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Sample records for neurologists neuroradiologists emergency

  1. Emergency electroencephalogram: Usefulness in the diagnosis of nonconvulsive status epilepticus by the on-call neurologist.

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    Máñez Miró, J U; Díaz de Terán, F J; Alonso Singer, P; Aguilar-Amat Prior, M J

    2018-03-01

    We aim to describe the use of emergency electroencephalogram (EmEEG) by the on-call neurologist when nonconvulsive status epilepticus (NCSE) is suspected, and in other indications, in a tertiary hospital. Observational retrospective cohort study of emergency EEG (EmEEG) recordings with 8-channel systems performed and analysed by the on-call neurologist in the emergency department and in-hospital wards between July 2013 and May 2015. Variables recorded were sex, age, symptoms, first diagnosis, previous seizure and cause, previous stroke, cancer, brain computed tomography, diagnosis after EEG, treatment, patient progress, routine control EEG (rEEG), and final diagnosis. We analysed frequency data, sensitivity, and specificity in the diagnosis of NCSE. The study included 135 EEG recordings performed in 129 patients; 51.4% were men and their median age was 69 years. In 112 cases (83%), doctors ruled out suspected NCSE because of altered level of consciousness in 42 (37.5%), behavioural abnormalities in 38 (33.9%), and aphasia in 32 (28.5%). The EmEEG diagnosis was NCSE in 37 patients (33%), and this was confirmed in 35 (94.6%) as the final diagnosis. In 3 other cases, NCSE was the diagnosis on discharge as confirmed by rEEG although the EmEEG missed this condition at first. EmEEG performed to rule out NCSE showed 92.1% sensitivity, 97.2% specificity, a positive predictive value of 94.6%, and a negative predictive value of 96%. Our experience finds that, in an appropriate clinical context, EmEEG performed by the on-call neurologist is a sensitive and specific tool for diagnosing NCSE. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Nonmydriatic Ocular Fundus Photography in the Emergency Department: How It Can Benefit Neurologists.

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    Bruce, Beau B

    2015-10-01

    Examination of the ocular fundus is a critical aspect of the neurologic examination. For example, in patients with headache the ocular fundus examination is needed to uncover "red flags" suggestive of secondary etiologies. However, ocular fundus examination is infrequently and poorly performed in clinical practice. Nonmydriatic ocular fundus photography provides an alternative to direct ophthalmoscopy that has been studied as part of the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) Study. Herein, the results of the FOTO-ED study are reviewed with a particular focus on the study's implications for the acute care of patients presenting with headache and focal neurologic deficits. In headache patients, not only optic disc edema and optic disc pallor were observed as would be expected, but also a large number of abnormalities associated with hypertension. Based upon subjects with focal neurologic deficits, the FOTO-ED study suggests that the ocular fundus examination may assist with the triage of patients presenting with suspected transient ischemic attack. Continued advances in the ease and portability of nonmydriatic fundus photography will hopefully help to restore ocular fundus examination as a routinely performed component of all neurologic examinations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Non-mydriatic ocular fundus photography in the emergency department: how it can benefit neurologists

    Science.gov (United States)

    Bruce, Beau B.

    2016-01-01

    Examination of the ocular fundus is a critical aspect of the neurological examination. For example, in patients with headache the ocular fundus examination is needed to uncover “red flags” suggestive of secondary etiologies. However, ocular fundus examination is infrequently and poorly performed in clinical practice. Non-mydriatic ocular fundus photography provides an alternative to direct ophthalmoscopy that has been studied as part of the Fundus photography vs. Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study. Herein, we review the results of the FOTO-ED study with a particular focus on the study's implications for the acute care of patients presenting with headache and focal neurologic deficits. In headache patients, we not only observed optic disc edema and optic disc pallor as would be expected, but also a large number of abnormalities associated with hypertension. Based upon subjects with focal neurological deficits, the FOTO-ED study suggests that the ocular fundus examination may assist with the triage of patients presenting with suspected transient ischemic attack. Continued advances in the ease and portability of non-mydriatic fundus photography will hopefully help to restore ocular fundus examination as a routinely performed component of all neurological examinations. PMID:26444394

  4. Effect of direct neuroradiologist participation in physician marketing on imaging volumes in outpatient radiology.

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    Grignon, L; Keiper, M; Vavricek, J; Horsley, W; Murphy, R; Grignon, A; Yu, F

    2014-08-01

    Over the past several years, decreased demand for and increased supply of imaging services has increased competition among outpatient imaging centers in the United States. This study hypothesizes that using a radiology sales representative and neuroradiologist as a team in marketing and sales will increase imaging referrals in outpatient imaging. From January to December 2009, baseline monthly physician referral data of CT and MR scans of 19 referring clinicians (neurologists, neurosurgeons, and anesthesiologists) to an outpatient radiology group were collected. During that time, a nonphysician radiology sales representative visited the referring clinicians' offices every 2 weeks. From January to June 2010, the same radiology sales representative visited the referring clinicians' offices every 2 weeks but was accompanied by a neuroradiologist once a month. From July 2010 to June 2011, the same radiology sales representative visited the referring clinicians' offices twice a month without a neuroradiologist. Cross-sectional imaging referral volumes were approximately 2.5 times greater during the 6-month period using the neuroradiologist for direct physician-to-physician marketing when compared with the volumes achieved with the sales representative alone, and continued neuroradiologist involvement in marketing and sales is required to maintain referral volumes over time. The impact on imaging referral volumes during the 6-month use of the neuroradiologist for direct physician-to-physician marketing in this study supports the assertion that neuroradiologist visits are an important element in establishing and maintaining a relationship with the referring clinician's office and thereby maximizing imaging referrals. © 2014 by American Journal of Neuroradiology.

  5. Psychotherapy for neurologists.

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    Hobday, Gabrielle S; Gabbard, Glen O

    2009-07-01

    Psychotherapy has traditionally been regarded as the purview of psychiatry rather than neurology. Yet, the doctor-patient relationship is fundamental to both specialties, and the principles that derive from psychotherapy theory and practice apply to that relationship regardless of the specialty. It is common knowledge that a large proportion of patients seen in the context of the practice of medicine have some kind of emotional disturbance. Moreover, patients with organic disease may also have significant emotional difficulties that complicate both the primary illness and its treatment. This experience inevitably has drawn attention to the need for the nonpsychiatric physician to have an understanding and proficiency in psychiatric diagnosis and psychotherapeutic principles. In this article, we consider basic psychotherapeutic principles that are useful in the everyday practice of neurologists and other nonpsychiatric physicians. These skills are important not only for practical reasons, but also because responsiveness to their emotional distress is essential to maintain empathy and caring as cornerstones of the art of medicine. With the use of clinical examples to illustrate these principles, we hope that readers can apply them to their own clinical experiences.

  6. Factors influencing professional life satisfaction among neurologists.

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    Teixeira-Poit, Stephanie M; Halpern, Michael T; Kane, Heather L; Keating, Michael; Olmsted, Murrey

    2017-06-19

    Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists. We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay. The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay. Satisfaction is a multidimensional construct that is associated with

  7. Positron emission tomography for neurologists.

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    Miletich, Robert S

    2009-02-01

    This short review focuses on practical, present day, clinical application of FDG PET, a technology available to practicing neurologists for managing their patients. Indications in the disease states of dementia, neuro-oncology, epilepsy, parkinsonism, and other less common settings are reviewed. Many third-party payers currently make reimbursements based on these indications. By measuring an aspect of brain function, PET provides information that often is unobtainable from other sources, thus facilitating more rationale and cost-effective management, which can only benefit the patient, the referring physician, and the health care system as a whole.

  8. Neurologists' understanding and management of conversion disorder.

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    Kanaan, Richard A; Armstrong, David; Wessely, Simon Charles

    2011-09-01

    Conversion disorder is largely managed by neurologists, for whom it presents great challenges to understanding and management. This study aimed to quantify these challenges, examining how neurologists understand conversion disorder, and what they tell their patients. A postal survey of all consultant neurologists in the UK registered with the Association of British Neurologists. 349 of 591 practising consultant neurologists completed the survey. They saw conversion disorder commonly. While they endorsed psychological models for conversion, they diagnosed it according to features of the clinical presentation, most importantly inconsistency and abnormal illness behaviour. Most of the respondents saw feigning as entangled with conversion disorder, with a minority seeing one as a variant of the other. They were quite willing to discuss psychological factors as long as the patient was receptive but were generally unwilling to discuss feigning even though they saw it as their responsibility. Those who favoured models in terms of feigning were older, while younger, female neurologists preferred psychological models, believed conversion would one day be understood neurologically and found communicating with their conversion patients easier than it had been in the past. Neurologists accept psychological models for conversion disorder but do not employ them in their diagnosis; they do not see conversion as clearly different from feigning. This may be changing as younger, female neurologists endorse psychological views more clearly and find it easier to discuss with their patients.

  9. The non-invasive detection of intracranial aneurysms: are neuroradiologists any better than other observers?

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    White, Philip M. [University Department of Neurosurgery and Department of Neuroradiology, Institute of Neurological Sciences, Southern General Hospital, Glasgow G52 4TF (United Kingdom); Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh EH4 2XU (United Kingdom); Wardlaw, Joanna M. [Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh EH4 2XU (United Kingdom); Lindsay, Kenneth W.; Sloss, Stuart; Teasdale, Evelyn M. [University Department of Neurosurgery and Department of Neuroradiology, Institute of Neurological Sciences, Southern General Hospital, Glasgow G52 4TF (United Kingdom); Patel, Dilip K.B. [Department of Radiology, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH4 2XU (United Kingdom)

    2003-02-01

    Can non-neuroradiologists detect intracranial aneurysms as well as neuroradiologists, using CT and MR angiography? Sixty patients undergoing intra-arterial digital subtraction angiography (IADSA) to detect aneurysms also underwent computed tomographic angiography (CTA) and time-of-flight magnetic resonance angiography (MRA). Consensus review of IADSA by two neuroradiologists was the reference standard. Two neuroradiologists, a neurosurgeon, a neuroradiographer and a general radiologist blinded to IADSA, plain CT and clinical data, independently reviewed hard-copy base and reconstructed maximum intensity projection images of the CTA and MRA studies. Thirty patients had a total of 63 aneurysms, 71.4% were {<=}5 mm in size. Compared with IADSA, mean accuracy per patient for neuroradiologists was CTA 0.87 (95% CI 0.75-0.94), and MRA 0.82 (0.70-0.90); for the other observers it was CTA 0.81 (0.75-0.86), and MRA 0.78 (0.71-0.84). Sensitivity per aneurysm for neuroradiologists was CTA 0.63 (0.50-0.75), and MRA 0.43 (0.6-0.74); for the other observers it was CTA 0.52 (0.44-0.59), and MRA 0.38 (0.31-0.45). Differences between readers and modalities were not statistically significant. Agreement with IADSA was ''good'' for neuroradiologists: kappa 0.73 for CTA, and 0.63 for MRA. For the other observers, agreement with IADSA was ''moderate'': kappa 0.59 for CTA, and 0.56 for MRA. Neuroradiologists performed consistently better than the other observers, although differences did not reach statistical significance. (orig.)

  10. Telemedicine Can Replace the Neurologist on a Mobile Stroke Unit.

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    Wu, Tzu-Ching; Parker, Stephanie A; Jagolino, Amanda; Yamal, Jose-Miguel; Bowry, Ritvij; Thomas, Abraham; Yu, Amy; Grotta, James C

    2017-02-01

    The BEST-MSU study (Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit) is a comparative effectiveness trial in patients randomized to mobile stroke unit or standard management. A substudy tested interrater agreement for tissue-type plasminogen activator eligibility between a telemedicine vascular neurologist and onboard vascular neurologist. On scene, both the telemedicine vascular neurologist and onboard vascular neurologist independently evaluated the patient, documenting their tissue-type plasminogen activator treatment decision, National Institutes of Health Stroke Scale score, and computed tomographic interpretation. Agreement was determined using Cohen κ statistic. Telemedicine-related technical failures that impeded remote assessment were recorded. Simultaneous and independent telemedicine vascular neurologist and onboard vascular neurologist assessment was attempted in 174 patients. In 4 patients (2%), the telemedicine vascular neurologist could not make a decision because of technical problems. The telemedicine vascular neurologist agreed with the onboard vascular neurologist on 88% of evaluations (κ=0.73). Remote telemedicine vascular neurologist assessment is reliable and accurate, supporting either telemedicine vascular neurologist or onboard vascular neurologist assessment on our mobile stroke unit. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02190500. © 2017 American Heart Association, Inc.

  11. Factors Associated with Neurologists' Provision of MS Patient Care

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    Halpern, Michael T.; Teixeira-Poit, Stephanie M.; Kane, Heather; Frost, Corey; Keating, Michael; Olmsted, Murrey

    2014-01-01

    Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists' provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2%) MS subspecialists and 486 (84.8%) “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS) and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population. PMID:24949203

  12. Women neurologist: a worldwide and Brazilian struggle

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    Marleide da Mota Gomes

    2011-10-01

    Full Text Available The main aim of this paper was to present some pioneer women neurologist, their struggle to pursue their career and the barriers mainly encountered at the beginning of their professional lives. It was also presented the progressive increasing of the feminine participation in medicine and in the neurology with study based on data of the School of Medicine of the Federal University of Rio de Janeiro and Brazilian Academy of Neurology. Their composition were analyzed according to gender, class and academic rank. In spite of this feminization, there is lack of a women's parallel advancement into leadership positions despite no visible barriers ("glass ceiling".

  13. On being a neurologist in industry.

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    Leppert, David; Glanzman, Robert

    2013-03-01

    Neurologists in the pharmaceutical industry have an attractive and rewarding career path that offers the chance to participate in large projects, contribute directly to clinical breakthroughs in drug development, and translate biomarker research into applied practice. This article describes the different and common features of corporate compared to academic environments, and highlights the key factors necessary for success in the business world. Integrity, communication skills, an open-minded attitude, and an ability to handle stress and manage complex organizational structures are prerequisites that enable physician-neuroscientists to pursue successful and exciting careers in the corporate environment. Copyright © 2013 American Neurological Association.

  14. Women neurologist: a worldwide and Brazilian struggle.

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    Gomes, Marleide da Mota

    2011-10-01

    The main aim of this paper was to present some pioneer women neurologist, their struggle to pursue their career and the barriers mainly encountered at the beginning of their professional lives. It was also presented the progressive increasing of the feminine participation in medicine and in the neurology with study based on data of the School of Medicine of the Federal University of Rio de Janeiro and Brazilian Academy of Neurology. Their composition were analyzed according to gender, class and academic rank. In spite of this feminization, there is lack of a women's parallel advancement into leadership positions despite no visible barriers ("glass ceiling").

  15. Non-Relative Value Unit-Generating Activities Represent One-Fifth of Academic Neuroradiologist Productivity.

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    Wintermark, M; Zeineh, M; Zaharchuk, G; Srivastava, A; Fischbein, N

    2016-07-01

    A neuroradiologist's activity includes many tasks beyond interpreting relative value unit-generating imaging studies. Our aim was to test a simple method to record and quantify the non-relative value unit-generating clinical activity represented by consults and clinical conferences, including tumor boards. Four full-time neuroradiologists, working an average of 50% clinical and 50% academic activity, systematically recorded all the non-relative value unit-generating consults and conferences in which they were involved during 3 months by using a simple, Web-based, computer-based application accessible from smartphones, tablets, or computers. The number and type of imaging studies they interpreted during the same period and the associated relative value units were extracted from our billing system. During 3 months, the 4 neuroradiologists working an average of 50% clinical activity interpreted 4241 relative value unit-generating imaging studies, representing 8152 work relative value units. During the same period, they recorded 792 non-relative value unit-generating study reviews as part of consults and conferences (not including reading room consults), representing 19% of the interpreted relative value unit-generating imaging studies. We propose a simple Web-based smartphone app to record and quantify non-relative value unit-generating activities including consults, clinical conferences, and tumor boards. The quantification of non-relative value unit-generating activities is paramount in this time of a paradigm shift from volume to value. It also represents an important tool for determining staffing levels, which cannot be performed on the basis of relative value unit only, considering the importance of time spent by radiologists on non-relative value unit-generating activities. It may also influence payment models from medical centers to radiology departments or practices. © 2016 by American Journal of Neuroradiology.

  16. Great attention to the standard training and certification system for interventional neuroradiologist

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    Li Tianxiao; Cheng Yongde

    2008-01-01

    During the past decades, interventional neuroradiology has become one of the most important modalities for treatment of cerebral vascular diseases. Chinese doctors have made great progress in this field, and their diagnosis and treament have also reached the international level in some territories. Following the need of specialized development for interventional neuroradiology, more and more problems have arisen and even caused argument in this field. To resolve the issue and promote the healthy and fast development of interventional neuroradiology, it is time for us to formulate the standard training and certification system for interventional neuroradiologist. (authors)

  17. Defending the solo and small practice neurologist.

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    Jones, Elaine C; Evans, David A

    2015-04-01

    Changes in health care are having a dramatic effect on the practice of medicine. In 2005, a National Center for Health Statistics survey showed that 55%-70% of physicians are in small/solo practices. These data also demonstrated that 70% of physicians identified themselves as owners. Since passage of the Affordable Care Act (ACA) in 2010, neurologists report an 8% increase in academic practice settings, a 2% decrease in private practice settings, and a 5% decrease in solo practice settings. Surveys of family physicians showed that 60% are now employees of hospitals or larger groups. A survey by The Physicians Foundation showed that 89% of physicians believed that the traditional model of independent private practice is either "on shaky ground" or "a dinosaur soon to go extinct." With the changes expected from the ACA, solo/small practices will continue to face challenges and therefore must pay close attention to business and clinical metrics.

  18. The 'hidden work' of a hospital neurologist: 1000 consults later.

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    Ali, E

    2012-02-01

    BACKGROUND: A new Web-based, internal neurology referral service was introduced in our department to expedite inpatient review for other departments and to allow assessment of the impact of neurology consults on patient care throughout the hospital, especially in the emergency department (ED). The results of the analysis of the first 1000 referrals using the new system are presented. Methods: An intranet referral system was designed by the consultant neurologists. The previous method of referral was by handwritten letter. The electronic template included \\'drop-down\\' menus and mandatory fields to help guide referring teams. An outcome section is completed by the neurology team. Results: An average of 17 referrals was seen weekly. Seventy-seven per cent were seen within 24 h of referral. A consultant neurologist saw 87% of the referrals directly; 13% were first seen by a registrar and later discussed with a consultant. Forty per cent were seen in the ED of which a one-third of the patients were discharged following assessment. The most common reason for referral was seizure(s) or an episode of collapse (28%). Patients presenting with stroke\\/transient ischaemic attack represented 13.5%, and 12.5% presented with headaches. The management of 79% of referred cases was deemed to have been significantly changed after neurology review. Discussion: The introduction of a neurology consultant-designed and consultant-led intranet referral service has greatly enhanced the delivery of the consult service to patients in our hospital. This referral system contributes significantly to hospital efficiency and to access for patients to specialist assessment.

  19. Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

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    Broadley, Simon A; Barnett, Michael H; Boggild, Mike; Brew, Bruce J; Butzkueven, Helmut; Heard, Robert; Hodgkinson, Suzanne; Kermode, Allan G; Lechner-Scott, Jeannette; Macdonell, Richard A L; Marriott, Mark; Mason, Deborah F; Parratt, John; Reddel, Stephen W; Shaw, Cameron P; Slee, Mark; Spies, Judith; Taylor, Bruce V; Carroll, William M; Kilpatrick, Trevor J; King, John; McCombe, Pamela A; Pollard, John D; Willoughby, Ernest

    2014-11-01

    In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs. We go on to compare the relative efficacies of these newer and emerging therapies alongside the existing therapies. The effectiveness of β-interferon in the treatment of different stages and the different disease courses of MS is critically reviewed with the conclusion that the absolute level of response in term of annualised relapse rates (where relapses occur) and MRI activity are similar, but are disappointing in terms of sustained disability progression for progressive forms of the disease. Finally we review the controversial area of combination therapy for MS. Whilst it remains the case that we have no cure or means of preventing MS, we do have a range of effective therapies that when used appropriately and early in the disease course can have a significant impact on short term and longer term outcomes. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  20. British Society of Neuroradiologists, annual meeting, Hilton National Hotel, Stansted Airport, Essex, UK, 8-9 October 1993. Abstracts

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    Anon.

    1994-01-01

    Eighteen abstracts of scientific papers are presented which were read at the Annual Meeting of the British Society of Neuroradiologists, held in Essex from 8-9 October 1993, dealing with the diagnostic evaluation of a variety of brain diseases. (orig.)

  1. Treatment adherence in multiple sclerosis: a survey of Belgian neurologists

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    Decoo D

    2015-11-01

    Full Text Available Danny Decoo,1 Mathieu Vokaer2 1Department of Neurology and Neurorehab, AZ Alma, Sijsele, Belgium; 2Multiple Sclerosis Clinic, Edith Cavell Hospital, CHIREC group, Brussels, Belgium Background: Poor treatment adherence is common among patients with multiple sclerosis (MS. This survey evaluated neurologists’ perception of treatment adherence among MS patients.Materials and methods: This questionnaire-based survey of Belgian neurologists treating MS patients was conducted between June and July 2014. Face-to-face interviews with the neurologists were based on a semistructured questionnaire containing questions regarding the perception of the treatment-adherence level.Results: A total of 41 neurologists participated in the survey. Of these, 88% indicated frequent discussions about treatment adherence as beneficial for treatment efficacy. The mean time spent on the treatment-adherence discussion during the initial consultation was 11 minutes, with 24% of doctors spending 5 minutes and 24% of doctors spending 10 minutes discussing this issue. The majority of neurologists (56% perceived the adherence level in MS as good, and 12% perceived it as excellent. The majority of neurologists (64% indicated intolerance as a main cause of poor adherence, and all neurologists reported insufficient efficacy as a consequence of nonadherence. The importance of adherence in the neurologists’ practice was evaluated on a scale of 1–10, with 1= “not very important” and 10= “very important”: 44% of doctors indicated a score of 10, and the mean score was 9.0.Conclusion: Belgian neurologists consider treatment adherence in MS as essential for the benefits of therapies. However, although neurologists are aware of the consequences of nonadherence, they generally spend limited time discussing the importance of treatment adherence with their patients. Keywords: multiple sclerosis, treatment adherence, physician survey

  2. Stroke Neurologist's Perspective on the New Endovascular Trials.

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    Grotta, James C; Hacke, Werner

    2015-06-01

    Before December 2014, the only proven effective treatment for acute ischemic stroke was recombinant tissue-type plasminogen activator (r-tPA). This has now changed with the publication of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE), Extending the Time for Thrombolysis in Emergency Neurological Deficits--Intra-Arterial (EXTEND IA), Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment Trial (SWIFT PRIME), and Randomized Trial of Revascularization With the Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset (REVASCAT) studies. We review the main results of these studies and how they inform stroke patient management going forward. The main take home points for neurologists are (1) intra-arterial thrombectomy is a potently effective treatment and should be offered to patients who have documented occlusion in the distal internal carotid or the proximal middle cerebral artery, have a relatively normal noncontrast head computed tomographic scan, severe neurological deficit, and can have intra-arterial thrombectomy within 6 hours of last seen normal; (2) benefits are clear in patients receiving r-tPA before intra-arterial thrombectomy; r-tPA should not be withheld if the patient meets criteria, and benefit in patients who do not receive r-tPA or have r-tPA exclusions requires further study; and (3) these favorable results occur when intra-arterial thrombectomy is performed in an endovascular stroke center by a coordinated multidisciplinary team that extends from the prehospital stage to the endovascular suite, minimizes time to recanalization, uses stent-retriever devices, and avoids general

  3. Patients' and neurologists' perception of epilepsy and psychogenic nonepileptic seizures.

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    Whitehead, Kimberley; Kandler, Rosalind; Reuber, Markus

    2013-04-01

    Although differences in illness perceptions between neurologists and patients with epilepsy or psychogenic nonepileptic seizures (PNES) are likely to be clinically relevant, this is the first study to attempt a direct comparison. In addition, this study compares the illness perceptions of patients with epilepsy with those of patients with PNES. Thirty-four patients with epilepsy, 40 patients with PNES, and 45 neurologists were recruited. All patient participants completed versions of the illness perception questionnaire revised (IPQ-R) adapted for epileptic or nonepileptic seizure disorders, single-item symptom attribution question (SAQ), Hospital Anxiety and Depression Scale (HADS), Quality of Life in Epilepsy-31 (QOLIE-31), and Liverpool Seizure Severity Scale (LSSS). Participating neurologists completed two versions of the IPQ-R and two SAQs for epileptic and nonepileptic seizure disorders. Differences in illness perceptions between patients with epilepsy and patients with PNES were minor compared to those between patients with either seizure disorder and neurologists. Neurologists considered both seizure disorders more treatable and more amenable to personal control than did the patients themselves. Neurologists had much more polarized views of the etiology of both conditions; whereas patients mostly considered the causes of their seizure disorders as partially "physical" and partially "psychological," neurologists perceived epilepsy as an essentially "physical" and PNES as a clearly "psychological" problem. There are considerable differences between the illness perceptions of patients with seizure disorders and their doctors, which could represent barriers to successful clinical management. In particular, a discrepancy between neurologists' and patients' beliefs about the personal control that patients may be able to exert over PNES could contribute to the confusion or anger some patients report after the diagnosis has been explained to them. Furthermore

  4. Perception of pediatric neurology among non-neurologists.

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    Jan, Mohammed M S

    2004-01-01

    Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.

  5. [Dissociative seizures: a manual for neurologists for communicating the diagnosis].

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    Fritzsche, K; Baumann, K; Schulze-Bonhage, A

    2013-01-01

    The great physical resemblance between epileptic and dissociative seizures and a diagnosis of epilepsy that had been made years ago and usually had been treated unsuccessfully makes it difficult for both physician and patient to communicate the diagnosis of dissociative seizures. A direct referral to psychotherapy treatment is rarely accepted by patients. Intermediate steps, which are based on cooperation between neurologists and psychotherapists, are necessary. The approach that we use to communicate diagnosis and motivation for psychotherapeutic treatment includes eight steps: 1. Welcome and introduction; 2. Jointly watching a video of documented seizures; 3. The message that the seizures are not of epileptic origin, 4. Development of an alternative disease concept; 5. Motivation for a conversation with a representative from psychosomatics; 6. Responding to the fear of "going crazy"; 7. If necessary, briefly touching on the subject of sexual violence; 8. More recommendations and conclusion of the conversation. The manual was discussed and practiced with the attending neurologist in two sessions and is now being regularly used by two neurologists with concomitant supervision.

  6. Current practice and views of neurologists on the transition from pediatric to adult care.

    Science.gov (United States)

    Oskoui, Maryam; Wolfson, Christina

    2012-12-01

    To describe the current practice and views of neurologists on transitioning patients from pediatric to adult care, a cross-sectional study of all pediatric and adult neurologists in the province of Quebec, Canada, was conducted. The response rate was 73% for pediatric and 49% for adult neurologists. Most pediatric neurologists do not have a patient transition program or policy in place. Although a transfer summary is commonly provided, critical information is often lacking. Nearly half of neurologists believed that patients experience a gap in care during the transition process, and most agreed that the transition process is often poorly coordinated, highlighting patient, family, and health care factors. Current practice does not follow existing consensus statements for transition of care with respect to timing, communication, and preparation, and many pediatric neurologists experience difficulty in finding an appropriate adult health care provider for their patients. Neurologists reported many challenges in the current transition of care process.

  7. AAN Epilepsy Quality Measures in clinical practice: a survey of neurologists.

    Science.gov (United States)

    Wasade, Vibhangini S; Spanaki, Marianna; Iyengar, Revathi; Barkley, Gregory L; Schultz, Lonni

    2012-08-01

    Epilepsy Quality Measures (EQM) were developed by the American Academy of Neurology (AAN) to convey standardization and eliminate gaps and variations in the delivery of epilepsy care (Fountain et al., 2011 [1]). The aim of this study was to identify adherence to these measures and other emerging practice standards in epilepsy care. A 15-item survey was mailed to neurologists in Michigan, USA, inquiring about their practice patterns in relation to EQM. One hundred thirteen of the 792 surveyed Michigan Neurologists responded (14%). The majority (83% to 94%) addressed seizure type and frequency, reviewed EEG and MRI, and provided pregnancy counseling to women of childbearing potential. Our survey identified gaps in practice patterns such as counseling about antiepileptic drug (AED) side effects and knowledge about referral for surgical therapy of intractable epilepsy. Statistical significance in the responses on the AAN EQM was noted in relation to number of years in practice, number of epilepsy patients seen, and additional fellowship training in epilepsy. Practice patterns assessment in relation to other comorbidities revealed that although bone health and sudden unexplained death in epilepsy are addressed mainly in patients at risk, depression is infrequently discussed. The findings in this study indicate that additional educational efforts are needed to increase awareness and to improve quality of epilepsy care at various points of health care delivery. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Safety of working patterns among UK neuroradiologists: what can we learn from the aviation industry and cognitive science?

    Science.gov (United States)

    Reicher, John; Currie, Stuart; Birchall, Daniel

    2018-04-01

    As the volume and complexity of imaging in the UK continues to rise, there is pressure on radiologists to spend increasing lengths of time reporting to cope with the growing workload. However, there is limited guidance for radiologists about structuring the working day to strike the necessary balance between achieving satisfactory reporting volume and maintaining quality and safety. We surveyed 86 neuroradiologists (receiving 59 responses), regarding time spent reporting, frequency and duration of work breaks, and break activities. Our results demonstrate that some neuroradiologists report for up to 12 h a day and for 4 h before taking a break. Mean duration of breaks is less than 15 min and these often consist of computer screen-based or cognitively demanding tasks. Many areas of medicine have looked to the aviation industry to develop improvements in safety through regulated, standardised practices. There are parallels between the work of air traffic controllers (ATCs) and radiologists. We review the legislation that controls the working hours of UK ATCs to minimise fatigue-related errors, and its scientific basis. We also consider the vigilance decrement, a concept in cognitive science which describes the reduction in performance with increasing time-on-task. We conclude that, in comparison with ATCs, work patterns among radiologists are poorly standardised and potentially dangerous. Evidence suggests that placing limits on reporting time and minimum break duration, as well as ensuring appropriate break activities, can benefit reporting quality. It is imperative that radiologists and managers heed these lessons, to improve standards and protect patients from error.

  9. [German neurology and neurologists during the Third Reich: the aftermath].

    Science.gov (United States)

    Martin, M; Fangerau, H; Karenberg, A

    2016-08-01

    The article discusses the consequences for neurology as a discipline which resulted from neurologists' participation in the crimes committed under National Socialism (NS). Chronologically, the current literature distinguishes mainly four overlapping stages: (1) a first phase was characterized by legal persecution and "denazification", which was also the time of the Nuremberg doctors' trial in which no neurologists were on trial. A detailed documentation of the trial for the German medical profession was published by Alexander Mitscherlich. (2) In the subsequent practice of wide amnestying and reintegration of former Nazi followers during the 1950s, neurologists were no exception as its elite continued in their positions. The year 1953 was the year of the Lisbon scandal, when chiefly Dutch representatives protested against the participation of Julius Hallervorden in the International Congress of Neurology. The newly founded societies, the German Society for Neurology (Deutsche Gesellschaft für Neurologie, DGN) and the German Society for Psychiatry and Neurology (Deutsche Gesellschaft für Psychiatrie und Neurologie, DGPN), unanimously supported their member. (3) The next period was characterized by a nascent criticism of the prevailing attitude of covering up the crimes committed by physicians during the Nazi period. The discovery of incriminating brain sections at various Max Planck Institutes brought neurology to the focus of the debate. (4) Since the 1980s and 1990s historians (of medicine) have been systematically examining medicine's Nazi past in a professional way, which resulted in a noticeable increase of knowledge. Additionally, a new generation of scholars provoked a change of mind insofar as they recognized medicine's responsibility for the crimes committed between 1933 and 1945. We expect that future historical research will further elucidate the history of neurology during the NS regime and have consequences for our current understanding of research

  10. Pain Without Lesion: Debate Among American Neurologists, 1850–1900

    OpenAIRE

    Daniel Goldberg

    2012-01-01

    The central claim of this paper is that neurologists in mid-to-late nineteenth-century America generally denied the possibility that pain could exist in the absence of material lesion. There is ongoing debate over the medical status of pain sufferers in mid-to-late nineteenth-century America, with some arguing that what we might now term “chronic pain” became invisible during the period; others assert that physicians of the time were acutely aware of and sensitive to the suffering of their p...

  11. Neurologists and technology: The changing "Facebook" of practice.

    Science.gov (United States)

    Potts, Daniel C; Hohler, Anna D

    2013-04-01

    Social and traditional media are revolutionizing health care. Medicine, once an art practiced behind closed doors, is now part of the public domain. This article will help neurologists navigate a complex maze of technology to optimize patient care without compromising privacy. We offer ideas for improving our digital "footprint." Guidance is given on maintaining professional demeanor in all private and public interactions to help us avoid personal or patient insult and injury. Acknowledging that neurology is becoming a specialty of increased personal and social education, we outline ways to proactively improve our patient care and education locally and globally.

  12. Facebook: can it be a diagnostic tool for neurologists?

    Science.gov (United States)

    Mittal, Manoj K; Sloan, Jeff A; Rabinstein, Alejandro A

    2012-01-01

    A 56-year-old woman presented with acute ischaemic stroke with NIHSS 13. She had right eye ptosis and miosis. She and her husband were not sure if her facial features were different than usual. With her consent, we compared her face with her pictures on Facebook. In the absence of any ptosis or miosis in her pictures, she was diagnosed with acute Horner syndrome. Facebook may be a useful tool for the neurologists to define the timing of facial neurological signs. PMID:22914235

  13. Early outcomes after carotid angioplasty with stenting performed by neurologists

    Directory of Open Access Journals (Sweden)

    Bathala Lokesh

    2010-01-01

    Full Text Available Aims: To evaluate the results of carotid artery angioplasty and stenting (CAS in treating extracranial carotid artery stenosis performed by neurologists in our center and compare the results with other large published series. Materials and Methods: Data for all patients who underwent CAS from January 2003 through November 2007, was retrieved from the Nanjing Stroke Registry. Perioperative and post-procedural complications within 30 days following stenting were analyzed and compared with that from other series. A total number of 75 patients were enrolled, with a mean age of 65.9 ± 8.8 years, and 64 (85.3% of them were male. Results: Procedural success was achieved in 74 patients (98.7%. Pre-treatment stenosis was 73.8 ± 14.9 and post-treatment residual stenosis was less than 10%. Thirty-four patients (45.3% had bilateral carotid artery disease and seven (9.3% had tandem stenosis. The neurological complication rate was 3.9% (one major and two minor strokes. Bradycardia in four (5.3% and hypotension in 13 (17.3% were observed during procedures. Using the Fischer′s exact t test, the complication rate compared with the large published series did not reveal any statistically significant difference (P > 0.05. Conclusions: We conclude that neurologists, with adequate training, can develop and add this technical skill to the existing cognitive skill of vascular neurology and safely perform stenting.

  14. Acute stroke imaging research roadmap

    NARCIS (Netherlands)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Koehrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Warach, Steven

    The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke

  15. Discrepancy in reporting among specialist registrars and the role of a paediatric neuroradiologist in reporting paediatric CT head examinations

    International Nuclear Information System (INIS)

    Nagaraja, S.; Ullah, Q.; Lee, K.J.; Bickle, I.; Hon, L.Q.; Griffiths, P.D.; Raghavan, A.; Flynn, P.; Connolly, D.J.A.

    2009-01-01

    Aim: To evaluate the discrepancy rate among specialist registrars (SPR) to assess whether seniority had a bearing on the discrepancy rate. To investigate which were the commonly missed abnormalities and the consequences for teaching purposes. To investigate the role of a specialist consultant neuroradiologist in reporting paediatric head computed tomography examinations. Materials and methods: The study was carried out over a 9-month period at the regional paediatric hospital during which time 270 CT head examinations were reported. Reporting in the department is carried out by one of the five general paediatric radiologists (GR) and also a specialist paediatric neuroradiologist (NR). The NR was considered the reference standard, who corroborated in areas of discrepancy with a second senior NR for this study. Of the 270 examinations, 260 were reported by the paediatric NR, 160 were reported by the SPR, GR, and NR, and 51 were reported by an SPR and the NR. In addition, four were reported by the GR and the NR, 45 by the NR only, seven by the GR only, and three cases were reported by the GR and an SPR. The discrepancy rates were calculated for GR versus NR, and SPR versus NR. All the discrepancies were re-evaluated by a second senior NR and confirmed in all cases. The reports of the SPR were further scrutinized. The trainees of training years 1-3 were considered junior and 4-5 were considered senior. Results: There was a discrepancy in 26/164 cases (15.9%) reported by the GR and NR. There was a discrepancy in 59/211 cases (28%) reported by an SPR and NR. The chi-squared test (two-sided) showed a significant difference (p = 0.005) between the two groups. There was a discrepancy in 36/118 cases (30.5%) reported by the junior SPR and NR. There was a discrepancy in 23/93 cases (24.7%) reported by a senior SPR and NR. The chi-squared test (two-sided) showed a non-significant difference (p = 0.353) between the two groups. Conclusion: The performance of the SPR was

  16. Neurologic emergencies in sports.

    Science.gov (United States)

    Williams, Vernon B

    2014-12-01

    Sports neurology is an emerging area of subspecialty. Neurologists and non-neurologists evaluating and managing individuals participating in sports will encounter emergencies that directly or indirectly involve the nervous system. Since the primary specialty of sports medicine physicians and other practitioners involved in the delivery of medical care to athletes in emergency situations varies significantly, experience in recognition and management of neurologic emergencies in sports will vary as well. This article provides a review of information and elements essential to neurologic emergencies in sports for the practicing neurologist, although content may be of benefit to readers of varying background and expertise. Both common neurologic emergencies and less common but noteworthy neurologic emergencies are reviewed in this article. Issues that are fairly unique to sports participation are highlighted in this review. General concepts and principles related to treatment of neurologic emergencies that are often encountered unrelated to sports (eg, recognition and treatment of status epilepticus, increased intracranial pressure) are discussed but are not the focus of this article. Neurologic emergencies can involve any region of the nervous system (eg, brain, spine/spinal cord, peripheral nerves, muscles). In addition to neurologic emergencies that represent direct sports-related neurologic complications, indirect (systemic and generalized) sports-related emergencies with significant neurologic consequences can occur and are also discussed in this article. Neurologists and others involved in the care of athletes should consider neurologic emergencies in sports when planning and providing medical care.

  17. Crystalline lens - Eyes under high radiological protection. From regulation to acts. With neuro-radiologists of the Pitie-Salpetriere

    International Nuclear Information System (INIS)

    2014-01-01

    As the limit exposure of workers' crystalline lens to ionizing radiations is about to be lowered, this set of three articles proposes an overview of this specific issue. A recent study performed by the IRSN revealed that interventional cardiologists display four more crystalline lens opacification that the rest of the population, and also revealed that other incidents could affect the eyes of some operators of nuclear medicine. In interventional radiology, fingers, fists and eyes are the most exposed and have not been so well protected as the rest of the body. After dosimetry measurements, the use of protective glasses has been introduced. These protective measures could be applied in other nuclear activities. Studies are being performed on the eyes of children living in areas contaminated by the Chernobyl accident. A second article comments the various actions and initiatives aiming at limiting the dose received by the crystalline lens: preparation of a new regulation for the follow-up of exposed workers, definition of standards for dose measurement devices, risk assessments, recommendation to interventional radiologists to optimize their exposure (process, protective clothes, and so on). A last article briefly reports the implementation of a dose follow-up for interventional neuro-radiologists in a Parisian hospital

  18. Most Scottish neurologists do not apply the 2010 McDonald criteria when diagnosing multiple sclerosis.

    Science.gov (United States)

    Lumley, R; Davenport, R; Williams, A

    2015-03-01

    The diagnostic criteria for multiple sclerosis have evolved over time and currently the 2010 McDonald criteria are the most widely accepted. These criteria allow the diagnosis of multiple sclerosis to be made at the clinically isolated syndrome stage provided certain criteria are met on a single magnetic resonance brain scan. Our hypothesis was that neurologists in Scotland did not use these criteria routinely. We sent a SurveyMonkey questionnaire to all Scottish neurologists (consultants and trainees) regarding the diagnosis of multiple sclerosis. Our questionnaire response rate was 65/99 (66%). Most Scottish neurologists were aware of the criteria and 31/58 (53%) felt that they were using these routinely. However, in a clinical vignette designed to test the application of these criteria, only 5/57 (9%) of neurologists appeared to use them. Scottish neurologists' use of the 2010 McDonald criteria for diagnosis of multiple sclerosis varies from practitioners' perception of their use of these criteria.

  19. In-Vivo Proton Magnetic Resonance Spectroscopy of 2-Hydroxyglutarate in Isocitrate Dehydrogenase-Mutated Gliomas: A Technical Review for Neuroradiologists

    International Nuclear Information System (INIS)

    Kim, Hyeonjin; Kim, Sungjin; Lee, Hyeong Hun; Heo, Hwon

    2016-01-01

    The diagnostic and prognostic potential of an onco-metabolite, 2-hydroxyglutarate (2HG) as a proton magnetic resonance spectroscopy (1H-MRS) detectable biomarker of the isocitrate dehydrogenase (IDH)-mutated (IDH-MT) gliomas has drawn attention of neuroradiologists recently. However, due to severe spectral overlap with background signals, quantification of 2HG can be very challenging. In this technical review for neuroradiologists, first, the biochemistry of 2HG and its significance in the diagnosis of IDH-MT gliomas are summarized. Secondly, various 1H-MRS methods used in the previous studies are outlined. Finally, wereview previous in vivo studies, and discuss the current status of 1H-MRS in the diagnosis of IDH-MT gliomas

  20. In-Vivo Proton Magnetic Resonance Spectroscopy of 2-Hydroxyglutarate in Isocitrate Dehydrogenase-Mutated Gliomas: A Technical Review for Neuroradiologists

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyeonjin [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Department of Biomedical Sciences, Seoul National University, Seoul 03087 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03080 (Korea, Republic of); Kim, Sungjin [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Lee, Hyeong Hun; Heo, Hwon [Department of Biomedical Sciences, Seoul National University, Seoul 03087 (Korea, Republic of)

    2016-11-01

    The diagnostic and prognostic potential of an onco-metabolite, 2-hydroxyglutarate (2HG) as a proton magnetic resonance spectroscopy (1H-MRS) detectable biomarker of the isocitrate dehydrogenase (IDH)-mutated (IDH-MT) gliomas has drawn attention of neuroradiologists recently. However, due to severe spectral overlap with background signals, quantification of 2HG can be very challenging. In this technical review for neuroradiologists, first, the biochemistry of 2HG and its significance in the diagnosis of IDH-MT gliomas are summarized. Secondly, various 1H-MRS methods used in the previous studies are outlined. Finally, wereview previous in vivo studies, and discuss the current status of 1H-MRS in the diagnosis of IDH-MT gliomas.

  1. Strategic planning for neuroradiologists.

    Science.gov (United States)

    Berlin, Jonathan W; Lexa, Frank J

    2012-08-01

    Strategic planning is becoming essential to neuroradiology as the health care environment continues to emphasize cost efficiency, teamwork and collaboration. A strategic plan begins with a mission statement and vision of where the neuroradiology division would like to be in the near future. Formalized strategic planning frameworks, such as the strengths, weaknesses, opportunities and threats (SWOT), and the Balanced Scorecard frameworks, can help neuroradiology divisions determine their current position in the marketplace. Communication, delegation, and accountability in neuroradiology is essential in executing an effective strategic plan. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Pain Without Lesion: Debate Among American Neurologists, 1850–1900

    Directory of Open Access Journals (Sweden)

    Daniel Goldberg

    2012-12-01

    Full Text Available The central claim of this paper is that neurologists in mid-to-late nineteenth-century America generally denied the possibility that pain could exist in the absence of material lesion. There is ongoing debate over the medical status of pain sufferers in mid-to-late nineteenth-century America, with some arguing that what we might now term “chronic pain” became invisible during the period; others assert that physicians of the time were acutely aware of and sensitive to the suffering of their patients from a variety of pain experiences. Drawing on prior work related to the social and cultural efficacy produced in fin-de-siècle American culture by imaging the visible lesion, I argue that these apparently divergent views are both correct. On the one hand, there is little support in the primary sources for the idea that mid-to-late nineteenth-century American physicians ignored or trivialized the pain experiences of their patients. Indeed, given the Victorian emphasis on suffering and sympathy, such behaviour would have been especially taboo, at least with regards to socially privileged patients. On the other hand, the fact that American physicians of the time were aware of and sensitive to their patients’ pain does not imply that the physicians allowed that such pain could exist in the absence of a material (morbid lesion. I contend that American neurologists followed their European counterparts in repeatedly insisting that if the patient experiences pain, then such a lesion must perforce exist, even if imaging techniques of the time simply did not permit discernment of the lesion itself. This finding has several implications. First, it fills a gap in the relevant literature inasmuch as there is little sustained historical analysis of the attitudes, practices, and beliefs of mid-to-late nineteenth-century American physicians regarding pain without lesion. Second, it contributes to the historiography demonstrating the power and significance

  3. New Zealand's neurologist workforce: a pragmatic analysis of demand, supply and future projections.

    Science.gov (United States)

    Ranta, Annemarei Anna; Tiwari, Priyesh; Mottershead, John; Abernethy, David; Simpson, Mark; Brickell, Kiri; Lynch, Christopher; Walker, Elizabeth; Frith, Richard

    2015-08-07

    To estimate current and future specialist neurologist demand and supply to assist with health sector planning. Current demand for the neurology workforce in New Zealand was assessed using neuroepidemiological data. To assess current supply, all New Zealand neurology departments were surveyed to determine current workforce and estimate average neurologist productivity. Projections were made based on current neurologists anticipated retirement rates and addition of new neurologists based on current training positions. We explored several models to address the supply-demand gap. The current supply of neurologists in New Zealand is 36 full-time equivalents (FTE), insufficient to meet current demand of 74 FTE. Demand will grow over time and if status quo is maintained the gap will widen. Pressures on healthcare dollars are ever increasing and we cannot expect to address the identified service gap by immediately doubling the number of neurologists. Instead we propose a 12-year strategic approach with investments to enhance service productivity, strengthen collaborative efforts between specialists and general service providers, moderately increase the number of neurologists and neurology training positions, and develop highly skilled non-specialists including trained.

