (4.9%) cases of radiologically proven vertebrobasilar stroke were identified. Of the 23 patients, 17 (74%) showed aggravation of vertigo or delayed neurologic signs during the admission. In the analysis of VNG, 11 (48%) cases of direction-changing gaze-evoked nystagmus, 7 (30%) cases of fixation failure in the caloric test, 6 (27%) cases of periodic alternating nystagmus, and 4 (17%) cases of atypical head-shaking nystagmus were presented. Stroke occurred in the cerebellum (n=18, 78%), medulla (n=4, 17%), and pons (n=1, 4%). In the early stage of vertebrobasilar stroke, an accurate diagnosis was difficult in the Emergency Department even though a radiologic study was performed, but various VNG abnormalities and delayed neurologic signs could help to diagnose whether the origin is central or not. Copyright © 2013 S. Karger AG, Basel.

Preliminary analysis of LED enhanced signs at a passive rural level crossing

DOT National Transportation Integrated Search

2015-03-23

The purpose of this research was to measure motor vehicle speed profiles at a rural level crossing following the replacement of the existing Crossbuck signs and Advance Warning signs (AWSs) with flashing light-emitting diode (LED) versions. Measureme...

46 CFR 35.30-1 - Warning signals and signs-TB/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... § 35.30-1 Warning signals and signs—TB/ALL. (a) Red warning signals. During transfer of bulk cargo while fast to a dock, a red signal (flag by day and electric lantern at night) shall be so placed that it will be visible on all sides. While transferring bulk cargo at anchor, a red flag only shall be...

46 CFR 35.30-1 - Warning signals and signs-TB/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... § 35.30-1 Warning signals and signs—TB/ALL. (a) Red warning signals. During transfer of bulk cargo while fast to a dock, a red signal (flag by day and electric lantern at night) shall be so placed that it will be visible on all sides. While transferring bulk cargo at anchor, a red flag only shall be...

46 CFR 35.30-1 - Warning signals and signs-TB/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... § 35.30-1 Warning signals and signs—TB/ALL. (a) Red warning signals. During transfer of bulk cargo while fast to a dock, a red signal (flag by day and electric lantern at night) shall be so placed that it will be visible on all sides. While transferring bulk cargo at anchor, a red flag only shall be...

Driving behaviour responses to a moose encounter, automatic speed camera, wildlife warning sign and radio message determined in a factorial simulator study.

PubMed

Jägerbrand, Annika K; Antonson, Hans

2016-01-01

In a driving simulator study, driving behaviour responses (speed and deceleration) to encountering a moose, automatic speed camera, wildlife warning sign and radio message, with or without a wildlife fence and in dense forest or open landscape, were analysed. The study consisted of a factorial experiment that examined responses to factors singly and in combination over 9-km road stretches driven eight times by 25 participants (10 men, 15 women). The aims were to: determine the most effective animal-vehicle collision (AVC) countermeasures in reducing vehicle speed and test whether these are more effective in combination for reducing vehicle speed; identify the most effective countermeasures on encountering moose; and determine whether the driving responses to AVC countermeasures are affected by the presence of wildlife fences and landscape characteristics. The AVC countermeasures that proved most effective in reducing vehicle speed were a wildlife warning sign and radio message, while automatic speed cameras had a speed-increasing effect. There were no statistically significant interactions between different countermeasures and moose encounters. However, there was a tendency for a stronger speed-reducing effect from the radio message warning and from a combination of a radio message and wildlife warning sign in velocity profiles covering longer driving distances than the statistical tests. Encountering a moose during the drive had the overall strongest speed-reducing effect and gave the strongest deceleration, indicating that moose decoys or moose artwork might be useful as speed-reducing countermeasures. Furthermore, drivers reduced speed earlier on encountering a moose in open landscape and had lower velocity when driving past it. The presence of a wildlife fence on encountering the moose resulted in smaller deceleration. Copyright © 2015 Elsevier Ltd. All rights reserved.

Packaging: a grounded theory of how to report physiological deterioration effectively.

PubMed

Andrews, Tom; Waterman, Heather

2005-12-01

The aim of this paper is to present a study of how ward-based staff use vital signs and the Early Warning Score to package physiological deterioration effectively to ensure successful referral to doctors. The literature tends to emphasize the identification of premonitory signs in predicting physiological deterioration. However, these signs lack sensitivity and specificity, and there is evidence that nurses rely on subjective and subtle indicators. The Early Warning Score was developed for the early detection of deterioration and has been widely implemented, with various modifications. The data reported here form part of a larger study investigating the practical problems faced by general ward staff in detecting physiological deterioration. During 2002, interviews and observations were carried out using a grounded theory approach, and a total of 44 participants were interviewed (30 nurses, 7 doctors and 7 health care support workers). Participants reported that quantifiable evidence is the most effective means of referring patients to doctors, and the Early Warning Score achieves this by improving communication between professionals. Rather than reporting changes in individual vital signs, the Early Warning Score effectively packages them together, resulting in a much more convincing referral. It gives nurses a precise, concise and unambiguous means of communicating deterioration, and confidence in using medical language. Thus, nurses are empowered and doctors can focus quickly on identified problems. The Early Warning Score leads to successful referral of patients by providing an agreed framework for assessment, increasing confidence in the use of medical language and empowering nurses. It is essential that nurses and nursing students are supported in its use and in developing confidence in using medical language by continued emphasis on physiology and pathophysiology in the nursing curriculum.

Prevent Cyberbullying

MedlinePlus

... Tips for Teachers Report Cyberbullying Print Share Prevent Cyberbullying Be Aware of What Your Kids are Doing ... Signs a Child is Being Cyberbullied or is Cyberbullying Others Many of the warning signs that cyberbullying ...

Diagnosing depression after stroke.

PubMed

Black, K J

1995-07-01

Neurobehavioral sequelae of strokes can limit a patient's ability to describe or express emotion, can cause him to give "yes" answers to the clinician who expects them, or can directly cause apathy or crying spells. Also, anosognosia for depressive signs can cause the patient to deny depressive signs that are objectively observable. These diagnostic confounders have not been adequately assessed in previous research on poststroke depression; thus many studies are of doubtful validity, as shown by studies of the dexamethasone suppression test for melancholia in stroke patients. Future studies on depression after stroke must prospectively rule out fluent aphasia, motor aprosody, and amnesia before relying on diagnostic information from the psychiatric interview, and the interview should always be supplemented by direct observation of vegetative signs and other behavior. With this extended information, major depression can and should be diagnosed using accepted symptom and duration criteria.

Do warning signs on electronic gaming machines influence irrational cognitions?

PubMed

Monaghan, Sally; Blaszczynski, Alex; Nower, Lia

2009-08-01

Electronic gaming machines are popular among problem gamblers; in response, governments have introduced "responsible gaming" legislation incorporating the mandatory display of warning signs on or near electronic gaming machines. These signs are designed to correct irrational and erroneous beliefs through the provision of accurate information on probabilities of winning and the concept of randomness. There is minimal empirical data evaluating the effectiveness of such signs. In this study, 93 undergraduate students were randomly allocated to standard and informative messages displayed on an electronic gaming machine during play in a laboratory setting. Results revealed that a majority of participants incorrectly estimated gambling odds and reported irrational gambling-related cognitions prior to play. In addition, there were no significant between-group differences, and few participants recalled the content of messages or modified their gambling-related cognitions. Signs placed on electronic gaming machines may not modify irrational beliefs or alter gambling behaviour.

["Healthy Region Lower Rhine ... against Stroke": the concept and implementation of an intersectoral public health programme 2003-2008].

PubMed

Rau, Rüdiger; Rumpeltin, Carsten; Hoop, Renate; Pfeiffer, Holger; Drees, Jeannette; Paas, Birgit; Schmitz-Buhl, Gabriele; Geraedts, Max

2009-01-01

When the Public Health Service Act of North Rhine-Westphalia (OGDG-NRW) came into effect local health conferences (KGK) were established in both rural and urban districts. These conferences are designed to optimize medical and social healthcare at the local level. In 2001 KGK managers from six neighbouring districts founded the Network Healthy Lower Rhine. From 2003 to 2008 this network was able to implement the "Healthy Lower Rhine ... against Stroke" programme. The initiative primarily aims at improving community knowledge of stroke with regard to 1) proper action ("Stroke is a medical emergency, so call the emergency number 112!") and 2) stroke warning signs. Eventually these steps are intended 3) to reduce prehospital delays. Before the program started a project plan was developed including evaluation approaches. The central elements of the concept include local health targets, intersectoral collaboration and networking, 5-year programme duration, social marketing and a communication strategy. Initially, a needs assessment was conducted using local expert panels, surveys on community knowledge, and clinical data sampling to assess healthcare quality. Subsequently, a package of measures with a "two-level implementation model" was prepared. Normative evaluation consisted of self-reflection within the network-team. The summative evaluation was based on two approaches: surveys on community knowledge of stroke (city of Düsseldorf and district of Wesel) as well as data sample collection in hospitals on health care quality. The central elements of the concepts were implemented. Community surveys revealed similar deficits in community knowledge of stroke in the city of Dusseldorf (2000 and 2004) and in the district of Wesel (2002 and 2008). Knowledge of proper action (call 112 in case of stroke) significantly improved in the Dusseldorf community from 32.5% of correct statements in 2000 to 50.6% correct answers in 2004 and, finally, in 2008 to 69% correct answers in the Wesel district. Hospitals in the district of Wesel collected three-month samples of data on prehospital times in 2003 (before the initiative was started) and in 2005. There was no significant change: the portion of 28% of patients being hospitalized within a three-hour window after the onset of stroke symptoms remained unchanged. Due to medical progress and demographic changes stroke remains a paramount issue of public health in Germany. With its programme "Healthy Lower Rhine ... against Stroke" the Network Healthy Lower Rhine provides a strategy for launching and implementing a complex and intersectoral public health intervention.

Heat-Related Illnesses

MedlinePlus Videos and Cool Tools

... for signs of heat stroke or exhaustion. Heat Stroke and Exhaustion Symptoms of early heat exhaustion symptoms ... heavy sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, ...

Testing the warning signs of suicidal behavior among suicide ideators using the 2009 National survey on drug abuse and health.

PubMed

Gunn, John F; Lester, David; McSwain, Stephanie

2011-01-01

In order to help crisis counselors assess clients for their suicidal risk, in 2003 the American Association of Suicidology proposed ten warning signs, memorized through the acronym IS PATH WARM However, little research has been done investigating their effectiveness for predicting suicidal behavior The present study compared (1) suicide ideators with non-suicide ideator controls and (2) suicide ideators with suicide attempters on six of the IS PATH WARM warning signs, along with depression in the past year, marital status, and gender With regards to the comparison between suicide ideators and non-ideators, all variables but gender; abuse of alcohol in the past year, and anxiety in the past year were predictive of suicide ideation. However, when comparing suicide ideators who had not made a suicide attempt with those who had, only anger/aggression, depression in the past year, and marital status were predictive of a suicide attempt.

Performance of advance warning systems in a coordinated system : final report.

DOT National Transportation Integrated Search

2016-09-01

The Advance Warning System (AWS), developed by the Nebraska Department of Roads (NDOR) has proven to be effective at improving traffic safety at isolated signalized intersections. However, the effectiveness of the system has not been analyzed at sign...

Domestic Violence in the Canadian Workplace: Are Coworkers Aware?

PubMed

MacGregor, Jennifer C D; Wathen, C Nadine; MacQuarrie, Barbara J

2016-09-01

Domestic violence (DV) is associated with serious consequences for victims, children, and families, and even national economies. An emerging literature demonstrates that DV also has a negative impact on workers and workplaces. Less is known about the extent to which people are aware of coworkers' experiences of DV. Using data from a pan-Canadian sample of 8,429 men and women, we examine: (1) awareness of coworker DV victimization and perpetration; (2) the warning signs of DV victimization and perpetration recognized by workers; (3) whether DV victims are more likely than nonvictims to recognize DV and its warning signs in the workplace; and (4) the impacts of DV that workers perceive on victims'/perpetrators' ability to work. Nearly 40% of participants believed they had recognized a DV victim and/or perpetrator in the workplace and many reported recognizing more than one warning sign. DV victims were significantly more likely to report recognizing victims and perpetrators in the workplace, and recognized more DV warning signs. Among participants who believed they knew a coworker who had experienced DV, 49.5% thought the DV had affected their coworker's ability to work. For those who knew a coworker perpetrating DV, 37.9% thought their coworker's ability to work was affected by the abusive behavior. Our findings have implications for a coordinated workplace response to DV. Further research is urgently needed to examine how best to address DV in the workplace and improve outcomes for victims, perpetrators, and their coworkers.

Warning Signs of Mental Illnesses

MedlinePlus

... Change Direction initiative is working to change the culture of mental health in America. It encourages people ... signs of emotional suffering and to change the culture around mental health and mental illness. Learn more ...

Iconic Sign Comprehension in Older Adults: The Role of Cognitive Impairment and Text Enhancement

ERIC Educational Resources Information Center

Scialfa, Charles; Spadafora, Pat; Klein, Marianne; Lesnik, Agata; Dial, Lindsay; Heinrich, Antje

2008-01-01

Sign comprehension is critical for effective driving, responses to warnings, and way-finding. Signs that are poorly comprehended by older people increase accident risk and may compromise independence. This study sought to determine whether iconic sign comprehension suffers in healthy aging and in the presence of cognitive impairment. Additionally,…

Aging road user, bicyclist, and pedestrian safety : effective bicycling signs and preventing left-turn crashes.

DOT National Transportation Integrated Search

2013-09-01

Task 1 of this report drivers' knowledge of various bicycle warning signs and pavement markings were assessed. In general knowledge was high. Share the Road and Three Foot Minimum signs were generally more quickly understood and recognized in version...

The nurse response to abnormal vital sign recording in the emergency department.

PubMed

Johnson, Kimberly D; Mueller, Lindsey; Winkelman, Chris

2017-01-01

To examine what occurs after a recorded observation of at least one abnormal vital sign in the emergency department. The aims were to determine how often abnormal vital signs were recorded, what interventions were documented, and what factors were associated with documented follow-up for abnormal vital signs. Monitoring quality of care, and preventing or intervening before harm occurs to patients are central to nurses' roles. Abnormal vital signs have been associated with poor patient outcomes and require follow-up after the observation of abnormal readings to prevent patient harm related to a deteriorating status. This documentation is important to quality and safety of care. Observational, retrospective chart review. Modified Early Warning Score was calculated for all recorded vital signs for 195 charts. Comparisons were made between groups: (1) no abnormal vital signs, (2) abnormal vital sign present, but normal Modified Early Warning Score and (3) critically abnormal Modified Early Warning Score. About 62·1% of charts had an abnormal vital sign documented. Critically abnormal values were present in 14·9%. No documentation was present in 44·6% of abnormal cases. When interventions were documented, it was usually to notify the physician. The timing within the emergency department visit when the abnormalities were observed and the degree of abnormality had significant relationships to the presence of documentation. It is doubtful that nurses do not recognise abnormalities because more severely abnormal vital signs were more likely to have documented follow-up. Perhaps the interruptive nature of the emergency department or the prioritised actions of the nurse impacted documentation within this study. Further research is required to determine why follow-up is not being documented. To ensure safety and quality of patient care, accurate documentation of responses to abnormal vital signs is required. © 2016 John Wiley & Sons Ltd.

Cigarette packaging and health warnings: the impact of plain packaging and message framing on young smokers

PubMed Central

Mays, Darren; Niaura, Raymond S.; Evans, W. Douglas; Hammond, David; Luta, George; Tercyak, Kenneth P.

2014-01-01

Objective This study examined the impact of pictorial cigarette warning labels, warning label message framing, and plain cigarette packaging on young adult smokers’ motivation to quit. Methods Smokers ages 18–30 (n=740) from a consumer research panel were randomized to one of four experimental conditions where they viewed online images of 4 cigarette packs with warnings about lung disease, cancer, stroke/heart disease, and death, respectively. Packs differed across conditions by warning message framing (gain versus loss) and packaging (branded versus plain). Measures captured demographics, smoking behavior, covariates, and motivation to quit in response to cigarette packs. Results Pictorial warnings about lung disease and cancer generated the strongest motivation to quit across conditions. Adjusting for pre-test motivation and covariates, a message framing by packaging interaction revealed gain-framed warnings on plain packs generated greater motivation to quit for lung disease, cancer, and mortality warnings (p < 0.05), compared with loss-framed warnings on plain packs. Conclusions Warnings combining pictorial depictions of smoking-related health risks with text-based messages about how quitting reduces risks may achieve better outcomes among young adults, especially in countries considering or implementing plain packaging regulations. PMID:24420310

10 Early Signs and Symptoms of Alzheimer's

MedlinePlus

... causes a slow decline in memory, thinking and reasoning skills. There are 10 warning signs and symptoms. ... may also increase your chances of participating in clinical drug trials that help advance research. > Learn more ...

Symptoms and Warning Signs

MedlinePlus

... Signs Past Issues / Spring 2008 Table of Contents Anorexia Nervosa emaciation (extremely thin from lack of nutrition) relentless ... from diuretic abuse severe dehydration from purging Binge Eating Disorder frequently eating large amounts of food (binge-eating) ...

Comparing Alcohol Marketing and Alcohol Warning Message Policies Across Canada.

PubMed

Wettlaufer, Ashley; Cukier, Samantha N; Giesbrecht, Norman

2017-08-24

In order to reduce harms from alcohol, evidence-based policies are to be introduced and sustained. To facilitate the dissemination of policies that reduce alcohol-related harms by documenting, comparing, and sharing information on effective alcohol polices related to restrictions on alcohol marketing and alcohol warning messaging in 10 Canadian provinces. Team members developed measurable indicators to assess policies on (a) restrictions on alcohol marketing, and (b) alcohol warning messaging. Indicators were peer-reviewed by three alcohol policy experts, refined, and data were collected, submitted for validation by provincial experts, and scored independently by two team members. The national average score was 52% for restrictions on marketing policies and 18% for alcohol warning message policies. Most provinces had marketing regulations that went beyond the federal guidelines with penalties for violating marketing regulations. The provincial liquor boards' web pages focused on product promotion, and there were few restrictions on sponsorship activities. No province has implemented alcohol warning labels, and Ontario was the sole province to have legislated warning signs at all points-of-sale. Most provinces provided a variety of warning signs to be displayed voluntarily at points-of-sale; however, the quality of messages varied. Conclusions/Importance: There is extensive alcohol marketing with comparatively few messages focused on the potential harms associated with alcohol. It is recommended that governments collaborate with multiple stakeholders to maximize the preventive impact of restrictions on alcohol marketing and advertising, and a broader implementation of alcohol warning messages.

Maintenance of signs and sign supports : a guide for local highway and street maintenance personnel.

DOT National Transportation Integrated Search

2010-01-01

Highway signs are the means by which the road agency communicates the rules, warnings, guidance and other highway information that drivers need to navigate their roads and streets. This guide, which is an update to the same titled guide published in ...

Histologic Analysis of Retrieved Clots in Acute Ischemic Stroke: Correlation with Stroke Etiology and Gradient-Echo MRI.

PubMed

Kim, S K; Yoon, W; Kim, T S; Kim, H S; Heo, T W; Park, M S

2015-09-01

It is unclear whether clot composition analysis is helpful to predict a stroke mechanism in acute large vessel occlusion. In addition, the relationship between early vessel signs on imaging studies and clot compositions has been poorly understood. The purpose of this study was to elucidate the relationship between clot composition and stroke etiology following mechanical thrombectomy and to investigate the effect of varied clot compositions on gradient-echo MR imaging of clots. Histopathologic analysis of retrieved clots from 37 patients with acute MCA occlusion was performed. Patients underwent gradient-echo imaging before endovascular therapy. Retrieved clots underwent semiquantitative proportion analysis to quantify red blood cells, fibrin, platelets, and white blood cells by area. Correlations between clot compositions and stroke subtypes and susceptibility vessel signs on gradient-echo imaging were assessed. Stroke etiology was classified as cardioembolism in 22 patients (59.4%), large-artery atherosclerosis in 8 (21.6%), and undetermined in 7 (18.9%). The clots from cardioembolism had a significantly higher proportion of red blood cells (37.8% versus 16.9%, P = .031) and a lower proportion of fibrin (32.3% versus 48.5%, P = .044) compared with those from large-artery atherosclerosis. The proportion of red blood cells was significantly higher in clots with a susceptibility vessel sign than in those without it (48.0% versus 1.9%, P < .001), whereas the proportions of fibrin (26.4% versus 57.0%, P < .001) and platelets (22.6% versus 36.9%, P = .011) were significantly higher in clots without a susceptibility vessel sign than those with it. The histologic composition of clots retrieved from cerebral arteries in patients with acute stroke differs between those with cardioembolism and large-artery atherosclerosis. In addition, a susceptibility vessel sign on gradient-echo imaging is strongly associated with a high proportion of red blood cells and a low proportion of fibrin and platelets in retrieved clots. © 2015 by American Journal of Neuroradiology.

