WorldWideScience

Sample records for identify emerging properties

  1. Investigations regarding the lowering of specific intellectual property risks identified in the production process

    Directory of Open Access Journals (Sweden)

    Pakocs Ramona

    2017-01-01

    Full Text Available The main purpose of this research is to decrease the emergence of specific intellectual property risks within the production process as well as increasing risk management performance of IP by preventing them. In order to achieve this, previous studies regarding the main specific intellectual property risks from industrial companies were analyzed together with their managerial methods as well as the possibility of reducing their emergence. As a result of the research conducted were identified five types of intellectual property risks that have a high potential of emergence in the production process, namely: the risk of production of goods in violation of IP rights; the know-how, production knowledge and trade secret disclosure risk; the technological risk of unprotected utility models; the technological risk of unprotected integrated circuits topographies and finally the risk of product counterfeit. In order to achieve the main purpose of our investigation, we have proposed new formulas for estimating the specific intellectual property risks identified in the production process. Their purpose was to minimalize the risk’s negative effects on industrial companies and to increase the managerial performance from the intellectual property domain through a new type of management appropriately named: intellectual property management. The research is finalized with a case study regarding the lapse of rights of a patented invention. Based on a case analysis, it was proved that the exploitation of an invention without a contract represents a counterfeit.

  2. A bibliometric model for identifying emerging research topics

    DEFF Research Database (Denmark)

    Wang, Qi

    2018-01-01

    –1843, 2015), the most serious problems are the lack of an acknowledged definition of emergence and incomplete elaboration of the linkages between the definitions that are used and the indicators that are created. With these issues in mind, this study first adjusts the definition of an emerging technology...... that Rotolo et al. (2015) have proposed to accommodate the analysis. Next, a set of criteria for the identification of emerging topics is proposed according to the adjusted definition and attributes of emergence. Using two sets of parameter values, several emerging research topics are identified. Finally...

  3. Emergent Properties in Natural and Artificial Dynamical Systems

    CERN Document Server

    Aziz-Alaoui, M.A

    2006-01-01

    An important part of the science of complexity is the study of emergent properties arising through dynamical processes in various types of natural and artificial systems. This is the aim of this book, which is the outcome of a discussion meeting within the first European conference on complex systems. It presents multidisciplinary approaches for getting representations of complex systems and using different methods to extract emergent structures. This carefully edited book studies emergent features such as self organization, synchronization, opening on stability and robustness properties. Invariant techniques are presented which can express global emergent properties in dynamical and in temporal evolution systems. This book demonstrates how artificial systems such as a distributed platform can be used for simulation used to search emergent placement during simulation execution.

  4. From System Complexity to Emergent Properties

    CERN Document Server

    Aziz-Alaoui, M. A

    2009-01-01

    Emergence and complexity refer to the appearance of higher-level properties and behaviours of a system that obviously comes from the collective dynamics of that system's components. These properties are not directly deductable from the lower-level motion of that system. Emergent properties are properties of the "whole'' that are not possessed by any of the individual parts making up that whole. Such phenomena exist in various domains and can be described, using complexity concepts and thematic knowledges. This book highlights complexity modelling through dynamical or behavioral systems. The pluridisciplinary purposes, developped along the chapters, are enable to design links between a wide-range of fundamental and applicative Sciences. Developing such links - instead of focusing on specific and narrow researches - is characteristic of the Science of Complexity that we try to promote by this contribution.

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

    Science.gov (United States)

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

    2018-04-01

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

  6. Scientometric methods for identifying emerging technologies

    Science.gov (United States)

    Abercrombie, Robert K; Schlicher, Bob G; Sheldon, Frederick T

    2015-11-03

    Provided is a method of generating a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, worldwide patents, news archives, and on-line mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain.

  7. Role of Pediatric Emergency Physicians in Identifying Bullying.

    Science.gov (United States)

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

    2017-02-01

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

  8. Bacterial social interactions and the emergence of community-intrinsic properties

    DEFF Research Database (Denmark)

    Madsen, Jonas Stenløkke; Sørensen, Søren Johannes; Burmølle, Mette

    2018-01-01

    Bacterial communities are dominated and shaped by social interactions, which facilitate the emergence of properties observed only in the community setting. Such community-intrinsic properties impact not only the phenotypes of cells in a community, but also community composition and function...... on community composition and interactions in multispecies biofilms. We hereby wish to emphasize the importance of studying social interactions in settings where community-intrinsic properties are likely to emerge....

  9. Identifying Emerging Trends of Financial Business Method Patents

    Directory of Open Access Journals (Sweden)

    Won Sang Lee

    2017-09-01

    Full Text Available Financial technology has become an important part of the banking industry in recent times. This study attempts to propose a framework to identify emerging areas and trends using financial business method patents. Based on the abstracts of financial business method patents registered at the United States Patent and Trademark Office, this study first applies latent Dirichlet allocation to identify emerging topics. The probability of the annual occurrence of each topic is adjusted through the exponentially weighted moving average to reflect the importance of the recent probability of topics. Each topic is classified as “hot” or “cold” depending on whether the exponentially weighted moving average of the probabilities exceeds the threshold. We applied survival analysis to the time gap of recurrently becoming hot from a cold status with the associated factor of financial business method patents. The findings suggest that the topic with the short granted period and high forward citation is likely to become hot. In addition, the topic that is aged and specific in narrow areas is likely to continuously change into the hot or cold status. The approach proposed in this study contributes toward understanding topic emergence in the financial area and pursuing sustainable development.

  10. Identifying and Managing Engineering Design Requirements for Emerging Markets

    DEFF Research Database (Denmark)

    Li, Xuemeng

    , especially for those companies originally from developed markets, to acquire an in-depth understanding of particular design requirements in emerging markets in order to adapt both company products and approaches in such contexts. Prior studies on the identification and management of design requirements have...... predominantly been conducted in the context of developed countries and relatively affluent markets. Emerging markets are distinct from developed markets in terms of numerous contextual factors, e.g., regulatory environments and competitive landscapes. These factors influence the requirement identification...... attention. There is a need for an overview of different perspectives in requirement identification for manufacturing companies and their corresponding assessments in the context of emerging markets. Therefore, this research project is motivated to 1) investigate the process of identifying and managing...

  11. Identifying and training non-technical skills of nuclear emergency response teams

    International Nuclear Information System (INIS)

    Crichton, M.T.; Flin, R.

    2004-01-01

    Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams

  12. Identifying and training non-technical skills of nuclear emergency response teams

    Energy Technology Data Exchange (ETDEWEB)

    Crichton, M.T. E-mail: m.crichton@abdn.ac.uk; Flin, R

    2004-08-01

    Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams.

  13. Identifying Patients at Risk of Deterioration in the Joint Emergency Department

    DEFF Research Database (Denmark)

    Schmidt, Thomas; Wiil, Uffe Kock

    2015-01-01

    at the case through the lenses of common information spaces. In particular, we apply Bossen’s seven-parameter framework to discover new dimensions of how Emergency Departments and individual clinicians identify and respond to unforeseen events, and how they handle the associated cognitive challenges. We......In recent years, Danish hospitals have merged their emergency facilities into Joint Emergency Departments. This poses new collaborative challenges across traditionally separated specialized departments, which now have to collaborate in a shared environment. Despite established protocols and patient...

  14. Identifying Local Hotspots of Pediatric Chronic Diseases Using Emergency Department Surveillance

    Science.gov (United States)

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

    2016-01-01

    Objective To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. Methods Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available. In addition, we used home addresses to map local variation in pediatric disease burden. Results We identified 549,547 New York City children who visited an emergency department at least once in 2009. Though our sample included more publicly insured and uninsured children, we found moderate to strong correlations of prevalence estimates when compared to health surveys and registry data at pre-specified geographic levels. Strongest correlations were found for asthma and mental health conditions by county among younger children (0.88, p=0.05 and 0.99, pdisease prevalence with higher geographic resolution. More studies are needed to investigate limitations of these methods and assess reliability of local disease estimates. What’s New This study demonstrated how emergency department surveillance may improve estimates of pediatric disease prevalence with higher geographic resolution. We identified 29% of New York City children with a single year of data and identified local hotspots of pediatric chronic diseases. PMID:28385326

  15. Metaphor and the 'Emergent Property' Problem: A Relevance-Theoretic Approach

    Directory of Open Access Journals (Sweden)

    Robyn Carston

    2008-08-01

    Full Text Available The interpretation of metaphorical utterances often results in the attribution of emergent properties; these are properties which are neither standardly associated with the individual constituents of the utterance in isolation nor derivable by standard rules of semantic composition. For example, an utterance of ‘Robert is a bulldozer’ may be understood as attributing to Robert such properties as single-mindedness, insistence on having things done in his way, and insensitivity to the opinions/feelings of others, although none of these is included in the encyclopaedic information associated with bulldozers (earth-clearing machines. An adequate pragmatic account of metaphor interpretation must provide an explanation of the processes through which emergent properties are derived. In this paper, we attempt to develop an explicit account of the derivation process couched within the framework of relevance theory. The key features of our account are: (a metaphorical language use is taken to lie on a continuum with other cases of loose use, including hyperbole; (b metaphor interpretation is a wholly inferential process, which does not require associative mappings from one domain (e.g. machines to another (e.g. human beings; (c the derivation of emergent properties involves no special interpretive mechanisms not required for the interpretation of ordinary, literal utterances.

  16. Transformation of accounting business processes in emergencies

    Directory of Open Access Journals (Sweden)

    D.O. Gritsyshen

    2016-12-01

    Full Text Available In the article the transformation of the accounting business processes in emergency situations. The models identify the consequences of emergencies, which is the basis for the transformation of the elements method of accounting, to address the consequences of emergencies isolation from the totality of objects of accounting and determine the properties that affect decision-making. Designed identify complex patterns of consequences of emergencies, allows accounting system to generate information that allows for a set of properties consequences of emergencies, and management decisions taking into account complex factors. Determined the possible consequences of emergency situations for individual objects accounting, information resources, which are accounts of accounting and financial reporting indicators.

  17. Identifying barriers to emergency care services.

    Science.gov (United States)

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

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

  18. A Study of Scientometric Methods to Identify Emerging Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert K [ORNL; Udoeyop, Akaninyene W [ORNL

    2011-01-01

    This work examines a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, worldwide patents, news archives, and on-line mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain we investigated.

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

    Science.gov (United States)

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

    2010-04-01

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

  20. Mechanical Properties in Metal-Organic Frameworks: Emerging Opportunities and Challenges for Device Functionality and Technological Applications

    International Nuclear Information System (INIS)

    Burtch, Nicholas C.; Heinen, Jurn

    2017-01-01

    We report that some of the most remarkable recent developments in metal–organic framework (MOF) performance properties can only be rationalized by the mechanical properties endowed by their hybrid inorganic–organic nanoporous structures. While these characteristics create intriguing application prospects, the same attributes also present challenges that will need to be overcome to enable the integration of MOFs with technologies where these promising traits can be exploited. In this review, emerging opportunities and challenges are identified for MOF-enabled device functionality and technological applications that arise from their fascinating mechanical properties. This is discussed not only in the context of their more well-studied gas storage and separation applications, but also for instances where MOFs serve as components of functional nanodevices. Recent advances in understanding MOF mechanical structure–property relationships due to attributes such as defects and interpenetration are highlighted, and open questions related to state-of-the-art computational approaches for quantifying their mechanical properties are critically discussed.

  1. Active Polymers — Emergent Conformational and Dynamical Properties: A Brief Review

    Science.gov (United States)

    Winkler, Roland G.; Elgeti, Jens; Gompper, Gerhard

    2017-10-01

    Active matter exhibits a wealth of emerging nonequilibrium behaviours. A paradigmatic example is the interior of cells, where active components, such as the cytoskeleton, are responsible for its structural organization and the dynamics of the various components. Of particular interest are the properties of polymers and filaments. The intimate coupling of thermal and active noise, hydrodynamic interactions, and polymer conformations implies the emergence of novel structural and dynamical features. In this article, we review recent theoretical and simulation developments and results for the structural and dynamical properties of polymers exposed to activity. Two- and three-dimensional filaments are considered propelled by different mechanisms such as active Brownian particles or hydrodynamically-coupled force dipoles.

  2. Identifying the emergence of design ideas

    DEFF Research Database (Denmark)

    Inie, Nanna

    This position paper outlines four types of design idea indicators that provide four starting points for exploration of the emergence of design ideas from a micro perspective. The results are derived from two empirical studies of design processes. The research builds on the assumption that we need...... better understanding and definition of design idea emergence and transformation in order to systematically explore the creative process....

  3. 76 FR 27377 - Additional Identifying Information Associated With Persons Whose Property and Interests in...

    Science.gov (United States)

    2011-05-11

    ... 13572 of April 29, 2011, ``Blocking Property of Certain Persons With Respect to Human Rights Abuses in... 29, 2011, ``Blocking Property of Certain Persons with Respect to Human Rights Abuses in Syria... Emergency Economic Powers Act (50 U.S.C. 1701-06). In the Order, the President expanded the scope of the...

  4. Emergent intelligent properties of progressively structured pattern recognition nets

    Energy Technology Data Exchange (ETDEWEB)

    Aleksander, I

    1983-07-01

    The n-tuple recognition net is seen as a building brick of a progression of network structures. The emergent intelligent properties of such systems are discussed. They include the amplification of confidence for the recognition of images that differ in small detail, a short term memory of the last seen image, sequence sensitivity, sequence sensitivity, sequence acceptance and saccadic inspection as an aid in scene analysis. 12 references.

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

    Science.gov (United States)

    Miller, Charles W

    2012-05-01

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

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

    Science.gov (United States)

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

    2018-02-21

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

  7. General intelligence is an emerging property, not an evolutionary puzzle.

    Science.gov (United States)

    Ramus, Franck

    2017-01-01

    Burkart et al. contend that general intelligence poses a major evolutionary puzzle. This assertion presupposes a reification of general intelligence - that is, assuming that it is one "thing" that must have been selected as such. However, viewing general intelligence as an emerging property of multiple cognitive abilities (each with their own selective advantage) requires no additional evolutionary explanation.

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

    Science.gov (United States)

    Blackmer, Rachel; Hayes-Harb, Rachel

    2016-01-01

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

  9. Thermodynamic properties of an emerging chemical disinfectant, peracetic acid.

    Science.gov (United States)

    Zhang, Chiqian; Brown, Pamela J B; Hu, Zhiqiang

    2018-04-15

    Peracetic acid (PAA or CH 3 COOOH) is an emerging disinfectant with a low potential to form carcinogenic disinfection by-products (DBPs). Basic thermodynamic properties of PAA are, however, absent or inconsistently reported in the literature. This review aimed to summarize important thermodynamic properties of PAA, including standard Gibbs energy of formation and oxidation-reduction (redox) potential. The standard Gibbs energies of formation of CH 3 COOOH (aq) , CH 3 COOOH (g) , CH 3 COOOH (l) , and CH 3 COOO (aq) - are -299.41kJ·mol -1 , -283.02kJ·mol -1 , -276.10kJ·mol -1 , and -252.60kJ·mol -1 , respectively. The standard redox potentials of PAA are 1.748V and 1.005V vs. standard hydrogen electrode (SHE) at pH 0 and pH 14, respectively. Under biochemical standard state conditions (pH 7, 25°C, 101,325Pa), PAA has a redox potential of 1.385V vs. SHE, higher than many disinfectants. Finally, the environmental implications of the thermodynamic properties of PAA were systematically discussed. Those properties can be used to predict the physicochemical and biological behavior of aquatic systems exposed to PAA. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Emergent material properties of developing epithelial tissues.

    Science.gov (United States)

    Machado, Pedro F; Duque, Julia; Étienne, Jocelyn; Martinez-Arias, Alfonso; Blanchard, Guy B; Gorfinkiel, Nicole

    2015-11-23

    Force generation and the material properties of cells and tissues are central to morphogenesis but remain difficult to measure in vivo. Insight is often limited to the ratios of mechanical properties obtained through disruptive manipulation, and the appropriate models relating stress and strain are unknown. The Drosophila amnioserosa epithelium progressively contracts over 3 hours of dorsal closure, during which cell apices exhibit area fluctuations driven by medial myosin pulses with periods of 1.5-6 min. Linking these two timescales and understanding how pulsatile contractions drive morphogenetic movements is an urgent challenge. We present a novel framework to measure in a continuous manner the mechanical properties of epithelial cells in the natural context of a tissue undergoing morphogenesis. We show that the relationship between apicomedial myosin fluorescence intensity and strain during fluctuations is consistent with a linear behaviour, although with a lag. We thus used myosin fluorescence intensity as a proxy for active force generation and treated cells as natural experiments of mechanical response under cyclic loading, revealing unambiguous mechanical properties from the hysteresis loop relating stress to strain. Amnioserosa cells can be described as a contractile viscoelastic fluid. We show that their emergent mechanical behaviour can be described by a linear viscoelastic rheology at timescales relevant for tissue morphogenesis. For the first time, we establish relative changes in separate effective mechanical properties in vivo. Over the course of dorsal closure, the tissue solidifies and effective stiffness doubles as net contraction of the tissue commences. Combining our findings with those from previous laser ablation experiments, we show that both apicomedial and junctional stress also increase over time, with the relative increase in apicomedial stress approximately twice that of other obtained measures. Our results show that in an epithelial

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

    Science.gov (United States)

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

    2010-07-01

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

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

    Science.gov (United States)

    Gustavsson, Maria; Ekberg, Kerstin

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Miles Parker

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

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

    Science.gov (United States)

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

    2014-01-01

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

  17. Identifying emergency department patients with chest pain who are at low risk for acute coronary syndromes [digest].

    Science.gov (United States)

    Markel, David; Kim, Jeremy

    2017-07-21

    Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing. The emerging role of new technologies, such as high-sensitivity troponin assays and advanced imaging techniques, are also presented. [Points & Pearls is a digest of Emergency Medicine Practice].

  18. Complex networks as an emerging property of hierarchical preferential attachment

    Science.gov (United States)

    Hébert-Dufresne, Laurent; Laurence, Edward; Allard, Antoine; Young, Jean-Gabriel; Dubé, Louis J.

    2015-12-01

    Real complex systems are not rigidly structured; no clear rules or blueprints exist for their construction. Yet, amidst their apparent randomness, complex structural properties universally emerge. We propose that an important class of complex systems can be modeled as an organization of many embedded levels (potentially infinite in number), all of them following the same universal growth principle known as preferential attachment. We give examples of such hierarchy in real systems, for instance, in the pyramid of production entities of the film industry. More importantly, we show how real complex networks can be interpreted as a projection of our model, from which their scale independence, their clustering, their hierarchy, their fractality, and their navigability naturally emerge. Our results suggest that complex networks, viewed as growing systems, can be quite simple, and that the apparent complexity of their structure is largely a reflection of their unobserved hierarchical nature.

  19. Emergent properties of patch shapes affect edge permeability to animals.

    Directory of Open Access Journals (Sweden)

    Vilis O Nams

    Full Text Available Animal travel between habitat patches affects populations, communities and ecosystems. There are three levels of organization of edge properties, and each of these can affect animals. At the lowest level are the different habitats on each side of an edge, then there is the edge itself, and finally, at the highest level of organization, is the geometry or structure of the edge. This study used computer simulations to (1 find out whether effects of edge shapes on animal behavior can arise as emergent properties solely due to reactions to edges in general, without the animals reacting to the shapes of the edges, and to (2 generate predictions to allow field and experimental studies to test mechanisms of edge shape response. Individual animals were modeled traveling inside a habitat patch that had different kinds of edge shapes (convex, concave and straight. When animals responded edges of patches, this created an emergent property of responding to the shape of the edge. The response was mostly to absolute width of the shapes, and not the narrowness of them. When animals were attracted to edges, then they tended to collect in convexities and disperse from concavities, and the opposite happened when animals avoided edges. Most of the responses occurred within a distance of 40% of the perceptual range from the tip of the shapes. Predictions were produced for directionality at various locations and combinations of treatments, to be used for testing edge behavior mechanisms. These results suggest that edge shapes tend to either concentrate or disperse animals, simply because the animals are either attracted to or avoid edges, with an effect as great as 3 times the normal density. Thus edge shape could affect processes like pollination, seed predation and dispersal and predator abundance.

  20. A Study of Scientometric Methods to Identify Emerging Technologies via Modeling of Milestones

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert K [ORNL; Udoeyop, Akaninyene W [ORNL; Schlicher, Bob G [ORNL

    2012-01-01

    This work examines a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, patents, news archives, and online mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain we investigated.

  1. Prospective validation of a predictive model that identifies homeless people at risk of re-presentation to the emergency department.

    Science.gov (United States)

    Moore, Gaye; Hepworth, Graham; Weiland, Tracey; Manias, Elizabeth; Gerdtz, Marie Frances; Kelaher, Margaret; Dunt, David

    2012-02-01

    To prospectively evaluate the accuracy of a predictive model to identify homeless people at risk of representation to an emergency department. A prospective cohort analysis utilised one month of data from a Principal Referral Hospital in Melbourne, Australia. All visits involving people classified as homeless were included, excluding those who died. Homelessness was defined as living on the streets, in crisis accommodation, in boarding houses or residing in unstable housing. Rates of re-presentation, defined as the total number of visits to the same emergency department within 28 days of discharge from hospital, were measured. Performance of the risk screening tool was assessed by calculating sensitivity, specificity, positive and negative predictive values and likelihood ratios. Over the study period (April 1, 2009 to April 30, 2009), 3298 presentations from 2888 individuals were recorded. The homeless population accounted for 10% (n=327) of all visits and 7% (n=211) of all patients. A total of 90 (43%) homeless people re-presented to the emergency department. The predictive model included nine variables and achieved 98% (CI, 0.92-0.99) sensitivity and 66% (CI, 0.57-0.74) specificity. The positive predictive value was 68% and the negative predictive value was 98%. The positive likelihood ratio 2.9 (CI, 2.2-3.7) and the negative likelihood ratio was 0.03 (CI, 0.01-0.13). The high emergency department re-presentation rate for people who were homeless identifies unresolved psychosocial health needs. The emergency department remains a vital access point for homeless people, particularly after hours. The risk screening tool is key to identify medical and social aspects of a homeless patient's presentation to assist early identification and referral. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  2. High-Dimensional Phenotyping Identifies Age-Emergent Cells in Human Mammary Epithelia

    Directory of Open Access Journals (Sweden)

    Fanny A. Pelissier Vatter

    2018-04-01

    Full Text Available Summary: Aging is associated with tissue-level changes in cellular composition that are correlated with increased susceptibility to disease. Aging human mammary tissue shows skewed progenitor cell potency, resulting in diminished tumor-suppressive cell types and the accumulation of defective epithelial progenitors. Quantitative characterization of these age-emergent human cell subpopulations is lacking, impeding our understanding of the relationship between age and cancer susceptibility. We conducted single-cell resolution proteomic phenotyping of healthy breast epithelia from 57 women, aged 16–91 years, using mass cytometry. Remarkable heterogeneity was quantified within the two mammary epithelial lineages. Population partitioning identified a subset of aberrant basal-like luminal cells that accumulate with age and originate from age-altered progenitors. Quantification of age-emergent phenotypes enabled robust classification of breast tissues by age in healthy women. This high-resolution mapping highlighted specific epithelial subpopulations that change with age in a manner consistent with increased susceptibility to breast cancer. : Vatter et al. find that single-cell mass cytometry of human mammary epithelial cells from 57 women, from 16 to 91 years old, depicts an in-depth phenotyping of aging mammary epithelia. Subpopulations of altered luminal and progenitor cells that accumulate with age may be at increased risk for oncogenic transformation. Keywords: human mammary epithelia, aging, mass cytometry, single-cell analysis, heterogeneity, breast cancer

  3. Instruments to Identify Commercially Sexually Exploited Children: Feasibility of Use in an Emergency Department Setting.

    Science.gov (United States)

    Armstrong, Stephanie

    2017-12-01

    This review examines the screening instruments that are in existence today to identify commercially sexually exploited children. The instruments are compared and evaluated for their feasibility of use in an emergency department setting. Four electronic databases were searched to identify screening instruments that assessed solely for commercial sexual exploitation. Search terms included "commercially sexually exploited children," "CSEC," "domestic minor sex trafficking," "DMST," "juvenile sex trafficking," and "JST." Those terms were then searched in combination with each of the following: "tools," "instruments," "screening," "policies," "procedures," "data collection," "evidence," and "validity." Six screening instruments were found to meet the inclusion criteria. Variation among instruments included number of questions, ease of administration, information sources, scoring methods, and training information provided. Two instruments were determined to be highly feasible for use in the emergency department setting, those being the Asian Health Services and Banteay Srei's CSEC Screening Protocol and Greenbaum et al's CSEC/child sex trafficking 6-item screening tool. A current dearth of screening instruments was confirmed. It is recommended that additional screening instruments be created to include developmentally appropriate instruments for preadolescent children. Numerous positive features were identified within the instruments in this review and are suggested for use in future screening instruments, including succinctness, a simple format, easy administration, training materials, sample questions, multiple information sources, designation of questions requiring mandatory reporting, a straightforward scoring system, and an algorithm format.

  4. Analytical assessment of current insurance as part of management of consequences of emergencies

    Directory of Open Access Journals (Sweden)

    K.Yu. Polyak

    2017-03-01

    Full Text Available The article examines the current state of the insurance system as a component of managing the consequences of emergencies. The researches are presented in the following areas: the insurance against accidents and fire risks and risks of natural disasters; property insurance (property, goods and agricultural products; the insurance of transport (by modes; liability insurance (by liability. So, the author made the statistical and analytical assessment of consequences of emergencies that was learned through the study of modern insurance system, which enabled to identify the complex of accounting objects in the management of consequences of emergencies.

  5. ContextD: an algorithm to identify contextual properties of medical terms in a Dutch clinical corpus.

    Science.gov (United States)

    Afzal, Zubair; Pons, Ewoud; Kang, Ning; Sturkenboom, Miriam C J M; Schuemie, Martijn J; Kors, Jan A

    2014-11-29

    In order to extract meaningful information from electronic medical records, such as signs and symptoms, diagnoses, and treatments, it is important to take into account the contextual properties of the identified information: negation, temporality, and experiencer. Most work on automatic identification of these contextual properties has been done on English clinical text. This study presents ContextD, an adaptation of the English ConText algorithm to the Dutch language, and a Dutch clinical corpus. We created a Dutch clinical corpus containing four types of anonymized clinical documents: entries from general practitioners, specialists' letters, radiology reports, and discharge letters. Using a Dutch list of medical terms extracted from the Unified Medical Language System, we identified medical terms in the corpus with exact matching. The identified terms were annotated for negation, temporality, and experiencer properties. To adapt the ConText algorithm, we translated English trigger terms to Dutch and added several general and document specific enhancements, such as negation rules for general practitioners' entries and a regular expression based temporality module. The ContextD algorithm utilized 41 unique triggers to identify the contextual properties in the clinical corpus. For the negation property, the algorithm obtained an F-score from 87% to 93% for the different document types. For the experiencer property, the F-score was 99% to 100%. For the historical and hypothetical values of the temporality property, F-scores ranged from 26% to 54% and from 13% to 44%, respectively. The ContextD showed good performance in identifying negation and experiencer property values across all Dutch clinical document types. Accurate identification of the temporality property proved to be difficult and requires further work. The anonymized and annotated Dutch clinical corpus can serve as a useful resource for further algorithm development.

  6. Examining the Psychometric Properties of the Identify as a Professional Social Worker Subscale

    Science.gov (United States)

    Farmer, Antoinette Y.

    2017-01-01

    The purpose of this study was to examine the psychometric properties of the Identify as a Professional Social Worker Subscale, which assessed the Council on Social Work Education--prescribed competency "identify as a professional social worker and conduct oneself accordingly." The results of confirmatory factory analysis indicated that…

  7. The Effect of Intellectual Property Standards on the Catch-Up Process Of Emerging Market Economies

    DEFF Research Database (Denmark)

    Darendeli, Izzet; Brandl, Kristin Martina; Hamilton, III, Robert D.

    2014-01-01

    The catch-up process of emerging market economies is dependent on multiple factors, such as local governmental regulations but also global industry developments. We investigate how intellectual property (IP) protection standards affect this catch-up process. The alignment of these standards...

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

    Science.gov (United States)

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

    2017-06-04

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

  9. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research

    Directory of Open Access Journals (Sweden)

    Boyden James

    2006-04-01

    Full Text Available Abstract Background There is widespread interest in measuring healthcare provider attitudes about issues relevant to patient safety (often called safety climate or safety culture. Here we report the psychometric properties, establish benchmarking data, and discuss emerging areas of research with the University of Texas Safety Attitudes Questionnaire. Methods Six cross-sectional surveys of health care providers (n = 10,843 in 203 clinical areas (including critical care units, operating rooms, inpatient settings, and ambulatory clinics in three countries (USA, UK, New Zealand. Multilevel factor analyses yielded results at the clinical area level and the respondent nested within clinical area level. We report scale reliability, floor/ceiling effects, item factor loadings, inter-factor correlations, and percentage of respondents who agree with each item and scale. Results A six factor model of provider attitudes fit to the data at both the clinical area and respondent nested within clinical area levels. The factors were: Teamwork Climate, Safety Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition. Scale reliability was 0.9. Provider attitudes varied greatly both within and among organizations. Results are presented to allow benchmarking among organizations and emerging research is discussed. Conclusion The Safety Attitudes Questionnaire demonstrated good psychometric properties. Healthcare organizations can use the survey to measure caregiver attitudes about six patient safety-related domains, to compare themselves with other organizations, to prompt interventions to improve safety attitudes and to measure the effectiveness of these interventions.

  10. The 'emergent scaling' phenomenon and the dielectric properties of random resistor-capacitor networks

    CERN Document Server

    Bouamrane, R

    2003-01-01

    An efficient algorithm, based on the Frank-Lobb reduction scheme, for calculating the equivalent dielectric properties of very large random resistor-capacitor (R-C) networks has been developed. It has been used to investigate the network size and composition dependence of dielectric properties and their statistical variability. The dielectric properties of 256 samples of random networks containing: 512, 2048, 8192 and 32 768 components distributed randomly in the ratios 60% R-40% C, 50% R-50% C and 40% R-60% C have been computed. It has been found that these properties exhibit the anomalous power law dependences on frequency known as the 'universal dielectric response' (UDR). Attention is drawn to the contrast between frequency ranges across which percolation determines dielectric response, where considerable variability is found amongst the samples, and those across which power laws define response where very little variability is found between samples. It is concluded that the power law UDRs are emergent pr...

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

    Science.gov (United States)

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

    2017-10-01

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

  12. Emergent properties during dorsal closure in Drosophila morphogenesis

    International Nuclear Information System (INIS)

    Peralta, X G; Toyama, Y; Edwards, G S; Kiehart, D P

    2008-01-01

    Dorsal closure is an essential stage of Drosophila development that is a model system for research in morphogenesis and biological physics. Dorsal closure involves an orchestrated interplay between gene expression and cell activities that produce shape changes, exert forces and mediate tissue dynamics. We investigate the dynamics of dorsal closure based on confocal microscopic measurements of cell shortening in living embryos. During the mid-stages of dorsal closure we find that there are fluctuations in the width of the leading edge cells but the time-averaged analysis of measurements indicate that there is essentially no net shortening of cells in the bulk of the leading edge, that contraction predominantly occurs at the canthi as part of the process for zipping together the two leading edges of epidermis and that the rate constant for zipping correlates with the rate of movement of the leading edges. We characterize emergent properties that regulate dorsal closure, i.e., a velocity governor and the coordination and synchronization of tissue dynamics

  13. Identifying potential surface water sampling sites for emerging ...

    African Journals Online (AJOL)

    Emerging chemical pollutants (ECPs) are defined as new chemicals which do not have a regulatory status, but which may have an adverse effect on human health and the environment. The occurrence and concentrations of ECPs in South African water bodies are largely unknown, so monitoring is required in order to ...

  14. Identifying potential surface water sampling sites for emerging chemical pollutants in Gauteng Province, South Africa

    OpenAIRE

    Petersen, F; Dabrowski, JM; Forbes, PBC

    2017-01-01

    Emerging chemical pollutants (ECPs) are defined as new chemicals which do not have a regulatory status, but which may have an adverse effect on human health and the environment. The occurrence and concentrations of ECPs in South African water bodies are largely unknown, so monitoring is required in order to determine the potential threat that these ECPs may pose. Relevant surface water sampling sites in the Gauteng Province of South Africa were identified utilising a geographic information sy...

  15. National Energy Board Emergency Management Program : annex to Natural Resources Canada Civil Emergency Plan no. 004

    International Nuclear Information System (INIS)

    Lever, G.; LeMay, R.

    2006-01-01

    As a matter of primary public interest, safety is included in the National Energy Board's (NEB) mandate. The Board is responsible for ensuring companies involved with energy development and pipelines comply with regulations concerning the safety of employees, the public, and the environment. The purpose of the NEB's Emergency Management Program is to establish a prompt and coordinated response to an emergency which occurs at any facility or operation regulated by the NEB; promote safety and security and assure compliance with regulatory requirements in order to protect the public, workers, property and the environment during the life cycle of facilities and operations; and, have a documented set of procedures that accomplish these objectives. The Board ensures that companies identify and manage the potential hazards associated with their facilities; conduct a risk analysis of those hazards; and, manage the risks in order to protect the public and personnel, the security of the facilities and the environment. All companies under the Board's jurisdiction are responsible for developing and maintaining an Emergency Response and Preparedness Program for all aspects of their operations. In the event an emergency occurs, the regulated company is responsible for responding to the emergency and coordinating emergency response activities. Typically, the NEB responds on site to incidents that result in death or serious injury; involve a significant release of hydrocarbons; could result in potential or real impact due to loss of service; pose imminent threats identified by Public Safety and Emergency Preparedness Canada or other agencies; attract significant media attention, or on the advice of Natural Resources Canada or other federal Agencies. The first part of this document described the initial response check list while the second part outlined the Emergency response framework. 2 tabs., 3 figs., 15 appendices

  16. Chemical warfare agent simulants for human volunteer trials of emergency decontamination: A systematic review.

    Science.gov (United States)

    James, Thomas; Wyke, Stacey; Marczylo, Tim; Collins, Samuel; Gaulton, Tom; Foxall, Kerry; Amlôt, Richard; Duarte-Davidson, Raquel

    2018-01-01

    Incidents involving the release of chemical agents can pose significant risks to public health. In such an event, emergency decontamination of affected casualties may need to be undertaken to reduce injury and possible loss of life. To ensure these methods are effective, human volunteer trials (HVTs) of decontamination protocols, using simulant contaminants, have been conducted. Simulants must be used to mimic the physicochemical properties of more harmful chemicals, while remaining non-toxic at the dose applied. This review focuses on studies that employed chemical warfare agent simulants in decontamination contexts, to identify those simulants most suitable for use in HVTs of emergency decontamination. Twenty-two simulants were identified, of which 17 were determined unsuitable for use in HVTs. The remaining simulants (n = 5) were further scrutinized for potential suitability according to toxicity, physicochemical properties and similarities to their equivalent toxic counterparts. Three suitable simulants, for use in HVTs were identified; methyl salicylate (simulant for sulphur mustard), diethyl malonate (simulant for soman) and malathion (simulant for VX or toxic industrial chemicals). All have been safely used in previous HVTs, and have a range of physicochemical properties that would allow useful inference to more toxic chemicals when employed in future studies of emergency decontamination systems. © 2017 Crown Copyright. Journal of Applied Toxicology published by John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2010-12-01

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

  18. Identifying the Critical Links in Road Transportation Networks: Centrality-based approach utilizing structural properties

    Energy Technology Data Exchange (ETDEWEB)

    Chinthavali, Supriya [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-04-01

    Surface transportation road networks share structural properties similar to other complex networks (e.g., social networks, information networks, biological networks, and so on). This research investigates the structural properties of road networks for any possible correlation with the traffic characteristics such as link flows those determined independently. Additionally, we define a criticality index for the links of the road network that identifies the relative importance in the network. We tested our hypotheses with two sample road networks. Results show that, correlation exists between the link flows and centrality measures of a link of the road (dual graph approach is followed) and the criticality index is found to be effective for one test network to identify the vulnerable nodes.

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

    Science.gov (United States)

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

    2017-09-15

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

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

    Science.gov (United States)

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

    2017-10-01

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

  1. Evaluating the Financial Stability of Banking System, Considering the Emergence Property

    Directory of Open Access Journals (Sweden)

    Lesik Vitaliy O.

    2017-03-01

    Full Text Available The article is concerned with analyzing the existing approaches to evaluation of the financial stability of banking system, substantiating the expedience of accounting, and generalizing the characteristics of the emergence property to determine its level. The article considers the interrelation of concepts of «financial stability» and «financial sustainability», the necessity of their correlation, taking account of the time factor, has been substantiated. A critical analysis of the approaches to evaluating the financial stability of banking system has been carried out, their eligibility according to the criteria of accounting of the identification attributes of systemacity and the analytical data aggregation has been examined. To determine the status of banking system as a system phenomenon, the necessity of carrying out an evaluation of its financial stability on the basis of the emergence approach has been substantiated, including the following directions: intensity of credit and financial interaction in the interbank market; functional load of the banking system as to ensuring the macroeconomic development; structural changes and financial disparities in the banking system; scale effects that arise as a consequence of change in the main financial parameters of the system banks.

  2. Photocatalytic Hybrid Semiconductor-Metal Nanoparticles; from Synergistic Properties to Emerging Applications.

    Science.gov (United States)

    Waiskopf, Nir; Ben-Shahar, Yuval; Banin, Uri

    2018-04-14

    Hybrid semiconductor-metal nanoparticles (HNPs) manifest unique combined and often synergetic properties stemming from the materials combination. These structures exhibit spatial charge separation across the semiconductor-metal junction upon light absorption, enabling their use as photocatalysts. So far, the main impetus of photocatalysis research in HNPs addresses their functionality in solar fuel generation. Recently, it was discovered that HNPs are functional in efficient photocatalytic generation of reactive oxygen species (ROS). This has opened the path for their implementation in diverse biomedical and industrial applications where high spatially temporally resolved ROS formation is essential. Here, the latest studies on the synergistic characteristics of HNPs are summarized, including their optical, electrical, and chemical properties and their photocatalytic function in the field of solar fuel generation is briefly discussed. Recent studies are then focused concerning photocatalytic ROS formation with HNPs under aerobic conditions. The emergent applications of this capacity are then highlighted, including light-induced modulation of enzymatic activity, photodynamic therapy, antifouling, wound healing, and as novel photoinitiators for 3D-printing. The superb photophysical and photocatalytic properties of HNPs offer already clear advantages for their utility in scenarios requiring on-demand light-induced radical formation and the full potential of HNPs in this context is yet to be revealed. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. RNA Transcriptional Biosignature Analysis for Identifying Febrile Infants With Serious Bacterial Infections in the Emergency Department

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-12-01

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

  5. Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

    Science.gov (United States)

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

    2017-10-31

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

  6. Emergent Behaviour

    NARCIS (Netherlands)

    Blom, H.A.P.; Everdij, M.H.C.; Bouarfa, S.; Cook, A; Rivas, D

    2016-01-01

    In complexity science a property or behaviour of a system is called emergent if it is not a property or behaviour of the constituting elements of the system, though results from the interactions between its constituting elements. In the socio-technical air transportation system these interactions

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Role of differential physical properties in emergent behavior of 3D cell co-cultures

    Science.gov (United States)

    Kolbman, Dan; Das, Moumita

    2015-03-01

    The biophysics of binary cell populations is of great interest in many biological processes, whether the formation of embryos or the initiation of tumors. During these processes, cells are surrounded by other cell types with different physical properties, often with important consequences. For example, recent experiments on a co-culture of breast cancer cells and healthy breast epithelial cells suggest that the mechanical mismatch between the two cell types may contribute to enhanced migration of the cancer cells. Here we explore how the differential physical properties of different cell types may influence cell-cell interaction, aggregation, and migration. To this end, we study a proof of concept model- a three-dimensional binary system of interacting, active, and deformable particles with different physical properties such as elastic stiffness, contractility, and particle-particle adhesion, using Langevin Dynamics simulations. Our results may provide insights into emergent behavior such as segregation and differential migration in cell co-cultures in three dimensions.

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

    Science.gov (United States)

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

    2014-01-01

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

  10. Time as an emergent property

    Energy Technology Data Exchange (ETDEWEB)

    Magnon, A. [Universite` Blaise Pascal-Clermont Fd 2, Aubiere Cedex, (France). Dept. de Mathematiques

    1996-03-01

    The time could be an emergent concept to be traced back to boundary conditions available in the primordial universe (ground-unification regime). Ultimate entities could be hidden, as a primordial alphabet, in the foundations of the pyramid of complicity which could originate in these boundary conditions and seems to culminate in the phenomenon of consciousness and perception of time.

  11. Resident Workflow and Psychiatric Emergency Consultation: Identifying Factors for Quality Improvement in a Training Environment.

    Science.gov (United States)

    Blair, Thomas; Wiener, Zev; Seroussi, Ariel; Tang, Lingqi; O'Hora, Jennifer; Cheung, Erick

    2017-06-01

    Quality improvement to optimize workflow has the potential to mitigate resident burnout and enhance patient care. This study applied mixed methods to identify factors that enhance or impede workflow for residents performing emergency psychiatric consultations. The study population consisted of all psychiatry program residents (55 eligible, 42 participating) at the Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles. The authors developed a survey through iterative piloting, surveyed all residents, and then conducted a focus group. The survey included elements hypothesized to enhance or impede workflow, and measures pertaining to self-rated efficiency and stress. Distributional and bivariate analyses were performed. Survey findings were clarified in focus group discussion. This study identified several factors subjectively associated with enhanced or impeded workflow, including difficulty with documentation, the value of personal organization systems, and struggles to communicate with patients' families. Implications for resident education are discussed.

  12. Identifying rural-urban differences in the predictors of emergency ambulance service demand and misuse.

    Science.gov (United States)

    Wong, Ho Ting; Lin, Teng-Kang; Lin, Jen-Jia

    2018-06-13

    This study aims to assess rural-urban differences in the predictors of emergency ambulance service (EAS) demand and misuse in New Taipei City. Identifying the predictors of EAS demand will help the EAS service managing authority in formulating focused policies to maintain service quality. Over 160,000 electronic EAS usage records were used with a negative binomial regression model to assess rural-urban differences in the predictors of EAS demand and misuse. The factors of 1) ln-transformed population density, 2) percentage of residents who completed up to junior high school education, 3) accessibility of hospitals without an emergency room, and 4) accessibility of EAS were found to be predictors of EAS demand in rural areas, whereas only the factor of percentage of people aged above 65 was found to predict EAS demand in urban areas. For EAS misuse, only the factor of percentage of low-income households was found to be a predictor in rural areas, whereas no predictor was found in the urban areas. Results showed that the factors predicting EAS demand and misuse in rural areas were more complicated compared to urban areas and, therefore, formulating EAS policies for rural areas based on the results of urban studies may not be appropriate. Copyright © 2018. Published by Elsevier B.V.

  13. Hydrogen bond networks determine emergent mechanical and thermodynamic properties across a protein family

    Directory of Open Access Journals (Sweden)

    Dallakyan Sargis

    2008-08-01

    intrinsic flexibility. Moreover, varying numbers of H-bonds and their strengths control the likelihood for energetic fluctuations as H-bonds break and reform, thus directly affecting thermodynamic properties. Consequently, these results demonstrate how unexpected large differences, especially within cooperativity correlation, emerge from subtle differences within the underlying H-bond network. This inference is consistent with well-known results that show allosteric response within a family generally varies significantly. Identifying the hydrogen bond network as a critical determining factor for these large variances may lead to new methods that can predict such effects.

  14. Failure mode effects and criticality analysis: innovative risk assessment to identify critical areas for improvement in emergency department sepsis resuscitation.

    Science.gov (United States)

    Powell, Emilie S; O'Connor, Lanty M; Nannicelli, Anna P; Barker, Lisa T; Khare, Rahul K; Seivert, Nicholas P; Holl, Jane L; Vozenilek, John A

    2014-06-01

    Sepsis is an increasing problem in the practice of emergency medicine as the prevalence is increasing and optimal care to reduce mortality requires significant resources and time. Evidence-based septic shock resuscitation strategies exist, and rely on appropriate recognition and diagnosis, but variation in adherence to the recommendations and therefore outcomes remains. Our objective was to perform a multi-institutional prospective risk-assessment, using failure mode effects and criticality analysis (FMECA), to identify high-risk failures in ED sepsis resuscitation. We conducted a FMECA, which prospectively identifies critical areas for improvement in systems and processes of care, across three diverse hospitals. A multidisciplinary group of participants described the process of emergency department (ED) sepsis resuscitation to then create a comprehensive map and table listing all process steps and identified process failures. High-risk failures in sepsis resuscitation from each of the institutions were compiled to identify common high-risk failures. Common high-risk failures included limited availability of equipment to place the central venous catheter and conduct invasive monitoring, and cognitive overload leading to errors in decision-making. Additionally, we identified great variability in care processes across institutions. Several common high-risk failures in sepsis care exist: a disparity in resources available across hospitals, a lack of adherence to the invasive components of care, and cognitive barriers that affect expert clinicians' decision-making capabilities. Future work may concentrate on dissemination of non-invasive alternatives and overcoming cognitive barriers in diagnosis and knowledge translation.

  15. Emergence of a new lineage of dengue virus type 2 identified in travelers entering Western Australia from Indonesia, 2010-2012.

    Directory of Open Access Journals (Sweden)

    Timo Ernst

    2015-01-01

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

  16. Virtual Reality and Its Potential Use in Special Education. Identifying Emerging Issues and Trends in Technology for Special Education.

    Science.gov (United States)

    Woodward, John

    As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper addresses the possible contributions of virtual reality technology to educational services for students with disabilities. An example of the use of virtual reality in medical imaging introduces the paper and leads to a brief review of…

  17. Cancer: an emergent property of disturbed resource-rich environments? Ecology meets personalized medicine.

    Science.gov (United States)

    Ducasse, Hugo; Arnal, Audrey; Vittecoq, Marion; Daoust, Simon P; Ujvari, Beata; Jacqueline, Camille; Tissot, Tazzio; Ewald, Paul; Gatenby, Robert A; King, Kayla C; Bonhomme, François; Brodeur, Jacques; Renaud, François; Solary, Eric; Roche, Benjamin; Thomas, Frédéric

    2015-07-01

    For an increasing number of biologists, cancer is viewed as a dynamic system governed by evolutionary and ecological principles. Throughout most of human history, cancer was an uncommon cause of death and it is generally accepted that common components of modern culture, including increased physiological stresses and caloric intake, favor cancer development. However, the precise mechanisms for this linkage are not well understood. Here, we examine the roles of ecological and physiological disturbances and resource availability on the emergence of cancer in multicellular organisms. We argue that proliferation of 'profiteering phenotypes' is often an emergent property of disturbed, resource-rich environments at all scales of biological organization. We review the evidence for this phenomenon, explore it within the context of malignancy, and discuss how this ecological framework may offer a theoretical background for novel strategies of cancer prevention. This work provides a compelling argument that the traditional separation between medicine and evolutionary ecology remains a fundamental limitation that needs to be overcome if complex processes, such as oncogenesis, are to be completely understood.

  18. Spectroscopic properties for identifying sapphire samples from Ban Bo Kaew, Phrae Province, Thailand

    Science.gov (United States)

    Mogmued, J.; Monarumit, N.; Won-in, K.; Satitkune, S.

    2017-09-01

    Gemstone commercial is a high revenue for Thailand especially ruby and sapphire. Moreover, Phrae is a potential gem field located in the northern part of Thailand. The studies of spectroscopic properties are mainly to identify gemstone using advanced techniques (e.g. UV-Vis-NIR spectrophotometry, FTIR spectrometry and Raman spectroscopy). Typically, UV-Vis-NIR spectrophotometry is a technique to study the cause of color in gemstones. FTIR spectrometry is a technique to study the functional groups in gem-materials. Raman pattern can be applied to identify the mineral inclusions in gemstones. In this study, the natural sapphires from Ban Bo Kaew were divided into two groups based on colors including blue and green. The samples were analyzed by UV-Vis-NIR spectrophotometer, FTIR spectrometer and Raman spectroscope for studying spectroscopic properties. According to UV-Vis-NIR spectra, the blue sapphires show higher Fe3+/Ti4+ and Fe2+/Fe3+ absorption peaks than those of green sapphires. Otherwise, green sapphires display higher Fe3+/Fe3+ absorption peaks than blue sapphires. The FTIR spectra of both blue and green sapphire samples show the absorption peaks of -OH,-CH and CO2. The mineral inclusions such as ferrocolumbite and rutile in sapphires from this area were observed by Raman spectroscope. The spectroscopic properties of sapphire samples from Ban Bo Kaew, Phrae Province, Thailand are applied to be the specific evidence for gemstone identification.

  19. Identifying the Physical Properties of Showers That Influence User Satisfaction to Aid in Developing Water-Saving Showers

    Directory of Open Access Journals (Sweden)

    Minami Okamoto

    2015-07-01

    Full Text Available This research was conducted with the goal of clarifying the required conditions of water-saving showerheads. In order to this, the research analyzes the mutual relationship between water usage flow, the level of satisfaction and the physical properties of spray of showerheads. The physical properties of spray were measured using physical properties test apparatus of standard or scheme for water-saving showerheads issued in several water-saving countries, and satisfaction evaluation data was acquired through bathing experiments. The evaluated showerheads were separated into three groups according to usage water flow and the level of satisfaction. The relationships between usage water flow, the level of satisfaction and physical properties were compared. The results identified that Spray Force and Spray Force-per-Hole were physical properties that influence usage water flow. Spray force-per-hole, water volume ratio in Spray Patterns within φ 100 and φ 150, Temperature Drop and Spray Angle were identified as physical properties that influenced the level of satisfaction. The level of satisfaction and usage water flow has a spurious correlation through the physical properties of Spray Force-per-Hole and Temperature Drop. It is possible to improve the level of satisfaction independent of amount of water usage through designs that set an appropriate value for water volume ratio and Spray Angle for Spray Patterns within φ 100 and φ 150.

  20. Seeking Sepsis in the Emergency Department- Identifying Barriers to Delivery of the Sepsis 6.

    Science.gov (United States)

    Bentley, James; Henderson, Susan; Thakore, Shobhan; Donald, Michael; Wang, Weijie

    2016-01-01

    The Sepsis 6 is an internationally accepted management bundle that, when initiated within one hour of identifying sepsis, can reduce morbidity and mortality. This management bundle was advocated by the Scottish Patient Safety Programme as part of its Acute Adult campaign launched in 2008 and adopted by NHS Tayside in 2012. Despite this, the Emergency Department (ED) of Ninewells Hospital, a tertiary referral centre and major teaching hospital in Scotland, was displaying poor success in the Sepsis 6. We therefore set out to improve compliance by evaluating the application of all aspects of the NHS Tayside Sepsis 6 bundle within one hour of ED triage time, to identify what human factors may influence achieving the one hour The Sepsis 6 bundle. This allowed us to tailor a number of specific interventions including educational sessions, regular audit and personal feedback and check list Sepsis 6 sticker. These interventions promoted a steady increase in compliance from an initial rate of 51.0% to 74.3%. The project highlighted that undifferentiated patients create a challenge in initiating the Sepsis 6. Pyrexia is a key human factor-trigger for recognising sepsis with initial nursing assessment being vital in recognition and identifying the best area (resus) of the department to manage severely septic patients. EDs need to recognise these challenges and develop educational and feedback plans for staff and utilise available resources to maximise the Sepsis 6 compliance.

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

    Science.gov (United States)

    Bank, Ilana; Snell, Linda; Bhanji, Farhan

    2014-12-01

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

  2. Exploring emergent properties in cellular homeostasis using OnGuard to model K+ and other ion transport in guard cells.