  4. Advancing Neurologic Care in the Neonatal Intensive Care Unit with a Neonatal Neurologist

    Science.gov (United States)

    Mulkey, Sarah B.; Swearingen, Christopher J.

    2014-01-01

    Neonatal neurology is a growing sub-specialty area. Given the considerable amount of neurologic problems present in the neonatal intensive care unit, a neurologist with expertise in neonates is becoming more important. We sought to evaluate the change in neurologic care in the neonatal intensive care unit at our tertiary care hospital by having a dedicated neonatal neurologist. The period post-neonatal neurologist showed a greater number of neurology consultations (Pneurology encounters per patient (Pneurology became part of the multi-disciplinary team providing focused neurologic care to newborns. PMID:23271754

  5. Emergency neuroradiology

    International Nuclear Information System (INIS)

    Scarabino, T.; Hospital of Andria; Salvolini, U.; Jinkins, J.R.

    2006-01-01

    The book is directed at emergency radiologists and neuroradiologists. It aims at providing exhaustive information that will help the reader understand the clinical problems in the full range of neurological emergencies and to select the methodological and technical options that will ensure prompt and effective response and correct interpretation of the clinical findings. The various chapters address the most common neuroradiological emergencies, summarize their fundamental physiopathological features, describe the main semiological and differential diagnostic features, and provide operative suggestions for the selection of the appropriate techniques to be applied in a sequential order. The book addresses the application of state-of-the-art techniques and their implications for clinical practice (particularly the contributions of standard and functional MRI and of spiral and multislice CT). The illustrations provide not only training but also reference material for routine clinical work. (orig.)

  6. Georges Marinesco (1863-1938): neurologist, neurohistologist and neuropathologist.

    Science.gov (United States)

    Catala, M; Poirier, J

    2012-01-01

    Gheorghe Marinescu (Georges Marinesco, in French) is a Romanian physician, founder of the School of Neurology in that country. He begins his medical studies in Bucharest, then has the opportunity to reach Paris and join the School of Neurology in La Salpêtrière Hospital, lead by Jean-Martin Charcot. This trip will forever imprint the mind of Marinescu, a great friend of France, a respectful student of Charcot and a friendly colleague of many Parisian neurologists. Marinescu's works are multiple and very important. He describes the succulent hand in syringomyelia and the palmar-jaw reflex. Marinescu is also one of the first to use the cinema for medical purposes. His work as an anatomo-clinician, a method developed by Charcot, is important. We denote the description of the locus niger affected by tuberculosis in a case of parkinsonism (this description paving Etienne Brissaud's way to highlight the anatomical origin of Parkinson's disease), the original clinical description of Marinesco-Sjögren syndrome, and that of medullomyoblastoma. Marinescu is also a famous neurocytologist as evidenced by his work, La Cellule Nerveuse, published in 1909. The first volume of the book is devoted to the aspects of the normal nervous tissue: the neurofibrillar network, the chromatophilic elements, and the paranucleolar corpuscles (now known as Marinescu's bodies). The second volume of the book is almost related to features revealed by experimental lesions: chromatolysis and neuronophagia. Furthermore, Marinescu describes with Oscar Blocq, small nodules than are now regarded as the first description of senile plaques.

  7. [The role of neurologists in deep brain stimulation for Parkinson disease: a neurosurgical perspective].

    Science.gov (United States)

    Umemura, Atsushi

    2012-01-01

    Deep brain stimulation (DBS) has been accepted as an effective treatment for medically refractory Parkinson disease (PD). Appropriate patient selection, safe and precise surgery, and proper postoperative adjustment of stimulation and medication, are essential for the success of DBS. Patient selection is the most important role for the neurologist in DBS treatment. Neurologists treating PD should understand the correct indications and contraindications for DBS, and introduce it in a timely manner to patients who can be expected to benefit substantially from it. For long term treatment of PD, ideally the neurologist in charge of the patient should adjust both the stimulation parameters and medication. Neurologists engaged in this treatment should also have a comprehensive understanding of the probable complications and how to avoid them.

  8. Qualitative study of burnout, career satisfaction, and well-being among US neurologists in 2016.

    Science.gov (United States)

    Miyasaki, Janis M; Rheaume, Carol; Gulya, Lisa; Ellenstein, Aviva; Schwarz, Heidi B; Vidic, Thomas R; Shanafelt, Tait D; Cascino, Terrence L; Keran, Chris M; Busis, Neil A

    2017-10-17

    To understand the experience and identify drivers and mitigating factors of burnout and well-being among US neurologists. Inductive data analysis was applied to free text comments (n = 676) from the 2016 American Academy of Neurology survey of burnout, career satisfaction, and well-being. Respondents providing comments were significantly more likely to be older, owners/partners of their practice, solo practitioners, and compensated by production than those not commenting. The 4 identified themes were (1) policies and people affecting neurologists (government and insurance mandates, remuneration, recertification, leadership); (2) workload and work-life balance (workload, electronic health record [EHR], work-life balance); (3) engagement, professionalism, work domains specific to neurology; and (4) solutions (systemic and individual), advocacy, other. Neurologists mentioned workload > professional identity > time spent on insurance and government mandates when describing burnout. Neurologists' patient and clerical workload increased work hours or work brought home, resulting in poor work-life balance. EHR and expectations of high patient volumes by administrators impeded quality of patient care. As a result, many neurologists reduced work hours and call provision and considered early retirement. Our results further characterize burnout among US neurologists through respondents' own voices. They clarify the meaning respondents attributed to ambiguous survey questions and highlight the barriers neurologists must overcome to practice their chosen specialty, including multiple regulatory hassles and increased work hours. Erosion of professionalism by external factors was a common issue. Our findings can provide strategic direction for advocacy and programs to prevent and mitigate neurologist burnout and promote well-being and engagement. © 2017 American Academy of Neurology.

  9. Burnout, psychological morbidity, job stress, and job satisfaction in Chinese neurologists.

    Science.gov (United States)

    Zhou, Xinyu; Pu, Juncai; Zhong, Xiaoni; Zhu, Dan; Yin, Dinghong; Yang, Lining; Zhang, Yuqing; Fu, Yuying; Wang, Haiyang; Xie, Peng

    2017-05-02

    To investigate the prevalence of and personal and professional characteristics associated with burnout, psychological morbidity, job stress, and job satisfaction in Chinese neurologists. The China Neurologist Association conducted a national cross-sectional study from September 2014 to March 2015. A questionnaire including the Maslach Burnout Inventory, the 12-item General Health Questionnaire, the Consultants' Mental Health Questionnaire, and questions assessing personal and professional characteristics, career satisfaction, and current doctor-patient relationships was administered. A total of 693 directors of neurology departments and 6,111 neurologists in 30 Chinese provinces returned surveys. Overall, 53.2% of responding neurologists experienced burnout, 37.8% had psychological morbidity, 50.7% had high levels of job stress, 25.7% had low levels of job satisfaction, 76.9% had poor doctor-patient relationships, and 58.1% regretted becoming a doctor. Factors independently associated with burnout were lower income, more hours worked per week, more nights on call per month, working in public hospitals, psychological morbidity, high levels of job stress, low levels of job satisfaction, and poor doctor-patient relationships. Factors independently associated with psychological morbidity included lower income, more nights on call per month, working in enterprise-owned hospitals, burnout, high levels of job stress, and low levels of job satisfaction. Burnout and psychological morbidity are common in Chinese neurologists. Burnout is the single greatest predictor of neurologists' psychological morbidity, high job stress, and low job satisfaction. © 2017 American Academy of Neurology.

  10. [Subjective job strain and job satisfaction among neurologists in German hospitals].

    Science.gov (United States)

    Bauer, J; Bendels, M H K; Groneberg, D A

    2016-06-01

    The number of sick leaves due to job strain is increasing. This study's scope is to examine working conditions of neurologists in hospitals in regard to job strain and job satisfaction. This study is part of the iCEPT-Study. The iCEPT-Study was conducted as a web based survey among physicians (n = 7090) in German hospitals. The focus was on working conditions regarding job strain. Job strain was measured by a questionnaire consisting of items and scales from the short version of the Effort-Reward-Imbalance (ERI) questionnaire and the short questionnaire for working analysis (KFZA). By calculation ratios of distinct scales according to validated stress models a conclusion could be drawn as to whether or not job strain was present. The total number of n = 354 neurologists were analyzed. The response rate was at 18.2 %. Job strain was encountered by 52.0 % (95 %-KI: 46.7|57.2) of all neurologists and no significant gender difference was present. However, resident neurologists were significantly more often exposed to job strain than attending neurologists (OR = 2.9; 95 %-KI: 1.6-4.7; p job satisfaction, 59.6 % (95 %-KI: 54.5-64.7) of all respondents stated to be satisfied with their job. Significantly more men were satisfied than women (OR = 1.5; 95 %-KI: 1.0-2.4; p job than residents (OR = 2.9; 95 %-KI: 1.7-4.8; p job strain among neurologists in German hospitals. Keeping the negative implications of mental and physical health in mind, the working conditions of neurologists must be improved. As shown in this study, a possible way to do so is to increase job control in order to decrease a major stressor at work.

  11. Correspondence and challenges as neurologists to Kumamoto Earthquakes in 2016.

    Science.gov (United States)

    Nakajima, Makoto; Nakane, Nozomi; Takamatsu, Kotaro; Yamashita, Satoshi; Nakane, Shunya; Yamashita, Taro; Ando, Yukio

    2016-12-28

    Kumamoto Earthquakes in 2016 severely affected medical circumstances and condition of each patient with neuro-muscular diseases, in addition to having destroyed life circumstances of local residence. Number of neuro-muscular disease patients admitted to the Department of Neurology, Kumamoto University, the only university hospital in the prefecture, increased approximately twice compared to usual years. Most of the related facilities were able to admit emergency patients with neuro-muscular diseases although the hospital buildings were damaged in various degrees. A number of issues remained unsolved as to emergency contact system, securement of emergency beds for severe neuro-muscular diseases, and information system for these patients.

  12. A real life clinical practice of neurologists in the ambulatory setting in Thailand: a pragmatic study

    Directory of Open Access Journals (Sweden)

    Kannikar Kongbunkiat

    2015-06-01

    Full Text Available The burden of neurological disorders is high in developing countries. Real life data from neurologists as to how they practice in Thailand are limited in literature. Practices of neurologists in a university hospital clinical setting in Thailand were studied. A prospective study was performed at the ambulatory neurology clinic, Khon Kaen University Hospital, between 1 February and 31 October 2009. The following data were recorded: numbers of patients, characteristics of patients, consultation notes, and time spent for each patient. There were three neurologists, each of whom ran one afternoon clinic, once a week. There were 6137 visits during the 9 months, with an average of 681 visits per month. The total number of patients was 2834. The three most common diseases were cerebrovascular diseases (33%, epilepsy (16%, and movement disorders (non-Parkinson’s disease, 12%. Neurologists spent an average of 6.34 minutes per patient. In conclusion, neurologists in medical schools have limited time to take care of each patient. Several strategies are needed in medical education and neurology training to improve the quality of care.

  13. European Association of Young Neurologists and Trainees: position paper on teaching courses for Generation Y.

    Science.gov (United States)

    Struhal, Walter; Falup-Pecurariu, Cristian; Sztriha, Laszlo K; Grisold, Wolfgang; Sellner, Johann

    2011-01-01

    The European Association of Young Neurologists and Trainees (EAYNT) is a non-profit organization which acts on behalf of young neurologists in Europe and concertedly exerts influence on the formation of a new generation of neurologists [Struhal et al.: Eur J Neurol 2009;16:e146-e148]. This concerns particularly the Generation Y (Gen Y), also known as Millennial Generation, Digital Natives or Generation Next, a demographic cohort defined by birth between 1981 and 1999 [Elkind: Neurology 2009;72:657-663]. A unifying feature is the increased use and familiarity with online media and digital technologies. Online social networks and interactive communication have not only shaped this cohort but necessitate a different approach towards educational matters. This position paper aims to address the changing needs for Gen Yers in the context of education. Copyright © 2011 S. Karger AG, Basel.

  14. Burnout, career satisfaction, and well-being among US neurologists in 2016.

    Science.gov (United States)

    Busis, Neil A; Shanafelt, Tait D; Keran, Christopher M; Levin, Kerry H; Schwarz, Heidi B; Molano, Jennifer R; Vidic, Thomas R; Kass, Joseph S; Miyasaki, Janis M; Sloan, Jeff A; Cascino, Terrence L

    2017-02-21

    To study prevalence of and factors that contribute to burnout, career satisfaction, and well-being in US neurologists. A total of 4,127 US American Academy of Neurology member neurologists who had finished training were surveyed using validated measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016. Response rate was 40.5% (1,671 of 4,127). Average age of participants was 51 years, with 65.3% male and nearly equal representation across US geographic regions. Approximately 60% of respondents had at least one symptom of burnout. Hours worked/week, nights on call/week, number of outpatients seen/week, and amount of clerical work were associated with greater burnout risk. Effective support staff, job autonomy, meaningful work, age, and subspecializing in epilepsy were associated with lower risk. Academic practice (AP) neurologists had a lower burnout rate and higher rates of career satisfaction and quality of life than clinical practice (CP) neurologists. Some factors contributing to burnout were shared between AP and CP, but some risks were unique to practice setting. Factors independently associated with profession satisfaction included meaningfulness of work, job autonomy, effectiveness of support staff, age, practicing sleep medicine (inverse relationship), and percent time in clinical practice (inverse relationship). Burnout was strongly associated with decreased career satisfaction. Burnout is common in all neurology practice settings and subspecialties. The largest driver of career satisfaction is the meaning neurologists find in their work. The results from this survey will inform approaches needed to reduce burnout and promote career satisfaction and well-being in US neurologists. © 2017 American Academy of Neurology.

  15. Carpal tunnel sonography by the rheumatologist versus nerve conduction study by the neurologist

    NARCIS (Netherlands)

    Swen, WAA; Jacobs, JWG; Bussemaker, FEAM; de Waard, J; Bijlsma, JWJ

    Objective. To determine the value of sonogaphy (SG) performed by the rheumatologist to diagnose carpal tunnel syndrome (CTS). Methods. Sixty-three patients with clinical signs of CTS according to the neurologist. based on patient history and clinical examination, were studied. In the 6 weeks prior

  16. The Neurologist's Work Flow - A Full Work Analysis at German Hospitals

    NARCIS (Netherlands)

    Mache, S.; Koch, M.; Vitzthum, K.; Schoeffel, N.; Scutaru, C.; Klapp, B.; Groneberg, D.

    Background During the past few years, neurologists have often complained about their working situation. It is necessary to analyse these statements using not only questionnaires but also by carrying out objective task analyses. However, such data are not available at present. Therefore, the aim of

  17. How many neurologists/epileptologists are needed to provide reliable descriptions of seizure types?

    NARCIS (Netherlands)

    van Ast, J. F.; Talmon, J. L.; Renier, W. O.; Hasman, A.

    2003-01-01

    We are developing seizure descriptions as a basis for decision support. Based on an existing dataset we used the Spearman-Brown prophecy formula to estimate how many neurologist/epileptologists are needed to obtain reliable seizure descriptions (rho = 0.9). By extending the number of participants to

  18. Where do neurologists look when viewing brain CT images? An eye-tracking study involving stroke cases.

    Directory of Open Access Journals (Sweden)

    Hideyuki Matsumoto

    Full Text Available The aim of this study was to investigate where neurologists look when they view brain computed tomography (CT images and to evaluate how they deploy their visual attention by comparing their gaze distribution with saliency maps. Brain CT images showing cerebrovascular accidents were presented to 12 neurologists and 12 control subjects. The subjects' ocular fixation positions were recorded using an eye-tracking device (Eyelink 1000. Heat maps were created based on the eye-fixation patterns of each group and compared between the two groups. The heat maps revealed that the areas on which control subjects frequently fixated often coincided with areas identified as outstanding in saliency maps, while the areas on which neurologists frequently fixated often did not. Dwell time in regions of interest (ROI was likewise compared between the two groups, revealing that, although dwell time on large lesions was not different between the two groups, dwell time in clinically important areas with low salience was longer in neurologists than in controls. Therefore it appears that neurologists intentionally scan clinically important areas when reading brain CT images showing cerebrovascular accidents. Both neurologists and control subjects used the "bottom-up salience" form of visual attention, although the neurologists more effectively used the "top-down instruction" form.

  19. A review of Edward Flatau's 1894 Atlas of the Human Brain by the neurologist Sigmund Freud.

    Science.gov (United States)

    Triarhou, Lazaros C

    2011-01-01

    In 1894, the Polish neurologist Edward Flatau (1868-1932), working in Berlin, published an exquisite photographic atlas of the unfixed human brain, preceding by 2 years Das Menschenhirn, the reference work of Gustaf Retzius (1842-1919) in Stockholm. In his early career as a neuroanatomist and neurologist, Sigmund Freud (1856-1939) wrote a review of Flatau's atlas for the Internationale klinische Rundschau, which has not been included in the 'Standard Edition of the Complete Psychological Works'. The aim of the present paper is twofold: to document Freud's review, and to revive the largely forgotten atlas of Flatau. The full text of Freud is presented in translation. Further, one element Flatau, Retzius and Freud had in common is discussed: their early role as protagonists and firm supporters of Ramón y Cajal's neuron theory, the cornerstone of modern neuroscience. Copyright © 2010 S. Karger AG, Basel.

  20. Diffusion-weighted imaging in diagnosing neurological disorders in children: a pediatric neurologist's perspective

    International Nuclear Information System (INIS)

    Benedict, Susan L.

    2007-01-01

    Diffusion-weighted imaging (DWI) has provided a way to measure early changes in cellular function in the central nervous system. It has permitted rapid, less invasive diagnosis and treatment of neurological disorders that were once thought to be untreatable. DWI has also created new avenues of research and alternative ways to measure study outcomes. Seven clinical cases illustrate how DWI enhances the ability of the pediatric neurologist to rapidly diagnose acute neurological disorders in infants and children. (orig.)

  1. [Present status of Japanese neurologists from the questionnaire survey - to support women doctor's career advancement].

    Science.gov (United States)

    Fukaura, Hikoaki

    2013-01-01

    Childcare issue and family care issue are critical factors for women doctors to make a career as a neurologist in Japan. To know the actual business conditions of Japanese neurologists an online questioner survey was conducted. Answers were obtained from 737 members of Japanese Society of Neurology and 21 neurological medical facilities. Most of the answers were form members at three major metropolitan areas such as Tokyo, Osaka and Nagoya. Nobody from some prefectures was replied any answer. Almost sixty percent woman doctors had to change their working style from full time to part time at their child raising period and had difficulty with returning to full time job. Some neurologists have answered they used paid vacation to care their families and they felt they could not keep it for a longer period. At 70 percent of medical facilities sick child day care center were not operated. Opinions form members extremely varied from "In the first place woman doctors are unnecessary"to "With the help of the partner I have survived my child raising period".

  2. What belgian neurologists and neuropsychiatrists tell their patients with Alzheimer disease and why: a national survey.

    Science.gov (United States)

    Tarek, Meriem Essabiri; Segers, Kurt; Van Nechel, Christian

    2009-01-01

    To check their opinions concerning the disclosure of the diagnosis of Alzheimer disease (AD), a questionnaire was sent to all neurologists and neuropsychiatrists currently active in Belgium, excluding neuropediatricians. Of 573 questionnaires, 44% were returned. Sixty-eight percent of the responders always announce the diagnosis to their patients, 24% prefer to reveal the diagnosis only to patients with mild dementia. Doctors who announce the diagnosis to all their patients and who believe that its a benefit for the patient (67%) were more likely to be younger, to be neurologists, and to speak Dutch. The most important arguments in favor of announcing the diagnosis were the patient's right to know and the reinforcement of the doctor-patient relationship. The main arguments against revealing the diagnosis were the patient's right not to know and fear of provoking a depression. Two-third of the participants informed the patients about the prognosis and natural evolution of AD. These doctors tended to be younger, to be neurologists, and to speak Dutch. Young doctors tend to be more "open" toward their patients concerning the diagnosis of AD, consistent with the current guidelines. The differences between Dutch and French speaking doctors might be partially due to the fact that in French, "démence" has a psychiatric connotation.

  3. Gender differences in psychological morbidity, burnout, job stress and job satisfaction among Chinese neurologists: a national cross-sectional study.

    Science.gov (United States)

    Pu, Juncai; Zhou, Xinyu; Zhu, Dan; Zhong, Xiaoni; Yang, Lining; Wang, Haiyang; Zhang, Yuqing; Fan, Songhua; Liu, Lanxiang; Xie, Peng

    2017-07-01

    Women are an important part of the medical workforce, yet little is known about gender differences in psychological morbidity, burnout, job stress and job satisfaction among neurologists. This study assessed gender differences in a large national sample of Chinese neurologists. Multivariate analyses were performed to examine associations. A total of 5558 neurologists were included in the analysis. Compared with their male counterparts, female neurologists were generally younger; were less likely to be married or to have children; had higher levels of education; were in practice for a shorter period of time; were less likely to hold senior roles; and had lower incomes. Male and female neurologists worked similar hours and spent a similar number of nights on call. No gender differences were found in psychological morbidity, burnout, and high levels of job stress for female and male, respectively. Women had higher emotional exhaustion scores, while men were more likely to have low levels of job satisfaction. The multivariate analysis showed that factors independently associated with psychological morbidity, burnout, high levels of job stress and low levels of job satisfaction were generally similar for women and men. These findings increase our understanding of gender differences in psychological morbidity, burnout, job stress, and job satisfaction among neurologists. As more women join the medical profession, these differences may be useful in designing medical training and practice.

  4. Childhood Central Nervous System Embryonal Tumors Treatment

    Science.gov (United States)

    ... medicine . These may include the following specialists : Pediatrician . Neurosurgeon . Neurologist . Neuropathologist . Neuroradiologist . Rehabilitation specialist . Radiation oncologist . Psychologist . ...

  5. Childhood Ependymoma Treatment

    Science.gov (United States)

    ... medicine . These may include the following specialists : Pediatric neurosurgeon . Neurologist . Neuropathologist . Neuroradiologist . Pediatrician . Rehabilitation specialist . Radiation oncologist . ...

  6. [German neurology and neurologists during the Third Reich: Preconditions and general framework before and after 1933].

    Science.gov (United States)

    Martin, M; Karenberg, A; Fangerau, H

    2016-08-01

    This article focuses on the institutional development of neurology in Germany up to the rise to power of the National Socialists and the radical sociopolitical changes after 1933. A wide range of scattered secondary literature was assessed and evaluated. Additionally, some original sources are literally quoted and interpreted according to the context. Since the end of the nineteenth century a complicated process of separation from internal medicine and psychiatry led to the formation of a self-conscious discipline of neurology. The first generation of German neurologists succeeded in founding the German Journal for Neurology ("Deutsche Zeitschrift für Nervenheilkunde") in 1890 and their own neurological association, the Society of German Neurologists ("Gesellschaft Deutscher Nervenärzte", GDN) in 1907. On an international scale, however, the institutional implementation of neurology with only a small number of chairs and few neurology departments remained more than modest. The ambitions for autonomy ended 2 years after the change of power in 1933. Regulatory interventions by the government and psychiatric interests led to the fusion of the GDN with the psychiatric specialist society, the new association being called the Society of German Neurologists and Psychiatrists ("Gesellschaft Deutscher Neurologen und Psychiater", GDNP) in 1935. In this group psychiatrists dominated the discourse. The expulsion, imprisonment and murder of physicians declared as non-Aryan or Jewish along with the forced consolidation ("Gleichschaltung") at the universities prompted profound changes in medical and academic life. It remains an ongoing challenge of neurological historical research to measure the impact of this upheaval on the few neurology departments in hospitals and private practices.

  7. [Survey on the attitude toward genetic testing of neurologists certified by the Japanese Society of Neurology].

    Science.gov (United States)

    Yoshida, Kunihiro; Ohata, Takako; Muto, Kaori; Tsuchiya, Atsushi; Sawada, Jinichi; Hazama, Takanori; Ikeda, Shu-Ichi; Toda, Tatsushi

    2013-01-01

    To clarify the attitude toward genetic testing for neuromuscular diseases, a questionnaire was sent to 4,762 neurologists certified by the Japanese Society of Neurology. By December 21, 2011, 1,493 questionnaires (31.4%) were returned. Of these, 1,233 (82.6%) had experienced genetic testing, but only 396 (26.5%) had referred to the guideline for genetic testing of the Japanese Society of Neurology (2009). The numbers of respondents who were positive, or more positive than negative for genetic testing for myotonic dystrophy type 1 (DM1), Huntington's disease (HD), and familial amyloid polyneuropathy (FAP) were 753 (50.4%), 915 (61.3%), and 980 (65.6%), respectively. The predominant reason for a positive attitude toward genetic testing was to confirm or exclude the diagnosis. Conversely, the predominant reason for a negative attitude toward genetic testing differed between the diseases. For DM1, it was to confirm the diagnosis without genetic testing. For HD, it was that genetic testing would not result in effective prevention or therapy. In FAP, it was that post-testing psychosocial support for the patient and their family was difficult. Common to DM1, HD, and FAP, a significant number of respondents (approximately 60%) felt it difficult to explain the negative aspects that might occur after the disclosure of test results. Concerning predictive or prenatal genetic testing, most respondents referred at-risk individuals to specialized genetic counseling clinics. In general, neurologists are likely to conduct genetic testing properly in consideration not only of the characteristics of the diseases but also of the circumstances of each patient and his or her family. To support neurologists who are involved in genetic testing, the guidelines should be more easily accessible. Many respondents wanted information on the institutions that provide genetic counseling and testing; however, financial support to such institutions is indispensable for fulfilling this requirement.

  8. The Profile of Neurology Patients Evaluated in the Emergency Department

    OpenAIRE

    Ufuk Emre; Ayşe Semra Demir; Esra Acıman; Nejla Çabuk; Sibel Kıran; Aysun Ünal

    2009-01-01

    OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood...

  9. Epidemiology of chronic pain in the office of a pain specialist neurologist

    Directory of Open Access Journals (Sweden)

    Karen dos Santos Ferreira

    2015-07-01

    Full Text Available Objective The objective of the present report was to describe the working experience of a pain specialist neurologist after concluding a medical residency program on neurology, area of concentration pain. Method A retrospective study was conducted for one year in the office of a pain specialist neurologist. Patients older than 18 years with chronic pain according to the criteria of the International Association for the Study of Pain, were included. Demographic data, chronic pain data and the treatments instituted were investigated. Results A total of 241 medical records were reviewed, mean patient age was 52.4 years and 79 (66.9% were women, and the mean score on a numeric pain scale was 8.69. The diagnoses were headaches (74.6%, neuropathic pain (17% and ostheomuscular pain (8.2%. We did not detect cancer pain. Patients received medication and procedures of anesthetic blockade. Conclusion This data can guide new medical residency programs on Neurology, area of concentration pain, to plan activities and studies.

  10. [Internet presence of neurologists, psychiatrists and medical psychotherapists in private practice].

    Science.gov (United States)

    Kuhnigk, Olaf; Ramuschkat, Meike; Schreiner, Julia; Anger, Anina; Reimer, Jens

    2014-04-01

    The world wide web provides new options to physicians in terms practice marketing, information brokerage, and process optimization. This study explores prevalence and content of homepages of neurologists, psychiatrists and medical psychotherapists in private practice. Through the legal bodies of physicians in private practice in six northern German states neurologists, psychiatrists and medical psychotherapists were identified. According to a standardized and operationalized criteria catalogue, homepages were rated. 1804 physicians were identified, 352 (19.5 %) had operated a homepage. Higher frequencies of homepages found for male physicians (vs. female physicians), practice centres (vs. single practices) and urban practices (vs. rural practices). In average, practices reached 18.8 (± 5.3) of 42 points; contact data and accessibility information were generally available; information as to qualification and specialization was provided more infrequently. Legal specifications were not considered in more than every second homepage, interactive elements like online appointment of follow-up prescription were only rarely offered. Only every fifth neurological or psychiatric practice operates an own homepage, higher competition (urban area) and higher professionalization (practice centres) seem to act as promotors. The legal framework has to be focused, and patient needs should be taken into account. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care.

    LENUS (Irish Health Repository)

    Costelloe, L

    2012-02-01

    BACKGROUND: Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised. AIMS\\/METHODS: We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care. RESULTS: Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days. CONCLUSIONS: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

  12. Diagnosis, management and prevention of ischemic stroke for non-neurologists

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2011-07-01

    Full Text Available Background: Stroke is the third common cause of disability and death. Diagnosis of stroke is based on its clinical manifestations and/or observation of infarct in the neuroimaging. Standard battery of diagnostic investigations and classification criteria is required for detection of stroke etiology. Materials and Method: This review article deals with the diagnosis and management of brain infarction particularly in our country and is provided for non-neurologists. Using online scientific search engines and in some parts referring to laboratory archives constituted base of this review article.Results: Acute stroke management is almost similar in its various etiologies. Neuroprotective drugs have little value in acute stroke management. At present time, a few Iranian medical centers have infrastructure of thrombolysis therapy. Prevention of stroke is based on the detection and control of its risk factors. Aspirin, 80 mg per day is the most common drug for stroke prevention. Co-administration of aspirin 80 mg/d and Dipyridamole 200-400 mg/d increases the preventive effects of aspirin. Clopidogrel 75 mg/d is the stroke preventive drug of choice in patients with peptic ulcer and coronary artery disease. Co-administration of aspirin and clopidogrel is more effective in stroke prevention but has more hemorrhagic complications. Using warfarin for stroke prevention is suggested only in patients who have facilities for repetitive coagulation tests. Carotid endarterectomy is indicated in symptomatic patients with more than 70% stenosis of extracranial internal carotid artery, if performed only by vascular surgeons experienced in carotid surgery.Conclusion: Many stroke patients are managed by general practitioners and non-neurologists, e.g. internists, cardiologists and neurosurgeons. This review article provides continuous medical education according to Iranian medical curriculum

  13. [German neurology and neurologists during the Third Reich: brain research and "euthanasia"].

    Science.gov (United States)

    Martin, M; Karenberg, A; Fangerau, H

    2016-08-01

    The connection between systematic killing of the mentally ill and disabled, euphemistically called "euthanasia" in the National Socialism ideology, and German brain research has been thoroughly investigated and in detail; however, the impact of this criminal nexus on the image and self-perception of German neurologists as well as the status of neurology as a medical discipline is still the subject of controversial debates.Between 1939 and 1945 the Kaiser Wilhelm Institute (KWI) in Berlin along with other research centres were insofar enmeshed in the "euthanasia" program as brains of killed patients were dissected in the guise of "concomitant research" in order to generate medical knowledge. Affected were mainly individuals suffering from oligophrenia, early childhood brain atrophy, cerebral palsy and epilepsy. According to current historical research, collegial networks were instrumental in receiving brains of killed patients. Furthermore, civil research units were supplemented by military ones at the KWI. These, too, were concerned with the collection of medical knowledge, for instance on injuries of the brain and spinal cord. The historical approach to consider the Nazi organizations and medicine as "resources for each other" seems, therefore, at least in part applicable to neurology.

  14. 'Breaking Good News': Neurologists' experiences of discussing SUDEP with patients in Scotland.

    Science.gov (United States)

    Nisbet, Tom; Turbull, Sue; Mulhern, Sharon; Razvi, Saif

    2017-05-01

    Since the findings of a Fatal Accident Inquiry (FAI) in 2010, clinicians working in Scotland have been advised to discuss the risk of Sudden Unexpected Death in Epilepsy (SUDEP) with patients immediately or soon after a diagnosis of epilepsy is made. A thematic analysis was used to describe the experiences discussing SUDEP of 10 clinicians (six Consultant Neurologists and four Neurology Registrars) working in Scotland. Contrary to previous research, clinicians appear to be routinely discussing SUDEP in a standardized fashion with newly diagnosed patients and the FAI appears to have instigated this change in practice. Clinicians are ambivalent about the practice and whether this is a Breaking Bad News (BBN) experience. Clinicians appear to anticipate that patients will be anxious or distressed discussing SUDEP, despite their experiences that patients do not react this way. There are further concerns that the pressure to discuss SUDEP, as a result of the FAI, hinders effective communication of the SUDEP message. Implications for guideline development are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Between resentment and aid: German and Austrian psychiatrist and neurologist refugees in Great Britain since 1933.

    Science.gov (United States)

    Loewenau, Aleksandra

    2016-01-01

    This article is a historiographical exploration of the experiences that German and Austrian émigré psychiatrists and neurologists made in Great Britain since 1933, after the Nazi Governments in Central Europe had ousted them from their positions. When placing these occurrences in a wider historiographical perspective, the in-depth analysis provided here also describes the living and working conditions of the refugee neuroscientists on the British Isles. In particular, it looks at the very elements and issues that influenced the international forced migration of physicians and psychiatrists during the 1930s and 1940s. Only a fraction of refugee neuroscientists had however been admitted to Britain. Those lucky ones were assisted by a number of charitable, local, and academic organizations. This article investigates the rather lethargic attitude of the British government and medical circles towards German-speaking Jewish refugee neuroscientists who wished to escape Nazi Germany. It will also analyze the help that those refugees received from the academic establishment and British Jewish organizations, while likewise examining the level and extent of the relationship between social and scientific resentments in Great Britain. A special consideration will be given to the aid programs that had already began in the first year after the Nazis had seized power in Germany, with the foundation of the British Assistance Council by Sir William Henry Beveridge (1879-1963) in 1933.

  16. Consensus on the Definition of Advanced Parkinson’s Disease: A Neurologists-Based Delphi Study (CEPA Study

    Directory of Open Access Journals (Sweden)

    Maria-Rosario Luquin

    2017-01-01

    Full Text Available To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD. To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study. An ad hoc questionnaire was designed with 33 questions concerning the relevance of several clinical features for APD diagnosis. In the first-round, 240 neurologists of the Spanish Movement Disorders Group participated in the study. The results obtained were incorporated into the questionnaire and both, results and questionnaire, were sent out to and fulfilled by 26 experts in Movement Disorders. Review of results from the second-round led to a classification of symptoms as indicative of “definitive,” “probable,” and “possible” APD. This classification was confirmed by 149 previous participating neurologists in a third-round, where 92% completely or very much agreed with the classification. Definitive symptoms of APD included disability requiring help for the activities of daily living, presence of motor fluctuations with limitations to perform basic activities of daily living without help, severe dysphagia, recurrent falls, and dementia. These results will help neurologists to identify some key factors in APD diagnosis, thus allowing users to categorize the patients for a homogeneous recognition of this condition.

  17. Interobserver agreement in ABCD scoring between non-stroke specialists and vascular neurologists following suspected TIA is only fair.

    LENUS (Irish Health Repository)

    Kinsella, Justin A

    2012-02-01

    The appropriateness of use and accuracy of age, blood pressure, clinical features and duration of symptoms (ABCD) scoring by non-stroke specialists while risk-stratifying patients with suspected transient ischaemic attack (TIA) are unknown. We reviewed all available ABCD data from referrals to a specialist neurovascular clinic. ABCD scoring was defined as \\'appropriate\\' in this study if an experienced vascular neurologist subsequently confirmed a clinical diagnosis of possible, probable or definite TIA, and \\'inappropriate\\' if the patient had an alternative diagnosis or stroke. Interobserver agreement between the referring physician and the neurologist was calculated. One hundred and four patients had completed ABCD referral proformas available for analysis. Forty-five (43%) were deemed appropriate, and 59 (57%) inappropriate. In the entire dataset, the neurologist agreed with the referring physician\\'s total ABCD score in only 42% of cases [kappa = 0.28]. The two most unreliable components of the scoring system were clinical features [kappa = 0.51], and duration of symptoms [kappa = 0.48]. ABCD scoring by non-stroke specialists is frequently inappropriate and inaccurate in routine clinical practice, emphasising the importance of urgent specialist assessment of suspected TIA patients.

  18. Benefit-risk perception of natalizumab therapy in neurologists and a large cohort of multiple sclerosis patients.

    Science.gov (United States)

    Heesen, Christoph; Kleiter, Ingo; Meuth, Sven G; Krämer, Julia; Kasper, Jürgen; Köpke, Sascha; Gaissmaier, Wolfgang

    2017-05-15

    Natalizumab (NAT) is associated with the risk of progressive multifocal leukoencephalopathy (PML). Risk stratification algorithms have been developed, however, without detectable reduction of PML incidence. To evaluate to which extent patients and physicians understand and accept risks associated with NAT treatment. Prospective observational cohort study in German MS centers (n=73) among NAT-treated MS patients (n=801) and their neurologists (n=99). Patients included in this study had mean disease duration of 10.2years and a mean NAT treatment duration of 24months. More than 90% of patients and physicians voted for shared decision making or an informed choice decision making approach. Patients and physicians perceived a similar threat from MS as serious disease and both overestimated treatment benefits from NAT based on trial data. Men perceived MS more severe than women and perception of seriousness increased with age in both groups and in patients as well with increasing disability. Although patients evaluated their PML risk higher, their risk acceptance was significantly higher than of their neurologists. Risk stratification knowledge was good among neurologists and significantly lower among patients. While patients and physicians seem to have realistic risk perception of PML and knowledge of risk stratification concepts, the threat of MS and the perception of treatment benefits may explain the ongoing high acceptance of PML risk. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. [Survey on the current situation of the young neurologists in Spain: analysis of their current working stability and degree of social protection].

    Science.gov (United States)

    Arenillas, J F; Cisteré, V; Bonaventura, I; Coll-Cantí, J; Luquin, M R; Martínez-Vila, E

    2006-03-01

    The aims of this study were to evaluate the working stability and degree of social protection of the Spanish young neurologists, and to know their opinion about their own situation. The 343 neurologists that became specialists in Spain between 2000 and 2004 were asked to participate in two consecutive surveys. The first, conducted online, included questions about the availability to change the place of work and the opinion about the situation of young neurologists, and obtained 66 answers. The second was a telephonic and online survey, answered by 217 neurologists, whose questions referred to: places of neurological education and work, type of working contract, and degree of social protection (estimated by the percentage of worked time during which they paid Social Security contributions). Sixty-three per cent (136/217) of the Spanish young neurologists had an unstable job. The most frequent unstable working contracts were: eventual (n=65; 31%), on-call contracts (n=54; 25%) and grants (n=53; 24%). Forty-eight per cent of the neurologists who ended their specialization in 2000 still remained working-unstable. The mean percentage of worked time with full social protection was 71.01+/-36.74%. Less than a half (n=101; 46%) had social protection during the entire worked time, 60 (28.6%) were socially protected during protection. A direct relationship was observed 68 between working instability and lower social protection (p=0.0002). The working situation of the Spanish young neurologists was seen as problematic by 97% of the 66 participants in the first survey. The current situation of the Spanish young neurologists, attending their working stability and degree of social protection, seems precarious and problematic. Urgent actions should be taken by the Administration to improve it.

  20. [Online survey of the organizational structures of emergency neurology in Germany].

    Science.gov (United States)

    Topka, H; Pfefferkorn, T; Andres, F; Kastrup, A; Klein, M; Niesen, W; Poppert, H

    2017-06-01

    In 2007, the first poll among neurologists provided some insight into the organizational structures of emergency neurology in Germany. Given that emergency neurology as well as emergency medicine in general have undergone substantial changes during the last decade, the subcommittee Neurological Emergency Medicine of the German Neurological Society conducted a follow-up study to explore current structures supporting neurological emergency medicine in German neurological hospitals. Between July and September 2016, an online questionnaire was e‑mailed to 675 neurologists in institutions participating in in-patient neurological care. Of these, some 32% (university hospitals 49%) answered. Neurological patients represent 12-16% and hence a significant proportion of emergency patients. The fraction of in-patients admitted to hospitals via emergency departments amounted to 78% (median) in general hospitals and 52% in university hospitals. Most emergency departments are organized as an interdisciplinary structure combining conservative with surgical disciplines frequently led by an independent department head. Neurology departments employ rather diverse strategies to organize neurological emergency care. Also, the way emergency patients are assigned to different disciplines varied largely. Currently, neurological patients represent a rather growing fraction of patients in emergency departments. An increasing proportion of neurology in-patients enter the hospital via emergency departments. Neurology departments in Germany face increasing challenges to cope with large numbers of neurological emergency patients. While most of the participating neurologists indicated suffering predominantly from scarce personal resources both in neurology and neuroradiology, an independent neurological emergency department was not considered an option.

  1. A review of Heinrich Obersteiner's 1888 textbook on the central nervous system by the neurologist Sigmund Freud.

    Science.gov (United States)

    Hatzigiannakoglou, Paul D; Triarhou, Lazaros C

    2011-06-01

    In 1888, the Austrian neuroanatomist Heinrich Obersteiner, founder of Vienna's Neurological Institute, published his "Introduction to the Study of the Structure of the Central Nervous Organs in Health and Disease", a fundamental textbook in which he summarised the state-of-the-art knowledge available then on the normal and pathological anatomy of the human nervous system, incorporating many of his original research findings. The book became "the Bible for generations of budding neurologists" worldwide and was crucial for the eventual development of neurology as an independent medical discipline. In his early career as a neuroanatomist, Sigmund Freud wrote a review of Obersteiner's book for the Wiener Medizinische Wochenschrift. That review was not included in the "Standard Edition of the Complete Psychological Works". The present article provides an English translation of Freud's review and further discusses its historical context, especially regarding the influence of Theodor Meynert on his two illustrious students, Freud and Obersteiner.

  2. [Here the world is burning: the 70th anniversary of the death of neurologist Dr. John Rittmeister].

    Science.gov (United States)

    Teller, Ch

    2013-09-01

    John Rittmeister was a German neurologist (1898-1943) who was executed in Berlin-Plötzensee because of his decision to support organized political resistance against National Socialism. He grew up in a socially and materially privileged environment and following his final school examinations (Abitur) in 1917 he volunteered for war duties despite limited physical capabilities and was posted as a private to the war front in the Italian Alps and the Champagne district. While he was there he made his first social experiences outside his original surroundings. After the war he studied medicine and following the final state examinations and graduation he progressed to specialist training as a neurologist in Munich. At this time he came into contact with C.G. Jung. During a study period in London in 1929 he worked for several weeks as a resident at Toynbee Hall, a university institution in Whitechapel and experienced the methods of community work used there which were known under the term settlement movement. He continued his specialist activities in the neurological clinic in Zürich founded by C. von Monakow. Following the experiences in London he broke up with C.G. Jung and turned to Sigmund Freud and therapeutic analysis under Gustav Bally. In 1937 he returned to Germany. In 1939 he became director of the Policlinic of the German Institute for Psychological Research and Psychotherapy. Probably also due to his own war experiences in 1941/1942 he participated in the drafting of a flyer for the Schulze-Boysen/Harnack group against the war and after 8 months in prison he was executed in Berlin on 13 May 1943.

  3. Direct-to-consumer marketing of prescription drugs: a current perspective for neurologists and psychiatrists.

    Science.gov (United States)

    Hollon, Matthew F

    2004-01-01

    In the US and New Zealand, the past decade has seen tremendous growth in the marketing of prescription drugs directly to patients. The pharmaceutical industry has applied pressure in other countries to relax regulations governing such marketing although this has not yet been successful. While we still have much to learn about the potential impact on the public's health of direct-to-consumer (DTC) marketing, some data are available. This article summarises the current literature on the benefits and risks of DTC marketing. This marketing strategy has grown substantially in the US, but only select drugs are advertised. Whether there is net benefit or harm to the public's health as a result of DTC marketing depends critically on which drugs are advertised and the quality of the information provided in promotional material. Critical reviews of this promotional material suggest the information is of poor quality. Notably, 18% of the 50 drugs advertised most intensively in the US were medications used to treat psychiatric and neurological disorders. The impairments in decisional capacity often seen in psychiatric and neurological illness leave patients vunerable to the controlling influence of DTC marketing and, thus, undermine the patient autonomy that is said to be promoted by this marketing strategy. If there is any benefit from DTC marketing it is for significantly undertreated conditions. International restrictions on DTC marketing should remain in place until further evidence of net benefit or harm emerges from the DTC marketing experiment that is taking place in the US and New Zealand.