Carotid Artery Disease

MedlinePlus

... have the condition may be a stroke or transient ischemic attack (TIA). A TIA is a temporary shortage of blood flow to ... your brain of blood, causing a stroke or TIA. Signs and symptoms of a stroke or TIA ...

Know Stroke: Know the Signs, Act in Time Video

MedlinePlus Videos and Cool Tools

... of the National Institutes of Health For more information about stroke, please call 1-800-352-9424 ... Merino. This 13 minute Spanish video provides critical information about stroke prevention and treatment through the compelling, ...

Highway signing for safety.

DOT National Transportation Integrated Search

1971-01-01

Signing that effectively warns the motorist of temporary obstructions on or near a roadway is essential to traffic safety. The general objective of this study was to become familiar with and investigate the suitability of various temporary maintenanc...

Best practices for maximizing driver attention to work zone warning signs.

DOT National Transportation Integrated Search

2016-05-01

Studies have shown that rear-end crashes in the advance warning area for a work zone are the most common type of work zone crashes. Driver inattention (or distraction) is reported as the most common issue and a major contributing factor to those type...

Sign-a-Palooza

ERIC Educational Resources Information Center

McMorran, Charles; Reynolds, Veronica

2010-01-01

A halo of signs, some stuffed into thick plastic sheaths while others curled under yellow tape, cluttered the service desks of the New City Library. They bleated out messages of closings, procedures, and warnings. Their number undermined their cause. All too often a customer would ask a question that was answered by the very sign they had pushed…

Heterogeneous population dynamics and scaling laws near epidemic outbreaks.

PubMed

Widder, Andreas; Kuehn, Christian

2016-10-01

In this paper, we focus on the influence of heterogeneity and stochasticity of the population on the dynamical structure of a basic susceptible-infected-susceptible (SIS) model. First we prove that, upon a suitable mathematical reformulation of the basic reproduction number, the homogeneous system and the heterogeneous system exhibit a completely analogous global behaviour. Then we consider noise terms to incorporate the fluctuation effects and the random import of the disease into the population and analyse the influence of heterogeneity on warning signs for critical transitions (or tipping points). This theory shows that one may be able to anticipate whether a bifurcation point is close before it happens. We use numerical simulations of a stochastic fast-slow heterogeneous population SIS model and show various aspects of heterogeneity have crucial influences on the scaling laws that are used as early-warning signs for the homogeneous system. Thus, although the basic structural qualitative dynamical properties are the same for both systems, the quantitative features for epidemic prediction are expected to change and care has to be taken to interpret potential warning signs for disease outbreaks correctly.

Clinical comparison between patients with selective immunoglobulin A deficiency and other primary immunodeficiencies.

PubMed

Lozano, Natalia A; Lozano, Alejandro; Sasia, Laura V; Saranz, Ricardo J; Agresta, María Fernanda; del Pilar Bovina Martijena, María; Ianiero, Luciano; Grenat, Andrés R

2015-04-01

Primary immunodeficiencies (PID) are low-prevalence diseases. There are warning signs that may raise clinical suspicion. The objectives of this study were to describe the clinical characteristics and warning signs of patients with PID and to compare the clinical differences between selective immunoglobulin A (IgA) deficiency and other PIDs. Eighty-nine patients were studied; their median age at the time of diagnosis was 6 years old (4.08-11.67). Fifty-three (59.5%) patients were male. Fifty-four (60.7%) patients had selective IgA deficiency, and 35 (39.3%) had other PIDs. The main clinical manifestations were rhinopharyngitis in 65 (73.03%) patients and atopy in 39 (43.82%). Twenty- four (26.97%) patients showed warning signs, and none had selective IgA deficiency. Patients with other PIDs had a higher incidence of lower respiratory tract infection, sepsis, skin infections, mucocutaneous candidiasis, dental alterations, cardiovascular malformations, angioedema, hospitalizations and death. Ten (28.57%) patients received intravenous gammaglobulin, 15 (42.85%) antibiotic prophylaxis, and 2 (2.24%) antifungal prophylaxis.

Vital signs monitoring and nurse-patient interaction: A qualitative observational study of hospital practice.

PubMed

Cardona-Morrell, M; Prgomet, M; Lake, R; Nicholson, M; Harrison, R; Long, J; Westbrook, J; Braithwaite, J; Hillman, K

2016-04-01

High profile safety failures have demonstrated that recognising early warning signs of clinical and physiological deterioration can prevent or reduce harm resulting from serious adverse events. Early warning scoring systems are now routinely used in many places to detect and escalate deteriorating patients. Timely and accurate vital signs monitoring are critical for ensuring patient safety through providing data for early warning scoring systems, but little is known about current monitoring practices. To establish a profile of nurses' vital signs monitoring practices, related dialogue, and adherence to health service protocol in New South Wales, Australia. Direct observations of nurses' working practices were conducted in two wards. The observations focused on times of the day when vital signs were generally measured. Patient interactions were recorded if occurring any time during the observation periods. Participants (n=42) included nursing staff on one chronic disease medical and one acute surgical ward in a large urban teaching hospital in New South Wales. We observed 441 patient interactions. Measurement of vital signs occurred in 52% of interactions. The minimum five vital signs measures required by New South Wales Health policy were taken in only 6-21% of instances of vital signs monitoring. Vital signs were documented immediately on 93% of vitals-taking occasions and documented according to the policy in the patient's chart on 89% of these occasions. Nurse-patient interactions were initiated for the purpose of taking vital signs in 49% of interactions, with nurse-patient discourse observed during 88% of all interactions. Nurse-patient dialogue led to additional care being provided to patients in 12% of interactions. The selection of appropriate vital signs measured and responses to these appears to rely on nurses' clinical judgement or time availability rather than on policy-mandated frequency. The prevalence of incomplete sets of vital signs may limit identification of deteriorating patients. The findings from this study present an important baseline profile against which to evaluate the impact of introducing continuous monitoring approaches on current hospital practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

Patient attitudes towards remote continuous vital signs monitoring on general surgery wards: An interview study.

PubMed

Downey, C L; Brown, J M; Jayne, D G; Randell, R

2018-06-01

Vital signs monitoring is used to identify deteriorating patients in hospital. The most common tool for vital signs monitoring is an early warning score, although emerging technologies allow for remote, continuous patient monitoring. A number of reviews have examined the impact of continuous monitoring on patient outcomes, but little is known about the patient experience. This study aims to discover what patients think of monitoring in hospital, with a particular emphasis on intermittent early warning scores versus remote continuous monitoring, in order to inform future implementations of continuous monitoring technology. Semi-structured interviews were undertaken with 12 surgical inpatients as part of a study testing a remote continuous monitoring device. All patients were monitored with both an early warning score and the new device. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Patients can see the value in remote, continuous monitoring, particularly overnight. However, patients appreciate the face-to-face aspect of early warning score monitoring as it allows for reassurance, social interaction, and gives them further opportunity to ask questions about their medical care. Early warning score systems are widely used to facilitate detection of the deteriorating patient. Continuous monitoring technologies may provide added reassurance. However, patients value personal contact with their healthcare professionals and remote monitoring should not replace this. We suggest that remote monitoring is best introduced in a phased manner, and initially as an adjunct to usual care, with careful consideration of the patient experience throughout. Copyright © 2018 Elsevier B.V. All rights reserved.

9 CFR 307.7 - Safety requirements for electrical stimulating (EST) equipment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... beam sensors form the enclosure, the stimulating equipment shall be automatically shut off when the sensor signals are broken. (3) Mandatory Warning Devices and Signals. The following warning devices or.... (ii) An ANSI Z53.1-Color Code sign reading (a) “Danger Electrical Hazard” for stimulating voltage...

9 CFR 307.7 - Safety requirements for electrical stimulating (EST) equipment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... beam sensors form the enclosure, the stimulating equipment shall be automatically shut off when the sensor signals are broken. (3) Mandatory Warning Devices and Signals. The following warning devices or.... (ii) An ANSI Z53.1-Color Code sign reading (a) “Danger Electrical Hazard” for stimulating voltage...

Advance traffic control warning systems for maintenance operations : final report.

DOT National Transportation Integrated Search

1976-07-01

The report discusses the effect of certain variables defined by sign size, height of installation and legend on the driver responses as measured by speed, conflict and queuing parameters. Effects of electronically actuated, directional flashing signs...

"Fiberoptic variable message signs" : Ladd Canyon - Drinking Fountain Grade Section , Old Oregon Trail Highway (Interstate 84) : final report.

DOT National Transportation Integrated Search

1995-02-01

The SYLVIA fiberoptic variable message signs (VMS) were installed on the Old Oregon Trail Highway (I-84) at milepost 263.4 near La Grande and at milepost 286.7 near North Powder. The purpose of the signs is to warn motorists of fog, winter blizzard c...

Evaluating the benefits of dynamic message signs on Missouri's rural corridors.

DOT National Transportation Integrated Search

2011-12-01

Dynamic message signs (DMSs) are traffic control devices that provide real-time traveler information and are used for traffic warning, regulation, routing and management. DMSs on freeways in rural areas in southeast Missouri were evaluated. First, mo...

Implementation Guide for Minimum Retroreflectivity Requirements for Traffic Signs

DOT National Transportation Integrated Search

1998-04-01

Although the "Manual on Uniform Traffic Control Devices" (MUTCD) stipulates that all warning and regulatory signs be illuminated or reflectorized to show the same color and shape by day or night, there are no specific guidelines for required retroref...

23 CFR 924.11 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., where applicable, for highway construction projects, 23 CFR part 172 for engineering and design services..., pavement markings, or installation of traffic signs, traffic lights, guardrails, impact attenuators... may amount up to 100 percent for projects for signing, pavement markings, active warning devices, and...

23 CFR 924.11 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., where applicable, for highway construction projects, 23 CFR part 172 for engineering and design services..., pavement markings, or installation of traffic signs, traffic lights, guardrails, impact attenuators... may amount up to 100 percent for projects for signing, pavement markings, active warning devices, and...

23 CFR 924.11 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., where applicable, for highway construction projects, 23 CFR part 172 for engineering and design services..., pavement markings, or installation of traffic signs, traffic lights, guardrails, impact attenuators... may amount up to 100 percent for projects for signing, pavement markings, active warning devices, and...

23 CFR 924.11 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., where applicable, for highway construction projects, 23 CFR part 172 for engineering and design services..., pavement markings, or installation of traffic signs, traffic lights, guardrails, impact attenuators... may amount up to 100 percent for projects for signing, pavement markings, active warning devices, and...

23 CFR 924.11 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., where applicable, for highway construction projects, 23 CFR part 172 for engineering and design services..., pavement markings, or installation of traffic signs, traffic lights, guardrails, impact attenuators... may amount up to 100 percent for projects for signing, pavement markings, active warning devices, and...

In-vehicle low-cost signing system

NASA Astrophysics Data System (ADS)

Greneker, Eugene F.

1997-02-01

There are approximately 20 million police radar detectors used on the highways of the United States daily. A highway hazard safety warning system has been developed by the Georgia Tech Research Institute, working under the sponsorship of the radar detector industry, to communicate highway safety alerts to the driver of any vehicle equipped with a police radar detector. In addition, the system causes the new generation of detectors that are already available to display a safety warning message on an alpha-numeric display. The Safety Warning SystemTM consists of a transmitter and a radar detector receiver or stand-alone safety warning receiver/display system. The transmitter can be mounted on police cars, emergency vehicles, utility vehicles, highly repair vehicles, and on stationary structures at fixed locations along the highway. The reception range of the transmitted signal is between 0.5 and 1.0 miles, depending on terrain. The system to be described may be one of the first applications of in-vehicle signing in the Intelligent Transportation System to be implemented, because the required infrastructure of receivers already exists.

Evaluation of dengue fever reports during an epidemic, Colombia.

PubMed

Romero-Vega, Liliana; Pacheco, Oscar; de la Hoz-Restrepo, Fernando; Díaz-Quijano, Fredi Alexander

2014-12-01

OBJECTIVE To assess the validity of dengue fever reports and how they relate to the definition of case and severity. METHODS Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics. RESULTS We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%. CONCLUSIONS Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.

Implementation and evaluation of early gastroscopy for patients with dyspepsia and warning signs in Primary Care.

PubMed

García-Alonso, Francisco Javier; Hernández Tejero, María; Rubio Benito, Elvira; Valer, Paz; Guerra, Iván; García Ceballos, Victoria Gema; Noguerol, Mar; Llinares, Victoria; Bermejo, Fernando

2017-05-01

Dyspepsia is a common disorder in both Primary (PC) and Specialised Care (SC). Gastroscopy is recommended at the start of the study if there are warning signs, although it is not always available in PC. We developed a pilot project establishing an early gastroscopy programme for patients with dyspepsia and warning signs in PC, subsequently extending it to the entire healthcare area. The aim was to evaluate the requirements, impact and opinion of this service at the PC level. Demographic, symptomatic and endoscopic variables on the patients referred to SC from the pilot centre were recorded. A satisfaction survey was conducted among the PC physicians. The one-year pilot study and the first year of implementation of the programme were evaluated. A total of 355 patients were included (median age 56.4 years; IQR 45.5-64.3); 61.2% (56.1-66.3%) were women. The waiting time for examination was 1.5 weeks (IQR 1.5-2.5). Gastroscopy was correctly indicated in 82.7% (78.4-86.3%) of patients. The median number of requests per month was 1.1 per 10,000 adults (range 0.8-1.6). Monthly referrals to SC clinics from the pilot centre fell by 11 subjects (95% CI 5.9-16) with respect to the previous median of 58 (IQR 48-64.5). Almost all those polled (98.4%) considered the programme useful in routine practice. The availability of an early gastroscopy programme in PC for patients with dyspepsia and warning signs reduced the number of referrals to SC. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

Awareness levels about breast cancer risk factors, early warning signs, and screening and therapeutic approaches among Iranian adult women: a large population based study using latent class analysis.

PubMed

Tazhibi, Mahdi; Feizi, Awat

2014-01-01

Breast cancer (BC) continues to be a major cause of morbidity and mortality among women throughout the world and in Iran. Lack of awareness and early detection program in developing country is a main reason for escalating the mortality. The present research was conducted to assess the Iranian women's level of knowledge about breast cancer risk factors, early warning signs, and therapeutic and screening approaches, and their correlated determinants. In a cross-sectional study, 2250 women before participating at a community based screening and public educational program in an institute of cancer research in Isfahan, Iran, in 2012 were investigated using a self-administered questionnaire about risk factors, early warning signs, and therapeutic and screening approaches of BC. Latent class regression as a comprehensive statistical method was used for evaluating the level of knowledge and its correlated determinants. Only 33.2%, 31.9%, 26.7%, and 35.8% of study participants had high awareness levels about screening approaches, risk factors, early warning signs and therapeutic modalities of breast cancer, respectively, and majority had poor to moderate knowledge levels. Most effective predictors of high level of awareness were higher educational qualifications, attending in screening and public educational programs, personal problem, and family history of BC, respectively. Results of current study indicated that the levels of awareness among study population about key elements of BC are low. These findings reenforce the continuing need for more BC education through conducting public and professional programs that are intended to raise awareness among younger, single women and those with low educational attainments and without family history.

Identification and Comprehension of Symbolic Exit Signs for Small Transport-Category Airplanes

DTIC Science & Technology

2014-02-01

8 Phase Two: Self -illuminated Exit Signs...11 Self -illuminated Exit Sign Comprehension ---------------------------------------------------------------------- 12 Automatic...other sign parameters such as stroke width to height, contrast ratios, and self -illumination, fall within those recommended by 14 CFR 25.812(b)(2

Detection of Early Ischemic Changes in Noncontrast CT Head Improved with "Stroke Windows".

PubMed

Mainali, Shraddha; Wahba, Mervat; Elijovich, Lucas

2014-01-01

Introduction. Noncontrast head CT (NCCT) is the standard radiologic test for patients presenting with acute stroke. Early ischemic changes (EIC) are often overlooked on initial NCCT. We determine the sensitivity and specificity of improved EIC detection by a standardized method of image evaluation (Stroke Windows). Methods. We performed a retrospective chart review to identify patients with acute ischemic stroke who had NCCT at presentation. EIC was defined by the presence of hyperdense MCA/basilar artery sign; sulcal effacement; basal ganglia/subcortical hypodensity; and loss of cortical gray-white differentiation. NCCT was reviewed with standard window settings and with specialized Stroke Windows. Results. Fifty patients (42% females, 58% males) with a mean NIHSS of 13.4 were identified. EIC was detected in 9 patients with standard windows, while EIC was detected using Stroke Windows in 35 patients (18% versus 70%; P < 0.0001). Hyperdense MCA sign was the most commonly reported EIC; it was better detected with Stroke Windows (14% and 36%; P < 0.0198). Detection of the remaining EIC also improved with Stroke Windows (6% and 46%; P < 0.0001). Conclusions. Detection of EIC has important implications in diagnosis and treatment of acute ischemic stroke. Utilization of Stroke Windows significantly improved detection of EIC.

23 CFR 973.212 - Indian lands safety management system (SMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... HIGHWAYS MANAGEMENT SYSTEMS PERTAINING TO THE BUREAU OF INDIAN AFFAIRS AND THE INDIAN RESERVATION ROADS... hardware including signs, guardrails, and lighting appurtenances (including terminals); and (iii) Traffic...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; (ii...

23 CFR 973.212 - Indian lands safety management system (SMS).

Code of Federal Regulations, 2012 CFR

2012-04-01

... HIGHWAYS MANAGEMENT SYSTEMS PERTAINING TO THE BUREAU OF INDIAN AFFAIRS AND THE INDIAN RESERVATION ROADS... hardware including signs, guardrails, and lighting appurtenances (including terminals); and (iii) Traffic...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; (ii...

23 CFR 972.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2013 CFR

2013-04-01

... as signs, delineators, and guardrails (including terminals); (iii) Traffic information including...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; and...., data collection, analyses, and standards) for low volume roads may be tailored to be consistent with...

23 CFR 972.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2014 CFR

2014-04-01

... as signs, delineators, and guardrails (including terminals); (iii) Traffic information including...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; and...., data collection, analyses, and standards) for low volume roads may be tailored to be consistent with...

23 CFR 972.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2012 CFR

2012-04-01

... as signs, delineators, and guardrails (including terminals); (iii) Traffic information including...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; and...., data collection, analyses, and standards) for low volume roads may be tailored to be consistent with...

23 CFR 973.212 - Indian lands safety management system (SMS).

Code of Federal Regulations, 2013 CFR

2013-04-01

... HIGHWAYS MANAGEMENT SYSTEMS PERTAINING TO THE BUREAU OF INDIAN AFFAIRS AND THE INDIAN RESERVATION ROADS... hardware including signs, guardrails, and lighting appurtenances (including terminals); and (iii) Traffic...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; (ii...

23 CFR 972.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... as signs, delineators, and guardrails (including terminals); (iii) Traffic information including...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; and...., data collection, analyses, and standards) for low volume roads may be tailored to be consistent with...

23 CFR 973.212 - Indian lands safety management system (SMS).

Code of Federal Regulations, 2014 CFR

2014-04-01

... HIGHWAYS MANAGEMENT SYSTEMS PERTAINING TO THE BUREAU OF INDIAN AFFAIRS AND THE INDIAN RESERVATION ROADS... hardware including signs, guardrails, and lighting appurtenances (including terminals); and (iii) Traffic...-rail crossing warning devices, signs, highway elements, and operational features where appropriate; (ii...

Sepsis in Obstetrics: Clinical Features and Early Warning Tools.

PubMed

Parfitt, Sheryl E; Bogat, Mary L; Hering, Sandra L; Ottley, Charlotte; Roth, Cheryl

Morbidity and mortality associated with sepsis has gained widespread attention on a local, state, and national level, yet, it remains a complicated disorder that can be difficult to identify in a timely manner. Sepsis in obstetric patients further complicates the diagnosis as alterations in physiology related to pregnancy can mask sepsis indicators normally seen in the general population. If early signs of sepsis go unrecognized, septic shock can develop, leading to organ dysfunction and potential death. Maternal early warning tools have been designed to assist clinicians in recognizing early indications of illness. Through use of clinical pathway-specific tools, disease processes may be detected early, subsequently benefitting patients with aggressive treatment management and intervention.This article is the second in a series of three that discuss the importance of sepsis and septic shock in pregnancy. Risk factors, causes of sepsis, signs and symptoms, and maternal early warning tools are discussed.