    Science.gov (United States)

    Blatt, Michael R; Wang, Yizhou; Leonhardt, Nathalie; Hills, Adrian

    2014-05-15

    It is widely recognized that the nature and characteristics of transport across eukaryotic membranes are so complex as to defy intuitive understanding. In these circumstances, quantitative mathematical modeling is an essential tool, both to integrate detailed knowledge of individual transporters and to extract the properties emergent from their interactions. As the first, fully integrated and quantitative modeling environment for the study of ion transport dynamics in a plant cell, OnGuard offers a unique tool for exploring homeostatic properties emerging from the interactions of ion transport, both at the plasma membrane and tonoplast in the guard cell. OnGuard has already yielded detail sufficient to guide phenotypic and mutational studies, and it represents a key step toward 'reverse engineering' of stomatal guard cell physiology, based on rational design and testing in simulation, to improve water use efficiency and carbon assimilation. Its construction from the HoTSig libraries enables translation of the software to other cell types, including growing root hairs and pollen. The problems inherent to transport are nonetheless challenging, and are compounded for those unfamiliar with conceptual 'mindset' of the modeler. Here we set out guidelines for the use of OnGuard and outline a standardized approach that will enable users to advance quickly to its application both in the classroom and laboratory. We also highlight the uncanny and emergent property of OnGuard models to reproduce the 'communication' evident between the plasma membrane and tonoplast of the guard cell. Copyright © 2014 The Authors. Published by Elsevier GmbH.. All rights reserved.

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

    Science.gov (United States)

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

    2015-06-01

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

  4. Applying network theory to animal movements to identify properties of landscape space use.

    Science.gov (United States)

    Bastille-Rousseau, Guillaume; Douglas-Hamilton, Iain; Blake, Stephen; Northrup, Joseph M; Wittemyer, George

    2018-04-01

    Network (graph) theory is a popular analytical framework to characterize the structure and dynamics among discrete objects and is particularly effective at identifying critical hubs and patterns of connectivity. The identification of such attributes is a fundamental objective of animal movement research, yet network theory has rarely been applied directly to animal relocation data. We develop an approach that allows the analysis of movement data using network theory by defining occupied pixels as nodes and connection among these pixels as edges. We first quantify node-level (local) metrics and graph-level (system) metrics on simulated movement trajectories to assess the ability of these metrics to pull out known properties in movement paths. We then apply our framework to empirical data from African elephants (Loxodonta africana), giant Galapagos tortoises (Chelonoidis spp.), and mule deer (Odocoileous hemionus). Our results indicate that certain node-level metrics, namely degree, weight, and betweenness, perform well in capturing local patterns of space use, such as the definition of core areas and paths used for inter-patch movement. These metrics were generally applicable across data sets, indicating their robustness to assumptions structuring analysis or strategies of movement. Other metrics capture local patterns effectively, but were sensitive to specified graph properties, indicating case specific applications. Our analysis indicates that graph-level metrics are unlikely to outperform other approaches for the categorization of general movement strategies (central place foraging, migration, nomadism). By identifying critical nodes, our approach provides a robust quantitative framework to identify local properties of space use that can be used to evaluate the effect of the loss of specific nodes on range wide connectivity. Our network approach is intuitive, and can be implemented across imperfectly sampled or large-scale data sets efficiently, providing a

  5. Identifying potential heirs properties in the Southeastern United States: a new GIS methodology utilizing mass appraisal data

    Science.gov (United States)

    Scott Pippin; Shana Jones; Cassandra. Johnson Gaither

    2017-01-01

    This report presents a methodology for identifying land parcels that have an increased probability of being heirs property. Heirs property is inherited land passed to successive generations intestate, without clear title, typically to family members. This land ownership type is widespread among rural, African-American populations and is also thought to be pervasive in...

  6. Nuclear accident/radiological emergency assistance plan. NAREAP - edition 2000. Emergency preparedness and response

    International Nuclear Information System (INIS)

    2000-01-01

    The purpose of the Nuclear Accident/Radiological Emergency Assistance Plan (NAREAP) is to describe the framework for systematic, integrated, co-ordinated, and effective preparedness and response for a nuclear accident or radiological emergency involving facilities or practices that may give rise to a threat to health, the environment or property. The purpose of the NAREAP is: to define the emergency response objectives of the Agency's staff in a nuclear accident or a radiological emergency; to assign responsibilities for performing the tasks and authorities for making the decisions that comprise the Agency staff's response to a nuclear accident or radiological emergency; to guide the Agency managers who must ensure that all necessary tasks are given the necessary support in discharging the Agency staff responsibilities and fulfilling its obligations in response to an emergency; to ensure that the development and maintenance of detailed and coherent response procedures are well founded; to act as a point of reference for individual Agency staff members on their responsibilities (as an individual or a team member) throughout a response; to identify interrelationships with other international intergovernmental Organizations; and to serve as a training aid to maintain readiness of personnel. The NAREAP refers to the arrangements of the International Atomic Energy Agency and of the United Nations Security and Safety Section at the Vienna International Centre (UNSSS-VIC) that may be necessary for the IAEA to respond to a nuclear accident or radiological emergency, as defined in the Early Notification and Assistance Conventions. It covers response arrangements for any situation that may have actual, potential or perceived radiological consequences and that could require a response from the IAEA, as well as the arrangements for developing, maintaining and exercising preparedness. The implementing procedures themselves are not included in the NAREAP, but they are required

  7. Criticality is an emergent property of genetic networks that exhibit evolvability.

    Directory of Open Access Journals (Sweden)

    Christian Torres-Sosa

    Full Text Available Accumulating experimental evidence suggests that the gene regulatory networks of living organisms operate in the critical phase, namely, at the transition between ordered and chaotic dynamics. Such critical dynamics of the network permits the coexistence of robustness and flexibility which are necessary to ensure homeostatic stability (of a given phenotype while allowing for switching between multiple phenotypes (network states as occurs in development and in response to environmental change. However, the mechanisms through which genetic networks evolve such critical behavior have remained elusive. Here we present an evolutionary model in which criticality naturally emerges from the need to balance between the two essential components of evolvability: phenotype conservation and phenotype innovation under mutations. We simulated the Darwinian evolution of random Boolean networks that mutate gene regulatory interactions and grow by gene duplication. The mutating networks were subjected to selection for networks that both (i preserve all the already acquired phenotypes (dynamical attractor states and (ii generate new ones. Our results show that this interplay between extending the phenotypic landscape (innovation while conserving the existing phenotypes (conservation suffices to cause the evolution of all the networks in a population towards criticality. Furthermore, the networks produced by this evolutionary process exhibit structures with hubs (global regulators similar to the observed topology of real gene regulatory networks. Thus, dynamical criticality and certain elementary topological properties of gene regulatory networks can emerge as a byproduct of the evolvability of the phenotypic landscape.

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

    Science.gov (United States)

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

    2017-11-01

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

  9. Innovativeness as an emergent property: a new alignment of comparative and experimental research on animal innovation.

    Science.gov (United States)

    Griffin, Andrea S

    2016-03-19

    Innovation and creativity are key defining features of human societies. As we face the global challenges of the twenty-first century, they are also facets upon which we must become increasingly reliant. But what makes Homo sapiens so innovative and where does our high innovation propensity come from? Comparative research on innovativeness in non-human animals allows us to peer back through evolutionary time and investigate the ecological factors that drove the evolution of innovativeness, whereas experimental research identifies and manipulates underpinning creative processes. In commenting on the present theme issue, I highlight the controversies that have typified this research field and show how a paradigmatic shift in our thinking about innovativeness will contribute to resolving these tensions. In the past decade, innovativeness has been considered by many as a trait, a direct product of cognition, and a direct target of selection. The evidence I review here suggests that innovativeness will be hereon viewed as one component, or even an emergent property of a larger array of traits, which have evolved to deal with environmental variation. I illustrate how research should capitalize on taxonomic diversity to unravel the full range of psychological processes that underpin innovativeness in non-human animals. © 2016 The Author(s).

  10. REQUIREMENTS FOR IMAGE QUALITY OF EMERGENCY SPACECRAFTS

    Directory of Open Access Journals (Sweden)

    A. I. Altukhov

    2015-05-01

    Full Text Available The paper deals with the method for formation of quality requirements to the images of emergency spacecrafts. The images are obtained by means of remote sensing of near-earth space orbital deployment in the visible range. of electromagnetic radiation. The method is based on a joint taking into account conditions of space survey, characteristics of surveillance equipment, main design features of the observed spacecrafts and orbital inspection tasks. Method. Quality score is the predicted linear resolution image that gives the possibility to create a complete view of pictorial properties of the space image obtained by electro-optical system from the observing satellite. Formulation of requirements to the numerical value of this indicator is proposed to perform based on the properties of remote sensing system, forming images in the conditions of outer space, and the properties of the observed emergency spacecraft: dimensions, platform construction of the satellite, on-board equipment placement. For method implementation the authors have developed a predictive model of requirements to a linear resolution for images of emergency spacecrafts, making it possible to select the intervals of space shooting and get the satellite images required for quality interpretation. Main results. To verify the proposed model functionality we have carried out calculations of the numerical values for the linear resolution of the image, ensuring the successful task of determining the gross structural damage of the spacecrafts and identifying changes in their spatial orientation. As input data were used with dimensions and geometric primitives corresponding to the shape of deemed inspected spacecrafts: Resurs-P", "Canopus-B", "Electro-L". Numerical values of the linear resolution images have been obtained, ensuring the successful task solution for determining the gross structural damage of spacecrafts.

  11. Business Responses to Climate Change. Identifying Emergent Strategies

    International Nuclear Information System (INIS)

    Kolk, A.; Pinkse, J.

    2005-01-01

    Companies face much uncertainty about the competitive effects of the recently adopted Kyoto Protocol on global climate change and the current and future regulations that may emerge from it. Companies have considerable discretion to explore different market strategies to address global warming and reduce greenhouse gas emissions. This article examines these strategic options by reviewing the market-oriented actions that are currently being taken by 136 large companies that are part of the Global 500. There are six different market strategies that companies use to address climate change and that consist of different combinations of the market components available to managers. Managers can choose between more emphasis on improvements in their business activities through innovation or employ compensatory approaches such as emissions trading. They can either act by themselves or work with other companies, NGOs, or (local) governments

  12. Research on Crowdsourcing Emergency Information Extraction of Based on Events' Frame

    Science.gov (United States)

    Yang, Bo; Wang, Jizhou; Ma, Weijun; Mao, Xi

    2018-01-01

    At present, the common information extraction method cannot extract the structured emergency event information accurately; the general information retrieval tool cannot completely identify the emergency geographic information; these ways also do not have an accurate assessment of these results of distilling. So, this paper proposes an emergency information collection technology based on event framework. This technique is to solve the problem of emergency information picking. It mainly includes emergency information extraction model (EIEM), complete address recognition method (CARM) and the accuracy evaluation model of emergency information (AEMEI). EIEM can be structured to extract emergency information and complements the lack of network data acquisition in emergency mapping. CARM uses a hierarchical model and the shortest path algorithm and allows the toponomy pieces to be joined as a full address. AEMEI analyzes the results of the emergency event and summarizes the advantages and disadvantages of the event framework. Experiments show that event frame technology can solve the problem of emergency information drawing and provides reference cases for other applications. When the emergency disaster is about to occur, the relevant departments query emergency's data that has occurred in the past. They can make arrangements ahead of schedule which defense and reducing disaster. The technology decreases the number of casualties and property damage in the country and world. This is of great significance to the state and society.

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

    Science.gov (United States)

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

    2015-01-01

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

  14. Measuring the Electronic Properties of DNA-Specific Schottky Diodes Towards Detecting and Identifying Basidiomycetes DNA

    Science.gov (United States)

    Periasamy, Vengadesh; Rizan, Nastaran; Al-Ta’ii, Hassan Maktuff Jaber; Tan, Yee Shin; Tajuddin, Hairul Annuar; Iwamoto, Mitsumasa

    2016-01-01

    The discovery of semiconducting behavior of deoxyribonucleic acid (DNA) has resulted in a large number of literatures in the study of DNA electronics. Sequence-specific electronic response provides a platform towards understanding charge transfer mechanism and therefore the electronic properties of DNA. It is possible to utilize these characteristic properties to identify/detect DNA. In this current work, we demonstrate a novel method of DNA-based identification of basidiomycetes using current-voltage (I-V) profiles obtained from DNA-specific Schottky barrier diodes. Electronic properties such as ideality factor, barrier height, shunt resistance, series resistance, turn-on voltage, knee-voltage, breakdown voltage and breakdown current were calculated and used to quantify the identification process as compared to morphological and molecular characterization techniques. The use of these techniques is necessary in order to study biodiversity, but sometimes it can be misleading and unreliable and is not sufficiently useful for the identification of fungi genera. Many of these methods have failed when it comes to identification of closely related species of certain genus like Pleurotus. Our electronics profiles, both in the negative and positive bias regions were however found to be highly characteristic according to the base-pair sequences. We believe that this simple, low-cost and practical method could be useful towards identifying and detecting DNA in biotechnology and pathology. PMID:27435636

  15. Automatic Emergence Detection in Complex Systems

    Directory of Open Access Journals (Sweden)

    Eugene Santos

    2017-01-01

    Full Text Available Complex systems consist of multiple interacting subsystems, whose nonlinear interactions can result in unanticipated (emergent system events. Extant systems analysis approaches fail to detect such emergent properties, since they analyze each subsystem separately and arrive at decisions typically through linear aggregations of individual analysis results. In this paper, we propose a quantitative definition of emergence for complex systems. We also propose a framework to detect emergent properties given observations of its subsystems. This framework, based on a probabilistic graphical model called Bayesian Knowledge Bases (BKBs, learns individual subsystem dynamics from data, probabilistically and structurally fuses said dynamics into a single complex system dynamics, and detects emergent properties. Fusion is the central element of our approach to account for situations when a common variable may have different probabilistic distributions in different subsystems. We evaluate our detection performance against a baseline approach (Bayesian Network ensemble on synthetic testbeds from UCI datasets. To do so, we also introduce a method to simulate and a metric to measure discrepancies that occur with shared/common variables. Experiments demonstrate that our framework outperforms the baseline. In addition, we demonstrate that this framework has uniform polynomial time complexity across all three learning, fusion, and reasoning procedures.

  16. [Emerging noninfectious diseases].

    Science.gov (United States)

    Consiglio, Ezequiel

    2008-11-01

    In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

  17. Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.

    Science.gov (United States)

    Manley, Kim; Martin, Anne; Jackson, Carolyn; Wright, Toni

    2016-08-09

    Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust. Data sources included 14 clinical settings where upstream or downstream pinch points are likely to occur including discharge planning and rapid response teams; ten regional stakeholder events (n = 102); a qualitative survey (n = 48); and a review of literature and analysis of policy documents including care pathways and protocols. The key workforce enablers for whole systems urgent and emergency care delivery identified were: clinical systems leadership, a single integrated career and competence framework and skilled facilitation of work based learning. In this study, participants agreed that whole systems urgent and emergency care allows for the design and implementation of care delivery models that meet complexity of population healthcare needs, reduce duplication and waste and improve healthcare outcomes and patients' experiences. For this to be achieved emphasis needs to be placed on holistic changes in structures, processes and patterns of the urgent and emergency care system. Often overlooked, patterns that drive the thinking and behavior in the workplace directly impact on staff recruitment and retention and the overall effectiveness of the organization. These also need to be attended to for transformational change to be achieved and sustained. Research to refine and validate a single

  18. Porous and Nanoporous Semiconductors and Emerging Applications

    Directory of Open Access Journals (Sweden)

    Helmut Föll

    2006-01-01

    Full Text Available Pores in single-crystalline semiconductors can be produced in a wide range of geometries and morphologies, including the “nanometer” regime. Porous semiconductors may have properties completely different from the bulk, and metamaterials with, for example, optical properties not encountered in natural materials are emerging. Possible applications of porous semiconductors include various novel sensors, but also more “exotic” uses as, for example, high explosives or electrodes for micro-fuel cells. The paper briefly reviews pore formation (including more applied aspects of large area etching, properties of porous semiconductors, and emerging applications.

  19. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-06-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  20. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-03-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  1. How can we identify patients with delirium in the emergency department?: A review of available screening and diagnostic tools.

    Science.gov (United States)

    Tamune, Hidetaka; Yasugi, Daisuke

    2017-09-01

    Delirium is a widespread and serious but under-recognized problem. Increasing evidence argues that emergency health care providers need to assess the mental status of the patient as the "sixth vital sign". A simple, sensitive, time-efficient, and cost-effective tool is needed to identify delirium in patients in the emergency department (ED); however, a stand-alone measurement has not yet been established despite previous studies partly because the differential diagnosis of dementia and delirium superimposed on dementia (DSD) is too difficult to achieve using a single indicator. To fill up the gap, multiple aspects of a case should be assessed including inattention and arousal. For instance, we proposed the 100 countdown test as an effective means of detecting inattention. Further dedicated studies are warranted to shed light on the pathophysiology and better management of dementia, delirium and/or "altered mental status". We reviewed herein the clinical questions and controversies concerning delirium in an ED setting. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The european emergency number 112 - the questionnaire

    Directory of Open Access Journals (Sweden)

    Krzysztof Goniewicz

    2017-07-01

    Conclusions. Most of the respondents (92% identify the 112 number as an emergency number that allows them to connect to emergency services from anywhere in the European Union. A significant number of respondents (47% identify the 112 number as an emergency number in Poland. One in three respondents will use the 999 number to contact the emergency services as a witness to an emergency in Poland. Non-medical university students more often (63% will use the 112 emergency number than medical college students (41%. Respondents (98% confirmed the usefulness of a unified emergency number throughout Europe, but decided that they were not sufficiently informed about 112 as the European emergency number.

  3. Interplay of differential cell mechanical properties, motility, and proliferation in emergent collective behavior of cell co-cultures

    Science.gov (United States)

    Sutter, Leo; Kolbman, Dan; Wu, Mingming; Ma, Minglin; Das, Moumita

    The biophysics of cell co-cultures, i.e. binary systems of cell populations, is of great interest in many biological processes including formation of embryos, and tumor progression. During these processes, different types of cells with different physical properties are mixed with each other, with important consequences for cell-cell interaction, aggregation, and migration. The role of the differences in their physical properties in their collective behavior remains poorly understood. Furthermore, until recently most theoretical studies of collective cell migration have focused on two dimensional systems. Under physiological conditions, however, cells often have to navigate three dimensional and confined micro-environments. We study a confined, three-dimensional binary system of interacting, active, and deformable particles with different physical properties such as deformability, motility, adhesion, and division rates using Langevin Dynamics simulations. Our findings may provide insights into how the differences in and interplay between cell mechanical properties, division, and motility influence emergent collective behavior such as cell aggregation and segregation experimentally observed in co-cultures of breast cancer cells and healthy breast epithelial cells. This work was partially supported by a Cottrell College Science Award.

  4. 29 CFR 541.706 - Emergencies.

    Science.gov (United States)

    2010-07-01

    ... damage to the employer's property, any work performed in an effort to prevent such results is considered... is not emergency work, even when necessary to prevent fire or explosion; however, repairing equipment may be emergency work if the breakdown of or damage to the equipment was caused by accident or...

  5. Properties of Two Novel Esterases Identified from Culture Supernatant of Penicillium purpurogenum Grown on Sugar Beet Pulp.

    Science.gov (United States)

    Oleas, Gabriela; Callegari, Eduardo; Sepulveda, Romina; Eyzaguirre, Jaime

    2016-01-01

    The filamentous fungus Penicillium purpurogenum grows on a variety of natural carbon sources, such as sugar beet pulp, and secretes to the medium a large number of enzymes that degrade the carbohydrate components of lignocellulose. Sugar beet pulp is rich in pectin, and the purpose of this work is to identify novel esterases produced by the fungus, which may participate in pectin degradation. Partially purified culture supernatants of the fungus grown on sugar beet pulp were subjected to mass spectrometry analysis. Peptides thus identified, which may be part of potential esterases were probed against the proteins deduced from the fungal genome sequence. The cDNAs of two putative esterases identified were expressed in Pichia pastoris and their properties studied. One of these enzymes, named FAET, is a feruloyl esterase, while the other, PE, is classified as a pectin methyl esterase. These findings add to our knowledge of the enzymology of pectin degradation by Penicillium purpurogenum, and define properties of two novel esterases acting on de-esterification of pectin. Their availability may be useful as tools for the study of pectin structure and degradation.

  6. 44 CFR 15.5 - Preservation of property.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Preservation of property. 15.5 Section 15.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... NATIONAL EMERGENCY TRAINING CENTER § 15.5 Preservation of property. At both Mt. Weather and NETC we...

  7. The role of infections and coinfections with newly identified and emerging respiratory viruses in children

    Directory of Open Access Journals (Sweden)

    Debiaggi Maurizia

    2012-10-01

    Full Text Available Abstract Acute respiratory infections are a major cause of morbidity in children both in developed and developing countries. A wide range of respiratory viruses, including respiratory syncytial virus (RSV, influenza A and B viruses, parainfluenza viruses (PIVs, adenovirus, rhinovirus (HRV, have repeatedly been detected in acute lower respiratory tract infections (LRTI in children in the past decades. However, in the last ten years thanks to progress in molecular technologies, newly discovered viruses have been identified including human Metapneumovirus (hMPV, coronaviruses NL63 (HcoV-NL63 and HKU1 (HcoV-HKU1, human Bocavirus (HBoV, new enterovirus (HEV, parechovirus (HpeV and rhinovirus (HRV strains, polyomaviruses WU (WUPyV and KI (KIPyV and the pandemic H1N1v influenza A virus. These discoveries have heavily modified previous knowledge on respiratory infections mainly highlighting that pediatric population is exposed to a variety of viruses with similar seasonal patterns. In this context establishing a causal link between a newly identified virus and the disease as well as an association between mixed infections and an increase in disease severity can be challenging. This review will present an overview of newly recognized as well as the main emerging respiratory viruses and seek to focus on the their contribution to infection and co-infection in LRTIs in childhood.

  8. 41 CFR 301-30.1 - What is emergency travel?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What is emergency travel? 301-30.1 Section 301-30.1 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES 30-EMERGENCY TRAVEL § 301-30.1 What is...

  9. Predicting and analyzing DNA-binding domains using a systematic approach to identifying a set of informative physicochemical and biochemical properties

    Science.gov (United States)

    2011-01-01

    Background Existing methods of predicting DNA-binding proteins used valuable features of physicochemical properties to design support vector machine (SVM) based classifiers. Generally, selection of physicochemical properties and determination of their corresponding feature vectors rely mainly on known properties of binding mechanism and experience of designers. However, there exists a troublesome problem for designers that some different physicochemical properties have similar vectors of representing 20 amino acids and some closely related physicochemical properties have dissimilar vectors. Results This study proposes a systematic approach (named Auto-IDPCPs) to automatically identify a set of physicochemical and biochemical properties in the AAindex database to design SVM-based classifiers for predicting and analyzing DNA-binding domains/proteins. Auto-IDPCPs consists of 1) clustering 531 amino acid indices in AAindex into 20 clusters using a fuzzy c-means algorithm, 2) utilizing an efficient genetic algorithm based optimization method IBCGA to select an informative feature set of size m to represent sequences, and 3) analyzing the selected features to identify related physicochemical properties which may affect the binding mechanism of DNA-binding domains/proteins. The proposed Auto-IDPCPs identified m=22 features of properties belonging to five clusters for predicting DNA-binding domains with a five-fold cross-validation accuracy of 87.12%, which is promising compared with the accuracy of 86.62% of the existing method PSSM-400. For predicting DNA-binding sequences, the accuracy of 75.50% was obtained using m=28 features, where PSSM-400 has an accuracy of 74.22%. Auto-IDPCPs and PSSM-400 have accuracies of 80.73% and 82.81%, respectively, applied to an independent test data set of DNA-binding domains. Some typical physicochemical properties discovered are hydrophobicity, secondary structure, charge, solvent accessibility, polarity, flexibility, normalized Van Der

  10. Energy emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    This Handbook identifies selected state and federal measures available to mitigate the impact of an energy emergency, and provides a comprehensive energy emergency communications directory. In the case of state remedial actions, particular emphasis has been placed on typical implementation procedures and likely impacts. The discussions of federal actions focus on initation and implementation procedures. The directory is designed to facilitate communications of all types (telephone, Telex, TWX, or facsimile) among key energy emergency officials in the federal and state governments.

  11. Identifying and tracking plumes affected by an ocean breeze in support of emergency preparedness

    International Nuclear Information System (INIS)

    Schwartz, P.E.

    1989-01-01

    To better support emergency preparedness, General Public Utilities (GPU) Nuclear has investigated the frequency of occurrence of the mesoscale ocean breeze at the Oyster Creek Nuclear Generating Station (OCNGS). Through the analysis of the horizontal wind direction and temperature patterns, simple identification of the ocean breeze along with a plume tracking procedure has been developed and incorporated into the site's emergency plant to better safeguard the public with sophisticated protective action measures in case of a nonroutine release. The ocean breeze will frequently produce wind trajectory fields within the plant's emergency planning zone that are different from the normal gradient wind flow. This could greatly alter proper protective action measures since most utilities employ straight-line trajectory air dispersion models. Knowledge of the existence of the ocean breeze and the location of the ocean breeze front become important in the results generated from the straight-line Gaussian dose calculation methodology and in the further development of a more complex dose assessment model. This paper describes the verification and existence of the sea breeze phenomenon and the incorporation of its effects into the OCNGS emergency plan

  12. Using Chief Complaint in Addition to Diagnosis Codes to Identify Falls in the Emergency Department.

    Science.gov (United States)

    Patterson, Brian W; Smith, Maureen A; Repplinger, Michael D; Pulia, Michael S; Svenson, James E; Kim, Michael K; Shah, Manish N

    2017-09-01

    To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme. Retrospective electronic record review. Academic medical center ED. Individuals aged 65 and older seen in the ED between January 1, 2013, and September 30, 2015. Two fall definitions were applied (individually and together) to the cohort: an ICD-9-based definition and a chief complaint definition. Admission rates and 30-day mortality (per encounter) were measured for each definition. Twenty-three thousand eight hundred eighty older adult visits occurred during the study period. Using the most-inclusive definition (ICD-9 code or chief complaint indicating a fall), 4,363 visits (18%) were fall related. Of these visits, 3,506 (80%) met the ICD-9 definition for a fall-related visit, and 2,664 (61%) met the chief complaint definition. Of visits meeting the chief complaint definition, 857 (19.6%) were missed when applying the ICD-9 definition alone. Encounters missed using the ICD-9 definition were less likely to lead to an admission (42.9%, 95% confidence interval (CI) = 39.7-46.3%) than those identified (54.4%, 95% CI = 52.7-56.0%). Identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls. Individuals missed according to the code-based definition were less likely to have been admitted than those who were captured. These findings call attention to the value of using chief complaint information to identify individuals who have fallen in the ED-for research, clinical care, or policy reasons. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  13. SYSTEMIC APPROACH AND ROUGHNESS APPLICATION TO CAUSE EMERGING PROPERTIES IN THE RESTORATION OF DEGRADED SOILS

    Directory of Open Access Journals (Sweden)

    Juarês José Aumond

    2014-09-01

    Full Text Available http://dx.doi.org/10.5902/1980509815737Based on the general systems theory, an ecological model for the restoration of ecosystems has been developed, which soils are highly degraded, and treating the ecosystem as a complex dynamic system, hyper-sensitive to initial conditions of soil preparation. Assuming that degraded ecosystems are sensitive to initial conditions of soil preparation, the technique of roughness was evaluated (relief variations alternating between concave and convex surfaces to trigger over time emergent properties that accelerate the process of ecological restoration. The degraded ecosystems can be understood as organizationally open systems, as a dissipative structure, in which irreversibly matter and energy flow. The main task in ecological restoration in areas that had the soil degraded is to achieve the internalization of matter and energy to induce the system to organizational closure. The roughness, represented by soil micro-topography is an effective technique in the internalization of matter, retaining water, sediment, organic matter, nutrients and seeds. Variations of relief trigger environmental changes over time in a dynamic and heterogeneous way, which influence the interactions between solar radiation, moisture and nutrients, creating different opportunities for plants and animal species. There must be an oriented concentration to flow structures and processes between the degraded ecosystem (system and the environment (neighborhood. In this approach, a particular concentration on the interrelationships between the system and the environment is dedicated. For ecological restoration, whose area is with degraded soil, such as mining and ranching, a new integrative degraded systemic approach is proposed, in which the roughness of the soil might trigger spatial and temporal patterns and emergent environmental properties due to the hyper-sensitivity to initial conditions of the land preparation.

  14. Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

    DEFF Research Database (Denmark)

    Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C

    2017-01-01

    BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...

  15. 41 CFR 101-26.607-3 - Emergency requirements.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Emergency requirements. 101-26.607-3 Section 101-26.607-3 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND...

  16. 44 CFR 19.120 - Transfers of property.

    Science.gov (United States)

    2010-10-01

    ... RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 19.120 Transfers of property. If a recipient sells or... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Transfers of property. 19.120 Section 19.120 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF...

  17. Emergency nurses' knowledge and self-rated practice skills when caring for older patients in the Emergency Department.

    Science.gov (United States)

    Rawson, Helen; Bennett, Paul N; Ockerby, Cherene; Hutchinson, Alison M; Considine, Julie

    2017-11-01

    Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia. Mean scores were 12.7 (SD 2.66) for the 25-item knowledge of older persons questionnaire, and 9.04 (SD 1.80) for the 15-item gerontic health related questions. Scores were unaffected by years of experience as a registered nurse or emergency nurse. More than 80% of nurses rated themselves as 'very good' or 'good' in assessing pain (94.9%), identifying delirium (87.8%), and identifying dementia (82.8%). Areas with a 'poor' ratings were identifying depression (46.5%), assessing polypharmacy (46.5%) and assessing nutrition (37.8%). There was variation in knowledge and self-rating of practice related to care of older patients. The relationship between knowledge and self-ratings of practice in relation to actual emergency nursing care of older people and patient outcomes warrants further exploration. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  18. Computational Models and Emergent Properties of Respiratory Neural Networks

    Science.gov (United States)

    Lindsey, Bruce G.; Rybak, Ilya A.; Smith, Jeffrey C.

    2012-01-01

    Computational models of the neural control system for breathing in mammals provide a theoretical and computational framework bringing together experimental data obtained from different animal preparations under various experimental conditions. Many of these models were developed in parallel and iteratively with experimental studies and provided predictions guiding new experiments. This data-driven modeling approach has advanced our understanding of respiratory network architecture and neural mechanisms underlying generation of the respiratory rhythm and pattern, including their functional reorganization under different physiological conditions. Models reviewed here vary in neurobiological details and computational complexity and span multiple spatiotemporal scales of respiratory control mechanisms. Recent models describe interacting populations of respiratory neurons spatially distributed within the Bötzinger and pre-Bötzinger complexes and rostral ventrolateral medulla that contain core circuits of the respiratory central pattern generator (CPG). Network interactions within these circuits along with intrinsic rhythmogenic properties of neurons form a hierarchy of multiple rhythm generation mechanisms. The functional expression of these mechanisms is controlled by input drives from other brainstem components, including the retrotrapezoid nucleus and pons, which regulate the dynamic behavior of the core circuitry. The emerging view is that the brainstem respiratory network has rhythmogenic capabilities at multiple levels of circuit organization. This allows flexible, state-dependent expression of different neural pattern-generation mechanisms under various physiological conditions, enabling a wide repertoire of respiratory behaviors. Some models consider control of the respiratory CPG by pulmonary feedback and network reconfiguration during defensive behaviors such as cough. Future directions in modeling of the respiratory CPG are considered. PMID:23687564

  19. Using Participatory and Service Design to Identify Emerging Needs and Perceptions of Library Services among Science and Engineering Researchers Based at a Satellite Campus

    Science.gov (United States)

    Johnson, Andrew; Kuglitsch, Rebecca; Bresnahan, Megan

    2015-01-01

    This study used participatory and service design methods to identify emerging research needs and existing perceptions of library services among science and engineering faculty, post-graduate, and graduate student researchers based at a satellite campus at the University of Colorado Boulder. These methods, and the results of the study, allowed us…

  20. 36 CFR 520.5 - Conformity with signs and emergency directions.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Conformity with signs and emergency directions. 520.5 Section 520.5 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES... INSTITUTION § 520.5 Conformity with signs and emergency directions. Persons in or on the premises shall comply...

  1. Emerging Fabric of Science: Persistent Identifiers and Knowledge Networks

    Science.gov (United States)

    Hugo, W.

    2017-12-01

    There is an increasing emphasis on the use of persistent identifiers in the description of scientific activity, whether this is done to cite scholarly publications and research output, reliably identify role players such as funders and researchers, or to provide long-lasting references to controlled vocabulary. The ICSU World Data System has been promoting the establishment of a "Knowledge Network" to describe research activity, realising that parts of the network will be established as a federated `system', based on linkages between registries of persistent identifiers. In addition, there is a growing focus on not only the relationship between these major role players and associated digital objects, but also on the processes of science: provenance, reproducibility, and re-usability being significant topics of discussion. The paper will focus on description of the `Fabric of Science' from the perspectives of both structure and processes, review the state of implementation of real services and infrastructure in support of it. A case is made for inclusion of persistent identifiers into the mainstream activities of scientists and data infrastructure managers, and for the development of services, such as Scholix, to make better use of the relationships between digital objects and major role players. A proposal is made for the adoption of a federated system of services that are based on a hybrid graph-object framework similar to Scholix for recording the activity of scientific research. Finally, links to related ideas are explored: novel ways of representing of knowledge (such as Nanopublications) and the possibility that the publication paradigm currently in use may have to be amended.

  2. Emergências hipertensivas Hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Gilson Soares Feitosa-Filho

    2008-09-01

    ão controlada. Este conhecimento deve ser rotineiro ao emergencista e Intensivista no momento de decidir sobre a conduta.Emergencies and hypertensive crises are clinical situations which may represent more than 25% of all medical emergency care. Considering such high prevalence, physicians should be prepared to correctly identify these crises and differentiate between urgent and emergent hypertension. Approximately 3% of all visits to emergency rooms are due to significant elevation of blood pressure. Across the spectrum of blood systemic arterial pressure, hypertensive emergency is the most critical clinical situation, thus requiring special attention and care. Such patients present with high blood pressure and signs of acute specific target organ damage (such as acute myocardial infarction, unstable angina, acute pulmonary edema, eclampsia, and stroke. Key elements of diagnosis and specific treatment for the different presentations of hypertensive emergency will be reviewed in this article. The MedLine and PubMed databases were searched for pertinent abstracts, using the key words "hypertensive crises" and "hypertensive emergencies". Additional references were obtained from review articles. Available English language clinical trials, retrospective studies and review articles were identified, reviewed and summarized in a simple and practical way. The hypertensive crisis is a clinical situation characterized by acute elevation of blood pressure followed by clinical signs and symptoms. These signs and symptoms may be mild (headache, dizziness, tinnitus or severe (dyspnea, chest pain, coma or death. If the patient presents with mild symptoms, but without acute specific target organ damage, diagnosis is hypertensive urgency. However, if severe signs and symptoms and acute specific target organ damage are present, then the patient is experiencing a hypertensive emergency. Some patients arrive at the emergency rooms with high blood pressure, but without any other sign or symptom. In

  3. Family emergency preparedness plans in severe tornadoes.

    Science.gov (United States)

    Cong, Zhen; Liang, Daan; Luo, Jianjun

    2014-01-01

    Tornadoes, with warnings usually issued just minutes before their touchdowns, pose great threats to properties and people's physical and mental health. Few studies have empirically investigated the association of family emergency preparedness planning and observed protective behaviors in the context of tornadoes. The purpose of this study was to examine predictors for the action of taking shelter at the time of tornadoes. Specifically, this study investigated whether having a family emergency preparedness plan was associated with higher likelihood of taking shelter upon receiving tornado warnings. This study also examined the effects of socioeconomic status and functional limitations on taking such actions. A telephone survey based on random sampling was conducted in 2012 with residents in Tuscaloosa AL and Joplin MO. Each city experienced considerable damages, injuries, and casualties after severe tornadoes (EF-4 and EF-5) in 2011. The working sample included 892 respondents. Analysis was conducted in early 2013. Logistic regression identified emergency preparedness planning as the only shared factor that increased the likelihood of taking shelter in both cities and the only significant factor in Joplin. In Tuscaloosa, being female and white also increased the likelihood of taking shelter. Disability was not found to have an effect. This study provided empirical evidence on the importance of having a family emergency preparedness plan in mitigating the risk of tornadoes. The findings could be applied to other rapid-onset disasters. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

  4. Opportunities to preserve forensic evidence in emergency departments.

    Science.gov (United States)

    Peel, Matthew

    2016-11-10

    Victims of violence often seek assistance from emergency departments, so emergency nurses are ideally placed to identify them, and other 'forensic' patients, and protect the evidence that could support any ensuing legal process. Emergency nurses who are trained to identify, collect and preserve forensic evidence can support the identification, elimination and prosecution of suspects. This article gives an overview of forensic evidence, and explains how emergency nurses can preserve and collect samples effectively.

  5. Emerging Corrosion Inhibitors for Interfacial Coating

    Directory of Open Access Journals (Sweden)

    Mona Taghavikish

    2017-12-01

    Full Text Available Corrosion is a deterioration of a metal due to reaction with environment. The use of corrosion inhibitors is one of the most effective ways of protecting metal surfaces against corrosion. Their effectiveness is related to the chemical composition, their molecular structures and affinities for adsorption on the metal surface. This review focuses on the potential of ionic liquid, polyionic liquid (PIL and graphene as promising corrosion inhibitors in emerging coatings due to their remarkable properties and various embedment or fabrication strategies. The review begins with a precise description of the synthesis, characterization and structure-property-performance relationship of such inhibitors for anti-corrosion coatings. It establishes a platform for the formation of new generation of PIL based coatings and shows that PIL corrosion inhibitors with various heteroatoms in different form can be employed for corrosion protection with higher barrier properties and protection of metal surface. However, such study is still in its infancy and there is significant scope to further develop new structures of PIL based corrosion inhibitors and coatings and study their behaviour in protection of metals. Besides, it is identified that the combination of ionic liquid, PIL and graphene could possibly contribute to the development of the ultimate corrosion inhibitor based coating.

  6. Thoughts on identifiers

    CERN Multimedia

    CERN. Geneva

    2005-01-01

    As business processes and information transactions have become an inextricably intertwined with the Web, the importance of assignment, registration, discovery, and maintenance of identifiers has increased. In spite of this, integrated frameworks for managing identifiers have been slow to emerge. Instead, identification systems arise (quite naturally) from immediate business needs without consideration for how they fit into larger information architectures. In addition, many legacy identifier systems further complicate the landscape, making it difficult for content managers to select and deploy identifier systems that meet both the business case and long term information management objectives. This presentation will outline a model for evaluating identifier applications and the functional requirements of the systems necessary to support them. The model is based on a layered analysis of the characteristics of identifier systems, including: * Functional characteristics * Technology * Policy * Business * Social T...

  7. Analysis of emergency physicians' Twitter accounts.

    Science.gov (United States)

    Lulic, Ileana; Kovic, Ivor

    2013-05-01

    Twitter is one of the fastest growing social media networks for communication between users via short messages. Technology proficient physicians have demonstrated enthusiasm in adopting social media for their work. To identify and create the largest directory of emergency physicians on Twitter, analyse their user accounts and reveal details behind their connections. Several web search tools were used to identify emergency physicians on Twitter with biographies completely or partially written in English. NodeXL software was used to calculate emergency physicians' Twitter network metrics and create visualisation graphs. The authors found 672 Twitter accounts of self-identified emergency physicians. Protected accounts were excluded from the study, leaving 632 for further analysis. Most emergency physicians were located in USA (55.4%), had created their accounts in 2009 (43.4%), used their full personal name (77.5%) and provided a custom profile picture (92.2%). Based on at least one published tweet in the last 15 days, there were 345 (54.6%) active users on 31 December 2011. Active users mostly used mobile devices based on the Apple operating system to publish tweets (69.2%). Visualisation of emergency physicians' Twitter network revealed many users with no connections with their colleagues, and a small group of most influential users who were highly interconnected. Only a small proportion of registered emergency physicians use Twitter. Among them exists a smaller inner network of emergency physicians with strong social bonds that is using Twitter's full potentials for professional development.

  8. Threats from emerging and re-emerging neglected tropical diseases (NTDs).

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2012-01-01

    Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (''EReNTDs''). We then identified common characteristics and risks associated with EReNTDs. Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Multi-sectorial efforts and targeted public-private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

  9. Acute Testicular Ischemia following Endovascular Abdominal Aortic Aneurysm Repair Identified in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Nathan Finnerty

    2014-01-01

    Full Text Available Endovascular aneurysm repair (EVAR is perhaps the most widely utilized surgical procedure for patients with large abdominal aortic aneurysms. This procedure is minimally invasive and reduces inpatient hospitalization requirements. The case involves a 72-year-old male who presented to the emergency department with right testicular ischemia two days following EVAR. Given the minimal inpatient hospitalization associated with this procedure, emergency physicians are likely to encounter associated complications. Ischemic and thromboembolic events following EVAR are extremely rare but require prompt vascular surgery intervention to minimize morbidity and mortality.

  10. Modelling Creativity: Identifying Key Components through a Corpus-Based Approach.

    Science.gov (United States)

    Jordanous, Anna; Keller, Bill

    2016-01-01

    Creativity is a complex, multi-faceted concept encompassing a variety of related aspects, abilities, properties and behaviours. If we wish to study creativity scientifically, then a tractable and well-articulated model of creativity is required. Such a model would be of great value to researchers investigating the nature of creativity and in particular, those concerned with the evaluation of creative practice. This paper describes a unique approach to developing a suitable model of how creative behaviour emerges that is based on the words people use to describe the concept. Using techniques from the field of statistical natural language processing, we identify a collection of fourteen key components of creativity through an analysis of a corpus of academic papers on the topic. Words are identified which appear significantly often in connection with discussions of the concept. Using a measure of lexical similarity to help cluster these words, a number of distinct themes emerge, which collectively contribute to a comprehensive and multi-perspective model of creativity. The components provide an ontology of creativity: a set of building blocks which can be used to model creative practice in a variety of domains. The components have been employed in two case studies to evaluate the creativity of computational systems and have proven useful in articulating achievements of this work and directions for further research.

  11. Micro- and nanoelectronics emerging device challenges and solutions

    CERN Document Server

    Brozek, Tomasz

    2014-01-01

    Micro- and Nanoelectronics: Emerging Device Challenges and Solutions presents a comprehensive overview of the current state of the art of micro- and nanoelectronics, covering the field from fundamental science and material properties to novel ways of making nanodevices. Containing contributions from experts in both industry and academia, this cutting-edge text:Discusses emerging silicon devices for CMOS technologies, fully depleted device architectures, characteristics, and scalingExplains the specifics of silicon compound devices (SiGe, SiC) and their unique propertiesExplores various options

  12. Challenges of measuring quality in emergency management

    DEFF Research Database (Denmark)

    Lynette, Jennifer Elyse

    2016-01-01

    This paper describes the challenges and importance of measuring quality within the field of emergency response. Using quality as a standard of measurement to evaluate response efforts of trained personnel in emergency situations is necessary to increase effectiveness in the response phase...... of an emergency event. The intended outcome of utilizing quality as a tool of measurement is to save additional lives, property, and resources. The adoption of a system to measure quality can be utilized by multiple professions under the broader field of emergency response services. Quality is discussed in terms...

  13. Mortality following emergency groin hernia surgery in Denmark

    DEFF Research Database (Denmark)

    Kjærgaard, Jesper; Bay-Nielsen, M; Kehlet, H

    2010-01-01

    The mortality following emergency groin hernia repair in Denmark is more than twice as high (7%) as in comparable countries. This article describes in detail the population that died following emergency herniotomy in order to identify aspects of care that may improve outcome.......The mortality following emergency groin hernia repair in Denmark is more than twice as high (7%) as in comparable countries. This article describes in detail the population that died following emergency herniotomy in order to identify aspects of care that may improve outcome....

  14. Measurement properties of the Health Literacy Questionnaire (HLQ) among older adults who present to the emergency department after a fall: a Rasch analysis.

    Science.gov (United States)

    Morris, Rebecca L; Soh, Sze-Ee; Hill, Keith D; Buchbinder, Rachelle; Lowthian, Judy A; Redfern, Julie; Etherton-Beer, Christopher D; Hill, Anne-Marie; Osborne, Richard H; Arendts, Glenn; Barker, Anna L

    2017-08-29

    Health literacy is an important concept associated with participation in preventive health initiatives, such as falls prevention programs. A comprehensive health literacy measurement tool, appropriate for this population, is required. The aim of this study was to evaluate the measurement properties of the Health Literacy Questionnaire (HLQ) in a cohort of older adults who presented to a hospital emergency department (ED) after a fall. Older adults who presented to an ED after a fall had their health literacy assessed using the HLQ (n = 433). Data were collected as part of a multi-centre randomised controlled trial of a falls prevention program. Measurement properties of the HLQ were assessed using Rasch analysis. All nine scales of the HLQ were unidimensional, with good internal consistency reliability. No item bias was found for most items (43 of 44). A degree of overall misfit to the Rasch model was evident for six of the nine HLQ scales. The majority of misfit indicated content overlap between some items and does not compromise measurement. A measurement gap was identified for this cohort at mid to high HLQ score. The HLQ demonstrated good measurement properties in a cohort of older adults who presented to an ED after a fall. The summation of the HLQ items within each scale, providing unbiased information on nine separate areas of health literacy, is supported. Clinicians, researchers and policy makers may have confidence using the HLQ scale scores to gain information about health literacy in older people presenting to the ED after a fall. This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).

  15. Threats from emerging and re-emerging neglected tropical diseases (NTDs

    Directory of Open Access Journals (Sweden)

    Tim K. Mackey

    2012-08-01

    Full Text Available Background: Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. Methods: We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (‘‘EReNTDs’’. We then identified common characteristics and risks associated with EReNTDs. Results: Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Discussion: Multi-sectorial efforts and targeted public–private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

  16. Emerging Contaminants – Dinitrotoluene (DNT)

    Science.gov (United States)

    This fact sheet, developed by the U.S. Environmental Protection Agency’s Federal Facilities Restoration and Reuse Office (FFRRO), provides a brief summary of the emerging contaminant Dinitrotoluene (DNT) including physical and chemical properties.

  17. Application of Satellite Remote Sensing to Identify Climatic and Anthropogenic Changes Related to Water and Health Conditions in Emerging Megacities

    Science.gov (United States)

    Akanda, A. S.; Serman, E. A.; Jutla, A.

    2014-12-01

    By 2050, more than 70% of the world's population is expected to be living in a city. In many of the urbanizing regions in Asia and Africa, most new development is taking place without adequate urban or regional planning, and a majority population is crowded into densely populated unplanned settlements, also known as slums. During the same period, precipitation and temperature patterns are likely to see significant changes in many of these regions while coastal megacities will have to accommodate sea-level rise in their ecosystems. The rapid increase in population is usually observed in fringes of the urban sprawl without adequate water or sanitation facilities or access to other municipal amenities (such as utilities, healthcare, and education). Collectively, these issues make the ever increasing slum dwellers in emerging megacities significantly vulnerable to a combination of climatic and anthropogenic threats. However, how the growth of unplanned urban and peri-urban sprawl and simultaneous change in climatic patterns have impacted public health in the emerging megacities remain largely unexplored due to lack of readily available and usable data. We employ a number of Remote Sensing products (GRACE, LANDSAT, MODIS) to bridge above knowledge gaps and to identify relevant hydrologic and anthropogenic changes in emerging megacities that are most vulnerable due to the climate-water-health nexus. We explore one of the largest and the fastest growing megacities in the world - Dhaka, Bangladesh - on identifying and investigating the changes in the water environment and growth of slum areas, and impact on water services and health outcomes. The hydroclimatology of South Asia is highly seasonal and the asymmetric availability of water affects vast areas of Bangladesh differently in space and time, exposing the population of Dhaka region to both droughts and floods and periodic spring-fall outbreaks of diarrheal diseases, such as cholera and rotavirus. This research

  18. Integration of experimental and computational methods for identifying geometric, thermal and diffusive properties of biomaterials

    Science.gov (United States)

    Weres, Jerzy; Kujawa, Sebastian; Olek, Wiesław; Czajkowski, Łukasz

    2016-04-01

    Knowledge of physical properties of biomaterials is important in understanding and designing agri-food and wood processing industries. In the study presented in this paper computational methods were developed and combined with experiments to enhance identification of agri-food and forest product properties, and to predict heat and water transport in such products. They were based on the finite element model of heat and water transport and supplemented with experimental data. Algorithms were proposed for image processing, geometry meshing, and inverse/direct finite element modelling. The resulting software system was composed of integrated subsystems for 3D geometry data acquisition and mesh generation, for 3D geometry modelling and visualization, and for inverse/direct problem computations for the heat and water transport processes. Auxiliary packages were developed to assess performance, accuracy and unification of data access. The software was validated by identifying selected properties and using the estimated values to predict the examined processes, and then comparing predictions to experimental data. The geometry, thermal conductivity, specific heat, coefficient of water diffusion, equilibrium water content and convective heat and water transfer coefficients in the boundary layer were analysed. The estimated values, used as an input for simulation of the examined processes, enabled reduction in the uncertainty associated with predictions.

  19. Psychosocial risk and protective factors for the health and well-being of professionals working in emergency and non-emergency medical transport services, identified via questionnaires.

    Science.gov (United States)

    Navarro Moya, P; González Carrasco, M; Villar Hoz, E

    2017-09-06

    Medical transport (MT) professionals are subject to considerable emotional demands due to their involvement in life-or-death situations and their exposure to the serious health problems of their clients. An increase in the demand for MT services has, in turn, increased interest in the study of the psychosocial risk factors affecting the health of workers in this sector. However, research thus far has not distinguished between emergency (EMT) and non-emergency (non-EMT) services, nor between the sexes. Furthermore, little emphasis has been placed on the protective factors involved. The main objective of the present study is to identify any existing differential exposure - for reasons of work setting (EMT and non-EMT) or of gender - to the various psychosocial risk and protective factors affecting the health of MT workers. Descriptive and transversal research with responses from 201 professionals. The scores obtained on the various psychosocial scales in our study - as indicators of future health problems - were more unfavourable for non-EMT workers than they were for EMT workers. Work setting, but not gender, was able to account for these differences. The scores obtained for the different psychosocial factors are generally more favourable for the professionals we surveyed than those obtained in previous samples. The significant differences observed between EMT and non-EMT personnel raise important questions regarding the organization of work in companies that carry out both services at the same time in the same territory. The relationships among the set of risk/protective factors suggests a need for further investigation into working conditions as well as a consideration of the workers' sense of coherence and subjective well-being as protective factors against occupational burnout syndrome.

  20. Preventative maintenance plan for emergency pumping trailers

    International Nuclear Information System (INIS)

    Wiggins, D.D.

    1994-09-01

    The purpose/goal of this document is to identify the maintenance requirements and resources available to properly maintain the readiness and condition of the Emergency Pumping Equipment controlled by the Tank Waste Remediation System Tank Farms Plant Engineering and Tank Stabilization Operations. This equipment is intended to pump a single-shell tank (SST) that has been identified as an assumed leaking tank. The goal is to commence pumping (submersible or jet) as soon as safely possible after identifying a SST as an assumed leaking tank. Important information pertaining to the Emergency Pumping Equipment, Over-Ground Piping installation, and procedures is found in WHC-SD-WM-AP-005, ''Single Shell Tank Leak Emergency Pumping Guide.''

  1. Identifying and Quantifying Emergent Behavior Through System of Systems Modeling and Simulation

    Science.gov (United States)

    2015-09-01

    the similarities and differences between Agent Based Modeling ( ABM ) and Equation Based Modeling (EBM). Both modeling approaches “simulate a system by...entities. For the latter difference, EBM focuses on the system level observables, while ABM defines behaviors at the individual agent level and observes...EMERGENT BEHAVIOR THROUGH SYSTEM OF SYSTEMS MODELING AND SIMULATION by Mary Ann Cummings September 2015 Dissertation Supervisor: Man-Tak Shing

  2. Educational program emergency planning.

    Science.gov (United States)

    Curtis, Tammy

    2009-01-01

    Tragic university shootings have prompted administrators of higher education institutions to re-evaluate their emergency preparedness plans and take appropriate measures for preventing and responding to emergencies. To review the literature and identify key components needed to prevent shootings at higher education institutions in the United States, and in particular, institutions housing radiologic science programs. Twenty-eight emergency preparedness plans were retrieved electronically and reviewed from a convenience sample of accredited radiologic science programs provided by the Joint Review Committee on Education in Radiologic Technology Web site. The review of the 28 emergency preparedness plans confirmed that most colleges are prepared for basic emergencies, but lack the key components needed to successfully address mass-casualty events. Only 5 (18%) of the 28 institutions addressed policies concerning school shootings.