  4. Some Clinically Useful Information that Neuropsychology Provides Patients, Carepartners, Neurologists, and Neurosurgeons About Deep Brain Stimulation for Parkinson's Disease

    Science.gov (United States)

    Tröster, Alexander I

    2017-01-01

    Abstract Deep brain stimulation (DBS) is an effective (but non-curative) treatment for some of the motor symptoms and treatment complications associated with dopaminergic agents in Parkinson's disease (PD). DBS can be done relatively safely and is associated with quality of life gains. In most DBS centers, neuropsychological evaluations are performed routinely before surgery, and sometimes after surgery. The purpose of such evaluation is not to decide solely on its results whether or not to offer DBS to a given candidate, but to provide the patient and treatment team with the best available information to make reasonable risk-benefit assessments. This review provides information relevant to the questions often asked by patients and their carepartners, neurologists, and neurosurgeons about neuropsychological outcomes of DBS, including neuropsychological adverse event rates, magnitude of cognitive changes, outcomes after unilateral versus bilateral surgery directed at various targets, impact of mild cognitive impairment (MCI) on outcome, factors implicated in neurobehavioral outcomes, and safety of newer interventions or techniques such as asleep surgery and current steering. PMID:29077802

  5. Array CGH Analysis and Developmental Delay: A Diagnostic Tool for Neurologists.

    Science.gov (United States)

    Cameron, F; Xu, J; Jung, J; Prasad, C

    2013-11-01

    Developmental delay occurs in 1-3% of the population, with unknown etiology in approximately 50% of cases. Initial genetic work up for developmental delay previously included chromosome analysis and subtelomeric FISH (fluorescent in situ hybridization). Array Comparative Genomic Hybridization (aCGH) has emerged as a tool to detect genetic copy number changes and uniparental disomy and is the most sensitive test in providing etiological diagnosis in developmental delay. aCGH allows for the provision of prognosis and recurrence risks, improves access to resources, helps limit further investigations and may alter medical management in many cases. aCGH has led to the delineation of novel genetic syndromes associated with developmental delay. An illustrative case of a 31-year-old man with long standing global developmental delay and recently diagnosed 4q21 deletion syndrome with a deletion of 20.8 Mb genomic interval is provided. aCGH is now recommended as a first line test in children and adults with undiagnosed developmental delay and congenital anomalies. Puce d'hybridation génomique comparative et retard de développement : un outil diagnostic pour les neurologues. Le retard de développement survient chez 1 à 3% de la population et son étiologie est inconnue chez à peu près 50% des cas. L'évaluation génétique initiale pour un retard de développement incluait antérieurement une analyse chromosomique et une analyse par FISH (hybridation in situ en fluorescence) de régions subtélomériques. La puce d'hybridation génomique comparative (CGHa) est devenue un outil de détection des changements du nombre de copies géniques ainsi que de la disomie uniparentale et elle est le test le plus sensible pour fournir un diagnostic étiologique dans le retard de développement. Le CGHa permet d'offrir un pronostic et un risque de récurrence, améliore l'accès aux ressources, aide à limiter les évaluations et peut modifier le traitement médical dans bien des cas

  6. Management of optic neuritis in Ireland: a survey comparing the management practices of acute demyelinating optic neuritis amongst ophthalmologists and neurologists in Ireland.

    Science.gov (United States)

    Kobayter, Lina; Chetty, Shivona

    2018-04-24

    Acute optic neuritis (ON) is often the first manifestation of multiple sclerosis which is particularly common in Ireland. Despite the specific clinical details regarding investigations and management of ON provided by the Optic Neuritis Treatment Trial (ONTT), international surveys have shown that there are still notable differences in the management of ON between neurologists and ophthalmologists. To compare the investigation and treatment of acute optic neuritis between ophthalmologists and neurologists in Ireland METHOD: A survey consisting of a case scenario and questions regarding treatment and investigations of a patient with ON was emailed to ophthalmology consultants, trainees and medical ophthalmologists registered with the Irish College of Ophthalmologists and to neurology consultants and registrars registered with the Irish Institute of Clinical Neuroscience. One hundred sixty recipients responded out of 350 (46%). The majority of the neurologists would initiate steroid treatment regardless of the patient's vision (75%), treat with 1 g IV methylprednisolone (100%) for 5 days (57%), perform an MRI brain and orbits with contrast (92%) and multiple laboratory tests (96%). In contrast, the ophthalmologists tended to initiate treatment depending on the patient's vision (48%), treat with 1 g IV methylprednisolone (97%) for 3 days instead of 5 days (93%), perform MRI brain and orbits with contrast (73%) and favour electrophysiology testing (73%) over laboratory testing (68%). Overall, most respondents would follow the ONTT guidelines regarding IV methylprednisolone. There was a significant difference in responses between the ophthalmologists and neurologists regarding who to treat, duration of treatment and appropriate investigations.

  7. The sleeping brain in Parkinson's disease: A focus on REM sleep behaviour disorder and related parasomnias for practicing neurologists.

    Science.gov (United States)

    Bhidayasiri, Roongroj; Sringean, Jirada; Rattanachaisit, Watchara; Truong, Daniel D

    2017-03-15

    Sleep disorders are identified as common non-motor symptoms of Parkinson's disease (PD) and recently this recognition has been expanded to include parasomnias, encompassing not only REM sleep behaviour disorder (RBD), but also other non-REM forms. RBD, a prototypical parasomnia in PD, exists even in the prodromal stage of the disease, and is characterized by the presence of dream enactment behaviours occurring alongside a loss of normal skeletal muscle atonia during REM sleep. In contrast, non-REM parasomnias are more frequently observed in the late stage PD. However, the development of these disorders often overlaps and it is not uncommon for PD patients to meet the criteria for more than one type of parasomnias, thus making a clinical distinction challenging for practicing neurologists who are not sleep specialists. Indeed, clinical recognition of the predominant form of parasomnia does not just depend on video-polysomnography, but also on an individual physician's clinical acumen in delineating pertinent clinical history to determine the most likely diagnosis and proceed accordingly. In this review article, we highlight the various forms of parasomnias that have been reported in PD, including, but not limited to, RBD, with a focus on clinical symptomatology and implications for clinical practice. In addition, we review the differences in PD-related parasomnias compared to those seen in general populations. With advances in sleep research and better technology for ambulatory home monitoring, it is likely that many unanswered questions on PD-related parasomnias will soon be resolved resulting in better management of this nocturnal challenge in PD. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. One Europe, one neurologist?

    Science.gov (United States)

    Grisold, W; Galvin, R; Lisnic, V; Lopes Lima, J; Mueller, E; Oberndorfer, St; Vodusek, D B

    2007-03-01

    In recent years, there has been a major shift in emphasis within neurology from being a largely diagnostic discipline to one much more actively involved in treating disease. There have been major scientific advances leading to new and effective treatments. There is also a much greater awareness of the burden of neurological disease (Olesen J, Leonardi M. European Journal of Neurology 2003; 10: 471) and informed sufferers are requesting specific intervention. There is wide variation in the delivery of neurological services throughout Europe. This is reflected in manpower levels, the place of neurology related to other medical specialties and different mixes of hospital and private office practice. These differences have been thrown into sharper focus by the recent expansion of the European Union (EU). Initial training in neurology is given to undergraduate/pre-graduate students. Post-graduate education is delivered within a residency program leading to specialist qualification and certification. We now recognize that this is only the beginning of a life long program of continuous education and development (CME/CPD). National and international exchange programs facilitate the growth of knowledge and promote professional harmony and cooperation. The free migration of medical specialists has been an aspiration but remains limited by cultural, linguistic, personal, professional, political and economic factors. Two bodies, the European Board of Neurology (EBN-UEMS) http://www.uems-neuroboard.org (Union Européenne des Médecins Spécialistes) and the European Federation of Neurological Societies (EFNS) http://www.efns.org are actively involved in harmonising and developing neurology at the European level.

  9. The role of emergency neurology in Italy: outcome of a consensus meeting for a Intersociety position.

    Science.gov (United States)

    Micieli, Giuseppe; De Falco, Fabrizio A; Consoli, Domenico; Inzitari, Domenico; Sterzi, Roberto; Tedeschi, Gioacchino; Toni, Danilo

    2012-04-01

    A possible definition of clinical, educational and organizing aspects of emergency neurology in Italy is reported in this position paper of Emergency Neurology Intersociety Group, created in 2008 among the two neurological Societies in Italy: Società Italiana di Neurologia and Società di Neuroscienze Ospedaliere. The aim of this Group has been the evaluation of the role of neurologist in the emergency setting of Italian hospitals, as well as of the description of different scenarios in which a ward dedicated to a semi-intensive care of neurological emergencies could have a role in the actual organization of academic or general hospitals in our Country. The actual great relevance of neurologist activity in the inpatients treatment, in fact, is actually misleaded as it is the considerable significance of neurological expertise, techniques and support in hospital care pathways also involving neurological manifestations throughout the course of other diseases. Finally, the possible contents of educational programs orienting neurological specialty towards a better comprehension and management of emergency neurological problems either in terms of specific formation or of techniques to be learned by emergency neurologist, are reported as a results of the Consensus Workshop hold in Castiglioncello (LI) in September 12th, 2009.

  10. Predictors of and attitudes toward counseling about SUDEP and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians.

    Science.gov (United States)

    Strzelczyk, Adam; Zschebek, Gerda; Bauer, Sebastian; Baumgartner, Christoph; Grond, Martin; Hermsen, Anke; Kieslich, Matthias; Krämer, Günter; Kurlemann, Gerhard; May, Theodor W; Mayer, Thomas; Neubauer, Bernd A; Pfäfflin, Margarete; Plecko, Barbara; Ryvlin, Philippe; Schubert-Bast, Susanne; Stefan, Hermann; Trinka, Eugen; Knake, Susanne; Seifart, Carola; Rosenow, Felix

    2016-04-01

    To examine the attitudes toward counseling about sudden unexpected death in epilepsy (SUDEP) and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians, and to determine factors associated with not discussing SUDEP. Questionnaires were sent to approximately 5,000 neurologists and neuropediatricians in 2014 regarding respondents' demographics, their working environments, and how often they discussed SUDEP, suicidal ideations on anticonvulsive medication, driving restrictions, and risks in daily life activities. In total, 519 surveys were completed (respondents' mean age: 45.5 years, 41.6% female, 66.9% adult neurologists, 31.0% neuropediatricians). A minority of 2.7% reported that they counseled all of their patients on SUDEP, 8.7% counseled most of the time (50-90%), 20.8% sometimes (10-49%), 44.5% rarely (1-9%), and 23.3% reported not counseling about SUDEP at all. In contrast, 92.9% reported that they counseled all patients about driving restrictions and 81.5% about risks in daily life activities. Suicidal ideations were discussed in 59.0% for some and in 3.3% for all patients, whereas 35.1% of respondents reported never discussing suicidal ideations. Independent predictors of not discussing SUDEP were no additional epilepsy training, no or uncertain SUDEP cases in the past, <10 years in practice, <25 epilepsy patients seen per quarter, and the opinion of a lack of consequences in SUDEP prevention. The opinion that SUDEP is a risk factor in particular patient groups and the attitude that all risks should be discussed predicted counseling on SUDEP. Our findings show a discrepancy between guidelines and practice regarding the discussion of premature mortality due to SUDEP or suicidality. Both are not discussed at all by a substantial proportion of neurologists and neuropediatricians. This is in contrast to ubiquitous education about driving restrictions. Dissemination of knowledge among physicians about potential

  11. THE TOMSK SCIENTIFIC SCHOOL OF NEUROLOGISTS. TO THE 120TH ANNIVERSARY OF THE DEPARTMENT OF NEUROLOGY AND NEUROSURGERY OF SIBERIAN STATE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    V. M. Alifirova

    2013-01-01

    Full Text Available The history of the development of the Tomsk Scientific School Neurologists and the past and current events in the Department of Neurology and Neurosurgery of Siberian State Medical University are described. The Department of Neurology was established in 1881–1882. At a different times the department was headed by many great Russian physicians such as Michail G. Kurlov, Leonid I. Omorokov, Nikolay V. Schubin, Nikolay I. Komandenko. In addition to the academic work the department leads research in many fields of neurology, including movement disorders, cerebrovascular diseases, demyelinating and paroxysmal diseases. 

  12. 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

  13. The elusive ideal of inclusiveness: lessons from a worldwide survey of neurologists on the ethical issues raised by whole-genome sequencing.

    Science.gov (United States)

    Hurlimann, Thierry; Jaitovich Groisman, Iris; Godard, Béatrice

    2017-04-11

    The anticipation of ethical issues that may arise with the clinical use of genomic technologies is crucial to envision their future implementation in a manner sensitive to local contexts. Yet, populations in low- and middle-income countries are underrepresented in studies that aim to explore stakeholders' perspectives on the use of such technologies. Within the framework of a research project entitled "Personalized medicine in the treatment of epilepsy", we sought to increase inclusiveness by widening the reach of our survey, inviting neurologists from around the world to share their views and practices regarding the use of whole-genome sequencing in clinical neurology and its associated ethics. We discuss herein the compelling scientific and ethical reasons that led us to attempt to recruit neurologists worldwide, despite the lack, in many low- or middle-income countries, of access to genomic technologies. Recruitment procedures and their results are presented and discussed, as well as the barriers we faced. We conclude that inclusive recruitment remains a challenging, albeit necessary and legitimate, endeavour.

  14. [Coma in the emergency room].

    Science.gov (United States)

    Braun, M; Ploner, C J; Lindner, T; Möckel, M; Schmidt, W U

    2017-06-01

    Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO. We propose an interdisciplinary standard operating procedure (SOP) for patients with acute CUO as has been established in our maximum care hospital. The SOP is triggered by simple triage criteria that are sufficient to identify CUO patients before arrival in hospital. The in-hospital response team is led by a neurologist. Collaboration with nursing staff, internal medicine, anesthesiology, neurosurgery and trauma surgery is organized along structured pathways that include standardized laboratory tests, including cerebrospinal fluid (CSF), toxicology, computed tomography (CT) and CT angiography imaging (CTA). Our data suggest that neurologists and internists need to be placed at the beginning of the diagnostic work-up. Imaging should not just be carried out depending on the clinical syndrome because sensitivity, specificity and inter-rater reliability of the latter are not sufficient and because in many cases, multiple pathologies can be detected that could each explain CUO alone. Clinical examination, imaging and laboratory testing should be regarded as components of an integrative diagnostic approach and the final aetiological classification should only be made after the diagnostic work-up is complete.

  15. Oral anticoagulant re-initiation following intracerebral hemorrhage in non-valvular atrial fibrillation: Global survey of the practices of neurologists, neurosurgeons and thrombosis experts.

    Science.gov (United States)

    Xu, Yan; Shoamanesh, Ashkan; Schulman, Sam; Dowlatshahi, Dar; Al-Shahi Salman, Rustam; Moldovan, Ioana Doina; Wells, Philip Stephen; AlKherayf, Fahad

    2018-01-01

    While oral anticoagulants (OACs) are highly effective for ischemic stroke prevention in atrial fibrillation, intracerebral hemorrhage (ICH) remains the most feared complication of OAC. Clinical controversy remains regarding OAC resumption and its timing for ICH survivors with atrial fibrillation because the balance between risks and benefits has not been investigated in randomized trials. To survey the practice of stroke neurologists, thrombosis experts and neurosurgeons on OAC re-initiation following OAC-associated ICH. An online survey was distributed to members of the International Society for Thrombosis and Haemostasis, Canadian Stroke Consortium, NAVIGATE-ESUS trial investigators (Clinicatrials.gov identifier NCT02313909) and American Association of Neurological Surgeons. Demographic factors and 11 clinical scenarios were included. Two hundred twenty-eight participants from 38 countries completed the survey. Majority of participants were affiliated with academic centers, and >20% managed more than 15 OAC-associated ICH patients/year. Proportion of respondents suggesting OAC anticoagulant resumption varied from 30% (for cerebral amyloid angiopathy) to 98% (for traumatic ICH). Within this group, there was wide distribution in response for timing of resumption: 21.4% preferred to re-start OACs after 1-3 weeks of incident ICH, while 25.3% opted to start after 1-3 months. Neurosurgery respondents preferred earlier OAC resumption compared to stroke neurologists or thrombosis experts in 5 scenarios (p<0.05 by Kendall's tau). Wide variations in current practice exist among management of OAC-associated ICH, with decisions influenced by patient- and provider-related factors. As these variations likely reflect the lack of high quality evidence, randomized trials are direly needed in this population.

  16. [The Contributions of the East-German Sports Medicine Specialist and Neurologist Bernhard Schwarz (1918-1991) in the Field of Boxing].

    Science.gov (United States)

    Bart, Katrin; Steinberg, Holger

    2018-03-01

    This study is the first to provide research on the East-German (GDR) sports physician and neurologist Bernhard Schwarz. It summarises Schwarz's publications from 1953 to 1966 regarding the impact of boxing on health, particularly craniocerebral injury. Also, the study analyses his work in the context of current discussions. It shows that Schwarz, who was a tenured professor and director of the Department of Psychiatry at the University Hospital of Leipzig and the physician of the GDR national boxing team, conducted systematic clinical surveys and pointed to the health impacts of boxing at an early point in time. He believed that risk exposure for athletes could be minimised through intensive and trained supervision by the coach and the physician as well as through changes to the conditions of boxing matches. Schwarz opposed a ban on boxing. Instead, he picked up suggestions concerning the prevention of adverse health impacts and added his own recommendations, which are remarkably similar to current practices aimed at minimising risk. For instance, he advised that ring-side physicians be trained to recognise dangerous conditions. Today, physicians must obtain a license to be allowed to care for a boxer. In addition, Schwarz pursued the concept of integral medicine. He called for a diversified training of boxers and argued that injured athletes should be treated holistically. Being a neurologist, he emphasised the important role of psychotherapy in this context. He identified the key role of rehabilitation, and suggested that rehabilitation is complete only with the patient's successful social and professional reintegration. © Georg Thieme Verlag KG Stuttgart · New York.

  17. 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 ...

  18. Is image selection a useful strategy to decrease the transmission time in teleradiology? A study using 100 emergency cranial CTs

    International Nuclear Information System (INIS)

    Ludwig, K.; Bick, U.; Oelerich, M.; Schuierer, G.; Puskas, Z.; Nicolas, K.; Koch, A.; Lenzen, H.

    1998-01-01

    This study examines the suitability of working with a selection of images in a teleradiology consulting system in neurological or neurosurgical emergency situations. The teleradiology system was based on IBM-compatible personal computers, video digitization for data acquisition, and data transmission by Integrated System Digital Network. Forty normal and 60 abnormal emergency cranial computed tomograms were shown to a radiologist on call who presented all cases he regarded as pathologic to a neuroradiologic expert by teleradiology. To reduce transmission time, only a selection of images from the CT study was presented (up to four images per case). For each case the on-call radiologist's diagnosis (D on-call ), the expert's diagnosis on the teleradiology screen (D monitor ), and the expert's diagnosis on the original film (D original ) was documented, together with an estimation of the agreement between those diagnoses. There was clinically relevant disagreement between the on-call radiologist's diagnosis and the neuroradiologist's diagnosis based on the image selection on the teleradiology monitor in 23 % of cases. A clinically important discrepancy between the neuroradiologist's diagnosis based on the image selection and his diagnosis using the original films was found in 30 % of cases. This was due to the presence of clinically relevant information on images not transferred by the on-call radiologist. Image quality of the transferred images was sufficient in all cases. Drastic selection of images from a complete CT study leads to a high rate of incorrect diagnoses and is not appropriate to reduce transmission time in teleradiology. (orig.)

  19. Emergency Communication

    Science.gov (United States)

    : Environmental Documents, Reports LANL Home Calendar Search Contacts Resources » Emergency Communication Emergency Communication Stay informed of emergencies, weather delays, closures, other alerts. Find links to

  20. 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 ...

  1. 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 ...

  2. 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. ...

  3. [Approach of gene medical treatment in neurological diseases with the neurologist's. "Approach of support to the patients with inherited and incurable neurological diseases"].

    Science.gov (United States)

    Hazama, Takanori; Sawada, Jin-ichi; Toda, Tatsushi

    2009-11-01

    Advancements in medical genetics have increased access to genetic diagnosis in clinical neurology and accompanying genetic counseling. However, its use has not yet spread and the frequency of general biochemistry inspection in medical treatment and by patients remains low. Many problems remain for doctors, though sociocultural and other various causes exist. Thus, a network of care specialists for inherited and incurable neurological diseases has been established, consisting of multi-occupational categories in medical treatment, health, and welfare such as clinical inheritance specialists, psychiatrists, public health nurses, and medical social workers, to meet the rise in availability of such methods. Businesses in areas such as training, consultation, and field research have arisen. An educational campaign for neurologists who have taken a central role in treatment of inherited and incurable neurological diseases, and related information have been disseminated to those working in fields related to regional welfare of neurological medicine, and patients are now supported totally by team and regional counseling. These new developments in support systems for inherited and incurable neurological diseases, have steadily achieved the respective goals. We aim to promote its evolution to a more advanced network to promote the independence of individual patients in the future.

  4. Recommendations for the use of new oral anticoagulants (NOACs) after TIA or stroke caused by atrial fibrillation (AF), after a consensus conference among Italian neurologists (the Venice group).

    Science.gov (United States)

    Toso, Vito

    2014-05-01

    Vascular neurologists of Veneto and Friuli Venezia Giulia, north-east regions of Italy, have sought an agreement on the two following questions: (A) what prophylactic treatment should we recommend to patients with a stroke ascribed to atrial fibrillation (AF), who were not previously on antithrombotic treatment, to prevent further strokes? (B) What should we do in the event of an ischemic or hemorrhagic stroke associated with AF in patients who were already on antithrombotic treatment? There was a unanimous consensus for preferring the new oral anticoagulants (NOACs) in patients not taking any antithrombotics and in cases treated with antithrombotic drugs (coumadin and/or antiplatelets), due to a lower incidence of intracranial bleeding complications and a noninferiority for recurrent stroke or TIA. Even after intracranial bleeding complications, when it is useful or necessary to continue anticoagulant treatment, the group of experts preferred the NOACs, suggesting, however, to be very cautious in cases with widespread leukoaraiosis or microbleeds, practice frequent monitoring of creatinine clearance (CrCl) and avoid using NOACs when CrCl is <30 mL/min.

  5. Idiopathic scoliosis from the point of view of the neuroradiologist

    Energy Technology Data Exchange (ETDEWEB)

    Roth, M.

    1981-04-01

    There is a simple morphological interrelation between the growing spinal cord-nerve root complex and the vertebral column, not unlike that between the growing brain and skull. The shape of the enveloping vertebral skeleton mirrors the anatomical features of the enclosed neural contents. During the cranio-caudally directed growth, spurts of elongation of the vertebral column may be too rapid for the slower growth rate of the spinal cord and nerve roots. The resulting disproportion of growth between spine and nervous system is compensated for by adaptive scoliotic curvature of the otherwise normally growing spine. The proposed pathogenetic concept readily explains the main clinical features of the deformity and is supported by a spring model experiment.

  6. Lung Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at increased risk of sudden lung ...

  7. [Knowledge of German neurologists on migraine around 1890. Paul Julius Möbius and his 1894 monograph Die Migräne].

    Science.gov (United States)

    Schobeß, C; Steinberg, H

    2013-08-01

    Paul Julius Möbius (1853-1907), a Leipzig-based author and editor on a vast majority of subjects, has often been acknowledged as a leading 19th-century German neurologist. His impact on the development of knowledge on migraine has likewise been pointed to. This study compares the monograph published by Möbius on the illness in 1894 with contemporary publications and with present day best practice to establish if the author really made an essential contribution to the problem of migraine. As a representative of the central theory Möbius assumed that migraine was caused by aberrations in the brain. At the same time he made it clear that due to very limited diagnostic options this was only a hypothesis. Apart from a genetic factor and these cerebral changes, for Möbius the general state of health was a decisive factor and prevention and change in lifestyle therefore played a crucial role in his therapeutic recommendations. Basically there were only few differences between the views of Möbius and his colleagues, the major dissimilarity being that Möbius postulated a merely suggestive impact but no physical effect of electrotherapy. Although Möbius's monograph on migraine lacks originality, it provides a concise, easy to understand and stylistically impressive overview on the state of knowledge at that time. Therefore, the book can be considered as a benchmark publication of German speaking neurology around 1890 on migraine and it is highly recommended to present day headache and migraine researchers as well as historians of psychiatry and neurology.

  8. [Driving license of patients with epilepsy, management of their oral drugs and suppositories by non-medical professionals, and the role of pediatric neurologists].

    Science.gov (United States)

    Ito, Masatoshi; Miyake, Shouta

    2004-05-01

    In June 2002, the following new driving regulations were enforced in Japan: 1. A person with epilepsy may be granted a driving license after a seizure-free period of two years. 2. A person with simple partial seizures that would not impair driving safety may be granted a driving license if no other seizures that may impair driving safety have occurred over a period of at least one year. 3. A person with seizures occurring only in sleep may be granted a driving license if no seizures have occurred in waking over a period of at least two years. 4. In case that the above requirements are going to be met within 6 months, driving should be prohibited for 6 months. 5. A person with epilepsy is recommended to apply for a license to drive heavy and/or public vehicles only after a seizure-free period of 5 years without medication. The committee for legal problems of the Japan Epilepsy Society proposed a guideline for non-medical teaching or caring professionals to give children with epilepsy antiepileptic medication or to insert suppositories, if needed, at schools or care institutions. The guideline indicated the following preconditions as important: 1. There must be a wish and consent of the patient or his/her family. 2. Drugs or suppositories are usually taken or used at home and regarded as a safe procedure. 3. Attending doctor should provide clear information about the use and risk of the medication or suppository. 4. Privacy of the patient should be protected. Pediatric neurologists are expected to play an important role on these issues.

  9. 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

  10. Critical Care Coding for Neurologists.

    Science.gov (United States)

    Nuwer, Marc R; Vespa, Paul M

    2015-10-01

    Accurate coding is an important function of neurologic practice. This contribution to Continuum is part of an ongoing series that presents helpful coding information along with examples related to the issue topic. Tips for diagnosis coding, Evaluation and Management coding, procedure coding, or a combination are presented, depending on which is most applicable to the subject area of the issue.

  11. Rasch-ionale for neurologists

    NARCIS (Netherlands)

    Vanhoutte, Els K.; Hermans, Mieke C. E.; Faber, Catharina G.; Gorson, Kenneth C.; Merkies, Ingemar S. J.; Thonnard, Jean-L.; Barreira, A. A.; Bennett, D.; Hadden, R. D.; Hughes, R. A. C.; Lunn, M. P. T.; Reilly, M. M.; van den Berg, L. H.; van Doorn, P. A.; Faber, C. G.; van der Kooi, A. J.; Merkies, I. S. J.; Notermans, N. C.; Raaphorts, J.; van Schaik, I. N.; de Visser, M.; Cats, E. A.; van den Bergh, P. Y. K.; Bombelli, F.; Costa, R.; Franques, J.; Léger, J.-M.; Pouget, J.; Bril, V.; Hahn, A. F.; Katzberg, H.; Campanella, A.; Devigili, G.; Gallia, F.; Lauria, G.; Nobile-Orazio, E.; Padua, L.; Cornblath, D. R.; Gorson, K. C.; Lewis, R. A.; Illa, I.; Querol, L.; van Nes, S. I.

    2015-01-01

    Outcome measures are considered the most important tools to monitor patients' outcome in both clinical and research settings. Measuring the clinical state of patients is a fundamental part of our daily clinical practice and research that sometimes is taken for granted. In peripheral neuropathies,

  12. Perception of stroke symptoms and utilization of emergency medical services

    Directory of Open Access Journals (Sweden)

    Maximiliano A. Hawkes

    Full Text Available ABSTRACT Lack of stroke awareness and slow activation of emergency medical services (EMS are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75% arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02. Nineteen patients (20% were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001. Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

  13. Emerging Hopes

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China looks to strategically important emerging industries for innovation-driven economic growthc hina will soon announce a decision to rev up seven strategically impor- tant emerging industries,said the National

  14. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  15. Emergency department evaluation of ischemic stroke and TIA: the BASIC Project.

    Science.gov (United States)

    Brown, D L; Lisabeth, L D; Garcia, N M; Smith, M A; Morgenstern, L B

    2004-12-28

    To identify demographic and clinical variables of emergency department (ED) practices in a community-based acute stroke study. By both active and passive surveillance, the authors identified cerebrovascular disease cases in Nueces County, TX, as part of the Brain Attack Surveillance in Corpus Christi (BASIC) Project, a population-based stroke surveillance study, between January 1, 2000, and December 31, 2002. With use of multivariable logistic regression, variables independently associated with three separate outcomes were sought: hospital admission, brain imaging in the ED, and neurologist consultation in the ED. Prespecified variables included age, sex, ethnicity, insurance status, NIH Stroke Scale score, type of stroke (ischemic stroke or TIA), vascular risk factors, and symptom presentation variables. Percentage use of recombinant tissue plasminogen activator (rt-PA) was calculated. A total of 941 Mexican Americans (MAs) and 855 non-Hispanic whites (NHWs) were seen for ischemic stroke (66%) or TIA (34%). Only 8% of patients received an in-person neurology consultation in the ED, and 12% did not receive any head imaging. TIA was negatively associated with neurology consultations compared with completed stroke (odds ratio [OR] 0.35 [95% CI 0.21 to 0.57]). TIA (OR 0.14 [0.10 to 0.19]) and sensory symptoms (OR 0.59 [0.44 to 0.81]) were also negatively associated with hospital admission. MAs (OR 0.58 [0.35 to 0.98]) were less likely to have neurology consultations in the ED than NHWs. Only 1.7% of patients were treated with rt-PA. Neurologists are seldom involved with acute cerebrovascular care in the emergency department (ED), especially in patients with TIA. Greater neurologist involvement may improve acute stroke diagnosis and treatment efforts in the ED.

  16. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  17. The Profile of Neurology Patients Evaluated in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Ufuk Emre

    2009-09-01

    Full Text Available OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood count, serum glucose level, urea, creatine, erythrocyte sedimentation rate, and D-dimer levels and imaging findings were retrospectively evaluated based on patient charts. RESULTS: Impaired consciousness was the most frequent reason for neurological consultation (19.7%. Among these patients, ischemic stroke was diagnosed in 27.9%, hypoxic encephalopathy in 18.2%, cerebral hemorrhage in 9.1%, and 11% had no neurological diagnosis. Other common reasons for neurological consultation were vertigo, headache, seizure, and stroke. Clinical findings were related to other systemic causes in 43.7% of the study group. Focal neurological findings were present, especially in patients that presented with ischemic and hemorrhagic stroke, epilepsy, and hypoxic encephalopathy. CONCLUSION: In emergency departments, metabolic causes should be ruled out in patients with impaired consciousness and the absence of focal neurological signs. Intracranial structural disorders must be evaluated when focal neurological signs are present. Cautiously prepared algorithms and neurological examination training will help improve the accuracy of emergency department diagnoses

  18. Emergency preparedness

    International Nuclear Information System (INIS)

    1997-01-01

    In 1996 the Nuclear Regulatory Authority of the Slovak Republic (NRA SR) continued in systematic development of its activities in the field of emergency planning according to the concept adopted by the Authority and according to the concept for building Emergency headquarters (EH) adopted after establishing of Emergency Response Centre (ERC). Major efforts were focused not only on building up a quality EH, but also tasks associated with completion and incorporation of ERC into emergency planning and emergency managing. An important role in building ERC was played by international missions. Significant position among these missions was taken by missions from Great Britain, which in the past years made a significant contribution to building up ERC. These missions focused on review of newly created standard procedures, preparation and implementation of first emergency exercises of the EH. The emergency exercises in which NRA SR took place in 1996 are reviewed. In order to make the co-operation of the Authority with the selected Army units of SR more effective in solving extraordinary situations in nuclear energy, an agreement was signed between NRA SR and the Headquarters of the Army of SR, which will help significantly to the objective

  19. Studying Emerge

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael; Selin, Cynthia; Rodegher, Sandra

    2015-01-01

    The Emerge event, held in Tempe, AZ in March 2012, brought together a range of scientists, artists, futurists, engineers and students in order to experiment with innovative methods for thinking about the future. These methodological techniques were tested through nine workshops, each of which made...... use of a different format; Emerge as a whole, then, offered an opportunity to study a diverse set of future-oriented engagement practices. We conducted an event ethnography, in which a team of 11 researchers collaboratively developed accounts of the practices at play within Emerge and its workshops...

  20. Chemical Emergencies - Multiple Languages

    Science.gov (United States)

    ... Chemical Emergencies - bosanski (Bosnian) PDF Chemical Emergencies - English MP3 Chemical Emergencies - bosanski (Bosnian) MP3 Chemical Emergencies - English MP4 Chemical Emergencies - bosanski (Bosnian) ...

  1. Emerging images

    KAUST Repository

    Mitra, Niloy J.; Chu, Hungkuo; Lee, Tongyee; Wolf, Lior; Yeshurun, Hezy; Cohen-Or, Daniel

    2009-01-01

    Emergence refers to the unique human ability to aggregate information from seemingly meaningless pieces, and to perceive a whole that is meaningful. This special skill of humans can constitute an effective scheme to tell humans and machines apart

  2. Emergent emotion

    OpenAIRE

    O'Connell, Elaine Finbarr

    2016-01-01

    I argue that emotion is an ontologically emergent and sui generis. I argue that emotion meets both of two individually necessary and jointly sufficient conditions for ontological emergence. These are, (i) that emotion necessarily has constituent parts to which it cannot be reduced, and (ii) that emotion has a causal effect on its constituent parts (i.e. emotion demonstrates downward causation).\\ud \\ud I argue that emotion is partly cognitive, partly constituted by feelings and partly perceptu...

  3. Dermatologic emergencies

    Directory of Open Access Journals (Sweden)

    M.P. Simón Díaz

    2016-01-01

    Full Text Available Dermatologic emergencies represent about 8–20% of the diseases seen in the Emergency Department of hospitals. It is often a challenge for primary care physicians to differentiate mundane skin ailments from more serious, life threatening conditions that require immediate intervention. In this review we included the following conditions: Stevens-Johnson syndrome/toxic epidermal necrosis, pemphigus vulgaris, toxic shock syndrome, fasciitis necrotising, angioedema/urticaria, meningococcemia, Lyme disease and Rocky Mountain spotted fever.

  4. EMERGENCY CALLS

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  5. Emerging images

    KAUST Repository

    Mitra, Niloy J.

    2009-01-01

    Emergence refers to the unique human ability to aggregate information from seemingly meaningless pieces, and to perceive a whole that is meaningful. This special skill of humans can constitute an effective scheme to tell humans and machines apart. This paper presents a synthesis technique to generate images of 3D objects that are detectable by humans, but difficult for an automatic algorithm to recognize. The technique allows generating an infinite number of images with emerging figures. Our algorithm is designed so that locally the synthesized images divulge little useful information or cues to assist any segmentation or recognition procedure. Therefore, as we demonstrate, computer vision algorithms are incapable of effectively processing such images. However, when a human observer is presented with an emergence image, synthesized using an object she is familiar with, the figure emerges when observed as a whole. We can control the difficulty level of perceiving the emergence effect through a limited set of parameters. A procedure that synthesizes emergence images can be an effective tool for exploring and understanding the factors affecting computer vision techniques. © 2009 ACM.

  6. Anorectal emergencies

    Science.gov (United States)

    Lohsiriwat, Varut

    2016-01-01

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. PMID:27468181

  7. Hematologic emergencies

    Directory of Open Access Journals (Sweden)

    Daniele Vallisa

    2012-01-01

    Full Text Available In recent years, the surprising progress made in other areas of hematology (advances in the understanding of leukemogenesis, improved transplant techniques has been conspicuously absent in the management of hematologic emergencies. And yet, every step toward greater knowledge, every new treatment option will be of little value unless we are able to manage the acute complications of hematologic diseases. These complications are better defined as hematologic emergencies, and they are characterized by a high rate of mortality. This review is based on a search of the literature that was initially confined to articles published in the journal Hematology from 2000 to 2009. The search was then extended to the Cochrane Library and to Pub Med in February 2010 with the following Keywords emergencies; urgencies; hematology. The same key words were employed in a search of the archives of Blood and the New England Journal of Medicine from 2000 to 2010. The results confirm that hematologic emergencies can be caused by hematologic malignancies as well as by non-neoplastic hematologic diseases. Within the former category; this review examines the causes; manifestations; treatment and prevention of disseminated intravascular coagulation; superior vena caval syndrome; spinal cord compression; tumor lysis syndrome; hyperleukocytosis; and hypercalcemia. We also review emergency situations associated with non-neoplatic haematological diseases; such as thrombotic thrombocytopenic purpura; drug-induced hemolytic anemia; and acute sickle-cell crisis.

  8. Emergency preparedness

    CERN Document Server

    Cennini, E; Oortman Gerlings, P

    2009-01-01

    On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

  9. Emergency situations

    International Nuclear Information System (INIS)

    2007-01-01

    The nuclear activities are exercised so as to prevent the accidents. They are subjected to a rule whom application is controlled by the Asn. The risk of grave accident is so limited to a very low level of probability. He cannot be however completely pushed aside. The expression ' radiological emergency situation ' indicates a situation which ensues from an incident or of an accident risking to lead to an emission of radioactive materials or a level of radioactivity susceptible to strike a blow at the public health. The term ' nuclear crisis ' is used for the events which can lead to a radiological emergency situation on a nuclear basic installation or during a transport of radioactive materials. The preparation and the management of emergency situations, that they are of natural, accidental or terrorist origin, became a major concern of our society. We propose you of to know more about it in this file. (N.C.)

  10. EMERGENCY CONTRACEPTION

    Directory of Open Access Journals (Sweden)

    Dragana Pantić

    2007-10-01

    Full Text Available Emergency contraception refers to any device or drug that is used as an emergency procedure to prevent pregnancy after unprotected sexual intercourse.The first method of emergency contraception was high dose of estrogen. Concern about side effects led to subsequent development of the so-called Yuzpe regimen which combined ethinil estradiol with levonorgestrel and levonorgestrel alone. Less convenient to use is the copper intauterine contraceptive device.It is known that in some women sexual steroids may inhibit or delay ovulation and may interfere with ovum and sperm transport and implantation. Copper intrauterine device causes a foreign-body effect on the endometrium and a direct toxic effect to sperm and blastocyst.The Yuzpe regimen reduces the risk of pregnancy after a single act of sexual intercourse by about 75% and the levonorgestrel alone by about 85%. The copper intrauterine device is an extremely effective method for selected patients.Nausea and vomiting are common among women using the Yuzpe regimen and considerably less common among women using levonorgestrel alone regimen.Emergency contraception is relatively safe with no contraindications except pregnancy. It is ineffective if a woman is pregnant. There is no need for a medical hystory or a phisical examination before providing emergency contraceptive pills. They are taken long before organogenesis starts, so they should not have a teratogenic effect.Counseling should include information about correct use of the method, possible side effects and her preferences for regular contraception.Unintended pregnancy is a great problem. Several safe, effective and inexpensive methods of emergency contraception are available including Yuzpe regimen, levonorges-trel-only regimen and copper intrauterine device.

  11. Nuclear emergencies

    International Nuclear Information System (INIS)

    1991-01-01

    This leaflet, which is in the form of a fold-up chart, has panels of text which summarize the emergencies that could arise and the countermeasures and emergency plans that have been prepared should nuclear accident occur or affect the United Kingdom. The levels of radiation doses at which various measures would be introduced are outlined. The detection and monitoring programmes that would operate is illustrated. The role of NRPB and the responsible government departments are set out together with an explanation of how the National Arrangements for Incidents involving Radioactivity would be coordinated. (UK)

  12. EMERGING MARKETS

    Directory of Open Access Journals (Sweden)

    GHEORGHE CARALICEA-MĂRCULESCU

    2012-03-01

    Full Text Available The emerging markets are winning the currency war, because at this very moment its the battle of global financial institutions , as to who is more vulnerable and more exposed to the debt crisis and have their hands in more risky assets. US and Euro with their intertwining the financial stuff of the nation, the banks and the corporations are in a deep mess. One goes down, takes the other ones too. Right now , they all are struggling and getting beaten up , while the emerging markets are quiet and not really expressing their stands on the current situation except are reacting by all only putting their own houses in order.

  13. Emergency radiology

    International Nuclear Information System (INIS)

    Keats, T.E.

    1986-01-01

    This book is the German, translated version of the original published in 1984 in the U.S.A., entitled 'Emergency Radiology'. The publication for the most part is made up as an atlas of the radiological images presenting the findings required for assessment of the emergency cases and their first treatment. The test parts' function is to explain the images and give the necessary information. The material is arranged in seven sections dealing with the skull, the facial part of the skull, the spine, thorax, abdominal region, the pelvis and the hip, and the limbs. With 690 figs [de

  14. Emergency Preparedness

    CERN Document Server

    2001-01-01

    The trends of RPC work in the area of preparedness for nuclear and radiological accidents are listed. RPC in cooperation with Swedish Government developed the project on preparation for iodine prophylaxis in case of accident at Ignalina NPP and arranged seminar on emergency preparedness issues in 2001.

  15. Emerging Materiality

    DEFF Research Database (Denmark)

    Bertelsen, Olav Wedege; Breinbjerg, Morten; Pold, Søren

    2009-01-01

    The authors examine how materiality emerges from complex chains of mediation in creative software use. The primarily theoretical argument is inspired and illustrated by interviews with two composers of electronic music. The authors argue that computer mediated activity should not primarily be und...

  16. Emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, J. [Key Safety and Blowout Control Corp., Sylvan Lake, AB (Canada)

    2001-07-01

    This presentation included several slides depicting well control and emergency preparedness. It provided information to help in pre-emergency planning for potential well control situations. Key Safety and Blowout Control Corp has gained experience in the Canadian and International well control industry as well as from the fires of Kuwait. The president of the company lectures on the complications and concerns of managers, wellsite supervisors, service companies, the public sector, land owners, government agencies and the media. The slides presented scenarios based on actual blowout recovery assignments and described what types of resources are needed by a well control team. The presentation addressed issues such as the responsibility of a well control team and what they can be expected to do. The issue of how government agencies become involved was also discussed. The presentation combines important information and descriptive images of personal experiences in fire fighting and well control. The emergency situations presented here demonstrate the need for a thorough understanding of preplanning for emergencies and what to expect when a typical day in the oil patch turns into a high stress, volatile situation. tabs., figs.

  17. OPERATION EMERGENCE.

    Science.gov (United States)

    MELBO, IRVING R.

    THE SIGNIFICANCE OF THE EMERGING ENVIRONMENT FOR THE FUTURE OF PUBLIC EDUCATION IN CALIFORNIA IS CONSIDERED. CERTAIN WORLD REVOLUTIONS HAVE AFFECTED CONTEMPORARY LIFE. THE INDUSTRIAL REVOLUTION BROUGHT WITH IT INCREASED PRODUCTIVITY, RESEARCH, HIGHER STANDARDS OF LIVING, LONGER LIFE SPANS, AND CATEGORIZATION OF NATIONS INTO HAVES AND HAVE NOTS.…

  18. 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

  19. Emergence delirium

    DEFF Research Database (Denmark)

    Munk, Louise; Andersen, Lars Peter Holst; Gögenur, Ismail

    2013-01-01

    Emergence delirium (ED) is a well-known phenomenon in the postoperative period. However, the literature concerning this clinical problem is limited. This review evaluates the literature with respect to epidemiology and risk factors. Treatment strategies are discussed. The review concludes...

  20. Thyroid emergencies.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Emerging Options for Emergency Contraception

    Directory of Open Access Journals (Sweden)

    Atsuko Koyama

    2013-01-01

    Full Text Available Emergency post-coital contraception (EC is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method, and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference.