Tsunami warnings: Understanding in Hawai'i

USGS Publications Warehouse

Gregg, Chris E.; Houghton, Bruce F.; Paton, Douglas; Johnston, David M.; Swanson, D.A.; Yanagi, B.S.

2007-01-01

The devastating southeast Asian tsunami of December 26, 2004 has brought home the destructive consequences of coastal hazards in an absence of effective warning systems. Since the 1946 tsunami that destroyed much of Hilo, Hawai'i, a network of pole mounted sirens has been used to provide an early public alert of future tsunamis. However, studies in the 1960s showed that understanding of the meaning of siren soundings was very low and that ambiguity in understanding had contributed to fatalities in the 1960 tsunami that again destroyed much of Hilo. The Hawaiian public has since been exposed to monthly tests of the sirens for more than 25 years and descriptions of the system have been widely published in telephone books for at least 45 years. However, currently there remains some uncertainty in the level of public understanding of the sirens and their implications for behavioral response. Here, we show from recent surveys of Hawai'i residents that awareness of the siren tests and test frequency is high, but these factors do not equate with increased understanding of the meaning of the siren, which remains disturbingly low (13%). Furthermore, the length of time people have lived in Hawai'i is not correlated systematically with understanding of the meaning of the sirens. An additional issue is that warning times for tsunamis gene rated locally in Hawai'i will be of the order of minutes to tens of minutes and limit the immediate utility of the sirens. Natural warning signs of such tsunamis may provide the earliest warning to residents. Analysis of a survey subgroup from Hilo suggests that awareness of natural signs is only moderate, and a majority may expect notification via alerts provided by official sources. We conclude that a major change is needed in tsunami education, even in Hawai'i, to increase public understanding of, and effective response to, both future official alerts and natural warning signs of future tsunamis. ?? Springer 2006.

Which System Variables Carry Robust Early Signs of Upcoming Phase Transition? An Ecological Example.

PubMed

Negahbani, Ehsan; Steyn-Ross, D Alistair; Steyn-Ross, Moira L; Aguirre, Luis A

2016-01-01

Growth of critical fluctuations prior to catastrophic state transition is generally regarded as a universal phenomenon, providing a valuable early warning signal in dynamical systems. Using an ecological fisheries model of three populations (juvenile prey J, adult prey A and predator P), a recent study has reported silent early warning signals obtained from P and A populations prior to saddle-node (SN) bifurcation, and thus concluded that early warning signals are not universal. By performing a full eigenvalue analysis of the same system we demonstrate that while J and P populations undergo SN bifurcation, A does not jump to a new state, so it is not expected to carry early warning signs. In contrast with the previous study, we capture a significant increase in the noise-induced fluctuations in the P population, but only on close approach to the bifurcation point; it is not clear why the P variance initially shows a decaying trend. Here we resolve this puzzle using observability measures from control theory. By computing the observability coefficient for the system from the recordings of each population considered one at a time, we are able to quantify their ability to describe changing internal dynamics. We demonstrate that precursor fluctuations are best observed using only the J variable, and also P variable if close to transition. Using observability analysis we are able to describe why a poorly observable variable (P) has poor forecasting capabilities although a full eigenvalue analysis shows that this variable undergoes a bifurcation. We conclude that observability analysis provides complementary information to identify the variables carrying early-warning signs about impending state transition.

The Effectiveness of School Signs with Flashing Beacons in Reducing Vehicle Speeds. Research Report No. 429.

ERIC Educational Resources Information Center

Zegeer, Charles V.

A detailed study of warning signs with flashers in school zones was conducted by the Kentucky Department of Transportation to determine the signs' effectiveness in reducing the speeds of vehicles during times of pedestrian activity. Field investigations were conducted at all of the 120 flasher locations in Kentucky Highway Districts 6, 7, and 9.…

Cigarette packaging and health warnings: the impact of plain packaging and message framing on young smokers.

PubMed

Mays, Darren; Niaura, Raymond S; Evans, W Douglas; Hammond, David; Luta, George; Tercyak, Kenneth P

2015-03-01

This study examined the impact of pictorial cigarette-warning labels, warning-label message framing and plain cigarette packaging, on young adult smokers' motivation to quit. Smokers aged 18-30 years (n=740) from a consumer research panel were randomised to one of four experimental conditions where they viewed online images of four cigarette packs with warnings about lung disease, cancer, stroke/heart disease and death, respectively. Packs differed across conditions by warning-message framing (gain vs loss) and packaging (branded vs plain). Measures captured demographics, smoking behaviour, covariates and motivation to quit in response to cigarette packs. Pictorial warnings about lung disease and cancer generated the strongest motivation to quit across conditions. Adjusting for pretest motivation and covariates, a message framing by packaging interaction revealed gain-framed warnings on plain packs generated greater motivation to quit for lung disease, cancer and mortality warnings (p<0.05), compared with loss-framed warnings on plain packs. Warnings combining pictorial depictions of smoking-related health risks with text-based messages about how quitting reduces risks, may achieve better outcomes among young adults, especially in countries considering or implementing plain packaging regulations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation.

PubMed

Sefton, Gerri; Lane, Steven; Killen, Roger; Black, Stuart; Lyon, Max; Ampah, Pearl; Sproule, Cathryn; Loren-Gosling, Dominic; Richards, Caitlin; Spinty, Jean; Holloway, Colette; Davies, Coral; Wilson, April; Chean, Chung Shen; Carter, Bernie; Carrol, E D

2017-05-01

Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team.

Embedding High-Fidelity Simulation Into a Foundations of Nursing Course.

PubMed

Talbot, Megan Sary

2015-01-01

Delay in recognizing the need for and initiating lifesaving measures is unacceptable in health care. It is never too early to teach novice nursing students to recognize and respond to early warning signs of patient deterioration. The rapid response system was developed to expedite recognition of and response to changes in a patient's condition. Use of high-fidelity simulation by beginning nursing students to practice recognizing and responding to patient deterioration is vital to both the welfare of patients and the edification of students. Recognizing and responding quickly to patients' early warning signs of deterioration can determine a patient's outcome. This article discusses the importance of instructing beginning nursing students in identifying and reacting appropriately to early signs of patient deterioration and in following the chain of command to activate the rapid response team.

Variable message fog hazard warning signs to control vehicle operating characteristics : interim report, Interstate 5, North Albany.

DOT National Transportation Integrated Search

1972-04-01

This project is aimed at determining the effectiveness of variable message signs in controlling traffic on an Interstate highway during periods of hazardous driving conditions such as fog, vehicle accidents, or congestion. : The effectiveness of the ...

23 CFR 970.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

23 CFR 970.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2012 CFR

2012-04-01

...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

23 CFR 970.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2013 CFR

2013-04-01

...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

23 CFR 970.212 - Federal lands safety management system (SMS).

Code of Federal Regulations, 2014 CFR

2014-04-01

...) An inventory of safety appurtenances such as signs, delineators, and guardrails (including terminals... upgrading safety appurtenances including highway-rail crossing warning devices, signs, highway elements, and... standards) for low volume roads may be tailored to be consistent with the functional classification of the...

Nipple Discharge: An Early Warning Sign of Breast Cancer

PubMed Central

Parthasarathy, Veda; Rathnam, Usharani

2012-01-01

Nipple discharge (ND) can be the earliest presenting symptom of breast cancer. We hereby present two cases of breast cancer with no palpable mass manifesting as isolated ND, which was whitish in color. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. Mammography showed diffuse, extensive microcalcifications. Simple mastectomy with axillary clearance was done. Histology in both cases revealed diffusely spreading intraductal carcinoma, with focus of microinvasion in one case. ND if scanty or not blood stained is often ignored by the patients and at times, the clinicians. This article highlights that ND can be an early warning sign of intraductal carcinomas that are non-invasive in early stage. Irrespective of the color or nature of the discharge, unilateral ND needs to be evaluated. Proper clinical assessment, cytological evaluation of the ND, and mammography ought to be performed in all such cases. Considering the low level of awareness in women regarding the warning signs of breast cancer, the current focus is to create “breast awareness.” Women should be sensitized to recognize any unusual changes in their breasts and report to their health care providers at the earliest. PMID:23189234

The Efficacy of Cigarette Warning Labels on Health Beliefs in the United States and Mexico

PubMed Central

MUTTI, SEEMA; HAMMOND, DAVID; REID, JESSICA L.; THRASHER, JAMES F.

2013-01-01

Concern over health risks is the most common motivation for quitting smoking. Health warnings on tobacco packages are among the most prominent interventions to convey the health risks of smoking. Face-to-face surveys were conducted in Mexico (n=1,072), and a web-based survey was conducted in the US (n=1,449) to examine the efficacy of health warning labels on health beliefs. Respondents were randomly assigned to view two sets of health warnings (each with one text-only warning and 5–6 pictorial warnings) for two different health effects. Respondents were asked whether they believed smoking caused 12 different health effects. Overall, the findings indicate high levels of health knowledge in both countries for some health effects, although significant knowledge gaps remained; for example: less than half of respondents agreed that smoking causes impotence and less than one third agreed that smoking causes gangrene. Mexican respondents endorsed a greater number of correct beliefs about the health impact of smoking than the US sample. In both countries, viewing related health warning labels increased beliefs about the health risks of smoking, particularly for less well-known health effects, such as gangrene, impotence, and stroke. PMID:23905611

Warnings/Watches - NOAA's National Weather Service

Science.gov Websites

select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

Researchers warn of neglect to basic science

NASA Astrophysics Data System (ADS)

Banks, Michael

2010-03-01

Russia is losing its standing as a scientific powerhouse and its science is in a state of decline, according to a new report by the information-services provider Thomson Reuters. Entitled "The New Geography of Science: Research and Collaboration in Russia", the report warns that the country's research base "has a problem, and it shows little sign of a solution".

Telehealth Stroke Dysphagia Evaluation Is Safe and Effective.

PubMed

Morrell, Kate; Hyers, Megan; Stuchiner, Tamela; Lucas, Lindsay; Schwartz, Karissa; Mako, Jenniffer; Spinelli, Kateri J; Yanase, Lisa

2017-01-01

Rapid evaluation of dysphagia poststroke significantly lowers rates of aspiration pneumonia. Logistical barriers often significantly delay in-person dysphagia evaluation by speech language pathologists (SLPs) in remote and rural hospitals. Clinical swallow evaluations delivered via telehealth have been validated in a number of clinical contexts, yet no one has specifically validated a teleswallow evaluation for in-hospital post-stroke dysphagia assessment. A team of 6 SLPs experienced in stroke care and a telestroke neurologist designed, implemented, and tested a teleswallow evaluation for acute stroke patients, in which 100 patients across 2 affiliated, urban certified stroke centers were sequentially evaluated by a bedside and telehealth SLP. Inter-rater reliability was analyzed using percent agreement, Cohen's kappa, Kendall's tau-b, and Wilcoxon matched-pairs signed rank tests. Logistic regression models accounting for age and gender were used to test the impact of stroke severity and stroke location on agreement. We found excellent agreement for both liquid (91% agreement; kappa = 0.808; Kendall's tau-b = 0.813, p < 0.001; Wilcoxon signed rank = -0.818, p = 0.417) and solid (87% agreement; kappa = 0.792; Kendall's tau-b = 0.844, p < 0.001; Wilcoxon signed rank = 0.243, p = 0.808) dietary textures. From regression modeling, there is suggestive but inconclusive evidence that higher National Institute of Health Stroke Scale (NIHSS) scores correlate with lower levels of agreement for liquid diet recommendations (OR [95% CI] 0.895 [0.793-1.01]; p = 0.07). There was no impact of NIHSS score for solid diet recommendations and no impact of stroke location on solid or liquid diet recommendations. Qualitatively, we identified professional, logistical, technical, and patient barriers to implementation, many of which resolved with experience over time. Dysphagia evaluation by a remote SLP via telehealth is safe and effective following stroke. We plan to implement teleswallow across our multistate telestroke network as standard practice for poststroke dysphagia evaluation. © 2017 S. Karger AG, Basel.

A Mathematical Framework for Critical Transitions: Normal Forms, Variance and Applications

NASA Astrophysics Data System (ADS)

Kuehn, Christian

2013-06-01

Critical transitions occur in a wide variety of applications including mathematical biology, climate change, human physiology and economics. Therefore it is highly desirable to find early-warning signs. We show that it is possible to classify critical transitions by using bifurcation theory and normal forms in the singular limit. Based on this elementary classification, we analyze stochastic fluctuations and calculate scaling laws of the variance of stochastic sample paths near critical transitions for fast-subsystem bifurcations up to codimension two. The theory is applied to several models: the Stommel-Cessi box model for the thermohaline circulation from geoscience, an epidemic-spreading model on an adaptive network, an activator-inhibitor switch from systems biology, a predator-prey system from ecology and to the Euler buckling problem from classical mechanics. For the Stommel-Cessi model we compare different detrending techniques to calculate early-warning signs. In the epidemics model we show that link densities could be better variables for prediction than population densities. The activator-inhibitor switch demonstrates effects in three time-scale systems and points out that excitable cells and molecular units have information for subthreshold prediction. In the predator-prey model explosive population growth near a codimension-two bifurcation is investigated and we show that early-warnings from normal forms can be misleading in this context. In the biomechanical model we demonstrate that early-warning signs for buckling depend crucially on the control strategy near the instability which illustrates the effect of multiplicative noise.

The Usefulness of the TOAST Classification and Prognostic Significance of Pyramidal Symptoms During the Acute Phase of Cerebellar Ischemic Stroke.

PubMed

Dziadkowiak, Edyta; Chojdak-Łukasiewicz, Justyna; Guziński, Maciej; Noga, Leszek; Paradowski, Bogusław

2016-04-01

Cerebellar stroke is a rare condition with very nonspecific clinical features. The symptoms in the acute phase could imitate acute peripheral vestibular disorders or a brainstem lesion. The aim of this study was to assess the usefulness of the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification in cerebellar stroke and the impact of clinical features on the prognosis. We retrospectively analyzed 107 patients with diagnosed ischemic cerebellar infarction. We studied the clinical features and compared them based on the location of the ischemic lesion and its distribution in the posterior interior cerebellar artery (PICA), superior cerebellar artery (SCA), and anterior inferior cerebellar artery (AICA) territories. According to the TOAST classification, stroke was more prevalent in atrial fibrillation (26/107) and when the lesion was in the PICA territory (39/107). Pyramidal signs occurred in 29/107 of patients and were more prevalent when the lesion was distributed in more than two vascular regions (p = 0.00640). Mortality was higher among patients with ischemic lesion caused by cardiac sources (p = 0.00094) and with pyramidal signs (p = 0.00640). The TOAST classification is less useful in assessing supratentorial ischemic infarcts. Cardioembolic etiology, location of the ischemic lesion, and pyramidal signs support a negative prognosis.

The Sign Told Me how to Play--A Lesson in Risk Reduction.

ERIC Educational Resources Information Center

Wallach, Frances

1988-01-01

Two constantly appearing claims in most playground accident suits are improper supervision and lack of warning to the users. This article discusses legal implications of improper signage, explains use of symbols, and presents general sign guidelines to ensure proper safety measures. (MLH)

Road Signs in Ethical Quicksand.

ERIC Educational Resources Information Center

Jerrell, S. Lee; Jerrell, Jeanette M.

1985-01-01

Some of the major moral and ethical dilemmas illustrated by authors in this special journal issue are highlighted. From an ethical viewpoint, the complexity of evaluation activities is likened to "quicksand" terrain in which directional or warning signs should be erected to aid personal choices when such issues are encountered.…

Learn What a Heart Attack Feels Like--It Could Save Your Life

MedlinePlus

Learn What a Heart Attack Feels Like— It Could Save Your Life. This fact sheet tells you about heart attack signs. It also tells you what to ... heart attack warning signs. Your chest hurts or feels squeezed. One or both arms, your back, shoulders, ...

Longitudinal analysis of one million vital signs in patients in an academic medical center.

PubMed

Bleyer, Anthony J; Vidya, Sri; Russell, Gregory B; Jones, Catherine M; Sujata, Leon; Daeihagh, Pirouz; Hire, Donald

2011-11-01

Recognition of critically abnormal vital signs has been used to identify critically ill patients for activation of rapid response teams. Most studies have only analyzed vital signs obtained at the time of admission. The intent of this study was to examine the association of critical vital signs occurring at any time during the hospitalization with mortality. All vital sign measurements were obtained for hospitalizations from January 1, 2008 to June 30, 2009 at a large academic medical center. There were 1.15 million individual vital sign determinations obtained in 42,430 admissions on 27,722 patients. Critical vital signs were defined as a systolic blood pressure <85 mmHg, heart rate >120 bpm, temperature <35°C or >38.9°C, oxygen saturation <91%, respiratory rate ≤ 12 or ≥ 24, and level of consciousness recorded as anything but "alert". The presence of a solitary critically abnormal vital sign was associated with a mortality of 0.92% vs. a mortality of 23.6% for three simultaneous critical vital signs. Of those experiencing three simultaneous critical vital signs, only 25% did so within 24h of admission. The Modified Early Warning Score (MEWS) and VitalPAC Early Warning Score (VIEWS) were validated as good predictors of mortality at any time point during the hospitalization. The simultaneous presence of three critically abnormal vital signs can occur at any time during the hospital admission and is associated with very high mortality. Early recognition of these events presents an opportunity for decreasing mortality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Improving the conspicuity of trailblazing signs for incident management.

DOT National Transportation Integrated Search

1998-03-01

This report represents efforts to design and evaluate a new sign design for emergency route trailblazing in a two-part series. : Study was an off-road field experiment conducted to determine the best sign color combination, letter stroke width, and l...

Mission Statement - NOAA's National Weather Service

Science.gov Websites

select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings data, forecasts and warnings for the protection of life and property and enhancement of the national Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and

Four Signs Your District Is Ready for an Early Warning System. A Discussion Guide

ERIC Educational Resources Information Center

Regional Educational Laboratory Pacific, 2016

2016-01-01

Although high school graduation rates continue to rise in the United States, reaching 81 percent in the 2012-2013 school year (U.S. Department of Education, 2015), dropout remains a pervasive issue for education systems across the nation. In recent years, Early Warning Systems (EWS), which utilize administrative data to identify students at risk…

Agreement between TOAST and CCS ischemic stroke classification: the NINDS SiGN study.

PubMed

McArdle, Patrick F; Kittner, Steven J; Ay, Hakan; Brown, Robert D; Meschia, James F; Rundek, Tatjana; Wassertheil-Smoller, Sylvia; Woo, Daniel; Andsberg, Gunnar; Biffi, Alessandro; Brenner, David A; Cole, John W; Corriveau, Roderick; de Bakker, Paul I W; Delavaran, Hossein; Dichgans, Martin; Grewal, Raji P; Gwinn, Katrina; Huq, Mohammed; Jern, Christina; Jimenez-Conde, Jordi; Jood, Katarina; Kaplan, Robert C; Katschnig, Petra; Katsnelson, Michael; Labovitz, Daniel L; Lemmens, Robin; Li, Linxin; Lindgren, Arne; Markus, Hugh S; Peddareddygari, Leema R; Pedersén, Annie; Pera, Joanna; Redfors, Petra; Roquer, Jaume; Rosand, Jonathan; Rost, Natalia S; Rothwell, Peter M; Sacco, Ralph L; Sharma, Pankaj; Slowik, Agnieszka; Sudlow, Cathie; Thijs, Vincent; Tiedt, Steffen; Valenti, Raffaella; Worrall, Bradford B

2014-10-28

The objective of this study was to assess the level of agreement between stroke subtype classifications made using the Trial of Org 10172 Acute Stroke Treatment (TOAST) and Causative Classification of Stroke (CCS) systems. Study subjects included 13,596 adult men and women accrued from 20 US and European genetic research centers participating in the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Genetics Network (SiGN). All cases had independently classified TOAST and CCS stroke subtypes. Kappa statistics were calculated for the 5 major ischemic stroke subtypes common to both systems. The overall agreement between TOAST and CCS was moderate (agreement rate, 70%; κ = 0.59, 95% confidence interval [CI] 0.58-0.60). Agreement varied widely across study sites, ranging from 28% to 90%. Agreement on specific subtypes was highest for large-artery atherosclerosis (κ = 0.71, 95% CI 0.69-0.73) and lowest for small-artery occlusion (κ = 0.56, 95% CI 0.54-0.58). Agreement between TOAST and CCS diagnoses was moderate. Caution is warranted when comparing or combining results based on the 2 systems. Replication of study results, for example, genome-wide association studies, should utilize phenotypes determined by the same classification system, ideally applied in the same manner. © 2014 American Academy of Neurology.