  3. Fairness Is an Emergent Self-Organized Property of the Free Market for Labor

    Directory of Open Access Journals (Sweden)

    Venkat Venkatasubramanian

    2010-06-01

    Full Text Available The excessive compensation packages of CEOs of U.S. corporations in recent years have brought to the foreground the issue of fairness in economics. The conventional wisdom is that the free market for labor, which determines the pay packages, cares only about efficiency and not fairness. We present an alternative theory that shows that an ideal free market environment also promotes fairness, as an emergent property resulting from the self-organizing market dynamics. Even though an individual employee may care only about his or her salary and no one else’s, the collective actions of all the employees, combined with the profit maximizing actions of all the companies, in a free market environment under budgetary constraints, lead towards a more fair allocation of wages, guided by Adam Smith’s invisible hand of self-organization. By exploring deep connections with statistical thermodynamics, we show that entropy is the appropriate measure of fairness in a free market environment which is maximized at equilibrium to yield the lognormal distribution of salaries as the fairest inequality of pay in an organization under ideal conditions.

  4. Creating Spin-One Fermions in the Presence of Artificial Spin-Orbit Fields: Emergent Spinor Physics and Spectroscopic Properties

    Science.gov (United States)

    Kurkcuoglu, Doga Murat; de Melo, C. A. R. Sá

    2018-05-01

    We propose the creation and investigation of a system of spin-one fermions in the presence of artificial spin-orbit coupling, via the interaction of three hyperfine states of fermionic atoms to Raman laser fields. We explore the emergence of spinor physics in the Hamiltonian described by the interaction between light and atoms, and analyze spectroscopic properties such as dispersion relation, Fermi surfaces, spectral functions, spin-dependent momentum distributions and density of states. Connections to spin-one bosons and SU(3) systems is made, as well relations to the Lifshitz transition and Pomeranchuk instability are presented.

  5. Key properties of expert movement systems in sport : an ecological dynamics perspective.

    Science.gov (United States)

    Seifert, Ludovic; Button, Chris; Davids, Keith

    2013-03-01

    This paper identifies key properties of expertise in sport predicated on the performer-environment relationship. Weaknesses of traditional approaches to expert performance, which uniquely focus on the performer and the environment separately, are highlighted by an ecological dynamics perspective. Key properties of expert movement systems include 'multi- and meta-stability', 'adaptive variability', 'redundancy', 'degeneracy' and the 'attunement to affordances'. Empirical research on these expert system properties indicates that skill acquisition does not emerge from the internal representation of declarative and procedural knowledge, or the imitation of expert behaviours to linearly reduce a perceived 'gap' separating movements of beginners and a putative expert model. Rather, expert performance corresponds with the ongoing co-adaptation of an individual's behaviours to dynamically changing, interacting constraints, individually perceived and encountered. The functional role of adaptive movement variability is essential to expert performance in many different sports (involving individuals and teams; ball games and outdoor activities; land and aquatic environments). These key properties signify that, in sport performance, although basic movement patterns need to be acquired by developing athletes, there exists no ideal movement template towards which all learners should aspire, since relatively unique functional movement solutions emerge from the interaction of key constraints.

  6. Emergence in Dynamical Systems

    Directory of Open Access Journals (Sweden)

    John Collier

    2013-12-01

    Full Text Available Emergence is a term used in many contexts in current science; it has become fashionable. It has a traditional usage in philosophy that started in 1875 and was expanded by J. S. Mill (earlier, under a different term and C. D. Broad. It is this form of emergence that I am concerned with here. I distinguish it from uses like ‘computational emergence,’ which can be reduced to combinations of program steps, or its application to merely surprising new features that appear in complex combinations of parts. I will be concerned specifically with ontological emergence that has the logical properties required by Mill and Broad (though there might be some quibbling about the details of their views. I restrict myself to dynamical systems that are embodied in processes. Everything that we can interact with through sensation or action is either dynamical or can be understood in dynamical terms, so this covers all comprehensible forms of emergence in the strong (nonreducible sense I use. I will give general dynamical conditions that underlie the logical conditions traditionally assigned to emergence in nature.The advantage of this is that, though we cannot test logical conditions directly, we can test dynamical conditions. This gives us an empirical and realistic form of emergence, contrary those who say it is a matter of perspective.

  7. Canadian Eskimo permanent tooth emergence timing.

    Science.gov (United States)

    Mayhall, J T; Belier, P L; Mayhall, M F

    1978-08-01

    To identify the times of emergence of the permanent teeth of Canadian Eskimos (Inuit), 368 children and adolescents were examined. The presence or absence of all permanent teeth except the third molars was recorded and these data subjected to probit analysis. Female emergence times were advanced over males. Generally, the Inuit of both sexes showed statistically significant earlier emergence times than Montreal children, except for the incisors. The present results do not support hypotheses indicating that premature extraction of the deciduous teeth advances the emergence of their succedaneous counterparts. There is some indication the controls of deciduous tooth emergence continue to play some part in emergence of the permanent dentition, especially the first permanent teeth that emerge.

  8. Emergent properties of gene evolution: Species as attractors in phenotypic space

    Science.gov (United States)

    Reuveni, Eli; Giuliani, Alessandro

    2012-02-01

    The question how the observed discrete character of the phenotype emerges from a continuous genetic distance metrics is the core argument of two contrasted evolutionary theories: punctuated equilibrium (stable evolution scattered with saltations in the phenotype) and phyletic gradualism (smooth and linear evolution of the phenotype). Identifying phenotypic saltation on the molecular levels is critical to support the first model of evolution. We have used DNA sequences of ∼1300 genes from 6 isolated populations of the budding yeast Saccharomyces cerevisiae. We demonstrate that while the equivalent measure of the genetic distance show a continuum between lineage distance with no evidence of discrete states, the phenotypic space illustrates only two (discrete) possible states that can be associated with a saltation of the species phenotype. The fact that such saltation spans large fraction of the genome and follows by continuous genetic distance is a proof of the concept that the genotype-phenotype relation is not univocal and may have severe implication when looking for disease related genes and mutations. We used this finding with analogy to attractor-like dynamics and show that punctuated equilibrium could be explained in the framework of non-linear dynamics systems.

  9. Priorities for emergency department syncope research

    NARCIS (Netherlands)

    Sun, Benjamin C.; Costantino, Giorgio; Barbic, Franca; Bossi, Ilaria; Casazza, Giovanni; Dipaola, Franca; McDermott, Daniel; Quinn, James; Reed, Matthew; Sheldon, Robert S.; Solbiati, Monica; Thiruganasambandamoorthy, Venkatesh; Krahn, Andrew D.; Beach, Daniel; Bodemer, Nicolai; Brignole, Michele; Casagranda, Ivo; Duca, Piergiorgio; Falavigna, Greta; Ippoliti, Roberto; Montano, Nicola; Olshansky, Brian; Raj, Satish R.; Ruwald, Martin H.; Shen, Win-Kuang; Stiell, Ian; Ungar, Andrea; van Dijk, J. Gert; van Dijk, Nynke; Wieling, Wouter; Furlan, Raffaello

    2014-01-01

    There is limited evidence to guide the emergency department (ED) evaluation and management of syncope. The First International Workshop on Syncope Risk Stratification in the Emergency Department identified key research questions and methodological standards essential to advancing the science of

  10. Emergency Management for Disasters in Malaysian Hotel Industry

    OpenAIRE

    AlBattat Ahmad Rasmi; Mat Som Ahmad Puad; Abukhalifeh Ala`a

    2014-01-01

    This paper aims to identify major emergencies that have the potential to place Malaysian hotels in emergency and disaster situations; investigate how hotels were prepared for emergencies, how they manage and overcome emergencies when occurred; and limitations and factors influencing successful emergency planning and adoption emergency management in Malaysian hotels. Face-to-face interview with managers from three, four and five star hotels from different backgrounds: local; regional; and Inte...

  11. Bactericidal assessment of nano-silver on emerging and re-emerging human pathogens.

    Science.gov (United States)

    Anuj, Samir A; Gajera, Harsukh P; Hirpara, Darshna G; Golakiya, Baljibhai A

    2018-04-24

    With the threat of the growing number of bacteria resistant to antibiotics, the re-emergence of previously deadly infections and the emergence of new infections, there is an urgent need for novel therapeutic agent. Silver in the nano form, which is being used increasingly as antibacterial agents, may extend its antibacterial application to emerging and re-emerging multidrug-resistant pathogens, the main cause of nosocomial diseases worldwide. In the present study, a completely bottom up method to prepare green nano-silver was used. To explore the action of nano-silver on emerging Bacillus megaterium MTCC 7192 and re-emerging Pseudomonas aeruginosa MTCC 741 pathogenic bacteria, the study includes an analysis of the bacterial membrane damage through Scanning Electron Microscope (SEM) as well as alternation of zeta potential and intracellular leakages. In this work, we observed genuine bactericidal property of nano-silver as compare to broad spectrum antibiotics against emerging and re-emerging mode. After being exposed to nano-silver, the membrane becomes scattered from their original ordered arrangement based on SEM observation. Moreover, our results also suggested that alternation of zeta potential enhanced membrane permeability, and beyond a critical point, it leads to cell death. The leakages of intracellular constituents were confirmed by Gas Chromatography-Mass Spectrometry (GC-MS). In conclusion, the combine results suggested that at a specific dose, nano-silver may destroy the structure of bacterial membrane and depress its activity, which causes bacteria to die eventually. Copyright © 2018 Elsevier GmbH. All rights reserved.

  12. Radiation Emergency Planning in Petroleum Industry

    International Nuclear Information System (INIS)

    El-Shinawy, R.M.K.; El-Naggar, M.A.; Abdel-Fattah, A.T.; Gomaa, A.M.

    2001-01-01

    Similar to all industrial activities utilizing radiation sources, or dealing with radioactive materials in its operations, petroleum industry requires the organization of a Radiation Emergency Plan. This plan should be based on a comprehensive and subtle understanding of the extensive multidisciplinary operations involved in petroleum processing and the dangers that threaten human health, environment and property; both from ordinary emergency situations common to petroleum industry activities and also from radiation emergency events. Radiation emergencies include radiological source accidents involving occurrence of high dose exposures. Radioactive contamination or spill are also major problems that may cause low dose exposures and environmental radioactive contamination. The simultaneous occurrence of other industrial emergency events such as fires or structural collapses will add to the seriousness of the emergency situation. The essential aspects of Radiation Emergency Planning include notification, assessment of situation, foresight, definition of roles and responsibilities including health safety and environmental concepts. An important contribution to the Emergency Planning is the proper intelligent medical response. Another essential parameter is the training of personnel that will undertake the responsibility of executing the emergency procedures according to the various emergency situations. The main features of the radiation Emergency Plan in Petroleum industry is presented in the text

  13. IAEA emergency response network ERNET. Emergency preparedness and response. Date effective: 1 December 2002

    International Nuclear Information System (INIS)

    2003-04-01

    The Parties to the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency have undertaken to co-operate among themselves and with the IAEA in facilitating the prompt provision of assistance in the event of a nuclear accident or radiological emergency, and in minimizing the consequences and in protecting life, property and the environment from the effects of any radioactive releases. As part of the IAEA strategy for supporting such co-operation, the Secretariat of the IAEA is establishing a global Emergency Response Network (ERNET) of teams suitably qualified to respond rapidly, on a regional basis, to nuclear accidents or radiological emergencies. This manual sets out the criteria and requirements to be met by ERNET teams. It is intended for use by institutions in Member States in developing, applying and maintaining their emergency response capabilities and in implementing quality assurance programmes within the context of ERNET. The manual is worded on the assumption that a State Competent Authority designated as the body responsible for reacting to nuclear accidents or radiological emergencies which occur outside the jurisdiction of that State will be the State Contact Point for receiving requests for assistance from the IAEA under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency

  14. IAEA emergency response network ERNET. Emergency preparedness and response. Date effective: 1 December 2000

    International Nuclear Information System (INIS)

    2000-12-01

    The Parties to the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency have undertaken to co-operate among themselves and with the IAEA in facilitating the prompt provision of assistance in the event of a nuclear accident or radiological emergency, and in minimizing the consequences and in protecting life, property and the environment from the effects of any radioactive releases. As part of the IAEA strategy for supporting such co-operation, the Secretariat of the IAEA is establishing a global Emergency Response Network (ERNET) of teams suitably qualified to respond rapidly, on a regional basis, to nuclear accidents or radiological emergencies. This manual sets out the criteria and requirements to be met by ERNET teams. It is intended for use by institutions in Member States in developing, applying and maintaining their emergency response capabilities and in implementing quality assurance programmes within the context of ERNET. The manual is worded on the assumption that a State Competent Authority designated as the body responsible for reacting to nuclear accidents or radiological emergencies which occur outside the jurisdiction of that State will be the State Contact Point for receiving requests for assistance from the IAEA under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency

  15. Does the emergency surgery score accurately predict outcomes in emergent laparotomies?

    Science.gov (United States)

    Peponis, Thomas; Bohnen, Jordan D; Sangji, Naveen F; Nandan, Anirudh R; Han, Kelsey; Lee, Jarone; Yeh, D Dante; de Moya, Marc A; Velmahos, George C; Chang, David C; Kaafarani, Haytham M A

    2017-08-01

    The emergency surgery score is a mortality-risk calculator for emergency general operation patients. We sought to examine whether the emergency surgery score predicts 30-day morbidity and mortality in a high-risk group of patients undergoing emergent laparotomy. Using the 2011-2012 American College of Surgeons National Surgical Quality Improvement Program database, we identified all patients who underwent emergent laparotomy using (1) the American College of Surgeons National Surgical Quality Improvement Program definition of "emergent," and (2) all Current Procedural Terminology codes denoting a laparotomy, excluding aortic aneurysm rupture. Multivariable logistic regression analyses were performed to measure the correlation (c-statistic) between the emergency surgery score and (1) 30-day mortality, and (2) 30-day morbidity after emergent laparotomy. As sensitivity analyses, the correlation between the emergency surgery score and 30-day mortality was also evaluated in prespecified subgroups based on Current Procedural Terminology codes. A total of 26,410 emergent laparotomy patients were included. Thirty-day mortality and morbidity were 10.2% and 43.8%, respectively. The emergency surgery score correlated well with mortality (c-statistic = 0.84); scores of 1, 11, and 22 correlated with mortalities of 0.4%, 39%, and 100%, respectively. Similarly, the emergency surgery score correlated well with morbidity (c-statistic = 0.74); scores of 0, 7, and 11 correlated with complication rates of 13%, 58%, and 79%, respectively. The morbidity rates plateaued for scores higher than 11. Sensitivity analyses demonstrated that the emergency surgery score effectively predicts mortality in patients undergoing emergent (1) splenic, (2) gastroduodenal, (3) intestinal, (4) hepatobiliary, or (5) incarcerated ventral hernia operation. The emergency surgery score accurately predicts outcomes in all types of emergent laparotomy patients and may prove valuable as a bedside decision

  16. Medical Emergencies in Goa

    Science.gov (United States)

    Saddichha, Sahoo; Saxena, Mukul Kumar

    2010-01-01

    Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa's roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs) were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%), which were mainly of the nature of accidents or assaults (17%) and fever related (17%). Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa. PMID:20606921

  17. Effect of Cover Crop Residues on Some Physicochemical Properties of Soil and Emergence Rate of Potato

    Directory of Open Access Journals (Sweden)

    M. Ghaffari

    2012-07-01

    Full Text Available The aim of this study, was to evaluate the effect of winter cover crop residues on speed of seed  potato emergence and percentage of organic carbon, soil specific weight and soil temperature. An experiment was carried out at the Research Farm of Agriculture Faculty, Bu-AliSinaUniversity, in 2008-2009. The experiment was a randomized complete block design with three replications. Winter cover crops consisted of rye, barley and oilseed rape, each one with common plant density (rye and barley at 190 kg.ha-1 and oilseed rape at 9 kg.ha-1 and triple plant densities(rye and barley 570 kg.ha-1 and oilseed rape, 27 kg.ha-1 and control (without cover crop. The results showed that rye and barley with triple plant densities produced higher biomass (1503.5 and 1392.2 g/m2, respectively than other treatments.Soil physicochemical properties were affected significantly by using cover crops. Rye, barley, and oilseed rape with triple rate and rye with common rape of plant densities produced, the highest organic carbon. Green manure of rye and barley with triple and rye with common rate plant densities, reduced soil specific weights by 17.3, 18 and 18 percent as compared with the control treatment (without cover crop planting. Rye and barley with triple plant densities increased average soil temperature by 12 and 11 percent respectively in comparison with control treatment. These treatments increased speed of seed potato emergence by 20 and 12 percent respectively as compared with that of control treatment, respectively. Other treatments showed no significant difference as compared to control. Cover crop residues increased plants speed of seed potato emergence through improving soil conditions.

  18. Emerging Science and Research Opportunities for Metals and Metallic Nanostructures

    Science.gov (United States)

    Handwerker, Carol A.; Pollock, Tresa M.

    2014-07-01

    During the next decade, fundamental research on metals and metallic nanostructures (MMNs) has the potential to continue transforming metals science into innovative materials, devices, and systems. A workshop to identify emerging and potentially transformative research areas in MMNs was held June 13 and 14, 2012, at the University of California Santa Barbara. There were 47 attendees at the workshop (listed in the Acknowledgements section), representing a broad range of academic institutions, industry, and government laboratories. The metals and metallic nanostructures (MMNs) workshop aimed to identify significant research trends, scientific fundamentals, and recent breakthroughs that can enable new or enhanced MMN performance, either alone or in a more complex materials system, for a wide range of applications. Additionally, the role that MMN research can play in high-priority research and development (R&D) areas such as the U.S. Materials Genome Initiative, the National Nanotechnology Initiative, the Advanced Manufacturing Initiative, and other similar initiatives that exist internationally was assessed. The workshop also addressed critical issues related to materials research instrumentation and the cyberinfrastructure for materials science research and education, as well as science, technology, engineering, and mathematics (STEM) workforce development, with emphasis on the United States but with an appreciation that similar challenges and opportunities for the materials community exist internationally. A central theme of the workshop was that research in MMNs has provided and will continue to provide societal benefits through the integration of experiment, theory, and simulation to link atomistic, nanoscale, microscale, and mesoscale phenomena across time scales for an ever-widening range of applications. Within this overarching theme, the workshop participants identified emerging research opportunities that are categorized and described in more detail in the

  19. Emergency management information system (EMINS)

    International Nuclear Information System (INIS)

    Desonier, L.M.

    1987-01-01

    In a time of crisis or in an emergency, a manager is required to make many decisions to facilitate the proper solution and conclusion to the emergency or crisis. In order to make these decisions, it is necessary for the manager to have correct up-to-date information on the situation, which calls for an automated information display and entry process. The information handling needs are identified in terms of data, video, and voice. Studies of existing Emergency Operations Centers and evaluations of hardware and software have been completed. The result of these studies and investigations is the design and implementation of an automated Emergency Management Information System. Not only is the system useful for Emergency Management but for any information management requirement

  20. The prefect facing emergency situation

    International Nuclear Information System (INIS)

    Masse, H.

    2006-01-01

    In the field of emergency procedures regarding the protection of life, property and the environment, the 'prefet' of a department is the only public authority both representative of the state and accountable. In France laws and regulations have been in recent years revised in order to modernize emergency situations management. The 'prefet' of the Drome 'department', Henri MASSE, presents a summary of recent developments and explains how his services are organised in order to be able to handle emergency situations. He also focuses on his experience of handling the specific difficulties of nuclear risks, his department sheltering numerous nuclear facilities: EURODIF Pierrelatte nuclear fuel enrichment plant, EDF Tricastin nuclear power plant, AREVA Valence FBFC nuclear fuel manufacturing unit, etc. (author)

  1. Emergency presurgical visit

    Directory of Open Access Journals (Sweden)

    Alfredo Castro Díaz

    2009-07-01

    Full Text Available The objective has been to create a Protocol of Structured Presurgical Visit applicable to the patients who are undergoing an emergency surgery, to provide the user and his family all the necessary cares on the basis of those nursing diagnosis that prevail in all the cases of surgical emergency interventions. The used method has been an analysis of the emergency surgical interventions more prevalent from February 2007 until October 2008 in our area (a regional hospital, and statistic of those nursing diagnosis that more frequently appeared in these interventions, the previous moment to the intervention and in addition common to all of them. The results were the following ones: the more frequent emergency operations were: Caesarean, ginecological curettage, laparotomy, help in risk childbirth, orthopaedic surgery and appendectomy. The more frequent nursing diagnosis in all the emergency operations at the previous moment of the intervention were: risk of falls, pain, anxiety, deficit of knowledge, risk of infection, movement stress syndrome, risk of hemorrhage, cutaneous integrity deterioration. The conclusion is that users present at the previous moment to an emergency operation several problems, which force to the emergency surgical ward nurse to the introduction of the nursing methodology, in order to identify the problems, to mark results and to indicate the interventions to achieve those results, besides in a humanitarian way and with quality. This can be obtained by performing a Structured Emergency Presurgical Visit.

  2. Los Alamos National Laboratory emergency management plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents, transportation accidents, electrical accidents, and natural disasters.

  3. Active-learning instruction on emergency contraception counseling.

    Science.gov (United States)

    Young, Shardae; Griffin, Brooke; Vest, Kathleen

    2013-06-12

    To increase pharmacy students' knowledge of and confidence in counseling patients regarding emergency contraception and to identify any barriers to counseling patients about emergency contraception. Approximately 200 third-year pharmacy students participated in the Women's Health Therapeutics workshop at Midwestern University Chicago College of Pharmacy. Students observed a 5-minute skit of a counseling session on emergency contraception and then were asked to pair up with a classmate and practice counseling each other regarding the use of emergency contraception following a checklist of key points. One hundred eighty-nine students completed pre- and post-workshop survey instruments. Students' knowledge scores increased from 86% to 93% (pemergency contraception before completing the active-learning exercise compared to 58.5% after (pemergency contraception and significantly reduced several barriers to counseling identified prior to participation.

  4. Emergency nurses' knowledge of pain management principles.

    Science.gov (United States)

    Tanabe, P; Buschmann, M

    2000-08-01

    The purpose of this study was to determine areas of emergency nurses' knowledge deficit regarding pain management, and to identify barriers to pain management as perceived by emergency nurses. Data were collected anonymously in a mail survey using a 52-item knowledge questionnaire addressing pain management principles and asking emergency nurses (Illinois Emergency Nurses Association members) to rate various barriers as to how often they affect their practice. Questionnaires were mailed to all Illinois ENA members (n = 1000). Three hundred five emergency nurses' questionnaires were returned. A significant deficit existed on 2 domains of knowledge: understanding of the terms "addiction," "tolerance," and "dependence"; and knowledge of various pharmacologic analgesic principles. Nurses with a master's degree or higher, or those who attended a 1-day seminar on pain management, achieved statistically significantly higher scores. The 2 barriers identified by emergency nurses as the most common were the inability to administer medication until a diagnosis is made (53%), and inadequate assessment of pain and pain relief (48%) (the percentage indicates how often the emergency nurses believed the barrier was present in their practice). The data indicate that emergency nurses may not have a good understanding of the management of pain with drugs, or of such issues as risk of addiction.

  5. 36 CFR 223.81 - Shorter advertising periods in emergencies.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Shorter advertising periods... OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER Timber Sale Contracts Advertisement and Bids § 223.81 Shorter advertising periods in emergencies. In emergency situations where prompt...

  6. Debates on Intellectual Property Rights

    Directory of Open Access Journals (Sweden)

    Paula – Angela VIDRAŞCU

    2014-09-01

    Full Text Available This paper supports the understanding of the definition of intellectual property rights and strong connection with intangible assets and, on the other hand, provides a brief presentation of the organizations supporting the protection of such rights. The essential aim of this article is represented by the detailed information obtained as a result of research carried out in order to define, identify and study the application of IPR in general and especially in our country. At the end of the paper I mentioned what involves protecting intellectual property rights and brought little concerned how our country is perceived to protect such rights. Most often, intellectual property is defined as a formal document of title, like a lease, which means that the property is a legal concept distinct from real property that are actually good without concrete material form. Constitute a special category of assets being perceived as an original creation, derived from creative ideas; has or may have a commercial value due to its contribution to earnings for its owner. The need for protection of intellectual property rights has emerged because of the changes in the contemporary society. The aim and purpose of which is to protect human intelligence product and, at the same time, ensuring that consumers benefit from the use of the attributes of this product. Always remember that the violation of intellectual property rights, causes injury to major economic, signifying a strong threat to the consumers health and safety.

  7. Web Science emerges

    OpenAIRE

    Shadbolt, Nigel; Berners-Lee, Tim

    2008-01-01

    The relentless rise in Web pages and links is creating emergent properties, from social networks to virtual identity theft, that are transforming society. A new discipline, Web Science, aims to discover how Web traits arise and how they can be harnessed or held in check to benefit society. Important advances are beginning to be made; more work can solve major issues such as securing privacy and conveying trust.

  8. Defining an emerging disease.

    Science.gov (United States)

    Moutou, F; Pastoret, P-P

    2015-04-01

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

  9. Identify-Isolate-Inform: A Tool for Initial Detection and Management of Zika Virus Patients in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Kristi L. Koenig

    2016-05-01

    Full Text Available First isolated in 1947 from a monkey in the Zika forest in Uganda, and from mosquitoes in the same forest the following year, Zika virus has gained international attention due to concerns for infection in pregnant women potentially causing fetal microcephaly. More than one million people have been infected since the appearance of the virus in Brazil in 2015. Approximately 80% of infected patients are asymptomatic. An association with microcephaly and other birth defects as well as Guillain-Barre Syndrome has led to a World Health Organization declaration of Zika virus as a Public Health Emergency of International Concern in February 2016. Zika virus is a vector-borne disease transmitted primarily by the Aedes aegypti mosquito. Male to female sexual transmission has been reported and there is potential for transmission via blood transfusions. After an incubation period of 2-7 days, symptomatic patients develop rapid onset fever, maculopapular rash, arthralgia, and conjunctivitis, often associated with headache and myalgias. Emergency department (ED personnel must be prepared to address concerns from patients presenting with symptoms consistent with acute Zika virus infection, especially those who are pregnant or planning travel to Zika-endemic regions, as well as those women planning to become pregnant and their partners. The identify-isolate-inform (3I tool, originally conceived for initial detection and management of Ebola virus disease patients in the ED, and later adjusted for measles and Middle East Respiratory Syndrome, can be adapted for real-time use for any emerging infectious disease. This paper reports a modification of the 3I tool for initial detection and management of patients under investigation for Zika virus. Following an assessment of epidemiologic risk, including travel to countries with mosquitoes that transmit Zika virus, patients are further investigated if clinically indicated. If after a rapid evaluation, Zika or other

  10. Transportation Emergency Preparedness Program (TEPP)

    International Nuclear Information System (INIS)

    1991-04-01

    The Transportation Emergency Preparedness Program (TEPP) will develop and enhance integrated emergency preparedness capabilities in two major areas. First, the program is responsible for planning and ensuring proper DOE response to transportation incidents involving DOE shipments. Second, the program is responsible for ensuring DOE can carry out its responsibilities under regulations, the National Contingency Plan (NCP) and the Federal Radiological Emergency Response Plan (FRERP) to provide technical advice and assistance as needed for any transportation incident involving radioactive or mixed hazard materials. This plan proposes a strategy for developing a comprehensive Transportation Emergency Preparedness Program, including a well organized central management and coordination structure, that serves as a process to identify, verify, and establish a consolidated effort across the Department in this very important area. This plan assumes Emergency Management to be the full range of emergency activities necessary for mitigation, preparedness, response and recovery while Emergency Preparedness activities are primarily those necessary in preparation for Incident Response Emergency Preparedness, which is the focus of this strategy plan, requires a well organized central coordination structure to be effective. 7 refs

  11. Identifying Patients with Bacteremia in Community-Hospital Emergency Rooms: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Taro Takeshima

    Full Text Available (1 To develop a clinical prediction rule to identify patients with bacteremia, using only information that is readily available in the emergency room (ER of community hospitals, and (2 to test the validity of that rule with a separate, independent set of data.Multicenter retrospective cohort study.To derive the clinical prediction rule we used data from 3 community hospitals in Japan (derivation. We tested the rule using data from one other community hospital (validation, which was not among the three "derivation" hospitals.Adults (age ≥ 16 years old who had undergone blood-culture testing while in the ER between April 2011 and March 2012. For the derivation data, n = 1515 (randomly sampled from 7026 patients, and for the validation data n = 467 (from 823 patients.We analyzed 28 candidate predictors of bacteremia, including demographic data, signs and symptoms, comorbid conditions, and basic laboratory data. Chi-square tests and multiple logistic regression were used to derive an integer risk score (the "ID-BactER" score. Sensitivity, specificity, likelihood ratios, and the area under the receiver operating characteristic curve (i.e., the AUC were computed.There were 241 cases of bacteremia in the derivation data. Eleven candidate predictors were used in the ID-BactER score: age, chills, vomiting, mental status, temperature, systolic blood pressure, abdominal sign, white blood-cell count, platelets, blood urea nitrogen, and C-reactive protein. The AUCs was 0.80 (derivation and 0.74 (validation. For ID-BactER scores ≥ 2, the sensitivities for derivation and validation data were 98% and 97%, and specificities were 20% and 14%, respectively.The ID-BactER score can be computed from information that is readily available in the ERs of community hospitals. Future studies should focus on developing a score with a higher specificity while maintaining the desired sensitivity.

  12. The genome sequence of the emerging common midwife toad virus identifies an evolutionary intermediate within ranaviruses.

    Science.gov (United States)

    Mavian, Carla; López-Bueno, Alberto; Balseiro, Ana; Casais, Rosa; Alcamí, Antonio; Alejo, Alí

    2012-04-01

    Worldwide amphibian population declines have been ascribed to global warming, increasing pollution levels, and other factors directly related to human activities. These factors may additionally be favoring the emergence of novel pathogens. In this report, we have determined the complete genome sequence of the emerging common midwife toad ranavirus (CMTV), which has caused fatal disease in several amphibian species across Europe. Phylogenetic and gene content analyses of the first complete genomic sequence from a ranavirus isolated in Europe show that CMTV is an amphibian-like ranavirus (ALRV). However, the CMTV genome structure is novel and represents an intermediate evolutionary stage between the two previously described ALRV groups. We find that CMTV clusters with several other ranaviruses isolated from different hosts and locations which might also be included in this novel ranavirus group. This work sheds light on the phylogenetic relationships within this complex group of emerging, disease-causing viruses.

  13. Security and Emergency Management Division

    Data.gov (United States)

    Federal Laboratory Consortium — Volpe's Security and Emergency Management Division identifies vulnerabilities, risks, and opportunities to improve the security of transportation systems, critical...

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Double-shell tank emergency pumping guide

    International Nuclear Information System (INIS)

    BROWN, M.H.

    1999-01-01

    This Double-Shell Tank Emergency Pumping Guide provides the preplanning necessary to expeditiously remove any waste that may leak from the primary tank to the secondary tank for Hanfords 28 DSTs. The strategy is described, applicable emergency procedures are referenced, and transfer routes and pumping equipment for each tank are identified

  16. Double-shell tank emergency pumping guide

    International Nuclear Information System (INIS)

    BROWN, M.H.

    1999-01-01

    This Double-Shell Tank Emergency Pumping Guide provides the preplanning necessary to expeditiously remove any waste that may leak from the primary tank to the secondary tank for Hanford's 28 DSTS. The strategy is described, applicable emergency procedures are referenced, and transfer routes and pumping equipment for each tank are identified

  17. Emergence of the second law out of reversible dynamics

    NARCIS (Netherlands)

    Willigenburg, van L.G.; Koning, de W.L.

    2009-01-01

    Abstract If one demystifies entropy the second law of thermodynamics comes out as an emergent property entirely based on the simple dynamic mechanical laws that govern the motion and energies of system parts on a micro-scale. The emergence of the second law is illustrated in this paper through the

  18. Emergency Response Resources guide for nuclear power plant emergencies

    International Nuclear Information System (INIS)

    1992-07-01

    On August 28 and September 18, 1990, the States of Louisiana and Mississippi, Gulf States Utilities, five local parishes, six Federal agencies, and the American Nuclear Insurers participated in a post-emergency TABLETOP exercise in Baton Rouge, Louisiana. One of the products developed from that experience was this guide for understanding the responsibilities and obtaining resources for specific needs from the various participants, particularly from those organizations within the Federal Government. This first revision of that guide broadens the focus of the original document. Also, new information defines the major Federal response facilities. This guide should assist State and local government organizations with identifying and obtaining those resources for the post-emergency response when their resources have been exhausted

  19. Innovations and Other Processes as Identifiers of Contemporary Trends in the Sustainable Development of SMEs: The Case of Emerging Regional Economies

    Directory of Open Access Journals (Sweden)

    Krzysztof Malik

    2018-04-01

    Full Text Available Small and medium enterprises (SMEs are the biggest group of enterprises in the European Union (EU; they are also characteristic of emerging economies. Given this situation, there is a need to provide instruments such as processes that allow them to realize a model of sustainable development. The ability to classify processes and the occurrences within these processes often affects the state of the enterprises. The implementation of innovations, as identified processes, facilities sustainable development for SMEs. The purpose of this article is to find out whether the identification of processes such as innovations has any influence on the competitiveness and sustainable development of SMEs. This study was based on pilot research that examined small and medium enterprises regionally based on the example of an emerging economic region of Poland. The research focused on the identification of the processes and changes happening inside enterprises in terms of understanding the sustainable development concept. The research composition allows the presentation of how SMEs understand the problems analyzed. The study features a new questionnaire, a new definition of sustainable development, and matches those processes identified by the enterprises analyzed with the particular sustainable development dimensions suggested by the authors. In light of the analysis of the literature and the results of this research, the study offers some important contributions in terms of understanding and offering practical meaning to the identification of various processes. The most important finding was that there is a need to raise awareness among entrepreneurs of the fact that innovations are also processes in themselves, which often constitute the sum of other supporting processes occurring within the enterprise. Support in the form of knowledge transfer from experts to SMEs would also be recommended.

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

    Science.gov (United States)

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

    2013-05-23

    Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed

  1. Emergency situations in SMEs : Are entrepreneurs prepared?

    NARCIS (Netherlands)

    Kleijn, E.; Montfort, van K.; Masurel, E.

    2012-01-01

    The article examines how entrepreneurs prepare for emergency situations in small and medium-sized enterprises (SMEs) in the Netherlands. It identifies the characteristics of SMEs and the theory related to emergency situations and the preparations for such situations. It also provides a detailed

  2. Whole genome-wide transcript profiling to identify differentially expressed genes associated with seed field emergence in two soybean low phytate mutants.

    Science.gov (United States)

    Yuan, Fengjie; Yu, Xiaomin; Dong, Dekun; Yang, Qinghua; Fu, Xujun; Zhu, Shenlong; Zhu, Danhua

    2017-01-18

    Seed germination is important to soybean (Glycine max) growth and development, ultimately affecting soybean yield. A lower seed field emergence has been the main hindrance for breeding soybeans low in phytate. Although this reduction could be overcome by additional breeding and selection, the mechanisms of seed germination in different low phytate mutants remain unknown. In this study, we performed a comparative transcript analysis of two low phytate soybean mutants (TW-1 and TW-1-M), which have the same mutation, a 2 bp deletion in GmMIPS1, but show a significant difference in seed field emergence, TW-1-M was higher than that of TW-1 . Numerous genes analyzed by RNA-Seq showed markedly different expression levels between TW-1-M and TW-1 mutants. Approximately 30,000-35,000 read-mapped genes and ~21000-25000 expressed genes were identified for each library. There were ~3900-9200 differentially expressed genes (DEGs) in each contrast library, the number of up-regulated genes was similar with down-regulated genes in the mutant TW-1and TW-1-M. Gene ontology functional categories of DEGs indicated that the ethylene-mediated signaling pathway, the abscisic acid-mediated signaling pathway, response to hormone, ethylene biosynthetic process, ethylene metabolic process, regulation of hormone levels, and oxidation-reduction process, regulation of flavonoid biosynthetic process and regulation of abscisic acid-activated signaling pathway had high correlations with seed germination. In total, 2457 DEGs involved in the above functional categories were identified. Twenty-two genes with 20 biological functions were the most highly up/down- regulated (absolute value Log2FC >5) in the high field emergence mutant TW-1-M and were related to metabolic or signaling pathways. Fifty-seven genes with 36 biological functions had the greatest expression abundance (FRPM >100) in germination-related pathways. Seed germination in the soybean low phytate mutants is a very complex process

  3. Interactive Sonification Exploring Emergent Behavior Applying Models for Biological Information and Listening

    Science.gov (United States)

    Choi, Insook

    2018-01-01

    Sonification is an open-ended design task to construct sound informing a listener of data. Understanding application context is critical for shaping design requirements for data translation into sound. Sonification requires methodology to maintain reproducibility when data sources exhibit non-linear properties of self-organization and emergent behavior. This research formalizes interactive sonification in an extensible model to support reproducibility when data exhibits emergent behavior. In the absence of sonification theory, extensibility demonstrates relevant methods across case studies. The interactive sonification framework foregrounds three factors: reproducible system implementation for generating sonification; interactive mechanisms enhancing a listener's multisensory observations; and reproducible data from models that characterize emergent behavior. Supramodal attention research suggests interactive exploration with auditory feedback can generate context for recognizing irregular patterns and transient dynamics. The sonification framework provides circular causality as a signal pathway for modeling a listener interacting with emergent behavior. The extensible sonification model adopts a data acquisition pathway to formalize functional symmetry across three subsystems: Experimental Data Source, Sound Generation, and Guided Exploration. To differentiate time criticality and dimensionality of emerging dynamics, tuning functions are applied between subsystems to maintain scale and symmetry of concurrent processes and temporal dynamics. Tuning functions accommodate sonification design strategies that yield order parameter values to render emerging patterns discoverable as well as rehearsable, to reproduce desired instances for clinical listeners. Case studies are implemented with two computational models, Chua's circuit and Swarm Chemistry social agent simulation, generating data in real-time that exhibits emergent behavior. Heuristic Listening is introduced

  4. Interactive Sonification Exploring Emergent Behavior Applying Models for Biological Information and Listening

    Directory of Open Access Journals (Sweden)

    Insook Choi

    2018-04-01

    Full Text Available Sonification is an open-ended design task to construct sound informing a listener of data. Understanding application context is critical for shaping design requirements for data translation into sound. Sonification requires methodology to maintain reproducibility when data sources exhibit non-linear properties of self-organization and emergent behavior. This research formalizes interactive sonification in an extensible model to support reproducibility when data exhibits emergent behavior. In the absence of sonification theory, extensibility demonstrates relevant methods across case studies. The interactive sonification framework foregrounds three factors: reproducible system implementation for generating sonification; interactive mechanisms enhancing a listener's multisensory observations; and reproducible data from models that characterize emergent behavior. Supramodal attention research suggests interactive exploration with auditory feedback can generate context for recognizing irregular patterns and transient dynamics. The sonification framework provides circular causality as a signal pathway for modeling a listener interacting with emergent behavior. The extensible sonification model adopts a data acquisition pathway to formalize functional symmetry across three subsystems: Experimental Data Source, Sound Generation, and Guided Exploration. To differentiate time criticality and dimensionality of emerging dynamics, tuning functions are applied between subsystems to maintain scale and symmetry of concurrent processes and temporal dynamics. Tuning functions accommodate sonification design strategies that yield order parameter values to render emerging patterns discoverable as well as rehearsable, to reproduce desired instances for clinical listeners. Case studies are implemented with two computational models, Chua's circuit and Swarm Chemistry social agent simulation, generating data in real-time that exhibits emergent behavior. Heuristic

  5. Enfermedades emergentes no infecciosas Emerging noninfectious diseases

    Directory of Open Access Journals (Sweden)

    Ezequiel Consiglio

    2008-11-01

    Full Text Available In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

  6. Anaphylaxis in an emergency care setting

    DEFF Research Database (Denmark)

    Ruiz Oropeza, Athamaica; Lassen, Annmarie; Halken, Susanne

    2017-01-01

    BACKGROUND: Current data on anaphylaxis is based on retrospective and register based studies. The objective of this study was to describe the epidemiology of anaphylaxis in a 1 year prospective study at the emergency care setting, Odense University Hospital, Denmark (2013-2014). METHODS: Prospect......BACKGROUND: Current data on anaphylaxis is based on retrospective and register based studies. The objective of this study was to describe the epidemiology of anaphylaxis in a 1 year prospective study at the emergency care setting, Odense University Hospital, Denmark (2013-2014). METHODS......: Prospective study at the emergency care setting, Odense University Hospital, Denmark (2013-2014). To identify anaphylaxis cases, records from all patients with clinical suspicion on anaphylaxis or a related diagnosis according to the International Classification of Diseases 10 and from patients treated...... at the emergency care setting or at prehospital level with adrenaline, antihistamines or glucocorticoids were reviewed daily. The identified cases were referred to the Allergy Center, where a standardized interview regarding the anaphylactic reaction was conducted. International guidelines were applied...

  7. 33 CFR 230.8 - Emergency actions.

    Science.gov (United States)

    2010-07-01

    ... to prevent or reduce imminent risk of life, health, property, or severe economic losses, district... describe proposed NEPA documentation or reasons for exclusion from documentation. NEPA documentation should be accomplished prior to initiation of emergency work if time constraints render this practicable...

  8. Nuclear emergency preparedness in Canada

    International Nuclear Information System (INIS)

    1993-03-01

    The preparedness of utilities and government agencies at various levels for dealing with nuclear emergencies occurring at nuclear reactors in Canada is reviewed and assessed. The review is centered on power reactors, but selected research reactors are included also. Emergency planning in the U.S.A., Germany and France, and international recommendations on emergency planning are reviewed to provide background and a basis for comparison. The findings are that Canadians are generally well protected by existing nuclear emergency plans at the electric utility and provincial levels but there are improvements that can be made, mainly at the federal level and in federal-provincial coordination. Ten issues of importance are identified: commitment to nuclear emergency planning by the federal government; division of federal and provincial roles and responsibilities; auditing of nuclear emergency preparedness of all levels of government and of electric utilities; the availability of technical guidance appropriate to Canada; protective action levels for public health and safety; communication with the public; planning and response for the later phases of a nuclear emergency; off-site exercises and training; coordination of international assistance; and emergency planning for research reactors. (L.L.) 79 refs., 2 tabs

  9. Late Emerging Reading Difficulties in English Language Learners

    OpenAIRE

    Garcia, Nicole Marie

    2015-01-01

    Research has identified a group of students who do not begin to exhibit reading difficulties until fourth or fifth grade, suggesting late-emerging reading difficulties. Considering that these students do not show signs of reading difficulties in early grades, attempting to identify these students early becomes problematic. Additionally, little is known regarding the characteristics of late-emerging reading deficits within English language learner (ELL) populations. The purpose of this study w...

  10. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  11. Optimized maritime emergency resource allocation under dynamic demand.

    Directory of Open Access Journals (Sweden)

    Wenfen Zhang

    Full Text Available Emergency resource is important for people evacuation and property rescue when accident occurs. The relief efforts could be promoted by a reasonable emergency resource allocation schedule in advance. As the marine environment is complicated and changeful, the place, type, severity of maritime accident is uncertain and stochastic, bringing about dynamic demand of emergency resource. Considering dynamic demand, how to make a reasonable emergency resource allocation schedule is challenging. The key problem is to determine the optimal stock of emergency resource for supplier centers to improve relief efforts. This paper studies the dynamic demand, and which is defined as a set. Then a maritime emergency resource allocation model with uncertain data is presented. Afterwards, a robust approach is developed and used to make sure that the resource allocation schedule performs well with dynamic demand. Finally, a case study shows that the proposed methodology is feasible in maritime emergency resource allocation. The findings could help emergency manager to schedule the emergency resource allocation more flexibly in terms of dynamic demand.

  12. Individual-Environment Interactions in Swimming: The Smallest Unit for Analysing the Emergence of Coordination Dynamics in Performance?

    Science.gov (United States)

    Guignard, Brice; Rouard, Annie; Chollet, Didier; Hart, John; Davids, Keith; Seifert, Ludovic

    2017-08-01

    Displacement in competitive swimming is highly dependent on fluid characteristics, since athletes use these properties to propel themselves. It is essential for sport scientists and practitioners to clearly identify the interactions that emerge between each individual swimmer and properties of an aquatic environment. Traditionally, the two protagonists in these interactions have been studied separately. Determining the impact of each swimmer's movements on fluid flow, and vice versa, is a major challenge. Classic biomechanical research approaches have focused on swimmers' actions, decomposing stroke characteristics for analysis, without exploring perturbations to fluid flows. Conversely, fluid mechanics research has sought to record fluid behaviours, isolated from the constraints of competitive swimming environments (e.g. analyses in two-dimensions, fluid flows passively studied on mannequins or robot effectors). With improvements in technology, however, recent investigations have focused on the emergent circular couplings between swimmers' movements and fluid dynamics. Here, we provide insights into concepts and tools that can explain these on-going dynamic interactions in competitive swimming within the theoretical framework of ecological dynamics.

  13. The emergency patient's participation in medical decision-making.

    Science.gov (United States)

    Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

    2016-09-01

    The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

  14. Inspection of Emergency Arrangements

    International Nuclear Information System (INIS)

    2013-01-01

    The Working Group on Inspection Practices (WGIP) was tasked by the NEA CNRA to examine and evaluate the extent to which emergency arrangements are inspected and to identify areas of importance for the development of good inspection practices. WGIP members shared their approaches to the inspection of emergency arrangements by the use of questionnaires, which were developed from the requirements set out in IAEA Safety Standards. Detailed responses to the questionnaires from WGIP member countries have been compiled and are presented in the appendix to this report. The following commendable practices have been drawn from the completed questionnaires and views provided by WGIP members: - RBs and their Inspectors have sufficient knowledge and information regarding operator's arrangements for the preparedness and response to nuclear emergencies, to enable authoritative advice to be given to the national coordinating authority, where necessary. - Inspectors check that the operator's response to a nuclear emergency is adequately integrated with relevant response organisations. - Inspectors pay attention to consider the integration of the operator's response to safety and security threats. - The efficiency of international relations is checked in depth during some exercises (e.g. early warning, assistance and technical information), especially for near-border facilities that could lead to an emergency response abroad. - RB inspection programmes consider the adequacy of arrangements for emergency preparedness and response to multi-unit accidents. - RBs assess the adequacy of arrangements to respond to accidents in other countries. - The RB's role is adequately documented and communicated to all agencies taking part in the response to a nuclear or radiological emergency. - Inspectors check that threat assessments for NPPs have been undertaken in accordance with national requirements and that up-to-date assessments have been used as the basis for developing emergency plans for

  15. Review of IAEA documentation on Nuclear and radiological emergency

    International Nuclear Information System (INIS)

    Mukhono, P. M.

    2014-10-01

    The project focuses on the review of IAEA documentation on nuclear or radiological emergencies with main focus on methodology for developing and arrangement for nuclear and radiological emergencies. The main objective of this work is to identify limitations in IAEA documentation on emergency preparedness and response (EPR) and provide recommendation on the main actions needed to fill the gaps identified thus aiding in improvement of emergency preparedness and response to nuclear and radiological accidents. The review of IAEA documentation on nuclear and radiological emergency has been carried out by evaluating various emergency response elements. Several elements for EPR were highlighted covering the safety fundamentals, general safety requirements and EPR methods for development of an effective emergence response capability for nuclear or radiological emergencies. From these issues, the limitations of IAEA documentation on EPR were drawn and recommendations suggested as a means of improving EPR methods. Among them was the need for IAEA consider establishment of follow up and inspection programmes to facilitate implementation of EPR requirements in most developing countries, establishment of programmes that provide platforms for the countries to be motivated to update their system in line with the current status of emergency preparedness, review of the international information exchange aspects of nuclear emergencies in order to improve capabilities to communicate reliable data, information and decisions quickly and effectively among national authorities and their emergency and emergency response centres. (au)

  16. Dental Emergencies: Management Strategies That Improve Outcomes [Digest].

    Science.gov (United States)

    Pedigo, Ryan Anthony; Zaurova, Milana

    2017-06-22

    Points & Pearls is a digest of Emergency Medicine Practice . Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.

  17. Department of Energy Emergency Management Functional Requirements Study

    International Nuclear Information System (INIS)

    1987-05-01

    This Study, the Emergency Management Functional Requirements Study (EMFRS), identifies the physical environment, information resources, and equipment required in the DOE Headquarters Emergency Operations Center (EOC) to support the DOE staff in managing an emergency. It is the first step toward converting the present Forrestal EOC into a practical facility that will function well in each of the highly diverse types of emergencies in which the Department could be involved. 2 figs

  18. 7 CFR 500.4 - Conformity with signs and emergency directions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Conformity with signs and emergency directions. 500.4 Section 500.4 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH... Conformity with signs and emergency directions. Persons in and on property of the USNA shall comply with...

  19. 7 CFR 501.4 - Conformity with signs and emergency directions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Conformity with signs and emergency directions. 501.4 Section 501.4 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH... § 501.4 Conformity with signs and emergency directions. Persons in and on property of the Research...

  20. 7 CFR 502.4 - Conformity with signs and emergency directions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Conformity with signs and emergency directions. 502.4 Section 502.4 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH..., MARYLAND § 502.4 Conformity with signs and emergency directions. Persons in and on property of BARC shall...

  1. Predictors of Transience among Homeless Emerging Adults

    Science.gov (United States)

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2014-01-01

    This study identified predictors of transience among homeless emerging adults in three cities. A total of 601 homeless emerging adults from Los Angeles, Austin, and Denver were recruited using purposive sampling. Ordinary least squares regression results revealed that significant predictors of greater transience include White ethnicity, high…

  2. Asymptotic safety, emergence and minimal length

    International Nuclear Information System (INIS)

    Percacci, Roberto; Vacca, Gian Paolo

    2010-01-01

    There seems to be a common prejudice that asymptotic safety is either incompatible with, or at best unrelated to, the other topics in the title. This is not the case. In fact, we show that (1) the existence of a fixed point with suitable properties is a promising way of deriving emergent properties of gravity, and (2) there is a sense in which asymptotic safety implies a minimal length. In doing so we also discuss possible signatures of asymptotic safety in scattering experiments.

  3. Bedaquiline resistance: Its emergence, mechanism and prevention.

    NARCIS (Netherlands)

    Nguyen, Thi Van Anh; Anthony, Richard M; Bañuls, Anne-Laure; Vu, Dinh Hoa; Alffenaar, Jan-Willem C

    2017-01-01

    Bedaquiline, a new anti-tuberculosis drug, has already been used in more than 50 countries. The emergence of bedaquiline resistance is alarming, as it may result in the rapid loss of this new drug. This paper aims to review currently identified mechanisms of resistance, the emergence of bedaquiline

  4. Psychometric Profile of an Experimental Emergent Literacy Screener for Preschoolers

    Science.gov (United States)

    Bailet, Laura L.; Zettler-Greeley, Cynthia; Lewis, Kandia

    2018-01-01

    Home literacy activities influence children's emergent literacy progress and readiness for reading instruction. To help parents fulfill this opportunity, we developed a new Emergent Literacy Screener (ELS) and conducted 2 studies of its psychometric properties with independent prekindergarten samples. For Study 1 (n = 812, M[subscript age] = 54.4…

  5. Dungeness Power Station off-site emergency plan

    International Nuclear Information System (INIS)

    1993-01-01

    This off-site Emergency Plan in the event of an accidental release of radioactivity at the Dungeness Nuclear power station sets out the necessary management and coordination processes between Nuclear Electric, operators of the site, the emergency services and relevant local authorities. The objectives promoting the aim are identified and the activities which will be undertaken to protect the public and the environment in the event of an emergency are outlined. (UK)

  6. Identifying the Role of the International Consortium ``MIT/ LINC'' in Supporting the Integration of ICT in Higher Education in Emerging Countries

    Science.gov (United States)

    Park, Young; Moser, Franziska Zellweger

    2008-04-01

    The goal of this research effort is to provide insights on what core needs and difficulties exist toward the implementation of ICT in higher education in emerging countries and how a consortium like LINC can best support these efforts. An exploratory research design combining a survey, on-site interviews, participant observation and document analysis were employed to answer the research questions. Main challenges in establishing technology- based learning environments were identified in the area of pedagogies, finances, technological infrastructure, cultural change, organization, and management. LINC, as an non-political organization embedded in an academic environment, can take an important role in facilitating the dialogue among participants through various platforms, take an active role in promoting joint programs and assist with efforts to "localize" tools and practice.