  2. Emerging Options for Emergency Contraception

    Science.gov (United States)

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-01-01

    Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

  3. Emergency management

    International Nuclear Information System (INIS)

    1996-01-01

    In 1995, major efforts of the Nuclear Regulatory Authority of the Slovak Republic (NRA SR) were focused on tasks associated with completion and incorporation of the Emergency Response Centre (ERC) of NRA SR in emergency planning and crisis management. Construction of the ERC had begun based on NRA SR's knowledge, as well as recommendations of Regulatory Assistance Management Group (RAMG) International Mission in 1993 and follow-up missions in 1994. Early in 1994, re-construction of selected rooms had been done and early in 1995, supported by the UK and U.S.A. Government's funding, technical equipment was purchased. The equipment was necessary for ERC operation as tools to improve NRA SR readiness for the management of emergency situations at nuclear installations. NRA SR commenced operation of the Centre in April 1995. The Centre has been on-line connected to a teledosimetric system of Radiation Monitoring Laboratory in Trnava. The basic software for assessment of radiation consequences of a NPP accident was supplied were also focused on cooperation with state administration authorities and organizations which were involved in an emergency planning structure. In September 1995, staffing of the ERC was completed and parallel, the first document concerning the ERC prime task, i.e. activities and procedures of of NRA SR Crisis crew in case of an accident at a nuclear installation on the territory of the Slovak Republic, was approved by the NRA SR's Management. In the period that is being assessed, NRA SR made significant progress in events classification and emergency planning terminology in order to unify the above between both the Slovak NPPs

  4. Emerging Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter

    South Korean and Taiwanese brands have long been household names. Today, however, the names of transnational companies (TNCs) from an increasingly diverse set of emerging and developing economies are regularly making if not the dinner table conversation then at least the headlines...... of the international business press. This reflects that companies such as Mittal and Tata (India), China National Offshore Oil Corporation (CNOOC), Haier and Lenovo (PRC), Embraer (Brazil), SAPMiller (South Africa), and Cemex (Mexico) are foraying ever deeper into the international economy and increasingly investing...... countries. Apart from a few early pioneering studies (Lecraw 1977; Lall 1983; Wells 1983; Agarwal 1985) only few studies have been made so far of outward investment from emerging and developing economies. This is in spite of the fact that the value of outward FDI stock from developing countries reached USD...

  5. Emerging Jets

    CERN Document Server

    Schwaller, Pedro; Weiler, Andreas

    2015-01-01

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilit...

  6. Emerging jets

    Energy Technology Data Exchange (ETDEWEB)

    Schwaller, Pedro; Stolarski, Daniel [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Weiler, Andreas [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2015-02-15

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  7. Emerging jets

    International Nuclear Information System (INIS)

    Schwaller, Pedro; Stolarski, Daniel

    2015-02-01

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  8. Emergency preparedness

    International Nuclear Information System (INIS)

    1998-01-01

    According the conception of the Emergency Response Centre (ERC) of the Nuclear Regulatory Authority of the Slovak Republic (NRA), and the obtained experience from exercises, and as well as on the basis of recommendations of international missions, the NRA SR started, in 1997 the ERC extension. The new room enable the work for radiation protection group, reactor safety and logistic group separately. At the same time special room was build for work of the NECRA Technical Support Group of the Emergency Commission for Radiation Accidents of the SR.This group co-operates closely with ERC while evaluation the situation, and by using the information system of the NRA and database of ERC to generate the conditions of nuclear facilities in once of emergency. Extension of the mentioned rooms was carried out. The financing by the European Union helped to build the project RAMG. In this way the NRA gained a working site which, with its equipment and parameters belongs to the top working sites of regulatory bodies of developed European countries. The NRA preparation of exercise and special staff education was carried out in 1997, for employees of the NRA and members of Emergency Headquarters (EH) for work in ERC in case of nuclear installation accident. The task of education of member of EH was their preparation for carrying out three exercises. These exercises are described. In the area of emergency preparedness, in accordance with inspection plan of the Office, 7 team inspections were carried out in individual localities; in NPP Bohunice, two in NPP Mochovce and one in Bohunice Conditioning Centre for radioactive wastes. Solution of the task of development of science and technology in the area of 'Development of technical and programme means for analyses of accidents and solutions of crisis situations'continued in 1997. Another regulations were elaborated for activity of members of EH of the NRA. The following was was carried out: selection of data for transfer and the

  9. Knowledge of TIA among general practitioners and emergency department physicians. A questionnaire survey in a French semi-rural area.

    Science.gov (United States)

    Massengo, Serge A; Cisse, M; Guiziou, C; Leray, E; Rajabally, Yusuf A; Edan, G

    2013-08-01

    Management of transient ischemic attacks (TIAs) is of vital importance in an attempt to prevent stroke. However, suboptimal management still raise concern among general practitioners (GPs) and emergency department (ED) physicians-the first medical contact of most TIA patients. This may relate to their poorly updated knowledge about TIA. The study was designed to assess knowledge of TIA among these non-neurologists. The study was a post-mailed questionnaire survey among GPs and ED physicians. The questionnaire related to selective clinical aspects on TIA. There were a total of 85 respondents for analysis, mostly GPs (n=64; 75.3%), out of 177 mailed physicians. Response rate was 52.7%. Many of these respondents were unaware of the newly proposed TIA definition (59%), unfamiliar with TIA mimics and predictors of post-TIA early stroke recurrence and therefore with the rationales underlying the need of emergency management of TIA. More than one third (39%) were unaware of the relevant national guidelines. Guidelines-aware respondents performed better in most part of the mailed questionnaire. Our results show that poorly updated knowledge about TIA among non-neurologists represents a potential contributing factor to the persisting sub-optimal management of the disorder. Although further studies are needed to confirm this, improved continuous medical education of this group of health care professionals appears warranted. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Abdominal emergencies

    International Nuclear Information System (INIS)

    Raissaki, M.

    2012-01-01

    Full text: There are numerous conditions that affect mainly or exclusively the pediatric population. These constitute true emergencies, related to patient's health. Delay in diagnosis and treatment of abdominal non-traumatic emergencies may result in rapid deterioration, peritonitis, sepsis, even death or in severe complications with subsequent morbidity. Abdominal emergencies in children mostly present with pain, tenderness, occasionally coupled by vomiting, fever, abdominal distension, and failure to pass meconium or stools. Diarrhea, blood per rectum, abnormal laboratory tests and lethargy may also be manifestations of acute abdominal conditions. Abdominal emergencies have a different aetiology, depending on age and whether the pain is acute or chronic. Symptoms have to be matched with age and gender. Newborns up to 1 months of age may have congenital diseases: atresia, low obstruction including Hirschsprung's disease, meconium ileus. Meconium plug is one of the commonest cause of low obstruction in newborns that may also develop necrotizing enterocolitis, incarcerated inguinal hernia and mid-gut volvulus. Past the immediate postnatal period, any duodenal obstruction should be considered midgut volvulus until proven otherwise and patients should undergo ultrasonography and/or properly performed upper GI contrast study that records the exact position of the deduno-jejunal junction. Infants 6 months-2 years carry the risk of intussusception, mid-gut volvulus, perforation, acute pyelonephritis. Preschool and school-aged children 2-12 years carry the risk of appendicitis, genito-urinary abnormalities including torsion, urachal abnormalities, haemolytic uremic syndrome and Henoch-Schonlein purpura. Children above 12 years suffer from the same conditions as in adults. Most conditions may affect any age despite age predilection. Abdominal solid organ ultrasonography (US) coupled with gastrointestinal ultrasonography is the principle imaging modality in radiosensitive

  11. Is it an Emergency?

    Science.gov (United States)

    ... Emergency 101 Share this! Home » Emergency 101 Is it an Emergency? Medical emergencies can be frightening and ... situation. Here you can find information about emergencies. It is essential to know how to recognize the ...

  12. The neurologist facing pain in dementia.

    Science.gov (United States)

    Álvaro González, Luis Carlos

    2015-01-01

    Ageing, a common background in dementia, is usually associated with painful disorders. Nevertheless, the use of analgesics is limited due to poor communication. On the other hand, dementia lesions are placed in the nociceptive pathways. For this reason, the painful experience becomes different and distinctive for every lesional type. The lateral nociceptive pathway (lateral thalamic nuclei and primary parietal cortex), which is in charge of the primary pain perception, is preserved in dementia. Thereafter, the shear painful perception, including pain intensity and threshold, remains unmodified. Distinctly, the medial pain pathways are affected by dementia lesions. In this pathway are included: the intralaminar thalamic nuclei, the pons (locus ceruleus:LC), the mesencephalon (periaacueductal grey substance: PGS), the hypothalamus (paraventricular nuclei, mamilary tuberculum) and different areas of the parietal (primary, secondary, operculum), temporal (amigdala, hypoccampus) and frontal (anterior cingular: ACC). As a consequence, the features of pain executed by these areas will be compromised: the cognitive assessment, the mood and emotion inherent to pain, the pain memory or the autonomic responses are modified in dementia. Specifically, in Alzheimer's disease (AD) there is a reduction in the anticipatory and avoidance responses and also a flattening of the autonomic responses. These are essentially secondary to the degenerative changes in the medial temporal (pain memory) and ACC (cognitive and mood aspects) areas. In vascular dementias, there is a cortico-subcortical deafferentation secondary to the white matter lesions. The consequence is the presence of hyperpathy and hyperalgesia. In the frontotemporal dementias, there is a reduction in pain expressivity. It is linked to the lesions in the orbitofrontal and anterior temporal areas, which are responsible of the emotional aspects of pain. In Parkinson's disease, painful conditions are a common characteristic. They are attributed to an early lesion in the LC, which reduces its prominent antinociceptive activity. Finally, in the demented patients there is a lack of expectations to analgesic treatments. This means an absence of the placebo effect, which is, alongside the pharmacokinetic action, an inherent part of the analgesic response. The placebo response is related to activity in the ACC and PGS. Giving its lack, higher doses of analgesics are necessary in dementias. The assessment of pain in dementia is rather complex, which is the main reason for the scarcity of the analgesic treatment in dementias. It must be specific and systematic. For this purpose, the pain scales are a useful tool. For communicative patients, simple visual scales are helpful, meanwhile in the non-communicative patients the multidimensional scales are the most suitable. By this means, the expressive, motor, emotional, functional and social interactions are evaluated. Pain may be responsible of progression and cognitive deterioration in dementia. This evolution could be reversible, and consequently it has to be foreseen in order to implement analgesic treatment. Trying to minimize adverse events, it has to be potent but closely monitored. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Emergency Medical Services

    Science.gov (United States)

    ... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

  14. Chemical Emergencies Overview

    Science.gov (United States)

    ... Address What's this? Submit What's this? Submit Button Chemical Emergencies Overview Recommend on Facebook Tweet Share Compartir ... themselves during and after such an event. What chemical emergencies are A chemical emergency occurs when a ...

  15. Household Chemical Emergencies

    Science.gov (United States)

    ... Content Home Be Informed Household Chemical Emergencies Household Chemical Emergencies Although the risk of a chemical accident ... reduce the risk of injury. Before a Household Chemical Emergency It is critical to store household chemicals ...

  16. Emergency Contraception Website

    Science.gov (United States)

    Text Only Full media Version Get Emergency Contraception NOW INFO about Emergency Contraception Q&A about Emergency Contraception Español | Arabic Find a Morning After Pill Provider Near You This website ...

  17. Emerging Pathogens Initiative (EPI)

    Data.gov (United States)

    Department of Veterans Affairs — The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software...

  18. TIA triage in emergency department using acute MRI (TIA-TEAM): a feasibility and safety study.

    Science.gov (United States)

    Vora, Nirali; Tung, Christie E; Mlynash, Michael; Garcia, Madelleine; Kemp, Stephanie; Kleinman, Jonathan; Zaharchuk, Greg; Albers, Gregory; Olivot, Jean-Marc

    2015-04-01

    Positive diffusion weighted imaging (DWI) on MRI is associated with increased recurrent stroke risk in TIA patients. Acute MRI aids in TIA risk stratification and diagnosis. To evaluate the feasibility and safety of TIA triage directly from the emergency department (ED) with acute MRI and neurological consultation. Consecutive ED TIA patients assessed by a neurologist underwent acute MRI/MRA of head/neck per protocol and were hospitalized if positive DWI, symptomatic vessel stenosis, or per clinical judgment. Stroke neurologist adjudicated the final TIA diagnosis as definite, possible, or not a cerebrovascular event. Stroke recurrence rates were calculated at 7, 90, 365 days and compared with predicted stroke rates derived from historical DWI and ABCD(2) score data. One hundred twenty-nine enrolled patients had a mean age of 69 years (± 17) and median ABCD(2) score of 3 (interquartile range [IQR] 3-4). During triage, 112 (87%) patients underwent acute MRI after a median of 16 h (IQR 10-23) from symptom onset. No patients experienced a recurrent event before imaging. Twenty-four (21%) had positive DWI and 8 (7%) had symptomatic vessel stenosis. Of the total cohort, 83 (64%) were discharged and 46 (36%) were hospitalized. By one-year follow-up, one patient in each group had experienced a stroke. Of 92 patients with MRI and index cerebrovascular event, recurrent stroke rates were 1.1% at 7 and 90 days. These were similar to predicted recurrence rates. TIA triage in the ED using a protocol with neurological consultation and acute MRI is feasible and safe. The majority of patients were discharged without hospitalization and rates of recurrent stroke were not higher than predicted. © 2014 World Stroke Organization.

  19. Rate and predictors of serious neurologic causes of dizziness in the emergency department.

    Science.gov (United States)

    Navi, Babak B; Kamel, Hooman; Shah, Maulik P; Grossman, Aaron W; Wong, Christine; Poisson, Sharon N; Whetstone, William D; Josephson, S Andrew; Johnston, S Claiborne; Kim, Anthony S

    2012-11-01

    To describe the rate and predictors of central nervous system (CNS) disease in emergency department (ED) patients with dizziness in the modern era of neuroimaging. We retrospectively reviewed the medical records of all adults presenting between January 1, 2007, and December 31, 2009, to an academic ED for a primary triage complaint of dizziness, vertigo, or imbalance. The final diagnosis for the cause of dizziness was independently assigned by 2 neurologists, with a third neurologist resolving any disagreements. The primary outcome was a composite of ischemic stroke, intracranial hemorrhage, transient ischemic attack, seizure, brain tumor, demyelinating disease, and CNS infection. Univariate and multivariate logistic regression were used to assess the association between clinical variables and serious CNS causes of dizziness. Of 907 patients experiencing dizziness (mean age, 59 years; 58% women [n=529]), 49 (5%) had a serious neurologic diagnosis, including 37 cerebrovascular events. Dizziness was often caused by benign conditions, such as peripheral vertigo (294 patients [32%]) or orthostatic hypotension (121 patients [13%]). Age 60 years or older (odds ratio [OR], 5.7; 95% confidence interval [CI], 2.5-11.2), a chief complaint of imbalance (OR, 5.9; 95% CI, 2.3-15.2), and any focal examination abnormality (OR, 5.9; 95% CI, 3.1-11.2) were independently associated with serious neurologic diagnoses, whereas isolated dizziness symptoms were inversely associated (OR, 0.2; 95% CI, 0.0-0.7). Dizziness in the ED is generally benign, although a substantial fraction of patients harbor serious neurologic disease. Clinical suspicion should be heightened for patients with advanced age, imbalance, or focal deficits. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  20. Emergency care of raptors.

    Science.gov (United States)

    Graham, Jennifer E; Heatley, J Jill

    2007-05-01

    Raptors may present with a variety of conditions, such as trauma, debilitation, and disease, that necessitate emergency care. Emergency treatment should prioritize stabilization of the patient. Diagnostic testing should be delayed until feasible based on patient status. This article reviews emergency medicine in raptors, including appropriate handling and restraint, hospitalization, triage and patient assessment, sample collection, supportive care, and common emergency presentations.

  1. 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

  2. Characterizing New England Emergency Departments by Telemedicine Use.

    Science.gov (United States)

    Zachrison, Kori S; Hayden, Emily M; Schwamm, Lee H; Espinola, Janice A; Sullivan, Ashley F; Boggs, Krislyn M; Raja, Ali S; Camargo, Carlos A

    2017-10-01

    Telemedicine connects emergency departments (ED) with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195) in the six New England states (excluding federal hospitals and college infirmaries). Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Of the 169 responding EDs (87% response rate), 82 (49%) reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03); less likely to be academic (1% of users vs. 11% of non-users, p=0.01); and less likely to have 24/7 access to neurology (ptelemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30-14.86), and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09-0.49]), and annual volume Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

  3. Emergencies and emergency planning in France

    International Nuclear Information System (INIS)

    Jammet, H.

    1986-01-01

    The organization for dealing with radiation emergencies in France is complex and centralized. It consists of the Radiation Security Council with participants from the Premier Ministre and the Ministers of Interior, Industry, Health, and Defense. A permanent general secretary for radiation security coordinates the work of the various departments. Planning for nuclear power emergencies is divided between on-site, in which organization and intervention are the responsibilities of the manager of the plant, and off-site, in which organization and intervention are the responsibility of the regional governor. Both on-site and off-site planning have models integrated into a special code of practice called the radiation emergency organization

  4. Emergency control; Kawalan kecemasan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1988-12-31

    The chapter briefly discussed the following subjects: plans and actions taken in emergency condition. It covers four main elements in planning, command, control center, emergency plans, continuous training and practices.

  5. Emergency care of reptiles.

    Science.gov (United States)

    Boyer, T H

    1998-09-01

    Common reptile emergencies are reviewed in this article and the fundamentals of emergency care are provided. Important points include obtaining a complete history and husbandry review, physical examination, diagnostic tests, fluid support, anesthetics, and antibiotics.

  6. [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.

  7. OEM Emergency Preparedness Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management compiles a wide variety of information in support of Emergency Preparedness, including certain elements of the System for Risk...

  8. Emergency Nurses Association

    Science.gov (United States)

    ... menu Join ENA Today! Membership in the Emergency Nurses Association offers a variety of benefits and allows ... a part of more than 42,000 emergency nurses working together to promote safe practice and safe ...

  9. Harwell emergency handbook

    International Nuclear Information System (INIS)

    1986-12-01

    The Harwell Laboratory Emergency Handbook 1987 contains emergency procedures to deal with any incident which might occur at AERE Harwell involving radioactive or toxic material releases. The Handbook gives details of the duties of members of the Site Emergency Organization and other key members of staff, the methods by which incidents are controlled, the communication links and liaison arrangements with other organizations and the possible consequences and actions that may be needed following an emergency. (UK)

  10. Derivatives in emerging markets

    OpenAIRE

    Dubravko Mihaljek; Frank Packer

    2010-01-01

    Turnover of derivatives has grown more rapidly in emerging markets than in developed countries. Foreign exchange derivatives are the most commonly traded of all risk categories, with increasingly frequent turnover in emerging market currencies and a growing share of cross-border transactions. As the global reach of the financial centres in emerging Asia has expanded, the offshore trading of many emerging market currency derivatives has risen as well. Growth in derivatives turnover is positive...

  11. A neuroradiologist's guide to arterial spin labeling MRI in clinical practice

    International Nuclear Information System (INIS)

    Grade, M.; Hernandez Tamames, J.A.; Pizzini, F.B.; Achten, E.; Golay, X.; Smits, M.

    2015-01-01

    Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to determine cerebral arterial territories. In acute stroke, the source of the collateral blood supply in the penumbra may be visualised. In chronic cerebrovascular disease, the extent and severity of compromised cerebral perfusion can be visualised, which may be used to guide therapeutic or preventative intervention. ASL has potential for the detection and follow-up of arteriovenous malformations. In the workup of dementia patients, ASL is proposed as a diagnostic alternative to PET. It can easily be added to the routinely performed structural MRI examination. In patients with established Alzheimer's disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with PET. Studies on ASL in brain tumour imaging indicate a high correlation between areas of increased CBF as measured with ASL and increased cerebral blood volume as measured with dynamic susceptibility contrast-enhanced perfusion imaging. Major advantages of ASL for brain tumour imaging are the fact that CBF measurements are not influenced by breakdown of the blood-brain barrier, as well as its quantitative nature, facilitating multicentre and longitudinal studies. (orig.)

  12. A neuroradiologist's guide to arterial spin labeling MRI in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Grade, M. [Queen Square, UCL Institute of Neurology, London (United Kingdom); Stanford School of Medicine, Stanford, CA (United States); Hernandez Tamames, J.A. [Rey Juan Carlos University, Medical Image Analysis and Biometry Laboratory, Madrid (Spain); Erasmus MC - University Medical Centre Rotterdam, Department of Radiology, PO Box 2040, Rotterdam (Netherlands); Pizzini, F.B. [Queen Square, UCL Institute of Neurology, London (United Kingdom); Verona University Hospital, Neuroradiology, Department of Diagnostics and Pathology, Verona (Italy); Achten, E. [Ghent University Hospital, Neuroradiology, Department of Radiology, Ghent (Belgium); Golay, X. [Queen Square, UCL Institute of Neurology, London (United Kingdom); Smits, M. [Erasmus MC - University Medical Centre Rotterdam, Department of Radiology, PO Box 2040, Rotterdam (Netherlands)

    2015-12-15

    Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to determine cerebral arterial territories. In acute stroke, the source of the collateral blood supply in the penumbra may be visualised. In chronic cerebrovascular disease, the extent and severity of compromised cerebral perfusion can be visualised, which may be used to guide therapeutic or preventative intervention. ASL has potential for the detection and follow-up of arteriovenous malformations. In the workup of dementia patients, ASL is proposed as a diagnostic alternative to PET. It can easily be added to the routinely performed structural MRI examination. In patients with established Alzheimer's disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with PET. Studies on ASL in brain tumour imaging indicate a high correlation between areas of increased CBF as measured with ASL and increased cerebral blood volume as measured with dynamic susceptibility contrast-enhanced perfusion imaging. Major advantages of ASL for brain tumour imaging are the fact that CBF measurements are not influenced by breakdown of the blood-brain barrier, as well as its quantitative nature, facilitating multicentre and longitudinal studies. (orig.)

  13. [Emergent viral infections

    NARCIS (Netherlands)

    Galama, J.M.D.

    2001-01-01

    The emergence and re-emergence of viral infections is an ongoing process. Large-scale vaccination programmes led to the eradication or control of some viral infections in the last century, but new viruses are always emerging. Increased travel is leading to a rise in the importation of exotic

  14. Emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Koivukoski, J.

    1993-01-01

    Although the menace of nuclear war still persists, the focus in national emergency preparedness in Finland is presently on emergencies involving nuclear installations. The nuclear power plants, nuclear submarines and other installations in the former USSR are a major reason for this. In this article the main features and organization of emergency preparedness in Finland are described. (orig.)

  15. Emerging technology and ethics

    CERN Document Server

    Wakunuma, Kutoma

    2011-01-01

    This e-book on Emerging Technologies and Ethics includes a collection of essays which explore the future and ethics of emerging information and communication technologies. Articles in the collection include an overview of the legal implications which may be relevant to the ethical aspects of emerging technologies and also ethical issues arising from the mass-take up of mobile technologies.

  16. The nuclear emergency plans

    International Nuclear Information System (INIS)

    Fuertes Menendez, M. J.; Gasco Leonarte, L.; Granada Ferrero, M. J.

    2007-01-01

    Planning of the response to emergencies in nuclear plants is regulated by the Basic Nuclear Emergency Plan (PLABEN). This basic Plan is the guidelines for drawing up, implementing and maintaining the effectiveness of the nuclear power plant exterior nuclear emergency plans. The five exterior emergency plans approved as per PLABEN (PENGUA, PENCA, PENBU, PENTA and PENVA) place special emphasis on the preventive issues of emergency planning, such as implementation of advance information programs to the population, as well as on training exercises and drills. (Author)

  17. Color on emergency mapping

    Science.gov (United States)

    Jiang, Lili; Qi, Qingwen; Zhang, An

    2007-06-01

    There are so many emergency issues in our daily life. Such as typhoons, tsunamis, earthquake, fires, floods, epidemics, etc. These emergencies made people lose their lives and their belongings. Every day, every hour, even every minute people probably face the emergency, so how to handle it and how to decrease its hurt are the matters people care most. If we can map it exactly before or after the emergencies; it will be helpful to the emergency researchers and people who live in the emergency place. So , through the emergency map, before emergency is occurring we can predict the situation, such as when and where the emergency will be happen; where people can refuge, etc. After disaster, we can also easily assess the lost, discuss the cause and make the lost less. The primary effect of mapping is offering information to the people who care about the emergency and the researcher who want to study it. Mapping allows the viewers to get a spatial sense of hazard. It can also provide the clues to study the relationship of the phenomenon in emergency. Color, as the basic element of the map, it can simplify and clarify the phenomenon. Color can also affects the general perceptibility of the map, and elicits subjective reactions to the map. It is to say, structure, readability, and the reader's psychological reactions can be affected by the use of color.

  18. Update on emergency contraception.

    Science.gov (United States)

    Fok, Wing Kay; Blumenthal, Paul D

    2016-12-01

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

  19. [Oncological emergencies in the emergency department].

    Science.gov (United States)

    Cimpoeşu, Diana; Dumea, Mihaela; Durchi, Simona; Apostoae, F; Olaru, G; Ciolan, Mioara; Popa, O; Corlade-Andrei, Mihaela

    2011-01-01

    to assess the profile and the characteristic of oncological patients, establishing management in patients with neoplasia presented in the emergency department (ED), the analysis of short-term movements in patients with neoplasia whilst in the ED. we performed a retrospective study on nonrandomized consecutive cases. The lot analysis included 1315 oncological patients admitted in the Emergency Department of the Clinical Emergency Hospital "St. Spiridon" Iaşi, in the period June 1st, 2009 - May 31st, 2010. 23.12% of the patients had high suspicion of neoplasia at the first visit to the ED. 67.07% of patients were in metastatic stage disease located as follows: liver metastasis 37.59%, lung metastasis 18.36%, lymph node metastasis 13, 29%. After processing the data there were found statistically significant correlations between the age of patients and the documented/suspected diagnosis of neoplasia (p = 0.01) in the sense that a neoplasia diagnosis in emergency was more frequent in people of young age. It should be mentioned that other studies rarely mention first diagnosis of neoplasia in emergency department with presence of complications. 1315 oncological patients presented in ED, almost a quarter of which presented high suspicion of neoplasia (still without histopathological confirmation) when in ED (23.12%). Most of them were aged male patients (over 65 years old), with tumors of the digestive system. A significant proportion (almost 60%) of these patients ended up in emergency due to complications and the therapy intended life support and pain management. Some of these patients were directed to further exploring and emergency outpatient therapy while 75% of patients were hospitalized after stabilization. Although we expected that the frequency of complications to be higher in patients previously diagnosed with cancer, data analysis showed no statistically significant differences (p = NS) between the rate of complications in patients previously diagnosed with

  20. Train operation in emergencies

    CERN Document Server

    Jia, Limin; Qin, Yong

    2017-01-01

    This book presents the latest findings on train operation theories and methods in the context of emergencies. It examines and assesses a range of aspects—including the definition of a railway emergency, transport organization modes in emergencies, calculating railway transport capacity in emergencies, line planning in emergencies, train re-pathing in emergencies and train re-scheduling in emergencies—that are urgently needed in the railway transportation field, which faces the serious challenge of dealing with emergencies worldwide. The book highlights the latest research results in an integrated and systematic way, and the methodology presented is oriented on real-world problems, allowing it to be used not only directly in railway operational management, but also as the point of departure for further applications or theoretical research. As such, the book will be of considerable interest to graduate students and researchers in the field of traffic and transportation engineering.>.

  1. 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.

  2. Moderate sensitivity and high specificity of emergency department administrative data for transient ischemic attacks.

    Science.gov (United States)

    Yu, Amy Y X; Quan, Hude; McRae, Andrew; Wagner, Gabrielle O; Hill, Michael D; Coutts, Shelagh B

    2017-09-18

    Validation of administrative data case definitions is key for accurate passive surveillance of disease. Transient ischemic attack (TIA) is a condition primarily managed in the emergency department. However, prior validation studies have focused on data after inpatient hospitalization. We aimed to determine the validity of the Canadian 10th International Classification of Diseases (ICD-10-CA) codes for TIA in the national ambulatory administrative database. We performed a diagnostic accuracy study of four ICD-10-CA case definition algorithms for TIA in the emergency department setting. The study population was obtained from two ongoing studies on the diagnosis of TIA and minor stroke versus stroke mimic using serum biomarkers and neuroimaging. Two reference standards were used 1) the emergency department clinical diagnosis determined by chart abstractors and 2) the 90-day final diagnosis, both obtained by stroke neurologists, to calculate the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the ICD-10-CA algorithms for TIA. Among 417 patients, emergency department adjudication showed 163 (39.1%) TIA, 155 (37.2%) ischemic strokes, and 99 (23.7%) stroke mimics. The most restrictive algorithm, defined as a TIA code in the main position had the lowest sensitivity (36.8%), but highest specificity (92.5%) and PPV (76.0%). The most inclusive algorithm, defined as a TIA code in any position with and without query prefix had the highest sensitivity (63.8%), but lowest specificity (81.5%) and PPV (68.9%). Sensitivity, specificity, PPV, and NPV were overall lower when using the 90-day diagnosis as reference standard. Emergency department administrative data reflect diagnosis of suspected TIA with high specificity, but underestimate the burden of disease. Future studies are necessary to understand the reasons for the low to moderate sensitivity.

  3. Demographic Analysis of Emergency Department Patients at the Ruijin Hospital, Shanghai

    Directory of Open Access Journals (Sweden)

    Wim Lammers

    2011-01-01

    Full Text Available Emergency medicine is an upcoming discipline that is still under development in many countries. Therefore, it is important to gain insight into the organization and patients presenting to the Emergency Department (ED. The aim of this cross-sectional study was to provide an epidemiological description of complaints and referrals of the patients visiting the ED of the Ruijin Hospital in Shanghai, China. A questionnaire was developed and completed for a convenience sample of all patients presenting to the Triage Desk of the ED. The study was performed in June 2008. A total of 2183 questionnaires were completed. The most common complaints were fever (15%, stomach/abdominal pain (15%, vertigo/dizziness (11%, and cough (10%. Following triage, patients were predominantly referred to an internist (41%, neurologist (14%, pulmonologist (11%, or general surgeon (9%. This study provides a better understanding of the reason for the ED visit and the triage system at the ED of the Ruijin Hospital. The results can be used in order to improve facilities appropriate for the specific population in the ED.

  4. 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.

  5. Nonneurologic emergencies in boxing.

    Science.gov (United States)

    Coletta, Domenic F

    2009-10-01

    Professional boxing has done an admirable job in promoting safety standards in its particular sport. However, injuries occur during the normal course of competition and, unfortunately, an occasional life-threatening emergency may arise. Although most common medical emergencies in boxing are injuries from closed head trauma, in this article those infrequent but potentially catastrophic nonneurologic conditions are reviewed along with some less serious emergencies that the physician must be prepared to address.

  6. Radiological Emergency Response Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — Quality Data Asset includes all current and historical emergency radiological response event and incident of national significance data and surveillance, monitoring,...

  7. Historicism and Industry Emergence

    DEFF Research Database (Denmark)

    Kirsch, David; Moeen, Mahka; Wadhwani, Dan

    2014-01-01

    Management and organization scholars have increasingly turned to historical sources to examine the emergence and evolution of industries over time. This scholarship has typically used historical evidence as observations for testing theoretically relevant processes of industry emergence....... In this chapter, an alternative approach is explored that focuses on reconstructing causes and processes that time and theory have erased. The emergence of three industries—plant biotechnology, savings banking, and the automobile—shows how time, along with prevailing functional models of industry evolution, leads...... excluded phenomena and explanations, reconstructing uncertainty and alternative paths of industry emergence, and studying the processes of information elision and exclusion in the formation of industry knowledge....

  8. 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

  9. Coma of unknown origin in the emergency department: implementation of an in-house management routine.

    Science.gov (United States)

    Braun, Mischa; Schmidt, Wolf Ulrich; Möckel, Martin; Römer, Michael; Ploner, Christoph J; Lindner, Tobias

    2016-04-27

    Coma of unknown origin is an emergency caused by a variety of possibly life-threatening pathologies. Although lethality is high, there are currently no generally accepted management guidelines. We implemented a new interdisciplinary standard operating procedure (SOP) for patients presenting with non-traumatic coma of unknown origin. It includes a new in-house triage process, a new alert call, a new composition of the clinical response team and a new management algorithm (altogether termed "coma alarm"). It is triggered by two simple criteria to be checked with out-of-hospital emergency response teams before the patient arrives. A neurologist in collaboration with an internal specialist leads the in-hospital team. Collaboration with anaesthesiology, trauma surgery and neurosurgery is organised along structured pathways that include standardised laboratory tests and imaging. Patients were prospectively enrolled. We calculated response times as well as sensitivity and false positive rates, thus proportions of over- and undertriaged patients, as quality measures for the implementation in the SOP. During 24 months after implementation, we identified 325 eligible patients. Sensitivity was 60 % initially (months 1-4), then fluctuated between 84 and 94 % (months 5-24). Overtriage never exceeded 15 % and undertriage could be kept low at a maximum of 11 % after a learning period. We achieved a median door-to-CT time of 20 minutes. 85 % of patients needed subsequent ICU treatment, 40 % of which required specialised neuro-ICUs. Our results indicate that our new simple in-house triage criteria may be sufficient to identify eligible patients before arrival. We aimed at ensuring the fastest possible proceedings given high portions of underlying time-sensitive neurological and medical pathologies while using all available resources as purposefully as possible. Our SOP may provide an appropriate tool for efficient management of patients with non-traumatic coma. Our results

  10. Emergências hipertensivas Hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Gilson Soares Feitosa-Filho

    2008-09-01

    Full Text Available As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É caracterizada por pressão arterial marcadamente elevada e sinais de lesões de órgãos-alvo (encefalopatia, infarto agudo do miocárdio, angina instável, edema agudo de pulmão, eclâmpsia, acidente vascular encefálico. O objetivo deste estudo foi apresentar os principais pontos sobre o seu apropriado diagnóstico e tratamento. Foi realizada busca por artigos originais com os unitermos "crise hipertensiva" e "emergência hipertensiva" nas bases de dados Pubmed e MedLine nos últimos dez anos. As referências disponíveis destes artigos foram verificadas. Os artigos foram identificados e revisados e o presente estudo condensa os principais resultados descritos. Para esta revisão foram considerados ensaios clínicos em língua inglesa, estudos retrospectivos e artigos de revisão. A crise hipertensiva é a entidade clínica com aumento súbito da PA (> 180 x 120 mmHg, acompanhada por sintomas, que podem ser leves (cefaléia, tontura, zumbido ou graves (dispnéia, dor precordial, coma e até morte, com ou sem lesão aguda de órgãos-alvo. Se os sintomas forem leves e sem lesão aguda de órgãos alvos, define-se a urgência hipertensiva. Se o quadro clínico apresentar risco de vida e refletir lesão aguda de órgãos-alvo têm-se, então, a emergência hipertensiva. Muitos pacientes também apresentam uma PA elevada demais, por não usarem suas medicações, tratando-se apenas de hipertensão arterial sistêmica crônica n

  11. The Emergence of Ideas

    DEFF Research Database (Denmark)

    Halskov, Kim; Dalsgård, Peter

    2007-01-01

    The development of new ideas is an essential concern for many design projects. There are, however, few in-depth studies of how such ideas emerge within these contexts. In this article we offer an analysis of the emergence of ideas from specific sources of inspiration, as they arise through...

  12. Emergency exercise scenario tools

    International Nuclear Information System (INIS)

    Sjoeblom, K.

    1998-03-01

    Nuclear power plant emergency exercises require a realistically presented accident situation which includes various aspects: plant process, radioactivity, radiation, weather and people. Experiences from nuclear power plant emergency exercises show that preparing accident scenarios even for relatively short exercises is tedious. In the future modern computer technology and past experience could be used for making exercise planning more effective. (au)

  13. Theme: Emerging Technologies.

    Science.gov (United States)

    Malpiedi, Barbara J.; And Others

    1989-01-01

    Consists of six articles discussing the effect of emerging technologies on agriculture. Specific topics include (1) agriscience programs, (2) the National Conference on Agriscience and Emerging Occupations and Technologies, (3) biotechnology, (4) program improvement through technology, (5) the Agriscience Teacher of the Year program, and (6)…

  14. 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.

  15. Emerging wind energy technologies

    DEFF Research Database (Denmark)

    Rasmussen, Flemming; Grivel, Jean-Claude; Faber, Michael Havbro

    2014-01-01

    This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive.......This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive....

  16. Competitiveness in Emerging Markets

    DEFF Research Database (Denmark)

    This book presents a collection of interrelated research advances in the field of technological entrepreneurship from the perspective of competition in emerging markets. Featuring contributions by scholars from different fields of interest, it provides a mix of theoretical developments, insights...... and research methods used to uncover the unexplored aspects of competitiveness in emerging markets in an age characterized by disruptive technologies....

  17. Radiology in emergency medicine

    International Nuclear Information System (INIS)

    Levy, R.; Barsan, W.G.

    1986-01-01

    This book gives a discussion of radiologic modalities currently being used in emergency situations. Radiographs, echocardiographs, radionuclide scans and CT scans are systematically analyzed and evaluated to provide a step-by-step diagnostic process for emergency physicians to follow when a radiologist is not present

  18. Emergent Collaboration on Twitter

    DEFF Research Database (Denmark)

    Lundgaard, Daniel; Razmerita, Liana; Tan, Chee-Wee

    2018-01-01

    This paper explores the organizing elements that foster emergent collaboration within large-scale communities on online social platforms like Twitter. This study is based on a case study of the #BlackLivesMatter social movement and draws on organizing dynamics and online social network literature...... foster emergent collaboration in social movements using Twitter....

  19. 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.

  20. Management of Radiological emergencies

    International Nuclear Information System (INIS)

    Lentijo, J. C.; Gil, E.; San Nicolas, J.; Lazuen, J. A.

    2004-01-01

    Spain has a system of planning and response to emergency situations that is structured and coordinated by the General Directorship of civil Defense of the Ministry of the Interior and in which all levels of the Public Administration. state, autonomous and municipal-and owners of potentially hazardous activities participate. Activities involving a nuclear or radiological risk have specific emergency plans whose general principles are based on the general emergency system and whose technical bases are consistent with international practices and recommendations. The Consejo de Seguridad Nuclear actively participates in the design, implementation and activation of these plans, and for this purpose has an organization superimposed on its ordinary working organization that is activated in the event of an accident, as well as an Emergency Room specifically designed to deal with nuclear and radiological emergencies. (Author)

  1. 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.

  2. Training for emergency management

    International Nuclear Information System (INIS)

    Grauf, E.

    1993-01-01

    There are specific boundary conditions where preparedness for in-plant emergency management is as necessary and useful as is the training for the management of design-based accidents. The shift personnel has to be trained to cope particularly with the difficult and demanding initial phase of an emergency, and care must be taken to be very close to reality. Only thus can weak points be discovered and removed by pinpointed measures such as organisational changes, optimization of emergency management procedures, or hardware conditions. (orig.) [de

  3. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  4. Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 1 historical and established therapies. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

    Science.gov (United States)

    Broadley, Simon A; Barnett, Michael H; Boggild, Mike; Brew, Bruce J; Butzkueven, Helmut; Heard, Robert; Hodgkinson, Suzanne; Kermode, Allan G; Lechner-Scott, Jeannette; Macdonell, Richard A L; Marriott, Mark; Mason, Deborah F; Parratt, John; Reddel, Stephen W; Shaw, Cameron P; Slee, Mark; Spies, Judith; Taylor, Bruce V; Carroll, William M; Kilpatrick, Trevor J; King, John; McCombe, Pamela A; Pollard, John D; Willoughby, Ernest

    2014-11-01

    Multiple sclerosis (MS) is a potentially life-changing immune mediated disease of the central nervous system. Until recently, treatment has been largely confined to acute treatment of relapses, symptomatic therapies and rehabilitation. Through persistent efforts of dedicated physicians and scientists around the globe for 160 years, a number of therapies that have an impact on the long term outcome of the disease have emerged over the past 20 years. In this three part series we review the practicalities, benefits and potential hazards of each of the currently available and emerging treatment options for MS. We pay particular attention to ways of abrogating the risks of these therapies and provide advice on the most appropriate indications for using individual therapies. In Part 1 we review the history of the development of MS therapies and its connection with the underlying immunobiology of the disease. The established therapies for MS are reviewed in detail and their current availability and indications in Australia and New Zealand are summarised. We examine the evidence to support their use in the treatment of MS. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  5. Create an Emergency Kit

    Science.gov (United States)

    ... models take up less space in your kit. Cell phone. Always carry a cell phone and let people know where you are going ... pump in your emergency kit. Remember that despite safety standards and careful monitoring, these devices can fail. ...

  6. Winter Weather Emergencies

    Science.gov (United States)

    Severe winter weather can lead to health and safety challenges. You may have to cope with Cold related health problems, including ... there are no guarantees of safety during winter weather emergencies, you can take actions to protect yourself. ...

  7. Emerging topics in FXTAS

    DEFF Research Database (Denmark)

    Hall, Deborah A; Birch, Rachael C; Anheim, Mathieu

    2014-01-01

    This paper summarizes key emerging issues in fragile X-associated tremor/ataxia syndrome (FXTAS) as presented at the First International Conference on the FMR1 Premutation: Basic Mechanisms & Clinical Involvement in 2013....

  8. 7. Emergency contraception

    African Journals Online (AJOL)

    Sitwala

    individually on each day after satisfying the selection criteria. ... thought the pills can work up to a maximum of 24 hours. The main source of information was from friends (80%). ... 6 – 10 years .... emergency contraceptive pills among Swedish.

  9. Clustering of Emerging Flux

    Science.gov (United States)

    Ruzmaikin, A.

    1997-01-01

    Observations show that newly emerging flux tends to appear on the Solar surface at sites where there is flux already. This results in clustering of solar activity. Standard dynamo theories do not predict this effect.

  10. Emergency management at sea

    International Nuclear Information System (INIS)

    Bockholts, I.P.

    1992-01-01

    In the past years, all kind of activities in the field of emergency management have been taken in order to handle accidents. In the scope of this paper, emergencies are those accidents that may lead to severe releases of oil and gas, whereby also attention is paid to collisions between offshore installations and drifting objects and the situation where people fall overboard. Case histories show that coping with these serious accidents is not always as effective and successful as intended. The stage from being aware of the risks, to being prepared to cope with the consequences, to actually being capable to combat is long and consists of many elements. This paper will deal with the general approach of emergency management, the development of automated tools for decision support on emergencies as well as some fate and effect models

  11. Emerging Targets in Photopharmacology

    NARCIS (Netherlands)

    Lerch, Michael M.; Hansen, Mickel J.; van Dam, Gooitzen M.; Szymanski, Wiktor; Feringa, Ben L.

    2016-01-01

    The field of photopharmacology uses molecular photoswitches to establish control over the action of bioactive molecules. It aims to reduce systemic drug toxicity and the emergence of resistance, while achieving unprecedented precision in treatment. By using small molecules, photopharmacology

  12. Transboundary and Emerging Diseases

    NARCIS (Netherlands)

    Michel, A.L.; Rutten, V.P.M.G.; Helden van, P.D.

    2013-01-01

    This supplement to Transboundary and Emerging Diseases is a compilation of selected papers presented at the International Wildlife Tuberculosis Conference, held from 9 to 12 September 2012 in Skukuza, South Africa.

  13. OEM Emergency Response Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management retains records of all incident responses in which it participates. This data asset includes three major sources of information:...

  14. Imaging of gynecologic emergencies

    International Nuclear Information System (INIS)

    Wagner, Matthias W.; Huisman, Thierry A.G.M.; John Hopkins Bayview Medical Center, Baltimore, MD; Kubik, Rahel A.

    2016-01-01

    Acute abdominal pain related to the female genital organs is frequently encountered in the emergency department. Gynecological emergencies are diseases of the female reproductive system that are potentially life-threatening and peril the sexual function and fertility. In the diagnostic work-up of acute abdominal pain, a wide variety of differential diagnoses needs to be considered depending on the age of the patient and a concomitant pregnancy. There is significant clinical overlap with gastrointestinal emergencies. Therefore, imaging plays a key role in diagnosing the cause of the pain and the planning of the therapy. The aim of this review is to illustrate the significant role of imaging in frequently encountered gynecologic emergencies.

  15. Emergency Notification System

    Data.gov (United States)

    US Agency for International Development — The USAID ENS provides quick and effective notification messages during any emergency affecting the Ronald Reagan Building, SA-44, Potomac Yards and USAID Washington...

  16. Football emergency medicine

    African Journals Online (AJOL)

    may be called upon to intervene medically when a football player succumbs to a severe ... including safety and security services, emergency and primary health care medical ..... of the European Resuscitation Council (ERC) guidelines 2005.

  17. Emerging nuclear suppliers

    International Nuclear Information System (INIS)

    Sands, A.

    1990-01-01

    Efforts to prevent the spread of nuclear weapons have usually taken two tracks: The traditional approach has concentrated on a potential proliferant's perceived need for nuclear technology and possibly weapons; a second approach has targeted the supply side of the proliferation equation. The issue being examined in this book---emerging nuclear suppliers---falls between these two approaches. The potential proliferants have emerged as possible unrestrained suppliers of nuclear materials and technology. They threaten the entire nonproliferation regime by their exporting, not their weapons development. Analyzing and understanding the issue of emerging suppliers requires a refined definition of suppliers in general. The simple dichotomy of traditional versus emerging suppliers is no longer an adequate framework for analysis. Suppliers differ significantly in their technical capabilities, experience, and regime involvement, and these distinctions result in different nuclear export policies

  18. Transfusion Related Emergencies

    OpenAIRE

    Osborn, Megan Boysen; Tran, Min-Ha

    2016-01-01

    Audience: This exercise is appropriate for all emergency medicine learners (residents and medical students) and learners from other specialties (internal medicine, family medicine, anesthesia). Introduction: About 85 million red blood cell units are transfused worldwide each year. Transfusion reactions can complicate up to 8% of blood transfusions and can range from benign to life threatening. An emergency physician must be able to discuss the risks and benefits of blood transfusion...