Teach Our Children: Stroke Education for Indigenous Children, First Nations, Ontario, Canada, 2009–2012

PubMed Central

Bodnar, Pauline; Fenton, Robert; Mason, Brenda; Bandoh, Grace

2017-01-01

Background Because of the heightened risk for stroke among indigenous people, we conducted this multiyear community case study from 2009 through 2012 to address stroke education needs among children aged 11 to 13 years residing in northern urban, rural, and remote First Nations in Ontario, Canada. The goal was to determine what young people understand about stroke and to develop an age-appropriate and culturally appropriate educational product. Community Context This project responded to First Nations requests that we educate their young people about the signs and symptoms of stroke and the need for early response. Ten First Nations and 4 indigenous health organizations took part; 7 contributed to the educational product. Methods This study was developed under the guidance of the Northwestern Ontario Regional Stroke Network Aboriginal Advisory Committee. It employed indigenous researchers and facilitators to ensure that methods used (questions assessing children’s knowledge of stroke and their ideas on how best to deliver messages) reflected the cultural values of participating study sites. Outcome Indigenous children had limited knowledge about stroke and its signs, symptoms, and consequences; children in remote communities were better informed than those in other locations. Educators agreed that a DVD was the most effective way to deliver stroke information to children in this age group. The principal outcome from this 3-year community engagement was an 11.5-minute DVD titled Act F-A-S-T 1-2-3!. Follow-up indicated that the educational tool continued to be used to educate indigenous children and adults about stroke signs and symptoms, the need for early response, and risk reduction. Interpretation Although indigenous communities are each unique in their culture and traditions, all have a strong commitment to improving health and are generous in their support for research that addresses their needs. Our study provides examples of the engagement and participatory research strategies that were effective, the practical supports required, limitations to the study, and how barriers to stroke education can be overcome. PMID:28817789

Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation

PubMed Central

Sefton, Gerri; Lane, Steven; Killen, Roger; Black, Stuart; Lyon, Max; Ampah, Pearl; Sproule, Cathryn; Loren-Gosling, Dominic; Richards, Caitlin; Spinty, Jean; Holloway, Colette; Davies, Coral; Wilson, April; Chean, Chung Shen; Carter, Bernie; Carrol, E.D.

2017-01-01

Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined “norm.” Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team. PMID:27832032

Use of a novel electronic maternal surveillance system to generate automated alerts on the labor and delivery unit.

PubMed

Klumpner, Thomas T; Kountanis, Joanna A; Langen, Elizabeth S; Smith, Roger D; Tremper, Kevin K

2018-06-26

Maternal early warning systems reduce maternal morbidity. We developed an electronic maternal surveillance system capable of visually summarizing the labor and delivery census and identifying changes in clinical status. Automatic page alerts to clinical providers, using an algorithm developed at our institution, were incorporated in an effort to improve early detection of maternal morbidity. We report the frequency of pages generated by the system. To our knowledge, this is the first time such a system has been used in peripartum care. Alert criteria were developed after review of maternal early warning systems, including the Maternal Early Warning Criteria (MEWC). Careful consideration was given to the frequency of pages generated by the surveillance system. MEWC notification criteria were liberalized and a paging algorithm was created that triggered paging alerts to first responders (nurses) and then managing services due to the assumption that paging all clinicians for each vital sign triggering MEWC would generate an inordinate number of pages. For preliminary analysis, to determine the effect of our automated paging algorithm on alerting frequency, the paging frequency of this system was compared to the frequency of vital signs meeting the Maternal Early Warning Criteria (MEWC). This retrospective analysis was limited to a sample of 34 patient rooms uniquely capable of storing every vital sign reported by the bedside monitor. Over a 91-day period, from April 1 to July 1, 2017, surveillance was conducted from 64 monitored beds, and the obstetrics service received one automated page every 2.3 h. The most common triggers for alerts were for hypertension and tachycardia. For the subset of 34 patient rooms uniquely capable of real-time recording, one vital sign met the MEWC every 9.6 to 10.3 min. Anecdotally, the system was well-received. This novel electronic maternal surveillance system is designed to reduce cognitive bias and improve timely clinical recognition of maternal deterioration. The automated paging algorithm developed for this software dramatically reduces paging frequency compared to paging for isolated vital sign abnormalities alone. Long-term, prospective studies will be required to determine its impact on patient outcomes.

Identifying the Safety Factors over Traffic Signs in State Roads using a Panel Quantile Regression Approach.

PubMed

Šarić, Željko; Xu, Xuecai; Duan, Li; Babić, Darko

2018-06-20

This study intended to investigate the interactions between accident rate and traffic signs in state roads located in Croatia, and accommodate the heterogeneity attributed to unobserved factors. The data from 130 state roads between 2012 and 2016 were collected from Traffic Accident Database System maintained by the Republic of Croatia Ministry of the Interior. To address the heterogeneity, a panel quantile regression model was proposed, in which quantile regression model offers a more complete view and a highly comprehensive analysis of the relationship between accident rate and traffic signs, while the panel data model accommodates the heterogeneity attributed to unobserved factors. Results revealed that (1) low visibility of material damage (MD) and death or injured (DI) increased the accident rate; (2) the number of mandatory signs and the number of warning signs were more likely to reduce the accident rate; (3)average speed limit and the number of invalid traffic signs per km exhibited a high accident rate. To our knowledge, it's the first attempt to analyze the interactions between accident consequences and traffic signs by employing a panel quantile regression model; by involving the visibility, the present study demonstrates that the low visibility causes a relatively higher risk of MD and DI; It is noteworthy that average speed limit corresponds with accident rate positively; The number of mandatory signs and the number of warning signs are more likely to reduce the accident rate; The number of invalid traffic signs per km are significant for accident rate, thus regular maintenance should be kept for a safer roadway environment.

Determination of early warning signs for photocatalytic degradation of titanium white oil paints by means of surface analysis

NASA Astrophysics Data System (ADS)

van Driel, B. A.; Wezendonk, T. A.; van den Berg, K. J.; Kooyman, P. J.; Gascon, J.; Dik, J.

2017-02-01

Titanium white (TiO2) has been widely used as a pigment in the 20th century. However, its most photocatalytic form (anatase) can cause severe degradation of the oil paint in which it is contained. UV light initiates TiO2-photocatalyzed processes in the paint film, degrading the oil binder into volatile components resulting in chalking of the paint. This will eventually lead to severe changes in the appearance of a painting. To date, limited examples of degraded works of art containing titanium white are known due to the relatively short existence of the paintings in question and the slow progress of the degradation process. However, UV light will inevitably cause degradation of paint in works of art containing photocatalytic titanium white. In this work, a method to detect early warning signs of photocatalytic degradation of unvarnished oil paint is proposed, using atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). Consequently, a four-stage degradation model was developed through in-depth study of TiO2-containing paint films in various stages of degradation. The XPS surface analysis proved very valuable for detecting early warning signs of paint degradation, whereas the AFM results provide additional confirmation and are in good agreement with bulk gloss reduction.

Do dogs bite without warning, or should we see it coming?

PubMed

2017-01-14

When dog bites occur, many owners will report the incident as being 'out of character' for the dog and as happening 'out of the blue'. But do dogs provide warning signs before biting and should owners and vets be able to see it coming? This question was explored in a session during the London Vet Show. Laura Honey reports. British Veterinary Association.

Capturing early signs of deterioration: the dutch-early-nurse-worry-indicator-score and its value in the Rapid Response System.

PubMed

Douw, Gooske; Huisman-de Waal, Getty; van Zanten, Arthur R H; van der Hoeven, Johannes G; Schoonhoven, Lisette

2017-09-01

To determine the predictive value of individual and combined dutch-early-nurse-worry-indicator-score indicators at various Early Warning Score levels, differentiating between Early Warning Scores reaching the trigger threshold to call a rapid response team and Early Warning Score levels not reaching this point. Dutch-early-nurse-worry-indicator-score comprises nine indicators underlying nurses' 'worry' about a patient's condition. All indicators independently show significant association with unplanned intensive care/high dependency unit admission or unexpected mortality. Prediction of this outcome improved by adding the dutch-early-nurse-worry-indicator-score indicators to an Early Warning Score based on vital signs. An observational cohort study was conducted on three surgical wards in a tertiary university-affiliated teaching hospital. Included were surgical, native-speaking, adult patients. Nurses scored presence of 'worry' and/or dutch-early-nurse-worry-indicator-score indicators every shift or when worried. Vital signs were measured according to the prevailing protocol. Unplanned intensive care/high dependency unit admission or unexpected mortality was the composite endpoint. Percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators were calculated at various Early Warning Score levels in control and event groups. Entering all dutch-early-nurse-worry-indicator-score indicators in a multiple logistic regression analysis, we calculated a weighted score and calculated sensitivity, specificity, positive predicted value and negative predicted value for each possible total score. In 3522 patients, 102 (2·9%) had an unplanned intensive care/high dependency unit admissions (n = 97) or unexpected mortality (n = 5). Patients with such events and only slightly changed vital signs had significantly higher percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators expressed than patients in the control group. Increasing number of dutch-early-nurse-worry-indicator-score indicators showed higher positive predictive values. Dutch-early-nurse-worry-indicator-score indicators alert in an early stage of deterioration, before reaching the trigger threshold to call a rapid response team and can improve interdisciplinary communication on surgical wards during regular rounds, and when calling for assistance. Dutch-early-nurse-worry-indicator-score structures communication and recording of signs known to be associated with a decline in a patient's condition and can empower nurses to call assistance on the 'worry' criterion in an early stage of deterioration. © 2016 John Wiley & Sons Ltd.

Small strokes causing severe vertigo: frequency of false-negative MRIs and nonlacunar mechanisms.

PubMed

Saber Tehrani, Ali S; Kattah, Jorge C; Mantokoudis, Georgios; Pula, John H; Nair, Deepak; Blitz, Ari; Ying, Sarah; Hanley, Daniel F; Zee, David S; Newman-Toker, David E

2014-07-08

Describe characteristics of small strokes causing acute vestibular syndrome (AVS). Ambispective cross-sectional study of patients with AVS (acute vertigo or dizziness, nystagmus, nausea/vomiting, head-motion intolerance, unsteady gait) with at least one stroke risk factor from 1999 to 2011 at a single stroke referral center. Patients underwent nonquantitative HINTS "plus" examination (head impulse, nystagmus, test-of-skew plus hearing), neuroimaging to confirm diagnoses (97% by MRI), and repeat MRI in those with initially normal imaging but clinical signs of a central lesion. We identified patients with diffusion-weighted imaging (DWI) strokes ≤10 mm in axial diameter. Of 190 high-risk AVS presentations (105 strokes), we found small strokes in 15 patients (median age 64 years, range 41-85). The most common vestibular structure infarcted was the inferior cerebellar peduncle (73%); the most common stroke location was the lateral medulla (60%). Focal neurologic signs were present in only 27%. The HINTS "plus" battery identified small strokes with greater sensitivity than early MRI-DWI (100% vs 47%, p < 0.001). False-negative initial MRIs (6-48 hours) were more common with small strokes than large strokes (53% [n = 8/15] vs 7.8% [n = 7/90], p < 0.001). Nonlacunar stroke mechanisms were responsible in 47%, including 6 vertebral artery occlusions or dissections. Small strokes affecting central vestibular projections can present with isolated AVS. The HINTS "plus" hearing battery identifies these patients with greater accuracy than early MRI-DWI, which is falsely negative in half, up to 48 hours after onset. We found nonlacunar mechanisms in half, suggesting greater risk than might otherwise be assumed for patients with such small infarctions. © 2014 American Academy of Neurology.

Clinical Features and Related Factors of Poststroke Pathological Laughing and Crying: A Case-Control Study.

PubMed

Wang, Geying; Teng, Fei; Chen, Yuhui; Liu, Yuanhua; Li, Yancheng; Cai, Li; Zhang, Xu; Nie, Zhiyu; Jin, Lingjing

2016-03-01

The purpose of this study was to analyze clinical features and related factors of poststroke pathological laughing and crying (PSPLC) and to differentiate PSPLC patients with and without pseudobulbar signs. We performed a case-control study in which 56 patients with PSPLC were matched to 56 control stroke patients by age and gender. The pathological laughing and crying scale was used to identify patients with PSPLC. Characteristics of PSPLC outbursts, presence of pseudobulbar signs and autonomic symptoms, lesion locations, and different clinical data were analyzed. Mild cognitive impairment (MCI) was evaluated by the Montreal Cognitive Assessment. Poststroke anger proneness (PSAP) was evaluated by comparison of the patients' premorbid states. Significantly more patients in the PSPLC group showed MCI, PSAP, and pseudobulbar signs than those in the control group. Most patients with PSPLC showed bilateral multiple lesions and the pons (especially the bilateral paramedian basal and basal-tegmental areas) stood out as the most important lesion location. Logistic regression analysis showed that pontine lesion, MCI, and PSAP were independently related to PSPLC; however, the presence of pseudobulbar signs was not related. PSPLC patients with pseudobulbar signs showed more recurrent strokes in the previous 2 years, more severe neurological deficits, as well as higher severity of PSPLC. In addition, more patients in the group with pseudobulbar signs showed concomitant autonomic symptoms. PSPLC, MCI, and PSAP could be manifestations of a more general disorder, in which pontine lesion plays an important role. PSPLC patients with pseudobulbar signs and those without show different features. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Relevance of stroke code, stroke unit and stroke networks in organization of acute stroke care--the Madrid acute stroke care program.

PubMed

Alonso de Leciñana-Cases, María; Gil-Núñez, Antonio; Díez-Tejedor, Exuperio

2009-01-01

Stroke is a neurological emergency. The early administration of specific treatment improves the prognosis of the patients. Emergency care systems with early warning for the hospital regarding patients who are candidates for this treatment (stroke code) increases the number of patients treated. Currently, reperfusion via thrombolysis for ischemic stroke and attention in stroke units are the bases of treatment. Healthcare professionals and health provision authorities need to work together to organize systems that ensure continuous quality care for the patients during the whole process of their disease. To implement this, there needs to be an appropriate analysis of the requirements and resources with the objective of their adjustment for efficient use. It is necessary to provide adequate information and continuous training for all professionals who are involved in stroke care, including primary care physicians, extrahospital emergency teams and all physicians involved in the care of stroke patients within the hospital. The neurologist has the function of coordinating the protocols of intrahospital care. These organizational plans should also take into account the process beyond the acute phase, to ensure the appropriate application of measures of secondary prevention, rehabilitation, and chronic care of the patients that remain in a dependent state. We describe here the stroke care program in the Community of Madrid (Spain). (c) 2009 S. Karger AG, Basel.

High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy.

PubMed

Shin, Jong Wook; Jeong, Hye Seon; Kwon, Hyon-Jo; Song, Kyu Sang; Kim, Jei

2018-01-01

We evaluated the composition of individual clots retrieved during intra-arterial thrombectomy in relation to recanalization success, stroke subtype, and the presence of clot signs on initial brain images. We analyzed clot and interventional data from 145 retrieval trials performed for 37 patients (69.5±14.0 years, 20 men, large artery atherosclerosis, n = 7; cardioembolism, n = 22; undetermined etiology, n = 8) who had undergone intra-arterial thrombectomy. Rates of clot retrieval and successful recanalization (Arterial Occlusive Lesion score of 2-3) for separate retrieval trials were evaluated. The area occupied by red blood cell (RBC), fibrin/platelets, and white blood cell (WBC) was measured from digitized images of hematoxylin-eosin stained clots. Compositional differences were compared according to recanalization success, stroke subtype, and the presence of hyperdense clot sign on initial computed tomography and/or blooming artifact on magnetic resonance image. Of the 145 total retrieval trials (3.4±2.4 times per patient), clot was retrieved in 93 trials (64%), while recanalization was successful in 73 (50%). Fibrin/platelets (63%) occupied the greatest area in retrieved clots, followed by RBCs (33%) and WBCs (4%). Clots retrieved from successful recanalization exhibited higher RBC composition (37%) than those retrieved from non-recanalization trials (20%, p = 0.001). RBC composition was higher in cardioembolic stroke (38%) rather than large artery atherosclerosis (23%) and undetermined etiology (26%, p = 0.01). Clots exhibiting clot signs (40%) had higher RBC composition than those without clot signs (19%, p = 0.001). RBC-rich clots were associated with successful recanalization of intra-arterial thrombectomy, cardioembolic stroke, and the presence of clot-signs on initial brain images.

High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy

PubMed Central

Shin, Jong Wook; Jeong, Hye Seon; Kwon, Hyon-Jo; Song, Kyu Sang

2018-01-01

We evaluated the composition of individual clots retrieved during intra-arterial thrombectomy in relation to recanalization success, stroke subtype, and the presence of clot signs on initial brain images. We analyzed clot and interventional data from 145 retrieval trials performed for 37 patients (69.5±14.0 years, 20 men, large artery atherosclerosis, n = 7; cardioembolism, n = 22; undetermined etiology, n = 8) who had undergone intra-arterial thrombectomy. Rates of clot retrieval and successful recanalization (Arterial Occlusive Lesion score of 2–3) for separate retrieval trials were evaluated. The area occupied by red blood cell (RBC), fibrin/platelets, and white blood cell (WBC) was measured from digitized images of hematoxylin-eosin stained clots. Compositional differences were compared according to recanalization success, stroke subtype, and the presence of hyperdense clot sign on initial computed tomography and/or blooming artifact on magnetic resonance image. Of the 145 total retrieval trials (3.4±2.4 times per patient), clot was retrieved in 93 trials (64%), while recanalization was successful in 73 (50%). Fibrin/platelets (63%) occupied the greatest area in retrieved clots, followed by RBCs (33%) and WBCs (4%). Clots retrieved from successful recanalization exhibited higher RBC composition (37%) than those retrieved from non-recanalization trials (20%, p = 0.001). RBC composition was higher in cardioembolic stroke (38%) rather than large artery atherosclerosis (23%) and undetermined etiology (26%, p = 0.01). Clots exhibiting clot signs (40%) had higher RBC composition than those without clot signs (19%, p = 0.001). RBC-rich clots were associated with successful recanalization of intra-arterial thrombectomy, cardioembolic stroke, and the presence of clot-signs on initial brain images. PMID:29782513

Neurological signs in 23 dogs with suspected rostral cerebellar ischaemic stroke.

PubMed

Thomsen, Barbara; Garosi, Laurent; Skerritt, Geoff; Rusbridge, Clare; Sparrow, Tim; Berendt, Mette; Gredal, Hanne

2016-06-07

In dogs with ischaemic stroke, a very common site of infarction is the cerebellum. The aim of this study was to characterise neurological signs in relation to infarct topography in dogs with suspected cerebellar ischaemic stroke and to report short-term outcome confined to the hospitalisation period. A retrospective multicentre study of dogs with suspected cerebellar ischaemic stroke examined from 2010-2015 at five veterinary referral hospitals was performed. Findings from clinical, neurological, and paraclinical investigations including magnetic resonance imaging were assessed. Twenty-three dogs, 13 females and 10 males with a median age of 8 years and 8 months, were included in the study. The Cavalier King Charles Spaniel (n = 9) was a commonly represented breed. All ischaemic strokes were located to the vascular territory of the rostral cerebellar artery including four extensive and 19 limited occlusions. The most prominent neurological deficits were gait abnormalities (ataxia with hypermetria n = 11, ataxia without hypermetria n = 4, non-ambulatory n = 6), head tilt (n = 13), nystagmus (n = 8), decreased menace response (n = 7), postural reaction deficits (n = 7), and proprioceptive deficits (n = 5). Neurological signs appeared irrespective of the infarct being classified as extensive or limited. All dogs survived and were discharged within 1-10 days of hospitalisation. Dogs affected by rostral cerebellar ischaemic stroke typically present with a collection of neurological deficits characterised by ataxia, head tilt, and nystagmus irrespective of the specific cerebellar infarct topography. In dogs with peracute to acute onset of these neurological deficits, cerebellar ischaemic stroke should be considered an important differential diagnosis, and neuroimaging investigations are indicated. Although dogs are often severely compromised at presentation, short-term prognosis is excellent and rapid clinical improvement may be observed within the first week following the ischaemic stroke.

Range estimation techniques in single-station thunderstorm warning sensors based upon gated, wideband, magnetic direction finder technology

NASA Technical Reports Server (NTRS)

Pifer, Alburt E.; Hiscox, William L.; Cummins, Kenneth L.; Neumann, William T.

1991-01-01

Gated, wideband, magnetic direction finders (DFs) were originally designed to measure the bearing of cloud-to-ground lightning relative to the sensor. A recent addition to this device uses proprietary waveform discrimination logic to select return stroke signatures and certain range dependent features in the waveform to provide an estimate of range of flashes within 50 kms. The enhanced ranging techniques are discussed which were designed and developed for use in single station thunderstorm warning sensor. Included are the results of on-going evaluations being conducted under a variety of meteorological and geographic conditions.

Advertising, computers, and pharmacy liability. A Michigan court's decision has ramifications for pharmaceutical care.