  7. Building a Natural Language Processing Tool to Identify Patients With High Clinical Suspicion for Kawasaki Disease from Emergency Department Notes.

    Science.gov (United States)

    Doan, Son; Maehara, Cleo K; Chaparro, Juan D; Lu, Sisi; Liu, Ruiling; Graham, Amanda; Berry, Erika; Hsu, Chun-Nan; Kanegaye, John T; Lloyd, David D; Ohno-Machado, Lucila; Burns, Jane C; Tremoulet, Adriana H

    2016-05-01

    Delayed diagnosis of Kawasaki disease (KD) may lead to serious cardiac complications. We sought to create and test the performance of a natural language processing (NLP) tool, the KD-NLP, in the identification of emergency department (ED) patients for whom the diagnosis of KD should be considered. We developed an NLP tool that recognizes the KD diagnostic criteria based on standard clinical terms and medical word usage using 22 pediatric ED notes augmented by Unified Medical Language System vocabulary. With high suspicion for KD defined as fever and three or more KD clinical signs, KD-NLP was applied to 253 ED notes from children ultimately diagnosed with either KD or another febrile illness. We evaluated KD-NLP performance against ED notes manually reviewed by clinicians and compared the results to a simple keyword search. KD-NLP identified high-suspicion patients with a sensitivity of 93.6% and specificity of 77.5% compared to notes manually reviewed by clinicians. The tool outperformed a simple keyword search (sensitivity = 41.0%; specificity = 76.3%). KD-NLP showed comparable performance to clinician manual chart review for identification of pediatric ED patients with a high suspicion for KD. This tool could be incorporated into the ED electronic health record system to alert providers to consider the diagnosis of KD. KD-NLP could serve as a model for decision support for other conditions in the ED. © 2016 by the Society for Academic Emergency Medicine.

  8. A top-five list for emergency medicine: a pilot project to improve the value of emergency care.

    Science.gov (United States)

    Schuur, Jeremiah D; Carney, Dylan P; Lyn, Everett T; Raja, Ali S; Michael, John A; Ross, Nicholas G; Venkatesh, Arjun K

    2014-04-01

    IMPORTANCE The mean cost of medical care in the United States is growing at an unsustainable rate; from 2003 through 2011, the cost for an emergency department (ED) visit rose 240%, from $560 to $1354. The diagnostic tests, treatments, and hospitalizations that emergency clinicians order result in significant costs. OBJECTIVE To create a "top-five" list of tests, treatments, and disposition decisions that are of little value, are amenable to standardization, and are actionable by emergency medicine clinicians. DESIGN, SETTING, AND PARTICIPANTS Modified Delphi consensus process and survey of 283 emergency medicine clinicians (physicians, physician assistants, and nurse practitioners) from 6 EDs. INTERVENTION We assembled a technical expert panel (TEP) and conducted a modified Delphi process to identify a top-five list using a 4-step process. In phase 1, we generated a list of low-value clinical decisions from TEP brainstorming and e-mail solicitation of clinicians. In phase 2, the TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. In phase 3, we surveyed all ordering clinicians from the 6 EDs regarding distinct aspects of each item. In phase 4, the TEP voted for a final top-five list based on survey results and discussion. MAIN OUTCOMES AND MEASURES A top-five list for emergency medicine. The TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. The survey asked clinicians to score items on the potential benefit or harm to patients and the provider actionability of each item. Voting and surveys used 5-point Likert scales. A Pearson interdomain correlation was used. RESULTS Phase 1 identified 64 low-value items. Phase 2 narrowed this list to 7 laboratory tests, 3 medications, 4 imaging studies, and 3 disposition decisions included in the phase 3 survey (71.0% response rate). All 17 items showed a significant positive correlation between benefit and actionability (r, 0.19-0.37 [P

  9. Planning of elimination of emergency consequences

    Directory of Open Access Journals (Sweden)

    S. Kovalenko

    2015-05-01

    Full Text Available Introduction. The volume of useful information in the planning of elimination of emergency consequences process is reasonable to assess with calculatory problems and mathematical models. Materials and methods. The expert survey method is used to calculate quantitative values of probability and to determine the optimal solution before the information in condition is received. Results. It is determined that the quality of the solution of elimination emergency consequences depends primarily on the number of factors that are taken into account in particular circumstances of the situation; on the level of information readiness of control bodies to take decision to eliminate emergency consequences as soon as possible and to consider several options for achieving reasonableness and concreteness of a particular decision. The ratio between volume of useful information collected and processed during operation planning which is required for identifying optimal solution is calculated. This ratio allows to construct a graph of probability of identifying a solution in existing environment and probability value of identifying optimal solution before information in P*condition is obtained. This graph also shows the ratio volume of useful information collected and processed during operation planning and necessary volume of information for identifying optimal solution. Conclusion. The results of this research can be used for improving control bodies decisions to ensure safe working conditions for employees of food industry.

  10. Radiological difficulty in identifying unicompartmental knee replacement dislocation

    Directory of Open Access Journals (Sweden)

    Mr Oruaro Adebayo Onibere, MBBS, MRCS

    2017-09-01

    Full Text Available Unicondylar knee replacement is a relatively common elective orthopedic procedure but is not often seen in the Emergency Department setting. Familiarity with normal clinical and radiological appearances is difficult to gain. Dislocation of the mobile bearing component “spacer” is a known complication of unicondylar knee replacements, and these patients will initially present to the accident and Emergency Department. In this setting, an accurate and prompt diagnosis is necessary to appropriately manage the patient's condition. There is normally a radiological challenge in identifying dislocated mobile bearings on plain radiographs. These patients may need to have further imaging, such as a computer tomographic scan to identify the dislocated mobile bearing.

  11. Emergency Shelter Grantee (ESG) Areas

    Data.gov (United States)

    Department of Housing and Urban Development — The Emergency Shelter Grants (ESG) program is designed to identify sheltered and unsheltered homeless persons, as well as those at risk of homelessness, and provide...

  12. The management of hypertensive emergencies in children after stem cell transplantation.

    Science.gov (United States)

    Horn, D G; Trame, M N; Hempel, G

    2011-04-01

    This work presents a short overview on the available data about drugs that are currently used to treat hypertensive emergencies in children with a focus on incidents after stem cell transplantation. It shows that the pediatric use of all hypotensive agents appears to be mainly based on personal experience of the attending physicians rather than on convincing clinical trials. A literature search was performed in MEDLINE, through PubMed, using the medical subject headings (MeSH) hypertensive emergencies, nifedipine, nicardipine, and children. Further articles were identified by checking cross-references of articles and books. Hypertensive emergencies in children after stem cell transplantation usually have a renal etiology, because of the treatment with the calcineurin inhibitors cyclosporine and tacrolimus. In these severe cases an immediate action is necessary to avoid possible appearance or exacerbation of endorgan damage. Because of their mechanism of action and a potential nephroprotective effect calcium channel blockers may be particularly suitable in cases of hypertensive emergencies. An intravenous application of nifedipine may compensate the difficulties of accurate dosing, but keeping in mind possible severe side effects and the lack of published experience its use in children is at least questionable. Nicardipine appears to be the hypotensive agent of first choice. In adults, the treatment of hypertensive emergencies with intravenous nicardipine is well-documented, but for an evaluation of safety in pediatric use, the published studies and case reports appear to be barely adequate. The actual treatment approaches vary widely, demonstrating the lack of hard science on which current treatment of hypertensive emergencies in children is based. The hypotensive agent for the individual situation should be chosen considering the properties, side effects, the limited experiences with its use and the patient's anamnesis.

  13. Blog and Podcast Watch: Cutaneous Emergencies

    Directory of Open Access Journals (Sweden)

    Andrew Grock

    2017-02-01

    Full Text Available The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM based on the ongoing Academic Life in Emergency Medicine (ALiEM Approved Instructional Resources (AIR and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of cutaneous emergencies from the AIR series.    The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors (CORD annual testing schedule. For each module, relevant content is collected from the top 50 most accessed sites per the Social Media Index published within the previous 12 months and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an “honorable mention” label, if the editorial board agrees that the post is accurate and educationally valuable. A total of 35 blog posts and podcasts were evaluated. None scored ≥30 points necessary for the AIR label, although four honorable mention posts were identified. Key educational pearls from these honorable mention posts are summarized. This Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expertbased, post-publication curation of educational social media content for EM clinicians with this installment focusing on cutaneous emergencies. [West J Emerg Med. 2017;18(2288-292.

  14. Emerging properties and functional consequences of noncoding transcription

    DEFF Research Database (Denmark)

    Ard, Ryan; Allshire, Robin C; Marquardt, Sebastian

    2017-01-01

    specific lncRNAs, support grows for the notion that the act of transcription rather than the RNA product itself is functionally important in many cases. Indeed, this alternative mechanism might better explain how low-abundance lncRNAs transcribed from noncoding DNA function in organisms. Here, we highlight......Eukaryotic genomes are rich in transcription units encoding "long noncoding RNAs" (lncRNAs). The purpose of all this transcription is unclear since most lncRNAs are quickly targeted for destruction during synthesis or shortly thereafter. As debates continue over the functional significance of many...... some of the recently emerging features that distinguish coding from noncoding transcription and discuss how these differences might have important implications for the functional consequences of noncoding transcription....

  15. 36 CFR 504.4 - Conformity with signs and emergency directions.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Conformity with signs and emergency directions. 504.4 Section 504.4 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND REGULATIONS GOVERNING SMITHSONIAN INSTITUTION BUILDINGS AND GROUNDS § 504.4 Conformity with signs...

  16. Growing Up of Autonomous Agents: an Emergent Phenomenon

    Science.gov (United States)

    Morgavi, Giovanna; Marconi, Lucia

    2008-10-01

    A fundamental research challenge is the design of robust artifacts that are capable of operating under changing environments and noisy input, and yet exhibit the desired behavior and response time. These systems should be able to adapt and learn how to react to unforeseen scenarios as well as to display properties comparable to biological entities. The turn to nature has brought us many unforeseen great concepts. Biological systems are able to handle many of these challenges with an elegance and efficiency still far beyond current human artifacts. A living artifact grows up when its capabilities, abilities/knowledge, shift to a further level of complexity, i.e. the complexity rank of its internal capabilities performs a step forward. In the attempt to define an architecture for autonomous growing up agents [1]. We conducted an experiment on the abstraction process in children as natural parts of a cognitive system. We found that linguistic growing up involve a number of different trial processes. We identified a fixed number of distinct paths that were crossed by children. Once a given interpretation paths was discovered useless, they tried to follow another path, until the new meaning was emerging. This study generates suggestion about the evolutionary conditions conducive to the emergence of growing up in robots and provides guidelines for designing artificial evolutionary systems displaying spontaneous adaptation abilities. The importance of multi-sensor perception, motivation and emotional drives are underlined and, above all, the growing up insights shows similarities to emergent self-organized behaviors.

  17. Emergency management in health: key issues and challenges in the UK.

    Science.gov (United States)

    Lee, Andrew C K; Phillips, Wendy; Challen, Kirsty; Goodacre, Steve

    2012-10-19

    Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Four thematic categories for future research emerged:(i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained.(ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required.(iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus specific planning, and reactive versus

  18. Energy emergency planning guide: Winter 1977-78

    Energy Technology Data Exchange (ETDEWEB)

    1977-11-01

    This Energy Emergency Planning Guide for Winter, 1977-78 has been prepared in order to: identify and evaluate actions available to deal with energy emergencies this winter; provide an advance indication to the public of those actions considered most likely to be taken by the government, and provide industry, state, and local governments with suggestions about actions which they can take to deal with energy emergencies. The Guide contains specifications for over 50 standby programs and procedures, recommended implementation guidelines for using these programs keyed to a pre-emergency phase and three phases of shortfalls, and a design for an Energy Emergency Center. Flexible implementation guidelines are proposed for natural gas, petroleum, electricity/coal, and propane shortages. (MCW)

  19. Emergence, Learning Difficulties, and Misconceptions in Chemistry Undergraduate Students' Conceptualizations of Acid Strength

    Science.gov (United States)

    Tümay, Halil

    2016-03-01

    Philosophical debates about chemistry have clarified that the issue of emergence plays a critical role in the epistemology and ontology of chemistry. In this article, it is argued that the issue of emergence has also significant implications for understanding learning difficulties and finding ways of addressing them in chemistry. Particularly, it is argued that many misconceptions in chemistry may derive from students' failure to consider emergence in a systemic manner by taking into account all relevant factors in conjunction. Based on this argument, undergraduate students' conceptions of acids, and acid strength (an emergent chemical property) were investigated and it was examined whether or not they conceptualized acid strength as an emergent chemical property. The participants were 41 third- and fourth-year undergraduate students. A concept test and semi-structured interviews were used to probe students' conceptualizations and reasoning about acid strength. Findings of the study revealed that the majority of the undergraduate students did not conceptualize acid strength as an emergent property that arises from interactions among multiple factors. They generally focused on a single factor to predict and explain acid strength, and their faulty responses stemmed from their failure to recognize and consider all factors that affect acid strength. Based on these findings and insights from philosophy of chemistry, promoting system thinking and epistemologically sound argumentative discourses among students is suggested for meaningful chemical education.

  20. Targeted Lipidomics in Drosophila melanogaster Identifies Novel 2-Monoacylglycerols and N-acyl Amides

    Science.gov (United States)

    Takacs, Sara M.; Stuart, Jordyn M.; Basnet, Arjun; Raboune, Siham; Widlanski, Theodore S.; Doherty, Patrick; Bradshaw, Heather B.

    2013-01-01

    Lipid metabolism is critical to coordinate organ development and physiology in response to tissue-autonomous signals and environmental cues. Changes to the availability and signaling of lipid mediators can limit competitiveness, adaptation to environmental stressors, and augment pathological processes. Two classes of lipids, the N-acyl amides and the 2-acyl glycerols, have emerged as important signaling molecules in a wide range of species with important signaling properties, though most of what is known about their cellular functions is from mammalian models. Therefore, expanding available knowledge on the repertoire of these lipids in invertebrates will provide additional avenues of research aimed at elucidating biosynthetic, metabolic, and signaling properties of these molecules. Drosophila melanogaster is a commonly used organism to study intercellular communication, including the functions of bioactive lipids. However, limited information is available on the molecular identity of lipids with putative biological activities in Drosophila. Here, we used a targeted lipidomics approach to identify putative signaling lipids in third instar Drosophila larvae, possessing particularly large lipid mass in their fat body. We identified 2-linoleoyl glycerol, 2-oleoyl glycerol, and 45 N-acyl amides in larval tissues, and validated our findings by the comparative analysis of Oregon-RS, Canton-S and w1118 strains. Data here suggest that Drosophila represent another model system to use for the study of 2-acyl glycerol and N-acyl amide signaling. PMID:23874457

  1. Identifying the molecular functions of electron transport proteins using radial basis function networks and biochemical properties.

    Science.gov (United States)

    Le, Nguyen-Quoc-Khanh; Nguyen, Trinh-Trung-Duong; Ou, Yu-Yen

    2017-05-01

    The electron transport proteins have an important role in storing and transferring electrons in cellular respiration, which is the most proficient process through which cells gather energy from consumed food. According to the molecular functions, the electron transport chain components could be formed with five complexes with several different electron carriers and functions. Therefore, identifying the molecular functions in the electron transport chain is vital for helping biologists understand the electron transport chain process and energy production in cells. This work includes two phases for discriminating electron transport proteins from transport proteins and classifying categories of five complexes in electron transport proteins. In the first phase, the performances from PSSM with AAIndex feature set were successful in identifying electron transport proteins in transport proteins with achieved sensitivity of 73.2%, specificity of 94.1%, and accuracy of 91.3%, with MCC of 0.64 for independent data set. With the second phase, our method can approach a precise model for identifying of five complexes with different molecular functions in electron transport proteins. The PSSM with AAIndex properties in five complexes achieved MCC of 0.51, 0.47, 0.42, 0.74, and 1.00 for independent data set, respectively. We suggest that our study could be a power model for determining new proteins that belongs into which molecular function of electron transport proteins. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The formation, properties and impact of secondary organic aerosol: current and emerging issues

    Directory of Open Access Journals (Sweden)

    J. Wildt

    2009-07-01

    Full Text Available Secondary organic aerosol (SOA accounts for a significant fraction of ambient tropospheric aerosol and a detailed knowledge of the formation, properties and transformation of SOA is therefore required to evaluate its impact on atmospheric processes, climate and human health. The chemical and physical processes associated with SOA formation are complex and varied, and, despite considerable progress in recent years, a quantitative and predictive understanding of SOA formation does not exist and therefore represents a major research challenge in atmospheric science. This review begins with an update on the current state of knowledge on the global SOA budget and is followed by an overview of the atmospheric degradation mechanisms for SOA precursors, gas-particle partitioning theory and the analytical techniques used to determine the chemical composition of SOA. A survey of recent laboratory, field and modeling studies is also presented. The following topical and emerging issues are highlighted and discussed in detail: molecular characterization of biogenic SOA constituents, condensed phase reactions and oligomerization, the interaction of atmospheric organic components with sulfuric acid, the chemical and photochemical processing of organics in the atmospheric aqueous phase, aerosol formation from real plant emissions, interaction of atmospheric organic components with water, thermodynamics and mixtures in atmospheric models. Finally, the major challenges ahead in laboratory, field and modeling studies of SOA are discussed and recommendations for future research directions are proposed.

  3. Real-time information support for managing plant emergency responses

    International Nuclear Information System (INIS)

    Cain, D.G.; Lord, R.J.; Wilkinson, C.D.

    1983-01-01

    The Three Mile Island Unit 2 accident highlighted the need to develop a systematic approach to managing plant emergency responses, to identify a better decision-making process, and to implement real-time information support for decision-making. The overall process management function is described and general information requirements for management of plant emergencies are identified. Basic information systems are being incorporated and future extensions and problem areas are discussed. (U.K.)

  4. Emergency response preparedness: the French experience of large scale exercises

    International Nuclear Information System (INIS)

    Chanson, D.; Desnoyers, B.; Chabane, J.M.

    2004-01-01

    In compliance with the IAEA regulations for the transport of radioactive material in the event of accidents during transport of radioactive material, emergency provisions to protect persons, property and environment have to be established and developed by the relevant national organisations. In France, the prefect of the department where the accident occurs is responsible for decisions and measures required to ensure the protection of both population and property at risk owing to the accident. During an accident, the ministers concerned provide the prefect with recommendations and information, in order to help him take the requisite decisions. On their side, the nuclear industry and transport companies also have to be prepared to intervene and to support the authorities at their request, depending on their capacities and their specialities. To prepare the emergency teams properly and acquire effective emergency plans, training exercises have to be conducted regularly with every ministerial department involved, the nuclear industry and transport companies, members of the public and the media. Then, the feedback from such exercises shall be taken into account to improve the emergency procedures. This paper will introduce: - emergency response preparedness: what is required by the relevant regulations? - emergency response preparedness: how is France organised? - the French experience of conducting large training exercises simulating accidents involving the transport of radioactive material; - the main difficulties and lessons learned; - the perspectives

  5. Adaptive process triage system cannot identify patients with gastrointestinal perforation

    DEFF Research Database (Denmark)

    Bohm, Aske Mathias; Tolstrup, Mai-Britt; Gögenur, Ismail

    2017-01-01

    INTRODUCTION: Adaptive process triage (ADAPT) is a triage tool developed to assess the severity and address the priority of emergency patients. In 2009-2011, ADAPT was the most frequently used triage system in Denmark. Until now, no Danish triage system has been evaluated based on a selective group...... triaged as green or yellow had a GIP that was not identified by the triage system. CONCLUSION: ADAPT is incapable of identifying one of the most critically ill patient groups in need of emergency abdominal surgery. FUNDING: none. TRIAL REGISTRATION: HEH-2013-034 I-Suite: 02336....

  6. Emergency Medicine Gender-specific Education.

    Science.gov (United States)

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

    2014-12-01

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

  7. Screening of the frail patient in the emergency department

    DEFF Research Database (Denmark)

    Jørgensen, Rasmus; Brabrand, Mikkel

    2017-01-01

    to detect frailty in patients. ≥. 65. years by their ability to identify the risk of adverse outcomes. Methods: An extensive medical literature search of Embase and PubMed was conducted, to identify studies using frailty screening scales in the emergency department. Data was subsequently extracted...... and evaluated from the results of the included studies. Results: Four studies met the exact inclusion criteria. Four different frailty screening scales: Clinical Frailty Scale, Deficit Accumulation Index, Identification of Seniors At Risk and The Study of Osteoporotic Fracture frailty index used...... emergency department visit. Frailty does however not predict increased risk of 30. day emergency department revisit. Further research highlighting the value of screening for frailty level in elderly emergency department patients is needed. Learning points: Although frail elders in need of further geriatric...

  8. Japanese situations to emerging themes

    International Nuclear Information System (INIS)

    Kubota, Ryuji

    2011-01-01

    Japanese regulatory body has audited more than ten cases of licensee's RCA since December 2007. We approve of opinions to emerging themes in 'CSNI Activity Plan', and based on achievements of these audits, Japanese situations to emerging themes are explained. As our conclusion, the more experience to identify HOF licensees have, the more problems may be solved. But as CA is difficult to measure for effectiveness, we propose to develop the outcome indicators such as the frequency of events. (author)

  9. The layperson in emergency situations

    OpenAIRE

    Pergola, AM; Araujo, IEM

    2008-01-01

    The layperson's qualification to provide early care in emergency situations and basic life support (BLS) is fundamental to save lives and prevent sequels. The objective was to identify the level of knowledge of lay people about approaching an emergency victim. Structured interviews in non-technical language were used with a 385-subject sample, average age 35.4 (+/- 14.55) years, with more than 50% having a high school or university education. Over 55% of these observed situations with loss of...

  10. The Use of Cellular Automata in the Learning of Emergence

    Science.gov (United States)

    Faraco, G.; Pantano, P.; Servidio, R.

    2006-01-01

    In recent years, research efforts on complex systems have contributed to improve our ability in investigating, at different levels of complexity, the emergent behaviour shown by a system in the course of its evolution. The study of emergence, an intrinsic property of a large number of complex systems, can be tackled by making use of Cellular…

  11. Off-site response for radiological emergencies

    International Nuclear Information System (INIS)

    Eldridge, J.S.; Oakes, T.W.; Hubbard, H.M.; Hibbitts, H.W.

    1982-01-01

    Environmental radiological surveillance under emergency conditions at off-site locations is one of the advisory functions provided by DOE within the ORO jurisdiction. The Department of Environmental Management of ORNL has been requested to provide sampling and analytical assistance at such emergency response activities. We have assembled and identified specific individuals and equipment to provide a rapid response force to perform field measurements for environmental radioactivity releases as a consequence of nuclear accidents. Survey teams for sample collection and field measurements are provided along with analytical assistance to operate the radioactivity measuring equipment in the DOE emergency van

  12. DEVELOPMENT OF A MOLECULAR METHOD TO IDENTIFY THE EMERGING PATHOGEN HEPATITIS E IN WATER SAMPLES

    Science.gov (United States)

    Hepatitis E virus (HEV) is an emerging pathogen that causes significant illness in the developing world. Like the hepatitis A virus, it is transmitted via the fecal-oral route and can cause short-term, acute hepatitis. In addition, hepatitis E has been found to cause a signific...

  13. Academic versus Non-Academic Emerging Adult College Student Technology Use

    Science.gov (United States)

    Swanson, Joan Ann; Walker, Erica

    2015-01-01

    Emerging adult college students have developmental and educational needs which are unique to their phase of life. Emerging adults are also increasingly identified by their technology use and practices. Collegiate instructors will be better equipped for educating these individuals when armed with insights concerning emerging adults' technology…

  14. Implementing evidence-based practices in an emergency department

    DEFF Research Database (Denmark)

    Kirk, Jeanette W.; Nilsen, Per

    2016-01-01

    of semi-structured interviews. An activity system analysis, as described in the Cultural Historical Activity Theory, was conducted to identify various contradictions that could exist between different parts of the activity system. RESULTS: The main contradiction identified was that guidelines......BACKGROUND: An emergency department is typically a place of high activity where practitioners care for unanticipated presentations, which yields a flow culture so that actions that secure available beds are prioritised by the practitioners. OBJECTIVES: How does the flow culture in an emergency...... department influence nurses' use of a research-based clinical guideline and a nutrition screening routine. METHODS: Ethnographic fieldwork was carried out over three months. The first author followed nurses, medical secretaries and doctors in the emergency department. Data were also collected by means...

  15. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Walsh, Steven Thomas; Groen, Arend J.; van der Sijde, Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies

  16. Emergence of Extensively Drug Resistant Tuberculosis

    Centers for Disease Control (CDC) Podcasts

    2007-03-01

    Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.  Created: 3/1/2007 by Emerging Infectious Diseases.   Date Released: 3/26/2007.

  17. Blockchain: properties and misconceptions

    Directory of Open Access Journals (Sweden)

    Daniel Conte de Leon

    2017-12-01

    Full Text Available Purpose - The purpose of this article is to clarify current and widespread misconceptions about the properties of blockchain technologies and to describe challenges and avenues for correct and trustworthy design and implementation of distributed ledger system (DLS or Technology (DLT. Design/methodology/approach - The authors contrast the properties of a blockchain with desired, however emergent, properties of a DLS, which is a complex and distributed system. They point out and justify, with facts and analysis, current misconceptions about the blockchain and DLSs. They describe challenges that these systems will need to address and possible solution avenues for achieving trustworthiness. Findings - Many of the statements that have appeared on the internet, news and academic articles, such as immutable ledger and exact copies, may be misleading. These are desired emergent properties of a complex system, not assured properties. It is well-known within the distributed systems and critical software community that it is extremely hard to prove that a complex system correctly and completely implements emergent properties. Further research and development for trustworthy DLS design and implementation is needed, both practical and theoretical. Research limitations/implications - This is the first known published attempt at describing current misconceptions about blockchain technologies. Further collaborative work, discussions, potential solutions, evaluations, resulting publications and verified reference implementations are needed to ensure DLTs are safe, secure, and trustworthy. Practical implications - Interdisciplinary teams with members from academia, business and industry, and from disciplines such as business, entrepreneurship, theoretical and practical computer science, cybersecurity, finance, mathematics and statistics, must be formed. Such teams must collaborate with the objective of developing strategies and techniques for ensuring the

  18. Identifying Emergency Stages in Facebook Posts of Police Departments with Convolutional and Recurrent Neural Networks and Support Vector Machines

    DEFF Research Database (Denmark)

    Pogrebnyakov, Nicolai; Maldonado, Edgar

    2017-01-01

    Classification of social media posts in emergency response is an important practical problem: accurate classification can help automate processing of such messages and help other responders and the public react to emergencies in a timely fashion. This research focused on classifying Facebook...

  19. Emergency Management for Disasters in Malaysian Hotel Industry

    Directory of Open Access Journals (Sweden)

    AlBattat Ahmad Rasmi

    2014-01-01

    Full Text Available This paper aims to identify major emergencies that have the potential to place Malaysian hotels in emergency and disaster situations; investigate how hotels were prepared for emergencies, how they manage and overcome emergencies when occurred; and limitations and factors influencing successful emergency planning and adoption emergency management in Malaysian hotels. Face-to-face interview with managers from three, four and five star hotels from different backgrounds: local; regional; and International in Kuala Lumpur, Subang, and Putrajaya are undertaken. The result revealed that Malaysian hotels are exposed to a wide range of natural and man-made disasters. Malaysian hotels lack proactive emergency planning and a lot of constraints which impede successful emergency planning for disasters in the hotel industry in Malaysia, with emphasizing on the relevant authority’s role to demonstrate emergency management to hotels convincing them to adopt such practices, so they can be able to cope with emergencies effectively.

  20. The IAEAs incident and emergency centre: the global focal point for nuclear and radiological emergency preparedness and response

    Energy Technology Data Exchange (ETDEWEB)

    Buglova, E.

    2016-08-01

    The continuous use of nuclear power to generate electricity and the continued threat of radioactive materials being used for nefarious reasons reminds us of the importance to stay prepared to respond to nuclear or radiological emergencies. Stringent nuclear safety and nuclear security requirements, the training of personnel, operational checks and legal frameworks cannot always prevent radiation-related emergencies. Though these events can range in severity, each has the potential to cause harm to the public, employees, patients, property and the environment. Until the Chernobyl nuclear accident in 1986, there was no international information exchange system. Immediately following that accident, the international community negotiated the so-called Emergency Conventions to ensure that the country suffering an accident with an international transboundary release of radioactive material would issue timely, authenticated information, while the States that could field technical support, would do so in a coordinated fashion. The Conventions also place specific legal obligations on the International Atomic energy Agency (IAEA) with regard to emergency preparedness and response. (Author)

  1. A Systematic Framework and Nanoperiodic Concept for Unifying Nanoscience: Hard/Soft Nanoelements, Superatoms, Meta-Atoms, New Emerging Properties, Periodic Property Patterns, and Predictive Mendeleev-like Nanoperiodic Tables.

    Science.gov (United States)

    Tomalia, Donald A; Khanna, Shiv N

    2016-02-24

    Development of a central paradigm is undoubtedly the single most influential force responsible for advancing Dalton's 19th century atomic/molecular chemistry concepts to the current maturity enjoyed by traditional chemistry. A similar central dogma for guiding and unifying nanoscience has been missing. This review traces the origins, evolution, and current status of such a critical nanoperiodic concept/framework for defining and unifying nanoscience. Based on parallel efforts and a mutual consensus now shared by both chemists and physicists, a nanoperiodic/systematic framework concept has emerged. This concept is based on the well-documented existence of discrete, nanoscale collections of traditional inorganic/organic atoms referred to as hard and soft superatoms (i.e., nanoelement categories). These nanometric entities are widely recognized to exhibit nanoscale atom mimicry features reminiscent of traditional picoscale atoms. All unique superatom/nanoelement physicochemical features are derived from quantized structural control defined by six critical nanoscale design parameters (CNDPs), namely, size, shape, surface chemistry, flexibility/rigidity, architecture, and elemental composition. These CNDPs determine all intrinsic superatom properties, their combining behavior to form stoichiometric nanocompounds/assemblies as well as to exhibit nanoperiodic properties leading to new nanoperiodic rules and predictive Mendeleev-like nanoperiodic tables, and they portend possible extension of these principles to larger quantized building blocks including meta-atoms.

  2. Strategy for developing and conducting nuclear emergency exercises

    International Nuclear Information System (INIS)

    2007-01-01

    Emergency situations demand that actions be taken by responsible organisations and individuals at the site of the emergency and at the local, national and international levels to mitigate the impact on people and the environment. Effective emergency response requires development and implementation of emergency plans and procedures; established arrangements at the local, national and international levels; acquisition and maintenance of resources (funding, equipment and personnel); training of personnel; conduct of exercises; and a 'feedback programme' whereby improvements to the emergency management system are made based on lessons identified from exercises and actual events. A means for demonstrating the effectiveness of an emergency programme is through the conduct of exercises. Exercises demonstrate the effectiveness of plans, procedures, training and equipment; adequacy of response arrangements and resources; capabilities of response personnel in performing their assigned tasks; ability of individuals and organisations to work together; and provide a forum for exploring and testing revisions, modifications, and new and/or proposed changes to any emergency programme element in near realistic situations. Exercises may range in scope from small-scale drills to large-scale national or international exercises. There is clear benefit to organisations in supporting, developing and conducting well-managed exercises. Exercising is a resource-intensive tool; however, it is a critical tool for enhancing performance, testing arrangements and identifying areas for improvement. A thoroughly developed strategy should therefore be in place to ensure maximum value from an exercise programme. This report contributes to the good practice and management of exercise programmes by providing a strategy for improving the value of planning, conducting, participating in and/or supporting exercises. The OECD/NEA International Nuclear Emergency Exercise (INEX) series undertaken over the

  3. Workplace violence against emergency versus non-emergency nurses in Mansoura university hospitals, Egypt.

    Science.gov (United States)

    Abou-ElWafa, Hala Samir; El-Gilany, Abdel-Hady; Abd-El-Raouf, Samar E; Abd-Elmouty, Samia Mahmoud; El-Sayed, Rabab El-Sayed Hassan

    2015-03-01

    Workplace violence (WPV) against nurses is a common but neglected problem in Egypt. The objectives are to estimate the prevalence and associated risk factors of different types of violence against nurses working in the emergency hospital compared with those working in non-emergency clinics, circumstances of violence, type of perpetrators, and victims' response. This cross-sectional comparative study was carried out at Mansoura University Hospitals, Egypt, during January 2013. The data were collected through the adapted version of a self-administered questionnaire developed by the International Labor Office/International Council of Nurses/World Health Organization/Public Services International on WPV in the health sector. All types of WPV are common among nurses. Precipitating factors for violent incidents identified by respondents are emergency specialty, having work shift, and younger age. Violent incidents result in work dissatisfaction and consequently impair work productivity. Nurses working in emergency hospital experienced a higher level of different types of WPV. There is an urgent need to formulate and implement a policy for dealing with violent events. © The Author(s) 2014.

  4. Transportation of Hazardous Materials Emergency Preparedness Hazards Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A.

    2000-02-28

    This report documents the Emergency Preparedness Hazards Assessment (EPHA) for the Transportation of Hazardous Materials (THM) at the Department of Energy (DOE) Savannah River Site (SRS). This hazards assessment is intended to identify and analyze those transportation hazards significant enough to warrant consideration in the SRS Emergency Management Program.

  5. Transportation of Hazardous Materials Emergency Preparedness Hazards Assessment

    International Nuclear Information System (INIS)

    Blanchard, A.

    2000-01-01

    This report documents the Emergency Preparedness Hazards Assessment (EPHA) for the Transportation of Hazardous Materials (THM) at the Department of Energy (DOE) Savannah River Site (SRS). This hazards assessment is intended to identify and analyze those transportation hazards significant enough to warrant consideration in the SRS Emergency Management Program

  6. Transportation of hazardous materials emergency preparedness hazards assessment

    International Nuclear Information System (INIS)

    Blanchard, A.

    2000-01-01

    This report documents the Emergency Preparedness Hazards Assessment (EPHA) for the Transportation of Hazardous Materials (THM) at the Department of Energy (DOE) Savannah River Site (SRS). This hazards assessment is intended to identify and analyze those transportation hazards significant enough to warrant consideration in the SRS Emergency Management Program

  7. Genomic Regions Affecting Cheese Making Properties Identified in Danish Holsteins

    DEFF Research Database (Denmark)

    Gregersen, Vivi Raundahl; Bertelsen, Henriette Pasgaard; Poulsen, Nina Aagaard

    The cheese renneting process is affected by a number of factors associated to milk composition and a number of Danish Holsteins has previously been identified to have poor milk coagulation ability. Therefore, the aim of this study was to identify genomic regions affecting the technological...

  8. The Natural Emergence of (Bio)Semiosic Phenomena.

    Science.gov (United States)

    van Hateren, J H

    Biological organisms appear to have agency, goals, and meaningful behaviour. One possibility is that this is mere appearance, where such properties are not real, but only 'as if' consequences of the physiological structure of organisms. Another possibility is that these properties are real, as emerging from the organism's structure and from how the organism interacts with its environment. Here I will discuss a recent theory showing that the latter position is most likely correct, and argue that the theory is largely consistent with the basics of the field of biosemiotics. The theory can be represented as a triad that resembles the semiotic triad proposed by Peirce, which connects a sign with its object through a process of interpretation. In the theory presented, the sign is an internalized version of fitness (i.e., expected reproductive rate) which refers to the true fitness through a feedback loop that in effect produces interpretation. The feedback loop entangles deterministic and stochastic forms of causation in such a way that genuine agency, goal-directedness, and their associated meaning emerge. It produces a strong form of emergence not reducible to its constituents. The result is that novel phenomena arise that are real and necessary components for a complete understanding of living organisms.

  9. Emergency management in the early phase

    International Nuclear Information System (INIS)

    Crick, M.

    2003-01-01

    Full text: An overview of emergency management is provided from a systems approach with the aim of providing a common understanding for the diverse symposium participants of the elements of the management system required for preparedness and response for the early phase of an emergency at a nuclear installation. The systems approach starts with the recognition of response goals, and using detailed analyses of threats, past experience, international law and principles, a response strategy is developed. This step is illustrated with the case of severe accidents at PWRs and identifies the need for and nature of: emergency classification based an plant conditions; notification; radiological monitoring and assessment strategies; operational criteria for implementing protective action decisions; management of public information. From the strategy, detailed functional requirements can be defined addressing: establishing emergency management and operations; identifying, notifying and activating; taking mitigatory action; taking urgent protective action; providing information and issuing instructions and warnings to the public; protecting emergency workers; assessing the initial phase; managing the medical response; keeping the public informed; taking countermeasures against ingestion; mitigating the non-radiological consequences of the emergency and the response. Meeting these requirements necessitates decisions from competent authorities, the means to implement them, and mechanisms for response co-ordination, which need to be prepared in advance. These are supported by infrastructure, including: clear authorities; organization; coordinated plans and procedures; logistical support, facilities and tools; training and exercises; and a quality assurance programme. Some reflections an the key differences between response to emergencies arising from accidents and these arising from deliberate acts will be provided. An impression will be given of the level of preparedness and

  10. Universality of emergent states in diverse physical systems

    Science.gov (United States)

    Guidry, Mike

    2017-12-01

    Our physics textbooks are dominated by examples of simple weakly-interacting microscopic states, but most of the real world around us is most effectively described in terms of emergent states that have no clear connection to simple textbook states. Emergent states are strongly-correlated and dominated by properties that emerge as a consequence of interactions and are not part of the description of the corresponding weakly-interacting system. This paper proposes a connection of weakly-interacting textbook states and realistic emergent states through fermion dynamical symmetries having fully-microscopic generators of the emergent states. These imply unique truncation of the Hilbert space for the weakly-interacting system to a collective subspace where the emergent states live. Universality arises because the possible symmetries under commutation of generators, which transcend the microscopic structure of the generators, are highly restricted in character and determine the basic structure of the emergent state, with the microscopic structure of the generators influencing emergent state only parametrically. In support of this idea we show explicit evidence that high-temperature superconductors, collective states in heavy atomic nuclei, and graphene quantum Hall states in strong magnetic fields exhibit a near-universal emergent behavior in their microscopically-computed total energy surfaces, even though these systems share essentially nothing in common at the microscopic level and their emergent states are characterized by fundamentally different order parameters.

  11. Key Emerging Technologies for Elementary and Secondary Education

    Science.gov (United States)

    Johnson, Laurence F.; Levine, Alan; Smith, Rachel S.; Haywood, Keene

    2010-01-01

    The Horizon Report series is the most visible outcome of the New Media Consortium's Horizon Project, an ongoing research effort that identifies and describes emerging technologies likely to have a large impact on teaching, learning, research, or creative expression within education around the globe. The report examines emerging technologies for…

  12. Access to In-Network Emergency Physicians and Emergency Departments Within Federally Qualified Health Plans in 2015

    Directory of Open Access Journals (Sweden)

    Stephen C. Dorner, MSc

    2016-01-01

    Full Text Available Introduction: Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through the federal Marketplace. These standards to become a qualified health plan (QHP include maintaining a provider network sufficient to assure access to services. However, the complexity of emergency physician (EP employment practices – in which the EPs frequently serve as independent contractors of emergency departments, independently establish insurance contracts, etc... – and regulations governing insurance repayment may hinder the application of network adequacy standards to emergency medicine. As such, we hypothesized the existence of QHPs without in-network access to EPs. The objective is to identify whether there are QHPs without in-network access to EPs using information available through the federal Marketplace and publicly available provider directories. Results: In a national sample of Marketplace plans, we found that one in five provider networks lacks identifiable in-network EPs. QHPs lacking EPs spanned nearly half (44% of the 34 states using the federal Marketplace. Conclusion: Our data suggest that the present regulatory framework governing network adequacy is not generalizable to emergency care, representing a missed opportunity to protect patient access to in-network physicians. These findings and the current regulations governing insurance payment to EPs dis-incentivize the creation of adequate physician networks, incentivize the practice of balance billing, and shift the cost burden to patients.

  13. Emergent biosynthetic capacity in simple microbial communities.

    Directory of Open Access Journals (Sweden)

    Hsuan-Chao Chiu

    2014-07-01

    Full Text Available Microbes have an astonishing capacity to transform their environments. Yet, the metabolic capacity of a single species is limited and the vast majority of microorganisms form complex communities and join forces to exhibit capabilities far exceeding those achieved by any single species. Such enhanced metabolic capacities represent a promising route to many medical, environmental, and industrial applications and call for the development of a predictive, systems-level understanding of synergistic microbial capacity. Here we present a comprehensive computational framework, integrating high-quality metabolic models of multiple species, temporal dynamics, and flux variability analysis, to study the metabolic capacity and dynamics of simple two-species microbial ecosystems. We specifically focus on detecting emergent biosynthetic capacity--instances in which a community growing on some medium produces and secretes metabolites that are not secreted by any member species when growing in isolation on that same medium. Using this framework to model a large collection of two-species communities on multiple media, we demonstrate that emergent biosynthetic capacity is highly prevalent. We identify commonly observed emergent metabolites and metabolic reprogramming patterns, characterizing typical mechanisms of emergent capacity. We further find that emergent secretion tends to occur in two waves, the first as soon as the two organisms are introduced, and the second when the medium is depleted and nutrients become limited. Finally, aiming to identify global community determinants of emergent capacity, we find a marked association between the level of emergent biosynthetic capacity and the functional/phylogenetic distance between community members. Specifically, we demonstrate a "Goldilocks" principle, where high levels of emergent capacity are observed when the species comprising the community are functionally neither too close, nor too distant. Taken together

  14. Collaboration in crisis and emergency management: Identifying the gaps in the case of storm 'Alexa'.

    Science.gov (United States)

    Sawalha, Ihab Hanna Salman

    2014-01-01

    Failing to collaborate in crisis and emergency situations will increase the vulnerability of organisations and societies towards potential disasters. This paper highlights the significance of effective collaboration at different levels in times of crises. The case of snow storm 'Alexa', which hit Jordan in December 2013, was considered for the purpose of this research. The impact of Alexa raised many questions regarding the country's preparedness and the capacity of its infrastructure to maintain critical business functions across various industry sectors. First, should people individually take all the responsibility to manage crises and emergencies in order to protect themselves and their belongings? Secondly, should organisations join efforts with other organisations within the same or different sectors? Thirdly, should governments seek external collaboration for the ultimate goal of securing their economies? These issues are significant as they underline the element of collaboration. This paper contributes to the understanding of the role of collaboration in times of intense difficulty and loss of control. The proposition made by this research is that an effective collaborative process is positively associated with perceptions of improved disaster risk reduction practices.

  15. Post-emergency response resources guide

    International Nuclear Information System (INIS)

    1991-07-01

    On August 28 and September 18, 1990, the States of Louisiana and Mississippi, Gulf States Utilities, five local parishes, six Federal agencies, and the American Nuclear Insurers participated in a post-emergency TABLETOP exercise in Baton Rouge, Louisiana. One of the products developed from that experience is this guide for understanding the responsibilities and obtaining resources for specific needs from the various participants, particularly those organizations within the federal government. This guide should assist state and local government organizations with identifying and obtaining those resources for the post-emergency response when theirs have been exhausted

  16. Local Emergency Planning Committee (LEPC) Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — The LEPC data set contains over 3000 listings, as of 2008, for name and location data identifying Local Emergency Planning Committees (LEPCs). LEPCs are people...

  17. Emergency Department Management of Delirium in the Elderly

    OpenAIRE

    Lynn E.J. Gower, DO; Medley O’Keefe Gatewood, MD; Christopher S. Kang, MD

    2012-01-01

    An increasing number of elderly patients are presenting to the emergency department. Numerous studies have observed that emergency physicians often fail to identify and diagnose delirium in the elderly. These studies also suggest that even when emergency physicians recognized delirium, they still may not have fully appreciated the import of the diagnosis. Delirium is not a normal manifestation of aging and, often, is the only sign of a serious underlying medical condition. This article will r...

  18. Market efficiency in the emerging securitized real estate markets

    OpenAIRE

    Schindler, Felix

    2010-01-01

    This paper tests the random walk hypothesis and market efficiency for twelve emerging as well as for four developed securitized real estate markets from 1992 to 2009. Random walk properties of equity prices influence return dynamics, and market efficiency is often considered an essential criterion in the assessment of the functionality of markets and the asset pricing process, which is of significant relevance for emerging markets in particular. The analysis is based on autocorrelation tests ...

  19. [Factors related to patient satisfaction with hospital emergency services].

    Science.gov (United States)

    Parra Hidalgo, Pedro; Bermejo Alegría, Rosa María; Más Castillo, Adelia; Hidalgo Montesinos, María Dolores; Gomis Cebrián, Rafael; Calle Urra, José Eduardo

    2012-01-01

    To determine the perceived quality variables related to satisfaction and to identify the influence of sociodemographic factors on user satisfaction with hospital emergencies. A telephone survey was conducted with a specifically designed questionnaire for use in a sample of 3,600 users of hospital emergency services in nine public hospitals in 2008 and 2009. The adjusted model including all perceived quality and sociodemographic variables explained 47.1% of the variance (adjusted R(2)). Of all the independent variables included, only eight were significant in predicting the level of patient satisfaction. These variables were related to the patient's opinion of the relationship with medical staff (p = 0.041), nurses' and porters' professionalism (p = 0.010 and 0.022), infrastructure (cleanliness and comfort) (p = 0.033 and 0.008), information received at discharge (p = 0.000), waiting time in the emergency department (p = 0.000) and the perception of treatment-diagnosis without failure (p = 0.028). The variables influencing emergency patients' satisfaction were determined, allowing areas where corrective action could be introduced to be identified. In addition, possible confounding factors that should be controlled for when comparing results among distinct hospitals were identified. The emergency satisfaction questionnaire is a useful instrument to evaluate and improve quality of care. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Benchmarking against the National Emergency Laparotomy Audit recommendations.

    Science.gov (United States)

    Ho, Yiu Ming; Cappello, Julie; Kousary, Ramin; McGowan, Brian; Wysocki, Arkadiusz P

    2018-05-01

    The Royal College of Anaesthetists published the National Emergency Laparotomy Audit (NELA) to describe and compare inpatient care and outcomes of major emergency abdominal surgery in England and Wales in 2015 and 2016. The purpose of this article is to compare emergency abdominal surgical care and mortality in a regional hospital (Logan Hospital, Queensland, Australia) with NELA results. Data were extracted from two databases. All deaths from May 2010 to April 2015 were reviewed and patients who had an emergency abdominal operation within 30 days of death were identified. The health records of all patients who underwent abdominal surgery were extracted and those who had an emergency laparotomy were identified for analysis. Three hundred and fifty patients underwent emergency laparotomy and were included in the analysis. The total 30-day mortality during this 5-year period was 9.7%. Factors affecting mortality included age, Portsmouth-Physiological and Operative Severity Score (P-POSSUM) and admission source. Timing of antibiotic administration, use of perioperative medical service and frequency of intensive care admission were the same in patients who died and survived. Mortality in patients following emergency laparotomy at Logan Hospital compares favourably with 11.1% reported by NELA. This may be partly attributable to case mix distribution as for each P-POSSUM risk Logan Hospital mortality was at the upper end of that reported by NELA. Further Australia data are required. Improved compliance with NELA recommendations may improve outcomes. © 2017 Royal Australasian College of Surgeons.

  1. Emergency Department Management of Delirium in the Elderly

    Directory of Open Access Journals (Sweden)

    Lynn E.J. Gower, DO

    2012-05-01

    Full Text Available An increasing number of elderly patients are presenting to the emergency department. Numerousstudies have observed that emergency physicians often fail to identify and diagnose delirium in theelderly. These studies also suggest that even when emergency physicians recognized delirium, theystill may not have fully appreciated the import of the diagnosis. Delirium is not a normal manifestation ofaging and, often, is the only sign of a serious underlying medical condition. This article will review thesignificance, definition, and principal features of delirium so that emergency physicians may betterappreciate, recognize, evaluate, and manage delirium in the elderly.

  2. Emergency response packaging: A conceptual outline

    International Nuclear Information System (INIS)

    Luna, R.E.; McClure, J.D.; Bennett, P.C.; Wheeler, T.A.

    1992-01-01

    The Packaging and Transportation Needs in the 1990's (PATN) component of the Transportation Assessment and Integration (TRAIN) program (DOE Nov. 1991) was designed to survey United States Department of Energy programs, both ongoing and planned, to identify needs for packaging and transportation services over the next decade. PATN also identified transportation elements that should be developed by the DOE Office of Environmental Restoration and Waste Management (DOE EM) Transportation Management Program (TMP). As a result of the predominant involvement of the TMP in radioactive material shipment issues and DOE EM's involvement with waste management issues, the primary focus of PATN was on waste packaging issues. Pending DOE regulations will formalize federal guidelines and regulations for transportation of hazardous and radioactive materials within the boundaries of DOE reservations and facilities and reflect a growing awareness of concern regarding safety environmental responsibility activities on DOE reservations. Future practices involving the transportation of radioactive material within DOE reservations will closely parallel those used for commercial and governmental transportation across the United States. This has added to the perceived need for emergency recovery packaging and emergency response features on primary packaging, for both on-site shipments and shipments between DOE facilities (off-site). Historically, emergency response and recovery functions of packaging have not been adequately considered in packaging design and construction concepts. This paper develops the rationale for emergency response packaging, including both overpack concepts for repackaging compromised packaging and primary packaging redesign to facilitate the recovery of packages via mobile remote handling equipment. The rationale will examine concepts for determination of likely use patterns to identify types of shipments where recovery packaging may have the most favorable payoff

  3. Perspectives on Bullying Among Children Who Present to the Emergency Department With Behavioral Misconduct

    Science.gov (United States)

    Waseem, Muhammad; Boutin-Foster, Carla; Robbins, Laura; Gonzalez, Rita; Vargas, Steven; Peterson, Janey C.