  19. Ten Questions about Emergence

    OpenAIRE

    Fromm, Jochen

    2005-01-01

    Self-Organization is of growing importance for large distributed computing systems. In these systems, a central control and manual management is exceedingly difficult or even impossible. Emergence is widely recognized as the core principle behind self-organization. Therefore the idea to use both principles to control and organize large-scale distributed systems is very attractive and not so far off. Yet there are many open questions about emergence and self-organization, ranging from a clear ...

  20. Diabetic and endocrine emergencies

    OpenAIRE

    Kearney, T; Dang, C

    2007-01-01

    Endocrine emergencies constitute only a small percentage of the emergency workload of general doctors, comprising about 1.5% of all hospital admission in England in 2004–5. Most of these are diabetes related with the remaining conditions totalling a few hundred cases at most. Hence any individual doctor might not have sufficient exposure to be confident in their management. This review discusses the management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, hyperca...

  1. Design of emergency shield

    International Nuclear Information System (INIS)

    Soliman, S.E.

    1993-01-01

    Manufacturing of an emergency movable shield in the hot laboratories center is urgently needed for the safety of personnel in case of accidents or spilling of radioactive materials. In this report, a full design for an emergency shield is presented and the corresponding dose rates behind the shield for different activities (from 1 mCi to 5 Ci) was calculated by using micro shield computer code. 4 figs., 1 tab

  2. Emergency response workers workshop

    International Nuclear Information System (INIS)

    Agapeev, S.A.; Glukhikh, E.N.; Tyurin, R.L.

    2012-01-01

    A training workshop entitled Current issues and potential improvements in Rosatom Corporation emergency prevention and response system was held in May-June, 2012. The workshop combined theoretical training with full-scale practical exercise that demonstrated the existing innovative capabilities for radiation reconnaissance, diving equipment and robotics, aircraft, emergency response and rescue hardware and machinery. This paper describes the activities carried out during the workshop [ru

  3. Planning for nuclear emergencies

    International Nuclear Information System (INIS)

    Lakey, J.R.A.

    1989-01-01

    This paper aims to stimulate discussions between nuclear engineers and the radiological protection professions in order to facilitate planning for nuclear emergencies. A brief review is given of the response to nuclear accidents. Studying accidents can lead to prevention, but some effort must be put into emergency response. Such issues as decontamination and decommissioning, socio-economic consequences, education and training for nuclear personnel and exercises and drills, are raised. (UK)

  4. Emerging technologies in surgery

    International Nuclear Information System (INIS)

    Satava, R.M.; Gaspari, A.; Di Lorenzo, N.

    2007-01-01

    Tremendous acceleration and changes in scientific discovery and progress are presently occurring. These important emerging technologies that will affect the practicing surgeon within the next 10 to 20 years are illustrated in detail in this volume. Its purpose is not to review clinical experience of the common surgical practice of the past decade, but to outline and illustrate the future trends. International experts in this field demonstrate emerging procedures and significant advances. (orig.)

  5. Accident and emergency management

    International Nuclear Information System (INIS)

    Andersen, V.; Moellenbach, K.; Heinonen, R.; Jakobsson, S.; Kukko, T.; Berg, Oe.; Larsen, J.S.; Westgaard, T.; Magnusson, B.; Andersson, H.; Holmstroem, C.; Brehmer, B.; Allard, R.

    1988-06-01

    There is an increasing potential for severe accidents as the industrial development tends towards large, centralised production units. In several industries this has led to the formation of large organisations which are prepared for accidents fighting and for emergency management. The functioning of these organisations critically depends upon efficient decision making and exchange of information. This project is aimed at securing and possibly improving the functionality and efficiency of the accident and emergency management by verifying, demonstrating, and validating the possible use of advanced information technology in the organisations mentioned above. With the nuclear industry in focus the project consists of five main activities: 1) The study and detailed analysis of accident and emergency scenarios based on records from incidents and rills in nuclear installations. 2) Development of a conceptual understanding of accident and emergency management with emphasis on distributed decision making, information flow, and control structure sthat are involved. 3) Development of a general experimental methodology for evaluating the effects of different kinds of decision aids and forms of organisation for emergency management systems with distributed decision making. 4) Development and test of a prototype system for a limited part of an accident and emergency organisation to demonstrate the potential use of computer and communication systems, data-base and knowledge base technology, and applications of expert systems and methods used in artificial intelligence. 5) Production of guidelines for the introduction of advanced information technology in the organisations based on evaluation and validation of the prototype system. (author)

  6. Emerging zoonotic viral diseases.

    Science.gov (United States)

    Wang, L-F; Crameri, G

    2014-08-01

    Zoonotic diseases are infectious diseases that are naturally transmitted from vertebrate animals to humans and vice versa. They are caused by all types of pathogenic agents, including bacteria, parasites, fungi, viruses and prions. Although they have been recognised for many centuries, their impact on public health has increased in the last few decades due to a combination of the success in reducing the spread of human infectious diseases through vaccination and effective therapies and the emergence of novel zoonotic diseases. It is being increasingly recognised that a One Health approach at the human-animal-ecosystem interface is needed for effective investigation, prevention and control of any emerging zoonotic disease. Here, the authors will review the drivers for emergence, highlight some of the high-impact emerging zoonotic diseases of the last two decades and provide examples of novel One Health approaches for disease investigation, prevention and control. Although this review focuses on emerging zoonotic viral diseases, the authors consider that the discussions presented in this paper will be equally applicable to emerging zoonotic diseases of other pathogen types.

  7. Emergency reactor cooling device

    International Nuclear Information System (INIS)

    Arakawa, Ken.

    1993-01-01

    An emergency nuclear reactor cooling device comprises a water reservoir, emergency core cooling water pipelines having one end connected to a water feeding sparger, fire extinguishing facility pipelines, cooling water pressurizing pumps, a diesel driving machine for driving the pumps and a battery. In a water reservoir, cooling water is stored by an amount required for cooling the reactor upon emergency and for fire extinguishing, and fire extinguishing facility pipelines connecting the water reservoir and the fire extinguishing facility are in communication with the emergency core cooling water pipelines connected to the water feeding sparger by system connection pipelines. Pumps are operated by a diesel power generator to introduce cooling water from the reservoir to the emergency core cooling water pipelines. Then, even in a case where AC electric power source is entirely lost and the emergency core cooling system can not be used, the diesel driving machine is operated using an exclusive battery, thereby enabling to inject cooling water from the water reservoir to a reactor pressure vessel and a reactor container by the diesel drive pump. (N.H.)

  8. Characterizing New England Emergency Departments by Telemedicine Use

    Directory of Open Access Journals (Sweden)

    Kori S. Zachrison

    2017-09-01

    Full Text Available Introduction: Telemedicine connects emergency departments (ED with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. Methods: We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195 in the six New England states (excluding federal hospitals and college infirmaries. Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Results: Of the 169 responding EDs (87% response rate, 82 (49% reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03; less likely to be academic (1% of users vs. 11% of non-users, p=0.01; and less likely to have 24/7 access to neurology (p<0.001, neurosurgery (p<0.001, orthopedics (p=0.01, plastic surgery (p=0.01, psychiatry (p<0.001, and hand surgery (p<0.001 consultants. Neuro/stroke (68%, pediatrics (11%, psychiatry (11%, and trauma (10% were the most commonly reported applications. On multivariable analysis, telemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30–14.86, and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09–0.49], and annual volume <20,000 (OR 0.24, 95% CI [0.08–0.68]. Conclusion: Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

  9. Abdominal emergencies during pregnancy.

    Science.gov (United States)

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management. Copyright © 2015. Published by Elsevier Masson SAS.

  10. Emergency planning zone reduction

    International Nuclear Information System (INIS)

    Edwards, C.

    2002-01-01

    This paper describes the process used by a large industrial Department of Energy (DOE) site to communicate changing hazards to its stakeholders and install the confidence necessary to implement the resulting emergency planning changes. Over the last decade as the sites missions have shifted from full-scale production to a greater emphasis on environmental restoration and waste management, the off-site threat from its operations has substantially decreased. The challenge was to clearly communicate the reduced hazards, install confidence in the technical analysis that documented the hazard reduction, and obtain stakeholder buy-in on the path forward to change the emergency management program. The most significant change to the emergency management program was the proposed reduction of the sites Emergency Planning Zone (EPZ). As the EPZ is defined as an area for which planning is needed to protect the public in the event of an accident, the process became politically challenging. An overview of how the site initially approached this problem and then learned to more substantially involve the state and local emergency preparedness agencies and the local Citizens Advisory Board will be presented. (author)

  11. Radiological emergencies - planning and preparedness

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-12-31

    This information and training film in three parts deals with the technical background for emergency planning, emergency planning concepts and emergency preparedness. It describes the technical characteristics of radiological emergencies on which important emergency planning concepts are based and the purpose of those concepts. The film also demonstrates how emergency organizations must work together to ensure adequate preparedness. The programme reflects the standards, guidance and recommendations of the International Atomic Energy Agency

  12. The Emerging World Order

    Directory of Open Access Journals (Sweden)

    PETER COLLECOTT

    2014-05-01

    Full Text Available It is common ground amongst almost all commentators that the world has changed radically over the past 25 years – the 25 years since the fall of the Berlin Wall heralded the ending of the Cold War, the reunification of a tragically divided Europe, and the acceleration of the process of globalisation which has its only comparable period in the decades leading up to the First World War in 1914. When analyzing the Emerging World Order it is important to cover more than Brazil economy or any other individual BRICs or other Emerging Powers. Instead, our analysis will provide a global view about the economic and political global power structures which are evolving and forming before our eyes, and then to talk about the challenges these emerging realities pose for us in Europe, and in the West in general.

  13. Emergency reactor shutdown device

    International Nuclear Information System (INIS)

    Ikehara, Morihiko.

    1982-01-01

    Purpose: To smoothen the emergency operation of the control rod in a BWR type reactor and to eliminate the external discharge of radioactively contaminated water. Constitution: A drain receiving tank is connected through a scram valve to the top of a cylinder which is containing a hydraulic piston connected to a trombone-shaped control rod and an accumulator is connected through another scram valve to the bottom of the cylinder. The respective scram valves are constructed to be opened by the reactor emergency shutdown signal from a reactor control system in such a manner that drain valve and a vent valve of the tank normally opened at the standby time are closed after approx. 10 seconds from the opening of the scram valves. In this manner, back pressure is not applied to the hydraulic piston at the emergency time, thereby smoothly operating the control rod. (Sikiya, K.)

  14. The emerging nuclear suppliers

    International Nuclear Information System (INIS)

    Dunn, L.A.

    1990-01-01

    Since the early 1980s, a growing amount of attention has been paid to a small group of mostly developing countries that have come to be called the emerging nuclear suppliers. Argentina and Brazil, China and South Korea, India and Pakistan, Spain and Yugoslavia have frequently been mentioned in this category. Their actual and potential nuclear export dealings and policies have been the subject of academic writings and policy papers, of scholarly symposia and exchanges at meetings of the traditional nuclear suppliers. With foundation and other support, UCLA's Center for International and Strategic Affairs has begun a major project to develop a database on the transactions, policies, and export control institutions of the emerging suppliers. This chapter provides some guidelines for policy toward the emerging nuclear suppliers

  15. Hanford Emergency Response Plan

    International Nuclear Information System (INIS)

    Wagoner, J.D.

    1994-04-01

    The Hanford Emergency Response Plan for the US Department of Energy (DOE), Richland Operations Office (RL), incorporates into one document an overview of the emergency management program for the Hanford Site. The program has been developed in accordance with DOE orders, and state and federal regulations to protect worker and public health and safety and the environment in the event of an emergency at or affecting the Hanford Site. This plan provides a description of how the Hanford Site will implement the provisions of DOE 5500 series and other applicable Orders in terms of overall policies and concept of operations. It should be used as the basis, along with DOE Orders, for the development of specific contractor and RL implementing procedures

  16. Emergent geometry of membranes

    Energy Technology Data Exchange (ETDEWEB)

    Badyn, Mathias Hudoba de; Karczmarek, Joanna L.; Sabella-Garnier, Philippe; Yeh, Ken Huai-Che [Department of Physics and Astronomy, University of British Columbia,6224 Agricultural Road, Vancouver (Canada)

    2015-11-13

    In work http://dx.doi.org/10.1103/PhysRevD.86.086001, a surface embedded in flat ℝ{sup 3} is associated to any three hermitian matrices. We study this emergent surface when the matrices are large, by constructing coherent states corresponding to points in the emergent geometry. We find the original matrices determine not only shape of the emergent surface, but also a unique Poisson structure. We prove that commutators of matrix operators correspond to Poisson brackets. Through our construction, we can realize arbitrary noncommutative membranes: for example, we examine a round sphere with a non-spherically symmetric Poisson structure. We also give a natural construction for a noncommutative torus embedded in ℝ{sup 3}. Finally, we make remarks about area and find matrix equations for minimal area surfaces.

  17. Hanford Emergency Response Plan

    Energy Technology Data Exchange (ETDEWEB)

    Wagoner, J.D.

    1994-04-01

    The Hanford Emergency Response Plan for the US Department of Energy (DOE), Richland Operations Office (RL), incorporates into one document an overview of the emergency management program for the Hanford Site. The program has been developed in accordance with DOE orders, and state and federal regulations to protect worker and public health and safety and the environment in the event of an emergency at or affecting the Hanford Site. This plan provides a description of how the Hanford Site will implement the provisions of DOE 5500 series and other applicable Orders in terms of overall policies and concept of operations. It should be used as the basis, along with DOE Orders, for the development of specific contractor and RL implementing procedures.

  18. 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

  19. Emergent technologies: 25 years

    Science.gov (United States)

    Rising, Hawley K.

    2013-03-01

    This paper will talk about the technologies that have been emerging over the 25 years since the Human Vision and Electronic Imaging conference began that the conference has been a part of, and that have been a part of the conference, and will look at those technologies that are emerging today, such as social networks, haptic technologies, and still emerging imaging technologies, and what we might look at for the future.Twenty-five years is a long time, and it is not without difficulty that we remember what was emerging in the late 1980s. Yet to be developed: The first commercial digital still camera was not yet on the market, although there were hand held electronic cameras. Personal computers were not displaying standardized images, and image quality was not something that could be talked about in a standardized fashion, if only because image compression algorithms were not standardized yet for several years hence. Even further away were any standards for movie compression standards, there was no personal computer even on the horizon which could display them. What became an emergent technology and filled many sessions later, image comparison and search, was not possible, nor the current emerging technology of social networks- the world wide web was still several years away. Printer technology was still devising dithers and image size manipulations which would consume many years, as would scanning technology, and image quality for both was a major issue for dithers and Fourier noise.From these humble beginnings to the current moves that are changing computing and the meaning of both electronic devices and human interaction with them, we will see a course through the changing technology that holds some features constant for many years, while others come and go.

  20. Efficiency of emergency exercises

    International Nuclear Information System (INIS)

    Zander, N.; Sogalla, M.

    2011-01-01

    In order to cope with accidents beyond the design basis within German nuclear power plants which possibly lead to relevant radiological consequences, the utilities as well as the competent authorities exist emergency organisations. The efficiency, capacity for teamwork and preparedness of such organisations should be tested by regular, efficient exercise activities. Such activities can suitably be based on scenarios which provide challenging tasks for all units of the respective emergency organisation. Thus, the demonstration and further development of the efficiency of the respective organisational structures, including their ability to collaborate, is promoted. (orig.)

  1. Preparing for Emergency

    DEFF Research Database (Denmark)

    Melchiors, Jacob; Todsen, Tobias; Nilsson, Philip

    2015-01-01

    OBJECTIVE: Emergency cricothyrodotomy (EC) is a lifesaving procedure. Evidence-based assessment of training effects and competency levels is relevant to all departments involved in emergency airway management. As most training uses low-fidelity models, the predictive value of good performance....... Sixteen physicians (7 experienced surgeons and 9 novice physicians) performed an EC on a low-fidelity model and a cadaver. Two blinded raters assessed video recordings of performances using the assessment tool. RESULTS: We found a high interrater reliability, based on a Pearson's r (0.81), and good...

  2. Characterization of radiological emergencies

    International Nuclear Information System (INIS)

    Chester, C.V.

    1985-01-01

    Several severe radiological emergencies were reviewed to determine the likely range of conditions which must be coped with by a mobile teleoperator designed for emergencies. The events reviewed included accidents at TMI (1978), SL-1 (1961), Y-12 (1958), Bethesda (1982), Chalk River (1952 and 1958), Lucens (1969). The important conditions were: radiation fields over 10,000 R/h, severe contamination, possible critical excursion, possible inert atmosphere, temperatures from 50 0 C to -20 0 C, 100% relative humidity, 60-cm-high obstacles, stairs, airlocks, darkness, and lack of electric power

  3. Ultrasonography in abdominal emergencies

    International Nuclear Information System (INIS)

    Risi, D.; Alessi, G.; Meli, C.; Marzano, M.; Fiori, E.; Caterino, S.

    1989-01-01

    From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 post-operative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the affidability of ultrasonography in abdominal emergencies, as shown in literature

  4. Abdominal Aortic Emergencies.

    Science.gov (United States)

    Lech, Christie; Swaminathan, Anand

    2017-11-01

    This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Emergency operation determination system

    International Nuclear Information System (INIS)

    Miki, Tetsushi.

    1993-01-01

    The system of the present invention can determine an emergency operation coping with abnormal events occurring during nuclear plant operation without replying on an operator's judgement. That is, the system of the present invention comprises an intelligence base which divides and classifies the aims of the plant operation for the function, structure and operation manual and puts them into network. Degree of attainment for the extend of the status normality is determined on every aim of operation based on various kinds of measured data during plant operation. For a degree of attainment within a predetermined range, it is judged that an emergency operation is possible although this is in an abnormal state. Degree of emergency is determined by a fuzzy theory based on the degree of attainment, variation coefficient for the degree of attainment and the sensitivity to external disturbance as parameters. Priority for the degree of emergency on every operation aims is determined by comparison. Normality is successively checked for the determined operation aims. As a result, equipments as objects of abnormality suppressing operation are specified, and the operation amount of the equipments as objects are determined so that the measuring data are within a predetermined range. (I.S.)

  6. Biodosimetry: emergency preparedness

    International Nuclear Information System (INIS)

    Pradeepkumar, K.S.

    2016-01-01

    Biodosimetry assays are the only methods available for ascertaining and estimating biological dose for suspected over-exposures and manage radiological emergency situations. These methods also plays a major role in medical management and triage. In the eventuality of radiological emergency, it becomes inevitable to provide care for exposed individuals. However, large numbers of unexposed individuals or those with clinically insignificant doses are to be screened off for effective medical management of those who really need the specialized medical attention. Majority of individuals involved in radiological accidents may not need any medical attention but will need ascertainment of dose estimation and counselling. The decision making and counselling is possible only with the evidence of dose estimation. Though Biodosimetry procedures-are known for their inherent delay, since radiation effects are very slow in nature, give ample time for such investigations to be completed without any hurry to take medical actions in most cases. High throughput facilities in the state of the art Biodosimetry lab established at HS and EG, BARC has helped us to address many small scale radiological emergencies in the past. These experiences also helped the lab to prepare itself for large scale scenario and support the emergency management with continually improving preparedness and indigenous development of facilities. (author)

  7. Emerging Communities of Practice

    Science.gov (United States)

    McAlister, Martha

    2016-01-01

    Communities of practice are emerging as an innovative approach to faculty development. While collaborative learning is becoming popular in the classroom, autonomy and individualism continue to dominate the culture of higher education for faculty. However, as we begin to recognize that old solutions to new problems are no longer effective, there is…

  8. Structural Emergency Control Paradigm

    DEFF Research Database (Denmark)

    Vu, Thanh Long; Chatzivasileiadis, Spyros; Chiang, Hsiao-Dong

    2017-01-01

    demand and hopefully stabilize the system. This traditional emergency control results in interrupted service with severe economic damage to customers. Also, such control is usually less effective due to the lack of coordination among protective devices. In this paper, we propose a novel structural...

  9. Emerging Asian Economics.

    Science.gov (United States)

    Trezise, Philip H.

    What we can expect in the future from the miracle economies of Japan, South Korea, Taiwan, Singapore, and Hong Kong, whether they pose a threat to the older industrial states of Western Europe and North American, and whether China is to be the next emerging Asian economy are discussed. The amazing economic recovery of these East Asian countries…

  10. Fire Department Emergency Response

    International Nuclear Information System (INIS)

    Blanchard, A.; Bell, K.; Kelly, J.; Hudson, J.

    1997-09-01

    In 1995 the SRS Fire Department published the initial Operations Basis Document (OBD). This document was one of the first of its kind in the DOE complex and was widely distributed and reviewed. This plan described a multi-mission Fire Department which provided fire, emergency medical, hazardous material spill, and technical rescue services

  11. Costs of Emergency Care

    Science.gov (United States)

    ... All RSS Feeds ACEP In the News Multimedia Image Gallery ACEP Video ACEP Radio ACEP Ads Resources Statistics & Reports Health Policy Campaigns Published Letters Journalism Awards Fact Sheets Social Media Contact Us Site Body Main Content Annals of Emergency Medicine | EMAF Website | ...

  12. LNG - emergency control

    Energy Technology Data Exchange (ETDEWEB)

    Berardinelli, Ricardo Porto; Correa, Kleber Macedo; Moura Filho, Nelson Barboza de; Fernandez, Carlos Antonio [TRANSPETRO, Rio de Janeiro, RJ (Brazil); Matos, Jose Eduardo Nogueira de [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2009-07-01

    The operation of liquefied natural gas (LNG) is pioneering within the PETROBRAS System. PETROBRAS Transporte - TRANSPETRO is going to operate two flexible LNG terminals, located in Ceara and Rio de Janeiro. In accordance with the Corporate Health, Safety and Environmental (HSE) Directive - Training, Education and Awareness, PETROBRAS Transporte S.A. - TRANSPETRO has prepared an action plan with the objective of ensuring the operational safety of the undertaking. Among other actions a training program for the emergency control of LNG will be inserted into the timetable. The above mentioned training program was held over a period of 20 hours, and was divided between theory and practice. In the theoretical part, the characteristics of the product, the history of accidents and the emergency response procedures were covered. In the practical part, 3000 gallons of LNG were utilized where the behavior of the product could be confirmed following a confined leak, thereby verifying the efficacy of the emergency control resources. The teaching process of the course was developed in the company through the preparation of specific procedures, emergency plans and the formation of internal instructors. (author)

  13. Financing emerging energies

    International Nuclear Information System (INIS)

    Row, J.

    2006-01-01

    This paper discusses the financing of emerging energies in Canada. Transforming energy markets will involve billions of dollars of investment from businesses and residents. Many different types of return on investment can be expected. These benefits will continue to grow over time and provide a permanent i ncome

  14. Emergence of regional clusters

    DEFF Research Database (Denmark)

    Dahl, Michael S.; Østergaard, Christian Richter; Dalum, Bent

    2010-01-01

    The literature on regional clusters has increased considerably during the last decade. The emergence and growth patterns are usually explained by such factors as unique local culture, regional capabilities, tacit knowledge or the existence of location-specific externalities (knowledge spillovers...

  15. Emerging Art Markets

    NARCIS (Netherlands)

    Kraussl, R.G.W.; Logher, R.

    2010-01-01

    This paper analyzes the performance and risk-return characteristics of three major emerging art markets: Russia, China, and India. According to three national art market indices, built by hedonic regressions based on auction sales prices, the geometric annual returns are 10.00%, 5.70%, and 42.20%

  16. Emergency preparedness in obstetrics.

    Science.gov (United States)

    Haeri, Sina; Marcozzi, David

    2015-04-01

    During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future.

  17. Assessing School Emergency Care Preparedness.

    Science.gov (United States)

    Hale, Charles; Varnes, Jill

    A study assessed the emergency health care preparedness of a north central Florida public school district in light of seven criteria: (1) school policies regarding delivery of emergency health care; (2) identification of school personnel responsible for rendering emergency care; (3) training levels of emergency health care providers (first aid and…

  18. The difficult medical emergency call

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren

    2017-01-01

    BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the ......BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories...... and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data. Logistic regression analysis (N = 78,040 individuals) was used for identification...

  19. Developing utility emergency preparedness exercises

    International Nuclear Information System (INIS)

    Sjoeblom, K.

    1986-01-01

    Utility emergency preparedness exercises constitute an important link in upgrading the response to nuclear power plant emergencies. Various emergency exercises are arranged annually at the Loviisa nuclear power plant. The on-site simulator is a practical tool in developing suitable accident scenarios and demonstrating them to the site emergency players and spectators. The exercises concentrate on emergency management and radiological activities. It is important to create a high degree of motivation. (author)

  20. Emergency Physicians at War.

    Science.gov (United States)

    Muck, Andrew E; Givens, Melissa; Bebarta, Vikhyat S; Mason, Phillip E; Goolsby, Craig

    2018-05-01

    Operation Enduring Freedom (OEF-A) in Afghanistan and Operation Iraqi Freedom (OIF) represent the first major, sustained wars in which emergency physicians (EPs) fully participated as an integrated part of the military's health system. EPs proved invaluable in the deployments, and they frequently used the full spectrum of trauma and medical care skills. The roles EPs served expanded over the years of the conflicts and demonstrated the unique skill set of emergency medicine (EM) training. EPs supported elite special operations units, served in medical command positions, and developed and staffed flying intensive care units. EPs have brought their combat experience home to civilian practice. This narrative review summarizes the history, contributions, and lessons learned by EPs during OEF-A/OIF and describes changes to daily clinical practice of EM derived from the combat environment.

  1. [Enterostomy post emergency enterectomy].

    Science.gov (United States)

    Gavrilescu, S; Velicu, D; Gheorghiu, L; Duţescu, S

    2002-01-01

    This is a clinical approach regarding 43 resection of intestine, performed in emergency condition, terminated as enterostomy, with represent 20% of enterectomyes performed in emergency condition and 1.6% of urgent operations. The decision of enterostomy has been taken in the conditions of peritoneal sepsis, occlusion or the association of the two circumstances. The results are comparatively analyzed between the cases with enterostomy that has been made from the beginning (66% success, 33% gone wrong), and those with enterostomy made at the second intervention (14% success, 86% gone wrong). One discusses problems of leading, technique and post-operating nursing. The intestinal reintegration has been made possible at 16 patients after a timing of three of four weeks.

  2. Emergency plan belgian experience

    International Nuclear Information System (INIS)

    Clymans, A.

    1989-01-01

    The Chernobyl disaster prompted authorities in Belgium to carry out a comprehensive review of all emergency plans and, in particular, those designed specifically for nuclear accidents. This review was aimed at determining what type of plans existed and to what extent such plans were operational. This paper sets out to present a broad overview of different aspects of this problem: organization of public emergency plans, co-ordination of operations, merits and demerits of centralization as opposed to decentralization, planning zones, obligation to release information to the public and relations with the media, and finally the international dimension to the problem. The author expresses the hope that the latter area will inspire practical suggestions [fr

  3. Emergency Physicians at War

    Directory of Open Access Journals (Sweden)

    Melissa Givens

    2018-03-01

    Full Text Available Operation Enduring Freedom (OEF-A in Afghanistan and Operation Iraqi Freedom (OIF represent the first major, sustained wars in which emergency physicians (EPs fully participated as an integrated part of the military’s health system. EPs proved invaluable in the deployments, and they frequently used the full spectrum of trauma and medical care skills. The roles EPs served expanded over the years of the conflicts and demonstrated the unique skill set of emergency medicine (EM training. EPs supported elite special operations units, served in medical command positions, and developed and staffed flying intensive care units. EPs have brought their combat experience home to civilian practice. This narrative review summarizes the history, contributions, and lessons learned by EPs during OEF-A/OIF and describes changes to daily clinical practice of EM derived from the combat environment.

  4. 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.

  5. [Hospital emergency rooms].

    Science.gov (United States)

    Tudela, Pere; Mòdol, Josep Maria

    2003-05-17

    Overuse of hospital emergency rooms (HERs) is parallel to their controversy. To understand this problem, some concepts should be first clarified. In HERs, there are some intrinsic aspects which are directly related to the emergency itself and thus cannot be modified (intermittent patient flow, need to prioritize, difficulty to achieve a rapid diagnosis, influence of time on treatment, value of clinical follow up, patient's expectations, impact of HER on the overall hospital working dynamics). On the other hand, there are some extrinsic aspects which indeed are not related to HER itself but are rather historically associated with it (precarious structure, delay on admission, lack of privacy, inadequate triage of cases, lack of professionalization); these latter aspects may be potentially modified and should be reconsidered.

  6. [Ambulance in emergency medicine].

    Science.gov (United States)

    Aksoy, Fikret; Ergun, Alper

    2002-07-01

    The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services

  7. Hantaviruses as emergent zoonoses

    Directory of Open Access Journals (Sweden)

    LS Ullmann

    2008-01-01

    Full Text Available Hantaviruses belong to the Bunyaviridae family, which consists of vector-borne viruses. These viruses can provoke two infection types: hemorrhagic fever with renal syndrome (HFRS - which occurs in the Old World - and hantavirus cardiopulmonary syndrome (HCPS - an emergent zoonosis that can be found in many countries of the western hemisphere. Rodents are hantavirus reservoirs and each species seems to host a different virus type. Humans acquire the infection by inhaling contaminated aerosol particles eliminated by infected animals. The factors involved in the emergence of hantavirus infections in the human population include ecological modifications and changes in human activities. The most important risk factor is contact between man and rodents, as a result of agricultural, forestry or military activities. Rodent control remains the primary strategy for preventing hantavirus diseases, including via health education and hygienic habits.

  8. Investigating the effect of clinical governess approach on patients' length of stay in emergency department: an action research study.

    Directory of Open Access Journals (Sweden)

    Tahmine Salehi

    2014-02-01

    Full Text Available Over the past decade, clinical governance approach with aims to improve the quality of health services has been proposed in Iran. Considering the obvious problems especially patients' length of stay (LOS in the emergency departments (EDs; the present study has been carried out with the purpose of Investigating the effect of clinical governess approach on patients' LOS in the one of the largest medical centers in the country. After the problem was specified by the 17 interviews with employees and managers of the ED; the emergency clinical governance committee was formed by two academic researchers and seven ED staff (key participants that had the most involvement with the subject of study. The activities of the committee, including planning, acting, observing and reflecting, was organized by using participatory action research approach and action research cycle (Kemmis 1995. During this time, three formal meetings with key participants were held in 6-month intervals. Monthly records of patients' average LOS and interview with ED staff were used to analyze the findings. The research was completed with two cycles in one year. Committee members took the following actions. As a result, the patients' LOS reduced from 2.68 days to 1.73 days. Make regular patients visits by medical groups especially orthopedists and neurologists; Decision making about patients situation by emergency physicians and transferring patients to the relevant units by bed managers; Refusing to admit elective patients during overcrowding times; to regulate the list of patients requiring ICU by anesthesiologists. Prolonged LOS can be due to various causes and a team approach, which is one of the requirements of clinical governance approach, is needed to manage it. The results showed that the multidisciplinary team could make positive changes and reduce LOS in emergency setting.

  9. Guidelines for emergency laparoscopy

    Directory of Open Access Journals (Sweden)

    Sauerland Stefan

    2006-10-01

    Full Text Available Abstract Acute abdominal pain is a leading symptom in many surgical emergency patients. Laparoscopy allows for accurate diagnosis and immediate therapy of many intraabdominal pathologies. The guidelines of the EAES (European Association for Endoscopic Surgery provides scientifically founded recommendations about the role of laparoscopy in the different situations. Generally, laparoscopy is well suited for the therapy of the majority of diseases that cause acute abdominal pain.

  10. Emerging contaminants in groundwater

    OpenAIRE

    Lapworth, Dan; Stuart, Marianne; Hart, Alwyn; Crane, Emily; Baran, Nicole

    2011-01-01

    The term ‘emerging contaminants’ (ECs) is used to cover not only newly developed compounds but also includes newly discovered compounds in the environment (often due to analytical developments), and compounds that have been recently categorised as contaminants. ECs include a huge array of different compounds (and their metabolites) that are used by society for a range of purposes and include; pharmaceuticals, pesticides, personal care products, veterinary medicines, engineered nano-materials,...

  11. 'Regular' and 'emergency' repair

    International Nuclear Information System (INIS)

    Luchnik, N.V.

    1975-01-01

    Experiments on the combined action of radiation and a DNA inhibitor using Crepis roots and on split-dose irradiation of human lymphocytes lead to the conclusion that there are two types of repair. The 'regular' repair takes place twice in each mitotic cycle and ensures the maintenance of genetic stability. The 'emergency' repair is induced at all stages of the mitotic cycle by high levels of injury. (author)

  12. 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.

  13. 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...

  14. Pediatric oncologic emergencies

    International Nuclear Information System (INIS)

    Zietz, Hallie A.

    1997-01-01

    Oncologic emergencies arise in three ways: disease or therapy induced cytopenias; a space occupying lesion causing pressure on or obstruction of surrounding tissues; or leukemia or tumors creating life-threatening metabolic or hormonal problems. Knowledge of presenting signs and symptoms of these emergencies are essential in pediatric oncologic nursing. Neutropenia opens the door for all manner of infections, but the most life threatening is septicemia progressing to shock. A variety of organisms can cause septic shock in the neutropenic patient, but episodes are most often due to gram-negative organisms and the endotoxins they release. Shock, while still compensated, may present with a elevated or subnormal temperature, flushed, warm, dry skin, widening pulse pressure, tachycardia, tachypnoea and irritability, but without medical intervention will progress to hypo tension, cool, clammy extremities, decreased urinary out- put, and eventually to bradycardia and cardiogenic shock. Another emergency in the cytopenia category is bleeding as a result of thrombocytopenia. Of greatest concern is intracranial hemorrhage that may occur at platelet counts of less than 5,000/mm3. Space-occupying lesions of the chest may produce superior vena cava syndrome (SVGS), pleural and pericardial effusions, and cardiac tamponade. SVGS is most often caused by non-Hodgkin's lymphoma (NHL) and presents as cough, hoarseness, dyspnea, orthopnea and chest pain. Signs include swelling, plethora, cyanosis, edema of conjunctiva and wheezing. Pleural and pericardial effusions present with respiratory or cardiac distress as does cardiac tamponade. Abdominal emergencies arise because of inflammation, mechanical obstruction, hemorrhage (often from steroid induced ulcers), and perforation. Pain is the most common presenting symptom, although vital sign alterations, fever, blood in vomitus or stool, abdominal distension and cessation of flatus are also important components of the acute abdomen

  15. 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...

  16. Tacit knowledge emergence

    International Nuclear Information System (INIS)

    Garland, B.

    2008-01-01

    This paper outlines tacit knowledge emergence. Tacit knowledge is 'knowledge that we have without knowing we have it and that once we know we have it, it becomes harder to know how we know what we know'. We learn by doing. Knowledge is not a thing; it is a process. It cites examples of tacit knowledge transfer failures. Failure in organization could be attributed to lack of explicit scientific and engineering knowledge, lack of research or improperly implemented knowledge

  17. Architecture humanitarian emergencies

    DEFF Research Database (Denmark)

    Gomez-Guillamon, Maria; Eskemose Andersen, Jørgen; Contreras, Jorge Lobos

    2013-01-01

    Introduced by scientific articles conserning architecture and human rights in light of cultures, emergencies, social equality and sustainability, democracy, economy, artistic development and science into architecture. Concluding in definition of needs for new roles, processes and education of arc......, Architettura di Alghero in Italy, Architecture and Design of Kocaeli University in Turkey, University of Aguascalientes in Mexico, Architectura y Urbanismo of University of Chile and Escuela de Architectura of Universidad Austral in Chile....

  18. Emerging drugs of abuse.

    Science.gov (United States)

    Nelson, Michael E; Bryant, Sean M; Aks, Steven E

    2014-02-01

    Many new emerging drugs of abuse are marketed as legal highs despite being labeled "not for human consumption" to avoid regulation. The availability of these substances over the Internet and in "head shops" has lead to a multitude of emergency department visits with severe complications including deaths worldwide. Despite recent media attention, many of the newer drugs of abuse are still largely unknown by health care providers. Slight alterations of the basic chemical structure of substances create an entirely new drug no longer regulated by current laws and an ever-changing landscape of clinical effects. The purity of each substance with exact pharmacokinetic and toxicity profiles is largely unknown. Many of these substances can be grouped by the class of drug and includes synthetic cannabinoids, synthetic cathinones, phenethylamines, as well as piperazine derivatives. Resultant effects generally include psychoactive and sympathomimetic-like symptoms. Additionally, prescription medications, performance enhancing medications, and herbal supplements are also becoming more commonly abused. Most new drugs of abuse have no specific antidote and management largely involves symptom based goal directed supportive care with benzodiazepines as a useful adjunct. This paper will focus on the history, epidemiology, clinical effects, laboratory analysis, and management strategy for many of these emerging drugs of abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. 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

  20. 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

  1. Emergency Victim Care. A Textbook for Emergency Medical Personnel.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

    This textbook for emergency medical personnel should be useful to fire departments, private ambulance companies, industrial emergency and rescue units, police departments, and nurses. The 30 illustrated chapters cover topics such as: (1) Emergency Medical Service Vehicles, (2) Safe Driving Practices, (3) Anatomy and Physiology, (4) Closed Chest…

  2. The Military Emergency Unit

    International Nuclear Information System (INIS)

    Gonzalez Requena, J. M.

    2007-01-01

    One of the most justified and pressing demands that society makes of the State, requiring a fast, forceful and effective response, is that it guarantees the safety of people and their assets when a disaster seriously endangers them. At the proposal of the President of the Government, the Cabinet of Ministers, in its meeting held on October 7, 2005, agreed to create the Military Emergency Unit, known since the as the UME. Its mission is to intervene anywhere in the national territory when the President of the Government, or the Minister to whom he delegates, so decides in order to assure the safety and welfare of citizens in cases of serious risk, disaster, catastrophe or any other public need. The UME is organically incorporated into the Ministry of Defense and its actions may be supported with all the available human and material needs of the Armed Forces. Availability and effectiveness, with calmness and humility, have characterized the early actions of the Military Emergency Unit and are the guidelines for future action. The first steps of this military unit have focused on a clear goal: collaboration and participation in situations whose seriousness requires the coordination of different forces in order to immediately respond to them. The UME is the States tool to join forces and, with other administration and institutions, help to rapidly and effectively deal with emergencies. It has taken its first step and achieved the capacity specified in the UME Operations Order for 2007. The 150 men and women per battalion, plus the 80 in the Gando detachment, are on active duty and have sufficient material means to deploy, if necessary and when requested by the regions, town councils an other administrative bodies, to help in the extinction of forest fires. (Author)

  3. Emergence of Life

    Directory of Open Access Journals (Sweden)

    Marie-Paule Bassez

    2011-09-01

    Full Text Available Indeed, even if we know that many individual components are necessary for life to exist, we do not yet know what makes life emerge. One goal of this journal Life is to juxtapose articles with multidisciplinary approaches and perhaps to answer in the near future this question of the emergence of life. Different subjects and themes will be developed, starting of course with the multiple definitions of life and continuing with others such as: life diversity and universality; characteristics of living systems; thermodynamics with energy and entropy; kinetics and catalysis; water in its different physical states; circulation of sap and blood and its origin; the first blood pump and first heart; the first exchange of nutrients between cells, sap and blood; essential molecules of living systems; chirality; molecular asymmetry and its origin; formation of enantiomer excess and amplification; microscopic observations on a micrometer and sub-micrometer scales, at molecular and atomic levels; the first molecules at the origin of genetic information, viroids, circular RNA; regions of space or the area inside membranes and cells capable of initiating and maintaining life; phenomena at the origin of the emergence of life; molecules studied in the traditional field of chemistry and in the recent field of nanoscience governed by new laws; interaction between the individual molecules and components of living systems; interaction between living systems and the environment; transfer of information through generations; continuation of life from one generation to the next; prebiotic chemistry and prebiotic signatures on Earth, on Mars, on other planets; biosignatures of the first forms of life; fossils and pseudofossils dating 3.5 Ga ago and more recent ones; experimental fossilization; pluricellular eukaryotes dating 2.1 Ga ago; sudden increase in oxygen in the atmosphere around 2.0 to 2.5 Ga ago and its relation to geology; shell symmetry; aging with

  4. Emerging hot spot analysis

    DEFF Research Database (Denmark)

    Reinau, Kristian Hegner

    Traditionally, focus in the transport field, both politically and scientifically, has been on private cars and public transport. Freight transport has been a neglected topic. Recent years has seen an increased focus upon congestion as a core issue across Europe, resulting in a great need for know...... speed data for freight. Secondly, the analytical methods used, space-time cubes and emerging hot spot analysis, are also new in the freight transport field. The analysis thus estimates precisely how fast freight moves on the roads in Northern Jutland and how this has evolved over time....

  5. Corruption in emergency procurement.

    Science.gov (United States)

    Schultz, Jessica; Søreide, Tina

    2008-12-01

    Corruption in emergency procurement reduces the resources available for life-saving operations, lowers the quality of products and services provided, and diverts aid from those who need it most.(1) It also negatively influences public support for humanitarian relief, both in the affected country and abroad. This paper aims to unpack and analyse the following question in order to mitigate risk: how and where does corruption typically occur, and what can be done? Suggested strategies reflect a multi-layered approach that stresses internal agency control mechanisms, conflict-sensitive management, and the need for common systems among operators.

  6. EDF national emergency organization

    International Nuclear Information System (INIS)

    Laverge, J.

    1992-01-01

    The scope of French nuclear power led Electricite de France (EDF) to design standard products, manufactured in series but adaptable to different sites. Standardization is based on the decision on a single technology: pressurized water reactors (PWR). Thirty-four 900 MW and seventeen 1300 MW units are in operation on seventeen sites. The specific nature of French organization for normal operation and accident management results from equipment standardization and single licensee. This specificity is based on emergency plan standardization and highly structured national organization. Figs

  7. Emergence and Evolution

    DEFF Research Database (Denmark)

    Bullwinkle, Tammy J; Ibba, Michael

    2013-01-01

    ancestor and as such they provide insights into the evolution and development of the extant genetic code. Although the aaRSs have long been viewed as a highly conserved group of enzymes, findings within the last couple of decades have started to demonstrate how diverse and versatile these enzymes really...... are. Beyond their central role in translation, aaRSs and their numerous homologs have evolved a wide array of alternative functions both inside and outside translation. Current understanding of the emergence of the aaRSs, and their subsequent evolution into a functionally diverse enzyme family...

  8. Preventive measures for emergencies?

    International Nuclear Information System (INIS)

    Calliess, J.

    1990-01-01

    The meeting discussed the new provisions for civil defense on account of the amended Disaster Control Act which had been recently adopted by the Lower House of Parliament. In 6 working groups it was discussed how appropriate and sensible the attempt is to make provisions for civil defence in order to protect the population, and how adequate legislative measures are in the face of true threat and var scenarios. Ethical aspects and aspects of international law were considered, as well as the role of public health and free charitable institutions concering preventive measures in emergencies. (orig. HSCH) [de

  9. Emergency response strategies

    International Nuclear Information System (INIS)

    Carrilo, D.; Dias de la Cruz, F.

    1984-01-01

    In the present study is estimated, on the basis of a release category (PWR4) and several accident scenarios previously set up, the emergency response efficacy obtained in the application of different response strategies on each of the above mentioned scenarios. The studied strategies contemplate the following protective measures: evacuation, shelter and relocation. The radiological response has been obtained by means of CRAC2 (Calculation of Reactor Accident Consequences) code, and calculated in terms of absorbed dose equivalent (Whole body and thyroid), as well as early and latent biological effects. (author)

  10. Dangerous goods emergency response

    International Nuclear Information System (INIS)

    Price, K.

    1991-01-01

    This paper reports on a general overview of the State of Western Australia including: the legal framework of the Dangerous Goods and Emergency response management scenarios (which consist mainly of fuel products such as LP gas); particular problems unique to the Western Australian environment; what has been done to overcome those problems. Western Australia has an area of about two and a half million square kilometers. The demography of the State is such that the population is concentrated in the south-west corner of the State with isolated pockets, mainly associated with mineral development but also associated with agriculture, scattered throughout the State

  11. CSN's New Emergency Room

    International Nuclear Information System (INIS)

    Sendin, P.