PubMed

Cacciatore, G G

1996-11-01

Arbor Drugs, Inc., advertised that its computer could detect dangerous drug interactions. A pharmacist failed to warn a patient accordingly and the patient suffered a stroke as a result of an interaction between tranylcypromine and a decongestant. The Michigan Court of Appeals held that this failure to warn was actionable under the theories of negligence and fraud as well as under the Michigan Consumer Protection Act. The court's basic message is that pharmacies may be held legally responsible for preventing harm when they represent themselves as being capable of doing so.

A narrative synthesis of factors that affect women speaking up about early warning signs and symptoms of pre-eclampsia and responses of healthcare staff.

PubMed

Carter, Wendy; Bick, Debra; Mackintosh, Nicola; Sandall, Jane

2017-02-13

One of the challenges for treating pre-eclampsia and preventing further deterioration is determining how best to enable early detection. If women or their partners and families are able to raise early warnings about potential signs and symptoms of pre-eclampsia in pregnancy, birth and in the postnatal period, women may be able to receive earlier intervention to prevent severe pre-eclampsia from developing. The aim of this study was to improve understanding of factors affecting the ability of women to recognise symptoms and signs of pre-eclampsia/eclampsia and seek appropriate medical help and factors affecting health care professionals' responses to women and their families who 'speak up' about early warning signs and symptoms. A narrative synthesis was conducted of evidence relevant to address the research question. The following electronic data bases were searched for qualitative studies which met inclusion criteria from January 1980 to April 2016; Medline, CINAHL, HMIC, PsycINFO, Embase, BNI, ASSIA, Scopus, Maternity and Infant Care, Web of Science, Google Scholar, Cochrane, JBI and IBSS with the support of an Information Service Consultant. Following thematic analysis, three themes were identified; 1: Women's understanding and knowledge of pre-eclampsia/eclampsia; 2: Factors affecting help seeking behaviour from perspectives of women and their families'; 3: Factors affecting staff response. There was widespread lack of knowledge and understanding of signs and symptoms of pre-eclampsia/eclampsia among women and their families, with some women not exhibiting signs and symptoms of pre-eclampsia or unable to distinguish them from 'normal' pregnancy changes. Women and their families not only need to be made aware of signs and symptoms of pre-eclampsia/eclampsia but also require information on the most effective ways to seek urgent medical assessment and care. Some women did not experience prodromal signs and symptoms, which raises concerns about how women and families can detect early onset, and is an issue which needs further exploration. There is very limited research exploring clinical staff response to women who raise concerns about their health when experiencing symptoms and signs of pre-eclampsia/eclampsia with further research needed if safety and quality of care are to be improved.

Implementing drought early warning systems: policy lessons and future needs

NASA Astrophysics Data System (ADS)

Iglesias, Ana; Werner, Micha; Maia, Rodrigo; Garrote, Luis; Nyabeze, Washington

2014-05-01

Drought forecasting and Warning provides the potential of reducing impacts to society due to drought events. The implementation of effective drought forecasting and warning, however, requires not only science to support reliable forecasting, but also adequate policy and societal response. Here we propose a protocol to develop drought forecasting and early warning based in the international cooperation of African and European institutions in the DEWFORA project (EC, 7th Framework Programme). The protocol includes four major phases that address the scientific knowledge and the social capacity to use the knowledge: (a) What is the science available? Evaluating how signs of impending drought can be detected and predicted, defining risk levels, and analysing of the signs of drought in an integrated vulnerability approach. (b) What are the societal capacities? In this the institutional framework that enables policy development is evaluated. The protocol gathers information on vulnerability and pending hazard in advance so that early warnings can be declared at sufficient lead time and drought mitigation planning can be implemented at an early stage. (c) How can science be translated into policy? Linking science indicators into the actions/interventions that society needs to implement, and evaluating how policy is implemented. Key limitations to planning for drought are the social capacities to implement early warning systems. Vulnerability assessment contributes to identify these limitations and therefore provides crucial information to policy development. Based on the assessment of vulnerability we suggest thresholds for management actions to respond to drought forecasts and link predictive indicators to relevant potential mitigation strategies. Vulnerability assessment is crucial to identify relief, coping and management responses that contribute to a more resilient society. (d) How can society benefit from the forecast? Evaluating how information is provided to potentially affected groups, and how mitigation strategies can be taken in response. This paper presents an outline of the protocol that was developed in the DEWFORA project, outlining the complementary roles of science, policy and societal uptake in effective drought forecasting and warning. A consensus on the need to emphasise the social component of early warning was reached when testing the DEWFORA early warning system protocol among experts from 18 countries.

Know Stroke. Know the Signs. Act in Time.

MedlinePlus

... About the Campaign Stroke Materials » Brochures » Toolkits and Posters » Radio PSAs » Videos and TV PSAs » Widgets » Infographics ... are reported in the U.S. each year. The good news is that treatments are available that can ...

Feedback interventions and driving speed: A parametric and comparative analysis

PubMed Central

Houten, Ron Van; Nau, Paul A.

1983-01-01

Five experiments were conducted to assess the effects of several variables on the efficacy of feedback in reducing driving speed. Experiment 1 systematically varied the criterion used to define speeding, and results showed that the use of a lenient criterion (20 km/hr over the speed limit), which allowed for the posting of high percentages of drivers not speeding, was more effective in reducing speeding than the use of a stringent criterion (10 km/hr over the speed limit). In Experiment 2 an analysis revealed that posting feedback reduced speeding on a limited access highway and the effects persisted to some degree up to 6 km. Experiments 3 and 4 compared the effectiveness of an unmanned parked police vehicle (Experiment 3) and a police air patrol speeding program (Experiment 4) with the feedback sign and determined whether the presence of either of these enforcement variables could potentiate the efficacy of the sign. The results of both experiments demonstrated that although the two enforcement programs initially produced larger effects than the feedback sign, the magnitude of their effect attenuated over time. Experiment 5 compared the effectiveness of a traditional enforcement program with a warning program which included handing out a flier providing feedback on the number and types of accidents occuring on the road during the past year. This experiment demonstrated that the warning program produced a marked reduction in speeding and the traditional enforcement program did not. Furthermore, the warning program and a feedback sign together produced an even greater reduction in speeding than either alone. PMID:16795666

Preeclampsia, of mice and women

PubMed Central

Davisson, Robin L.

2016-01-01

Preeclampsia (PE) is a devastating disorder of pregnancy that affects up to 8% of pregnant women in the United States. The diagnosis of PE is made by the presentation of new-onset hypertension, ≥140 mmHg systolic blood pressure (BP) or ≥90 mmHg diastolic BP, and either proteinuria or another accompanying sign/symptom, such as renal insufficiency, thrombocytopenia, hepatic dysfunction, pulmonary edema, or cerebral/visual. These signs can occur suddenly and without warning. PE that presents before 34 wk of gestation is considered early onset and carries a greater risk for perinatal morbidity/mortality than late-onset PE that occurs at or after 34 wk of gestation. At this time there is no cure for PE, and the only effective treatment is delivery of the baby and placenta. If allowed to progress to eclampsia (PE with neurologic involvement), seizures will occur and possibly death through stroke. PE also carries the risk of significant fetal and neonatal morbidity/mortality in addition to long-term health risks for mother and child. Despite significant research efforts to accurately predict, diagnose, and treat PE, a cure eludes us. Elucidating the pathophysiological mechanisms that can cause PE will aid in our ability to accurately prevent, manage, and treat PE to avoid maternal and fetal losses. Intense research efforts are focused on PE, and the mouse has proven to be a useful animal model for investigating molecular mechanisms that may hold the key to unraveling the mysteries of PE in women. PMID:27260843

Preeclampsia, of mice and women.

PubMed

Sones, Jenny L; Davisson, Robin L

2016-08-01

Preeclampsia (PE) is a devastating disorder of pregnancy that affects up to 8% of pregnant women in the United States. The diagnosis of PE is made by the presentation of new-onset hypertension, ≥140 mmHg systolic blood pressure (BP) or ≥90 mmHg diastolic BP, and either proteinuria or another accompanying sign/symptom, such as renal insufficiency, thrombocytopenia, hepatic dysfunction, pulmonary edema, or cerebral/visual. These signs can occur suddenly and without warning. PE that presents before 34 wk of gestation is considered early onset and carries a greater risk for perinatal morbidity/mortality than late-onset PE that occurs at or after 34 wk of gestation. At this time there is no cure for PE, and the only effective treatment is delivery of the baby and placenta. If allowed to progress to eclampsia (PE with neurologic involvement), seizures will occur and possibly death through stroke. PE also carries the risk of significant fetal and neonatal morbidity/mortality in addition to long-term health risks for mother and child. Despite significant research efforts to accurately predict, diagnose, and treat PE, a cure eludes us. Elucidating the pathophysiological mechanisms that can cause PE will aid in our ability to accurately prevent, manage, and treat PE to avoid maternal and fetal losses. Intense research efforts are focused on PE, and the mouse has proven to be a useful animal model for investigating molecular mechanisms that may hold the key to unraveling the mysteries of PE in women. Copyright © 2016 the American Physiological Society.

Centile-based early warning scores derived from statistical distributions of vital signs.

PubMed

Tarassenko, Lionel; Clifton, David A; Pinsky, Michael R; Hravnak, Marilyn T; Woods, John R; Watkinson, Peter J

2011-08-01

To develop an early warning score (EWS) system based on the statistical properties of the vital signs in at-risk hospitalised patients. A large dataset comprising 64,622 h of vital-sign data, acquired from 863 acutely ill in-hospital patients using bedside monitors, was used to investigate the statistical properties of the four main vital signs. Normalised histograms and cumulative distribution functions were plotted for each of the four variables. A centile-based alerting system was modelled using the aggregated database. The means and standard deviations of our population's vital signs are very similar to those published in previous studies. When compared with EWS systems based on a future outcome, the cut-off values in our system are most different for respiratory rate and systolic blood pressure. With four-hourly observations in a 12-h shift, about 1 in 8 at-risk patients would trigger our alerting system during the shift. A centile-based EWS system will identify patients with abnormal vital signs regardless of their eventual outcome and might therefore be more likely to generate an alert when presented with patients with redeemable morbidity or avoidable mortality. We are about to start a stepped-wedge clinical trial gradually introducing an electronic version of our EWS system on the trauma wards in a teaching hospital. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Methodology for a Community Based Stroke Preparedness Intervention: The ASPIRE Study

PubMed Central

Boden-Albala, Bernadette; Edwards, Dorothy F.; Clair, Shauna St; Wing, Jeffrey J; Fernandez, Stephen; Gibbons, Chris; Hsia, Amie W.; Morgenstern, Lewis B.; Kidwell, Chelsea S.

2014-01-01

Background and Purpose Acute stroke education has focused on stroke symptom recognition. Lack of education about stroke preparedness and appropriate actions may prevent people from seeking immediate care. Few interventions have rigorously evaluated preparedness strategies in multiethnic community settings. Methods The Acute Stroke Program of Interventions Addressing Racial and Ethnic Disparities (ASPIRE) project is a multi-level program utilizing a community engaged approach to stroke preparedness targeted to underserved black communities in the District of Columbia (DC). This intervention aimed to decrease acute stroke presentation times and increase intravenous tissue plasminogen activator (IV tPA) utilization for acute ischemic stroke. Results Phase 1 included: 1) enhancement of EMS focus on acute stroke; 2) hospital collaborations to implement and/or enrich acute stroke protocols and transition DC hospitals toward Primary Stroke Center certification; and 3) pre-intervention acute stroke patient data collection in all 7 acute care DC hospitals. A community advisory committee, focus groups, and surveys identified perceptions of barriers to emergency stroke care. Phase 2 included a pilot intervention and subsequent citywide intervention rollout. A total of 531 community interventions were conducted with over 10,256 participants reached; 3289 intervention evaluations were performed, and 19,000 preparedness bracelets and 14,000 stroke warning magnets were distributed. Phase 3 included an evaluation of EMS and hospital processes for acute stroke care and a yearlong post-intervention acute stroke data collection period to assess changes in IV tPA utilization. Conclusions We report the methods, feasibility, and pre-intervention data collection efforts of the ASPIRE intervention. PMID:24876243

The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings.

PubMed

Nathan, Hannah L; Boene, Helena; Munguambe, Khatia; Sevene, Esperança; Akeju, David; Adetoro, Olalekan O; Charanthimath, Umesh; Bellad, Mrutyunjaya B; de Greeff, Annemarie; Anthony, John; Hall, David R; Steyn, Wilhelm; Vidler, Marianne; von Dadelszen, Peter; Chappell, Lucy C; Sandall, Jane; Shennan, Andrew H

2018-01-05

Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device. Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach. Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device's accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period. The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral.

Determination of geographic variance in stroke prevalence using Internet search engine analytics.

PubMed

Walcott, Brian P; Nahed, Brian V; Kahle, Kristopher T; Redjal, Navid; Coumans, Jean-Valery

2011-06-01

Previous methods to determine stroke prevalence, such as nationwide surveys, are labor-intensive endeavors. Recent advances in search engine query analytics have led to a new metric for disease surveillance to evaluate symptomatic phenomenon, such as influenza. The authors hypothesized that the use of search engine query data can determine the prevalence of stroke. The Google Insights for Search database was accessed to analyze anonymized search engine query data. The authors' search strategy utilized common search queries used when attempting either to identify the signs and symptoms of a stroke or to perform stroke education. The search logic was as follows: (stroke signs + stroke symptoms + mini stroke--heat) from January 1, 2005, to December 31, 2010. The relative number of searches performed (the interest level) for this search logic was established for all 50 states and the District of Columbia. A Pearson product-moment correlation coefficient was calculated from the statespecific stroke prevalence data previously reported. Web search engine interest level was available for all 50 states and the District of Columbia over the time period for January 1, 2005-December 31, 2010. The interest level was highest in Alabama and Tennessee (100 and 96, respectively) and lowest in California and Virginia (58 and 53, respectively). The Pearson correlation coefficient (r) was calculated to be 0.47 (p = 0.0005, 2-tailed). Search engine query data analysis allows for the determination of relative stroke prevalence. Further investigation will reveal the reliability of this metric to determine temporal pattern analysis and prevalence in this and other symptomatic diseases.

Maternal bacteremia and the Irish maternity early warning system.

PubMed

Maguire, Patrick J; O'Higgins, Amy C; Power, Karen A; Daly, Niamh; McKeating, Aoife; Turner, Michael J

2015-05-01

To assess whether introduction of the Irish maternity early warning system (IMEWS) in 2013 has improved the recording of vital signs among women with proven maternal bacteremia. In a mixed retrospective and prospective study at a single center in Dublin, Ireland, the patient records of all cases of maternal bacteremia between January 1, 2009, and March 31, 2014, were reviewed. The IMEWS chart was applied retrospectively to records of vital signs from January 2009 to March 2013, and prospectively from April 2013 to March 2014. For the 61 cases from the period before IMEWS introduction, vital signs were recorded inconsistently on multiple pages. The frequency of recordings was not standardized. Respiratory rate, in particular, was under-recorded. Among the 17 cases between April 2013 and March 2014 that were eligible for IMEWS chart use, 14 women had vital signs recorded on an IMEWS chart. As compared with the period before IMEWS introduction, there was an improvement in respiratory rate recording as part of the first set of observations. Among pregnant women with proven bacteremia, introduction of IMEWS has been associated with an improvement in the recording of vital signs, particularly respiratory rate. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Children's misunderstandings of hazard warning signs in the new globally harmonized system for classification and labeling.

PubMed

Latham, Garry; Long, Tony; Devitt, Patric

2013-12-01

Accidental chemical poisoning causes more than 35 000 child deaths every year across the world, and it leads to disease, disability, and suffering for many more children. Children's ignorance of dangers and their failure to interpret hazard warning signs as intended contribute significantly to this problem. A new Globally Harmonized System for Classification and Labeling is being implemented internationally with a view to unifying the current multiple and disparate national systems. This study was designed to establish a productive, effective means of teaching the new GHS warning signs to primary school children (aged 7-11 years). A pre-test, post-test, follow-up test design was employed, with a teaching intervention informed by a Delphi survey of expert opinion. Children from one school formed the experimental group (n = 49) and a second school provided a control group (n = 23). Both groups showed a gain in knowledge from pre-test to post-test, the experimental group with a larger gain but which was not statistically significant. However, longer-term retention of knowledge, as shown by the follow-up test, was statistically significantly greater in the experimental group (p = 0.001). The employment of teaching to match children's preferred learning styles, and the use of active learning were found to be related to improved retention of knowledge. Part of the study involved eliciting children's interpretation of standard hazard warning symbols, and this provoked considerable concern over the potential for dangerous misinterpretation with disastrous consequences. This article focuses on the reasons for such misconception and the action required to address this successfully in testing the intervention.

Warning Signs of Lung Disease

MedlinePlus

... each(function(i){ var city = $(this).find('city').text(); var state = $(this).find('state').text(); var date = $(this).find('date').text(); if ((city != "") && (state != "")){ var citystate = ' | ' + city + ', ' + state; } else ...

Effect of In-Vehicle Audio Warning System on Driver’s Speed Control Performance in Transition Zones from Rural Areas to Urban Areas

PubMed Central

Yan, Xuedong; Wang, Jiali; Wu, Jiawei

2016-01-01

Speeding is a major contributing factor to traffic crashes and frequently happens in areas where there is a mutation in speed limits, such as the transition zones that connect urban areas from rural areas. The purpose of this study is to investigate the effects of an in-vehicle audio warning system and lit speed limit sign on preventing drivers’ speeding behavior in transition zones. A high-fidelity driving simulator was used to establish a roadway network with the transition zone. A total of 41 participants were recruited for this experiment, and the driving speed performance data were collected from the simulator. The experimental results display that the implementation of the audio warning system could significantly reduce drivers’ operating speed before they entered the urban area, while the lit speed limit sign had a minimal effect on improving the drivers’ speed control performance. Without consideration of different types of speed limit signs, it is found that male drivers generally had a higher operating speed both upstream and in the transition zones and have a larger maximum deceleration for speed reduction than female drivers. Moreover, the drivers who had medium-level driving experience had the higher operating speed and were more likely to have speeding behaviors in the transition zones than those who had low-level and high-level driving experience in the transition zones. PMID:27347990

Determination of early warning signs for photocatalytic degradation of titanium white oil paints by means of surface analysis.

PubMed

van Driel, B A; Wezendonk, T A; van den Berg, K J; Kooyman, P J; Gascon, J; Dik, J

2017-02-05

Titanium white (TiO 2 ) has been widely used as a pigment in the 20th century. However, its most photocatalytic form (anatase) can cause severe degradation of the oil paint in which it is contained. UV light initiates TiO 2 -photocatalyzed processes in the paint film, degrading the oil binder into volatile components resulting in chalking of the paint. This will eventually lead to severe changes in the appearance of a painting. To date, limited examples of degraded works of art containing titanium white are known due to the relatively short existence of the paintings in question and the slow progress of the degradation process. However, UV light will inevitably cause degradation of paint in works of art containing photocatalytic titanium white. In this work, a method to detect early warning signs of photocatalytic degradation of unvarnished oil paint is proposed, using atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). Consequently, a four-stage degradation model was developed through in-depth study of TiO 2 -containing paint films in various stages of degradation. The XPS surface analysis proved very valuable for detecting early warning signs of paint degradation, whereas the AFM results provide additional confirmation and are in good agreement with bulk gloss reduction. Copyright © 2016 Elsevier B.V. All rights reserved.

Do elderly patients call 911 when presented with clinical scenarios suggestive of acute stroke? A cross-sectional study.

PubMed

Caruso, Diego; Perez Akly, Manuel; Costantini, Pablo Daniel; Fridman, Sebastian; Esnaola, Maria Martha

2015-01-01

Among patients with acute stroke symptoms, delay in hospital admission is the main obstacle for the use of thrombolytic therapy and other interventions associated with decreased mortality and disability. The primary aim of this study was to assess whether an elderly clinical population correctly endorsed the response to call for emergency services when presented with signs and symptoms of stroke using a standardized questionnaire. We performed a cross-sectional study among elderly out-patients (≥60 years) in Buenos Aires, Argentina randomly recruited from a government funded health clinic. The correct endorsement of intention to call 911 was assessed with the Stroke Action Test and the cut-off point was set at ≥75%. Knowledge of stroke and clinical and socio-demographic indicators were also collected and evaluated as predictors of correct endorsement using logistic regression. Among 367 elderly adults, 14% correctly endorsed intention to call 911. Presented with the most typical signs and symptoms, only 65% reported that they would call an ambulance. Amaurosis Fugax was the symptom for which was called the least (15%). On average, the correct response was chosen only 37% of the time. Compared to lower levels of education, higher levels were associated to correctly endorsed intention to call 911 (secondary School adjusted OR 3.53, 95% CI 1.59-7.86 and Tertiary/University adjusted OR 3.04, 95% CI 1.12-8.21). These results suggest the need to provide interventions that are specifically designed to increase awareness of potential stroke signs and symptoms and appropriate subsequent clinical actions. © 2015 S. Karger AG, Basel.