    2015-01-01

    The problem of bullying is an increasing public health threat encountered by emergency physicians especially in inner city emergency departments (EDs). Bullying may result in emotional disturbances and psychological trauma in children. Many children sent to the ED because of behavioral misconduct require immediate stabilization and treatment. The emergency physician performs an initial assessment and stabilization. Emergency departments are increasingly on the frontline of the bullying problem. Objectives Our objective was to explore children's perspective of bullying and their views of potential solutions. Methods A qualitative study was conducted in a cohort of 50 children (age, 8–17 years),who were referred to the ED from school because of their behavioral misconduct. An interview survey tool about bullying was administered. It focused on what bullying meant to them and what advice they have for a child who is bullied. They were also asked what advice they would have for adults who try to help. We used grounded theory to analyze the data. Similar concepts were grouped, and the categories with similar properties and dimensions were defined. Common themes were then identified. Results We interviewed 50 children, of whom 27 were boys and 23 were girls. Their mean (SD) age was 12.5 (2.12) years (range, 8–17 years). Bullying was identified by children as including physical, verbal, and emotional actions. Several themes emerged. First, a power imbalance between a bully and victim may render an individual vulnerable to bullying. Being different and weak also increases the risk of being bullied. Second, bullying is wrong, and the bully should be punished. Third, children should learn how to handle bullying situations and develop resilience against bullying. Finally, adults need to be more proactive to prevent or stop bullying. Conclusions Our results provide insights into the perceptions of children regarding bullying. We have garnered a better understanding of what

  4. Where is the evidence for emergency planning: a scoping review.

    Science.gov (United States)

    Challen, Kirsty; Lee, Andrew C K; Booth, Andrew; Gardois, Paolo; Woods, Helen Buckley; Goodacre, Steve W

    2012-07-23

    Recent terrorist attacks and natural disasters have led to an increased awareness of the importance of emergency planning. However, the extent to which emergency planners can access or use evidence remains unclear. The aim of this study was to identify, analyse and assess the location, source and quality of emergency planning publications in the academic and UK grey literature. We conducted a scoping review, using as data sources for academic literature Embase, Medline, Medline in Process, Psychinfo, Biosis, Science Citation Index, Cinahl, Cochrane library and Clinicaltrials.gov. For grey literature identification we used databases at the Health Protection Agency, NHS Evidence, British Association of Immediate Care Schemes, Emergency Planning College and the Health and Safety Executive, and the websites of UK Department of Health Emergency Planning Division and UK Resilience.Aggregative synthesis was used to analyse papers and documents against a framework based on a modified FEMA Emergency Planning cycle. Of 2736 titles identified from the academic literature, 1603 were relevant. 45% were from North America, 27% were commentaries or editorials and 22% were event reports.Of 192 documents from the grey literature, 97 were relevant. 76% of these were event reports.The majority of documents addressed emergency planning and response. Very few documents related to hazard analysis, mitigation or capability assessment. Although a large body of literature exists, its validity and generalisability is unclear There is little evidence that this potential evidence base has been exploited through synthesis to inform policy and practice. The type and structure of evidence that would be of most value of emergency planners and policymakers has yet to be identified.

  5. Where is the evidence for emergency planning: a scoping review

    Directory of Open Access Journals (Sweden)

    Challen Kirsty

    2012-07-01

    Full Text Available Abstract Background Recent terrorist attacks and natural disasters have led to an increased awareness of the importance of emergency planning. However, the extent to which emergency planners can access or use evidence remains unclear. The aim of this study was to identify, analyse and assess the location, source and quality of emergency planning publications in the academic and UK grey literature. Methods We conducted a scoping review, using as data sources for academic literature Embase, Medline, Medline in Process, Psychinfo, Biosis, Science Citation Index, Cinahl, Cochrane library and Clinicaltrials.gov. For grey literature identification we used databases at the Health Protection Agency, NHS Evidence, British Association of Immediate Care Schemes, Emergency Planning College and the Health and Safety Executive, and the websites of UK Department of Health Emergency Planning Division and UK Resilience. Aggregative synthesis was used to analyse papers and documents against a framework based on a modified FEMA Emergency Planning cycle. Results Of 2736 titles identified from the academic literature, 1603 were relevant. 45% were from North America, 27% were commentaries or editorials and 22% were event reports. Of 192 documents from the grey literature, 97 were relevant. 76% of these were event reports. The majority of documents addressed emergency planning and response. Very few documents related to hazard analysis, mitigation or capability assessment. Conclusions Although a large body of literature exists, its validity and generalisability is unclear There is little evidence that this potential evidence base has been exploited through synthesis to inform policy and practice. The type and structure of evidence that would be of most value of emergency planners and policymakers has yet to be identified.

  6. User-identified gel characteristics: a qualitative exploration of perceived product efficacy of topical vaginal microbicides.

    Science.gov (United States)

    Morrow, Kathleen M; Underhill, Kristen; van den Berg, Jacob J; Vargas, Sara; Rosen, Rochelle K; Katz, David F

    2014-10-01

    Research has demonstrated that certain vaginal gel products--microbicides containing antiretroviral drugs--may reduce HIV infection risk among women. But for vaginal gels to avert HIV and other sexually transmitted infections (STIs), at-risk women must be willing to use them as directed. These products must therefore be "acceptable" to women and an important component of acceptability is users' perception that the product will work to prevent infection. We sought to understand how women's perceptions of vaginal gel properties may shape their understanding of product efficacy for HIV and STI prevention. Sixteen women completed two in-depth qualitative interviews (k = 32) to identify the range and types of sensory perceptions they experienced when using two vaginal gels. We identified emergent themes and linkages between users' sensory perceptions and their beliefs about product efficacy. Users' predictions about product efficacy for preventing infection corresponded to measurable physical properties, including gel volume, location in the vagina, coating behavior, sensation of the gel in the vagina, leakage, and gel changes during coital acts. Although the women described similar sensory experiences (e.g., gel leaked from the vagina), they interpreted these experiences to have varying implications for product efficacy (e.g., leakage was predicted to increase or decrease efficacy). To improve microbicide acceptability, gel developers should investigate and deliberately incorporate properties that influence users' perceptions of efficacy. When a microbicide is approved for use, providers should educate users to anticipate and understand their sensory experiences; improving users' experience can maximize adherence and product effectiveness.

  7. Soliton Attenuation and Emergent Hydrodynamics in Fragile Matter

    Directory of Open Access Journals (Sweden)

    N. Upadhyaya

    2014-03-01

    Full Text Available Disordered packings of soft grains are fragile mechanical systems that lose rigidity upon lowering the external pressure toward zero. At zero pressure, we find that any infinitesimal strain impulse propagates initially as a nonlinear solitary wave progressively attenuated by disorder. We demonstrate that the particle fluctuations generated by the solitary-wave decay can be viewed as a granular analogue of temperature. Their presence is manifested by two emergent macroscopic properties absent in the unperturbed granular packing: a finite pressure that scales with the injected energy (akin to a granular temperature and an anomalous viscosity that arises even when the microscopic mechanisms of energy dissipation are negligible. Consistent with the interpretation of this state as a fluidlike thermalized state, the shear modulus remains zero. Further, we follow in detail the attenuation of the initial solitary wave, identifying two distinct regimes—an initial exponential decay, followed by a longer power-law decay—and suggest simple models to explain these two regimes.

  8. Emerging infectious diseases of wildlife: a critical perspective.

    Science.gov (United States)

    Tompkins, Daniel M; Carver, Scott; Jones, Menna E; Krkošek, Martin; Skerratt, Lee F

    2015-04-01

    We review the literature to distinguish reports of vertebrate wildlife disease emergence with sufficient evidence, enabling a robust assessment of emergence drivers. For potentially emerging agents that cannot be confirmed, sufficient data on prior absence (or a prior difference in disease dynamics) are frequently lacking. Improved surveillance, particularly for neglected host taxa, geographical regions and infectious agents, would enable more effective management should emergence occur. Exposure to domestic sources of infection and human-assisted exposure to wild sources were identified as the two main drivers of emergence across host taxa; the domestic source was primary for fish while the wild source was primary for other taxa. There was generally insufficient evidence for major roles of other hypothesized drivers of emergence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Emergence of charge density waves and a pseudogap in single-layer TiTe2.

    Science.gov (United States)

    Chen, P; Pai, Woei Wu; Chan, Y-H; Takayama, A; Xu, C-Z; Karn, A; Hasegawa, S; Chou, M Y; Mo, S-K; Fedorov, A-V; Chiang, T-C

    2017-09-11

    Two-dimensional materials constitute a promising platform for developing nanoscale devices and systems. Their physical properties can be very different from those of the corresponding three-dimensional materials because of extreme quantum confinement and dimensional reduction. Here we report a study of TiTe 2 from the single-layer to the bulk limit. Using angle-resolved photoemission spectroscopy and scanning tunneling microscopy and spectroscopy, we observed the emergence of a (2 × 2) charge density wave order in single-layer TiTe 2 with a transition temperature of 92 ± 3 K. Also observed was a pseudogap of about 28 meV at the Fermi level at 4.2 K. Surprisingly, no charge density wave transitions were observed in two-layer and multi-layer TiTe 2 , despite the quasi-two-dimensional nature of the material in the bulk. The unique charge density wave phenomenon in the single layer raises intriguing questions that challenge the prevailing thinking about the mechanisms of charge density wave formation.Due to reduced dimensionality, the properties of 2D materials are often different from their 3D counterparts. Here, the authors identify the emergence of a unique charge density wave (CDW) order in monolayer TiTe 2 that challenges the current understanding of CDW formation.

  10. Product Design and intentional Emergence facilitated by Serious Play

    DEFF Research Database (Denmark)

    Mabugunje, Ade; Hansen, Poul H. Kyvsgård; Eris, Ozgur

    2008-01-01

    "In this paper we discuss the phenomenon "intentional emergence" in a product development process context. We point to play as an enabler for intentional emergence and report on experiences with the Lego Serious Play method. Following our initial empirical experiences we identify six central...

  11. Understanding the "Weekend Effect" for Emergency General Surgery.

    Science.gov (United States)

    Hoehn, Richard S; Go, Derek E; Dhar, Vikrom K; Kim, Young; Hanseman, Dennis J; Wima, Koffi; Shah, Shimul A

    2018-02-01

    Several studies have identified a "weekend effect" for surgical outcomes, but definitions vary and the cause is unclear. Our aim was to better characterize the weekend effect for emergency general surgery using mortality as a primary endpoint. Using data from the University HealthSystem Consortium from 2009 to 2013, we identified urgent/emergent hospital admissions for seven procedures representing 80% of the national burden of emergency general surgery. Patient characteristics and surgical outcomes were compared between cases that were performed on weekdays vs weekends. Hospitals varied widely in the proportion of procedures performed on the weekend. Of the procedures examined, four had higher mortality for weekend cases (laparotomy, lysis of adhesions, partial colectomy, and small bowel resection; p < 0.01), while three did not (appendectomy, cholecystectomy, and peptic ulcer disease repair). Among the four procedures with increased weekend mortality, patients undergoing weekend procedures also had increased severity of illness and shorter time from admission to surgery (p < 0.01). Multivariate analysis adjusting for patient characteristics demonstrated independently higher mortality on weekends for these same four procedures (p < 0.01). For the first time, we have identified specific emergency general surgery procedures that incur higher mortality when performed on weekends. This may be due to acute changes in patient status that require weekend surgery or indications for urgent procedures (ischemia, obstruction) compared to those without a weekend mortality difference (infection). Hospitals that perform weekend surgery must acknowledge and identify ways to manage this increased risk.

  12. Predictive features of persistent activity emergence in regular spiking and intrinsic bursting model neurons.

    Directory of Open Access Journals (Sweden)

    Kyriaki Sidiropoulou

    Full Text Available Proper functioning of working memory involves the expression of stimulus-selective persistent activity in pyramidal neurons of the prefrontal cortex (PFC, which refers to neural activity that persists for seconds beyond the end of the stimulus. The mechanisms which PFC pyramidal neurons use to discriminate between preferred vs. neutral inputs at the cellular level are largely unknown. Moreover, the presence of pyramidal cell subtypes with different firing patterns, such as regular spiking and intrinsic bursting, raises the question as to what their distinct role might be in persistent firing in the PFC. Here, we use a compartmental modeling approach to search for discriminatory features in the properties of incoming stimuli to a PFC pyramidal neuron and/or its response that signal which of these stimuli will result in persistent activity emergence. Furthermore, we use our modeling approach to study cell-type specific differences in persistent activity properties, via implementing a regular spiking (RS and an intrinsic bursting (IB model neuron. We identify synaptic location within the basal dendrites as a feature of stimulus selectivity. Specifically, persistent activity-inducing stimuli consist of activated synapses that are located more distally from the soma compared to non-inducing stimuli, in both model cells. In addition, the action potential (AP latency and the first few inter-spike-intervals of the neuronal response can be used to reliably detect inducing vs. non-inducing inputs, suggesting a potential mechanism by which downstream neurons can rapidly decode the upcoming emergence of persistent activity. While the two model neurons did not differ in the coding features of persistent activity emergence, the properties of persistent activity, such as the firing pattern and the duration of temporally-restricted persistent activity were distinct. Collectively, our results pinpoint to specific features of the neuronal response to a given

  13. Identifying Cancer Driver Genes Using Replication-Incompetent Retroviral Vectors

    Directory of Open Access Journals (Sweden)

    Victor M. Bii

    2016-10-01

    Full Text Available Identifying novel genes that drive tumor metastasis and drug resistance has significant potential to improve patient outcomes. High-throughput sequencing approaches have identified cancer genes, but distinguishing driver genes from passengers remains challenging. Insertional mutagenesis screens using replication-incompetent retroviral vectors have emerged as a powerful tool to identify cancer genes. Unlike replicating retroviruses and transposons, replication-incompetent retroviral vectors lack additional mutagenesis events that can complicate the identification of driver mutations from passenger mutations. They can also be used for almost any human cancer due to the broad tropism of the vectors. Replication-incompetent retroviral vectors have the ability to dysregulate nearby cancer genes via several mechanisms including enhancer-mediated activation of gene promoters. The integrated provirus acts as a unique molecular tag for nearby candidate driver genes which can be rapidly identified using well established methods that utilize next generation sequencing and bioinformatics programs. Recently, retroviral vector screens have been used to efficiently identify candidate driver genes in prostate, breast, liver and pancreatic cancers. Validated driver genes can be potential therapeutic targets and biomarkers. In this review, we describe the emergence of retroviral insertional mutagenesis screens using replication-incompetent retroviral vectors as a novel tool to identify cancer driver genes in different cancer types.

  14. Emergent properties resulting from type-II band alignment in semiconductor nanoheterostructures.

    Science.gov (United States)

    Lo, Shun S; Mirkovic, Tihana; Chuang, Chi-Hung; Burda, Clemens; Scholes, Gregory D

    2011-01-11

    The development of elegant synthetic methodologies for the preparation of monocomponent nanocrystalline particles has opened many possibilities for the preparation of heterostructured semiconductor nanostructures. Each of the integrated nanodomains is characterized by its individual physical properties, surface chemistry, and morphology, yet, these multicomponent hybrid particles present ideal systems for the investigation of the synergetic properties that arise from the material combination in a non-additive fashion. Of particular interest are type-II heterostructures, where the relative band alignment of their constituent semiconductor materials promotes a spatial separation of the electron and hole following photoexcitation, a highly desirable property for photovoltaic applications. This article highlights recent progress in both synthetic strategies, which allow for material and architectural modulation of novel nanoheterostructures, as well as the experimental work that provides insight into the photophysical properties of type-II heterostructures. The effects of external factors, such as electric fields, temperature, and solvent are explored in conjunction with exciton and multiexciton dynamics and charge transfer processes typical for type-II semiconductor heterostructures.

  15. Nurse management skills required at an emergency care unit

    OpenAIRE

    Montezeli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth

    2013-01-01

    Objective: To identify the management skills needed for this professional at an emergency care unit. Method: An exploratory descriptive qualitative study conducted with eight nurses in which semi-structured interviews with nonparticipating systematic observation were conducted; the data was processed by content analysis. Results: The categories which emerged from the content analysis served as a list of management skills necessary to their work at the emergency care unit: leadership, decision...

  16. Use of telehealth in the management of non-critical emergencies in rural or remote emergency departments: a systematic review.

    Science.gov (United States)

    du Toit, Marie; Malau-Aduli, Bunmi; Vangaveti, Venkat; Sabesan, Sabe; Ray, Robin A

    2017-01-01

    Background Telehealth has been used extensively in emergency departments to improve healthcare provision. However, its impact on the management of non-critical emergency presentations within rural and remote emergency department settings has not been adequately explored. The objective of this systematic review is to identify how telehealth has been used to assist in the management of non-critical presentations in rural and remote emergency departments and the outcomes. Methods Articles were identified through database searches of CINAHL, Cochrane, MEDLINE (OVID), Informit and SCOPUS, as well as the screening of relevant article reference and citation lists. To determine how telehealth can assist in the management of non-critical emergencies, information was extracted relating to telehealth programme model, the scope of service and participating health professionals. The outcomes of telehealth programmes were determined by analysing the uptake and usage of telehealth, the impact on altering a diagnosis or management plan as well as patient disposition including patient transfer, discharge, local hospital admission and rates of discharge against medical advice. Results Of the 2532 identified records, 15 were found to match the eligibility criteria and were included in the review. Uptake and usage increased for telehealth programmes predominantly utilised by nursing staff with limited local medical support. Teleconsultation conservatively altered patient diagnosis or management in 18-66% of consultations. Although teleconsultation was associated with increased patient transfer rates, unnecessary transfers were reduced. Simultaneously, an increase in local hospital admission was noted and fewer patients were discharged home. Discharge against medical advice rates were low at 0.9-1.1%. Conclusion The most widely implemented hub-and-spoke telehealth model could be incorporated into existing referral frameworks. Telehealth programmes may assist in reducing unnecessary

  17. Emergence Unites Ecology and Society

    Directory of Open Access Journals (Sweden)

    Ronald L. Trosper

    2005-06-01

    Full Text Available The effort to combine analysis of ecosystems and social systems requires a firm theoretical basis. When humans are present in an ecosystem, their actions affect emergent structures; this paper examines forms of emergence that account for the presence of humans. Humans monitor and regulate ecosystems based on their cultural systems. Cultural systems consist of concepts linked in complicated ways that can form consistent world views, can contain inconsistencies, and may or may not accurately model the properties of a social-ecological system. Consequently, human monitoring and regulating processes will differ, depending on cultural systems. Humans, as agents, change or maintain pre-existing material and cultural emergent structures. The presentation is illustrated with a case study of fire-prone forests. The paper shows that explicit attention to emergence serves very well in unifying the following requirements for social-ecological analysis: coherent and observable definitions of sustainability; ways to link ecological and social phenomena; ways to understand cultural reasons for stability and instability in dynamic social-ecological systems; and ways to include human self-evaluation and culture within dynamic models of social-ecological systems. Analysis of cultural emergent structures clarifies many differences in assumptions among the fields of economics, sociology, political science, ecology, and ecological economics. Because it can be readily applied to empirical questions, the framework provides a good way to organize policy analysis that is not dominated by one or another discipline.

  18. Parameter identifiability and redundancy: theoretical considerations.

    Directory of Open Access Journals (Sweden)

    Mark P Little

    Full Text Available BACKGROUND: Models for complex biological systems may involve a large number of parameters. It may well be that some of these parameters cannot be derived from observed data via regression techniques. Such parameters are said to be unidentifiable, the remaining parameters being identifiable. Closely related to this idea is that of redundancy, that a set of parameters can be expressed in terms of some smaller set. Before data is analysed it is critical to determine which model parameters are identifiable or redundant to avoid ill-defined and poorly convergent regression. METHODOLOGY/PRINCIPAL FINDINGS: In this paper we outline general considerations on parameter identifiability, and introduce the notion of weak local identifiability and gradient weak local identifiability. These are based on local properties of the likelihood, in particular the rank of the Hessian matrix. We relate these to the notions of parameter identifiability and redundancy previously introduced by Rothenberg (Econometrica 39 (1971 577-591 and Catchpole and Morgan (Biometrika 84 (1997 187-196. Within the widely used exponential family, parameter irredundancy, local identifiability, gradient weak local identifiability and weak local identifiability are shown to be largely equivalent. We consider applications to a recently developed class of cancer models of Little and Wright (Math Biosciences 183 (2003 111-134 and Little et al. (J Theoret Biol 254 (2008 229-238 that generalize a large number of other recently used quasi-biological cancer models. CONCLUSIONS/SIGNIFICANCE: We have shown that the previously developed concepts of parameter local identifiability and redundancy are closely related to the apparently weaker properties of weak local identifiability and gradient weak local identifiability--within the widely used exponential family these concepts largely coincide.

  19. International Business Education: Identifying the Emergent Topics in International Business and Their Relevance for Knowledge Development.

    Science.gov (United States)

    Yeoh, Poh-Lin

    2001-01-01

    Sampled faculty in international business (IB) to better understand emerging themes in that area. Seven major topical areas were uncovered: general knowledge of IB, international trade and institutions, cross-cultural issues, managing global operations, international ethics, international monetary systems, and international political/regulatory…

  20. Emergency Nurses' Perceptions of Providing End-of-Life Care in a Hong Kong Emergency Department: A Qualitative Study.

    Science.gov (United States)

    Tse, Johnson Wai Keung; Hung, Maria Shuk Yu; Pang, Samantha Mei Che

    2016-05-01

    Provision of end-of-life (EOL) care in the emergency department has improved globally in recent years and has a different scope of interventions than traditional emergency medicine. In 2010, a regional hospital established the first ED EOL service in Hong Kong. The aim of this study was to understand emergency nurses' perceptions regarding the provision of EOL care in the emergency department. A qualitative approach was used with purposive sampling of 16 nurses who had experience in providing EOL care. Semi-structured, face-to-face interviews were conducted from May to October, 2014. All the interviews were transcribed verbatim for content analysis. Four themes were identified: (1) doing good for the dying patients, (2) facilitating family engagement and involvement, (3) enhancing personal growth and professionalism, and (4) expressing ambiguity toward resource deployment. Provision of EOL care in the emergency department can enhance patients' last moment of life, facilitate the grief and bereavement process of families, and enhance the professional development of staff in emergency department. It is substantiated that EOL service in the emergency department enriches EOL care in the health care system. Findings from this study integrated the perspectives on ED EOL services from emergency nurses. The integration of EOL service in other emergency departments locally and worldwide is encouraged. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  1. The Role of Templating in the Emergence of RNA from the Prebiotic Chemical Mixture

    Directory of Open Access Journals (Sweden)

    Andrew S. Tupper

    2017-10-01

    Full Text Available Biological RNA is a uniform polymer in three senses: it uses nucleotides of a single chirality; it uses only ribose sugars and four nucleobases rather than a mixture of other sugars and bases; and it uses only 3′-5′ bonds rather than a mixture of different bond types. We suppose that prebiotic chemistry would generate a diverse mixture of potential monomers, and that random polymerization would generate non-uniform strands of mixed chirality, monomer composition, and bond type. We ask what factors lead to the emergence of RNA from this mixture. We show that template-directed replication can lead to the emergence of all the uniform properties of RNA by the same mechanism. We study a computational model in which nucleotides react via polymerization, hydrolysis, and template-directed ligation. Uniform strands act as templates for ligation of shorter oligomers of the same type, whereas mixed strands do not act as templates. The three uniform properties emerge naturally when the ligation rate is high. If there is an exact symmetry, as with the chase of chirality, the uniform property arises via a symmetry-breaking phase transition. If there is no exact symmetry, as with monomer selection and backbone regioselectivity, the uniform property emerges gradually as the rate of template-directed ligation is increased.

  2. Factors enhancing career satisfaction among female emergency physicians.

    Science.gov (United States)

    Clem, Kathleen J; Promes, Susan B; Glickman, Seth W; Shah, Anand; Finkel, Michelle A; Pietrobon, Ricardo; Cairns, Charles B

    2008-06-01

    Attrition rates in emergency medicine have been reported as high as 25% in 10 years. The number of women entering emergency medicine has been increasing, as has the number of female medical school graduates. No studies have identified factors that increase female emergency physician career satisfaction. We assess career satisfaction in women emergency physicians in the American College of Emergency Physicians (ACEP) and identify factors associated with career satisfaction. The survey questionnaire was developed by querying 3 groups: (1) ACEP women in the American Association of Women Emergency Physicians, the (2) Society for Academic Emergency Medicine Mentoring Women Interest Group, and (3) nonaffiliated female emergency physicians. Their responses were categorized into 6 main areas: schedule, relationships with colleagues, administrative support and mentoring, patient/work-related issues, career advancement opportunities, and financial. The study cohort for the survey included all female members of ACEP with a known e-mail address. All contact with survey recipients was exclusively through the e-mail that contained a uniform resource locator link to the survey itself. Two thousand five hundred two ACEP female members were sent the uniform resource locator link. The Web survey was accessed a total of 1,851 times, with a total of 1,380 surveys completed, an overall response rate of 56%. Most women were satisfied with their career as an emergency physician, 492 (35.5%) very satisfied, 610 (44.0%) satisfied, 154 (11.1%) neutral, 99 (7.1%) not satisfied, and 31 (2.3%) very unsatisfied. Significant factors for career satisfaction included amount of recognition at work, career advancement, schedule flexibility, and the fairness of financial compensation. Workplace factors associated with high satisfaction included academic practice setting and sex-equal opportunity for advancement and sex-equal financial compensation. Most of the ACEP female physicians surveyed were

  3. Physical properties of Kentucky's AML landslides: Case studies analyzed

    International Nuclear Information System (INIS)

    Iannacchione, A.T.; Vallejo, L.E.

    1994-01-01

    Once an abandoned mined land (AML) landslide occurs and is identified as an emergency, engineers must rapidly implement a slope stabilization design. Correct slope remediation solutions are generally derived from well-executed geotechnical examinations. This paper summarizes a large body of geotechnical data compiled by the US office of Surface Mining Reclamation and Enforcement (OSM) from AML landslides in eastern Kentucky. Special attention is placed on the examination of subsurface failures, phreatic water levels, soil profiles, and soil composition information from numerous borehole exploration programs. Strength properties calculated from laboratory procedures and stability analysis techniques were also reviewed. Laboratory-determined soil shear strength values were found to be higher than those inferred from stability analysis. This suggests that postfailure determinations of the phreatic surface may be largely inappropriate when used in stability analysis or that laboratory-measured shear strengths are ineffective in replicating in situ colluvium/spoil slope properties

  4. Challenge of hospital emergency preparedness: analysis and recommendations.

    Science.gov (United States)

    Barbera, Joseph A; Yeatts, Dale J; Macintyre, Anthony G

    2009-06-01

    In the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research.

  5. IDENTIFYING DEMENTIA IN ELDERLY POPULATION : A CAMP APPROACH

    OpenAIRE

    Anand P; Chaukimath; Srikanth; Koli

    2015-01-01

    BACKGROUND: Dementia is an emerging medico social problem affecting elderly, and poses a challenge to clinician and caregivers. It is usually identified in late stage where management becomes difficult. AIM: The aim of camp was to identify dementia in elderly population participating in screening camp. MATERIAL AND METHODS : The geriatric clinic and department of psychiatry jointly organised screening camp to detect dementia in elderly for five days in Sept...

  6. Simulation and the emergency department overcrowding problem

    OpenAIRE

    Nahhas, A.; Awaldi, A.; Reggelin, T.

    2017-01-01

    In this paper, a brief review on the emergency department overcrowding problem and its associated solution methodologies is presented. In addition, a case study of an urgent care center is investigated that demonstrates different simulation-based solution strategies to deal with the Emergency Department overcrowding problem. More precisely, a simulation study is conducted to identify critical aspects and propose possible scenarios to configure an urgent care center. Based on statistical data ...

  7. Emerging technologies, innovative teachers and moral cohesion

    CSIR Research Space (South Africa)

    Batchelor, J

    2012-05-01

    Full Text Available efficacy when they engage with emerging technologies. The concept of moral cohesion is further expanded and forms the main focus of this article. Keywords: emerging technologies, innovative teachers, moral cohesion, pedagogies, ethics, teacher.... African Renaissance and teacher disposition is identified as the strongest drivers. Teacher training forms the link between the strong drivers and the outcomes manifest as Stewardship and ethical considerations. 3.2 Professional Burden The theme...

  8. Feasibility study for a computerized emergency preparedness simulation facility

    International Nuclear Information System (INIS)

    Gerhardstein, L.H.; Schroeder, J.O.; Sandusky, W.F.

    1979-11-01

    This report details the feasibility of a computerized Emergency Preparedness Simulation Facility (EPSF) for use by the Nuclear Regulatory Commission (NRC). The proposed facility would be designed to provide the NRC and other federal, state, and local government agencies with a capability to formulate, test, and evaluate the Emergency Preparedness Plans (EPP) which local and state agencies have/will establish for use during nuclear emergencies. In cases of any state emergency (including a nuclear emergency), high level state government officials will direct emergency procedures and insure that state and local emergency teams carry out tasks which have been established in their EPP. When an emergency exists, rapid mobilization of emergency teams, efficient communication, and effective coordination of individual team efforts is essential to safety, preservation of property, and overall public welfare. Current EPP evaluation procedures are qualitative in nature and while they do compare emergency drill performance with the EPP, the nature of the drills often does not provide enough realism to actual emergency conditions. Automated simulation of real emergency conditions using modern computer equipment and programming techniques will provide the NRC emergency evaluation teams a simulated environment which closely approximates conditions which would actually exist during a real emergency. In addition, the computer can be used to collect and log performance and event data which will aid the evaluation team in making assessments of the state or local area's EPP and their Emergency Preparedness Teams performance during emergency drills. Overall, a computerized EPSF can improve drill testing and evaluation efficiency, provide approximate emergency condition realism, and improve public awareness of local emergency procedures

  9. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

    Science.gov (United States)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

    2018-01-05

    Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

  10. Identification and assessment of site treatment plan implementation opportunities for emerging technologies

    International Nuclear Information System (INIS)

    Bernard, E.A.

    1995-01-01

    The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX sm , Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE's mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM's Office of Technology Development, has funded this work

  11. Developing emergency department-based education about emergency contraception: adolescent preferences.

    Science.gov (United States)

    Mollen, Cynthia J; Miller, Melissa K; Hayes, Katie L; Wittink, Marsha N; Barg, Frances K

    2013-11-01

    The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking. Participants completed a computerized survey that used ACA, a technique that can be used to assess patients' relative preferences for services. ACA uses the individual's answers to update and refine questions through trade-off comparisons, so that each respondent answers a customized set of questions. The survey assessed preferences for the following attributes of emergency contraception education: who should deliver the education, if anyone (e.g., nurse, doctor); how the education should be delivered (e.g., by a person or via video); how often the education should be offered if patients were to frequent the ED (e.g., every time or only when asking for it); length (e.g., 5 minutes, 10 minutes); and chief complaint that would trigger the education (e.g., headache or stomach pain). A total of 223 patients were enrolled (37.2% at Hospital 1 and 62.8% at Hospital 2). The mean (±SD) age of the participants was 16.1 (±1.3) years. Just over half (55%) reported a history of sexual activity; 8% reported a history of pregnancy. Overall, the participants preferred education that was delivered by a person, specifically a doctor or nurse. They preferred a slightly longer education session and preferred education directed at patients seeking care in the ED for complaints potentially related to sexual activity. Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve adolescents' knowledge about pregnancy prevention

  12. Brief introduction of nuclear power plant emergency system EmInfoSys

    International Nuclear Information System (INIS)

    Xiao Yuhua; Zhao Zhigang

    2014-01-01

    Nuclear safety is the lifeline of nuclear energy and nuclear technology, nuclear accident emergency response is the last line of nuclear security defense, and is one of the important measures to ensure the healthy development of the nuclear energy safety. The establishment of complete function, sensitive reaction and efficient emergency management system for operation of nuclear and radiation accidents is an important task of nuclear security. From 2001 China Techenergy Co., Ltd. participated in the Qinshan, Tianwan, Ministry of Environmental Protection, Haiyang, Taishan, Fangchenggang, Sanmen, etc. nuclear emergency projects, and the nuclear emergency EmInfoSys (emergency management information system) platform was developed with independent intellectual property rights. A brief introduction about EmInfoSys system was performed in this paper. (authors)

  13. Radiation emergency preparedness in nuclear power plants

    International Nuclear Information System (INIS)

    Geetha, P.V.; Ramamirtham, B.; Khot, P.

    2008-01-01

    The purpose of planning for radiation emergency response is to ensure adequate preparedness for protection of the plant personnel and members of the public from significant radiation exposures in the unlikely event of an accident. With a number of safety features in the reactor design and sound operating procedures, the probability of a major accident resulting in the releases of large quantities of radioactivity is extremely small. However, as an abundant cautious approach a comprehensive radiation emergency response preparedness is in place in all the nuclear power plants (NPPs). Radiation Emergency in NPPs is broadly categorized into three types; plant emergency, site emergency and off-site emergency. During off site emergency conditions, based on levels of radiation in the environment, Civil Authorities may impose several counter measures such as sheltering, administering prophylaxis (stable iodine for thyroid blocking) and evacuation of people from the affected area. Environmental Survey Laboratory (ESL) carries out environmental survey extensively in the affected sector identified by the meteorological survey laboratory. To handle emergency situations, Emergency Control Centre with all communication facility and Emergency Equipment Centre having radiation measuring instruments and protective equipment are functional at all NPPs. AERB stipulates certain periodicity for conducting the exercises on plant, site and off site emergency. These exercises are conducted and deficiencies corrected for strengthening the emergency preparedness system. In the case of off site emergency exercise, observers are invited from AERB and Crisis Management Group of Department of Atomic Energy (DAE). The emergency exercises conducted by Nuclear Power Plant Sites have been very satisfactory. (author)

  14. Using a Counterfactual Process to Identify the Applicability of Emerging Technology

    Science.gov (United States)

    2014-09-01

    conditions that must exist for the antecedent to happen.129 Crafting a 126 Michael W. Morris and...opportunities of interrupting the sequence of events. For example, if the bombers were identified on Monday then the events that unfold on Tuesday ...www.telegraph.co.uk/news/worldnews/northamerica/usa/10006491/Boston- marathon-bombings-Dzhokhar-Tsarnaev-pictured-behind-eight-year-old- victim.html Morris , Michael

  15. Population-level genomics identifies the emergence and global spread of a human transmissible multidrug-resistant nontuberculous mycobacterium

    Science.gov (United States)

    Rodriguez-Rincon, Daniela; Everall, Isobel; Brown, Karen P; Moreno, Pablo; Verma, Deepshikha; Hill, Emily; Drijkoningen, Judith; Gilligan, Peter; Esther, Charles R; Noone, Peadar G; Giddings, Olivia; Bell, Scott C.; Thomson, Rachel; Wainwright, Claire E.; Coulter, Chris; Pandey, Sushil; Wood, Michelle E; Stockwell, Rebecca E; Ramsay, Kay A; Sherrard, Laura J; Kidd, Timothy J; Jabbour, Nassib; Johnson, Graham R; Knibbs, Luke D; Morawska, Lidia; Sly, Peter D; Jones, Andrew; Bilton, Diana; Laurenson, Ian; Ruddy, Michael; Bourke, Stephen; Bowler, Ian CJW; Chapman, Stephen J; Clayton, Andrew; Cullen, Mairi; Daniels, Thomas; Dempsey, Owen; Denton, Miles; Desai, Maya; Drew, Richard J; Edenborough, Frank; Evans, Jason; Folb, Jonathan; Humphrey, Helen; Isalska, Barbara; Jensen-Fangel, Søren; Jönsson, Bodil; Jones, Andrew M.; Katzenstein, Terese L; Lillebaek, Troels; MacGregor, Gordon; Mayell, Sarah; Millar, Michael; Modha, Deborah; Nash, Edward F; O’Brien, Christopher; O’Brien, Deirdre; Ohri, Chandra; Pao, Caroline S; Peckham, Daniel; Perrin, Felicity; Perry, Audrey; Pressler, Tania; Prtak, Laura; Qvist, Tavs; Robb, Ali; Rodgers, Helen; Schaffer, Kirsten; Shafi, Nadia; van Ingen, Jakko; Walshaw, Martin; Watson, Danie; West, Noreen; Whitehouse, Joanna; Haworth, Charles S; Harris, Simon R; Ordway, Diane; Parkhill, Julian; Floto, R. Andres

    2016-01-01

    Lung infections with Mycobacterium abscessus, a species of multidrug resistant nontuberculous mycobacteria, are emerging as an important global threat to individuals with cystic fibrosis (CF) where they accelerate inflammatory lung damage leading to increased morbidity and mortality. Previously, M. abscessus was thought to be independently acquired by susceptible individuals from the environment. However, using whole genome analysis of a global collection of clinical isolates, we show that the majority of M. abscessus infections are acquired through transmission, potentially via fomites and aerosols, of recently emerged dominant circulating clones that have spread globally. We demonstrate that these clones are associated with worse clinical outcomes, show increased virulence in cell-based and mouse infection models, and thus represent an urgent international infection challenge. PMID:27846606

  16. Contaminants of Emerging Concern - Methods Documents

    Science.gov (United States)

    Analytical methods developed by EPA to identify and measure certain contaminants of emerging concern. These methods are not approved under 40 CFR Part 136, but may be of interest to regulated entities, permitting authorities, and the public.

  17. Shared cross-modal associations and the emergence of the lexicon

    OpenAIRE

    Cuskley, Christine F.

    2013-01-01

    This thesis centres around a sensory theory of protolanguage emergence, or STP. The STP proposes that shared biases to make associations between sensory modalities provided the basis for the emergence of a shared protolinguistic lexicon. Crucially, this lexicon would have been grounded in our perceptual systems, and thus fundamentally non-arbitrary. The foundation of such a lexicon lies in shared cross-modal associations: biases shared among language users to map properties in ...

  18. Identifying open magnetic field regions of the Sun and their heliospheric counterparts

    Science.gov (United States)

    Krista, L. D.; Reinard, A.

    2017-12-01

    Open magnetic regions on the Sun are either long-lived (coronal holes) or transient (dimmings) in nature. Both phenomena are fundamental to our understanding of the solar behavior as a whole. Coronal holes are the sources of high-speed solar wind streams that cause recurrent geomagnetic storms. Furthermore, the variation of coronal hole properties (area, location, magnetic field strength) over the solar activity cycle is an important marker of the global evolution of the solar magnetic field. Dimming regions, on the other hand, are short-lived coronal holes that often emerge in the wake of solar eruptions. By analyzing their physical properties and their temporal evolution, we aim to understand their connection with their eruptive counterparts (flares and coronal mass ejections) and predict the possibility of a geomagnetic storm. The author developed the Coronal Hole Automated Recognition and Monitoring (CHARM) and the Coronal Dimming Tracker (CoDiT) algorithms. These tools not only identify but track the evolution of open magnetic field regions. CHARM also provides daily coronal hole maps, that are used for forecasts at the NOAA Space Weather Prediction Center. Our goal is to better understand the processes that give rise to eruptive and non-eruptive open field regions and investigate how these regions evolve over time and influence space weather.

  19. X-Ray structure and biophysical properties of rabbit fibroblast growth factor 1

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jihun; Blaber, Sachiko I.; Irsigler, Andre; Aspinwall, Eric; Blaber, Michael; (FSU)

    2010-01-14

    The rabbit is an important and de facto animal model in the study of ischemic disease and angiogenic therapy. Additionally, fibroblast growth factor 1 (FGF-1) is emerging as one of the most important growth factors for novel pro-angiogenic and pro-arteriogenic therapy. However, despite its significance, the fundamental biophysical properties of rabbit FGF-1, including its X-ray structure, have never been reported. Here, the cloning, crystallization, X-ray structure and determination of the biophysical properties of rabbit FGF-1 are described. The X-ray structure shows that the amino-acid differences between human and rabbit FGF-1 are solvent-exposed and therefore potentially immunogenic, while the biophysical studies identify differences in thermostability and receptor-binding affinity that distinguish rabbit FGF-1 from human FGF-1.

  20. Intuition in emergency nursing: a phenomenological study.

    Science.gov (United States)

    Lyneham, Joy; Parkinson, Camillus; Denholm, Carey

    2008-04-01

    The evidence of experience of intuitive knowing in the clinical setting has to this point only been informal and anecdotal. Reported experiences thus need to be either validated or refuted so that its place in emergency nursing can be determined. The history, nature and component themes captured within the intuitive practice of emergency nursing are described. This study was informed by the philosophy and method of phenomenology. Participants were 14 experienced emergency nurses. Through their narrative accounts and recall of events their experience of knowing was captured. Through a Van Manen process and a Gadamerian analysis, six themes associated with the ways in which the participants experienced intuition in clinical practice, were identified. This paper reveals the six emerging themes as knowledge, experience, connection, feeling, syncretism and trust.

  1. Human Trafficking in the Emergency Department

    OpenAIRE

    Patel, Ronak B; Ahn, Roy; Burke, Thomas F

    2010-01-01

    Human trafficking continues to persist, affecting up to 200 million people worldwide. As clinicians in emergency departments commonly encounter victims of intimate partner violence, some of these encounters will be with trafficking victims. These encounters provide a rare opportunity for healthcare providers to intervene and help. This case report of a human trafficking patient from a teaching hospital illustrates the complexity in identifying these victims. Clinicians can better identify pot...

  2. Joint radiation emergency management plan of the international organizations. Emergency preparedness and response. Date effective: 1 December 2002

    International Nuclear Information System (INIS)

    2002-11-01

    The Convention on Early Notification of a Nuclear Accident (the 'Early Notification Convention') and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (the 'Assistance Convention') are the prime legal instruments that establish an international framework to facilitate the exchange of information and the prompt provision of assistance in the event of a nuclear accident or radiological emergency, with the aim of minimizing the consequences. The International Atomic Energy Agency (IAEA) has specific functions allocated to it under these Conventions, to which, in addition to a number of States, the World Health Organization (WHO), the World Meteorological Organization (WMO) and the Food and Agriculture Organization of the United Nations (FAO) are full Parties. Since 1989, the arrangements between these organizations for facilitating the practical implementation of those articles of the two Conventions that are operational in nature have been documented by the IAEA in the Emergency Notification and Assistance Technical Operations Manual (ENATOM). The manual is intended for use primarily by Contact Points as identified in the Conventions. Pursuant to the obligations placed on it by the Conventions, the IAEA regularly convenes the Inter-Agency Committee on Response to Nuclear Accidents (lACRNA), whose purpose is to co-ordinate the arrangements of the relevant international intergovernmental organizations ('international organizations') for preparing for and responding to nuclear or radiological emergencies. Although the Conventions assign specific response functions and responsibilities to the IAEA and the Parties, various international organizations have - by virtue of their statutory functions or of related legal instruments - general functions and responsibilities that encompass aspects of preparedness and response. Moreover, some regional organizations (e.g. the European Union) are party to legally binding treaties and have

  3. Below the radar innovations and emerging property right approaches in Tibetan medicine.

    Science.gov (United States)

    Madhavan, Harilal

    2017-11-01

    Outside the established legal framework of intellectual property rights, countries have pursued multiple pathways to protect and promote traditional medicine. As Tibetan medicine is a late entrant into commercialization, the proposals to propertize generally fall within the rationale of existing sui-generis paradigms of Intellectual property. In this context, the article enquires the state of innovations in this sector viz-a-viz the property right approaches in place especially in India and China. It argues that beyond the usual complex medical science and technology led-innovations, the pathways of cumulative processes and creative additions through informal experiential learning platforms, where the transfers of knowledge become part of livelihood and social benefits (we call them "below the radar innovations") is ubiquitous in Tibetan medicine. The trends and politics in two recent strategies of protection, that is, Tibetan medicine as economic property (emphasizing patents here among many others) and as a cultural property (intangible cultural heritage) are juxtaposed with these informal innovative attempts. The paper underlines that the productivity-based economic rationale of these protection mechanisms should not obscure sustainability alternatives of "below the radar" (BtR) innovations in Tibetan medicine.

  4. Emerging trends in surface metrology

    DEFF Research Database (Denmark)

    Lonardo, P.M.; Lucca, D.A.; De Chiffre, Leonardo

    2002-01-01

    Recent advancements and some emerging trends in the methods and instruments used for surface and near surface characterisation are presented, considering the measurement of both topography and physical properties. In particular, surfaces that present difficulties in measurement or require new...... procedures are considered, with emphasis on measurements approaching the nanometre scale. Examples of new instruments and promising innovations for roughness measurement and surface integrity characterisation are presented. The new needs for tolerancing, traceability and calibration are also addressed....

  5. Emergency Kausch-Whipple procedure: indications and experiences.

    Science.gov (United States)

    Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

    2010-03-01

    Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

  6. Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams.

    Science.gov (United States)

    Reddy, Madhu C; Paul, Sharoda A; Abraham, Joanna; McNeese, Michael; DeFlitch, Christopher; Yen, John

    2009-04-01

    The purpose of this study is to identify the major challenges to coordination between emergency department (ED) teams and emergency medical services (EMS) teams. We conducted a series of focus groups involving both ED and EMS team members using a crisis scenario as the basis of the focus group discussion. We also collected organizational workflow data. We identified three major challenges to coordination between ED and EMS teams including ineffectiveness of current information and communication technologies, lack of common ground, and breakdowns in information flow. The three challenges highlight the importance of designing systems from socio-technical perspective. In particular, these inter-team coordination systems must support socio-technical issues such as awareness, context, and workflow between the two teams.

  7. Emergency Nurses' Perspectives: Factors Affecting Caring.

    Science.gov (United States)

    Enns, Carol L; Sawatzky, Jo-Ann V

    2016-05-01

    Caring is a universal phenomenon. However, as a result of higher patient acuity and staff shortages within the chaotic ED environment, caring behaviors may be in peril. The purpose of this study was to gain insight into the meaning of caring from the perspective of emergency nurses. Exploring nurses' perspectives of caring is central to improving staffing and retention issues in this unique work environment. As part of a larger study, a subsample of emergency nurses who work in public hospitals in Manitoba, Canada (n = 17) were interviewed. A qualitative descriptive design was used to gain insight into the caring perspectives of nurses by asking them, "What does caring meaning to you?" and "What affects caring in your practice in the emergency department?" Emerging themes were extracted through analysis of audio tapes and transcripts. Advocacy and holistic care emerged as major themes in the meaning of caring for emergency nurses. Caring was affected by a number of factors, including workload, lack of time, staffing issues, shift work, and lack of self-care. However, lack of management support was the most consistent hindrance to caring identified by study participants. Caring continues to be a unifying concept in nursing; however, influencing factors continue to undermine caring for emergency nurses. Caring is not subsidiary to nursing; it is the central core of nursing. Therefore, fostering a caring working environment is essential for nurses to practice holistic nursing care. It is also imperative to job satisfaction and the retention of emergency nurses. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  8. The Emergence of Individual and Collective Leadership in Task Groups

    DEFF Research Database (Denmark)

    Paunova, Minna

    2015-01-01

    leader emergence in task groups as influenced by individual traits, states, and behaviors. However, current approaches to leadership in groups rely on functional achievement explanations of how collective leadership emerges, influenced by positive states and behaviors. Attention to ascription......This review synthesizes conceptual and empirical research on the emergence of individual and collective leadership in task groups, and proposes avenues for leadership research. To advance multilevel study of leadership emergence, including emergence of distributed and shared leadership, the paper...... reviews research on individual leader emergence, structured around two identified theoretical mechanisms—one of leadership achievement (i.e., based on functional behaviors) and another of leadership ascription (i.e., based on nominal characteristics). These approaches compete to elucidate individual...

  9. Identification and assessment of site treatment plan implementation opportunities for emerging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Bernard, E.A. [Sandia National Labs., Germantown, MD (United States)

    1995-12-31

    The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX{sup sm}, Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE`s mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM`s Office of Technology Development, has funded this work.

  10. Bioethics and Emergency Medicine: problems and perspectives

    Directory of Open Access Journals (Sweden)

    Maurizio Mori

    2005-10-01

    Full Text Available Before examining the specific problems of emergency medicine, the article identifies the cardinal points for orientation in bioethics, in the conviction that the knowledge of the basic aspects of the subject allow the reader to make more conscious and suitable choices. The questions of moral relativism and the consequences of the biomedical revolution are addressed in detail in order to support the argument for a new ethical base for healthcare in general and for emergency medicine.

  11. Nuclear medicine in emergency

    International Nuclear Information System (INIS)

    Mansi, L.; Rambaldi, P.F.; Cuccurullo, V.; Varetto, T.

    2005-01-01

    The role of a procedure depends not only on its own capabilities but also on a cost/effective comparison with alternative technique giving similar information. Starting from the definition of emergency as a sudden unexpected occurrence demanding immediate action, the role of nuclear medicine (NM) is difficult to identify if it is not possible to respond 24h a day, 365 days a year, to clinical demands. To justify a 24 h NM service it is necessary to reaffirm the role in diagnosis of pulmonary embolism in the spiral CT era, to spread knowledge of the capabilities of nuclear cardiology in reliability diagnosis myocardial infraction (better defining admission and discharge to/from the emergency department), to increase the number of indications. Radionuclide technique could be used as first line, alternative, complementary procedures in a diagnostic tree taking into account not only the diagnosis but also the connections with prognosis and therapy in evaluating cerebral pathologies, acute inflammation/infection, transplants, bleeding, trauma, skeletal, hepatobiliary, renal and endocrine emergencies, acute scrotal pain

  12. Assessing Emergency Preparedness and Response Capacity Using Community Assessment for Public Health Emergency Response Methodology: Portsmouth, Virginia, 2013.

    Science.gov (United States)

    Kurkjian, Katie M; Winz, Michelle; Yang, Jun; Corvese, Kate; Colón, Ana; Levine, Seth J; Mullen, Jessica; Ruth, Donna; Anson-Dwamena, Rexford; Bayleyegn, Tesfaye; Chang, David S

    2016-04-01

    For the past decade, emergency preparedness campaigns have encouraged households to meet preparedness metrics, such as having a household evacuation plan and emergency supplies of food, water, and medication. To estimate current household preparedness levels and to enhance disaster response planning, the Virginia Department of Health with remote technical assistance from the Centers for Disease Control and Prevention conducted a community health assessment in 2013 in Portsmouth, Virginia. Using the Community Assessment for Public Health Emergency Response (CASPER) methodology with 2-stage cluster sampling, we randomly selected 210 households for in-person interviews. Households were questioned about emergency planning and supplies, information sources during emergencies, and chronic health conditions. Interview teams completed 180 interviews (86%). Interviews revealed that 70% of households had an emergency evacuation plan, 67% had a 3-day supply of water for each member, and 77% had a first aid kit. Most households (65%) reported that the television was the primary source of information during an emergency. Heart disease (54%) and obesity (40%) were the most frequently reported chronic conditions. The Virginia Department of Health identified important gaps in local household preparedness. Data from the assessment have been used to inform community health partners, enhance disaster response planning, set community health priorities, and influence Portsmouth's Community Health Improvement Plan.

  13. Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China

    Directory of Open Access Journals (Sweden)

    Weili Duan

    2015-07-01

    Full Text Available In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs is a significant issue in China. An emergency response system (ERS was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency.

  14. Identifying factors affecting destination choice of medical tourists: a ...

    African Journals Online (AJOL)

    medical tourism”, has emerged as a new source of competitive advantage all over the world. The present study seeks to identify the factors that affect destination choice of medical tourists. Methods: We systematically searched relevant databases ...

  15. Identifying co-targets to fight drug resistance based on a random walk model

    Directory of Open Access Journals (Sweden)

    Chen Liang-Chun

    2012-01-01

    Full Text Available Abstract Background Drug resistance has now posed more severe and emergent threats to human health and infectious disease treatment. However, wet-lab approaches alone to counter drug resistance have so far still achieved limited success due to less knowledge about the underlying mechanisms of drug resistance. Our approach apply a heuristic search algorithm in order to extract active network under drug treatment and use a random walk model to identify potential co-targets for effective antibacterial drugs. Results We use interactome network of Mycobacterium tuberculosis and gene expression data which are treated with two kinds of antibiotic, Isoniazid and Ethionamide as our test data. Our analysis shows that the active drug-treated networks are associated with the trigger of fatty acid metabolism and synthesis and nicotinamide adenine dinucleotide (NADH-related processes and those results are consistent with the recent experimental findings. Efflux pumps processes appear to be the major mechanisms of resistance but SOS response is significantly up-regulation under Isoniazid treatment. We also successfully identify the potential co-targets with literature confirmed evidences which are related to the glycine-rich membrane, adenosine triphosphate energy and cell wall processes. Conclusions With gene expression and interactome data supported, our study points out possible pathways leading to the emergence of drug resistance under drug treatment. We develop a computational workflow for giving new insights to bacterial drug resistance which can be gained by a systematic and global analysis of the bacterial regulation network. Our study also discovers the potential co-targets with good properties in biological and graph theory aspects to overcome the problem of drug resistance.