    2005-01-01

    During the month of July 2005 the physical renovation works and technological updating of the basic infrastructures of the CSN Emergency Room (SALEM) were finished, allowing the Room to now have greater functionality and a broader technical capacity. Nevertheless, the technological improvement process of SALEM will reach its full potential within the next few years, once the installation currently underway of the new information integration and monitoring systems and the decision making support systems have been completed. This article describes the improvements introduced to the Room and the objectives pursued in this renovation project to convert the SALEM into a new generation room in accordance with its current technological context. (Author) 4 refs

  12. Emergency procedures in London

    International Nuclear Information System (INIS)

    Cree, D.

    1984-01-01

    This chapter discusses the following: emergency services (fire brigade, ambulance and police) that would be involved in dealing with an accident to a nuclear fuel flask in transport through London, with special reference to procedures used by the Metropolitan Police; geographical area covered by Metropolitan Police; initiation of action; decision whether to evacuate the area of the accident; examples of action taken to deal with non-radiation accidents (in absence of any example of relevant radiation accident); specific instructions, or advice, to police relating to the movement of irradiated fuel; training exercises. (U.K.)

  13. German emergency management concept

    International Nuclear Information System (INIS)

    Burkart, K.

    1993-01-01

    The advantages and disadvantages of the margin and start-up value concepts (according to ICRP 40 and EU-ordinances) are explained, and it is demonstrated that the two concepts are combinable. The combined concept has the advantage of immediately providing, if required, intervention levels for the various measures to be taken, and of obliging those persons concerned with emergency protection to study and quantify, already at the planning stage, the influence of a range of accident conditions on the decision on measures. In this context, the use of computerized decision support systems which are currently being developed is indispensable. (orig./DG) [de

  14. Emergency peripartum hysterectomy

    DEFF Research Database (Denmark)

    Jakobsson, Maija; Tapper, Anna Maija; Colmorn, Lotte Berdiin

    2015-01-01

    peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10 000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n = 91, 43.1%), atonic bleeding (n = 69, 32.......7%), uterine rupture (n = 31, 14.7%), other bleeding disorders (n = 12, 5.7%), and other indications (n = 8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum...

  15. Wind emergency response system

    International Nuclear Information System (INIS)

    Garrett, A.J.; Buckner, M.R.; Mueller, R.A.

    1981-01-01

    The WIND system is an automated emergency response system for real-time predictions of the consequences of liquid and airborne releases from SRP. The system consists of a minicomputer and associated peripherals necessary for acquisition and handling of large amounts of meteorological data from a local tower network and the National Weather Service. The minicomputer uses these data and several predictive models to assess the impact of accidental releases. The system is fast and easy to use, and output is displayed both in tabular form and as trajectory map plots for quick interpretation. The rapid response capabilities of the WIND system have been demonstrated in support of SRP operations

  16. On-site emergency planning

    International Nuclear Information System (INIS)

    Kueffer, K.

    1980-01-01

    This lecture covers the Emergency Planning of the Operating organization and is based on the Code of Practice and Safety Guides of the IAEA as well as on arrangements in use at the Swiss Nuclear Power Station Beznau and - outlines the basis and content of an emergency plan - describes the emergencies postulated for emergency planning purposes - describes the responsibilities, the organization and the procedures of the operating organization to cope with emergency situations and the liaison between the operating organization, the regulatory body and public authorities - describes the facilities and equipment which should be available to cope with emergency sitauations - describes the measures and actions to be taken when an emergency arises in order to correct abnormal plant conditions and to protect the persons on-and off-site - describes the aid to be given to affected personnel - describes the aspects relevant to maintaining the emergency plan and organization in operational readiness. (orig./RW)

  17. Plan for radiological emergencies situations

    International Nuclear Information System (INIS)

    Estrada Figueroa, E.R.

    1998-01-01

    The objective for the Emergencies plan it is to reestablish the stock that they should be executed by the regulatory Entity in Guatemala during a real potential radiological emergency situation in the national territory

  18. Emergency Meal Planning for Diabetics

    Science.gov (United States)

    ... emergency . What should I expect during an emergency situation? Many things we depend on daily may not ... 2017 National Kidney Foundation, Inc., 30 East 33rd Street, New York, NY 10016, 1-800-622-9010. ...

  19. Ideas Production in Emerging Economies

    OpenAIRE

    Luintel, Kul B; Kahn, Mosahid

    2012-01-01

    We model 'new ideas' production in a panel of 17 emerging countries. Our results reveal: (i) ideas production is duplicative, (ii) externality associated with domestic knowledge stocks is of above unit factor proportionality, (iii) OECD countries raise the innovation-bar for emerging countries, (iv) there is no significant knowledge diffusion across emerging countries, and (v) growth in emerging countries appear far from a balanced growth path.

  20. Communication system for emergency

    International Nuclear Information System (INIS)

    Ajioka, Yoshiteru

    1996-01-01

    People are apprehensive that a strong earthquake with a magnitude of nearly 8 may occur in Tokai area. The whole area of Shizuoka Prefecture has been specified as the specially strengthened region for earthquake disaster measures. This report outlines the communication system for emergency with respect to atomic disaster caused by an earthquake. Previously, wireless receiving system is stationed in the whole area to simultaneously inform the related news to the residents and so, communications with them are possible at any time by using the system. Since mobile wireless receiving sets are stationed in all town halls, self defense organizations and all the places of refuge, mutual communications are possible. These communication system can be utilized for either earthquake or nuclear disaster. Further, Shizuoka general information network system has been established as a communication system for anti-disaster organization and a wireless network via a communication satellite, ''super bird'' has been constructed in addition to the ground network. Therefore, the two communication routes became usable at emergency and the systems are available in either of nuclear disaster or earthquake. (M.N.)

  1. Orion Emergency Mask Approach

    Science.gov (United States)

    Tuan, George C.; Graf, John C.

    2009-01-01

    Emergency mask approach on Orion poses a challenge to the traditional Shuttle or Station approaches. Currently, in the case of a fire or toxic spill event, the crew utilizes open loop oxygen masks that provide the crew with oxygen to breath, but also dumps the exhaled oxygen into the cabin. For Orion, with a small cabin volume, the extra oxygen will exceed the flammability limit within a short period of time, unless a nitrogen purge is also provided. Another approach to a fire or toxic spill event is the use of a filtering emergency masks. These masks utilize some form of chemical beds to scrub the air clean of toxic providing the crew safe breathing air for a period without elevating the oxygen level in the cabin. Using the masks and a form of smoke-eater filter, it may be possible to clean the cabin completely or to a level for safe transition to a space suit to perform a cabin purge. Issues with filters in the past have been the reaction time, breakthroughs, and high breathing resistance. Development in a new form of chemical filters has shown promise to make the filtering approach feasible.

  2. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  3. Emergency core cooling system

    International Nuclear Information System (INIS)

    Ando, Masaki.

    1987-01-01

    Purpose: To actuate an automatic pressure down system (ADS) and a low pressure emergency core cooling system (ECCS) upon water level reduction of a nuclear reactor other than loss of coolant accidents (LOCA). Constitution: ADS in a BWR type reactor is disposed for reducing the pressure in a reactor container thereby enabling coolant injection from a low pressure ECCS upon LOCA. That is, ADS has been actuated by AND signal for a reactor water level low signal and a dry well pressure high signal. In the present invention, ADS can be actuated further also by AND signal of the reactor water level low signal, the high pressure ECCS and not-operation signal of reactor isolation cooling system. In such an emergency core cooling system thus constituted, ADS operates in the same manner as usual upon LOCA and, further, ADS is operated also upon loss of feedwater accident in the reactor pressure vessel in the case where there is a necessity for actuating the low pressure ECCS, although other high pressure ECCS and reactor isolation cooling system are not operated. Accordingly, it is possible to improve the reliability upon reactor core accident and mitigate the operator burden. (Horiuchi, T.)

  4. Emergency preparedness and response

    International Nuclear Information System (INIS)

    Griffiths, M.

    1996-01-01

    After the Chernobyl accident, it became painfully obvious to the international community that there was an urgent need to establish a system for the coordination of international disaster assistance. It became the task of the United Nations Office for Disaster Relief (UNDRO) to develop such a system. The former UNDRO was subsumed into the Department of Humanitarian Affairs (DHA), established in January 1992 on the basis of UN General Assembly Resolution 46/182 adopted in December 1991, and the disaster relief system presently found in DHA is a further evolution of the system established by UNDRO. One particular importance in relation to nuclear accidents is the fact that UNDRO and the International Atomic Energy Agency (IAEA) signed a Memorandum of Understanding defining their respective responsibilities and the need for cooperation in case of accidents involving the unintentional release of nuclear radiation. In essence, the MOU makes it clear that the responsibilities of the IAEA, in connection with accidents at Nuclear Power Plants, related to the technical and radiological aspects, in particular to accident prevention, to the on-site preparedness, and to remedial measures within the 30-km zone outside the NPP. DHA's responsibilities, on the other hand, relate to the general preparedness and the rescue efforts outside the 30 km zone. In this respect, the preparedness and emergency response system is no different from the system employed in any other type of sudden-onset emergency

  5. Emergency reactor cooling circuit

    International Nuclear Information System (INIS)

    Araki, Hidefumi; Matsumoto, Tomoyuki; Kataoka, Yoshiyuki.

    1994-01-01

    Cooling water in a gravitationally dropping water reservoir is injected into a reactor pressure vessel passing through a pipeline upon occurrence of emergency. The pipeline is inclined downwardly having one end thereof being in communication with the pressure vessel. During normal operation, the cooling water in the upper portion of the inclined pipeline is heated by convection heat transfer from the communication portion with the pressure vessel. On the other hand, cooling water present at a position lower than the communication portion forms cooling water lumps. Accordingly, temperature stratification layers are formed in the inclined pipeline. Therefore, temperature rise of water in a vertical pipeline connected to the inclined pipeline is small. With such a constitution, the amount of heat lost from the pressure vessel by way of the water injection pipeline is reduced. Further, there is no worry that cooling water to be injected upon occurrence of emergency is boiled under reduced pressure in the injection pipeline to delay the depressurization of the pressure vessel. (I.N.)

  6. Emergency contraception: clinical outcomes.

    Science.gov (United States)

    Glasier, Anna

    2013-03-01

    Emergency contraception (EC) is widely used to prevent unwanted pregnancy. This review considers the safety and efficacy of three commonly used methods -- levonorgestrel (LNG-EC), ulipristal acetate (UPA) and the copper intrauterine device. All are extremely safe, and side effects are minimal. Concerns about increased risks of ectopic pregnancy after EC use have proved unfounded, and possible teratogenic effects seem unlikely. Although the true effectiveness of EC is impossible to estimate, recent research suggests that LNG-EC prevents around 50% of expected pregnancies in women using the method within 72 h of intercourse, whereas UPA appeared to prevent almost two thirds of pregnancies. Emergency intrauterine device insertion probably prevents over 95% of pregnancies. However, although improved accessibility of EC has clearly led to increased use, it does not appear to have had any public health benefit in reducing unintended pregnancy rates. Most of the data on sexual behavior following improved access to EC do not show any detrimental effect on subsequent use of other more effective methods of contraception or on the incidence of unintended pregnancy or sexually transmitted infection. However, unless these other methods of contraception are also made easily available from pharmacies, improved access to EC risks unlinking its use with use of subsequent ongoing contraception. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Emergency Teacher Certification. ERIC Digest.

    Science.gov (United States)

    Ashburn, Elizabeth A.

    Emergency certification involves the issuance of teaching licenses to individuals who have not completed a traditional college or university teacher education program. This two-page information review examines the problems arising from emergency certification and its relationship to student achievement. Some alternatives to emergency certification…

  8. Emergency Health Services Selected Bibliography.

    Science.gov (United States)

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    This annotated bibliography contains books, journal articles, visual aids, and other documents pertaining to emergency health care, which are organized according to: (1) publications dealing with day-to-day health emergencies that occur at home, work, and play, (2) documents that will help communities prepare for emergencies, including natural…

  9. Training teams for emergency management

    NARCIS (Netherlands)

    Schaafstal, A.M.; Johnston, J.H.; Oser, R.L.

    2001-01-01

    Emergency management (EM), the decision making involved in directing the relief operation after a disaster or otherwise catastrophic accident is an issue of great public and private concern because of the high stakes involved. Due to the nature of emergencies, and especially mass emergencies, EM

  10. NLM Emergency Access Initiative: FAQs

    Science.gov (United States)

    Facebook Visit us on Twitter Visit us on Youtube Emergency Access Initiative Home | Journals | Books | Online Databases | FAQs Take Short Survey FAQ What is the Emergency Access Initiative? The Emergency Access Initiative (EAI) is a collaborative partnership between NLM and participating publishers to

  11. 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.

  12. 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.

  13. Emergency department CT screening of patients with nontraumatic neurological symptoms referred to the posterior fossa: comparison of thin versus thick slice images.

    Science.gov (United States)

    Kamalian, Shervin; Atkinson, Wendy L; Florin, Lauren A; Pomerantz, Stuart R; Lev, Michael H; Romero, Javier M

    2014-06-01

    Evaluation of the posterior fossa (PF) on 5-mm-thick helical CT images (current default) has improved diagnostic accuracy compared to 5-mm sequential CT images; however, 5-mm-thick images may not be ideal for PF pathology due to volume averaging of rapid changes in anatomy in the Z-direction. Therefore, we sought to determine if routine review of 1.25-mm-thin helical CT images has superior accuracy in screening for nontraumatic PF pathology. MRI proof of diagnosis was obtained within 6 h of helical CT acquisition for 90 consecutive ED patients with, and 88 without, posterior fossa lesions. Helical CT images were post-processed at 1.25 and 5-mm-axial slice thickness. Two neuroradiologists blinded to the clinical/MRI findings reviewed both image sets. Interobserver agreement and accuracy were rated using Kappa statistics and ROC analysis, respectively. Of the 90/178 (51 %) who were MR positive, 60/90 (66 %) had stroke and 30/90 (33 %) had other etiologies. There was excellent interobserver agreement (κ > 0.97) for both thick and thin slice assessments. The accuracy, sensitivity, and specificity for 1.25-mm images were 65, 44, and 84 %, respectively, and for 5-mm images were 67, 45, and 85 %, respectively. The diagnostic accuracy was not significantly different (p > 0.5). In this cohort of patients with nontraumatic neurological symptoms referred to the posterior fossa, 1.25-mm-thin slice CT reformatted images do not have superior accuracy compared to 5-mm-thick images. This information has implications on optimizing resource utilizations and efficiency in a busy emergency room. Review of 1.25-mm-thin images may help diagnostic accuracy only when review of 5-mm-thick images as current default is inconclusive.

  14. Part I. Emergency workers

    International Nuclear Information System (INIS)

    2004-01-01

    This monograph deals with assessment of radiological health effects of the Chernobyl accident for emergency workers (part 1) and the population of the contaminated areas in Russia (part 2). The Chernobyl emergency workers and people living in the contaminated areas of Russia received much lower doses than the population of Hiroshima and Nagasaki and it was unclear whether risks of radiation-induced cancers derived with the Japanese data could be extrapolated to the low dose range However, it was predicted as early as in 1990 that the thyroid cancer incidence might be increasing due to incorporated 131 irradiation. What conclusions can be drawn from regarding cancer incidence among emergency workers and residents of the contaminated areas in Russia and the role of the radiation factor on the basis of the registry data? Leukemia incidence. Leukemia incidence is known to be one of principal indications of radiation effects. The radiation risk for leukemias is 3-4 times higher that for solid cancers and its latent period is estimated to be 2-3 years after exposure. Results of the radiation epidemiological studies discussed in this book show that in the worst contaminated Bryansk region the leukemia incidence rate is not higher than in the country in general. Even though some evidence exists for the dose response relationship, the radiation risks appear to be not statistically significant. Since risks of leukemia are known to be higher for those who were children at exposure, long-term epidemiological studies need to be continued. The study of leukemias among emergency workers strongly suggest the existence of dose response relationship. In those who received external doses more than 0.15 Gy the leukemia incidence rate is two time higher and these emergency workers should be referred to as a group of increased radiation risk. Solid cancers. The obtained results provide no evidence to a radiation-induced increase in solid cancers among residents of the contaminated areas

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

    Science.gov (United States)

    Carlton, Sally; Mills, Colleen E

    2017-10-01

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

  16. Emergency exercise ''Mosel 90''

    International Nuclear Information System (INIS)

    Miska, H.H.

    1993-01-01

    An emergency exercise for the environs of the nuclear power plant CPN de Cattenom was performed from April, 5th to 7th, 1990. Administration and operational personnel from Luxembourg, Saarland, and Rhineland-Palatinate (RP) participated in the combined staff and field exercise; the competent French authority, la Prefecture de Metz, played the role of the licencee. While each responsible authority tested its alarm -and response plan and trained its personnel, a major aim of the off-site exercise was to investigate and improve the methods of communication in this border region location; the outer planning zone (radius 25 km) of the French reactors encompasses parts of Luxembourg and of the two German states mentioned above. Preparation and scenario of the exercise will be explained and lessons learned will be discussed

  17. Emergent Computation Emphasizing Bioinformatics

    CERN Document Server

    Simon, Matthew

    2005-01-01

    Emergent Computation is concerned with recent applications of Mathematical Linguistics or Automata Theory. This subject has a primary focus upon "Bioinformatics" (the Genome and arising interest in the Proteome), but the closing chapter also examines applications in Biology, Medicine, Anthropology, etc. The book is composed of an organized examination of DNA, RNA, and the assembly of amino acids into proteins. Rather than examine these areas from a purely mathematical viewpoint (that excludes much of the biochemical reality), the author uses scientific papers written mostly by biochemists based upon their laboratory observations. Thus while DNA may exist in its double stranded form, triple stranded forms are not excluded. Similarly, while bases exist in Watson-Crick complements, mismatched bases and abasic pairs are not excluded, nor are Hoogsteen bonds. Just as there are four bases naturally found in DNA, the existence of additional bases is not ignored, nor amino acids in addition to the usual complement of...

  18. Upgrading France's emergency plans

    International Nuclear Information System (INIS)

    Moures, Y.

    1991-01-01

    In France as elsewhere, the Chernobyl accident spurred a new stage in the development of nuclear safety. In the months following the accident, France's Minister of Industry launched a campaign to strengthen research and safety measures to: prevent reactor accidents; reinforce the concept of quality in operations; train staff, in areas such as crisis management; systematically review plans, installations and techniques related to crisis management; study accident containment procedures. There was also a systematic review of communication links with authorities and outside emergency organizations during the critical phase of an accident. On the operational level regulatory monitoring procedures were reorganized and reinforced. France has not opted for the permanent presence of on-site inspectors, but rather for the total, continuous responsibility of the power plant operator, with the safety authority intervening at frequent intervals. A major programme was also established to increase capabilities for investigation and intervention in a radioactive environment in nuclear installations. (author)

  19. Emergency core cooling device

    International Nuclear Information System (INIS)

    Suzaki, Kiyoshi; Inoue, Akihiro.

    1979-01-01

    Purpose: To improve core cooling effect by making the operation region for a plurality of water injection pumps more broader. Constitution: An emergency reactor core cooling device actuated upon failure of recycling pipe ways is adapted to be fed with cooling water through a thermal sleeve by way of a plurality of water injection pump from pool water in a condensate storage tank and a pressure suppression chamber as water feed source. Exhaust pipes and suction pipes of each of the pumps are connected by way of switching valves and the valves are switched so that the pumps are set to a series operation if the pressure in the pressure vessel is high and the pumps are set to a parallel operation if the pressure in the pressure vessel is low. (Furukawa, Y.)

  20. Implementation of Emerging Technologies

    DEFF Research Database (Denmark)

    Barba, F. J.; Orlien, Vibeke; Mota, Maria J.

    2016-01-01

    safety are presented and discussed with an ultimate goal to explore strategies for their implementation in the food industry. Novel thermal and nonthermal technologies have shown clear environmental benefits by improving the overall energy efficiency of the process and reducing the use of nonrenewable......Novel processing technologies have been gaining interest among food researchers due to their lower impact on nutritional and sensory properties of the products compared to the conventional thermal techniques. In this chapter some of the most well-studied (eg, high-pressure processing, pulsed...... electric fields, ohmic heating, microwave, and ultrasound) emerging technologies are briefly reviewed. Most of these technologies have found niche applications in the food industry, replacing or complementing conventional preservation technologies. Thereby, data on commercialization, energy, and microbial...

  1. Communication in nuclear emergency

    International Nuclear Information System (INIS)

    Nozawa, Masao

    1996-01-01

    In order to take protection measures smoothly at the time of emergency in nuclear power stations and others, it is necessary to prepare information communication facilities mutually among disaster prevention organizations including the state and information transmission network for residents in surrounding areas. The matters decided in ''the measures to be taken for the time being for the countermeasures to prevent disaster in nuclear power stations and others'' are shown. In order to avoid the congestion of communication, the exclusively used communication systems are adopted for disaster prevention organizations, in which facsimile is used to transmit graphic information. The data communication circuits for distributing SPEEDI are installed between Science and Technology Agency, Nuclear Power Safety Technology Center and respective prefectures. The routes, means and order of notices must be confirmed beforehand mutually among the related organizations. As to the general communication for disaster countermeasures, the communication systems in ministries and agencies are described. (K.I.)

  2. Emerging treatments in alopecia.

    Science.gov (United States)

    Falto-Aizpurua, Leyre; Choudhary, Sonal; Tosti, Antonella

    2014-12-01

    Alopecia is a common concern encountered in the medical practice. Treatment approach varies according to the type and severity of alopecia. However, available treatment options have limited efficacy and several adverse effects. Presently, there are different treatment options being studied to overcome these limitations. Additionally, cellular pathways involved in the pathophysiology of alopecia are further being clarified to potentially target pathogenic molecules. We searched the literature for recently published articles discussing new treatment options as well as mechanisms involved in alopecia. We discuss the use of stem cells, growth factors, cellular pathways and robotic hair transplant, among other emerging therapies used for alopecia. Future looks very promising and new effective treatments such as janus kinase inhibitors could possibly be available for alopecia areata. The stem-cell technology is advancing and companies involved in hair follicle neogenesis are starting clinical trials on patients with androgenetic alopecia.

  3. Emergency planning knowledge

    International Nuclear Information System (INIS)

    Gheorghe, A.; Vamanu, D.

    1996-01-01

    This book is an essay in dealing with the risks and consequences of disruptive events in some emblematical enterprises of our time. The striking relevance of the variability factor in emergency management makes it difficult to encompass the entire difficulty in a fully generic, streamlined discourse. That is why, while trying its best to extract generic pieces of wisdom from the varied experience reported in the exploding literature around that deals with the subject, this text would rather focus on a few case histories at hand, that may more eloquently, if implicitly, illustrate authors' stand. The three projects that served the purpose - ETH-NUMERISK, MONITOT.HSK, and ETH-CHEMRISK - are components of a research project in the Swiss academic and educational environment. figs., tabs., refs,

  4. Emergent traffic jams

    International Nuclear Information System (INIS)

    Nagel, K.; Paczuski, M.

    1995-01-01

    We study a single-lane traffic model that is based on human driving behavior. The outflow from a traffic jam self-organizes to a critical state of maximum throughput. Small perturbations of the outflow far downstream create emergent traffic jams with a power law distribution P(t)∼t -3/2 of lifetimes t. On varying the vehicle density in a closed system, this critical state separates lamellar and jammed regimes and exhibits 1/f noise in the power spectrum. Using random walk arguments, in conjunction with a cascade equation, we develop a phenomenological theory that predicts the critical exponents for this transition and explains the self-organizing behavior. These predictions are consistent with all of our numerical results

  5. Emergent traffic jams

    Science.gov (United States)

    Nagel, Kai; Paczuski, Maya

    1995-04-01

    We study a single-lane traffic model that is based on human driving behavior. The outflow from a traffic jam self-organizes to a critical state of maximum throughput. Small perturbations of the outflow far downstream create emergent traffic jams with a power law distribution P(t)~t-3/2 of lifetimes t. On varying the vehicle density in a closed system, this critical state separates lamellar and jammed regimes and exhibits 1/f noise in the power spectrum. Using random walk arguments, in conjunction with a cascade equation, we develop a phenomenological theory that predicts the critical exponents for this transition and explains the self-organizing behavior. These predictions are consistent with all of our numerical results.

  6. Conceptions of mobile emergency service health professionals concerning psychiatric emergency

    Directory of Open Access Journals (Sweden)

    Diego Bonfada

    2012-06-01

    Full Text Available Under the Brazilian Psychiatric Reformation, assistance to psychological seizures represents a challenge for the emergency services. Therefore, the objective of this paper is the analysis of the conceptions of health professionals who work at the Mobile Emergency Service in Natal on psychiatric emergency care. This paper is, then, a qualitative study that used interviews as tools for collecting information. By using thematic analysis, the speeches were grouped into three categories: the stigma on patients and the professionals' fear of services interventions in psychiatric emergencies; having psychiatric emergencies regarded as harmful to patients and others' security; psychiatric emergencies being taken as patients' aggressiveness or severe depression. The data collected indicate that the interviewed professionals' ideas are supported by elements associated with the ideology that insanity implies social segregation and dangerousness. Thus, the survey prompted reflection on relevant issues to the process of psychiatric reformation implementation.

  7. Nipah virus encephalitis: A cause for concern for Indian neurologists?

    Directory of Open Access Journals (Sweden)

    Halder Amit

    2006-01-01

    Full Text Available The first and only recorded outbreak of Nipah virus (NV encephalitis in India occurred in the winter of 2001, although the causative organism could only be identified 5 years down the line in 2006. The first ever-recorded outbreak of NV encephalitis occurred in the Malaysian peninsula in 1998-99; though between 2001 and 2005, at least four outbreaks occurred in our neighboring country of Bangladesh. The threat of further outbreaks of this dangerous disease looms large on the Indian subcontinent, given the natural reservoir of the definitive host, namely, fruit-eating bats of the genus Pteropus. This review would briefly highlight the epidemiology, clinical aspects and diagnosis of NV encephalitis to enlighten the neurological community of the country for early detection and implementation of preventive measures in the event of further outbreaks, especially those which are generally passed of as ′mystery diseases′ in the lay press and even by governmental agencies.

  8. The Top 5 Neurotransmitters from a Clinical Neurologist's Perspective

    DEFF Research Database (Denmark)

    Kondziella, Daniel

    2017-01-01

    that we routinely prescribe. Most of us can hardly come up with more than a handful of relevant neurochemicals. From our point of view the most important neurotransmitters are, in alphabetical order, acetylcholine (associated with Alzheimer's disease and myasthenia gravis), dopamine (Parkinson's disease...

  9. [Weaning--definition and clinical context from the neurologist's view].

    Science.gov (United States)

    Müllges, Wolfgang

    2013-10-01

    Special conditions in neurologic patients arise, first, from abnormal breathing patterns with brain lesions. These however may be managed effectively by adaptive ventilator settings together with special drugs thus not ultimatively precluding weaning. Second, failure of respiratory muscle strength is a leading cause of weaning failure. In acute neuromuscular diseases during the weaning process special attention should be payed to the parameters of muscle strength, and for disturbances of swallowing at least after extubation. In degenerative terminally decompensated neuromuscular disease, an exact diagnosis and information is essential to help the patient in decision-making towards terminal weaning or long-term home ventilatory support. © Georg Thieme Verlag Stuttgart · New York.

  10. A neurologist looks at mind and brain: "the enchanted loom".

    Science.gov (United States)

    Hansotia, Phiroze

    2003-10-01

    For a long time, before we developed an appreciation of the neuroanatomy and neurophysiology of the brain, there was uncertainty as to the nature and source of the human mind. Philosophers linked the mind to mythical "humors" that controlled the human body, and others speculated that the mind was associated with "life-force" or soul. Few felt that there was a relation between the human mind and brain, but they had to wait for the Age of Enlightenment and scientific discovery in the 18th and 19th centuries to establish a clear association between the two. Three centuries ago Rene Descartes described the mind as an extracorporeal entity that was expressed through the pineal gland. Descartes was wrong about the pineal, but the debate he set off regarding the relationship between mind and brain rages on. This review looks at the history of speculation on the mind and the development of ideas that have led to our present understanding of this phenomenon. The basic anatomy and physiology of the brain is reviewed to help us understand the brain's association with the complex function we call mind. This is followed by a look at some syndromes that may result when part of the brain is damaged-the parietal lobe is arbitrarily selected as an example-and the resulting effect on the subject's mind. This assists us in understanding the association of mind and brain, and also to better understanding its components, behavior, function and dysfunction.

  11. William Henry Broadbent (1835-1907) as a neurologist.

    Science.gov (United States)

    Eadie, Mervyn

    2015-01-01

    By the end of his career, Sir William Broadbent (1835-1907) had become an eminent London general physician who had been appointed Physician-in-Ordinary to King Edward VII and to the Prince of Wales. Previously he had been Physician-in-Extraordinary to Queen Victoria. At earlier stages in his professional life, he had played a significant role in the development of clinical neurology in Victorian-era Britain. In 1866, he had enunciated a principle (Broadbent's hypothesis) that for the first time satisfactorily accounted for the mechanisms by which the trunk and bulbar muscles and the upper face were spared in hemiplegia. He had also carried out original investigations into the distribution of fiber tracts in the human cerebral hemispheres. At intervals over the years, he published on aspects of aphasia and developed a rather complicated though logical conceptual schema of the presumed anatomical background to the process of speech, based on clinic-pathological correlations. His role in all this neurological research and his other contributions on subjects such as neurosyphilis have largely been forgotten by subsequent generations.

  12. From Genetics to Genomics: A Short Introduction for Pediatric Neurologists.

    Science.gov (United States)

    Neubauer, Bernd A; Lemke, Johannes R

    2016-01-01

    It is estimated that in humans approximately 50% of all 22500 genes are needed for the development and maintenance of the nervous system. The introduction of high-throughput technology in genetic analysis has therefore major implications, not only for the investigation of specific disease entities but also for the diagnostic workup of single individuals with neurologic disorders of genetic origin. A short primer for clinicians is presented, addressing aspects of current developments in medical genomics. Significant findings of the last years are exemplified in an educational manner to provide a basic understanding of disease mechanisms that were unraveled by recent genomic analysis. Georg Thieme Verlag KG Stuttgart · New York.

  13. Diagnostic workup in carotid stenosis - a neurologist's perspective

    International Nuclear Information System (INIS)

    Rosenkranz, Michael; Gerloff, Christian

    2010-01-01

    Carotid artery stenosis is associated with the risk of stroke, myocardial infarction, and vascular death. In selected patients, revascularization of carotid narrowing by endarterectomy may reduce the risk of stroke distal to the stenosis. Carotid artery stenting has evolved as a potential alternative to endarterectomy. Four randomized clinical trials comparing safety and efficacy of endarterectomy versus stenting of symptomatic carotid stenosis have been published in recent years, but there remains some uncertainty about the implications of these trials for clinical routine. Both carotid stenting and endarterectomy are based on different treatment strategies which may result in different specific risk factors associated with each procedure. Hence, the procedural risk of either modality varies not only with the skills of the surgeon or the interventionalist but may depend on patient characteristics. It appears that the most important question is not whether one revascularization modality is superior but for which patient one modality is better than the other. A comprehensive diagnostic workup of patients with carotid stenosis based on a broad panel of covariates that affect the risk of vascular events may improve selection of patients for carotid revascularization and may help to decide for whom one revascularization modality is likely to be better than the other. (orig.)

  14. Electromagnetic hypersensitivity: The opinion of an observer neurologist

    Science.gov (United States)

    Marc-Vergnes, Jean-Pierre

    2010-11-01

    Electromagnetic hypersensitivity (EHS) is a recent, uncertain and somehow confusing concept. It is now widely agreed that people claiming to be EHS really experience symptoms. However, no evidence for a causal link between the symptoms and electromagnetic fields (EMF) has been reported. Thus, we have to wonder whether EHS constitutes truly a relevant entity. Most of the previous studies suffer from methodological flaws. Owing to the quantification of symptoms, the interdisciplinary assessment of patients, and the use of personal exposimeters, the recent studies are of better quality. A set of convergent associated signs suggests that individual neuropsychic factors take a prominent, but maybe not unique, part in this condition.

  15. A neurologist's reflections on boxing. V. Conclude remarks.

    Science.gov (United States)

    Unterharnscheidt, F

    1995-01-01

    Clinical and morphological publications have shown convincingly, that participation in boxing leads to a severe permanent brain damage. The extent of the brain damage is correlated to the number of bouts fought, which correspondents in a certain way how many blows against his head a boxer received and to his weight class. The intensity of a boxing blow of a heavyweight is much more severe than those achieved by boxers of lighter weight classes. The permanent brain damage in a boxer, the amateur and the professional boxer, manifests itself in several clinical syndromes in which the pyramidal, the extrapyramidal and the cerebellar systems are involved. A traumatic Parkinsonism, in its complete or abortive form, develops as the result of the numerous boxing blows a boxer sustains in his boxing career. Especially lateral parts of the substantia nigra are affected and reveal at macroscopical and microscopical examination a severe loss of pigmented neurons. Melanin pigment is visible free in the tissue and/or is phagozytosed in macrophages and glial cells. The traumatic Parkinson syndrome, often only in an abortive form, is combined in a boxer with additional clinical and morphological findings due to traumatic lesions in other areas of the brain. It is not as pure as in a patient with a Parkinson syndrome sui generis. The permanent brain damage in a boxer is diffuse, involving all areas of the brain. Especially involved are the large neurons of different layers of the cerebral cortex, the neurons of the Ammons horn formation, the Purkinje cells of the cerebellum. In place of destroyed and lost neurons, proliferation of glial elements, especially astroglial cells, has occurred. The defects are first replaced by protoplasmatic astroglial elements, and later by fibrillary astroglia. The destroyed neurons are replaced by glial scar tissue, which cannot perform the functions of the lost neurons. It is a process which is called partial necrosis of brain tissue. There is no reparation or restitution of the destroyed neural tissue of the brain. What is destroyed remains so, a restitution ad integrum does not occur. As the result of the diffuse loss of neurons in the brain a cerebral atrophy exists. The septum pellucidum, which consists of two thin lamellae, and is small or very small in a normal brain, forms a Cavum septi pellucidi, which is considerably enlarged. The walls of this structure, especially in its dorsal parts are considerably thinned; they show fenestrations and are, in dorsal parts no longer detectable, so that a direct connection between the two lateral ventricles exists. The clinically and morphologically existing permanent brain damage is the result of the boxing activity. Diagnostically, processes of another origin, such as alcoholism, luetic processes, other forms of dementia, etc. can undoubtedly be excluded. A permanent brain damage develops in professional and amateur boxers. The objection, which are voiced by members of the different Amateur Boxing Association, that such permanent brain damage in amateur boxers today no longer exists, after stricter protective measurements were introduced, is not tenable. Individuals who represent today the opinion, that a permanent brain damage or punch drunkenness in boxers does not occur, are not familiar with the pertinent medical literature. The argument, the injury quotient in boxing is lower than in all other athletic activities is not sound, since the statistics show only the inconsequential injuries of boxers, as lesions of the skin of the face, injuries of the hand, fractures, etc. but not the much more important and severe permanent brain damage, which is not taken into consideration in these so-called statistics. Besides of the permanent brain damage of former boxers as the result of the repeated and numerous blows against their head, severe permanent damage of the eyes and the hearing organ exists.

  16. Emergency preparedness at Ignalina NPP

    International Nuclear Information System (INIS)

    Kairys, A.

    1998-01-01

    Brief review of Ignalina NPP safety upgrading and personnel preparedness to act in cases of accidents is presented. Though great activities are performed in enhancing the plant operation safety, the Ignalina NPP management pays a lot of attention to preparedness for emergency elimination and take measures to stop emergency spreading. A new Ignalina NPP emergency preparedness plan was drawn up and became operational. It is the main document to carry out organizational, technical, medical, evacuation and other activities to protect plant personnel, population, the plant and the environment from accident consequences. Great assistance was rendered by Swedish experts in drawing this new emergency preparedness plan. The plan consists of 3 parts: general part, operative part and appendixes. The plan is applied to the Ignalina NPP personnel, Special and Fire Brigade and also to other contractor organizations personnel carrying out works at Ignalina NPP. There are set the following emergency classes: incident, emergency situation, alert, local emergency, general emergency. Separate intervention level corresponds to each emergency class. Overview of personnel training to act in case of an emergency is also presented

  17. Breastfeeding in emergencies.

    Science.gov (United States)

    Kelly, M

    1995-02-01

    In emergency situations created by wars, natural disasters, and famines, people are forced to live in crowded, unsanitary conditions where access to food and health care is limited and the danger of infection, particularly with diarrheal diseases, is great. The situation is compounded when anxieties exist concerning breast feeding; this usually occurs in industrialized countries where artificial feeding was widespread prior to the crisis, breast feeding skills were lost, and inaccurate information replaced traditional knowledge. It is believed that psychological stress and poor diet cause breast milk to dry up. Although diet is important, undernourished women are capable of producing enough milk to feed their babies. Psychological stress can temporarily prevent the release of milk from the breast, but it does not affect milk production. Large supplies of infant formula are not needed, and unrestricted distribution of breast milk substitutes can undermine breast feeding and increase the risk of disease and death. Almost all mothers are physically capable of breast feeding. Those who provide health care and relief assistance during emergencies should undertake the following measures to support breast feeding and to protect the health of mothers: 1) work for agreement between outside agencies and local health workers on breast feeding policy and practice, share up-to-date information, and establish mechanisms to ensure actions are implemented in a coordinated manner; 2) ensure that maternity care practices follow WHO/UNICEF guidelines; 3) encourage women who are not breast feeding to do so, rather than criticizing them; 4) educate the whole community about the benefits of breast feeding and highlight the importance of family and social support; 5) offer one-to-one assistance to mothers who are experiencing difficulty breast feeding through use of a network of experienced mothers, or by training breast feeding counselors (women), who are sensitive to the culture

  18. Technical support and emergency centre

    International Nuclear Information System (INIS)

    Bohun, L.; Kapisovsk y, M.

    1997-01-01

    This paper presents technical support and emergency management center which will be on two places: Mochovce NPP Emergency Centre (Technical support center and Support working center) and Reserve Emergency Centre in Levice (Reserve emergency center and Environmental Evaluation Center). The main aims of the emergency management centers are: the management and coordination of all persons and organisations; provision of the all information needed to evaluation of the accident and its mitigation; continuous evaluation of the potential or real radiological consequences; taking measure for an early notification of the governmental bodies and the organizations, warning and protection of the public; and other aims. In the next part the data for technical support and emergency centre are discussed

  19. [Cryptosporidiosis: an emerging zoonosis].

    Science.gov (United States)

    Del Coco, V F; Córdoba, M A; Basualdo, J A

    2009-01-01

    The genus Cryptosporidium, responsible for producing cryptosporidiosis, includes several species. Humans and livestock are the main sources of infection. Waterborne cryptosporidiosis outbreaks are associated with drinking water. The infective parasite stage is the oocyst, which is resistant to conventional potabilization treatments. In immunocompetent hosts it produces acute, self-limiting diarrhoea. In immunocompromised people, it could develop severe, life-threatening pattern forms of the infection. People with AIDS are especially susceptible to these clinical forms. Cryptosporidium infections are also considered a major cause of morbimortality in calves, which leads to important economic losses. In the last years, there has been an increase of patients suffering from different causes of immunosuppression, and the need to find an effective therapy against Cryptosporidium has become greater. In spite of the many attempts of the pharmaceutical industry to develop an effective antiparasitic agent to treat cryptosporidiosis, this infection and its clinical consequences still constitute a major public health problem. This article analizes the taxonomy, morphology, biology and life cycle of Cryptosporidium. Clinical, immunological, epidemiological features and diagnosis of cryptosporidiosis are also included. Treatment and prevention of the infection are discussed, and future tendencies are suggested for this emerging parasitic infection.

  20. Octocrylene, an emerging photoallergen.

    Science.gov (United States)

    Avenel-Audran, Martine; Dutartre, Hervé; Goossens, An; Jeanmougin, Michel; Comte, Christelle; Bernier, Claire; Benkalfate, Lamia; Michel, Maryse; Ferrier-Lebouëdec, Marie Christine; Vigan, Martine; Bourrain, Jean Luc; Outtas, Omar; Peyron, Jean Louis; Martin, Ludovic

    2010-07-01

    Octocrylene is a new emerging photoallergen. We report and discuss 50 cases of photoallergic contact dermatitis from octocrylene use and/or positive photopatch test reactions to this UV filter and draw attention to the unexpected association in adults with a history of photoallergic contact dermatitis from ketoprofen. Patients were divided in 3 groups: group A comprised 11 children; group B, 28 adults with a history of photoallergy from sunscreen products; and group C, 14 adults systematically tested with octocrylene because of a history of photoallergy from ketoprofen. All patients but 3 in group C had positive test reactions to octocrylene. Ten of 11 children in group A and 9 of 28 adults in group B had positive patch test reactions to octocrylene. One child in group A, the other 19 adults in group B, and 11 of 14 adults in group C had positive photopatch test reactions to octocrylene. All adults in group C and 24 of 28 adults in group B had a history of photoallergy from ketoprofen and positive patch test or photopatch test reactions to other allergens that are often positive in patients with photoallergy from ketoprofen, especially fragrance components. Octocrylene appears to be a strong allergen leading to contact dermatitis in children and mostly photoallergic contact dermatitis in adults with an often-associated history of photoallergy from ketoprofen. Patients with photoallergy from ketoprofen frequently have positive photopatch test reactions to octocrylene. These patients need to be informed of sunscreen products not containing octocrylene, benzophenone-3, or fragrances.

  1. Carbon market emerges

    International Nuclear Information System (INIS)

    Hordern, N.

    2001-01-01

    Last November COP6, the UN climate change conference in The Hague, failed to agree on the rules of the Kyoto Protocol, the treaty limiting developed countries' emissions of greenhouse gases ('carbon'). Many in the Australian resource and energy sector were relieved that COP6 was inconclusive. As Industry Minister Senator Nick Minchin put it: 'Better no outcome than a bad outcome.' However, the financial services sector -potentially a major beneficiary of the international carbon it hoped COP6 would endorse -received a setback. Apparently not for long. Only months later, a nascent Australian carbon trading market seems to be emerging by stealth, irrespective of COP6's fortunes. This poses both opportunities and costs for the resources and energy sectors. Whoever succeeds in influencing the design of a trading scheme, 'pilot' or not, will have a box seat when - not if - a 'mandatory' emissions trading scheme is introduced. Government policy is that there will be no mandatory emissions trading scheme until the establishment of a UN endorsed international market requires one of Australia. This, in turn, depends upon the conclusion of the negotiations that stalled in The Hague. COP6 is set to resume in Germany, probably in July

  2. Emerging Power Europe

    DEFF Research Database (Denmark)

    Zank, Wolfgang

    2016-01-01

    the only one to influence matters on a global scale besides, the US. Of particular importance in this context has been the growing attractiveness of the EU market and the considerable “soft power” which the EU exerts in some parts of the world. The paper reconstructs the most important steps of Europe......Many observers posit that a shift in global power has taken place the last many years, away from the West to “emerging powers”, in particular the BRICS. In contrast to this view, this paper accepts Moravcsik’s view that it has been the EU which has developed into the “second superpower”, being......’s rise, with emphasis on the “expansionist” character of the EU. Internal developments in the EU have been crucial for its growing external influence. The “expansionism” of the EU and its system has until recently been peaceful. In the case of Ukraine, however, another (regional) power has applied...

  3. BWR emergency procedure guidelines

    International Nuclear Information System (INIS)

    Post, J.S.; Karner, E.F.; Stratman, R.A.

    1984-01-01

    This chapter describes plans for dealing with reactor accidents developed by the Boiling Water Reactor (BWR) Owners' Group in response to post-Three Mile Island US NRC requirements. The devised Emergency Procedure Guidelines (EPGs), applicable to all BWRs, are symptom-based rather than event-based. According to the EPGs, the operator does not need to identify what event is occurring in the plant in order to decide what action to take, but need only observe the symptoms (values and trends of key control parameters) which exist and take appropriate action to control these symptoms. The original objective was to provide reactor operator guidance in responding to a small break loss-of-coolant accident (LOCA), but subsequent revisions have included other types of reactor accidents. Topics considered include the reactor pressure vessel (RPV) control guideline, the primary containment control guideline, the secondary containment control guideline, the radioactivity release control guideline, multiple failures vs. the design basis, safe limits vs. technical specifications, the technical status, licensing, and implementation. The EPGs are based upon maintaining both adequate core cooling and primary containment integrity

  4. Automated emergency operating procedures

    International Nuclear Information System (INIS)

    Perez-Ramirez, G.; Nelson, P.F.

    1990-01-01

    This paper describes the development of a training tool for the symptom oriented emergency operating procedures used at the Laguna Verde Nuclear Power Plant. EOPs and operator training are intended to assist the operator for managing accident situations. A prototype expert system based on the EOPs has been developed for operator training. The demonstration expert system was developed using a commercial shell. The knowledge base consists of two parts. The specific operator actions to be executed for 5 selected accident sequences and the EOPs steps for the reactor pressure vessel control of the water level, pressure, and power. The knowledge is expressed in the form of IF-THEN production rules. A typical training session will display a set of conditions and will prompt the trainee to indicate the appropriate step to perform. This mode will guide the trainee through selected accident sequences. A second mode of the expert system will prompt the trainee for the current plant conditions and the expert system will respond with the EOPs which are required to be performed under these conditions. This allows the trainee to study What if situations

  5. Emergency core cooling system

    International Nuclear Information System (INIS)

    Arai, Kenji; Oikawa, Hirohide.