Perception of recurrent stroke risk among black, white and Hispanic ischemic stroke and transient ischemic attack survivors: the SWIFT study.

PubMed

Boden-Albala, Bernadette; Carman, Heather; Moran, Megan; Doyle, Margaret; Paik, Myunghee C

2011-01-01

Risk modification through behavior change is critical for primary and secondary stroke prevention. Theories of health behavior identify perceived risk as an important component to facilitate behavior change; however, little is known about perceived risk of vascular events among stroke survivors. The SWIFT (Stroke Warning Information and Faster Treatment) study includes a prospective population-based ethnically diverse cohort of ischemic stroke and transient ischemic attack survivors. We investigate the baseline relationship between demographics, health beliefs, and knowledge on risk perception. Regression models examined predictors of inaccurate perception. Only 20% accurately estimated risk, 10% of the participants underestimated risk, and 70% of the 817 study participants significantly overestimated their risk for a recurrent stroke. The mean perceived likelihood of recurrent ischemic stroke in the next 10 years was 51 ± 7%. We found no significant differences by race-ethnicity with regard to accurate estimation of risk. Inaccurate estimation of risk was associated with attitudes and beliefs [worry (p < 0.04), fatalism (p < 0.07)] and memory problems (p < 0.01), but not history or knowledge of vascular risk factors. This paper provides a unique perspective on how factors such as belief systems influence risk perception in a diverse population at high stroke risk. There is a need for future research on how risk perception can inform primary and secondary stroke prevention. Copyright © 2011 S. Karger AG, Basel.

21 CFR 1002.10 - Product reports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... those products which may produce increased radiation with aging, describe the methods and procedures... procedures. (j) Report for each model all warning signs, labels, and instructions for installation, operation...

21 CFR 1002.10 - Product reports.

Code of Federal Regulations, 2011 CFR

2011-04-01

... which may produce increased radiation with aging, describe the methods and procedures used, and...) Report for each model all warning signs, labels, and instructions for installation, operation, and use...

32 CFR 537.8 - Investigation.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., for example, vehicle defects or improper maintenance, road design and absence of warning signs... furnish necessary information, it can usually be obtained by other means, for example, from an accident...

Suicide in pediatrics: epidemiology, risk factors, warning signs and the role of the pediatrician in detecting them.

PubMed

Dilillo, Dario; Mauri, Silvia; Mantegazza, Cecilia; Fabiano, Valentina; Mameli, Chiara; Zuccotti, Gian Vincenzo

2015-07-07

Epidemiological data suggests suicide is uncommon in childhood but becomes an extremely serious issue among adolescents.Several risk factors have been identified and include the presence of psychiatric illness, a previous suicide attempt, family factors, substance abuse, sexual and physical abuse, disorders in gender identity or bullying. Pediatricians have a primary role in searching for these risk factors, recognizing them and acting synergistically with other specialists to prevent and treat suicidal behavior.Pediatricians should also be able to identify the "warning signs" for suicide since their presence implies a need for immediate action, as attempted suicide may occur in a few hours or days.The use of antidepressant drugs and its association with suicidal risk in pediatric age is another topic of ongoing debate. Food and Drug Administration has recently introduced the so-called "black box" on antidepressants' packages with the aim of gaining attention to the possible risk of suicide among adolescents who are treated with antidepressants, with a warning that the risk of suicide is higher when starting a therapy or while adjusting its dosage.

Development and Experimental Application of International Affairs Indicators. Volume B. Supportive Research

DTIC Science & Technology

1974-06-01

i INDICATORS Approaches to Early Warning The Quantitative Indicators Approach: A ... 5 Summary Indicators and Early Warning...Indicators for Early ^ Wa rning 3. Quantitative Signs of Unusual or Ominous Activity 9 13 4. Simulated Cables 25 5 . TEXSCAN...Behavior) for Czechoslovakia 1 mmmmm mmm LIST OF FIGURES vi Pa£« 1. 2. 3. 4. 5 . 6. 7. 8. 9. 10. U. 12. 13. 14. 15. 16. 17. 18

Road sign recognition during computer testing versus driving simulator performance for stroke and stroke+aphasia groups.

DOT National Transportation Integrated Search

2015-07-01

Driving is essential to maintaining independence. For most Americans preserving personal mobility is a : key element to retaining jobs, friends, activities and the basic necessities to maintain a household. This : is particularly true for older peopl...

Evaluating physical and behavioral changes in older adults.

PubMed

Walton, J C; Miller, J M

1998-04-01

In older adults, subtle and sometime not so subtle physical or behavior changes can act as early warning signs of changing status. Nonspecific signs and symptoms occurring in older adults such as decline in previous functional capacity, urinary incontinence, anorexia, confusion, or unexplained falls may be signs of infection, medication interaction, dehydration, constipation, or sleep deprivation. Nurses, by critically assessing the situation early, may identify a developing problem. Prompt and early diagnosis of the underlying problem may save costly extended hospitalization or even prevent life-threatening complications.

Knowledge and perception of stroke amongst hospital workers in an African community.

PubMed

Akinyemi, R O; Ogah, O S; Ogundipe, R F; Oyesola, O A; Oyadoke, A A; Ogunlana, M O; Otubogun, F M; Odeyinka, T F; Alabi, B S; Akinyemi, J O; Osinfade, J K; Kalaria, R N

2009-09-01

Stroke is a growing public health problem worldwide. Hospital workers are sources of knowledge on health issues including stroke. The present study aimed at assessing the knowledge and perception of a sample of Nigerian hospital workers about stroke. Hospital-based, cross-sectional survey. Respondents selected by systematic random sampling were interviewed using a 29-item pre-tested, structured, semi-closed questionnaire. There were 370 respondents (63% female, mean age: 34.4 +/- 7.5 years; 61% non-clinical workers). Twenty-nine per cent of respondents did not recognize the brain as the organ affected. Hypertension (88.6%) was the commonest risk factor identified; 13.8% identified evil spirit/witchcraft as a cause of stroke, whilst one-sided body weakness (61.9%) was most commonly identified as warning symptom. Hospital treatment was most preferred by 61.1% of respondents whilst spiritual healing was most preferred by 13.0%. In the bivariate analysis, higher level of education and being a clinical worker correlated with better stroke knowledge (P < 0.001). This study demonstrates gaps in the knowledge of these hospital workers about stroke, and treatment choice influenced by cultural and religious beliefs. Health education is still important, even, amongst health workers and stroke awareness campaigns may need to involve faith-based organizations.

University reforms spark mass protests

NASA Astrophysics Data System (ADS)

Cartlidge, Edwin

2011-02-01

A controversial bill designed to modernize Italy's underperforming universities has been signed into law despite critics warning that it will cut university resources, damage researchers' career prospects and reduce universities' autonomy.

Bullying Laws and Policies

MedlinePlus

... you provide is encrypted and transmitted securely. Menu Bullying What Is Bullying The Roles Kids Play Who Is at Risk Warning Signs for Bullying Effects of Bullying Diversity, Race & Religion LGBTQ Youth ...

Bullying and LGBTQ Youth

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... you provide is encrypted and transmitted securely. Menu Bullying What Is Bullying The Roles Kids Play Who Is at Risk Warning Signs for Bullying Effects of Bullying Diversity, Race & Religion LGBTQ Youth ...

Brain Aneurysm Warning Signs/Symptoms

MedlinePlus

... Physical Challenge Emotional Challenges Potential Deficits Strategies For Short-Term Memory Loss Rehabilitation Kinds of Therapy What to Expect Common Questions How Long Until I Get Better? Why am I so ...

Development of an Alert System to Detect Drug Interactions with Herbal Supplements using Medical Record Data.

PubMed

Archer, Melissa; Proulx, Joshua; Shane-McWhorter, Laura; Bray, Bruce E; Zeng-Treitler, Qing

2014-01-01

While potential medication-to-medication interaction alerting engines exist in many clinical applications, few systems exist to automatically alert on potential medication to herbal supplement interactions. We have developed a preliminary knowledge base and rules alerting engine that detects 259 potential interactions between 9 supplements, 62 cardiac medications, and 19 drug classes. The rules engine takes into consideration 12 patient risk factors and 30 interaction warning signs to help determine which of three different alert levels to categorize each potential interaction. A formative evaluation was conducted with two clinicians to set initial thresholds for each alert level. Additional work is planned add more supplement interactions, risk factors, and warning signs as well as to continue to set and adjust the inputs and thresholds for each potential interaction.

Stroke Atlas: A 3D Interactive Tool Correlating Cerebrovascular Pathology with Underlying Neuroanatomy and Resulting Neurological Deficits

PubMed Central

Nowinski, W.L.; Chua, B.C.

2013-01-01

Understanding stroke-related pathology with underlying neuroanatomy and resulting neurological deficits is critical in education and clinical practice. Moreover, communicating a stroke situation to a patient/family is difficult because of complicated neuroanatomy and pathology. For this purpose, we created a stroke atlas. The atlas correlates localized cerebrovascular pathology with both the resulting disorder and surrounding neuroanatomy. It also provides 3D display both of labeled pathology and freely composed neuroanatomy. Disorders are described in terms of resulting signs, symptoms and syndromes, and they have been compiled for ischemic stroke, hemorrhagic stroke, and cerebral aneurysms. Neuroanatomy, subdivided into 2,000 components including 1,300 vessels, contains cerebrum, cerebellum, brainstem, spinal cord, white matter, deep grey nuclei, arteries, veins, dural sinuses, cranial nerves and tracts. A computer application was developed comprising: 1) anatomy browser with the normal brain atlas (created earlier); 2) simulator of infarcts/hematomas/aneurysms/stenoses; 3) tools to label pathology; 4) cerebrovascular pathology database with lesions and disorders, and resulting signs, symptoms and/or syndromes. The pathology database is populated with 70 lesions compiled from textbooks. The initial view of each pathological site is preset in terms of lesion location, size, surrounding surface and sectional neuroanatomy, and lesion and neuroanatomy labeling. The atlas is useful for medical students, residents, nurses, general practitioners, and stroke clinicians, neuroradiologists and neurologists. It may serve as an aid in patient-doctor communication helping a stroke clinician explain the situation to a patient/family. It also enables a layman to become familiarized with normal brain anatomy and understand what happens in stroke. PMID:23859169

Stroke atlas: a 3D interactive tool correlating cerebrovascular pathology with underlying neuroanatomy and resulting neurological deficits.

PubMed

Nowinski, W L; Chua, B C

2013-02-01

Understanding stroke-related pathology with underlying neuroanatomy and resulting neurological deficits is critical in education and clinical practice. Moreover, communicating a stroke situation to a patient/family is difficult because of complicated neuroanatomy and pathology. For this purpose, we created a stroke atlas. The atlas correlates localized cerebrovascular pathology with both the resulting disorder and surrounding neuroanatomy. It also provides 3D display both of labeled pathology and freely composed neuroanatomy. Disorders are described in terms of resulting signs, symptoms and syndromes, and they have been compiled for ischemic stroke, hemorrhagic stroke, and cerebral aneurysms. Neuroanatomy, subdivided into 2,000 components including 1,300 vessels, contains cerebrum, cerebellum, brainstem, spinal cord, white matter, deep grey nuclei, arteries, veins, dural sinuses, cranial nerves and tracts. A computer application was developed comprising: 1) anatomy browser with the normal brain atlas (created earlier); 2) simulator of infarcts/hematomas/aneurysms/stenoses; 3) tools to label pathology; 4) cerebrovascular pathology database with lesions and disorders, and resulting signs, symptoms and/or syndromes. The pathology database is populated with 70 lesions compiled from textbooks. The initial view of each pathological site is preset in terms of lesion location, size, surrounding surface and sectional neuroanatomy, and lesion and neuroanatomy labeling. The atlas is useful for medical students, residents, nurses, general practitioners, and stroke clinicians, neuroradiologists and neurologists. It may serve as an aid in patient-doctor communication helping a stroke clinician explain the situation to a patient/family. It also enables a layman to become familiarized with normal brain anatomy and understand what happens in stroke.

Child Behavior Disorders

MedlinePlus

... a death in the family may cause a child to act out. Behavior disorders are more serious. ... The behavior is also not appropriate for the child's age. Warning signs can include Harming or threatening ...

Tsunamis

MedlinePlus

... Extreme Heat Older Adults (Aged 65+) Infants and Children Chronic Medical Conditions Low Income Athletes Outdoor Workers Pets Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ...

Volcanoes

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... Extreme Heat Older Adults (Aged 65+) Infants and Children Chronic Medical Conditions Low Income Athletes Outdoor Workers Pets Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ...

Stroke education using an animated cartoon and a manga for junior high school students.

PubMed

Shigehatake, Yuya; Yokota, Chiaki; Amano, Tatsuo; Tomii, Yasuhiro; Inoue, Yasuteru; Hagihara, Takaaki; Toyoda, Kazunori; Minematsu, Kazuo

2014-07-01

We investigated whether junior high school students could be educated regarding stroke with an animated cartoon and a Manga that we produced for the purpose of dissemination of this knowledge. We produced a 10-minute animated cartoon and a Manga that provided information regarding stroke risk factors, stroke signs and symptoms, and awareness to immediately contact emergent medical service (EMS) on identification of stroke signs and symptoms. From December 2011 to March 2012, 493 students in 15 classes of the first grade (age 12-13 years) of 3 junior high schools were enrolled in the study. Each subject watched the animated cartoon and read the Manga; this was referred to as "training." Lessons about stroke were not given. Questionnaires on stroke knowledge were evaluated at baseline, immediately after the training, and 3 months after the training. The proportion of correct answers given immediately after the training was higher for all questions, except those related to arrhythmia, compared with baseline. Percentage of correct answers given at 3 months was higher than that at baseline in questions related to facial palsy (75% versus 33%), speech disturbance (91% versus 60%), hemiplegia (79% versus 52%), numbness of 1 side (58% versus 51%), calling for EMS (90% versus 85%), alcohol intake (96% versus 72%), and smoking (69% versus 54%). At 3 months after the training, 56% of students answered the FAST (facial droop, arm weakness, speech disturbance, time to call for EMS) mnemonic correctly. Stroke education using these teaching aids of the animated cartoon and the Manga improved stroke knowledge in junior high school students. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Acute Transient Vestibular Syndrome: Prevalence of Stroke and Efficacy of Bedside Evaluation.

PubMed

Choi, Jae-Hwan; Park, Min-Gyu; Choi, Seo Young; Park, Kyung-Pil; Baik, Seung Kug; Kim, Ji-Soo; Choi, Kwang-Dong

2017-03-01

The aim of this study was to determine the prevalence of stroke and efficacy of bedside evaluation in diagnosing stroke in acute transient vestibular syndrome (ATVS). We performed a prospective, single-center, observational study that had consecutively recruited 86 patients presenting with ATVS to the emergency department of Pusan National University Yangsan Hospital from January to December 2014. All patients received a constructed evaluation, including HINTS plus (head impulse, nystagmus patterns, test of skew, and finger rubbing) and brain magnetic resonance imagings. Patients without an obvious cause further received perfusion-weighted imaging. Multivariable logistic regression was used to determine clinical parameters to identify stroke in ATVS. The prevalence of stroke was 27% in ATVS. HINTS plus could not be applied to the majority of patients because of the resolution of the vestibular symptoms, and magnetic resonance imagings were falsely negative in 43% of confirmed strokes. Ten patients (12%) showed unilateral cerebellar hypoperfusion on perfusion-weighted imaging without an infarction on diffusion-weighted imaging, and 8 of them had a focal stenosis or hypoplasia of the corresponding vertebral artery. The higher risk of stroke in ATVS was found in association with craniocervical pain (odds ratio, 9.6; 95% confidence interval, 2.0-45.2) and focal neurological symptoms/signs (odds ratio, 15.2; 95% confidence interval, 2.5-93.8). Bedside examination and routine magnetic resonance imagings have a limitation in diagnosing strokes presenting with ATVS, and perfusion imaging may help to identify strokes in ATVS of unknown cause. Associated craniocervical pain and focal neurological symptoms/signs are the useful clues for strokes in ATVS. © 2017 American Heart Association, Inc.

Teen Gambling

MedlinePlus

... Listen Español Text Size Email Print Share Teen Gambling Page Content Article Body How can I tell ... son or daughter is having a problem with gambling? Look for the following warning signs: Finding gambling " ...

Highway Funding 1995-1998

DOT National Transportation Integrated Search

2012-07-01

This document describes the system requirements for three connected vehicle V2I safety applications related to intersection safety and speed management. Specifically, these applications include: Red-Light Violation Warning (RLVW) Stop Sign Ga...

30 CFR 56.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... authorities for over-the-road use. Facilities other than magazines used to store blasting agents shall contain... appropriate warning signs that indicate the contents and are visible from each approach. ...

30 CFR 56.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... authorities for over-the-road use. Facilities other than magazines used to store blasting agents shall contain... appropriate warning signs that indicate the contents and are visible from each approach. ...

30 CFR 56.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... authorities for over-the-road use. Facilities other than magazines used to store blasting agents shall contain... appropriate warning signs that indicate the contents and are visible from each approach. ...

Usefulness of the volume-viscosity swallow test for screening dysphagia in subacute stroke patients in rehabilitation income.

PubMed

Guillén-Solà, Anna; Marco, Ester; Martínez-Orfila, Joan; Donaire Mejías, M Fernanda; Depolo Passalacqua, Marina; Duarte, Esther; Escalada, Ferran

2013-01-01

Swallowing disorders affect up to 35-85% of patients with stroke. Dysphagia complications can lead to malnutrition, dehydration, bronchoaspirative pneumonia and death, and have impact on health care costs. To evaluate the clinical screening capacity of the Volume Viscosity Swallow Test (V-VST) for oropharyngeal dysphagia and aspiration in a homogeneous stroke patient sample. Cohort study of 52 stroke patients in a subacute phase. Piecemeal deglutition and oropharyngeal residue were considered signs of impaired efficacy and cough, fall in oxygen saturation and voice changes, signs of impaired safety. Sensitivity, specificity, positive and negative predictive values, accuracy and likelihood ratios were calculated for V-VST results and compared with those of videofluoroscopy (VFS), the gold standard for studies on swallowing disorders. The V-VST is a highly sensitive and specific test to detect aspiration with sensitivity of 88.2% and specificity of 71.4%; negative predictive value was 92.6%; accuracy index was 0.74. Sensitivity and specificity for penetration were 34.3% and 70.6%, respectively; accuracy was 32%. The V-VST is low in cost, easy to use and very sensitive, meeting the requirements of oropharyngeal dysphagia and aspiration screening test in subacute stroke patients.

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome mimicking herpes simplex encephalitis on imaging studies.

PubMed

Gieraerts, Christopher; Demaerel, Philippe; Van Damme, Philip; Wilms, Guido

2013-01-01

We present a case in which mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes syndrome mimicked the clinical and radiological signs of herpes simplex encephalitis. In a patient with subacute encephalopathy, on computed tomography and magnetic resonance imaging, lesions were present in both temporal lobes extending to both insular regions with sparing of the lentiform nuclei and in both posterior straight and cingulate gyri. Final diagnosis of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes syndrome was based on biochemical investigations on cerebrospinal fluid, electromyogram, muscle biopsy, and genetic analysis. On diffusion-weighted imaging, diffusion restriction was present in some parts of the lesions but not throughout the entire lesions. We suggest that this could be an important sign in the differential diagnosis with herpes simplex encephalitis.

The value of vital sign trends for detecting clinical deterioration on the wards

PubMed Central

Churpek, Matthew M; Adhikari, Richa; Edelson, Dana P

2016-01-01

Aim Early detection of clinical deterioration on the wards may improve outcomes, and most early warning scores only utilize a patient’s current vital signs. The added value of vital sign trends over time is poorly characterized. We investigated whether adding trends improves accuracy and which methods are optimal for modelling trends. Methods Patients admitted to five hospitals over a five-year period were included in this observational cohort study, with 60% of the data used for model derivation and 40% for validation. Vital signs were utilized to predict the combined outcome of cardiac arrest, intensive care unit transfer, and death. The accuracy of models utilizing both the current value and different trend methods were compared using the area under the receiver operating characteristic curve (AUC). Results A total of 269,999 patient admissions were included, which resulted in 16,452 outcomes. Overall, trends increased accuracy compared to a model containing only current vital signs (AUC 0.78 vs. 0.74; p<0.001). The methods that resulted in the greatest average increase in accuracy were the vital sign slope (AUC improvement 0.013) and minimum value (AUC improvement 0.012), while the change from the previous value resulted in an average worsening of the AUC (change in AUC −0.002). The AUC increased most for systolic blood pressure when trends were added (AUC improvement 0.05). Conclusion Vital sign trends increased the accuracy of models designed to detect critical illness on the wards. Our findings have important implications for clinicians at the bedside and for the development of early warning scores. PMID:26898412

The value of vital sign trends for detecting clinical deterioration on the wards.