  16. Exploring the spatial variation in quality-adjusted rental prices and identifying hot spots in Berlin’s residential property market

    DEFF Research Database (Denmark)

    Meulen, Philipp an de; Mitze, Timo Friedel

    2014-01-01

    In this work, we use residual values obtained from an estimated hedonic pricing model to assess the role of district-level neighbourhood effects for the spatial variation in quality-adjusted rental prices in Berlin between 2008 and 2013. By doing so, we also aim at identifying hot and cold spots ...... analysis (ESDA) toolbox, we finally pinpoint particular hot spots of the city’s residential property market associated with a significant spatial clustering of similar rental price values around individual observations....... proximity to the city centre compared to similar properties in Berlin’s periphery once we control for the properties’ physical characteristics. The observed temporal evolution of the rental price distribution between 2008 and 2013 thereby hints at an ongoing gentrification process in Germany’s capital...... associated with the current housing market boom. This visual impression is also confirmed by the application of quantile regressions for a correlation analysis between quality-adjusted rental price values and Berlin district-level characteristics obtained from the last census in 2011. Among other factors, we...

  17. The proposals on cooperation to foreign centers of science on thermophysical properties of reactor materials in a broad band of pressure and temperatures realized at normal transient and emergency operation activity of nuclear power plants

    International Nuclear Information System (INIS)

    Fortov, V.E.

    1996-01-01

    The proposals on cooperation in the area of thermophysical properties of reactor materials in a broad band of pressure and temperature realized at normal transient and emergency operation activity of nuclear power plants are discussed. 1 fig

  18. 44 CFR 5.27 - Deletion of identifying details.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Deletion of identifying... Availability of General Agency Information, Rules, Orders, Policies, and Similar Material § 5.27 Deletion of..., interpretation, or staff manual or instruction. However, the justification for each deletion will be explained...

  19. Emergence of acoustic waves from vorticity fluctuations: impact of non-normality.

    Science.gov (United States)

    George, Joseph; Sujith, R I

    2009-10-01

    Chagelishvili et al. [Phys. Rev. Lett. 79, 3178 (1997)] discovered a linear mechanism of acoustic wave emergence from vorticity fluctuations in shear flows. This paper illustrates how this "nonresonant" phenomenon is related to the non-normality of the operator governing the linear dynamics of disturbances in shear flows. The non-self-adjoint nature of the governing operator causes the emergent acoustic wave to interact strongly with the vorticity disturbance. Analytical expressions are obtained for the nondivergent vorticity perturbation. A discontinuity in the x component of the velocity field corresponding to the vorticity disturbance was originally identified to be the cause of acoustic wave emergence. However, a different mechanism is proposed in this paper. The correct "acoustic source" is identified and the reason for the abrupt nature of wave emergence is explained. The impact of viscous damping is also discussed.

  20. Identifying product development crises: The potential of adaptive heuristics

    DEFF Research Database (Denmark)

    Münzberger, C.; Stingl, Verena; Oehmen, Josef

    2017-01-01

    This paper introduces adaptive heuristics as a tool to identify crises in design projects and highlights potential applications of these heuristics as decision support tool for crisis identification. Crises may emerge slowly or suddenly, and often have ambiguous signals. Thus the identification...... for the application of heuristics in design sciences. To achieve this, the paper compares crises to 'business as usual', and presents sixteen indicators for emerging crises. These indicators are potential cues for adaptive heuristics. Specifically three adaptive heuristics, One-single-cue, Fast-and-Frugal-Trees...

  1. American National Standard: for radiological emergency-preparedness exercises for nuclear power plants

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    The development of emergency plans and procedures should provide for testing and evaluating the emergency response organization and decision making processes. To test and evaluate emergency plans and procedures, realistic scenarios should be used for drills or exercises. Emergency exercises are training activities that require a substantial effort to plan and coordinate effectively. The exercise trains personnel who would be expected to participate in the emergency response. Emergency exercises should be conducted as realistically as possible. Insofar as possible, the participants should not be notified in advance except where necessary to assure that the exercise will not cause injuries or property damage. A real emergency will naturally impart stress on emergency response personnel and their organizations. Exercises should be designed to duplicate this sense of stress insofar as practical. An important element of testing the emergency response is to ensure that provisions have been made for observation, evaluation, and critiquing each exercise. These evaluations and critiques should be used to improve and revise emergency plans and procedures where required

  2. The process of implementation of emergency care units in Brazil.

    Science.gov (United States)

    O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Lopes, Mônica Guimarães Macau; Agostinho, Danielle Fernandes; Alves, Gabriel Farias

    2017-12-11

    To analyze the process of implementation of emergency care units in Brazil. We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network.

  3. The process of implementation of emergency care units in Brazil

    Directory of Open Access Journals (Sweden)

    Gisele O'Dwyer

    2017-12-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the process of implementation of emergency care units in Brazil. METHODS We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. RESULTS Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. CONCLUSIONS The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the

  4. Identifying Witness Accounts from Social Media Using Imagery

    Directory of Open Access Journals (Sweden)

    Marie Truelove

    2017-04-01

    Full Text Available This research investigates the use of image category classification to distinguish images posted to social media that are Witness Accounts of an event. Only images depicting observations of the event, captured by micro-bloggers at the event, are considered Witness Accounts. Identifying Witness Accounts from social media is important for services such as news, marketing and emergency response. Automated image category classification is essential due to the large number of images on social media and interest in identifying witnesses in near real time. This paper begins research of this emerging problem with an established procedure, using a bag-of-words method to create a vocabulary of visual words and classifier trained to categorize the encoded images. In order to test the procedure, a set of images were collected for case study events, Australian Football League matches, from Twitter. Evaluation shows an overall accuracy of 90% and precision and recall for both classes exceeding 83%.

  5. Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

    Science.gov (United States)

    Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

    2016-01-01

    To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

  6. Quality improvement in emergency service delivery: Assessment of knowledge and skills amongst emergency nurses at Connaught Hospital, Sierra Leone

    Directory of Open Access Journals (Sweden)

    Hedda Bøe Nyhus

    2017-09-01

    Conclusion: This study has identified key aspects of emergency nursing speciality training to be developed through theoretical and skill-based education provided by the nursing schools and hospital clinical facilities in Sierra Leone.

  7. Using decision analysis to support proactive management of emerging infectious wildlife diseases

    Science.gov (United States)

    Grant, Evan H. Campbell; Muths, Erin L.; Katz, Rachel A.; Canessa, Stefano; Adams, Michael J.; Ballard, Jennifer R.; Berger, Lee; Briggs, Cheryl J.; Coleman, Jeremy; Gray, Matthew J.; Harris, M. Camille; Harris, Reid N.; Hossack, Blake R.; Huyvaert, Kathryn P.; Kolby, Jonathan E.; Lips, Karen R.; Lovich, Robert E.; McCallum, Hamish I.; Mendelson, Joseph R.; Nanjappa, Priya; Olson, Deanna H.; Powers, Jenny G.; Richgels, Katherine L. D.; Russell, Robin E.; Schmidt, Benedikt R.; Spitzen-van der Sluijs, Annemarieke; Watry, Mary Kay; Woodhams, Douglas C.; White, C. LeAnn

    2017-01-01

    Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts even before a disease is detected, and plan subsequent actions that are conditional on disease emergence. We identify four main obstacles to developing proactive management strategies for the newly discovered salamander pathogen Batrachochytrium salamandrivorans (Bsal). Given that uncertainty is a hallmark of wildlife disease management and that associated decisions are often complicated by multiple competing objectives, we advocate using decision analysis to create and evaluate trade-offs between proactive (pre-emergence) and reactive (post-emergence) management options. Policy makers and natural resource agency personnel can apply principles from decision analysis to improve strategies for countering emerging infectious diseases.

  8. Business continuity, emergency planning and special needs: How to protect the vulnerable.

    Science.gov (United States)

    Reilly, Daniel

    2015-01-01

    Emergencies and disasters affect all segments of the population. Some segments are more at risk during the emergency response and recovery efforts owing to vulnerabilities that increase the risk of harm. These vulnerabilities are due to individuals' disabilities, which must be incorporated into emergency and business continuity planning. Some disabilities are obvious, such as impaired vision, hearing or mobility, while other are less evident, but equally disabling, such as cognitive disorders, geographical or language isolation, and numerous age-related factors. Taken together when creating emergency or business continuity plans, the issues identified as disabilities can be grouped by functionality and termed as special needs. This paper will detail the identification of special needs populations, explain how these persons are vulnerable during the emergency or disaster response and recovery process, and provide examples of how to partner with individuals within identified special needs populations to improve the planning process.

  9. Factors Contributing to the Uptake and Maintenance of Regular Exercise Behaviour in Emerging Adults

    Science.gov (United States)

    Langdon, Jody; Johnson, Chad; Melton, Bridget

    2017-01-01

    Objective: To identify the influence of parental autonomy support, basic need satisfaction and motivation on emerging adults' physical activity level and exercise behaviours. Design: Cross-sectional survey. Setting: This study convenience-sampled approximately 435 college students identified as emerging adults--aged 18-25 years, who did not have a…

  10. Municipal landfill leachates: A significant source for new and emerging pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Eggen, Trine, E-mail: Trine.Eggen@bioforsk.no [Bioforsk, Vest Saerheim, Norwegian Institute for Agricultural and Environmental Research, Postveien 213, N-4353 Klepp st. (Norway); Moeder, Monika [Helmholtz Centre for Environmental Research UFZ, Department of Analytical Chemistry, Permoserstrasse 15, D-04318 Leipzig (Germany); Arukwe, Augustine [Department of Biology, Norwegian University of Science and Technology (NTNU), Hogskoleringen 5, 7491 Trondheim (Norway)

    2010-10-01

    Landfills have historically remained the most common methods of organized waste disposal and still remain so in many regions of the world. Thus, they may contain wastes resulting from several decades of disposal and decomposition with subsequent release of organic compounds that may have environmental, wildlife and human health consequences. Products containing different types of additives with unique beneficial improvement properties are in daily use. However, when these products are decomposed, additives are release into the environment, some of which have been shown to have negative environmental impacts, resulting in the ban or at least restricted application of some chemicals. New and emerging compounds are continuously discovered in the environment. Herein, we report qualitative and quantitative data on the occurrence of new and emerging compounds with increasing environmental and public health concern in water- and particle phase of landfill leachates. Under normal environmental conditions, several of these chemicals are persistent high-volume products. Identified chemicals in the leachates at nanogram (ng) or microgram ({mu}g) per liter levels include - chlorinated alkylphosphates such as tris(1-chloro-2-propyl) phosphate (TCPP), N-butyl benzensulfonamide (NBBS), the insect repellent diethyl toluamide (DEET) and personal care products such as the non-steroidal anti-inflammatory drug ibuprofen and polycyclic musk compounds. Among new and emerging contaminants, perfluorinated compounds (PFCs) were measured in the water phase at concentrations up to 6231 ng/L. Compared with the other chemicals, PFCs were primarily distributed in water phase. An effective removal method for PFCs and other polar and persistent compounds from landfill leachates has been a major challenge, since commonly used treatment technologies are based on aeration and sedimentation. Thus, the present study has shown that municipal landfill leachates may represent a significant source of

  11. Municipal landfill leachates: A significant source for new and emerging pollutants

    International Nuclear Information System (INIS)

    Eggen, Trine; Moeder, Monika; Arukwe, Augustine

    2010-01-01

    Landfills have historically remained the most common methods of organized waste disposal and still remain so in many regions of the world. Thus, they may contain wastes resulting from several decades of disposal and decomposition with subsequent release of organic compounds that may have environmental, wildlife and human health consequences. Products containing different types of additives with unique beneficial improvement properties are in daily use. However, when these products are decomposed, additives are release into the environment, some of which have been shown to have negative environmental impacts, resulting in the ban or at least restricted application of some chemicals. New and emerging compounds are continuously discovered in the environment. Herein, we report qualitative and quantitative data on the occurrence of new and emerging compounds with increasing environmental and public health concern in water- and particle phase of landfill leachates. Under normal environmental conditions, several of these chemicals are persistent high-volume products. Identified chemicals in the leachates at nanogram (ng) or microgram (μg) per liter levels include - chlorinated alkylphosphates such as tris(1-chloro-2-propyl) phosphate (TCPP), N-butyl benzensulfonamide (NBBS), the insect repellent diethyl toluamide (DEET) and personal care products such as the non-steroidal anti-inflammatory drug ibuprofen and polycyclic musk compounds. Among new and emerging contaminants, perfluorinated compounds (PFCs) were measured in the water phase at concentrations up to 6231 ng/L. Compared with the other chemicals, PFCs were primarily distributed in water phase. An effective removal method for PFCs and other polar and persistent compounds from landfill leachates has been a major challenge, since commonly used treatment technologies are based on aeration and sedimentation. Thus, the present study has shown that municipal landfill leachates may represent a significant source of

  12. The safety implications of emerging software paradigms

    International Nuclear Information System (INIS)

    Suski, G.J.; Persons, W.L.; Johnson, G.L.

    1994-10-01

    This paper addresses some of the emerging software paradigms that may be used in developing safety-critical software applications. Paradigms considered in this paper include knowledge-based systems, neural networks, genetic algorithms, and fuzzy systems. It presents one view of the software verification and validation activities that should be associated with each paradigm. The paper begins with a discussion of the historical evolution of software verification and validation. Next, a comparison is made between the verification and validation processes used for conventional and emerging software systems. Several verification and validation issues for the emerging paradigms are discussed and some specific research topics are identified. This work is relevant for monitoring and control at nuclear power plants

  13. Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

    Science.gov (United States)

    Safdar, Basmah; Greenberg, Marna R

    2014-12-01

    With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the

  14. Abstract to publication ratio for papers presented at scientific meetings: how does emergency medicine compare?

    Science.gov (United States)

    Walby, A; Kelly, A M; Georgakas, C

    2001-12-01

    The aims of the present study were to determine the publication rate of abstracts presented by Australasian emergency physicians at major emergency medicine meetings and to identify the site of publication of papers. All free paper abstracts presented (oral and poster) by Australasian emergency physicians and trainees at five Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings between 1995 and 1998 were identified retrospectively from conference programmes. In order to determine whether or not the abstract had been published, the PubMed database (http://www4.ncbi.nlm.nih.gov/PubMed/) was searched using the presenter's name and key words from the abstract. In addition, a hand search of the non-abstracted journal Emergency Medicine was conducted. Of the 207 free paper abstracts identified, 73 (35%) had been published as full articles. Papers were published in a variety of journals; however, Emergency Medicine accounted for almost half the published papers. The mean time between presentation and publication was 12.6 months (median 11 months). The abstract to publication rate for papers presented by Australasian emergency physicians and trainees at Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings is 35%, which is lower than that reported by some other established specialities, but comparable to rates reported for US-based national and international emergency medicine meetings. Future research should look at barriers to the publication of findings and ways to assist the publication process.

  15. Establishing functional requirements for emergency management information systems

    Energy Technology Data Exchange (ETDEWEB)

    Reed, J.H.; Rogers, G.O.; Sorensen, J.H.

    1991-01-01

    The advancement of computer technologies has led to the development of a number of emergency management information systems (e.g., EIS, CAMEO, IEMIS). The design of these systems has tended to be technologically driven rather than oriented to meeting information management needs during an emergency. Of course, emergency management needs vary depending on the characteristics of the emergency. For example, in hurricanes, onset is typically slow enough to allow emergency managers to simulate evacuations dynamically while in chemical disasters onset may be sufficiently rapid to preclude such simulation(s). This paper describes a system design process in which the analysis of widely recognized emergency management functions was used to identify information requirements and the requisite software and hardware capabilities to deal with rapid onset, low probability, high consequence events. These requirements were then implemented as a prototype emergency management system using existing hardware and software to assure feasibility. Data, hardware, and software requirements were further developed, refined, and made more concrete through an iterative prototyping effort. This approach focuses attention directly on meeting emergency management information needs while avoiding unneeded technological innovations. 10 refs., 4 figs., 1 tab.

  16. Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival-An evaluation of 548 emergency calls.

    Science.gov (United States)

    Viereck, Søren; Palsgaard Møller, Thea; Kjær Ersbøll, Annette; Folke, Fredrik; Lippert, Freddy

    2017-02-01

    This study aimed at evaluating if time for initiation of bystander cardiopulmonary resuscitation (CPR) - prior to the emergency call (CPR prior ) versus during the emergency call following dispatcher-assisted CPR (CPR during ) - was associated with return of spontaneous circulation (ROSC) and 30-day survival. The secondary aim was to identify predictors of CPR prior . This observational study evaluated out-of-hospital cardiac arrests (OHCA) occurring in the Capital Region of Denmark from 01.01.2013 to 31.12.2013. OHCAs were linked to emergency medical dispatch centre records and corresponding emergency calls were evaluated. Multivariable logistic regression analyses were applied to evaluate the association between time for initiation of bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of CPR prior . The study included 548 emergency calls for OHCA patients receiving bystander CPR, 34.9% (n=191) in the CPR prior group and 65.1% (n=357) in the CPR during group. Multivariable analyses showed no difference in ROSC (OR=0.88, 95% CI: 0.56-1.38) or 30-day survival (OR=1.14, 95% CI: 0.68-1.92) between CPR prior and CPR during . Predictors positively associated with CPR prior included witnessed OHCA and healthcare professional bystanders. Predictors negatively associated with CPR prior included residential location, solitary bystanders, and bystanders related to the patient. The majority of bystander CPR (65%) was initiated during the emergency call, following dispatcher-assisted CPR instructions. Whether bystander CPR was initiated prior to emergency call versus during the emergency call following dispatcher-assisted CPR was not associated with ROSC or 30-day survival. Dispatcher-assisted CPR was especially beneficial for the initiation of bystander CPR in residential areas. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  17. Civil Defense, U. S. A.: A Programmed Orientation to Civil Defense. Unit 4. Warning, Emergency Operations, and Support Programs.

    Science.gov (United States)

    Defense Civil Preparedness Agency (DOD), Battle Creek, MI.

    The need for, and a description of, emergency functions required to save lives and protect property in nuclear or natural disasters are presented. Topics discussed include: (1) The Civil Defense Warning System, (2) Introduction to the Emergency Operations Program, (3) Five subprograms of the Emergency Operations Program, (4) Emergency Operations…

  18. Emerging Market Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter; Hobdari, Bersant

    2017-01-01

    International knowledge flows and innovation are becoming ever more important to the competitiveness of multinational corporations. Emerging market multinationals (EMNCs) in specific are deploying increasingly activist measures to harness foreign sources of knowledge and innovation as a strategy...... in which this disagreement can be reconciled through recognition of other EMNC advantages, particularly abilities to leverage country-specific assets, and possession and development of dynamic capabilities. Finally, we identify a set of core themes in the recent literature on strategic asset...

  19. Who breaches the four-hour emergency department wait time target? A retrospective analysis of 374,000 emergency department attendances between 2008 and 2013 at a type 1 emergency department in England.

    Science.gov (United States)

    Bobrovitz, Niklas; Lasserson, Daniel S; Briggs, Adam D M

    2017-11-02

    The four-hour target is a key hospital emergency department performance indicator in England and one that drives the physical and organisational design of the ED. Some studies have identified time of presentation as a key factor affecting waiting times. Few studies have investigated other determinants of breaching the four-hour target. Therefore, our objective was to describe patterns of emergency department breaches of the four-hour wait time target and identify patients at highest risk of breaching. This was a retrospective cohort study of a large type 1 Emergency department at an NHS teaching hospital in Oxford, England. We analysed anonymised individual level patient data for 378,873 emergency department attendances, representing all attendances between April 2008 and April 2013. We examined patient characteristics and emergency department presentation circumstances associated with the highest likelihood of breaching the four-hour wait time target. We used 374,459 complete cases for analysis. In total, 8.3% of all patients breached the four-hour wait time target. The main determinants of patients breaching the four-hour wait time target were hour of arrival to the ED, day of the week, patient age, ED referral source, and the types of investigations patients receive (p target were older, presented at night, presented on Monday, received multiple types of investigation in the emergency department, and were not self-referred (p target including patient age, ED referral source, the types of investigations patients receive, as well as the hour, day, and month of arrival to the ED. Efforts to reduce the number of breaches could explore late-evening/overnight staffing, access to diagnostic tests, rapid discharge facilities, and early assessment and input on diagnostic and management strategies from a senior practitioner.

  20. DOUBLE SHELL TANK EMERGENCY PUMPING GUIDE

    International Nuclear Information System (INIS)

    REBERGER, D.W.

    2006-01-01

    This document provides preplanning necessary to expeditiously remove any waste that may leak from the primary tank to the secondary tank for Hanford's 28 DSTs. The strategy is described, applicable emergency procedures are referenced, and transfer routes and pumping equipment for each tank are identified

  1. CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine".

    Science.gov (United States)

    Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J

    2015-05-01

    We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a

  2. Emergence of Twisted Magnetic Flux Related Sigmoidal Brightening ...

    Indian Academy of Sciences (India)

    tribpo

    We have examined the morphological properties of a sigmoid associated with an SXR. (soft X ray) flare. The sigmoid is cospatial with the EUV (extreme ultra violet) images and in the optical part lies along an S shaped Hα filament. The photoheliogram shows flux emergence within an existing δ type sunspot which has.

  3. 46 CFR 121.510 - Recommended emergency broadcast instructions.

    Science.gov (United States)

    2010-10-01

    ... Immediate Danger to Life or Property. (4) Say: “THIS IS (INSERT VESSEL'S NAME), (INSERT VESSEL'S NAME), (INSERT VESSEL'S NAME), (INSERT VESSEL'S CALL SIGN), OVER.” (5) Release the microphone button briefly and... 16 VHF and 2182 kHz on SSB are for emergency and calling purposes only.) (3) Press microphone button...

  4. Combating slavery in the 21st century: the role of emergency medicine.

    Science.gov (United States)

    Chisolm-Straker, Makini; Richardson, Lynne D; Cossio, Tania

    2012-08-01

    Human trafficking (HT) victims may present to emergency departments (ED) as patients, but are infrequently identified. To address this issue, we developed and piloted a training intervention for emergency providers on HT and how to identify and treat these patients. Included in the intervention participants were emergency medicine residents, ED attendings, ED nurses, and hospital social workers. Prior to the intervention, 4.8% felt some degree of confidence in their ability to identify and 7.7% to treat a trafficked patient. After the 20-minute intervention, 53.8% felt some degree of confidence in their ability to identify and 56.7% care for this patient population. Because this problem is global, we created a Website that includes an instructive toolkit and an interactive course for self-learning and/or assessment. This intervention will give ED providers the tools they need to assess and treat a patient who might be a victim of human trafficking.

  5. Developing practical knowledge content of emergency nursing professionals.

    Science.gov (United States)

    Chu, Wen; Hsu, Li-Ling

    2011-06-01

    There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.

  6. [When should a patient with abdominal pain be referred to the emergency ward?].

    Science.gov (United States)

    de Saussure, Wassila Oulhaci; Andereggen, Elisabeth; Sarasin, François

    2010-08-25

    When should a patient with abdominal pain be referred to the emergency ward? The following goals must be achieved upon managing patients with acute abdominal pain: 1) identify vital emergency situations; 2) detect surgical conditions that require emergency referral without further diagnostic procedures; 3) in "non surgical acute abdomen patients" perform appropriate diagnostic procedures, or in selected cases delay tests and reevaluate the patient after an observation period, after which a referral decision is made. Clues from the history and physical examination are critical to perform this evaluation. A good knowledge of the most frequent acute abdominal conditions, and identifying potential severity criteria allow an appropriate management and decision about emergency referral.

  7. The politics of emergency health powers and the isolation of public health.

    Science.gov (United States)

    Colmers, John M; Fox, Daniel M

    2003-03-01

    The Model State Emergency Health Powers Act became a contentious document in more than 30 states in 2001 and 2002. Controversy has focused on recommendations by the authors of the Model Act that seemed to accord higher priority to collective action in emergencies than to protecting privacy and property. This situation has several causes that derive from the characteristics of public health emergencies during the past half century and the relative isolation of public health officials from both their colleagues in government and many members of the public.

  8. Silk nanoparticles—an emerging anticancer nanomedicine

    Directory of Open Access Journals (Sweden)

    F. Philipp Seib

    2017-03-01

    Full Text Available Silk is a sustainable and ecologically friendly biopolymer with a robust clinical track record in humans for load bearing applications, in part due to its excellent mechanical properties and biocompatibility. Our ability to take bottom-up and top-down approaches for the generation of silk (inspired biopolymers has been critical in supporting the evolution of silk materials and formats, including silk nanoparticles for drug delivery. Silk nanoparticles are emerging as interesting contenders for drug delivery and are well placed to advance the nanomedicine field. This review covers the use of Bombyx mori and recombinant silks as an anticancer nanomedicine, highlighting the emerging trends and developments as well as critically assessing the current opportunities and challenges by providing a context specific assessment of this multidisciplinary field.

  9. Lessons Learned from the Response to Radiation Emergencies (1945-2010)

    International Nuclear Information System (INIS)

    2012-01-01

    An underlying concept in the safety standards of the International Atomic Energy Agency (IAEA) is that prevention is better than cure. This is achieved through the application of appropriate standards in design and operation. Nevertheless, radiation incidents and emergencies do occur and safety standards are necessary that define the approaches to be used in mitigating the consequences. The IAEA Safety Requirements publication, Preparedness and Response for a Nuclear or Radiological Emergency, GS-R-2, establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. They take account of several other Safety Standards at the Safety Requirements level, namely: the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS); Governmental, Legal and Regulatory Framework for Safety, GSR Part 1; Safety of Nuclear Power Plants: Design, NS-R-1; and Safety of Nuclear Power Plants: Operation, NS-R-2. Implementation of the requirements is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. Although developed before the publication of the Fundamental Safety Principles, they define the requirements that must be satisfied in order to achieve the overall objective and apply the principles that are presented in publications relating to emergencies. An emergency is defined in the Agency's glossary as 'a non-routine situation or event that necessitates prompt action, primarily to mitigate a hazard or adverse consequences for human health and safety, quality of life, property or the environment. This includes nuclear and radiological emergencies and conventional emergencies such as fires, release of hazardous chemicals, storms or earthquakes. It includes situations for which prompt action is warranted to mitigate the effects of a perceived hazard'. Several nuclear emergencies have

  10. Lessons Learned from the Response to Radiation Emergencies (1945-2010)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-08-15

    An underlying concept in the safety standards of the International Atomic Energy Agency (IAEA) is that prevention is better than cure. This is achieved through the application of appropriate standards in design and operation. Nevertheless, radiation incidents and emergencies do occur and safety standards are necessary that define the approaches to be used in mitigating the consequences. The IAEA Safety Requirements publication, Preparedness and Response for a Nuclear or Radiological Emergency, GS-R-2, establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. They take account of several other Safety Standards at the Safety Requirements level, namely: the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS); Governmental, Legal and Regulatory Framework for Safety, GSR Part 1; Safety of Nuclear Power Plants: Design, NS-R-1; and Safety of Nuclear Power Plants: Operation, NS-R-2. Implementation of the requirements is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. Although developed before the publication of the Fundamental Safety Principles, they define the requirements that must be satisfied in order to achieve the overall objective and apply the principles that are presented in publications relating to emergencies. An emergency is defined in the Agency's glossary as 'a non-routine situation or event that necessitates prompt action, primarily to mitigate a hazard or adverse consequences for human health and safety, quality of life, property or the environment. This includes nuclear and radiological emergencies and conventional emergencies such as fires, release of hazardous chemicals, storms or earthquakes. It includes situations for which prompt action is warranted to mitigate the effects of a perceived hazard'. Several nuclear emergencies have

  11. Effect of business regulation on investment in emerging market economies

    Directory of Open Access Journals (Sweden)

    Birungi Korutaro

    2013-01-01

    Full Text Available This paper provides an empirical analysis of the business regulatory factors that influence investment in a selection of 29 emerging market economies. Both theoretical and empirical literature on the effect of the regulatory environment on investment is reviewed. A panel data analysis over the period 2003–2007 reveals that investment is influenced by secure property rights and the degree of business entry regulation. The results carry important policy implications for improving the investment climate of emerging market economies.

  12. [The layperson in emergency situation].

    Science.gov (United States)

    Pergola, Aline Maino; Araujo, Izilda Esmenia Muglia

    2008-12-01

    The layperson's qualification to provide early care in emergency situations and basic life support (BLS) is fundamental to save lives and prevent sequels. The objective was to identify the level of knowledge of lay people about approaching an emergency victim. Structured interviews in non-technical language were used with a 385-subject sample, average age 35.4 (+/- 14.55) years, with more than 50% having a high school or university education. Over 55% of these observed situations with loss of consciousness, but only 31% called for specialized help. 34% underwent a first-aid course, but only 13% feel prepared. The most often cited place of learning was the driving school (DS), 35.9%. Other training places were higher when compared to the DS (p = 0.048). Almost 17% do not know how to recognize the presence of vital signs. Almost 31% do not know the telephone number of the emergency service. Laypersons have incomplete or incorrect knowledge about care for unconscious victims.

  13. Emergency Department Visits Following Elective Total Hip and Knee Replacement Surgery: Identifying Gaps in Continuity of Care.

    Science.gov (United States)

    Finnegan, Micaela A; Shaffer, Robyn; Remington, Austin; Kwong, Jereen; Curtin, Catherine; Hernandez-Boussard, Tina

    2017-06-21

    Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty. Factors associated with increased risk of an ED visit were estimated using hierarchical regression models controlling for patient variables with a fixed hospital effect. The main outcome was an ED visit within 30 days of discharge. Among the 152,783 patients who underwent major joint replacement, 5,229 (3.42%) returned to the inpatient setting and 8,883 (5.81%) presented to the ED for care within 30 days. Among ED visits, 17.94% had a primary diagnosis of pain and 25.75% had both a primary and/or a secondary diagnosis of pain. Patients presenting to the ED for subsequent care had more comorbidities and were more frequently non-white with public insurance relative to those not returning to the ED (p care insurance coverage expansions are uncertain; however, there are ongoing attempts to improve quality across the continuum of care. It is therefore essential to ensure that all patients, particularly vulnerable populations, receive appropriate postoperative care, including pain management. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  14. Identifying cognitive complexity factors affecting the complexity of procedural steps in emergency operating procedures of a nuclear power plant

    International Nuclear Information System (INIS)

    Park, Jinkyun; Jeong, Kwangsup; Jung, Wondea

    2005-01-01

    In complex systems such as a nuclear and chemical plant, it is well known that the provision of understandable procedures that allow operators to clarify what needs to be done and how to do it is one of the requisites to secure their safety. As a previous study in providing understandable procedures, the step complexity (SC) measure that can quantify the complexity of procedural steps in emergency operating procedures (EOPs) of a nuclear power plant (NPP) was suggested. However, the necessity of additional complexity factors that can consider a cognitive aspect in evaluating the complexity of procedural steps is raised. To this end, the comparisons between operators' performance data measured by the form of a step performance time with their behavior in carrying out the prescribed activities of procedural steps are conducted in this study. As a result, two kinds of complexity factors (the abstraction level of knowledge and the level of engineering decision) that could affect an operator's cognitive burden are identified. Although a well-designed experiment is indispensable for confirming the appropriateness of the additional complexity factors, it is strongly believed that the change of operators' performance data can be more authentically explained if the additional complexity factors are taken into consideration

  15. Identifying cognitive complexity factors affecting the complexity of procedural steps in emergency operating procedures of a nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jinkyun [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, P.O. Box 105, Duckjin-Dong, Yusong-Ku, Taejon 305-600 (Korea, Republic of)]. E-mail: kshpjk@kaeri.re.kr; Jeong, Kwangsup [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, P.O. Box 105, Duckjin-Dong, Yusong-Ku, Taejon 305-600 (Korea, Republic of); Jung, Wondea [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, P.O. Box 105, Duckjin-Dong, Yusong-Ku, Taejon 305-600 (Korea, Republic of)

    2005-08-01

    In complex systems such as a nuclear and chemical plant, it is well known that the provision of understandable procedures that allow operators to clarify what needs to be done and how to do it is one of the requisites to secure their safety. As a previous study in providing understandable procedures, the step complexity (SC) measure that can quantify the complexity of procedural steps in emergency operating procedures (EOPs) of a nuclear power plant (NPP) was suggested. However, the necessity of additional complexity factors that can consider a cognitive aspect in evaluating the complexity of procedural steps is raised. To this end, the comparisons between operators' performance data measured by the form of a step performance time with their behavior in carrying out the prescribed activities of procedural steps are conducted in this study. As a result, two kinds of complexity factors (the abstraction level of knowledge and the level of engineering decision) that could affect an operator's cognitive burden are identified. Although a well-designed experiment is indispensable for confirming the appropriateness of the additional complexity factors, it is strongly believed that the change of operators' performance data can be more authentically explained if the additional complexity factors are taken into consideration.

  16. Identifying cognitive complexity factors affecting the complexity of procedural steps in emergency operating procedures of a nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Jinkyun Park; Kwangsup Jeong; Wondea Jung [Korea Atomic Energy Research Institute, Taejon (Korea). Integrated Safety Assessment Division

    2005-08-15

    In complex systems such as a nuclear and chemical plant, it is well known that the provision of understandable procedures that allow operators to clarify what needs to be done and how to do it is one of the requisites to secure their safety. As a previous study in providing understandable procedures, the step complexity (SC) measure that can quantify the complexity of procedural steps in emergency operating procedures (EOPs) of a nuclear power plant (NPP) was suggested. However, the necessity of additional complexity factors that can consider a cognitive aspect in evaluating the complexity of procedural steps is raised. To this end, the comparisons between operator' performance data measured by the form of a step performance time with their behavior in carrying out the prescribed activities of procedural steps are conducted in this study. As a result, two kinds of complexity factors (the abstraction level of knowledge and the level of engineering decision) that could affect an operator's cognitive burden are identified. Although a well-designed experiment is indispensable for confirming the appropriateness of the additional complexity factors, it is strongly believed that the change of operators' performance data can be more authentically explained if the additional complexity factors are taken into consideration. (author)

  17. Emerging and re-emerging infectious diseases in Iran

    Science.gov (United States)

    Parhizgari, Najmeh; Gouya, Mohammad Mehdi; Mostafavi, Ehsan

    2017-01-01

    Despite development of preventive and controlling strategies regarding infectious diseases, they are still considered as one of the most significant leading causes of morbidity and mortality, worldwide. Changes in humans’ demographics and behaviors, microbial and ecological alterations, agricultural development, international travels and susceptibility to infectious diseases have resulted in increased reports of emerging infectious diseases (EIDs) and reemerging infectious diseases (RIDs) in various geographical areas. Because of the various types of geographic properties in Iran, substantial climatic variability, as well as unstable political situations and poor public health conditions in some of neighboring countries, EIDs and RIDs are serious public health problems; among them, zoonotic and drug resistant diseases are the most significant. Hence, this review provides an overview of the significant bacterial, viral and fungal EIDs and RIDs in Iran regarding their epidemiological aspects. PMID:29225752

  18. The Where-How of Leadership Emergence (WHOLE) Landscape: Charting Emergent Collective Leadership

    OpenAIRE

    Johnson, Norman; Watkins, Jennifer H

    2008-01-01

    Leadership resources are constantly adapting to the challenge of the dynamic and complex systems in which they must function. To understand the changing leadership types and to better guide the development of new leadership resources, we propose a two-dimensional leadership landscape that provides a perspective into past leadership resources and identifies new frontiers of leadership. In the Where-How of Leadership Emergence (WHOLE) Landscape, one dimension is where leadership occurs – rangi...

  19. AN INFORMATION SERVICE MODEL FOR REMOTE SENSING EMERGENCY SERVICES

    Directory of Open Access Journals (Sweden)

    Z. Zhang

    2017-09-01

    Full Text Available This paper presents a method on the semantic access environment, which can solve the problem about how to identify the correct natural disaster emergency knowledge and return to the demanders. The study data is natural disaster knowledge text set. Firstly, based on the remote sensing emergency knowledge database, we utilize the sematic network to extract the key words in the input documents dataset. Then, using the semantic analysis based on words segmentation and PLSA, to establish the sematic access environment to identify the requirement of users and match the emergency knowledge in the database. Finally, the user preference model was established, which could help the system to return the corresponding information to the different users. The results indicate that semantic analysis can dispose the natural disaster knowledge effectively, which will realize diversified information service, enhance the precision of information retrieval and satisfy the requirement of users.

  20. Love me Tinder: Untangling emerging adults’ motivations for using the dating application Tinder

    NARCIS (Netherlands)

    Sumter, S.R.; Vandenbosch, L.; Ligtenberg, L.

    2017-01-01

    Although the smartphone application Tinder is increasingly popular among emerging adults, no empirical study has yet investigated why emerging adults use Tinder. Therefore, we aimed to identify the primary motivations of emerging adults to use Tinder. The study was conducted among Dutch 18–30 year

  1. 41 CFR 102-75.760 - Who must the Office of Justice Programs (OJP) and the Federal Emergency Management Agency (FEMA...

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who must the Office of Justice Programs (OJP) and the Federal Emergency Management Agency (FEMA) notify that surplus real property is available for correctional facility, law enforcement, or emergency management response purposes? 102-75.760 Section 102-75.760 Public...

  2. 30 CFR 75.1507 - Emergency Response Plan; refuge alternatives.

    Science.gov (United States)

    2010-07-01

    ... accident at a mine. (3) Permissions to cross properties, build roads, and construct drill sites. (4.... 75.1507 Section 75.1507 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Mine Emergencies § 75...

  3. Developing Emergency Department–based Education About Emergency Contraception: Adolescent Preferences

    Science.gov (United States)

    Mollen, Cynthia J.; Miller, Melissa K.; Hayes, Katie L.; Wittink, Marsha N.; Barg, Frances K.

    2014-01-01

    Objectives The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. Methods This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking. Participants completed a computerized survey that used ACA, a technique that can be used to assess patients’ relative preferences for services. ACA uses the individual’s answers to update and refine questions through trade-off comparisons, so that each respondent answers a customized set of questions. The survey assessed preferences for the following attributes of emergency contraception education: who should deliver the education, if anyone (e.g., nurse, doctor); how the education should be delivered (e.g., by a person or via video); how often the education should be offered if patients were to frequent the ED (e.g., every time or only when asking for it); length (e.g., 5 minutes, 10 minutes); and chief complaint that would trigger the education (e.g., headache or stomach pain). Results A total of 223 patients were enrolled (37.2% at Hospital 1 and 62.8% at Hospital 2). The mean (±SD) age of the participants was 16.1 (±1.3) years. Just over half (55%) reported a history of sexual activity; 8% reported a history of pregnancy. Overall, the participants preferred education that was delivered by a person, specifically a doctor or nurse. They preferred a slightly longer education session and preferred education directed at patients seeking care in the ED for complaints potentially related to sexual activity. Conclusions Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve

  4. Effects of High-Energy Proton-Beam Irradiation on the Magnetic Properties of ZnO Nanorods

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jun Kue; Kwon, Hyeok-Jung; Cho, Yong Sub [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    There are still many problem for the application due to its unstable magnetism state and too small magnetization values. Here we investigate magnetic properties of ZnO nanorods after high-energy proton-beam irradiation. Electron spin resonance (ESR) measurement on temperature was made to identify intrinsic or extrinsic defects as well as to observe magnetic ordering after irradiation. Understanding the effects of proton beam irradiation on magnetic behavior may help to shed light on the mechanism responsible for the magnetic ordering in this material. We have investigated proton-beam irradiation effects on the magnetic properties of ZnO nanorods. After irradiation a broad ESR line is observed, indicating emergence of ferromagnetic ordering up to room temperature. In M-H curve, stronger coercive field is observed after irradiation.

  5. Psychosomatic plasticity: An "emergent property" of personality research?

    Science.gov (United States)

    Jawer, Michael

    2006-03-01

    Psychosomatic plasticity, defined as an extreme capacity to turn suggestions into bodily realities, is as phenomenon well worth investigating because it challenges mainstream conceptions about the relationship between mind and body in health as well as illness. The field of psychoneuroimmunology (PNI) offers a framework within which to understand this phenomenon because PNI makes a compelling case for the biological unity of self. Hartmann's Boundaries concept is particularly applicable because it suggests that the minds of "thin-boundary" persons are relatively fluid and able to make numerous connections. Wilson and Barber's identification of the fantasy prone person and Thalbourne's transliminality concept are similarly relevant. Taking these explorations a step further, this author proposes that the flow of feeling within individuals represents the key to psychosomatic plasticity. Blushing, psoriasis, and immune reactions are offered as examples, as are more anomalous reports such as those provided by heart transplantation recipients and cases said to be indicative of reincarnation. In each instance, persons who are highly sensitive (ie, have a speedier and more direct flow of feeling) are more likely to evidence physical reactions. Psychosomatic plasticity represents an emerging area of interest in personality research, one that clearly merits further investigation.

  6. Modeling statistical properties of written text.

    Directory of Open Access Journals (Sweden)

    M Angeles Serrano

    Full Text Available Written text is one of the fundamental manifestations of human language, and the study of its universal regularities can give clues about how our brains process information and how we, as a society, organize and share it. Among these regularities, only Zipf's law has been explored in depth. Other basic properties, such as the existence of bursts of rare words in specific documents, have only been studied independently of each other and mainly by descriptive models. As a consequence, there is a lack of understanding of linguistic processes as complex emergent phenomena. Beyond Zipf's law for word frequencies, here we focus on burstiness, Heaps' law describing the sublinear growth of vocabulary size with the length of a document, and the topicality of document collections, which encode correlations within and across documents absent in random null models. We introduce and validate a generative model that explains the simultaneous emergence of all these patterns from simple rules. As a result, we find a connection between the bursty nature of rare words and the topical organization of texts and identify dynamic word ranking and memory across documents as key mechanisms explaining the non trivial organization of written text. Our research can have broad implications and practical applications in computer science, cognitive science and linguistics.

  7. Emergence of linear elasticity from the atomistic description of matter

    Energy Technology Data Exchange (ETDEWEB)

    Cakir, Abdullah, E-mail: acakir@ntu.edu.sg [Division of Physics and Applied Physics, School of Physical and Mathematical Sciences, Nanyang Technological University (Singapore); Pica Ciamarra, Massimo [Division of Physics and Applied Physics, School of Physical and Mathematical Sciences, Nanyang Technological University (Singapore); Dipartimento di Scienze Fisiche, CNR–SPIN, Università di Napoli Federico II, I-80126 Napoli (Italy)

    2016-08-07

    We investigate the emergence of the continuum elastic limit from the atomistic description of matter at zero temperature considering how locally defined elastic quantities depend on the coarse graining length scale. Results obtained numerically investigating different model systems are rationalized in a unifying picture according to which the continuum elastic limit emerges through a process determined by two system properties, the degree of disorder, and a length scale associated to the transverse low-frequency vibrational modes. The degree of disorder controls the emergence of long-range local shear stress and shear strain correlations, while the length scale influences the amplitude of the fluctuations of the local elastic constants close to the jamming transition.

  8. Emergence of linear elasticity from the atomistic description of matter

    International Nuclear Information System (INIS)

    Cakir, Abdullah; Pica Ciamarra, Massimo

    2016-01-01

    We investigate the emergence of the continuum elastic limit from the atomistic description of matter at zero temperature considering how locally defined elastic quantities depend on the coarse graining length scale. Results obtained numerically investigating different model systems are rationalized in a unifying picture according to which the continuum elastic limit emerges through a process determined by two system properties, the degree of disorder, and a length scale associated to the transverse low-frequency vibrational modes. The degree of disorder controls the emergence of long-range local shear stress and shear strain correlations, while the length scale influences the amplitude of the fluctuations of the local elastic constants close to the jamming transition.

  9. Bats, emerging infectious diseases, and the rabies paradigm revisited

    Science.gov (United States)

    Kuzmin, Ivan V.; Bozick, Brooke; Guagliardo, Sarah A.; Kunkel, Rebekah; Shak, Joshua R.; Tong, Suxiang; Rupprecht, Charles E

    2011-01-01

    The significance of bats as sources of emerging infectious diseases has been increasingly appreciated, and new data have been accumulated rapidly during recent years. For some emerging pathogens the bat origin has been confirmed (such as lyssaviruses, henipaviruses, coronaviruses), for other it has been suggested (filoviruses). Several recently identified viruses remain to be ‘orphan’ but have a potential for further emergence (such as Tioman, Menangle, and Pulau viruses). In the present review we summarize information on major bat-associated emerging infections and discuss specific characteristics of bats as carriers of pathogens (from evolutionary, ecological, and immunological positions). We also discuss drivers and forces of an infectious disease emergence and describe various existing and potential approaches for control and prevention of such infections at individual, populational, and societal levels. PMID:24149032

  10. Bats, emerging infectious diseases, and the rabies paradigm revisited.

    Science.gov (United States)

    Kuzmin, Ivan V; Bozick, Brooke; Guagliardo, Sarah A; Kunkel, Rebekah; Shak, Joshua R; Tong, Suxiang; Rupprecht, Charles E

    2011-06-20

    The significance of bats as sources of emerging infectious diseases has been increasingly appreciated, and new data have been accumulated rapidly during recent years. For some emerging pathogens the bat origin has been confirmed (such as lyssaviruses, henipaviruses, coronaviruses), for other it has been suggested (filoviruses). Several recently identified viruses remain to be 'orphan' but have a potential for further emergence (such as Tioman, Menangle, and Pulau viruses). In the present review we summarize information on major bat-associated emerging infections and discuss specific characteristics of bats as carriers of pathogens (from evolutionary, ecological, and immunological positions). We also discuss drivers and forces of an infectious disease emergence and describe various existing and potential approaches for control and prevention of such infections at individual, populational, and societal levels.

  11. Operational Research during the Ebola Emergency.

    LENUS (Irish Health Repository)

    Fitzpatrick, Gabriel

    2017-07-01

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

  12. Episodes of care: is emergency medicine ready?

    Science.gov (United States)

    Wiler, Jennifer L; Beck, Dennis; Asplin, Brent R; Granovsky, Michael; Moorhead, John; Pilgrim, Randy; Schuur, Jeremiah D

    2012-05-01

    Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting. Copyright © 2011. Published by Mosby, Inc.

  13. Emergence of Metallic Properties at LiFePO4 Surfaces and LiFePO4/Li2S Interfaces: An Ab Initio Study.

    Science.gov (United States)

    Timoshevskii, Vladimir; Feng, Zimin; Bevan, Kirk H; Zaghib, Karim

    2015-08-26

    The atomic and electronic structures of the LiFePO4 (LFP) surface, both bare and reconstructed upon possible oxygenation, are theoretically studied by ab initio methods. On the basis of total energy calculations, the atomic structure of the oxygenated surface is proposed, and the effect of surface reconstruction on the electronic properties of the surface is clarified. While bare LFP(010) surface is insulating, adsorption of oxygen leads to the emergence of semimetallic behavior by inducing the conducting states in the band gap of the system. The physical origin of these conducting states is investigated. We further demonstrate that deposition of Li2S layers on top of oxygenated LFP(010) surface leads to the formation of additional conducting hole states in the first layer of Li2S surface because of the charge transfer from sulfur p-states to the gap states of LFP surface. This demonstrates that oxygenated LFP surface not only provides conducting layers itself, but also induces conducting channels in the top layer of Li2S. These results help to achieve further understanding of potential role of LFP particles in improving the performance of Li-S batteries through emergent interface conductivity.

  14. Intellectual Property Strategies of Multinational Companies Patenting in China

    DEFF Research Database (Denmark)

    Wolfram, Pierre; Schuster, Gerd; Brem, Alexander

    2014-01-01

    While global intellectual property trends show a stable rate of worldwide patent applications during the last five years, patent applications in emerging economies strongly increased within the same period. Unless the increasing number of applications in emerging economies, the indigenous legal...... archetypes of the world’s largest patent applicants using the case of China as an empirical context. Using Questel’s professional patent search application Orbit, we build a unique data set of the world’s top patent applicants combining data from the World Intellectual Property Organization and the State...... Intellectual Property Office of China comprising data of about 620.000 patents. Referring to the study of Keupp et al. (2012), we extend previous qualitative studies on patenting strategy archetypes by adding quantitative evidence from a data set of the world’s largest intellectual property owners. Model based...

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

    Science.gov (United States)

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

    2017-07-01

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

  16. Characterization of the electromechanical properties of EAP materials

    Science.gov (United States)

    Bar-Cohen, Yoseph; Sherrita, Stewart; Bhattachary, Kaushik; Lih, Shyh-Shiuh

    2001-01-01

    Electroactive polymers (EAP) are an emerging class of actuation materials. Their large electrically induced strains (longitudinal or bending), low density, mechanical flexibility, and ease of processing offer advantages over traditional electroactive materials. However, before the capability of these materials can be exploited, their electrical and mechanical behavior must be properly quantified. Two general types of EAP can be identified. The first type is ionic EAP, which requires relatively low voltages (EAP and it involves electrostrictive and/or Maxwell stresses. This type of materials requires large electric fields (>100MV/m) to achieve longitudinal deformations at the range from 4 - 360%. Some of the difficulties in characterizing EAP include: nonlinear properties, large compliance (large mismatch with metal electrodes), nonhomogeneity resulting from processing, etc. To support the need for reliable data, the authors are developing characterization techniques to quantify the electroactive responses and material properties of EAP materials. The emphasis of the current study is on addressing electromechanical issues related to the ion-exchange type EAP also known as IPMC. The analysis, experiments and test results are discussed in this paper.

  17. Emerging and Future Cyber Threats to Critical Systems

    OpenAIRE

    Djambazova , Edita; Almgren , Magnus; Dimitrov , Kiril; Jonsson , Erland

    2010-01-01

    Part 2: Adversaries; International audience; This paper discusses the emerging and future cyber threats to critical systems identified during the EU/FP7 project ICT-FORWARD. Threats were identified after extensive discussions with both domain experts and IT security professionals from academia, industry, and government organizations. The ultimate goal of the work was to identify the areas in which cyber threats could occur and cause serious and undesirable consequences, based on the character...

  18. Rates of workplace aggression in the emergency department and nurses' perceptions of this challenging behaviour: A multimethod study.

    Science.gov (United States)

    Hyland, Simone; Watts, Joanne; Fry, Margaret

    2016-08-01

    Over the last 10 years, the rate of people presenting with challenging behaviour to emergency departments (EDs) has increased and is recognised as a frequent occurrence facing clinicians today. Challenging behaviour often includes verbal aggression, physical aggression, intimidation and destruction of property. The aim of this research was to (i) identify the characteristics and patterns of ED-reported incidents of challenging behaviour and (ii) explore emergency nurses' perceptions of caring for patients displaying challenging behaviour. This was a multi-method study conducted across two metropolitan Sydney district hospitals. Phase 1 involved a 12-month review of the hospital's incident management database. Phase 2 involved a survey of emergency nurses' perceptions of caring for patients displaying challenging behaviour. Over 12 months there were 34 incidents of aggression documented and the perpetrators were often male (n=18; 53.0%). The average age was 34.5 years. The majority of reported incidents (n=33; 90.1%) involved intimidation, verbal assault and threatening behaviour. The median time between patient arrival and incident was 109.5min (IQR 192min). The median length of stay for patients was 302.5min (IQR 479min). There was no statistical difference between day of arrival and time of actual incident (t-test p=0.235), length of stay (t-test p=0.963) or ED arrival to incident time (t-test p=0.337). The survey (n=53; 66.2%) identified the average ED experience was 12.2 years (SD 9.8 years). All participants surveyed had experienced verbal abuse and/or physical abuse. Participants (n=52) ranked being spat at (n=37; 71.1%) the most difficult to manage. Qualitative survey open-ended comments were analysed and organised thematically. The survey identified three themes which were (i) increasing security, (ii) open access and (iii) rostering imbalance. The study provides insight into emergency nurses' reported perceptions of patients who display challenging

  19. Perspectives on bullying among children who present to the emergency department with behavioral misconduct: a qualitative study.