    1990-01-01

    The device according to this invention can ensure cooling water required for emerency core cooling upon emergence such as abnormally, for example, loss of coolant accident, without using dynamic equipments such as a centrifugal pump or large-scaled tank. The device comprises a pressure accumulation tank containing a high pressure nitrogen gas and cooling water inside, a condensate storage tank, a pressure suppression pool and a jet stream pump. In this device there are disposed a pipeline for guiding cooling water in the pressure accumulation tank as a jetting water to a jetting stream pump, a pipeline for guiding cooling water stored in the condensate storage tank and the pressure suppression pool as pumped water to the jetting pump and, further, a pipeline for guiding the discharged water from the jet stream pump which is a mixed stream of pumped water and jetting water into the reactor pressure vessel. In this constitution, a sufficient amount of water ranging from relatively high pressure to low pressure can be supplied into the reactor pressure vessel, without increasing the size of the pressure accumulation tank. (I.S.)

  6. Emergency core cooling system

    International Nuclear Information System (INIS)

    Sato, Akira; Kobayashi, Masahide.

    1983-01-01

    Purpose: To enable a stable operation of an emergency core cooling system by preventing the system from the automatic stopping at an abnormally high level of the reactor water during its operation. Constitution: A pump flow rate signal and a reactor water level signal are used and, when the reactor water level is increased to a predetermined level, the pump flow rate is controlled by the reactor water level signal instead of the flow rate signal. Specifically, when the reactor water level is gradually increased by the water injection from the pump and exceeds a setting signal for the water level, the water level deviation signal acts as a demand signal for the decrease in the flow rate of the pump and the output signal from the water level controller is also decreased depending on the control constant. At a certain point, the output signal from the water level controller becomes smaller than the output signal from the flow rate controller. Thus, the output signal from the water level controller is outputted as the output signal for the lower level preference device. In this way, the reactor water level and the pump flow rate can be controlled within a range not exceeding the predetermined pump flow rate. (Horiuchi, T.)

  7. Gas spill emergency

    International Nuclear Information System (INIS)

    1997-01-01

    This video presentation was designed to explain the steps that should be taken in the event of a petroleum product spill on land, to keep damages and consequences to a minimum. The events that took place when an oil truck full of gasoline overturned and smashed into a house on a residential street were described to illustrate the principles involved. The following sequence of events and actions, based on general principles of bringing the situation under control during an emergency operation were depicted: (1) identification of spilled product, (2) assessment of the situation, (3) setting priorities and evacuating the endangered area, and (4) setting up a communication system. The fire fighters sprayed the area with foam because of the fire and explosion potential. Sand was used to contain the spill and to keep it out of the storm sewers. The spilled oil was recovered. Three other spill situations - a spill at a service station, a spill in a ditch, and a spill in a waterway - were also documented. It was emphasized that while it is not possible to establish a single set of rules and actions that would apply to all situations since no two accidents involving petroleum products are alike, the general principles are universal and can be applied in all situations. First priority to consider should always be human life, then property, then the environment

  8. Emerging radiation protection

    International Nuclear Information System (INIS)

    Allard, D.J.

    1993-01-01

    In recent years, a number of radiation protection issues have emerged into the public forum. The perceived high risks associated with radiation exposure, and disproportionate media attention to such issues, have contributed to heightened concerns by the public and the individual occupationally exposed worker. This paper examines the new and controversial radiation risk estimates of the National Research Council's BEIR V committee, which are based on the most current atomic-bomb survivor data and a revised dosimetry model. These risk estimates are somewhat higher than past values, and may eventually impact the legal framework in the United States through the regulations of the EPA, NRC, DOE, OSHA, and other agencies that set radiation exposure standards. Additionally, present regulations and standards are often based upon differing levels of acceptable risk, which have led to conflicting exposure and effluent release criteria. Further, due to inherent boundaries in legal authority, many potentially significant sources of radiation exposure to the public remain unregulated Radiation exposure scenarios such as medical x-ray, radon, and other technology enhanced sources have no legal limits. These issues and others are examined and analyzed with respect to regulatory policy

  9. Emergency core cooling system

    International Nuclear Information System (INIS)

    Kato, Ken.

    1989-01-01

    In PWR type reactors, a cooling water spray portion of emergency core cooling pipelines incorporated into pipelines on high temperature side is protruded to the inside of an upper plenum. Upon rupture of primary pipelines, pressure in a pressure vessel is abruptly reduced to generate a great amount of steams in the reactor core, which are discharged at a high flow rate into the primary pipelines on high temperature side. However, since the inside of the upper plenum has a larger area and the steam flow is slow, as compared with that of the pipelines on the high temperature side, ECCS water can surely be supplied into the reactor core to promote the re-flooding of the reactor core and effectively cool the reactor. Since the nuclear reactor can effectively be cooled to enable the promotion of pressure reduction and effective supply of coolants during the period of pressure reduction upon LOCA, the capacity of the pressure accumulation vessel can be decreased. Further, the re-flooding time for the reactor is shortened to provide an effect contributing to the improvement of the safety and the reduction of the cost. (N.H.)

  10. Emergency core cooling system

    International Nuclear Information System (INIS)

    Abe, Nobuaki.

    1993-01-01

    A reactor comprises a static emergency reactor core cooling system having an automatic depressurization system and a gravitationally dropping type water injection system and a container cooling system by an isolation condenser. A depressurization pipeline of the automatic depressurization system connected to a reactor pressure vessel branches in the midway. The branched depressurizing pipelines are extended into an upper dry well and a lower dry well, in which depressurization valves are disposed at the top end portions of the pipelines respectively. If loss-of-coolant accidents should occur, the depressurization valve of the automatic depressurization system is actuated by lowering of water level in the pressure vessel. This causes nitrogen gases in the upper and the lower dry wells to transfer together with discharged steams effectively to a suppression pool passing through a bent tube. Accordingly, the gravitationally dropping type water injection system can be actuated faster. Further, subsequent cooling for the reactor vessel can be ensured sufficiently by the isolation condenser. (I.N.)

  11. Emerging optical nanoscopy techniques

    Directory of Open Access Journals (Sweden)

    Montgomery PC

    2015-09-01

    Full Text Available Paul C Montgomery, Audrey Leong-Hoi Laboratoire des Sciences de l'Ingénieur, de l'Informatique et de l'Imagerie (ICube, Unistra-CNRS, Strasbourg, France Abstract: To face the challenges of modern health care, new imaging techniques with subcellular resolution or detection over wide fields are required. Far field optical nanoscopy presents many new solutions, providing high resolution or detection at high speed. We present a new classification scheme to help appreciate the growing number of optical nanoscopy techniques. We underline an important distinction between superresolution techniques that provide improved resolving power and nanodetection techniques for characterizing unresolved nanostructures. Some of the emerging techniques within these two categories are highlighted with applications in biophysics and medicine. Recent techniques employing wider angle imaging by digital holography and scattering lens microscopy allow superresolution to be achieved for subcellular and even in vivo, imaging without labeling. Nanodetection techniques are divided into four subcategories using contrast, phase, deconvolution, and nanomarkers. Contrast enhancement is illustrated by means of a polarized light-based technique and with strobed phase-contrast microscopy to reveal nanostructures. Very high sensitivity phase measurement using interference microscopy is shown to provide nanometric surface roughness measurement or to reveal internal nanometric structures. Finally, the use of nanomarkers is illustrated with stochastic fluorescence microscopy for mapping intracellular structures. We also present some of the future perspectives of optical nanoscopy. Keywords: microscopy, imaging, superresolution, nanodetection, biophysics, medical imaging

  12. The Brazilian emergency response system

    International Nuclear Information System (INIS)

    Santos, Raul dos

    1997-01-01

    With the objective of improving the response actions to potential or real emergency situations generated by radiological or nuclear accidents, the Brazilian National Nuclear Energy Commission (CNEN) installed an integrated response system on a 24 hours basis. All the natiowide notifications on events that may start an emergency situation are converged to this system. Established since July 1990, this system has received around 300 notifications in which 5% were classified as potential emergency situation. (author)

  13. Regulatory aspects of emergency planning

    International Nuclear Information System (INIS)

    Jamgochian, M.T.

    1986-01-01

    The paper discusses the advances that have been made in the USA in the field of emergency planning over the past several years and considers regulatory changes that may be on the horizon. The paper examines the importance of severe accident source terms and their relationship to emergency preparedness, recent research results of work on source terms, and the experience gained from evaluation of licensee performance during annual emergency preparedness exercises. (author)

  14. Transport accident emergency response plan

    International Nuclear Information System (INIS)

    Vallette-Fontaine, M.; Frantz, P.

    1998-01-01

    To comply with the IAEA recommendations for the implementation of an Emergency Response Plan as described in Safety Series 87, Transnucleaire, a company deeply involved in the road and rail transports of the fuel cycle, masters means of Emergency Response in the event of a transport accident. This paper aims at analyzing the solutions adopted for the implementation of an Emergency Response Plan and the development of a technical support and adapted means for the recovery of heavy packagings. (authors)

  15. Curved backgrounds in emergent gravity

    Science.gov (United States)

    Chaurasia, Shikha; Erlich, Joshua; Zhou, Yiyu

    2018-06-01

    Field theories that are generally covariant but nongravitational at tree level typically give rise to an emergent gravitational interaction whose strength depends on a physical regulator. We consider emergent gravity models in which scalar fields assume the role of clock and rulers, addressing the problem of time in quantum gravity. We discuss the possibility of nontrivial dynamics for clock and ruler fields, and describe some of the consequences of those dynamics for the emergent gravitational theory.

  16. Fire Service Emergency Management Handbook

    Science.gov (United States)

    1985-01-01

    Adapted from Formulating Public Policy in Emergency Management Course Book and ResourceMRanual for Public OTTicials, ILMA Emergency Management Institute...659-2447 (202) 785-2757 Christian Reformed World Relief Presbyterian Church in U.S. Committee General Assemby Mission Board C. Neil Molenaar 341 Ponce...Healer, Mind as Slayer. New York: Delta Books , 1977. 86B:6 B-45 4) Mitchell, J.T., & Resnik, HLP: Emergency Response to Crisis: A Crisis Intervention

  17. Emergency medicine and general practice

    OpenAIRE

    Abela, Gunther

    2005-01-01

    Emergency Medicine and Immediate Medical Care are relatively new specialties. In Malta, there is quite a considerable area of overlap between these specialties and general practice. Indeed, the family physician is confronted with some sort of medical emergency quite regularly. The brief of this article is to go through recent developments in Emergency Medicine as applied to General Practice. The areas considered are Basic Life Support, Head Injury, Asthma, Anaphylaxis, Community Acquired Pneu...

  18. Emergency medicine in Dubai, UAE.

    Science.gov (United States)

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-08-18

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  19. Emergency medicine in Dubai, UAE

    OpenAIRE

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  20. First Response to Medical Emergency

    International Nuclear Information System (INIS)

    Manisah Saedon; Sarimah Mahat; Muhamad Nurfalah Karoji; Hasnul Nizam Osman

    2015-01-01

    Accident or medical emergencies, both minor and critical, occurs each day and can happen in any workplace. In any medical emergencies, time is a critical factor because the first person to arrive at the scene of an accident has a key role in the rescue of a victim. With the knowledge of some common medical procedures and emergency actions, this first responder can make a positive contribution to the welfare of the accident victim. In some cases, this contribution can make difference between life and death. Improper response to medical emergencies by an untrained person can result in worsen injuries or death. Therefore, first aids training are necessary to provide the information. (author)

  1. 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...

  2. Local Emergency Operations Centers (EOC)

    Data.gov (United States)

    Department of Homeland Security — The physical location at which the coordination of information and resources to support domestic incident management activities normally takes place. An Emergency...

  3. Visioning future emergency healthcare collaboration

    DEFF Research Database (Denmark)

    Söderholm, Hanna M.; Sonnenwald, Diane H.

    2010-01-01

    physicians, nurses, administrators, and information technology (IT) professionals working at large and small medical centers, and asked them to share their perspectives regarding 3DMC's potential benefits and disadvantages in emergency healthcare and its compatibility and/or lack thereof......New video technologies are emerging to facilitate collaboration in emergency healthcare. One such technology is 3D telepresence technology for medical consultation (3DMC) that may provide richer visual information to support collaboration between medical professionals to, ideally, enhance patient......, and resources. Both common and unique perceptions regarding 3DMC emerged,illustrating the need for 3DMC, and other collaboration technologies,to support interwoven situational awareness across different technological frames....

  4. The future of emergency medicine.

    Science.gov (United States)

    Schneider, Sandra M; Gardner, Angela F; Weiss, Larry D; Wood, Joseph P; Ybarra, Michael; Beck, Dennis M; Stauffer, Arlen R; Wilkerson, Dean; Brabson, Thomas; Jennings, Anthony; Mitchell, Mark; McGrath, Roland B; Christopher, Theodore A; King, Brent; Muelleman, Robert L; Wagner, Mary J; Char, Douglas M; McGee, Douglas L; Pilgrim, Randy L; Moskovitz, Joshua B; Zinkel, Andrew R; Byers, Michelle; Briggs, William T; Hobgood, Cherri D; Kupas, Douglas F; Krueger, Jennifer; Stratford, Cary J; Jouriles, Nicholas J

    2010-08-01

    The specialty of emergency medicine (EM) continues to experience a significant workforce shortage in the face of increasing demand for emergency care. In July 2009, representatives of the leading EM organizations met in Dallas for the Future of Emergency Medicine Summit. Attendees at the Future of Emergency Medicine Summit agreed on the following: 1) Emergency medical care is an essential community service that should be available to all; 2) An insufficient emergency physician workforce also represents a potential threat to patient safety; 3) Accreditation Council for Graduate Medical Education/American Osteopathic Association (AOA)-accredited EM residency training and American Board of Medical Specialties/AOA EM board certification is the recognized standard for physician providers currently entering a career in emergency care; 4) Physician supply shortages in all fields contribute to-and will continue to contribute to-a situation in which providers with other levels of training may be a necessary part of the workforce for the foreseeable future; 5) A maldistribution of EM residency-trained physicians persists, with few pursuing practice in small hospital or rural settings; 6) Assuring that the public receives high quality emergency care while continuing to produce highly skilled EM specialists through EM training programs is the challenge for EM's future; 7) It is important that all providers of emergency care receive continuing postgraduate education. Copyright 2010. Published by Elsevier Inc.

  5. Medical emergencies in dental practice.

    LENUS (Irish Health Repository)

    Wilson, M H

    2009-06-01

    Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.

  6. Burden of emerging/re emerging diseases in India

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Burden of emerging/re emerging diseases in India. 1-2 million deaths for 1994 epidemic of plague. 20,565 deaths in 2004 due to rabies. 400 million chronic carriers of hepatitis B virus. More than 18 million carriers of hepatitis C virus. 'Mutant' measles virus infection in ...

  7. Preparing for Emergency Situations

    Science.gov (United States)

    Asproth, Viveca; Amcoff Nyström, Christina

    2010-11-01

    Disaster relief can be seen as a dynamic multi actor process with actors both joining and leaving the relief work during the help and rescue phase after the disaster has occurred. Actors may be governmental agencies, non profit voluntary organisations or spontaneous helpers comprised of individual citizens or temporal groups of citizens. Hence, they will vary widely in agility, competence, resources, and endurance. To prepare for for disasters a net based Agora with simulation of emergency situations for mutual preparation, training, and organisational learning is suggested. Such an Agora will ensure future security by: -Rising awareness and preparedness of potential disaster responders by help of the components and resources in the netAgora environment; -Improving cooperation and coordination between responders; -Improving competence and performance of organisations involved in security issues; -Bridging cultural differences between responders from different organizations and different backgrounds. The developed models are intended to reflect intelligent anticipatory systems for human operator anticipation of future consequences. As a way to catch what should be included in this netbased Agora and to join the split pictures that is present, Team Syntegrity could be a helpful tool. The purpose of Team Syntegrity is to stimulate collaboration and incite cross fertilization and creativity. The difference between syntegration and other group work is that the participants are evenly and uniquely distributed and will collectively have the means, the knowledge, the experience, the perspectives, and the expertise, to deal with the topic. In this paper the possibilities with using Team Syntegrity in preparation for the development of a netbased Agora is discussed. We have identified that Team Syntegrity could be useful in the steps User Integration, Designing the netAgora environment, developing Test Scenarios, and assessment of netAgora environment.

  8. Interventions for emergency contraception.

    Science.gov (United States)

    Shen, Jie; Che, Yan; Showell, Emily; Chen, Ke; Cheng, Linan

    2017-08-02

    Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are available for EC. Information on the comparative effectiveness, safety and convenience of these methods is crucial for reproductive healthcare providers and the women they serve. This is an update of a review previously published in 2009 and 2012. To determine which EC method following unprotected intercourse is the most effective, safe and convenient to prevent pregnancy. In February 2017 we searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, Popline and PubMed, The Chinese biomedical databases and UNDP/UNFPA/WHO/World Bank Special Programme on Human Reproduction (HRP) emergency contraception database. We also searched ICTRP and ClinicalTrials.gov as well as contacting content experts and pharmaceutical companies, and searching reference lists of appropriate papers. Randomised controlled trials including women attending services for EC following a single act of unprotected intercourse were eligible. We used standard methodological procedures recommended by Cochrane. The primary review outcome was observed number of pregnancies. Side effects and changes of menses were secondary outcomes. We included 115 trials with 60,479 women in this review. The quality of the evidence for the primary outcome ranged from moderate to high, and for other outcomes ranged from very low to high. The main limitations were risk of bias (associated with poor reporting of methods), imprecision and inconsistency. Comparative effectiveness of different emergency contraceptive pills (ECP)Levonorgestrel was associated with fewer pregnancies than Yuzpe (estradiol-levonorgestrel combination) (RR 0.57, 95% CI 0.39 to 0.84, 6 RCTs, n = 4750, I 2 = 23%, high-quality evidence). This suggests that if the chance of pregnancy using Yuzpe is assumed to be 29 women per 1000, the chance of pregnancy using levonorgestrel would be between

  9. Spinoffs from radiological emergency preparedness programmes to generic emergency management

    International Nuclear Information System (INIS)

    Sanders, M.E.

    1986-01-01

    In the USA, the radiological emergency preparedness (REP) programme for nuclear power plants is being used to enhance emergency management programmes for other types of emergencies. The REP programme is particularly useful in developing plans and preparedness measures for chemical accidents. The Integrated Emergency Management System (IEMS) approach provides a means for maximizing relationships between the REP programme and other programmes. IEMS essentially involves applying common elements of planning and preparedness to all types of emergencies, while recognizing that unique characteristics of specific natural and man-made emergencies require special planning and preparedness considerations. Features of the REP programme that make it compatible with the IEMS approach and useful in coping with other types of emergencies are: (1) the close co-operation between the national nuclear regulatory and emergency management organizations; (2) the programme integration among all levels of government, the nuclear power industry, public interest groups and the general public and (3) the comprehensiveness and sophistication of the programme. The REP programme in the USA represents a state-of-the-art emergency management capability. Some of its elements are readily transferrable to most other types of emergency preparedness programmes, while other elements can be adapted more readily to other hazard-specific programmes. The Bhopal accident has been a catalyst for this adaptation to chemical accidents, in such areas as furnishing hazard-specific information to the public, alert and notification systems, definition of the hazards and risks involved, establishing planning zones and developing close working relationships among the industry, the public and government

  10. Neurology Concepts: Young Women and Ischemic Stroke-Evaluation and Management in the Emergency Department.

    Science.gov (United States)

    Chang, Bernard P; Wira, Charles; Miller, Joseph; Akhter, Murtaza; Barth, Bradley E; Willey, Joshua; Nentwich, Lauren; Madsen, Tracy

    2018-01-01

    Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g., premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting. A panel of six board-certified emergency physicians, one with fellowship training in stroke and one with training in sex- and sex-based medicine, along with one vascular neurologist were coauthors involved in the paper. Each author used various search strategies (e.g., PubMed, PsycINFO, and Google Scholar) for primary research and reviewed articles related to their section. The references were reviewed and evaluated for relevancy and included based on review by the lead authors. Estimates on the incidence of ischemic stroke in premenopausal women range from 3.65 to 8.9 per 100,000 in the United States. Several risk factors for ischemic stroke exist for young women including oral contraceptive (OCP) use and migraine with aura. Pregnancy and the postpartum period (up to 12 weeks) is also an important transient state during which risks for both ischemic stroke and cerebral hemorrhage are elevated, accounting for 18% of strokes in women under 35. Current evidence regarding the management of acute ischemic stroke in young women is also summarized including use of thrombolytic agents (e.g., tissue plasminogen activator) in both pregnant and nonpregnant individuals. Unique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment

  11. Emergence Issues - not so simple

    African Journals Online (AJOL)

    Anaesthetics Supplement: Emergence Issues - not so simple. S Afr Fam Pract 2014. Vol 56 No 2 Supplement 1. Introduction. Emergence from anaesthesia is by definition the process of return to baseline physiological function of all organ systems after cessation of administration of general anaesthesia and is the stage from ...

  12. 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

  13. Periodontal Emergencies in General Practice.

    Science.gov (United States)

    Wadia, Reena; Ide, Mark

    2017-05-01

    Diagnosing and managing periodontal emergencies is a common part of general dental practice. This article summarises the presentation, aetiology and management of the key periodontal emergencies, including gingival abscess, periodontal abscess, peri-coronitis/peri-coronal abscess, perio-endo lesion/ abscess, necrotising gingivitis and periodontitis, acute herpetic gingivostomatitis, acute physical/chemical/thermal injury and subgingival root fracture.

  14. 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

  15. Threat from Emerging Vectorborne Viruses

    Centers for Disease Control (CDC) Podcasts

    2016-06-09

    Reginald Tucker reads an abridged version of the commentary by CDC author Ronald Rosenberg, Threat from Emerging Vectorborne Viruses.  Created: 6/9/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/9/2016.

  16. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  17. SICOEM: emergency response data system

    International Nuclear Information System (INIS)

    Martin, A.; Villota, C.; Francia, L.

    1993-01-01

    The main characteristics of the SICOEM emergency response system are: -direct electronic redundant transmission of certain operational parameters and plant status informations from the plant process computer to a computer at the Regulatory Body site, - the system will be used in emergency situations, -SICOEM is not considered as a safety class system. 1 fig

  18. SICOEM: emergency response data system

    Energy Technology Data Exchange (ETDEWEB)

    Martin, A.; Villota, C.; Francia, L. (UNESA, Madrid (Spain))

    1993-01-01

    The main characteristics of the SICOEM emergency response system are: -direct electronic redundant transmission of certain operational parameters and plant status informations from the plant process computer to a computer at the Regulatory Body site, - the system will be used in emergency situations, -SICOEM is not considered as a safety class system. 1 fig.

  19. Work shifts in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Roberto Recupero

    2007-06-01

    Full Text Available Emergency Medicine is known as a high stress specialty. The adverse effect of constantly rotating shifts is the single most important reason given for premature attrition from the field. In this work problems tied with night shift work will be taken into account and some solutions to reduce the impact of night work on the emergency physicians will be proposed.

  20. Emergency Medical Services - Multiple Languages

    Science.gov (United States)

    ... Well-Being 11 - Emergency Room - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Arabic (العربية) Expand Section ... Well-Being 11 - Emergency Room - myanma bhasa (Burmese) MP3 Siloam Family Health Center Dari (دری) Expand Section ...

  1. How can emerging powers speak?

    DEFF Research Database (Denmark)

    Kristensen, Peter Marcus

    2015-01-01

    Emerging powers like China, India and Brazil are receiving growing attention as objects in International Relations (IR) discourse. Scholars from these emerging powers are rarely present as subjects in mainstream IR discourse, however. This paper interrogates the conditions for scholars in emergin...

  2. [Emergency medicine and vulnerable populations].

    Science.gov (United States)

    Guillemaud, André-Michel

    2012-01-01

    In emergency medicine, assessing a situation of precarity is sometimes extremely complex. Home visits often provide useful information which can lead to the putting in place of a system of support. Medical marginalisation results from a combination of multiple difficulties, notably financial. This article is the testimony of a doctor working in a structure providing emergency medical care in the home.

  3. Emergence of Symmetries from Entanglement

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    Maximal Entanglement appears to be a key ingredient for the emergence of symmetries. We first illustrate this phenomenon using two examples: the emergence of conformal symmetry in condensed matter systems and  the relation of tensor networks to holography. We further present a Principle of Maximal Entanglement that seems to dictate to a large extend the structure of gauge symmetry.

  4. Anticipatory Ethics for Emerging Technologies

    NARCIS (Netherlands)

    Brey, Philip A.E.

    2012-01-01

    In this essay, a new approach for the ethical study of emerging technology ethics will be presented, called anticipatory technology ethics (ATE). The ethics of emerging technology is the study of ethical issues at the R&D and introduction stage of technology development through anticipation of

  5. The Comprehensive Emergent Literacy Model

    OpenAIRE

    Leigh Rohde

    2015-01-01

    The early skills of Emergent Literacy include the knowledge and abilities related to the alphabet, phonological awareness, symbolic representation, and communication. However, existing models of emergent literacy focus on discrete skills and miss the perspective of the surrounding environment. Early literacy skills, including their relationship to one another, and the substantial impact of the setting and context, are ...

  6. Emergency planning for industrial hazards

    International Nuclear Information System (INIS)

    Gow, H.B.F.; Kay, R.W.

    1988-01-01

    The European Communities have produced a Directive on the Major Accident Hazards of Certain Industrial Activities which sets out standards for the control and mitigation of the hazards presented by sites and storages which contain significant quantities of dangerous substances. An essential element of these controls is the provision of effective on-and off-site emergency plans. This conference explores the considerable research effort which is going on throughout the world in the improvement of systems for emergency planning. Attention was also drawn to areas where difficulties still exist, for example in predicting the consequences of an accident, the complexities of communication problems and the difficulties arising from involvement of the public. The proceedings are in six parts which deal with organizations implementing emergency planning: on- and off-site emergency planning and design; techniques for emergency plans; expenses and auditing of emergency plans; lessons learnt from the emergency management of major accidents; information to the public to and during emergencies. (author)

  7. Institutional planning for radiation emergencies

    International Nuclear Information System (INIS)

    Keil, E.R.

    1986-01-01

    Persons providing health care pride themselves on their ability to handle emergencies. This pride is born of the daily experience of caring for the sick and injured. Emergencies include traumatic injuries, sudden changes in health status, and various minor disturbances in the physical environment inside the hospital. The effectiveness of this ability is unquestioned in limited-scale problems. However, survey experience of the Joint Commission on the Accreditation of Hospitals (JCAH) reveals weaknesses when health care organizations are faced with larger scale problems such as earthquakes and plane crashes. One may speculate that a massive emergency such as occurred at Chernobyl would overwhelm this ability. Based on the same survey experience, JCAH believes that health care organizations can plan and train to prepare for large-scale emergencies in a careful and systematic manner. Through such study and practice, their existing confidence and ability to deal with limited emergencies can be explained

  8. Emergency preparedness at the UJD

    International Nuclear Information System (INIS)

    Seliga, Mojmir

    2001-01-01

    The objective of the emergency planning is to suggest optimum organisational and technical measures to restrict the threat or to eliminate the menace to the population in case of incident or accident at nuclear facility. The emergency plan is activated and executed through the set of emergency procedures, which define basic activities of the UJD during the emergency situations in compliance with legislation regulations. The assessment of the course and consequences of serious incidents and accidents of nuclear installations is carried out by the Emergency Response Centre (KKC). The Emergency Plan of UJD is the set of technical and organisation measures with the aim to propose optimal measures for protection of population and environment. The UJD- Department of Emergency Management and Informatics has an irreplaceable role in the structure of emergency response. The Emergency Response Centre is its organisational part. The UJD is a contact point of the Slovak Republic with the IAEA in frame of convention on early notification of nuclear accidents. The same is valid for bilateral agreements between the Slovak Republic and Czech Republic, Germany, Austria, Hungary, Poland and Ukraine. Uninterrupted 24 hours duty service of the contact point is assured for the UJD by the Office of Civil Protection of Ministry of Interior. In order to fulfil the tasks of the emergency planning UJD established its Emergency Response Group, which consists of four professional teams: 1. Reactor safety group, 2. Radiation protection group, 3. Logistic group, 4. Information group. Information Group consists of the head of Group, the report analysis experts and news service experts. The information group is responsible for public information as well as for informing the authorities. The Information Centre is situated closely to the Emergency Response Centre. The information group gathers, coordinates and prepares all pieces of information in compliance with commitments of the Slovak Republic

  9. 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

  10. Emergency preparedness: a comprehensive plan

    International Nuclear Information System (INIS)

    Wilson, R.H.

    1975-01-01

    The Atlantic Richfield Hanford Company (ARHCO) has developed comprehensive plans for coping with emergencies ranging from criticality to civil disturbance. A unique notification system provides for immediate contact with key personnel by using a central communications center, crash alarm warning networks, and a continuing telephone cascade notification system. There is also the capability of immediately contacting other contractor key personnel. Certain jobs have been predetermined as necessary for coping with an emergency. An emergency staff consisting of responsible management, with alternates, has been preselected to automatically fill these jobs when notified. Control centers for headquarters and ''field'' are established with telephone and radio communication capabilities and are also supplied with some source materials to assist initiating plans for containing an emergency for recovery. A comprehensive emergency procedures manual has been developed, which contains information of company-wide application and procedures for specific facilities covering almost all accident situations

  11. Evolutionary ecology of virus emergence.

    Science.gov (United States)

    Dennehy, John J

    2017-02-01

    The cross-species transmission of viruses into new host populations, termed virus emergence, is a significant issue in public health, agriculture, wildlife management, and related fields. Virus emergence requires overlap between host populations, alterations in virus genetics to permit infection of new hosts, and adaptation to novel hosts such that between-host transmission is sustainable, all of which are the purview of the fields of ecology and evolution. A firm understanding of the ecology of viruses and how they evolve is required for understanding how and why viruses emerge. In this paper, I address the evolutionary mechanisms of virus emergence and how they relate to virus ecology. I argue that, while virus acquisition of the ability to infect new hosts is not difficult, limited evolutionary trajectories to sustained virus between-host transmission and the combined effects of mutational meltdown, bottlenecking, demographic stochasticity, density dependence, and genetic erosion in ecological sinks limit most emergence events to dead-end spillover infections. Despite the relative rarity of pandemic emerging viruses, the potential of viruses to search evolutionary space and find means to spread epidemically and the consequences of pandemic viruses that do emerge necessitate sustained attention to virus research, surveillance, prophylaxis, and treatment. © 2016 New York Academy of Sciences.

  12. State of emergency and emergency: Comparative terminological and semantic aspects

    OpenAIRE

    Avramović, Dragutin; Mlađan, Dragan

    2014-01-01

    The issue of theoretical definition and distinction between a state of emergency and an emergency is made current in recent national and international literature, as well as in different comparative law normative solutions. Considering the usage inconsistencies of the two terms, this paper attempts to highlight the differences between them, as they essentially carry distinctive legal meanings despite their implied lexical and logical similarity. The paper stresses the necessity of their clear...

  13. Emergency department discharge prescription interventions by emergency medicine pharmacists.

    Science.gov (United States)

    Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

    2013-02-01

    We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

  14. 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.

  15. Experiences of Emerging Economy Firms

    DEFF Research Database (Denmark)

    Experiences of Emerging Economy Firms investigates the different elements of the experiences of emerging economy firms and sheds essential light on a large variety of aspects associated with their functioning in both home and host contexts. For example, firms must be able to overcome the liability...... of foreign and emerging issues when they expand their activities in various contexts, enter, exit, and re-enter overseas markets; they have to overcome institutional barriers, adapt the cultural challenges in foreign markets, undergo the impact of large multinational firms from developed economies...

  16. Environmental monitoring in emergency situations

    International Nuclear Information System (INIS)

    1966-01-01

    This manual gives technical guidance on emergency monitoring procedures to those who would have to assess the situation after an accident leading to the uncontrolled release of radioactive substances to the environment. Its aim is to draw attention to the important factors that should be considered in formulating emergency plans. The seven annexes contain inventories of fission products and possible releases; dispersion, deposition and dose-exposure relationships for airborne releases; α-, β- and γ-radiation surveys; information on sample collection and field evaluation; and brief descriptions of the environmental monitoring procedures adopted in previous emergencies (Windscale 1957, AERE Harwell 1961 and NRTS Idaho 1961).

  17. Nuclear emergency planning in Norway

    International Nuclear Information System (INIS)

    Baarli, J.

    1986-01-01

    The nuclear emergency planning in Norway is forming a part of the Search and Rescue Service of the country. Due to the fact that Norway do not have any nucleat power reactor, the nuclear emergency planning has not been given high priority. The problems however are a part of the activity of the National Institute of Radiation Hygiene, and the emergency preparedness is at the present time to a large extent based on the availability of professional health physicists and their knowledge, rather than established practices

  18. Decision support for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1989-05-01

    A short introduction will be given to the Nordic project ''NKA/INF: Information Technology for Accident and Emergency Management'', which is now in its final phase. To perform evaluation of the project, special scenarious have been developed, and experiments based on these will be fulfilled and compared with experiments without use of the decision support system. Furthermore, the succeeding European project, ''IT Support for Emergency Management - ISEM'', with the purpose of developing a decision support system for complex and distributed decision making in emergency management in full scale, will be described and the preliminary conceptual model for the system will be presented. (author)

  19. Educational course in emergency radiology

    International Nuclear Information System (INIS)

    Velkova, K.; Stoeva, M.; Cvetkova, S.; Hilendarov, A.; Petrova, A.; Stefanov, P.; Simova, E.; Georgieva, V.; Sirakov, N.

    2012-01-01

    Emergency radiology is the part of radiology primarily focused on acute diagnosing conditions in ER patients. This advanced area of radiology improves the quality of care and treatment of patients and of the emergency medicine as a whole. The educational course in Emergency (ER) Radiology is available for medical students in their 8th and 9th semester. The main objective of the ER course is to obtain knowledge about the indications, possibilities and diagnostic value of the contemporary imaging methods in ER cases. Therapeutic methods under imaging control are also covered by the course. The curriculum of the course consists of 6 lectures and 12 practical classes. (authors)

  20. Emerging & re-emerging infections in India: An overview

    Directory of Open Access Journals (Sweden)

    T Dikid

    2013-01-01

    Full Text Available The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed.

  1. Emerging and Re-Emerging Zoonoses of Dogs and Cats

    Directory of Open Access Journals (Sweden)

    Bruno B. Chomel

    2014-07-01

    Full Text Available Since the middle of the 20th century, pets are more frequently considered as “family members” within households. However, cats and dogs still can be a source of human infection by various zoonotic pathogens. Among emerging or re-emerging zoonoses, viral diseases, such as rabies (mainly from dog pet trade or travel abroad, but also feline cowpox and newly recognized noroviruses or rotaviruses or influenza viruses can sicken our pets and be transmitted to humans. Bacterial zoonoses include bacteria transmitted by bites or scratches, such as pasteurellosis or cat scratch disease, leading to severe clinical manifestations in people because of their age or immune status and also because of our closeness, not to say intimacy, with our pets. Cutaneous contamination with methicillin-resistant Staphylococcus aureus, Leptospira spp., and/or aerosolization of bacteria causing tuberculosis or kennel cough are also emerging/re-emerging pathogens that can be transmitted by our pets, as well as gastro-intestinal pathogens such as Salmonella or Campylobacter. Parasitic and fungal pathogens, such as echinococcosis, leishmaniasis, onchocercosis, or sporotrichosis, are also re-emerging or emerging pet related zoonoses. Common sense and good personal and pet hygiene are the key elements to prevent such a risk of zoonotic infection.

  2. American College of Emergency Physicians

    Science.gov (United States)

    ... these... Read More More Than 850 Hours of Online Education Log In Now > Physicians Podcasts and Apps Reimbursement Quality Issues MOC Resource Center International Residents & Students Contracts & ... Medicine Foundation Online Buyers' Guide Emergency Care For You emCareers.org ...

  3. Rural transportation emergency preparedness plans.

    Science.gov (United States)

    2009-07-01

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

  4. 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.

  5. Retention of Emergency Care Knowledge.

    Science.gov (United States)

    Burckes, Mardie E.; Shao, Kung Ping Pam

    1984-01-01

    Data on the emergency care knowledge of college students were measured by a pretest, posttest, and retention test. A high relationship was found between students' posttest scores and retention test scores. Findings are discussed. (Author/DF)

  6. Warning Signs of Childhood Emergencies

    Science.gov (United States)

    ... signs - and act on them - by taking a first aid class and learning CPR (cardiopulmonary resuscitation). Your local hospital, ... Care For You Copyright © American College of Emergency Physicians ...

  7. Emergency Disinfection of Drinking Water

    Science.gov (United States)

    How to boil and disinfect water to kill most disease-causing microorganisms during emergency situations where regular water service has been interrupted and local authorities recommend using only bottled water, boiled water, or disinfected water.

  8. 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...

  9. Emerging Contaminants in the Environment

    Science.gov (United States)

    This chapter explores the use of mass spectrometry and its application to emerging contaminants (ECs) in the environment; such classes of compounds as organometallics, pharmaceuticals/drugs, nanomaterials, and dispersants (surfactants). Table 1 shows the variety of ECs that are...

  10. Emergency Medical Service (EMS) Stations

    Data.gov (United States)

    Kansas Data Access and Support Center — EMS Locations in Kansas The EMS stations dataset consists of any location where emergency medical services (EMS) personnel are stationed or based out of, or where...

  11. [Anthropocene and Emerging viral diseases].

    Science.gov (United States)

    Chastel, C

    2016-08-01

    We propose to bring together the new geologic concept of Anthropocene and its consequences on our environment with the observed increasing emergence of new viruses - a pathogen for both humans and animals, mainly since the mid of the twentieth century.

  12. Collaborative Approaches in Emerging Markets

    DEFF Research Database (Denmark)

    Søberg, Peder Veng; Han, Yang

    2011-01-01

    , in order to increase innovation performance. The theoretical framework is based on theories on trust, as well as institutional theory. The findings suggest that cognition-based trust as well as affect-based trust is needed for successful innovative collaboration, however, in emerging markets affect......The paper investigates innovative collaboration undertaken by newly established foreign invested R&D units in emerging markets. In particular, the paper investigates how foreign invested newly established R&D centers in emerging markets can leverage local knowledge networks, such as universities......-based trust is more important than Westerners are used to. This is due to the different institutional backgrounds, in emerging markets and developed markets respectively....

  13. Radiation emergency planning in Poland

    Energy Technology Data Exchange (ETDEWEB)

    Niewodniczanski, J [National Atomic Energy Agency, Warsaw (Poland)

    1996-08-01

    The paper presents a schematic outline of the radiation emergency policy in Poland, rather from the point of view of logistics of the problem than discussing details of existing or proposed procedures. (author). 5 refs, 1 fig.

  14. Emergency preparedness of OSBRA Pipeline

    Energy Technology Data Exchange (ETDEWEB)

    Magalhaes, Milton P.; Torres, Carlos A.R.; Almeida, Francisco J.C. [TRANSPETRO, Rio de Janeiro, RJ (Brazil)

    2009-07-01

    This paper presents the experience of PETROBRAS Transporte S. A. - TRANSPETRO in the preparation for emergencies in the OSBRA pipeline, showing specific aspects and solutions developed. The company has a standardized approach for the emergency management, based on risk analysis studies, risk management plan and contingency plans. To cover almost 1,000 km of pipeline, the Company avails of Emergency Response Centers and Environmental Defense Center, located at strategic points. In order to achieve preparation, fire fighting training and oil leakage elimination training are provided. Additionally, simulation exercises are performed, following a schedule worked out according to specific criteria and guidelines. As a conclusion, a picture is presented of the evolution of the preparation for emergencies in the OSBRA System which bears the enormous responsibility of transporting flammable products for almost 1,000 km of pipeline, crossing 40 municipalities, 3 states and the Federal District. (author)

  15. Dose monitoring in nuclear emergency

    International Nuclear Information System (INIS)

    Nan Hongjie; Yang Zhongping; Lei Xin

    2012-01-01

    In order to protect people from irradiation sickness and rebuild the radiation filed in nuclear emergency, personal and environmental dose need to be monitored. The application of TLD in dose monitoring is discussed in this paper. (authors)

  16. Poison control center - emergency number

    Science.gov (United States)

    For a POISON EMERGENCY call: 1-800-222-1222 ANYWHERE IN THE UNITED STATES This national hotline number will let you ... is a free and confidential service. All local poison control centers in the United States use this ...

  17. An update on emergency contraception.

    Science.gov (United States)

    Bosworth, Michele C; Olusola, Patti L; Low, Sarah B

    2014-04-01

    Emergency contraception decreases the risk of unintended pregnancy after unprotected sexual intercourse or after suspected failure of routine contraception (e.g., a condom breaking). Oral methods include combined contraceptive pills (i.e., Yuzpe method), single- or split-dose levonorgestrel, and ulipristal. The Yuzpe method and levonorgestrel are U.S. Food and Drug Administration-approved for use 72 hours postcoitus, whereas the newest method, ulipristal, is approved for up to 120 hours postcoitus. The copper intrauterine device may be used as emergency contraception up to seven days after unprotected intercourse. It is nonhormonal and has the added benefit of long-term contraception. Advanced provision of emergency contraception may be useful for all patients, and for persons using ulipristal because it is available only by prescription. Physicians should counsel patients on the use and effectiveness of emergency contraception, the methods available, and the benefits of routine and consistent contraception use.

  18. Regional cooperation for emergency plan

    International Nuclear Information System (INIS)

    Chu, D.S.L.; Liu, P.C.

    1981-01-01

    It has become increasingly evident since the Three Mile Island (TMI) accident that a sound emergency plan is indispensable to the overall nuclear power generation program. In some developing countries in Eastern Aisa, the availability of manpower resources and facilities to handle a nuclear power plant accident are rather limited. Therefore, the establishment of a regional mutual emergency plan is deemed necessary. A preliminary idea concerning this establishment is presented for deliberation by this Conference

  19. 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)

  20. Acute hematologic emergencies in oncology

    International Nuclear Information System (INIS)

    Kristof, L.

    2012-01-01

    Malignant disease and its treatment are often being complicated by development of serious and at times life-threatening emergencies. Early recognition and treatment of these acute events are important to reduce morbidity and mortality in cancer patients. The following article provides an overview of several hematologic emergencies, which occur due abnormal hemopoiesis (e.g. hyperleukocytosis, anemia, thrombocytopenia), abnormal hemo stasis (e.g. hemorrhage, pulmonary embolism, disseminated intravascular coagulation), or are related to blood products transfusions (transfuse reactions). (author)

  1. Advertising Emergency Department Wait Times

    OpenAIRE

    Weiner, Scott G

    2013-01-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED se...

  2. Exploring Emerging India - Eight Essays

    OpenAIRE

    Müller-Brandeck-Bocquet, Gisela; Gieg, Philipp; Lowinger, Timo; Gsänger, Matthias; Becker, Michael; Kundu, Amitabh; Valerian, Rodrigues; S, Shaji; Schömbucher-Kusterer, Elisabeth; Biswas, Aparajita

    2015-01-01

    India's economic rise since the 1990s has been followed by a more prominent global role for the country. Despite economic setbacks in recent years and huge domestic challenges like poverty, caste issues, and gender inequality, India today is almost universally characterised as an “emerging power”. At the same time, the country continues to show an enormous diversity. Thus, exploring emerging India can surely not be confined to economic analysis only. Instead, it is vital to take current devel...

  3. 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...

  4. Credit derivatives in emerging markets

    OpenAIRE

    Romain Rancière

    2002-01-01

    Credit Derivatives are securities that offer protection against credit or default risk of bonds or loans. The credit derivatives emerging market has grown rapidly and credit derivatives are widely used. This paper describes the emerging credit derivatives market structure. The current market activity is analyzed through elementary pricing dynamics and the study of the term structure of default risk. Focusing on the performance of credit derivatives in stress situation, including legal and mar...

  5. Soil sampling in emergency situations

    International Nuclear Information System (INIS)

    Carvalho, Zenildo Lara de; Ramos Junior, Anthenor Costa

    1997-01-01

    The soil sampling methods used in Goiania's accident (1987) by the environmental team of Brazilian Nuclear Energy Commission (CNEN) are described. The development of this method of soil sampling to a emergency sampling method used in a Nuclear Emergency Exercise in Angra dos Reis Reactor Site (1991) is presented. A new method for soil sampling based on a Chernobyl environmental monitoring experience (1995) is suggested. (author)

  6. Information technology for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1990-01-01

    Improved performance in emergency management by the use of modern information technology has been investigated. Limited parts of a preparedness system have been chosen based on analysis of drills with respect to emergency situations and real accidents. Specific functions relevant for the situation have been selected and implemented in prototype test systems. Finally, the usefulness of the prototype systems has been evaluated by experiments following specific scenarios. (author) 24 refs

  7. Asset Pricing in Emerging Markets

    OpenAIRE

    Ajrapetova, Tamara

    2017-01-01

    General content: Current methods of estimation of cost of capital in the emerging markets are often neglecting various contradictions with the essentials of the model structure and assumptions. As the result of such imprecisions, the cost of equity is often understated (overstated). This thesis will attempt to assess current level of emerging market integration, liquidity and concentration. This will be followed by evaluation of traditional and alternative models for estimation of cost of equ...