PubMed

Churpek, Matthew M; Adhikari, Richa; Edelson, Dana P

2016-05-01

Early detection of clinical deterioration on the wards may improve outcomes, and most early warning scores only utilize a patient's current vital signs. The added value of vital sign trends over time is poorly characterized. We investigated whether adding trends improves accuracy and which methods are optimal for modelling trends. Patients admitted to five hospitals over a five-year period were included in this observational cohort study, with 60% of the data used for model derivation and 40% for validation. Vital signs were utilized to predict the combined outcome of cardiac arrest, intensive care unit transfer, and death. The accuracy of models utilizing both the current value and different trend methods were compared using the area under the receiver operating characteristic curve (AUC). A total of 269,999 patient admissions were included, which resulted in 16,452 outcomes. Overall, trends increased accuracy compared to a model containing only current vital signs (AUC 0.78 vs. 0.74; p<0.001). The methods that resulted in the greatest average increase in accuracy were the vital sign slope (AUC improvement 0.013) and minimum value (AUC improvement 0.012), while the change from the previous value resulted in an average worsening of the AUC (change in AUC -0.002). The AUC increased most for systolic blood pressure when trends were added (AUC improvement 0.05). Vital sign trends increased the accuracy of models designed to detect critical illness on the wards. Our findings have important implications for clinicians at the bedside and for the development of early warning scores. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Without Warning: Worker Deaths From Heat 2014-2016.

PubMed

Roelofs, Cora

2018-01-01

Worker deaths from heat exposure are unlike heat deaths in the general population; workers tend to be outside in variable temperatures and younger than sixty-five years. Climate change will increase the frequency, duration, and variability of hot temperatures. Public health warning systems, such as the Heat Index of the National Weather Service, do not generally account for workers' greater likelihood of exposure to direct sunlight or exertion. Only 28% of the 79 worker heat-related fatalities during 2014-2016 occurred on days when the National Weather Service warning would have included the possibility of fatal heat stroke. Common heat illness prevention advice ignores workers' lack of control over their ability to rest and seek cooler temperatures. Additionally, acclimatization, or phased-in work in the heat, may be less useful given temperature variability under climate change. Workers' vulnerability and context of heat exposure should inform public health surveillance and response to prevent heat illness and death.

Improvement of the performance of animal crossing warning signs.

PubMed

Khalilikhah, Majid; Heaslip, Kevin

2017-09-01

Animal-vehicle collisions (AVCs) can result in serious injury and death to drivers, animals' death, and significant economic costs. However, the cost effectiveness of the majority of AVC mitigation measures is a significant issue. A mobile-based data collection effort was deployed to measure signs under the Utah Department of Transportation's (UDOT) jurisdiction. The crash data were obtained from the UDOT risk management database. ArcGIS was employed to link these two data sets and extract animal-related crashes and signs. An algorithm was developed to process the data and identify AVCs that occurred within sign recognition distance. Kernel density estimation (KDE) technique was applied to identify potential crash hotspots. Only 2% of AVCs occurred within the recognition distance of animal crossing signs. Almost 58% of animal-related crashes took place on the Interstate and U.S. highways, wherein only 30% of animal crossing signs were installed. State routes with a higher average number of signs experienced a lower number of AVCs per mile. The differences between AVCs that occurred within versus outside of sign recognition distance were not statistically significant regarding crash severity, time of crash, weather condition, driver age, vehicle speed, and type of animal. It is more likely that drivers become accustomed to deer crossing signs than cow signs. Based on the historical crash data and landscape structure, with attention given to the low cost safety improvement methods, a combination of different types of AVC mitigation measures can be developed to reduce the number of animal-related crashes. After an in-depth analysis of AVC data, warning traffic signs, coupled with other low cost mitigation countermeasures can be successfully placed in areas with higher priority or in critical areas. Practical applications: The findings of this study assist transportation agencies in developing more efficient mitigation measures against AVCs. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

The impact and acceptability of Canadian-style cigarette warning labels among U.S. smokers and nonsmokers.

PubMed

Peters, Ellen; Romer, Daniel; Slovic, Paul; Jamieson, Kathleen Hall; Wharfield, Leisha; Mertz, C K; Carpenter, Stephanie M

2007-04-01

Cigarette smoking is a major source of mortality and medical costs in the United States. More graphic and salient warning labels on cigarette packs as used in Canada may help to reduce smoking initiation and increase quit attempts. However, the labels also may lead to defensive reactions among smokers. In an experimental setting, smokers and nonsmokers were exposed to Canadian or U.S. warning labels. Compared with current U.S. labels, Canadian labels produced more negative affective reactions to smoking cues and to the smoker image among both smokers and nonsmokers without signs of defensive reactions from smokers. A majority of both smokers and nonsmokers endorsed the use of Canadian labels in the United States. Canadian-style warnings should be adopted in the United States as part of the country's overall tobacco control strategy.

Athletics, minor trauma, and pediatric arterial ischemic stroke.

PubMed

Sepelyak, Kathryn; Gailloud, Philippe; Jordan, Lori C

2010-05-01

Pediatric arterial ischemic stroke may occur as the result of trivial head or neck trauma sustained during a sports activity. We describe three cases of sports-related stroke in previously healthy school-age children and discuss acute and long-term stroke care. Possible mechanisms of sports-related stroke are addressed, as is evaluation for cause of stroke in children. In one of the reported cases, the child was found to have a vertebral artery dissection as the cause of his stroke, but no definitive cause of stroke was identified in the other two cases despite extensive evaluation. The advisability and timing of returning to athletic activities after stroke is also discussed. Many children with sports-related stroke are initially seen by a sports trainer, a pediatrician, or an ER physician. Thus, it is particularly important that these professionals are aware of the possibility of ischemic stroke occurring after even mild athletic injury. Childhood stroke may result from injuries sustained during athletic activities and should be considered when a child has acute focal neurologic signs.

Warning Signs of Heart Failure

MedlinePlus

... the two terms are used interchangeably. View an animation of heart failure . If you have been diagnosed ... resources here Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

Patient's Guide to Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

MedlinePlus

Skip to main content American Heart Association Science Volunteer Warning Signs Search for this keyword Search Advanced Search Donate Home About this Journal Editorial Board General Statistics Circulation Doodle Doodle Gallery ...

Heat emergencies

MedlinePlus

Heatstroke; Heat illness ... who is in good shape can suffer heat illness if warning signs are ignored. The following make ... Heat cramps are the first stage of heat illness. If these symptoms are not treated, it can ...

30 CFR 57.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... local authorities for over-the-road use. Facilities other than magazines used to store blasting agents... or other appropriate warning signs that indicate the contents and are visible from each approach. ...

30 CFR 57.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... local authorities for over-the-road use. Facilities other than magazines used to store blasting agents... or other appropriate warning signs that indicate the contents and are visible from each approach. ...

30 CFR 57.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... local authorities for over-the-road use. Facilities other than magazines used to store blasting agents... or other appropriate warning signs that indicate the contents and are visible from each approach. ...

Common Tests for Arrhythmia

MedlinePlus

... the heart's conduction system. Most significantly, it also triggers latent tachycardia or bradycardia . Induced tachycardias can usually ... Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms in Women 4 Warning Signs of a ...

Highway Performance Monitoring System reassessment

DOT National Transportation Integrated Search

2012-05-01

This document describes the concept of operations for three connected vehicle V2I safety applications related to intersection safety and speed management. Specifically, these applications include: Red-Light Violation Warning (RLVW) Stop Sign ...

Perception of Recurrent Stroke Risk among Black, White and Hispanic Ischemic Stroke and Transient Ischemic Attack Survivors: The SWIFT Study

PubMed Central

Boden-Albala, Bernadette; Carman, Heather; Moran, Megan; Doyle, Margaret; Paik, Myunghee C.

2011-01-01

Objectives Risk modification through behavior change is critical for primary and secondary stroke prevention. Theories of health behavior identify perceived risk as an important component to facilitate behavior change; however, little is known about perceived risk of vascular events among stroke survivors. Methods The SWIFT (Stroke Warning Information and Faster Treatment) study includes a prospective population-based ethnically diverse cohort of ischemic stroke and transient ischemic attack survivors. We investigate the baseline relationship between demographics, health beliefs, and knowledge on risk perception. Regression models examined predictors of inaccurate perception. Results Only 20% accurately estimated risk, 10% of the participants underestimated risk, and 70% of the 817 study participants significantly overestimated their risk for a recurrent stroke. The mean perceived likelihood of recurrent ischemic stroke in the next 10 years was 51 ± 7%. We found no significant differences by race-ethnicity with regard to accurate estimation of risk. Inaccurate estimation of risk was associated with attitudes and beliefs [worry (p < 0.04), fatalism (p < 0.07)] and memory problems (p < 0.01), but not history or knowledge of vascular risk factors. Conclusion This paper provides a unique perspective on how factors such as belief systems influence risk perception in a diverse population at high stroke risk. There is a need for future research on how risk perception can inform primary and secondary stroke prevention. Copyright © 2011 S. Karger AG, Basel PMID:21894045

Recall of indoor tanning salon warnings and safety guidelines among a national sample of tanners.

PubMed

Day, Ashley K; Coups, Elliot J; Manne, Sharon L; Stapleton, Jerod L

2016-12-01

Indoor tanning (IT) is a known carcinogen, and regulation has increased across the USA. However, there is minimal point-of-sale regulation for adult users. The purpose of the present study is to explore whether IT users recall being provided with warnings or safety guidelines at tanning salons. A national sample of 273 young adult, female IT users (mean age = 22.26, SD = 2.38) was surveyed regarding the frequency that they recalled being provided with six different warnings and safety guidelines when at tanning salons. Between 65 and 90.1 % of participants reported recalling the various warnings and guidelines. Having very fair skin was reported by 16.8 % of participants, and these high-risk individuals were less likely to recall having read and signed a consent form than other IT users (p = .002). The current level of regulation is insufficient to provide IT users with consistent warnings and safety guidelines at tanning salons.

Effects of posted point-of-sale warnings on alcohol consumption during pregnancy and on birth outcomes.

PubMed

Cil, Gulcan

2017-05-01

In 23 states and Washington D.C., alcohol retailers are required by law to post alcohol warning signs (AWS) that warn against the risks of drinking during pregnancy. Using the variation in the adoption of these laws across states and within states over time, I find a statistically significant reduction in prenatal alcohol use associated with AWS. I then use this plausibly exogenous change in drinking behavior to establish a causal link between prenatal alcohol exposure and birth outcomes. I find that AWS laws are associated with decreases in the odds of very low birth weight and very pre-term birth. Copyright © 2017 Elsevier B.V. All rights reserved.

46 CFR 183.220 - General safety provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... equipment and circuits must be clearly marked and identified. (e) Any cabinet, panel, box, or other enclosure containing more than one source of power must be fitted with a sign warning persons of this...

46 CFR 183.220 - General safety provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... equipment and circuits must be clearly marked and identified. (e) Any cabinet, panel, box, or other enclosure containing more than one source of power must be fitted with a sign warning persons of this...

46 CFR 183.220 - General safety provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... equipment and circuits must be clearly marked and identified. (e) Any cabinet, panel, box, or other enclosure containing more than one source of power must be fitted with a sign warning persons of this...

Teen Mental Health

MedlinePlus

... worthless could be warning signs of a mental health problem. Mental health problems are real, painful, and sometimes severe. You ... or others Feel depressed (sad and hopeless) Mental health problems can be treated. To find help, talk ...

Fact Sheet: Early Warning Signs of Psychosis

MedlinePlus

... 2 items) Genetics (1 item) Brain Anatomy and Physiology (1 item) Other Treatments (4 items) Coping with ... 2 items) Genetics (1 item) Brain Anatomy and Physiology (1 item) Other Treatments (4 items) Coping with ...

Warning Signs of Vision Problems in Children

MedlinePlus

... Life Family Life Family Life Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community ... and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually ...

24 CFR 3282.410 - Contents of notice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... home is repaired. (d) An evaluation of the risk to manufactured home occupants' safety and the... that warning would be, and any signs which the owner might see, hear, smell, or feel which might...

Microvascular Angina

MedlinePlus

... to the Terms and Conditions and Privacy Policy Heart Attack Tools & Resources My Cardiac Coach What Is a ... Heart Attack Warning Signs: Patient sheet | Infographic | Quiz Heart Attack • Home • About Heart Attacks Acute Coronary Syndrome (ACS) ...

Systemic Lupus Erythematosus (Lupus)

MedlinePlus

... lupus treatment. Treatment generally consists of a team approach. Learning to recognize the warning signs of a flare can help with reducing or preventing the flares. Systemic lupus erythematosus (lupus) happens when the body’s defense ...

Winter Weather Frequently Asked Questions

MedlinePlus

... Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ... PSAs for Disasters Resources for Emergency Health Professionals Social Media Health and Safety Concerns for All Disasters Animals ...

Winter Weather: Outdoor Safety

MedlinePlus

... Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ... PSAs for Disasters Resources for Emergency Health Professionals Social Media Health and Safety Concerns for All Disasters Animals ...

Health Effects of Tsunamis

MedlinePlus

... Extreme Heat Older Adults (Aged 65+) Infants and Children Chronic Medical Conditions Low Income Athletes Outdoor Workers Pets Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ...

Trench Foot or Immersion Foot

MedlinePlus

... Extreme Heat Older Adults (Aged 65+) Infants and Children Chronic Medical Conditions Low Income Athletes Outdoor Workers Pets Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ...

Mesenteric Lymphadenitis

MedlinePlus

... results from an intestinal infection. It mainly affects children and teens. This painful condition can mimic the warning signs ... see a doctor Abdominal pain is common in children and teens, and it can be hard to know when ...

Quantifying risk of adverse clinical events with one set of vital signs among primary care patients with hypertension.

PubMed

Tierney, William M; Brunt, Margaret; Kesterson, Joseph; Zhou, Xiao-Hua; L'Italien, Gil; Lapuerta, Pablo

2004-01-01

Hypertension is often uncontrolled. One reason might be physicians' reticence to modify therapy in response to single office measurements of vital signs. Using electronic records from an inner-city primary care practice, we extracted information about vital signs, diagnoses, test results, and drug therapy available on the first primary care visit in 1993 for patients with hypertension. We then identified multivariable predictors of subsequent vascular complications in the ensuing 5 years. Of 5,825 patients (mean age 57 years) previously treated for hypertension for 5.6 years, 7% developed myocardial infarctions, 17% had strokes, 24% developed ischemic heart disease, 22% had heart failure, 12% developed renal insufficiency, and 13% died in 5 years. Controlling for other clinical data, a 10-mmHg increase in systolic blood pressure was associated with 13% increased risk (95% confidence interval [CI], 6%-21%) of renal insufficiency, 9% (95% CI, 3%-15%) increased risk of ischemic heart disease, 7% (95% CI, 3%-11%) increased risk of stroke, and 6% (95% CI, 2%-9%) increased risk of first stroke or myocardial infarction. A 10-mmHg elevation in mean blood pressure predicted a 12% (95% CI, 5%-20%) increased risk of heart failure. An increase in heart rate of 10 beats per minute predicted a 16% (95% CI, 2%-5%) increased risk of death. Diastolic blood pressure predicted only a 13% (95% CI, 4%-23%) increased risk of first stroke. Vital signs-especially systolic blood pressure-recorded routinely during a single primary care visit had significant prognostic value for multiple adverse clinical events among patients treated for hypertension and should not be ignored by clinicians.

Management of dengue in Australian travellers: a retrospective multicentre analysis.

PubMed

Tai, Alex Yc; McGuinness, Sarah L; Robosa, Roselle; Turner, David; Huang, G Khai Lin; Leder, Karin; Korman, Tony M; Thevarajan, Irani; Stewardson, Andrew J; Padiglione, Alexander A; Johnson, Douglas F

2017-04-17

To describe the epidemiology, clinical and laboratory features and outcomes of dengue in returned Australian travellers, applying the revised WHO dengue classification (2009) to this population. Retrospective case series analysis of confirmed dengue cases hospitalised at one of four Australian tertiary hospitals, January 2012 - May 2015. Clinical features, laboratory findings and outcomes of patients with dengue; dengue classification according to 2009 WHO guidelines. 208 hospitalised patients (median age, 32 years; range, 4-76 years) were included in the study. Dengue was most frequently acquired in Indonesia (94 patients, 45%) and Thailand (40, 19%). The most common clinical features were fever (98% of patients) and headache (76%). 84 patients (40%) met the WHO criteria for dengue with warning signs, and one the criteria for severe dengue; the most common warning signs were mucosal bleeding (44 patients, 21%) and abdominal pain (43, 21%). Leukopenia (176 patients, 85%), thrombocytopenia (133, 64%), and elevated liver enzyme levels (154, 76%) were the most common laboratory findings. 46 patients (22%) had serological evidence of previous exposure to dengue virus. WHO guidelines were documented as a management benchmark in ten cases (5%); 46 patients (22%) received non-steroidal anti-inflammatory drugs (NSAIDs). A significant proportion of returning Australian travellers hospitalised for dengue have unrecognised warning signs of severe disease. Many received NSAIDs, which can increase the risk of haemorrhage in dengue. As travel to Asia from Australia continues to increase, it is vital for averting serious outcomes that clinicians can recognise and manage dengue.

The revised WHO dengue case classification: does the system need to be modified?

PubMed

Hadinegoro, Sri Rezeki S

2012-05-01

There has been considerable debate regarding the value of both the 1997 and 2009 World Health Organization (WHO) dengue case classification criteria for its diagnosis and management. Differentiation between classic dengue fever (DF) and dengue haemorrhagic fever (DHF) or severe dengue is a key aspect of dengue case classification. The geographic expansion of dengue and its increased incidence in older age groups have contributed to the limited applicability of the 1997 case definitions. Clinical experience of dengue suggests that the illness presents as a spectrum of disease instead of distinct phases. However, despite the rigid grouping of dengue into DF, DHF and dengue shock syndrome (DSS), overlap between the different manifestations has often been observed, which has affected clinical management and triage of patients. The findings of the DENCO study evaluating the 1997 case definitions formed the basis of the revised 2009 WHO case definitions, which classified the illness into dengue with and without warning signs and severe dengue. Although the revised scheme is more sensitive to the diagnosis of severe dengue, and beneficial to triage and case management, there remain issues with its applicability. It is considered by many to be too broad, requiring more specific definition of warning signs. Quantitative research into the predictive value of these warning signs on patient outcomes and the cost-effectiveness of the new classification system is required to ascertain whether the new classification system requires further modification, or whether elements of both classification systems can be combined.

STARTING-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Intravenous Thrombolysis for Stroke.

PubMed

Cappellari, Manuel; Turcato, Gianni; Forlivesi, Stefano; Zivelonghi, Cecilia; Bovi, Paolo; Bonetti, Bruno; Toni, Danilo

2018-02-01

Symptomatic intracerebral hemorrhage (sICH) is a rare but the most feared complication of intravenous thrombolysis for ischemic stroke. We aimed to develop and validate a nomogram for individualized prediction of sICH in intravenous thrombolysis-treated stroke patients included in the multicenter SITS-ISTR (Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register). All patients registered in the SITS-ISTR by 179 Italian centers between May 2001 and March 2016 were originally included. The main outcome measure was sICH per the European Cooperative Acute Stroke Study II definition (any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline or death <7 days). On the basis of multivariate logistic model, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver-operating characteristic curve and calibration of risk prediction model by using the Hosmer-Lemeshow test. A total of 15 949 patients with complete data for generating the nomogram was randomly dichotomized into training (3/4; n=12 030) and test (1/4; n=3919) sets. After multivariate logistic regression, 10 variables remained independent predictors of sICH to compose the STARTING-SICH (systolic blood pressure, age, onset-to-treatment time for thrombolysis, National Institutes of Health Stroke Scale score, glucose, aspirin alone, aspirin plus clopidogrel, anticoagulant with INR ≤1.7, current infarction sign, hyperdense artery sign) nomogram. The area under the receiver-operating characteristic curve of STARTING-SICH was 0.739. Calibration was good ( P =0.327 for the Hosmer-Lemeshow test). The STARTING-SICH is the first nomogram developed and validated in a large SITS-ISTR cohort for individualized prediction of sICH in intravenous thrombolysis-treated stroke patients. © 2018 American Heart Association, Inc.

Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study.