    Science.gov (United States)

    Waseem, Muhammad; Boutin-Foster, Carla; Robbins, Laura; Gonzalez, Rita; Vargas, Steven; Peterson, Janey C

    2014-11-01

    The problem of bullying is an increasing public health threat encountered by emergency physicians especially in inner city emergency departments (EDs). Bullying may result in emotional disturbances and psychological trauma in children. Many children sent to the ED because of behavioral misconduct require immediate stabilization and treatment. The emergency physician performs an initial assessment and stabilization. Emergency departments are increasingly on the frontline of the bullying problem. Our objective was to explore children's perspective of bullying and their views of potential solutions. A qualitative study was conducted in a cohort of 50 children (age, 8-17 years), who were referred to the ED from school because of their behavioral misconduct. An interview survey tool about bullying was administered. It focused on what bullying meant to them and what advice they have for a child who is bullied. They were also asked what advice they would have for adults who try to help. We used grounded theory to analyze the data. Similar concepts were grouped, and the categories with similar properties and dimensions were defined. Common themes were then identified. We interviewed 50 children, of whom 27 were boys and 23 were girls. Their mean (SD) age was 12.5 (2.12) years (range, 8-17 years). Bullying was identified by children as including physical, verbal, and emotional actions. Several themes emerged. First, a power imbalance between a bully and victim may render an individual vulnerable to bullying. Being different and weak also increases the risk of being bullied. Second, bullying is wrong, and the bully should be punished. Third, children should learn how to handle bullying situations and develop resilience against bullying. Finally, adults need to be more proactive to prevent or stop bullying. Our results provide insights into the perceptions of children regarding bullying. We have garnered a better understanding of what these children feel adults should do to

  20. Genetic architecture of local adaptation in lunar and diurnal emergence times of the marine midge Clunio marinus (Chironomidae, Diptera).

    Science.gov (United States)

    Kaiser, Tobias S; Heckel, David G

    2012-01-01

    Circadian rhythms pre-adapt the physiology of most organisms to predictable daily changes in the environment. Some marine organisms also show endogenous circalunar rhythms. The genetic basis of the circalunar clock and its interaction with the circadian clock is unknown. Both clocks can be studied in the marine midge Clunio marinus (Chironomidae, Diptera), as different populations have different local adaptations in their lunar and diurnal rhythms of adult emergence, which can be analyzed by crossing experiments. We investigated the genetic basis of population variation in clock properties by constructing the first genetic linkage map for this species, and performing quantitative trait locus (QTL) analysis on variation in both lunar and diurnal timing. The genome has a genetic length of 167-193 centimorgans based on a linkage map using 344 markers, and a physical size of 95-140 megabases estimated by flow cytometry. Mapping the sex determining locus shows that females are the heterogametic sex, unlike most other Chironomidae. We identified two QTL each for lunar emergence time and diurnal emergence time. The distribution of QTL confirms a previously hypothesized genetic basis to a correlation of lunar and diurnal emergence times in natural populations. Mapping of clock genes and light receptors identified ciliary opsin 2 (cOps2) as a candidate to be involved in both lunar and diurnal timing; cryptochrome 1 (cry1) as a candidate gene for lunar timing; and two timeless (tim2, tim3) genes as candidate genes for diurnal timing. This QTL analysis of lunar rhythmicity, the first in any species, provides a unique entree into the molecular analysis of the lunar clock.

  1. The emergence of time's arrows and special science laws from physics.

    Science.gov (United States)

    Loewer, Barry

    2012-02-06

    In this paper, I will argue that there is an important connection between two questions concerning how certain features of the macro world emerge from the laws and processes of fundamental microphysics and suggest an approach to answering these questions. The approach involves a kind of emergence but quite different from 'top-down' emergence discussed at the conference, for which an earlier version of this paper was written. The two questions are (i) How do 'the arrows of time' emerge from microphysics? (ii) How do macroscopic special science laws and causation emerge from microphysics? Answering these questions is especially urgent for those, who like myself, think that a certain version of physicalism, which I call 'micro-physical completeness' (MC), is true. According to MC, there are fundamental dynamical laws that completely govern (deterministically or probabilistically), the evolution of all micro-physical events and there are no additional ontologically independent dynamical or causal special science laws. In other words, there is no ontologically independent 'top-down' causation. Of course, MC does not imply that physicists now or ever will know or propose the complete laws of physics. Or even if the complete laws were known we would know how special science properties and laws reduce to laws and properties of fundamental physics. Rather, MC is a contingent metaphysical claim about the laws of our world. After a discussion of the two questions, I will argue the key to showing how it is possible for the arrows of time and the special science laws to emerge from microphysics and a certain account of how thermodynamics is related to fundamental dynamical laws.

  2. Medical intervention in radiological emergencies, formation and training

    International Nuclear Information System (INIS)

    Cardenas H, J.

    2006-01-01

    The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

  3. Emerging energy-efficient industrial technologies

    Energy Technology Data Exchange (ETDEWEB)

    Martin, N.; Worrell, E.; Ruth, M.; Price, L.; Elliott, R.N.; Shipley, A.M.; Thorne, J.

    2000-10-01

    U.S. industry consumes approximately 37 percent of the nation's energy to produce 24 percent of the nation's GDP. Increasingly, industry is confronted with the challenge of moving toward a cleaner, more sustainable path of production and consumption, while increasing global competitiveness. Technology will be essential for meeting these challenges. At some point, businesses are faced with investment in new capital stock. At this decision point, new and emerging technologies compete for capital investment alongside more established or mature technologies. Understanding the dynamics of the decision-making process is important to perceive what drives technology change and the overall effect on industrial energy use. The assessment of emerging energy-efficient industrial technologies can be useful for: (1) identifying R&D projects; (2) identifying potential technologies for market transformation activities; (3) providing common information on technologies to a broad audience of policy-makers; and (4) offering new insights into technology development and energy efficiency potentials. With the support of PG&E Co., NYSERDA, DOE, EPA, NEEA, and the Iowa Energy Center, staff from LBNL and ACEEE produced this assessment of emerging energy-efficient industrial technologies. The goal was to collect information on a broad array of potentially significant emerging energy-efficient industrial technologies and carefully characterize a sub-group of approximately 50 key technologies. Our use of the term ''emerging'' denotes technologies that are both pre-commercial but near commercialization, and technologies that have already entered the market but have less than 5 percent of current market share. We also have chosen technologies that are energy-efficient (i.e., use less energy than existing technologies and practices to produce the same product), and may have additional ''non-energy benefits.'' These benefits are as important (if

  4. Small-scale Magnetic Flux Emergence in the Quiet Sun

    Science.gov (United States)

    Moreno-Insertis, F.; Martinez-Sykora, J.; Hansteen, V. H.; Muñoz, D.

    2018-06-01

    Small bipolar magnetic features are observed to appear in the interior of individual granules in the quiet Sun, signaling the emergence of tiny magnetic loops from the solar interior. We study the origin of those features as part of the magnetoconvection process in the top layers of the convection zone. Two quiet-Sun magnetoconvection models, calculated with the radiation-magnetohydrodynamic (MHD) Bifrost code and with domain stretching from the top layers of the convection zone to the corona, are analyzed. Using 3D visualization as well as a posteriori spectral synthesis of Stokes parameters, we detect the repeated emergence of small magnetic elements in the interior of granules, as in the observations. Additionally, we identify the formation of organized horizontal magnetic sheets covering whole granules. Our approach is twofold, calculating statistical properties of the system, like joint probability density functions (JPDFs), and pursuing individual events via visualization tools. We conclude that the small magnetic loops surfacing within individual granules in the observations may originate from sites at or near the downflows in the granular and mesogranular levels, probably in the first 1 or 1.5 Mm below the surface. We also document the creation of granule-covering magnetic sheet-like structures through the sideways expansion of a small subphotospheric magnetic concentration picked up and pulled out of the interior by a nascent granule. The sheet-like structures that we found in the models may match the recent observations of Centeno et al.

  5. Traffic Management for Emergency Vehicle Priority Based on Visual Sensing

    Directory of Open Access Journals (Sweden)

    Kapileswar Nellore

    2016-11-01

    Full Text Available Vehicular traffic is endlessly increasing everywhere in the world and can cause terrible traffic congestion at intersections. Most of the traffic lights today feature a fixed green light sequence, therefore the green light sequence is determined without taking the presence of the emergency vehicles into account. Therefore, emergency vehicles such as ambulances, police cars, fire engines, etc. stuck in a traffic jam and delayed in reaching their destination can lead to loss of property and valuable lives. This paper presents an approach to schedule emergency vehicles in traffic. The approach combines the measurement of the distance between the emergency vehicle and an intersection using visual sensing methods, vehicle counting and time sensitive alert transmission within the sensor network. The distance between the emergency vehicle and the intersection is calculated for comparison using Euclidean distance, Manhattan distance and Canberra distance techniques. The experimental results have shown that the Euclidean distance outperforms other distance measurement techniques. Along with visual sensing techniques to collect emergency vehicle information, it is very important to have a Medium Access Control (MAC protocol to deliver the emergency vehicle information to the Traffic Management Center (TMC with less delay. Then only the emergency vehicle is quickly served and can reach the destination in time. In this paper, we have also investigated the MAC layer in WSNs to prioritize the emergency vehicle data and to reduce the transmission delay for emergency messages. We have modified the medium access procedure used in standard IEEE 802.11p with PE-MAC protocol, which is a new back off selection and contention window adjustment scheme to achieve low broadcast delay for emergency messages. A VANET model for the UTMS is developed and simulated in NS-2. The performance of the standard IEEE 802.11p and the proposed PE-MAC is analysed in detail. The NS-2

  6. Traffic Management for Emergency Vehicle Priority Based on Visual Sensing.

    Science.gov (United States)

    Nellore, Kapileswar; Hancke, Gerhard P

    2016-11-10

    Vehicular traffic is endlessly increasing everywhere in the world and can cause terrible traffic congestion at intersections. Most of the traffic lights today feature a fixed green light sequence, therefore the green light sequence is determined without taking the presence of the emergency vehicles into account. Therefore, emergency vehicles such as ambulances, police cars, fire engines, etc. stuck in a traffic jam and delayed in reaching their destination can lead to loss of property and valuable lives. This paper presents an approach to schedule emergency vehicles in traffic. The approach combines the measurement of the distance between the emergency vehicle and an intersection using visual sensing methods, vehicle counting and time sensitive alert transmission within the sensor network. The distance between the emergency vehicle and the intersection is calculated for comparison using Euclidean distance, Manhattan distance and Canberra distance techniques. The experimental results have shown that the Euclidean distance outperforms other distance measurement techniques. Along with visual sensing techniques to collect emergency vehicle information, it is very important to have a Medium Access Control (MAC) protocol to deliver the emergency vehicle information to the Traffic Management Center (TMC) with less delay. Then only the emergency vehicle is quickly served and can reach the destination in time. In this paper, we have also investigated the MAC layer in WSNs to prioritize the emergency vehicle data and to reduce the transmission delay for emergency messages. We have modified the medium access procedure used in standard IEEE 802.11p with PE-MAC protocol, which is a new back off selection and contention window adjustment scheme to achieve low broadcast delay for emergency messages. A VANET model for the UTMS is developed and simulated in NS-2. The performance of the standard IEEE 802.11p and the proposed PE-MAC is analysed in detail. The NS-2 simulation results

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

    Science.gov (United States)

    Sawatzky, Jo-Ann V; Enns, Carol L

    2012-07-01

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

  8. Radiological emergency response planning in Pennsylvania

    International Nuclear Information System (INIS)

    Henderson, O.K.

    1981-01-01

    The most important aspect of emergency preparedness is to recognize and accept the fact that there exists a potential for a problem or a condition and that it requires some attention. Emergency plans should be sufficiently flexible so as to accommodate the emergency situation as it unfolds. Of the several emergency responses that may be taken following a nuclear power plant accident evacuation evokes the greatest attention and discussion as to whether it is truly a feasible option. Movements of people confined to mass care facilities or on life support systems involve special requirements. The Three Mile Island accident has been the most studied nuclear incident in the history of the nuclear power reactor industry. The findings of these reports will have a major influence on nuclear power issues as they are addressed in the future. The question remains as to whether the political leadership will be willing to provide the resources required by the emergency plan. Future safety and emergency response to nuclear accidents depend upon Government and industry acting responsibly and not merely responding to regulations. The Three Mile Island accident has had some beneficial side effects for the emergency management community. It has: increased the level of awareness and importance of emergency planning; served as a catalyst for the sharing of experiences and information; encouraged standardization of procedures; and emphasized the need for identifying and assigning responsibilities. The Emergency Management Organization in responding to a disaster situation does not enjoy the luxury of time. It needs to act decisively and correctly. It does not often get a second chance. Governments, at all levels, and the nuclear power industry have been put on notice as a result of Three Mile Island. The future of nuclear energy may well hang in the balance, based upon the public's perception of the adequacy of preparedness and safety measures being taken. (author)

  9. Exploring mHealth Participation for Emergency Response Communities

    Directory of Open Access Journals (Sweden)

    David G. Schwartz

    2017-03-01

    Full Text Available We explore the challenges of participation by members of emergency response communities who share a similar condition and treatment, and are called upon to participate in emergency events experienced by fellow members. Smartphones and location-based social networking technologies present an opportunity to re-engineer certain aspects of emergency medical response. Life-saving prescription medication extended in an emergency by one individual to another occurs on a micro level, anecdotally documented. We illustrate the issues and our approach through the example of an app to support patients prone to anaphylaxis and prescribed to carry epinephrine auto-injectors. We address unique participation challenges in an mHealth environment in which interventions are primarily short-term interactions which require clear and precise decision-making and constant tracking of potential participants in responding to an emergency medical event. The conflicting effects of diffused responsibility and shared identity are identified as key factors in modeling participation.

  10. 41 CFR 301-30.2 - What is considered to be “family” with respect to emergency travel?

    Science.gov (United States)

    2010-07-01

    ... âfamilyâ with respect to emergency travel? 301-30.2 Section 301-30.2 Public Contracts and Property... 30-EMERGENCY TRAVEL § 301-30.2 What is considered to be “family” with respect to emergency travel..., on a case-by-case basis, expand this definition to include other members of your and/or your spouse's...

  11. Emergency procedures

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following subjects are discussed - Emergency Procedures: emergency equipment, emergency procedures; emergency procedure involving X-Ray equipment; emergency procedure involving radioactive sources

  12. Mapping the Landscape of Emerging Research Topics in Supply Chain Management

    DEFF Research Database (Denmark)

    Wieland, Andreas; Handfield, Robert B.; Durach, Christian F.

    2014-01-01

    The purpose of this article is to identify research topics that are emerging in the field of supply chain management [SCM]. The analysis is based on survey data collected from leading SCM researchers. It is found that big data analytics, sustainability, risk management, health care, emerging mark...

  13. Radiological emergency response - a functional approach

    International Nuclear Information System (INIS)

    Chowdhury, P.

    1998-01-01

    The state of Louisiana's radiological emergency response programme is based on the federal guidance 'Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants' (NUREG-0654, FEMA-REP-1 Rev. 1). Over the past 14 years, the planning and implementation of response capabilities became more organized and efficient; the training programme has strengthened considerably; co-ordination with all participating agencies has assumed a more co-operative role, and as a result, a fairly well integrated response planning has evolved. Recently, a more 'functional' approach is being adopted to maximize the programme's efficiency not only for nuclear power plant emergency response, but radiological emergency response as a whole. First, several broad-based 'components' are identified; clusters of 'nodes' are generated for each component; these 'nodes' may be divided into 'sub-nodes' which will contain some 'attributes'; 'relational bonds' among the 'attributes' will exist. When executed, the process begins and continues with the 'nodes' assuming a functional and dynamic role based on the nature and characteristics of the 'attributes'. The typical response based on stand-alone elements is thus eliminated, the overlapping of functions is avoided, and a well structured and efficient organization is produced, that is essential for today's complex nature of emergency response. (author)

  14. Emerging and Disruptive Technologies

    OpenAIRE

    Kricka, Larry J.

    2016-01-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home test...

  15. Challenges emerging from future cloud application scenarios

    NARCIS (Netherlands)

    Jeferry, K.; Kousiouris, G.; Kyriazis, D.; Altmann, J.; Ciuffoletti, A.; Maglogiannis, I.; Nesi, P.; Suzic, B.; Zhao, Z.

    2015-01-01

    The cloud computing paradigm encompasses several key differentiating elements and technologies, tackling a number of inefficiencies, limitations and problems that have been identified in the distributed and virtualized computing domain. Nonetheless, and as it is the case for all emerging

  16. Do emergency nurses have enough emotional intelligence?

    Science.gov (United States)

    Codier, Estelle; Codier, David

    2015-06-01

    A significant body of research suggests there is a correlation between measured emotional intelligence (EI) abilities and performance in nursing. The four critical elements of EI, namely the abilities to identify emotions correctly in self and others, using emotions to support reasoning, understanding emotions and managing emotions, apply to emergency care settings and are important for safe patient care, teamwork, retention and burnout prevention. This article describes 'emotional labour' and the importance of EI abilities for emergency nurses, and suggests that such abilities should be considered core competencies for the profession.

  17. Design Methods in the Emergent City

    DEFF Research Database (Denmark)

    Samson, Kristine

    The paper seeks to define urban design in relation to the specific challenges of emerging cities. Through a case study of Mudo Coletivos temporary structure, Bolha Imobiliaria, and the making of it, I wish to outline a design approach for urban design in cities lacking public spaces. Urban design...... is understood in a broad sense, not as architectural design but as spatial design and artistic interventions in public space. Through the paper I will address how the designer can co-create and reassemble existing urban spaces through design acts. The approach suggests a situated design methodology but is based...... on a theoretical understanding. It is my belief that the designer, by looking into the emergent properties of urban spaces, instead of its physical and cartographical outlines, can see her work as a processual intervention in the city rather than durable object design....

  18. The Budding Yeast “Saccharomyces cerevisiae” as a Drug Discovery Tool to Identify Plant-Derived Natural Products with Anti-Proliferative Properties

    Directory of Open Access Journals (Sweden)

    Bouchra Qaddouri

    2011-01-01

    Full Text Available The budding yeast Saccharomyces cerevisiae is a valuable system to study cell-cycle regulation, which is defective in cancer cells. Due to the highly conserved nature of the cell-cycle machinery between yeast and humans, yeast studies are directly relevant to anticancer-drug discovery. The budding yeast is also an excellent model system for identifying and studying antifungal compounds because of the functional conservation of fungal genes. Moreover, yeast studies have also contributed greatly to our understanding of the biological targets and modes of action of bioactive compounds. Understanding the mechanism of action of clinically relevant compounds is essential for the design of improved second-generation molecules. Here we describe our methodology for screening a library of plant-derived natural products in yeast in order to identify and characterize new compounds with anti-proliferative properties.

  19. Emergency pediatric anesthesia - accessibility of information.

    Science.gov (United States)

    King, Hannah; Pipe, Georgina E M; Linford, Sarah L; Moppett, Iain K; Armstrong, James A M

    2015-03-01

    Emergency pediatric situations are stressful for all involved. Variation in weight, physiology, and anatomy can be substantial and errors in calculating drugs and fluids can be catastrophic. To evaluate the reliability of information resources that anesthetic trainees might use when faced with common pediatric emergencies. Anesthetic trainees from a single UK deanery were recruited and timed while they identified 18 predetermined pieces of information from three Advanced Pediatric Life Support (APLS) scenarios. The two most popular smartphone applications identified from a previous survey, PaedsED (PaedsED. iED limited, Version 1.0.8, Updated March 2011. ©2009) and Anapaed (AnaPaed. Thierry Girard, Version 1.4.2, Updated Nov 2, 2012. ©Thierry Girard), the British National Formulary for Children (cBNF) and trainee's inherent knowledge were compared with a local, check-list style, handbook of pediatric emergency algorithms - Pediatric Anesthetic Emergency Data sheets (PAEDs). Twenty anesthetic trainees were recruited. The fastest source of information was the trainees own knowledge (median 61 s, IQR 51-83 s). Second fastest was PAEDs (80, [59-110] s), followed by PaedsED (84, [65-111]). The most accurate source overall was PaedsED (100, [83-100]) although the accuracy varied between scenarios. The handbook was rated as the most popular resource by the trainees. Although fastest, trainees own knowledge is inaccurate, highlighting the need for additional, rapidly accessible, information. Of the two smartphone applications, PaedsED proved to be fast, accurate, and more popular, while Anapaed was accurate but slow to use. The PAEDs handbook, with its checklist-style format, was also fast, accurate and rated the most popular information source. © 2014 John Wiley & Sons Ltd.

  20. Social media best practices in emergency management.

    Science.gov (United States)

    Siskey, Ashley; Islam, Tanveer

    2016-01-01

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

  1. Key Emerging Technologies for Postsecondary Education

    Science.gov (United States)

    Johnson, Laurence F.; Levine, Alan; Smith, Rachel S.; Haywood, Keene

    2010-01-01

    The annual "Horizon Report" describes the continuing work of the New Media Consortium's Horizon Project, a qualitative research project established in 2002 that identifies and describes emerging technologies likely to have a large impact on teaching, learning, or creative inquiry on college and university campuses within the next five years. This…

  2. Emergence of Extensively Drug Resistant Tuberculosis

    Centers for Disease Control (CDC) Podcasts

    Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.

  3. Web 2.0 and Emerging Technologies in Online Learning

    Science.gov (United States)

    Diaz, Veronica

    2010-01-01

    As online learning continues to grow, so do the free or nearly free Web 2.0 and emerging online learning technologies available to faculty and students. This chapter explores the implementation process and corresponding considerations of adapting such tools for teaching and learning. Issues addressed include copyright, intellectual property,…

  4. Factors affecting the organization and management of emergency ...

    African Journals Online (AJOL)

    Factors affecting the organization and management of emergency mass casualty ... service all under a unified command of leadership with a specified job description. Factors identified were: Political will, human resource planning, appropriate ...

  5. Emerging Techniques in Stratified Designs and Continuous Gradients for Tissue Engineering of Interfaces

    Science.gov (United States)

    Dormer, Nathan H.; Berkland, Cory J.; Detamore, Michael S.

    2013-01-01

    Interfacial tissue engineering is an emerging branch of regenerative medicine, where engineers are faced with developing methods for the repair of one or many functional tissue systems simultaneously. Early and recent solutions for complex tissue formation have utilized stratified designs, where scaffold formulations are segregated into two or more layers, with discrete changes in physical or chemical properties, mimicking a corresponding number of interfacing tissue types. This method has brought forth promising results, along with a myriad of regenerative techniques. The latest designs, however, are employing “continuous gradients” in properties, where there is no discrete segregation between scaffold layers. This review compares the methods and applications of recent stratified approaches to emerging continuously graded methods. PMID:20411333

  6. Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review.

    Science.gov (United States)

    Ramsbottom, Anna; O'Brien, Eleanor; Ciotti, Lucrezio; Takacs, Judit

    2018-04-01

    Public health emergency preparedness (PHEP) all too often focusses only on institutional capabilities, including their technical expertise and political influence, while overlooking community capabilities. However, the success of institutional emergency preparedness plans depends upon communities and institutions working together to ensure successful anticipation, response and recovery. Broader community engagement is therefore recommended worldwide. This literature review was carried out to identify enablers and barriers to community and institutional synergies in emergency preparedness. Searches were undertaken across bibliographic databases and grey literature sources. The literature identified was qualitative in nature. A qualitative, 'best fit' framework approach using a pre-existing framework was used to analyse the literature, whereby themes were added and changed as analysis progressed. A working definition of community was identified, based on a 'whole community' approach, inclusive of the whole multitude of stakeholders including community residents and emergency management staff. Given the diversity in community make-up, the types of emergencies that could be faced, the socio-economic, environmental and political range of communities, there are no set practices that will be effective for all communities. The most effective way of engaging communities in emergency preparedness is context-dependent and the review did draw out some important key messages for institutions to consider.

  7. Properties of gluon jets

    International Nuclear Information System (INIS)

    Sugano, K.

    1988-01-01

    The properties of gluon jets are reviewed from an experimental point of view. The measured characteristics are compared to theoretical expectations. Although neither data nor models for the gluon jets are in the mature stage, there are remarkable agreements and also intriguing disagreements between experiment and theory. Since much interesting data have begun to emerge from various experiments and the properties of gluon jets are deeply rooted in the basic structure of non-Abelian gauge theory, the study of gluon jets casts further light on understanding of QCD. The future prospects are discussed

  8. Predictors of psychiatric boarding in the emergency department.

    Science.gov (United States)

    Misek, Ryan K; DeBarba, Ashley E; Brill, April

    2015-01-01

    The emergency psychiatric care is system is overburdened in the United States. Patients experiencing psychiatric emergencies often require resources not available at the initial treating facility and frequently require transfer to an appropriate psychiatric facility. Boarding of psychiatric patients, defined as a length of stay greater than four hours after medical clearance, is ubiquitous throughout emergency departments (EDs) nationwide. Boarding is recognized as a major cause of ambulance diversions and ED crowding and has a significant adverse impact on healthcare providers, patient satisfaction, and hospital costs. We sought to identify differences between patients who boarded versus patients who did not board, to identify factors amenable to change and identify interventions that could lead to a decrease in overall psychiatric patient length of stay and improve patient care. This study is a retrospective multicenter cohort study of all patients assessed to require inpatient psychiatric hospitalization at two community EDs in Illinois from July 1, 2010 through June 30, 2012. We identified 671 patients and collected insurance status, sex, age, time of arrival, time of disposition and time of transfer. There was a statistically significant difference in the insurance status between the cohort of patients boarding in the ED compared to non-boarders prior to inpatient psychiatric admission. Our study identified 95.4% of uninsured patients who were boarded in the ED, compared to 71.8% of Medicare/Medicaid patients and 78.3% of patients with private insurance (χ(2)=50.6, df=2, pboarded significantly longer than Medicare/Medicaid and privately insured patients. Patients with private insurance boarded longer than those with Medicare/Medicaid. Patients transferred to publicly funded facilities had significantly longer ED length of stay than patients transferred to private facilities.

  9. Optical properties of amorphous silicon: Some problem areas

    International Nuclear Information System (INIS)

    Ravindra, N.M.; Chelle, F. de; Ance, C.; Ferraton, J.P.; Berger, J.M.; Coulibaly, S.P.

    1983-08-01

    In this presentation we essentially attempt to throw light on some problem areas concerning the various optical properties of amorphous silicon. The problems seem to emerge from the classical methods employed to determine the optical properties like the optical gap, urbach tail parameter and other related characteristics. Additional problems have emerged in recent years by virtue of many attempts to generalize the property-behaviour relationships for amorphous silicon without attributing any importance to the method of preparation of the films. It should be noted here that although many authors believe disorder to be the controlling parameter, we are of the opinion that at least for films containing fairly large concentrations of hydrogen, the hydrogen concentration has an equally important role to play. The present study has been carried out for films prepared by glow-discharge and chemical vapour deposition. (author)

  10. Osteopathic emergency medicine programs infrequently publish in high-impact emergency medicine journals.

    Science.gov (United States)

    Baskin, Sean M; Lin, Christina; Carlson, Jestin N

    2014-11-01

    Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. We performed a retrospective literature review using the Journal Citation Report database and identified the top five journals in the category of 'Emergency Medicine' by their 2011 Impact Factor. We examined all publications from each journal for 2011. For each article we recorded article type, authors' names, position of authorship (first, senior or other), the author's degree and affiliated institution. We present the data in raw numbers and percentages. The 2011 EM journals with the highest impact factor were the following: Annals of Emergency Medicine, Resuscitation, Journal of Trauma, Injury, and Academic Emergency Medicine. Of the 9,298 authors published in these journals in 2011; 1,309 (15%) claimed affiliation with U.S.-based EM programs, of which 16 (1%) listed their affiliations with eight different osteopathic EM programs. The 16 authors claimed affiliation with 8 of 46 osteopathic EM programs (17%), while 1,301 authors claimed affiliation with 104 of 148 (70%) U.S.-based allopathic programs. Authors from osteopathic EM programs are under-represented in the top EM journals. With the pending ACGME/AOA merger, there is a significant opportunity for improvement in the rate of publication of osteopathic EM programs in top tier EM journals.

  11. IDENTIFYING COMPETENCIES OF VOLUNTEER BOARD MEMBERS OF COMMUNITY SPORTS CLUBS

    OpenAIRE

    A. BALDUCK; A. VAN ROSSEM; M. BUELENS

    2009-01-01

    This study contributes to the emerging empirical studies on roles and responsibilities of boards in nonprofit organizations by identifying competencies of volunteer board members. We identified how two types of constituents—volunteer board members and sports members—perceived competencies of volunteer board members in community sports clubs. We used the repertory grid technique to draw cognitive maps and to reveal the perceived reality of these constituents. Our results suggest that constitue...

  12. Resilience and Brittleness in a Nuclear Emergency Response Simulation: Focusing on Team Coordination Activity

    International Nuclear Information System (INIS)

    Costa, Wagner Schenkel; Buarque, Lia; Voshell, Martin; Branlat, Matthieu; Woods, David D.; Gomes, Jose Orlando

    2008-01-01

    The current work presents results from a cognitive task analysis (CTA) of a nuclear disaster simulation. Audio-visual records were collected from an emergency room team composed of individuals from 26 different agencies as they responded to multiple scenarios in a simulated nuclear disaster. This simulation was part of a national emergency response training activity for a nuclear power plant located in a developing country. The objectives of this paper are to describe sources of resilience and brittleness in these activities, identify cues of potential improvements for future emergency simulations, and leveraging the resilience of the emergency response System in case of a real disaster. Multiple CTA techniques were used to gain a better understanding of the cognitive dimensions of the activity and to identify team coordination and crisis management patterns that emerged from the simulation training. (authors)

  13. Emergent scar lines in chaotic advection of passive directors

    Science.gov (United States)

    Hejazi, Bardia; Mehlig, Bernhard; Voth, Greg A.

    2017-12-01

    We examine the spatial field of orientations of slender fibers that are advected by a two-dimensional fluid flow. The orientation field of these passive directors are important in a wide range of industrial and geophysical flows. We introduce emergent scar lines as the dominant coherent structures in the orientation field of passive directors in chaotic flows. Previous work has identified the existence of scar lines where the orientation rotates by π over short distances, but the lines that were identified disappeared as time progressed. As a result, earlier work focused on topological singularities in the orientation field, which we find to play a negligible role at long times. We use the standard map as a simple time-periodic two-dimensional flow that produces Lagrangian chaos. This class of flows produces persistent patterns in passive scalar advection and we find that a different kind of persistent pattern develops in the passive director orientation field. We identify the mechanism by which emergent scar lines grow to dominate these patterns at long times in complex flows. Emergent scar lines form where the recent stretching of the fluid element is perpendicular to earlier stretching. Thus these scar lines can be labeled by their age, defined as the time since their stretching reached a maximum.

  14. Response of human populations to large-scale emergencies

    Science.gov (United States)

    Bagrow, James; Wang, Dashun; Barabási, Albert-László

    2010-03-01

    Until recently, little quantitative data regarding collective human behavior during dangerous events such as bombings and riots have been available, despite its importance for emergency management, safety and urban planning. Understanding how populations react to danger is critical for prediction, detection and intervention strategies. Using a large telecommunications dataset, we study for the first time the spatiotemporal, social and demographic response properties of people during several disasters, including a bombing, a city-wide power outage, and an earthquake. Call activity rapidly increases after an event and we find that, when faced with a truly life-threatening emergency, information rapidly propagates through a population's social network. Other events, such as sports games, do not exhibit this propagation.

  15. Conjunction Errors in Recognition: Emergent Structure and Metacognitive Control

    Science.gov (United States)

    Verde, Michael F.

    2010-01-01

    Pictures consisted of component halves from either the same photographic scene (SS) or different scenes (DS). SS pictures possessed the emergent property of forming a continuous scene. In Experiment 1, conjunction lures were created by rearranging halves from studied DS pictures into new DS or SS lures. Despite equally familiar components,…

  16. Commons, Piracy and the Crisis of Property

    Directory of Open Access Journals (Sweden)

    James Arvanitakis

    2016-02-01

    Full Text Available This article takes the politicisation of copyright and file sharing as a starting point to discuss the concept of the commons and the construction of property. Empirically, the article draws on a series of interviews with Pirate Party members in Sweden, Australia, Germany, the UK and USA; placed in the theoretical framework of the commons. We argue that piracy, as an act and an ideology, interrogates common understandings of property as something self-evident, natural and uncontestable. Such constructions found liberal market ideology. The article has two broad aims: to outline the different phases of enclosure, from the physical commons, to the institutional and finally the cultural commons; and to discuss the way that piracy highlights the emergent crisis in private property rights, brought to the fore by the global financial crisis and ongoing privatization of public resources. We conclude by questioning what new modes of enclosure are emerging in a digital economy driven by excessive data mining and centralized streaming services.

  17. 14 CFR 155.5 - Property and releases covered by this part.

    Science.gov (United States)

    2010-01-01

    ... national emergency, to facilitate financing the operation and maintenance or further development of a... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Property and releases covered by this part... TRANSPORTATION (CONTINUED) AIRPORTS RELEASE OF AIRPORT PROPERTY FROM SURPLUS PROPERTY DISPOSAL RESTRICTIONS § 155...

  18. Dynamic decision making for dam-break emergency management - Part 2: Application to Tangjiashan landslide dam failure

    Science.gov (United States)

    Peng, M.; Zhang, L. M.

    2013-02-01

    Tangjiashan landslide dam, which was triggered by the Ms = 8.0 Wenchuan earthquake in 2008 in China, threatened 1.2 million people downstream of the dam. All people in Beichuan Town 3.5 km downstream of the dam and 197 thousand people in Mianyang City 85 km downstream of the dam were evacuated 10 days before the breaching of the dam. Making such an important decision under uncertainty was difficult. This paper applied a dynamic decision-making framework for dam-break emergency management (DYDEM) to help rational decision in the emergency management of the Tangjiashan landslide dam. Three stages are identified with different levels of hydrological, geological and social-economic information along the timeline of the landslide dam failure event. The probability of dam failure is taken as a time series. The dam breaching parameters are predicted with a set of empirical models in stage 1 when no soil property information is known, and a physical model in stages 2 and 3 when knowledge of soil properties has been obtained. The flood routing downstream of the dam in these three stages is analyzed to evaluate the population at risk (PAR). The flood consequences, including evacuation costs, flood damage and monetized loss of life, are evaluated as functions of warning time using a human risk analysis model based on Bayesian networks. Finally, dynamic decision analysis is conducted to find the optimal time to evacuate the population at risk with minimum total loss in each of these three stages.

  19. Emergency material allocation with time-varying supply-demand based on dynamic optimization method for river chemical spills.

    Science.gov (United States)

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

    2018-04-13

    Aiming to minimize the damage caused by river chemical spills, efficient emergency material allocation is critical for an actual emergency rescue decision-making in a quick response. In this study, an emergency material allocation framework based on time-varying supply-demand constraint is developed to allocate emergency material, minimize the emergency response time, and satisfy the dynamic emergency material requirements in post-accident phases dealing with river chemical spills. In this study, the theoretically critical emergency response time is firstly obtained for the emergency material allocation system to select a series of appropriate emergency material warehouses as potential supportive centers. Then, an enumeration method is applied to identify the practically critical emergency response time, the optimum emergency material allocation and replenishment scheme. Finally, the developed framework is applied to a computational experiment based on south-to-north water transfer project in China. The results illustrate that the proposed methodology is a simple and flexible tool for appropriately allocating emergency material to satisfy time-dynamic demands during emergency decision-making. Therefore, the decision-makers can identify an appropriate emergency material allocation scheme in a balance between time-effective and cost-effective objectives under the different emergency pollution conditions.

  20. Global approach of emergency response, reflection analysis

    International Nuclear Information System (INIS)

    Velasco Garcia, E.; Garcia Ahumada, F.; Albaladejo Vidal, S.

    1998-01-01

    The emergency response management approach must be dealt with adequately within company strategy, since a badly managed emergency situation can adversely affect a company, not only in terms of asset, but also in terms of the negative impact on its credibility, profitability and image. Thereby, it can be said that there are three main supports to manage the response in an emergency situation. a) Diagnosis b) Prognosis. c) Communications. To reach these capabilities it is necessary a co-ordination of different actions at the following levels. i. Facility Operation implies Local level. ii. Facility Property implies National level iii. Local Authority implies Local level iv. National Authority implies National level Taking into account all the last, these following functions must be covered: a) Management: incorporating communication, diagnosis and prognosis areas. b) Decision: incorporating communication and information means. c) Services: in order to facilitate the decision, as well as the execution of this decision. d) Analysis: in order to facilitate the situations that make easier to decide. e) Documentation: to seek the information for the analysts and decision makers. (Author)

  1. PFP Emergency Lighting Study

    International Nuclear Information System (INIS)

    BUSCH, M.S.

    2000-01-01

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

  2. Operationalising emergency care delivery in sub-Saharan Africa: consensus-based recommendations for healthcare facilities.

    Science.gov (United States)

    Calvello, Emilie J B; Tenner, Andrea G; Broccoli, Morgan C; Skog, Alexander P; Muck, Andrew E; Tupesis, Janis P; Brysiewicz, Petra; Teklu, Sisay; Wallis, Lee; Reynolds, Teri

    2016-08-01

    A major barrier to successful integration of acute care into health systems is the lack of consensus on the essential components of emergency care within resource-limited environments. The 2013 African Federation of Emergency Medicine Consensus Conference was convened to address the growing need for practical solutions to further implementation of emergency care in sub-Saharan Africa. Over 40 participants from 15 countries participated in the working group that focused on emergency care delivery at health facilities. Using the well-established approach developed in the WHO's Monitoring Emergency Obstetric Care, the workgroup identified the essential services delivered-signal functions-associated with each emergency care sentinel condition. Levels of emergency care were assigned based on the expected capacity of the facility to perform signal functions, and the necessary human, equipment and infrastructure resources identified. These consensus-based recommendations provide the foundation for objective facility capacity assessment in developing emergency health systems that can bolster strategic planning as well as facilitate monitoring and evaluation of service delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Diabetic Emergencies

    Science.gov (United States)

    ... Campaigns Share this! EmergencyCareForYou » Emergency 101 » Diabetic Emergencies Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  4. Global Emergency Medicine: A Review of the Literature From 2016.

    Science.gov (United States)

    Becker, Torben K; Hansoti, Bhakti; Bartels, Susan; Hayward, Alison Schroth; Hexom, Braden J; Lunney, Kevin M; Marsh, Regan H; Osei-Ampofo, Maxwell; Trehan, Indi; Chang, Julia; Levine, Adam C

    2017-09-01

    The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year 13,890 articles written in four languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 716 articles met our inclusion criteria and underwent full review. Fifty-nine percent were categorized as emergency care in resource-limited settings, 17% as EM development, and 24% as disaster and humanitarian response. Nineteen articles received scores of 18.5 or higher out of a maximum score of 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed Cohen's kappa of 0.441. In 2016, the total number of articles identified by our search continued to increase. The proportion of articles in each of the three categories remained stable. Studies and reviews with a focus on infectious diseases, pediatrics, and the use of ultrasound in resource-limited settings represented the majority of articles selected for final review. © 2017 The Authors. Academic Emergency Medicine published by Wiley Periodicals, Inc. on behalf of the Society for Academic Emergency Medicine (SAEM).

  5. 44 CFR 9.10 - Identify impacts of proposed actions.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Identify impacts of proposed... impacts of proposed actions. (a) Purpose. The purpose of this section is to ensure that the effects of... adverse impacts associated with the occupancy and modification of floodplains and wetlands and the...

  6. Emerging and Disruptive Technologies.

    Science.gov (United States)

    Kricka, Larry J

    2016-08-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages.

  7. Next Generation Public Safety and Emergency Technologies

    DEFF Research Database (Denmark)

    Bonde, Camilla; Tadayoni, Reza; Skouby, Knud Erik

    2014-01-01

    The paper researches the existing European standards for Public Safety and Emergency (PSE) services (also called Public Protection Disaster Relief “PPDR”), and identifies based on user studies in Denmark conflicts between the current deployments of the standards and the user requirements. The aim...

  8. Risk stratification in emergency patients by copeptin

    DEFF Research Database (Denmark)

    Iversen, Kasper; Gøtze, Jens P; Dalsgaard, Morten

    2014-01-01

    BACKGROUND: Rapid risk stratification is a core task in emergency medicine. Identifying patients at high and low risk shortly after admission could help clinical decision-making regarding treatment, level of observation, allocation of resources and post discharge follow-up. The purpose of the pre...

  9. Major alternatives for government policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States

    International Nuclear Information System (INIS)

    1980-01-01

    The purpose of this report is to identify and assess major alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States. The National Academy of Public Administration agreed to identify and evaluate alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management. It agreed to review present policies and practices in civilian nuclear reactor emergency management, to review selected experiences and practices of governmental agencies other than the Nuclear Regulatory Commission, and industries other than the nuclear power industry, and to identify alternatives to the present nuclear emergency system

  10. Emergency notification and assistance technical operations manual. Emergency preparedness and response. Date effective: 1 December 2002

    International Nuclear Information System (INIS)

    2002-11-01

    last edition of ENATOM was issued, several factors have warranted some modifications to the existing ENATOM arrangements: the publication of Safety Requirements on Preparedness and Response for a Nuclear or Radiological Emergency, GS-R-2, in the IAEA's Safety Standards Series, in particular those requirements relating to the threshold for early notification and information exchange; feedback from the first meeting of representatives of competent authorities identified under the Early Notification and Assistance Convention, held in June 2001; and lessons identified from the Joint International Exercise CONVEX 3/JINEX 1 (2001) conducted in May 2001 based on a national exercise held at the Gravelines nuclear power plant in France. Other factors that called for updating the ENATOM manual were: changes due to revision of the Joint Plan, in particular those arising from incorporating an additional four co-sponsoring international organizations; recommendations from the Inter-Agency Committee on Nuclear Accidents (IACRNA) concerning the modalities of international exercises; lessons identified from experience in responding to requests for information and assistance during radiological emergencies in the past two years; changes to better reflect that emergency situations can arise from both accidents and deliberate acts; and recent resolutions of the IAEA General Conference. This manual describes arrangements operative from 1 December 2002 and supersedes the previous edition, EPR-ENATOM (2000). A new edition of ENATOM will be reissued in two years time. Any important amendments before completion of the new edition will be communicated through information bulletins. The current version of ENATOM is not restricted and will be maintained on the IAEA public web site under http://www.iaea.org/ns/rasanet/programme/emergency/enatom.htm. The General Conference of the IAEA in resolution GC(44)/RES/16 has encouraged Member States 'to implement instruments for improving their response

  11. Identifying structural damage with ground penetrating radar

    CSIR Research Space (South Africa)

    Van Schoor, Abraham M

    2008-07-01

    Full Text Available Ground penetrating radar (GPR) and electrical resistance tomography (ERT) surveys were conducted in an urban environment in an attempt to identify the cause of severe structural damage to a historically significant residential property...

  12. Positive Coping: A Unique Characteristic to Pre-Hospital Emergency Personnel.

    Science.gov (United States)

    Ebadi, Abbas; Froutan, Razieh

    2017-01-01

    It is important to gain a thorough understanding of positive coping methods adopted by medical emergency personnel to manage stressful situations associated with accidents and emergencies. Thus, the purpose of this study was to gain a better understanding of positive coping strategies used by emergency medical service providers. This study was conducted using a qualitative content analysis method. The study participants included 28 pre-hospital emergency personnel selected from emergency medical service providers in bases located in different regions of the city of Mashhad, Iran, from April to November 2016. The purposive sampling method also was used in this study, which was continued until data saturation was reached. To collect the data, semistructured open interviews, observations, and field notes were used. Four categories and 10 subcategories were extracted from the data on the experiences of pre-hospital emergency personnel related to positive coping strategies. The four categories included work engagement, smart capability, positive feedback, and crisis pioneering. All the obtained categories had their own subcategories, which were determined based on their distinctly integrated properties. The results of this study show that positive coping consists of several concepts used by medical emergency personnel, management of stressful situations, and ultimately quality of pre-hospital clinical services. Given the fact that efficient methods such as positive coping can prevent debilitating stress in an individual, pre-hospital emergency authorities should seek to build and strengthen "positive coping" characteristics in pre-hospital medical emergency personnel to deal with accidents, emergencies, and injuries through adopting regular and dynamic policies.

  13. The AFFORD clinical decision aid to identify emergency department patients with atrial fibrillation at low risk for 30-day adverse events.

    Science.gov (United States)

    Barrett, Tyler W; Storrow, Alan B; Jenkins, Cathy A; Abraham, Robert L; Liu, Dandan; Miller, Karen F; Moser, Kelly M; Russ, Stephan; Roden, Dan M; Harrell, Frank E; Darbar, Dawood

    2015-03-15

    There is wide variation in the management of patients with atrial fibrillation (AF) in the emergency department (ED). We aimed to derive and internally validate the first prospective, ED-based clinical decision aid to identify patients with AF at low risk for 30-day adverse events. We performed a prospective cohort study at a university-affiliated tertiary-care ED. Patients were enrolled from June 9, 2010, to February 28, 2013, and followed for 30 days. We enrolled a convenience sample of patients in ED presenting with symptomatic AF. Candidate predictors were based on ED data available in the first 2 hours. The decision aid was derived using model approximation (preconditioning) followed by strong bootstrap internal validation. We used an ordinal outcome hierarchy defined as the incidence of the most severe adverse event within 30 days of the ED evaluation. Of 497 patients enrolled, stroke and AF-related death occurred in 13 (3%) and 4 (aid included the following: age, triage vitals (systolic blood pressure, temperature, respiratory rate, oxygen saturation, supplemental oxygen requirement), medical history (heart failure, home sotalol use, previous percutaneous coronary intervention, electrical cardioversion, cardiac ablation, frequency of AF symptoms), and ED data (2 hours heart rate, chest radiograph results, hemoglobin, creatinine, and brain natriuretic peptide). The decision aid's c-statistic in predicting any 30-day adverse event was 0.7 (95% confidence interval 0.65, 0.76). In conclusion, in patients with AF in the ED, Atrial Fibrillation and Flutter Outcome Risk Determination provides the first evidence-based decision aid for identifying patients who are at low risk for 30-day adverse events and candidates for safe discharge. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Evaluation of the angular response of LaBr{sub 3}(Ce) and NaI(Tl) radiological identifiers for emergency situations attendance

    Energy Technology Data Exchange (ETDEWEB)

    Izidório, Ana C.A.C.; Cardoso, Domingos D’O.; Oliveira, Luciano S.R.; Balthar, Mario C.V.; Amorim, Aneuri S. de; Santos, Avelino dos; Guimarães Junior, Walter J.; Arbach, Mayara N., E-mail: carolizidorio@hotmail.com, E-mail: domingos.oliveiralvr71@gmail.com, E-mail: walter_guimaraes@ime.eb.br, E-mail: lucianosantarita@gmail.com, E-mail: mariobalthar@gmail.com, E-mail: aneurideamorim@gmail.com, E-mail: hiperav@gmail.com, E-mail: mayaraarbach@gmail.com [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil); Instituto de Defesa Química, Biológica, Radiológica e Nuclear (IDQBRN/CTEx), Barra de Guaratiba, RJ (Brazil); Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2017-11-01

    The Institute of Chemical, Biological, Radiological and Nuclear Defense (IDQBRN) of the Brazilian Army has been developing activities aimed at characterizing radiological detectors for use during emergency situations and radiological incidents and also for research and academic activities. This work describes the experiments performed in order to evaluate the angular response of LaBr{sub 3}(Ce) and NaI(Tl) portable radiological identifiers (PRI) with scintillator crystal detectors measuring 1.5” x 1.5” and 3.0” x 1.5”, respectively. A {sup 137}Cs source with corrected activity of 2.623 GBq (July 29, 2017) supplied the beam for the experiments. It was positioned at a distance of 1.00 m from the PRIs, together with attenuators, in order to yield different ambient dose equivalent rate, H⁎(10), thus allowing the adjustment of the counting statistics and the analysis of the responses obtained. The objective of this work was to evaluate the angular dependence of the response of LaBr{sub 3}(Ce) and NaI(Tl) PRIs exposed to a {sup 137}Cs source by azimuthally varying the angle of incidence of the primary beam within the 0° ± 30° range, measured from the center of the sensitive volume of the scintillators. The PRIs were programmed to reach a maximum count of 10{sup 6} in order to ensure that the relative uncertainty of the measured data would be negligible which led to improved angular response data, in addition to higher correlation factors and greater reliability in the responses obtained with LaBr{sub 3}(Ce) and NaI(T1) portable radiological identifiers. (author)

  15. Global Emergency Medicine: A review of the literature from 2017.

    Science.gov (United States)

    Becker, Torben K; Trehan, Indi; Hayward, Alison Schroth; Hexom, Braden J; Kivlehan, Sean M; Lunney, Kevin M; Modi, Payal; Osei-Ampofo, Maxwell; Pousson, Amelia; Cho, Daniel K; Levine, Adam C

    2018-05-23

    The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Another two reviewers searched the gray literature, yielding an additional 11 articles. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 848 articles met our inclusion criteria and underwent full review. 63% were categorized as emergency care in resource-limited settings, 23% as disaster and humanitarian response, and 14% as emergency medicine development. 21 articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed a Cohen's Kappa of 0.344. In 2017, the total number of articles identified by our search continued to increase. Studies and reviews with a focus on infectious diseases, pediatrics, and trauma represented the majority of top-scoring articles. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. Bradford Hill’s criteria, emerging zoonoses, and One Health

    OpenAIRE

    G.V. Asokan; Vanitha Asokan

    2016-01-01

    Zoonoses constitute more than 60% of infectious diseases and 75% of emerging infectious diseases. Inappropriate overemphasis of specialization of disciplines has ignored public health. Identifying the causes of disease and determining how exposures are related to outcomes in “emerging zoonoses” affecting multiple species are considered to be the hallmarks of public health research and practice that compels the adoption of “One Health”. The interactions within and among populations of vertebra...

  17. Candidate nematicidal proteins in a new Pseudomonas veronii isolate identified by its antagonistic properties against Xiphinema index.

    Science.gov (United States)

    Canchignia, Hayron; Altimira, Fabiola; Montes, Christian; Sánchez, Evelyn; Tapia, Eduardo; Miccono, María; Espinoza, Daniel; Aguirre, Carlos; Seeger, Michael; Prieto, Humberto

    2017-03-17

    The nematode Xiphinema index affects grape vines and transmits important viruses associated with fanleaf degeneration. Pseudomonas spp. are an extensive bacterial group in which important biodegradation and/or biocontrol properties can occur for several strains in the group. The aim of this study was to identify new Pseudomonas isolates with antagonist activity against X. index. Forty bacterial isolates were obtained from soil and root samples from Chilean vineyards. Thirteen new fluorescent pseudomonads were found and assessed for their antagonistic capability. The nematicide Pseudomonas protegens CHA0 was used as a control. Challenges of nematode individuals in King's B semi-solid agar Petri dishes facilitated the identification of the Pseudomonas veronii isolate R4, as determined by a 16S rRNA sequence comparison. This isolate was as effective as CHA0 as an antagonist of X. index, although it had a different lethality kinetic. Milk-induced R4 cultures exhibited protease and lipase activities in cell supernatants using both gelatin/tributyrin Petri dish assays and zymograms. Three proteins with these activities were isolated and subjected to mass spectrometry. Amino acid partial sequences enabled the identification of a 49-kDa protease similar to metalloprotease AprA and two lipases of 50 kDa and 69 kDa similar to LipA and ExoU, respectively. Electron microscopy analyses of challenged nematodes revealed degraded cuticle after R4 supernatant treatment. These results represent a new and unexplored property in this species associated with the presence of secretable lipases and protease, similar to characterized enzymes present in biocontrol pseudomonads.

  18. Interprofessional communication supporting clinical handover in emergency departments: An observation study.

    Science.gov (United States)

    Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey

    2017-08-01

    Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  19. Emergency department interpretation of CT of the brain: a systematic review.