  8. Radiological emergency preparedness (REP) program

    International Nuclear Information System (INIS)

    Kwiatkowski, D.H.

    1995-01-01

    This talk focuses on the accomplishments of Radiological Emergency Preparedness Program. Major topics include the following: strengthening the partnership between FEMA, the States, and the Industry; the Standard Exercise Report Format (SERF); Multi-year performance partnership agreement (MYPPA); new REP Program guidance; comprehensive exercise program; federal radiological emergency response plan (FRERP); international interest; REP user fee; implementation EPA PAGs and Dose Limits; Contamination monitoring standard for portal monitors; guidance documents and training

  9. Oncological emergencies for the internist

    Directory of Open Access Journals (Sweden)

    Umesh Das

    2015-01-01

    Full Text Available An oncologic emergency is defined as any acute, potentially life-threatening event, either directly or indirectly related to a patient′s cancer (ca or its treatment. It requires rapid intervention to avoid death or severe permanent damage. Most oncologic emergencies can be classified as metabolic, hematologic, structural, or side effects from chemotherapy agents. Tumor lysis syndrome is a metabolic emergency that presents as severe electrolyte abnormalities. The condition is treated with aggressive hydration, allopurinol or urate oxidase to lower uric acid levels. Hypercalcemia of malignancy is treated with aggressive rehydration, furosemide, and intravenous (IV bisphosphonates. Syndrome of inappropriate antidiuretic hormone should be suspected if a patient with ca presents with normovolemic hyponatremia. This metabolic condition usually is treated with fluid restriction and furosemide. Febrile neutropenia is a hematologic emergency that usually requires inpatient therapy with broad-spectrum antibiotics, although outpatient therapy may be appropriate for low-risk patients. Hyperviscosity syndrome usually is associated with Waldenstrφm′s macroglobulinemia, which is treated with plasmapheresis and chemotherapy. Structural oncologic emergencies are caused by direct compression of surrounding structures or by metastatic disease. Superior vena cava syndrome is the most common structural oncological emergency. Treatment options include chemotherapy, radiation, and IV stenting. Epidural spinal cord compression can be treated with dexamethasone, radiation, or surgery. Malignant pericardial effusion, which often is undiagnosed in ca patients, can be treated with pericardiocentesis or a pericardial window procedure.

  10. Common understanding of Emergency Workers

    International Nuclear Information System (INIS)

    2015-11-01

    While the protection of Emergency Workers is regulated in most countries, national definitions, respectively interpretations differ. The prevailing regulatory frameworks are: - Basic Safety Standards (2013/59/EURATOM) The Basis Safety Standards (BSS) are binding for members of the EU. The BSS give a definition of Emergency Workers. - IAEA General Safety Requirements Part 7 (Draft). The Agency's definition is consistent with the BSS-definition. In addition, the Helper is defined. - The Nordic Flag-book. The Nordic Flag-book's Emergency Worker is consistent with the BSS-definition. In addition, workers are defined. Flag-book-Workers (FBW) are neither coterminous with GSR-P-7-helpers nor with BSS-workers. The possible need for harmonization was assessed by the means of a questionnaire, asking members of the Working Group Emergencies to attribute regulatory categories to different roles that might arise in an emergency. While showing a rich variation in interpretations, there is general agreement for the most important roles. Wherever differences are found, the bilateral impact is deemed to be marginal at worst. Therefore, no need for harmonisation with respect to the concept of Emergency Workers is seen

  11. The Comprehensive Emergent Literacy Model

    Directory of Open Access Journals (Sweden)

    Leigh Rohde

    2015-03-01

    Full Text Available The early skills of Emergent Literacy include the knowledge and abilities related to the alphabet, phonological awareness, symbolic representation, and communication. However, existing models of emergent literacy focus on discrete skills and miss the perspective of the surrounding environment. Early literacy skills, including their relationship to one another, and the substantial impact of the setting and context, are critical in ensuring that children gain all of the preliminary skills and awareness they will need to become successful readers and writers. Research findings over the last few decades have led to a fuller understanding of all that emergent literacy includes, resulting in a need for a new, more comprehensive model. A new model, described in this article, strives to explain how emergent literacy can be viewed as an interactive process of skills and context rather than a linear series of individual components. Early literacy learning opportunities are more likely to happen when teachers have a solid knowledge base of emergent literacy and child development. Research has shown that preschool teachers with limited knowledge about literacy development are significantly less able to provide such experiences for children. Teachers will be better able to facilitate all of the components of emergent literacy if they have access to, and understanding of, a model that describes the components, their interactions, and the importance of environmental factors in supporting children.

  12. Emergency management logistics must become emergency supply chain management.

    Science.gov (United States)

    Young, Richard R; Peterson, Matthew R

    2014-01-01

    Much has been written about how emergency management (EM) needs to look to the future regarding issues of resource management (monetary, human, and material). Constraints on budgets are ongoing and the staffing of emergency response activities is often difficult because volunteers have little to no training. The management of material resources has also been a challenge because 1) the categories of material vary by the type of emergency, 2) the necessary quantities of material are often not located near the ultimate point of need, and 3) the transportation assets are rarely available in the form and quantity required to allow timely and effective response. The logistics and resource management functions of EM (what we refer to as EM logistics) have been largely reactive, with little to no pre-event planning for potential demand. We applied the Supply Chain Operational Reference (SCOR) model to EM logistics in an effort to transform it to an integrated and scalable system of physical, information, and financial flows into which are woven the functions of sourcing, making, delivering, and returning, with an overarching planning function that transcends the organizational boundaries of participants. The result is emergency supply chain management, which embraces many more participants who share in a larger quantity of more useful information about the resources that need to be deployed when responding to and recovering from emergency events.

  13. Emergency surgery for Crohn's disease.

    Science.gov (United States)

    Smida, Malek; Miloudi, Nizar; Hefaiedh, Rania; Zaibi, Rabaa

    2016-03-01

    Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis. Indicate the incidence of indications in emergent surgery for Crohn's disease. Specify the types of procedures performed in these cases and assess the Results of emergency surgery for Crohn's disease postoperatively,  in short , medium and long term. Retrospective analysis of collected data of 38 patients, who underwent surgical resection for Crohn's disease during a period of 19 years from 1992 to 2011 at the department of surgery in MONGI SLIM Hospital, and among them 17 patients underwent emergency surgery for Crohn's disease. In addition to socio-demographic characteristics and clinical presentations of our study population, we evaluated the indications, the type of intervention, duration of evolution preoperative and postoperative complications and overall prognosis of the disease. Of the 38 patients with Crohn's disease requiring surgical intervention, 17/38 patients underwent emergency surgery. Crohn's disease was inaugurated by the complications requiring emergency surgery in 11 patients. The mean duration of symptoms prior to surgery was 1.5 year. The most common indication for emergency surgery was acute intestinal obstruction (n=6) followed by perforation and peritonitis (n=5). A misdiagnosis of appendicitis was found in 4 patients and a complicated severe acute colitis for undiagnosed Crohn's disease was found in 2 cases. The open conventional surgery was performed for 15 patients. Ileocolic resection was the most used intervention. There was one perioperative mortality and 5 postoperative morbidities. The mean of postoperative hospital stay was 14 days (range 4-60 days). Six patients required a second operation during the follow-up period. The incidence of emergency surgery for Crohn's disease in our experience was high (17/38 patients), and is not as rare as the published estimates

  14. OEM Emergency Prevention and Mitigation Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management maintains information relevant to preventing emergencies before they occur, and/or mitigating the effects of emergency when they...

  15. Information technology support for emergency management

    International Nuclear Information System (INIS)

    Uuspaeae, P.

    1990-01-01

    Information systems for distributed decision support for emergency management are considered. Specific applications include nuclear power plant emergencies. Emergencies in other industries such as chemical industry may also be considered. Research in the ISEM project is briefly summarized

  16. When to use the emergency room - child

    Science.gov (United States)

    Emergency room - child; Emergency department - child; Urgent care - child; ER - when to use ... How quickly does your child need care? If your child could die or be permanently disabled, it is an emergency. Call 911 to have the ...

  17. Non-communicable diseases in emergencies

    DEFF Research Database (Denmark)

    Demaio, Alessandro; Jamieson, Jennifer; Horn, Rebecca

    2013-01-01

    emergencies; • Raised awareness through greater advocacy for the issue and challenges of noncommunicable diseases during and following emergencies; • Incorporation of noncommunicable diseases into existing emergency-related policies, standards, and resources; • Development of technical guidelines...

  18. Neonatal endocrine emergencies: a primer for the emergency physician.

    Science.gov (United States)

    Park, Elizabeth; Pearson, Nadia M; Pillow, M Tyson; Toledo, Alexander

    2014-05-01

    The resuscitation principles of securing the airway and stabilizing hemodynamics remain the same in any neonatal emergency. However, stabilizing endocrine disorders may prove especially challenging. Several organ systems are affected simultaneously and the clinical presentation can be subtle. Although not all-inclusive, the implementation of newborn screening tests has significantly reduced morbidity and mortality in neonates. Implementing routine screening tests worldwide and improving the accuracy of present tests remains the challenge for healthcare providers. With further study of these disorders and best treatment practices we can provide neonates presenting to the emergency department with the best possible outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Ulipristal acetate in emergency contraception.

    Science.gov (United States)

    Goldstajn, Marina Sprem; Baldani, Dinka Pavicić; Skrgatić, Lana; Radaković, Branko; Vrbić, Hrvoje; Canić, Tomislav

    2014-03-01

    Despite the widespread availability of highly effective methods of contraception, unintended pregnancy is common. Unplanned pregnancies have been linked to a range of health, social and economic consequences. Emergency contraception reduces risk of pregnancy after unprotected intercourse, and represents an opportunity to decrease number of unplanned pregnancies and abortions. Emergency contraception pills (ECP) prevent pregnancy by delaying or inhibiting ovulation, without interfering with post fertilization events. If pregnancy has already occurred, ECPs will not be effective, therefore ECPs are not abortificants. Ulipristal acetate (17alpha-acetoxy-11beta-(4N-N,N-dymethilaminophenyl)-19-norpregna--4,9-diene-3,20-dione) is the first drug that was specifically developed and licensed for use as an emergency contraceptive. It is an orally active, synthetic, selective progesterone modulator that acts by binding with high affinity to the human progesterone receptor where it has both antagonist and partial agonist effects. It is a new molecular entity and the first compound in a new pharmacological class defined by the pristal stem. Up on the superior clinical efficacy evidence, UPA has been quickly recognized as the most effective emergency contraceptive pill, and recently recommended as the first prescription choice for all women regardless of the age and timing after intercourse. This article provides literature review of UPA and its role in emergency contraception.

  20. Emergency Managers Confront Climate Change

    Directory of Open Access Journals (Sweden)

    John R. Labadie

    2011-08-01

    Full Text Available Emergency managers will have to deal with the impending, uncertain, and possibly extreme effects of climate change. Yet, many emergency managers are not aware of the full range of possible effects, and they are unsure of their place in the effort to plan for, adapt to, and cope with those effects. This may partly reflect emergency mangers’ reluctance to get caught up in the rancorous—and politically-charged—debate about climate change, but it mostly is due to the worldview shared by most emergency managers. We focus on: extreme events; acute vs. chronic hazards (floods vs. droughts; a shorter event horizon (5 years vs. 75–100 years; and a shorter planning and operational cycle. This paper explores the important intersection of emergency management, environmental management, and climate change mitigation and adaptation. It examines the different definitions of terms common to all three fields, the overlapping strategies used in all three fields, and the best means of collaboration and mutual re-enforcement among the three to confront and solve the many possible futures that we may face in the climate change world.

  1. Emergency response planning in Pennsylvania

    International Nuclear Information System (INIS)

    Reilly, M.A.

    1988-01-01

    In the decade since the accident at Three Mile Island, emergency planning for response to these events has undergone a significant change in Pennsylvania, as elsewhere. Changes respond to federal guidance and to state agency initiatives. The most singular change is the practice of implementing a protective action throughout the entire emergency planning zone (EPZ). Due to Pennsylvania agency experiences during the accident, the decision was made soon after to develop a staff of nuclear engineers, each giving special day-to-day attention to a specific nuclear power station in the state. Changes in communications capabilities are significant, these being dedicated phone lines between the Commonwealth and each power station, and the reorientation of the Department of Environmental Resources radio network to accommodate direction of field monitoring teams from Harrisburg. Changes that are being or will be implemented in the near future include assessing the emergency response data system for electronic delivery of plant parameter data form facilities during accidents, increased participation in exercises, emergency medical planning, and training, the inclusion of all 67 counties in Pennsylvania in an ingestion EPZ, and the gradual severance of dependence on land-line emergency communication systems

  2. 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.

  3. State of emergency medicine in Azerbaijan

    OpenAIRE

    Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

    2008-01-01

    Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the ?specialty? model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

  4. Handling of emergency situations: organization and plans

    International Nuclear Information System (INIS)

    Swindell, G.E.

    1975-01-01

    Sources of exposure and foreseeable types of accidents; responsibilities for the prevention and control of accidents; organization for controlling emergency situations; emergency control plans. (HP) [de

  5. Emergency Medical Care Training and Adolescents.

    Science.gov (United States)

    Topham, Charles S.

    1982-01-01

    Describes an 11-week emergency medical care training program for adolescents focusing on: pretest results; factual emergency instruction and first aid; practical experience training; and assessment. (RC)

  6. 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.

  7. Graduates perception towards instructional methods of emergency ...

    African Journals Online (AJOL)

    Graduates perception towards instructional methods of emergency medicine: affecting their self-confidence in emergency departments. Mohamed Daffalla Awadalla, Ahmed Abd Elrahman Abdalla, Sami Mahjoub Taha ...

  8. Hazardous Materials Management and Emergency Response (HAMMER)

    Data.gov (United States)

    Federal Laboratory Consortium — The Volpentest Hazardous Materials Management and Emergency Response (HAMMER) Federal Training Center is a safety and emergency response training center that offers...

  9. Emergency contraception: different bioethical perspectives

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2007-10-01

    Full Text Available Emergency contraceptives, in this case post-morning pills, are contraceptive methods used to avoid an unwanted pregnancy after an unprotected sexual intercourse. Their use is feeding a strong ethical debate between subjects for and against their prescription and leading some health professionals to conscientious objection. Among people contrary to prescription some oppose to it because of a general refuse of all contraceptive methods, others considering post-morning pills as abortive. Among people supporting prescription, some consider emergency contraception necessary to assure fundamental women’s rights, in particular the right to sexual auto-determination, while others prescribe emergency contraception only to avoid a greater demand for abortion. It is up to the Italian National Health Service warranting a correct balance between the two opposite positions, that can protect women’s right of access to health services.

  10. Reactor Emergency Action Level Monitor

    International Nuclear Information System (INIS)

    Touchton, R.A.

    1987-01-01

    The Reactor Emergency Action Level Monitor (REALM) Expert System is designed to provide assistance in the identification of a nuclear power plant emergency situation and the determination of its severity. REALM has been developed to operate in a real-time processing environment. REALM embodies a hybrid architecture utilizing both rule-based reasoning and object-oriented programming techniques borrowed from the Artificial Intelligence discipline of Computer Sciences. The rulebase consists of event-based rules and symptom-based rules. The symptom-based rules go beyond the current EAL structure to address the more problematic scenarios and entail a more symbolic representation of the plant information. The results to date have been encouraging that expert system technology can provide improved emergency decision-making capability in nuclear power plants

  11. Emergency planning and operating experience

    International Nuclear Information System (INIS)

    Halpern, O.; Breniere, J.

    1984-01-01

    The purpose of this paper is to derive lessons from operating experience for the planning of emergency measures. This operating experience has two facets: it is obtained not only from the various incidents and accidents which have occurred in countries with nuclear power programmes and from the resulting application of emergency plans but also from the different exercises and simulations carried out in France and in other countries. Experience generally confirms the main approaches selected for emergency plans. The lessons to be derived are of three types: first, it appears necessary to set forth precisely the responsibilities of each person involved in order to prevent a watering-down of decisions in the event of an accident; secondly, considerable improvements need to be made in the different communication networks to be used; and thirdly, small accidents with minor radiological consequences deserve as systematic and thorough an approach as large and more improbable accidents. (author)

  12. ICT Innovation in Emerging Economies

    DEFF Research Database (Denmark)

    Xiao, Xiao; B. Califf, Christopher; Sarker, Saonee

    2013-01-01

    ICT innovation is known to significantly elevate a country’s growth and to enhance productivity. It is now well-acknowledged that emerging economies are beginning to innovate at a rapid rate despite some of the challenges they face. Given that these countries with such economies now comprise...... economies, what needs to be studied, and how they should be studied. We attempt to contribute in this area by: (1) providing a comprehensive framework of existing research on ICT innovation in emerging economies, (2) highlighting the gaps that have been left behind, and (3) providing specific guidelines...... to future researchers, including a research model summarizing the salient issues that need examination. We believe that our study makes an important contribution to research on ICT innovation in emerging economies, and can be a useful resource for future researchers interested in this topic....

  13. Organizational emergence in networked collaboration

    CERN Document Server

    Hameri, Ari Pekka; Syrjalahti, Mikko

    2002-01-01

    Research on complex adaptive systems has generated several conceptual parables to explain systems with emergent behaviour. One prominent use for terms such as self-organization, evolutionary trajectories, co-evolution and punctuated equilibrium has been in understanding human organizations. In such systems, emergent behaviour is demonstrated in novel structures, processes and spin-offs that cannot be explained just by studying single components of the organization and the intelligence embedded in them. Instead of solely exploiting the qualitative explanatory power of the evolutionary concepts, this paper focuses also on quantitative methods to track emergent behaviour in a globally distributed, constantly fluctuating and highly networked project organization. The underlying case is that of CERN and its decade long accelerator project, which strongly relies on electronic communication and networking to achieve its major objectives due to be accomplished by the year 2007. By using time series and self-organizin...

  14. Quantifying Information Flow During Emergencies

    Science.gov (United States)

    Gao, Liang; Song, Chaoming; Gao, Ziyou; Barabási, Albert-László; Bagrow, James P.; Wang, Dashun

    2014-02-01

    Recent advances on human dynamics have focused on the normal patterns of human activities, with the quantitative understanding of human behavior under extreme events remaining a crucial missing chapter. This has a wide array of potential applications, ranging from emergency response and detection to traffic control and management. Previous studies have shown that human communications are both temporally and spatially localized following the onset of emergencies, indicating that social propagation is a primary means to propagate situational awareness. We study real anomalous events using country-wide mobile phone data, finding that information flow during emergencies is dominated by repeated communications. We further demonstrate that the observed communication patterns cannot be explained by inherent reciprocity in social networks, and are universal across different demographics.

  15. Contemporary imaging in abdominal emergencies

    International Nuclear Information System (INIS)

    Sivit, Carlos J.

    2008-01-01

    Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)

  16. 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)

  17. The underutilization of emergency contraception.

    Science.gov (United States)

    Devine, Kit S

    2012-04-01

    Despite the availability of effective contraceptive methods, unintended pregnancy continues to be a significant health problem for women throughout the world. The reasons for unplanned pregnancy include failure to use contraception, incorrect use of contraception, unplanned consensual intercourse, and rape. Emergency contraception was once heralded as a means of reducing the rates of unintended pregnancy, elective abortion, and unwanted childbirth. But more than three decades after the first oral form was introduced, the use of emergency contraception remains suboptimal-even in the United States, where it is available to most women of childbearing age without a prescription. Nurses can help narrow this clinical gap in women's health care by increasing awareness of emergency contraception, correcting common misconceptions about its mechanism of action and potential adverse effects, and facilitating patient access.

  18. Emerging and re-emerging bacterial diseases in India

    Indian Academy of Sciences (India)

    PRAKASH KUMAR

    et al (2003) have discussed the epidemiology of V. cholerae and Aeromonas in a five year prospective study in Mumbai. 3.3 Listeria monocytogenes. Listerosis is an emerging zoonotic disease. It is estimated that L. monocytogenes is responsible for 28% deaths due to foodborne illnesses in the United States. The organism.

  19. The emerging story of emerging technologies in neuropsychiatry.

    Science.gov (United States)

    Coffey, M Justin; Coffey, C Edward

    2016-06-01

    The growth of new technologies in health care is exponential, and the impact of such rapid technological innovation on health care delivery is substantial. This review describes two emerging technologies-mobile applications and wearable technologies-and uses a virtual case report to illustrate the impact of currently available technologies on the health care experience of a patient with neuropsychiatric illness.

  20. The emerging story of emerging technologies in neuropsychiatry

    OpenAIRE

    Coffey, M. Justin; Coffey, C. Edward

    2016-01-01

    The growth of new technologies in health care is exponential, and the impact of such rapid technological innovation on health care delivery is substantial. This review describes two emerging technologies?mobile applications and wearable technologies?and uses a virtual case report to illustrate the impact of currently available technologies on the health care experience of a patient with neuropsychiatric illness.

  1. CHIRONOMID EMERGENCE AND RELATIVE EMERGENT BIOMASS FROM TWO ALABAMA STREAMS

    Science.gov (United States)

    Chironomid pupal exuviae were sampled monthly using drift nets and hand sieves over an annual cycle from Hendrick Mill Branch (HMB; Blount County, AL) and Payne Creek (PC; Hale County, AL). Taxon richness, community composition, and emergence phonologies were similar despite mar...

  2. Radiological emergencies the first response

    International Nuclear Information System (INIS)

    2011-11-01

    This national training course about radiological emergencies first answer include: Targets and preparation for emergency response in case of a nuclear or radiological accident. Operations center, action guide for fire fighting, medical coverage, forensic test, first aid, basic instrumentation for radiation, safety equipment, monitoring radiation, gamma rays, personnel exposed protection , radiation exposure rate, injury and illness for radiation, cancer risk, contamination, decontamination and treatment, markers, personnel dosimetry, training, medical and equipment transportation, shielded and tools. Psychological, physical (health and illness), economical (agriculture and industry) and environment impacts. Terrorist attacks, security belts. Support and international agreements (IAEA)

  3. Chapter No.9. Emergency planning

    International Nuclear Information System (INIS)

    2002-01-01

    Emergency preparedness is a set of measures the aim of which is to mitigate possible impacts of events during the operation of nuclear facilities, transport of nuclear materials and radioactive waste as well as to reduce consequences to environment and population. An emergency planning of UJD is understood as an establishment of technical and organisational means determined for prognosis of development of events having radiation consequences together with capability to suggest the countermeasures needed to minimise the impact to population. Emergency Response Centre (ERC) of UJD is a technical support tool of UJD and at the same time it fulfils the role of advisory body for the National Emergency Commission for Radiation Accidents (NECRA) In 2001 UJD continued in further increase of equipment quality in the ERC by completion of facilities necessary to transmit necessary data from nuclear facilities, for communication and other HW and SW means. That it is why the application of geographic information systems (GIS), higher quality of data transmission from nuclear facilities and installation of new database platform could be enabled. Also the documentation of ERC has been completed by the emergency procedures of NPP Mochovce and guides of the RODOS system were finished. In the area of emergency preparedness UJD activities in 2001 were focused on preparation and realisation of emergency exercises and execution of inspections. In accordance with the inspection plan inspectors executed several inspections which were targeted to control the course of exercises at nuclear facilities, documentation and the way of training of members of the UJD headquarters. The function of systems of notification and warning, communication, monitoring and technical support means of both NPP Bohunice and NPP Mochovce has been verified and checked as well. The ultimate attention, however, was paid to the preparation of UJD emergency headquarters. The preparation was realised in a form of

  4. Radionuclide diagnosis of emergency states

    International Nuclear Information System (INIS)

    Ishmukhametov, A.I.

    1985-01-01

    Solution of emergency state radionuclide diagnostics from the technical point of view is provided by the application of the mobile quick-operating equipment in combination with computers, by the use of radionuclides with acceptable for emergency medicine characteristics and by development of radionuclide investigation data propcessing express-method. Medical developments include the study of acute disease and injury radioisotope semiotics, different indication diagnostic value determining, comparison of the results, obtained during radionuclide investigation, with clinicolaboratory and instrumental data, separation of methodical complex series

  5. New trends in emerging pathogens.

    Science.gov (United States)

    Skovgaard, Niels

    2007-12-15

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

  6. Emerging GLP-1 receptor agonists

    DEFF Research Database (Denmark)

    Lund, Asger; Knop, Filip K; Vilsbøll, Tina

    2011-01-01

    and liraglutide, as well as the emerging GLP-1R agonists including the long-acting compounds. Expert opinion: An emerging therapeutic trend toward initial or early combination therapy with metformin- and incretin-based therapy is anticipated for patients with type 2 diabetes. GLP-1-based therapy has so far proven...... development may improve the effects of GLP-1 even further with optimized pharmacokinetic profiles resulting in fewer side effects. Meta-analyses have shown promising effects on cardiovascular disease and data from ongoing multicenter trials with cardiovascular endpoints are expected in 2015....

  7. Post-Chernobyl emergency planning

    International Nuclear Information System (INIS)

    1986-01-01

    This report is the result of a study ordered by the Swedish Nuclear Power Inspectorate and the National Swedish Institute of Radiation Protection to evaluate the measurements taken in Sweden in response to the Chernobyl accident. The enquiry was also given the task of suggesting improvements of the nuclear accidents emergency planning and other activities relevant to nuclear accidents. Detailed accounts are given of the course of events in Sweden at the Chernobyl accident and the steps taken by central or local authorities are discussed. Several alterations of the emergency planning are proposed and a better coordination of the affected organizations is suggested. (L.E.)

  8. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    services (EMS) response times and advanced prehospital care increase the number of critically injured patients surviving sufficiently long to reach a hospital “in extremis.” Both scenarios provide challenges in the management of traumatized patients. This article addresses the management of severely......Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  9. Emergence

    Directory of Open Access Journals (Sweden)

    Raven John

    2014-07-01

    Full Text Available In this paper I first list a number of areas in which recent research seems to reinforce the need to follow through on activities identified in Simonetta Magari’s article (Magari, Cavaleri 2009. A careful review of research in these areas would lead us into deeply mysterious psychological processes and underline the need to change the most fundamental assumptions on which modern psychology is built. Unfortunately, I am in no position to undertake this review.

  10. Emergency!

    Science.gov (United States)

    Geissler, Rebecca

    2006-01-01

    For generations, schools have routinely held fire drills. However, ensuring a safe learning environment is more complicated than staging an occasional drill. Schools and universities should have an integrated school safety plan, and it must address how to manage site hazards in science labs, kitchens and other building areas. It is essential for…

  11. Evaluation of a Low-risk Mild Traumatic Brain Injury and Intracranial Hemorrhage Emergency Department Observation Protocol.

    Science.gov (United States)

    Yun, Brian J; Borczuk, Pierre; Wang, Lulu; Dorner, Stephen; White, Benjamin A; Raja, Ali S

    2017-11-20

    Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. This retrospective cohort study was approved by the institutional review board. Study subjects were patients ≥ 18 years of age with an International Classification of Diseases code corresponding to a traumatic ICH and admitted to an ED observation unit (EDOU) of an urban, academic Level I trauma center between February 1, 2015, and January 31, 2017. Patient data and discharge disposition were abstracted from the electronic health record, and imaging data, from the final neuroradiologist report. To measure kappa, two abstractors independently collected data for presence of neuro deficit from a 10% random sample of the medical charts. Using a multivariable logistic regression model with a propensity score of the probability of placement in the EDOU before and after protocol implementation as a covariate, we sought to determine the pre-post effects of implementing a protocol on the composite outcome of admission to the floor, intensive care unit, or operating room from the EDOU and the proportion of patients with worsening findings on repeat computed tomography (CT) head scan in the EDOU. A total of 379 patients were identified during the study period; 83 were excluded as they were found to have no ICH on chart review. Inter-rater reliability kappa statistic was 0.63 for 30 charts. Among the 296 patients who remained eligible and comprised the study population, 143 were in the preprotocol period and 153 after protocol implementation. The EDOU protocol was associated with an independently statistically significant decreased odds ratio (OR) for admission or worsening ICH on repeat CT scan (OR = 0.45, 95% confidence interval [CI

  12. On-site emergency planning

    International Nuclear Information System (INIS)

    Kueffer, K.

    1981-01-01

    This lecture covers the Emergency Planning of the Operating Organization and does not describe the functions and responsibilities of the Regulatory Body and public authorities. The lecture is based on the Codes of Practice and Safety Guides of the International Atomic Energy Agency (IAEA) and arrangements as in use in the Swiss Nuclear Power Station Beznau. (orig.)

  13. The Emergence of Entrepreneurial Milieus

    DEFF Research Database (Denmark)

    Gretzinger, Susanne; Matiaske, Wenzel; Royer, Susanne

    This work in progress article focusses the development of a framework explaining the emergence of entrepreneurial milieu from a social capital perspective within a multiple domain setting. Beside embedded scarcities and relationships, specific supporting key actors and embedding processes...... the entrepreneurial milieu....

  14. Emerging Cloud Computing Security Threats

    OpenAIRE

    Ahmat, Kamal

    2015-01-01

    Cloud computing is one of the latest emerging innovations of the modern internet and technological landscape. With everyone from the White house to major online technological leaders like Amazon and Google using or offering cloud computing services it is truly presents itself as an exciting and innovative method to store and use data on the internet.

  15. The Emergence of City Logistics

    DEFF Research Database (Denmark)

    Gammelgaard, Britta; Aastrup, Jesper

    2014-01-01

    Purpose: Many city logistics projects in Europe have failed. The purpose of this article is to increase understanding of how city logistics emerge. A better understanding of the complex organizational processes with many actors and stakeholders in city logistics projects may prevent further failu...

  16. Emergency response planning in Saskatchewan

    International Nuclear Information System (INIS)

    Irwin, R.W.

    1998-01-01

    Release reporting and spill clean-up requirements by Saskatchewan Energy and Mines were reviewed. Wascana's experience in response planning was discussed. It was suggested that the key to prevention was up-front due diligence, including facility and oil well analysis. Details of Wascana's emergency plan, and details of Saskatchewan Energy and Mines release reporting procedures were also provided

  17. Integrated emergency management in KKG

    International Nuclear Information System (INIS)

    Kluegel, J.U.; Plank, H.

    2007-01-01

    The development and introduction of emergency measures in Switzerland was mainly characterized by the evaluation of international experience and by systematic analysis of beyond-design basis accidents within the framework of plant-specific probabilistic safety analyses. As early as in the mid-eighties, the Swiss regulatory authority demanded that measures be taken against severe accidents, and periodically added more detailed requirements, most recently in 2000 when the introduction of Severe Accident Management Guidelines (SMAG) was demanded for power operation as well as operation in the non-power mode. The SMAG were introduced at the Goesgen nuclear power station within a project in the period between 2003 and 2005. For this purpose, a concept of integrated emergency management was developed which is based on updates of the proven emergency manual. One important aspect of this integrative concept is the distinction between preventive and mitigating procedures by defining appropriate criteria. The findings made in the implementation phase of the project include the realization that the introduction of procedures dealing with severe accidents also requires the ability to develop new ways of thinking and acting in accident management. This implies the awareness that procedures covering severe accidents must be applied much more flexibly and in the light of the situation than regulations covering fault conditions. Also possibilities to simulate severe accidents were created within the project both for the development of procedures and for training plant operators and members of the emergency staff. (orig.)

  18. EMERGENCY STATES IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. A. Gurevich

    2014-01-01

    Full Text Available The article describes in detail potential emergency states in patients with different stages of arterial hypertension with special attention to diagnosis and rational management of hypertensive crisis. Differentiated approach to management of different forms of hypertensive crisis is specified.

  19. Financial Services and Emerging Markets

    NARCIS (Netherlands)

    B. Karreman (Bas)

    2011-01-01

    textabstractThis study addresses the organization and strategy of firms in emerging markets with an explicit application to financial services. Given the relevance of a well-functioning financial system for economic growth, understanding the organization and strategy of firms contributing to the

  20. Plasmonics for emerging quantum technologies

    DEFF Research Database (Denmark)

    Bozhevolnyi, Sergey I.; Mortensen, N. Asger

    2017-01-01

    to exponentially increase computing power, quantum computing opens up possibilities to carry out calculations that ordinary computers could not finish in the lifetime of the Universe, while optical communications based on quantum cryptography become completely secure. At the same time, the emergence of Big Data...

  1. Transient virulence of emerging pathogens.

    Science.gov (United States)

    Bolker, Benjamin M; Nanda, Arjun; Shah, Dharmini

    2010-05-06

    Should emerging pathogens be unusually virulent? If so, why? Existing theories of virulence evolution based on a tradeoff between high transmission rates and long infectious periods imply that epidemic growth conditions will select for higher virulence, possibly leading to a transient peak in virulence near the beginning of an epidemic. This transient selection could lead to high virulence in emerging pathogens. Using a simple model of the epidemiological and evolutionary dynamics of emerging pathogens, along with rough estimates of parameters for pathogens such as severe acute respiratory syndrome, West Nile virus and myxomatosis, we estimated the potential magnitude and timing of such transient virulence peaks. Pathogens that are moderately evolvable, highly transmissible, and highly virulent at equilibrium could briefly double their virulence during an epidemic; thus, epidemic-phase selection could contribute significantly to the virulence of emerging pathogens. In order to further assess the potential significance of this mechanism, we bring together data from the literature for the shapes of tradeoff curves for several pathogens (myxomatosis, HIV, and a parasite of Daphnia) and the level of genetic variation for virulence for one (myxomatosis). We discuss the need for better data on tradeoff curves and genetic variance in order to evaluate the plausibility of various scenarios of virulence evolution.

  2. Network Leadership: An Emerging Practice

    Science.gov (United States)

    Tremblay, Christopher W.

    2012-01-01

    Network leadership is an emerging approach that can have an impact on change in education and in society. According to Merriam-Webster (2011), a network is "an interconnected or interrelated chain, group, or system." Intentional interconnectedness is what separates network leadership from other leadership theories. Network leadership has the…

  3. Planning in emergencies and disasters

    African Journals Online (AJOL)

    surgical training - although this mainly comprises the clinical aspect of it. A disaster is a large-scale emergency and thus involves many other disciplines other than medical. In the last .... old, refugees and migrants .... Thought should be put into the preservation, dignity ... especially rescue workers and volunteers, working in.

  4. Growing an Emerging Research University

    Science.gov (United States)

    Birx, Donald L.; Anderson-Fletcher, Elizabeth; Whitney, Elizabeth

    2013-01-01

    The emerging research college or university is one of the most formidable resources a region has to reinvent and grow its economy. This paper is the first of two that outlines a process of building research universities that enhance regional technology development and facilitate flexible networks of collaboration and resource sharing. Although the…

  5. Emerging Infectious Diseases Cover Art

    Centers for Disease Control (CDC) Podcasts

    2017-07-26

    Byron Breedlove, managing editor of the EID Journal, discusses his approach to cover art.  Created: 7/26/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 7/26/2017.

  6. The Emergence of Homo sapiens.

    Science.gov (United States)

    Rensberger, Boyce

    1980-01-01

    Describes chronologically the evolution of the human race on earth so as to refute Darwin's theory of descent from animals. Skull fragments from sites around the world suggest at least two possible routes toward the emergence of Homo sapiens sapiens. (Author/SK)

  7. First Aid in Emergency Care.

    Science.gov (United States)

    Parcel, Guy S.

    This book is written for advanced courses in first aid. The content of the book is the combined work of contributing authors including health educators, an emergency medical technician, nurses, physicians, a lawyer, a community organizer, a social worker, and a sociologist. There are five major sections: (1) parameters for administering first aid…

  8. Workplace violence in emergency medicine

    Directory of Open Access Journals (Sweden)

    A. Chatterjee*

    2013-12-01

    Conclusion: Violence against ED health care workers is a real problem with significant implications to the victims, patients, and departments/institutions. ED WPV needs to be addressed urgently by stakeholders through continued research on effective interventions specific to Emergency Medicine. Coordination, cooperation, and active commitment to the development of such interventions are critical.

  9. 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.

  10. Nuclear emergency preparedness: national organisation

    Energy Technology Data Exchange (ETDEWEB)

    El Messaoudi, M.; Essadki, H.; Lferde, M.; Moutia, Z. [Faculte des Sciences, Dept. de Physique, Rabat (Morocco)

    2006-07-01

    As in all other industries, the nuclear facilities can be the object of accidents whose consequences go beyond the limits of their site and consequently radioactive releases would be issued in the environment justifying the protection measures of population. Even if all the precautions were taken during the stages from the design to the operation, to reduce the risk of accident in nuclear installations, this risk can not be completely suppressed. For the radiological risk, as for the other major risks, the protection of the public always was taken in consideration by public power. The nuclear emergency plan gives the opportunity to have a quick appropriate reaction to a sudden event, which has (or might have) direct consequences for the population. The Moroccan public authorities had proceeded to reinforce at the national level, the control of nuclear safety and protection against radiation by the set up of a new nuclear safety authority. Evidently, the organization and the management of a nuclear and/or radiological emergency were at centre of this reform. Taking into account the subjective risk of radiological terrorism, the authorities should reinforce measurements guaranteeing radiological safety and security, and elaborate the appropriate emergency plans. The aim of this paper is to give a progress report on nuclear emergency plan aspects and to present a corresponding organization which could be applied by national authority. (authors)

  11. Pre-hospital Emergency Care

    African Journals Online (AJOL)

    20 Apr 1974 ... lance services, training programmes that are not geared to the needs of these personnel and, not least, a lack of interest on the part of the medical profession, with a few notable exceptions, in the whole question of emergency care. There is a re- luctance on the part of many doctors to assist in the training of ...

  12. Developing an emergency ultrasound app

    DEFF Research Database (Denmark)

    Foss, Kim Thestrup; Subhi, Yousif; Aagaard, Rasmus

    2015-01-01

    Focused emergency ultrasound is rapidly evolving as a clinical skill for bedside examination by physicians at all levels of education. Ultrasound is highly operator-dependent and relevant training is essential to ensure appropriate use. When supplementing hands-on focused ultrasound courses, e-le...

  13. Electronic Whiteboards in Emergency Medicine

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus

    2012-01-01

    As more and more Emergency Departments replace the manual dry-erase whiteboards used for coordination of patient care and communication among clinicians with IT-based electronic whiteboards a need to clarify the effects of implementing these systems arises. This paper seeks to answer this questio...

  14. Nuclear emergency preparedness: national organisation

    International Nuclear Information System (INIS)

    El Messaoudi, M.; Essadki, H.; Lferde, M.; Moutia, Z.

    2006-01-01

    As in all other industries, the nuclear facilities can be the object of accidents whose consequences go beyond the limits of their site and consequently radioactive releases would be issued in the environment justifying the protection measures of population. Even if all the precautions were taken during the stages from the design to the operation, to reduce the risk of accident in nuclear installations, this risk can not be completely suppressed. For the radiological risk, as for the other major risks, the protection of the public always was taken in consideration by public power. The nuclear emergency plan gives the opportunity to have a quick appropriate reaction to a sudden event, which has (or might have) direct consequences for the population. The Moroccan public authorities had proceeded to reinforce at the national level, the control of nuclear safety and protection against radiation by the set up of a new nuclear safety authority. Evidently, the organization and the management of a nuclear and/or radiological emergency were at centre of this reform. Taking into account the subjective risk of radiological terrorism, the authorities should reinforce measurements guaranteeing radiological safety and security, and elaborate the appropriate emergency plans. The aim of this paper is to give a progress report on nuclear emergency plan aspects and to present a corresponding organization which could be applied by national authority. (authors)

  15. Nuclear power plant emergency preparedness

    International Nuclear Information System (INIS)

    2005-01-01

    The guide sets forth detailed requirements on how the licensee of a nuclear power plant shall plan, implement and maintain emergency response arrangements. The guide is also applied to nuclear material and nuclear waste transport in situations referred to in guide YVL 6.5. Requirements on physical protection are presented in a separate guide of Finnish Radiation and Nuclear Safety Authority (STUK)

  16. Design of an Emergency Footbridge

    NARCIS (Netherlands)

    Rihal, S.; Kamerling, M.W.

    2014-01-01

    This paper will describe the design of a temporary emergency floating footbridge, to be made when the infrastructure is destroyed by a flood, hurricane, tsunami or any other disaster. The bridge is made of identical floating modules. The modules are composed of prefabricated elements: two trusses, a

  17. Design of an Emergency Shelter

    NARCIS (Netherlands)

    Kamerling, M.W.

    2013-01-01

    This paper presents the design of a light and robust temporary emergency shelter with a triangulated polyhedral grid to transfer the lateral and vertical loads efficiently. To simplify the construction the variety of the elements is minimized, only two sizes of elements are applied. For the

  18. Globally emerging hantaviruses: An overview

    Directory of Open Access Journals (Sweden)

    Sara Chandy

    2017-01-01

    Full Text Available Hantaviruses are known to cause haemorrhagic fever with renal syndrome in Eurasia and hantavirus cardiopulmonary syndrome in the Americas. They are globally emerging pathogens as newer serotypes are routinely being reported. This review discusses hantavirus biology, clinical features and pathogenesis of hantavirus disease, its diagnostics, distribution and mammalian hosts. Hantavirus research in India is also summarised.

  19. Opportunities in SMR Emergency Planning

    Energy Technology Data Exchange (ETDEWEB)

    Moe, Wayne L. [Idaho National Lab. (INL), Idaho Falls, ID (United States). Advanced Reactor Technologies Program

    2014-10-01

    Using year 2014 cost information gathered from twenty different locations within the current commercial nuclear power station fleet, an assessment was performed concerning compliance costs associated with the offsite emergency Planning Standards contained in 10 CFR 50.47(b). The study was conducted to quantitatively determine the potential cost benefits realized if an emergency planning zone (EPZ) were reduced in size according to the lowered risks expected to accompany small modular reactors (SMR). Licensees are required to provide a technical basis when proposing to reduce the surrounding EPZ size to less than the 10 mile plume exposure and 50 mile ingestion pathway distances currently being used. To assist licensees in assessing the savings that might be associated with such an action, this study established offsite emergency planning costs in connection with four discrete EPZ boundary distances, i.e., site boundary, 2 miles, 5 miles and 10 miles. The boundary selected by the licensee would be based on where EPA Protective Action Guidelines are no longer likely to be exceeded. Additional consideration was directed towards costs associated with reducing the 50 mile ingestion pathway EPZ. The assessment methodology consisted of gathering actual capital costs and annual operating and maintenance costs for offsite emergency planning programs at the surveyed sites, partitioning them according to key predictive factors, and allocating those portions to individual emergency Planning Standards as a function of EPZ size. Two techniques, an offsite population-based approach and an area-based approach, were then employed to calculate the scaling factors which enabled cost projections as a function of EPZ size. Site-specific factors that influenced source data costs, such as the effects of supplemental funding to external state and local agencies for offsite response organization activities, were incorporated into the analysis to the extent those factors could be

  20. Emergency navigation without an infrastructure.

    Science.gov (United States)

    Gelenbe, Erol; Bi, Huibo

    2014-08-18

    Emergency navigation systems for buildings and other built environments, such as sport arenas or shopping centres, typically rely on simple sensor networks to detect emergencies and, then, provide automatic signs to direct the evacuees. The major drawbacks of such static wireless sensor network (WSN)-based emergency navigation systems are the very limited computing capacity, which makes adaptivity very difficult, and the restricted battery power, due to the low cost of sensor nodes for unattended operation. If static wireless sensor networks and cloud-computing can be integrated, then intensive computations that are needed to determine optimal evacuation routes in the presence of time-varying hazards can be offloaded to the cloud, but the disadvantages of limited battery life-time at the client side, as well as the high likelihood of system malfunction during an emergency still remain. By making use of the powerful sensing ability of smart phones, which are increasingly ubiquitous, this paper presents a cloud-enabled indoor emergency navigation framework to direct evacuees in a coordinated fashion and to improve the reliability and resilience for both communication and localization. By combining social potential fields (SPF) and a cognitive packet network (CPN)-based algorithm, evacuees are guided to exits in dynamic loose clusters. Rather than relying on a conventional telecommunications infrastructure, we suggest an ad hoc cognitive packet network (AHCPN)-based protocol to adaptively search optimal communication routes between portable devices and the network egress nodes that provide access to cloud servers, in a manner that spares the remaining battery power of smart phones and minimizes the time latency. Experimental results through detailed simulations indicate that smart human motion and smart network management can increase the survival rate of evacuees and reduce the number of drained smart phones in an evacuation process.