PubMed

Paliwoda, Michelle; New, Karen; Bogossian, Fiona

2016-09-01

All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. A retrospective case-control study. A maternity unit in a tertiary public hospital in Australia. Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of care. The Standard Observation Tool triggered an escalation of care more frequently than the Early Warning Tools, which may be as a result of behavioural data captured on the Standard Observation Tool and escalated, which could not be on the Early Warning Tools. Findings demonstrate that a single tool applied to all gestational age ranges may not be effective in identifying early deterioration or may over trigger an escalation of care. Further research is required into the sensitivity and specificity of Early Warning Tools in neonatal sub-populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

CDC Vital Signs: Preventing Melanoma

MedlinePlus

... not use the device. Include warning statements in marketing materials about the risk of using the device. ... MB] en Español [PDF – 1.16 MB] CDC Digital Press Kit Read the MMWR Science Clips Language: ...

Keep Your Skin Healthy: Protecting Your Outer Self

MedlinePlus

... A yellow tint might indicate liver disease. And dark or unusual moles might be a warning sign ... Household Burns Your Microbes and You Healthy Skin Matters Skin Care and Aging Skin Cancer (Including Melanoma) ...

Community Outreach and Education on Soil Fumigants

EPA Pesticide Factsheets

Information on how outreach programs can help address the risk of bystander exposure by educating community members about fumigants, buffer zones, how to recognize warning signs, and how to respond appropriately in case of an incident.

Warning signs and symptoms of heart disease

MedlinePlus

... RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier ... RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier ...

30 CFR 75.1403-10 - Criteria-Haulage; general.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Warning lights or reflective signs or tapes should be installed along haulage roads at locations of abrupt... pulled by animals. (b) Cars on main haulage roads should not be pushed, except where necessary to push...

30 CFR 75.1403-10 - Criteria-Haulage; general.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Warning lights or reflective signs or tapes should be installed along haulage roads at locations of abrupt... pulled by animals. (b) Cars on main haulage roads should not be pushed, except where necessary to push...

30 CFR 75.1403-10 - Criteria-Haulage; general.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Warning lights or reflective signs or tapes should be installed along haulage roads at locations of abrupt... pulled by animals. (b) Cars on main haulage roads should not be pushed, except where necessary to push...

30 CFR 75.1403-10 - Criteria-Haulage; general.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Warning lights or reflective signs or tapes should be installed along haulage roads at locations of abrupt... pulled by animals. (b) Cars on main haulage roads should not be pushed, except where necessary to push...

30 CFR 75.1403-10 - Criteria-Haulage; general.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Warning lights or reflective signs or tapes should be installed along haulage roads at locations of abrupt... pulled by animals. (b) Cars on main haulage roads should not be pushed, except where necessary to push...

Expert Locator: Immunologists

MedlinePlus

... Educational materials & the 10 Warning Signs MEDICAL ACADEMY Access Research Grants, Travel Grants & more WJMF Read breaking news & view our PSA Campaign TOWN HALL Advocate with JMF about important PI topics INTERNET CAFÉ Connect with the PI Community VILLAGE PARK ...

Jeffrey Modell Foundation

MedlinePlus

... Educational materials & the 10 Warning Signs MEDICAL ACADEMY Access Research Grants, Travel Grants & more WJMF Read breaking news & view our PSA Campaign TOWN HALL Advocate with JMF about important PI topics INTERNET CAFÉ Connect with the PI Community VILLAGE PARK ...

Pediatric Rapid Response Team: Vital Sign Based System vs. Pediatric Early Warning Score System

DTIC Science & Technology

2017-09-16

quality improvement initiative using the evidence-based PEWS criteria to improve recognition of deteriorating pediatric patients, allocation of PRRT resources, and pediatric staff satisfaction regarding the PRRT process.

Spot Sign in Acute Intracerebral Hemorrhage in Dynamic T1-Weighted Magnetic Resonance Imaging.

PubMed

Schindlbeck, Katharina A; Santaella, Anna; Galinovic, Ivana; Krause, Thomas; Rocco, Andrea; Nolte, Christian H; Villringer, Kersten; Fiebach, Jochen B

2016-02-01

In computed tomographic imaging of acute intracerebral hemorrhage spot sign on computed tomographic angiography has been established as a marker for hematoma expansion and poor clinical outcome. Although, magnetic resonance imaging (MRI) can accurately visualize acute intracerebral hemorrhage, a corresponding MRI marker is lacking to date. We prospectively examined 50 consecutive patients with acute intracerebral hemorrhage within 24 hours of symptom onset. The MRI protocol consisted of a standard stroke protocol and dynamic contrast-enhanced T1-weighted imaging with a time resolution of 7.07 s/batch. Stroke scores were assessed at admission and at time of discharge. Volume measurements of hematoma size and spot sign were performed with MRIcron. Contrast extravasation within sites of the hemorrhage (MRI spot sign) was seen in 46% of the patients. Patients with an MRI spot sign had a significantly shorter time to imaging than those without (P<0.001). The clinical outcome measured by the modified Rankin Scale was significantly worse in patients with spot sign compared with those without (P≤0.001). Hematoma expansion was observed in the spot sign group compared with the nonspot sign group, although the differences were not significant. Spot sign can be detected using MRI on postcontrast T1-weighted and dynamic T1-weighted images. It is associated with worse clinical outcome. The time course of contrast extravasation in dynamic T1 images indicates that these spots represent ongoing bleeding. © 2015 American Heart Association, Inc.

Enhanced early warning system impact on nursing practice: A phenomenological study.

PubMed

Burns, Kathleen A; Reber, Tracey; Theodore, Karen; Welch, Brenda; Roy, Debra; Siedlecki, Sandra L

2018-05-01

To determine how an enhanced early warning system has an impact on nursing practice. Early warning systems score physiologic measures and alert nurses to subtle changes in patient condition. Critics of early warning systems have expressed concern that nurses would rely on a score rather than assessment skills and critical thinking to determine the need for intervention. Enhancing early warning systems with innovative technology is still in its infancy, so the impact of an enhanced early warning system on nursing behaviours or practice has not yet been studied. Phenomenological design. Scripted, semistructured interviews were conducted in September 2015 with 25 medical/surgical nurses who used the enhanced early warning system. Data were analysed using thematic analysis techniques (coding and bracketing). Emerging themes were examined for relationships and a model describing the enhanced early warning system experience was developed. Nurses identified awareness leading to investigation and ease of prioritization as the enhanced early warning system's most important impact on their nursing practice. There was also an impact on organizational culture, with nurses reporting improved communication, increased collaboration, increased accountability and proactive responses to early changes in patient condition. Rather than hinder critical thinking, as many early warning systems' critics claim, nurses in this study found that the enhanced early warning system increased their awareness of changes in a patient's condition, resulting in earlier response and reassessment times. It also had an impact on the organization by improving communication and collaboration and supporting a culture of proactive rather than reactive response to early signs of deterioration. © 2017 John Wiley & Sons Ltd.

Safety Outcomes Using a Proximal Protection Device in Carotid Stenting of Long Carotid Stenoses

PubMed Central

Atchaneeyasakul, Kunakorn; Khandelwal, Priyank; Ambekar, Sudheer; Ramdas, Kevin; Guada, Luis; Yavagal, Dileep

2016-01-01

Background Embolic protection devices can prevent atherosclerotic emboli during carotid stenting. Newer proximal protection devices reverse flow in the internal carotid artery (ICA), leading to reduction in perioperative microemboli. The risk of stroke is high for carotid stenting of ICA lesions with a length >10 mm and/or angiographic string sign. Objective We aimed to evaluate the safety outcomes of proximal embolic protection device usage in this high-risk group. Methods This is a retrospective analysis of patients who underwent carotid stenting procedures with proximal embolic protection devices at a tertiary care center. High-risk features for adverse events with carotid stenting were identified. Peri- and postprocedural outcomes were recorded. We further compared outcomes in patients with a carotid stenosis length >10 mm to those with shorter stenosis. Results From January 2011 to December 2014, we included 27 patients; 96.3% were symptomatic and 3.7% were asymptomatic. There was a stent placement technical success rate of 100%. No major stroke or coronary events were recorded. One minor stroke event developed in one patient. A carotid lesion length >10 mm and/or angiographic string sign was noted in 21/27 patients, with an average lesion length of 14.4 mm. One patient (4.8%) in this group developed a minor stroke event. Neither a coronary nor a major stroke event was recorded in this group. There was no significant difference in the complication rate between the long lesion and the control group. Conclusion In our patient cohort, it was found that a proximal embolic protection device is safe for patients with carotid stenosis, including those with a carotid lesion length >10 mm and/or angiographic string sign. PMID:27781040

Race/ethnic Differences in Post-stroke Depression (PSD): Findings from the Stroke Warning Information and Faster Treatment (SWIFT) Study.

PubMed

Goldmann, Emily; Roberts, Eric T; Parikh, Nina S; Lord, Aaron S; Boden-Albala, Bernadette

2016-01-21

Post-stroke depression (PSD) is common and associated with poor stroke outcomes, but few studies have examined race/ethnic disparities in PSD. Given the paucity of work and inconsistent findings in this important area of research, our study aimed to examine race/ethnic differences in depression in a multi-ethnic cohort of stroke patients. Longitudinal. Prospective trial of a post-stroke educational intervention. 1,193 mild/moderate ischemic stroke/transient ischemic attack (TIA) patients. We used the Center for Epidemiologic Studies Depression (CES-D) Scale to assess subthreshold (CES-D score 8-15) and full (CES-D score ≥ 16) depression at one month ("early") and 12 months ("late") following stroke. Multinomial logistic regression analyses examined the association between race/ethnicity and early and late PSD separately. The prevalence of subthreshold and full PSD was 22.5% and 32.6% in the early period and 22.0% and 27.4% in the late period, respectively. Hispanics had 60% lower odds of early full PSD compared with non-Hispanic Whites after adjusting for other covariates (OR=.4, 95% CI: .2, .8). Race/ethnicity was not significantly associated with late PSD. Hispanic stroke patients had half the odds of PSD in early period compared with Whites, but no difference was found in the later period. Further studies comparing trajectories of PSD between race/ethnic groups may further our understanding of race/ethnic disparities in PSD and help identify effective interventions.

Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest.

PubMed

Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla C; Petersson, Göran I; Bath, Peter A

2016-03-01

Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPAC™ Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. © The Author(s) 2014.

A Detection Device for the Signs of Human Life in Accident

NASA Astrophysics Data System (ADS)

Ning, Li; Ruilan, Zhang; Jian, Liu; Ruirui, Cheng; Yuhong, Diao

2017-12-01

A detection device for the signs of human life in accidents is a device used in emergency situations, such as the crash site. the scene of natural disasters, the battlefield ruins. it designed to detect the life signs of the distress under the injured ambulance vital signs devices. The device can on human vital signs, including pulse, respiration physiological signals to make rapid and accurate response. After some calculations, and after contrast to normal human physiological parameters given warning signals, in order for them to make timely ambulance judgment. In this case the device is required to do gymnastics convenience, ease of movement, power and detection of small flexible easy realization. This device has the maximum protection of the wounded safety significance.

Pharmacogenetic Associations of β1-Adrenergic Receptor Polymorphisms With Cardiovascular Outcomes in the SPS3 Trial (Secondary Prevention of Small Subcortical Strokes).

PubMed

Magvanjav, Oyunbileg; McDonough, Caitrin W; Gong, Yan; McClure, Leslie A; Talbert, Robert L; Horenstein, Richard B; Shuldiner, Alan R; Benavente, Oscar R; Mitchell, Braxton D; Johnson, Julie A

2017-05-01

Functional polymorphisms (Ser49Gly and Arg389Gly) in ADRB1 have been associated with cardiovascular and β-blocker response outcomes. Herein we examined associations of these polymorphisms with major adverse cardiovascular events (MACE), with and without stratification by β-blocker treatment in patients with a history of stroke. Nine hundred and twenty-six participants of the SPS3 trial's (Secondary Prevention of Small Subcortical Strokes) genetic substudy with hypertension were included. MACE included stroke, myocardial infarction, and all-cause death. Kaplan-Meier and multivariable Cox regression analyses were used. Because the primary component of MACE was ischemic stroke, we tested the association of Ser49Gly with ischemic stroke among 41 475 individuals of European and African ancestry in the NINDS (National Institute of Neurological Disorders and Stroke) SiGN (Stroke Genetics Network). MACE was higher in carriers of the Gly49 allele than in those with the Ser49Ser genotype (10.5% versus 5.4%, log-rank P =0.005). Gly49 carrier status was associated with MACE (hazard ratio, 1.62; 95% confidence interval, 1.00-2.68) and ischemic stroke (hazard ratio, 1.81; 95% confidence interval, 1.01-3.23) in SPS3 and with small artery ischemic stroke (odds ratio, 1.14; 95% confidence interval, 1.03-1.26) in SiGN. In SPS3, β-blocker-treated Gly49 carriers had increased MACE versus non-β-blocker-treated individuals and noncarriers (hazard ratio, 2.03; 95% confidence interval, 1.20-3.45). No associations were observed with the Arg389Gly polymorphism. Among individuals with previous small artery ischemic stroke, the ADRB1 Gly49 polymorphism was associated with MACE, particularly small artery ischemic stroke, a risk that may be increased among β-blocker-treated individuals. Further research is needed to define β-blocker benefit among ischemic stroke patients by ADRB1 genotype. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059306. © 2017 American Heart Association, Inc.

The Role of Cash Flow in Financial Early Warning of Agricultural Enterprises Based on Logistic Model

NASA Astrophysics Data System (ADS)

Sun, Fengru

2018-01-01

This paper chooses the agricultural listed companies as the research object, compares the financial situation of the enterprise and the theory of financial early warning, combines the financial status of the agricultural listed companies, selects the relevant cash flow indicators, discusses the application of the Logistic financial early warning model in the agricultural listed companies, Agricultural enterprises get better development. Research on financial early warning of agricultural listed companies will help the agricultural listed companies to predict the financial crisis. Financial early warning model is simple to establish, operational and strong, the use of financial early warning model, to help enterprises in the financial crisis before taking rapid and effective measures, which can avoid losses. Help enterprises to discover signs of deterioration of the financial situation in time to maintain the sustainable development of agricultural enterprises. In addition, through the financial early warning model, investors can correctly identify the financial situation of agricultural enterprises, and can evaluate the financial situation of agricultural enterprises and to help investors to invest in scientific and rational, beneficial to investors to analyze the safety of investment. But also help the relevant regulatory agencies to effectively monitor the market and promote the healthy and stable development of the market.

Evaluation of the Prince William County collision countermeasure system.

DOT National Transportation Integrated Search

2001-02-01

The Collision Countermeasure System (CCS) is an ITS application intended to reduce side-impact accident potential at rural, limited sight-distance intersections. It consists of activated warning signs and pavement loop detectors designed to enhance d...

Who's at Risk? Warning Signs | NIH MedlinePlus the Magazine

MedlinePlus

... this page please turn Javascript on. Feature: Preventing Suicides Who's at Risk? Past Issues / Winter 2010 Table ... times more likely than women to die from suicide. However, three times more women than men attempt ...

Implementation of aerial LiDAR technology to update highway feature inventory.

DOT National Transportation Integrated Search

2016-12-01

Highway assets, including traffic signs, traffic signals, light poles, and guardrails, are important components of : transportation networks. They guide, warn and protect drivers, and regulate traffic. To manage and maintain the : regular operation o...

77 FR 55099 - National Prostate Cancer Awareness Month, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... be more likely to develop the disease. Most men who suffer from prostate cancer are over the age of... learn the warning signs of this disease. My Administration will continue to stand with men and their...

Mouth Growths

MedlinePlus

... also may become cancer over time. Oral cancer People who use tobacco, alcohol, or both are at much greater ... of cancer, and although evaluation is not urgent, people with warning signs (particularly those who use tobacco) should not put off being evaluated. Because ...

Special Problems in the Library Setting.

ERIC Educational Resources Information Center

Keller, Daniel P.

1997-01-01

Discussion of violence in the workplace focuses on libraries. Highlights include types of violence in libraries; recognizing warning signs of employee violence; preventive action; and strategies for a safer library, including appropriate security systems and other devices. (LRW)

21 CFR 1250.67 - Watering equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... permanent signs warning that the water is unfit for drinking. (c) Ice. If bulk ice is used for the cooling..., washing, handling, and delivery to conveyances of such bulk ice, and such equipment shall be used for no...

21 CFR 1250.67 - Watering equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... permanent signs warning that the water is unfit for drinking. (c) Ice. If bulk ice is used for the cooling..., washing, handling, and delivery to conveyances of such bulk ice, and such equipment shall be used for no...

21 CFR 1250.67 - Watering equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... permanent signs warning that the water is unfit for drinking. (c) Ice. If bulk ice is used for the cooling..., washing, handling, and delivery to conveyances of such bulk ice, and such equipment shall be used for no...

21 CFR 1250.67 - Watering equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... permanent signs warning that the water is unfit for drinking. (c) Ice. If bulk ice is used for the cooling..., washing, handling, and delivery to conveyances of such bulk ice, and such equipment shall be used for no...

77 FR 53189 - Notice of Public Meetings for the Draft Legislative Environmental Impact Statement for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

... and facilitate maintenance of prohibited entry and hazardous area warning signs along the CMAGR... military training. Selection of this alternative would trigger planning and actions to compensate for the...

Some interactions among driver, vehicle, and roadway variables in normal driving

NASA Technical Reports Server (NTRS)

Ritchie, M. L.; Howard, J. M.; Myers, W. D.

1972-01-01

Effects of road and vehicle conditions, visual warning signs, direction of turns, night time, and skill on automobile driver performance are studied in several experiments. Considered criteria are variability in speed and acceleration.

Aging Parents: 7 Warning Signs of Health Problems

MedlinePlus

... or smell as good as it used to. Social issues. Your parents might have difficulty shopping or have ... 27, 2017. Tomioka K, et al. Association between social participation and ... 2018. Dec. 13, 2017 Original article: http://www. ...

A Lightning Safety Primer for Camps.

ERIC Educational Resources Information Center

Attarian, Aram

1992-01-01

Provides the following information about lightning, which is necessary for camp administrators and staff: (1) warning signs of lightning; (2) dangers of lightning; (3) types of lightning injuries; (4) prevention of lightning injury; and (5) helpful training tips. (KS)

The role of nitrous oxide in stroke

PubMed Central

Zhang, Zhu-wei; Zhang, Dong-ping; Li, Hai-ying; Wang, Zhong; Chen, Gang

2017-01-01

Stroke that is caused by poor blood flow into the brain results in cell death, including ischemia stroke due to lack of blood into brain tissue, and hemorrhage due to bleeding. Both of them will give rise to the dysfunction of brain. In general, the signs and symptoms of stroke are the inability of feeling or moving on one side of body, sometimes loss of vision to one side. Above symptoms will appear soon after the stroke has happened. If the symptoms and signs happen in 1 or 2 hours, we often call them as transient ischemic attack. Moreover, hemorrhagic stroke often leads to severe headache. It is known that neuronal death can happen after stroke, and it depends upon the activation of N-methyl-D-aspartate (NMDA) excitatory glutamate receptor which is the goal for a lot of neuroprotective agents. Nitrous oxide was discovered by Joseph Priestley in 1772, and then he and his friends, including the poet Coleridge and Robert Sauce, experimented with the gas. They found this gas could make patients loss the sense of pain and still maintain consciousness after inhalation. Shortly the gas was used as an anesthetic, especially in the field of dentists. Now, accroding to theme of Helene N. David and other scientists, both of nitrous oxide at 75 vol% and xenon at 50 vol% could reduce ischemic neuronal death in the cortex by 70% and decrease NMDA-induced Ca2+ influx by 30%. Therefore, more clinical and experimental studies are important to illuminate the mechanisms of how nitrous oxide protects brain tissue and to explore the best protocol of this gas in stroke treatment. PMID:29497489

Cancer awareness changes after an educational intervention among undergraduate students.

PubMed

Hwang, Lih-Lian

2013-06-01

The objectives of this study are to assess undergraduate awareness of cancer risk factors, prevention strategies, and warning signs and to evaluate whether an educational intervention increases cancer awareness. This study adopts a nonequivalent control group pretest-posttest design. Of the 386 students who completed the pretest, only 35-39 % identified low fruit and vegetable intake, being overweight, and physical inactivity as cancer risk factors, and <30 % recognized persistent changes in bowel or bladder habits and persistent cough or hoarseness as cancer warning signs. After the educational intervention, the analysis of variance of changes from baseline (the pretest score) for all four experimental groups were all significantly higher than those of the two control groups (p ≤.001), except for the change of the retention test score from the pretest score for experimental group 3. This study highlights the need to improve undergraduates' cancer awareness and the effectiveness of educational intervention.