    Science.gov (United States)

    Evans, Lachlan R; Fitzgerald, Mark C; Mitra, Biswadev; Varma, Dinesh

    2017-08-01

    CT of the brain (CTB) is one of the most common radiological investigations performed in the emergency department (ED). Emergency clinicians rely upon this imaging modality to aid diagnosis and guide management. However, their capacity to accurately interpret CTB is unclear. This systematic review aims to determine this capacity and identify the potential need for interventions directed towards improving the ability of emergency clinicians in this important area. A systematic review of the literature was conducted without date restrictions. We searched MEDLINE, EMBASE and Cochrane databases and studies reporting the primary outcome of concordance of CTB interpretation between a non-radiologist and a radiology specialist were identified. Studies were assessed for heterogeneity and a subgroup analysis of pooled data based on medical specialty was carried out to specifically identify the concordance of ED clinicians. The quality of evidence was assessed using the GRADE criteria. There were 21 studies included in this review. Among the included studies, 12 reported on the concordance of emergency clinicians, 5 reported on radiology trainees and 4 on surgeons. Clinical and statistical heterogeneity between studies was high (I 2 =97.8%, perror rate ranging from 0.02 to 0.24. Heterogeneity and the presence of bias limit our confidence in these findings. However, the variance in the interpretation of CTB between emergency clinicians and radiologists suggests that interventions towards improving accuracy may be useful. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Role of contextual factors in the rehabilitation of adolescent survivors of traumatic brain injury: emerging concepts identified through modified narrative review.

    Science.gov (United States)

    Ciccia, Angela Hein; Threats, Travis

    2015-07-01

    Recently research in traumatic brain injury (TBI) intervention has identified the benefits of contextualized, embedded, functionally based approaches to maximize treatment outcomes. An essential component of contextualized intervention is the direct and purposeful consideration of the broader context, in which the person with TBI functions. However, systematic consideration of contextual factors remains limited both in research and clinical practice. The purposes of this modified narrative review were (1) to provide a succinct review of the available literature regarding the contextual factors that are specific to adolescent survivors of TBI, one of highest incidence groups for brain injury; (2) to connect these contextual factors to the direct long-term management of TBI and to identify their potential impact on outcome; and (3) to highlight areas that are open to research and clinical advances that could enhance positive outcomes for adolescent survivors of TBI. The framework of the World Health Organization's (WHO) International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY; 2007) was used as a foundation for this review. A systematic literature search was conducted using databases and hand searches. A total of 102 articles were originally identified. Twenty-five original research articles, eight review papers and four expert opinion papers met inclusion and exclusion criteria and were included in the final review. The body of research specifically focused on contextual factors is an emerging area. Early findings indicate that a focus on the direct modification of contextual factors is promising for the facilitation of positive outcomes long into the chronic phase of management for adolescences who have survived a TBI. The contextual factors included in this review were the overall ability of the school to support a student post-TBI, family psychosocial risk (sibling/sibling relationships/stress/burden/support), coping

  1. Identifying victims of violence using register-based data

    DEFF Research Database (Denmark)

    Kruse, Marie; Sørensen, Jan; Brønnum-Hansen, Henrik

    2010-01-01

    AIMS: The aim of this study was twofold. Firstly we identified victims of violence in national registers and discussed strengths and weaknesses of this approach. Secondly we assessed the magnitude of violence and the characteristics of the victims using register-based data. METHODS: We used three...... nationwide registers to identify victims of violence: The National Patient Register, the Victim Statistics, and the Causes of Death Register. We merged these data and assessed the degree of overlap between data sources. We identified a reference population by selecting all individuals in Denmark over 15....... RESULTS: In 2006, 22,000 individuals were registered as having been exposed to violence. About 70% of these victims were men. Most victims were identified from emergency room contacts and police records, and few from the Causes of Death Register. There was some overlap between the two large data sources...

  2. Analysis of University Management of Emerging Technologies and Recommendations for Developing Countries

    Science.gov (United States)

    Villa Enciso, Eliana María; Picón Jácome, Edgar; Valencia-Arias, Alejandro; Jiménez Hernández, Claudia Nelcy

    2017-01-01

    University management seeks to achieve the objectives established by higher education's institutions, including their third mission, which corresponds to the transfer of research results into the industry; in this regard, emerging technologies play an important role to solve problems identified in the industry. Emerging technologies are those…

  3. Multiple performance measures are needed to evaluate triage systems in the emergency department.

    Science.gov (United States)

    Zachariasse, Joany M; Nieboer, Daan; Oostenbrink, Rianne; Moll, Henriëtte A; Steyerberg, Ewout W

    2018-02-01

    Emergency department triage systems can be considered prediction rules with an ordinal outcome, where different directions of misclassification have different clinical consequences. We evaluated strategies to compare the performance of triage systems and aimed to propose a set of performance measures that should be used in future studies. We identified performance measures based on literature review and expert knowledge. Their properties are illustrated in a case study evaluating two triage modifications in a cohort of 14,485 pediatric emergency department visits. Strengths and weaknesses of the performance measures were systematically appraised. Commonly reported performance measures are measures of statistical association (34/60 studies) and diagnostic accuracy (17/60 studies). The case study illustrates that none of the performance measures fulfills all criteria for triage evaluation. Decision curves are the performance measures with the most attractive features but require dichotomization. In addition, paired diagnostic accuracy measures can be recommended for dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 for ordinal analyses. Other performance measures provide limited additional information. When comparing modifications of triage systems, decision curves and diagnostic accuracy measures should be used in a dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 in an ordinal approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Reactor emergency preparedness: lifesaving or as low as reasonable achievable

    International Nuclear Information System (INIS)

    Hull, A.P.

    1981-01-01

    An emergency is defined as an unforseen combination of circumstances or the resultant state that calls for immediate action. Although not explicitly indicated, the implication is that the action is intended to protect life, limb and or property from extreme peril. For the most part, the kind and extent of the emergency planning required under current regulations of the USNRC do not appear to be so much related to emergencies (within the above definition) as they do toward the reduction of the off-site radiation doses from uncontrolled releases during reactor accident conditions to as low as reasonably achievable levels. Not only do the latter appear to be of questionable cost-effectiveness, but in their extent and complexity beyond normal disaster planning they may in fact be counter productive to optimum public safety

  5. Reactor emergency preparedness: lifesaving or as low as reasonable achievable

    Energy Technology Data Exchange (ETDEWEB)

    Hull, A.P.

    1981-01-01

    An emergency is defined as an unforseen combination of circumstances or the resultant state that calls for immediate action. Although not explicitly indicated, the implication is that the action is intended to protect life, limb and or property from extreme peril. For the most part, the kind and extent of the emergency planning required under current regulations of the USNRC do not appear to be so much related to emergencies (within the above definition) as they do toward the reduction of the off-site radiation doses from uncontrolled releases during reactor accident conditions to as low as reasonably achievable levels. Not only do the latter appear to be of questionable cost-effectiveness, but in their extent and complexity beyond normal disaster planning they may in fact be counter productive to optimum public safety.

  6. Radiological emergency response - a functional approach

    International Nuclear Information System (INIS)

    Chowdhury, Prosanta

    1997-01-01

    The radiological emergency response program in the State of Louisiana is discussed. The improved approach intends to maximize the efficiency for both nuclear power plant and radiological emergency response as a whole. Several broad-based components are identified: cluster of 'nodes' are generated for each component; these 'nodes' may be divided into 'sub-nodes' which will contain some 'attributes'; 'relational bonds' among the 'attributes' will exist. When executed, the process begins and continues with the 'nodes' assuming a functional and dynamic role based on the nature and characteristics of the 'attributes'. The typical response based on stand-alone elements is eliminated; overlapping of functions is avoided, and is produced a well-structure and efficient organization

  7. Highlights in emergency medicine medical education research: 2008.

    Science.gov (United States)

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

    2009-12-01

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

  8. Microbiological Zoonotic Emerging Risks, Transmitted Between Livestock Animals and Humans (2007-2015).

    Science.gov (United States)

    Filippitzi, M E; Goumperis, T; Robinson, T; Saegerman, C

    2017-08-01

    As part of the Emerging Risk Identification (ERI) activities of the European Food Safety Authority (EFSA), a literature search was conducted to identify the microbiological agents transmitted between livestock animals and humans that have been suggested as having emerged between 2007 and 2015 in peer-reviewed scientific literature published during the same period (2007-2015). According to the criteria set, the search identified seven such zoonotic agents, namely West Nile Fever virus, Rift Valley Fever virus, Crimean-Congo Haemorrhagic Fever virus, Influenza A H1N1 virus, Coxiella burnetii, Streptococcus suis and livestock-associated methicillin-resistant Staphylococcus aureus clonal complex 398. An explanation of the agents' consideration as emerging risks is provided. The experience gained from these emergences has shown that the detection of and response to such risks can be achieved faster and more successfully within a multidisciplinary, collaborative context at the field, local, national and international levels. © 2016 Blackwell Verlag GmbH.

  9. [The correlation between personality characteristics and burnout syndrome in emergency ambulance workers].

    Science.gov (United States)

    Bergmueller, A; Zavgorodnii, I; Zavgorodnia, N; Kapustnik, W; Boeckelmann, I

    The work in Emergency Medical Ambulance Service is one of the professions, which is accompanied by high psychological and emotional stress. The aim was to determine the risk of professional burnout syndrome of Emergency Medical Ambulance Service staff and the relationship between burnout syndrome and personality. Ninety-seven doctors (57 women and 40 men, aged 37.0±12.21) of Emergency Medical Ambulance Service were interviewed using the MBI-GS questionnaire and the Freiburg personality questionnaire (FPI). Correlation and regression analysis were used. Nine (11.5%) of respondents had a risk of burnout syndrome and 28 (35.9%) had some symptoms. In the group, aged 45 years and older, the risk of burnout syndrome was not identified. The staff of Emergency Medical Ambulance Service is characterized by stable personality features. It is necessary to identify the prevalence of burnout syndrome and also to identity the causes for its prevention and development of measures on the increase of personal stress resilience.

  10. Analysis of emergency response to fukushima nuclear accident in Japan and suggestions for China's nuclear emergency management

    International Nuclear Information System (INIS)

    Li Wei; Ding Qihua; Wu Haosong

    2014-01-01

    On March 11, 2011, the Fukushima Dai-ichi Nuclear Power Station of the Tokyo Electric Power Company ('TEPCO') was hit and damaged by a magnitude 9 earthquake and accompanying tsunami. The accident is determined to be of the highest rating on the International Nuclear Event Scale. The Government of Japan and TEPCO have taken emergency response actions on-site and off-site at the accident. It became clear through the investigation that the accident had been initiated on the occasion of a natural disaster of an earthquake and tsunami, but there have been various complex problems behind this very serious and large scale accident. For an example, the then-available accident preventive measures and disaster preparedness of TEPCO were insufficient against tsunami and severe accidents; inadequate TEPCO emergency responses to the accident at the site were also identified. The accident rang the alarm for the nuclear safety of nuclear power plants. It also taught us a great of lessons in nuclear emergency management. (authors)

  11. Systematic Molecular Phenotyping: A Path Towards Precision Emergency Medicine?

    Science.gov (United States)

    Limkakeng, Alexander T.; Monte, Andrew; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L.; Shapiro, Nathan I.

    2016-01-01

    Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department. While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the emergency department will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end users. PMID:27288269

  12. Identifying links between origami and compliant mechanisms

    Directory of Open Access Journals (Sweden)

    H. C. Greenberg

    2011-12-01

    Full Text Available Origami is the art of folding paper. In the context of engineering, orimimetics is the application of folding to solve problems. Kinetic origami behavior can be modeled with the pseudo-rigid-body model since the origami are compliant mechanisms. These compliant mechanisms, when having a flat initial state and motion emerging out of the fabrication plane, are classified as lamina emergent mechanisms (LEMs. To demonstrate the feasibility of identifying links between origami and compliant mechanism analysis and design methods, four flat folding paper mechanisms are presented with their corresponding kinematic and graph models. Principles from graph theory are used to abstract the mechanisms to show them as coupled, or inter-connected, mechanisms. It is anticipated that this work lays a foundation for exploring methods for LEM synthesis based on the analogy between flat-folding origami models and linkage assembly.

  13. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... IUD placed inside the uterus CHOICES FOR EMERGENCY CONTRACEPTION Two emergency contraceptive pills may be bought without a prescription. ...

  14. Factors influencing disaster nursing core competencies of emergency nurses.

    Science.gov (United States)

    Park, Hye-Young; Kim, Ji-Soo

    2017-10-01

    Emergency nurses are expected to provide required nursing services by using their professional expertise to reduce the risk posed by disasters. Thus, emergency nurses' disaster nursing core competencies are essential for coping with disasters. The purpose of the study reported here was to identify factors influencing the disaster nursing core competencies of emergency nurses. A survey was conducted among 231 emergency nurses working in 12 hospitals in South Korea. Data were collected on disaster-related experience, attitude, knowledge, and disaster nursing core competencies by means of a questionnaire. In multiple regression analysis, disaster-related experience exerted the strongest influence on disaster nursing core competencies, followed by disaster-related knowledge. The explanatory power of these factors was 25.6%, which was statistically significant (F=12.189, pcompetencies of emergency nurses could be improved through education and training programs that enhance their disaster preparedness. The nursing profession needs to participate actively in the development of disaster nursing education and training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Unmarried Mother's Knowledge and Attitudes toward Emergency Contraceptive Pills

    Directory of Open Access Journals (Sweden)

    Gyeong Mi Lee

    2013-06-01

    Full Text Available PurposeThis study was conducted to identify relationships among knowledge and attitudes of unmarried mothers toward emergency contraceptive pills.MethodsData were collected through structured questionnaires from 135 unmarried mothers enrolled in 7 single mothers' facilities nationwide. Data were analyzed using the SPSS/WIN 17.0 program for descriptive statistics, t-test, ANOVA, Scheffe-test, and Pearson correlation coefficients.ResultsFor knowledge about emergency contraceptive pills, there were significant differences among who live with her before pregnancy, experience of past pregnancies, state of present pregnancy and preparation in using contraceptives. For attitude toward emergency contraceptive pills, there were significant differences according to age, education level and religion. There were significant positive relationships between knowledge and attitudes toward emergency contraceptive pills.ConclusionThe results of this study suggest that unmarried women should be better informed about emergency contraceptive pills, and reassured about their safety. Efforts are needed to disseminate up-to-date information to experts in sex education including nurses.

  16. Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

    Science.gov (United States)

    Plint, Amy C; Stang, Antonia S; Calder, Lisa A

    2015-01-01

    Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

  17. Information maximization explains the emergence of complex cell-like neurons

    Directory of Open Access Journals (Sweden)

    Takuma eTanaka

    2013-11-01

    Full Text Available We propose models and a method to qualitatively explain the receptive field properties of complex cells in the primary visual cortex. We apply a learning method based on the information maximization principle in a feedforward network, which comprises an input layer of image patches, simple cell-like first-output-layer neurons, and second-output-layer neurons (Model 1. The information maximization results in the emergence of the complex cell-like receptive field properties in the second-output-layer neurons. After learning, second-output-layer neurons receive connection weights having the same size from two first-output-layer neurons with sign-inverted receptive fields. The second-output-layer neurons replicate the phase invariance and iso-orientation suppression. Furthermore, on the basis of these results, we examine a simplified model showing the emergence of complex cell-like receptive fields (Model 2. We show that after learning, the output neurons of this model exhibit iso-orientation suppression, cross-orientation facilitation, and end stopping, which are similar to those found in complex cells. These properties of model neurons suggest that complex cells in the primary visual cortex become selective to features composed of edges to increase the variability of the output.

  18. Effectiveness of preoperative intranasal dexmedetomidine, compared with oral midazolam, for the prevention of emergence delirium in the pediatric patient undergoing general anesthesia: a systematic review.

    Science.gov (United States)

    FitzSimons, James; Bonanno, Laura S; Pierce, Stephanie; Badeaux, Jennifer

    2017-07-01

    Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury. A newer drug, dexmedetomidine, is a selective alpha-2 agonist, which works in the brain and spinal cord that has sedative, analgesic and anxiolytic properties. Dexmedetomidine also has the ability to lower the overall anesthetic requirements by reducing sympathetic outflow in response to painful surgical stimulation. In current literature, there is not a systematic review that compares the effectiveness of preoperative intranasal dexmedetomidine administration against oral midazolam for the prevention of emergence delirium. The objective of this review was to identify the effectiveness of preoperative intranasal dexmedetomidine compared to oral midazolam for the prevention of emergence delirium in the pediatric patient undergoing general anesthesia. This review considered studies that included pediatric patients aged three to seven years, with an American Society of Anesthesiologists (ASA) classification of I or II, and undergoing general anesthesia for elective/ambulatory surgery. This review excluded studies that included patients who had special needs including: developmental delay, chronic pain issues, and/or any preexisting mental or physical health disorders which categorized them above an ASA II. This review considered studies that compared preoperative intranasal administration of dexmedetomidine with preoperative oral administration of midazolam for the prevention of emergence delirium. This review considered both experimental and non-experimental study

  19. Code Blue Emergencies: A Team Task Analysis and Educational Initiative.

    Science.gov (United States)

    Price, James W; Applegarth, Oliver; Vu, Mark; Price, John R

    2012-01-01

    The objective of this study was to identify factors that have a positive or negative influence on resuscitation team performance during emergencies in the operating room (OR) and post-operative recovery unit (PAR) at a major Canadian teaching hospital. This information was then used to implement a team training program for code blue emergencies. In 2009/10, all OR and PAR nurses and 19 anesthesiologists at Vancouver General Hospital (VGH) were invited to complete an anonymous, 10 minute written questionnaire regarding their code blue experience. Survey questions were devised by 10 recovery room and operation room nurses as well as 5 anesthesiologists representing 4 different hospitals in British Columbia. Three iterations of the survey were reviewed by a pilot group of nurses and anesthesiologists and their feedback was integrated into the final version of the survey. Both nursing staff (n = 49) and anesthesiologists (n = 19) supported code blue training and believed that team training would improve patient outcome. Nurses noted that it was often difficult to identify the leader of the resuscitation team. Both nursing staff and anesthesiologists strongly agreed that too many people attending the code blue with no assigned role hindered team performance. Identifiable leadership and clear communication of roles were identified as keys to resuscitation team functioning. Decreasing the number of people attending code blue emergencies with no specific role, increased access to mock code blue training, and debriefing after crises were all identified as areas requiring improvement. Initial team training exercises have been well received by staff.

  20. Code Blue Emergencies: A Team Task Analysis and Educational Initiative

    Directory of Open Access Journals (Sweden)

    James W. Price

    2012-04-01

    Full Text Available Introduction: The objective of this study was to identify factors that have a positive or negative influence on resuscitation team performance during emergencies in the operating room (OR and post-operative recovery unit (PAR at a major Canadian teaching hospital. This information was then used to implement a team training program for code blue emergencies. Methods: In 2009/10, all OR and PAR nurses and 19 anesthesiologists at Vancouver General Hospital (VGH were invited to complete an anonymous, 10 minute written questionnaire regarding their code blue experience. Survey questions were devised by 10 recovery room and operation room nurses as well as 5 anesthesiologists representing 4 different hospitals in British Columbia. Three iterations of the survey were reviewed by a pilot group of nurses and anesthesiologists and their feedback was integrated into the final version of the survey. Results: Both nursing staff (n = 49 and anesthesiologists (n = 19 supported code blue training and believed that team training would improve patient outcome. Nurses noted that it was often difficult to identify the leader of the resuscitation team. Both nursing staff and anesthesiologists strongly agreed that too many people attending the code blue with no assigned role hindered team performance. Conclusion: Identifiable leadership and clear communication of roles were identified as keys to resuscitation team functioning. Decreasing the number of people attending code blue emergencies with no specific role, increased access to mock code blue training, and debriefing after crises were all identified as areas requiring improvement. Initial team training exercises have been well received by staff.

  1. Childhood Emergencies

    Science.gov (United States)

    ... SUBSCRIBE Emergency 101 Share this! Home » Emergency 101 Childhood Emergencies Keeping children healthy and safe is every ... and tools to prevent, recognize and address a childhood emergency is the first step in keeping your ...

  2. Seed vigour tests for predicting field emergence of maize under severe conditions

    OpenAIRE

    García de Yzaguirre, Álvaro; Lasa Dolhagaray, José Manuel

    1989-01-01

    [EN] With 40 to 50 different seed vigour tests available, appropiate procedures for choosing the best single test or combination the best predictors of seedling emergence of maize (Zea Mays L.) under severe conditions. Thirteen vigour tests and various field emergence trials were performed on six inbred lines and two commercial hybrids. The best single predictors of field emergence were identified by calculating simple correlation coefficients. The calculation of the geometric mean of the res...

  3. Public health implications of complex emergencies and natural disasters.

    Science.gov (United States)

    Culver, Amanda; Rochat, Roger; Cookson, Susan T

    2017-01-01

    During the last decade, conflict or natural disasters have displaced unprecedented numbers of persons. This leads to conditions prone to outbreaks that imperil the health of displaced persons and threaten global health security. Past literature has minimally examined the association of communicable disease outbreaks with complex emergencies (CEs) and natural disasters (NDs). To examine this association, we identified CEs and NDs using publicly available datasets from the Center for Research on the Epidemiology of Disasters and United Nations Flash and Consolidated Appeals archive for 2005-2014. We identified outbreaks from World Health Organization archives. We compared findings to identify overlap of outbreaks, including their types (whether or not of a vaccine-preventable disease), and emergency event types (CE, ND, or Both) by country and year using descriptive statistics and measure of association. There were 167 CEs, 912 NDs, 118 events linked to 'Both' types of emergencies, and 384 outbreaks. Of CEs, 43% were associated with an outbreak; 24% NDs were associated with an outbreak; and 36% of 'Both' types of emergencies were associated with an outbreak. Africa was disproportionately affected, where 67% of total CEs, 67% of 'Both' events (CE and ND), and 46% of all outbreaks occurred for the study period. The odds ratio of a vaccine-preventable outbreak occurring in a CE versus an ND was 4.14 (95% confidence limits 1.9, 9.4). CEs had greater odds of being associated with outbreaks compared with NDs. Moreover, CEs had high odds of a vaccine-preventable disease causing that outbreak. Focusing on better vaccine coverage could reduce CE-associated morbidity and mortality by preventing outbreaks from spreading.

  4. Eye Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

  5. Mechanisms of action of hormonal emergency contraceptives.

    Science.gov (United States)

    Leung, Vivian W Y; Levine, Marc; Soon, Judith A

    2010-02-01

    Hormonal emergency contraceptives have been used to prevent unwanted pregnancy for more than 3 decades. The mechanisms of action of the regimen containing a combination of estrogen and progestin, known as the Yuzpe regimen, and those of the levonorgestrel regimen continue to be controversial, especially over the possibility that these regimens might act by interfering with implantation of the fertilized ovum. We performed a search of the PubMed (1949-July 2009) and EMBASE (1980-July 2009) databases to identify literature on the mechanisms of action of these contraceptive regimens, and data were extracted from pertinent English-language studies. We classified studies according to the approach taken by the investigators to study the actions of emergency contraceptives on pregnancy: an indirect method that uses statistical models to determine whether emergency contraceptives would be as effective as reported if they act only by disrupting ovulation; direct observation of the effects of emergency contraceptives on surrogate outcomes, including ovulation, sperm activity, hormonal levels, and endometrial receptivity to implantation; and analysis of directly observed pregnancy outcomes against statistical data. Acceptability of emergency contraceptives by women and clinicians may depend on personal opinions about when life or pregnancy begins. The evidence strongly supports disruption of ovulation as a mechanism of action. The data suggest that emergency contraceptives are unlikely to act by interfering with implantation, although the possibility has not been completely excluded. The data also suggest that emergency contraceptives are ineffective after ovulation. Women and clinicians who consider implantation or later events to be the beginning of pregnancy should be aware that emergency contraceptives are likely nonabortive by this definition of pregnancy.

  6. Screening for violence risk factors identifies young adults at risk for return emergency department visit for injury.

    Science.gov (United States)

    Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra

    2014-08-01

    Homicide is the second leading cause of death among youth aged 15-24. Prior cross-sectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED) visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18-24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3-5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a) aggression, b) perceived likelihood of violence, c) recent violent behavior, d) peer behavior, e) community exposure to violence, and f) positive future outlook. At 12 months following the initial ED visit, the participants' medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chi-square and logistic regression analyses. Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants' average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first visit, return visits for injuries were significantly

  7. Patients in prehospital transport to the emergency department

    DEFF Research Database (Denmark)

    Bech, Camilla Louise Nørgaard; Brabrand, Mikkel; Mikkelsen, Søren

    2018-01-01

    BACKGROUND: Ambulance transfer is the first contact with the healthcare system for many patients in emergency conditions.We aimed to identify prognostic risk factors accessible in the prehospital phase that indicate an increased risk of 7-day mortality. PATIENTS AND METHODS: We included patients ...... aged 18 years or older, transferred by ambulance to the emergency department at Odense University Hospital, from 1 April 2012 to 30 September 2014. We carried out multivariate logistic regressions, adjusted for age and sex, to describe the relationship between vital sign values recorded...

  8. Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

    OpenAIRE

    Gulzar H. Shah; Bobbie Newell; Ruth E. Whitworth

    2016-01-01

    Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved em...

  9. Lessons Learned from the Response to Radiation Emergencies (1945-2010) (French Edition)

    International Nuclear Information System (INIS)

    2014-01-01

    An underlying concept in the safety standards of the International Atomic Energy Agency (IAEA) is that prevention is better than cure. This is achieved through the application of appropriate standards in design and operation. Nevertheless, radiation incidents and emergencies do occur and safety standards are necessary that define the approaches to be used in mitigating the consequences. The IAEA Safety Requirements publication, Preparedness and Response for a Nuclear or Radiological Emergency, GS-R-2, establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. They take account of several other Safety Standards at the Safety Requirements level, namely: the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS); Governmental, Legal and Regulatory Framework for Safety, GSR Part 1; Safety of Nuclear Power Plants: Design, NS-R-1; and Safety of Nuclear Power Plants: Operation, NS-R-2. Implementation of the requirements is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. Although developed before the publication of the Fundamental Safety Principles, they define the requirements that must be satisfied in order to achieve the overall objective and apply the principles that are presented in publications relating to emergencies. An emergency is defined in the Agency's glossary as 'a non-routine situation or event that necessitates prompt action, primarily to mitigate a hazard or adverse consequences for human health and safety, quality of life, property or the environment. This includes nuclear and radiological emergencies and conventional emergencies such as fires, release of hazardous chemicals, storms or earthquakes. It includes situations for which prompt action is warranted to mitigate the effects of a perceived hazard'. Several nuclear emergencies have

  10. Lessons Learned from the Response to Radiation Emergencies (1945-2010) (Spanish Edition)

    International Nuclear Information System (INIS)

    2014-01-01

    An underlying concept in the safety standards of the International Atomic Energy Agency (IAEA) is that prevention is better than cure. This is achieved through the … application of appropriate standards in design and operation. Nevertheless, radiation incidents and emergencies do occur and safety standards are necessary that define the approaches to be used in mitigating the consequences. The IAEA Safety Requirements publication, Preparedness and Response for a Nuclear or Radiological Emergency, GS-R-2, establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. They take account of several other Safety Standards at the Safety Requirements level, namely: the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS); Governmental, Legal and Regulatory Framework for Safety, GSR Part 1; Safety of Nuclear Power Plants: Design, NS-R-1; and Safety of Nuclear Power Plants: Operation, NS-R-2. Implementation of the requirements is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. Although developed before the publication of the Fundamental Safety Principles, they define the requirements that must be satisfied in order to achieve the overall objective and apply the principles that are presented in publications relating to emergencies. An emergency is defined in the Agency's glossary as 'a non-routine situation or event that necessitates prompt action, primarily to mitigate a hazard or adverse consequences for human health and safety, quality of life, property or the environment. This includes nuclear and radiological emergencies and conventional emergencies such as fires, release of hazardous chemicals, storms or earthquakes. It includes situations for which prompt action is warranted to mitigate the effects of a perceived hazard'. Several nuclear emergencies have

  11. Lessons Learned from the Response to Radiation Emergencies (1945-2010) (Arabic Edition)

    International Nuclear Information System (INIS)

    2014-01-01

    An underlying concept in the safety standards of the International Atomic Energy Agency (IAEA) is that prevention is better than cure. This is achieved through the application of appropriate standards in design and operation. Nevertheless, radiation incidents and emergencies do occur and safety standards are necessary that define the approaches to be used in mitigating the consequences. The IAEA Safety Requirements publication, Preparedness and Response for a Nuclear or Radiological Emergency, GS-R-2, establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. They take account of several other Safety Standards at the Safety Requirements level, namely: the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS); Governmental, Legal and Regulatory Framework for Safety, GSR Part 1; Safety of Nuclear Power Plants: Design, NS-R-1; and Safety of Nuclear Power Plants: Operation, NS-R-2. Implementation of the requirements is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. Although developed before the publication of the Fundamental Safety Principles, they define the requirements that must be satisfied in order to achieve the overall objective and apply the principles that are presented in publications relating to emergencies. An emergency is defined in the Agency's glossary as 'a non-routine situation or event that necessitates prompt action, primarily to mitigate a hazard or adverse consequences for human health and safety, quality of life, property or the environment. This includes nuclear and radiological emergencies and conventional emergencies such as fires, release of hazardous chemicals, storms or earthquakes. It includes situations for which prompt action is warranted to mitigate the effects of a perceived hazard'. Several nuclear emergencies have

  12. Lessons Learned from the Response to Radiation Emergencies (1945-2010) (Russian Edition)

    International Nuclear Information System (INIS)

    2013-01-01

    An underlying concept in the safety standards of the International Atomic Energy Agency (IAEA) is that prevention is better than cure. This is achieved through the application of appropriate standards in design and operation. Nevertheless, radiation incidents and emergencies do occur and safety standards are necessary that define the approaches to be used in mitigating the consequences. The IAEA Safety Requirements publication, Preparedness and Response for a Nuclear or Radiological Emergency, GS-R-2, establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. They take account of several other Safety Standards at the Safety Requirements level, namely: the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS); Governmental, Legal and Regulatory Framework for Safety, GSR Part 1; Safety of Nuclear Power Plants: Design, NS-R-1; and Safety of Nuclear Power Plants: Operation, NS-R-2. Implementation of the requirements is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. Although developed before the publication of the Fundamental Safety Principles, they define the requirements that must be satisfied in order to achieve the overall objective and apply the principles that are presented in publications relating to emergencies. An emergency is defined in the Agency's glossary as 'a non-routine situation or event that necessitates prompt action, primarily to mitigate a hazard or adverse consequences for human health and safety, quality of life, property or the environment. This includes nuclear and radiological emergencies and conventional emergencies such as fires, release of hazardous chemicals, storms or earthquakes. It includes situations for which prompt action is warranted to mitigate the effects of a perceived hazard'. Several nuclear emergencies have

  13. A Tour de Force: The Discovery, Properties, and Function of Piezo Channels.

    Science.gov (United States)

    Gottlieb, P A

    2017-01-01

    Mechanical transducers appear throughout cell biology and are used to convert mechanical stress into chemical or electrical signals that allow the cell to respond to environmental changes. In the past six years, a eukaryotic mechanical channel family with two members, Piezo1 and Piezo2, has been identified. Piezo1 was shown to be a cation-selective channel that does not require ancillary proteins for activity. Mouse Piezo1 is large, with over 2500 amino acids, and is not homologous to other ion channels. Both piezo channels have rapid voltage-dependent inactivation with a reversal potential near 0mV. The CryoEm structure of Piezo1 at 4.8Å shows trimer stoichiometry. Since the discovery of the piezo channels, their roles in the physiological response of cells have started to emerge. Significant progress has been made in understanding the intrinsic properties of the channels and how these properties are modulated by cytoskeletal elements. Specific diseases, such as hereditary xerocytosis affecting red blood cells, have mutations in Piezo1 that alter the cell's response to force, typically slowing inactivation and introducing a latency for activation. A number of physiological functions for piezo channels have been identified. These range from sensing the stiffness of surrounding substrate, to the response to light touch, to serotonin release from the gut. This review provides a general overview of the properties and roles of Piezo1 and Piezo2 in eukaryotic mechanotransduction. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Trampoline injury in New Zealand: emergency care.

    Science.gov (United States)

    Hume, P A; Chalmers, D J; Wilson, B D

    1996-01-01

    OBJECTIVE: To examine trampoline related injuries resulting in emergency department attendance. METHODS: Cases were identified by searching free text descriptions of the circumstances of injury contained in the records of the emergency department of a large city hospital. RESULTS: 114 cases were identified for a 12 month period, giving an incidence rate of 108 per 100,000 population per year (95% confidence interval = 89 to 129) compared with 9.3 hospital admissions per 100,000 population per year (95% confidence interval = 8.3 to 10.4) for a corresponding period reported in earlier research from New Zealand. This suggested that for every one hospital admission there are approximately 12 emergency department attendances. Of the cases, 95% were aged less than 20 years. As for the earlier research, falls from the trampoline to the surrounding surface were the commonest cause of injury. In the present study, sprains and strains were the commonest type of injury (40%), and the body site most frequently involved was the lower limb (46%). CONCLUSIONS: The findings support the conclusion from earlier research that although existing trampoline standards address many of the issues relating to trampoline safety, the need remains for measures to reduce the impact of falls from the trampoline to the ground surface and to prohibit the use of trampolines as unsupervised "play equipment". PMID:9015596

  15. VIDEOCARE: Decentralised psychiatric emergency care through videoconferencing

    Directory of Open Access Journals (Sweden)

    Trondsen Marianne V

    2012-12-01

    Full Text Available Abstract Background Today the availability of specialists is limited for psychiatric patients in rural areas, especially during psychiatric emergencies. To overcome this challenge, the University Hospital of North Norway has implemented a new decentralised on-call system in psychiatric emergencies, by which psychiatrists are accessible by videoconference 24/7. In September 2011, the new on-call system was established in clinical practice for patients and health staff at three regional psychiatric centres in Northern Norway. Although a wide variety of therapies have been successfully delivered by videoconference, there is limited research on the use of videoconferenced consultations with patients in psychiatric emergencies. The aim of this study is to explore the use of videoconference in psychiatric emergencies based on the implementation of this first Norwegian tele-psychiatric service in emergency care. Methods/design The research project is an exploratory case study of a new videoconference service in operation. By applying in-depth interviews with patients, specialists and local health-care staff, we will identify factors that facilitate and hinder use of videoconferencing in psychiatric emergencies, and explore how videoconferenced consultations matter for patients, professional practice and cooperation between levels in psychiatric care. By using an on-going project as the site of research, the case is especially well-suited for generating reliable and valid empirical data. Discussion Results from the study will be of importance for understanding of how videoconferencing may support proper treatment and high-quality health care services in rural areas for patients in psychiatric emergencies.

  16. Rapid BAL Variability: Re-Emerging Absorption

    Energy Technology Data Exchange (ETDEWEB)

    Erakuman, Damla [Department of Astronomy and Space Sciences, Faculty of Science, Erciyes University, Kayseri (Turkey); Filiz Ak, Nurten, E-mail: damla.erakuman@gmail.com [Department of Astronomy and Space Sciences, Faculty of Science, Erciyes University, Kayseri (Turkey); Astronomy and Space Sciences Observatory and Research Center, Erciyes University, Kayseri (Turkey)

    2017-11-08

    We study BAL variations of SDSS J141955.28+522741.4 utilizing 32 epochs of spectroscopic observations from SDSS. We identify three individual BAL troughs for C iv and one BAL trough for Si iv. The deepest C iv BAL trough shows significant EW variations in timescales of a few 10 h. The fast component of the deepest C iv BAL presents disappearance and re-emergence preserving its initial velocity range and profile. All identified BAL troughs show coordinated variations supporting that the possible mechanism behind variations are the ionization level changes of the absorbing gas.

  17. Emerging interdependence between stock values during financial crashes

    OpenAIRE

    Rocchi, Jacopo; Tsui, Enoch Yan Lok; Saad, David

    2016-01-01

    To identify emerging interdependencies between traded stocks we investigate the behavior of the stocks of FTSE 100 companies in the period 2000-2015, by looking at daily stock values. Exploiting the power of information theoretical measures to extract direct influences between multiple time series, we compute the information flow across stock values to identify several different regimes. While small information flows is detected in most of the period, a dramatically different situation occurs...

  18. Inadequate emergence after anesthesia: emergence delirium and hypoactive emergence in the Postanesthesia Care Unit.

    Science.gov (United States)

    Xará, Daniela; Silva, Acácio; Mendonça, Júlia; Abelha, Fernando

    2013-09-01

    To evaluate the frequency, determinants, and outcome of inadequate emergence after elective surgery in the Postanesthesia Care Unit (PACU). Prospective observational study. 12-bed PACU of a tertiary-care hospital in a major metropolitan area. 266 adult patients admitted to the PACU. To evaluate inadequate emergence, the Richmond Agitation and Sedation Scale (RASS) was administered to patients 10 minutes after their admission to the PACU. Demographic data, perioperative variables, and postoperative length of stay (LOS) in the PACU and the hospital were recorded. 40 (15%) patients showed symptoms of inadequate emergence: 17 patients (6.4%) screened positive for emergence delirium and 23 patients (8.6%) showed hypoactive emergence. Determinants of emergence delirium were longer duration of preoperative fasting (P = 0.001), higher visual analog scale (VAS) scores for pain (P = 0.002), and major surgical risk (P = 0.001); these patients had a higher frequency of postoperative delirium (P = 0.017) and had higher nausea VAS score 6 hours after surgery (P = 0.001). Determinants of hypoactive emergence were duration of surgery (P = 0.003), amount of crystalloids administered during surgery (P = 0.002), residual neuromuscular block (P < 0.001), high-risk surgery (P = 0.002), and lower core temperature on PACU admission (P = 0.028); these patients also had more frequent residual neuromuscular block (P < 0.001) postoperative delirium (P < 0.001), and more frequent adverse respiratory events (P = 0.02). Patients with hypoactive emergence had longer PACU and hospital LOS. Preventable determinants for emergence delirium were higher postoperative pain scores and longer fasting times. Hypoactive emergence was associated with longer postoperative PACU and hospital LOSs. © 2013 Elsevier Inc. All rights reserved.

  19. The Economic Emergence of China

    OpenAIRE

    Kui, Ng Beoy

    2008-01-01

    The purpose of this paper is to analyze strategic policy implications arising from possible threats and opportunities in the face of the emergence of China as an economic powerhouse. The focus of the paper is not on the regional approach through mainly regional co-operations but more on policy strategies and responses at the national level. Depending on their degree of national economic development, economic structure and comparative advantage, eight strategic positionings have been identifie...

  20. [Emergency contraception in Brazil: facilitators and barriers].

    Science.gov (United States)

    Hardy, E; Duarte, G A; Osis, M J; Arce, X E; Possan, M

    2001-01-01

    A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions) factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability would be greater if it were included in reproductive health programs, emphasizing its prescription for emergency situations. Participants highlighted that strategic components in Brazil would be training of providers and inclusion of the method in family planning services.

  1. Developing an Emergency Physician Productivity Index Using Descriptive Health Analytics.

    Science.gov (United States)

    Khalifa, Mohamed

    2015-01-01

    Emergency department (ED) crowding became a major barrier to receiving timely emergency care. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, we identified variables and factors affecting crowding and performance to develop indicators to help evaluation and improvement. Measuring efficiency of work and activity of throughput processes; it was important to develop an ED physician productivity index. Data on all ED patients' encounters over the last six months of 2014 were retrieved and descriptive health analytics methods were used. Three variables were identified for their influence on productivity and performance; Number of Treated Patients per Physician, Patient Acuity Level and Treatment Time. The study suggested a formula to calculate the productivity index of each physician through dividing the Number of Treated Patients by Patient Acuity Level squared and Treatment Time to identify physicians with low productivity index and investigate causes and factors.

  2. Access Barriers to Prenatal Care in Emerging Adult Latinas.

    Science.gov (United States)

    Torres, Rosamar

    2016-03-01

    Despite efforts to improve access to prenatal care, emerging adult Latinas in the United States continue to enter care late in their pregnancies and/or underutilize these services. Since little is known about emerging adult Latinas and their prenatal care experiences, the purpose of this study was to identify actual and perceived prenatal care barriers in a sample of 54 emerging adult Latinas between 18 and 21 years of age. More than 95% of the sample experienced personal and institutional barriers when attempting to access prenatal care. Results from this study lend support for policy changes for time away from school or work to attend prenatal care and for group prenatal care. © 2016. All rights reserved.

  3. Evaluation criteria for emergency response plans in radiological transportation

    International Nuclear Information System (INIS)

    Lindell, M.K.; Perry, R.W.

    1980-01-01

    This paper identifies a set of general criteria which can be used as guides for evaluating emergency response plans prepared in connection with the transportation of radiological materials. The development of criteria takes the form of examining the meaning and role of emergency plans in general, reviewing the process as it is used in connection with natural disasters and other nonnuclear disasters, and explicitly considering unique aspects of the radiological transportation setting. Eight areas of critical importance for such response plans are isolated: notification procedures; accident assessment; public information; protection of the public at risk; other protective responses; radiological exposure control; responsibility for planning and operations; and emergency response training and exercises. (Auth.)

  4. Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

    Science.gov (United States)

    Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

    2017-04-28

    Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

  5. Maori intellectual property rights and the formation of ethnic boundaries

    NARCIS (Netherlands)

    Meijl, A.H.M. van

    2009-01-01

    This article questions and contextualizes the emergence of a discourse of intellectual property rights in Māori society. It is argued that Māori claims regarding intellectual property function primarily to demarcate ethnic boundaries between Māori and non-Māori. Māori consider the reinforcement of

  6. [Scientific publication output of Spanish emergency physicians from 2005 to 2014: a comparative study].

    Science.gov (United States)

    Fernández-Guerrero, Inés María; Martín-Sánchez, Francisco Javier; Burillo-Putze, Guillermo; Miró, Òscar

    2017-10-01

    To analyze the research output of Spanish emergency physicians between 2005 and 2014 and to compare it to their output in the previous 10-year period (1995-2004) as well as to that of emergency physicians in other countries and Spanish physicians in other specialties. Original articles indexed in the Science Citation Index Expanded of the Web of Science were included. Documents from Spanish emergency physicians were identified by combining the word Spain and any other search term identifying an emergency service or unit in Spain. To identify articles from 7 other Spanish specialties (hematology, endocrinology, cardiology, pneumology, digestive medicine, pediatrics, surgery and orthopedic medicine or traumatology) and emergency physicians in 8 other countries (United States, United Kingdom, Ireland, Italy, France, Germany, Netherlands, Belgium) we used similar strategies. Information about production between 1995 and 2004 was extracted from a prior publication. Spanish emergency physicians signed 1254 articles (mean [SD], 125 [44] articles/y) between 2005 and 2014. That level of productivity was greater than in the 1995-2004 period (mean, 26 [14] articles/y), although the annual growth rate fell from 12.5% in the previous 10-year period to 5.2% in the most recent one. Emergency medicine was among the least productive Spanish specialties we studied, but our discipline's annual growth rate of 5.2% was the highest. Spanish emergency medicine occupies an intermediate position (ranking fifth) among the 9 countries studied, although the population-adjusted rank was higher (fourth). When output was adjusted for gross domestic product, Spain climbed higher in rank, to second position. The annual growth rate was the fourth highest among countries, after Germany (9.9%), the Netherlands (7.3%), and Italy (6.0%). The research output of Spanish emergency physicians continues to be quantitatively lower than that of other Spanish specialties and of emergency physicians in other

  7. Breastfeeding status as a predictor of mortality among refugee children in an emergency situation in Guinea-Bissau

    DEFF Research Database (Denmark)

    Jakobsen, Marianne; Sodemann, Morten; Nylén, Gunnar

    2003-01-01

    To identify the population risk factors in emergency situations, we studied breastfeeding status as a predictor for child mortality during a war in Guinea-Bissau.......To identify the population risk factors in emergency situations, we studied breastfeeding status as a predictor for child mortality during a war in Guinea-Bissau....

  8. Illicit Drug Use in a Community-Based Sample of Heterosexually Identified Emerging Adults

    Science.gov (United States)

    Halkitis, Perry N.; Manasse, Ashley N.; McCready, Karen C.

    2010-01-01

    In this study we assess lifetime and recent drug use patterns among 261 heterosexually identified 18- to 25-year-olds through brief street intercept surveys conducted in New York City. Marijuana, hallucinogens, powder cocaine, and ecstasy were the most frequently reported drugs for both lifetime and recent use. Findings further suggest significant…

  9. Radiological emergency response - a functional approach

    Energy Technology Data Exchange (ETDEWEB)

    Chowdhury, Prosanta [Louisiana Radiation Protection Div., Baton Rouge, LA (United States)

    1997-12-31

    The radiological emergency response program in the State of Louisiana is discussed. The improved approach intends to maximize the efficiency for both nuclear power plant and radiological emergency response as a whole. Several broad-based components are identified: cluster of `nodes` are generated for each component; these `nodes` may be divided into `sub-nodes` which will contain some `attributes`; `relational bonds` among the `attributes` will exist. When executed, the process begins and continues with the `nodes` assuming a functional and dynamic role based on the nature and characteristics of the `attributes`. The typical response based on stand-alone elements is eliminated; overlapping of functions is avoided, and is produced a well-structure and efficient organization 1 ref., 6 figs.; e-mail: prosanta at deq.state.la.us

  10. Assessing Mental Models of Emergencies Through Two Knowledge Elicitation Tasks.

    Science.gov (United States)

    Whitmer, Daphne E; Sims, Valerie K; Torres, Michael E

    2017-05-01

    The goals of this study were to assess the risk identification aspect of mental models using standard elicitation methods and how university campus alerts were related to these mental models. People fail to follow protective action recommendations in emergency warnings. Past research has yet to examine cognitive processes that influence emergency decision-making. Study 1 examined 2 years of emergency alerts distributed by a large southeastern university. In Study 2, participants listed emergencies in a thought-listing task. Study 3 measured participants' time to decide if a situation was an emergency. The university distributed the most alerts about an armed person, theft, and fire. In Study 2, participants most frequently listed fire, car accident, heart attack, and theft. In Study 3, participants quickly decided a bomb, murder, fire, tornado, and rape were emergencies. They most slowly decided that a suspicious package and identify theft were emergencies. Recent interaction with warnings was only somewhat related to participants' mental models of emergencies. Risk identification precedes decision-making and applying protective actions. Examining these characteristics of people's mental representations of emergencies is fundamental to further understand why some emergency warnings go ignored. Someone must believe a situation is serious to categorize it as an emergency before taking the protective action recommendations in an emergency warning. Present-day research must continue to examine the problem of people ignoring warning communication, as there are important cognitive factors that have not yet been explored until the present research.

  11. Emergent literacy profiles of preschool-age children with specific language impairment.

    Science.gov (United States)

    Cabell, Sonia Q; Lomax, Richard G; Justice, Laura M; Breit-Smith, Allison; Skibbe, Lori E; McGinty, Anita S

    2010-12-01

    The primary aim of the present study was to explore the heterogeneity of emergent literacy skills among preschool-age children with specific language impairment (SLI) through examination of profiles of performance. Fifty-nine children with SLI were assessed on a battery of emergent literacy skills (i.e., alphabet knowledge, print concepts, emergent writing, rhyme awareness) and oral language skills (i.e., receptive/expressive vocabulary and grammar). Cluster analysis techniques identified three emergent literacy profiles: (1) Highest Emergent Literacy, Strength in Alphabet Knowledge; (2) Average Emergent Literacy, Strength in Print Concepts; and (3) Lowest Emergent Literacy across Skills. After taking into account the contribution of child age, receptive and expressive language skills made a small contribution to the prediction of profile membership. The present findings, which may be characterized as exploratory given the relatively modest sample size, suggest that preschool-age children with SLI display substantial individual differences with regard to their emergent literacy skills and that these differences cannot be fully determined by children's age or oral language performance. Replication of the present findings with a larger sample of children is needed.

  12. Medical dispatchers recognise substantial amount of acute stroke during emergency calls

    DEFF Research Database (Denmark)

    Viereck, Søren; Møller, Thea Palsgaard; Iversen, Helle Klingenberg

    2016-01-01

    without an inappropriate amount of false positive cases. CONCLUSIONS: We report an overall high recognition of stroke by medical dispatchers. A final diagnosis of TIA, compared to ICH, was positively associated with recognition of acute stroke. Emergency medical dispatchers serve as the essential first...... stroke are therefore critical in organising emergency stroke care. We aimed to describe the sensitivity and positive predictive value of medical dispatchers' ability to recognise acute stroke during emergency calls, and to identify factors associated with recognition. METHODS: This was an observational...... study of 2653 consecutive unselected patients with a final diagnosis of stroke or transient ischemic attack (TIA). All admitted through the Emergency Medical Services Copenhagen, during a 2-year study period (2012-2014). Final diagnoses were matched with dispatch codes from the Emergency Medical...

  13. Emergency Response Guideline Development

    International Nuclear Information System (INIS)

    Gary D Storrick

    2007-01-01

    Task 5 of the collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled 'Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor' focuses on operator control and protection system interaction, with particular emphasis on developing emergency response guidelines (ERGs). As in the earlier tasks, we will use the IRIS plant as a specific example of an integrated primary system reactor (IPSR) design. The present state of the IRIS plant design--specifically, the lack of a detailed secondary system design--precludes establishing detailed emergency procedures at this time. However, we can create a structure for their eventual development. This report summarizes our progress to date. Section 1.2 describes the scope of this effort. Section 2 compares IPSR ERG development to the recent AP1000 effort, and identifies three key plant differences that affect the ERGs and control room designs. The next three sections investigate these differences in more detail. Section 3 reviews the IRIS Safety-by-Design philosophy and its impact on the ERGs. Section 4 looks at differences between the IRIS and traditional loop PWR I and C Systems, and considers their implications for both control room design and ERG development. Section 5 examines the implications of having one operating staff control multiple reactor units. Section 6 provides sample IRIS emergency operating procedures (EOPs). Section 7 summarizes our conclusions

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

    Science.gov (United States)

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

    2017-12-01

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

  15. Global Microbial Identifier

    DEFF Research Database (Denmark)

    Wielinga, Peter; Hendriksen, Rene S.; Aarestrup, Frank Møller

    2017-01-01

    ) will likely also enable a much better understanding of the pathogenesis of the infection and the molecular basis of the host response to infection. But the full potential of these advances will only transpire if the data in this area become transferable and thereby comparable, preferably in open-source...... of microorganisms, for the identification of relevant genes and for the comparison of genomes to detect outbreaks and emerging pathogens. To harness the full potential of WGS, a shared global database of genomes linked to relevant metadata and the necessary software tools needs to be generated, hence the global...... microbial identifier (GMI) initiative. This tool will ideally be used in amongst others in the diagnosis of infectious diseases in humans and animals, in the identification of microorganisms in food and environment, and to track and trace microbial agents in all arenas globally. This will require...

  16. Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

    Science.gov (United States)

    Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

    2016-11-16

    Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

  17. Report to Congress on NRC emergency communications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1980-09-01

    The accident at Three Mile Island highlighted the need for improved communications among the NRC and other organizations which respond to such emergencies. This report summarizes the communication problems identified by several major review groups after the accident, the status of corrective actions, and NRC plans to improve communications still further. (author)

  18. Modeling the Solar Convective Dynamo and Emerging Flux

    Science.gov (United States)

    Fan, Y.

    2017-12-01

    Significant advances have been made in recent years in global-scale fully dynamic three-dimensional convective dynamo simulations of the solar/stellar convective envelopes to reproduce some of the basic features of the Sun's large-scale cyclic magnetic field. It is found that the presence of the dynamo-generated magnetic fields plays an important role for the maintenance of the solar differential rotation, without which the differential rotation tends to become anti-solar (with a faster rotating pole instead of the observed faster rotation at the equator). Convective dynamo simulations are also found to produce emergence of coherent super-equipartition toroidal flux bundles with a statistically significant mean tilt angle that is consistent with the mean tilt of solar active regions. The emerging flux bundles are sheared by the giant cell convection into a forward leaning loop shape with its leading side (in the direction of rotation) pushed closer to the strong downflow lanes. Such asymmetric emerging flux pattern may lead to the observed asymmetric properties of solar active regions.

  19. Bradford Hill’s criteria, emerging zoonoses, and One Health

    Directory of Open Access Journals (Sweden)

    G.V. Asokan

    2016-09-01

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

  20. Systematic Molecular Phenotyping: A Path Toward Precision Emergency Medicine?

    Science.gov (United States)

    Limkakeng, Alexander T; Monte, Andrew A; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L; Shapiro, Nathan I

    2016-10-01

    Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department (ED). While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the ED will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end-users. © 2016 by the Society for Academic Emergency Medicine.